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Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.7 Laboratory on-site assessments
(a) An environmental laboratory seeking or holding a certificate of approval under this Part shall, as a condition of approval, permit on-site assessments to be conducted by the department or by a State program recognized by the department pursuant to section 55-2.9 of this Subpart during the laboratory's normal business hours.
(b) The factors to be considered during on-site assessments shall include, but not be limited to, the competence and qualifications of staff, adequacy of facilities and equipment, appropriateness of sampling protocols, use of approved methods, and the laboratory's quality system, including, but not limited to, quality assurance and quality control procedures, and recordkeeping and reporting practices, as specified in this Subpart.
(c) Each environmental laboratory shall, following each on-site assessment, be furnished with an assessment report which shall set forth the findings of the on-site assessment and any deficiencies to be corrected.
(d) Environmental laboratories located outside of the State of New York shall be assessed the approval fee specified in Subpart 55-3 of this Part, as well as additional expenses incurred by the department in conducting on-site assessments of each laboratory. Such on-site assessments shall not be performed before the department receives payment for such additional costs.
(e) If deficiencies are found during an on-site assessment, the environmental laboratory may be granted a grace period not to exceed 90 calendar days from the date of notification to correct the deficiencies, provided that, within 30 calendar days of such notification, the laboratory submits to the department or recognized State program performing the assessment a written plan of correction to be implemented within 90 calendar days. If, at the end of the grace period, any of the deficiencies found remain uncorrected, the certificate of approval shall be revoked in affected analytes and/or categories pursuant to section 55-2.6 of this Subpart. If the deficiencies found do not necessarily or immediately affect either the accuracy or reliability of results, and if the environmental laboratory demonstrates in writing that corrections of deficiencies have been delayed for reasons beyond its control, the grace period granted pursuant to this subdivision may be extended further for a period not to exceed 90 calendar days. Such extension may not be renewed further.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.1 Definitions
As used in this Subpart, the following words shall have the following meanings:
(a) Commissioner means the State Commissioner of Health.
(b) Health facilities shall include, but not be limited to hospitals as defined pursuant to section 2801(1) of the Public Health Law, facilities as defined pursuant to section 1.03(6) of the Mental Hygiene Law (other than community residences), certified home health agencies and long term home health care programs as defined pursuant to article 36 of the Public Health Law, hospices as defined pursuant to article 40 of the public Health Law, and health maintenance organizations as defined pursuant to article 44 of the Public Health Law.
(c) Health resources shall include health services (including the provision of health care to individuals and the administration of health facilities), health professional personnel, and health facilities.
(d) Provider of health care means an individual:
(1) who is a direct provider of health care (including but not limited to a physician, licensed midwife, dentist, nurse practitioner, licensed nurse, podiatrist, optometrist, physician' s assistant, or ancillary personnel employed under the supervision of a physician) and whose primary current activity is the provision of health care to individuals or the administration (including trustees or members of boards of directors) of health facilities in which such care is provided; or
(2) who holds a fiduciary position with, or has a fiduciary interest in, any entity which has as its primary purpose the delivery of health care, the conduct of research into or instruction for health professionals in the provision of health care, or the production of or supply of drugs or other articles for individuals or entities for use in the provision of or in research into or instruction in the provision of health care; or
(3) who is a professional employee of a health professions school; or
(4) who is the spouse of an individual described in paragraph (1), (2) or (3) of this subdivision.
Subchapter B STATE AID AND FUNDING
Part 41 GRANTS FOR SCHOOL HEALTH PROJECTS
10 CRR-NY 41.3 Grant contracts
The Commissioner of Health shall, with the consent of the Commissioners of Education and Social Services, enter into contracts with the selected applicants with respect to the distribution and administration of grant funds, and the management, operation and evaluation of the school health projects. Such contracts shall contain provisions relating to, among other matters:
(a) those provisions of the Public Health Law and regulations that are waived;
(b) services to be provided;
(c) use of grant funds;
(d) staffing;
(e) submission of claims for grant funds and distribution of grant funds; and
(f) recordkeeping and reporting requirements.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-3 HEALTH MAINTENANCE ORGANIZATIONS
10 CRR-NY 86-3.4 Administrative procedures
Implementation of these regulations shall be based on the following:
(a) No written agreement between hospital and HMO is required to initiate and continue this reimbursement methodology.
(b) Upon request by the HMO, a hospital shall furnish documentation of the certified IX-C rate(s) in effect at the hospital, or other approved IX-C reimbursement if per diem is not in use.
(c) Upon receipt of inpatient statements itemizing charges and stating total IX-C reimbursement due to the hospital, the HMO may reimburse the hospital directly. The HMO shall pay such obligations within 30 days of receipt of the statement(s), unless other arrangements are approved by the hospital.
(d) HMO's and hospitals shall mutually furnish administrative and medical data as is customarily required when third parties are involved in the process of hospital admission, discharge and reimbursement.
(e) The HMO is responsible for paying retroactive adjustments to IX-C Medicaid and Medicare rates on the basis of the number of patient days of care utilized when the reimbursement method is the 86-3 IX-C access rate.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.11 Licensure
No person shall own or operate a hematopoietic progenitor cell procurement service, processing facility or transplantation facility in New York State unless licensed by the department under Subpart 52-2 of this Title. All provisions of Subpart 52-2 of this Title shall apply to a hematopoietic progenitor cell procurement service, processing facility and/or transplantation facility, except for the recordkeeping requirements contained in section 52-2.9 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.289 Remuneration
Compensation for value of service rendered or expense incurred.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED
10 CRR-NY 5-1.52 Tables
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TABLE 5—DISTRIBUTION SYSTEM TURBIDITY MAXIMUM CONTAMINANT LEVEL DETERMINATION
| Contaminant | MCL | Determination of MCL violation | | --- | --- | --- | | Distribution point turbidity | 5 NTU | A violation occurs when the monthly average of the results of all distribution samples collected in any calendar month exceeds the MCL rounded off to the nearest whole number. | | | | |
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TABLE 8A—INORGANIC CHEMICALS AND PHYSICAL CHARACTERISTICS MINIMUM MONITORING REQUIREMENTS FOR ASBESTOS
| Initial Frequency by Source Type 5 | | | | | | --- | --- | --- | --- | --- | | Contaminant | Type of water system | Groundwater only | Surface only or surface and groundwater | Repeat sampling and compliance | | Asbestos1 | Community and NTNC | One sample at entry point by 12/31/952,3,4 | One sample at entry point by 12/31/952,3,4 | If GT MCL, one sample quarterly6,7 | | | | | | If LT MCL, one sample every nine years | | | | | | |
GT - Greater Than LT - Less Than
1 If a system is not vulnerable to asbestos contamination, either at its source or due to corrosion of asbestos cement pipe, it is not required to monitor if granted a waiver by the State. The waiver must be renewed by the State every nine years. The basis for a waiver must include the following:
a. Lack of potential asbestos contamination of the water source.
b. No use of asbestos cement pipe for finished water distribution and noncorrosive nature of the water.
2 If asbestos monitoring data collected after January 1, 1990 are consistent with the requirements of this table, the State may allow systems to use that data to satisfy the initial monitoring requirement beginning January 1, 1993.
3 If a system is vulnerable to asbestos contamination due to source water and corrosion of asbestos cement pipe or solely to corrosion of asbestos cement pipe, it shall take one sample at a tap served by asbestos cement pipe and under conditions where asbestos contamination is most likely to occur.
4 If a system is vulnerable to asbestos contamination due to source water only, monitoring shall be conducted as follows: Groundwater -Collect a minimum of one sample at each entry point to the distribution system representative of each well after treatment. Surface water - Collect a minimum of one sample at each entry point to the distribution system after any application of treatment or in the distribution system at a point which is representative of each source after treatment.
5 For both types of water sources the system shall take each sample at the same sampling point unless conditions make another sampling point more representative of each source or treatment plant. If a system draws water from more than one source and the sources are combined before distribution, the system must sample at an entry point to the distribution system during periods of normal operating conditions when water is representative of all sources.
6 A system which exceeds the MCL for asbestos shall monitor quarterly beginning in the next quarter after the violation occurred.
7 The State may decrease the quarterly monitoring requirement to the initial sampling requirement provided that the State has determined that the system is reliably and consistently below the MCL on the basis of a minimum of two quarterly groundwater samples and a minimum of four quarterly samples for surface water.
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TABLE 8C—INORGANIC CHEMICALS AND PHYSICAL CHARACTERISTICS MINIMUM MONITORING REQUIREMENTS-NITRATES, NITRITES
| Initial Frequency by Source Type 1,6 | | | | | | --- | --- | --- | --- | --- | | Contaminant | Type of water system | Groundwater only | Surface only or surface and groundwater | Accelerated sampling 7 | | Nitrate | Community and noncommunity2 | One sample per entry point per year | One sample per entry point quarterly | For groundwater: If equal to or GT 50 percent MCL, quarterly for one year3 | | | | | | For surface water: If LT 50 percent MCL, one sample per year3,4 | | Nitrite | Community and noncommunity | One sample per entry point by 12/31/95 | One sample per entry point by 12/31/95 | If equal to or GT 50 percent MCL, repeat quarterly for at least one year3,4 | | | | | | If LT 50 percent MCL sample frequency at State discretion.5 | | | | | | |
GT - Greater Than
LT - Less Than
1 The State may require, or the water system may request, more frequent monitoring frequencies than is minimally required. The State, at its discretion may require confirmation samples for positive and negative results.
2 Noncommunity water systems must sample annually beginning 1/1/93 regardless of the water source.
3 The frequency may be reduced to annual if the State determines the system's contaminant concentration is consistently and reliably less than the MCL and annual samples are collected during the quarter(s) having the highest analytical results.
4 A surface water shall return to quarterly monitoring if any one sample is GT 50 percent of MCL.
5 State discretion shall mean requiring monitoring when the State has reason to believe the MCL has been violated, the potential exists for an MCL violation or the contaminant may present a risk to public health.
6 For both types of water sources the system shall take each sample at the same sampling point unless conditions make another sampling point more representative of each source or treatment plant. If a system draws water from more than one source and the sources are combined before distribution, the system must sample at an entry point to the distribution system during periods of normal operating conditions when water is representative of all sources. The average of the initial and confirmation sample contaminant concentration at each sampling point shall be used to determine compliance with the MCL.
TABLE 8D—INORGANIC CHEMICALS AND PHYSICAL CHARACTERISTICS MINIMUM MONITORING REQUIREMENTS-OTHER CHEMICALS
| Initial Frequency by Source Type | | | | | | --- | --- | --- | --- | --- | | Contaminant | Type of water system | Groundwater only | Surface only or surface and groundwater | Repeat sampling and compliance | | Chloride | Community | State discretion2 | State discretion2 | State discretion2 | | Iron | and NTNC | | | | | Manganese | | | | | | Silver | | | | | | Sodium1 | | | | | | Sulfate | | | | | | Zinc | | | | | | Color | | | | | | Odor | | | | |
1 All community systems with sodium levels exceeding 20 mg/l will be required to sample for sodium analysis.
2 State discretion shall mean requiring monitoring when the State has reason to believe the MCL has been violated, the potential exists for an MCL violation or the contaminant may present a risk to public health.
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TABLE 9D-ORGANIC CHEMICALS-POCs MINIMUM MONITORING REQUIREMENTS
| Contaminant | | Specific contaminants for analysis | | --- | --- | --- | | POC's | benzene1 | 1,1-dichloropropene | | | bromobenzene | cis-1,3-dichloropropene | | | bromochloromethane | trans-1,3-dichloropropene | | | bromomethane | ethylbenzene1 | | | n-butylenzene | hexachlorobutadiene | | | sec-butylbenzene | isopropylbenzene | | | tert-butylbenzene | p-isopropyltoluene | | | carbon tetrachloride1 | methylene chloride1 | | | chlorobenzene | n-propylbenzene | | | chloroethane | styrene1 | | | chloromethane | 1,1,1,2-tetrachloroethane | | | 2-chlorotoluene | 1,1,2,2-tetrachloroethane | | | 4-chlorotoluene | tetrachloroethene1 | | | didromomethane | toluene1 | | | 1,2-dichlorobenzene1 | 1,2,3-trichlorobenzene | | | 1,3-dichlorobenzene | 1,2,4-trichlorobenzene1 | | | 1,4-dichlorobenzene1 | 1,1,1-trichloroethane1 | | | dichlorodifluoromethane | 1,1,2-trichloroethane1 | | | 1,1-dichioroethane | trichloroethene1 | | | 1,2-dichloroethane1 | trichlorofluoromethane | | | 1,1-dichlorethane1 | 1,2,3-trichloropropane | | | cis-1,2-dichloroethene1 | 1,2,4-trimethylbenzene | | | trans-1,2-dichloroethene1 | 1,3,5-trimethylbenzene | | | 1,2-dichloropropane1 | m-xylene1 | | | 1,3-dichloropropane | o-xylene1 | | | 2,2-dichloropropane | p-xylene1 | | | | |
1 Notification must contain mandatory health effect language.
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TABLE 10A—TURBIDITY MINIMUM MONITORING REQUIREMENTS 1
| | | | Source type | | --- | --- | --- | --- | | Contaminant | Type of water system | Groundwater | Surface water 1 | | Filtered water turbidity | Community and noncommunity | Not applicable | Continuous monitoring for composite filter effluent and individual filters.2,3,4,5 | | Raw water turbidity | Unfiltered surface: community and noncommunity | Not applicable | Every four hours or continuous monitoring5 | | Distribution point turbidity | Community | State discretion7 | Five distribution samples each week unless otherwise determined by the State. No two samples may be obtained on the same day and no two samples are to be collected from the same distribution point during the same week. | | | Noncommunity | State discretion7 | State discretion6 | | | | | |
1 Surface water sources or groundwater sources directly influenced by surface water.
2 Effective January 1, 2002 systems serving 10,000 or more people must record the results of individual filter monitoring every 15 minutes, and combined filter effluent every four hours. Effective January 14, 2005 systems serving fewer than 10,000 persons must record the results of individual filter monitoring every 15 minutes, and combined filter effluent every four hours. Until January 14, 2005, systems serving fewer then 10,000 persons must continuously monitor the composite filter effluent turbidity, or record the turbidity every four hours. The State may allow systems with two filters to monitor the combined filter effluent continuously (recording every 15 minutes) in lieu of monitoring individual filter turbidity. Results of individual filter monitoring must be maintained for at least three years.
3 If there is a failure in the continuous turbidity monitoring equipment, the system must conduct grab sampling every four hours instead of continuous monitoring, but for no more than five working days following the failure of the equipment.
4 For systems using slow sand filtration or filtration treatment, other than conventional treatment, direct filtration or D.E. filtration, the State may reduce sampling frequency to once per day if it determines that less frequent monitoring is sufficient to indicate effective filtration performance.
5 If a system uses continuous monitoring, it must use the turbidity values recorded every four hours to determine if an MCL violation occurs, unless the State has approved in writing a different time interval.
6 State discretion shall mean requiring monitoring when the State has reason to believe the MCL has been violated, the potential exists for an MCL violation or the contaminant may present a risk to public health.
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TABLE 11A—MICROBIOLOGICAL/FILTRATION AVOIDANCE CRITERIA MINIMUM MONITORING REQUIREMENTS1
| Contaminant 2 | Type of water system | Population served: | Minimum number of samples per week 3,4 | | --- | --- | --- | --- | | Raw water fecal or total coliform | Community and noncommunity | Up to 500 501 to 3,300 | 1 2 | | | | 3,301 to 10,000 | 3 | | | | 10,001 to 25,000 | 4 | | | | 25,001 or more | 5 | | | | | |
1 The monitoring requirement applies to surface water sources and groundwater sources directly influenced by surface water.
2 Either fecal or total coliform density measurements are acceptable. If both analyses are performed, the fecal coliform results will take precedence.
3 Monitoring sampling must be performed on separate days.
4 Samples must be taken and analyzed every day the system serves water to the public and the turbidity of the raw water exceeds 1.49 NTU. The samples count toward the weekly sampling requirement.
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TABLE 12—RADIOLOGICAL MINIMUM MONITORING REQUIREMENTS
| Contaminant | Type of water system | Monitoring Requirement1 | | | --- | --- | --- | --- | | | | Initial | Reduced monitoring2,3 | | Combined radium-226 and radium-228 and gross alpha particle activity | Community | Four consecutive quarterly samples at every entry point before December 31, 2007, 4,5,6 | One sample every nine years at every entry point when monitoring results are below the detection limit.7,8 | | | | | One sample every six years at every entry point when monitoring results are at or above the detection limit but below half of the MCL.7,8 | | | | | One sample every three years at every entry point when monitoring results are above half of the MCL but at or below the MCL.7,8 | | | | | | | | Noncommunity | | Not applicable | | | | | | | Beta particle and photon radioactivity from manmade radionuclides | Community systems designated by the State as vulnerable9 | Quarterly samples for beta particle and annual samples for tritium and Sr-90, beginning within one quarter after being notified by the State.10,11 | If the gross beta particle activity minus the naturally occurring K-40 beta particle activity at a sampling point has a running annual average (computed quarterly) less than or equal to 50 pCi/L (screening level), the State may reduce the frequency of monitoring at that sampling point to once every 3 years.14,15 | | | Community systems designated by the State as utilizing waters contaminated by effluents from nuclear facilities9 | Quarterly samples for beta emitters and I-131 and annual samples for tritium and Sr-90, beginning within one quarter after being notified by the State.10,11,12,13 | If the gross beta particle activity minus the naturally occurring K-40 beta particle activity at a sampling point has a running annual average (computed quarterly) less than or equal to 15 pCi/L (screening level), the State may reduce the frequency of monitoring at that sampling point to once every 3 years.14,15 |
1 All radiological samples must be collected at every entry point to distribution system (EPTDS).
2 The State may allow systems to reduce the frequency of monitoring based on initial monitoring or historical results as noted in footnote 4 below.
3 Systems on a reduced monitoring schedule must perform quarterly sampling if a sample result exceeds the MCL.
4 The State may allow historical monitoring data collected between June 2000 and December 8, 2003 for systems with:
(1) only one entry point to the distribution system;
(2) multiple entry points and having appropriate historical monitoring data for each entry point to the distribution system;
(3) appropriate historical data for a representative point in the distribution system, provided that the State finds that the historical data satisfactorily demonstrate that each entry point to the distribution system is expected to be in compliance based upon the historical data and reasonable assumptions about the variability of contaminant levels between entry points.
5 The State may waive the final two quarters of initial monitoring for a sampling point if the results of the samples from the previous two quarters are below the detection limit.
6 If the average of the initial monitoring results for a sampling point is above the MCL, the system must collect and analyze quarterly samples at the sampling point until the system has results from four consecutive quarters that are at or below the MCL.
7 A gross alpha particle activity measurement may be substituted for the required radium-226 measurement provided that the measured gross alpha particle activity does not exceed 5 pCi/L. A gross alpha particle activity measurement may be substituted for the required uranium measurement provided that the measured gross alpha particle activity does not exceed 15 pCi/L. The gross alpha measurement shall have a confidence interval of 95 % (1.65σ, where σ is the standard deviation of the net counting rate of the sample) for radium-226 and uranium. When a system uses a gross alpha activity measurement in lieu of a radium-226 and/or uranium measurement, the gross alpha particle activity analytical result will be used be determine the future monitoring frequency for radium-226 and/or or uranium. If the gross alpha particle activity result is less than detection, ½ the detection limit can be used to substitute to radium-226 and determine compliance for future monitoring frequency.
8 Radium-228 measurement can not be substituted by the gross alpha particle activity result.
9 For systems in the vicinity of a nuclear facility, the State may allow the CWS to utilize environmental surveillance data collected by the nuclear facility in lieu of monitoring the systems entry point(s), where the State determines that such data is applicable.
10Systems already designed by the State must continue to sample until the State reviews and either reaffirms or removes the designation.
11Quarterly monitoring for gross beta particle activity shall be based on the analysis of monthly samples or the analysis of a composite of three monthly samples.
12Annual monitoring for Sr-90 and tritium shall be conducted by means of the analysis of a composite of four consecutive quarterly samples or analysis of four quarterly samples.
13For iodine-131, a composite of five consecutive daily samples shall be analyzed once each quarter. As ordered by the State, more frequent monitoring shall be conducted when iodine-131 is identified in the finished water.
14Systems must collect all samples for beta emitters, tritium and strontium-90 during the reduced monitoring period.
15A system that exceeds the gross beta particle activity minus the naturally occurring potassium-40 beta particle screening level (50 pCi/L for vulnerable systems or 15 pCi/L for systems utilizing waters contaminated by effluents from nuclear facilities), must further analyze the sample for the major radioactive constituents. The potassium-40 beta particle activity must be calculated by multiplying elemental potassium concentrations in mg/L by a factor of 0.82.
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TABLE 14A—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 0.5 DEGREES CELSIUS OR LOWER1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 137 | 163 | 195 | 237 | 277 | 329 | 390 | | 0.6 | 141 | 168 | 200 | 239 | 286 | 342 | 407 | | 0.8 | 145 | 172 | 205 | 246 | 295 | 354 | 422 | | 1.0 | 148 | 176 | 210 | 253 | 304 | 365 | 437 | | 1.2 | 152 | 180 | 215 | 259 | 313 | 376 | 451 | | 1.4 | 155 | 184 | 221 | 266 | 321 | 387 | 464 | | 1.6 | 157 | 189 | 226 | 275 | 329 | 397 | 477 | | 1.8 | 162 | 193 | 231 | 279 | 338 | 407 | 489 | | 2.0 | 165 | 197 | 236 | 286 | 346 | 417 | 500 | | 2.2 | 169 | 201 | 242 | 297 | 353 | 426 | 511 | | 2.4 | 172 | 205 | 247 | 298 | 361 | 435 | 522 | | 2.6 | 175 | 209 | 252 | 304 | 368 | 444 | 533 | | 2.8 | 178 | 213 | 257 | 310 | 375 | 452 | 543 | | 3.0 | 181 | 217 | 261 | 316 | 382 | 460 | 552 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated pH values may be determined by linear interpolation. CT values between the indicated temperatures of different tables may be determined by linear interpolation. If no interpolation is used, use the CT99.9; value at the lower temperature, and at the higher pH.
TABLE 14B—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 5.0 DEGREES CELSIUS1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 97 | 117 | 139 | 166 | 198 | 236 | 279 | | 0.6 | 100 | 120 | 143 | 171 | 204 | 244 | 291 | | 0.8 | 103 | 122 | 146 | 175 | 210 | 252 | 301 | | 1.0 | 105 | 125 | 149 | 179 | 216 | 260 | 312 | | 1.2 | 107 | 127 | 152 | 183 | 221 | 267 | 320 | | 1.4 | 109 | 130 | 155 | 187 | 227 | 274 | 329 | | 1.6 | 111 | 132 | 158 | 192 | 232 | 281 | 337 | | 1.8 | 114 | 135 | 162 | 196 | 238 | 287 | 345 | | 2.0 | 116 | 138 | 165 | 200 | 243 | 294 | 353 | | 2.2 | 118 | 140 | 169 | 204 | 248 | 300 | 361 | | 2.4 | 120 | 143 | 172 | 209 | 253 | 306 | 368 | | 2.6 | 122 | 146 | 175 | 213 | 258 | 312 | 375 | | 2.8 | 124 | 148 | 178 | 217 | 263 | 318 | 382 | | 3.0 | 126 | 151 | 182 | 221 | 268 | 324 | 389 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated pH values may be determined by linear interpolation. CT values between the indicated temperatures of different tables may be determined by linear interpolation. If no interpolation is used, use the CT99.9 value at the lower temperature, and at the higher pH.
TABLE 14C—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 10.0 DEGREES CELSIUS1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 73 | 88 | 104 | 125 | 149 | 177 | 209 | | 0.6 | 75 | 90 | 107 | 128 | 153 | 183 | 218 | | 0.8 | 78 | 92 | 110 | 131 | 158 | 189 | 226 | | 1.0 | 79 | 94 | 112 | 134 | 162 | 195 | 234 | | 1.2 | 80 | 95 | 114 | 137 | 166 | 200 | 240 | | 1.4 | 82 | 98 | 116 | 140 | 170 | 206 | 247 | | 1.6 | 83 | 99 | 119 | 144 | 174 | 211 | 253 | | 1.8 | 86 | 101 | 122 | 147 | 179 | 215 | 259 | | 2.0 | 87 | 104 | 124 | 150 | 182 | 221 | 265 | | 2.2 | 89 | 105 | 127 | 153 | 186 | 225 | 271 | | 2.4 | 90 | 107 | 129 | 157 | 190 | 230 | 276 | | 2.6 | 92 | 110 | 131 | 160 | 194 | 234 | 281 | | 2.8 | 93 | 111 | 134 | 163 | 197 | 239 | 287 | | 3.0 | 95 | 113 | 137 | 166 | 201 | 243 | 292 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated pH values may be determined by linear interpolation. CT values between the indicated temperatures of different tables may be determined by linear interpolation. If no interpolation is used, use the CT99.9 value at the lower temperature, and at the higher pH.
TABLE 14D—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 15.0 DEGREES CELSIUS1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 49 | 59 | 70 | 83 | 99 | 118 | 140 | | 0.6 | 50 | 60 | 72 | 86 | 102 | 122 | 146 | | 0.8 | 52 | 61 | 73 | 88 | 105 | 126 | 151 | | 1.0 | 53 | 63 | 75 | 90 | 108 | 130 | 156 | | 1.2 | 54 | 64 | 76 | 92 | 111 | 134 | 160 | | 1.4 | 55 | 65 | 78 | 94 | 114 | 137 | 165 | | 1.6 | 56 | 66 | 79 | 96 | 116 | 141 | 169 | | 1.8 | 57 | 68 | 81 | 98 | 119 | 144 | 173 | | 2.0 | 58 | 69 | 83 | 100 | 122 | 147 | 177 | | 2.2 | 59 | 70 | 85 | 102 | 124 | 150 | 181 | | 2.4 | 60 | 72 | 86 | 105 | 127 | 153 | 184 | | 2.6 | 61 | 73 | 88 | 107 | 129 | 156 | 188 | | 2.8 | 62 | 74 | 89 | 109 | 132 | 159 | 191 | | 3.0 | 63 | 76 | 91 | 111 | 134 | 162 | 195 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated pH values may be determined by linear interpolation. CT values between the indicated temperatures of different tables may be determined by linear interpolation. If no interpolation is used, use the CT99.9 value at the lower temperature, and at the higher pH.
TABLE 14E—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 20.0 DEGREES CELSIUS 1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 36 | 44 | 52 | 62 | 74 | 89 | 105 | | 0.6 | 38 | 45 | 54 | 64 | 77 | 92 | 109 | | 0.8 | 39 | 46 | 55 | 66 | 79 | 95 | 113 | | 1.0 | 39 | 47 | 56 | 67 | 81 | 98 | 117 | | 1.2 | 40 | 48 | 57 | 69 | 83 | 100 | 120 | | 1.4 | 41 | 49 | 58 | 70 | 85 | 103 | 123 | | 1.6 | 42 | 50 | 59 | 72 | 87 | 105 | 126 | | 1.8 | 43 | 51 | 61 | 74 | 89 | 108 | 129 | | 2.0 | 44 | 52 | 62 | 75 | 91 | 110 | 132 | | 2.2 | 44 | 53 | 63 | 77 | 93 | 113 | 135 | | 2.4 | 45 | 54 | 65 | 78 | 95 | 115 | 138 | | 2.6 | 46 | 55 | 66 | 80 | 97 | 117 | 141 | | 2.8 | 47 | 56 | 67 | 81 | 99 | 119 | 143 | | 3.0 | 47 | 57 | 68 | 83 | 101 | 122 | 146 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated PH values may be determined by linear interpolation. CT values between the indicated temperatures of different tables may be determined by linear interpolation. If no interpolation is used, use the CT99.9 value at the lower temperature, and at the higher pH.
TABLE 14F—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY FREE CHLORINE AT 25.0 DEGREES CELSIUS AND HIGHER1
| Free chlorine residual (mg/l) | pH | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | ≤6.0 | 6.5 | 7.0 | 7.5 | 8.0 | 8.5 | ≤9.0 | | | | | | | | | | | ≤0.4 | 24 | 29 | 35 | 42 | 50 | 59 | 70 | | 0.6 | 25 | 30 | 36 | 43 | 51 | 61 | 73 | | 0.8 | 26 | 31 | 37 | 44 | 53 | 63 | 75 | | 1.0 | 26 | 31 | 37 | 45 | 54 | 65 | 78 | | 1.2 | 27 | 32 | 38 | 46 | 55 | 67 | 80 | | 1.4 | 27 | 33 | 39 | 47 | 57 | 69 | 82 | | 1.6 | 28 | 33 | 40 | 48 | 58 | 70 | 84 | | 1.8 | 29 | 34 | 41 | 49 | 60 | 72 | 86 | | 2.0 | 29 | 35 | 41 | 50 | 61 | 74 | 88 | | 2.2 | 30 | 35 | 42 | 51 | 62 | 75 | 90 | | 2.4 | 30 | 36 | 43 | 52 | 63 | 77 | 92 | | 2.6 | 31 | 37 | 44 | 53 | 65 | 78 | 94 | | 2.8 | 31 | 37 | 45 | 54 | 66 | 80 | 96 | | 3.0 | 32 | 38 | 46 | 55 | 67 | 81 | 97 | | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated pH values may be determined by linear interpolation CT values between the indicated temperatures of different tables may be determined by linear interpolation If no interpolation is used, use the CT99.9 value at the lower temperature, and at the higher pH.
TABLE 14G—CT VALUES (CT99.9) FOR 99.9 PERCENT INACTIVATION OF GIARDIA LAMBLIA CYSTS BY CHLORINE DIOXIDE AND OZONE1, 2
| Degrees Celsius | | | | | | | | --- | --- | --- | --- | --- | --- | --- | | | ≤1 | 5 | 10 | 15 | 20 | ≥25 | | | | | | | | | | Chlorine dioxide | 63 | 26 | 23 | 19 | 15 | 11 | | Ozone | 2.9 | 1.9 | 1.4 | 0.95 | 0.72 | 0.48 | | | | | | | | |
1 These CT values achieve greater than a 99.99 percent inactivation of viruses. CT values between the indicated temperatures may be determined by linear interpolation. If no interpolation is used, use the CT99.9 value at the lower temperature for determining CT99.9 values between indicated temperatures.
2 The use of these alternative disinfectants shall be approved in accordance with the provisions of section 5-1.22 of this Subpart.
)
)
)
)
TABLE 15—ENTRY POINT DISINFECTANT MONITORING FREQUENCY FOR SYSTEMS USING CHEMICAL DISINFECTION1
| Water system source type | Population served | Samples per day4 | | --- | --- | --- | | Surface water or ground water under the direct influence of surface water (GWUDI)2,3 | Up to 500 501 - 1,000 1,001 - 2,500 2,501 - 3,300 > 3,300 | 1 2 3 4 Continuous monitoring required5 | | Ground water system or ground water source required to provide 4-log virus treatment and process compliance monitoring6,7,8 | ≤3,300 > 3,300 | 19 Continuous monitoring required5 | | Ground Water System or ground water source with other than 4-log virus treatment | Any | 19 |
1 See also Table 15A for distribution system disinfectant residual sampling locations and frequency depending on disinfectant used.
2 If at any time chlorine residual concentration falls below 0.2 mg/L at the entry point for a surface water or GWUDI system, the system must collect and analyze a grab sample every four hours until the chlorine residual concentration is again equal to or greater than 0.2 mg/L.
3 Entry point samples collected at Surface Water or GWUDI systems.
4 The day's grab samples may not be conducted at the same time.
5 If there is a failure in the continuous monitoring equipment, grab samples, every four hours, may be conducted in lieu of continuous monitoring, but for no more than five working days (14 working days for ground water systems) following the failure of the equipment.
6 If at any time the disinfectant concentration at a ground water system falls below the minimum required in the process compliance monitoring plan approved by the State, the system must collect and analyze a grab sample every four hours until the disinfectant residual concentration is again at or above minimum required levels, without exceeding other applicable concentration requirements in Table 3A.
7 Any ground water system required to provide 4-log virus treatment because of fecal contamination of the source or because of significant deficiencies in system operation, and using chemical disinfection, must demonstrate minimum disinfectant residual at a location that demonstrates adequate concentration to provide the required treatment at the first customer during peak flow according to the sampling plan developed for the system. These samples to confirm the minimum disinfection residual are to be collected at the frequency in this table.
8 Lowest daily concentration must be recorded on operation report.
9 A minimum of one disinfectant residual concentration must be recorded on operation report every day.
TABLE 15A—DISINFECTANT RESIDUAL MINIMUM DISTRIBUTION SYSTEM MONITORING REQUIREMENTS FOR SYSTEMS USING CHEMICAL DISINFECTION
| Disinfectant | Type of water system | Routine monitoring | | --- | --- | --- | | | | | | Chlorine | Community and nontransient | Sample at the same time and same points in | | Chloramines | noncommunity | the distribution system as total coliform | | | | sampling.1 | | Chlorine dioxide2 | Community, nontransient | Daily sample at the entrance to the | | | noncommunity and transient | distribution system3 | | | noncommunity | | | | | |
1 Community Water Systems using surface water or ground water under the direct influence of surface water may use heterotrophic plate count results of equal to or less than 500 colonies per milliliter as equivalent to a free chlorine residual as outlined in table 11, footnote 5, in lieu of taking separate samples for disinfection residuals.
2 Monitoring is required if chlorine dioxide is used for either oxidation or disinfection.
3 If the Maximum Residual Disinfectant Level (MRDL) of 0.8 mg/L is exceeded, the system must take three samples in the distribution system on the following day. If chlorine dioxide or chloramines are used to maintain a disinfectant residual in the distribution system, or if chlorine is used and there are no rechlorination stations, the system must take three samples as close to the first customer as possible, at intervals of at least six hours. If chlorine is used and there is a rechlorination station, the system must take one sample as close to the first customer as possible, one sample representing average residence time, and one sample representing maximum residence time.
TABLE 16—ADDITIONAL CONTAMINANTS FOR WHICH REPORTING IS REQUIRED PURSUANT TO SECTION 5-1.72(e)-(h) OF THIS SUBPART
Contaminant name
2,4-dinitrotoluene
2,6-dinitrotoluene
DCPA monoacid
DCPA di acid
4.4'-DDE
EPTC
Molinate
MTBE
Nitrobenzene
Terbacil
Acetochlor
Perchlorate
Diuron
Linuron
Proneton
2,4,6-trichlorophenol
2,4-dichlorophenol
2,4-dinitrophenol
2-methyl-1-phenol
Alachlor ESA
1,2-diphenylhydrazine
Diazinon
Disulfoton
Fonofos
Terbufos
Aeromonas Hydrophilia
Polonium-210
RDX
Algae and toxins
Echoviruses
Coxsackie viruses
Helicobacter pylori
Microsporidia
Caliciviruses
Adenoviruses
Lead - 210
Napthalene
TABLE 17—INFORMATION COLLECTION RULE CONTAMINANT
REPORTING REQUIREMENTS
| Contaminant | Reporting requirements for finished water | | --- | --- | | Total Trihalomethanes (chloroform, bronodichloromethane, dibronochloromethane, and bronoform) | Report as a group if detected | | Haleocetic acids (mono-,di-,and trichloroacetic acid, and mono- and di-bronoacetic acid) | Report as a group if detected | | Haloacetilenitriles (dichloro-,trichloro-,bromochloro-, and dibromoacetonitrile) | Report as a group if detected | | Haloketones (1,1-dichloropropanone and 1,1,1-trichloropropanine) | Report as a group if detected | | Chloropicrin | Reporting required if detected | | Chloral Hydrate | Reporting required if detected | | Total Organic Halides | Reporting required if detected | | Disinfectant residual | Reporting required if detected | | Cyanogen Chloride | Report if detected and treatment plant uses Chloramines | | Chlorate | Report if detected and treatment plant uses Hypochlorite solutions | | Bromate, Aldehydes | Report if detected and treatment plant uses Ozone | | Chlorine Dioxide residual, Chlorite, Chlorate, Bromate, Aldehydes | Report if detected and treatment plant uses Chlorine Dioxide | | Total coliforms | Report if detected | | Fecal coliforms or Escherichia coli | Report if detected | | Gardia | Report if detected | | Total culturable viruses | Report if detected |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-9 STANDARD INFANT AUTOPSY PROCEDURES
10 CRR-NY 69-9.3 New York State Infant Autopsy Protocol
New York State department Of Health
Infant Autopsy Protocol
| Decedent's name | Age | Sex | Race/Ethnicity | | --- | --- | --- | --- | | | | | | | Local accession number | Date of birth | Date/time of death | Date of autopsy | | | | | | | Pathologist | | County | | | | | | | | | | | | | 1) FINAL CAUSE AND MANNER OF DEATH | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| 2) STUDIES | | | | | | --- | --- | --- | --- | --- | | Routine Studies | Normal | Abnormal | Not Done | Findings | | Photographs | □ | □ | □ | | | Full-body X-Rays | □ | □ | □ | | | Toxicology | □ | □ | □ | | | Histopathology | □ | □ | □ | | | Neuropathology | □ | □ | □ | | | Metabolic Screening | □ | □ | □ | | | Blood/Tissue for future studies | □ | □ | □ | | | Studies, as indicated | Normal | Abnormal | Not Done | Findings | | Viterous samples for glucose | □ | □ | □ | | | Microbiology/Virology | □ | □ | □ | | | Genetic Studies | □ | □ | □ | | | Electrolytes | □ | □ | □ | | | HIV Testing | □ | □ | □ | |
COMMENTS:
_____ DOH-4278 (9/30) p1
| 3) CLINICAL SUMMARY | | | | | | --- | --- | --- | --- | --- | | Maternal Age: | | | | | | Birth Weight (in grams): | Gestational Age: | | | | | Pregnancy Complications: | | | | | | Medical History | YES | NO | NOT AVAILABLE | COMMENTS | | Maternal Smoking | □ | □ | □ | | | Maternal Alcohol Use | □ | □ | □ | | | Maternal Drug Use | □ | □ | □ | | | Sibling with SIDS | □ | □ | □ | | | Other Relative with SIDS | □ | □ | □ | | | Other Infant or Child Deaths | □ | □ | □ | | | | | | | | | | | | | | | | | | | |
| Sleeping Position (put to sleep): | □ Supine | □ Prone | □ Side | □ Unknown | | --- | --- | --- | --- | --- | | Co-Sleeping: | □ Yes | □ No | □ Unknown | | | Describe sleep habits and bedding, if known: | | | | | | | | | | | | | | | | | | | | | | | | COMMENTS: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4) DEATH SCENE INVESTIGATION | | | | | | | □ Indicated | If indicated, state date: | | | | | □ Not indicated | If not indicated, state reason: | | | | | | | | | | COMMENTS: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | PATHOLOGIST | Date Form Completed | | | | | | | | | | | DOH-4278 (9/03) p2 | | | | |
Autopsy Format
• Final Diagnoses
• Final Cause and Manner of Death
• External Examination
• Portmortem Changes
• Scars / Other Distinguishing Characteristics
• Clothing
• Weights and Measures
• General Appearance / Development
• Injuries (External and Internal)
• Therapeutic Procedures
• Resuscitation Evidence
• External Integument
• Internal Examination Head Neck Body Cavities Cardiovascular System Respiratory System Liver, Gallbladder and Pancreas Hemolymphatic System Genitourinary System Endocrine System Digestive System Musculoskeletal System
• Post-Mortem Studies Full body X-rays Histopathology Toxicology Metabolic Screen Neuropathology Cultures Blood/Tissue retained for future studies Other
_____ DOH-4278 (9/03) p3
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 458 NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 458.1 Introduction
This Part contains the definitions (where necessary) of the natural classifications of expense which, as indicated in section 453.2(c) of this Article are a mandated reporting level for expenses. Also contained in this Part are two indexes: one for salaries and wages, by job title; the other, a supplies and materials classification index. The indexes present guidelines for classifying wages and salaries by specific job titles and for proper classification of supplies and services expense.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
LICENSURE LICENSURE
10 CRR-NY 89.11 Denial of licensure
(a) If the department determines that an applicant is ineligible for licensure pursuant to this Part, the department shall provide written notice to the applicant of the determination, the reasons therefor and information regarding his/her rights to petition.
(b) An applicant who has been denied licensure may petition the department, within 30 days of notification of the denial, for a review thereof. If the commissioner or his or her designee decides in his/her discretion that a hearing should be held, the petitioner shall be entitled to all the rights of a respondent specified in subdivisions 2, 3, and 4 of section 3511 of the Public Health Law.
(c) Where an applicant has been denied licensure, the department may, after the expiration of two years or upon the granting to the applicant of a pardon or of a certificate of good conduct, or of a certification of relief from disability, entertain a new application for examination.
(d) Where an applicant is a defendant in a pending criminal proceeding under charges for an offense that bears a direct relationship to the practice of radiologic technology, the department may withhold the final determination of eligibility for a license pending the outcome of the proceeding.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.11 Separability
If any section, subsection, clause or provision of this Part shall be deemed by any court of competent jurisdiction to be unconstitutional, ineffective or otherwise legally invalid or unenforceable, in whole or in part, to the extent that it is not unconstitutional, ineffective or otherwise legally invalid or unenforceable, it shall be valid and effective and no other section, subsection, clause or provision shall, on account thereof, be deemed invalid or ineffective.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PERSONNEL PERSONNEL
10 CRR-NY 14-1.72 Employee consumption of food and use of tobacco, hair restraints
(a) Employees are to consume food only in designated dining areas where it will not result in contamination of other food, equipment, utensils or other items needing protection.
(b) Tobacco in any form is not to be used by employees while engaged in food preparation or service, or while washing equipment or utensils, or where its use will result in contamination of food equipment or utensils, or where its use will result in contamination of food, equipment or utensils.
(c) All persons within a food service establishment who work in areas where food is prepared are to use hats, caps or hair nets as restraints which minimize hair contact with hands, food and food-contact surfaces.
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.116 Cleaning record
A record of cleaning operations is to be maintained by the operator. It is to be located in each machine or be returned daily to headquarters, and is to be available at the time of inspection and be current for at least the past 30 days.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.8 Processing and storage of tissue
(a) Fresh musculoskeletal tissue shall be stored in an isotonic storage medium demonstrated to maximize tissue viability in a sealed, sterile container at a temperature between one and 10 degrees Celsius for a period not to exceed 14 days from retrieval. Storage shall take place in a refrigerator reserved for musculoskeletal or other tissue intended for transplantation, or blood intended for transfusion, equipped with a thermometer calibrated at least annually against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer. The temperature shall be visually monitored and recorded daily unless the refrigerator is equipped with a calibrated mechanical temperature monitor and alarm system to detect an increase in temperature to above 10 degrees Celsius or a decrease in temperature to below one degree Celsius.
(b) Musculoskeletal tissue processing for freezing shall be performed under aseptic conditions within 48 hours of retrieval. Until processing, tissue shall be stored at between one and 10 degrees Celsius. Once processed, musculoskeletal tissue shall be stored frozen at a target temperature of minus 40 degrees Celsius or lower in labeled containers until released for use, in either:
(1) a freezer reserved for musculoskeletal or other tissue intended for transplantation, or blood intended for transfusion, equipped with an audible alarm to detect an increase in temperature to above the limit established by the director and a recording thermometer calibrated at least annually against a NIST-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer; or
(2) a liquid nitrogen tank reserved for musculoskeletal or other tissue intended for transplantation.
(c) Freeze-dried musculoskeletal tissue shall be processed in a manner that meets the minimum standards of the manufacturer of the freeze-drier. The freeze-drier shall be equipped with a temperature recording device unless another mechanism for recording temperature is in place, and documentation shall allow tracing of each tissue product to a specific batch. Sterility testing of each freeze-dried tissue unit shall be performed using a properly validated method of 100 percent nondestructive testing or another method approved by the medical director the tissue bank in consultation with the medical advisory committee and approved by the department. Testing for residual moisture shall be performed on one representative sample from each freeze-dried batch for each type of musculoskeletal tissue, such as cartilage, ligament and bone. Freeze-dried tissue shall be stored at room temperature or lower.
(d) If musculoskeletal tissue is sterilized by ethylene oxide, testing for ethylene oxide, ethylene glycol and ethylene chlorhydrin residue shall be performed on each type of tissue within a batch. Residue amounts shall not exceed:
Parts per Million
| Tissue Quantity | Ethylene Oxide | Ethylene Chlorhydrin | Ethylene Glycol | | --- | --- | --- | --- | | Small (< 10 g) | 250 | 250 | 5,000 | | Medium (10-100 g) | 100 | 100 | 2,000 | | Large (> 100 g) | 25 | 25 | 500 |
(e) Storage equipment shall have clearly defined and labeled areas for all musculoskeletal tissue stored, and untested tissue shall be maintained in a quarantine area segregated from tissue awaiting distribution.
(f) Thermometers shall be visually monitored daily, or temperatures shall be continuously monitored mechanically, and, if applicable, liquid nitrogen levels shall be checked at least twice a week for fluctuations potentially affecting the quality of the musculoskeletal tissue. Storage shall be at a target temperature of minus 40 degrees Celsius or lower. Temperature records and, if applicable, liquid nitrogen level records shall be available for inspection by the department for the entire period of storage and for one year afterwards.
(g) Musculoskeletal tissue from two or more donors shall not be pooled.
(h) The age and sex of the donor, and, if the musculoskeletal tissue is from a living donor, the patient's orthopedic diagnosis shall be made available to the transplanting surgeon, upon request.
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.3 Administrative responsibility
The director of a human milk bank shall ensure the development and implementation of policies and procedures consistent with this Part for the operation of the bank, and the appointment of a medical director and a medical advisory committee composed of physicians with experience in pediatrics, neonatology, blood banking, nutrition and/or other appropriate fields, including at least one member with expertise in infectious diseases, as well as other allied health personnel.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 122 LEWIS COUNTY
10 CRR-NY 122.1 Village of Lowville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as finally amended by chapter 510 of the Laws of 1921, as heretofore set forth, shall apply to the property of the village of Lowville, Lewis County, N. Y., on which are located the springs and reservoirs which supply water to the village of Lowville, consisting of lots numbers 250, 252, 265, 267, 279, 280, 281 and 292 located in the town of Watson, Lewis County, adjacent to and southeast of the southeastern corner of the town of New Bremen, Lewis County, N. Y., and bound as follows: Beginning at a point at the northwest corner of lot number 267, and running thence south 82° east 57.70 chains, thence south 8° west 31 chains, thence north 82° west 21.50 chains, thence south 8° west 6 chains, thence north, 82° west 9 chains, thence south 8° west 31 chains, thence south 83° east 30.50 chains, thence south 8° west 32.80 chains, thence south 83° east 119.90 chains, thence north 8° east 61 chains, thence north 45° east 22.25 chains, thence north 45° west 9.68 chains, thence north 45° east 14 chains, thence south 45° east 9.68 chains, thence north 45° east 70.35 chains to the point of beginning.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a reservoir or watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such reservoir or watercourse.
(c) Privies, sewage, house slops, etc.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind, used for the temporary or permanent storage of human excreta, shall be located within the boundary of the above described village property unless placed there by authority of the board of water commissioners of Lowville, in which case such privy, privy vault, pit, cesspool or receptacle of any kind shall be so placed as not to cause any possible pollution of the water supply of the village of Lowville.
(2) No house slops, bath water, laundry or garage wastes or sewage or other excretal matter from any water closet, privy, receptacle or other source shall be thrown, placed, led, discharged, directly or indirectly into any reservoir or watercourse of the water supply of the village of Lowville nor shall any such matters be thrown, placed, led, discharged or allowed to escape on or beneath the surface of the ground within the boundary of the above described village property tributary to the source of public water supply of the village of Lowville.
(3) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or waste from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Animals, manure, compost.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain within the boundary of the above described village property, except that incidental to the supervision and maintenance of the public water supply of the village of Lowville in which case special precautions shall be taken to prevent any possible pollution of the public water supply of the village of Lowville.
(2) No cattle, horses, mules, sheep, goats, pigs or poultry shall be allowed to graze or pasture within the boundaries of the above described property.
(3) No manure or compost of any kind shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the ground within 300 feet of any such reservoir or watercourse within the above described village property.
(e) Bathing and fishing.
No person shall be allowed to bathe or fish in any reservoir or watercourse of the public water supply of the village of Lowville, nor shall any person, other than employees of the village of Lowville, engaged in the work of supervision or maintenance of the public water supply of the village of Lowville, be allowed to trespass, hunt or trap on the above described village property.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, birds, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed or discharged into any reservoir or watercourse of the water supply of the village of Lowville nor onto the surface of the ground or beneath the surface of the ground within the boundary of the above described village property.
(g) Cemeteries.
No interment of a human body shall be made within the limits of the above described village property.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained on the above described village property within 500 feet of any reservoir or watercourse of the water supply of the village of Lowville unless such structure is so located as not to be on the drainage area tributary to the sources of water supply.
(i) Inspections.
The board of water commissioners of the village of Lowville or their duly authorized representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-2 REQUIRED SIGNAGE
10 CRR-NY 9-2.3 Penalties
A violation of any provision of this Subpart is subject to all civil and criminal penalties as provided for by law. For purposes of civil penalties, each day that a place of business fails to post signage required by this Subpart shall constitute a separate violation under this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
ADDITIONAL INFORMATION ADDITIONAL INFORMATION
10 CRR-NY 446.29 Additional information
(a) Are any hospital employees represented by a labor organization?
(b) If so, please provide the following data for each representation unit:
(1) Complete name of representation unit (including local designation).
(2) Number of employees in unit.
(3) Expiration date of current contract(s).
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
CONSTRUCTION CONSTRUCTION
10 CRR-NY 7-1.7 Building construction, enlargement, development, improvement or conversion required
(a) Notice of construction, modification or conversion required.
No person shall modify an existing temporary residence or develop or convert a property for use as a temporary residence without first notifying the permit-issuing official at least 60 days before construction commences. Notices shall be submitted on a form acceptable to the permit-issuing official and shall give the name and location of the property, a brief description of the construction, modification or conversion, and the name, telephone number and mailing address of the person giving notice.
(b) Requirement for new construction.
All new construction including alterations, enlargements and improvements, and change of occupancy shall be in accordance with the uniform code. The building permit and certificate of occupancy/certificate of compliance as issued by the code enforcement official and a copy of the plans as approved by the CEO shall be readily available for review by the permit-issuing official. The permit-issuing official may require the operator to submit, prior to temporary residence permit issuance and/or occupancy of newly constructed or modified facilities, a construction compliance certificate prepared and signed by a professional engineer or registered architect licensed to practice in New York State that shall include a statement that the construction pertaining to fire safety was in accordance with the uniform code and the approved plans. A copy of the approved plans shall be readily available for review by the permit-issuing official or designated representative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.3 General requirements related to filing of annual audited financial reports and audit committee appointment
(a) Every MCO shall file an audited financial report with the commissioner on or before April 1st for the year ended December 31st immediately preceding.
(b) Every MCO required to file an annual audited financial report pursuant to this Subpart shall designate a group of individuals to constitute its audit committee.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.6 Denial, suspension and revocation of department approval
(a) The department may deny an environmental laboratory's application for a certificate of approval for the following reasons:
(1) except as provided in section 55-2.4(c) of this Subpart, failure to undergo an on-site assessment conducted by the department or by a State program recognized by the department pursuant to section 55-2.9 of this Subpart or failure to demonstrate, during any on-site assessment so conducted: compliance with the staffing, methodological and other requirements of this Subpart; and effective implementation of a quality system for planning and assessing work performed by the laboratory and for conducting required quality assurance and quality control procedures to promote and maintain the accuracy and reliability of test results;
(2) failure to participate or perform satisfactorily in proficiency testing pursuant to section 55-2.8 of this Subpart for the analytes for which the laboratory seeks approval;
(3) failure of the laboratory technical director(s) to meet the required qualifications in section 55-2.10 of this Subpart;
(4) misrepresentation of any material fact pertinent to obtaining or retaining approval for any laboratory owned or directed by an owner or technical director listed on the application including, but not limited to, falsification of any report on or related to a laboratory analysis or submission of proficiency test results which were, in fact, generated by a laboratory other than the laboratory to which the samples were distributed;
(5) failure to submit a complete approval application, including the attestation required in section 55-2.4(a) of this Subpart, or failure to provide documentation of a quality system as defined in this Subpart or any additional information required by the department to support the application;
(6) failure to remit the required fees;
(7) the owner(s) and/or technical director(s) listed on the application are determined by the department to lack the character and competence necessary to ensure compliance with the applicable laws, rules and regulations after consideration of factors including but not limited to:
(i) evidence of aiding and/or abetting in violation of any of the provisions of this Subpart;
(ii) prior sustained charges of administrative violations of State or Federal Laws, rules and regulations related to the provision of environmental laboratory services or reimbursement for such services, against the owner or a technical director, individually or jointly, or against any laboratory owned or directed by an owner or technical director listed on the application, or a finding by a municipality that a laboratory has violated a local ordinance relating to collection and analysis of samples or specimens, or to reporting of results for examination of said samples or specimens;
(iii) conviction of any crime, including, but not limited to, any offense related to furnishing of, or billing for, environmental laboratory services, which is considered an offense involving theft or fraud;
(iv) consideration of whether any environmental laboratory directed by a technical director listed on the application has demonstrated a pattern of repetitive unsatisfactory performance in required proficiency testing in one or more proficiency testing categories, excluding an unsatisfactory score for administrative reasons such as late result submission; and/or
(v) any other factor having a direct bearing on the ability of the owner(s) and technical director(s) listed on the application to provide, direct or supervise the provision of high quality environmental laboratory services, or to ensure compliance with applicable statutory and regulatory requirements;
(8) failure to respond to an on-site assessment report with a corrective action plan within the required 30 calendar days after receipt of the report;
(9) failure to respond to an on-site assessment report with an acceptable corrective action plan within the specified timeframe;
(10) failure to implement the responsive actions detailed in the corrective action plan with the specified timeframe; and/or
(11) denial of entry to representatives of the department or a State program recognized by the department pursuant to section 55-2.9 of this Subpart, for on-site assessment during normal business hours.
(b)
(1) If the department proposes to deny an environmental laboratory's application for a certificate of approval, the laboratory shall be given written notice of the proposed denial, stating the reason or reasons for such proposed denial. Such notice shall be sent by certified mail and shall be a final determination to be effective 30 days from the date of the notice, unless reconsideration is requested.
(2) If the department gives notice of proposed denial, the laboratory may request reconsideration of the proposed denial by submitting a written request for reconsideration to the department within 30 days of the date of the notice of proposed denial. Submission of a request for reconsideration within 30 days shall stay any action to deny a laboratory's application for a certificate of approval, pending the department's decision regarding such request for reconsideration.
(3) The written request for reconsideration shall be signed by the owner(s) and technical director(s), and shall include all information of the owner(s) and technical director(s) wish to be considered, including any written documentation that would controvert the reason(s) for the denial or disclose that the denial was based upon a mistake of fact.
(4) If the laboratory properly seeks reconsideration of the proposed denial, the department shall review its proposed denial and shall issue a written determination after reconsideration. The determination after reconsideration may affirm, revoke or modify the proposed denial, allow issuance of a certificate of approval conditional on maintenance of corrective action, or require that the laboratory take corrective action. Such determination shall be the final decision of the department.
(c)
(1) An environmental laboratory's certificate of approval shall be suspended automatically upon a change in laboratory ownership, technical direction, or location. However, provided re-application has been made in writing to the department within 30 calendar days of the change, the department may extend an environmental laboratory's certificate of approval for a period not to exceed 90 calendar days after any change in laboratory ownership, technical direction or location, in order to permit the department to evaluate, as applicable, the character and competence of the new technical director(s) and/or new owner(s) considering requirements in section 55-2.4(b) of this Subpart; the qualifications of the new technical director(s); and/or the effect of the change in location on the environmental laboratory's ability to produce accurate and reliable analytical data.
(2) An environmental laboratory's certificate of approval shall be suspended automatically upon failure to remit at least the quarterly payment of the annual approval fee pursuant to Subpart 55-3 of this Part, unless otherwise expressly authorized by the department.
(3) An environmental laboratory's certificate of approval shall be suspended automatically, in affected analytes and/or categories, for failure to maintain a record of at least two satisfactory proficiency testing (PT) events within the three most recent PT events.
(4)
(i) The department may suspend an environmental laboratory's certificate of approval, in affected analytes and/or categories, for reasons including:
(a) a pattern of deficiencies on on-site assessment or other demonstration that the laboratory lacks an effective quality system for planning and assessing work performed by the laboratory, and for conducting required quality assurance and quality control procedures to promote and maintain the accuracy and reliability of test results; and
(b) failure to notify the department of any change in major analytical instrumentation within 30 calendar days of the change.
(ii) If the department proposes to suspend a laboratory's certificate of approval, the laboratory shall be given written notice of the proposed suspension, stating the reason or reasons for such proposed suspension. Such notice shall be sent by certified mail and shall be a final determination to be effective 10 days from the date of the notice, unless reconsideration is requested. A laboratory may request reconsideration of the proposed suspension by submitting a written request for reconsideration to the department within 10 days of the date of the notice of proposed suspension. Submission of a request for reconsideration within 10 days shall stay any action to suspend department approval, pending the department's decision regarding such request for reconsideration. The written request for reconsideration shall be signed by the owner(s) and the technical director(s) designated responsible for the affected category(ies), and shall include all information the owner(s) and technical director(s) wish to be considered, including any written documentation that would controvert the reason(s) for the suspension or disclose that the suspension was based upon a mistake of fact. The department shall review its proposal to suspend approval and shall issue a written determination after reconsideration. The determination after reconsideration may affirm, revoke or modify the proposed suspension, allow retention of the certificate of approval conditional on maintenance of corrective action, or require that the laboratory take corrective action. Such determination shall be the final decision of the department.
(5) An environmental laboratory whose certificate of approval is suspended pursuant to paragraph (3) or (4) of this subdivision shall retain approval for the analytes and/or categories for which it continues to meet department requirements. A laboratory so suspended shall discontinue analysis of samples for the analytes and/or categories affected by the suspension, as of the date of the suspension.
(6) The department shall change a laboratory's certification status from suspended to approved upon receipt of sufficient documentation to permit the department to determine that the conditions meriting suspension no longer exist, and the laboratory meets the criteria for a certificate of approval in section 55-2.4 of this Subpart.
(7) Notwithstanding any of the provisions of this subdivision, the Commissioner of Health may suspend a laboratory's certificate of approval pursuant to the summary action provisions of Public Health Law, section 16.
(d)
(1) The department may revoke an environmental laboratory's certificate of approval in affected analytes and/or categories for reasons including:
(i) failure to respond to an on-site assessment report with an acceptable corrective action plan within the specified timeframe;
(ii) a pattern of deficiencies on on-site assessment, or other demonstration that the laboratory lacks an effective quality system for planning and assessing work performed by the laboratory, and for conducting required quality assurance and quality control procedures to promote and maintain the accuracy and reliability of test results;
(iii) failure to implement the responsive actions detailed in the corrective action plan within the specified timeframe;
(iv) failure to correct the deficiencies meriting suspension within six months of the effective date of the suspension; or
(v) for an environmental laboratory suspended pursuant to paragraph (c)(3) of this section, unsatisfactory performance in the next PT event results in three consecutive failed PT events.
(2) An environmental laboratory whose certificate of approval is revoked pursuant to paragraph (1) of this subdivision shall retain approval for the analytes and/or categories for which it continues to meet department requirements, and may reapply for approval once the deficiencies meriting revocation have been corrected.
(3) The department may revoke an environmental laboratory's certificate of approval, in total, for reasons including:
(i) failure to respond to an on-site assessment report with a corrective action plan within the required 30 calendar days after receipt of the report;
(ii) failure to participate in a PT program acceptable to the department;
(iii) falsification of any report on or related to a laboratory analysis, including, but not limited to. submission of proficiency test results which were, in fact, generated by a laboratory other than the laboratory to which the samples were distributed;
(iv) misrepresentation of any material fact pertinent to obtaining or maintaining approval;
(v) denial of laboratory entry to representatives of the department or of a State program recognized by the department pursuant to section 55-2.9 of this Subpart for on-site assessment during normal business hours;
(vi) sustained charges of administrative violations of State or Federal laws, rules and regulations related to the provision of environmental laboratory services, or reimbursement for such services, against the owner(s) or technical director(s), individually or jointly, or against any laboratory owned or directed by such individuals;
(vii) conviction of any crime, including, but not limited to, any offense related to furnishing of, or billing for, environmental laboratory services, which is considered an offense involving theft or fraud;
(viii) failure to remit the annual approval fee, or, for partial fee payments, failure to remit such payments within the timeframes established by the department;
(ix) aiding and/or abetting in the violation of any of the provisions of this Subpart; and/or
(x) a finding by a municipality that the environmental laboratory has violated a local ordinance related either to collection and analysis of samples or specimens, or to reporting of results for examination of such samples or specimens.
(4) If an environmental laboratory's certificate of approval has been revoked pursuant to paragraph (3) of this subdivision and the department finds that the violation was willful, or due to recklessness or gross negligence, no application shall be accepted, for a period of time to be determined by the Commissioner of Health or his or her designee, from any person who was an owner or technical director of such laboratory on the date of notification of proposed approval revocation.
(e) No environmental laboratory's certificate of approval may be revoked without a hearing or an opportunity for a hearing. The environmental laboratory shall be given written notice of proposed revocation, stating the reason(s) for the department's proposed action. Such notice shall be sent by certified mail and shall be a final determination, to be effective 30 calendar days from the date of the notice, unless a hearing is requested by the laboratory. The environmental laboratory may request a hearing by submitting a written request for a hearing, signed by both the owner(s) and the technical director(s) designated responsible for the affected category(ies), within 10 calendar days of the date of the department's notice of proposed revocation. Approval shall be automatically suspended while any hearing requested is pending, provided the hearing is scheduled to begin within 90 calendar days of the request for such hearing.
(f) An environmental laboratory whose certificate of approval has been revoked shall submit a new application for approval and shall meet all criteria for approval provided in section 55-2.4 of this Subpart to be issued a certificate of approval. The department may conduct an on-site assessment of the environmental laboratory before acting on such application.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.6 Village of Victor
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells and spring which comprise the source of the public water supply of the Village of Victor, Ontario County, NY. Said spring and wells are located or to be located on land owned by the Village of Victor and are situated on Modock Road in the Town of Victor, on East Main Street in Village of Victor, and a well to be developed on Strong Road in the Town of Victor.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for road maintenance) or sodium chloride (commonly used for water softener regeneration or road maintenance).
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(5) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(6) Refuse shall mean all putrescible and nonputrescible solid waste including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(7) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(8) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(9) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(10) Water supply shall mean the public water supply of the Village of Victor, Ontario County, NY.
(11) Wells shall mean the wells now used as a source of this public water supply or to any additional wells which may be constructed at this point as a source for this public water supply.
(12) Springs shall mean the springs now used as ground water sources for the public water supply, or any additional springs which may be developed on said property.
(c) Human excreta.
(1) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 250 feet of the wells and springs.
(2) No human excreta shall be deposited or spread upon or beneath the surface of the ground within 250 feet of the wells and springs.
(d) Sewage.
No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground (except into watertight pipes connected to a sewage disposal system, a permit for which shall have been granted by the appropriate State agency having jurisdiction over such facility) within 250 feet of the wells and springs. It is provided, however, that no such watertight pipe shall be located within 15 feet of the wells and springs.
(e) Refuse.
No refuse shall be deposited on or beneath the surface of ground within 250 feet of the wells and springs.
(f) Refuse disposal area.
No refuse disposal area shall be located within 500 feet of the wells and springs.
(g) Cemeteries.
No interment of a human body shall be made within 250 feet of the wells and springs.
(h) Chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within 500 feet of the wells and springs.
(i) Chloride salt.
No chloride salt storage area shall be located within 500 feet of the wells and springs except in weatherproof buildings or watertight vessels.
(j) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, of this Title, shall be disposed of by burial in soil within 500 feet of the wells and springs.
(k) Junkyards.
No junkyard shall be located within 250 feet of the wells and springs.
(l) Trespassing.
No trespassing shall be allowed upon the property of the Village of Victor upon which the wells and springs are located and no person or persons as may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the supply or except such other persons as may be authorized to enter said property by the Village of Victor.
(m) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(n) Inspections.
The trustees of the Village of Victor, or any person or persons as may be charged with the maintenance or supervision of the water supply, its officers or their duly appointed representatives, shall make regular and thorough inspections of the area surrounding the wells and springs to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid trustees of the Village of Victor to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the Village of Victor to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees of the Village of Victor shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of notices served, the number of violations abated and the general surrounding of the wells and springs at the time of the last inspection.
(o) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.36 Medical staff service
This functional reporting center must contain all the expenses associated with services to patients provided by physicians who are not assigned to specific professional service departments. All remuneration for physicians' services should be reported under this functional classification for payment to chiefs of service, house officers, and all other physicians not assigned to a specific professional service department. Note that the assignment of physicians' costs are not subject to the reclassification criteria and must be directly assigned in accordance with section 452.4(i) of this Article.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
UPSTATE BLUE CROSS SUPPLEMENTAL DATA UPSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.30 Cost allocation adjustments
| Description of adjustment | Cost center affected | Account number | | | | --- | --- | --- | --- | --- | | (a) | Interest on inter-fund borrowing | | | | | (1) | Funded depreciation | (i) | Interest—Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (2) | Donor-restricted funds | (i) | Interest—Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (3) | Other (specify) | (i) | Interest—Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (b) | Unincorporated business tax | Provision for Income Taxes | 9410 | | | (c) | Corporate income taxes | Provision for Income Taxes | 9410 | | | (d) | Unrecovered cost of courtesy allowances to employees and dependents | Employee Benefits—Non-Payroll-Related | 8830 | | | (e) | Voluntary Agency Proficiency Testing Program | | | | | (1) | Clinical laboratory | Laboratory Services—Clinical | 7210 | | | (2) | Other (specify) | Specify | Specify | | | (f) | Grants, gifts and income for specific purposes | Specify | Specify | | | (g) | Depreciation—straight line to accelerated | Depreciation and Amortization-Movable Equipment | 8820 | | | (h) | 28B funding requirements | | | | | (1) | Building and fixtures | Depreciation/Amortization-Fixed Assets | 8810 | | | (2) | Movable equipment | Depreciation/Amortization— Movable Equipment | 8820 | | | (i) | Hospital-based physicians on direct physician billing | | | | | (1) | Diagnostic X-ray | (i) | Radiology—Diagnostic, and/or | 7320 | | | | (ii) | CT Scanner, and/or | 7340 | | | | (iii) | Radiology—Therapeutic, and/or | 7360 | | | | (iv) | Nuclear Medicine | 7380 | | (2) | Laboratory | (i) | Laboratory Services-Clinical, and/or | 7210 | | | | (ii) | Laboratory Services— Pathological, and/or | 7230 | | | | (iii) | Blood Storing and Processing | 7260 | | (3) | Electrocardiology | Electrocardiology | 7290 | | | (4) | Emergency room physicians | Emergency Services | 6710 | | | (j) | Other (specify) | Specify | Specify | | | (k) | Amounts may be expressed as: | | | | | (1) | increases; or | | | | | (2) | decreases | | | |
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.4 Governing body
(a) The entity or person established as operator of the PCH/CAH shall be legally responsible for the quality of patient care services; for the conduct and obligations of the hospital as an institution and for ensuring compliance with all Federal, State and local laws. The operator's governing body, which shall mean the governing authority as defined in section 600.9(a) of this Title, shall operate in accordance with the provisions of section 405.2 of this Title except as provided for below. In addition, the governing body shall:
(1) ensure that all officers, directors, trustees, partners, or sole proprietors participate in orientation and continuing education programs addressing the mission, role and responsibilities of the hospital, the local EMS system and if appropriate, the network of which the PCH/CAH is a member in meeting the health care needs of patients and the community;
(2) adopt by-laws which reflect the role, purpose and responsibilities of the PCH/CAH within any rural health network in which it may operate;
(3) establish and maintain a coordinated program, in conjunction with an affiliated full service hospital and other area providers as appropriate, which integrates the operational review activities of all hospital services for the purpose of enhancing the quality of patient care and identifying and preventing potential malpractice issues;
(4) sets policies that assure that a doctor of medicine or osteopathy and/or a registered physician's assistant under the general supervision of a physician or a nurse practitioner collaborating with a physician, is on duty at all times during regular scheduled hours of operation of emergency care services, and other services at times determined appropriate by the governing body of the hospital and specified by hospital policies and procedures; and
(5) sets policies that ensure that a doctor of medicine or osteopathy is on call at all times.
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.6 Admission, continued stay and registrant assessment
(a) The operator must:
(1) select, admit and retain in the adult day health care program only those persons for whom adequate care and needed services can be provided and who, according to the comprehensive assessment conducted by the operator or by the managed long term care plan or care coordination model that referred the applicant to the adult day health care program, can benefit from the services and require a minimum of at least one visit per week to the program;
(2) assess each applicant, unless the assessment was conducted by a managed long term care plan or care coordination model that referred the applicant to the adult day health care program, utilizing an assessment instrument designated by the department, with such assessment addressing, at a minimum:
(i) medical needs, including the determination of whether the applicant is expected to need continued services for a period of 30 or more days from the date of the assessment. An operator may request approval by the appropriate department regional office for an exemption, based on special circumstances, to the requirement for determining whether there is a need for continued services for 30 days or more;
(ii) use of medication and required treatment;
(iii) nursing care needs;
(iv) functional status;
(v) mental/behavioral status;
(vi) sensory impairments;
(vii) rehabilitation therapy needs, including a determination of the specific need for physical therapy, occupational therapy, speech language pathology services, and rehabilitative, restorative or maintenance care;
(viii) family and other informal supports;
(ix) home environment;
(x) psycho-social needs;
(xi) nutritional status;
(xii) ability to tolerate the duration and method of transportation to the program; and
(xiii) evidence of any substance abuse problem;
(3) register an applicant only upon appropriate recommendation from the applicant's practitioner after completion of a personal interview by appropriate program personnel;
(4) register an applicant only after determining that the applicant is not receiving the same services from another facility or agency.
(b) An individual may be registered in an adult day health care program only if his/her comprehensive assessment indicates that the program can adequately and appropriately care for the physical and emotional health needs of the individual.
(c) No individual suffering from a communicable disease that constitutes a danger to other registrants or staff may be registered or retained for services on the premises of the program.
(d) The operator may admit, on any given day, up to 10 percent over the approved capacity for that program. The average annual capacity, however, may not exceed the approved capacity of the operator's program.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE OPERATION FOOD VENDING MACHINE OPERATION
10 CRR-NY 14-5.24 Definition of frozen desserts
(a) Frozen desserts are ice cream, frozen custard, French ice cream, French custard ice cream, artificially sweetened ice cream, ice milk, artificially sweetened ice milk, fruit sherbet, non-fruit sherbet, water ices, non-fruit water ices, confection frozen without stirring, dairy confection frozen without stirring, manufactured dessert mix, frozen confection, melloream frozen dessert, paravine, frozen yogurt, freezer made shakes, freezer made milk shakes, dietary frozen dessert, whipped cream confection and bisque tortoni, as all such products are commonly known, together with any mix used in making such frozen desserts, and any products which are similar in appearance, odor or taste to such products, or are prepared or frozen as frozen desserts are customarily prepared and frozen, whether made with dairy products or non-dairy products. Any operation producing chips or flakes of ice made from water with or without additives, served to the consumer with or without flavorings added by the operator or consumer, is included as a retail frozen dessert within this definition. This operation is commonly known as a slush operation.
(b) Retail frozen desserts are to be manufactured from ingredients and are to be identified in conformance with the applicable requirements of Part 39 of the rules and regulations of the State Department of Agriculture and Markets (1 NYCRR Part 39).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.23 Ambulatory care statistics
(a) Ambulance Service (account 6850).
(1) How many ambulance vehicles do you operate?
(2) Report the total trips made.
(3) Report the number of unnecessary trips.
(4) Report the disposition of patients.
(i) Transfers.
(ii) Admissions.
(iii) Emergency room only.
(iv) Other hospital.
(v) Not removed.
(vi) D.O.A.
(vii) All other dispositions.
(b) Outpatient Department Visits by Clinic (account 6720)
(1) Report each clinic operated by the facility separately.
(2) Refer to section 443.5(b) of this Article for a partial listing.
(3) Report total clinic visits:
(i) Exclude Community Mental Health Center.
(ii) Exclude Free Standing Clinic.
(4) Clinic visits with physician contact.
(5) Clinic visits with non-physician contact.
(6) Number of patients treated—unduplicated count.
(c) Free Standing Clinics (accounts 6870, 6880 and 6890).
(1) Name and address.
(2) Funding source (OEO, Title II, etc.).
(3) Type (family, pediatric, etc.).
(4) When is clinic open?
(i) Evenings.
(ii) Weekends.
(5) Walk-in patients:
(i) Do you maintain a screening clinic?
(ii) If so, is it part of a general clinic?
(iii) If not, how are patients assigned?
(6) Number of patients on annual clinic register.
(7) Number of visits during the year by pay classification:
(i) Medicaid.
(ii) Medicare.
(iii) Compensation.
(iv) Blue Cross.
(v) Commercial insurance.
(vi) Free.
(vii) Self-pay in full.
(viii) All other.
(8) Emergency room:
(i) Do you operate one at this Free Standing Clinic?
(ii) If so, report number of visits during reporting period.
(9) Each separate Free Standing Clinic must be reported separately.
(d) Ambulatory Service (account 6720)
(1) Do you have organized clinics at your main hospital facility?
(2) Do you have a Ghetto Medicine Contract?
(3) Do you have a pre-admission testing program?
(i) Report number of patients treated in prior reporting period.
(ii) Report number of patients treated in current reporting period.
(4) Do you have an ambulatory surgical program?
(i) Report number of procedures in prior reporting period.
(ii) Report number of procedures in current reporting period.
(5) Do you operate evening clinic sessions?
(6) Do you operate weekend clinic sessions?
(7) Do you maintain a screening clinic for:
(i) New patients to be seen by a physician?
(ii) If so, is the screening clinic part of a general clinic?
(e) Private (Referred) Ambulatory Patients.
(1) Do you provide for the care of private (referred) ambulatory patients (patients referred by their physician, for specific ancillary services[s], from his private office)?
(2) Report the number of visits for the current reporting period.
(f) Mental Health Services.
(1) Do you provide this service on an ambulatory basis?
(2) If so, are these services provided under contract, in whole or in part, with the Community Mental Health Board?
(3) If so, are these part of an organized Community Mental Health Center?
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.64 Manhasset-Lakeville Water District, town of North Hempstead
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all wells of the public water supply of the Manhasset-Lakeville Water District, town of North Hempstead, Nassau County, New York.
(b) [Definition.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be removed and disposed of as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the Manhasset-Lakeville Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal, may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any well of the public water supply of the Manhasset-Lakeville Water District, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape on or beneath the surface of the ground within 300 feet of any well of the public water supply of the Manhasset-Lakeville Water District, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. The watertight receptacles provided above, however, shall not be located within 50 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 200 feet from any well of the public water supply of the Manhasset-Lakeville Water District, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface between the limiting distances of 50 feet and 200 feet of any well of the public water supply of the Manhasset-Lakeville Water District, except into watertight receptacles, the contents of which are to be removed and disposed of as provided by paragraphs (4) and (5) of subdivision (c).
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within less than 200 feet of any well of the public water supply of the Manhasset-Lakeville Water District, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the Manhasset-Lakeville Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well nor to be thrown, placed, piled or spread upon the surface of the ground within 500 feet of any well of the public water supply of the Manhasset-Lakeville Water District, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of any well of the public water supply of the Manhasset-Lakeville Water District, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to remain on the surface of the ground or beneath the surface of the ground within a distance of 300 feet of any well of the Manhasset-Lakeville Water District, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any well of said public water supply without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet.
(g) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Manhasset-Lakeville Water District.
(i) Inspections.
The board of water commissioners of the Manhasset-Lakeville Water District of the town of North Hempstead or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
RESIDENTIAL RIGHTS AND SERVICES RESIDENTIAL RIGHTS AND SERVICES
10 CRR-NY 415.4 Resident behavior and facility practices
The facility shall provide each resident with considerate and respectful care designed to promote the resident's independence and dignity in the least restrictive environment commensurate with the resident's preference and physical and mental status.
(a) Physical and chemical restraints.
The facility and all medical, nursing, and other professional staff shall assure that:
(1) the resident is free, consistent with subdivision (l) of section 415.12 of this Part, from any psychotropic drug administered for purposes of discipline or convenience, and not required to treat the resident's medical conditions or symptoms; and
(2) physical restraints, any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body, are:
(i) used only to protect the health and safety of the resident and to assist the resident to attain and maintain optimum levels of physical and emotional functioning;
(ii) an integral part of the interdisciplinary care plan that is individualized as to the type of restraint, release schedules, type of exercise, necessary skin care and ambulation to be provided, and is intended to lead to less restrictive treatment to manage the problem for which the restraint is applied;
(iii) used only in unusual circumstances and only after all reasonable less restrictive alternatives have been considered and rejected for reasons related to the resident's well-being which shall be documented showing evidence of consultation with appropriate professionals such as social workers and physical therapists. Less restrictive measures that would not clearly jeopardize the resident's safety shall not be rejected before a trial to demonstrate whether a more restrictive restraint would promote greater functional independence;
(iv) not used for staff convenience, for purposes of discipline or as substitutes for direct care, activities and other services;
(v) an enabler of the highest practicable physical, mental or psychosocial well-being; and
(vi) implemented only after the resident or designated representative, to the extent permitted by State law, agrees to this treatment alternative, except in an emergency situation in accordance with paragraph (6) of this subdivision. If the resident or designated representative withdraws agreement to the treatment after implementation, the usage shall be stopped;
(3) when physical restraints are used:
(i) they are used in accordance with paragraph (2) of this subdivision and are time limited. They are used for specified periods of time, properly applied allowing for some body movement and not impairing circulation;
(ii) they are monitored closely as specified in paragraph (5) of this subdivision; and
(iii) all plans for restraints are reviewed at a frequency determined by the resident's condition or more frequently if requested by the resident or designated representative. The clinical record shall include documentation of periodic reevaluation of the need for the restraint and efforts made to substitute other measures.
(4) Policies and procedures regarding the ordering and use of physical restraints and the recording, reporting, monitoring and review and modification thereof are:
(i) incorporated into the inservice education programs of the facility, with changes made in such programs when policies and procedures are modified; and
(ii) made known to all medical, nursing and other appropriate resident care personnel in advance of implementation.
(5) When physical restraints are used the resident is:
(i) released as frequently as necessary to meet resident care needs, but at least every two hours except when asleep in bed, then released as indicated by the type of restraint and by the residents' condition;
(ii) provided with changes of position, ambulation or exercise at the time of release; and
(iii) observed at least as frequently as at the time of dressing and undressing for any evidence of adverse effects, including but not limited to circulatory problems or skin abrasions.
(6) In an emergency situation a physical restraint may only be used if it is:
(i) approved by the medical director, attending physician or nursing director, or in his or her absence, by a registered professional nurse;
(ii) used for that specific emergency and for a limited period of time with physician consultation regarding the physical measure or safety device obtained within 24 hours;
(iii) applied under the direction of a licensed nurse who documents in the clinical record the circumstances necessitating the physical restraint and the resident's response; and
(iv) monitored frequently by a licensed nurse until the resident is seen by a physician.
(7) There are written policies specifying and defining each type of physical restraint that is acceptable and available in the facility and the purposes for which each shall be used. Locked restraints shall not be considered acceptable.
(b) Staff treatment of residents.
The nursing home shall develop and implement written policies and procedures that prohibit mistreatment, neglect or abuse of residents of misappropriation of resident property.
(1) The facility shall:
(i) not use, or permit, verbal, mental, sexual or physical abuse, including corporal punishment, or involuntary seclusion of residents; and
(ii) not employ individuals who have:
(a) been found guilty of abusing, neglecting or mistreating individuals by a court of law; or
(b) had a finding entered into the New York State Nurse Aide Registry concerning abuse, neglect or mistreatment of residents or misappropriation of their property;
(iii) report any knowledge it has of actions by a court of law against an employee which would indicate unfitness for service as a nurse aide or other facility staff to the New York State Nurse Aide Registry or to appropriate licensing authorities.
(2) The facility shall ensure that alleged violations involving mistreatment, neglect or abuse, including injuries of unknown source, are reported immediately to the administrator of the facility and, when required by law or regulation, to the Department of Health in accordance with section 2803-d of the Public Health Law and Part 81 of this Title through established procedures.
(3) The facility shall document that all alleged violations are thoroughly investigated and shall prevent further potential abuse while the investigation is in progress.
(4) The results of all investigations shall be reported to the administrator or his or her designated representative or to other officials in accordance with State law and if the alleged violation is verified, effective corrective action shall be taken.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.4 Qualified entities
(a) Each qualified entity shall:
(1) maintain and operate a network of qualified entity participants seeking to securely exchange patient information;
(2) connect to the statewide infrastructure to allow qualified entity participants to exchange information with qualified entity participants of other qualified entities;
(3) submit to regular audits of qualified entity functions and activities by the New York State Department of Health as necessary to ensure the quality, security, and confidentiality of data in the SHIN-NY;
(4) ensure that data from qualified entity participants is only made available through the SHIN-NY in accordance with applicable law;
(5) enter into agreements with qualified entity participants that supply patient information to, or access patient information from, the qualified entity. A qualified entity must be the business associate , as defined in 42 USC section 17921, of any qualified entity participant that supplies patient information and is a health care provider, and must be a qualified service organization of any qualified entity participant that supplies patient information and is an alcohol or drug abuse program required to comply with Federal regulations regarding the confidentiality of alcohol and substance abuse patient records;
(6) allow participation of all health care providers in the geographical area served by the qualified entity that are seeking to become qualified entity participants, list the names of such qualified entity participants on its website, and make such information available at the request of patients;
(7) submit reports on health care provider participation and usage, system performance and data quality, in a format determined by the New York State Department of Health;
(8) adopt policies and procedures to provide patients with access to their own patient information that is accessible directly from the qualified entity, except as prohibited by law;
(9) implement policies and procedures to provide patients with information identifying qualified entity participants that have obtained access to their patient information using the qualified entity, except as otherwise prohibited by law.
(b) Each qualified entity shall have procedures and technology:
(1) to exchange patient information for patients of any age, consistent with all applicable law regarding minor consent patient information;
(2) to allow patients to deny access to specific qualified entity participants; and
(3) to honor a minor’s consent or revocation of consent to access minor consent patient information.
(c) Each qualified entity shall provide the following minimum set of core services to qualified entity participants:
(1) allow qualified entity participants to search existing patient records on the network;
(2) make available to qualified entity participants and public health authorities a clinical viewer to securely access patient information;
(3) permit secure messaging among health care providers;
(4) provide tracking of patient consent;
(5) provide notification services to establish subscriptions to pre-defined events and receive notifications when those events occur;
(6) provide identity management services to authorize and authenticate users in a manner that ensures secure access;
(7) support public health reporting to public health authorities;
(8) deliver diagnostic results and reports to health care providers.
(d) The New York State Department of Health shall certify qualified entities that demonstrate that they meet the requirements of this section to the satisfaction of the New York State Department of Health. The New York State Department of Health may, in its sole discretion, select a certification body to review applications and make recommendations to the New York State Department of Health regarding certification. The New York State Department of Health shall solely determine whether to certify qualified entities. To be certified, a qualified entity must demonstrate that it meets the following requirements:
(1) The qualified entity is capable of supporting and advancing the use of health information technology in the public interest and has a board of directors and officers with such character, experience, competence and standing as to give reasonable assurance of its abilities in this respect.
(2) The qualified entity has the capability and infrastructure to operationalize the requirements in this section.
(3) The qualified entity has technical infrastructure, privacy and security policies and processes in place to: manage patient consent for access to health information; support the authorization and authentication of users who access the system; audit system use; and implement remedies for breaches of patient information.
(e) The New York State Department of Health shall periodically require qualified entities to demonstrate continued compliance with the certification standards required pursuant to subdivision (d) of this section through a process of audit and re-certification by the New York State Department of Health or a certification body designated by the New York State Department of Health.
(f) The New York State Department of Health may, as it deems appropriate, audit qualified entities to ensure ongoing compliance with criteria and standards.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.1 Certification of administrative programs
(a) The local government of a town, city, village or county may apply to the department, care of the engineering section (see section 128-1.5 of this Part), for certification of a program to administer specific provisions of these rules and regulations.
(b) A local government's proposed program for administration of specific provisions of these rules and regulations may include processing and review of, and determinations on, applications for approval of specific regulated activities.
(c) An application for certification of a local government's administrative program shall include the following information:
(1) identification of the specific substantive and procedural provisions of the rules and regulations that the local government is requesting to administer;
(2) number, technical expertise and experience of personnel and identification of other resources that will be dedicated to administration of the program;
(3) identification of funding or revenue sources for implementation of the program, including a commitment of such funding for the next fiscal year;
(4) identification of the specific department, unit or officials who will be designated to administer these rules and regulations;
(5) identification of information management capability to insure efficient administration and adequate recordkeeping;
(6) identification of applicable existing local laws and rules and regulations and plans for coordination of such laws and rules and regulations with the requirements of these rules and regulations; and
(7) any other information requested by the department.
(d)
(1) The department shall review an application for certification of an administrative program and make a preliminary determination to certify or deny certification of a program within 60 business days of receipt of such application. A determination to certify shall be based upon a finding by the department that the resources, funding and administrative program proposed by the applicant will provide a level of efficiency and effective protection of the water supply equal to that which would otherwise be provided by the department under these rules and regulations. Notice of the preliminary determination shall be provided in writing by the department to the designated representative of the local government submitting the application for certification.
(2) Within 60 business days of the department's preliminary certification of the administrative program, the department and the local government shall commence negotiating and writing a draft memorandum of understanding setting forth the requirements and conditions of the program.
(3) A governmental agency or unit of a town, city, village or county that has a program for administration and/or enforcement that has been certified by the department pursuant to this subpart shall be referred to as a “certified local government.”
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.28 Incorporation by reference
The provisions of the Code of Federal Regulations which have been incorporated by reference in this Subpart have been filed in the Office of the Secretary of State of the State of New York, the publication so filed being the booklet entitled: Code of Federal Regulations , title 21, parts 630 and 640, revised as of May 22, 2015 and April 1, 2016, respectively, published by the Office of the Federal Register, National Archives and Records Administration. The regulations incorporated by reference may be examined at the Records Access Office, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237 or can be directly obtained from the Superintendent of Documents, US Government Printing Office, Washington, DC 20402.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.3 Tissue procurement services
(a) A facility that engages in donor selection and solicitation, and retrieval of cardiovascular tissue shall be licensed by the department as a comprehensive tissue procurement service.
(b) A facility whose tissue acquisition activities are limited to donor selection and solicitation by its own staff shall be licensed by the department as a limited tissue procurement service.
(c) Comprehensive tissue procurement services retrieving cardiovascular tissue from cadaveric donors shall maintain written standard operating procedures that assure that the retrieval environment, including, but not limited to, walls, floors and permanent equipment, is suitable for retrieval and adequate to prepare an aseptic field. A working sink shall be available.
(d) Cardiovascular tissue retrieval shall be performed only by trained retrieval technicians under the supervision of the director of a licensed comprehensive tissue procurement service. The director of the licensed comprehensive tissue procurement service shall be responsible for developing policies, procedures and standards for the educational background, training, certification and continuing education of retrieval technicians. Documentation of compliance with this requirement and the standards developed shall be maintained.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.2 Annual approval fee
An environmental laboratory which is issued a certificate of approval pursuant to Subpart 55-2 of this Part shall pay an annual approval fee.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.11 Additional requirements for manufacturers and distributors
In addition to the requirements set forth in article 33 of the Public Health Law, holders of licenses shall comply with the following requirements:
(a) A class 1 manufacturer who produces a final product that by its composition or combination with other ingredients is intended for human or animal consumption and presents a potential for abuse, must employ a full-time pharmacist and the licensed controlled substance activity must be under the personal supervision of a pharmacist or a chemist. The supervisor shall not be at the same time a supervisor of any other class 1 or class 2 establishment licensed by the New York State Department of Health. A chemist is a person who meets the following requirements:
(1) possess a bachelor of science or a bachelor of arts degree in chemistry, pharmacology or equivalent specialization and have had not less than four years of experience in the manufacture of drug products;
(2) be a citizen of the United States or an alien lawfully admitted for permanent residence in the United States;
(3) be of the age of 21 years or older;
(4) be of good moral character and, if the person has been convicted of one or more criminal offenses, he or she must be found eligible after a balancing of the factors set out in article 23-A of Correction Law. In accordance with that article, no person shall be deemed not to be a chemist on account of having been previously convicted of one or more criminal offense unless:
(i) there is a direct relationship between one or more of the previous criminal offenses and the duties required of the position; or
(ii) deeming the person a chemist would involve an unreasonable risk to property or the safety or welfare of a specific individual or the general public. In addressing these questions, the department shall evaluate all factors listed under New York State Correction Law section 753; and
(5) not be, and not have been, a habitual user of narcotics or any other habit-forming drugs.
(b) A class 1 manufacturer who produces a final product that by its composition or combination with other ingredients is not intended for human or animal consumption and does not present a potential for abuse, must employ either a full-time pharmacist or a full-time chemist and the licensed activity in which he or she is engaged must be under the supervision of either a pharmacist, or a chemist, as defined in subdivision (a) of this section. The supervisor shall not be at the same time a supervisor of any other class 1 or class 2 establishment licensed by the New York State Department of Health.
(c) An applicant for licensure who is a registered outsourcing facility pursuant to title 8 of the Education Law and who compounds controlled substances not pursuant to a patient specific prescription shall be deemed as conducting manufacturing activities of controlled substances. Manufacturing activities shall be conducted under the personal supervision of a licensed pharmacist. An applicant for licensure who is a registered wholesaler pursuant to title 8 of the Education Law who bottles or rebottles, packs or repacks, labels or relabels, controlled substances shall be deemed as conducting class 1 manufacturing activities of controlled substances and subject to the requirements of subdivision (a) of this section. An applicant for licensure who is a registered wholesaler pursuant to title 8 of the Education Law who does not bottle or rebottle, pack or repack, label or relabel, controlled substances may obtain a class 2 distributor license, provided that the licensed activity in which he or she is engaged is conducted under the personal supervision of a pharmacist or a person approved by the department. The supervisor shall not be at the same time a supervisor of any other establishment registered by the New York State Board of Pharmacy. A person not a pharmacist shall meet the following requirements:
(1) possess a high school diploma, or the equivalent thereof;
(2) be a citizen of the United States or an alien lawfully admitted for permanent residence in the United States;
(3) be of the age of 21 years or over;
(4) be of good moral character and if the person has been convicted of one or more criminal offenses, he or she must be found eligible after a balancing of the factors set out in article 23-A of Correction Law. In accordance with that article, no distributor license shall be denied by reason of the applicable employee having been previously convicted of one or more criminal offenses unless:
(i) there is a direct relationship between one or more of the previous criminal offenses and the duties required of the license; or
(ii) licensing the applicant would involve an unreasonable risk to property or the safety or welfare of a specific individual or the general public. In determining these questions, the agency will look at all factors listed under New York State Correction Law section 753;
(5) not be, and not have been, an habitual user of narcotics or other habit-forming drugs; and
(6) have had not less than eight years of experience in the wholesaling of controlled substances, or such other experience determined by the department to be the equivalent thereof.
(d) Persons conducting manufacturing activities of controlled substances within the State of New York shall obtain a class 1 license from the department.
(e) Persons conducting manufacturing activities of controlled substances outside of the State of New York and doing business within the State of New York shall obtain a class 1a license from the department. A class 1a license applicant shall meet the following requirements:
(1) the out-of-state manufacturer possesses a valid New York State Board of Pharmacy registration or exemption; and
(2) the out-of-state manufacturer possesses a valid U.S. Drug Enforcement Administration registration; and
(3) based on the application, the commissioner is satisfied that the out-of-state manufacturer will be able to maintain effective control against diversion of controlled substances.
(f) Persons conducting distributing activities of controlled substances within the State of New York shall obtain a class 2 license from the department, except that:
(1) except in an adult care facility subject to the provisions of 18 NYCRR Parts 487, 488 and 490, a pharmacy may distribute a controlled substance to a practitioner in a class 3a institutional dispenser limited solely for stocking in sealed emergency medication kits. Such distribution shall be pursuant only to a written request by the class 3a facility indicating the name and address of the facility, the name and address of the pharmacy, the date of the request, the type and quantity of the drug requested and the signature of the authorized person making the request. With each distribution, the pharmacy shall provide the class 3a facility with an itemized list indicating the name and address of the pharmacy, the name and address of the class 3a facility, the date of the distribution, the type and quantity of the drug distributed, and the signature of the pharmacist.
(g) Out-of-state persons conducting distributing activities of controlled substances to persons within the State of New York shall obtain a class 2a license from the department. A class 2a license applicant shall meet the following requirements:
(1) the out-of-state distributor possesses a valid New York State Board of Pharmacy registration or exemption; and
(2) the out-of-state distributor possesses a valid U.S. Drug Enforcement Administration registration; and
(3) based on the application, the commissioner is satisfied that the out-of-state distributor will be able to maintain effective control against diversion of controlled substances.
(h) All persons authorized to manufacture or distribute controlled substances shall accept returns of such controlled substances manufactured or distributed by them, and either destroy them or provide for the return, disposition, and disposal of such controlled substances in a manner approved by the department pursuant to section 80.51(c)(2) of this Part.
(i) An individual who is designated as the supervisor of controlled substance activity pursuant to subdivision (a), (b) or (c) of this section shall be responsible for the following non-delegable tasks:
(1) maintaining all required records relating to the purchase and distribution of all controlled substances manufactured or repacked at that facility;
(2) providing for the proper storage of controlled substances in order to prevent loss or theft;
(3) assuring security and limiting access to all areas holding controlled substances;
(4) insuring against all unauthorized sales or distribution of controlled substances to establishments or professionals not authorized to receive such items;
(5) issuing verbal and written notice to each of his or her subordinates concerning the applicable State and Federal laws, regulations and rules to ensure full compliance;
(6) for manufacturers, assuring that all good manufacturing procedures as outlined by the FDA are followed; and
(7) for manufacturers engaged in compounding of controlled substances, assuring that all controlled substances are compounded under the personal supervision of a licensed pharmacist.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.4 Maintaining eligibility for awards
(a) Full-time continuous enrollment.
Award recipients must be enrolled full-time except as permitted by section 42.7(a)(1) of this Part and in good standing in accordance with the standards and regulations established by the New York State Higher Education Services Corporation and the institution where the award recipient is receiving training. The recipient who receives awards for completing two years of education must do so in two consecutive academic years.
(b) Transfers.
An award recipient may receive permission from the Commissioner of Health to transfer to another institution provided:
(1) the recipient continues training in the profession for which the award was granted;
(2) the transfer does not increase the total period of training; and
(3) the school to which the recipient transfers has a program approved by the New York State Department of Health pursuant to standards established in this Title, or the New York State Board of Regents.
(c) Reporting requirements.
Award recipients must report semiannually to the Department of Health and the Higher Education Services Corporation on forms and at such times as required by these agencies.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.15 Housing maintenance
A temporary residence shall be structurally sound, safe, adequately illuminated and ventilated, clean and adequately maintained, free from health and safety hazards, adequate in size for its use, and have weathertight roof and sides. Adequate toilet and handwashing facilities shall be provided and maintained.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.4 Fiscal services
This functional reporting center must contain all expenses related to managing the residential health care facility's fiscal affairs, including general ledger accounting, budgeting, accounts payable, plant asset records, payroll, inventory accounting and data processing. Additional activities include but are not restricted to the following: entering abstracted data on insurance forms; accounting for sales to other institutions; patient accounting, including the processing of patient charges, preparing claims for patient-related billings, receiving and processing payments from or on behalf of patients for services rendered, extending credit, collecting outstanding accounts, and recording and accounting for patient trust funds.
(a) Standard unit of measure: total operating expenses.
The total operating expenses of the residential health care facility, less depreciation and lease costs for land, buildings and fixed equipment, and interest on capital debt.
(b) Data source.
The costs shall be determined from the general accounting records.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.197 Maintenance
Effort expended to maintain assets in fit condition to do their work—such items are ordinary and recurring and do not improve the asset or add to its life. A useful distinction can be made between maintenance as preventive and repairs as curative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.8 Managers
(a) The manager of each funeral firm shall be a funeral director or undertaker duly licensed as such under and pursuant to the laws of the State of New York and shall be duly registered with the department as such manager.
(b) A funeral director or undertaker shall not serve and shall not be registered as a manager of more than one funeral firm.
(c) When a funeral firm owned and operated by a corporation organized under and pursuant to the laws of the State of New York for such purpose, the board of directors of such corporation shall designate an employee as manager. Such employee shall be a duly licensed and registered funeral director or undertaker of the funeral firm and his/her designation as manager shall be filed with the department.
(d) When a funeral firm is owned and operated by the estate of a deceased funeral director or undertaker, the duly appointed representative of the estate shall designate a duly licensed and registered funeral director or undertaker as manager, and his/her designation as manager shall be filed with the department.
(e) The funeral establishment of a funeral firm shall be under the immediate and personal supervision, direction, management and control of the manager, and his/her failure to exercise such supervision, direction, management and control adequately, shall constitute a violation of the rules and regulations of the State Commissioner of Health. Any violation of the provisions of article 34 of the Public Health Law, the Sanitary Code, the rules and regulations of the commissioner or of any statute, code, rule or regulation relating to the practice of funeral directing, embalming or vital statistics by the funeral firm or its personnel shall constitute a violation of the rules and regulations of the commissioner by the manager unless he/she exercised adequate supervision, management, direction and control to prevent said violation.
(f) If the manager is unable, for any reason, to exercise adequate supervision, direction, management and control of the funeral establishment, the manager, owner, board of directors or the representative of the estate, as the case may be, shall designate any funeral director or undertaker to serve as temporary manager and notify the department thereof in writing. If such inability of the manager exceeds 90 days or is expected to exceed 90 days, a new manager shall be designated and registered with the department as hereinbefore provided.
(g) The owner and operator or estate representative of a funeral firm shall notify the department in writing within 10 days of any change of manager of any funeral firm and shall file designation of the new manager as herein provided. In the case of a corporation, the designation of a new manager shall, unless otherwise acceptable to the department, be in the form of a resolution of the board of directors appointing such manager and a certified copy of such resolution shall be filed with the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.210 Neonatal intensive care unit
A special unit, approved by the State, set up for the treatment of infants from hour of birth through first 28 days; also of infants up to three months of age with medical and surgical problems which are best managed in a neonatal intensive care unit.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.60 Therapy equipment operated at potentials up to 10 million volts.11
(a) Equipment.
(1) The protective tube housing shall be of therapeutic type.
(2) Fixed diaphragms or cones used to restrict the useful beam shall be so constructed as to provide the same degree of protection as is required of the tube housing.
(3) Adjustable or removable beam limiting diaphragms or cones shall not transmit more than five percent of the useful beam at the maximum kilovoltage and with the maximum treatment filter.
(4) The filter system shall be so arranged as to minimize the possibility of error in filter selection and alignment. The filter slot shall be so constructed that the radiation escaping through it does not produce an exposure exceeding one roentgen per hour at one meter, or if the patient is likely to be exposed to radiation escaping from the slot, 30 roentgens per hour at two inches (5 centimeters) from the external opening. Each removable filter shall be marked with its thickness and material.
(5) It shall be possible for the person operating the controls of the therapeutic equipment to determine from the operating position what filters are in place in the equipment. Filters shall be so mounted as to prevent their movement during the treatment.
(6) The X-ray tube shall be secured so that it cannot move in respect to the housing aperture. A mark on the exterior of the tube housing is recommended to indicate the focal spot.
(7) Adequate devices shall be provided to secure the tube housing during stationary portal treatment.
(8) An easily discernible indicator which shows whether or not X-rays are being produced shall be on the control panel.
(9) A suitable exposure control device ( e.g., an automatic timer, exposure meter or dose meter) shall be provided to terminate the exposure automatically after a preset time interval or preset exposure or dose limit. Means shall be provided for the operator to terminate the exposure at any time.
(10) Equipment utilizing shutters to control the useful beam shall have a shutter position indicator on the control panel.
(b) Structural shielding.
(1) The protective barriers for all therapy equipment operating at voltages above 60 kVp shall be fixed to the wall of the building.
(2) The control panel for all therapy equipment operating at voltages above 150 kVp installed after January 1, 1963, shall be located outside the treatment room.
(c) Conditions for operation of equipment.
(1) The output of the X-ray generator shall be calibrated prior to the use of the apparatus for treating humans. Calibration shall be performed by a person qualified pursuant to section 16.122(f) of this Part. The method of calibration used shall be in accordance with procedures recommended by the American Association of Physicists in Medicine for the energy and type of radiation employed. Calibration shall be made at least annually. Recalibration, however, shall be made after each tube replacement and after any changes or replacements in the generating apparatus, or changes or updates in computer programs which govern or interact with the functions of the machine and which could change the X-ray output.
(2) No person other than the patient, shall be permitted to remain within the X-ray therapy room while the X-ray generator is in operation.
(3) Every entrance to an X-ray therapy room in which equipment is capable of operating above 150 kV shall be protected by interlocks to insure that during the production of X-rays no person can enter the therapy room without turning off the radiation equipment. They shall be so arranged that irradiation equipment cannot be started again without manually resetting the controls.
(4) Windows, mirror systems, or closed-circuit television viewing screens shall be provided to permit continuous observation of the patient during irradiation and shall be so located that the operator may see the patient and the control panel from the same position.
(5) Provision shall be made for oral communication with the patient.
(6) In addition to the interlocking controls, there shall be installed signals which are readily observable or discernible near the outside of all access doors to indicate the production of X-rays.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 57 CONDITIONS UNDER WHICH A DOG ACTIVELY IMMUNIZED AGAINST RABIES MAY BE AT LARGE IN DESIGNATED AREAS CERTIFIED FOR RABIES
10 CRR-NY 57.1 Definitions
(a) Three-year vaccine is a rabies vaccine for dogs which the Federal government has accepted as providing three-year duration of immunity.
(b) Active immunization, to permit a dog to be at large,* shall mean the injection of a three-year vaccine which meets the standards prescribed by the United States Department of Agriculture for interstate sale** and has been administered by a duly licensed veterinarian not later than the expiration date on the package. Vaccines shall be administered following the directions of the manufacturer as approved by the Federal government.
(c) Certified area means an area certified by the State Commissioner of Health in accordance with section 2140 of article 21 of the Public Health Law as one in which, or in the vicinity of which, rabies exists.
(d) Designated area means an area which the State Commissioner of Health has designated as one in which dogs which have been actively immunized against rabies in accordance with the provisions in the rules may be permitted to be at large.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 152 WARREN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 152.6 Bolton Water District, Town of Bolton
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Edgecomb Pond and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Bolton Water District, Town of Bolton, Warren County, New York, and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Bolton Water District public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh or channel of any kind, the waters of which flow or may flow into the Bolton Water District public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Bolton Water District public water supply.
(16) Water supply shall mean the public water supply of the Bolton Water District, Town of Bolton, Warren County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse, except:
(i) watertight receptacles;
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraphs (4) and (9) of this subdivision shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) of this subdivision or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) of this subdivision shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse, nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 16-A (Ionizing Radiation), of this Title, shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Bolton Water District.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Bolton Water District.
(j) Boating.
No boats with motors utilizing fossil fuel shall be allowed in or upon the waters of any reservoir or watercourse owned by the Bolton Water District except by duly authorized employees of the Bolton Water District in the performance of their duties of supervision and maintenance of the water supply.
(k) Herbicides, pesticides and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(l) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of a reservoir or watercourse.
(m) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III (Public Water Supplies), of this Title.
(n) Inspection.
The town board or town water superintendent, or any person or persons as may be charged with the maintenance or supervision of the water supply, shall make regular and thorough inspections of the reservoir, watercourse and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. The aforesaid town board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections made, the number of violations found, the number of notices served and the number of violations abated and the general condition of the watershed at the time of the last inspection.
(o) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NUTRITIONIST PUBLIC HEALTH NUTRITIONIST
10 CRR-NY 11.131 Entry level qualifications
A local public health nutritionist must possess a baccalaureate degree, with major studies in food and nutrition, from a regionally accredited or New York State-registered college or university, and be registered as a dietician by the American Dietetic Association.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.219 Non-revenue-producing cost centers
These are overhead units, such as dietary and plant operations and maintenance, that provide necessary support services to revenue-producing centers.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.12 Quality management program
(a) An MCO shall develop and implement a quality management program, that is supervised by the medical director and that includes organizational arrangements and ongoing procedures for the identification, evaluation, resolution and follow-up of potential and actual problems in health care administration and delivery to enrollees. MCOs shall include in such quality management programs standards for management of access to, continuity and quality of care and, except for PCPCPs, utilization and cost of services.
(b) MCOs shall also develop a quality assessment and performance improvement program that includes performance and outcome-based quality standards for enrollee health status, satisfaction, and for MLTCPs, functional status also. The program shall achieve required minimum levels of performance on standardized quality measures established by the commissioner. In the case of an HIV SNP, the quality indicator measures must include HIV-specific quality measures.
(c) A health information system shall be maintained that collects, analyzes, integrates, and reports data necessary to develop and implement the quality assurance and performance improvement programs.
(d) The quality assessment and performance improvement programs shall be approved by the commissioner prior to issuance of a certificate of authority and monitored periodically thereafter by the commissioner.
(e) The quality assessment organizational arrangements and ongoing procedures must be fully described in written form, provided to all members of the governing authority, providers and staff, and made available to enrollees in the MCO.
(f) The organizational arrangements for the quality assessment program must be clearly defined and transmitted to all individuals involved in the quality assessment program, and should include, but not be limited to, the following:
(1) an internal quality assurance committee or comparable designated committee responsible for quality assurance activities;
(i) accountability of the committee to the governing authority of the MCO, including periodic written and oral reports to the governing authority;
(ii) participation from an appropriate base of providers and support staff;
(iii) regularly scheduled meetings at appropriate periodic intervals, no fewer than four per year; and
(iv) minutes or records of the meetings, describing in detail the actions of the committee, including the medical charts reviewed, problems discussed, recommendations made, and any other pertinent discussions and activities; and
(2) a peer review committee responsible for monitoring provider performance.
(g) The quality assurance procedures shall include defined methods for the identification and selection of clinical and administrative problems. Input for problem identification should come from multiple sources, including but not limited to medical chart reviews, member complaints, epidemiological data, utilization data, patient surveys, and other data which identify patterns of care, utilization review, and shall cover all MCO services. Methods shall be established by which potential problems are selected and scheduled for further study.
(h) An MCO shall document the manner by which it examines actual and potential problems in health care administration and delivery to enrollees. While a variety of methods may be utilized, the following components should be present:
(1) the existence of procedures for the analysis;
(2) the acquisition of sufficient data to perform a meaningful analysis; for example, a statistically valid sample size for medical chart review; and
(3) involvement of appropriate clinical personnel, including physicians and other providers for peer review.
(i) The quality assurance activities shall include the development of timely and appropriate recommendations. For problems in health care administration and delivery to enrollees that are identified, the MCO must demonstrate an operational mechanism for responding to those problems. Such a mechanism should include:
(1) development of appropriate recommendations for corrective action or, when no action is indicated, an appropriate response;
(2) assignment of responsibility at the appropriate level or with the appropriate person for the implementation of the recommendation; and
(3) implementation of action which is appropriate to the subject or problem in health care administration and delivery to enrollees.
(j) There shall be evidence of adequate follow-up on recommendations. The MCO must be able to demonstrate that recommendations of the committee responsible for quality assurance activities are reviewed in a timely manner, in order to:
(1) assure the implementation of action relative to the recommendations;
(2) assess the results of such action; and
(3) provide for revision of recommendations or actions and continued monitoring when necessary.
(k) Physicians and other health professionals providing covered services to enrollees shall be licensed, certified and currently registered, in accordance with New York State law. MCOs must develop and utilize credentialing and recredentialing processes, consistent with generally accepted standards, that are performed under the direction of the medical director.
(l) Whenever a health care professional is unable to provide health care services due to a final disciplinary action by a state licensing board or other governmental agency that impairs the health care professional's ability to practice, the MCO must take immediate action, upon receipt of notice, to remove the professional from the network.
(m) Laboratory, pathology and radiology services shall be under the direction of a qualified medical professional.
(n) The MCO shall require and assure that the medical records of enrollees be retained for six years after the date of service rendered to enrollees, and in the case of a minor, for three years after majority or six years after the date of the service, whichever is later.
(o) The MCO or, if specifically provided for in the contract, the contracted provider must provide to each health care provider or to each IPA with which the MCO contracts a provider manual which, unless otherwise provided for in the contract, shall contain a description of the policies and operating procedures established by the MCO for the provision of covered services to enrollees of the MCO, and include provider rights. The provider manual shall be furnished to the provider prior to the effective date of the provider's participation in the network and subsequent to the satisfactory completion of the MCO's credentialing process, and shall be amended as the MCO's operational policies change. Revisions to the provider manual may be provided through provider bulletins or other communication to providers; however, revisions must be incorporated in the appropriate section of the manual.
Chapter I STATE SANITARY CODE
Part 1 GENERAL PROVISIONS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 1.30 Disclosure of confidential information concerning cancer, tuberculosis and venereal diseases to the medical examiner of an induction center of the armed forces authorized
To facilitate the administration of the Selective Service Act, State health officers or local health officers having custody of cancer, tuberculosis and venereal disease case records may divulge to the medical examiner of an induction center of the armed forces the identity, laboratory examination results and treatment status of individuals who have been reported to them as cases of cancer, tuberculosis or venereal disease.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.47 Institutional dispenser, limited
(a) Nursing homes, convalescent homes, health-related facilities, adult care facilities subject to the provisions of 18 NYCRR Parts 487, 488 and 490, dispensaries or clinics not qualifying as institutional dispensers in license class 3 shall apply for an institutional dispenser, limited license. Such institutional dispensers qualifying for controlled substances privileges shall obtain a class 3a license from the department.
(b) An institutional dispenser licensed in class 3a may administer controlled substances to patients only pursuant to a prescription issued by an authorized physician or other authorized practitioner and filled by a registered pharmacy; except that controlled substances in emergency medication kits may be administered to patients as provided in section 80.49(d) of this Part; however, controlled substances in emergency medication kits may not be administered to patients in an adult care facility subject to the provisions of 18 NYCRR Parts 487, 488 and 490.
(c) An institutional dispenser, limited, licensed in class 3a, which is operated as an integral and physical part of a facility licensed as a class 3 institutional dispenser may be provided with bulk stocks of controlled substances obtained pursuant to such class 3 institutional dispenser license. Records of distribution and administration of such bulk stocks of controlled substances shall be kept as provided in section 80.48(a) of this Part.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.1 Definitions
The following definitions apply to this Part:
(a) Anticipatory guidance means providing parents or guardians of children under the age of six and pregnant women with information regarding the major causes of lead poisoning and means of preventing lead exposure. Such guidance shall be pertinent to the environment of the child or pregnant woman.
(b) Certificate of lead screening means documentation prepared by the health care provider who ordered the blood lead test for the child indicating the date the test was performed.
(c) Child shall refer to an individual from birth to less than 18 years, unless otherwise specified.
(d) Confirmed blood lead level means a blood lead concentration measured on venous blood.
(e) Elevated blood lead level means a blood lead concentration equal to or greater than five micrograms per deciliter of whole blood.
(f) Environmental management means environmental investigation and exposure assessment, sampling for lead, environmental testing and reporting, notice and demand of discontinuance of conditions conducive to lead poisoning, environmental intervention and abatement, and enforcement in accordance with Subpart 67-2 of this Part.
(g) Follow-up means actions by local health units and health care providers which, depending on the blood lead level and exposure history of the child, shall include as appropriate: risk reduction education, follow-up testing, confirmatory testing, diagnostic evaluation, medical management, environmental management and case management, in accordance with generally accepted medical standards and public health guidelines.
(h) Health care provider means any health care practitioner who is authorized to order a blood lead test and any facility licensed pursuant to article 28 of the Public Health Law.
(i) Lead screening means measuring lead concentration in whole blood to identify elevated blood lead levels.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.13 Groupings
(a) For the purpose of establishing reimbursable operating costs, facilities shall be compared on the basis of the following general criteria:
(1) similarity of services; and
(2) regional economic factors.
(b) Comparisons using similarity of services shall be based on the following:
(1) Comprehensive primary medical care services shall mean those health care services organized to provide basic medical care to the general population without regard to patient category or characteristics such as health status, diagnosis, age or sex. Such primary medical care services shall be provided by staff sufficient in number and capable of delivering comprehensive primary medical care services. A facility providing comprehensive primary medical care services as its principal mission shall be categorized as a comprehensive primary medical care facility.
(2) Limited primary medical care services shall mean those health care services organized to provide basic medical care to a population of individuals with a specific medical condition or dysfunction. Such primary medical care services focus on the medical care needs of this population that are incidental to, interrelated with or a consequence of the specific primary medical diagnosis/disease process. When limited primary medical care services are not the principal mission of a facility, the facility providing limited primary medical care services shall be categorized based on the services, as defined in this section, which it provides as its principal mission and shall not be categorized as a comprehensive primary medical care facility.
(3) Family planning services shall mean those services organized to provide reproductive and/or gynecological related health care services to men and women of reproductive age. A facility providing family planning services as its principal mission shall be categorized as a family planning facility.
(4) Abortion services shall mean those services related to the termination of pregnancy including services associated with verification of the pregnancy, abortion counseling services and post-procedure examinations. Sterilization procedures done as outpatient surgery shall be included in this category as well. A facility providing abortion services as its principal mission shall be categorized as an abortion facility.
(5) Developmentally disabled services shall mean those services organized to provide ongoing/long-term rehabilitation therapy services to individuals with developmentally related physical disabilities. A facility providing developmentally disabled services as its principal mission shall be categorized as a developmentally disabled services facility.
(6) Rehabilitation therapy services shall mean those services organized to provide episodic or short-term restorative therapy services to individuals physically disabled from causes that are predominantly other than developmentally related. A facility providing such rehabilitation therapy services as its principal mission shall be categorized as a rehabilitation therapy facility.
(7) Speech and hearing services shall mean speech/language pathology and audiology services. A facility providing speech and hearing services as its principal mission shall be categorized as a speech and hearing facility.
(8) Dental services shall mean those services organized to provide basic dental care to the general population. A facility providing dental services as its principal mission shall be categorized as a dental facility.
(9) Dialysis services shall mean hemodialysis, peritoneal dialysis and home dialysis services provided to patients with chronic renal disease. A facility providing dialysis services as its principal mission shall be categorized as a dialysis facility.
(10) Optometric services shall mean optometry and services related to eye and vision care. A facility providing optometric services as its principal mission shall be categorized as an optometric facility.
(11) Methadone maintenance treatment services shall mean drug detoxification and drug dependency counseling and rehabilitation services which include chemical management of the patient with methadone. A facility providing methadone maintenance treatment services as its principal mission and certified by the Office of Alcoholism and Substance Abuse Services shall be categorized as a methadone maintenance treatment program (MMTP) facility.
(12) Drug free services shall mean drug dependency counseling and rehabilitation services, including incidental and interrelated medical care services, provided in a drug free environment. A facility providing drug free services as its principal mission shall be categorized as a drug free facility.
(13) Child health services shall mean acute, episodic, preventive and well child care services, including immunizations, provided to the pediatric population. A facility providing child health services as its principal mission shall be categorized as a child health facility.
(14) A county sponsored facility which does not provide comprehensive primary medical care services but provides health care services such as dental, well child care, immunizations, TB services, STD services, and prenatal and/or other reproductive related health care services shall be categorized as a county sponsored multiservice facility.
(c) Regional economic factors shall be defined to mean significant differences in labor cost experienced by facilities that are due to their geographic location and which impact on the delivery of patient care services.
(d) For the purpose of comparison, when there are fewer than three facilities defining a particular category of service as their principal mission, the facilities will be treated as ungrouped until such time as there are at least two other similar facilities.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.2 Surrogacy program licensure
(a) In order to operate a surrogacy program in New York State, a person or entity must be duly and currently licensed by the department. As a condition for licensure, each owner shall submit to the department, on a form and in a manner prescribed by the department:
(1) proof of the program’s professional liability insurance or other appropriate insurance coverage;
(2) the program’s administrative policies and procedures, including:
(i) a conflict of interest policy satisfactory to the department;
(ii) policies and procedures to ensure that surrogacy agreements meet the requirements of article 5-C of the Family Court Act;
(iii) policies and procedures to ensure that the surrogate has given informed consent for the surrogacy and is afforded all of the rights set forth in and that all parties were provided with a copy of the Surrogate’s Bill of Rights in article 5-C of the Family Court Act at the time of the initial consultation;
(iv) policies and procedures to monitor parties’ compliance with the terms of the surrogacy agreement, and ensure that such surrogacy agreement is in compliance with article 5-C of the Family Court Act; and
(v) training materials for all surrogacy program staff;
(3) a background investigation report from an independent licensed private investigation company:
(i) demonstrating that the owners of the program, the individual functioning as the chief executive officer, and the individual functioning as the chief operating officer, regardless of adjudication, have never previously been convicted or found guilty of, or entered a plea of guilty or a plea of nolo contendere to any offense involving racketeering, fraud, theft, embezzlement, fraudulent conversion, or misappropriation of property; and
(ii) specifying any judgments and liens filed with the county clerk in counties where the individuals identified in subparagraph (i) of this paragraph worked and resided and all counties contiguous to those counties (within the past 10 years); and
(4) a comprehensive credit report for each owner of the program.
(b) Each applicant shall submit to the department any other information as may be requested under the department’s application process for licensure, including information about the owners of the program, the individual functioning as the chief executive officer, and the individual functioning as the chief operating officer, such as allegations of malpractice, actions taken against the individual’s license, hospital restrictions, criminal convictions, civil and bankruptcy court actions, disputes settled through arbitration or alternative dispute resolution, whether the individual is aware of being under investigation by a governmental agency, whether a criminal charge or civil or administrative action is currently pending against the individual, and termination from employment.
(c) Changes of information.
(1) Any change in accuracy of the information provided under this section following the date of licensure and prior to renewal of licensure shall be reported to the department.
(2) Any failure to disclose a change of information within 30 days of the change shall constitute grounds for the department to revoke the license of such surrogacy program pursuant to section 69-11.10 of this Part.
(d) Each surrogacy program shall, as a condition of licensure, maintain and regularly monitor an account for a program owner and at least one other program official on the health commerce system.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.198 Closure
When action is taken to order closure and cessation of operations, the permit-issuing official or his designated representative is to:
(a) conspicuously post a notice or placard at each entrance of the food-vending commissary, or on the mobile food service vehicle, stating the existence of such order and the authority for such order. This order is not to be concealed, mutilated or altered by any person or removed without permission of the permit-issuing official; and
(b) public notice of the order, with the reasons for the order, in one or more newspapers in the county or city in which the commissary is located, or the mobile food establishment operates.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.5 Duties of the responsible provider
The responsible provider shall obtain initial screening results within 14 days of birth and shall ensure compliance with the following procedures:
(a) When notified by the testing laboratory that a repeat specimen is required, the responsible provider shall notify the parent(s) within one business day that a repeat specimen is required from the newborn. The responsible provider, or his or her designee, shall collect the repeat specimen, pursuant to guidance issued by the testing laboratory, and submit it to the testing laboratory as soon as practicable.
(b) Specimen collection forms shall be properly stored in a cool and dry environment prior to use.
(c) All specimens shall be air dried thoroughly on a flat nonabsorbent surface for a minimum of three hours prior to forwarding to the testing laboratory. All specimens shall be forwarded to the testing laboratory within 24 hours of collection to ensure delivery of specimens to the testing laboratory no later than 48 hours after collection.
(d) If a satisfactory specimen or repeat specimen is not collected due to newborn mortality, the responsible provider shall submit a written and/or electronic notification to the testing laboratory within five days after death.
(e) The responsible provider shall document on the newborn’s health record the LAB I.D., as it appears on the specimen collection form, the date and time of specimen collection, and all screening results. The responsible provider shall inform parents of the newborn screening result.
(f) Except when a newborn is under the care of a specialty care center, the responsible provider shall report diagnostic evaluation and test results, case management information, and follow-up reviews to the testing laboratory no later than 90 days following receipt of testing laboratory test results. The responsible provider shall arrange for a diagnostic evaluation and case management with an approved specialty care center as necessary.
(g) Before performing any tasks relating to collection of specimens, the responsible provider, and any staff under his or her supervision performing specimen collection, shall complete comprehensive specimen collection training, and shall complete such training annually thereafter. The responsible provider shall retain documentation of all such training.
(h) The responsible provider shall establish written policies and procedures, which shall be available for the department’s review, for:
(1) the collection, storage, and shipping of specimens; and
(2) the tracking and disposition of test results.
(i) The responsible provider shall comply with the following additional requirements for all newborns who test positive for HIV antibodies:
(1) the responsible provider shall arrange for follow-up care with a provider experienced in the treatment of HIV. The responsible provider shall also submit to the department any specimen necessary to confirm the HIV infection status of the newborn; or submit documentation of confirmatory test results from a laboratory permitted pursuant to section 574 of the Public Health Law;
(2) the responsible provider shall provide or arrange for post-test counseling for the birth mother or person authorized by law to give consent to health care for the newborn if the mother lacks capacity to consent;
(3) the responsible provider shall provide, or refer the newborn for, appropriate and/or specialized health care, case management and other social services as needed;
(4) the responsible provider shall provide the parent(s) with referrals for health and social services as needed and shall transfer a copy of the newborn's HIV test result to the mother's physician as permitted by article 27-F of the Public Health Law; and
(5) the responsible provider shall maintain in the newborn’s health record the newborn’s HIV test result in accordance with article 27-F of the Public Health Law.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.71 Practitioner; dispensing controlled substances
(a) Practitioners, in good faith and in the course of their professional practice only, and as limited in this Part may dispense controlled substances.
(b) Except as provided in subdivision (c) of this section, the quantity of substances dispensed may not exceed a 30-day supply if the substances were used in accordance with the directions for use. No additional dispensing of a controlled substance may be made by a practitioner to an ultimate user within 30 days of the date of the previous dispensing unless and until the ultimate user has exhausted all but a seven days' supply of that controlled substance previously dispensed.
(c)
(1) A practitioner may dispense up to a three-month supply of a controlled substance, including chorionic gonadotropin, or up to a six-month supply of an anabolic steroid if used in accordance with the directions for use, provided that such supply has been dispensed for the treatment of a condition specified in sections 80.67(d) and 80.69(d) of this Part.
(d) No controlled substance shall be dispensed unless it is enclosed within a suitable and durable container upon which is indelibly typed, printed or otherwise legibly written upon an orange label affixed to such container, in a manner which would inhibit its removal, the following:
(1) name and address of the ultimate user for whom the substance is intended, or, if intended for use upon an animal, the species of such animal and the name and address of the owner or person having custody of such animal;
(2) name, address and telephone number of the dispensing practitioner;
(3) specific directions for use, including but not limited to the dosage and frequency of dosage, and the maximum daily dosage;
(4) the legend, prominently marked or printed in either boldface or upper case lettering: “CONTROLLED SUBSTANCE, DANGEROUS UNLESS USED AS DIRECTED”;
(5) the date of dispensing; and
(6) either the name of the substance or such code number assigned by the department for the particular substance pursuant to section 80.24 of this Part.
(e) The practitioner shall submit dispensing information, for all controlled substances dispensed, electronically to the department utilizing a transmission format acceptable to the department, not later than 24 hours after the substance was delivered. A waiver allowing a practitioner to make such filings within a longer period of time may be issued by the commissioner based upon a showing of economic hardship, technological limitations that are not reasonably within the control of the practitioner, or other exceptional circumstance demonstrated by the practitioner. Such waiver and any subsequent waiver shall be applied for in the same manner and shall be subject to the same requirements as specified in section 80.63(c)(2)(x) of this Part and, if granted, such waiver shall not provide for a filing period longer than the 15th day of the next month following the month in which the substance was delivered. The information filed with the department shall include but not be limited to:
(1) dispenser identifier;
(2) patient name, in the case of an animal, the patient name field shall be filled with the name of the animal’s owner;
(3) patient address, including street, city, state, ZIP code;
(4) patient date of birth;
(5) patient's sex;
(6) date controlled substance dispensed;
(7) metric quantity;
(8) national drug code number of the drug;
(9) number of days supply;
(10) prescriber's Drug Enforcement Administration (DEA) number;
(11) payment method;
(12) species code; and
(13) name of animal, if applicable.
When applicable, the practitioner shall file a zero report with the department as specified in section 80.73(f)(2)(i) of this Part, or a practitioner may apply for a waiver of the requirement to file a zero report as specific in section 80.73(f)(2)(ii) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.10 Approval to operate a hospital
A corporation which has received Public Health Council establishment approval to operate as a central services facility rural health network and seeks approval to establish and construct or aquire a hospital, or seeks joint establishment approval to share operational authority with the operator of a hospital in accordance with subdivision (c) of section 405.1 of this Title, shall comply with the provisions of Parts 600 and 610 of this Title.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.45 Trauma centers
(a) Definitions.
The following terms when used in this section shall have the following meanings:
(1) Trauma patient means a patient at high risk of death or disability from multiple and severe injuries.
(2) Trauma care means health care provided to a trauma patient.
(3) Level I trauma center means a facility verified by the American College of Surgeons Committee on Trauma (ACS-COT), or other entity determined by the department, and designated by the department as a facility that is capable of providing the full range of services required of trauma patients; conducts trauma research; and provides training to surgical residents that comports with the ACS-COT’s publication entitled Resources for Optimal Care of the Injured Patient (2014). The standards set forth in the ACS-COT’s publication entitled Resources for Optimal Care of the Injured Patient (2014) are hereby incorporated by reference with the same force and effect as if fully set forth herein. A copy of Resources for Optimal Care of the Injured Patient (2014) is available for inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Copies are also available from the American College of Surgeons Committee on Trauma, 633 North Saint Clair Street, Chicago, Illinois 60611. A Level I trauma center shall have a transfer agreement with at least one pediatric trauma center for trauma patients whose needs exceed the clinical capabilities of the facility.
(4) Level II trauma center means a facility verified by the ACS-COT, or other entity determined by the department, and designated by the department as a facility that is capable of providing comprehensive trauma care. A Level II trauma center shall have a transfer agreement with at least one Level I trauma center and, unless otherwise designated, at least one pediatric trauma center for trauma patients whose needs exceed the clinical capabilities of the facility.
(5) Level III trauma center means a facility verified by the ACS-COT, or other entity determined by the department, and designated by the department to serve communities that do not have immediate access to a Level I or II trauma center that is capable of providing prompt assessment, resuscitation, emergency operations and stabilization of trauma patients. A Level III trauma center shall have a transfer agreement with at least one Level I or Level II trauma center, whichever is the most appropriate trauma center, and at least one pediatric trauma center for trauma patients whose needs exceed the clinical capabilities of the facility.
(6) Level IV trauma center means a facility located in a rural area verified by the ACS-COT, or other entity determined by the department, and designated by the department as a facility that is capable of providing initial evaluation and stabilization of trauma patients prior to transfer to a higher level trauma center. A Level IV trauma center shall have a transfer agreement with at least one Level I, Level II, or Level III trauma center, whichever is the most appropriate trauma center, and at least one pediatric trauma center for trauma patients whose needs exceed the clinical capabilities of the facility.
(7) Pediatric trauma center means a facility verified by the ACS-COT, or other entity determined by the department, and designated by the department as a Level I or Level II trauma center and as a facility that is capable of providing comprehensive pediatric trauma care to pediatric trauma patients. A pediatric trauma center shall have a transfer agreement with at least one Level I or Level II trauma center, whichever is the most appropriate trauma center.
(8) Region means a defined geographic area of the State where a regional trauma advisory committee has been established pursuant to PHL section 3065.
(9) Regional trauma center means a Level I or Level II trauma center selected by the department to coordinate regional trauma performance improvement activities in its region. The regional trauma center will be selected from facilities in a region that have been successfully verified by ACS-COT, or other entity determined by the department, and designated as a trauma center by the department, with a history of leadership and commitment to the region.
(10) Transfer agreement means a written and fully executed agreement between a hospital that has limited capability to receive and treat trauma patients in need of specialized emergency care and a designated trauma center that is capable of providing such care, for the transfer of such patients, that is consistent with the criteria, policies and procedures set forth in the hospitals’ trauma affiliation agreement with the regional trauma center.
(11) Trauma affiliation agreement means a written and fully executed agreement between the regional trauma center and each of the Level I, Level II, Level III, and Level IV trauma centers and non-designated hospitals in the regional trauma center’s region. A trauma affiliation agreement shall include provisions for:
(i) criteria, policies and procedures for the transfer of trauma patients to trauma centers and between levels of trauma center;
(ii) participation in the New York State Trauma Registry including the maintenance of confidentiality and protection of all data provided to the registry;
(iii) cooperation in outreach, education, training and data collection activities; and
(iv) authority for a representative or representatives of the regional trauma center to participate in and receive information from the affiliate hospital’s quality assurance committee, participate in other reviews of the quality of trauma care provided by the affiliate, and provide recommendations for quality improvement of trauma care.
(b) General provisions.
(1) The department may designate a hospital as a designated trauma center if the hospital demonstrates that it has met the requirements of section 3066 of the Public Health Law and this Part, to the department’s satisfaction.
(2) Only those hospitals designated as trauma centers by the department shall admit and provide trauma care to trauma patients; provided, however, that if the existing designated trauma centers have exceeded their capacity during a state-declared disaster or an emergency surge, an undesignated hospital, upon approval by the commissioner, may temporarily provide trauma care.
(3) Any hospital not designated as a trauma center that receives a trauma patient shall transfer such patient to the most appropriate trauma center pursuant to a transfer agreement as required under section 405.19 of this Part. Trauma centers shall be consulted prior to transfer. Trauma patients requiring trauma care shall be transported to the most appropriate trauma centers in accordance with State Emergency Medical Advisory Committee (SEMAC) approved Emergency Medical Services (EMS) protocols developed and adopted pursuant to subdivision two of section 3002-a of the Public Health Law.
(4) No hospital shall state that it has trauma center status unless so designated by the department.
(c) Trauma center designation.
(1) A hospital seeking designation as a trauma center must receive verification by the American College of Surgeons, Committee on Trauma (ACS-COT), or other entity determined by the department. To receive verification, the hospital must undergo a consultation site visit and verification site visit by the ACS-COT, or other entity determined by the department. During the verification site visit, the hospital must exhibit that it is capable of providing Level I, Level II, Level III, Level IV or pediatric trauma care in accordance with the trauma care standards set forth in ACS-COT’s publication entitled Resources for Optimal Care of the Injured Patient (2014).
(i) Consultation site visits. A hospital seeking designation as a trauma center shall request a consultation site visit by the ACS-COT, or other entity determined by the department, for the purpose of providing recommendations and assistance in preparation for verification.
(a) The cost of the consultation site visit shall be at the facility’s own expense.
(b) A hospital shall provide 30 days’ notice to the department prior to any and all consultation site visits.
(c) The department may participate in any consultation site visits.
(ii) Verification site visit. A hospital seeking designation as a trauma center shall request an official verification site visit by the ACS-COT, or other entity determined by the department, no later than two years following a hospital’s receipt of its consultation site visit report. The hospital must receive confirmation from the ACS-COT, or other entity determined by the department, that the hospital meets the criteria for trauma center verification in accordance with the criteria outlined in the ACS-COT’s publication entitled Resources for Optimal Care of the Injured Patient (2014).
(a) The cost of any verification site visit shall be at the hospital’s own expense.
(b) A hospital shall provide 30 days’ notice to the department prior to any and all verification site visits.
(c) The department may participate in any verification site visits.
(d) A hospital seeking Level I, Level II, or Level III trauma center designation shall require that any verification review team, as provided by ACS-COT, or other entity determined by the department, include a nurse reviewer. The hospital shall submit to the department documentation confirming that a nurse reviewer was a member of the verification review team.
(e) A hospital shall submit to the department a copy of all verification site visit reports and verification certificates issued by the ACS-COT, or other entity determined by the department, within 10 business days of receipt.
(f) A hospital shall submit to the department immediately upon receipt any statement of deficiencies found or interim reports of focused surveys issued by the ACS-COT, or other entity determined by the department, during a verification review.
(g) A hospital shall notify the department immediately upon receipt of notice of failure to be verified by the ACS-COT, or other entity determined by the department. Such notification must be made in writing to the department by the hospital’s chief administrative official.
(2) A hospital seeking designation as a trauma center must provide to the department any additional materials received by the hospital from the ACS-COT, or other entity determined by the department, upon the department’s request.
(3) A verified trauma center must be re-verified every three years by the ACS-COT, or other entity determined by the department, and in accordance with subparagraph (1)(ii) of this subdivision.
(d) Requirements for operating a trauma center.
(1) Upon designation, a hospital operating a trauma center shall:
(i) remain subject to the provisions of this Part and all other applicable requirements of this Title and of the Public Health Law related to general hospitals;
(ii) comply with the trauma care standards set forth in ACS-COT’s publication entitled Resources for Optimal Care of the Injured Patient (2014);
(iii) have age and size appropriate resuscitation equipment consistent with section 405.19(b) and this Part;
(iv) participate and submit information to the New York State Trauma Registry as set forth in subdivision (f) of this section;
(v) maintain transfer agreements with non-designated hospitals and the nearest designated Level I, Level II, Level III and pediatric trauma center, as appropriate for the region, to assure the timely transfer of trauma patients to the appropriate level of trauma care;
(vi) participate in the performance improvement process as set forth in subdivision (g) of this section;
(vii) submit to the department any notices of noncompliance issued by the ACS-COT, or other entity determined by the department, within one business day of receipt;
(viii) provide to the department any additional materials received by the hospital from the ACS-COT, or other entity determine by the department, upon the department’s request; and
(ix) notify the department immediately of any inability to meet the capabilities required by its current designation. Such notification must be made in writing to the department by the hospital’s chief administrative official.
(e) Withdrawal of designation.
(1) The department may withdraw designation from a hospital if:
(i) the hospital’s trauma center verification certificate lapses;
(ii) the hospital is not issued a certificate of trauma center verification after a reverification site visit; or
(iii) the hospital fails to comply with paragraph (d)(1) of this section.
(2) Upon withdrawal of a trauma care designation, the hospital shall immediately take measures to notify affected parties and divert trauma patients to designated trauma centers, and within 30 days, provide to the department a written plan describing the specific measures it has taken to notify affected parties and its process for diversion of trauma patients to designated trauma centers. In addition, the hospital shall ensure that it has a transfer agreement with at least one designated Level I, Level II or Level III trauma center, whichever is the most appropriate trauma center available, and at least one pediatric trauma center to assure the timely transfer of trauma patients in need of specialized emergency care, consistent with section 405.19 of this Part.
(f) New York State Trauma Registry.
Each designated trauma center, and every hospital that treats trauma patients prior to transferring them to a designated trauma center, shall submit information to the New York State Trauma Registry. The data elements that are required to be reported to the New York State Trauma Registry are set forth in the New York State Trauma Registry’s data dictionary. Hospitals must submit data to the New York State Trauma Registry at least quarterly and at such other times as the department may require. The hospital shall have in place appropriate measures to ensure the confidentiality of all information provided to the registry.
(g) Performance improvement.
(1) Each designated trauma center shall participate with the coordinating regional trauma center and other hospitals and healthcare facilities, EMS agencies and governmental disaster preparedness programs in regional trauma performance improvement activities that shall include:
(i) evaluation of the quality and appropriateness of care provided, including providing referring hospitals with information on trauma patient outcome;
(ii) analysis of data from the New York State Trauma Registry, patient care report database and other sources to identify opportunities for improvement. The regional trauma center shall have in place appropriate measures to ensure the confidentiality of all data utilized to conduct this analysis;
(iii) development of trauma protocols, procedures, guidelines and policies;
(iv) assessment of the regional trauma system;
(v) utilization of trauma and EMS data sources to guide public education and injury prevention efforts;
(vi) provision of trauma-related/injury prevention education to allied healthcare providers; and
(vii) participation in emergency and disaster planning including incorporation of resources and capabilities into plans to address mass casualty and other disaster events.
(2) The regional trauma center in each region will coordinate with each hospital within its region to participate in regional trauma performance improvement activities.
(i) Each regional trauma center shall enter into and comply with a trauma affiliation agreement with each hospital in its region. A representative of the regional trauma center may participate in and receive information from the affiliate hospital’s quality assurance committee, and may review other reviews of the quality of trauma care provided by the affiliate hospital, in order to make informed recommendations about improving trauma care and about the performance improvement process. Each regional trauma center and each affiliate hospital shall take actions necessary, including but not limited to, incorporating necessary provisions in the trauma affiliation agreement, to authorize such participation. For purposes of such participation, the regional trauma center’s representative(s) shall be deemed a member(s) of the affiliate hospital’s quality assurance committee. The regional trauma center’s representative(s) shall only access confidential patient information for purposes of quality improvement of trauma care. Members of an affiliate hospital’s quality assurance committee shall maintain the confidentiality of patient information and are subject to all applicable confidentiality laws and regulations, including subdivision (3) of section 3006 of the Public Health Law.
(ii) The regional trauma center shall participate in the review of information and data for quality improvement purposes as described in the affiliation agreement, which shall include:
(a) a quarterly review of all pediatric trauma deaths, delays of three hours or more in transferring trauma patients to a higher level of trauma care, and any transport and/or admission of trauma patients to a non-trauma center;
(b) making quality improvement recommendations for trauma care for the hospitals in its region; and
(c) periodic review, at the department’s request, of potential issues with trauma care in its region identified by the department during routine analysis of regional data in the New York State Trauma Registry; and
(d) any other activities required by the department for quality improvement purposes.
(iii) The regional trauma center shall submit to the department on a quarterly basis a report, in a format determined by the department, describing its quality improvement reviews of all pediatric trauma deaths, delays of three hours or more in transferring trauma patients to a higher level of trauma care, any transport and/or admission of trauma patients to a non-trauma center and any additional information requested by the department, and a report, in a format determined by the department, describing any quality improvement recommendations made to the hospitals in its region.
(iv) The regional trauma center shall cooperate with the department in regular reviews by the department of the regional trauma center’s quality improvement activities, including providing medical records and other relevant documents and information on a timely basis when requested.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.24 General requirements
(a) Care of suits and towels.
All bathing suits and towels furnished or rented shall be washed with a detergent in hot water, rinsed and thoroughly dried after each use.
(b) Pollution of swimming pool prohibited.
Urinating, discharge of fecal matter, expectorating or blowing the nose in any swimming pool is prohibited.
(c) Posting regulations.
Placards reciting the contents of subdivisions (b), (d) and (e) (where applicable), inclusive, of this section shall be posted conspicuously at the swimming pool or enclosure and in the dressing rooms and offices of all swimming pools.
(d) Deck slides.
(1) Sliding shall not occur in water less than four feet deep.
(2) Sliding shall be performed only in a feet forward position.
(e) Starting blocks.
Use of starting blocks is prohibited except during competitive swimming or swimmer-training activities.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.9 Admission/discharge
(a) General.
(1) The governing body shall establish and implement written admission and discharge policies to protect the health and safety of the patients and shall not assign or delegate the functions of admission and discharge to any referral agency and shall not permit the splitting or sharing of fees between a referring agency and the hospital.
(b) Admission.
(1) Each patient shall be advised of their rights pursuant to section 405.7 of this Part and, as appropriate, the criteria for Medicaid eligibility.
(2) No person shall be denied admission to the hospital because of race, creed, national origin, sex, disability within the capacity of the hospital to provide treatment, sexual orientation or source of payment.
(3) Except in emergencies, patients shall be admitted only upon referral and under the care of a licensed and currently registered practitioner who is granted admitting privileges by the governing body. The patient's condition and provisional diagnosis shall be established on admission by the patient's admitting practitioner and shall be noted in the patient's medical record.
(4) Except in emergencies, a hospital shall admit as patients only those persons who require the type of medical services authorized by the hospital's operating certificate.
(5) Except as provided in section 405.2(f)(4) of this Part, the hospital shall have a licensed and currently registered physician, or a registered physician's assistant under the general supervision of a physician, or a nurse practitioner in collaberation with a physician, available on the premises at all times who shall be responsible for receiving patients for care in accordance with policies established by the hospital and for the appropriate disposition of requests to admit patients.
(6) Insofar as it is practicable, the admitting practitioner shall request of each person being admitted, information concerning signs or symptoms of recent exposure to communicable diseases as defined in Part 2 of this Title. Whenever there are positive findings of exposure to such communicable disease, the patient shall be isolated and managed in accordance with the hospital's infection control policies and the provisions of Part 2 of this Title.
(7) Pediatrics.
(i) The hospital shall admit pediatric patients consistent with its ability to provide qualified staff, space and size appropriate equipment necessary for the unique needs of pediatric patients. The hospital shall establish a separate pediatric unit if the hospital regularly has 16 or more pediatric patients at one time or if pediatric patients cannot be adequately and safely cared for in other than separately certified pediatric beds. If a hospital cannot meet these requirements the hospital must develop criteria and policies and procedures for transfer of pediatric patients.
(ii) Hospitals maintaining certified pediatric beds shall assure that admission to those beds is limited to patients who have not yet reached their 21st birthday except in instances when there are no other available beds within the hospital. In such instances, the hospital shall afford priority admission to the pediatric bed to patients 20 years of age or younger.
(iii) Children under the age of 14 shall not be admitted to a room with patients 21 years of age or over except with the knowledge and agreement of the child's attending practitioner and parent or guardian and the concurrence of the other patients occupying the room and their attending practitioners.
(iv) In the event a separate unit is not available, arrangements for the admission of all children shall be made consistent with written policies and procedures to ensure the safety of each patient.
(v) The hospital shall develop policies and procedures enabling parents/guardians to stay with pediatric patients. To the extent possible given the patient’s health and safety, the hospital shall allow at least one parent/guardian to remain with the patient at all times.
(8) The hospital shall require that a member of the medical staff who has privileges to admit patients shall assume the principal obligation and responsibility for managing the patient's medical care. Postgraduate trainees and supervising physicians shall consult with and be directed by the attending practitioner with regard to therapeutic decisions and changes in patient status. Direct patient care may be provided by postgraduate trainees and medical students, within their permitted scope of responsibility and privileges with supervision as required in section 405.4 of this Part with the concurrence of the attending practitioner. Occurrence of urgent or emergent situations may preclude the attending or admitting practitioner from direct participation in decisionmaking regarding patient care. In such circumstances, the supervising physician shall concur in the decision, and the attending practitioner shall be notified as soon as possible. Responsibility for such decisions made in the absence of consultation with the responsible attending practitioner resides with the involved postgraduate trainees and supervising physicians.
(9) The hospital shall provide for the assignment, management, and disposition of patients who are not admitted as private patients of members of the medical staff. The hospital shall develop and implement policies and procedures which provide for the continuity of care of such patients and shall include a procedure by which each patient is assigned to a member of the medical staff, who shall be the personal practitioner to the patient and assume professional responsibility for his/her care in the hospital and for a proper plan of care after discharge.
(10) No hospital shall be required to admit any patient for the purpose of performing an induced termination of pregnancy, nor shall any hospital be liable for its failure or refusal to participate in any such act, provided that the hospital shall inform the patient of its decision not to participate in such an act or acts. The hospital in such event shall inform the patient of appropriate resources for services or information.
(11) A complete and permanent record shall be maintained of all patients admitted, including but not limited to the date and time of admission, name and address, date of birth, the next of kin or sponsor, veteran status (insofar as these are obtainable), the admitting diagnosis, condition, the name of the referring practitioner, the hospital attending practitioner or service, and as to discharge, the date and time, condition and principal diagnosis.
(i) If a patient is identified as a veteran, the hospital shall notify such veteran of the possible availability of services at a hospital operated by the Veteran's Administration. For the purposes of this paragraph, a veteran shall be defined as a person who served in the United States Military, who received a discharge other than a dishonorable discharge and who is eligible for benefits provided by the Veteran's Administration.
(ii) If a patient eligible for transfer to a hospital operated by the Veteran's Administration requests such transfer, hospital staff shall make such arrangements. Transfer shall be effected in accordance with paragraph (h)(7) of this section.
(12) Every patient shall have a complete history and physical examination performed by an appropriately credentialed practitioner within 30 days before or 24 hours after admission. If recorded in the patient's medical record by an individual other than the attending practitioner, the history and physical examination shall be reviewed and countersigned by the attending practitioner. When the history and physical is completed within the 30 days prior to admission, an examination, to update any changes in the patient's health status, must be completed and documented in the patient's medical record within 24 hours after admission.
(i) Such examination shall include a screening uterine cytology smear on women 21 years of age and over, unless such test is medically contraindicated or has been performed within the previous three years, and palpation of breast, unless medically contraindicated, for all women over 21 years of age. These examinations shall be recorded in the medical record.
(ii) Insofar as it is possible to identify patients who may be susceptible to sickle cell anemia, all such presumptively susceptible patients, including infants over six months of age, shall be examined for the presence of sickle cell hemoglobin unless such test has been previously performed and the results recorded in the patient's medical record or otherwise satisfactorily recorded, such as on an identification card.
(13) No patient 18 years of age or older shall be detained in a hospital against his will, nor shall a minor be detained against the will of his parent or legal guardian, except as authorized by law. This provision shall not be construed to preclude or prohibit attempts to persuade a patient to remain in the hospital in his/her own interest, nor the temporary detention of a mentally disturbed patient for the protection of himself/herself or others, pending prompt legal determination of his/her rights. In no event shall a patient be detained solely for nonpayment of his/her hospital bill or practitioner's statement for medical services.
(14) The hospital shall adopt and make public the following admission notices to be provided to all patients receiving inpatient hospital care. Medicare patients shall be given the notice set forth in subparagraph (i) and all other inpatients shall be given the notice set forth in subparagraph (ii) of this paragraph.
(i) Hospital Admission Notice for Medicare Patients
You have the following rights under the New York State law:
Before you are discharged, you must receive a written Discharge Plan. You or your representative have the right to be involved in your discharge planning.
Your written Discharge Plan must describe the arrangements for any future health care that you may need after discharge. You may not be discharged until the services required in your written Discharge Plan are secured or determined to be reasonably available.
If you do not agree with the Discharge Plan or believe the services are not reasonably available, you may call the New York State Health Department to investigate your complaint and the safety of your discharge. The hospital must provide you with the Health Department's telephone number if you ask for it.
For important information about your rights as a Medicare patient, see the “IMPORTANT MESSAGE FROM MEDICARE,” which you must receive when admitted to a hospital.
(ii) Hospital Admission Notice
An Important Message Regarding Your Rights as a Hospital Inpatient
Your Rights While a Hospital Patient
You have the right to receive all of the hospital care that you need for the treatment of your illness or injury. Your discharge date is determined only by YOUR health care needs, not by your DRG category or your insurance.
You have the right to be fully informed about decisions affecting your care and your insurance coverage. ASK QUESTIONS. You have the right to designate a representative to act on your behalf.
You have the right to know about your medical condition. Talk to your doctor about your condition and your health care needs. If you have questions or concerns about hospital services, your discharge date or your discharge plan, consult your doctor or a hospital representative (such as the nurse, social worker, or discharge planner).
Before you are discharged you must receive a written DISCHARGE NOTICE and a written DISCHARGE PLAN. You and/or your representative have the right to be involved in your discharge planning.
You have the right to appeal the written discharge plan or notice you receive from the hospital.
IF YOU THINK YOU ARE BEING ASKED TO LEAVE THE HOSPITAL TOO SOON
Be sure you have received the written notice of discharge that the hospital must give you. You need this discharge notice in order to appeal.
This notice will say who to call and how to appeal. To avoid extra charges you must call to appeal by 12 noon of the day after you receive the notice. If you miss this time you may still appeal. However, you may have to pay for your continued stay in the hospital, if you lose your appeal.
DISCHARGE PLANS
In addition to the right to appeal, you have the right to:
Receive a written discharge plan that describes the arrangements for any future health care you may need after discharge. You may not be discharged until the services required in your written discharge plan are secured or determined by the hospital to be reasonably available. You also have the right to appeal this discharge plan.
PATIENTS' RIGHTS
A general statement of your additional rights as a patient must be provided to you at this time.
FOR ASSISTANCE/HELP
The Independent Professional Review Agent (IPRA) for your area and your insurance coverage is:
(Hospitals are permitted to use a checklist to indicate the IPRA that the patient should contact.)
(15) In conjunction with the requirements for complete history and physical examination as established in this section, hospitals approved by the Office of Alcoholism and Substance Abuse Services (OASAS) or the Division of Alcoholism and Alcohol Abuse, a predecessor agency, shall provide a health intervention services (HIS) program to screen all admitted patients for signs of alcoholism or alcohol abuse that may relate to the condition requiring hospital admission. Specifically, such hospitals shall:
(i) maintain a dedicated staff that are adequate in number and trained, including continuing education and inservice training, to perform all the activities required of the HIS program;
(ii) identify patients who exhibit signs of alcoholism or alcohol abuse through a comprehensive screening protocol; and
(iii) offer patients intervention and referral services consistent with their assessed needs.
(16) The hospital shall ask each patient for the name of his or her primary care provider, if known, on admission and shall document such information in the patient’s medical record.
(c) Treatment of sexual offense survivors and maintenance of sexual offense evidence.
(1) Treatment of survivors. Hospital shall:
(i) maintain current protocols regarding the care of patients reporting sexual assault;
(ii) provide a patients who are suspected or confirmed victims of sexual offenses appropriate assessment, emergency treatment and referrals to meet the health care needs of such individuals, to provide emotional support to them and to minimize further trauma;
(iii) advise patients of the availability of services provided by a local rape crisis or victim assistance organization and, unless the patient declines such services, contact such organization with information concerning the age and sex of the victim, language spoken by the victim if other than English, and any other information that may impact the assignment of a victim advocate, such as mental retardation, etc., so that a representative may offer the patient the services that the organization provides;
(iv) as provided by the department and consistent with current standards of professional practice, provide to patients written and verbal information necessary to make an informed choice in regard to treatment options, including pregnancy prophylaxis;
(v) provide to patients, upon request, prophylaxis against pregnancy, sexually transmitted diseases, hepatitis B and HIV, as medically indicated;
(vi) discuss with patients the option of reporting the sexual offense to the police, and upon consent of the patient, report the offense to the local law enforcement agency; and
(vii) reasonably assure patients an appropriate and safe discharge.
(2) Maintenance of sexual offense evidence.
The hospital shall provide for the maintenance of evidence of sexual offenses. The hospital shall establish and implement written policies and procedures that are consistent with the requirements of this section and that shall apply to all service units of the hospital which treat victims of sexual offenses, including but not limited to medicine, surgery, emergency, pediatric and outpatient services.
(i) The sexual offenses subject to the provisions of this subdivision shall be sexual misconduct, rape, sodomy, sexual abuse and aggravated sexual abuse as defined in article 130 of the Penal Law.
(ii) The sexual offense evidence shall include, as appropriate to the injuries sustained in each case, slides, cotton swabs, clothing or portion thereof, hair combings, fingernail scrapings, photographs, and other items specified by the local police agency and forensic laboratory in each particular case.
(iii) The hospital shall preserve items of sexual offense evidence and ensure that clothes and samples or swabs are dried, stored in paper bags and labeled, and shall mark and log each item of evidence with a code number corresponding to the patient's medical record number.
(iv) Privileged sexual offense evidence shall mean evidence collected or obtained from the patient during the hospital examination and treatment of injuries sustained as a result of a sexual offense.
(v) Sexual offense evidence that is not privileged shall mean evidence which is obtained from victims of suspected child abuse or maltreatment, and that derived from other alleged crimes, attendant to or committed simultaneously with the sexual offense, which are required to be reported to a police agency, such as bullet or gunshot wounds, powder burns, burn injuries, which may also be required to be reported to the state fire administrator, or other injuries arising from or caused by the discharge of a gun or firearm, or wounds which may result in death and which are inflicted by a knife, ice pick or other sharp or pointed instrument in accordance with sections 265.25 and 265.26 of the Penal Law. Nothing in this paragraph shall prevent the reporting of diseases or medical conditions required by law to be reported to health authorities.
(vi) Upon admission of a patient who is an alleged sexual offense survivor, the hospital shall seek patient consent, or consent of the person authorized to act on the patient's behalf, for collection and storage of the sexual offense evidence and shall explain the specific rights of the patient and obligations of the hospital as outlined in this paragraph. The hospital shall store the sexual offense evidence in a locked, separate and secure area for not less than 30 days unless:
(a) the patient or person authorized to act on the patient's behalf signs a statement directing the hospital not to collect and keep privileged evidence; or
(b) such evidence is privileged and the patient or person authorized to act on the patient's behalf signs a statement directing the hospital to surrender the evidence to the police before the 30-day period has expired; or
(c) the evidence is not privileged and the police request its surrender before 30-day period has expired.
(vii) If none of the above acts have occurred within 30 days from commencement of treatment, the evidence shall be discarded and the patient's possessions shall be returned upon the patient's request.
(viii) The hospital shall designate a staff member to coordinate the required actions and to contact the local police agency and forensic laboratory to determine their specific needs and requirements for the maintenance of sexual offense evidence.
(d) Child abuse and maltreatment. The hospital shall provide for the identification, assessment, reporting and management of cases of suspected child abuse and maltreatment. The hospital shall establish and implement written policies and procedures which are consistent with the requirements of this section and which shall apply to all service units of the hospital which treat victims of child abuse and maltreatment, including but not limited to medicine, surgery, emergency, pediatrics and outpatient services.
(1) The hospital shall provide orientation and continuing education to the nursing, medical and social work personnel of, at least, the hospital's emergency, pediatric and outpatient services in the recognition of indicators of domestic violence and suspected child abuse and maltreatment and in the individual's responsibilities in dealing with such case.
(2) A staff member shall be designated to coordinate the required reporting to the New York State Central Register of Child Abuse and Maltreatment and the hospital's actions taken with respect to such cases in accordance with procedures set forth in article 6, title 6 of the State Social Services Law.
(e) Domestic violence. The hospital shall provide for the identification, assessment, treatment and appropriate referral of cases of suspected or confirmed domestic violence victims. The hospital shall establish and implement written policies and procedures consistent with the requirements of this section which shall apply to all service units of the hospital.
(f) Individuals with substance use disorders. The hospital shall develop and maintain written policies and procedures for inpatient and outpatient care of individuals with documented substance use disorders or who appear to have or be at risk for substance use disorders, as that term is defined in section 1.03 of the Mental Hygiene Law. Such policies and procedures shall, at a minimum, meet the following requirements:
(1) policies and procedures shall provide for the use of an evidence-based approach to identify and assess individuals for substance use disorders, and to refer individuals with documented substance use disorders or who appear to have or be at risk for substance use disorders;
(2) upon admission, treatment, or discharge of an individual with a documented substance use disorder or who appears to have or be at risk for a substance use disorder, including discharge or transfer from the emergency service of the hospital or assignment to observation services pursuant to section 405.19(e)(2) of this Part, the hospital shall inform the individual of the availability of the substance use disorder treatment services that may be available to him or her through a substance use disorder services program. Such information may be provided verbally and/or in writing as appropriate;
(3) during discharge planning, the hospital shall provide to each individual with a documented substance use disorder or who appears to have or be at risk for a substance use disorder with educational materials, identified by the office of Alcoholism and Substance Abuse Services in consultation with the department and provided to the hospital pursuant to section 2803-u(1) of the Public Health Law;
(4) except where an individual has come into the hospital under section 22.09 of the Mental Hygiene Law, and where the hospital does not directly provide substance use disorder services, the hospital shall refer individuals in need of substance use disorder services to and coordinate with appropriate substance use disorder services programs that provide behavioral health services, as defined in section 1.03 of the Mental Hygiene Law; and
(5) the hospital shall establish and implement training, in addition to current training programs, for all individuals licensed or certified pursuant to Title 8 of the Education Law who provide direct patient care regarding the policies and procedures established in this paragraph.
(g) Human trafficking.
The hospital shall provide for the identification, assessment, and appropriate treatment or referral of individuals who are suspected to be human trafficking victims, as that term is defined in section 483-aa of the Social Services Law and used in article 10-D of the Social Services Law. The hospital shall establish and implement written policies and procedures, which shall apply to all service unites of the hospital and, at a minimum, shall meet the following requirements:
(1) policies and procedures shall provide for the identification, assessment, and appropriate treatment or referral of individuals who are suspected to be human trafficking victims;
(2) in the case of individuals who are suspected to be human trafficking victims and are under 18 years old, policies and procedures shall provide for the reporting of such persons as an abused or maltreated child if required under title 6 of article 6 of the Social Services Law;
(3) the hospital shall inform individuals who are suspected to be human trafficking victims of services that may be available, including those referenced in article 10-D of the Social Services Law. Referrals also may be made to other health care providers, appropriate state agencies, and/or other providers of services as appropriate. Such information may be provided verbally and/or in writing as appropriate;
(4) the hospital shall post the human trafficking hotline poster issued by the National Human Trafficking Resources Center, or a variation of such poster created by the Office of Temporary and Disability Assistance (OTDA) consistent with section 483-ff of the Social Services Law, whichever OTDA makes available on its website. Posters shall be placed in conspicuous locations near primary public entrances and where other posters and notices are posted; and
(5) the hospital shall establish and implement training, which may be incorporated into current training programs, for all individuals licensed or certified pursuant to title 8 of the Education Law who provide direct patient care, and for all security personnel, regarding the policies and procedures established pursuant to this subdivision. Such training shall include training in the recognition of indicators of a human trafficking victim and the responsibilities of such personnel in dealing with persons suspected as human trafficking victims.
(h) Discharge.
(1) The hospital shall ensure that each patient has a discharge plan which meets the patient's post-hospital care needs. No patient who requires continuing health care services in accordance with such patient discharge plan may be discharged until such services are secured or determined by the hospital to be reasonably available to the patient.
(2) The hospital shall have a discharge planning coordinator responsible for the coordination of the hospital discharge planning program. The discharge planning coordinator shall be an individual with appropriate training and experience as determined by the hospital to coordinate the hospital discharge planning program.
(3) The hospital shall ensure:
(i) that discharge planning staff have available current information regarding home care programs, institutional health care providers, and other support services within the hospital's primary service area, including their range of services, admission and discharge policies and payment criteria;
(ii) the utilization of written criteria as part of a screening system for the early identification of those patients who may require post-hospital care planning and services. Such criteria shall reflect the hospital's experience with patients requiring post-hospital care and shall be reviewed and updated annually;
(iii) that upon the admission of each patient, information is obtained as required to assist in identifying those patients who may require post-hospital care planning;
(iv) that each patient is screened as soon as possible following admission in accordance with the written criteria described in subparagraph (ii) of this paragraph and that this screening is coordinated with the utilization review process;
(v) that each patient identified through the screening system as potentially in need of post-hospital care is assessed by those health professionals whose services are appropriate to the needs of the patient to determine the patient's post-hospital care needs. Such assessment shall include an evaluation of the extent to which the patient or patient's personal support system can provide or arrange to provide for identified care needs while the patient continues to reside in his/her personal residence;
(vi) that for each patient determined to need assistance with post-hospital care, the health professionals whose services are medically necessary, together with the patient and the patient's family/representative shall develop an individualized comprehensive discharge plan consistent with medical discharge orders and identified patient needs;
(vii) that each patient determined to need assistance with post-hospital care and the patient's family/representative receive verbal and written information regarding the range of services in the patient's community which have the capability of assisting the patient and the patient's family/representative in implementing the patient' s individualized discharge plan which is appropriate to the patient's level of care needs;
(viii) that the patient and the patient's family/representative shall have the opportunity to participate in decisions regarding the selection of post-hospital care consistent with and subject to any limitations of Federal and State laws. Planning for post-hospital care shall not be limited to placement in residential health care facilities for persons assessed to need that level of care, but shall include consideration of noninpatient services such as home care, long-term home health care, hospice, day care and respite care;
(ix) that when residential health care facility placement is indicated, the patient and the patient's family/representative shall be afforded the opportunity, consistent with and subject to any limitations of Federal and State laws, to participate in the selection of the residential health care facilities to which applications for admission are made.
(x) that contact with appropriate providers of health care and services is made as soon as possible, but no later than the day of assignment of alternate level of care status and that each patient's record contains a record of all such contacts including date of contact and provider response as well as a copy of any standard assessment form, including but not limited to any hospital/community patient review instrument as contained in section 400.13 of this Title and any home health assessment, completed by the hospital for purposes of post-hospital care;
(xi) that relevant discharge planning information is available for the utilization review committee; and
(xii) the development and implementation of written criteria for use in the hospital emergency service indicating the circumstances in which discharge planning services shall be provided for a person who is in need of post emergency care and services but not in need of inpatient hospital care.
(4) The hospital shall establish and implement written policies and procedures governing the admissions and discharge process which ensure compliance with State and Federal antidiscrimination laws which apply to the operator. Such laws include, but need not be limited to, the applicable provisions of this Part; Public Health Law, section 2801-a(9); the New York State Civil Rights Law, sections 40 and 40-c; article 15 (Human Rights Law) of the State Executive Law, sections 291, 292 and 296; and title 42 of the United States Code, sections 1981, 2000a, 2000a-2, 2000d, 3602, 3604 and 3607. Copies of the cited State and Federal statutes are available from West Publishing Company, P.O. Box 64526, St. Paul, MN 55164-0526, the publisher of McKinney's Consolidated Laws of New York annotated and the United States Code annotated. Copies of such statutes are also available for public inspection and copying at the Records Access Office, New York State Department of Health, Corning Tower Building, Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237.
(5) Discharge planners shall inform each patient and his/her family of the admission policies of the residential health care facilities to which they are referred.
(6) The requirements of this subdivision relating to a patient's family/representative participating in the discharge planning process and in receiving an explanation of the reason for a patient's transfer or discharge shall not apply in the following circumstances:
(i) when a competent adult patient objects to such participation by, or to an explanation regarding transfer or discharge being given to, any family/representative. Any such objections shall be noted in the patient's medical record; or
(ii) when the hospital has made a reasonable effort to contact a patient's family/representative in order to provide an opportunity to participate in the discharge planning process or to explain the reason for transfer or discharge, and the hospital is unable to locate a responsible family member/representative, or, if located, such individual refuses to participate. The reasons a patient's family/representative did not participate in the discharge planning process or did not receive an explanation of the reason for a patient's transfer or discharge shall be noted in the patient's medical record. A reasonable effort shall include, but not be limited to, attempts to contact a patient's family/representative by telephone, telegram and/or mail.
(7) The hospital shall ensure that no person presented for medical care shall be removed, transferred or discharged from a hospital based upon source of payment. Each removal, transfer or discharge shall be carried out after a written order made by a physician that, in his/her judgment, such removal, transfer or discharge will not create a medical hazard to the person or that such removal, transfer or discharge is considered to be in the person's best interest despite the potential hazard of movement. Such a removal, transfer or discharge shall be made only after explaining the need for removal, transfer or discharge to the patient and to the patient's family/representative and prior notification to the medical facility expected to receive the patient.
(i) The hospital shall maintain a record of all removals, discharges and transfers from the hospital, including the date and time of the hospital reception or admission, name, sex, age, address, presumptive diagnosis, treatment provided, clinical condition, reason for removal, transfer or discharge and destination. A copy of such information shall accompany any person transferred or discharged to a health care facility or a certified or licensed home care services agency and, where applicable become a part of the person's medical record.
(ii) Patients discharged from the hospital by their attending practitioner shall not be permitted to remain in the hospital without the consent of the chief executive officer of the hospital except in accordance with provisions of subdivision (i) of this section.
(iii) In the absence of a written order of an attending practitioner discharging a patient, with respect to a patient who insists upon discharging himself from the hospital, the hospital shall obtain, where practicable, a written release from the patient absolving the hospital and the patient's attending practitioner of liability and damages resulting from such discharge.
(8) Unless otherwise provided by law, the hospital shall ensure that a minor shall be discharged only in the custody of his parent, a member of his immediate family or his legal guardian or custodian, unless such parent or guardian shall otherwise direct.
(9) A dead body, including a stillborn infant or fetus estimated by an attending physician to have completed 20 weeks of gestation, shall be delivered only to a licensed funeral director or undertaker or his/her agent. If, at the time of death, the patient was diagnosed as having a specific communicable or infectious disease, including but not limited to those diseases designated in Part 2 of this Title, a written report of such disease shall accompany the body when it is released to the funeral director or his/her agent.
(10) The hospital shall develop and implement written policies and procedures pertaining to the review and communication of laboratory and diagnostic test/service results ordered for a patient while admitted or receiving emergency services to the patient. If the patient lacks medical decision-making capacity, the communication shall be to the patient’s medical decision-maker. The results shall also be provided to the patient’s primary care provider, if known. Such policies and procedures shall be reviewed and updated as necessary and at a minimum shall include:
(i) a requirement that all laboratory and other diagnostic tests/service results be reviewed upon completion by a physician, physician assistant or nurse practitioner familiar with the patient’s presenting condition;
(ii) a requirement that all laboratory and other diagnostic test services results be forwarded to the patient’s primary provider, if known, after review by a physician, physician assistant or nurse practitioner;
(iii) provisions to include in the discharge plan information regarding the patient’s completed and pending laboratory and other diagnostic test/service results, medications, diagnoses, and follow-up care and to review such information with the patient or, if the patient is not legally capable of making decisions, the patient’s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations;
(iv) a requirement that patients may not be discharged from the hospital or the emergency room until any tests that could reasonably be expected to yield “critical value” results – results that suggest a life-threatening or otherwise significant condition such that it requires immediate medical attention – are reviewed by a physician, physician assistant (PA) and/or nurse practitioner (NP);
(v) a requirement that before a patient is discharged, any critical laboratory test results are communicated to the patient or, if the patient is not legally capable of making decisions, the patient’s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations;
(vi) a requirement that all information be presented to the patient or if the patient is not legally capable of making decisions, the patient’s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations, in a manner that reasonably assures that the patient, their parents or other medical decision makers understand the health information provided in order to make appropriate health decisions.
(i) Hospital inpatient discharge review program.
(1) A hospital inpatient discharge review program applicable to all patients other than beneficiaries of title XVIII of the Federal Social Security Act (Medicare) shall be established in accordance with this subdivision. No hospital inpatient subject to the provisions of this subdivision may be discharged on the basis that inpatient hospital service in a general hospital is no longer medically necessary and that an appropriate discharge plan has been established unless a written notice of such determinations and a copy of the discharge plan have been provided to the patient or the appointed personal representative of the patient. The patient or the appointed personal representative of the patient shall have the opportunity to sign the notice and a copy of the discharge plan and receive a copy of both signed documents. Every hospital shall use the common notice set forth in paragraph (9) of this subdivision. The patient, or the appointed personal representative of the patient may request a review of such determinations by the appropriate independent professional review agent or review agent in accordance with paragraph (4) of this subdivision. Notwithstanding that the patient discharge review process provided in accordance with Federal law and regulation shall apply to beneficiaries of title XVIII of the Federal Social Security Act (Medicare), a written copy of the discharge plan, and discharge notice shall be provided to the beneficiary or the appointed personal representative of the beneficiary. The beneficiary or the appointed personal representative of the beneficiary shall have the opportunity to sign the documents and receive a copy of the signed documents.
(2)
(i) For patients eligible for payments by state governmental agencies for hospital inpatient services as the patient's primary payor an independent professional review agent shall mean the commissioner or his designee. In conducting hospital inpatient discharge reviews in accordance with this paragraph, the commissioner may utilize the services of department personnel or other authorized representatives, including a review agent approved in accordance with subparagraph (ii) of this paragraph.
(ii) For patients who are not beneficiaries of title XVIII of the Federal Social Security Act (Medicare) nor eligible for payments by state governmental agencies as the patient's primary payor, an independent professional review agent shall mean a third-party payor of hospital services or other corporation approved by the commissioner in writing for purposes of conducting hospital inpatient discharge reviews in accordance with this subdivision. For a third-party payor of hospital services or other corporation to be approved as an independent professional review agent in accordance with this subparagraph, such third-party payor or other corporation must meet the following approval criteria:
(a) the review agent shall employ or otherwise secure the services of adequate medical personnel qualified to determine the necessity of continued inpatient hospital services and the appropriateness of hospital discharge plans;
(b) the review agent shall demonstrate the ability to render review decisions in a timely manner as provided in this subdivision;
(c) the review agent shall agree to provide ready access by the commissioner to all data, records and information it collects and maintains concerning its review activities under this subdivision;
(d) the review agent shall agree to provide to the commissioner such data, information and reports as the commissioner determines necessary to evaluate the review process provided pursuant to this subdivision;
(e) the review agent shall provide assurances that review personnel shall not have a conflict of interest in conducting a discharge review for a patient based on hospital or professional affiliation; and
(f) the review agent meets such other performance and efficiency criteria regarding the conduct of reviews pursuant to this subdivision established by the commissioner
The commissioner may withdraw approval of an independent professional review agent where such review agent fails to continue to meet approval criteria established pursuant to this subparagraph.
(iii) Each hospital shall enter into contracts with one or more independent professional review agents approved by the commissioner in accordance with subparagraph (ii) of this paragraph for purposes of conducting hospital inpatient discharge reviews in accordance with this subdivision for patients, including uncompensated care patients, who are not beneficiaries of title XVIII of the Federal Social Security Act (Medicare) nor eligible for payments by State governmental agencies as the patient's primary payor; provided, however, a payor of hospital service authorized under article 43 of the State Insurance Law or certified as health maintenance organizations under article 44 of the Public Health Law, may designate the review agent for their subscribers or beneficiaries or enrolled members and shall reimburse such designated review agent for costs of the discharge review program.
(3)
(i) If a hospital and the attending physician agree that inpatient hospital service in a hospital is no longer medically necessary for a patient, other than a beneficiary of title XVIII of the Federal Social Security Act (Medicare), and an appropriate discharge plan has been established for such patient, at that time the hospital shall provide the patient or the appointed personal representative of the patient with a written discharge notice and a copy of the discharge plan, meeting the requirements of paragraph (1) of this subdivision.
(ii) If a hospital has determined that inpatient hospital service in a hospital is no longer medically necessary for a patient, other than a beneficiary of title XVIII of the Federal Social Security Act (Medicare), and an appropriate discharge plan has been established for such patient but the attending physician has not agreed with the hospital's determinations, the hospital may request by telephone a review of the validity of the hospital's determinations by the appropriate independent professional review agent. Such review agent shall conduct a review of the hospital's determinations and prior to the conclusion of the review shall provide an opportunity to the treating physician and an appropriate representative of the hospital to confer and provide information which may include the patient's clinical records if requested by the review agent. Such review agent shall notify the hospital of the results of its review not later than one working day after the date the review agent has received the request, the records required to conduct such review, and the date of such conferring and receipt of any additional information requested. The hospital shall provide notice to the attending physician of the results of the review. If the review agent concurs with the hospital's determinations, the hospital shall provide the patient or his appointed personal representative with a written notice of such determinations and notice that the patient shall be financially responsible for continued stay, and with a copy of the proposed discharge plan. The patient or the appointed personal representative of the patient shall have the opportunity to sign the notice and a copy of the proposed discharge plan and receive a copy of both signed documents. Every hospital shall use the notice set forth in paragraph (l0) of this subdivision which shall indicate the determinations made, shall state the reasons therefor and that the patient's attending physician has disagreed, and shall state that the patient or the appointed personal representative of the patient may request a review of such determinations by the appropriate review agent.
(4) A patient in a hospital, or the appointed personal representative of the patient, who receives a written notice in accordance with subparagraph (3)(i) or (3)(ii) of this subdivision, may request a review by the appropriate review agent of the determinations set forth in such notice related to medical necessity of continued inpatient hospital service, the appropriateness of the discharge plan and the availability of required continuing health care services.
(i) If a patient while still hospitalized or while no longer an inpatient, or the appointed personal representative of such patient, requests a review by the appropriate review agent, the hospital shall promptly provide to the review agent the records required to review the determinations. Such request for a patient no longer an inpatient shall take place no later than 30 days after receipt of a notice provided in accordance with paragraph (3) of this subdivision or seven days after receipt of a complete bill for all inpatient services rendered, whichever is later. The review agent shall conduct a review of such determinations, and shall provide the treating physician and an appropriate representative of the hospital with an opportunity to confer and provide information prior to the conclusion of the review. The review agent shall provide written notice to the patient, or the appointed personal representative of the patient, and the hospital of the results of the review within three working days of receipt of the requests for review and the records required to review the determinations. The hospital shall provide notice to the attending physician of the results of the review.
(ii) If a patient while still an inpatient in the hospital, or the appointed personal representative of the patient, requests a review by the appropriate review agent not later than noon of the first working day after the date the patient, or the appointed personal representative of the patient, receives the written notice, the hospital shall provide to the appropriate review agent the records required to review the determinations by the close of business of such working day. The appropriate review agent shall conduct a review of such determinations and provide written notice to the patient, or the appointed personal representative of the patient, and the hospital of the results of the review not later than one full working day after the date the review agent has received the request for review and such records. The hospital shall provide notice to the attending physician of the results of the review.
(5) If the appropriate review agent, upon any review conducted pursuant to subparagraph (3)(ii) or pursuant to paragraph (4) of this subdivision does not concur in the determinations, continued stay in a hospital shall be deemed necessary and appropriate for the patient for purposes of payment for such continued stay.
(6) If a patient eligible for payment for inpatient hospital services under the casebased payment per discharge system or the appointed personal representative of the patient, requests a review by the appropriate review agent in accordance with subparagraph (4)(ii) of this subdivision, the hospital may not demand or request any payment for additional inpatient hospital services provided to such patient subsequent to the proposed time of discharge and prior to noon of the day after the date the patient or the appointed personal representative of the patient receives notice of the results of the review by the review agent except deductibles, copayments, or other charges that would be authorized for a patient for whom inpatient hospital services in a hospital continue to be necessary and appropriate.
(7) In any review conducted pursuant to subparagraph (3)(ii) or pursuant to paragraph (4) of this subdivision, the review agent shall solicit the views of the patient involved, or the appointed personal representative of the patient, and the attending physician.
(8) Each patient, or the appointed personal representative of the patient, provided a notice by a hospital in accordance with paragraph (3) of this subdivision shall be provided at such time by the hospital with a notice of such patient's right to request a discharge review in accordance with this subdivision. The patient or the appointed personal representative of the patient shall have the opportunity to sign this form and receive a copy of the signed form.
(9) Notice that inpatient hospital service is no longer medically necessary. For purposes of subparagraph (3)(i) of this subdivision, the hospital shall utilize the following notices:
(i) The following form shall be used for patients covered under the case payment system:
DISCHARGE NOTICE
DATE:/___/___
READ THIS LETTER CAREFULLY—IT CONCERNS YOUR PRIVATE INSURANCE
BENEFITS OR MEDICAID BENEFITS OR IF YOU ARE UNINSURED
PATIENT NAME: __________ PRIMARY PAYOR
AT DISCHARGE:
ATT.
PHYS.:
______
MR NO.:
ADM DATE:
___
/
___
/
___
Dear Patient:
Your doctor and the hospital have determined that you no longer require care in the hospital and will be ready for discharge on:
Day of Week
__
/
Date /
__
IF YOU AGREE with this decision, you will be discharged. Be sure you have already received your written discharge plan which describes the arrangements for any future health care you may need.
IF YOU DO NOT AGREE and think you are not medically ready for discharge or feel that your discharge plan will not meet your health care needs, you or your representative may request a review. Contact the review agent indicated on the reverse side of this letter if you would like a review of the discharge decision.
IF YOU WOULD LIKE A REVIEW, you should immediately, but not later than noon of
(Day and Date)
call the telephone number checked off on the reverse side of this page.
IF YOU CANNOT REQUEST THE REVIEW YOURSELF, and you do not have a family member or friend to help you, you may ask the hospital representative at extension
, who will request the review for you.
IF YOU REQUEST A REVIEW, the following will happen:
1. The review agent will ask you or your representative why you or your representative think you need to stay in the hospital and also will ask your name, admission date and telephone number where you or your representative can be reached.
2. After speaking with you or your representative and your doctor and after reviewing your medical record, the review agent will make a decision which will be given to you in writing.
3. While this review is being conducted, you will not have to pay for any additional hospital days until you have received the review agent's decision.
IF THE REVIEW AGENT AGREES WITH THE DISCHARGE DECISION, you will be financially responsible for your continued stay after noon of the day after you or your representative has been notified of the review agent's decision.
IF THE REVIEW AGENT AGREES THAT YOU STILL NEED TO BE IN THE HOSPITAL: for Medicaid patients, Medicaid benefits will continue to cover your stay; for private health insurance patients, coverage for your continued stay is limited to the scope of your private health insurance policy.
NOTE: If you miss the noon deadline mentioned on the first page of this notice, you may still request a review. However, if the review agent disagrees with you, you will be financially responsible for the days of care beginning with the proposed discharge date.
If you would like a review of your hospital stay after you have been discharged, you may request a review by the review agent within 30 days of the receipt of this notice or seven days after receipt of a complete bill from the hospital, whichever is later, by writing to the review agent.
I have received this notice on behalf of myself as the patient or as the representative of the patient:
Signature
__
/
Date /
__
Time
Relationship
(ii) The following form shall be used for patients covered under a per diem reimbursement system:
DISCHARGE NOTICE
DATE /__/__
READ THIS LETTER CAREFULLY—IT CONCERNS YOUR PRIVATE INSURANCE
BENEFITS OR MEDICAID BENEFITS OR IF YOU ARE UNINSURED
PATIENT NAME: __________ PRIMARY PAYOR
AT DISCHARGE:
ATT.
PHYS.:
______
MR NO.:
ADM DATE:
___
/
___
/
___
Dear Patient:
Your doctor and the hospital have determined that you no longer require care in the hospital and will be ready for discharge on:
Day of Week
__
/
Date /
__
IF YOU AGREE with this decision, you will be discharged. Be sure you have already received your written discharge plan which describes the arrangements for any health care you may need when you leave the hospital.
IF YOU DO NOT AGREE and think you are not medically ready for discharge or feel that your discharge plan will not meet your health care needs, you or your representative may request a review of the discharge decision by contacting your review agent indicated on the reverse side of this page.
IMPORTANT NOTICE ABOUT THE PAYMENT FOR YOUR CARE
• If your hospital care is covered by private health insurance, you may be charged directly while you remain in the hospital while the discharge review is being conducted. Whether you have to pay during this period will depend on your private health insurance benefits and if the review agent agrees with you that you need to stay in the hospital.
• If your hospital care is covered under the Medicaid program, Medicaid will pay for the days you remain in the hospital while the discharge review is being conducted.
IF YOU WOULD LIKE A REVIEW, you should immediately, but not later than noon of
(Day and Date)
call the telephone number checked off on the reverse side of this page.
IF YOU CANNOT REQUEST THE REVIEW YOURSELF, and you do not have a family member or friend to help you, you may ask the hospital representative at extension
, who will request the review for you.
IF YOU REQUEST A REVIEW, the following will happen:
1. The review agent will ask you or your representative why you or your representative think you need to stay in the hospital and also will ask your name, admission date and telephone number where you or your representative can be reached.
2. After speaking with you or your representative and your doctor and after reviewing your medical record, the review agent will make a decision which will be given to you in writing.
IF THE REVIEW AGENT AGREES WITH THE DISCHARGE DECISION, you will be financially responsible for your continued stay after noon of the day you or your representative has been notified of the review agent's decision.
IF THE REVIEW AGENT AGREES THAT YOU STILL NEED TO BE IN THE HOSPITAL: for Medicaid patients, Medicaid benefits will continue to cover your stay; for private health insurance patients, coverage for your continued stay is limited to the scope of your private health insurance policy.
NOTE: If you miss the noon deadline mentioned on the first page of this notice, you may still request a review. However, if the review agent disagrees with you, you will be financially responsible for the days of care beginning with the proposed discharge date.
If you would like a review of your hospital stay after you have been discharged, you may request a review by the review agent within 30 days of the receipt of this notice or seven days after receipt of a complete bill from the hospital, whichever is later, by writing to the review agent.
I have received this notice on behalf of myself as the patient or as the representative of the patient:
Signature
__
/
Date /
__
Time
Relationship
(10) Notice that inpatient hospital services is no longer medically necessary. For purposes of subparagraph (3)(ii) of this subdivision, a hospital shall utilize the following notice:
HOSPITAL LETTERHEAD
DATE /__/__
CONTINUED STAY DISCHARGE NOTICE
(ATTENDING PHYSICIAN AGREES/REVIEW AGENT AGREES)
READ THIS LETTER CAREFULLY—IT CONCERNS YOUR INSURANCE
BENEFITS OR MEDICAID BENEFITS
PATIENT NAME:
PRIMARY PAYOR:
ADDRESS:
ATT.
PHYS.:
MR NO.:
ADM. DATE: __/__/__
Dear Patient:
After careful review of your medical record and consideration of your own views regarding medical condition, the (name of review agent) (the review agent approved by the Department of Health) has agreed with the hospital that you no longer require care in the hospital because you are ready for discharge.
IF YOU AGREE with this decision, you should discuss with your doctor the arrangements for any further health care you may need. This means if you have health insurance benefits or Medicaid benefits, these benefits will no longer pay for any additional hospital days as of:
Day of Week
__
/
Date /
__
IF YOU DO NOT AGREE THAT YOU ARE READY FOR DISCHARGE, IMMEDIATELY AFTER RECEIPT OF THIS NOTICE YOU OR YOUR REPRESENTATIVE MAY CALL THE (name of review agent) AT (phone no.) TO REQUEST AN IMMEDIATE REREVIEW OF YOUR MEDICAL RECORD.
If you cannot request the reconsideration yourself and you do not have a representative to help you, you may notify the hospital representative at extension __ to request the reconsideration to you. In either case, the individual review agent approved by the Department of Health will request your name, admission date, and telephone number where you or your representative can be reached. If the individual review agent approved by the Department of Health did not ask your views before, it must do so now.
IF YOU REQUEST A REVIEW, the following will happen:
(1) You or your representative will be informed in writing of the results of the review.
(2) IF THE REVIEW AGENT AGREES WITH THE HOSPITAL's DECISION that you are ready for discharge or that your condition could be safely treated in another setting and you have health insurance benefits or Medicaid benefits, your health insurance benefits or Medicaid benefits will PAY FOR YOUR STAY ONLY UNTIL NOON OF THE NEXT DAY AFTER YOU OR YOUR REPRESENTATIVE HAVE BEEN NOTIFIED.
(3) If the review agent determines that you still need to be in the hospital, for purposes of payments under health insurance or Medicaid benefits, your continued stay will be considered necessary and appropriate.
IN EITHER CASE (2 OR 3), YOU WILL NOT HAVE TO PAY FOR ANY ADDITIONAL HOSPITAL DAYS UNTIL YOU HAVE BEEN NOTIFIED OF THE REVIEW AGENT DETERMINATION.
NOTE: If you miss the noon deadline mentioned on the reverse side of this notice, you may still request a review during your hospital stay. However, if the review agent rules against you, you will be financially responsible starting on the date you receive the notice. Of course, if the review agent determination is in your favor, you are not liable for payment for the extra days.
If you would like a review of your hospital stay after you have been discharged, you may request an individual review agent review within 30 days of receipt of this notice or seven days after receipt of a complete bill from the hospital, whichever is later, by writing to the review agent.
(REVIEW AGENT NAME/ADDRESS)
(Hospital Representative Signature)
(Date)
(Time)
If your hospital stay is not covered under the per case payment system, you may still request a discharge review. However, you will continue to be charged for hospital services during the review process.
IF YOU HAVE ANY DIFFICULTY UNDERSTANDING THIS NOTICE OR IF YOU NEED MORE INFORMATION, YOU MAY CALL THE REVIEW AGENT DIRECTLY
AT: (Telephone No.)
I have received this notice on behalf of myself as the patient or as a representative of the patient to whom it is addressed:
Signature
__
/
Date /
__
Time
Relationship
cc: Attending Physician
Hospital Billing Office
(11) The provisions of this subdivision shall apply to hospital inpatients admitted on and after January 1, 1988.
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.9 Governing authority or operator
(a) The governing authority or operator is the party responsible for the operation of a medical facility.
(b) The governing authority or operator shall mean:
(1) the policy making body of a government agency;
(2) the board of directors or trustees of a not-for-profit corporation;
(3) the officers, directors and stockholders of a business corporation; and
(4) the proprietor or proprietors of a proprietary medical facility.
(c) An individual, partnership or corporation which has not received establishment approval may not participate in the total gross income or net revenue of a medical facility.
(d)
(1) Except as provided in section 405.3 of this Title, the governing authority or operator may not contract for management services with a party which has not received establishment approval.
(2) The criteria set forth in this paragraph shall be used in determining whether there has been an improper delegation to the management consultant by the governing authority or operator of its responsibilities:
(i) authority to hire or fire the administrator or other key management employees;
(ii) maintenance and control of the books and records;
(iii) authority over the disposition of assets and the incurring of liabilities on behalf of the facility;
(iv) the adoption and enforcement of policies regarding the operation of the facility.
(3) The criteria set forth in paragraph (2) of this subdivision shall not be the sole determining factors, but indicators to be considered with such other factors that may be pertinent in particular instances. Professional expertise shall be exercised in the utilization of the criteria. All of the listed indicia need not be present in a given instance for there to be an improper delegation of authority.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.3 Application procedures and requirements
(a) These procedures shall apply to the following:
(1) applications for review and approval of regulated activities, including renewals of approvals of regulated activities. An application for renewal of an approval of a regulated activity shall be submitted to the department no less than 180 days prior to the expiration of the approval. This deadline shall apply unless stated otherwise in a special condition of the approval;
(2) applications for review and approval of a substantial alteration or modification of any regulated activity;
(3) applications for review and approval of any substantial alteration or modification of a noncomplying regulated activity; and
(4) applications for variances pursuant to Subpart 128-6 of this Part.
(b) The applicant shall meet the following requirements:
(1) No person shall undertake any activity listed in section 128-1.4 of this Part which requires the review and approval of the department without first obtaining written approval from the department, except where a temporary emergency approval has been obtained from the department pursuant to section 128-2.4 of this Subpart.
(2) Any person proposing to undertake any activity listed in section 128-1.4 of this Part which requires the review and approval of the department, shall submit to the department, at the address of the department representative for the area where the regulated activity is to be undertaken set forth in section 128-1.5 of this Part, an application for review and approval which includes a plan of the activity which meets the requirements of this subpart and any additional requirements for the specific activity set forth in these rules and regulations. Failure by the applicant to submit information to the department or to follow the department procedures set forth in these rules and regulations is sufficient grounds to deny the approval.
(3) Any person seeking approval of an activity may be subject to such terms and conditions as the department may require, including time limitations and limitations on transfer of the approval given by the department.
(4)
(i) An applicant shall affirmatively state in the application whether any enforcement action has been commenced during the five years preceding the application against the applicant, or any principal or affiliate of the applicant, for alleged violations of law related to the specific regulated activity for which the approval is sought, or related to the facility or site at which the activity is located. The applicant shall supply the following information with respect to each enforcement action: the agency or entity commencing the action, the date of commencement, the facility location and address where the alleged violation occurred, and disposition of the action.
(ii) Failure to fully and accurately disclose any material information required to be disclosed pursuant to subparagraph (i) of this paragraph shall be a basis for the department to deny a permit application.
(iii) Failure to cure any adjudicated violation of this Part or any law, rule or regulation enforced by the department shall be a basis to deny a permit application.
(iv) If the department or the city has commenced an enforcement action against the applicant for violations of law related to the facility or site at which the activity for which the approval is sought is located, the department may suspend processing of the application until such alleged violations are cured.
(5) Any property owner may request that the department perform a site visit and evaluation to determine and flag the presence of a watercourse, reservoir, reservoir stem or controlled lake on the owner's property. If the property owner supplies the department with a surveyor's map of the property which includes a representation of the flagged watercourses, reservoirs, reservoir stems or controlled lakes identified by the department, the department shall confirm or amend the findings upon the surveyor's map as soon as is practicable. A confirmed survey map shall be binding upon the department for five years following the date of the confirmation.
(6) If an applicant for department review and approval of a regulated activity requests that the department conduct a site visit and evaluation to determine and flag the presence of a watercourse, reservoir, reservoir stem or controlled lake on the applicant's property the department shall do so as soon as is practicable. If the applicant supplies the department with a surveyor's map of the property which includes a representation of the flagged watercourses, reservoirs, reservoir stems or controlled lakes identified by the department, the department shall confirm or amend the findings upon the surveyor's map within 20 business days of receipt thereof. A confirmed survey map shall be binding upon the department for five years following the date of the confirmation. The absence of a department confirmed surveyor's map will not cause an application to be considered incomplete.
(c) An application shall contain the following information:
(1) An application for the review and approval of any activity listed in section 128-1.4 of this Part shall provide a description of the activity, the location and topography of the area of the activity, identification of any existing structures at the location, and any engineering, construction or other plans which detail the methods to be used in undertaking the activity such that it shall meet the requirements of this Subpart and any additional requirements for the specific activity set forth in these rules and regulations.
(2) An application for review and approval of any activity listed in section 128-1.4 of this Part shall include a copy of any Environmental Assessment Form (EAF), and either a Draft Environmental Impact Statement (DEIS) or a determination of non-significance by the lead agency, where such documents are prepared pursuant to article 8 of the Environmental Conservation Law and the rules and regulations promulgated thereunder.
(3) When a regulated activity requires a related approval from any other agency or more than one approval from the department, the application for review and approval shall include a list of such approvals which the applicant knows to be required, and a statement of the status of any required approval at the time of filing of the application with the department.
(d) Review and approval procedures.
(1) The applicant proposing to engage in any activity listed in section 128-1.4 of this Part which requires the review and approval of the department shall certify in writing that she or he believes that the application is complete and in compliance with the requirements of this Subpart and any additional requirements for the specific activity set forth in these rules and regulations.
(2) An application is complete when it is determined by the department to contain sufficient information for the purpose of commencing review of the application. The department retains the right to seek additional information in order to enable the department to make a determination pursuant to these rules and regulations. Within 10 days of receiving an application for review and approval of a conventional individual sewage treatment system to be installed on an individual lot which is not within a subdivision, or within 20 days of receiving any other type of application for review or approval, the department shall either:
(i) notify the applicant in writing that the application is complete and that the department shall commence its review; or
(ii) notify the applicant in writing that the application is incomplete and specifically request all additional information from the applicant as the department deems necessary. if additional information is requested or comments are issued by the department that need to be addressed by the applicant, the 20-day period described in paragraph (4) of this subdivision or the 45-day period described in paragraph (5) of this subdivision shall not commence to run. The department shall notify the applicant in writing within 10 days of receiving the additional information that has been requested either that the application is complete and that the department has commenced its review or that further information is required.
(iii) Except in cases where the applicant has submitted false or misleading information or where a change in relevant law has occurred or changes have been proposed for the project, the department may require further information based only upon the additional information submitted by the applicant or new issues raised by such information. In addition, the department may also require further information based on a change in ownership of the property, the identity of the applicant, or the identity of the applicant's owners, principals, shareholder, directors, or officers.
(3) If the department fails to notify an applicant in writing of its determination as to the completeness or incompleteness of the application within the time periods set forth in paragraph (2) of this subdivision, the applicant may notify the department of its failure by means of certified mail, return receipt requested, to the local department representative identified in section 128-1.5 of this Part, who is responsible for processing the application and a copy to the engineering section. If the department fails to notify the applicant of its determination as to the completeness or incompleteness of the application within 10 business days of receiving the notice, the application shall be deemed complete as of the 11th day.
(4) The department shall notify the applicant in writing of its determination within 20 days of determining that an application for review and approval of a conventional individual sewage treatment system to be installed on an individual lot which is not within a subdivision is complete pursuant to the procedures set forth in paragraph (2) of this subdivision unless the department and the applicant mutually agree in writing upon an extension of the 20-day review period.
(5) For all applications for review and approval, other than for a conventional individual sewage treatment system to be installed on an individual lot which is not within a subdivision, the department shall notify an applicant in writing of its determination within 45 days of notifying the applicant that the application is complete pursuant to the procedures set forth in paragraph (2) of this subdivision unless the department and the applicant mutually agree in writing upon an extension of the 45-day review period.
(6) If the department fails to notify an applicant in writing of its determination within the 20-day time period set forth in paragraph (4) of this subdivision or the 45-day time period set forth in paragraph (5) of this subdivision, the applicant may notify the department of its failure by means of certified mail, return receipt requested to the local department representative identified in section 128-1.5 of this Part who is responsible for processing the application and a copy to the engineering section. The notice shall contain the applicant's name, location of the proposed project, the office in which the application was filed, and a statement that a decision is sought in accordance with this subdivision. Any notice failing to provide this information will not invoke this provision.
(i) If the department fails to notify the applicant of its decision within 10 business days of the receipt of such notice, the application shall be deemed approved subject to the standard terms and conditions applicable to such an approval.
(7) Notwithstanding the time period for notifying an applicant of the department's determination specified in paragraphs (4)-(6) of this subdivision, if a lead agency has determined that a project may have a significant effect on the environment for purposes of the State Environmental Quality Review Act (SEQRA), such time periods shall be suspended pending receipt from the lead agency of either a Final Environmental Impact Statement (FEIS) or a determination of nonsignificance. Upon receipt of either document, the time periods shall resume, provided, however, that the department shall have at least 20 days to notify an applicant of its determination.
(8) Notwithstanding the time periods for decisions specified in this subdivision, the department may condition an approval on the applicant providing satisfactory proof of any bonds required by the department within 30 days of the applicant receiving the conditional approval from the department.
(9) Any notice required or permitted to be given by the department under this Subpart shall be given in such manner designed to reach the applicant, as the department deems appropriate, and may include, but is not limited to, regular mail, certified mail return receipt requested, or telecopier.
Chapter I STATE SANITARY CODE
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.6 Presiding officer to convene local board and take action directed
Upon the receipt of such notice from the State Commissioner of Health, the presiding officer of the local board of health shall promptly convene such local board, which shall take the action directed by the said commissioner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.8 Notification of criminal charges or convictions incurred subsequent to hiring
(a) Upon receiving notification from the division that there is a pending criminal action or proceeding, or conviction, with regard to an employee, the department shall promptly notify an authorized person(s) of a provider of the allegation or new conviction.
(b) The provider shall determine whether the action or proceeding or conviction presents a threat to the health, safety and well-being of a resident or patient.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.8 Subpoenas
The commissioner or any person designated by him for the purpose may issue subpoenas and administer oaths in connection with any investigation or hearing conducted under section 206-a of the Public Health Law and shall issue subpoenas at the request of and in behalf of a party.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.66 Sumpwams Water Works Company, town of Babylon
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well, located on land owned by the Sumpwams Water Works Company and situated on a plot of ground in the town of Babylon near the point where the central branch of the Long Island Railroad crosses Albins Avenue, and which forms the source of the public water supply of the incorporated villages of Babylon and Lindenhurst and to that part of the town of Babylon known as West Babylon, Suffolk County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage of the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the Sumpwams Water Works Company.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Sumpwams Water Works Company.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the Sumpwams Water Works Company.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of the well of the public water supply of the Sumpwams Water Works Company.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of the well of the public water supply of the Sumpwams Water Works Company.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Sumpwams Water Works Company, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from the well of the public water supply of the Sumpwams Water Works Company.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of the well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of the well of the public water supply of the Sumpwams Water Works Company.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of the well of the public water supply of the Sumpwams Water Works Company.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Sumpwams Water Works Company upon which the wells of the public water supply of the incorporated Villages of Babylon and Lindenhurst and that part of the Town of Babylon known as West Babylon are located, and no person or persons shall enter in or upon such property except the duly authorized representatives of said company in the official performance of their duties of supervision or maintenance of this public water supply or except such other persons as may be authorized to enter said property by the Sumpwams Water Works Company.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of the well of the public water supply of the Sumpwams Water Works Company.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the well of the public water supply of the Sumpwams Water Works Company.
(j) Inspections.
The duly authorized officials of the Sumpwams Water Works Company or such other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or their duly authorized representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Sumpwams Water Works Company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Sumpwams Water Works Company to promptly notify the State Commissioner of Health of such violations. The Sumpwams Water Works Company shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.8 Default
(a) A recipient of an award will be considered in default if the recipient has not been granted a waiver or deferral by the Commissioner of Health and:
(1) the scholarship award is rescinded after disbursal of scholarship monies on the recipient's behalf; or
(2) the recipient is not available to fulfill his/her service obligation on the reporting date; or
(3) the recipient fails to complete a training program; or
(4) the recipient resigns, is dismissed from employment or otherwise fails, refuses or is unable to fulfill the service obligation.
(b) An individual found to be in default will be required to pay the State, within five years from the date of default, all monies received, plus interest, plus liquidated damages as determined by the following formula:
A =2B (T-S)/T
“A” is the amount the State is entitled to recover; “B” is the sum of all payments made to the recipient and the interest on such amount which would be payable if at the time such awards were paid they were loans bearing interest at the maximum prevailing rate determined by the Higher Education Services Corporation; “T” is the total number of months in the recipient's period of obligated service; and “S” is the number of months of service actually rendered by the recipient.
(c) Department of Health shall advise the Higher Education Services Corporation of any default, and the Higher Education Services Corporation shall collect repayments and, where indicated, initiate action for prosecution to recover monies owed the State.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.2 Laboratory inspection and reference fee
Each laboratory issued a permit by the department pursuant to section 575 of the Public Health Law shall be charged an annual laboratory inspection and reference fee.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.5 Technical advisory groups
The commissioner shall appoint appropriate technical advisory groups to be comprised of members with expertise in the area of innovations in medical technology, the medical profession, and health care industry to review, and make recommendations relating to, the selection of applications for demonstration projects. The technical advisory groups shall meet as appropriate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.6 Audits
(a) All fiscal and statistical records and reports shall be subject to audit, which must commence no later than six years from the date of filing or the date when due, whichever is later. There shall be no limitation in situations involving possible fraud or where the facility or its agent prevents the Department of Health or the Department of Social Services from performing an audit. Notification by either department to the facility of the department's intent to audit shall toll the six-year period.
(b) All underlying books, records and documentation which form the basis for fiscal and statistical reports filed by the facility with the department, shall be kept and maintained by the facility for not less than six years from the date of filing or the date upon which the fiscal and statistical records were to be filed, whichever date is later. Any rate of payment certified or approved by the commissioner prior to audit shall represent a provisional rate until an audit is performed and completed, at which time such rate or adjusted rate shall represent the audit rate.
(c) Rate revisions resulting from audits shall be retroactive to the audited rate period or periods. Any resulting overpayments or underpayments shall be corrected by retroactive adjustment of the provisional rate paid, based upon the period audited.
(d) The commissioner may promulgate rate revisions based upon audits completed by the department or other State agencies. Unless otherwise indicated, such audits shall not be considered final and shall not preclude conduct of a complete audit by the Department of Health, Department of Social Services or their agents.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.14 Activities program
This functional reporting center must contain all the expenses associated with providing recreational and leisure-time facilities, activities and services to patients both at the facility and on special group activities including trips for recreational purposes, excluding transportation costs. This department is supervised by personnel trained for administration of an activities program. Additional activities encompassed by this functional reporting center include but are not limited to the following: coordinating and scheduling activity programs; arranging for special group activities and trips; arranging for transportation to activities; supervising activity programs; participating in discharge coordination as required by code.
(a) Standard unit of measure: total number of participants in program.
Count one participant for each person participating in each activity.
(b) Data source.
The total number of participants in the program shall be determined from the activities logs.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.4 Registration of shared health facilities required
(a) No shared health facility shall be operated in New York State after the effective date of this Part unless the facility operator shall possess a valid facility registration issued by the department.
(b) The registration may specify the kind or kinds of medical care, services or supplies which may be provided in the shared health facility. Such determinations may be based on the availability of space, equipment and appropriate trained personnel in the facility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.107 New York Inter-Urban Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 72 of the Public Health Law heretofore set forth shall apply to that portion of the drainage area of Mamaroneck Creek which forms or is tributary to the source of water supply of the New York Inter-Urban Water Company of Westchester County, N. Y. They shall also apply to the reservoirs and to the coagulation basins of the said company.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to any reservoir or coagulation basins of the New York Inter-Urban Water Company.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and coagulations basins), stream, ditch, gutter or other channel or permeable pipe or conduit of every kind, the water of which when running, whether continuously or occasionally, eventually flows or may flow into the water supply of the said New York Inter-Urban Water Company.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet of any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company, except the properly constructed and operated sewage treatment plant as hereinafter set forth in subdivision (e), provided, however, that the property on which the privy, privy vault, pit, cesspool or any other receptacle intended for the deposit of human excreta is built or to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle, used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained within the limits of such property, shall be placed as far as possible from the reservoir or watercourse and shall be especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight vessels or receptacles are provided, they shall be placed in watertight concrete or masonry receptacles and shall be located as far as practicable from the reservoir or watercourse. All receptacles referred to in this paragraph shall be constructed only with the approval of and under the supervision of the New York Inter-Urban Water Company and so located that the tops of such receptacles shall be above the highest known water level of Mamaroneck Creek or tributaries.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta is especially constructed and made watertight and located nearer the reservoir or watercourse than the distances named in paragraph (1) of this subdivision, such receptacle shall be emptied at regular intervals and disinfected as often as may be necessary to maintain it in a proper sanitary condition and to effectually prevent any overflow and in the case of a property occupied by the owner during the summer only, the said receptacle shall be emptied at least once every fall at the end of the summer season, disinfected with lime and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the directions of the New York Inter-Urban Water Company and in such a manner as to effectually prevent any pollution of the public water supply of the New York Inter-Urban Water Company and in a manner provided hereinafter in paragraphs (6) and (7) of this subdivision.
(4) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 150 point of any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company.
(5) Every privy, privy vault, pit, cesspool or other receptacle or place, used for the temporary storage of human excreta, which is constructed, located or maintained within the aforesaid 150 feet, horizontal measurement, of the water line of any reservoir or the edge, margin or precipitous bank of any watercourse of the water supply of the New York Inter-Urban Water Company, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth in paragraphs (6) and (7) of this subdivision.
(6) The excreta collected in the aforesaid receptacles referred to in paragraph (5) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary, in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(7) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in any aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of the New York Inter-Urban water supply.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or any aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse in an imperfectly purified condition, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) [House slops, bath water, garbage, sewage.]
(1)
(i) No house slops, bath water, sewage nor excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company, nor shall any such matters be placed, led, discharged or allowed to escape onto the surface of the ground or into the ground beneath the surface within 150 feet of any such reservoir or watercourse except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (7) of subdivision (c).
(ii) Subparagraph (i) of this paragraph, however, shall not prohibit the discharge into a watercourse tributary to the water supply of said company of a satisfactorily purified effluent from a modern sewage treatment plant, constructed in strict accordance with plans approved by the State engineer and in accordance with permit issued by this department, nor shall this subparagraph prohibit the location of such sewage treatment plant within the limiting distance given above.
(2)
(i) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from creameries, cheese factories, laundries nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have beeen washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company, nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of the ground or into the ground beneath the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company within 100 feet of any such reservoir or within 75 feet of any such watercourse, except into watertights vessels or receptacles, the contents of which are to be removed as provided by paragraph (7) of subdivision (c).
(ii) Subparagraph (i) of this paragraph, however, shall not prohibit the discharge into a watercourse tributary to the water supply of said company of a satisfactorily purified effluent from a modern sewage or waste treatment plant, constructed in strict accordance with plans approved by the State engineer and in accordance with permit issued by this department, nor shall this subparagraph prohibit the location of such sewage or waste treatment plant within the limiting distance given above.
(3) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company.
(e) [Approval of sewage treatment plants.]
No sewage or waste treatment plant, the effluent from which is to be discharged or allowed flow directly or indirectly into Mamaroneck Creek or any watercourse tributary thereto, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved by the State engineer and a permit issued by the State Commissioner of Health allowing the discharge of such effluent and a copy of the plans, as approved, filed with the New York Inter-Urban Water Company.
(f) Bathing, manure, compost, animals, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or 50 feet from any watercourse of the water supply of the New York Inter-Urban Water Company; and none of the above-named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having been passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from any reservoir or 200 feet from any watercourse of the water supply of the New York Inter-Urban Water Company; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 100 feet of any such reservoir or 50 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(g) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the water supply of the New York Inter-Urban Water Company; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(h) Fishing and boating.
No fish shall be taken from any reservoir or Silver Lake nor shall any person fish in any reservoir or Silver Lake or through the ice upon the same nor trespass upon the waters of any reservoir or Silver Lake or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the New York Inter-Urban Water Company in the exercise of their duties in the management and operation of the reservoirs or Silver Lake.
(i) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or 250 feet of any watercourse.
(j) Cemeteries.
No interment of a human body shall be made within 300 feet of any reservoir or watercourse.
(k) Inspections.
The New York Inter-Urban Water Company, through its superintendent or other duly authorized official, shall maintain systematic and thorough inspection of the reservoirs, streams and of the entire drainage area tributary thereto for the purpose of determining whether the above rules are being complied with. At least four such inspections shall be made each year and such others as may directed by the State Commissioner of Health. A full and detailed report of each such inspection, including a statement of such violation or noncompliance with the rules, shall be submitted in writing to the State Commissioner of Health within 10 days of the completion of such inspection.
(l) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.26 Statewide Planning and Research Cooperative System (SPARCS)
Each general hospital shall be assessed an annual fee calculated on the basis of the hospital's proportionate share of the sum of total costs reported by all general hospitals in the most recent calendar year for which certified data are available. Such amount shall not exceed one tenth of one percent of the total certified cost of the hospital. The commissioner shall inform each such hospital of its actual fee to support the statewide planning and research cooperative system and each hospital shall submit such fee on a quarterly basis to be received by the commissioner not later than the 15th of February, May, August and November of each year. Failure to submit such fees in accordance with this schedule may result in a two-percent reduction in the affected hospital's rate beginning on the first day following the due date and continuing until the last day of the calendar month in which said fees are submitted. These funds shall be pooled on a statewide basis and will be restricted and used to support the costs of the statewide planning and research cooperative systems.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.209 Modernization
Includes the alteration, expansion, major repair (to the extent permitted by regulations), remodeling, replacement and renovation of existing buildings (including initial equipment thereof and the replacement of obsolete equipment of existing buildings).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.6 Registrations
(a) Funeral firm registrations.
No funeral firm shall be registered from a funeral establishment that is not in compliance with section 77.5 of this Part, provided that nothing herein contained shall be construed or interpreted to prohibit the practice of funeral directing by more than one registered funeral firm from the same funeral establishment.
(b) Corporations.
Application for registration of a new corporate funeral firm must be accompanied by a true copy of the certificate of incorporation as filed with the Secretary of State; a copy of the notice from the Secretary of State showing that the corporation has been duly incorporated; the name, residence address and title of each of its officers and directors; the name and residence address of each stockholder and other person, firm and corporation having a 10 per centum or greater proprietary, beneficial, equitable or credit interest; and the designation of a manager, which shall, unless otherwise acceptable to the department, be in the form of a certified copy of a resolution of the board of directors appointing such manager. A corporation which changes its name shall file with the Department of Health true copies of the amended corporate name certificate and filing receipt from the Secretary of State.
(c) Individual proprietor.
Application for registration of a funeral firm to be operated under the individual name of the applicant must be accompanied by a certificate executed under penalty of perjury by the applicant certifying that he is the only person having a proprietary or financial interest in the business.
(d) Estates.
Application for registration of a funeral firm operated by the estate of a deceased funeral director or undertaker shall be accompanied by an administrator's or executor's certificate, the names and addresses of all executors or administrators, and a certified copy of the assumed business name certificate as filed in the county clerk's office. Such duly appointed estate representatives, subject to the provisions of the Estates, Powers and Trusts Law and the Surrogate's Court Procedure Act, may operate the funeral firm for a period of not more than 30 months from the date of death of the funeral director, provided the estate representative files a designation of, and registers, a licensed manager. In the event the funeral director or undertaker conducted 50 or fewer funerals during the 12 months immediately preceding his death, the estate representative may temporarily appoint any funeral director or undertaker to act as manager for the first six months following the death of the funeral director or undertaker, after which period a new manager shall be designated and registered with the department as hereinabove provided.
(e) Partnerships.
Application for registration of a funeral firm operated by a partnership shall be signed by all partners and shall be accompanied by a certified copy of the certificate of assumed business name, as filed in the office of the county clerk, and by a certificate executed under penalty of perjury by the applicants certifying that they are the only persons having a proprietary or financial interest in the business.
(f) Assumed name.
Application for registration of a funeral firm under a new assumed business name must be accompanied by a certified copy of the assumed business name certificate as filed in a county clerk's office.
(g) Changes.
The individual, partnership or corporate owner or estate representative of a funeral firm operating from a funeral establishment shall notify the department in writing within 10 days of any change in name, address, ownership or other legal status. A change in ownership shall be considered a first registration for fee purposes under section 3428 of the Public Health Law.
(h) Individual licensee registration; special provisions.
(1) The department shall issue a single certificate of biennial registration to any person who holds and registers both an undertaker and embalmer license, upon payment of the fees required for such license by the Public Health Law.
(2) Every person entitled to engage in the business and practice of funeral directing, undertaking or embalming shall at all times while actively so engaged or while the premises of any funeral establishment, carry on his person a current certificate of biennial registration duly issued to him by the department. He shall exhibit such certificate when so requested by any of the following:
(i) a representative of the State or municipal government engaged in the administration or enforcement of law;
(ii) a representative of a cemetery, crematory, hospital, common carrier or casket showroom;
(iii) a person having lawful possession of a dead human body, the release of which is sought by such licensee.
(3) Every registrant shall give notice in writing to the department of any change his residence address within 10 days after such change of residence.
(i) Registration periods.
(1) The biennial registration of licensed funeral directors, embalmers and undertakers shall be renewable July first of each even year.
(2) The biennial registration of funeral firms shall be renewable July first of each odd year.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.170 Hospital patient
An individual receiving, in person or otherwise (telemetry), hospital-based or coordinated medical services for which the hospital is responsible.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MOBILE FOOD SERVICE ESTABLISHMENTS MOBILE FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-4.32 Definition of person
A person, as used by this Subpart, is an individual, firm, estate, partnership, company, corporation, trustee, association, or any public or private entity.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.4 Death records; disclosure
(a) No certified copy or certified transcript of a death certificate shall be subject to disclosure under article six of the Public Officers Law.
(b) A certified copy of a death certificate or a certified transcript of a death certificate shall be issued only:
(1) pursuant to the order of a court of competent jurisdiction on a showing of necessity; or
(2) upon specific request of the spouse, sibling, children, or parents of the deceased or the lawful representative of such persons; or
(3) when a documented need to establish a legal right or claim has been demonstrated; or
(4) when a documented medical need has been demonstrated; or
(5) upon specific request by municipal, State or Federal agencies for statistical or official purposes; or
(6) when needed for medical or scientific research approved by the State Health Commissioner; and
(7) when needed for statistical or epidemiological purposes approved by the State Health Commissioner.
(c) Commencing on January 1, 1988 all death certificate forms shall contain a confidential section which shall list the cause and circumstances of the death. When a certified copy of a death certificate or a certified transcript of death certificate is issued, the confidential section shall be detached and no information from that section shall be disclosed in any other form or manner, except:
(1) pursuant to the order of a court of competent jurisdiction on a showing of necessity; or
(2) upon specific request for such information by the spouse, children, or parents of the deceased or the lawful representative of such persons; or
(3) when a documented medical need for such information has been demonstrated; or
(4) when a documented need for such information for the purpose of establishing a legal right or claim has been demonstrated; or
(5) upon specific request for such information by municipal, State or Federal agencies for statistical or official purposes; or
(6) when such information is needed for medical or scientific research approved by the State Health Commissioner; and
(7) when such information is needed for statistical or epidemiological purposes approved by the State Health Commissioner.
(d) A certification of death containing only the name, the date of death and the place of death of the person to whom it relates shall be issued when required for a proper purpose. A proper purpose shall not exist when the record is requested for commercial or profitmaking purposes or to satisfy idle curiosity.
(e) The request for a certified copy of a death certificate, a certified transcript of a death certificate or a certification of death shall include such documentation required by the State Health Commissioner to establish the stated need.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.3 Environmental assessment
(a) By September 1, 2016, all covered facilities must perform an environmental assessment of the facility using forms provided or approved by the department, unless an environmental assessment was performed on or after September 1, 2015.
(b) Environmental assessments shall be updated annually and under the following conditions:
(1) in the event that one or more cases of legionellosis are, or may be, associated with the facility;
(2) upon completion of any construction, modification, or repair activities that may affect the potable water system;
(3) expansion or relocation of a facility’s hematopoietic stem cell transplant and solid organ transplant units; or
(4) any other conditions specified by the department.
(c) The facility shall retain copies of the completed environmental assessment form in accordance with section 4-2.6 of this Subpart.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.32 Protection of finished water storage facilities
Finished water storage facilities which deliver water to the user without later treatment shall be covered, or the water from an uncovered finished water storage facility shall be continuously treated to achieve inactivation or removal of at least 99.99 percent virus, 99.9 percent Giardia lamblia, and 99 percent Cryptosporidium in a manner approved by the State, in accordance with section 5-1.22(b) of this Subpart, before being discharged to the distribution system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.32 Project construction
(a) All payments made by a hospital after mortgage closing for construction and development costs require the written approval of the State Department of Health. Payments may only be made for expenditures authorized in the development cost and capital requirement budget approved by the State Department of Health. Payments may be permitted monthly from either mortgage loans or capital contribution funds in accordance with procedures approved by the State Department of Health. Any capital or development costs determined by the State Department of Health to be ineligible under the 28-B program will not be approved for payment as a project cost. All payment approvals shall be subject to and conditioned upon audit by the State Department of Health.
(b) From mortgage closing until completion of the development period, the hospital may only enter into construction contracts contemplated by the approved tract and/or only with the prior approval of the department.
(c) Acceptable surveys and title reports, or satisfactory updates of such acceptable to the State Department of Health and the State Housing Finance Agency or the State Medical Care Facilities Finance Agency, free and clear of all exceptions not approved by the State Department of Health, shall be submitted prior to approval of payments after mortgage closing.
(d) Satisfactory evidence of identification of materials and insurance coverage in a form and amount acceptable to the State Department of Health shall be furnished for any project materials stored off the site of the project.
(e) All construction contract changes shall have prior written State Department of Health approval, except changes that must be started immediately to correct emergency field conditions. Requests for change orders from contingency funds may only be approved if required to meet emergency and life safety requirements, unforeseen field conditions or errors and omissions in contract documents. Requested changes of scope or of quality or type of functions, materials or equipment may be approved if the cost and the proposal are reasonable, if funds are available and if the change will not result in an increase in operating cost unless such change is approved by the article 28 process and the State Housing Finance Agency, or the State Medical Care Facilities Finance Agency. All change orders proposed shall contain a statement specifying if the contract completion time is to be changed. The State Department of Health shall limit all change order approvals from contingency funds to those necessary for completion of the project in order to protect the adequacy of the contingency budget.
(f) Acceptance of a restricted donation or a donation in kind which may result in an increase in operational costs shall have the prior approval of the State Department of Health.
(g) The equity funds of a hospital not currently required shall be invested. Such investments shall have the prior approval of the State Department of Health.
(h) Equipment may only be purchased by projects after approval of an equipment list by the State Department of Health. Such list shall be in accordance with the requirements set forth in the State Department of Health “Manual for the Preparation of Equipment Lists”. Unit and total cost approval for all items shall be approved by the State Department of Health.
(i) Final payment for the completion of any contract shall require satisfactory evidence of payment of all sub-contractors and materialmen, the submission of all releases required by the State Department of Health, and such affidavits, certifications and consents of the hospital, the architect, the contractor and the surety as the State Department of Health may require.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.37 Complaints
Information concerning noncompliance with a requirement of this Subpart may be brought forward by any person. Copies of the complaint shall be delivered to the institution concerned and to the commissioner. The institution shall cause the complaint to be investigated and report the results of its investigation and any action thereon promptly to the commissioner. Such further action as the commissioner shall deem appropriate shall be taken by the institution or the commissioner or both, including enforcement action authorized under section 3223 of the Public Health Law and withdrawal of approval of the institutional biosafety committee.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.199 Waiver
The permit-issuing official may waive, in writing, any of the requirements of this Subpart, and the waiver included as a condition of the permit to operate, when it reasonably appears that the public health will not be endangered by such waiver. All such waivers are to be only for the same period as the term of the permit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-3 HEALTH MAINTENANCE ORGANIZATIONS
10 CRR-NY 86-3.1 Definitions
As used in this Subpart, health maintenance organization or HMO means any entity or entities providing a comprehensive prepaid health service plan(s) certified under article 44 of the Public Health Law. IX-C rate refers to individual hospital rates promulgated by IX-C hospital service plans pursuant to formulae certified by the Commissioner of Health. For the purposes of this Subpart, this shall currently mean the rate established for Blue Cross plans under Subpart 86-1, which constitute the only certified rates at this time. In the event that rates are certified by the commissioner for another IX-C plan in any area in which an HMO is situated, the IX-C rate shall mean the rate approved for the Blue Cross plan in that area.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.5 Required treatment
All bottled water facilities packaging water for distribution in New York State must provide satisfactory treatment of each water supply source used.
(a) Minimum treatment of each water supply source used shall be disinfection by chlorination, ozonation, ultraviolet radiation or other disinfection methods as protective of the public health as the above.
(b) The commissioner may, when requested in writing, grant a waiver which is renewable annually, to the disinfection requirement for ground water sources, if:
(1) The record of the bacteriological characteristics for each ground water source demonstrates conformance to the maximum contaminant levels for microbiological contaminants in section 5-6.11 of this Subpart, for the 12 months immediately preceding the date of application for waiver; such record shall be established under procedures provided by the commissioner.
(2) A laboratory, as described in section 5-6.13 of this Subpart is used by the bottling facility to provide monitoring of source and finished product water quality.
(c) Where treatment is provided, all equipment must meet, as a minimum, the standards outlined in Recommended Standards for Water Works.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 93 IMPROPER PRACTICES IN HOSPITAL STAFF APPOINTMENTS AND EXTENSION OF PROFESSIONAL PRIVILEGES
10 CRR-NY 93.1 Filing of complaint
(a) A person claiming to be aggrieved by an improper practice as defined in subdivision 1 of section 2801-b of the Public Health Law may, be himself/herself or his/her attorney, file with the Public Health Council a written complaint which satisfies all of the requirements set forth in section 93.2 of this Part. The complaint must be signed and verified by the complainant personally, or by his/her attorney if the material allegations of the complaint are within the attorney's personal knowledge.
(b) At the time such complaint is filed with the Public Health Council, a copy of the entire complaint, including all attachments and related exhibits, must be filed with the hospital alleged to have committed the improper practice.
(c) An affirmation by the complainant stating that he or she has provided the hospital with a copy of the entire complaint must accompany the complaint being filed with the Public Health Council.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 15.3 Enforcement
(a) Permits and placarding.
(1) Operation of a mgrant farmworker housing facility without a permit is a violation of this Part. The permit-issuing official may order any facility operaing without a permit to close and remain closed until a valid permit for operation of the facility is obtained.
(2) The enforcement procedures delineated in sections 12, 12-a, 12-b, 16, 206, 225, 308, 309, 1303-1305, 1308 and 1330 of the Public Health Law shall be used as appropriate. Where a public health hazard is found, the building or portion of the migrant farmworker housing facility constituting the hazard may be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of the occupants. When a placard is used, it shall be conspicuously posted at each entrance or walkway leading to the portion of the property where the hazard exists. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law.
(3) As soon as possible and in any event within 15 days after placarding a facility, the operator shall be provided with an opportunity to be heard and present evidence that continued operation of the facility does not constitute a danger to the health or safety of the occupants or the public. The hearing shall be conducted by the permit-issuing official or his designated hearing officer.
(4) The permit-issuing official or his designated representative shall inspect the premises within two working days of notification that the hazard has been eliminated, to remove the placards after verifying correction.
(b) Public health hazards.
(1) A public health hazard is any condition which could be reasonably expected to be responsible for illness, physical injury or death.
(2) Any of the following violations are public health hazards which require the permit-issuing official or his designated representative to order immediate correction or to immediately institute action as provided in the law and in this Part:
(i) the condition of the electric service, wiring, or electrical system components is such that an imminent fire or shock hazard exists;
(ii) installation or operation of stoves, including cook stoves, or other heat producing equipment constituting a fire hazard or inadequate venting of fumes;
(iii) failure to provide required fire exits or blockage of a required exit by locking or other obstruction;
(iv) use of construction materials resulting in an imminent fire, or structural safety hazard;
(v) potable water system serving the camp contains contaminants in excess of the levels prescribed in applicable sections of Part 5 of this Title;
(vi) treatment of the camp water system, when required for disinfection or removal of contaminants, is not continuous;
(vii) presence of cross-connections or other faults in the plumbing system which result, or may result in contamination of the potable water supply;
(viii) inadequately treated sewage discharging on the ground surface in an area accessible to camp occupants, or in a manner which may contaminate food service areas, or result in pollution of a ground or surface water supply source;
(ix) storage of hazardous materials, including agricultural chemicals and pesticides, or their containers in a manner which is hazardous to the health or safety of the housing occupants, or contamination of housing by hazardous materials that are hazardous to the health and safety of the housing occupant;
(x) other conditions which constitute a public health hazard.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.13 Campsites
Campsites at a temporary residence shall meet the requirements of Subpart 7-3 of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.4 Use of the application form
(a) The State-approved application form must be completed:
(1) for each applicant upon initial application and recertification, if required; and
(2) documentation may be required when there is a change in status affecting eligibility.
(b) The signature of the individual applying for assistance is required on the State-approved application form. In any case where the applicant is incapable of signing the application because of physical incapability, or mental incompetency, application shall be signed on behalf of such a person by his/her authorized representative.
(c) The State-approved form shall contain the following information, in addition to any other information which the Department of Health may require for the proper administration of the program:
(1) name, gender, date of birth, social security number, marital status, address and telephone number of the applicant;
(2) name and relationship to applicant for applicant's household members;
(3) income information for the applicant and members of the applicant's household; and
(4) information regarding any other health benefits or insurance coverage that is available to the applicant.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 68 POISON CONTROL NETWORK
10 CRR-NY 68.1 New York State poison control network
The New York State poison control network shall consist of general hospitals that have been designated by the commissioner as regional poison control centers.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.7 Hematopoietic progenitor cell processing facilities
(a) If hematopoietic progenitor cells are to be frozen, the following requirements apply:
(1) unless otherwise specifically authorized in writing by the director of the hematopoietic progenitor cell processing facility, hematopoietic progenitor cells shall be frozen within 48-hours of collection using cryopreservation techniques generally accepted by experts in transplantation medicine and meeting the requirements of this Subpart;
(2) until used, hematopoietic progenitor cells shall be stored continuously within a temperature range of minus 196°C to minus 80°C, under one of the following conditions:
(i) in a mechanical freezer reserved for hematopoietic progenitor cells, equipped with an automatic temperature recording device, an audible alarm and a back-up system in the event of unexpected mechanical failure; or
(ii) in a liquid nitrogen freezer reserved for hematopoietic progenitor cells, equipped with an automatic liquid nitrogen level monitor, an audible alarm and a back-up system in the event of unexpected liquid nitrogen loss;
(3) frozen hematopoietic progenitor cells in transit from a processing facility to a transplantation facility or other facility shall be:
(i) maintained, at a minimum, on dry ice or in a liquid nitrogen dry shipper. Storage/transport procedures for the frozen hematopoietic progenitor cells shall be validated, and such validation shall be documented;
(ii) transported as fast as reasonably possible and without any unnecessary delay; and
(iii) used immediately upon arrival or stored as required in paragraph (2) of this subdivision until thawed for use; and
(4) hematopoietic progenitor cell specimens shall be inspected visually at the time of freezing and thawing. If the color or physical appearance is abnormal, the cells shall not be released for transplantation unless authorized, in writing, by the transplantation service director.
(b) Hematopoietic progenitor cells stored in the liquid state shall be maintained at a temperature and for a period of time specified in a protocol approved by the director of the hematopoietic progenitor cell procurement service and/or processing facility.
(c) Storage temperature records for hematopoietic progenitor cells shall be maintained as required in section 58-5.8(c) and (d) of this Subpart, and be made available for inspection by the department for the entire period of storage and for one year afterward.
(d) Unless needed to meet a medical emergency, hematopoietic progenitor cells shall be transported in a leak-resistant, crush-resistant and puncture-resistant container featuring a prominent label which:
(1) identifies the contents as “human blood,” “human hematopoietic progenitor cells” or “human bone marrow”;
(2) describes the contents, the packing agent, if any, and any special precautions necessary in handling such contents; and
(3) contains the name, address and 24-hour telephone number of the person or entity to be contacted in the event that the container is found leaking or damaged, or is misdirected.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.85 Deductible
Under the Medicare program, that portion of covered hospital and medical charges which an insured person must pay before his policy benefits begin. Proposed as a mechanism to discourage over-utilization or to avoid processing small claims.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.88 Food protection during dispensing
The delivery tube or chute and orifice of bulk food vending machines are to be protected from normal manual contact, dust, insects, rodents and other contamination. The design is to divert condensation or moisture from the normal filling position of the container receiving the food. The vending stage of such machines is to be provided with a tight-fitting, self-closing door or cover which is kept closed except when food is being removed. The cup-filling area or platform of controlled-location vending machines does not require a door or cover if there is no opening into the cabinet interior at that point other than for dispensing tube(s) or trapped waste tubing. The dispensing compartment of prepackaged candy and similar product vending machines is to be equipped with a self-closing lid at the vending locations where insect or rodent entry into the machine may occur.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.43 Certified home health care agency ceilings
(a) Effective for services provided on and after April 1, 2011 through March 31, 2012, Medicaid payments for certified home health care agencies (agencies), except for such services provided to children under 18 years of age, shall reflect ceiling limitations determined in accordance with this section. Ceilings for each agency shall be based on a blend of:
(1) the agency's 2009 average per patient Medicaid claim, weighted at 51 percent; and
(2) the 2009 statewide average per patient Medicaid claim for all agencies, as adjusted by the regional wage index factor and by each agency's patient case mix index, and weighted at 49 percent.
(b) Effective for rate periods on and after April 1, 2011, the department shall determine, based on 2009 claims data, each agency's projected average per patient Medicaid claim for the period April 1, 2011 through March 31, 2012, as compared to the applicable ceiling computed pursuant to subdivision (a) of this section. To the extent that each agency's projected average claim is in excess of such ceiling, the department shall reduce such agency's payments for periods on and after April 1, 2011 by an amount reflecting the degree that such agency's projected average claim is in excess of such ceiling.
(c) The regional wage index factor (WIF) will be computed in accordance with the following and applied to the portion of the statewide average per patient Medicaid claim attributable to labor costs:
(1) Average wages will be determined for agency service occupations for each of the 10 labor market regions as defined by the New York State Department of Labor.
(2) The average wages in each region will be assigned relative weights in proportion to the Medicaid utilization for each of the agency service categories as reported in the most recently available agency cost report submissions.
(3) Based on the average wages as determined pursuant to paragraph (1) of this subdivision, as weighted pursuant to paragraph (2) of this subdivision, an index will be determined for each region, based on a comparison of the weighted average regional wages to the statewide average wages.
(4) The department may adjust the regional WIFs proportionately, if necessary, to assure that the application of the WIFs is revenue-neutral on a statewide basis.
(d) Agency specific case mix indexes (CMIs) will be calculated for each agency and applied to the statewide average CMI. Computation of such CMIs shall utilize the episodic payment system grouper and shall reflect:
(1) 2009 adjusted agency Medicaid claims as grouped into 60 day episodes of patient care;
(2) data for each agency patient as derived from the Federal Outcome Assessment Information Set (OASIS) and as reflecting the assignment of such patients to OASIS resource groups;
(3) the assignment of a relative weight to each OASIS resource group;
(4) the assignment of each agency's CMI index based on the sum of the weights for all of its grouped episodes of care divided by the number of episodes.
(e) Ceiling limitations determined pursuant to this section shall be subject to retroactive adjustment and reconciliation. In determining payment adjustments based on such reconciliation, adjusted agency ceilings shall be established. Such adjusted ceilings shall be based on a blend of:
(1) an agency's 2009 average per patient Medicaid claim adjusted by the percentage of increase or decrease in such agency's patient case mix from the 2009 calendar year to the annual period April 1, 2011 through March 31, 2012, weighted at 51 percent; and
(2) the 2009 statewide average per patient Medicaid claim adjusted by a regional wage index factor and the agency's patient case mix index for the annual period April 1, 2011 through March 31, 2012, weighted at 49 percent. Such adjusted agency ceiling shall be compared to actual Medicaid paid claims for the period April 1, 2011 through March 31, 2012. In those instances when an agency's actual average per patient Medicaid claim is determined to exceed the agency's adjusted ceiling, the amount of such excess shall be due from each such agency to the State and may be recouped by the department in a lump sum amount or through reductions in the Medicaid payments due to the agency. In those instances where an interim payment or rate of payment adjustment was applied to an agency in accordance with subdivision (a) of this section and such agency's actual average per patient Medicaid claim is determined to be less than the agency's adjusted ceiling, the amount by which such Medicaid claims are less than the agency's adjusted ceiling shall be remitted to each such agency by the department in a lump sum amount or through an increase in the Medicaid payments due to the agency.
(f) Projected payment adjustments computed pursuant to subdivision (b) of this section shall be based on Medicaid paid claims, as determined by the department, for services provided by agencies in the base year 2009. Amounts due or owed from reconciling projected payment adjustments pursuant to subdivision (e) of this section shall be based on Medicaid paid claims, as determined by the department, for services provided by agencies in 2009 and Medicaid paid claims, as determined by the department, for services provided by agencies in the reconciliation period April 1, 2011 through March 31, 2012.
(g) The department may require agencies to collect and submit any data deemed by the department to be required to implement the provisions of this section.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
CARRIERS AND CONTROL OF CARRIERS OF DISEASE CARRIERS AND CONTROL OF CARRIERS OF DISEASE
10 CRR-NY 2.41 Duties of health officers in relation to typhoid carriers
(a) The health officer, upon the determination that a person is a typhoid carrier, shall immediately report the fact to the State Department of Health giving the full name, age, occupation and address of such carrier, together with any other information relative to possible or probable infection of others. He shall also inform such person, or in the case of a minor, his guardian, that he is a typhoid carrier and shall give instructions in detail as to the precautions to be observed in preventing the spread of typhoid fever. Instructions given by the health officer shall include a copy of section 2.42 of this Part and directions to wash the hands thoroughly with soap and water immediately after using the toilet and to use individual towels.
(b) The health officer shall inform the head of the household in which a carrier resides that such an individual is a typhoid carrier and of the precautions to be observed, and no persons other than members of the family to which the carrier is immediately related, shall continue to be or become a member of the household in which the typhoid carrier lives, except with the permission of the health officer, and then only after the head of the household has first informed such person, or in the case of a minor, his parent or duly appointed guardian, of the presence of such carrier in the household.
(c) The health officer shall obtain a minimum of one stool culture, at least once each year, from known typhoid carriers, in order to ascertain their carrier status. A negative culture shall be followed up by referral to section 2.43 of this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
VILLAGES VILLAGES
10 CRR-NY 100.4 Village of Altamont
(a)
[Application.]
The rules and regulations hereinafter given, duly made, and enacted in accordance with the provisions of section 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to the mountain stream and to all watercourses entering or ultimately discharging into said stream above the intake at the impounding reservoir, said stream being a source of water supply of the village of Altamont.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and distributing reservoirs on the stream used as a source of water supply by the village and to any additional reservoirs which may be constructed on said stream or any of its tributaries.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel or permeable pipe or conduit of every kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the water supply of the said village of Altamont.
(3) Wherever a linear distance of structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any reservoir or watercourse of the water supply of the village of Altamont.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 150 feet of any reservoir or watercourse of the water supply of the village of Altamont.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances of 75 feet and 150 feet as provided by paragraphs (1) and (2) of this subdivision from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of said water supply.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or waste from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse of the water supply of the village of Altamont, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow on to the surface of the ground or into the ground beneath the surface within 300 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the village of Altamont; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the village of Altamont within 100 feet of any such reservoir or within 75 feet of any such watercourse.
(3) No clothing, bedding, carpets, harness, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the village of Altamont.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the village of Altamont, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the water supply of the village of Altamont; and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excreta, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from any reservoir or 200 feet from any watercourse of the water supply of the village of Altamont; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the village of Altamont without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the village of Altamont; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(g) Fishing, boating and ice cutting.
No fish shall be taken from the impounding reservoir, nor shall any person fish in said reservoir or through the ice upon the same nor trespass upon the waters or ice thereof nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the village of Altamont in the exercise of their duties in the management and operation of the reservoirs; nor shall any ice cutting or other operations incident thereto be allowed on any of the reservoirs which form or are tributary to the sources of the public water supply of the village of Altamont except by permission and under rigid inspection and supervision of the board of water commissioners of the village of Altamont.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the village of Altamont.
(i) Inspections.
The board of water commissioners of the village of Altamont shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules or regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general sanitary condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.12 Record
(a) The record of a hearing will include:
(1) all notices, pleadings, motions, intermediate rulings;
(2) evidence presented;
(3) questions, offers of proof, objections and rulings;
(4) proposed findings and exceptions, if any; and
(5) any decision or report rendered.
(b) Hearings may be mechanically, electronically, or otherwise recorded under the supervision of the tribunal representative, and the original recording or an official trsnscript thereof shall be part of the record.
(c) Upon request made by any party, the department will prepare the record together with any transcript of proceedings within a reasonable time and shall furnish a copy to the requester. Except when any statute authorizes otherwise, the department is authorized to charge the cost for preparation and furnishing of such record or transcript or any part thereof.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.196 Living trust funds
Funds acquired by an institution subject to agreement whereby resources are made available to the institution on condition that the institution pay periodically to a designated person, or persons, the income earned on the resources acquired for the lifetime of the designated person or persons, or for a specified period.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.1 Definitions
(a) Health care provider means a physician or other health care professional licensed to practice in New York State.
(b) Health care facility means a facility in New York State where children are born including those facilities licensed pursuant to Article 28 of the Public Health Law.
(c) Clinical laboratory means a laboratory which possesses a permit to test for hepatitis B surface antigen (HBsAg) issued under Article 5, Title 5 of the Public Health Law.
(d) Hepatitis B surface antigen (HBsAg) test means a test which has been approved for in vitro diagnostic use by the United States Food and Drug Administration.
(e) Satisfactory specimen means a specimen received by a clinical laboratory in a condition suitable for testing.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.14 Applicability
The requirements of this Subpart shall:
(a) Apply within a county health district, a part-county health district, and a city having a city health department, when adopted by the appropriate local authority.
(b) Apply in those State district health areas designated by the State Commissioner of Health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.3 Project development
(a) This section shall apply to the project development period from the inception of a nursing home company to the final financing occupancy date declared by the State Commissioner of Health.
(b) All professional service contracts and all consultant contracts shall require the written approval of the State Department of Health and all of said contracts shall be in writing and executed by the parties thereto:
(1) Prior to execution, drafts of all architectural and engineering contracts shall be submitted to the State Department of Health for approval. The architect or engineer shall comply with all of the State Department of Health requirements including the provision of acceptable professional liability insurance, the assurance of continuity of professional services, the satisfactory evidence of the ability to perform the architectural services required, and agreement to attend conferences and provide professional services as required by the State Department of Health.
(2) Prior to execution, drafts of all attorney retainers shall be submitted to the State Department of Health for review and approval. The attorney shall comply with State Department of Health requirements including the assurance of continuity of professional services and the agreement to attend conferences and provide professional services as required by the State Department of Health.
(3) Prior to execution, drafts of all written consultant contracts relating to the development period shall be submitted to the State Department of Health for review and approval. The consultant shall comply with all the State Department of Health requirements including the assurance of continuity of consultive services, the satisfactory evidence of ability to perform the consultive services required, and agreement to attend conferences and provide consultive services as required by the State Department of Health.
(4) Professional service contracts and consultant contracts shall set forth fee and payment provisions in an amount no greater than contained in the fee guidelines approved by the State Department of Health.
(c) A nursing home company shall obtain exempt organization certificates from the Federal Internal Revenue Service as a hospital under section 501(c)(3) and statements of exemption from the State Department of Taxation and Finance.
(d) A nursing home company shall provide acceptable topographical surveys of the project site certified by a licensed surveyor to the company, the company's title insurance company and the State Department of Health in accordance with the requirements of the State Department of Health. A company shall also provide title reports from an acceptable title insurance company stating that the company may take title to its property free and clear of all liens as required by the State Department of Health. Updating of surveys by letter certification from the surveyor may be used providing there is no change from the exterior physical condition of the project as shown on the previous survey.
(e) Application by a company for nursing home development funds shall be on a form required by the State Commissioner of Health, be limited to eligible items and include such certifications and evidence of payment as may be required. The State Commissioner of Health may approve such applications only to the extent of nursing home development funds available.
(f) A nursing home company shall submit an acceptable schedule of estimated development costs and capital requirements, an acceptable schedule of annual expenses and income, an acceptable supporting schedule of all estimated development costs and capital requirements and annual expenses and income, an acceptable project cost analysis schedule and such other project statistics, space requirements and financial data as the State Department of Health may require.
(g) Construction contracts shall include the standard form of agreement* between owner and contractor as amended by the State Department of Health which includes the required “Modification to Standard Form of Agreement Between Owner and Contractor”, the “Supplementary Conditions of the Contract for Construction” and such further terms, provisions and documents as may be required by the Department of Health. A company shall conform with the bid requirements and procedures of the State Department of Health providing for competitive bidding by contractors or subcontractors and the provisions of “Supplementary Instructions to Bidders”.*
(h) Payment and performance bonds acceptable to the State Department of Health shall be required to insure the faithful payment for and performance of labor and the furnishing of materials for all contracts.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.189 Hearings
The hearings provided for in this section are to be conducted by the permit-issuing official or his designated hearing officer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.152 General journal
The journal in which are recorded transactions not provided for in specialized journals.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.27 Inhalation therapy
This functional reporting center must contain all the expenses associated with the administration of oxygen and certain potent drugs through inhalation or positive pressure and other forms of rehabilitative therapy as prescribed by physicians. This function is performed by specially trained personnel who initiate, monitor and evaluate patient performance, cooperation and ability during testing procedures. Additional activities include but are not limited to the following: assisting physician in performance of emergency care; maintaining open airways, breathing and blood circulation; maintaining aseptic conditions; transporting equipment to patients' bedsides; observing and instructing patients during therapy; visiting all assigned patients to ensure that physicians' orders are being carried out; inspecting and testing equipment; enforcing safety rules; and calculating test results.
(a) Standard unit of measure: number of treatments.
Count each procedure as one treatment. Administering of oxygen should be reported as one procedure, regardless of service time, except in those instances where oxygen is continuously administered. In such instances, one treatment would be counted for each 24-hour period.
(b) Data source.
The number of treatments shall be obtained from an actual count maintained by the inhalation therapy department.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.323 Tests
Refers to each determination for which a specimen is analyzed. For example, a specimen for the SMA-12/60 is a single-patient serum on which 12 different tests are performed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.5 Licenses
(a) Licenses for controlled substances privileges shall be issued by the department in the following classifications:
| Class Issued to: | | | --- | --- | | Manufacturers and distributors | | | 1 | Manufacturer | | 1a | Manufacturer out-of-state | | 2 | Distributor | | 2a | Distributor out-of-state | | Institutional dispenser | | | 3 | Institutional dispenser | | 3a | Institutional dispenser, limited | | Research and instructional | | | 4 | Researcher—II to V | | 4a | Researcher—special industrial II to V | | 5 | Instructional activities—II to V | | 6 | Treatment programs, methadone | | 6a | Treatment programs, methadone and other substances | | 6b | Hospital pharmacies—detoxification, temporary treatment | | 7 | Research and instructional activities—I | | 8 | Analytical laboratories | | Importers and exporters | | | 9 | Importer | | 9a | Importer broker | | 10 | Exporter | | 10a | Exporter broker | | Registered community pharmacy | | | 11 | Registered community pharmacy—automated dispensing system |
(1) A person licensed to manufacture or import any controlled substance shall be authorized to distribute that substance, but no other substance which he is not licensed to manufacture or import;
(2) A person licensed to manufacture any controlled substance listed in schedules II through V shall be authorized to conduct chemical analysis and preclinical research (including quality control analysis) with narcotic and non-narcotic controlled substances listed in those schedules in which he is authorized to manufacture;
(3) A person licensed to conduct research with a controlled substance listed in schedule I shall be authorized to manufacture such class if, and to the extent that, such manufacture is set forth in the research protocol filed with the application for license and to distribute such class to other persons licensed or authorized to conduct research with such class or licensed or authorized to conduct chemical analysis with controlled substances;
(4) A person licensed or authorized to conduct chemical analysis with controlled substances shall be authorized to manufacture and import such substances for analytical or instructional purposes, to distribute such substances to other persons licensed or authorized to conduct chemical analysis or instructional activities or research with such substances and to persons exempted from license pursuant to section 3305 of Public Health Law, to export such substances to persons in other countries performing chemical analysis or enforcing laws relating to controlled substances or drugs in those countries, and to conduct instructional activities with controlled substances; and
(5) A person licensed or authorized to conduct research with controlled substances listed in schedules II through V shall be authorized to conduct chemical analysis with controlled substances listed in those schedules in which he is authorized to conduct research to manufacturer such substances if, and to the extent that, such manufacture is set forth in a statement filed with the application for license, and to distribute such substances to other persons licensed or authorized to conduct chemical analysis, instructional activities, or research with, such substances and to persons exempted from licensing under section 3305 of the Public Health Law, and to conduct instructional activities with controlled substances;
(6) A person licensed to dispense controlled substances listed in schedules II through V shall be authorized to conduct research and to conduct instructional activities with those substances.
(7) A single license to engage in any group of independent activities may include one or more controlled substances listed in the schedules authorized in that group of independent activities.
(8) A separate license is required for each principal place of business or professional practice at one general physical location where controlled substances are manufactured, distributed or dispensed by a person.
(9) The following locations shall be deemed not to be places where controlled substances are manufactured, distributed or dispensed:
(i) a warehouse where controlled substances are stored by or on behalf of a licensed person, unless such substances are distributed directly from such warehouse other than the licensed location from which the substances were delivered or to persons not required to be licensed in accordance with section 3305 of the Public Health Law;
(ii) an office used by agents of a licensee where sales of controlled substances are solicited, made or supervised, but which neither contains such substances nor serves as a distribution point for filling sales orders; and
(iii) an office used by a practitioner (who is registered at another location) where controlled substances are prescribed but neither administered nor otherwise dispensed as a regular part of the professional practice of the practitioner at such office, and where no supplies of controlled substances are maintained.
(b) Holders of licenses shall register with the appropriate Federal agency or agencies in the comparable controlled substances schedule and license class provided for under Federal regulations.
(c) A controlled substances license shall be permanently displayed in the place to which it applies.
(d) No controlled substances license shall be considered valid and in good standing unless the indicated activity is conducted at the address stated therein and by the person in whose name the license has been issued and unless the license has been renewed as required.
(e) A controlled substances license shall be promptly returned to the department upon revocation or suspension, or when the activity for which the applicant is licensed has been discontinued.
(f) A registered community pharmacy licensed in class 11 and maintaining a separate registration with the Drug Enforcement Administration may install and operate automated dispensing systems in a Residential Health Care Facility ("RHCF") which is licensed or approved by the department.
(g) A registered community pharmacy operating an automated dispensing system as provided in subdivision (f) of this section shall provide to such system only those controlled substances obtained under the Drug Enforcement Administration registration of the registered community pharmacy and not the Drug Enforcement Administration registration of the automated dispensing system.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.3 Qualifications required
(a) Preliminary qualifications.
(1) An applicant for certification as a water treatment operator, water treatment assistant operator or distribution system operator must satisfactorily complete training courses or demonstrate equivalent training, education, experience, and take and pass a validated examination, under the requirements of sections 5-4.4 and 5-4.5 of this Subpart.
(2) An applicant for certification as a water treatment operator or water treatment assistant operator must be able to demonstrate the ability to make all operational and water quality tests necessary for the operation of a water treatment plant, such as, but not limited to, chlorine residual, color, pH, turbidity, bacteriological sampling techniques and fluoride when fluoridation is provided.
(b) Required experience and education/training.
Table 5-4.3 of this Subpart provides the requisite experience, education, training, and examination for each grade of water treatment operator, water treatment assistant operator and distribution system operator.
Table 5–4.3–Required Experience, Education, Training and Examination
| Grade | Experience | Education | Training and examination | | --- | --- | --- | --- | | IA | Ten years of operating experience; with at least one year operating experience at a grade IA water treatment plant and one year at a minimum of a grade IIA water treatment plant. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade I Course — minimum 60 hours • Grade A course — minimum 60 hours • Validated examination for grade IA as outlined in section 5-4.5 of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. | | IIA | One year of operating experience at a water treatment plant with facilities for filtration. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade A course — minimum 60 hours • Validated examination for grade IIA as outlined in section 5-4.5 of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. | | IB | Ten years of operating experience at a water treatment plant, with two years operating experience at a minimum of a grade B water treatment plant. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade I course— minimum 60 hours • Grade B course — minimum 30 hours • Validated examination for grade IB as outlined in section 5-4.3(d) of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. | | IIB | One year of operating experience at a water treatment plant. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade B Course — minimum 30 hours • Validated examination for grade IIB as outlined in section 5-4.5 of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. | | C | Six months of operating experience at a minimum of a grade C water treatment plant. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade C course — minimum 18 hours • Validated examination for grade C as outlined in section 5-4.5 of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. | | D | One year of operating and maintenance experience in a distribution system serving 1,000 people or more. | Minimum of a high school diploma or New York State equivalency diploma. | • Grade D course — minimum 15 hours • Validated examination for grade D as outlined in section 5-4.5 of this Subpart • And/or the requirements of section 5-4.4 of this Subpart. |
(1) The department will require proof of education to be submitted with the initial application. This proof will include:
(i) a copy of the high school diploma, or general equivalency diploma; and/or
(ii) a copy of a college diploma and transcripts duly signed, notarized or sealed by the individual that has the authority to issue such transcripts must be submitted for all education, experience, and/or training substitutions as outlined in section 5–4.4 of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.4 Payment of subsidy
If a practitioner is a solo practitioner responsible for payment of his/her malpractice insurance premium, such subsidy will be paid directly to the practitioner. If the practitioner is a member of a partnership or professional corporation which is responsible for payment of his/her malpractice insurance premiums, such subsidy will be paid to the partnership or professional corporation.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.29 New hospitals and hospitals on budgeted rates
(a) New hospitals.
Payments to new hospitals without adequate cost experience for inpatient acute care services that are not exempt from DRG case-based rates of payment shall be computed in accordance with this Subpart except as follows:
(1) Rates of payment shall be computed on the basis of 100 percent of the statewide base price determined pursuant to section 86-1.16 of this Subpart multiplied by the service intensity weight for each DRG set forth in section 86-1.18 of this Subpart.
(2) The WEF used to adjust the statewide base price shall be equal to 1.0 until adequate data becomes available.
(3) The indirect teaching adjustment shall be determined pursuant to the provisions of section 86-1.20 of this Subpart.
(4) The noncomparable operating costs of new facilities as defined in section 86-1.15 of this Subpart and direct graduate medical education costs shall consist of the hospital's budgeted operating costs for these services.
(b) Hospitals on budgeted rates.
Payments to hospitals without adequate cost experience whose rates are based on budgeted cost projections for inpatient acute care services that are not exempt from DRG case-based rates of payment shall be computed in accordance with this Subpart except as follows:
(1) Reimbursement for the costs of graduate medical education and noncomparable services shall be calculated pursuant to the provisions of paragraphs (a)(3) and (4) of this section.
(2) The WEF used shall be calculated for the facility based on available historical data.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS
10 CRR-NY 80.39 Records; analytical laboratories
Analytical laboratories authorized to possess and use controlled substances shall keep a record of all controlled substances received and used by them.
(a) The record of controlled substances received shall include date of receipt, name and address of vendor, type and quantity of drug received. A duplicate invoice or separate itemized list furnished by the vendor will be sufficient to meet this record requirement providing it contains all the information required and is maintained in a separate file. In addition, duplicate copies of Federal order forms for schedule II controlled substances shall be retained.
(b) A record of controlled substances used shall include the name of the person authorized to control and use such drugs, the date, type and quantity of drug used and signature of the user.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT
10 CRR-NY 43-1.15 Records and reports
The local health officials shall submit all reports as required by the department.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.5 Legionella culture analysis
All Legionella culture analyses must be performed by a laboratory that is approved to perform such analysis by the New York State Environmental Laboratory Approval Program (ELAP).
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.4 Village of Gilbertsville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as heretofore set forth, shall apply to all natural and artificial reservoirs on Dunderberg Creek and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Village of Gilbertsville, Otsego County, New York.
(b) Definitions.
(1) The term reservoir, wherever used in this section, is intended to mean and refer to all storage and impounding reservoirs on Dunderberg Creek which are tributary to or which serve as sources of this public water supply, or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse, wherever used in this section, is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind, the waters of which, when running continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Gilbertsville.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed, by pump or other satisfactory means, through watertight pipes or conduits, to some proper place of ultimate disposal, as hereinafter provided, or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified, and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered, and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less then 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(6) Whenever, owing to the character of the soil or of the surface of the ground, or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal, or the garbage or wastes from any dump, may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Village of Gilbertsville, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (c)(4) of this section, within 200 feet of any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry, nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed, nor any polluted water or liquid of any kind, shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(3) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils, nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein within 1,000 feet of the intake. The watering of animals or poultry in any reservoir of the public water supply of the Village of Gilbertsville is prohibited, nor shall any such watering be allowed in any watercourse tributary to this water supply within 1,000 feet of said reservoir. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the Village of Gilbertsville.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 50 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville, and none of the above-named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that the proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Gilbertsville, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 150 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(g) Fishing, boating, ice cutting and trespassing on reservoirs.
No skating, no ice cutting, no boating of any kind, no fishing from boats or from shore or through the ice nor any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs.
(h) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Gilbertsville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the Village of Gilbertsville.
(j) Inspections.
The board of trustees of the Village of Gilbertsville shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first of January, the results of the regular inspection made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $ 100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.18 Statewide Planning and Research Cooperative System (SPARCS)
(a) Definitions.
For the purposes of this section, these terms shall have the following meanings:
(1) Health care facilities shall mean facilities licensed under article 28 of the Public Health Law.
(2) Identifying data elements shall mean those SPARCS data elements that, if disclosed without any restrictions on use or re-disclosure would constitute an unwarranted invasion of personal privacy. A list of identifying data elements shall be specified by the commissioner and will be made available publicly.
(3) Inpatient hospitalization data shall mean SPARCS data submitted by hospitals for patients receiving inpatient services at a general hospital that is licensed under article 28 of the Public Health Law and that provides inpatient medical services.
(4) Outpatient data shall mean emergency department data, ambulatory surgery data, and outpatient services data.
(i) Emergency department data shall mean SPARCS data submitted by a facility licensed to provide emergency department services under article 28 of the Public Health Law.
(ii) Ambulatory surgery data shall mean SPARCS data submitted by a facility licensed to provide ambulatory surgery services under article 28 of the Public Health Law.
(iii) Outpatient services data shall mean all data submitted by licensed article 28 facilities excluding inpatient hospitalization data, emergency department data, and ambulatory surgery data.
(5) SPARCS Administrator shall mean a person in the SPARCS program designated by the commissioner to act as administrator for all SPARCS activities.
(6) SPARCS data shall mean the data collected by the commissioner under section 2816 of the Public Health Law and this section, including inpatient hospitalization data and outpatient data.
(7) SPARCS program shall mean the program in the New York State Department of Health (NYSDOH) that collects and maintains SPARCS data and discloses SPARCS data.
(b) Reporting SPARCS data.
(1) Health care facilities shall report data as follows:
(i) Health care facilities shall submit, or cause to have submitted, SPARCS data in an electronic, computer-readable format through a secure electronic network designated by the department according to specifications provided by the commissioner.
(ii) All SPARCS data must be supported by documentation in the patient’s medical and billing records.
(iii) Health care facilities must submit on a monthly basis to the SPARCS program, or cause to have submitted on a monthly basis to the SPARCS program, data for all inpatient discharges and outpatient visits. Health care facilities must submit, or cause to have submitted, at least 95 percent of data for all inpatient discharges and outpatient visits within 60 days from the end of the month of a patient’s discharge or visit. Health care facilities must submit, or cause to have submitted, 100 percent of data for all inpatient discharges and outpatient visits within 180 days from the end of the month of a patient’s discharge or visit.
(iv) The SPARCS program may conduct an audit evaluating the quality of submitted SPARCS data and issue an audit report to a health care facility listing any inadequacies or inconsistencies in the data. Any health care facility so audited must submit corrected data to the SPARCS program within 90 days of the receipt of the audit report.
(2) Content of the SPARCS data.
(i) Health care facilities shall submit, or cause to have submitted, uniform bill data elements as required by the commissioner. The data elements required by the commissioner shall be based on those approved by the National Uniform Billing Committee (NUBC) or required under national electronic data interchange (EDI) standards for health care transactions and shall be published on the NYSDOH website to the extent allowed by copyright law.
(ii) Health care facilities shall submit, or cause to have submitted, additional data elements as required by the commissioner. Such additional data elements shall be from medical records or demographic information maintained by the health care facilities.
(iii) The list of specific SPARCS data elements and their definitions shall be maintained by the commissioner, will be made available publicly, and may be modified by the commissioner.
(c) Maintenance of SPARCS data.
The commissioner shall be responsible for protecting the privacy and security of the health care information reported to the SPARCS program.
(d) Requests for SPARCS data.
(1) SPARCS data may be used for medical or scientific research or statistical or epidemiological purposes approved by the commissioner.
(2) The commissioner may determine that additional purposes are proper uses of SPARCS data.
(3) In determining the purpose of a request for SPARCS data, the SPARCS program shall not be limited to information contained in the data request form and may request supplemental information from the applicant.
(4) The commissioner shall charge a reasonable fee to all persons and organizations receiving SPARCS data based upon costs incurred and recurring for data processing, platform/data center and software. The commissioner may discount the base fee or waive the fee upon request to the SPARCS program. The fee may be waived in the following circumstances:
(i) Use by a health care facility of the data it submitted to the SPARCS program.
(ii) Use by a health care facility that is licensed under article 28 of the Public Health Law for the purpose of rate determinations or rate appeals and for health care-related research.
(iii) Use by a Federal, New York State, county or local government agency for health care-related purposes.
(5) The SPARCS program shall follow applicable Federal and State laws when determining whether SPARCS data contain identifying data elements may be shared and whether a disclosure of SPARCS data constitutes an unwarranted invasion of personal privacy.
(6) All entities seeking SPARCS data must submit a request to the SPARCS program using standard data request forms specified by the SPARCS program. Data users shall take all necessary precautions to prevent unwarranted invasions of personal privacy resulting from any data analysis or release. Data users may not release any information that could be used, alone or in combination with other reasonably available information, to identify an individual who is a subject of the information. Data users bear full responsibility for breaches or unauthorized disclosures of personal information resulting from use of SPARCS data. Applications for SPARCS data must provide an explicit plan for preventing breaches or unauthorized disclosures of personal information of any individual who is a subject of the information.
(7) Each data request form must include an executed data use agreement in a form prescribed by the SPARCS program. Data use agreements are required of: a representative of the requesting organization; a representative of each other organization associated with the project; and all individuals who will have access to any data including identifying data elements.
(8) The SPARCS program shall publish and make publicly available the name of the project director, the organization, and the title of approved projects.
(9) The SPARCS administrator shall review and make recommendations on requests for SPARCS data containing identifying data elements to a data release committee established by the commissioner. The data release committee shall have at least three members, including at least one member not otherwise affiliated with NYSDOH. The members of the data release committee shall be posted on the NYSDOH website. Requests will be granted only upon formal, written approval for access by a majority of the members of the data release committee. The commissioner has the final authority over the approval, or disapproval, of all requests. Requests for identifying data elements shall be approved only if:
(i) the purpose of the request is consistent with the purposes for which SPARCS data may be used;
(ii) the applicant is qualified to undertake the project; and
(iii) the applicant requires such identifying data elements for the intended project and is able to ensure that patient privacy will be protected.
(10) The SPARCS administrator may recommend approval of a request in which future SPARCS data is to be supplied on a periodic basis under the following conditions:
(i) SPARCS data may be requested for a predetermined time not to exceed three years beyond the current year provided that the organization and uses of the data remain as indicated in the data request form submitted to the SPARCS program.
(ii) During the period of retention of SPARCS data, no additional individuals may access SPARCS data without an executed data use agreement on file with the SPARCS program.
(11) The commissioner may rescind for cause, at any time, approval of a data request.
(e) Penalties.
(1) Any person or entity that violates the provisions of this section or any data use agreement may be liable pursuant to the provisions of the Public Health Law, including, but not limited to, sections 12 and 12-d of the Public Health Law.
(2) Any person or entity that violates the provisions of this section or any data use agreement may be denied access to SPARCS data.
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.3 Residential health care facilities
(a) Notwithstanding the provisions of subdivisions (a), (b) and (c) of section 670.1 of this Part, the factors, methodology and procedures to be used by the Public Health Council for determining the public need for residential health care facility beds shall include, but not be limited to, the substantive criteria, methodology and procedure set forth in section 709.3 of this Chapter and the provisions of subdivision (c) of this section.
(b) Any application for establishment wherein a determination of public need is made pursuant to this section, shall be subject to the provisions of subdivision (d) of section 670.1 of this Part.
(c)
(1) In determining the need for residential health care facilities, beds and services, consideration shall be given to the needs of persons who receive or are eligible to receive medical assistance benefits at the time of admission to a facility pursuant to title XIX of the Federal Social Security Act and title 11 of article 5 of the Social Services Law, hereafter referred to as Medicaid patients, and the extent to which the applicant serves or proposes to serve such persons, as reflected by factors including, but not necessarily limited to, the applicant's admissions policies and practices. An application by an applicant that is or will be a provider that participates in the medical assistance (Medicaid) program shall not be approved unless the applicant agrees to comply with the requirements of this subdivision. An applicant that, at the time of consideration of its application by the Public Health Council, proposes not to participate in the Medicaid program may be approved, provided all other review criteria have been met, upon the condition that if, in the future, it does participate in the Medicaid program, it would comply fully with the requirements of this subdivision.
(2) To ensure that the needs of Medicaid patients in an applicant's service area are met and that such patients have adequate access to appropriate residential health care facilities, beds and services, applicants shall be required to accept and admit at least a reasonable percentage of Medicaid patients as determined pursuant to this subdivision. Such reasonable percentage of Medicaid patient admissions, also referred to herein as the Medicaid patient admissions standard, shall be equal to 75 percent of the annual percentage of all residential health care facility admissions, in the long-term care planning area in which the applicant facility is located, that are Medicaid patients. The calculation of such planning area percentage shall not include admissions to residential health care facilities that have an average length of stay of 30 days or less. If there are four or fewer residential health care facilities in a planning area, the applicable Medicaid patient admissions standard for such planning area shall be equal to 75 percent of the planning area annual percentage of all residential health care facility admissions that are Medicaid patients or 75 percent of the annual percentage of all residential health care facility admissions, in the health systems agency area in which the facility is located, that are Medicaid patients, whichever is less. In calculating such percentages, the department will use the most current admissions data which have been received and analyzed by the department. An applicant will be required to make appropriate adjustments in its admissions policies and practices so that the proportion of its own annual Medicaid patient admissions is at least equal to 75 percent of the planning area percentage or health systems agency area percentage, whichever is applicable.
(3) The proportion of an applicant's admissions that must be Medicaid patients, as calculated under paragraph (2) of this subdivision, may be increased or decreased based on the following factors:
(i) the number of individuals within the planning area currently awaiting placement to a residential health care facility and the proportion of total individuals awaiting such placement that are Medicaid patients, provided that patients awaiting placement include, but need not be limited to, alternate level of care patients in general hospitals;
(ii) the proportion of the facility's total patient days that are Medicaid patient days and the length of time that the facility's patients who are admitted as private paying patients remain such before becoming Medicaid eligible;
(iii) the proportion of the facility's admissions who are Medicare patients or patients whose services are paid for under provisions of the Federal Veterans' Benefit Law;
(iv) the facility's patient case mix based on the intensity of care required by the facility's patients or the extent to which the facility provides services to patients with unique or specialized needs; and
(v) the financial impact on the facility due to an increase in Medicaid patient admissions.
(4)
(i) An applicant shall submit a written plan, subject to the approval of the department, for reaching the Medicaid patient admissions standard required by this subdivision. The plan shall provide for reaching the standard within no longer than a two-year period and the facility shall give preference, as necessary, to Medicaid patients in order to reach the admissions standard within the prescribed time period.
(ii) Once the Medicaid patient admissions standard is reached, the facility shall not reduce its proportion of Medicaid patient admissions so as to go below the standard unless and until the applicant, in writing, requests the approval of the department to adjust the standard and the department's written approval is obtained. In reviewing requests to adjust a facility's Medicaid patient admissions standard, the department shall consider factors which may include, but need not be limited to, those factors set forth in paragraphs (2) and (3) of this subdivision.
(iii) After a facility's initial Medicaid patient admissions standard has been reached, the department may increase such facility's Medicaid patient admissions standard, based on the criteria set forth in this subdivision, if the percentage of Medicaid patients admitted by residential health care facilities in the facility's planning area or health systems agency area, as appropriate, increases due to factors other than an increase in Medicaid patient admissions by the applicant.
(5)
(i) Subject to the provisions of subparagraph (ii) of this paragraph, after the phase-in period provided for in paragraph (4) of this subdivision, a facility shall be prohibited from failing, refusing or neglecting to accept or admit a Medicaid patient for whom it is otherwise able to provide care, regardless of whether the level of reimbursement received for such patient is less than the rate the facility charges private pay patients, unless the facility has reached and is maintaining compliance with the Medicaid patient admissions standard imposed by this subdivision. Compliance with the requirements of this subdivision shall be determined on the basis of a facility's total annual admissions, so that a facility may exercise its discretion in determining when during a year it will admit a sufficient number of Medicaid patients to maintain its Medicaid patient admissions standard.
(ii) A facility may be exempt from the requirement of admitting a Medicaid patient in order to meet or maintain its Medicaid patient admissions standard if it can demonstrate in writing to the satisfaction of the commissioner that the Medicaid patient was denied admission solely in order to admit another patient who had a greater need of residential health care facility services, as determined by the intensity of care anticipated to be required by such patient, and that there was only one bed available in the facility at the time of the admission decision to accommodate a new admission. Facilities shall not be required to obtain prior department approval in order to accept a non-Medicaid patient in place of a Medicaid patient pursuant to this subparagraph, but shall maintain sufficient documentation including, but not necessarily limited to, a copy of the patient review instrument for the patient admitted and the Medicaid patient denied admission in order to justify the admission decision. Copies of such documentation shall be provided to the department upon request.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.91 Depreciation
Lost usefulness; expired utility; the diminution of service yield from a fixed asset or fixed-asset group that cannot or will not be restored by repairs or by replacement of parts.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.1 Definitions
(a) Adequate shall mean sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of the Subpart.
(b) Camping unit shall mean a tent, camping cabin, recreational vehicle or other type of portable shelter intended, designed or used for temporary human occupancy.
(c) Occupancy unit shall mean a room or group of rooms forming a single habitable unit intended to be used for overnight occupancy.
(d) Permit-issuing official (PIO) shall mean the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law.
(e) Person shall mean an individual, group of individuals, partnership, firm, corporation, association, political subdivision, government agency, municipality, estate or any other legal entity.
(f) Potable water shall mean water provided or used for human consumption, food preparation, or for lavatory, culinary, bathing or laundry purposes.
(g) Public health hazard shall mean any existing or imminent condition, which can be responsible for or cause illness, physical injury or death.
(h) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanup, dead animals, offal and solid commercial waste.
(i) Sewage shall mean excreta and the waste from a flush toilet, bath, sink, lavatory, dish washing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(j) Temporary residence shall mean a tract or tracts of land and any hotel, motel, cabin colony, building, camping unit or other structures including worker housing that may be pertinent to its use, maintained primarily for overnight occupancy by persons who are provided at least some part or portion of the use of the facilities.
(k) Uniform code shall mean the 19 NYCRR Chapter XXXIII, Subchapter A – State Uniform Fire Prevention and Building Code.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.2 Lead screening and follow-up of children by health care providers
(a) Lead screening and follow-up of children by primary health care providers.
(1) At each routine well-child visit, or at least annually if a child has not had routine well-child visits, primary health care providers shall assess each child who is at least six months of age but under six years of age, for high dose lead exposure using a risk assessment tool based on currently accepted public health guidelines. Each child found to be at risk for high dose lead exposure shall be screened or referred for lead screening.
(2) Primary health care providers shall provide the parent or guardian of each child under six years of age anticipatory guidance on lead poisoning prevention as part of routine care.
(3) Primary health care providers shall screen or refer each child for blood lead screening, at or around one and two years of age, preferably as part of routine well child care.
(4) The Commissioner of Health may provide recommended alternative schedules for other high risk groups as deemed necessary.
(5) Results of blood lead analysis performed in a health care practitioner’s office pursuant to Public Health Law, section 579(1) that is certified by the Centers for Medicare and Medicaid Services under regulations implementing the Federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) must be reported to the Commissioner of Health and to the local health officer in whose jurisdiction the subject of the test resides. Such results shall be reported within 14 business days of the date of analysis and on such forms as prescribed by the Commissioner of Health. Such reports must include the subject’s name, date of birth, race, gender, address, county of residence, type of sample (venous or fingerstick) and blood lead level; the health care practitioner ordering the test, facility identifiers, the date of sample collection, and the date of analysis.
(6) Each primary health care provider who screens a child for elevated blood lead levels shall explain the blood lead test results and provide documentation of lead screening to the parent or guardian of the child or other person authorized to consent for the medical care of the child.
(7) Primary health care providers shall provide or make reasonable efforts ensure the provision of follow-up testing for each child with an elevated blood lead level in accordance with currently accepted medical standards and public health guidelines.
(8) Primary health care providers shall provide or make reasonable efforts to ensure the provision of risk reduction education and nutritional counseling for each child with an elevated blood lead level equal to or greater than five micrograms per deciliter of whole blood.
(9) Primary health care providers shall confirm blood lead levels equal to or greater than five micrograms per deciliter of whole blood obtained on a capillary specimen from a child using a venous blood sample.
(10) For each child who has a confirmed blood lead level equal to or greater than five micrograms per deciliter of whole blood, primary health care providers shall provide or make reasonable efforts to ensure the provision of a complete diagnostic evaluation; medical treatment, if necessary; and referral to the appropriate local or State health unit for environmental management. A complete diagnostic evaluation shall include at a minimum: a detailed lead exposure assessment, a nutritional assessment including iron status, and a developmental screening.
(11) Primary health care providers shall communicate and coordinate as appropriate with local health units to ensure that each child with an elevated blood lead level receives appropriate follow-up, as prescribed in paragraphs (6) through (10) of this subdivision.
(b) Lead screening and follow-up of children by non-primary care providers.
(1) A health care provider that provides services to a child who is at least six months of age but under six years of age and who is not the child's ongoing primary care provider, such as a hospital inpatient facility, an emergency service if the child's condition permits, or other facility or practitioner which provides services to the child on a one-time or walk-in basis, shall inquire if the child has been appropriately assessed and screened for elevated blood lead levels in accordance with the schedule prescribed in paragraphs (1) and (3) of this subdivision.
(2) If the child has not received such appropriate lead screening, the health care provider shall screen the child for elevated blood lead levels, or refer the child to the child's primary health care provider or, if the child's primary care provider is unavailable or the child has no primary health care provider, to another primary health care provider, or to the local health unit to obtain a blood lead test.
(3) If screening is performed, the blood lead test result shall be sent to the child's primary care provider or to the local health unit to enable appropriate follow-up in accordance with paragraphs (a)(6) through (11) of this section.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.1 Definitions
As used in this Subpart, the following definitions shall apply:
(a) Residential health care facility, medical facility or facility shall mean all facilities or organizations covered by the term nursing home as defined in article 28 of the Public Health Law, including hospital-based residential health care facilities, and nursing facilities as defined in section 1919 of the Federal Social Security Act, provided that such facility possesses a valid operating certificate issued by the State Commissioner of Health and, where required, has been established by the Public Health Council.
(b) Patient classification groups shall mean patient categories contained in the classification system, Resource Utilization Groups-II (RUG-II), which identifies the relative resource consumption required by different types of long-term care patients as specified in Appendix 13-A, infra.
(c) Case mix shall mean the patient population of a facility as classified and aggregated into patient classification groups.
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.8 Quality of care requirements
(a) Each shared health facility shall:
(1) have an individual designated as a manager or administrator, who shall have functional responsibility for the management and coordination of activities within the facility, and who shall help to ensure that the facility and its providers, purveyors and employees comply with the various provisions of this Part;
(2) have an appropriate means of ensuring that:
(i) patients will be scheduled to return to the facility for follow-up care or services when such follow-up care or services are deemed necessary and appropriate; and
(ii) each patient will be treated or served by practitioners, providers or purveyors familiar with the patient's medical history.
(b) Each individual provider or purveyor practicing his profession or conducting his business in the facility shall maintain proper records, which at a minimum shall contain:
(1) the full name, address and medical assistance program number of each patient treated or served in the facility;
(2) the date of each patient visit to the individual provider or purveyor;
(3) the patient's chief complaint for each visit;
(4) the patient's pertinent medical history and the findings for any physical examination performed by any provider;
(5) the diagnostic impressions for each visit;
(6) a notation of all medication prescribed and the precise dosage and prescription regimen for each medication prescribed;
(7) a description of any X-rays, laboratory tests and electrocardiograms ordered or performed and a notation of the results thereof;
(8) a notation as to any referral by any provider or purveyor in the facility to another provider, practitioner or purveyor, a statement as to the reason for such referral, and the results of such referral; and
(9) a statement as to whether or not the patient is expected to return for further treatment, and the prospective dates for all return appointments.
(c) Each individual provider and purveyor practicing his profession or conducting his business in a shared health facility shall furnish to patients only services and supplies which are of high quality and necessary to prevent, diagnose, correct or cure conditions that cause acute suffering, endanger life, result in illness or infirmity, interfere with the patients' capacity for normal activity or threaten some significant handicap.
(d) Each shared health facility shall:
(1) provide suitable space and equipment for the storage of medical records, and maintain in a centralized location within the facility, original or true copies of each provider's or purveyor's medical records and medical assistance program invoices submitted for reimbursement;
(2) assign an individual and clearly identified practitioner to each patient requesting treatment or services in the shared health facility, provided, however, that the assignment may be changed at any time at the patient's discretion;
(3) conspicuously post and otherwise make available to patients either:
(i) the manned central answering service telephone number of each patient's designated practitioner or such designated colleague(s); or
(ii) the telephone number of the facility's centralized 24 hour-a-day, 7 days-a-week manned telephone line for off-hour emergency patient questions.
(e) Each shared health facility shall provide equipment and space which will ensure that all patients have a maximum of privacy during interview, examination and treatment.
(f) Each shared health facility shall post in a location and manner conspicuous to visiting and waiting patients a notice which shall provide the telephone number and identity of the New York State Department of Health agency which is responsible for providing information concerning shared health facilities and for receiving complaints concerning the provision of health care services in shared health facilities. Such notices may be provided to the facility by the department, and if so provided, shall be posted in lieu of any notices to the same or similar effect
(g) The facility shall post in a location and manner conspicuous and comprehensible to visiting and waiting patients the names and scheduled office hours of all practitioners practicing in the facility.
(h) Nothing in this Part shall in any way be interpreted as infringing upon the patient's right to free selection of a personal practitioner.
(i) The department shall have the right to inspect patient medical records, business records, leases and other contracts executed by any provider or purveyor in a shared health facility. Such inspection may be by onsite visits to the facility.
Subchapter I ENVIRONMENTAL HEALTH
Part 71 REQUIREMENTS FOR VENT-FREE GAS SPACE HEATING APPLIANCES
10 CRR-NY 71.1 Purpose
The purpose of this rule is to protect public health, safety and welfare by specifying requirements for vent-free gas space heating appliances offered for sale or sold in New York State.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.22 Definition of person
A person, as used in this Subpart, is an individual, firm, estate, partnership, company, corporation, trustee, association or any public or private entity.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.122 Extraordinary expense
A material expense (see materiality ) so unusual in nature or in frequency of occurrence as to be accorded special treatment in the accounts or separate disclosure in financial statements.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.200 Reporting of foodborne disease
Any food service operator having actual or constructive knowledge of the occurrence of illness allegedly due to the consumption of food served at the establishment, shall report the same within 24 hours by telephone, telegram or in person to the permit-issuing official.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.23 Advance
(a) Payment of cash or the transfer of goods for which an accounting must be rendered by the recipient at some later date.
(b) A payment of a contract before its completion.
(c) The payment of wages, salaries, or commissions before they have been earned.
(d) Deferred income or expense.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 37 HANDLING OF BODIES OF PERSONS DYING ON COMMON CARRIERS
10 CRR-NY 37.3 Registration district
The name of the registration district in which a body is removed from a common carrier shall be entered on the certificate of death as the place of death.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.20 Capital cost reimbursement
The capital cost of a facility for purposes of determining and certifying the capital cost component of a rate shall be determined and computed in accordance with the provisions of sections 86-4.23 through 86-4.26 of this Subpart, and shall be certified and audited as actually having been expended. Capital costs shall not be trended or held to operating cost ceilings pursuant to sections 86-4.15 and 86-4.14, respectively.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.2 Establishing the SHIN-NY
The New York State Department of Health shall:
(a) oversee the implementation and ongoing operation of the SHIN-NY;
(b) implement the infrastructure and services to support the private and secure exchange of health information among qualified entities and qualified entity participants;
(c) administer the statewide collaboration process and facilitate the development, regular review and update of SHIN-NY policy guidance;
(d) perform regular audits, either directly or through contract, of qualified entity functions and activities as necessary to ensure the quality, security and confidentiality of data in the SHIN-NY;
(e) provide technical services, either directly or through contract, to ensure the quality, security and confidentiality of data in the SHIN-NY;
(f) assess qualified entity participation in the SHIN-NY and, if necessary, suspend a qualified entity’s access to or use of the SHIN-NY, when it reasonably determines that the qualified entity has created, or is likely to create, an immediate threat of irreparable harm to the SHIN-NY, to any person accessing or using the SHIN-NY, or to any person whose information is accessed or transmitted through the SHIN-NY;
(g) publish reports on health care provider participation and usage, system performance, data quality, the qualified entity certification process, and SHIN-NY security;
(h) take such other actions as may be needed to promote development of the SHIN-NY.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.16 Revisions in certified rates
(a) The commissioner shall consider only those applications for prospective revisions of certified or approved rates which are in writing and which address one or more of the issues set forth in this section.
(b) Errors, whether mathematical or clerical, made by the department or an article 43 corporation in the rate calculation process or in the development of group ceilings, and errors, whether mathematical or clerical or otherwise, in data submitted by a facility, when the revised data submitted meet the same certification requirements as the original data, may be the basis for an application for prospective revision of a certified or approved rate. Such errors may include, but shall not be limited to, the following areas related to the development of reimbursable costs:
(1) funding of depreciation, capital costs, patient visits/procedures; and
(2) nonallowable costs, such as revenue recoveries. Applications pursuant to this subdivision must be submitted within 120 days of receipt of the applicable title XIX or article 43 corporation program initial rate computation sheet. Any modified rate certified or approved pursuant to this paragraph shall be effective the first day of the rate period. If not commenced within 120 days of receipt of the commissioner's initial rate computation sheet, a rate appeal pursuant to this subdivision may be initiated at time of audit of the base-year cost figures upon or prior to receipt of the notice of program reimbursement. Such rate appeals shall be recognized only to the extent that they are based upon mathematical or clerical errors in cost and/or statistical data originally submitted by the facility, or revisions initiated by a third-party fiscal intermediary or, in the case of a governmental facility, by the sponsor government, or mathematical or clerical errors made by the Department of Health. Such notice of appeal must be presented in writing prior to or at the exit conference for such audits.
(c) Documented increases in the overall operating costs of a facility resulting from the implementation of additional or expanded programs, staff or services specifically mandated for the facility by the commissioner may be the basis for an application for prospective revision of a certified or approved rate. An appeal may be submitted pursuant to this subdivision at any time throughout the rate period, or within 60 days after the end of the rate period. Any modified rate certified or approved pursuant to this subdivision shall be effective on the date additional staff not reflected in the base year is hired by the facility.
(d) Documented increases in overall operating costs of a facility resulting from capital renovation, expansion, replacement or the inclusion of new programs, staff or services approved by the commissioner through the certificate of need (CON) process may be the basis for an application for revision of a certified rate, provided, however, that such CON approval shall not be required with regard to such applications for rate revisions which are submitted by federally qualified health centers or rural health centers which are exempt from such CON approval pursuant to section 2807-z of the Public Health Law. To receive consideration for reimbursement of such costs in the current rate year, a facility shall submit, at the time of appeal or as requested by the commissioner, detailed staffing documentation, proposed budgets and financial data, anticipated utilization expressed in terms of threshold visits and/or procedures and, where relevant, the final certified costs of construction approved by the department. An appeal may be submitted pursuant to this paragraph at any time throughout the rate period. Any modified rate certified or approved pursuant to this paragraph shall be effective on the date the new service or program is implemented or, in the case of capital renovation, expansion or replacement, on the date the project is completed and in use.
(e) Upon receipt of actual cost data for appeals pursuant to subdivisions (c) and (d) of this section, the modified rate based on projections will be retroactively revised to reflect actually incurred costs held to operating cost ceiling limitations and utilization standards set forth in this Subpart.
(f) Appeals pursuant to subdivision (c) or (d) of this section for subsequent rate periods must be submitted for each subsequent period within 120 days of receipt of the commissioner's initial rate computation sheet for that year.
(g) Appeals to adjustments made as a result of audits conducted by the Department of Health may be the basis for an application for rate revision. The specific items of appeal and any material documentation necessary to support provider's position must be submitted within 30 days of the receipt of the audit.
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.7 Rate corrections for prevocational services (site-based) and respite (hourly and free-standing) rates
(a) Arithmetic or calculation errors will be adjusted accordingly in instances that would result in a change of $5,000 or more in a provider’s annual reimbursement for prevocational services.
(b) In order to request a rate correction in accordance with subdivision (a) of this section, the provider must send DOH its request by certified mail, return receipt requested, within 90 days of the provider receiving the rate computation or with 90 days of the first day of the rate period in question, whichever is later.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.60 Ordering
No practitioner shall obtain schedule II controlled substances except by means of his or her official Federal written order forms. Schedules II, III, IV and V controlled substances shall be obtained from manufacturers or distributors licensed under article 33 of the Public Health Law and this Part.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.15 Bathhouse and toilet facilities
(a) General.
Toilet facilities and lavatories including diaper changing areas shall be maintained and conveniently located at a spray ground.
(b) Walls and floors of the bathhouse shall be kept clean and free from cracks or open joints. The floors shall be well drained.
(c) All fixtures within the bathhouse shall be maintained in a clean and sanitary condition at all times.
(d) All toilet facilities and dressing rooms shall be ventilated and maintained.
(e) Showers, when provided, shall be supplied with water at a temperature no more than 110°F. Thermostatic, tempering or mixing valves shall be kept in good operation to prevent scalding of the users. Shower curtains shall be kept clean.
(f) All lavatories shall be provided with soap, paper towels or electrical hand-drying units, and covered waste receptacles. Suitable sanitary napkin receptacles shall be provided in toilet facilities used by females.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.13 Requirements for laboratories engaged in testing for critical agents in environmental samples
(a) For purposes of this Subpart, critical agent shall mean an organism, chemical element or chemical compound, which is recognized as posing a risk to national security and/or requiring special action to protect the public health because the agent: can be disseminated ( e.g., in air, water or food) or transmitted person-to-person with ease; causes moderate to high mortality and/or morbidity; and can have a significant public health impact. The term organism includes, but is not limited to, a virus, bacterium, or product or component of an organism ( e.g., a toxin). Critical agents shall include critical biological and chemical agents, including select agents, specified by the Federal Centers for Disease Control and Prevention (CDC) in published documents, and other such agents as the Commissioner of Health has determined meet the above criteria. The terms chemical element and chemical compound include substances that emit ionizing radiation including alpha, beta, gamma or neutron radiation.
(b)
(1) Prior to performing testing for any critical agent in an environmental sample, a laboratory shall submit a request to the department, and receive an initial or revised certificate of approval that includes the specialty of critical agent testing and the approved method(s) the laboratory is authorized to employ as stipulated in sections 55-2.1 and 55-2.5 of this Subpart. The certificate of approval shall also list the specific critical agent(s) included in the approval, the approved method(s), and the types of samples ( e.g., surface swipes, powder, air, fluid and bulk material) the laboratory may accept for testing. No laboratory shall examine an environmental sample for a critical biological agent or critical chemical agent without certification of approval specific to each critical agent for which testing is conducted.
(2) The department may withhold or limit its approval if the department is not satisfied that the laboratory has in place adequate policies, procedures, facilities, equipment, instrumentation; and trained personnel to ensure that: collection; labeling; accessioning; preparation; analysis' result reporting or, for an autonomous detection system as defined in section 55-2.14(a) of this Subpart, responding to a signal indicating the presence of a critical agent; storage; transportation; shipping; and disposition of all environmental samples, derivatives and related materials shall be performed in a manner that: ensures consistently correct performance of the approved methods; ensures the protection of the health, safety and welfare of the laboratory's employees and the public; and is consistent with the requirements of this Subpart, and all other applicable laws, rules and regulations. The department shall also consider a laboratory's biosafety level facilities, safety practices, and its capability to assume an appropriate role in the public health and safety response(s) to critical agents, in its determination to approve the laboratory for critical agent testing in environmental samples.
(c) In addition to application and attestation requirements found elsewhere in this Subpart, a laboratory seeking approval to perform critical agent testing in environmental samples shall submit:
(1) a standard operating procedure manual documenting laboratory policies, procedures, facilities, equipment, supplies, instrumentation and personnel for critical agent testing, which are designed to ensure that: collection; labeling; accessioning; preparation; analysis; result reporting or, for an autonomous detection system as defined in section 55-2.14(a) of this Subpart, responding to a signal indicating the presence of a critical agent; storage; transportation; shipping; and disposition of all environmental samples, derivatives and related materials shall be performed in a manner that ensures consistently correct performance of the approved methods; ensures the protection of the health, safety and welfare of the laboratory's employees and the public; and is consistent with the requirements of this Subpart, and all other applicable laws, rules and regulations; and
(2) an attestation signed by the owner(s) and director(s) that the laboratory will accept only the type(s) of samples ( e.g., surface swipes, powder, air, fluid and bulk material) specified on the laboratory's certificate of approval, and that the owner(s) and director(s) will take whatever action is necessary to ensure that such samples are collected, labeled, accessioned, prepared, analyzed, stored, transported, shipped and disposed of, and all results are reported in a manner consistent with the approved method and with all other documentation submitted to the department.
(d) In addition to meeting the preceding requirements of this Subpart, a laboratory engaged in critical agent testing in environmental samples, through its owner(s) and director(s), shall:
(1) establish, maintain, review periodically, and implement written policies and procedures designed to ensure that: collection; labeling; accessioning; preparation; analysis; result reporting or, for an autonomous detection system as defined in section 55-2.14(a) of this Subpart, responding to a signal indicating the presence of a critical agent; storage; transportation; shipping; and disposition of samples shall be performed in a manner that ensures consistently correct performance of the approved methods, ensures the protection of the health, safety and welfare of laboratory personnel, sample collectors and the public to the extent possible, and is consistent with all applicable laws, rules and regulations, as well as recognized standards of practice designed to minimize the risks associated with potential exposure to similar hazardous substances or critical agents. Such policies and procedures shall include specific procedures for containment, secured storage, decontamination, and/or disposal or destruction of the sample(s), derivatives, and related collection materials, supplies and/or equipment, as necessary and/or appropriate for the relevant suspected critical agent;
(2) have written policies and procedures in place to implement a chain-of-custody protocol whenever required by a law enforcement agency. Such policies and procedures shall be developed in consultation with law enforcement officials or other persons with appropriate experience and training in chain-of-custody issues, and shall at a minimum require an intact continuous record of the physical possession, storage, and disposition of the sample and any derivatives, including the signatures of all persons who access the sample and derivatives, the date of such access and other pertinent information;
(3)
(i) ensure that all laboratory employees engaged in collecting and/or transporting environmental samples receive sufficient training in hazardous material handling techniques to ensure they will perform their responsibilities in a safe and reliable manner. Such training shall include, but not be limited to, training in sample collection, packaging, decontamination, transportation, and chain-of-custody policies and procedures established by the laboratory. The laboratory shall maintain documentation of such training for a minimum of three years and take such other action as is necessary to ensure ongoing compliance with such policies and procedures;
(ii) develop and implement sample acceptance criteria designed to protect the health, safety and welfare of laboratory personnel, sample collectors, and the public to the extent feasible. Such criteria shall be consistent with approved methods for sample collection, handling, packaging and decontamination, and shall minimally define conditions under which a sample shall be rejected, and conditions under which a sample shall be tested and results reported with limitations. The laboratory shall make its sample acceptance criteria available to clients;
(4) issue reports of test results in a format and of a content required by the approved method, and necessary for interpretation of the test results or an autonomous detection system signal indicating the presence of a critical agent, including, but not limited to, unambiguous identification of the tested environmental sample, including collection location and time, source and sample type, and limitations of the method. The department may restrict a laboratory's ability to report information concerning a test result whenever confirmatory or supplemental testing is required by the approved method;
(5) report laboratory findings to the department or an authority designated by the department as soon as practicable, but no later than:
(i) 24 hours following generation of a test result, via telephone, facsimile and/or electronic transmission, using a number or e-mail address designated by the department or the department's designee; and
(ii) as specified in section 55-2.14 of this Subpart for an autonomous detection system, i.e., as soon as practicable but no later than one hour, whenever the findings indicate that an environmental sample contains an organism, its product or component, or a chemical, any of which exhibits characteristics or properties consistent with those of a critical agent. Whenever the department determines that supplemental testing is necessary, the laboratory shall submit all or part of the sample or its derivative(s) to the department or its designee, as directed by the department.
For purposes of this section and section 55-2.14 of this Subpart, the term supplemental testing shall mean performance of analyses following an initial indication that a critical agent has been detected, including, but not limited to, confirmatory testing and technical procedures to identify further the characteristics of a critical agent for public health protection and/or law enforcement purposes. The term confirmatory testing shall mean supplemental testing that definitively substantiates or refutes the presence of a critical agent;
(6) unless precluded by law enforcement, prosecutorial or homeland security authorities, make available the findings of confirmatory testing conducted in response to an autonomous detection system signal to the approved laboratory operating the autonomous detection system; and
(7) establish and implement a critical agent inventory and tracking system that accounts for all environmental samples and their derivatives suspected or confirmed to contain critical agents. Unless required to demonstrate implementation of chain-of-custody procedures required pursuant to paragraph (2) of this subdivision or required by this paragraph, a laboratory may discontinue inventory and tracking of samples and derivatives, provided laboratory findings have established the absence of a critical agent. Inventory and tracking documentation shall include the identity of all individuals who access such materials and the date and time of access, as well as specific information regarding transfer, disposal or other disposition of the materials. Samples and their derivatives, access records, chain-of-custody records and records of the analyses performed shall be maintained in a secure manner until the statute of limitations for bringing any related criminal or civil action has expired, and the sample and its derivatives are no longer needed for evidence in any pending legal matter or by law enforcement officials. Access records, chain-of-custody records and records of the analyses of confirmed positive samples shall be maintained for 10 years, or as required above if longer.
(e) For critical biological agents, an environmental laboratory's proficiency testing performance shall be evaluated based on the known presence or absence of the critical agent, or, as applicable, its product or component. Satisfactory performance shall be a result correctly indicating the presence or absence of the critical agent, or, as applicable, its product or component. Unsatisfactory performance shall be a result incorrectly indicating the presence or absence of the critical agent, or, as applicable, its product or component.
(f) Personnel requirements for environmental sample testing for critical biological agents that are organisms shall be as follows:
(1) notwithstanding the requirements of section 55-2.10 of this Subpart, the environmental laboratory shall employ, as director, one of the following:
(i) a person who holds or meets the qualifications for a New York State clinical laboratory director certificate of qualification in the applicable subspecialty of microbiology (such as bacteriology), pursuant to Part 19 of this Title, and, for analyses using technologies other than conventional microbiologic techniques, at least one year of experience in analysis using the specified technology of the device, instrument or system ( e.g., nucleic acid detection by the polymerase chain reaction [PCR] technique). For purposes of this subdivision, conventional microbioloic techniques shall mean culture, use of differential media, stains and/or biochemical reactions, and morphologic examination of colonies and/or organisms;
(ii) a person with an earned doctoral degree or master's degree in the chemical, environmental, physical or biological sciences or engineering, with at least 16 college semester credit hours in the biological sciences, including:
(a) at least one course having microbiology as a major component, and at least one year of experience in analysis using one or more conventional microbiologic techniques for which the laboratory is approved or seeking approval; or
(b) at least two years of experience in analysis using the specific technology of the device, instrument or system ( e.g., nucliec acid detection by PCR) for which the laboratory is approved or seeking approval; however, one course in the specific technology may be substituted for one year's experience; or
(iii) a person with a bachelor's degree in the chemical, environmental, physical or biological sciences or engineering, with at least 16 college semester credit hours in the biological sciences, including:
(a) at least one course having microbiology as a major component, and at least two years of experience in analysis using one or more conventional microbiologic techniques for which the laboratory is approved or seeking approval; or
(b) at least three years of experience in analysis using the specific technology of the device, instrument or system ( e.g., nucliec acid detection by PCR) for which the laboratory is approved or seeking approval; however, one course in the specific technology may be substituted for one year's experience; and
(iv) with respect to environmental laboratories that limit their critical biological agent testing to toxin analysis, any of the following personnel qualifications may be substituted for qualifications set forth above, as follows: a New York State clinical laboratory director certificate of qualification in toxicology may be substituted for the certification in microbiology requirement specified in subparagraph (i) of this paragraph; and coursework consisting of a minimum of 16 college semester credit hours in the biological and/or chemical sciences including at least one course in biochemistry may be substituted for the coursework requirements, but not the educational degree requirements specified in clauses (ii)( a ) and (iii)( a ) of this paragraph; and
(2) with the exception of autonomous detection systems, sample preparation, analysis and related responsibilities shall be performed by an analyst who shall have an associate's degree or equivalent, with at least 12 college semester credit hours in the biological sciences, and at least one year of experience in analysis of representative analytes; however, a person with at least three years' experience in the analysis of representative analytes immediately preceding the effective date of this section shall be deemed to have met the requisite qualifications for performing critical agent analysis in the laboratory in which such experience has been obtained. Analysts with critical biological agent testing responsibilities that are limited to toxin sample preparation, analysis and related responsibilities may meet the semester credit hour qualifications set forth in this paragraph by completing a minimum of 12 college semester credit hours in the biological and/ or chemical sciences.
(g) This section shall not apply to bacteriologic testing for total and fecal coliform bacteria ( i.e., the common form of Escherichia coli ) in potable and nonpotable water.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.318 Subsidiary ledger
A supporting ledger consisting of a group of accounts the total of which is in agreement with a control account.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.2 Permit required to hold or promote a mass gathering; application, issuance, revocation, posting
(a) No person shall hold or promote, by advertising or otherwise, a mass gathering unless a permit has been issued for the gathering by the permit-issuing official.
(b) Application for a permit to promote or hold a mass gathering shall be made to the permit-issuing official, on a form and in a manner prescribed by the State Commissioner of Health, by the person who will promote or hold the mass gathering. Application for a permit to promote or hold a mass gathering shall be made at least 15 days before the first day of advertising and at least 45 days before the first day of the gathering. Water and sewage facilities shall be constructed and operational not later than 48 hours before the first day of the mass gathering. The application shall be accompanied by such plans, reports and specifications as the permit-issuing official shall deem necessary. The plans, reports and specifications shall provide for adequate and satisfactory water supply and sewerage facilities, adequate drainage, adequate toilet and lavatory facilities, adequate refuse storage and disposal facilities, adequate sleeping areas and facilities, wholesome food and sanitary food service, adequate medical facilities, insect and noxious weed control, adequate fire protection, and such other matters as may be appropriate for security of life or health.
(c) A separate permit shall be required for each mass gathering.
(d) A permit may be revoked by the permit-issuing official or the State Commissioner of Health if he finds that the mass gathering for which the permit was issued is maintained, operated or occupied in violation of law, this Title, or the sanitary code of the health district in which the mass gathering is located. A permit may be revoked upon request of the operator or upon abandonment of operation.
(e) A permit issued for the operation of a mass gathering shall be posted or kept on file and made available by the operator on request.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
APPLICATION AND PURPOSE APPLICATION AND PURPOSE
10 CRR-NY 14-4.10 Purpose
The purpose of this code is to protect the public health. Owners and operators of mobile food service establishments and pushcarts are to operate in such a way as to avoid health hazards by limiting operations and the kinds of food to those which can be safely prepared, stored and served with the equipment available.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.2 Definitions
(a) Swimming pool shall mean a structure, together with buildings and appurtenances used in connection therewith, intended for bathing, swimming or diving purposes, made of concrete, masonry, metal, or other impervious material, located either indoors or outdoors.
(b) Wading pool shall mean a swimming pool that contains water a maximum of two feet deep.
(c) Spa pool shall mean a swimming pool, primarily designed for therapeutic use or relaxation, which is normally not drained, cleaned or refilled for each individual. It may include, but is not limited to, hydrojet circulation, hot water, cold water, mineral bath, air induction, bubbles or any combination thereof. Spa pools are shallow in depth and are not designed for swimming or diving.
(d) White-water slide shall mean a swimming pool consisting of a starting platform, one or more flumes, and a plunge pool.
(e) Wave pool shall mean a swimming pool of special shape and design, with waterwave- making machinery.
(f) Special-purpose pool shall mean a swimming pool of special design primarily for use by persons with physical disabilities.
(g) Movable-bottom pool shall mean a swimming pool with a hydraulic lift arrangement for floor movement and a jet water self-cleaning system.
(h) Permit-issuing official (PIO) shall mean the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law. The permit-issuing official may designate additional persons to act in his behalf to issue permits required by this Subpart.
(i) Bathing shall mean to become partially or totally immersed in water.
(j) Adequate shall mean sufficient to accomplish the purposes for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(k) Uniform Code shall mean the New York State Uniform Fire Prevention and Building Code, 9 NYCRR Subtitle S, Chapter I.
(l) Qualified swimming pool treatment operator shall mean an individual possessing evidence of the successful completion of either of the following courses:
(1) a New York State Department of Health Water Treatment Plant Operator Certification Course Type A or B; or
(2) an adequate course of instruction regarding the safe and effective operation and maintenance of pool treatment equipment.
(m) Aquatic supervisory staff shall mean, effective May 15, 1993, an individual possessing the qualifications as found in section 6-1.31 of this Subpart for Supervision Level II, III, or IV and section 6-2.20(a) of this Part for Supervision Level I.
(n) Effective May 15, 1993, supervising lifeguard shall mean, an individual at least 18 years of age, who possesses as minimum qualifications Supervision Level IIb, and has at least two seasons of adequate lifeguarding experience.
(o) Homeowner swimming pool means a swimming pool owned and operated by a condominium ( i.e., property subject to the article 9-B of the Real Property Law, also known as the Condominium Act), a property commonly known as a cooperative, in which the property is owned or leased by a corporation, the stockholders of which are entitled, solely by reason of their ownership of stock in the corporation, and occupy apartments for dwelling purposes, provided an “offering statement” or “prospectus” has been filed with the Department of Law, or an incorporated or unincorporated property association, all of whose members own residential property in a fixed or defined geographical area with deeded rights to use, with similarly situated owners, a defined swimming pool, provided such swimming pool is used exclusively by members of the condominium, cooperative apartment project or corporation or association, and their family and friends.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.18 Separability
If any provision of this Part are held invalid, such invalidity shall not affect other portions which can be given effect without the invalid provisions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.3 Reporting
(a) On or before May 1st of each State fiscal year (April 1st to March 31st), the department will advise each laboratory of the total estimated cost of the clinical laboratory improvement program for the previous State fiscal year.
(b) On or before May 15th, each laboratory will certify and report its gross annual receipts for the previous calendar year on forms to be provided by the department. If requested by the laboratory, this report shall be deemed confidential and exempt from disclosure under the Freedom of Information Law (article 6 of the Public Officers Law), pursuant to the authority in section 89(5) of the Public Officers Law. Knowing and/or willful failure to report or inaccurate reporting shall result in nonrenewal of the laboratory permit.
(c) On or before June 1st, the department shall bill each laboratory for its inspection and reference fee and shall advise each laboratory of the total gross receipts reported by all laboratories.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.8 Requirements during construction
(a) The applicant shall request and must obtain the prior approval of the commissioner for any changes proposed during construction relating to the description of the program scope or functional space concept of the project, total project costs, total basic costs of construction, increased interest rates relating to the financing of any aspect of the project, or major items of equipment as approved. The commissioner shall respond in writing within 30 days of the receipt of such a request, unless the change constitutes an amendment to the application, in which event the provisions of section 710.5 of this Part shall apply.
(b) The applicant may authorize change orders to the construction contract which contribute to the necessary coordination and orderly completion of the project without the need for prior approval of the commissioner if such change orders can be funded within the approved construction contingency and the changes do not relate to changes in the program scope or functional space concept of the project. Any change order relating to changes in program scope or functional space concept must be submitted for prior approval. If the total value of change orders exceeds the budgeted construction contingency, which may constitute an amendment pursuant to the provisions of section 710.5 of this Part, then all change orders, including those previously authorized by the applicant, will be reviewed by the commissioner as to acceptability for reimbursement. In such event, only those change orders that have been given prior approval under subdivision (a) of this section, those change orders which are deemed necessary by the commissioner for prudent coordination and continuation of the project, and those change orders which are related to unforeseen conditions or which can demonstrate positive financial impact on the project may be considered reimbursable. The costs associated with change orders, in excess of those effectuated under the approved design and/or construction contingency, made by the applicant, its architects, contractors or agents, will be eligible for reimbursement pursuant to the provisions of Part 86 of this Title only to the extent that the applicant has not been able to recover such costs from a responsible party, if any, insurance carrier or bonding agency.
(c) For projects exceeding $15 million in total basic cost of construction, an updated functional stack diagram which includes square footages, type of construction and estimated cost of construction and equipment for each functional area displayed and, where appropriate, the relative cost of each area as well as the total construction cost for each discrete physical structure involved, and indicating the percentage of completion for each functional area, shall be submitted every six months during construction in accordance with section 710.2(b)(10)(i)( b ) of this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 108 CLINTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 108.1 Village of Keeseville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all the natural and artificial reservoirs and to all watercourses tributary thereto or ultimately discharging into any of said reservoirs that form the source or sources of the public water supply of the village of Keeseville, which is located partly in Clinton County and partly in Essex County, N. Y.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to Butternut Pond, the watershed of which lies wholly in Essex County and which serves as a source of public water supply of the village of Keeseville or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Keeseville.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the village of Keeseville.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Keeseville.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such a manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary to maintain them or the privy or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or 250 feet from any watercourse tributary to the public water supply of the village of Keeseville.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Keeseville, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivison (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village Keeseville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Keeseville.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the village of Keeseville.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall bathe nor shall any animal or poultry be allowed to stand, wallow, wade or swim nor be washed in any reservoir of the public water supply of the village of Keeseville. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Keeseville.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet from any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Keeseville, and none of the above named objects or sources of pollution shall be so constructed, placed or allowed to remain where or in such a manner that the drainings, leachings or washings therefrom may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Keeseville.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Keeseville, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or within 250 feet of any watercourse tributary to the public water supply of the village of Keeseville, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 300 feet from any reservoir or within 75 feet from any watercourse tributary to the public water supply of the village of Keeseville.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the village of Keeseville.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of Keeseville, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of Keeseville.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Butternut Pond within 1000 feet of the intake of the public water supply of the village of Keeseville. All ice cutting on Butternut Pond beyond the above specified distance shall be done in strict compliance with the regulations to be adopted by the board of water commissioners and under the rigid inspection and supervision of such board.
(h) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the village of Keeseville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Keeseville.
(j) Inspections.
The board of water commissioners of the village of Keeseville shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 2 PUBLIC HEALTH NURSE 2
10 CRR-NY 11.43 Qualifications
A public health nurse 2 must meet the qualifications for public health nurse 1 and have one year of experience in public hearing nursing. A public health nurse 2 must complete 15 hours of continuing education in public health-related topics approved by the New York State Department of Health within the first year of employment in the title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.2 Construction
Terms not defined in this Subpart are defined in Subpart 52-1 of this Part. Musculoskeletal tissue banks shall apply for licensure and otherwise comply with Subpart 52-2 of this Part, and shall meet all general technical standards for tissue banks specified in Subpart 52-3 of this Part.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-1.181 Living areas
Operation of a food service establishment is not to be conducted in any room used as living or sleeping quarters. Food service operations are to be separated from living or sleeping quarters by complete partitioning and solid self-closing doors.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 108 CLINTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 108.2 Village of Plattsburgh
L. 1893, ch. 661; L. 1899, ch. 251
(a) [Human excreta.]
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 75 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind the water in which when running flows eventually into a reservoir of the public water supply of the village of Plattsburgh, New York.
(2) No privy, vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir or within 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse, as aforesaid.
(3) Every privy or place for the deposit of human excreta which is constructed, located or maintained between the aforesaid limits of 75 and 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir or 75 and 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid and from which the said excreta is not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of disposal beyond the maximum aforesaid limit shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolute watertight condition and which shall admit of convenient removal to some place of ultimate disposal beyond the said maximum limit.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or floor of said privy.
(5) The excreta so collected shall be removed so as to cause the least possible nuisance and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slope or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water mark as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink waste, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid within 75 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, ditch, stream or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any cattle, horses, sheep, swine or other animals be allowed to enter, wallow or stand in any reservoir, spring, stream, ditch or watercourse aforesaid.
(c) Garbage and refuse.
No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream. ditch or watercourse aforesaid, nor shall any such substances be placed upon or below the surface of the ground where they may be washed into any reservoir, spring, stream, ditch or watercourse aforesaid within 75 feet of the high-water mark or precipitous bank thereof.
(d) Manures, composts and similar matter.
(1) No stable, pigsty, henhouse, stable yard, barnyard, hogyard, duckyard, hitching or standing place for horses or cattle nor any compost or manure heap or other place where animal manure accumulates shall be located or maintained within 100 feet of any reservoir, spring, stream, ditch or watercourse aforesaid. These and also watering places for horses or cattle or other animals must be so arranged that the polluted drainage therefrom shall not flow into any such reservoir, springs, streams, ditches or watercourses without having undergone proper purification. Such drainings shall not be allowed to flow through open or covered drains within 75 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse as aforesaid without having undergone proper purification.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir or within 130 feet of the high-water mark or precipitous bank of any stream, spring, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so as to be washed a less distance than 50 feet over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface for less than 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(f) [Cemeteries.]
No interment of a human body shall be made within 1000 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(g) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, the penalty for each and every violation or noncompliance with any of the above rules and regulations is hereby fixed and imposed at $200, to be recovered, as provided by law, from every corporation, person or persons guilty of any such violation or noncompliance.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.14 Cardiac services
(a) These standards will be used to evaluate certificate of need applications for cardiac catheterization laboratory center services and cardiac surgery center services. It is the intent of the Public Health and Health Planning Council that these standards, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decision-making tools for directing the distribution of cardiac catheterization laboratory center services and cardiac surgery center services. These planning principles and decision making tools build on the existing regional resources that have been developed through the regulatory planning process. The goals and objectives of the standards expressed herein are expected to promote access to cardiac catheterization laboratory center services and cardiac surgery center services, and maintain provider and operator volumes associated with high quality care, and avoid the unnecessary duplication of resources while addressing the geographic distribution of services necessary to meet the needs of patients in need of emergency percutaneous coronary interventional (PCI) procedures. Additionally, it is intended that the methodology provide sufficient flexibility to consider additional circumstances that reflect on the need for cardiac services, including providing flexibility for regional health systems to provide cardiac services at sites that are convenient to patients in the communities they serve.
(b) Cardiac surgery centers . The factors for determining the public need for cardiac surgery center services shall include, but not be limited to the following:
(1) The planning area for determining the public need for cardiac surgery center services shall include the applicant's designated health systems agency (HSA) region and the use area of the applicant facility. For purposes of determining cardiac surgery center services need, the use area of a facility is defined as the area within a 100 mile radius of the applicant facility.
(2) Planning for cardiac surgery center services shall ensure that, to the extent possible, 80 percent of the total population of each HSA region resides within 100 miles of one or more facilities providing cardiac surgical services.
(3) A facility proposing to initiate an adult cardiac surgery center must document a cardiac patient base and current cardiac interventional referrals sufficient to support a projected annual volume of at least 300 cardiac surgery cases and a projected annual volume of at least 36 emergency PCI cases within two years of approval. The criteria for evaluating the need for additional adult cardiac surgery centers within the planning area shall include consideration of appropriate access and utilization, and the ability of existing services within the planning area to provide such services. Waiver of this planning area volume requirement may be considered if:
(i) the HSA region's age adjusted, population based use rate is less than the statewide average use rate; and
(ii) existing adult cardiac surgery centers in the applicant facility's planning area do not have the capacity or cannot adequately address the need for additional cardiac surgical procedures, such determinations to be based on factors including but not necessarily limited to analyses of recent volume trends, analyses of Cardiac Reporting System data, and review by the area health systems agency(s); and
(iii) existing cardiac surgical referral patterns within the planning area indicate that approval of an additional service at the applicant facility will not jeopardize the minimum volume required at other existing cardiac surgical programs.
(4) No finding of need for the addition of pediatric cardiac surgery center services will be made unless each existing pediatric cardiac surgery center service in the planning area is operating and expected to continue to operate at a level of at least 200 pediatric cardiac surgical procedures per year, and unless such existing pediatric cardiac surgery center services do not have the further capacity to meet projected need for additional pediatric cardiac surgical procedures. Where public need is established herein, a facility proposing to provide pediatric cardiac surgical services must demonstrate the ability to perform a minimum of 200 pediatric cardiac surgical procedures per year by the end of the second full calendar year of operation or demonstrate the ability to perform a minimum of 50 cases a year on-site and operate as part of a coordinated program based on a fully executed written agreement, approved by the commissioner, with another pediatric cardiac surgery program in accordance with standards at section 405.29(d)(5)(ii) of this Title. For hospitals seeking approval as part of a coordinated program, the agreement must be submitted with the certificate of need application and must be approved by the department prior to initiation of the service.
(5) A facility proposing to provide adult and/or pediatric cardiac surgery center services shall:
(i) submit a written plan to the Department of Health which, when implemented, will ensure access to cardiac surgical services for all segments of the HSA region's population. Such plan shall provide a detailed plan to reach patients not currently served within the planning area, ensure continuity of care for patients transferred between facilities, and shall otherwise promote planning for cardiac services within the region; and
(ii) propose a hospital based heart disease prevention program that, when implemented, shall include:
(a) Treatment plans for cardiac inpatients with a principal diagnosis of ischemic heart disease. These patients are at high risk for development of adverse cardiovascular events and the program shall provide for the following in a comprehensive, systematic way:
(1) protocols shall be developed and implemented for the assessment of risk factors including lipid disorders, hypertension, diabetes, obesity, cigarette smoking, and sedentary lifestyle. Such protocols shall be in keeping with generally accepted standards;
(2) the hospital shall provide patient education that shall include, but not be limited to, information on the importance of assessing risk factors for heart disease in first-degree relatives, and the importance of cardiopulmonary (CPR) training for family members and care givers;
(3) discharge plans must include:
(i) a request for consent to allow patient medical information to be shared with the patient’s primary care providers;
(ii) patient referral to their primary care provider with documentation of treatments provided by the hospital and follow-up care recommended by the hospital; and
(iii) patient referral to cardiac rehabilitation programs appropriate to their needs.
(b) Professional education:
(1) the hospital shall sponsor or co-sponsor at least three professional education programs per year related to heart disease risk assessment and control and that are open to local community based health professionals.
(c) Hospital based heart health promotion:
(1) the program shall implement policies and health programs in the hospital and establish environments that promote heart-healthy behaviors among hospital staff, employees and visitors, including:
(i) prohibiting the sale and use of tobacco products on hospital premises;
(ii) offering and promoting, on a regular basis, healthful choices in hospital cafeterias and patient menus; and
(iii) offering employee wellness and fitness programs that provide opportunities for employees to make healthy choices.
(d) Community based heart health promotion:
(1) The hospital shall organize or participate in a consortium of existing community-based organizations and key community leaders to engage in activities to improve cardiac health in the community; and
(2) organize or participate in at least one major community based campaign (not including health fairs) each year related to major heart disease risk factors.
(e) Program administration:
(1) hospitals shall identify a team within their organization to coordinate heart disease prevention activities. Members of the team shall include a broad range of expertise, including but not limited to: community organization, planning, and social marketing, public health skills and health education.
(6) When considering an application to meet public need for adult and or pediatric cardiac surgery center services, priority consideration shall be given to the expansion of an existing service as opposed to the initiation of a new cardiac surgery center.
(7) Where public need is established herein, priority consideration will be given to applicants that agree to serve the medically indigent and patients regardless of the source of payment.
(8) Applicants proposing to initiate an adult and or pediatric cardiac surgery center service must:
(i) demonstrate the ability to comply with standards set forth in sections 405.29(c) and (d) and 711.4(h) of this Title; and
(ii) in addition, a facility providing pediatric cardiac surgery center services also must comply with the requirements specified in section 711.4(f) of this Title.
(9) All hospitals approved as adult cardiac surgery centers shall be approved as PCI capable cardiac catheterization laboratory centers and must meet standards in sections 405.29(c), (e)(1), and (2) of this Title. All hospitals approved as pediatric cardiac surgery centers shall be approved as pediatric cardiac catheterization laboratory centers and must meet the standards in section 405.29(c), (e)(1) and (4) of this Title.
(c) For the purposes of this section the terms cardiac catheterization laboratory center, percutaneous coronary intervention (PCI) capable cardiac catheterization laboratory center, cardiac electrophysiology (EP) laboratory program and pediatric cardiac catheterization laboratory center shall have the same meanings as in section 405.29(a)(4) of this Title.
(d) Public need for cardiac catheterization laboratory centers:
(1) PCI capable cardiac catheterization laboratory centers. The factors and methodology for determining the public need for PCI capable cardiac laboratory centers shall include, but not be limited to the following:
(i) PCI capable cardiac catheterization laboratory centers at hospitals with a cardiac surgery center on site. Applicants approved as cardiac surgery centers are approved PCI capable cardiac catheterization laboratory centers as provided under paragraph (b)(9) of this section and must meet standards at section 405.29(c), (e)(1) and (2) of this Title.
(ii) PCI capable cardiac catheterization laboratory centers at hospitals with no cardiac surgery on site. Determinations of public need for PCI capable cardiac catheterization laboratory centers at hospitals with no cardiac surgery on-site will be differentiated between:
(a) hospitals that are established by the Public Health and Health Planning Council as co-operators with a hospital that is a cardiac surgery center as defined in section 405.29(a)(3) of this Title; and
(b) hospitals that have a clinical sponsorship with a cardiac surgery center as defined in section 405.3(f)(3) of this Title and that are applying to be a PCI capable cardiac catheterization laboratory center. For the purposes of this section, clinical sponsorship shall mean that the hospital applying to be a PCI capable cardiac catheterization laboratory center has entered into a clinical sponsorship agreement with a cardiac surgery center acceptable to the department and in accordance with the standards established in section 405.29(c)(8)(i) of this Title.
(iii) For both co-operated hospitals and hospitals that are proposing to enter into a clinical sponsorship agreement, factors for determining public need shall include, but are not limited to:
(a) the planning area for determining the public need for PCI capable cardiac catheterization laboratory centers at hospitals with no cardiac surgery on-site shall be the area within a one hour average surface travel time, as determined by the department of transportation and adjusted for typical weather conditions, of the applicant facility, unless otherwise determined by the commissioner in accordance with section 709.1(c) of this Title;
(b) documentation by the applicant must demonstrate the hospital’s ability to provide high quality appropriate care that would yield a minimum of 36 emergency PCI procedures per year within the first year of operation.
(1) Documentation of the number of cardiologists on staff at the proposed site, credentialed by the co-operated hospital, and/or employed by the clinical sponsorship hospital who currently perform percutaneous coronary interventions at other hospital sites and a summary of experience (including the most recent three years of volume and outcomes) for each.
(2) Documentation in support of volume projections for emergency PCI procedures must include, at a minimum: discharge data indicating the number of patients with a diagnosis of acute myocardial infarction (AMI) and/or other diagnoses associated with PCI, the number of doses of thrombolytic therapy ordered for acute MI patients in the applicant hospital’s emergency department (as documented through hospital pharmacy records), and documentation of transfers to existing PCI capable cardiac catheterization laboratory centers for PCI.
(3) Additional documentation that may be submitted in support of the need for a proposed PCI capable cardiac catheterization laboratory center include:
(i) the number of acute care beds at the applicant hospital and the range of acute care services provided;
(ii) documentation by the applicant of barriers that impact care experienced by specific population groups within the planning area and demonstration of cultural competency at the applicant site specific to the proposed populations to be served by the applicant;
(iii) documentation by the applicant demonstrating outreach to underserved populations that identifies potential new PCI cases within the service area;
(iv) emergency department discharge data;
(v) documentation by the applicant of regional demographics and transport patterns within the applicant's emergency medical service (EMS) region that impact the provision of cardiac care;
(vi) the geographic distribution of PCI capable cardiac catheterization laboratory center services and the ability of such existing centers to serve the patients in the applicant's service area;
(vii) letters from local physicians quantifying the number of PCI referrals from their practice and the portion of those that would have been treated at the applicant facility if PCI had been available;
(c) a written plan submitted by the applicant that demonstrates the hospital’s ability to comply with standards for PCI capable cardiac catheterization laboratory centers at sections 405.29(c), (e)(1) and (2) of this Title;
(d) a written plan submitted by the applicant that outlines staff training and demonstrates the hospital’s readiness to accommodate the needs of the PCI patients;
(e) a written plan has been submitted by the applicant which would promote access to cardiac catheterization laboratory center services for all segments of the hospital service area's population. The document shall include:
(1) a description of current and proposed initiatives for improving outcomes for patients with heart disease;
(2) a plan documenting the hospital's ability to maintain a comprehensive program in which high quality interventional procedures are provided as a component of a broad range of cardiovascular care within the hospital and within the community, to include an emphasis on processes of care and a description of how a patient will traverse through the system of care to be offered;
(3) a plan for ensuring continuity of care for patients transferred between facilities;
(4) documentation of outreach to regional EMS councils served by the applicant;
(5) documentation that EMS system capabilities have been taken into consideration in the delivery of cardiac services;
(6) a description of activities that promote planning for cardiac services within the region; and
(7) a description of current and proposed initiatives and strategies for reaching patients not currently served within the area.
(f) comments and recommendations received from community organizations;
(g) the hospital shall propose and implement a hospital heart disease prevention program as set forth at subparagraph (b)(5)(ii) of this section;
(h) a description of existing and planned activities to serve the medically indigent and populations that experience health disparities;
(2) Cardiac EP laboratory programs. Factors for determining public need for cardiac EP laboratory programs shall include but not be limited to the following:
(i) Each applicant for a cardiac EP laboratory program shall be an approved PCI capable cardiac catheterization laboratory center or an approved diagnostic cardiac catheterization service operating in compliance with standards at section 405.29(c) and (e) of this Title. Applicants for EP laboratory programs will also be considered in conjunction with requests for approval of PCI capable cardiac catheterization laboratory center services.
(ii) Each applicant shall submit documentation, describing how the hospital will comply with standards at section 405.29(e)(5) of this Title.
(iii) Each applicant shall submit documentation of existing referrals for cardiac electrophysiology patients treated by cardiologists on staff at the hospital.
(iv) Applicants for cardiac EP laboratory programs at hospitals with no cardiac surgery center on-site must submit a copy of the patient selection criteria for the proposed program in accordance with the standards at section 405.29(e)(5)(iii) of this Title.
(v) Hospitals approved as cardiac surgery centers shall be deemed to have demonstrated public need to perform cardiac electrophysiology.
(3) Pediatric cardiac catheterization laboratory centers. Public need for a pediatric cardiac catheterization laboratory center shall be determined only in conjunction with an application for a pediatric cardiac surgery center and when need has been demonstrated for pediatric cardiac surgery centers in accordance with standards at subdivision (b) of this section.
(4) For co-operated hospitals under subdivision (d)(1)(ii) of this section:
(i) the application for PCI services must be submitted jointly by the applicant facility and the co-operated parent;
(ii) documentation acceptable to the department must be submitted demonstrating that all cardiac catheterization laboratory centers within the co-operated parent’s system have staff sharing agreements that include, at a minimum, provisions for rotation and training of staff with the parent hospital and integration into the parent hospital’s quality and patient safety programs, quality assurance and peer review;
(iii) documentation acceptable to the department must be submitted demonstrating that the co-operated parent hospital will be responsible for maintaining the competency of the cardiac interventionalist physicians, nursing, and technical staff performing services at the applicant facility;
(iv) documentation acceptable to the department must be submitted demonstrating that the co-operated parent hospital will be responsible for ensuring that the applicant facility can provide PCI services on a 24 hour a day, 365 days a year basis and is capable of assembling a dedicated team within 30 minutes of the activation call to provide coronary interventions 24 hours a day and 365 days each year;
(v) if the co-operated parent is not in the planning area of the applicant facility, then the applicant facility must document that it has an emergency transfer agreement with a New York State cardiac surgery center in the planning area that has an on-site cardiac surgery program.
(5) For applicant hospitals in a clinical sponsorship relationship with a New York State cardiac surgery center:
(i) the application for PCI services must be submitted by the applicant hospital;
(ii) the sponsoring New York State cardiac surgery center must be located in the same planning area as the applicant hospital;
(iii) the sponsoring New York State cardiac surgery center must perform at a level of at least 600 PCI procedures per year;
(iv) a written and signed PCI clinical sponsorship agreement with the sponsoring New York State cardiac surgery center, acceptable to the department and in accordance with standards at section 405.29(c)(8)(i) of this Title, must be submitted. The PCI clinical sponsorship agreement must specify that the department shall be provided 60 days prior written notification of any proposed change, termination or expiration of the agreement, and any changes must be found acceptable to the department prior to implementation. The agreement shall further provide that the parties agree that termination or expiration of the agreement shall result in closure of the applicant hospital’s cardiac catheterization laboratory center;
(v) both the applicant hospital and the sponsoring hospital must submit written documentation demonstrating that the respective governing bodies have approved the clinical sponsorship agreement.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS
10 CRR-NY 80.85 Administration of controlled substances to addicts and habitual users
(a) The administration of controlled substances to narcotic addicts or habitual users of controlled substances is prohibited except as provided for in this Part.
(b) Controlled substances may be administered to narcotic addicts or habitual users of controlled substances upon the order of a person authorized by law to practice medicine or osteopathy in this State and who possesses a Federal registration by the Drug Enforcement Administration, United States Department of Justice, authorizing him to use controlled substances in connection with his professional practice as follows:
(1) for bona fide patients suffering from disease known to be incurable, such as cancer, advanced tuberculosis, and other diseases well recognized as coming within this class;
(2) for addicts who are aged and infirm, or severely ill and it is determined that withdrawal of controlled substances would be dangerous to life, provided that:
(i) such determination has been confirmed by adequate consultation;
(ii) complete records of treatment, administration or dispensing of controlled substances including patient's name, date and type and quantity of controlled substance administered or dispensed are kept;
(iii) adequate safeguards have been taken against diversion of the controlled substances from the intended use; and
(iv) the patient is carefully supervised;
(3) to relieve acute withdrawal symptoms, except that:
(i) only the amount of controlled substances essential for relief of such acute symptoms shall be administered; and
(ii) administration shall be in an institutional or other setting reasonably certain to provide a drug-free environment;
(4) for detoxification of an addict participating in an authorized treatment program approved pursuant to article 23 of the Mental Hygiene Law; and
(5) for treatment of addicts participating in an authorized methadone or other controlled substances maintenance program approved pursuant to article 23 of the Mental Hygiene Law.
(c) In properly verified cases of severe illness, infirmity, or physical disability, a licensed physician, registered nurse, licensed practical nurse, or registered pharmacist may deliver medication to the patient.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.337 Useful life
Normal operating life in terms of utility to the hospital.
Chapter I STATE SANITARY CODE
Part 1 GENERAL PROVISIONS
VIOLATIONS AND PENALTIES VIOLATIONS AND PENALTIES
10 CRR-NY 1.20 Interference with placards prohibited
(a) No person shall interfere with or obstruct any health authority in the posting of any placard in accordance with the requirements of the Public Health Law or this Chapter, in or on any place or premises, nor shall any person conceal, mutilate, or remove any such placard, except by direction of the health officer.
(b) In the event of any such placard being concealed, mutilated or torn down, it shall be the duty of the occupant, owner or person in charge of the premises whereon such placard was posted immediately to notify the health officer of such fact.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NUTRITIONIST PUBLIC HEALTH NUTRITIONIST
10 CRR-NY 11.132 Supervisory level qualifications
A supervising public health nutritionist must meet the qualifications for a public health nutritionist and have two years' experience as a public health nutritionist, or have a master's degree in nutrition or public health nutrition from a regionally accredited or New York State-registered college or university, and one year of experience as a public health nutritionist.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.321 Teaching program (nonapproved)
To be a nonapproved teaching program means that, a medical internship or residency training program is not approved by the Council of Medical Education of the American Medical Association or, in the case of an osteopathic hospital, is not approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. An intern or residency program in the field of dentistry is not approved unless approval has been received by the Council on Dental Education of the American Dental Association.
Subchapter B HOSPITAL ESTABLISHMENT
Part 640 PROCEDURES FOR APPROVAL OF THE DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES AND THE ESTABLISHMENT OF SUCH FACILITIES
10 CRR-NY 640.1 General provisions
The provisions of this Part shall apply to all persons interested in the development of comprehensive health services, which may include but are not necessarily limited to in-patient hospital and physician care, ambulatory health care and out-patient preventive medical services, and which might require the establishment of hospital facilities. While it is not necessary that such parties comply with the provisions of sections 640.2, 640.3 and 640.4 of this Part in sequence, it is recommended that they do so, although any party capable of meeting the requirements of any such section need not comply with the provisions of any other section in order to obtain the approval provided for in the section pursuant to which application has been made.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.6 Transition periods and reimbursement
(a) Transition to new methodology.
The reimbursement methodology described in this Subpart for prevocational services (site-based) and respite (hourly and free-standing) will be phased-in over a two year period, with a year for purposes of the transition period meaning a 12 month period from July 1st to the following June 30th, and with full implementation in the beginning of the third year. During this transition period, the base operating rate will transition to the target rate according to the phase-in schedule immediately below. The base operating rate will remain fixed and the target rate, as determined by the reimbursement methodology in this Subpart, will be updated to reflect rebasing of cost data, trend factors and other appropriate adjustments.
| | Phase-in percentage | | | --- | --- | --- | | Transition | Base operating rate | Target rate | | Year one (July 1, 2015 – June 30, 2016) | 50% | 50% | | Year two (July 1, 2016 - June 30, 2017) | 25% | 75% | | Year three (July 1, 2017 – June 30, 2018) | 0% | 100% |
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.8 Periodic review
For each approved rape crisis program, the department of Health shall perform on-site visits, review records or reports related to the program, and/or observe the training of rape crisis counselors as necessary to ensure compliance with the requirements of this Subpart.
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.7 Responsibilities of the parent or legal guardian
The parent or guardian of any child born to a woman with a positive HBsAg test result shall have administered to such child immunizing doses of hepatitis B immune globulin and hepatitis B vaccine at birth as well as follow-up doses of hepatitis B vaccine.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.11 Reporting of pesticide poisoning
Every physician, health facility, and clinical laboratory in attendance on a person with confirmed or suspected pesticide poisoning or with any of the clinical laboratory results as described in section 22.12 of this Part, shall report such occurrence to the State Commissioner of Health within 48 hours. This report shall be on such forms or in such manner as prescribed by the State Commissioner of Health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 113 ERIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 113.1 Village of Akron
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on an unnamed branch of Murder Creek which empties into said creek at the hamlet of Griswold and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Village of Akron, Erie County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoir on that branch of Murder Creek, which is tributary to or which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Akron.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall placed, maintained or allowed to remain within 300 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the Village of Akron.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 500 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Village of Akron.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle removable container which shall be emptied as set forth in paragraphs (4) (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removal containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, order to maintain the privy or receptacle in proper sanitary condition effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the Village of Akron.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Village of Akron, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Village of Akron.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Village of Akron, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the Village of Akron.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the Village of Akron.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the Village of Akron. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Village of Akron.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the Village of Akron, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 30 feet from any watercourse tributary to the public water supply of the Village of Akron.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Akron, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Village of Akron; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the Village of Akron.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 30 feet from any watercourse tributary to the public water supply of the Village of Akron.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance for a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Village of Akron.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Village of Akron, except by duly authorized employees of the Village of Akron in the performance of their duties of supervision and maintenance of the public water supply of the Village of Akron.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Akron.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the Village of Akron.
(j) Inspections.
The board of water commissioners of the Village of Akron or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Akron or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 149 TIOGA COUNTY
10 CRR-NY 149.1 Village of Waverly
L. 1893, ch. 661; L. 1906, ch. 582
(a) [Human excreta.]
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind, the water of which when running flows eventually into a reservoir of the Waverly public water supply.
(2) No privy, vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or within 150 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit of human excreta which is constructed, located or maintained between the aforesaid limits of 50 and 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or 50 and 150 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid, and from which the said excreta is not at once removed automatically by means of suitable watertight pipes or conduits to some place of disposal beyond the maximum aforesaid limits shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limits.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or floor of said privy.
(5) The excreta so collected shall be removed so as to cause the least nuisance possible and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid, without having been thereby, in the judgment of the State Department of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water mark as shall be considered safe and proper by the said Department of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement, or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid.
(3) No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, stream, ditch or watercourse aforesaid; nor shall any such polluted matter be thrown or discharged into the ground below the surface in any manner whereby the same, or washings from the same, may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through the earth for a distance of at least 50 feet, horizontal measurement, to the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse contributary in any way to the water supply of the village of Waverly, N. Y.
(c) [Animals.]
(1) No stable, pigsty, henhouse, barnyard, hog or duck yard, hitching or standing place for cattle or horses or other place where animal manure accumulates and no compost or manure heaps shall be located or maintained within 250 feet of, nor shall they or any watering place for horses, cattle or other animals be so arranged that the polluted drainings therefrom shall be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement, nor flow into or through open or covered drains within 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No cattle shall be allowed to pasture or graze along the shores of the lower reservoir, nor shall they be allowed to stand in or drink from the waters of the lower reservoir and a proper fence or barrier shall be built and constantly maintained along the shores of said reservoir to prevent all access of cattle to the waters of said reservoir.
(d) [Compost.]
No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so that they may be washed a less distance than 250 feet over the surface of the ground or 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid, and no compost containing human excreta shall be placed or spread upon any ground whatever draining into any reservoir, spring, stream, ditch or watercourse aforesaid, if such ground slopes directly to such reservoir, spring, stream, ditch or watercourse at an average slope of more than 10 feet vertical to 100 feet horizontal.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed over or on the surface a distance of less than 250 feet or through the subsoil a distance of less than 50 feet into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(f) [Cemeteries.]
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(g) Use of reservoirs for cutting ice and fishing.
(1) The reservoirs of the Waverly public water supply shall not be used to supply ice for public or private purposes and teams, cattle or men shall not enter upon the pond in winter for the purpose of cutting or removing and storing ice.
(2) No person shall either with nets, line and hook or in any other way fish or catch or attempt to catch any fish from the reservoirs of the Waverly water supply.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.16 Certification procedures
All bottled or bulk water products sold or distributed in New York State must be certified. The following procedures must be met to apply for certification:
(a) Any person applying for bottled water certification shall, at a minimum, meet the requirements listed below:
(1) Complete and submit a signed application form, GEN 222 Application for Certification of Approval for Distribution of Bottled or Bulk Water.
(2) Submit a statement from the appropriate regulatory agency of the state or country having jurisdiction over the bottling operation, indicating that the facility has been approved to bottle or package water for human consumption. This approval may be a copy of a certificate, license, permit or a letter of approval from the agency. A copy of the laws and regulations on bottled water processing from the regulatory agency having jurisdiction must also be submitted. When another state or country has no program for inspection and approval of bulk or bottled water facilities, the commissioner may make a determination based on an inspection and evaluation by an independent individual or organization knowledgeable in bulk or bottled water handling practices.
(3) Submit an engineering report, plans and specifications for the proposal prepared by a registered professional engineer licensed to practice in New York State or in the state which the facility is located. This submittal must include, but not be limited to, the development of the source, methods used in the bottling operation, the water treatment used and laboratory control of water quality provided and a flow diagram from source through the bottling operation. The report submitted with the application must show compliance with the requirements of this Subpart.
(4) Submit two caps and two labels for each container size of the bottled water product that is to be certified.
(5) Submit complete inorganic chemical, organic chemical, microbiological and radiological analyses for contaminants listed in section 5-6.11 of this Subpart for each source and each finished bottled water product type be distributed in New York State. Results of these analyses must be submitted with the application. Additional analyses may be required, if in the judgment of the commissioner they are needed to determine the acceptability of the source or treatment provided. All analyses must be performed by an approved laboratory and in accordance with the sampling methods as outlined in section 5-6.13 of this Subpart. All analyses must have been performed within the last six months from the date of the application for certification except for the microbiological analyses which must have been performed within 30 days from the date of the application for certification.
(6) Submit a list of names, addresses and telephone numbers of those who are now or are expected to be distributing the product in New York State.
(7) Submit a recall plan in accordance with the requirements as outlined in section 5-6.7 of this Subpart.
(b) Any person applying for a maximum contaminant level exemption of a bottled water product shall, at a minimum, meet the requirements listed below:
(1) An exemption request must be submitted with the above certification data for each chemical or radiological contaminant that exceeds the MCL. No exemption will be given for microbiological or organic chemical MCLs.
(2) The request must include documentation that the 'contaminant exceeding the MCL will not constitute an unreasonable health risk. The documentation must include:
(i) the identification of the contaminant or contaminants exceeding the MCL;
(ii) the concentration level in milligrams per liter of the contaminant, including the maximum, minimum and average value found in the product;
(iii) the target consumer group;
(iv) the consumption pattern in milliliters per day of the consumers based on estimated or actual market surveys; and
(v) the health significance of the higher contaminant concentration level;
(c) Any person applying for bulk water certification shall, at a minimum, meet the requirements listed below:
(1) Complete and submit a signed application form, GEN 222 Application for Certification of Approval for Distribution of Bottled or Bulk Water.
(2) Submit a statement from the appropriate regulatory agency of the State having jurisdiction over the bulk water operation indicating that an inspection of the water source, transporting vehicles and sanitation procedures has been made and is in conformance with the appropriate minimum standards as outlined in this Subpart. When another state has no program for inspection and approval of bulk water operators, the commissioner may make a determination based on an inspection and evaluation by an independent individual or organization knowledgeable in bulk water handling practices.
(3) Submit a report that includes the procedures used in the sanitizing of the tank interior, the name and location of the source water, source treatment, other uses of the tank truck, frequency and type of water quality analyses performed, quantities and frequencies of shipments, primary use of potable water shipped and loading and unloading procedures.
(4) Submit complete inorganic chemical, organic chemical, microbiological and radiological analyses of contaminants as listed in section 5-6.11 of this Subpart for each source to be used. Results of these analyses must be submitted with the application. Additional analyses may be required if, in the judgment of the commissioner, they are needed to determine the acceptability of the source or treatment provided. All analyses must be performed in accordance with the sampling methods as outlined in section 5-6.13 of this Subpart. All analyses must have been performed within the last six months from the date of the application for certification, except for the microbiological analyses which must have been performed within 30 days from the date of the application for certification.
(d) The following conditions must be met to maintain certification approval:
(1) Each year, a statement must be submitted from the appropriate regulatory agency of the state or country having jurisdiction over the bottling facility indicating that the facility has been inspected and approved to bottle or package water for human consumption.
(2) Each month, a form, GEN 221 Report on Bottled Water Operation, must be completed and submitted no later than the 10th of the month following the month of the reporting period. The microbiological sample results on source and finished products must conform to the requirements of sections 5-6.10, 5-6.11 and 5-6.13 of this Subpart. Results of each analysis must be entered on the GEN 221 opposite the date the sample was collected. The quantity of water shipped for distribution in New York State must be entered on the GEN 221 in the daily product column opposite the date of actual shipment.
(3) The required organic chemical, inorganic chemical and radiological analyses on the source and finished water product, must be completed for the calendar year as required in section 5-6.11 of this Subpart.
(4) Any interruption or change in the operation or treatment, or a change of source shall be reported immediately to the State. Submission of plans or an engineering report may be required.
(5) All exemption reqests must be submitted by July 1st for the calendar year. The required annual water quality monitoring data will be reviewed along with any other available data. Besides the submission of data for maintaining approval, the data as outlined in subdivision (b) of this section, must also be submitted.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.1 Definitions
(a) Underserved area shall mean a site, area or facility designated under section 47-3.1 of this Part.
(b) Recipient shall mean a physician who has signed a service agreement pursuant to this Subpart agreeing to practice medicine in an underserved area.
(c) Service agreement shall mean the written agreement prepared by the Department of Health and signed by a recipient specifying the terms of the award and service obligation. Each agreement will require a minimum two-year service obligation.
(d) Award shall mean the funds, provided under this Subpart on an annual basis, for the purpose of repaying some or all of the qualifying debt of the recipient.
(e) Qualifying debt shall mean any outstanding, unpaid debt incurred by the recipient for loans to cover tuition and other related educational expenses made by, or guaranteed by, the Federal or State government, or made by a lending or educational institution approved under title IV of the Federal Higher Education Act.
(f) License shall mean a license to practice medicine in New York State issued by the State Education Department.
(g) Service obligation shall mean the period of time a recipient must practice in an underserved area.
(h) Rescission shall mean the withdrawal, cancellation or revocation of an award in accordance with the provisions of section 47-5.4 of this Subpart, after the signing of a service agreement.
(i) Waiver shall mean full or partial release by the commissioner of the service obligation and/or financial obligation for repayment of an award incurred or owed by a recipient.
(j) Deferral shall mean a delay or temporary suspension granted by the commissioner of an award payment, service obligation, or any financial obligation for repayment of an award by the recipient, with no resulting reduction in service or financial obligation.
(k) Default shall occur if the recipient has not received an approved deferral or waiver and the recipient is not available to fulfill his/her service obligation on the start date, the recipient fails to complete the service obligation, or the award is rescinded after payment of monies to the recipient.
(l) President shall mean the president of the New York State Higher Education Services Corporation.
(m) Primary care physician means a physician specialist in the field of family practice, general pediatrics, primary care internal medicine, or primary care obstetrics and gynecology who provides or arranges for coordinated primary care services.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.5 Use of nontransplant anatomic parts
(a) Whenever a whole body is donated for educational purposes, unless another lawful donee is specified in the donor consent, the whole body user shall be an entity authorized to receive the bodies of deceased persons pursuant to Public Health Law, section 4211 in accordance with the priorities established therein.
(b) A whole body user shall not transfer the whole body or body segment to any other entity, except as authorized in writing by the whole body acquisition service from which the whole body or body segment was obtained.
(c) A whole body user shall have at least one staff member with a graduate degree in the health sciences, and training specific to human dissection or to the activity to be performed.
(d) In addition to the records required in section 52-2.9(i) of this Part, a whole body user shall maintain complete and accurate records of receipt, use and disposition of whole bodies, body segments, organs and tissues. These records shall include, but not be limited to:
(1) identification of the whole body, or, in the case of a body segment, a description and source of the body segment;
(2) a copy of any contract or letter of agreement between the whole body acquisition service and whole body user, and documentation of the method of final disposition of whole bodies or body segments; and
(3) in the case of whole body transfers, a copy of a properly executed burial transit permit.
(e) The dissection and/or other authorized use of whole bodies and body segments shall occur only in dedicated rooms on the premises of the facility identified on the license or at an off-site location approved by the director of the whole body acquisition service from which whole bodies and/or body segments were obtained. Such rooms shall feature:
(1) lockable doors with access restricted to individuals directly associated with the dissection and/or other authorized use;
(2) isolation from public view;
(3) sufficient size, and construction and equipment suitable to ensure safe and respectful handling of whole bodies and body segments;
(4) tables designed for dissection of whole bodies or other work spaces appropriate for the specific authorized activity to be performed;
(5) a working sink and adequate counter space to ensure the safety of individuals involved in using whole bodies and body segments in dissection or other authorized use;
(6) surfaces constructed of nonporous materials;
(7) OSHA-approved eye wash stations; and
(8) facilities for storage of chemicals, if any, in accordance with OSHA guidelines.
(f) Other nontransplant anatomic banks.
(1) All other nontransplant anatomic banks shall conduct authorized activities in spaces that feature:
(i) lockable doors with access restricted to individuals directly associated with the education and/or research activities conducted;
(ii) isolation from public view;
(iii) sufficient size, and construction and equipment suitable to ensure safe and respectful handling of the organs and/or tissues;
(iv) a working sink and adequate work space to ensure the safety of individuals involved in using organs and/or tissues in education and/or research; and
(v) surfaces constructed of nonporous materials.
(2) Nontransplant anatomic banks using nontransplant anatomic parts that are not whole bodies or segments shall maintain complete and accurate records of receipt, use and disposition of organs and tissues. These records shall include the source and a full description of each organ or tissue.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.10 Investigation
The department official shall review and verify information received on applications, as required. Documents, personal observation, personal and collateral interviews and contacts, reports, correspondence and conferences are means of verification of information supplied. When information is sought from collateral sources other than public records or sources designated by the applicant on the application form, the department will inform the applicant/participant or his/her representative of what information is desired, why it is needed and how it will be used.
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.4 Sewerage facilities
(a) A community sewerage system is required when:
(1) a subdivision is located in an existing sewer district or service area;
(2) a subdivision is reasonably accessible to an existing sewer district or service area. This requirement shall apply in the absence of proof satisfactory to the department that the developer cannot effect arrangements for the installation and/or connection of the sewerage system to the existing sewer district or service area facilities;
(3) the soil percolation rate is lower than 60 min/in.;
(4) the subdivision consists of 50 lots or more;
(5) the subdivision consists of 200 or more residents in the aggregate;
(6) a minimum separation of two feet cannot be maintained between the lowest part of the leaching system and the highest elevation of the top of the zone of water saturation, rock, hardpan or other impermeable material at all times of year; or
(7) an approved comprehensive study exists.
(b) Only subsurface leaching systems utilizing a septic tank may be employed on an individual basis in lieu of the provision of a community system. Septic tanks shall be designed and installed so that they are readily accessible for inspection and cleaning. Where individual water supply and sewage disposal systems are to be installed on a single lot, the minimum lot area shall be 20,000 square feet.
(c) When a community system is required and where the soil is suitable, interim individual sewerage systems may be permitted by the commissioner, provided that:
(1) dry sewers are designed and installed consistent with the community sewerage plan;
(2) plumbing is installed from the house to the dry sewer to facilitate individual connection to the community system; and
(3) such community sewerage service will be operative in five years.
(d) The relevant provisions of Bulletin 1* entitled New York State Health Department Standards for Waste Treatment Works will be the basis upon which all plans, specifications and reports for sewerage systems, individual or community, will be reviewed for approval by the department.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.100 General requirements
(a) Records of all transactions concerning controlled substances required to be kept by manufacturers, distributors, importers, exporters, institutional dispensers, persons conducting research, instructional, analytical or maintenance treatment programs, pharmacies and practitioners shall be kept for a period of five years from the date of transaction.
(b) Records, orders and prescriptions required by this Part or article 33 of the Public Health Law, shall be readily available and promptly produced for inspection and copying upon request by authorized representatives of the Bureau of Narcotic Enforcement, New York State Department of Health.
(c) Records, orders and prescriptions required by this Part or provisions of article 33 of the Public Health Law shall be maintained at the premises where the licensed activity is conducted. Records, orders and prescriptions required by this Part or provisions of article 33 of the Public Health Law that are maintained electronically shall be made available to the department upon request, in a hardcopy format that is readily understandable, at the premises where the licensed activity is conducted.
(d) Records, orders and prescriptions required to be maintained by this Part or article 33 of the Public Health Law and which may be required as evidence of a violation in connection with an investigation by this department shall be released to authorized representatives of the Bureau of Narcotic Enforcement, New York State Department of Health, upon request and upon the furnishing of a receipt therefor.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.56 Radiographic installations excluding dental, veterinary and podiatric installations
(a) Equipment.
(1) The protective tube housing shall be of diagnostic type.
(2) Collimating devices capable of restricting the useful beam to the area of clinical interest shall be used and shall provide the same degree of protection as is required of the tube housing.
(3) The X-ray films used as the recording medium during the X-ray examination shall show substantial evidence of cut-off (beam delineation).
(4) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(5) A device shall be provided which terminates the exposure after a preset time interval or exposure.
(6) A dead-man type of exposure switch shall be used and so arranged that it cannot be operated outside a shielded area. Exposure switches for “spot-film” devices used in conjunction with fluoroscopic equipment are excepted from this shielding requirement.
(7) The tube head shall remain stationary when placed in the exposure position.
(b) Structural shielding.
(1) Control apparatus for the radiographic equipment shall be located in an adjacent room or in a fixed booth within the same room provided such booth is composed of radiation shielding to a minimum height of seven feet. The control booth either shall be so arranged that the radiation has to be scattered at least twice before entering the booth, or shall be provided with a protective door that is interlocked in such a way that the X- ray tube(s) cannot be energized unless the door is in the closed position.
(2) The operator shall be able to see the patient by means of a mirror or through a window of lead equivalent sufficient for the required protection and so placed that the operator is always in a shielded position.
(3) Provision shall be made for the operator to communicate with the patient from a shielded position.
(c) Conditions for operation of equipment.
(1) No person shall be regularly employed to hold patients or films during exposures nor shall such duty be performed by any individual occupationally exposed to radiation during the course of his/her other duties. When it is necessary to restrain the patient, mechanical supporting or restraining devices shall be used whenever possible. If patients or films must be held by an individual, that individual shall be provided with appropriate shielding devices such as protective gloves and a protective apron of at least 0.25 mm lead equivalent. No part of the attendant's body shall be in the useful beam. The exposure of any individual used for holding patients shall be determined. Pregnant women and persons under 18 years of age shall not hold patients under any conditions.
(2) Only persons required for the radiographic procedure shall be in the radiographic room during exposure; and, except for the patient, all such persons shall be equipped with appropriate shielding devices such as protective gloves and a protective apron of at least 0.25 mm lead equivalent.
(3) Gonadal shielding of not less than 0.5 mm lead equivalent shall be used for patients who have not passed the reproductive age during radiographic procedures in which the gonads are in the useful beam, except for cases in which this would interfere with the diagnostic procedure.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.7 Natural classification of revenue
[ 2400 ]
(a) The coding system for revenue provides for the use of six digits; four digits to the left of the decimal point and two digits to the right of the decimal point. In addition, for daily hospital service, ambulatory service and ancillary service revenue accounts only, positions seven and eight (third and fourth digits to the right of the decimal point) may be used for designating the program in which the patient is being served.
(b) Digit designations are as follows:
(1) First digit—indicates the primary account classification of the revenue account.
0-2 Not Used
3 Daily Hospital and Ambulatory Service Revenue
4 Ancillary Service Revenue
5 Other Operating Revenue and Deductions from Revenue
6-8 Not Used
9 Non-Operating Revenue
(2) Second through fourth digits (010-999)—indicate the primary subclassification of accounts.
(3) Decimal Point.
(4) Fifth digit—indicates the classification of service category of the patient service which the patient received.
.0 Inpatient - Acute Care
.1 Inpatient - Intensive Care
.2 Inpatient - Skilled Nursing Care
.3 Inpatient - Other
.4 Outpatient - Emergency
.5 Outpatient - Clinic
.6 Outpatient - Referred
.7 Home Health Care
.8 Day Care
.9 Non - Patient
(5) Sixth digit—indicates primary payor (admission status unless changed at later date) for patient as follows:
0 — Medicare - Part A
1 — Medicare - Part B
2 — Medicaid
3 — Other Government
4 — Workers' Compensation
5 — Blue Cross
6 — Commercial Insurance
7 — Charity/Uncompensated Care
8 — Self Pay
9 — Other
(6) Seventh and eighth digits—Used to designate program.
(7) Use of the sixth digit is unnecessary if logs are maintained.
(c) Examples of the coding of daily hospital and ancillary service revenue are as follows:
(1) A room and board charge made to a Pediatric Acute patient whose bill will be assumed by Blue Cross.
Daily Hospital Service Revenue
Pediatric Acute
1730
Decimal Point
.
Inpatient Acute Care
0
Blue Cross
5
Pediatric Acute Care
17
or 3170.0517
(2) A laboratory charge (cytology) made to the same patient.
Ancillary Service Revenue
4
Pathological Laboratory (Cytology)
231
Decimal Point
.
Inpatient Acute Care
0
Blue Cross
5
Pediatric Acute Care
17
or 4231.0517
(3) Digits seven and eight ( e.g., 17) are optional digits indicating the program in which the patient is being served.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.15 Requirements for laboratories performing testing for medical marihuana
(a) For purposes of this Subpart, the following terms shall have the following meanings:
(1) Medical marihuana shall mean marihuana as defined in subdivision 21 of section 3302 of the Public Health Law, intended for a certified medical use, as determined by the commissioner in his or her sole discretion.
(2) Medical marihuana product shall mean any material produced from medical marihuana prior to its final packaging, e.g., extracts.
(3) Final medical marihuana product shall mean the final medical marihuana product as dispensed to the patient. Any form of medical marihuana not approved by the commissioner is expressly prohibited.
(4) Registered organization shall mean a for-profit business entity or not-for-profit corporation organized for the purpose of acquiring, processing manufacturing, selling, delivering, transporting, distributing or dispensing medical marihuana in accordance with the requirements of title 5-A of article 33 of the Public Health Law.
(b)
(1) Prior to performing testing for any medical marihuana, medical marihuana product or final medical marihuana product, a laboratory physically located within New York State shall submit a request to the department, and receive an initial or revised certificate of approval that includes the specialty of medical marihuana testing and the approved method(s) the laboratory is authorized to employ as stipulated in sections 55-2.1 and 55-2.5 of this Subpart, in addition to a valid class 8 analytical laboratory license, issued by the department's Bureau of Narcotic Enforcement. The certificate of approval shall also list the specific subcategories, analytes, and approved methods included in the approval. No laboratory shall examine a sample related to medical marihuana without certification of approval specific to this category and meeting all other provisions within this Subpart; and
(2) the department may withhold or limit its approval if the department is not satisfied that:
(i) the laboratory has in place adequate policies, procedures, and facility security (physical and cyber security) to ensure proper: collection; labeling; accessioning; preparation; analysis; result reporting for; and disposal of and storage of medical marihuana, medical marihuana product or final medical marihuana product as defined in section 55-2.15(a) of this Subpart; or
(ii) the laboratory is able to meet the requirements applicable to it as set forth in title V-A of article 33 of the Public Health Law, and section 1004.14 of this Title.
(c) In addition to application and attestation requirements found elsewhere in this Subpart, a laboratory seeking approval to perform medical marihuana, medical marihuana product or final medical marihuana product testing shall submit:
(1) a standard operating procedure manual documenting laboratory policies, procedures, facilities, equipment, supplies, instrumentation and personnel for medical marihuana, medical marihuana product or final medical marihuana product testing, which are designed to ensure proper: collection; labeling; accessioning; preparation; analysis; result reporting or, disposal of and storage of medical marihuana, medical marihuana product or final medical marihuana product as defined in subdivision (a) of this section including any validation summaries or data as requested; and
(2) an attestation signed by the owner(s) and director(s) that, in addition to meeting the preceding requirements of this Subpart, a laboratory engaged in medical marihuana testing, through its owner(s) and director(s), shall:
(i) confirm that the laboratory shall accept only the type(s) of samples specified on the laboratory’s certificate of approval;
(ii) confirm that the laboratory owner(s) and director(s) is independent of any owner and employee of a registered organization; and
(iii) confirm that the owner(s) and director(s) will ensure that all test results are reported in a manner and form consistent with the approved method and with requirements in title V-A of article 33 of the Public Health Law, including but not limited to:
(a) reporting of results, as applicable, including regulated analytes as well as any contaminants listed in section 1004.14(g) of this Title to the registered organization and the department using a department approved mechanism; and
(b) reporting of any improprieties regarding the medical marihuana product testing, including but not limited to, theft and the falsification of any data, documentation, or attestation related to the medical marihuana product testing to the department within two business days from the date of learning of the impropriety.
(c) The approval of mobile laboratories is prohibited for the purposes of this section.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.5 Accountant's certification
The financial and statistical reports shall be certified by an independent licensed public accountant or an independent certified public accountant.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.35 Other data required
(a) Blue Cross patient days by program service in section 446.44(b) of this Part.
(b) Collection fees applicable to Blue Cross patients by program service in section 446.44(b) of this Part.
(c) Per diem collection expense applicable to Blue Cross patients (collection fees divided by patient days) by program service in section 446.44(b) of this Part.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.180 Permits; application, issuance, inspection
(a) A valid permit, issued by the permit-issuing official having jurisdiction is required for lawful operation of a food vending machine commissary, a food vending operation or controlled location vending machine. At establishments that serve retail frozen desserts the $25 permit fee imposed by Public Health Law, section 225(5)(s) shall be paid at the time any other permit fees related to the operation of the food service establishment are collected by the permit-issuing official and the establishment's permit shall indicate that the facility can manufacture and sell retail frozen desserts.
(b) The term permit-issuing official means the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area district director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, a public health director or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district or such grade I or grade II public health administrator or public health director or county health director may designate the director of environmental health of such district; and the State regional health director or area director may designate the district director as additional persons to issue the permits required by this Subpart.
(c) Not less than 21 days before starting a food vending commissary, an application for a permit is to be submitted to the permit-issuing official having jurisdiction. This application is to be completed in full on forms acceptable to the permit-issuing official. The application is to include the proposed and existing location of all food vending machines.
(d) A permit will be issued subject to the food vending commissary and food vending operations being operated in compliance with this Subpart and not presenting a danger to the health of the consumer or to the public. An applicant's past history of compliance or noncompliance will be a consideration in evaluating each of the previously mentioned criteria. The condition of the vending machines, commissary, its equipment, utensils, personnel, mode of operation, surroundings, water supply, sewage disposal, waste handling, furnishings, food and appurtenances are all factors in determining whether its continued operation may affect public health. After making the preliminary inspection, a permit may be issued or the operator advised of violations prohibiting issuance of such permit by the permit-issuing official.
(e) It is unlawful for a food vending commissary or food vending machine operator to operate without a permit during the 21 days from the time a permit has been requested. In the event the permit-issuing official or his designated representative does not make an inspection of the commissary or food vending operation during this 21-day period, operation may commence without being in violation of this Subpart until such time as the permit-issuing official or his designated representative makes an inspection and issues a permit or issues an order to cease operation for cause.
(f) The designated representative of the permit-issuing official is a person authorized to perform inspections of commissaries and food vending operations on behalf of the permit-issuing official. Persons authorized to make inspections are to complete required inspection report forms and to take mandated enforcement actions required by this Subpart.
(g) Each food vending machine which is coin- or token-operated is to have the name, address and telephone number of the person responsible for its operation posted to be readily visible to anyone operating the machine.
Part 16 IONIZING RADIATION
10 CRR-NY 16.0 Introductory note
This Part applies to all radiation equipment and radioactive material within the jurisdiction of the New York State Department of Health. Sections of this Part set forth under the heading “General Provisions” (§§ 16.1-16.26) contain provisions applicable to radiation equipment operators and persons in possession of radioactive materials, including general radiation protection requirements. Sections of this Part set forth under the heading “Radiation Equipment” (§§ 16.50-16.63) contain the registration provisions for radiation equipment and general and additional radiation protection requirements applicable only to specific radiation equipment. Sections of this Part set forth under the heading “Licensing of Radioactive Materials” (§§ 16.100-16.123) contain the licensing provisions for radioactive materials, i.e., byproduct material, source material, special nuclear material in quantities not sufficient to form a critical mass, naturally occurring radioactive materials, and accelerator-produced radioactive material.1 Section 16.130, “Radon testing and reporting”, contains provisions applicable to firms performing radon measurements in NY State. Section 16.200, “Material incorporated by reference”, provides a list of Federal rules and regulations also related to the regulation of ionizing radiation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.3 Qualified consultants
Professional services rendered by medical and dental specialists or consultants will be approved for reimbursement only if rendered by personnel listed in the department's file of clinical consultants and, when in-hospital care is required, if the hospital meets standards set forth in section 46.4 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.24 Environmental health
The hospital shall be operated and maintained to ensure the safety of patients.
(a) Building and grounds.
Facility grounds and physical plant shall be maintained in a manner to assure a safe and suitable environment for patients.
(1) Grounds and buildings shall be maintained in functional condition and to meet design intent, free of safety hazards, excessive noise, odors and environmental pollutants as may adversely affect the health or welfare of patients.
(2) There shall be facilities for emergency provision of adequate fuel and water supplies during any period in which the supply of fuel and/or water from usual sources temporarily becomes disrupted.
(b) Life safety from fire.
(1) Buildings and equipment shall be so maintained as to prevent fire.
(2) The hospital shall have a written master fire plan that contain provisions for prompt reporting of fires; extinguishing fires; protection of patients, personnel and visitors; evacuation; and cooperation with firefighting authorities.
(3) Personnel shall be trained in procedures to be followed in emergencies, including but not limited to the use of firefighting equipment, evacuation of patients and personnel and all other duties in the master fire plan.
(4) Fire drills shall be conducted at irregular intervals at least 12 times per year covering all shifts.
(5) The hospital shall ensure the thorough investigation of all fires. A written report of the investigation shall be produced and shall remain on file for not less than six years.
(c) Engineering and maintenance.
(1) Water supplies of medical facilities. All water used in operation shall be provided in conformance with Part 5 of the State Sanitary Code and section 702.1(a) of this Title.
(2) Preventive maintenance. A written preventive maintenance program shall be established and implemented to insure that all equipment and buildings are operative, safe, sanitary and maintained in good repair.
(i) Hospitals shall develop and adhere to schedules for testing, maintenance and calibration of all patient care and life safety equipment. Such maintenance schedules shall, at a minimum, be conducted in accordance with manufacturer's specifications.
(ii) Written reports documenting such tests, maintenance and calibration shall be retained on file for not less than three years after the date of such tests, maintenance or calibration.
(d) Waste.
Hospitals shall develop and implement infectious waste management programs as required by the provisions of title XIII of article 13 of the Public Health Law.
(e) Housekeeping.
(1) The entire facility, including but not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment and furnishings, shall be kept clean and maintained in good repair.
(2) The facility shall be kept free of insects and rodents.
(3) All cleaning shall be done in a manner which will not spread dust or other particulate matter.
(4) Supplies and equipment for housekeeping functions shall be provided with cleaning compounds and hazardous substances properly labeled and stored.
(f) Linen and laundry.
(1) Clean linen shall be provided to meet the requirements of patients.
(2) All linen shall be handled, stored, laundered and processed, and transported in a manner that will prevent infection and assure the maintenance of linen that is clean and in good repair. The hospital shall ensure that any use of inks or dyes contained aniline oil (aminobenzene) or oil of mirbane (nitrobenzene) or other benzene derivatives by such hospital, laundry or diaper service conforms to the requirements in section 12.10 of the State Sanitary Code.
(3) All linen, including blankets, shall be laundered between patient use.
(4) To prevent the spread of infection, all soiled linen shall be enclosed in containers within the patient care unit for transportation to the laundry.
(5) All linen from isolation rooms, infectious patients and the pathology service shall be enclosed in identifiable containers distinguishable from other laundry.
(g) Emergency and disaster preparedness.
The hospital shall have a written plan, rehearsed and updated at least twice a year, with procedures to be followed for the proper care of patients and personnel, including but not limited to the reception and treatment of mass casualty victims, in the event of an internal or external emergency or disaster arising from the interruption of normal services resulting from earthquake, flood, bomb threat, chemical spills, strike, interruption of utility services, nuclear accidents and similar occurrences. Personnel responsible for the hospital's accommodation to extraordinary events shall be trained in all aspects of preparedness for any interruption of services and for any disaster. This shall be in addition to the Surge and Flex Plan that is required pursuant to Part 360 of this Title.
(h) Animals.
Animals, exclusive of those required for laboratory purposes, shall only be allowed in a hospital in the following instances:
(1) service dogs or other service animals which have been individually trained to do work or perform tasks for the benefit of an individual with a disability when the presence of such animal will not pose a significant risk to the health or safety of others that cannot be eliminated by reasonable accommodation and is not medically contraindicated. However, if the safe operation of the hospital would be jeopardized, a service animal need not be allowed to enter. A finding by appropriate medical personnel at the hospital that the presence or use of a service animal would pose a significant health risk in certain designated areas of a hospital may serve as a basis for excluding service animals in those areas;
(2) when a hospital chooses to initiate and operate an organized animal visitation or animal-assisted therapy program that is jointly developed, approved and monitored by the hospital’s quality assurance, risk management and infection control committees or designees. In each such approved program, the hospital must at a minimum ensure that:
(i) participating animals meet the qualifications set by the hospital including:
(a) certification of current vaccinations and being free of communicable diseases or infections;
(b) documentation of having training and temperament acceptable to the hospital;
(ii) each participating patient signs a patient consent form that includes an assessment of the risks and benefits of program participation;
(iii) hospital personnel and non-participating patients in proximity to the program are not negatively impacted by the presence of such animals;
(iv) the well-being of the participating animals is considered and maintained;
(v) patient and staff satisfaction is assessed, ensuring that participating patients and staff as well as a representative sample of non-participating patients and staff are routinely sampled for feedback; and
(vi) infection control protocols established for the program include a comparative assessment of infections for participating and non-participating patients.
(i) Central supply services.
The hospital shall ensure the provision of central supply services for the preparation, storage, handling and distribution of sterile supplies and other patient care items. The hospital shall conform to current, acceptable standards of practice for central services.
(1) Central services shall be under the direction of an individual qualified by education, training and experience to supervise the personnel and functions of central services, and who shall be responsible to the chief executive officer either directly, or through a designated department head.
(2) Central services shall be evaluated as part of the hospital's ongoing quality assurance program.
(3) The functional design and workflow patterns in central services shall provide for the separation of soiled and contaminated supplies from those that are clean and sterile.
(4) There shall be written policies and procedures for the decontamination and sterilization activities performed in central services and elsewhere in the hospital, and for related requirements. These policies and procedures shall include, but not be limited to provisions for:
(i) the decontamination, cleaning, preparation and sterilization of patient care supplies and equipment;
(ii) the separation of soiled or contaminated supplies and equipment from clean and sterilized supplies and equipment;
(iii) the assembly, wrapping, storage, handling and distribution of sterile supplies and equipment in central services and all other areas of the hospital as applicable;
(iv) requirements for aeration of gas-sterilized items;
(v) maintaining and recording time and temperature for each sterilization cycle and aeration cycle, if any, with provisions for records to be kept at least one year;
(vi) the labeling of each sterilized item with the date sterilized, cycle and expiration date indicating the shelf life of the sterilized item if the hospital chooses to use time-related sterility criteria with established expiration dating of in-house reprocessed and sterilized supplies and equipment;
(vii) event-related sterility assurance if the hospital chooses to use such criteria for sterility assurance. Such sterility assurance shall:
(a) comply with generally accepted standards for sterility assurance such as those endorsed by the Association for the Advancement of Medical Instrumentation, the Joint Commission on the Accreditation of Healthcare Organizations or other such entities recognized as appropriate by the commissioner;
(b) be based on the results of an evaluation of current hospital policies and procedures for handling sterile supplies;
(c) be reflected in the hospital’s written policies which detail the process and responsibilities and which have been approved by the infection control officer and Infection Control Committee, if any;
(d) be addressed through inservice education of staff; and
(e) provide for quality assurance monitoring to evaluate effectiveness;
(viii) the use of chemical indicators with each cycle and weekly bacteriological spore monitoring for all sterilizers;
(ix) the rotation and reprocessing of sterile equipment and supplies; and
(x) the routine checking and removal of outdated or damaged sterile supplies and equipment or supplies or equipment which no longer meet the sterility standards of the event-related sterility assurance criteria and the recall of such supplies and equipment from all areas of the hospital.
(j) Injury control.
The hospital shall:
(1) have a safety education program which shall include both orientation of new employees and continuing inservice training programs;
(2) develop and implement programs designed to eliminate safety hazards; and
(3) maintain, during any construction, alterations or repairs, a safe environment and safe access.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.68 Contract service
Services performed in whole or in part by an outside organization on a contractual basis.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASE CONTROL
10 CRR-NY 40-2.20 Sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV); performance standards
The local health department shall maintain a program designed to minimize the incidence of STDs and HIV. The program shall include, at a minimum, activities to ensure:
(a) epidemiologic case finding, timely disease surveillance and reporting, in accordance with Part 2 of this Title;
(b) availability of accessible laboratory testing for STDs and HIV;
(c) provision of adequate facilities for diagnosis and treatment of STDs, directly or by contract, pursuant to article 23 of the Public Health Law;
(d) provision of partner notification and referral services for priority patients, as determined in an investigation undertaken pursuant to section 2.6 of this Title;
(e) provision of prophylactic treatment to exposed partners for STDs;
(f) information, referral and assistance in utilizing appropriate community service programs;
(g) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials and campaigns, to promote healthy behaviors and reduce risk factors associated with STDs, HIV and related health disparities; and
(h) distribution of at least one communication per year to health care providers, clinics and laboratories on local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities and department reporting requirements for STDs and HIV.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.37 Services for residents with acquired immune deficiency syndrome (AIDS)
(a) Applicability.
(1) This section applies to a nursing home approved by the commissioner pursuant to Part 710 of this Title as a provider of specialized services for residents with AIDS. Such facility shall provide comprehensive and coordinated health services and programs in accordance with the requirements set forth in this section and this Part, unless a contrary requirement is contained in this section.
(2) For purposes of these regulations, AIDS shall mean acquired immune deficiency syndrome and other human immunodeficiency virus (HIV) related illness.
(b) General requirements.
The nursing home shall ensure that:
(1) the facility is staffed and equipped to manage the care and treatment of residents with AIDS requiring nursing home care;
(2) [ Reserved ]
(3) a written transfer agreement exists with a designated AIDS center or other hospital for the transfer of residents in need of emergency or acute inpatient care services;
(4) special services are provided to residents in need thereof. Such special services shall include, as a minimum, substance abuse services, case management, HIV education, risk reduction, mental health services and pastoral counseling. These special services may be provided directly by the facility or through a formal arrangement;
(5) a written, comprehensive care plan is developed and implemented for each resident by an interdisciplinary team of health-care professionals in coordination with the case manager and in consultation with the resident or the resident's legal representative. The interdisciplinary team shall include health-care professionals as appropriate to the needs of the AIDS resident, but as a minimum shall include the attending physician, a registered professional nurse and a social worker. The resident care plan is reviewed at least every month by the interdisciplinary team and modified as necessary;
(6) in-service and continuing education programs, which address the medical, psychological, social problems and care needs specific to persons with AIDS, are conducted for all nursing home personnel on a regular basis but not less than every three months. A record of the programs attended shall be maintained for each employee;
(7) staff counseling and supportive services are made available to personnel to address problems related to the care of persons with AIDS; and
(8) as part of the facility's infection control program, infection control policies and procedures specific to AIDS are developed and implemented.
(c) Staffing requirements.
The nursing home shall ensure that:
(1) specialty oversight of the AIDS program, including the development of policies and procedures, is provided by a physician who has experience in the care and clinical management of persons with AIDS;
(2) the health care of each resident is under the continuing supervision of an attending physician who sees and evaluates the resident whenever necessary:
(i) physician visits for residents who are assessed as requiring a skilled level of nursing care shall not be less frequent than once per week; and
(ii) physician visits for residents who are assessed as requiring an intermediate level of nursing care based on their ambulant status and other relevant medical factors, shall not be less frequent than once per month;
(3) the facility makes provision for onsite physician coverage sufficient to meet the medical needs of residents seven days a week. This coverage may be part of the routine physician visits or in addition to such visits;
(4) nursing services for the AIDS program are under the supervision of a registered professional nurse with experience in the care and management of persons with AIDS; and
(5) each resident is evaluated by rehabilitation therapy staff to include, as a minimum, physical therapy and occupational therapy staff. Based on the evaluation, a plan of care is developed which establishes restoration or maintenance rehabilitation goals.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.23 Quality assurance programs for diagnostic facilities
(a) A quality assurance program is a system of plans, actions, reviews, reports and records whose purpose is to ensure that diagnostic facilities achieve consistently high quality imaging and other diagnostic results, while maintaining radiation output and personnel doses within limits prescribed by the department.
(1) Each radiation facility conducting diagnostic X-ray or radioactive materials procedures, excepting dental, podiatric and veterinary facilities, shall implement a quality assurance program including at a minimum:
(i) the adoption of a manual containing written policies and procedures for radiation protection and describing the facility's quality assurance program. Policies and procedures must be consistent with the types of equipment and services provided, including but not limited to, use of gonad or scoliosos shielding; personnel monitoring; protection of pregnant workers and patients; and holding of patients. The quality assurance manual must describe the various processing, generator and systems quality control tests appropriate for the types of equipment and services provided in sufficient detail to ensure that they will be performed properly;
(ii) the performance of quality control tests and the correction of deficiencies as specified in the quality assurance manual;
(iii) the maintenance of equipment records for each diagnostic imaging system, containing test results, records of equipment repairs and other pertinent information;
(iv) the provision of a formalized in-service training program for employees, including, but not limited to, quality assurance and radiation safety procedures;
(v) the measurement of radiation output at the point of skin entry for common X-ray examinations;
(vi) the measurement of the amount of activity of each dose of a radiopharmaceutical administered to a patient;
(vii) the calculated absorbed dose for diagnostic procedures involving radioactive materials;
(viii) the provision of the information described in subparagraphs (v), (vi) and (vii) of this paragraph to any patient upon request; and
(ix) the conduct of an ongoing analysis of repeated, rejected or misadministered diagnostic studies which is designed to identify and correct problems and to optimize quality.
(b) Mammography image quality.
Each facility performing mammography examinations shall ensure that the mammographic system is optimized to provide consistent, high quality imaging. A mammography system includes the X-ray generator, X-ray tube, image receptor and all components of the imaging process. The facility shall use a breast equivalent phantom approved by the department to monitor image resolution. The breast phantom contains test objects which represent low density areas and micro-calcifications which are related to the imaging of breast lesions. A test object is either a mass, fiber, or speck set as constituents of, and exemplified by, the model breast phantoms hereafter described.
(1) No patient mammograms shall be performed unless the minimum test object resolution established in paragraph (2) of this subdivision is met.
(2) The mammography system shall be capable of imaging, at the minimum, the following test objects:
(i) 0.75 millimeter (mm) mass, 0.75 mm fiber and 0.54 mm speck set using the Model 152D phantom manufactured by Radiation Measurements Inc. (RMI); or
(ii) the 0.75 mm mass, 0.75 mm fiber, and 0.40 mm speck set using the American College of Radiology (ACR) mammography accreditation phantom; or
(iii) the equivalent test object resolution on another approved phantom.
(3) All facilities shall optimize the mammography systems used and determine the breast equivalent phantom test object resolution of the system prior to performing patient mammograms. The number of test objects resolved is the reference image the facility shall use for comparison during periodic testing. Under any conditions, if during the testing required under subdivision (a) of this section, the system is found to have lost the ability to resolve two test objects previously visible in the reference image, the facility shall investigate the reason and optimize the system.
(4) Diminished phantom test object resolution and facility follow-up.
(i) Whenever the phantom image indicates that the mammography system fails to meet the minimum test object resolution defined in paragraph (2) of this subdivision the facility shall investigate the reason. Correction to achieve the minimum level shall be completed prior to performance of patient mammograms.
(ii) In addition, if the imaging system resolves fewer than seven test objects on the RMI Model 152D phantom, the ACR phantom, or the equivalent on another approved phantom, the investigation shall include:
(a) a review of monthly phantom images to determine at which point the image resolution fell below the minimum; and
(b) a review by a panel of physicians selected by the department for this review of mammograms performed since the last phantom image that was identified as meeting the minimum level. Physicians selected for the panel must be certified in diagnostic radiology by the American Board of Radiology or the American Osteopathic Board of Radiology or have equivalent qualifications and will be selected for addition to this panel in consultation with the New York State Radiological Society. Members of the panel are deemed volunteers in service to the department within the meaning of paragraph (a) of subdivision one of section 17 of the Public Officers Law and, in lieu of expenses, shall be compensated by the department at the prevailing departmental per diem rate. The cases chosen for review shall include images from the range of studies performed by the facility which the panel ascertains to be sufficient to determine that the clinical images are of diagnostic quality. A record of the review and findings shall be maintained for inspection.
(iii) If film images are identified by the physician conducting the review as non-diagnostic, the facility shall, within five business days, notify:
(a) the referring physician, or other authorized referring practitioner as defined in section 16.19(a) of this Part, or the patient, if not referred by a practitioner, of the need for follow-up; and
(b) the department of the results of the investigation and follow-up contacts.
(iv) A record of the results of the investigation and actions taken to correct any deficiency shall be maintained for review by the department for a period of three years.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-4.173 Ventilation
Enclosed mobile food service establishments and pushcarts are to be provided with sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, odors, smoke and fumes. Ventilation systems are not to create an unsightly or harmful discharge or create a nuisance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 448 SAMPLING SPECIFICATIONS
10 CRR-NY 448.1 Specifications for cost reporting periods beginning in 1980
(a) The cost allocation statistics and required Standard Units of Measure, except inpatient days, may be estimated using statistical sampling instead of taking complete counts. Statistical sampling is most appropriate for those SUM's and cost allocation statistics which can be obtained from a physical record of the transaction or procedure. For example, the laundry and linen cost center might keep a log of the number of pounds processed daily. At the end of the year or at convenient intervals through the year, a random sample of days can be taken from the log and an estimate of the total pounds processed for the year can be made. It may also be possible to use sampling techniques for those transactions for which no record is kept. In this case, however, the procedures are likely to be more complex and costly.
(b) If statistical sampling is to be used, it will be necessary to adhere strictly to the appropriate procedures. Subsequent audits may be conducted by fiscal intermediaries. At some time in the future, the Health Care Financing Administration (HCFA) will publish procedures that will have wide applicability to a variety of items and situations. If the published procedures are not applicable or it is desired to use alternative methods, the hospital must be prepared to demonstrate that its plan adheres to the principle of scientific statistical sampling.
(c) Until such time as the Health Care Financing Administration (HCFA) publishes the necessary procedures mentioned above, the following methodology must be used:
(1) A minimum of eight calendar weeks will be selected each year for the accumulation of data.
(2) These eight weeks will be representative of the full year. In order to achieve this, the hospital will select a two-week block (14 consecutive days) within each fiscal quarter for the collection of data.
(3) The same two-week block need not be used for all statistics.
(4) During the testing period, actual counting, weighting, etc. will be done for all shifts involved in the particular area.
(5) Periods of “unusual” circumstances should be avoided as test weeks. The principle of representative samples is the ultimate goal.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.8 Specialized template populations
Notwithstanding any other provisions of this Subpart, rates for individuals identified by OPWDD as qualifying for specialized template populations funding shall be as follows. As used in this section, downstate shall mean the counties of New York, Kings, Bronx, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, Orange, Sullivan, Putnam and Dutchess, and upstate shall mean all other counties in New York State.
(a) For individuals initially identified as qualifying for specialized template populations funding between November 1, 2011 and March 31, 2014.
| Residential – Specialized Level of Care | | | --- | --- | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $166,400 | | Upstate | $150,500 | | | | | Residential – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $189,500 | | Upstate | $171,500 | | | | | Residential – Auspice Change | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $136,500 | | Upstate | $123,500 | | | | | Day Habilitation – Specialized Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $41,730 | | Upstate | $37,562 | | | | | Day Habilitation – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $46,433 | | Upstate | $43,063 |
(b) For individuals initially identified as qualifying for specialized template populations funding after March 31, 2014.
| Residential – Highly Complex Level of Care | | | --- | --- | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $189,500 | | Upstate | $171,500 | | | | | Residential – Auspice Change | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $136,500 | | Upstate | $123,500 | | | | | Day Habilitation – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $46,433 | | Upstate | $43,063 |
(c) January 1, 2015 increase. The fees for specialized template populations funding will be revised to incorporate funding for compensation increases to direct support professional employees. Such fee increases will be effective January 1, 2015. The compensation increase funding will be included in the provider’s fee issued for January 1, 2015 or in a subsequent fee with the inclusion of funding in the amount necessary to achieve the same funding impact as if the fee had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(d) April 1, 2015 increase. In addition to compensation funding effective January 1, 2015, the fees for specialized template population funding will revised to incorporate funding for a compensation increase to direct support professional and clinical employees to be effective April 1, 2015. The April 1, 2015 direct support compensation funding will be compounded on the amount which was calculated for the January 1, 2015 compensation increase and will be an augmentation to the January 1, 2015 increase.
(e) Calculations.
(1) The portion of the fee that is identified as direct care and support will be increased by two percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional direct support compensation increases for January 1, 2015 and April 1, 2015.
(2) The portion of the fee that is identified as clinical will be increased by two percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional clinical compensation increase for April 1, 2015.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PLUMBING PLUMBING
10 CRR-NY 14-5.142 Toilet facilities
(a) Each food vending operation is to have adequate, conveniently located and properly installed toilet fixtures accessible to machine attendants and servicers. Toilet fixtures are to be of sanitary design and readily cleanable. Toilet rooms are to be completely enclosed and to have tight-fitting, self-closing doors.
(b) Toilet facilities are to be kept clean, in good repair and free from objectionable odors. A supply of toilet tissue is to be provided at all times at each toilet. Easily cleanable receptacles for waste paper and other refuse are to be provided. One receptacle in toilet rooms used for women is to be covered. Employee handwashing signs are to be posted in each employee toilet room area.
(c) All food vending operations with a seating capacity of 20 or more, except those in operation on or before December 5, 1977, are to provide toilet facilities for their patrons as required by chapter 774 of the Laws of 1977.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.16 Biological containment levels
The following levels of biological containment (HV or host-vector systems) for prokaryotes are established:
(a) HV1.
A host-vector system which provides a moderate level of containment. Specific systems:
(1) EK1.
The host is always E. coli K-12 or a derivative thereof, and the vectors include nonconjugative plasmids ( e.g., pSC101, ColE1, or derivatives thereof) and variants of bacteriophage, such as. The E. coli K-12 hosts shall not contain conjugation-proficient plasmids, whether autonomous or integrated, or generalized transducing phages.
(2) Other prokaryotes.
Hosts and vectors shall be, at a minimum, comparable in containment to E. coli K-12 with a nonconjugative plasmid or bacteriophage vector.
(b) HV2.
These are host-vector systems shown to provide a high level of biological containment as demonstrated by data from suitable tests performed in the laboratory. Escape of the recombinant DNA either via survival of the organisms or via transmission of recombinant DNA to other organisms should be less than 1/108 under specified conditions. Specific systems:
(1) For EK2 host-vector systems in which the vector is a plasmid, no more than one in 108 host cells should be able to perpetuate a cloned DNA fragment under the specified nonpermissive laboratory conditions designed to represent the natural environment, either by survival of the original host or as a consequence of transmission of the cloned DNA fragment.
(2) For EK2 host-vector systems in which the vector is a phage, nor more than one in 108 phage particles should be able to perpetuate a cloned DNA fragment under the specified nonpermissive laboratory conditions designed to represent the natural environment either:
(i) as a prophage (in the inserted or plasmid form) in the laboratory host used for phage propagation; or
(ii) by surviving in natural environments and transferring a cloned DNA fragment to other hosts (or their resident prophages).
(c) Responsibility.
HV1 systems other than E. coil K-12, and HV2 host-vector systems, may not be designated as such until they have been certified by the director, NIH.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.8 Research and educational activities
(a) All research costs shall be excluded from allowable costs in computing reimbursement rates. Research includes those studies and projects which have as their purpose the enlargement of general knowledge and understandings, are experimental in nature and hold no prospect of immediate benefit to the hospital or its patients.
(b) The costs of educational activities less tuition and supporting grants shall be included in the calculation of the basic rate, provided such activities are directly related to patient care services.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.12 Limitations on State aid
(a) No State aid is available to local health officials or providers for tuberculosis health care services which do not meet the terms of this Subpart or:
(1) if payment of a claim is available from any other third-party payer which equals or exceeds the per diem rate or fee for services;
(2) for tuberculosis health care services for persons listed in subdivision (b) of section 43-1.3 of this Subpart; or
(3) for services for which payment by a local health official is not required under this Subpart.
(b) If a local health official pays a provider more than it was responsible to pay under section 43-1.9 of this Subpart, State aid shall not exceed the amount that would have been due if the local health official has so limited payment in accordance with said section.
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.9 Stipulations
(a) Hearings into findings of violations may be waived upon stipulation between the respondent and the department.
(b) Stipulations shall comply with terms and conditions prescribed by the department, and may include assessment of a penalty not to exceed the maximum penalty assessable for each violation cited in the finding of violation.
(c) The department inspector, in serving the finding of violation, shall be authorized to represent the department in explaining the options available to the respondent in answering the finding of violations, including the option for stipulation.
(d) The tribunal or tribunal representative shall be authorized to offer a stipulation to the respondent.
(e) Information concerning stipulations made under this section is subject to public release.
Subchapter S LAND ACQUISITION
Part 99 PAYMENTS TO AN OWNER OR TENANT OF RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY UPON APPLICATION FOR ALLOWANCE OF MOVING EXPENSES IN VACATING PROPERTY ACQUIRED BY THE DEPARTMENT OF HEALTH
10 CRR-NY 99.2 Definitions
For the purposes of this Part, the following terms shall mean:
(a) Eligible person.
Any individual, family, business concern (including the operation of a farm), and nonprofit organization to be displaced by the acquisition and use of the property by the State who were occupants prior to the date of State taking possession of such property.
(b) Relocation payment.
Any payment made to eligible persons for their moving expenses for moving personal property, exclusive of trade fixtures, caused by their displacement from real property acquired by the State pursuant to the above-mentioned law, and for which reimbursement or compensation is not made as part of the compensation for the real property under an agreement of adjustment or a court award.
(c) Individual.
A person who is not a member of a family as hereinafter defined (considered as a “family” for the purposes of this Part).
(d) Family.
Two or more persons who are living together in the same quarters.
(e) Business concern.
A corporation, association, partnership, individual or other private entity, engaged in a business or professional activity requiring the use of fixtures, equipment, stock in trade, or other tangible personal property for the carrying on of the business or profession on the premises.
(f) Nonprofit organization.
A corporation, partnership, individual or other private entity, engaged in a business, professional or institutional activity on a nonprofit basis requiring the use of fixtures, equipment, stock in trade, or other tangible personal property for the carrying on of the business, profession or institution on the premises.
(g) Operation of a farm.
The operation of a parcel of land (or parcels operated as a single unit) which is used for the production of one or more agricultural commodities for sale and home use and which customarily produces or is capable of producing such commodities in sufficient quantity to contribute materially to the operator's support, including the operation of stock, dairy, poultry, fruit, fur-bearing animal, and truck farms, plantations, ranches, nurseries, ranges, and greenhouses or other similar structures used primarily for raising agricultural or horticultural commodities.
(h) Moving expenses.
Cost of dismantling, disconnecting, crating, loading, insuring, temporary storage not in excess of six months, transporting, unloading, reinstalling of personal property, exclusive of the cost of any additions, improvements, alterations or other physical changes in or to any structure in connection with effecting such reinstallation.
(i) Counted rooms.
Counted rooms shall be that space in a building or structure containing a substantial and usual quantity of household furniture and equipment and personal property. They shall include such space as basements, cellars, recreation rooms, living rooms, libraries, studios, dining rooms, kitchens, laundry rooms (when containing mechanical equipment such as washers and dryers), enclosed sun porches (when they contain furniture, household equipment and personal property comparable to a room), bedrooms, attics (when they contain substantial storage of household equipment and furniture and personal property), also garages, outbuildings and playhouses (when they contain storage of household or garden equipment, furniture and personal property). Foyers and alcoves will be counted as one-half rooms when they contain furniture and household equipment. Combination living rooms - dining rooms and kitchen-dinettes shall be considered one and one-half counted rooms. Vestibules, bathrooms and powder rooms shall not be considered counted rooms.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-3.12 Charge for treatment
The director shall, from time to time, determine the actual and necessary costs of treatment and shall file such reports relating thereto as may be required by the Commissioner of Health or any provisions of law. It is the policy of the institute to require full payment of the cost of care as determined by the director or as provided by agreements with third-party payors providing coverage to patients undergoing either in-patient or out-patient services. The director shall have the authority to waive part or all of the such charges, according to policies in effect at that time which were promulgated by the director and approved by the Commissioner of Health in the event that:
(a) The patient is determined to be unable to pay charges at the established rates by reason of insufficient resources. A schedule for determining ability to pay shall be maintained at the institute and shall be subject to public inspection. Such schedule shall be revised from time to time with the approval of the Commissioner of Health.
(b) The patient is admitted to treatment either as in-patient or out-patient under a research protocol duly approved by the director. Each patient so admitted to treatment will sign (or have signed on his behalf by a legally constituted authority) a statement of consent indicating that such patient or his or her authorized representative has been informed of the research protocol applicable and the extent to which the proposed therapeutic regimen is considered to be experimental and accepts the risks thereof.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 93 IMPROPER PRACTICES IN HOSPITAL STAFF APPOINTMENTS AND EXTENSION OF PROFESSIONAL PRIVILEGES
10 CRR-NY 93.3 Investigation
After receipt of any such complaint, the Public Health Council shall promptly initiate an investigation of the complaint. The Public Health Council will send notice to the hospital that it will conduct an investigation in connection with such complaint. The council may dismiss a complaint, or a portion of a complaint that raises issues which do not fall within the scope of section 2801-b of the Public Health Law. In such instance, the Public Health Council shall notify the complainant and hospital of the reasons for such dismissal.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.66 Schedule I substances
No prescriptions shall be made or filled for controlled substances in schedule I.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.1 Purpose
The purpose of this Subpart is to assure a sanitary, healthful and safe environment for the public when using swimming pools.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.30 Maintenance of effort
(a) A local health department shall maintain public health programs and services and gross expenditures for those services at “base year” levels, as defined below.
(b) The base year shall be the most recent local health department fiscal year for which the local health department has filed all quarterly claim forms with the department.
(c) Maintenance of effort shall be monitored by the department throughout the fiscal year.
(d) Adjustment to State aid reimbursement shall be made when a local health department reduces its expenditures beneath the amount expended in its base year. State aid shall be reduced by the percentage reduction in expenditures between the base year and the current fiscal year. When calculating the amount by which a local health department has reduced its expenditure, the commissioner shall exclude extraordinary expenditures of a temporary nature, such as disaster relief; unavoidable or justifiable program reductions, such as a program being subsumed by another agency; or expenditures for which the local health department can demonstrate to the commissioner’s satisfaction that the need for the expenditure no longer exists.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 116 FULTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 116.4 Village of Northville
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the Northville Reservoir and all watercourses tributary thereto or which may ultimately discharge into said Northville Reservoir or which may be developed in the future to serve as sources of the water supply to the village of Northville, Fulton County, N.Y.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the village of Northville water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the village of Northville, Fulton County, N.Y.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the village of Northville water supply.
(18) Watershed shall mean the entire drainage area contributing water to the village of Northville water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and in subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the village of Northville.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the village of Northville, except by duly authorized employees of the village in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the village of Northville within a 1,000-foot linear distance of the water supply intakes, except by duly authorized employees of the village in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the village of Northville.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The board of trustees of the village of Northville or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissoner of Health of such violations. The aforesaid board of trustees shall report to the State Commissoner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.10 Basis of valuation
[1190]
(a) Historical cost is the basis used in accounting for the valuation of all assets and in recording all expenses (except fair market value in the case of donations and imputed value in the case of nonpaid workers). Historical cost, simply defined, is the amount of cash or cash equivalents given in exchange for properties or services at the time of acquisition. It is the basis for the valuation of assets and for the recording of most expenses. Cost ordinarily has been the basis for accounting for assets and expenses because it is a permanent and objective measurement that reflects the accountability of management for the utilization of hospital funds.
(b) Hospitals, however, frequently acquire property, equipment, services and supplies by donation. The property, equipment, service and/or supply is considered donated when acquired without the hospital making any payment for it in the form of cash, property or services. The property, equipment, service and/or supply should be valued at the fair market value which is the price that the asset would cost by bona fide bargaining between well-informed buyers and sellers at the date of donation (regardless of date of receipt). Failure to give accounting recognition to donated properties and services results in an understatement of hospital assets, revenues and expenses.
(c) Many hospitals receive the services of members of an organization of nonpaid workers that has arrangements with the hospital for the performance of services. The services are in positions customarily held by full-time employees, and are performed on a regularly scheduled basis. The fair value of donated services must be reported when there is the equivalent of an employer-employee relationship and an objective basis for valuing such services. The value of services donated by organizations must be evidenced by a contractual relationship which provides the basis for valuation. The amounts reported are not to exceed those paid others for similar work.
(d) The value of services of a type of which hospitals generally do not remunerate individual's performances are not included as operating cost ( e.g., donated services of individuals such as volunteers and trustees).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.97 Single-service articles; when required
Single-service articles are to be furnished to consumers at all food service establishments which do not have effective facilities for cleaning and sanitizing tableware. Single-service articles are to be discarded after one use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.8 Administration
(a) Prior to being certified for an award payment, a recipient must sign a written acceptance of the award and a service agreement describing the conditions of the award, the service obligation, and the terms of repayment in the event of rescission or default.
(b) A recipient is required to comply with all administrative and reporting requirements of the Department of Health and the Higher Education Services Corporation.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 84.5 Agreement between State and employee organization
The provisions of these attendance rules, insofar as they apply to employees in the negotiating units, established pursuant to article 14 of the Civil Service Law, shall be continued; provided, however, that during periods of time when there is in effect an agreement between the State and an employee organization reached pursuant to the provisions of said article 14, the provisions of such agreement and the provisions of such rules shall both be applicable. In the event the provisions of the agreement are different from the provisions of the attendance rules, the provisions of the agreement shall be controlling.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.11 Fraud and abuse
(a) The commissioner, his agents or designees, shall investigate and refer for prosecution any violations of State laws pertaining to fraud or abuse in the program.
(b) Where review indicates substantial evidence of abuse of the program, the participant may be removed from the program or restricted to a single provider.
(c) If the recipient did not provide accurate information regarding his income and expenses, the commissioner may summarily suspend an enrollee's participation in the program, and the department can recover the amount of assistance granted, to which the recipient is not entitled.
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
STATE AID LIMITATIONS STATE AID LIMITATIONS
10 CRR-NY 42.10 Laboratory services eligible for reimbursement
State aid will be granted to a municipality performing or contracting for laboratory tests related to the municipal health department's performance of eligible services described in this Part for, the cost of laboratory services required for:
(a) the detection and control of disease as prescribed by the Public Health Law, the State Sanitary Code or the State Commissioner of Health;
(b) the maintenance of a safe and healthful environment; and
(c) the conduct of health research approved by the State Commissioner of Health.
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.6 Topics and requirements for annual refresher asbestos safety training programs
The refresher safety training programs shall be specific to each discipline. Refresher programs shall be conducted as separate and distinct programs and not combined with any other training during the period of the refresher program. Upon successful completion of the annual refresher program the student shall have his/her accreditation extended for an additional year from the date of completion of the refresher program.
(a) All sections of this Part relative to requirements for training providers, instructor credentials and application procedures are also applicable to annual refresher training programs.
(b) The annual refresher training program for inspectors shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) review of key aspects of the inspector function;
(3) case studies to highlight important considerations; and
(4) developments in state-of-the-art work practices and safety procedures.
(c) The annual refresher training program for allied trades shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) developments in state-of-the-art work practices and safety procedures;
(3) case studies to highlight important work safety concepts; and
(4) review and update of key aspects of allied trades functions.
(d) The annual refresher training program for asbestos project air sampling technician shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) review and update of key aspects of functions performed by asbestos project air sampling technicians;
(3) developments in state-of-the-art work practices and safety procedures; and
(4) case studies to highlight important concepts.
(e) The annual refresher training program for operations and maintenance workers shall include the following topics:
(1) review and update of State, Federal, and local regulations;
(2) review of key aspects of functions performed and developments in state-of-the-art work practices and safety procedures; and
(3) review of recognition of damaged asbestos material and proper methods of handling asbestos material.
(f) The annual refresher training program for management planner shall include the inspector refresher training program as described in subdivision (b) of this section and will include at a minimum the following additional topics:
(1) review and update of key functions performed;
(2) review and update of relevant State, Federal and local regulations;
(3) developments in state-of-the-art work practices and safety procedures; and
(4) case studies to highlight important concepts.
(g) The annual refresher training program for project designer shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) review and update of key aspects of functions performed and developments in state-of-the-art work practices and safety procedures; and
(3) case studies to highlight important concepts.
(h) The annual refresher training program for asbestos handler shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) review and update of key aspects of functions performed and developments in state-of-the-art work practices and safety procedures; and
(3) case studies to highlight important safety concepts.
(i) The annual refresher training program for contractor/supervisor shall include the following topics:
(1) review and update of State, Federal and local regulations;
(2) review and update of key aspects of functions performed including, but not limited to, developments in state-of-the-art work practices and safety procedures, work area inspection procedures and recordkeeping required by State and Federal regulations; and
(3) case studies to highlight important concepts.
(j) The annual refresher training program for project monitor shall include the following topics:
(1) review and update of State, Federal, and local regulations;
(2) review and update of key aspects of functions performed including, but not limited to developments in state-of-the-art work practices and safety procedures, work area inspection procedures, air sampling strategies, and recordkeeping; and
(3) case studies to highlight important concepts.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.2 Certificate of public advantage
(a) Effect.
Parties that have received a certificate of public advantage issued by the department shall be provided state action immunity under Federal antitrust laws and immunity from private claims under state antitrust laws and may negotiate, enter into, and conduct business pursuant to, a cooperative agreement or a planning process covered by a duly issued certificate of public advantage. The Attorney General may seek relief under state antitrust law after:
(1) consulting with the department, the mental hygiene agencies as appropriate, and the parties to the certificate of public advantage; and
(2) providing the parties with a reasonable opportunity to modify their conduct or agreement, if the challenged conduct is inconsistent with or beyond the scope of the certificate of public advantage or if the Attorney General determines that the anticompetitive effects of the parties’ conduct or business arrangement outweigh the benefits of the conduct or business arrangement.
(b) Application.
(1) Parties to a cooperative agreement or planning process may apply to the department for a certificate of public advantage governing that cooperative agreement or planning process. The application must be submitted in a format determined by the department and shall be provided by the department to the Attorney General and, as appropriate, the mental hygiene agencies.
(2) The application for a certificate of public advantage governing a cooperative agreement must include a copy of the cooperative agreement, any related agreements or side letters (including a description of any related oral agreement), a description of the nature and scope of the activities and cooperation included in the cooperative agreement, a full description of any consideration passing to any party under the cooperative agreement and any additional documentation or information required by the department.
(3) The application for a certificate of public advantage governing a planning process must include a detailed letter of intent with respect to the potential cooperative agreement, a description of the nature and scope of the activities and cooperation likely to be included in the potential cooperative agreement and any additional documentation or information required by the department.
(4) The applicants must supply any additional documentation or information requested by the department within 30 days, or any other stated time frame of such request, or must obtain from the department an extension of the time in which to provide such documentation or information which is requested during the review of the application. Any request for an extension of time shall set forth reasons why such documentation or information could not be obtained within the prescribed time. The granting of a request for an extension shall be at the discretion of the department.
(5) Failure to provide such documentation or information within the time prescribed or as extended by the department shall constitute an abandonment or withdrawal of the application without any further action from the department, the Attorney General, mental hygiene agencies as appropriate, or the public health and health planning council.
(c) To the extent that the cooperative agreement contemplates activities that are subject to certificate of need or other approval or notice submission requirements pursuant to law or regulation, the parties shall also submit the required applications or notices.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.3 Patient assessment
(a) Long-term home health care program participation.
The direct costs for patient assessments and reassessments to the LTHHCP shall be included in the administrative costs of the LTHHCP and shall be included in the program's conversion of its cost report to an hourly or visit cost basis. These costs shall be limited to LTHHCP staff participation in the patient assessment.
(b) The cost of hospital/RHCF staff participating in patient assessment and discharge planning is included in the Medicaid rate of the facility and may not be added to the costs of the long-term home health care program.
(c) The cost of staff of the local social services district may not be included in the cost of the patient assessment.
(d) Physician participation.
(1) If the patient is in a hospital/RHCF and the physician is not on the staff of that facility, reimbursement for the physician's initial assessment is included in his visit fee in accordance with the Medicaid fee schedule.
(2) If the patient is in the community:
(i) and the assessment takes place in a clinic, reimbursement for the initial assessment is included in the clinic rate for medical or social care provided;
(ii) and the assessment takes place in the home, reimbursement for the initial assessment is included in the physician's home visit fee;
(iii) and the assessment takes place in the nonfacility-related physician's office, reimbursement for the initial assessment is included in the physician's office visit fee.
(e) Initial assessments for Medicaid patients shall be conducted only with authorization of the local social services district unless arrangements for patient admission have been made pursuant to section 3616 of the State Public Health Law.
(f) If an assessment of the person's needs demonstrates that he/she requires services the payment for which would exceed the monthly maximum, but it can be reasonably anticipated that total expenditures for required services for such person will not exceed such maximum calculated over a one-year period, the social services official may authorize payment for such services.
(g) If a change in the patient's level of care occurs between required patient assessment periods, the LTHHCP must formally notify the local social services district with justification for change. A new plan of care must be submitted in writing to the local social services district for their review and approval.
(h) If the patient requires unanticipated services but not a change of level of care between assessment periods, the program may provide such services if:
(1) the patient's budget is below the 75-percent ceiling and/or there are accrued savings and the costs of the needed services are equal to or less than 10 percent of the current budget for the services provided by the program; or
(2) the additional services exceed the 75-percent ceiling and there is not an accrued savings, providing that the additional cost does not exceed the patient's budget by more than 10 percent. This contingency provision may only be used when it can be reasonably anticipated that total expenditures for required services for such person will not exceed such maximum calculated over a one-year period.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.29 Swimming pool design standards
1.0 Definitions.
1.1 Swimming pool shall mean a man-made structure, together with buildings and appurtenances used in connection therewith, intended for bathing, swimming or diving purposes, made of concrete, masonry, metal or other impervious material, located either indoors or outdoors, and provided with a controlled water supply.
1.2 Spa pool shall mean a swimming pool, primarily designed for therapeutic use or relaxation, which is normally not drained, cleaned or refilled for each individual. It may include, but is not limited to, hydrojet circulation, hot water, cold water, mineral bath, air induction, bubbles or any combination thereof. Spa pools are shallow in depth and not designed for swimming or diving use.
1.3 Uniform Code shall mean the New York State Uniform Fire Prevention and Building Code, 9 NYCRR Subtitle S, Chapter I.
1.4 Adequate shall mean sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
2.0 Submission of plans.
2.1 General. All plans shall be prepared by a person licensed by the State of New York to practice engineering or architecture. All construction shall comply with the requirements of the Uniform Code. It is desirable that preliminary plans, specifications and an engineer's design report be submitted for review prior to the preparation of final plans. Plans, specifications and reports submitted for formal approval must contain sufficient information to demonstrate to the reviewing authority that the proposed swimming pool, or improvements thereto, will meet the standards contained herein and shall include, but not be limited to, those factors hereinafter set forth in items 2.2.1 through 2.2.7, inclusive.
2.2 Basis of design report.
2.2.1 Swimming pool perimeter, area and volume.
2.2.2 Flow rate, turnover and filtration rate.
2.2.3 Anticipated swimmer load (maximum and average).
2.2.4 Source, quality, quantity available and characteristics of water supply, including alkalinity, pH, iron and manganese.
2.2.5 Detailed description of filtration, recirculation equipment and chemical feed equipment.
2.2.6 Hydraulic computations, including head loss in all piping and recirculation equipment.
2.2.7 Pump curves, showing that the proposed recirculation pump can adequately pump proposed flows.
2.3 Plans and specifications.
2.3.1 General layout plan.
2.3.1.1 Name and address of the proposed facility and the name and address of the owner.
2.3.1.2 Scale, north point and direction of prevailing wind.
2.3.1.3 Date, address, name, professional seal and signature of the designing engineer or architect.
2.3.1.4 A plot plan of the property to be used, indicating the topography, the arrangement and location of present and proposed structures, and the location of present and proposed swimming pool.
2.3.2 Detailed plans. All detailed plans shall be drawn to a suitable scale and include the following information:
2.3.2.1 Complete construction details, including dimensions, elevations and appropriate cross-sections.
2.3.2.2 Schematic diagrams and plan and elevation views of the pool water treatment and recirculation system.
2.3.2.3 Size and location of all piping, including elevations.
2.3.3 Specifications. Complete, detailed specifications for the construction of the swimming pool, bathhouse, recirculation system, filtration facilities, disinfection equipment and all other appurtenances shown on detailed plans shall be submitted.
3.0 Patron use.
3.1 Designation of areas. For purposes of computing patron use within the pool enclosure, those portions of the swimming pool five feet or less in depth shall be designated the “shallow area.” Those portions of the swimming pool over five feet in depth shall be designated the “deep area.”
3.2 Design bather capacity.
3.2.1 Shallow area. Fifteen square feet of pool water surface area shall be provided for each patron.
3.2.2 Deep area. Twenty-five square feet of pool water surface area shall be provided for each patron.
3.2.3 Diving area. Three hundred square feet of pool water surface area shall be reserved around each diving board or diving platform, and this area shall not be included in computing the permissible patron use.
3.2.4 Spa pools. Ten square feet per person shall be provided for each patron.
3.3 Excess deck allowance. Additional allowance will be made on the basis of one additional patron allowed per each 50 square feet of pool deck in excess of the minimum area of deck required in item 5.9 of this section.
4.0 Construction material.
4.1 Materials. Swimming pools shall be constructed of materials which are inert, stable, nontoxic, watertight and enduring. Sand or earth bottoms or unlined wooden tubs are not permitted.
4.2 Corners. All corners formed by intersection of pool walls and floor shall be rounded.
4.3 Finish. Pool bottom and sides must be white or a light color with a smooth and easily cleanable surface.
5.0 Design, detail and structural stability. All swimming pools shall be designed and constructed to withstand all anticipated loading for both full and empty conditions. A hydrostatic relief valve and/or a suitable underdrain system shall be provided. The designing architect or engineer shall be responsible for certifying the structural stability and safety of the pool during full and empty conditions.
5.1 Shape. The shape of any swimming pool shall be such that the circulation of pool water and control of swimmers' safety are not impaired. There shall be no underwater or overhead projections or obstructions which would endanger patron safety or interfere with pool operation.
5.2 Minimum depth. The minimum depth of water in the pool shall be three feet, except for special-purpose and wading pools.
5.3 Bottom slope. The bottom of the pool shall slope toward the main drain. The slope in water depths less than five feet shall not exceed 1 foot vertical to 12 feet horizontal.
5.4 Area marked. The boundary line between the shallow and deep areas shall be marked with a four-inch stripe of contrasting color on the floor and walls of the pool, and by a safety rope and floats equipped with float keepers. Ledges and step edges shall also be marked with a four-inch stripe of contrasting color.
5.5 Pool walls. Walls of a swimming pool shall be either: (1) vertical for a distance of at least six feet; or (2) vertical for a distance of at least three feet below the water level; below which the wall may be curved to the bottom with a radius not greater than the difference between the depth at that point and three feet; provided that vertical is interpreted to permit slopes not greater than one foot horizontal for each five feet of depth of sidewall (11 degrees from vertical).
5.5.1 Ledges. Ledges shall not extend into the pool unless they are essential for support of the upper wall construction.
5.6 Diving areas. The minimum dimensions of the swimming pool and appurtenances in the diving area shall conform to Table 1 of this section. Pools designed for competitive diving can upon application utilize nationally recognized competitive design standards.
TABLE 1
MINIMUM DIMENSIONS FOR POOLS WITH DIVING EQUIPMENT
)
Note:
Minimum depth of five feet must be maintained when a wall terminates pool area opposite diving boards. Otherwise, the specified shallow area floor slope may be used to shallow end.
| | | | Minimum dimensions | | | | --- | --- | --- | --- | --- | --- | | Max. board height over water | Max. diving board length | D | L1 | L2 | Pool width | | 26″ (2/3 meter) | 10′ | 8′6″ | 2′6″ | 10′0″ | 20′0″ | | 30″ (¾ meter) | 12′ | 9′0″ | 3′0″ | 10′0″ | 20′0″ | | 1 meter | 16′ | 11′0″ | 4′0″ | 20′0″ | 20′0″ | | 3 meters | 16′ | 12′0″ | 6′0″ | 20′0″ | 24′0″ |
Placement of boards shall observe the following minimum dimensions. With multiple board installations, minimum pool widths must be increased accordingly.
1 meter or less—Board to pool side
10′0″
3 meters—Board to pool side
12′0″
Distance between adjacent boards
10′0″
5.6.1 Headroom. There shall be a completely unobstructed clear distance of 16 feet above the diving board, measured from the center of the front end of the board. This area shall extend at least eight feet behind, eight feet to each side, and 16 feet ahead of the measuring point.
5.6.2 Diving boards and platforms. The use of diving boards and platforms in excess of three meters in height must be based on a design that adequately addresses the special safety considerations associated with such devices.
5.6.3 Steps and guardrails for diving boards. Supports, platforms and steps for diving boards shall be of substantial construction and of sufficient structural strength to safely carry the maximum anticipated loads. Steps shall be of corrosion-resistant material, easily cleanable and of nonslip design. Handrails shall be provided at all steps and ladders leading to diving boards one meter or more above the water. The guardrails shall be 30 inches high, extending at least to the edge of the water.
5.7 Deck slides. All swimming pool slides, which may be installed at a swimming pool, shall be labeled to show compliance with the requirements of the U.S. Consumer Product Safety Commission or other generally acceptable standards that will provide adequate protection for public health and safety.
5.7.1 Depth. The bottom of any slide must discharge into a minimum water depth of four feet.
5.8 Ladders, recessed steps and stairs.
5.8.1 Location. Recessed steps, ladders or stairs shall be provided at the shallow and deep ends. Recessed steps or ladders shall be provided in the deep portion. If the pool is over 30 feet wide, such steps, ladders or stairs shall be installed on each side.
5.8.2 Ladders. Pool ladders shall be corrosion-resistant and shall be equipped with nonslip treads. All ladders shall be so designed as to provide a handhold. There shall be a clearance of not more than six inches nor less than three inches between any ladder and the pool wall.
5.8.3 Recessed steps. Recessed steps shall be readily cleanable and shall be arranged to drain into the pool. Recessed steps shall have a minimum tread of 5 inches and a minimum width of 14 inches.
5.8.4 Handrails. Where recessed steps or ladders are provided, there shall be a handrail at the top of each side thereof extending over the coping or edge of the deck.
5.8.5 Stairs. Where stairs are provided, they shall be located diagonally in a corner of the pool or be recessed. They shall be equipped with a handrail. Stairs shall be of nonslip design, have a minimum tread of 12 inches and a maximum rise of 10 inches.
5.9 Decks. A continuous clear deck shall surround the entire pool perimeter. It shall be not less than five feet wide. The deck shall be of a uniform, easily cleaned, impervious material and be protected from surface runoff. Where diving boards or slides are installed, a clear deck of not less than five feet shall be provided behind the diving boards or slides.
5.9.1 Slope. The deck shall be sloped at least one-fourth inch per foot to deck drains or grades.
5.9.2 Drainage. Deck drains, when used, shall be spaced and arranged so that not more than 400 square feet of area is tributary to each drain, and drains shall not be spaced more than 25 feet apart. There shall be no direct connection between the pool deck drains and the sanitary sewer system, or the pool gutter or recirculation system.
5.9.3 Roll-out gutters. If the pool is equipped with roll-out deck level gutters, not more than five feet of deck shall be sloped toward the gutters.
5.9.4 Carpeting. Carpeting shall not be permitted on pool decks unless the carpet contains a label indicating it complies with the National Sanitation Foundation Standards or other standards that will provide adequate protection for public health and safety.
5.9.5 Hose bibbs. Hose bibbs shall be provided to facilitate flushing of the deck areas and shall be provided with antisiphonage devices.
5.9.6 Spectator areas. There shall be an effective separation between spectator areas and swimmer areas.
5.9.7 Food concessions. There shall be a separation between areas where food and drink are served and areas used by pool patrons.
5.10 Fencing. All swimming pools, including wading pools, shall be provided with an enclosure which shall comply with the following:
5.10.1 Shall be at least four feet in height and have a maximum vertical clearance to grade of two inches.
5.10.2 Where a picket-type fence is provided, horizontal openings between pickets shall not exceed four inches.
5.10.3 Where a chain-link fence is provided, the openings between links shall not exceed ⅜ inches.
5.10.4 Enclosure shall be constructed so as not to provide footholds.
5.10.5 Pickets and chain-link twists shall extend above the upper horizontal bar.
5.10.6 Such enclosure shall have railings and posts within the enclosure, which shall be capable of resisting a minimum lateral load of 150 pounds applied midway between posts and at top of posts, respectively. Enclosures, fence material or fabric shall be capable of withstanding a concentrated lateral load of 50 pounds applied anywhere between supports on an area 12 inches square, without failure or permanent deformation. Gates provided in the enclosure shall be self-closing and self-latching, with the latch handle located within the enclosure and at least 40 inches above grade.
5.10.7 A wall of a multiple dwelling is permitted to serve as part of the enclosure, provided that there is no direct access from the dwelling to the pool.
6.0 Safety requirements.
6.1 Depth markings.
6.1.1 Location of depth markings. Depth of water shall be plainly marked at or above the water surface on the vertical pool wall and/or on the edge of the deck at maximum and minimum points and at break between the deep and shallow portions, and at intermediate two-foot increments of depth, spaced at not more than 25-foot intervals. Markings shall be on both sides and ends of the pool. Where depth markings cannot be placed on the vertical walls above the water level, other means shall be used so that the markings will be plainly visible to persons in the pool. Water depth shall be measured at a point three feet from the pool wall.
6.1.2 Size of depth markings. Depth markings shall be in numerals of four-inch minimum height, followed by the words “foot depth” or “feet deep,” and with color contrasting with background. Depth markers must be of durable material and permanently installed.
6.2 Lifeguard chairs. Elevated lifeguard chairs shall be provided at all pools having an area greater than 2,000 square feet that provide Supervision Level IIa or IIb aquatic supervisory staff. One elevated lifeguard chair is required for each 3,400 square feet of pool surface area or fraction thereof. Chairs should be placed in locations which will eliminate sun glare on the water, and in positions which will give complete coverage of the pool area under surveillance.
6.3 Lifesaving equipment. Lifesaving equipment shall be provided as required in section 6-1.23(b) of this Subpart.
6.4 First aid room. Swimming pools with a surface area in excess of 4,000 square feet shall have a readily accessible room or area designated and equipped for emergency care.
6.5 Emergency exit. An emergency exit from the pool room shall be provided. All exits should be clearly marked.
7.0 Lighting, electrical, ventilation requirements.
7.1 Lighting. Artificial lighting shall be provided at all swimming pools which are to be used at night, or which do not have adequate natural lighting, so that all portions of the pool, including the bottom, may be readily seen without glare.
7.1.1 Water surface. Overhead illumination on the water surface shall be a minimum of 30 foot-candles when underwater lighting as specified in item 7.1.2 is provided. Without underwater lighting, a minimum illumination of 50 foot-candles on the water surface shall be provided.
7.1.2 Underwater. When underwater lighting is used, not less than 0.5 watt per square foot of swimming pool water surface shall be provided.
7.1.3 Decks. A minimum of 50 foot-candles should be provided at deck level of competition pools.
7.1.4 Emergency lighting. All indoor pools where night swimming is permitted, and indoor pools where no natural light is present shall be provided with an adequate emergency lighting service. For outdoor pools, a portable battery-powered light source is acceptable and shall be adequate and maintained to facilitate swimming pool evacuation.
7.1.5 Equipment rooms. All swimming pool equipment and chemical storage rooms shall be provided with artificial lighting sufficient to illuminate all equipment and supplies.
7.2 Electrical.
7.2.1 Wiring shall conform to the Uniform Code and the requirements of the appropriate regulatory agency. A certificate shall be submitted for all new electrical work.
7.2.1.1 Overhead clearance. No electrical wiring shall pass overhead within a 20-foot horizontal distance of the pool.
7.2.2 Electrical receptacles. Ground-fault circuit interrupters shall be provided on all pools, for all lighting and other electrical circuits in the area of the pool. These devices may be required in an existing pool, when the permit-issuing official determines it is necessary to protect the safety of bathers.
7.2.3 Grounding. Each underwater light shall be individually grounded by means of an adequate ground-wire screwed or bolted connection to the metal junction box from which the branch circuit to the individual light proceeds. Such junction boxes shall not be located in the swimming pool deck within four feet of the pool wall.
7.3 Ventilation.
7.3.1 Room ventilation. Bathhouses, mechanical equipment rooms, storage areas and indoor swimming pool enclosures shall be ventilated, either by natural or mechanical means. Room ventilation shall prevent direct drafts on swimmers and shall minimize condensation. A minimum of two air changes per hour shall be provided for indoor pool areas. A heating unit shall be kept from contact with swimmers. Fuel-burning heating equipment shall be installed and vented to the outdoors in accordance with the Uniform Code.
8.0 Water supply and wastewater disposal.
8.1 Water supply. The source and quality of the water supplied to the pool and all plumbing fixtures, including drinking fountains, lavatories and showers, shall after treatment meet the applicable requirements of Part 5 of the State Sanitary Code (10 NYCRR Part 5) for potable water.
8.2 Cross-connection control. All portions of the water distribution system serving the swimming pool and auxiliary facilities shall be protected against backflow and back-siphonage. Water introduced into the pool, either directly or to the recirculation system, shall be supplied through an air gap or by another method which will prevent backflow and back-siphonage.
8.3 Fill spout. When a fill spout is used to introduce water into the swimming pool, it shall be shielded so as not to create a hazard. The open end of the fill spout shall have no sharp edges, shall not protrude more than two inches beyond the edge of the pool and shall be at least six inches above the deck level. If the swimming pool is equipped with a diving board, consideration shall be given to locating the fill spout under the diving board.
8.4 Sanitary wastes. Sanitary sewage shall be disposed of through a municipal sanitary sewerage system. If a private subsurface disposal system or other system must be used, approval of the system must be obtained from the appropriate regulatory agency.
8.5 Pool waste water. Pool waste water shall be discharged to the sewer system or storm drain through a suitable air gap so as to preclude the possibility of backup of sewage or waste water into the swimming pool piping system. Approval of the system must be obtained from the appropriate regulatory agency.
8.6 Drinking fountains. Drinking fountains shall be of slanting jet-type with a surrounding guard and nonsubmersible opening. They shall be located at a convenient point and be supplied with adequate water pressure.
9.0 Recirculation systems and equipment. A recirculation system consisting of pumps, piping, filters, water conditioning and disinfection equipment, and other accessory equipment, shall be provided which will clarify, chemically balance and disinfect the swimming pool water. A minimum turnover of the entire volume in six hours (four times in 24 hours) is required, except that the recirculation rate shall be increased to provide a two-hour turnover for wading pools, and as set forth in item 15.0 of this section for special-purpose pools.
9.1 Equipment approval. Equipment used or proposed for use in swimming pools shall be of proven design and construction and be tested as follows: (1) tested and listed by the National Sanitation Foundation (NSF) or another testing laboratory under standards promulgated by NSF; or (2) use-tested in New York or another state in at least 10 pools of comparable design for a period of at least 60 days, with engineering reports on results of use submitted; or (3) pilot-plant testing of at least 90 days, with formal submission of an operational report prepared by the design engineer or architect; or (4) a combination of use and testing or a trial use period approved by the permit-issuing official and the State Commissioner of Health.
9.2 Piping.
9.2.1 Materials. The recirculating piping and fittings shall be of nontoxic material, resistant to corrosion, and able to withstand operating pressures. Acceptable materials for pool recirculation systems are plastic, copper, stainless steel, asbestos cement, aluminum, cast iron or other material suitable for water supply use.
9.2.2 Velocities. The pipes, fittings and valves of the pool recirculation system shall be sized so that velocities do not exceed 6 feet per second under suction, 10 feet per second under pressure and 3 feet per second in gravity flow.
9.3 Drainage and installation. All equipment and piping shall be designed and fabricated to drain completely by use of drain plugs, drain valves or other means. All piping shall be supported continuously or at sufficiently close intervals to prevent sagging. All suction piping shall be sloped in one direction, preferably toward the pump. All supply and return pipelines to the pool shall be provided with insertable plugs or valves to allow the piping to be drained to a point below the frost line. Provision shall be made for expansion and contraction of pipes.
9.4 Color coding. All exposed piping should be color-coded in accordance with the following table:
| Piping | Color code | Waste lines | Color code | | --- | --- | --- | --- | | Potable water lines | Dark blue | Backwash waste | Dark brown | | Filtered water | Aqua | Sewer (sewer or other) | Dark gray | | Skimmer or gutter return | Olive green | Deck drains | Light brown | | Main drain | Black | | | | Alum | Orange | Other | | | Chlorine (gas/solution) | Yellow | Compressed air | Dark green | | Soda ash | White | Gas | Red | | Acid | Pink | | |
Where two colors do not have sufficient contrast to easily differentiate between them, a six-inch band of contrasting color should be painted on one pipe at approximately 30-inch intervals. The name of the liquid or gas, and arrows indicating direction of flow, should be shown on the pipe.
9.5 Overflow systems. All pools shall be designed to provide continuous skimming (removal of surface water). Make-up water supply equipment shall be provided to maintain continuous skimming.
9.5.1 Gutters (perimeter overflow systems). The overflow shall extend completely around the pool. It shall be level within a tolerance of plus or minus one-eighth inch. Piping connections shall be provided to permit water to flow from overflows to the recirculation system.
9.5.1.1 Size and shape. The gutter system shall be designed for continuous removal of water from the pool's upper surface at a rate of at least 100 percent of the recirculation rate. The gutter shall be designed to serve as a handgrip and to prevent entrapment of arms and legs. It shall permit ready inspection, cleaning and repair.
9.5.1.2 Outlets. Drop boxes, converters, return piping or flumes used to convey water from the gutter shall be designed to handle 100 percent of the recirculation rate. Drainage shall be sufficient to minimize flooding and prevent backflow of skimmed water into the pool.
9.5.1.3 Surge capacity. All overflow systems shall be designed with an effective surge capacity of not less than one gallon for each square foot of pool surface area. Surge shall be provided within a surge tank, in the gutter or filter above the normal flow line, or elsewhere in the system. Surge tanks, gutters and filter tanks should have overflow pipes to convey excess water to waste. Surge tanks shall be provided with means for complete draining.
9.5.2 Skimmers. The use of skimmers shall be limited to pools with widths of 30 feet or less and a water surface area less than 1,600 square feet.
9.5.2.1 Number. In pools where skimmers are used, one skimmer for each 400 square feet of surface area or fraction thereof shall be provided. Additional skimmers may be required to achieve effective skimming.
9.5.2.2 Location. Skimmers shall be so located as to provide effective skimming of the entire water surface with minimum interference and short-circuiting.
9.5.2.3 Flow rate. Skimmers shall be designed for a flow-through rate of at least 30 gallons per minute or 3.75 gallons per minute per lineal inch of weir. The swimming pool recirculation rate is determined by the total of: design flow rate required by the number of skimmers, and the flow through the main drain system, as specified in item 9.6.4, and must supply the minimum turnover rate required by item 9.0.
9.5.2.4 Control. Skimmers shall have weirs that adjust automatically and operate freely and continuously with variations of at least four inches in water level. All skimmed water shall pass through an easily removable and cleanable basket or screen before encountering control valves or entering the pump suction line. Each skimmer shall be equipped with a device to control flow. Skimmers shall include a device to prevent an air lock in the suction line. If equalizer pipes are used, they shall pass an adequate amount of water to meet pump suction requirements should pool water drop below the weir level. The equalizer pipes shall be located at least one foot below the lowest overflow level of the skimmer. A valve or equivalent device that will remain tightly closed under normal operating conditions, but automatically open when the water level drops below the minimum operating level of the skimmer, shall be provided on each equalizer pipe.
9.5.2.5 Construction. Skimmers shall be installed in the pool walls, be sturdy and be constructed of corrosion-resistant materials. Surface skimmers shall be of a type the permit-issuing official determines as adequate and suitable for such purpose.
9.5.2.6 Handgrips. Bull-nosed coping not more than two inches thick or other handgrip adjacent to the pool wall shall be provided. The handgrip shall not be more than nine inches above the minimum skimmer operating level. When the handgrip is formed by the pool deck, it shall slope away from the pool with a one-inch drop in a one-foot distance.
9.5.3 Testing. Flotation testing should be performed to determine and adjust the recirculation system for optimum skimming.
9.6 Main drain system. Two main drain suction outlets shall be installed in the pool floor at the deepest point with a separation distance of three feet or more provided. If the floor of a spa pool is insufficient for a separation distance of three feet, then the separation distance shall be as great as possible. The suction outlets shall be connected to a single main suction pipe by branch lines and the branch lines shall not be valved so as to be capable of operating independently.
9.6.1 Spacing. The drains shall not be greater than 20 feet on centers and the drain outlets shall be provided not more than 15 feet from each side wall.
9.6.2 Grating. The main drain suction outlet shall be protected by antivortex covers or gratings. The open area shall be large enough to assure the velocity does not exceed 1½ feet per second through the grating. Openings in grates shall not be over one-half inch wide. Gratings or drain covers shall not be removable without the use of tools.
9.6.3 Piping. The branch pipe from each main drain suction outlet shall be designed to carry 100 percent of the recirculation rate. The suction velocity in the pipe shall not exceed six feet per second. The single main suction pipe to the pump shall be equipped with a valve to control total main drain flow.
9.6.4 Minimum flow. At least 30 percent of the total recirculation rate should flow through the main drain.
9.7 Pumps and strainers.
9.7.1 Strainers. Strainers shall be provided through which all water shall pass before entering the pump. The strainers shall be of rigid construction, fabricated of corrosion-resistant material and sufficiently strong to prevent collapsing when clogged. The openings shall be no greater than one-eighth inch in any dimension. The total clear area of all openings shall be at least four times the area of the connecting pipe. The strainer shall have a quick-opening cover. Spare strainer baskets shall be provided. In systems where the filter is located on the suction side of the pump, strainers are not required.
9.7.2 Pumping equipment. The recirculation pump shall have adequate capacity to meet the design requirements of the pool, including filter backwashing. It shall be of a self-priming type if installed above the hydraulic gradient. A gauge which indicates both pressure and vacuum shall be installed on the pump suction header and a pressure gauge shall be installed on the discharge side of the pump.
9.8 Flow measurement and control.
9.8.1 Flow measurement. A means of continuously measuring rate of flow shall be provided in the recirculation system. For sand filters, the flow-measuring equipment shall be located where the backwash flow rate can also be determined. The indicator shall be capable of measuring at least 1½ times the design flow rate and shall be accurate within 10 percent of true flow. The indicator shall have a range of readings appropriate for the anticipated flow rates, and be installed where it is readily accessible for reading and maintenance, and with straight pipe upstream and downstream of any fitting or restriction in accordance with the manufacturer's recommendation.
9.8.2 Flow regulation. An automatic device for regulating the rate of flow shall be provided in the recirculation pump discharge piping. Where multiple pumps or filters are provided, each unit shall have a flow-regulating device installed.
9.9 Inlets.
9.9.1 Number. Wall inlets shall be spaced not over 20 feet apart, with one inlet within five feet of each corner of the pool and one in each recessed step area.
9.9.2 Location. Wall inlets shall be located at least 12 inches below the design water surface. Bottom inlets shall be uniformly spaced with a separation distance of no greater than 20 feet and with rows of inlets within 15 feet of each side wall. In any pool over 60 feet in width, bottom inlets should be provided. These must be flush with the floor.
9.9.3 Type. Inlet fittings shall be of the adjustable rate-of-flow type. Directional flow inlets shall be used with skimmer-type pools. Inlets shall not extend from the floor Or wall to create a hazard.
9.9.4 Testing. Dye testing (crystal violet or equivalent) should be performed to determine and adjust the recirculation pattern.
10.0 Filtration (general). A swimming pool water treatment system shall have one or more filters. It shall be installed with adequate clearance and facilities for ready and safe inspection, maintenance, disassembly and repair.
10.1 Sand filters. The design filtration rate of rapid sand filters shall not exceed three gallons per minute per square foot of filter area. High-rate sand filters (pressure or vacuum) shall not exceed a filtration rate of 15 gallons per minute per square foot of filter area. For multiple-cell rapid sand filters, the rate of filtration shall not exceed 3 gpm per square foot of filter area. For multi-cell high-rate sand filters, filtration rate shall not exceed 5 gpm per square foot of filter area. The sand filter system shall be equipped to backwash each filter at a rate of 12 to 15 gallons per minute per square foot of filter bed area, or as recommended by the manufacturer. The backwash water shall be discharged to waste through a suitable air gap.
10.1.1 Filter media. Sand or other media shall be carefully graded and meet the manufacturer's recommendation for pool use.
10.1.2 Accessories shall include influent pressure gauge, effluent pressure gauge, backwash sight glass and air relief valve.
10.2 Diatomaceous earth. The design filtration rate for pressure or vacuum filters shall be no greater than 1.5 gallons per minute per square foot of effective filter area, except that a maximum filtration rate of 2.0 gallons per minute per square foot may be allowed where continuous “body feed” is provided. The filter and all component parts shall be of such materials, design and construction to withstand normal continuous use without significant deformation, deterioration, corrosion or wear which could adversely affect filter operation.
10.2.1 Precoating. The filter piping shall be designed to refilter or waste the effluent until a uniform body coat is applied. For pressure-type filters, precoat feed equipment shall be provided to apply not less than 0.1 pound of diatomaceous earth per square foot of filter area.
10.2.2 Body feed equipment. Body feed equipment capable of applying not less than 0.1 pound of diatomaceous earth per square foot of filter area per 24 hours should be provided.
10.2.3 Regenerative-type filters. Regenerative type of filters shall meet the same standards as pressure filters. Pumping by air or manual means must be provided for, and provision for visual inspection of elements shall be provided.
10.2.4 Accessories. Accessories for vacuum filters shall include a vacuum gauge and a vacuum limit switch interconnected with the pump. Pressure filters require a backwash sight glass, influent pressure gauge, influent pressure gauge and air relief valve.
10.2.5 Backwash. Diatomaceous earth filter backwash water must discharge to the sewer system through a separation tank. The separation tank sludge shall be disposed of in an approved solid waste disposal facility.
10.3 Cartridge filters: filter rate. The design filtration rate for cartridge filters shall not exceed 0.375 gallon per minute per square foot of filter media.
10.3.1 Cartridges. A complete extra set of filter cartridges must be on hand at user's location.
10.3.2 Accessories shall include influent pressure gauge, effluent pressure gauge and air relief valve.
11.0 Disinfection. Swimming pools shall be designed to provide for continuous disinfection of the pool water with a chemical which is an effective disinfectant and which imparts an easily measured, active residual.
11.1 Disinfectant feeders. An automatic feeder which is easily adjustable shall be provided for the application of disinfectant.
11.1.1 Construction. Feeders shall be of sturdy construction and materials which will withstand wear, corrosion or attack by disinfectant solutions or vapors, and which are not adversely affected by repeated, regular adjustments or other normal use conditions.
11.1.2 Maintenance. Feeders shall be capable of being easily disassembled for cleaning and maintenance.
11.1.3 Operation. The design and construction shall minimize stoppage from chemicals intended to be used or foreign materials that may be contained therein.
11.1.4 Safeguards. The feeders shall incorporate antisiphon safeguards so that the disinfectant cannot continue to feed into the swimming pool, the pool piping system or the swimming pool enclosure if any type of failure of the pool equipment occurs.
11.1.5 Capacity. Feeders shall be capable of supplying disinfectant to the pool in the range up to 10 mg/l chlorine or equivalent.
11.2 Gas chlorination. When compressed chlorine gas is used, the following features shall be provided. Gas chlorine should not be used at pools in densely populated areas.
11.2.1 Location. The chlorinator room shall be located on the opposite side of the pool from the direction of the prevailing winds. Chlorine storage and chlorinating equipment shall be in a separate room. This room shall be at or above grade.
11.2.2 Venting. The chlorine room shall have a ventilating fan with an airtight duct beginning near the floor and terminating at a safe point of discharge to the out-of-doors. A louvered air intake shall be provided near the ceiling. The ventilating fan shall provide one air change per minute and operate from a switch located outside the door.
11.2.3 Door. The door of the chlorinator room shall not open to the swimming pool, and shall open outward directly to the exterior of the building. The door shall be provided with a shatterproof inspection window and should be provided with “panic hardware.”
11.2.4 Chlorine cylinders. Chlorine cylinders shall be anchored. The cylinders in use shall stand on a scale capable of indicating gross weight with one-half pound accuracy. Storage space shall be provided so that chlorine cylinders are not subjected to direct sunlight. Storage space shall be in an area inaccessible to the general public.
11.2.5 Injection location. Mixing of chlorine gas and water shall occur in the chlorine room, except where vacuum-type chlorinators are used.
11.2.6 Backflow. The chlorinators shall be designed to prevent the backflow of water or moisture into the chlorine gas cylinder.
11.2.7 Breathing apparatus. A self-contained breathing apparatus designed for use in a chlorine atmosphere (and of a type approved by the appropriate regulatory agency) shall be provided. A closed cabinet shall be provided to house the breathing apparatus. It shall be located outside of the chlorinator room.
11.2.8 Leak detection. A plastic bottle of ammonia for leak detection shall be provided.
11.3 Hypochlorinators. Where hypochlorinators are used, the following requirements shall apply:
11.3.1 Feed. Feed shall be continuous under all conditions of pressure in the recirculation system without constriction of the recirculation pump suction.
11.3.2 Solution tanks. If calcium hypochlorite is used, two solution tanks, each with minimum capacity of one-day supply, should be provided. All chemical containers, including those used with chemical feeders, must be clearly labeled regarding their contents.
11.4 Disinfection with bromine. Where bromine is used as a disinfectant, the permit-issuing official shall first approve use of solid stick-type bromine and the equipment provided for feeding on a continuous basis.
11.5 Chemical feed equipment. Equipment and piping used to apply chemicals to the water shall be of such size, design and material that they may be cleaned. All material used for such equipment and piping shall be resistant to action of chemicals to be used therein.
11.5.1 Ozone generating equipment (OGE) is acceptable only as a supplement to a chlorine or bromine disinfection system. When OGE is installed, the following design performance standards must be met:
11.5.1.1 Ozone concentration in the pool water shall not exceed 0.1 mg/l. Off-gassing of ozone shall not result in ozone levels in the equipment room or in the pool area exceeding 0.1 ppm. At the time the OGE is installed and annually thereafter the air space within six inches of the pool water level and air in the equipment room shall be tested to determine compliance with this requirement.
11.5.1.2 All corona discharge OGE’s must be vacuum systems.
11.5.1.3 Backflow of pool water into the OGE shall not occur.
11.6 pH adjustment. Mechanical feed equipment for the purpose of adding a chemical for pH adjustment shall be provided, except where pH can be maintained within the required limits without the use of positive feed equipment. The methods for addition of chemicals must be specified in the safety plan. The method of chemicals addition must protect the bather from contact with concentrated chemicals. The method must provide adequate distribution of the chemical throughout the pool and distribution must be verified by pool water testing prior to bather exposure.
11.6.1 Where carbon dioxide (CO2) is used as a method of pH control, the following features shall be provided:
11.6.1.1 CO2 shall be injected into the recirculation pipe at the same point where pH adjustment solutions ( i.e., acid) would normally be added. The recirculation pipe shall be of sufficient size and length to provide a minimum of five seconds contact time prior to bather contact.
11.6.1.2 CO2 cylinders shall be anchored to prevent damage. Cylinders shall be inaccessible to the general public.
11.6.1.3 The manufacturer's instructions shall be followed for installation and operation of cylinders. The units shall be operated by the designated persons listed in the safety plan.
11.6.1.4 CO2 cylinders should be stored in a protective enclosure at the exterior of occupied structures. If CO2 cylinders are provided in the interior of occupied structures, they shall be placed in a ventilated enclosure. A louvered fresh air intake shall be provided near the ceiling. Mechanical exhaust ventilation shall be provided at the rate of one air change every three minutes and take suction near the floor as far as practical from the door and fresh air intake. Exhausted air shall be deducted to the exterior of the building through a continuous pipe of at least 1½ inches in diameter with the point of discharge so located as not to contaminate air inlets to any rooms or structures.
11.7 An automatic device shall be provided to deactivate chemical feeders when their is no flow in the recirculation system.
11.8 Test kit. Colorimetric test kits shall be provided for the determination of free disinfectant residual, pH of the pool water and, where necessary, total alkalinity and calcium hardness. A supply of appropriate reagents for making each type of test shall be provided. Color standards shall be furnished for each of the tests, that allow an accurate comparison of the sample to be tested, both from the standpoint of color and density, and shall be reasonably permanent and nonfading. Electronic residual and pH monitoring devices may be used in addition to the test kit.
11.8.1 Standards. A DPD (Diethyl-P-Phenylene Diamine) test kit with the following increments: 0.2, 0.4, 0.6, 0.8, 1.0, 1.5, 2.0 and 3.0, as a minimum, shall be provided to measure the chlorine residual. If other halogens are used, an appropriate scale shall be provided.
11.8.2 pH kit. A pH test kit with a range from 6.8 to 8.2, accurate to the nearest 0.2 pH unit, shall be provided.
12.0 Bathhouse.
12.1 General. Adequate dressing rooms and sanitary facilities shall be provided for all swimming pools. Omission of part or all of the poolside toilet facilities may be approved when such facilities are available within 300 feet and no more than one floor level above or below the swimming pool.
12.2 Location. The bathhouse shall be located so that the patrons must pass through the bathhouse to enter the pool. The layout of the bathhouse shall be such that the patrons on leaving the dressing room pass the toilets, then the showers, en route to the swimming pool.
12.3 Bathhouse design. Floors of the bathhouse shall be of smooth-finished material with nonslip surfaces, impervious to moisture, easily cleanable and sloped at least one-fourth inch per foot to drains. Carpeting shall not be permitted in shower and toilet areas. Junctions between walls and floors shall be coved and of smooth, impervious materials, free from cracks or open joints. Partitions between dressing cubicles shall terminate at least 10 inches above the floor, or shall be placed on continuous raised masonry or concrete bases at least four inches high. Lockers shall be set either on solid masonry or concrete bases at least four inches above the floor. Lockers shall be vented.
12.4 Fixture requirements. An adequate number of toilet and handwashing facilities shall be provided.
12.4.1 Fixtures. Plumbing fixtures and installations shall be in accordance with the Uniform Code.
12.5 Suits and towels. Where towels and/or swimming suits are provided, facilities shall be provided to adequately launder, store and sanitize these items after each usage.
12.6 Foot baths. The use of foot baths is prohibited.
12.7 Hose bibbs. Hose bibbs shall be provided within the bathhouse to enable the entire area to be flushed with a 50-foot hose. Hose bibbs shall be provided with antisiphonage devices.
13.0 Miscellaneous.
13.1 Pool cleaning system. A cleaning system shall be provided to remove dirt from the bottom of the pool. When a vacuum system is used as an integral part of the recirculation system, connections shall be located in the walls of the swimming pool at least eight inches below the waterline, and at such points that the floor of the pool can be cleaned with not more than 50 feet of suction hose. Nothing in this section shall prohibit the use of surface skimmers for vacuum cleaning purposes.
13.2 Manual. A manual for operation of the pool shall be provided. It shall include instructions for each filter, pump or other piece of equipment, drawings, illustrations, charts, operating instructions and parts list, to permit installation, operation, winterization and maintenance.
14.0 Spa pools. Spa pools shall comply with the following special requirements, in addition to other applicable requirements contained in these design standards.
14.1 Construction material. The construction material shall comply with the requirements of item 4.0 of this section. Use of unlined wood tanks is prohibited.
14.2 Dimensional design.
14.2.1 The maximum water depth shall be 4′0″, measured from the waterline. Exceptions may be made for spas designed for a special purpose, such as instruction, treatment, swimming and therapy.
14.2.2 The maximum depth of any seat shall be 2′0″, measured from the waterline.
14.2.3 Spas shall be provided with a suitable handhold around their perimeter in areas where water depths exceed 3′6″. Handholds shall be provided no further apart than 4′0″, and may consist of any one or a combination of the following:
14.2.3.1 Coping, ledges, raised flanges, or decks along the immediate top edge of the spa shall provide a suitable slip-resistant handhold located not over 12 inches above the waterline.
14.2.3.2 Ladders, steps or seat ledges.
14.2.3.3 A railing, placed at or not over 12 inches above the waterline, fastened to the wall.
14.3 Steps. Design of steps shall conform to the following:
14.3.1 Step treads shall have a minimum unobstructed horizontal tread depth of 10 inches for a minimum continuous width of 12 inches.
14.3.2 Riser height shall not be less than 7 inches nor greater than 12 inches. When the bottom tread serves as a bench or seat, the bottom riser may be a maximum of 14 inches.
14.3.3 Step treads shall have slip-resistant tread surfaces.
14.3.4 Each set of steps shall be provided with at least one handrail to fully serve all treads and risers.
14.3.5 Seats or benches may be provided as part of the steps.
14.4 Ladders. Ladders shall conform to the requirements of item 5.8.2 of this section.
14.5 Recessed steps. Recessed steps shall conform to item 5.8.3.
14.6 Decks. Decks shall conform to the requirements set forth in item 5.9, with the exception that, at spa pools, decks may be waived for 50 percent of the pool perimeter. Placement of chairs or other furniture shall be prohibited within three feet of the edge of any spa pool.
14.7 Heater and temperature requirements.
14.7.1 Heaters shall comply with the standards contained in the Uniform Code.
14.7.2 The maximum temperature of the spa water shall be 104°F. A thermostatic control for the water shall be required. An alarm system set to ring a bell or buzzer shall be installed to warn of any temperature over 104°F. The alarm shall ring in the spa area as well as at the attendant's normal work station. A manual timer shall be installed that will require resetting after 15 minutes. This timer will ring a warning bell and may control the agitation pump.
14.8 Circulation systems. The equipment for circulation and filtration shall be sized to turn over the entire spa water capacity at least once every 30 minutes, and shall be capable of returning the spa water to a turbidity of less than 0.50 NTU within four hours following the peak bather load.
14.8.1 Overflow system. An overflow system shall be provided. It shall be designed and constructed so that the water level of the spa is at the operating level of the rim or weir device during use and nonuse of the spa. When surface skimmers are used, one surface skimmer shall be provided for each 100 square feet or fraction thereof of spa surface area. Recirculation through the skimmer shall be at least 30g pm/ skimmer. When two or more skimmers are used in a spa, they shall be located to maintain effective skimming action over the entire surface area of the spa. Skimmers shall be approved, as set forth in item 9.0 of this section.
14.9 Filters. Filters shall be designed to maintain spa water under anticipated operating conditions in accordance with item 14.8 of this section. The requirements specified in item 10.0 shall apply.
14.10 Pumps and strainers. The recirculation pump and strainer shall comply with the requirements of item 9.7.
14.11 Air induction systems. An air induction system shall be designed to prevent water backup that could cause electrical shock hazards. Air intakes shall not induce contaminants (such as deck water, dirt, etc.) into the spa.
14.12 Disinfection. The requirements specified in item 11.0 shall apply. Equipment shall be designed to provide a minimum free residual chlorine of 1.5 mg/l at all times and capable of superchlorination at 10 mg/l to minimize problems with combined chlorine build-up.
14.13 Safety. A warning sign with an area of at least three square feet, stating the following caution statements, shall be conspicuously posted in the vicinity of the spa.
CAUTION
1. Elderly persons, and those suffering from heart disease, diabetes, high or low blood pressure, should be prohibited from using the spa pool.
2. Unsupervised use by children is prohibited.
3. Do not use while under the influence of alcohol, anticoagulants, antihistamines, vasoconstrictors, vasodilators, stimulants, hypnotics, narcotics or tranquilizers.
4. Do not use alone.
5. Observe a reasonable time limit ( e.g., 15 minutes), then shower, cool down and, if you wish, return for another brief stay. Long exposure may result in nausea, dizziness or fainting.
6. Help can be obtained by using the telephone and posted emergency telephone numbers for police, fire department, physician, ambulance and hospital.
15.0 Special-purpose pools. This item covers additional special requirements applicable to special-purpose pools. The design engineer shall consult with the department prior to preparation and submission of engineer's plans and specifications for special-purpose pools.
15.1 White-water slides. A white-water slide facility shall consist of one or more flumes, plunge pool, recirculation and chemical treatment facilities.
15.1.1 Water depth. The minimum plunge pool operating water depth shall be three feet. This depth should be maintained in front of the flume for a distance of at least 20 feet.
15.1.2 Slide flume terminus. The slide flume terminus shall be at a minimum depth of six inches below the plunge pool operating water surface level, at water surface level or up to a maximum of two inches above the water surface level. The flume shall be perpendicular to the plunge pool wall for at least 10 feet from its end.
15.1.2.1 The distance between the side of a flume exit and a plunge pool side wall should be at least five feet. The distance between sides of adjacent flume terminuses should be at least six feet.
15.1.3 Pump reservoir. A pump reservoir shall be provided for the slide pump intakes. It shall be connected to the plunge pool by a weir. The minimum reservoir volume shall be equal to twice the combined flow rate in gallons per minute of all filters and slide pumps.
15.1.4 The flume shall be designed to prevent users from becoming airborne while in the ride.
15.1.5 Recirculation rate. The recirculation-filtration system of water slides shall recirculate and filter a water volume equal to the total volume of the facility in a period of one hour or less.
15.2 Wave pools. Wave pools shall be of such shapes and design as to be operated and maintained in a safe and sanitary manner.
15.2.1 The recirculation-filtration system of wave pools shall be capable of one turnover every two hours. The recirculation system shall be operated continuously 24 hours a day.
15.2.2 A perimeter overflow gutter shall be provided. The gutter may be interrupted in the area where the water is less than two feet deep.
15.3 Special-purpose pools. Facilities for persons with physical disabilities shall be designed to provide safe entry and exit from the pool and sanitary conditions. Facilities for parking, path of travel, walks, ramps, drinking fountains, telephone, toilets and showers shall comply with the requirements of Part 1100 of the Uniform Code.
15.3.1 Pool entry. Access for persons with physical disabilities shall be at the shallow end of the pool. Pool entry should be an 18-inch-high block of steps followed by a normal set of pool steps. As an alternate, hoists or ramps are acceptable. Where removable ramps or steps are provided, the area beneath the ramp or steps shall be protected to prevent access to swimmers.
15.3.2 Steps and handrails. Stair steps should have risers 5¾ inches and a tread 12 to 18 inches wide to allow for sitting. A handrail 32 inches high, extending 18 inches beyond top and bottom steps, must be provided. A 22-inch handrail must be provided for children. A six-inch handrail will aid entry for those who cannot stand.
15.3.3 Wheelchairs, if immersed in pool, must be safe, waterproof and designed for use in the pool environment.
15.3.4 The recirculation-filtration system shall be capable of one turnover every four hours. The recirculation systems shall be operated continuously 24 hours a day.
15.4 Movable-bottom pools. Hydraulic-lift swimming pool floors, where provided, shall be safe and maintenance-free.
15.4.1 Inlets. A jet-water self-cleaning system should be provided so that the entire pool is self-cleaning. Two sets of return inlets located at two different heights should be provided to obtain adequate mixing at all times when the pool is shallow or deep.
15.4.2 Floor movement. Floor movement shall be designed to minimize turbulence and provide safe entry and exit by persons with physical disabilities.
15.4.3 Depth signs. A sign for pool water depth in use shall be provided and clearly lit and visible. “NO DIVING” sign shall also be provided. The control panel for changing water depth must be located in a safe place, accessible only to lifeguards and pool operator.
15.4.4 Diving boards. For depths other than design diving depth, the diving board must be in an upright position and chained or secured to stop use.
15.4.5 The recirculation-filtration system shall be capable of ne turnover every four hours. The recirculation system shall be operated continuously 24 hours a day.
15.5 Rolling bulkheads. Rolling bulkheads, when used, shall be provided with traction wheels running on the pool floor or alternatively in the overflow gutter. When not in use, these should be stored in a safe manner. The design should be such that the bathers are not entrapped under the bulkhead.
15.6 Starting blocks. Starting blocks, when provided, shall be designed according to nationally recognized competitive design standards. These blocks shall be installed over a minimum water depth of six feet. Starting blocks shall only be used during supervised practices or swim meets.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.19 Medical records
This functional reporting center must contain all the expenses associated with maintaining a record system for the use, transcription, retrieval, storage and disposal of patient medical records and production of indexes, abstracts and statistics for residential health care facility management and medical staff use. Additional activities include but are not limited to: operating microfilm equipment (or equivalent).
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.38 Computation of basic rates of payment for services provided to Medicaid patients by specialty clinics
(a) Notwithstanding other provisions of this Subpart or Subpart 86-1, rates of reimbursement for specialty services, including but not limited to hemo and peritonial dialysis and outpatient rehabilitative services, shall be calculated in the manner described in section 86-4.37(a) through (h) of this Subpart. Rates of reimbursement for methadone maintenance treatment services shall be calculated in the manner described in section 86-4.39. Rates of reimbursement for day health care services provided to patients with acquired immune deficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) related illnesses by free-standing ambulatory care facilities shall be calculated in the manner described in section 86-4.41 of this Subpart. Such payment levels will be made available to providers who document in writing and through site inspection or records review that they are, in fact, organized and providing specialty services.
(b) The criteria for recognition as a specialty service include but are not limited to: requirement for highly specialized staff, equipment or facilities; whether the facility presently provides the services to the population in need; whether the services may be provided safely and effectively on an outpatient basis; and whether the services are structured to address extensive and complex needs for patients with chronic or infectious medical conditions.
(c) In addition to complying with the requirements for recording and reporting financial and statistical data in sections 86-4.3, 86-4.4 and 86-4.5 of this Subpart, facilities shall complete surveys of patient characteristics, treatment patterns, health care organization factors, costs associated with patient care, and other factors as undertaken from time to time by the commissioner.
Chapter I STATE SANITARY CODE
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.1 Definitions
As used in this Part, the following words and terms shall have the following meanings:
(a) Public function means any scheduled or advertised event open to the public and likely to attract 5,000 or more people at any one time, except that the term shall not apply to any single day of a planned multi-day series of events at which 5,000 or more people are not likely to attend.
(b) Emergency health care facility means a sheltered area or building either naturally or artifically so lighted as will promote the health and safety of patients provided medical care, and containing cot(s) and/or litter(s) and emergency medical equipment and supplies as required by section 18.2 of this Part.
(c) Emergency medical technician means an individual who has been certified as such by the department pursuant to sections 800.6 or 800.8 of this Title.
(d) Permit-issuing official means the State Commissioner of Health or the commissioner's designee.
(e) Person means an individual, group of individuals, partnership, firm, corporation, association, political subdivision, government agency, municipality, industry, estate or any other legal entity.
(f) Ambulance means a motor vehicle especially designed, equipped, and staffed pursuant to sections 800.21, 800.22, 800.23 and 800.24 of this Title to provide emergency medical services during transit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.2 Definitions
As used in this Part, the following words and terms have the indicated meanings:
(a) Commissioner means the State Commissioner of Health.
(b) Department means the State Department of Health.
(c) Person means any statutory or legal entity recognized in New York State law.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.34 Personnel; training and qualifications
The PI shall be responsible for providing instruction and training in microbiological procedures and techniques to ensure safe work conditions and awareness of procedures for dealing with accidents. Outlines for imparting knowledge appropriate for recombinant DNA activity shall be provided by the IBC consistent with recommendations made by NIH. Unless inconsistent with such recommendations, all laboratory workers and other personnel with duties in recombinant DNA activity facilities shall receive training to include, as appropriate, the following:
(a) governmental and institutional requirements respecting biohazardous research;
(b) an explanation of the recombinant DNA activity engaged in, including organisms and degree of hazard;
(c) general safety measures, including required containment levels, use and disposal of protective clothing, handling techniques, disposal of wastes and decontamination of wastes, clothing and work surfaces;
(d) spill contamination notification procedures;
(e) identification of chemicals employed in the recombinant DNA activity and in decontamination, including possible hazards; and
(f) a description of health monitoring procedures, including frequency of physicals, nature of tests and symptoms, and filing and confidentiality of health records.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
SEWAGE SEWAGE
10 CRR-NY 14-1.130 General
All sewage, including liquid waste, is to be disposed of in a public sewer system or by a sewage disposal system constructed and operated in a manner acceptable to the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.31 Termination of service
The bureau shall be notified within 30 days of the deletion of any previously offered service or if services are withheld from patients paid for by any government agency. Such notification shall include a statement indicating the date of the deletion or withholding of the service and the cost impact of such action on the facility. Rates shall be adjusted to reflect the deletion or withholding of a service. Should the facility fail to provide timely notice to the bureau and receive overpayments, penalties and rate reduction in the manner provided in sections 86-4.3 and 86-4.6 of this Subpart shall apply.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASE CONTROL
10 CRR-NY 40-2.22 Communicable disease control; performance standards
The local health department shall maintain a program designed to minimize the incidence of communicable disease. The program shall include, at a minimum, activities to ensure:
(a) compliance with disease specific protocols, as established by the department or, for New York City, the Department of Health and Mental Hygiene, for:
(1) disease surveillance;
(2) timely disease investigation;
(3) reporting of diseases to the commissioner, pursuant to Part 2 of this Title;
(b) verification and diagnosis of infections in a timely manner, ascertainment of the sources of infections, and follow up with infected persons as needed;
(c) minimization of the spread of disease, through the identification and, when appropriate, prophylaxis of persons possibly exposed to disease;
(d) performance of multiple, simultaneous investigations of communicable diseases, and maintenance of capacity to do so; and
(e) distribution of at least one communication per year to healthcare providers, clinics and laboratories regarding local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities, and department reporting requirements for reportable diseases.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.3 General requirements
(a) Each State approved education or training program and home care services entity must request and submit information required for the registry as specified in this Part. Each program and entity shall designate at least two individuals to access and enter data in the registry and shall submit the names, positions and contact information for each such individual to the department in the form and manner required by the department.
(b) Each program or entity subject to the provisions of this Part shall have policies and procedures designed to implement the provisions of this Part.
(c) Only an individual designated in accordance with subdivision (a) of this section shall submit the information to the registry. Home care services workers or trainees may submit information to any such individual for inclusion in the registry as specified in this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.2 Examinations
(a) A candidate for examination shall submit evidence satisfactory to the department that such applicant:
(1) has met the academic requirements for funeral director examination contained in section 77.1 of this Part; and
(2) is a citizen of the United States at the time of filing such application, or an alien lawfully admitted for permanent residence.
(b) An applicant for examination, who has been convicted of a felony (by any court in this State or by any court of the United States or by any court of any other state of the United States, or of any crime of which such applicant shall have been convicted, by any court of the United States or of any other state, which is not a felony in the jurisdiction in which the conviction is had, but is a felony in the State of New York) or a misdemeanor, shall submit such documentation as the department may require to make a determination as to whether there is satisfactory evidence of the applicant's good moral character as required by section 3421(1) of the Public Health Law.
(c) Where applicable, an applicant for examination shall submit supporting documentation of a change in name, such as a photocopy of a judicial order from a court of legal jurisdiction or a marriage certificate.
(d) An applicant for examination who is a veteran of the Armed Forces of the United States shall submit a photocopy of an official United States Armed Forces Certificate of Discharge and/or an official Report of Transfer or Discharge.
(e) Examinations for funeral director license may include the following subjects:
(1) the law;
(2) the State Sanitary Code (Chapter I of this Title);
(3) rules and regulations of the commissioner;
(4) tests for death;
(5) hygiene and sanitary science;
(6) disinfection;
(7) mortuary law;
(8) pathology;
(9) bacteriology;
(10) anatomy;
(11) applied chemistry;
(12) practical embalming;
(13) restorative art;
(14) funeral management;
(15) care and preparation of the human dead for final disposition;
(16) ethics;
(17) accounting;
(18) psychology;
(19) business English; and
(20) speech.
(f) Every candidate for a funeral director license shall pass such an examination with a grade of not less than 75.
(g) Gradings need not represent arithmetic percentages, but may, in the department's discretion, be higher than percentage ratings and be computed on the basis of either an arithmetic addition of a certain number of points to the percentage rating of each candidate, or an arithmetic adjustment of deductions for errors or of credits for correct answers obtained by each candidate.
(h) The department shall determine the method of grading each examination separately, and shall apply the method uniformly to all candidates taking that examination. The department shall not disclose the percentage ratings of candidates by individual identity to any of its officers or employees responsible for determining the final grading of an examination until such determination has been made.
(i) In determining the method to be used in grading an examination, the department shall take into consideration:
(1) the advice and judgment of department officers, employees and consultants regarding the difficulty of the examination in relation to the minimum requirements for satisfactory performance as a funeral director; and
(2) the results of any studies conducted regarding the difficulty of the examination.
(j) The department may conditionally admit to examination for licensure an applicant who, on the date of a scheduled examination for licensure, has not fully established his qualifications, if, in the judgment of the department, it appears that such qualifications will be fully completed within 45 days after the date of such examination. Unless such applicant submits satisfactory evidence of such completion of qualifications within 45 days following the date of the examination, the department shall notify the applicant that he is not qualified for licensure.
(k) The department shall accept, in lieu of an applicant's passing with acceptable scores its own examination, certification from The Conference of Funeral Service Examining Boards of the United States, granted on the basis of an applicant's passing with acceptable scores an approved National Board Examination taken after August 31, 1973. For acceptance of such certification, an applicant must meet all the requirements for admission to the New York State funeral director licensing examination. However, such certification shall not be applicable to the department examination required by section 3421(4)(d) of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.55 Subcutaneous or intradermal diagnostic tests administered by individuals other than health care practitioners licensed under title 8 of the Education Law
(a) As part of any approved public health program, an individual other than a health care practitioner licensed under title 8 of the Education Law may administer subcutaneous or intradermal diagnostic tests, including but not limited to tuberculin and histoplasmin tests, when so authorized by the State Commissioner of Health or local health officer.
(b) Before individuals may administer subcutaneous or intradermal diagnostic tests as provided in subdivision (a) of this section they must have received training satisfactory to the State Commissioner of Health or local health officer to include techniques, indications, precautions and contraindications in the use of the agent or agents and techniques of administration.
(c) The State Commissioner of Health or local health officer shall maintain a current list of all individuals whose training is satisfactory to him for the administration of subcutaneous or intradermal diagnostic tests under his direction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.7 Audits
All fiscal and statistical records and reports shall be subject to audit. All underlying books, records and documentation which formed the basis for the fiscal and statistical reports, filed by the residential health care facility with the department, shall be kept and maintained by the facility for a period of time not less than six years from the date of filing, or the date upon which the fiscal and statistical records were to be filed, whichever is the later date. In this respect, any rate of payment certified by the State Commissioner of Health based on the initial submission of base year data and reports will be construed to represent a provisional rate until such audit is performed and completed, at which time such rate or adjusted rate will be construed to represent the audited rate.
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.60 Standards for review and approval
(a) State aid applications for vector control activities in the absence of a concurrent arthropod vector surveillance program shall not be approved. However, there will be State aid for vector surveillance programs in the absence of control activities where the surveillance activities are directed to the detection of arthropod vector-borne diseases which may constitute a public health threat.
(b) Plans for surveillance activities must be described within the State aid application for vector surveillance (form DOH 0627-2377) and be approved in advance by the designee of the commissioner.
(c) Localities implementing nonchemical control measures should take steps that do not create any risks to public health, that minimize any risks to the environment, that can be accomplished in a cost effective manner, and produce long-term benefits to the community by permanent vector control. Each control effort must be approved by the designee of the commissioner.
(d) Request for State aid reimbursement for pesticide spray application for vector control shall meet the following requirements:
(1) Pesticide spray applications conducted by the municipality must be in response to a public health threat determined pursuant to section 44.50 of this Part.
(2) [ Reserved ]
(3) When pesticide control measures are found necessary, ground application of pesticides shall be the preferred method of control. No aerial pesticide application shall be approved for State aid reimbursement except under conditions involving specific arboviruses such as Eastern Equine Encephalitis or St. Louis Encephalitis and the commissioner concludes, because of the inaccessibility of the target areas by land, that aerial spraying is the only practicable way in which vector control activities can be carried out. The department, in its review of each application, will consider physiography, accessibility to the area where the vector is located, rapidity of response required as determined by the seriousness of the public health threat, and the likelihood that vectors in nearby areas not subject to control measures will migrate from the area if not subject to control.
(4) If a public health threat warranting control measures is found to exist, control measures must be limited to the immediate area where the vector population has been determined to exist through vector surveillance and may include adjacent areas considered at risk for imminent disease transmissions as documented through vector surveillance activities.
(5) The pesticides to be applied and the manner of application must be approved on a timely basis in advance of use by the department and must be conditionally approved by the Department of Environmental Conservation subject to a further timely review and opportunity, pursuant to paragraph (8) of this subdivision, for the Department of Environmental Conservation to request a modification of an order of the Commissioner of Health declaring a public health threat. Such approval will be based upon, among other things, an assessment of effectiveness of the proposed pesticides applied to control the vector in the target area including pesticide type and timing in the vector's life cycle, the potential impact of the pesticide on people and the potential adverse ecosystem effects of any proposed pesticide based on its toxicity, persistence and target organism specificity, and potential for non-target impacts.
(6) Sources for public water supplies will not be subjected to direct pesticide applications nor to the drift of such activities. Surface water shall not be subjected to mosquito larvicide application without a NYSDEC aquatic pesticide permit, when required, and any such application shall comply with the label restrictions of the pesticide used.
(7) Under conditions of a current public health threat as declared by the commissioner, the applicant shall announce to the general public, via the print and broadcast news media, the use of vector control activities in the target area at least 24 hours in advance of such use. The time period for advance notice may be shortened by the commissioner or designee in the event that 24-hour advance notice is not possible or that delay would endanger the public health. Vector control activities taken under conditions supported only by historical evidence shall be announced similarly to the general public at least 72 hours in advance of such activities.
(8) The Commissioner of Environmental Conservation shall have an opportunity to consult with the Conmissioner of Health and request such modification of orders declaring public health threats as are deemed necessary to implement the purposes of the Environmental Conservation Law.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.12 Variance
(a) Where the permit-issuing official finds that compliance with all requirements of this Subpart would result in undue hardship, a variance from any one or more such requirements may be granted by the State Department of Health to the extent necessary to ameliorate such undue hardship and to the extent such variance can be granted without impairing the intent and purpose of this Subpart.
(b) An application for a variance shall be submitted to the permit-issuing official by the applicant including any requested additional information concerning the application.
Part 12 MATERNAL AND CHILD HEALTH
PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS
10 CRR-NY 12.12 Warning label required on certain plastic material
(a) Warning statement required.
No person shall sell, offer for sale, or deliver, or offer for delivery, or give away any plastic bag or partial plastic bag intended for domestic or household use, or for packaging articles intended for domestic or household use, or which is so designed or decorated as to encourage its use as a toy, the length and width of which when added together totals 25 inches or more and the opening side of which is seven inches or more and the material of which is less than one mil (1/1,000 of an inch) in thickness; unless such plastic bag bears the following warning statement, or a warning statement which the Commissioner of Health has approved as the equivalent thereof:
“WARNING: To avoid danger of suffocation, keep this plastic bag away from babies and children. Do not use this bag in cribs, beds, carriages or play pens.”
(b) Placement, printing of label.
Such warning statement shall be imprinted in a prominent place on the plastic bag or shall appear on a label securely attached to the bag in a prominent place, and shall be printed in legible type which shall be contrasted by typography, lay-out or color from the contents of the bag and from other printed matter on the bag, if any.
(c) Size of print of label.
The size of the print of such statement shall be as follows:
| Total length and width of the bag | Size of print | | --- | --- | | 60 inches or more | At least 24 point | | 40 inches to, but not including, 60 inches | ″ ″ 18 ″ | | 30 inches to, but not including, 40 inches | ″ ″ 14 ″ | | 25 inches to, but not including, 30 inches | ″ ″ 10 ″ |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.1 Definitions
As used in this Subpart:
(a) Activities of daily living mean basic self-care tasks such as dressing and undressing, self-feeding, bowel and bladder management, ambulation with or without the use of an assistive device, communication, functional transfers from one place to another, and personal hygiene and grooming.
(b) Assistive technology ( AT ) means those devices, controls, appliances, items, pieces of equipment, or supplies of either a communication or an adaptive type, determined necessary by a physician for purposes of the enrollee's habilitation, ability to function or safety in his or her current or desired residence which are not listed in the Medicaid Durable Medical Equipment (DME) Provider Manual at https://www.emedny.org/ProviderManuals/DME/index.aspx. Such technology may also be referred to as adaptive technology or adaptive equipment. In the event that a particular item or piece of equipment falls within the definition of both assistive technology and an environmental modification as defined in subdivision (m) of this section, it will be considered to be an environmental modification for purposes of these regulations.
(c) Birth-related neurological injury means an injury to the brain or spinal cord of a live infant caused by the deprivation of oxygen or mechanical injury that occurred in the course of labor, delivery or resuscitation or by other medical services provided or not provided during delivery admission that rendered the infant with a permanent and substantial motor impairment or with a developmental disability as that term is defined by section 1.03 of the Mental Hygiene Law, or both.
(d) Case manager means a person who performs the functions set out in section 69-10.4 of this Subpart.
(e) Claims assistance manager means the person or persons who perform(s) the functions set out in section 69-10.3 of this Subpart.
(f) Commissioner of Health or commissioner means the New York State Commissioner of Health.
(g) Commissioner of Taxation means the New York State Commissioner of Taxation and Finance.
(h) Delivery admission means a hospital admission for the specific purpose of giving birth.
(i) Department of Financial Services means the New York State Department of Financial Services.
(j) Durable medical equipment means devices and equipment that have been ordered by a physician in the treatment of a specific medical condition and that have all of the following characteristics:
(1) can withstand repeated use for a protracted period of time;
(2) are primarily and customarily used for medical purposes;
(3) are generally not useful in the absence of an illness or injury;
(4) are not usually fitted, designed or fashioned for a particular individual's use; and
(5) if intended for use by only one patient, the equipment may be either custom-made or customized.
For purposes of this Subpart, durable medical equipment also includes medical/surgical supplies, orthotic appliances and devices and orthopedic footwear as defined in 18 NYCRR section 505.5 and listed in the Medicaid DME Provider Manual at https://www.emedny.org/ProviderManuals/DME/index.aspx.
(k) Emergency means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the patient's health in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of any bodily organ or part. Only a qualified ordering practitioner may determine, using his or her professional judgment, whether a situation constitutes an emergency.
(l) Enrollee means a qualified plaintiff accepted into the fund or for notification and decision making purposes only, the person authorized to act on his or her behalf; provided, however, that nothing in this Subpart shall be read to authorize payment or reimbursement of medical services provided to any person other than the qualified plaintiff.
(m) Environmental modification ( emod ) means an interior or exterior physical adaptation to the residence in which an enrollee lives that is necessary to ensure the health, welfare, and safety of the enrollee, enables him or her to function with greater independence in the community and/or helps avoid institutionalization and has been ordered by a physician. Emods include but are not limited to: ramps, widened doorways and handrails, roll-in showers, vertical lifts, elevators only when there is no other safe and cost effective alternative and cabinet and shelving adaptations. Emods do not include any routine home maintenance. Emods also do not include adaptations or modifications that are of general utility and that do not provide direct medical or remedial benefit to the enrollee. With respect to new construction, emods do not include modifications needed as a result of avoidable barriers created by the new construction floor plan.
(n) Experimental treatment means a drug, device, or treatment for which:
(1) there is insufficient outcome data available from controlled clinical trials published in the peer-reviewed literature to substantiate its safety and effectiveness for the illness or injury involved; or
(2) approval required from the FDA for marketing to the public has not been granted; or
(3) a recognized national medical or dental society or regulatory agency has determined, in writing, that it is experimental or investigational, or for research purposes; or
(4) it is a type of drug, device or treatment that is the subject of an investigational new drug treatment pursuant to 21 CFR section 312.21, or is the subject of an investigational device treatment pursuant to 21 CFR section 812.36; or
(5) the written protocol or protocols used by the treating facility or by another facility studying the same drug, device, procedure, or treatment, states that it is experimental or investigational.
(o) Fund means the “New York State Medical Indemnity Fund” created pursuant to chapter 59 of the Laws of 2011 to provide a funding source for future health care costs associated with birth-related neurological injuries.
(p) Fund administrator means the Superintendent of Financial Services or any person or entity designated by the superintendent for purposes of administering the fund.
(q) Habilitation services mean services designed to provide assistance with the retention, acquisition or improvement of the enrollee's activities of daily living such as personal grooming and cleanliness, eating and dressing, communication, and mobilization; and when appropriate, the instrumental activities of daily living such as household chores, food preparation, mobility training for maximum independence involving local travel, including the use of public transportation, socially appropriate behavior, the development of basic health and safety skills, and simple money management.
(r) Hospital means a general hospital or a maternity hospital, including a birthing center located in a general hospital or a maternity hospital, a birthing center operating as a diagnostic and treatment center, or a midwifery birth center, as defined by section 2801 of the Public Health Law.
(s) Informal supports means those immediate family members, other family members, friends, volunteers, and other people in the enrollee's community who provide or are willing to provide unpaid care and services for the enrollee.
(t) Instrumental activities of daily living mean those functions not necessary for fundamental functioning but necessary for an individual to be able to live independently in the community such as taking medications as prescribed, performing housekeeping tasks, managing money, using the telephone or other form of communication, shopping for groceries and clothing, and managing transportation within the community.
(u) Nurse practitioner means an individual:
(1) certified to practice as a nurse practitioner pursuant to article 139 of the New York State Education Law;
(2) duly authorized to practice as a nurse practitioner or the equivalent of a nurse practitioner in any other state in the United States or in the District of Columbia; or
(3) duly authorized to practice as a nurse practitioner or the equivalent of a nurse practitioner in another country.
(v) Physician means a physician licensed to:
(1) practice in New York State pursuant to article 131 of the New York State Education Law;
(2) duly authorized to practice in any other state in the United States or in the District of Columbia; or
(3) duly authorized to practice as a physician in another country.
(w) Physician assistant means an individual:
(1) licensed to practice as a physician assistant in New York State pursuant to article 131-B of the New York State Education Law;
(2) duly authorized to practice as a physician assistant or the equivalent of a physician assistant in any other state in the United States or in the District of Columbia; or
(3) duly authorized to practice as a physician assistant or the equivalent in another country.
(x) Prior approval means the process set forth in section 69-10.6 of this Subpart for review of proposed, non-routine expenditures such as emods, vehicle modifications, assistive technology, private duty nursing, planned specialist appointments and/or hospital treatment requiring travel and accommodations, hearing aids, custom made equipment, myo-electric limbs, treatment with specialty drugs, and experimental treatments and/or procedures, including the review process for any denial of a request for prior approval.
(y) Qualified plaintiff means every plaintiff or claimant who:
(1) has been found by a jury or court to have sustained a birth-related neurological injury as the result of medical malpractice; or
(2) has sustained a birth-related neurological injury as the result of alleged medical malpractice and has settled his or her lawsuit or claim therefor.
(z) Qualifying health care costs mean the future costs for medical, hospital, surgical, nursing, dental, rehabilitation services, habilitation services and custodial care; respite care, subject to a maximum of 1,080 hours per year unless prior approval has been obtained for additional respite care; durable medical equipment; environmental home modifications (emods), assistive technology, and vehicle modifications; prescription and over the counter medications when prescribed by a physician, dentist, nurse practitioner, certified nutritionist or physician assistant; psychological, social work, nutritional counseling, chiropractic, hospice and palliative care; transportation for purposes of health care related appointments in accordance with section 69-10.12 of this Subpart; copayments and deductibles for services, items, equipment or medication paid for by commercial insurance; and any other health care costs actually incurred for services rendered to and supplies utilized by a qualified plaintiff that his or her physician, physician assistant, or nurse practitioner, has stated in writing on his or her letterhead, or on the supervising or collaborating physician's letterhead, if applicable, is necessary to meet the qualified plaintiff's health care needs. The statement of necessity may be based on the assessment of a dentist, podiatrist, psychologist, physical therapist, occupational therapist, chiropractor, certified nutritionist or dietician, and/or speech pathologist. The fund administrator may make coverage of ongoing therapeutic services subject to the receipt of periodic treatment plans and progress reports. Qualifying health care costs shall not include:
(1) any services, supplies, items or equipment potentially available to the enrollee under an Individualized Education Program, Preschool Supportive Health Services Program, Early Intervention Program or equivalent program in another country unless the enrollee’s parent or guardian can demonstrate that he or she made a reasonable effort to obtain the services, supplies, items or equipment through such program; or
(2) any services, supplies, items, equipment or medications that any commercial insurance under which the enrollee is covered is legally obligated to provide.
(aa) Respite means the provision of paid intermittent, temporary substitute care, including care provided in an institutional setting, for the benefit of the primary caregiver, who is a family member, a guardian or other informal support functioning as the enrollee's non-paid primary caregiver, for the purpose of providing relief from the responsibilities of daily caregiving of the enrollee, including any substitute care provided to an enrollee and paid for by the fund because the primary caregiver is not at home because of work and/or school. All respite care in excess of 1,080 hours a year will require prior approval.
(ab) Specialty drug means a drug that is typically high in cost and has one or more of the following characteristics:
(1) is a component of complex therapy for treatment of a complex disease;
(2) requires specialized patient training and coordination of care prior to therapy initiation and/or during therapy;
(3) requires unique patient adherence to treatment regimen and safety monitoring of the patient during treatment with the drug;
(4) requires unique handling, shipping, and storage; and
(5) presents a potential for significant waste because of the manner in which the drug is packaged/dispensed or the failure to follow accepted clinical protocols prior to administration to the patient or both.
(ac) Superintendent of Financial Services means the Superintendent of the New York State Department of Financial Services.
(ad) Usual and customary charges mean the usual, customary and reasonable (UCR) charges for services provided in private physician practices as described in section 69-10.21 of this Subpart.
(ae) Vehicle modifications mean:
(1) adaptive equipment designed to enable an enrollee to operate a vehicle or be transported in a vehicle such as hand controls, deep dish steering wheels, spinner knobs, wheelchair lock down devices, parking brake extensions, foot controls, wheelchair lifts, left foot gas pedals; or
(2) changes to the structure, internal design, or existing equipment of a vehicle such as replacement of the roof with elevated fiberglass top, floor cut-outs, extension of the steering column, raised door, repositioning of seats, wheelchair floor, and dashboard adaptations.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.10 Spray ground operation and maintenance
(a) Every spray ground shall be maintained and operated in a clean, safe and sanitary manner at all times. Spray ground recirculation and chemical disinfection equipment shall be operated continuously. Ultraviolet light disinfection units shall be operated in accordance with approved plans and specifications.
(b) Spray ground equipment and appurtenances shall be operated and maintained in accordance with approved plans and specifications.
(c) Cracks in the spray pad and/or decking shall be repaired when they may be a potential for leakage, present a tripping hazard, a potential cause of lacerations, or impact the ability to properly clean and maintain the spray pad area.
(d) Drain grates shall be secured in place at all times. Broken or missing drain grates shall be repaired or replaced before the spray pad is used.
(e) Inlets shall be adjusted to produce uniform circulation of water and to facilitate the maintenance of a uniform disinfectant residual throughout the spray pad treatment tank.
(f) The water level in the spray pad treatment tank shall be maintained continuously by an automatic level control system.
(g) The deck shall be kept clean and free of puddled water. Glass containers are prohibited from the spray pad and all deck areas.
(h) Foot showers shall be kept clean and free of puddled water.
(i) At the beginning of each day prior to use and at other times when needed, the spray pad must be adequately cleaned and flushed to remove any materials or contaminants on the surface of the spray pad. The water must be flushed to waste and not discharged into the spray pad treatment tank. Flushing may be accomplished by use of a hose supplied with potable water or by operation of the spray features providing it adequately flushes the entire pad surface and is discharged to waste.
(j) The spray pad treatment tank shall be completely drained and cleaned at a frequency necessary to maintain water quality.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.283 Reporting period
The period of time for which an operating statement is prepared. This period shall consist of the 12 consecutive calendar months or 13 four-week periods that begin on the first day of a month with an additional day (two in a leap year) added to the last period to make it coincide with the end of the month.
Chapter I STATE SANITARY CODE
Part 23 SEXUALLY TRANSMISSIBLE DISEASES (STD)
10 CRR-NY 23.5 Expedited partner therapy for chlamydia trachomatis infection
(a) Definitions.
As used in this section:
(1) Expedited partner therapy or EPT means a practice whereby a health care practitioner chooses to provide a patient with either antibiotics intended for the patient's sexual partner or partners or a written prescription for antibiotics for the sexual partner or partners to be delivered by the patient to the sexual partner or partners for treatment of exposure to chlamydia trachomatis.
(2) Health care practitioner means a physician, midwife, nurse practitioner, physician assistant, or other person who is authorized under title 8 of the Education Law to diagnose and prescribe drugs for chlamydia trachomatis, acting within his or her lawful scope of practice.
(b) Liability.
A health care practitioner who reasonably and in good faith renders expedited partner therapy in accordance with section 2312 of the Public Health Law and this section, and a pharmacist who reasonably and in good faith dispenses drugs pursuant to a prescription written in accordance with section 2312 of the Public Health Law and this section, shall not be subject to civil or criminal liability or be deemed to have engaged in unprofessional conduct.
(c) Eligibility criteria for EPT.
EPT shall:
(1) be provided only for the partner or partners of a patient diagnosed with chlamydia trachomatis infection; and
(2) not be provided for any partner or partners, when the patient with chlamydia trachomatis infection seen by the health care practitioner is found to be concurrently infected with gonorrhea, syphilis or HIV.
(d) Educational material requirements for patients provided with EPT.
Each patient provided with antibiotics or a prescription in accordance with this section must be given informational materials for the patient to give to his or her sexual partner or partners. Each patient shall be counseled by his or her health care practitioner to inform his or her partner or partners that it is important to read the information contained in the materials prior to the partner or partners taking the medication. The materials shall:
(1) encourage the partner to consult a health care practitioner for a complete sexually transmitted infection evaluation as a preferred alternative to EPT and regardless of whether they take the medication;
(2) disclose the risk of potential adverse drug reactions, including allergic reactions, and the possibility of dangerous interactions between the patient-delivered therapy and other medications that the partner may be taking;
(3) inform the partner that he or she may be affected by other sexually transmitted infections that may be left untreated by the delivered medicine;
(4) inform the partner that if symptoms of a more serious infection are present (such as abdominal, pelvic, or testicular pain, fever, nausea or vomiting) he or she should seek medical care as soon as possible;
(5) recommend that a partner who is or could be pregnant should consult a health care practitioner as soon as possible;
(6) instruct the patient and the partner to abstain from sexual activity for at least seven days after treatment of both the patient and the partner in order to decrease the risk of recurrent infection;
(7) inform a partner who is at high risk of co-morbidity with HIV infection that he or she should consult a health care practitioner for a complete medical evaluation including testing for HIV and other sexually transmitted infections; and
(8) inform the patient and the partner how to prevent repeated chlamydia infection.
(e) Prescription format.
Whenever a health care practitioner provides EPT through the use of a prescription:
(1) the designation EPT must be written in the body of the prescription form above the name of the medication and dosage for all prescriptions issued;
(2) if the name, address, and date of birth of the sexual partner are available, this should be written in the designated area of the prescription form; and
(3) if the sexual partner's name, address, and date of birth are not available, the written designation EPT shall be sufficient for the pharmacist to fill the prescription.
(f) Reporting of cases of Chlamydia trachomatis by health care providers.
(1) This section shall not affect the obligation to report individual cases and suspected cases of chlamydia trachomatis imposed by Part 2 of this Title.
(2) Reports of cases of chlamydia trachomatis who are provided with EPT shall include the added designation of EPT plus the number of sexual partners for whom a prescription or medication was provided.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.56 Capital expenditure
An expenditure intended to benefit future periods, in contrast to a revenue expenditure, which benefits a current period; an addition to a capital asset. The term is generally restricted to expenditures that add fixed-asset units or that have the effect of increasing the capacity, efficiency, life span, or economy of operation of an existing fixed asset.
Subchapter B HOSPITAL ESTABLISHMENT
Part 610 SPECIAL REQUIREMENTS FOR NONPROFIT CORPORATIONS
10 CRR-NY 610.1 Application for nonprofit corporation
A nonprofit corporation seeking Public Health Council approval shall comply with the provisions of Part 600 of this Title and in addition shall file the following:
(a) a photocopy of the executed proposed corporate certificate;
(b) a request for the council's approval of such certificate, which request shall be properly executed by one or more authorized persons and shall contain the prescribed information;
(c) approval of another State department or agency where required by law, provided:
(1) such approval or consent shall be obtained and attached to application; or
(2) in the absence thereof, the processing of such an application shall not be delayed provided that evidence is submitted that a concurrent application has been made in good faith to obtain the approval or consent of such State department or agency as required by law. Such approval shall be obtained prior to action on the application by the council;
(d) a certified copy of the resolution of the board of directors authorizing the undertaking which is the subject of the application and the subscribing and submission thereof by an appropriate designated individual;
(e) such additional pertinent information or documents necessary for the council's consideration.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.2 Applications for approval
(a) Applications for approval of water supply and related sewerage facilities to serve a realty subdivision as conforming with the standards prescribed in this Part shall be made on forms provided by the department.
(b) Applications for approval shall be accompanied by such maps, plans, reports, specifications and data as the commissioner may require or direct.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 707 PHYSICIAN'S ASSISTANTS AND SPECIALIST'S ASSISTANTS
10 CRR-NY 707.2 Medical board responsibility
The medical board, or for medical facilities having no medical board a medical advisory committee composed of at least two currently registered physicians, shall adopt with governing board approval by-laws rules and regulations which provide formal procedures for the evaluation of the application and credentials of registered physician's assistants and registered specialist's assistants applying for employment or privileges in the facility for the purpose of providing medical services under the supervision of a physician.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.5 Students
(a) A sponsoring institution shall report in writing to the department the name of each student who has successfully completed the radiologic technology course of study within 30 days of such completion.
(b) A sponsoring institution shall ensure that students do not apply radiation to a human being for clinical practice until they have completed instruction in, and have understanding of radiation safety as it pertains to protecting themselves, patients and personnel from unnecessary exposure to radiation. This instruction shall include practical experience using phantoms or other non-human devices. The sponsoring institution shall ensure that the initial applications of radiation to human beings by students shall be under the personal supervision of a radiologist, radiographer, radiation therapist or nuclear medicine technologists, as applicable, until the student’s performance has been evaluated as satisfactory.
(c) Notwithstanding the requirements of section 16.11(a)(1) of the State Sanitary Code, a sponsoring institution shall provide all students with a personal radiation monitoring device during their radiologic technology course of study. The sponsoring institution shall ensure that student exposure to radiation shall be within the occupational limits prescribed by the applicable regulations and shall routinely inform students of their radiation exposure readings.
(d) A sponsoring institution shall ensure that its students apply radiation to human beings only at its clinical facilities and only for the purpose of clinical practice in the use of medical imaging or radiation therapy equipment.
(e) A sponsoring institution shall ensure that students enrolled in and attending a radiologic technology program shall wear at all times, while at any of the sponsoring institution's clinical facilities, identification tags that conspicuously shows their name and title as "STUDENT, Radiographer" or "STUDENT, Radiation Therapist," or "STUDENT, Nuclear Medicine Technologist," as appropriate. A sponsoring institution shall issue identification tags only to enrolled students and shall collect the identification tag of each student who graduates or withdraws from the school.
(f) A sponsoring institution may assign students to clinical practice on evenings, nights, weekends or legal holidays, provided that such clinical assignments:
(1) shall be given only to students in the final six months of training;
(2) shall not exceed a total of 80 hours;
(3) shall not result in the student attending in excess of 8 hours in a 24-hour period of combined classroom and clinical assignments; and
(4) shall be based upon a written plan and adequately maintained records, which include the designation of a radiologic technologist to supervise each such assignment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.246 Payor
A person or organization which pays the hospital for services rendered to patients. This can be the patient and/or third party, such as Medicare, Medicaid, Blue Cross or other private insurance plan.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.1 Preamble
Enrollees, and in the case of a retrospective adverse determination, an enrollee's health care provider shall have the right to request an external appeal of a final adverse determination which is made by a health care plan on the grounds that the health care service is not medically necessary or is experimental or investigational. This Subpart shall be applicable to health care plans as defined in subdivision 4-e of section 4900 of the Public Health Law that offer health care services to an enrolled population that is not exclusively covered by title XVIII of the Social Security Act and to external appeal agents certified pursuant to title II of article 49 of the Public Health Law and Insurance Law and this Subpart and to applicants for certification as external appeal agents.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-3 PROHIBITION ON THE SALE OF ELECTRONIC LIQUIDS WITH CHARACTERIZING FLAVORS
10 CRR-NY 9-3.3 Penalties
A violation of any provision of this Subpart is subject to all civil and criminal penalties as provided for by law. For purposes of civil penalties, each individual container or other separate unit of flavored e-liquid, product containing the same, or any component part that imparts flavor to an e-cigarette, that is possessed, manufactured, distributed, sold, or offered for sale, shall constitute a separate violation under this Subpart.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.5 Permit for operation
(a) No municipality, school district, person, group of persons, firm, corporation, association, organization or institution shall operate or maintain or permit the use of any spray ground and other related facilities without a permit from the permit-issuing official to be issued subject to the provisions of this Chapter and such additional sanitary or safety safeguards as may be required by the permit-issuing official. The permit shall be posted conspicuously at the facility.
(b) Application for a permit shall be made to the permit-issuing official at least 45 days before the expiration of a permit or at least 45 days before the opening of any spray ground. Such application shall include a written safety plan as described in section 6-3.22(c) of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.4 Donor qualifications
(a) In addition to all the requirements of this Subpart, limited tissue procurement services and comprehensive tissue procurement services shall comply with the donor qualification requirements in Subpart 52-3 of this Part.
(b) Unless specifically authorized by the tissue bank medical director, skin shall not be released for allogeneic transplant from donors with any of the following conditions:
(1) a disease of unknown etiology;
(2) malaria within the last three years or travel to a malarially endemic area within the last six months; or
(3) drowning as a terminal event.
(c) Social history as recorded in the medical chart of the donor, or as provided by a friend or family member shall be considered in the donor selection process.
(d) The medical director of the comprehensive tissue procurement service shall be responsible for determining that the donor and the donated skin are acceptable based on medical history information and established donor selection criteria as specified in this Part, and a physical examination.
(e) A written policy shall specify the range of acceptable donor age and weight limits for allogeneic skin donation. This policy shall be determined by the tissue bank director in consultation with the medical director and medical advisory committee of the comprehensive tissue procurement service.
(f) Written criteria for acceptance of donors of autogeneic tissue shall be specified by the transplantation service director of the tissue transplantation facility, unless such criteria have been specified already by the medical director of a comprehensive tissue procurement service.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.160 Gross square feet
The total floor areas of the plant, including common areas (hallways, stairways, elevators, lobbies, closets, etc.).
10 CRR-NY 441.121 Expired cost
An expenditure from which no further benefit is anticipated; an expense; a cost absorbed over the period during which benefits were enjoyed or a loss incurred.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.1 Title
This Subpart shall be known and cited as "Laboratory Business Practices".
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.13 Sewage treatment/collection
An agricultural fairground owner shall provide and maintain facilities for the adequate disposal or adequate treatment and disposal of sewage at an agricultural fairground, and ensure that such facilities meet the following requirements:
(a) Submission of plans.
A plan for a proposed new or modified sewage collection and/or treatment facility shall be submitted to the permit-issuing official at least 30 days prior to beginning construction of such facility.
(b) Plan approval and construction.
A permit or written approval for the sewage collection and/or treatment system plan(s) shall be obtained from the permit-issuing official and/or the New York State Department of Environmental Conservation. No construction of a new or modified sewage treatment facility shall be commenced until all required permits and/or written approvals have been received by the applicant. Construction shall be in accordance with the approved plans.
(c) The presence of inadequately treated sewage on the surface of the ground is prohibited.
(d) Privies and portable chemical toilets shall be so located, constructed and maintained that they will not contaminate a water supply, surface water, adjacent ground surface, or permit access of flies or rodents. The contents shall be emptied and/or adequately treated as necessary to prevent discharge to the surface of the ground or to any area readily accessible to patrons.
(e) At least one sanitary dumping station for each 100 campsites or less, or an acceptable operator-run scavenger service for routine collection of sewage from recreational vehicles must be provided. Information regarding the scavenger equipment and collection schedule shall be submitted to the permit-issuing official for review and approval. Sites with individual sewer connections shall not be counted when determining the required number of sanitary dumping stations. Sanitary dump stations shall not be required at campgrounds for tent use only.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 412 REPORTING INFORMATION FOR INSPECTIONS
10 CRR-NY 412.2 Certification by operator or administrator
(a) The report shall be certified by the operator or the administrator on behalf of the operator of the residential health care facility.
(b) The form of the certification required in subdivision (a) of this section shall be prescribed in the report form provided by the department.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.7 Production, equipment and packaging
All bottled water production, including transporting, packaging and storage, shall be conducted under such conditions and controls as are necessary to minimize the potential for chemical contamination, undesirable bacterial or other microbiological growth, toxic formation, deterioration or contamination of the finished product.
(a) Bottles must be mechanically filled and closed.
(b) Fillers, piping, pumps and other process equipment used in the production of bottled water products may not be used for the production of milk, and/or dairy products. Other beverage production that may impart deleterious substances to bottled water produced in the same equipment or cause microbiological contamination of the bottled water, may also be prohibited when the contamination is confirmed by two documented cases.
(c) All equipment shall be of sanitary design and shall be constructed of nontoxic, nonabsorbent material which will not impart flavor, color or odor to the bottled water. All equipment shall be installed and maintained to facilitate the cleaning of equipment and of all adjacent spaces. All material used in the design, construction and repair of the water transmission and/or production piping in a bottled or bulk water facility must be lead free. For this Subpart, lead free shall mean solder or flux which contains no more than 0.2 percent lead and pipes, pipe fittings and any appurtenances which contain no more than eight percent lead.
(d) Storage tanks used for bottled water production shall be:
(1) Tightly closed to exclude all foreign matter and vented through inverted air filters.
(2) Without connections to sources of water not approved in writing, by the State or the governmental regulatory agency having jurisdiction over facilities located outside the State.
(3) Protected from cross-connection and equipped with backflow prevention devices approved by the State or the governmental regulatory agency having jurisdiction over facilities located outside the State.
(4) Equipped with linings or coatings conforming to the listing of acceptable linings for process and potable water tanks from the State or the governmental regulatory agency having jurisdiction over facilities located outside the State.
(5) Used only for water and not for storage of any other food product or nonfood substance.
(e) There shall be no cross-connections between finished product water lines and any other water pipelines.
(f) Hoppers shall be provided with covers.
(g) Fillers shall have the inlet so designed as to prevent the entrance of condensation. Filling valves shall be equipped with a condensation diverting apron.
(h) Containers and packaging shall, at a minimum, meet the following requirements:
(1) Packaging processes and materials shall not transmit contaminants or objectionable, toxic or deleterious substances to the bottled water.
(2) Containers and closures for bottled water shall be in compliance with those requirements contained in Food and Drugs 21 CFR.
(3) Only sanitary, nontoxic lubricants shall be used on container contact surfaces.
(4) Bottles shall be provided with a tamper-evident seal or cap.
(5) Screw, snap and crown caps shall be new.
(6) Screw, snap and crown caps must be sanitized unless protected and received clean and kept free from bacterial contamination.
(7) When sanitized bottles cannot be filled immediately, they shall be closed or covered immediately when removed from packages. When they are to be filled, such closed bottles shall be opened, resanitized, filled and closed immediately in one continuous operation.
(8) All cleaned bottles shall be protected from dust, dirt, insects, debris and other forms of contamination.
(9) Each container of bottled drinking water shall be identified by a clear and conspicuous production code indicating, in English, the day, month and year of production. The production code shall identify a particular batch or segment of a continuous production run. The plant shall record and maintain information as to the kind of product, volume produced, date produced, production code used and the distribution of the finished product to wholesale and retail outlets to which the plant directly supplies product.
(10) Multi-use containers shall have the production date code affixed to the primary container. Cap coding is not acceptale unless the dispenser system retains the cap with the multi-use container, after opening.
(i) The plant shall have on file a written recall plan which shall detail procedures for recall of any particular batch as identified by the production code.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.82 Date of acquisition
The effective purchase date of an asset. Usually, this is the date title is acquired, or the burdens of ownership are assumed and the asset is in possession.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.4 Education, experience, and/or training substitutions
The department will allow education, experience and/or training substitutions in lieu of the requirements outlined in section 5-4.3(b) of this Subpart. Experience that is used to meet the experience requirement for any grade of certification may not be substituted for education. Education that is used to meet the education requirement for any grade of certification may not be substituted for experience. Experience and education may not be used more than once as a substitution. The following substitutions may be accepted:
(a) A New York State professional engineer's license, or a bachelor's degree in engineering, natural science or a related field from an accredited or New York State registered college or university, may be substituted for eight years of experience. A minimum of two years operating experience, at the level described in Table 5-4.3 of this Subpart must be obtained if this substitution is used.
(b) An associate degree in applied science, with at least a one semester course in water treatment plant operations, from an accredited or New York State registered college or university, may be substituted for six years of experience. A minimum of two years (four years for grade[s] IA and IB) operating experience, at the level described in Table 5-4.3 of this Subpart, must be obtained if this substitution is used.
(c) An associate degree in applied science, from an accredited or New York State registered college or university, may be substituted for four years of experience. A minimum of two years (six years for grade[s] IA and IB) operating experience, at the level described in Table 5-4.3 of this Subpart, must be obtained if this substitution is used.
(d) Experience and/or relevant training may be substituted for a high school diploma or GED for grades C and D.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.3 Statewide collaboration process and SHIN-NY policy guidance
(a) SHIN-NY policy guidance.
The New York State Department of Health shall establish SHIN-NY policy guidance as set forth below:
(1) The New York State Department of Health shall establish or designate a policy committee to make recommendations on SHIN-NY policy guidance and standards.
(2) Policy committee agendas, meeting minutes, white papers and recommendations shall be made publicly available.
(3) The New York State Department of Health shall consider SHIN-NY policy guidance recommendations made through the statewide collaboration process and may accept or reject SHIN-NY policy guidance recommendations at its sole discretion.
(b) Minimum contents of SHIN-NY policy guidance.
SHIN-NY policy guidance standards shall include, but not be limited to policies and procedures on:
(1) privacy and security;
(2) monitoring and enforcement;
(3) minimum service requirements;
(4) organizational characteristics of qualified entities; and
(5) qualified entity certification.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.2 Definitions
As used in this Subpart, the following terms shall have the stated meanings:
(a) Action level means 15 micrograms per liter (µg/L) or parts per billion (ppb). Exceedance of the action level requires a response, as set forth in this Subpart.
(b) Building means any structure, facility, addition, or wing of a school that may be occupied by children or students. The terms shall not include any structure, facility, addition, or wing of a school that is lead-free, as defined in section 1417 of the Federal Safe Drinking Water Act.
(c) Commissioner means the State Commissioner of Health.
(d) Department means the New York State Department of Health.
(e) Outlet means a potable water fixture currently or potentially used for drinking or cooking purposes, including but not limited to a bubbler, drinking fountain, or faucets.
(f) Potable water means water that meets the requirements of Subpart 5-1 of this Title.
(g) School means any school district or board of cooperative educational services (BOCES).
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.5 Denial or termination
A determination by the department that course work or training offered is inadequate or incomplete shall result in the denial or termination of departmental approval.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.3 Review of application; project scope and concept
(a) The department may request the applicant in writing to submit additional documentation and information in order to complete the review of the application, project scope and concept. Except as provided for in subdivision (b) of this section, if the applicant does not submit the additional documentation or information to the department within the time specified in the request, or as extended by the department in writing, the application shall be deemed abandoned and withdrawn upon written notice to the applicant.
(b) If an application includes a proposal to correct a violation of any provision of the Public Health Law or this Title, which violation, as determined by the commissioner, directly affects or threatens to directly affect the health, safety or welfare of any patient or resident, the application shall not be deemed abandoned or withdrawn due solely to the failure by the applicant to submit the requested documentation and information within the prescribed time. The provisions of this subdivision shall not affect the authority of the department to institute any action or proceeding with respect to the facility concerning the violation of any provision of the Public Health Law or this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.4 Notification of patient rights
(a) If a provider denies access to patient information the provider shall inform, in writing, the qualified person of the reasons for denial and the qualified person's right to obtain a review of the denial. The provider shall furnish the qualified person a form, approved by the Department of Health, which can be used for requesting such a review.
(b) If a qualified person decides to request a review, he or she shall do so by forwarding the request to the API coordinator for review. The API coordinator shall notify the provider of the request for review and of the name and address of the chairperson of the committee where the patient information shall be sent. A copy of the patient information, and a statement of the reasons for denial must be sent by the provider to the chairperson within 10 days of notification of the request. The qualified person shall be given a reasonable opportunity to present written information and written statements.
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.8 Accreditation of asbestos safety training providers
(a) Provisional accreditation. The department shall grant provisional accreditation of a provider's asbestos safety training program only after a full review of the application. If a program is not granted provisional accreditation, the reasons for disapproval will be sent in writing to the program provider. Training providers will be notified in writing if a particular program has been granted provisional accreditation. The letter will identify the specific program accredited and the effective approval date of the provisional accreditation. Provisional accreditation will continue until full accreditation is granted as described in subdivision (b) of this section, or until provisional accreditation is terminated in accordance with section 73.9(a) of this Part.
(b) Full accreditation shall be granted after the Department of Health has observed and evaluated a provisionally accredited asbestos safety program in progress and has determined that the program meets the requirements of these regulations. A training provider will be notified in writing of a program's full accreditation status. If the program is not granted full accreditation, the reasons for disapproval will be sent in writing to the training provider.
(c) Upon receipt of accreditation, whether provisional or full, the training provider shall maintain documentation of each program offered as required by this Part.
(d) All records pertaining to the asbestos safety program shall be available to the Department of Health or the Department of Labor upon request.
(e) Programs with full accreditation shall be monitored periodically by the department to ensure continuing compliance with this Part.
(f) Provisional and/or full accreditation is not transferable upon sale or transfer of a training program; however, if an asbestos safety training provider transfers all of the asbestos safety training programs which the training provider is authorized to conduct pursuant to this Part, the provisional and/or full accreditation of such programs may be transferred, upon the prior approval of the department.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.10 Statement
The rules contained in this Subpart, together with the watershed rules and regulations set forth in Parts 100 through 158 of this Title, have been promulgated to protect present or future sources of water supply.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.44 Acquired Immune Deficiency Syndrome
This functional reporting center must contain all the expenses associated with the care of individuals with AIDS, AIDS-related complex, and those diagnosed with other human immunodeficiency virus-related illnesses in a discrete AIDS unit within a residential health care facility or in a free-standing designated AIDS center. Costs associated with AIDS patients in designated or undesignated AIDS beds in an existing non-AIDS unit will remain a part of that unit's costs.
(a) Standard unit of measure: number of patient days of care for all patients admitted to this unit.
Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.3 Notice of hearing and statement of charges
(a) The notice of hearing shall contain a statement of the legal authority and jurisdiction under which the proceeding is to be held, a reference to the particular sections of the statutes and regulations violated, if any, and a short and plain statement of the matters asserted, or at issue, and/or a statement of charges.
(b) The notice of hearing shall specify the time, place and date for a hearing.
(c) Service of the notice of hearing and statement of charges, if any, shall be served at least 15 days prior to the date of the hearing and shall be by certified or registered mail, or by service consistent with article 3 of the CPLR. Where service is by mail, service shall be deemed complete three days after mailing.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.1 Definitions
As used in this Part:
(a) Assisted reproductive technology service or ART service means a medical procedure intended to result in a pregnancy, including, but not limited to, in vitro fertilization (including intracytoplasmic sperm injection), embryo transfer and gamete intrafallopian transfer. This definition, for purposes of this Part, does not include artificial insemination, the process by which fresh or frozen sperm sample is introduced into a vagina other than by sexual intercourse.
(b) Assisted reproduction service provider means a medical provider, fertility clinic, or reproductive tissue bank (which shall include a gamete bank), or any other entity which either provides ART services in New York State or for which any component of the ART services arranged by the entity is performed in New York State.
(c) Child means a born individual of any age whose parentage may be determined under article 5-C of the Family Court Act or any other law.
(d) Donor means an individual who does not intend to be a parent and provides reproductive tissue used for ART procedures performed on recipients other than that person or that person’s spouse, whether or not for consideration.
(e) Health commerce system or HCS shall mean the department's secure internet portal used for communications and information exchange with organizations licensed and certified by the department and health care providers, or any successor system used for such information exchange as required by the department.
(f) Intended parent means an individual, married or unmarried, who manifests the intent to be legally bound as the parent of a child resulting from ART or a surrogacy agreement.
(g) Surrogate means an adult who is not an intended parent, who enters into a surrogacy agreement to bear a child resulting from an embryo formed using an egg other than their own.
(h) Surrogacy program means any person or entity licensed under this Subpart as a surrogacy program.
(1) Persons or entities who arrange or facilitate transactions contemplated in a surrogacy agreement under article 5-C of the Family Court Act, regardless of whether such agreement ultimately comports with the requirements of article 5-C of the Family Court Act, are required to be licensed as a surrogacy program. under this Subpart if:
(i) such person or entity is doing business in New York;
(ii) the surrogate resides in New York State during the term of the surrogacy agreement; or
(iii) any medical procedures under the surrogacy agreement are performed within New York State.
(2) A surrogacy program does not include the parties to a surrogacy agreement.
(3) For the purposes of this definition, a person or entity is considered to arrange or facilitate the transactions contemplated in a surrogacy agreement by performing any of the following acts:
(i) planning or arranging the details of ART services with the intended parent(s);
(ii) setting the timeline for ART services; establishing the type of ART services to be rendered; acquiring or coordinating the ART services of third-party licensed professionals;
(iii) recruiting and/or obtaining personal information regarding surrogates;
(iv) making, negotiating, or completing the financial arrangements for ART services;
(v) directing, being in charge or apparent charge of, or supervising, directly or indirectly, the matching process between the intended parent(s) and surrogates;
(vi) directing, being in charge or apparent charge of, or supervising, directly or indirectly, the ART services to be provided by another licensed person;
(vii) using in connection with one’s name or employment the words or terms assisted reproduction , surrogacy , or any other word, term, title, or picture, or combination of any of the above, that when considered in the context in which used would imply that such person is engaged in the practice of surrogacy program ownership or that such person is holding themself out to the public as being engaged in the practice of providing services related to matching intended parents with surrogates; or
(viii) managing or supervising the operation of a surrogacy program, except for administrative matters such as budgeting, accounting and personnel, maintenance of buildings, equipment and grounds, and routine clerical and recordkeeping functions.
(4) Surrogacy programs shall not include individuals or entities acting solely as gamete or embryo donor programs; escrow agents providing escrow services pursuant to a surrogacy agreement; insurance providers providing insurance pursuant to a surrogacy agreement or providing insurance review services in connection with a surrogacy arrangement; assisted reproduction service providers providing medical services pursuant to a surrogacy agreement; mental health providers providing mental health services in connection with a surrogacy arrangement; or attorneys representing a party to a surrogacy agreement.
(i) Owner means any and all persons who, directly or indirectly, or acting by or through one or more persons, owns a five percent or greater interest in a surrogacy program.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.25 Definition of adequate
Adequate shall mean sufficient to accomplish the purposes for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.6 Initial review of actions
Upon receipt of an application for a funding or approval action, the department shall:
(a) determine whether the action is subject to SEQR. If the action is an exempt, an excluded, or a type II action, the agency shall have no further responsibilities under this Part;
(b) determine whether the action involves a Federal agency. If the action involves a Federal agency, the provisions of section 97.15 of this Part shall apply;
(c) determine whether the action involves one or more other agencies.
(1) if the action is a type I action, the provisions of section 97.7 of this Part shall govern the designation of lead agency;
(2) if the action is an unlisted action, the provisions of section 97.8 of this Part shall govern the designation of lead agency;
(d) determine whether the action is located in the coastal area. If the action is either a type I action or an unlisted action and is in the coastal area, the provisions of 19 NYCRR Part 600 shall apply.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.6 Exclusion of susceptibles in the event of a disease outbreak
(a) In the event of an outbreak of measles, mumps or rubella in an institution, the commissioner may order the appropriate officials of the institution to exclude from attendance all students without documentation of immunity as specified in section 66-2.2(b) or (c) and those who have been excused from immunization under section 66-2.2(d) or (e) of this Subpart.
(b) The exclusion shall continue until the commissioner determines that the danger of transmission has passed or until the documentation specified in section 66-2.2(b) or (c) of this Subpart has been submitted.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.49 Bond discount
The excess of the face amount of a bond or class of bonds over the net amount yielded from its sale. On the books and balance sheet of the issuer it appears as a deferred charge.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 147.2 South Huntington Water District, town of Huntington
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all wells of the public water supply of the South Huntington Water District, town of Huntington, Suffolk County, New York.
(b) [Definitions.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any well of the public water supply of the South Huntington Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the South Huntington Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be removed and disposed of as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the South Huntington Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any well of the public water supply of the South Huntington Water District, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape on or beneath the surface of the ground within 200 feet of any well of the public water supply of the South Huntington Water District, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. The watertight receptacles provided above, however, shall not be located within 50 feet of any well of the public water supply of the South Huntington Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the South Huntington Water District, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface between the limiting distances of 50 feet and 100 feet of any well of the public water supply of the South Huntington Water District, except into watertight receptacles, the contents of which are to be removed and disposed of as provided by paragraphs (4) and (5) of subdivision (c).
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within less than 75 feet of any well of the public water supply of the South Huntington Water District, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well of the public water supply of the South Huntington Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well nor to be thrown, placed, piled or spread upon the surface of the ground within 200 feet of any well of the public water supply of the South Huntington Water District, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 200 feet of any well of the public water supply of the South Huntington Water District, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the South Huntington Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to remain on the surface of the ground or beneath the surface of the ground within a distance of 300 feet of any well of the South Huntington Water District, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leaching or washings therefrom may reach any well of said public water supply without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the South Huntington Water District.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the South Huntington Water District.
(i) Inspections.
The board of water commissioners of the South Huntington Water District of the town of Huntington or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.105 Practitioners
Every physician, dentist, podiatrist, veterinarian, or other authorized practitioner shall keep a record of all controlled substances purchased by him and a record of all such drugs dispensed or administered by him out of his own stock of such drugs.
(a) Records of controlled substances purchased shall include date of delivery, type and quantity of drugs and the name and address of the supplier of the drug. A duplicate invoice or separate itemized list furnished by the vendor will be sufficient to satisfy this record requirement for schedule III, IV, and V controlled substances provided it includes all required information and is retained in a separate file. In addition, duplicate copies of Federal order forms for schedule I and II controlled substances shall be retained.
(b) Records of disposition of controlled substances shall include date of dispensing or administering of such drug, name and address of patient, and type and quantity of drug.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.7 Required laboratory tests on donors and donated tissue
All required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state skin procurements, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulatory authority, the United States Health Care Financing Administration, or by the department.
(a) Blood samples from all allogeneic skin donors shall be tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), and hepatitis C virus (HCV), as well as for hepatitis B surface antigen (HBsAg) and for syphilis, and, unless the tissue is to be virally inactivated, antibodies to human T-lymphotropic virus type I (HTLV-I), for purposes of donor selection.
(b) Microbial testing of skin from each anatomical site for aerobic and anaerobic contamination shall be performed using standard laboratory procedures. Whenever fresh skin is transplanted, the results of cultures shall be made available to the transplantation surgeon on a daily basis until the final reading has been completed.
(c) All skin tissue from living donors intended for allogeneic use shall be quarantined for at least six months. After such time and prior to the distribution of the tissue for transplantation, the donor shall be retested for HBsAg and antibodies to HCV, HIV-1 and HIV-2 and tested for antibodies to hepatitis B core antigen (anti-HBc).
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 1 PUBLIC HEALTH NURSE 1
10 CRR-NY 11.41 Entry level qualifications
A public health nurse 1 must possess a baccalaureate degree in nursing from a regionally accredited or New York State-registered college or university, as well as licensure and current registration to practice as a registered professional nurse in New York State.
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.12 Reportable laboratory tests for pesticide poisoning
For purposes of section 22.11 of this Part the following laboratory tests are reportable to the State Commissioner of Health:
(a) Blood cholinesterase levels which are below the normal range established by the clinical laboratory performing the test in accordance with quality assurance requirements established by the permit-issuing agency.
(b) Levels of pesticides in human tissue samples which exceed the normal range established by the clinical laboratory performing the test in accordance with quality assurance requirements established by the permit-issuing agency.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.86 Nonfood-contact surface cleanability
Nonfood-contact surfaces of the interior of vending machines are to be designed and constructed to permit easy cleaning and to facilitate maintenance operations, and are to be kept clean and in good repair.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.13 Tribunal appeals
(a) The tribunal shall serve as a review board within the department and will have jurisdiction to review all decisions and orders of tribunal representatives with regard to whether the facts found therein are supported by substantial evidence in the record and the law. The tribunal, whose decisions shall be by a majority of its members, shall have the power to reverse, remand or modify any decision and order appealed from, and may change the amount of any penalty imposed.
(b) A respondent who elects to seek review of any final decision or order of a tribunal representative shall file a notice of appeal with the department within 15 days of receipt of a copy of the decision and order of the tribunal representative. The notice of appeal is to be accompanied by a brief or memorandum outlining specific reasons why the decision and order should be changed. The filing of a notice of appeal will stay the collection of any fine or imposition of a penalty or order until the tribunal has rendered its decision. However, such notice of appeal shall not stay an order for closure nor public release of information regarding such order for closure. Appeals shall be made upon the record of the hearing and are to be made without physical appearance of the respondent unless requested by the respondent in the notice of appeal. Any appeal in which an appearance is made by the respondent will be open to the public.
(c) The tribunal shall issue its decision in writing within 30 days of receipt of the appeal and furnish a copy to the respondent by certified or registered mail.
(d) Final orders or determinations of the tribunal shall be subject to review as provided in article 78 of the Civil Practice Law and Rules.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
FAMILY HEALTH FAMILY HEALTH
10 CRR-NY 40-2.11 Family health; services eligible, but not required, for State aid
The following public health services are eligible for State aid but not required as a condition of State aid eligibility:
(a) primary care services to uninsured persons under 21 years of age, in a clinic setting, provided that such services shall be eligible for State aid only to the extent that the local health department makes good faith efforts to assist such persons with Medicaid or other insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective;
(b) provision of public health home visits associated with eligible services. Such public health home visits may include visits only for the following purposes: assessing women’s preconception, prenatal, postpartum and interconception health and social support needs; assessing child and family health and social support needs; providing information to promote positive birth outcomes and child health; and referring persons to needed services. Activities undertaken in relation to the Child Find System under the Early Intervention Program, as required pursuant to sections 69-4.1(c) and 69-4.2 of this Title, shall not be eligible for State aid;
(c) provision of reproductive health care and family planning services for men and women of reproductive age, in a clinic setting; and
(d) prenatal and postpartum care, in a clinic setting, provided that such services shall be eligible for State aid only to the extent that the local health department makes good faith efforts to assist such women with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.2 Village of Geneseo
See section 123.1, supra
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
BALANCE SHEETS BALANCE SHEETS
10 CRR-NY 444.5 RESTRICTED FUND LIABILITIES
[ 3140 ]
(a) PLANT REPLACEMENT AND EXPANSION FUND LIABILITIES.
[ 3141 ]
2580
DUE TO OTHER FUNDS
2581
Due to Operating Fund
2582
Due to Board-Designated Assets
2584
Due to Specific Purpose Fund
2585
Due to Endowment Fund
These accounts reflect the amounts due to other funds by the Plant Replacement and Expansion Fund.
(b) SPECIFIC PURPOSE FUND LIABILITIES.
[ 3142 ]
2780
DUE TO OTHER FUNDS
2781
Due to Operating Fund
2782
Due to Board-Designated Assets
2783
Due to Plant Replacement and Expansion Fund
2785
Due to Endowment Fund
These accounts reflect the amounts due to other funds by the Specific Purpose Fund.
(c) ENDOWMENT FUND LIABILITIES.
[ 3143 ]
(1) 2810
MORTGAGES PAYABLE
(2) 2870
OTHER NON-CURRENT LIABILITIES
(3) These accounts reflect liabilities on Endowment Fund assets that existed at the time the assets were received by the hospital or were incurred subsequent to receipt of these assets, based upon the endowment agreement.
(4) 2880
DUE TO OTHER FUNDS
2881
Due to Operating Fund
2882
Due to Board-Designated Assets
2883
Due to Plant Replacement and Expansion Fund
2884
Due to Specific Fund
These accounts reflect the amounts due to other funds by the Endowment Fund.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.195 Access
The permit-issuing official or his designated representative is to be permitted access for purposes of inspection at all times while the mobile food service establishment or pushcart is in operation, whether open to the public for service of food or not. Refusal of admittance, after proper identification, is cause for action to obtain permit revocation and an order to close.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.6 Payment for outpatient and related medical care
Fees for outpatient and related medical care may not exceed those established pursuant to title 11 of article five (Medicaid) of the Social Services Law.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.3 Environmental investigation
Whenever an area of high risk is designated or when a child has been referred for environmental management in accordance with section 67-1.2(a)(9) of this Part, the commissioner or his designated representative shall coordinate follow-up activities as defined in section 67-1.1(e) and (f) of this Part and required by section 67-1.6 of this Part. An assessment of conditions conducive to lead poisoning shall be performed and should include an environmental investigation of:
(1) any dwelling;
(2) any child care facility; and
(3) any other area where the child spends a signifigant amount of time.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM
10 CRR-NY 85.22 Maximum reimbursable price and limitations on reimbursement for non-prescription drugs
Pursuant to section 365-a of the Social Services Law, the amount which may be reimbursed for those nonprescription drugs specified in this Part by the commissioner as a reimbursable item of medical assistance shall be the lower of:
(a) the provider's usual and customary price to the general public on the date of provision of service, but not to exceed the lower sale price, if any, in effect on that date;
(b) the maximum reimbursable price established and maintained by the commissioner; or
(c) reimbursement shall not be available under the medical assistance program for any nonprescription drug in the following categories:
(1) a drug regularly supplied as an integral part of a medical care program activity to a Medicaid recipient by private, voluntary or public agencies such as the Veterans Administration, Department of Health and Human Services, State Department of Health or other funded programs;
(2) any drug for which there are low-cost alternatives if purchased by a Medicaid recipient, either nonprescription or prescription drugs;
(3) any drug considered ineffective in accordance with standards developed by the Food and Drug Administration;
(4) any drug sold after the expiration date printed on the container label; and
(5) any drug in a container whose expiration date has been altered, mutilated, destroyed, obliterated or removed by means of an affixed price sticker or other change.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.5 Funeral establishments
(a) The business and practice of funeral directing shall be conducted and registered only from a fixed funeral establishment.
(b) Separate buildings or portions thereof connected by a private passageway, walk or driveway shall constitute a single funeral establishment.
(c) After February 28, 1974, all funeral firms and their funeral establishments shall comply and conform as follows:
(1) Embalming. No embalming of a body of a deceased person shall be performed in a funeral establishment except in a room set aside exclusively for embalming or other preparation of a body of a deceased person. Such room shall be maintained and kept in a clean and sanitary condition.
(2) Embalming and preparation room. Every embalming and preparation room shall be constructed, equipped and maintained as follows:
(i) the surfaces of the floor, walls and ceiling shall be covered with tile or other hard, smooth, impervious washable material;
(ii) the room shall be adequately lighted and adequately ventilated. The ventilation shall be provided by an exhaust fan or by an appropriate air-conditioning unit which will completely remove objectionable fumes;
(iii) the room shall be equipped and provided with hot and cold running water, a utility sink, and cabinets, closets or shelves for instruments and supplies;
(iv) the room shall be equipped with adequate sewage and waste disposal and drainage facilities and systems;
(v) the doors shall be tight-closing and rigid, and any windows of the room shall be so maintained as to obstruct any view into such room;
(vi) the embalming or preparation table shall be nonporous; and
(vii) the room shall be equipped with proper and convenient receptacles for refuse, bandages, cotton and other waste materials.
(3) Business telephone. Every registered funeral firm shall have, listed and in working order, at its registered address a business telephone, the number of which shall be indicated as the business telephone number. Any other telephone number also listed for the funeral firm shall be specifically designated as "residence telephone number," "number to call if no answer," or otherwise identified.
(4) Display of signs. Every registered funeral firm shall display a sign indicating the true funeral firm name as registered with the department. Such sign shall be conspicuously located at or near the main entrance and shall be visible from the exterior of the building. The lettering of the funeral firm name shall be legible and shall have a minimum height of 1½ inches. Wherever the name of the funeral firm appears on a sign indicating the location or presence of an establishment, only the funeral firm name registered with the department shall be used. A change in a funeral firm's registered name shall be indicated on any and all signs. Signs shall conform with all local laws, ordinances and regulations.
(5) Listings, publications and advertising. Only true funeral firm names and addresses, as registered with the department, shall appear in telephone listings or other publications and in advertising by any media whatsoever of funeral firms. This paragraph shall not apply to the listing or advertising of funeral firms outside the State.
(6) Food and beverages. The provision of space, facilities, equipment, accommodations or supplies for, or the preparation, sale, service or distribution of, or the consumption of, food or nonalcoholic beverages to or by friends, relatives, mourners, family, visitors or next of kin of any deceased person in the funeral establishment is permitted, but not required to be offered. Food or nonalcoholic beverages may also be provided by a third-party catering service, provided that such catering service is not owned by or affiliated with the funeral firm engaged in funeral directing at the funeral establishment. This paragraph is subject to the following conditions:
(i) the preparation and serving of food and nonalcoholic beverages in the funeral establishment shall be limited to arranging, opening, displaying, and assembling items for consumption, and does not include cooking or heating of food items with the exception of hot beverages such as coffee, tea or similar items;
(ii) food items must be limited to incidental refreshments such as baked goods, sandwiches, snacks, platters, pre-packaged food items and items which may be required by the religious practices of the family members, mourners, visitors or friends of the deceased;
(iii) the preparation and serving of any food and beverages shall be prohibited in the preparation area as defined in paragraph (d)(3) of this section and the chapel or reposing room as defined in paragraph (d)(1) of this section, whenever there is a deceased person present for a viewing, visitation or funeral services;
(iv) any separate charges for the use of facilities for the serving of food and nonalcoholic beverages:
(a) shall be charged only for a specifically dedicated food and beverage service area;
(b) shall be stated clearly on the general price list; and
(c) shall include any charges for cleaning, equipment or the like, as required by section 79.4(e)(6) of this Title.
(d) A funeral establishment of a funeral firm registering after February 28, 1974 shall, in addition to the provisions of subdivision (c) of this section, contain at least one of each of the following:
(1) a chapel or reposing room, containing at least 300 square feet of floor space, to be used exclusively for the conduct of funeral services;
(2) an arrangement office, to be used exclusively for making funeral arrangements and for other related business matters; and
(3) a preparation room, containing at least 120 square feet of floor space. The preparation, disinfection, embalming, washing, dressing and casketing or other care of a body of a deceased person shall take place only in such room, which room shall contain only articles and equipment necessary for such preparation. Such room and equipment, instruments and articles contained therein shall be maintained and kept in a clean and sanitary condition. Temporary storage of an uncasketed body of a deceased person awaiting burial or other final disposition shall take place only in such preparation room or in a storage room in a manner acceptable to the commissioner.
(e) No change in name or transfer of title or interest to a successor entity or transfer of title to or leasehold of real property wherein a funeral establishment is located by a firm registered prior to March 1, 1974, and continuing thereafter to operate from such funeral establishment, shall require compliance with the provisions of subdivision (d) of this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.21 Radiology and other diagnostic services
(a) The facility shall provide or obtain radiology and other diagnostic services to meet the needs of its residents pursuant to an order by an appropriate practitioner. The facility shall be responsible for the quality and timeliness of such services.
(1) The facility shall promptly perform such services as the facility is licensed to provide directly under Part 16 of this Title. The services shall be provided in accordance with generally recognized standards of care and services.
(i) The diagnostic radiology and other diagnostic services shall be free from hazards for residents and staff.
(ii) Personnel. A qualified full-time, part-time, or consulting physician, who is qualified by education and experience in radiology, shall supervise the ionizing radiology services and shall interpret those tests that are determined by the governing body, and the medical director, to require such physician's specialized knowledge. Upon recommendation of such qualified physician, the medical director shall designate the practitioners and staff, in accordance with Part 89 of this Title, who may use the radiologic equipment, administer procedures and interpret test results.
(iii) Records. Records of diagnostic radiologic services shall be maintained.
(a) The practitioner who performs radiology services shall prepare and authenticate reports of his or her interpretations.
(b) The facility shall maintain for at least six years or three years after a resident who is a minor reaches the age of majority (18) films, scans, and other image records which have not been incorporated into the resident's clinical record.
(2) The facility shall promptly arrange for ordered radiology and other diagnostic services which the facility is not licensed to provide. Such services shall be obtained from entities approved under Part 16 of this Title and which are certified by the Medicare program.
(b) The facility shall:
(1) promptly notify the ordering practitioner of the results of radiologic and other diagnostic services;
(2) assist the resident, if needed, with transportation arrangements to and from the source of services; and
(3) file in the resident's clinical record authenticated and dated reports of diagnostic radiology and other diagnostic services.
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.29 Physical environment
The nursing home shall be designed, constructed, equipped and maintained to provide a safe, healthy, functional, sanitary and comfortable environment for residents, personnel and the public.
(a) Life safety from fire and other hazards.
(1) Buildings and equipment shall be maintained and operated so as to prevent fire and other hazards to personal safety.
(2) Nursing homes shall comply with section 711.2(a) of this Title.
(3) The nursing home shall maintain a procedure to investigate fires. A written report of the investigation containing all pertinent information shall be made. The report shall remain on file for not less than six years.
(4) The nursing home shall maintain a procedure for reporting to a designated administrative officer on a standard form adopted for the purpose, all accidents to residents, staff, employees or visitors. The report shall include all pertinent information and shall be kept on file for not less than six years after the occurrence was reported.
(b) Equipment.
The nursing home shall maintain all essential mechanical, electrical, and resident care equipment in safe operating condition.
(c) Resident rooms.
Resident rooms shall be designed and equipped for adequate nursing care, comfort and privacy of residents. The nursing home shall provide each resident with:
(1) a separate bed of proper size and height for the convenience of the resident;
(2) a clean, comfortable mattress;
(3) bedding appropriate to the weather and climate; and
(4) functional furniture appropriate to the resident's needs, and individual closet space in the resident's bedroom with clothes racks and shelves accessible to the resident.
(d) Toilet, handwashing and bathing facilities.
Plumbing and plumbing fixtures shall be properly maintained and operable.
(e) Dining and resident activities.
The facility shall provide one or more rooms designated for resident dining and activities. These rooms shall:
(1) be well lighted;
(2) be well ventilated, with smoking areas identified;
(3) be adequately furnished; and
(4) have sufficient space to accommodate all activities.
(f) Water supplies.
Water supplies of nursing homes shall be operated in conformance with the following requirements:
(1) all water used in operation shall be provided from a public water supply or from an alternate source, in either event as approved by the department;
(2) no changes shall be made in the source or treatment of the water supply without approval of the department;
(3) water shall be adequate in volume and pressure for all medical purposes;
(4) the water system shall not be operated with physical connections to other piping systems or connections to fixtures that may permit contamination of the water supply;
(5) the water system shall be operated with a hot water system adequate for all medical purposes;
(6) the hot water supply used by residents or the public shall be regulated to maintain hot water temperature within the range of 90 degrees to 120 degrees F; and
(7) the nursing home shall ensure that water is available to essential areas when there is a loss of normal water supply.
(g) Waste systems.
Waste systems shall be operated so that all sewage and other liquid wastes are disposed of by connection to a public sewer system or by an alternate method, in either event as approved by the department.
(h) Ventilating, heating, and air conditioning systems.
Such systems shall:
(1) be maintained in good repair and shall be operated in a manner which will not allow for the spread of infection and provide for resident health and comfort; and
(2) be maintained and operated in such manner that air shall not be circulated from resident isolation rooms, laboratories in which work is done in pathology, virology or bacteriology, autopsy rooms, kitchen and dishwashing areas, toilet and bath rooms, janitors' closets and soiled utility rooms or soiled linen rooms, to other parts of the facility.
(i) Grounds and building.
Grounds and buildings shall be maintained:
(1) in a clean condition free of safety hazards;
(2) in such manner as will prevent standing water, flooding or leakage; and
(3) free of excessive noise, odors, pollens, dusts or other environmental pollutants and such nuisances as may adversely affect the health or welfare of residents.
(j) Housekeeping.
(1) The entire nursing home, including but not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment and furnishings, shall be clean. The facility shall be maintained in good repair including, but limited to buildings, utilities, fixed equipment, resident care equipment and furnishings.
(2) Responsibility for direct supervision of housekeeping service shall be assigned to a person, properly qualified by training and experience.
(3) Dusting, mopping and vacuum cleaning shall be done in a manner which will not spread dust or other particulate matter.
(4) Adequate supplies and equipment for housekeeping functions shall be provided with cleaning compounds and hazardous substances properly labeled and stored.
(5) The facility shall maintain an effective pest control program so that it is free of insects and rodents.
(6) Waste.
(i) Solid wastes, including garbage, rubbish and other refuse, biological wastes and infectious materials, shall be collected, stored and disposed of in a manner that will prevent the transmission of disease and not create a nuisance or fire hazard, nor provide a breeding place for insects or rodents.
(ii) Facilities shall manage regulated medical waste in accordance with the provisions of Part 70 of this Title.
(k) Linen and laundry.
The nursing home shall:
(1) provide a sufficient quantity of clean linen to meet the requirements of residents; nursing homes shall maintain a linen inventory equal to at least three times the average daily census, and of this one-third shall be in use, one-third in laundry and one-third in reserve;
(2) maintain linen in proper condition for use, free from rips and tears;
(3) provide for satisfactory laundering of linens and other washable fabrics;
(4) handle, store and process laundry in a manner that will prevent the spread of infection and assure the maintenance of clean linen;
(5) wash all linen, including blankets, between resident use;
(6) bag or enclose all used linen in suitable containers within the resident care unit for transportation to the laundry;
(7) separately bag or enclose used linens from residents with a communicable disease in readily identifiable containers distinguishable from other laundry;
(8) properly maintain space and equipment for laundry storage and transportation;
(9) launder only in areas and with equipment properly maintained and approved for such purpose by the department;
(10) launder in a manner designed to prevent contamination of clean linen and to prevent infection; and
(11) transport clean linen in clean covered containers used exclusively for the purpose, and store clean linen in clean storage areas in a manner to prevent its contamination.
(l) Animals.
(1) Animals, exclusive of those required for laboratory purposes, shall not be allowed in a nursing home, except in a nursing home animal visitation or animal-assisted therapy program as permitted in paragraphs (2) and (3) of this subdivision. Also, service dogs and other service animals which have been individually trained to do work or perform tasks for the benefit of an individual with a disability may accompany such persons when the presence of such animals will not pose a significant risk to the health and safety of others that cannot be eliminated by reasonable accommodation and is not medically contraindicated. However, if the safe operation of the facility would be jeopardized, a service animal need not be allowed to enter. A finding by appropriate medical personnel at the facility that the presence or use of a service animal would pose a significant health risk in certain designated area of a nursing home may serve as a basis for excluding service animals in those areas.
(2) A nursing home may board animals as part of an animal-assisted therapy program, provided that:
(i) the health, safety, welfare and rights of all residents on the unit are assured;
(ii) a staff member has been designated to be responsible for the care and management of the animal or animals and has had appropriate training for such responsibilities;
(iii) the animal or animals are free from disease and have received all immunizations as recommended by a licensed veterinarian;
(iv) the animal or animals shall not be allowed in laundry, utensil storage or food preparation areas;
(v) the well-being of the participating animal or animals is considered and maintained.
(3) Animal visitations are permitted in a nursing home provided that:
(i) the visit is prescheduled and approved by the facility;
(ii) the animal shall not be allowed in laundry, utensil storage or food preparation areas; and
(iii) the animal will at all times be accompanied by a person familiar with and capable of controlling the animal's behavior.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
APPROVAL OF LABORATORIES APPROVAL OF LABORATORIES
10 CRR-NY 55-1.3 Method of approval
Application for approval shall be made on forms provided by the State Department of Health. Approval will be granted to a laboratory or institution in the name of the person who is the highest level administrator in that laboratory or institution. The certificate of approval is not transferable and the State Department of Health shall be advised promptly if the individual in whose name approval has been granted shall cease to be in charge.
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.2 Conditions eligible
Conditions for which medical service is reimbursable under State aid to counties or the City of New York under the children and youth with special health care needs support services program shall be only those approved by the Bureau of Medical Rehabilitation, the Bureau of Dental Health, or the Bureau of Maternal and Child Health of the State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.13 Recordkeeping
(a) An integrated services provider shall maintain a record of all integrated care services provided to an individual who is admitted to and treated by such provider, and this may be accomplished via a single integrated record for the individual.
(b) Regardless of form or format, each integrated care services program shall establish a recordkeeping system which is maintained in accordance with recognized and accepted principles of recordkeeping.
(c) Each integrated care services program shall designate a staff member who has overall supervisory responsibility for the recordkeeping system. The recordkeeping supervisor shall ensure that:
(1) the integrated care record for each patient contains and centralizes all physical and behavioral health information which identifies the patient, justifies the treatment and documents the results of such treatment;
(2) entries in the integrated care record are current, legible to individuals other than the author, are authenticated with a signature of the person making the entry, date, and time;
(3) handwritten entries must be made in permanent, non-erasable blue or black ink or typed;
(4) information contained in the integrated care record is securely maintained, kept confidential, safeguarded from environmental damage, and made available only to authorized persons who have a need to know the information; and
(5) when a patient is treated by an outside provider, and that treatment is relevant to the patient's care, a clinical summary or other pertinent documents are obtained to promote continuity of care; if documents cannot be obtained, the reason must be noted in the integrated care record.
(d) The integrated care record format shall facilitate the ability to record the following information for each patient, as relevant:
(1) patient basic demographic information;
(2) patient physical health and behavioral health history:
(i) physical health information:
(a) physical examination reports;
(b) diagnosis or medical impression;
(c) diagnostic procedures/tests reports;
(d) medical orders and anesthesia record;
(e) immunization and drug history; and
(f) notation of allergic or adverse reactions to medications;
(ii) mental health information:
(a) diagnosis or diagnostic impression;
(b) psychosocial assessment; and
(c) mental health treatment history;
(iii) substance use information:
(a) diagnosis or diagnostic impression;
(b) substance use disorder assessment, including the use of tobacco;
(c) the impact of the use of substances, on self and significant others; and
(d) substance use disorder treatment history including prior periods of sustained recovery and how such recovery was supported;
(3) admission note;
(4) assessment of the patient's goals regarding basic treatment goals and needs;
(5) treatment plan and applicable reviews;
(6) dated progress notes that relate to goals and objectives of treatment;
(7) discharge plan;
(8) documentation of the services provided and any referrals made;
(9) discharge summary;
(10) dated and signed records of all medications prescribed by the clinic and other prescription medications being used by the patient, if applicable;
(11) consent forms, if applicable; and
(12) record of contacts with collaterals if applicable.
(e) Patient case records must be retained for a minimum period of six years from the date of the last service provided to a patient or, in the case of a minor, for at least six years after the last date of service or three years after he/she reaches majority whichever time period is longer.
(f) Confidentiality.
(1) Notwithstanding any other New York State regulation, in cases where component providers of an integrated care services program are governed by different State or Federal laws and regulations protecting clinical records and information, the integrated care record shall be governed by the State and Federal privacy rules and regulations that give the most protection to the record, unless it is possible to redact provisions of the record with more protection without compromising the purpose for which the record is being disclosed.
(2) An integrated care services program providing substance use disorder services must obtain patient consent prior to making any disclosures from the integrated care record, unless the disclosure is authorized as an exception pursuant to Federal regulations.
(3) AIDS and HIV information shall only be disclosed in accordance with article 27-F of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
OPERATORS OPERATORS
10 CRR-NY 10.31 Health of operators
No person known to be affected with any communicable disease in an infectious stage shall engage in barbering or cosmetology and no person so affected shall be employed as a barber or cosmetologist.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.4 Certificate of incorporation or articles of organization
(a) No person shall file a certificate of incorporation or articles of organization, or amendment thereto, containing powers related to the operation of an MCO or an IPA with the Secretary of State, without first having submitted the proposed certificate, articles or amendment to the commissioner for his or her review and approval and received all approvals required by law.
(b) The proposed purpose and powers of an MCO shall include the following:
(1) to perform studies, feasibility surveys and planning with respect to the development and formation of an MCO; and in conjunction, to accumulate, compile and analyze statistics and such other data that will promote the health, safety and welfare of the general public; and
(2) upon obtaining a certificate of authority from the commissioner, to own, operate and manage a health maintenance organization or, as appropriate, a PHSP, or comprehensive HIV special needs plan, or managed long-term care plan or primary care partial capitation provider, including providing or arranging for the provision of comprehensive health services, to an enrolled population, and to have and exercise all powers necessary and convenient to effect any or all of the foregoing purposes for which the entity is formed, together with all the powers now or hereafter granted to it by the State of New York.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.6 Supplemental financial assistance program
(a) The supplemental financial assistance program provides enhanced payments to patients with special needs as defined in section 86-6.1(k) of this Subpart using payment rates established pursuant to section 86-6.2(g) of this Subpart.
(b) To receive the enhanced Medicaid payment rates as set forth in section 86-6.2(g) of this Subpart, a hospice must:
(1) meet all certification requirements pursuant to article 40 of the Public Health Law;
(2) continue efforts to obtain financial support from public and community funding sources;
(3) make a reasonable effort to collect payments for services from third party insurance payers, governmental payers and self paying patients;
(4) establish a reasonable relationship between costs and charges, or establish charges at approximate costs; and
(5) with respect to the enhanced payment rates for escort services, provide the commissioner with an acceptable written plan explaining how escort services will be used by each agency which may be billing the routine home care rates with escort.
(c) The provisions set forth in this section, and sections 86-6.1(k) and 86-6.2(g) of this Subpart shall expire and be deemed to have no further force or effect on and after the date on which section 4012-a of the Public Health Law, which authorizes establishment of the supplemental financial assistance program, expires.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-5.53 Utensils, single-service items, food-contact equipment protection
Utensils, single-service items and food-contact equipment are to be protected during transit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.14 Ova donation guidelines
(a) Assisted reproduction service providers shall develop policies and procedures relating to the selection and evaluation of prospective ova donors as set forth in Part 52 of this Title.
(b) Such policies and procedures must adhere to the department’s guidelines and best practices relating to screening of ova donors, which shall be published on the department’s website.
(c) The department shall develop and distribute, in printed and electronic form maintained on the department’s website, informational material relating to ova donation, which shall be made available by the assisted reproduction services provider in hard copy to all prospective donors who contact such provider.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.16 Accessibility to storage areas; schedule I-V controlled substances
(a) In order to minimize the possibility of internal diversion the licensee shall limit access to the storage areas for controlled substances to a minimum number of employees with a security pass system if the size, type or other factors indicate a need, as determined by the department.
(b) Where it is necessary for employee maintenance or nonemployee maintenance personnel, business guests or other visitors to have access to or pass through the controlled substances storage area the licensee shall authorize in writing an employee to provide adequate observation during the time these otherwise unauthorized persons are in the storage area.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.28 Blowoff facilities
All blowoff drains or discharge pipes connected to the public water system should be terminated at points where these structures will not be subject to flooding or otherwise subject to contamination.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.20 Waved requirements for MLTCPs
Section 365-i of the Social Services Law, pertaining to prescription drug payments, is deemed waived for MLTCPs by the commissioner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.22 Related organizations
[ 1430 ] A hospital itself may be subsidiary to or under the control of a larger organization such as a university, governmental entity or parent corporation. It is typical in such situations for hospitals to receive services from these related organizations. Examples of services received are administration, purchasing, general accounting and menu planning. In addition, related organizations lease property, plant and equipment to hospitals as well as paying for various other items such as insurance. The related organization then usually charges for the service either directly or through a management fee. For uniform reporting purposes, the direct charges must be reported as purchased services in the appropriate functional cost centers as billed, and the management fee must be reported in the functional cost centers in amounts relative to the services received for which the fee is paid.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.25 Additional requirements for camps enrolling campers with disabilities
(a) Effective October 1, 2016, the following requirements shall apply to all camps enrolling a child with a physical or developmental disability, except that any camp for children with developmental disabilities as defined in section 7-2.2 of this Subpart shall comply with this section upon the effective date of this Subpart:
(1) Personnel and supervision.
(i) The ratio of counselors to campers who use a wheelchair, adaptive equipment or bracing to achieve ambulation, but who do not possess, for whatever reason, the ability to fit, secure or independently manipulate such devices satisfactorily to achieve ambulation, shall be 1:2.
(ii) Camp staff providing direct care of a camper with a disability shall be trained on the specific needs of the campers in their charge.
(2) Medical requirements.
(i) A camp operator shall obtain existing individual treatment, care, and behavioral plans for campers with a disability. Camp staff shall implement adequate procedures to protect the health and safety of a camper based on the plan provided and, when necessary, in consultation with an individual’s parent, guardian and/or clinical team.
(ii) The confidential medical history for a camper with a disability shall, in addition to the requirements of section 7-2.8(c)(1) of this Subpart, include:
(a) any restrictions, allergies, medications, special dietary needs, and other pre-existing medical, physical or psychological conditions and illnesses;
(b) the camper’s physician’s name, address and telephone number.
(iii) Modified diets and other special needs related to a camper’s disability shall be identified for each camper prior to arrival at camp, planned for, provided for in accordance with supplied directions, and reviewed by the designated camp health director.
(3) Recreational safety.
(i) The minimum counselor-to-camper ratio during swimming pool and bathing beach activities shall be one counselor for each camper who is non-ambulatory or has a disability identified by the camper's parents, guardian, physician or residential care provider that may result in an increased risk of an emergency in the water, such as uncontrolled epilepsy.
(ii) The minimum counselor-to-camper ratio during swimming pool and bathing beach activities shall be one staff member for every five campers with a developmental disability not designated in subparagraph (i) of this paragraph.
(iii) No camper with a developmental disability can participate in swimming activities unless a written permission statement signed by the camper’s parent, guardian or residential care provider is on file at the camp.
(iv) The camp safety plan approved under section 7-2.5(n) of this Subpart shall contain a procedure to address the handling of seizures and aspiration of water for campers with developmental disabilities. All bathing beach and swimming pool staff shall be trained to implement the procedure prior to the date the camp begins operation. In-service training using this procedure shall be conducted and documented every two weeks after the commencement of the camp’s operation or as otherwise approved by the permit-issuing official in the camp’s safety plan.
(4)
Toilets, privies, lavatories, showers. All lavatories and showers used by a camper with a physical disability shall be equipped with specialized fixtures, grab bars or other controls appropriate for the camper’s disability. Lavatories and showers used by campers with physical, intellectual or developmental disabilities, who are unable to moderate water temperature safely, shall have a water temperature not greater than 110°F.
(5) Sleeping quarters.
(i) Buildings housing campers who are non-ambulatory or use a wheelchair shall have ramps constructed in accordance with the Uniform Code to facilitate access and egress.
(ii) Non-ambulatory campers shall not have their sleeping accommodations above the ground floor.
(6) Location; grounds. Exterior paths of travel shall be free of encumbrances and provide an appropriate surface for movement during inclement weather as appropriate for the camp population being served.
(b) Children’s camps for children with developmental disabilities. In addition to the requirements listed in subdivision (a) of this section, the following requirements shall apply to all children’s camps for children with developmental disabilities, as defined as defined in section 7-2.2 of this Subpart:
(1) Definitions. The following definitions apply to this subdivision:
(i) Camp staff shall mean a director, operator, employee or volunteer of a children's camp; or a consultant, employee or volunteer of a corporation, partnership, organization or government entity which provides good or services to a children's camp pursuant to contract or other arrangement that permits such person to have regular or substantial contact with individuals who are cared for by the children's camp.
(ii) Department shall mean the New York State Department of Health.
(iii) Justice Center shall mean the Justice Center for the Protection of People with Special Needs, as established pursuant to section 551 of the Executive Law.
(iv) Reportable incidents shall include the following:
(a) Abuse and neglect shall mean those actions by camp staff that satisfies the definitions of “physical abuse”, “sexual abuse”, “psychological abuse”, “deliberate use of restraints”, “use of aversive conditioning”, “obstruction of reports of reportable incidents”, “unlawful use or administration of controlled substance” and “neglect” all as defined in section 488 of Social Services Law.
(b) Significant incident shall mean an incident, other than an incident of abuse or neglect as defined by clause ( a ) of this subparagraph that because of its severity or the sensitivity of the situation may result in, or has the reasonably foreseeable potential to result in, harm to the health, safety, or welfare of a camper with a developmental disability. A significant incident shall include but not limited to:
(1) conduct between campers with developmental disabilities that would constitute abuse, as defined in this section, if it had been conducted by a camp staff member; or
(2) conduct by a camp staff member which is inconsistent with the individual treatment plan for a camper with a developmental disability, generally accepted treatment practices and/or applicable Federal or State laws, regulations or policies, and impairs or creates a reasonably foreseeable potential to impair the health, safety or welfare of a camper with a developmental disability. Such conduct shall include but is not limited to: actions incorporated within the definitions of “unauthorized seclusion,” “unauthorized use of time-out,” “administration of a prescribed or over-the-counter medication, which is inconsistent with a prescription or order issued by a licensed, qualified health care practitioner, and which has an adverse effect,” and “inappropriate use of restraints,” as defined in section 488 of the Social Services Law.
(v) Personal representative shall mean a camper’s parent, guardian, or person authorized under State, tribal, military or other applicable law to act on behalf of a camper with a developmental disability in making health care decisions.
(2) Personnel and supervision.
(i) The camp director, who may also be the camp operator, shall possess a bachelor's degree from an accredited program in the field of physical education, recreation, education, social work, psychology, rehabilitation or related human services fields and shall present evidence of specialized training or one year of experience in treating or working with individuals with a developmental disability.
(ii) A camp director does not have to meet the minimum requirements of subparagraph (i) of this paragraph if:
(a) the individual was a camp director for a camp for children with developmental disabilities during each of the three camping seasons preceding the 1986 camping season;
(b) conditions at the camp did not threaten the health or safety of campers during that person's tenure as camp director; and
(c) the individual otherwise meets the minimum qualifications for a camp director, as set forth in section 7-2.5 of this Subpart.
(iii) The camp director shall not be on the Justice Center staff exclusion list (SEL) consistent with paragraph (6) of this subdivision.
(iv) The camp director shall develop a written staff training program appropriate to the specific needs of the campers with developmental disabilities enrolled in the camp.
(v) There shall be at least one counselor in addition to the driver in any vehicle transporting campers with developmental disabilities or as provided in the camp safety plan approved under section 7-2.5(n) of this Subpart.
(3) Medical requirements. The camp health director shall be a physician, physician's assistant, registered nurse or licensed practical nurse and shall be on-site for the period the camp is in operation.
(4) Reporting. In addition to reporting incidents as required by Part 5 of this Title and by sections 7-2.8(d), 7-2.5(n)(3) and 7-2.6(f)(4) of this Subpart, all camp staff shall immediately report any reportable incident, as defined in subparagraph (1)(iv) of this subdivision, involving a camper with a developmental disability, to the permit-issuing official and to the Justice Center's vulnerable person's central register (VPCR). Such report shall be provided in a form and manner as required by the department and Justice Center.
(5) Immediate protections and notifications.
(i) Immediately upon notification of abuse, neglect or significant incident as defined by subparagraph (1)(iv) of this subdivision, the camp operator or designee shall ensure appropriate actions are taken to address the immediate physical and psychological needs of the camper(s), implement protections to ensure the safety and mitigate further risk to campers, and document such actions and implementations.
(ii) The camp director or designee shall notify a camper with a developmental disability and the camper’s personal representative that the camper is an alleged victim or potential witness of an incident of abuse or neglect. Alleged victims shall be notified within 24 hours and potential witnesses shall be notified within 48 hours of the permit-issuing official reporting, to the camp director or designee, that an incident of abuse or neglect has been accepted by the Justice Center for investigation. There shall be no notification of a personal representative if the alleged victim or potential witness objects to such notification or if providing such notification would compromise the investigation, violate relevant confidentiality laws, be contrary to court order, or otherwise contrary to the best interests of the alleged victim or the potential witness.
(iii) Camp staff shall document in writing that notice was given or that a diligent effort to make such notification was made for each camper.
(6) Camp staff screening, training, and code of conduct.
(i) Prior to hiring anyone who will or may have direct contact with campers, or approving credentials for any camp staff, the operator shall follow the procedures established by the Justice Center in regulations or policy, to verify that such person is not on the Justice Center’s staff exclusion list (SEL) established pursuant to section 495 of the Social Services Law. If such person is not on the Justice Center's staff exclusion list (SEL), the operator shall also consult the Office of Children and Family Services State Central Registry of Child Abuse and Maltreatment as required by section 424-a of the Social Services Law. Such screening is in addition to the requirement that the operator similarly verify that a prospective camp staff is not on the sexual abuse registry, as required by section 7-2.5(l) of this Subpart.
(ii) A camp operator shall ensure that camp staff receive training regarding mandated reporting and their obligations as mandated reporters as defined by article 11 of Social Services Law. A camp operator shall ensure that the telephone number for the Justice Center's VPCR hotline for the reporting of reportable incidents is conspicuously displayed in areas accessible to mandated reporters and campers.
(iii) The camp operator shall ensure that all camp staff are provided with a copy of the code of conduct established by the Justice Center pursuant to section 554 of Executive Law. Such code of conduct shall be provided at the time of initial employment, and at least annually thereafter during the term of employment. Receipt of the code of conduct shall be acknowledged and the recipient shall further acknowledge that he or she has read and understands such code of conduct.
(7) Disclosure of information.
(i) Except to the extent otherwise prohibited by law, the camp operator shall be obliged to share information relevant to the investigation of any incident subject to the reporting requirements of this Subpart with the permit-issuing official, the department, and the Justice Center. The permit-issuing official, the department and the Justice Center shall, when required by law, or when so directed by the department or the Justice Center and except as otherwise prohibited by law, be permitted to share information obtained in their respective investigations of incidents subject to the reporting requirements of paragraph (4) of this subdivision.
(ii) Except as otherwise prohibited by law, the operator of a camp not otherwise subject to article 6 of the Public Officers Law shall make records available for public inspection and copying to the extent required by subdivision 6 of section 490 of the Social Services Law.
(8) Incident management.
(i) The camp operator shall cooperate fully with the investigation of reportable incidents involving campers with developmental disabilities and shall provide all necessary information and access to conduct the investigation. The camp operator shall promptly obtain an appropriate medical examination of a physically injured camper with a developmental disability. The camp operator shall provide information, whether obtained pursuant to the investigation or otherwise, to the Justice Center and permit-issuing official upon request, in the form and manner requested. Such information shall be provided in a timely manner so as to support completion of the investigation subject to the time limits set forth in this subdivision.
(ii) Unless delegated by the Justice Center to the department, an allegation of abuse or neglect as defined in clause (1)(iv)( a ) of this subdivision, shall be investigated by the Justice Center. With regard to an alleged significant incident, as defined in clause (1)(iv)( b ) of this subdivision, the permit-issuing official shall initiate a prompt investigation of the allegation, unless the Justice Center agrees that it will undertake such investigation. An investigation conducted by the permit-issuing official shall commence no later than five business days after notification of such an incident. Additional time for completion of the investigation may be allowed, subject to the approval of the department, upon a showing of good cause for such extension. At a minimum, the investigation of any reportable incident shall comply with the following:
(a) Investigations shall include a review of medical records and reports, witness interviews and statements, expert assessments, and the collection of physical evidence, observations and information from care providers and any other information that is relevant to the incident. Interviews should be conducted by qualified, objective individuals in a private area which does not allow those not participating in the interview to overhear. Interviews must be conducted of each party or witness individually, not in the presence of other parties or witnesses or under circumstances in which other parties or witnesses may perceive any aspect of the interview. The person alleging the incident, or who is the subject of the incident, must be offered the opportunity to give his/her version of the event. At least one of the persons conducting the interview must have an understanding of, and be able to accommodate, the unique needs or capabilities of the person being interviewed. The procedures required by this clause may be altered if, and only to the extent necessary to, comply with an applicable collective bargaining agreement.
(b) All evidence must be adequately protected and preserved.
(c) Any information, including but not limited to documents and other materials, obtained during or resulting from any investigation shall be kept confidential, except as otherwise permissible under law or regulation, including but not limited to article 11 of the Social Services Law.
(d) Upon completion of the investigation, a written report shall be prepared which shall include all relevant findings and information obtained in the investigation and details of steps taken to investigate the incident. The results of the investigation shall be promptly reported to the department, if the investigation was not performed by the department.
(e) If any remedial action is necessary, the permit-issuing official shall establish a plan in writing with the camp operator. The plan shall indicate the camp operator’s agreement to the remediation and identify a follow-up date and person responsible for monitoring the remedial action. The plan shall be provided, and any measures taken in response to such plan shall be reported to the department.
(f) The investigation and written report shall be completed and provided to the department within 45 days of when the incident was first reported to the Justice Center.
(iii) At the conclusion of an investigation of an alleged reportable incident, the camp operator shall:
(a) assess the need for corrective actions;
(b) report corrective actions plans to the permit-issuing official within 45 days of the conclusion of an investigation from the Justice Center or permit-issuing official; and
(c) implement corrective actions identified by the camp, or required by the permit issuing official or the Justice Center. Corrective action plans shall be implemented as soon as possible but within 90 days of the completion of an investigation unless the camp has closed for the season. If closed for the season, corrective action plans shall be implemented when the camp reopens.
(iv) Incident review committee.
(a) The camp shall maintain a facility incident review committee, in accordance with 14 NYCRR Part 704. The incident review committee shall be composed of members of the governing body of the children’s camp and other persons identified by the camp operator, including some members of the following: camp administrative staff, direct support staff, licensed health care practitioners, service recipients, the permit-issuing official or designee and representatives of family, consumer and other advocacy organizations, but not the camp director. The camp operator shall convene a facility incident review committee to review the timeliness, thoroughness and appropriateness of the camp's responses to reportable incidents; recommend additional opportunities for improvement to the camp operator, if appropriate; review incident trends and patterns concerning reportable incidents; and make recommendations to the camp operator to assist in reducing reportable incidents. The facility incident review committee shall meet each year in which there is a reportable incident. When the incident review committee is responsible for approving or developing corrective action plans, the committee shall meet within 45 days of the conclusion of an investigation, unless an extension for such plans has been granted by the Justice Center.
(b) Pursuant to paragraph (f) of subdivision (1) of section 490 of the Social Services Law and 14 NYCRR Part 704, a camp operator may seek an exemption from the requirement to establish and maintain an incident review committee. In order to obtain an exemption, the camp operator shall file an application with the permit-issuing official and provide sufficient documentation and information to demonstrate that compliance would present undue hardship, that granting an exemption would not create an undue risk of harm to campers' health and safety and specify an alternative process to ensure appropriate review and evaluation of reportable incidents. The permit-issuing official shall consult with the department and shall not grant or deny an application for an exemption unless it first obtains department approval for the proposed decision. An operator shall meet all terms of an approved exemption(s). An exemption shall remain in effect until revoked by the permit-issuing official. A camp operator shall immediately notify the permit-issuing official when conditions, upon which the incident review committee exemption was granted, have changed.
(9) In addition to the requirements specified by section 7-2.4(d) and (g) of this Subpart, a permit may be denied, revoked, or suspended if the children's camp fails to comply with regulations, policies, or other requirements of the Justice Center. In considering whether to issue a permit to a children's camp, the permit-issuing official shall consider the children's camp's past and current compliance with the regulations, policies, or other requirements of the Justice Center.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.8 Village of Silver Creek
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the Hopper Road Reservoir and the Smith Mills Reservoir and all watercourses tributary thereto or which may ultimately discharge into said Hopper Road and Smith Mills Reservoirs or which may be developed in the future to serve as sources of the water supply to the Village of Silver Creek.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for the deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Agricultural-associated animal waste storage area shall mean land used for the temporary or permanent deposition of agricultural-associated animal waste where said deposition is not directly for the purposes of fertilization.
(4) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(5) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(6) Human excreta shall mean human feces and urine.
(7) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(8) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(9) Manure shall mean animal feces and urine.
(10) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(11) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(12) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural- and nonagricultural-associated animal waste.
(13) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(14) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(15) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(16) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(17) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Silver Creek water supply.
(18) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(19) Sewage disposal system shall mean any system used for disposing of sewage.
(20) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(21) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(22) Water supply shall mean the public water supply of the Village of Silver Creek.
(23) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flow or may flow into the Village of Silver Creek's water supply.
(24) Watershed shall mean the entire drainage area contributing water to the Village of Silver Creek's water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste area.
No agricultural-associated animal waste area shall be located within a 250-foot linear distance of any reservoir or watercourse. Beyond that distance such area shall be maintained in such manner that surface runoff will not carry agricultural-associated animal waste directly into the reservoir or watercourse.
(2) Agricultural-associated animal waste storage area.
No agricultural-associated animal waste storage area shall be located within a 250-foot linear distance of any reservoir or watercourse.
(3) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(4) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(5) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so is obtained from the appropriate State agency having jurisdiction.
(6) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having Jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(ix) When an existing subsurface sewage disposal system fails, the entire system must be inspected and the site thoroughly evalated in accordance with article IV of the Sanitary Code of the Chautauqua County Health District, prior to modifications or alterations to the existing system.
(7) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(8) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Silver Creek.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Silver Creek except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Silver Creek within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Silver Creek in the performance of their duties of supervision and maintenance of the water supply.
(9) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Manure. Manure shall not be field spread within 75 feet of the reservoir or watercourse unless it is plowed underground the same day it is spread.
(iii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(iv) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(10) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(11) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Silver Creek.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The trustees of village, or any other person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid trustees of village to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of village, to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law. The aforesaid trustees of village shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.41 Sprinkler systems
(a) Subject to the availability of Federal financial participation, the capital cost components of the rates of eligible residential health care facilities for periods on and after the effective date of this regulation shall be adjusted in accordance with the following:
(1) For the purposes of this section, eligible facilities are those facilities which the commissioner determines are financially distressed in terms of their being unable to finance, at terms acceptable to the commissioner, the installation of automatic sprinkler systems, in conformity with the provisions of Federal regulations set forth in 42 CFR 483.70(a)(8). In making such determinations of eligibility the commissioner shall consider information obtained from a facility's cost report, other more recent financial information to be provided by the facility, and such other information as may be required by the commissioner, including, but not limited to:
(i) operating profits and losses;
(ii) eligibility for funding pursuant to subdivision twenty-one of section 2808 of the Public Health Law;
(iii) unrestricted fund balances;
(iv) documentation demonstrating the inability of the facility to obtain credit, at terms acceptable to the commissioner, without the reimbursement treatment accorded pursuant to this section;
(v) working capital;
(vi) days of cash expense on hand;
(vii) days of revenue in accounts receivable;
(viii) transfers and withdrawals;
(ix) information related to the health and safety of a facility's residents;
(x) other financial information as may be required from the facility by the commissioner; and
(xi) the filing of a notice pursuant to subdivision 1-a of section 2802 of the Public Health Law, or the receipt of required CON approvals, as appropriate.
(2) The capital cost component of the Medicaid rates of each eligible facility shall be adjusted in an amount, as determined by the commissioner, to reflect the costs of the annual debt service related to the financing of equipment and other capital improvements directly related to the financing of an automatic sprinkler system that will be in compliance with applicable Federal regulations.
(3) As a condition for receipt of funding pursuant to this section, each eligible facility shall submit to the commissioner the costs of the project, the proposed terms of the financing, including interest rate and term of the financing, and a schedule setting forth by month the estimated debt service payable over the life of the financing. Such schedule, along with such other information as may be required by the commissioner, shall be provided to the commissioner for review and approval at least 60 days prior to the due date of such first debt service payment, or such shorter period as the commissioner may permit.
(4) As a condition for receipt of funding pursuant to this section, Medicaid revenues attributable to the rate adjustments authorized by this section and any other additional facility revenues needed to cover scheduled debt service payments relating to the financing of an automatic sprinkler system that is in compliance with Federal regulation as described in this section, shall be deposited into a separate account maintained by the facility and the deposits in such account shall be used solely for the purpose of satisfying such debt service payments.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.34 Services not covered
(a) Specific services not covered.
(1) Blood (account 7250—Whole Blood and Packed Red Cells).
(2) Blood Plasma (account 7150—Drugs Sold).
(3) Special Appliances for patients:
(i) Chargeable (account 7110—Medical Supplies Sold).
(ii) Nonchargeable (cost center utilizing the appliance).
(4) Other (specify):
(b) Program services for which data is to be reported.
(1) Inpatients:
(i) Acute Care (accounts 6010 through 6290), plus
(ii) Intensive Care (accounts 6310 through 6410).
(2) Newborn Nursery (account 6510).
(3) Premature Nursery (account 6520).
(4) Other (specify).
(5) Emergency Services (account 6710).
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.8 Registrant continued-stay evaluation
The operator, directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, must ensure that a written comprehensive assessment and evaluation is completed pursuant to section 425.6 of this Part at least once every six months for each registrant, addressing the appropriateness of the registrant's continued stay in the program, such assessment and evaluation to address, at a minimum:
(a) a reassessment of the registrant's needs, including an interdisciplinary evaluation of the resident's need for continued services;
(b) the appropriateness of the registrant's continued stay in the program;
(c) the necessity and suitability of services provided; and
(d) the potential for transferring responsibility for or the care of the registrant to other more appropriate agencies or service providers.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.169 Hospital boarder
An individual who receives lodging in the hospital but who is not an inpatient. In most hospitals, a small number of persons who are not patients and who are not hospital personnel or physicians may, nevertheless, be occasionally provided with room and board, often in “areas of the hospital where patients generally stay at least overnight”. Most often this is arranged so that they can be near children or other members of the family who are ill.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.9 Approved courses of study; registration
(a) The board shall establish an acceptable course content outline for each of the five required courses specified in section 96.8 of this Part identifying the minimum subject areas and topics required to provide the applicant with the knowledge and skills necessary to serve as a nursing home administrator.
(b) The content outlines shall be made available to accredited academic institutions seeking prior approval by the board of their course(s) for the purpose of licensure.
(c) Academic institutions seeking prior approval of their course(s) shall follow the requirements set forth in section 96.10 of this Part.
(d) The board shall maintain a listing, available upon request, of approved courses offered by accredited academic institutions in each of the five subject areas, as such courses are approved by the board.
(e) Applicants may submit course materials for review by the board if the course does not have such prior approval. Courses approved in this manner shall be added to the listing of approved courses.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.28 Related organizations
(a) A related organization shall be defined as any entity which controls the facility or which the facility controls, either directly or indirectly, or an organization or institution whose actions or policies the facility has the power, directly or indirectly, to significantly influence or direct, or a special purpose organization or where an association of material interest exists in an entity which supplies goods and/or services to the facility, or any entity which is controlled directly or indirectly by the immediate family of the operator. Immediate family shall include each parent, child, spouse, brother, sister, first cousin, aunt and uncle, whether such relationship arises by reason of birth, marriage or adoption. A special purpose organization shall be defined as an organization which is established to conduct certain of the facility's patient-care-related or nonpatient-care related activities. The special purpose organization shall be considered to be related if:
(1) the facility controls the special purpose organization through contracts or other legal documents that allow direct authority over the organization's activities, management and policies; or
(2) the facility is, for all practical purposes, the sole beneficiary of the special organization's activities. The facility shall be considered the special purpose organization's sole beneficiary if one or more of the three following circumstances exist:
(i) a special purpose organization has solicited funds in the name of and with the expressed or implied approval of the facility, and substantially all the funds solicited by the organization were intended by the contributor or were otherwise required to be transferred to the facility or used at its discretion of direction;
(ii) the facility has transferred some of its resources to a special purpose organization, substantially all of whose resources are held for the benefit of the facility; or
(iii) the facility has assigned certain of its functions (such as the operation of a dormitory) to a special purpose organization that is operating primarily for the benefit of the facility.
(b) The costs of goods and/or services furnished to a facility by a related organization shall be included in the computation of the basic rate at the lower of the cost to the related organization or the market price of comparable goods and/or services available in the facility's region within the course of normal business operations.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 38 INFORMATION OBTAINED UNDER PROVISIONS OF STATE OR FEDERAL LAWS
10 CRR-NY 38.1 Confidential information
(a) Definition; restricted use.
All information as to personal facts and circumstances in the Maternal and Child Health and Crippled Children's Programs shall be considered privileged communications and shall be held confidential, and:
(1) except only in summary, statistical or other form which does not identify particular individuals; and
(2) except as may be necessary to provide services to individual mothers and children;
such records shall not be divulged without the consent of the patient, parent or guardian.
(b) Application; limitation.
This section shall apply to State, municipal, private and voluntary agencies. Information divulged to such agencies shall be confined to that necessary to achieve the specific purpose involved and shall be released only after appropriate assurances are received that the information will be held confidential in accordance with the provisions of this section.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.12 Availability and maintenance of CPA work papers
Every MCO shall require the CPA to make available for review by the commissioner all work papers prepared in the conduct of the CPA’s audit and any communications related to the audit between the CPA and the MCO, at the offices of the MCO, at the Health Department or at any other reasonable place designated by the commissioner. Every MCO shall require that the CPA retain the audit work papers and communications for six calendar years from the date of the audit report.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.6 Tissue processing facilities
A facility which processes ocular tissue shall be licensed by the department as a tissue processing facility. Such facilities shall make available to the department a statement of the procedures used in the preparation, testing and preservation of the tissue or tissues distributed, or offered for use. The premises, equipment, procedures, records, brochures and other informational materials, instructions, manufactured media and tissues shall be available for inspection and/or testing by the department as required. Copies of all general circulars of information and instructions, including descriptions of methods of tissue handling, shall be available to the department. Each container of tissue shall be clearly labeled with the donor identification code or a unique tissue identification number and collection date.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.5 Reporting requirements
(a) Providers shall report costs and maintain financial and statistical records in accordance with 14 NYCRR Subpart 635-4.
(b) Generally accepted accounting principles (GAAP). The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the provider unless the reporting instructions authorized specific variation in such principles. The State shall identify provider cost and providers shall submit cost data in accordance with generally accepted accounting principles (GAAP).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.31 New York State RHCF Nurse Aide Registry
(a) Content.
The New York State RHCF Nurse Aide Registry shall include but not be limited to the following information concerning each certified nurse aide as applicable/appropriate:
(1) full name of nurse aide, including maiden name and/or other surnames used;
(2) address of nurse aide when certified/recertified;
(3) date of birth;
(4) social security number;
(5) name and date of State-approved training and competency program(s) successfully completed;
(6) certification number of nurse aide with a descriptive modifier indicating how the nurse aide obtained certification;
(7) most recent recertification date of nurse aide;
(8) final findings of instances of resident abuse, mistreatment or neglect against a nurse aide with date of hearing or finding;
(9) the nursing home employer at the time of certification/recertification and date of employment by that employer;
(10) a record of criminal conviction for resident abuse, mistreatment, neglect or misappropriation of resident property against a nurse aide and the date of conviction; and
(11) a statement by the nurse aide disputing the findings or conviction that may not exceed 150 words, nor contain information which identifies other persons.
(b) Fees.
The New York State RHCF Nurse Aide Registry shall be supported and maintained by charging fees in accordance with Public Health Law, section 2803-j.
(c) Access.
The New York State RHCF Aide Registry shall be accessible by telephone, during the hours established by the Department, or in writing.
(d) Obtaining information by telephone.
The New York State RHCF Nurse Aide Registry shall provide the following information upon request to residential health care facilities, nurse aide agencies/employment organizations and nurse aide registries maintained by other states in response to a telephone inquiry:
(1) telephone verification that the individual is a certified nurse aide;
(2) an indication of findings of resident abuse, mistreatment or neglect or criminal convictions of resident abuse, mistreatment, neglect or misappropriation of resident property by a nurse aide; and
(3) follow-up documentation as described in subdivision (e) of this section.
(e) Obtaining written information.
New York State RHCF Nurse Aide Registry shall provide the following information upon the receipt of a written request, in accordance with the provisions of the Freedom of Information Law:
(1) verification that the individual is a certified nurse aide, the certification number and date of certification/recertification;
(2) copies of final findings of resident abuse, mistreatment or neglect by a nurse aide and a statement from the nurse aide disputing the findings, if any; and
(3) a report of a criminal conviction for resident abuse, mistreatment, neglect or misappropriation of resident property and the date of the conviction.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.201 Separability
If any provision of this Subpart is held invalid, such invalidity shall not affect other provisions which shall be given effect without the invalid provisions.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 452 BASIC CONCEPTS, REPORTING PRINCIPLES AND SPECIALIZED REPORTING AREAS
10 CRR-NY 452.1 purpose
The purpose of this Article is to establish a foundation for uniform reporting by residential health care facilities. In making their reports, such facilities will be bound by the basic principles and concepts set forth in this Article. Any reporting principles not specifically discussed herein should be reported according to generally accepted accounting principles as interpreted in the opinions of the American Institute of Certified Public Accountants (AICPA) and in the statements by the Financial Accounting Standards Board.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-3.11 Expenses prior to admission
Except when specifically authorized by the Commissioner of Health or his authorized representative, expenses incurred prior to admission for the purpose of complying with requirements for admission, other than authorized expenses incurred by State employees in the line of duty, shall not be a charge upon the State.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT INSTALLATION AND LOCATION EQUIPMENT INSTALLATION AND LOCATION
10 CRR-NY 14-1.100 Supplies and equipment; location
Supplies and equipment, including ice makers and ice storage equipment, are not to be located under exposed or unprotected sewer lines, open stairwells or other sources of contamination. This requirement does not apply to location under automatic fire protection sprinkler heads that may be required by law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.35 Disproportionate share limitations
(a) Disproportionate share payment distributions made to general hospitals pursuant to article 28 of the Public Health Law shall be limited in accordance with the provisions of this section. The latest available annual cost report submitted by a hospital prior to the disproportionate share distribution period shall be used to determine eligibility pursuant to subdivision (b) of this section and for projected limits pursuant to subdivision (e) of this section. Annual cost reports having an end date in the applicable annual disproportionate share distribution period, or for certain State-operated general hospitals, annual cost reports having an end date in the subsequent annual disproportionate share distribution period, shall be used to reconcile limits pursuant to subdivision (f) of this section.
(b) General hospitals whose inpatient Medicaid eligible patient days are less than one percent of total inpatient patient days shall not be eligible to receive disproportionate share distributions.
(c) No general hospital shall receive in total from disproportionate share payment distributions an amount which exceeds the costs incurred during the periods described in subdivision (a) of this section for furnishing inpatient and ambulatory hospital services to individuals who are eligible for medical assistance benefits pursuant to title XIX of the Federal Social Security Act (hereinafter referred to as “Medicaid cost”) or to individuals who have no health insurance for the services provided or other source of third party coverage (hereinafter referred to as “self-pay cost”), reduced by medical assistance payments made pursuant to title XIX of the Federal Social Security Act (hereinafter referred to as “Medicaid revenue”), other than disproportionate share payments, and payments by uninsured patients. For purposes of this section, payments to a general hospital for services provided to indigent patients made by the State or a unit of local government within the State shall not be considered a source of third party payment.
(d) In order to ensure the continued flow of disproportionate share payments to hospitals, the commissioner shall make projections of each hospital's disproportionate share limitation based on the most current data available from the hospital's annual cost reports. The commissioner shall use annual cost reports in accordance with the provisions of subdivision (e) of this section to estimate Medicaid and self-pay costs in the projection methodology for a particular rate year. This shall be referred to as the “projection methodology”. Subsequent to the receipt of a hospital's annual cost report having an end date in the applicable annual disproportionate share distribution period, or for certain State-operated general hospitals whose annual cost reports have an end date within the subsequent annual period, each hospital's disproportionate share limitation shall be reconciled to the actual rate year data. This shall be referred to as the “reconciliation methodology”.
(e) Projection methodology.
Each hospital's projected disproportionate share limitation for each rate year shall be the sum of its inpatient and outpatient Medicaid and uninsured gains/(losses) as calculated using reported base year data and statistics from the year two years immediately preceding the rate year and as used for projection methodology purposes for that prior year.
(f) Reconciliation methodology.
The commissioner shall revise the projected limitation based on actual data reported to the commissioner for such rate year in accordance with the following and in accordance with final regulations issued by the Federal Department of Health and Human Services implementing 42 USC section 1396r-4. The commissioner shall revise the projected limitations for each hospital within eight months from the date required reports are submitted to the department, except if such reports are determined to be unacceptable by the department. For hospitals which have submitted unacceptable reports, the commissioner shall revise the projected limitations within eight months from the date acceptable reports have been resubmitted to the department.
(1) Each hospital shall submit, by the same date the annual cost reports are required to be filed pursuant to section 86-1.2 of this Subpart, a disproportionate share limitation schedule in a form and manner prescribed by the commissioner within which the hospital shall calculate, in accordance with the instructions, its inpatient and outpatient Medicaid and self-pay gains/(losses) during the cost reporting year. The disproportionate share limitation schedule shall be accompanied by a certification by the hospital's independent public accountant which provides the commissioner sufficient assurance as to the accuracy of the information contained in such schedule.
(i) The final limit shall be calculated by excluding inpatient and outpatient Medicaid revenue impacts resulting from prospective adjustments to rates for periods prior to the implementation of the Federal hospital specific disproportionate share payment limits from the inpatient and outpatient Medicaid and self-pay gains/(losses) reported on the disproportionate share payment limitation schedule.
(2) Failure of a hospital to submit the information required by this section in a form acceptable to the commissioner shall result in the immediate withholding of all subsequent disproportionate share distributions. Such withholding shall continue until the hospital complies with the reporting requirements of this subdivision.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.22 Program evaluation
(a) Quality improvement.
The operator must develop and implement a quality improvement process that provides for an annual or more frequent review of the operator's program. Such evaluation must include a profile of the characteristics of the registrants admitted to the program, the services and degree of services most utilized, the length of stay and use rate, registrant need for care and services, and disposition upon discharge. The process must:
(1) include an evaluation of all services in order to enhance the quality of care and to identify actual or potential problems concerning service coordination and clinical performance;
(2) review accident and incident reports, registrant complaints and grievances and the actions taken to address problems identified by the process;
(3) develop and implement revised policies and practices to address problems found and the immediate and systematic causes of those problems; and
(4) assess the impact of the revisions implemented to determine if they were successful in preventing recurrence of past problems.
(b) The results of the quality improvement process must be reported to the chief executive officer, nursing home administrator or governing body.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
GENERAL GENERAL
10 CRR-NY 415.1 Basis and scope
(a) Statement of purpose.
(1) New York's residential health care facilities are responsible for the health and well-being of more than 100,000 residents ranging from infants with multiple impairments to young adults suffering from the sequelae of traumatic brain injury to the frail elderly with chronic disabilities. For the vast majority of residents, the residential health care facility is their last home. A license to operate a nursing home carries with it a special obligation to the residents who depend upon the facility to meet every basic human need.
(2) Each resident comes to the nursing home with unique life experiences, values, attitudes and desires, and a singular combination of clinical and psychological needs. In order to assure the highest practicable quality of life, the individuality of the nursing home resident must be recognized, and the exercise of self-determination protected and promoted, by the operator and staff of the facility. The physical environment, care policies and staff behavior must at once acknowledge the dependence of the residents while fostering their highest possible level of independence.
(3) In writing a code of minimum operating standards for nursing homes, it is also critical that the regulator recognize the infinite diversity of the nursing home population. A code intended to assure the highest possible quality of care and most meaningful quality of life for all residents must not only accept, but in fact invite variety in nursing home environments, policies and practices, and encourage creativity among nursing home managers and staff.
(4) In order to meet obligations to nursing home residents, this set of requirements, to the extent possible, expresses expectations for facility operation in terms of performance and outcomes rather than by dictating structure and process. It is the intent of these requirements to grant a high degree of latitude and flexibility to administrators and staff while insisting upon conformance to fundamental principles of individual rights and to accepted professional standards. In those areas where a detailed process or procedure is mandated, it is based upon a firm belief that experience has proven the specific practice to be necessary in all cases to assure the high quality of care we expect nursing homes to provide.
(5) In addition to the emphasis on individuality and self-determination, the code reflects certain precepts: that nursing homes should be viewed as homes as much as medical institutions, with the resident's psychosocial needs deserving a prominence at least equal to medical condition; that clinical interventions for the nursing home resident must be part of a comprehensive approach planned and provided by an interdisciplinary care team, with the participation of the resident, rather than through a physician-directed acute care orientation; and that quality assurance is a work ethic rather than an oversight method or a department.
(b) General information.
(1) Nursing homes, which shall include all facilities subject to article 28 of the Public Health Law and providing residential skilled nursing care and services and residential health-related care and services, shall provide such care and services in a manner and quality consistent with generally accepted standards of practice.
(2) In accordance with article 28 of the Public Health Law, nursing homes, as defined in section 415.2 of this Part, and which include facilities referred to elsewhere in this Title as skilled nursing facilities, health-related facilities or residential health care facilities, shall comply with all the requirements of this Part.
(3) Nursing homes shall comply with construction standards contained in Article 2 of Subchapter C of this Chapter (Medical Facility Construction).
(4) Nursing homes shall comply with all pertinent Federal, State and local laws, regulations, codes, standards and principles including but not limited to those pertaining to nondiscrimination on the basis of race, color, national origin, handicap, protection of human subjects of research and fraud and abuse and the Public Health Law, Mental Hygiene Law, Social Services Law and Education Law of the State of New York.
(5) The provisions of Parts 700 and 702, of Article 1 of Subchapter C of this Chapter shall not apply to nursing homes.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-2 REQUIRED SIGNAGE
10 CRR-NY 9-2.4 Severability
If any provisions of this Subpart or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Subpart or the application thereof to other persons, entities, and circumstances.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter F DISEASE REGISTRY
Part 62 ALZHEIMER'S DISEASE AND RELATED DISORDERS REGISTRY
10 CRR-NY 62.2 Confidentiality
Reports of Alzheimer's disease and all related disorders shall be kept confidential in accordance with Public Health Law, section 206.1(j).
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 142 SCHENECTADY COUNTY
VILLAGES VILLAGES
10 CRR-NY 142.2 Schenectady Aquifer, Schenectady County
(a) Applicability.
These rules and regulations herein set forth, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the sources of public water supply for the following municipal jurisdictions in Schenectady County:
City of Schenectady
Town of Glenville
Town of Niskayuna
Town of Rotterdam
Village of Scotia
This Part shall apply to any lands, premises and uses within the respective protection zones created herein and shown on the Intermunicipal Watershed Rules and Regulations Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990 and the Intermunicipal Watershed Rules and Regulations Municipal Property Inventory Maps, dated February 1990. Said map, or series of maps, all notations or other information shown thereon are part of this Part and are located in the office of the clerk of each municipality and the county. This Part is intended to be superimposed on the existing land use laws of each municipality served by the Schenectady Aquifer to augment and enhance those protective measures already in place. This Part shall in no way affect the limitations or requirements applicable in the underlying municipal land use and zoning districts.
(b) Definitions.
(1) Aboveground storage tank.
Any stationary tank which is not entirely covered with earth or other material, or any tank which can be inspected in a subterranean vault.
(2) Board.
The Intermunicipal Watershed Rules and Regulations Board comprised of the chief elected official of each of the municipal jurisdictions in Schenectady County served by the Schenectady Aquifer and established to enforce and administer this Part and to conduct the central review function of actions taking place within the designated protection zones. The board was established by adoption of an agreement for intermunicipal cooperation for an aquifer protection program, and was previously known as the watershed committee.
(3) Bulk storage.
The holding or containment of dry, semi-dry or liquid materials in large quantities as defined in Environmental Conservation Law, sections 596.1 and 612.1 or in related paragraphs of this section, either packaged or loose, usually dispensed in smaller quantities for sale, use or consumption.
(4) Chloride salt.
Any bulk quantities of chloride compounds and other deicing compounds excluding liquid chlorides intended for application to roads, including mixtures of sand and chloride compounds in any proportion where the chloride compounds constitute over eight percent of the mixture. If any portion of a bulk quantity of chloride compounds or chloride-and-sand mixture is intended for application to roadways, then the entire bulk quantity is road salt. A bulk quantity of chloride compounds means a quantity of 1,000 pounds or more, but does not include any chloride compounds in a solid form, including granules, which are packaged in waterproof bags or containers which do not exceed 100 pounds each.
(5) Fertilizer.
Any commercially produced mixture generally containing phosphorus, nitrogen and/or potassium which is applied to the ground to provide nutrients to plants.
(6) General aquifer recharge zone.
The land outside the primary recharge zone through which runoff and precipitation flow directly and rapidly into the ground, also to be known as Zone III. (See Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990.)
(7) Groundwater.
Any water beneath the land surface in the saturated zone.
(8) Hazardous material.
Any substance listed in either 6 NYCRR Part 371, or 6 NYCRR Part 597, alone or in combination, including but not limited to petroleum products, organic chemical solvents, heavy metal sludges, acids with a pH less than or equal to 2, alkalies with a pH greater than or equal to 12.5, radioactive substances, pathogenic or infectious wastes or any material exhibiting the characteristics of ignitability, corrosivity, reactivity or EP toxicity.
(9) Human excreta.
Human feces and urine.
(10) Linear distance.
The shortest horizontal distance from the nearest point of a structure or object to the boundary of any protection zone, or to the edge, margin or steep bank forming the ordinary high water line of a water body.
(11) Municipal water purveyor.
The local official responsible for the operation, maintenance, and provision of the public water supply in each of the communities served by the Schenectady Aquifer also to be known as the Superintendent of Water in the City of Schenectady, the Superintendent of Public Works in the Village of Scotia, the Superintendent of Water in the Town of Glenville, the Commissioner of Public Works in the Town of Niskayuna and the Commissioner of Public Works in the Town of Rotterdam.
(12) Nonconforming use.
A building, structure or permitted use of land lawfully existing at the time of the effective date of this Part or any amendments thereto and which does not conform to the standards and prohibitions of the protection zone within which it is situated.
(13) Onsite disposal system.
Any system used for the disposal of sewage on a site or parcel of land.
(14) Open storage.
The holding of a material in a way that the material is exposed to the elements of nature.
(15) Pesticide.
Any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any pest, and any substance or mixture of substances intended for use as a plant regulator, defoliant or desiccant, and being those substances defined as pesticides pursuant to Environmental Conservation Law, section 33-0101 et seq.
(16) Primary recharge zone.
Those land areas of general aquifer recharge that contribute groundwater to the public wells, including and encompassing the wellhead protection zone, also to be known as Zone II. (See Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990.)
(17) Protection zones.
Specific areas, also known as Zones I-IV, that define a hierarchy of aquifer sensitive land as designated and described herein and delineated on the Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990.
(18) Radiation.
Ionizing radiation, that is, any alpha-particle, beta particle, gamma ray, X-ray, neutron, high speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(19) Radioactive material.
Any material in any form that emits radiation spontaneously.
(20) Salvage yards.
An area where four or more unregistered, old or second hand motor vehicles are being accumulated for disposal, resale of used parts or reclaiming certain materials such as metal, gas, fabric and/or the like.
(21) Schenectady Aquifer.
The saturated and overlying unsaturated geologic formations generally existing in the Mohawk Valley lowland areas within the municipal boundaries of the City of Schenectady, Village of Scotia, and the Towns of Rotterdam, Glenville, Niskayuna and Princetown.
(22) Septage.
The contents of a septic tank, cesspool, or other individual wastewater treatment work which receives domestic sewage wastes.
(23) Sewage.
Any liquid, semi-liquid or solid human or animal waste matter from a domestic, commercial, private or industrial establishment or other place with such groundwater infiltration and surface water as may be present including mixtures of sewage with industrial wastes or other wastes as defined in section 17-0105 of article 17 of the New York State Environmental Conservation Law.
(24) Sludge.
Any solid, semisolid or liquid waste generated from a wastewater treatment plant, water supply treatment plant, or air pollution control facility but does not include the treated effluent from a wastewater treatment plant.
(25) Solid waste.
All putrescible and nonputrescible materials or substances that are discarded or rejected including but not limited to garbage, refuse, industrial and commercial waste, sludges, rubbish, tires, ashes, contained gaseous material, incinerator residue, demolition and construction debris, discarded automobiles and offal; but not including those exclusions contained in 6 NYCRR 360-1.2(a)(4).
(26) Spill.
Any unpermitted releasing, spilling, discharging, leaking, pumping, pouring, emitting, emptying or dumping of a petroleum product, or any other hazardous material so that such substance, products or materials may enter the environment, regardless of whether such entry was the result of intentional or unintentional action or omission.
(27) Solid waste management facility.
Any facility employed beyond the initial solid waste collection process including, but not limited to, transfer stations, bailing facilities, rail haul or barge haul facilities, processing systems, including resource recovery facilities or other facilities for reducing solid waste volume, sanitary landfills, facilities for the disposal of construction and demolition debris, plants and facilities for compacting, composting or pyrolization of solid wastes, incinerators and other solid waste disposal, reduction or conversion facilities, as defined in Environmental Conservation Law, section 27-0701 et seq.
(28) Tributary watershed zone.
Land outside the aquifer area that contributes runoff overland and/or through surface streams for groundwater recharge, also known a Zone IV. (See Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990.)
(29) Underground injection.
The subsurface emplacement of fluids through a bored, drilled, or driven well; or through a dug well, where the depth of the dug well is greater than the surface dimensions, including but not limited to the use of this procedure for the production of oil or gas or the excavation of minerals.
(30) Underground storage tank.
Any tank completely covered with earth or other material such as concrete, pavement, or other material which visually restricts the identification of leaks. Tanks in subterranean vaults accessible for inspections are considered above ground tanks.
(31) Waste treatment facility.
Any facility used for treating, neutralizing, stabilizing or disposing of sewage, but excluding small scale septic systems and leach fields serving fewer than five residential units.
(32) Water body.
Any river, stream, spring, pond, lake, reservoir or channel of water or any man-made culvert which flows directly into one of the aforementioned.
(33) Wellhead protection zone.
The surface extent of the cone of depression, immediately adjacent to the public wells, also known as Zone I. (See Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990.)
(c)
(1) General provisions.
(i) The manufacture, use, storage, disposal, or discharge of any products, materials, or by-products, such as wastewater, solid waste, hazardous waste or any pollutant within the identified protection zones which may adversely affect the quality of water supply sources must conform to the requirements of this Part.
(ii) Where groundwater deterioration is likely to be caused by land development, municipal officials shall insure that appropriate zoning or other controls are carried out to prevent groundwater contamination.
(2) Accidental spills.
Within any of the herein defined Protection Zones, any person who is the owner of, or in actual or constructive possession or control of a hazardous material, or any agent or employee thereof, or any person in a contractual relationship therewith, who is responsible for, or has knowledge of any spill, as defined in subdivision (b) of this section, of any petroleum, hazardous material, toxic substance or radioactive material to the ground surface or any water body, which is likely to have any adverse affect on water quality or quantity, shall notify the appropriate municipal water purveyor, the New York State Departments of Environmental Conservation and Health, as described in subparagraphs (i) and (ii) of this paragraph. The municipal water purveyor shall notify all other appropriate agencies and the board of any spill.
(i) All spills shall be reported to the appropriate municipal water purveyor and the New York State Department of Environmental Conservation within two hours of such spill, or when knowledge of such spill is obtained, and shall be addressed in accordance with the provisions of article 12 of the Navigation Law, sections 170 through 197, and article 17 of the New York State Environmental Conservation Law. Cleanup of spills is the responsibility of the owners; in case of material in transit, cleanup is the responsibility of the carrier.
(ii) The State Department of Health shall be advised of any spills within 12 hours.
(3) SPDES permits.
Within any of the herein defined protection zones, all applicants for the permit pursuant to the New York State Pollutant Discharge Elimination System (SPDES) shall simultaneously submit a copy of the application to the New York State Department of Environmental Conservation and the appropriate municipal water purveyor. The municipal water purveyor shall send a copy of this application to the board for its information.
(4) Exceptions.
Exception to the rules and regulations may be granted by the Commissioner of the New York State Department of Health after appropriate study and review, based on prior usage and unique local conditions if, in his judgement, the health and safety of the consuming public will be protected because of treatment provided or other remedial action taken. Such exceptions shall be in writing. Hearings may be held at the commissioner's discretion.
(5) Protection zone boundary adjustments.
(i) When the location of a protection zone boundary, as shown on the adopted Schenectady Aquifer Protection Zone Map, Plate #1, dated February 1990, is disputed by any owner or abutter affected by said boundary, the owner or abutter at his own expense may engage a licensed engineer or professional hydrogeologist to conduct such investigations as are necessary to determine if a discrepancy exists in the mapped boundary.
(ii) The owner or abutter shall submit all pertinent findings to the appropriate municipal water purveyor. The municipal water purveyor shall transmit the submission to the board. The board shall investigate and hear evidence regarding the proposed adjustment and make a recommendation to the appropriate municipality. The appropriate municipality shall in turn, hear evidence regarding the proposed boundary zone adjustment and make a recommendation to the commissioner. The commissioner shall act to grant, grant with conditions, or deny a boundary adjustment request.
(iii) All amendments and adjustments to a protection zone boundary or designation, granted by the commissioner, shall be officially recorded on the Intermunicipal Watershed Rules and Regulations Schenectady Aquifer Protection Zones Map, Plate #1, dated February 1990. The board shall transmit to the Commissioner of the New York State Department of Health, a copy of any such recorded amendments or adjustments.
(6) Nonconforming buildings, structures and/or uses. Nonconforming buildings, structures or use of land may be continued subject to the owner of such building, structure or use of land demonstrating compliance with conditions set forth in subparagraphs (i) through (iii) of this paragraph. No nonconforming building, structure or use of land shall be enlarged, altered or extended in any manner without a site plan review and specific prior approval by the local water purveyor. No nonconforming building, structure or use of land, many be modified in any way which is determined, by the local water purveyor, to increase its threat to the groundwater or otherwise contravene the purpose and intent of these watershed rules and regulations; however, in no event shall a nonconforming building, structure or use be permitted to expand, enlarge or extend the capacity to store or handle any materials or substances which may be a threat to the Schenectady Aquifer, including, but not limited to, pesticides, fertilizers, chloride salt, septage, sewage, sludge, solid waste, hazardous materials, or radioactive materials. If any nonconforming use is stopped for a period of six months, or more, it shall permanently desist. Any new building, structure or use of land shall conform to the purpose, intent and literal provisions of this Part, and any amendment thereto. A nonconforming use of land may only be changed to a conforming use of land. Compliance conditions:
(i) provide a written report to the appropriate municipal water purveyor with the following information at least annually and/or on the occurrence of the following:
(a) change in operation;
(b) any intended sale(s) of property;
(c) results of state agencies' programs including, without limitations, test results and audits from such programs as petroleum or chemical bulk storage, Resources Conservation and Recovery Act (RCRA), etc. The owner shall be responsible to immediately remove the contamination from the aquifer;
(d) accidental spills (see paragraph [c][2] of this section).
(ii) develop and carry out a plan to protect the aquifer from potential contamination associated with land use activities. The plan must be approved by the appropriate local water purveyor and must include:
(a) restrictions or management of activities on the property;
(b) dams/berms (revised drainage control) planned;
(c) identification and development of operating procedures for potential pollution activities ( i.e., changing oil of a car); and
(d) disposal procedures for hazardous material.
(iii) should implementation of the plan described in subparagraph (ii) of this paragraph not prevent contamination of the aquifer or any portion thereof, the owner shall immediately cease the offending activity and initiate remedial actions to remove the contamination from the aquifer as required by the agency having jurisdiction.
(d) Specific regulations.
Zone IV tributary watershed zone.
(1) The discharge or disposal of any hazardous material, or radioactive material except as may be authorized pursuant to a permit issued by the New York State Department of Environmental Conservation or the New York State Department of Health, is prohibited.
(2) The discharge, land application, burial or disposal of any septage, sewage, sludge, animal wastes, animal remains or human excreta within 100 feet of any waterbody is prohibited, except as allowed by a valid permit issued by the New York State Department of Environmental Conservation or the New York State Department of Health or for agricultural uses consistent with appropriate best management practices which have been endorsed by the board (see Schenectady Aquifer Schenectady Intermunicipal Watershed Rules and Regulations Administrative Procedures Manual filed at each municipal clerks office).
(3) The dumping or disposing of snow or ice collected offsite from roadways or parking areas within 50 feet of any water body is prohibited.
(4) The open storage of agricultural chemicals and pesticides within 50 feet linear distance of any water body is prohibited.
(5) The open storage of coal or chloride salts within 50 feet linear distance of any water body is prohibited.
(e) Specific regulation.
Zone III general aquifer recharge zone. Except to the extent that broader prohibitions or more stringent limitations and requirements are set forth in this subdivision, all regulations and provisions applicable to Zone IV shall also apply to Zone III. In addition:
(1) The construction, installation, maintenance or use of any aboveground storage facility that discharges any petroleum product, hazardous material or toxic substance into the groundwater or into any water body except as allowed by a valid SPDES permit, is prohibited.
(2) The establishment of any raw waste landfill, ash landfill, construction/demolition landfill, junk yard, salvage yard or dump is prohibited.
(3) Underground injection is prohibited, with the sole exception of underground injection activities specifically and directly related to development or maintenance of water supply wells. Except for single family residences, proposals to undertake water supply well development or maintenance related underground injection require prior review and approval from the appropriate municipal water purveyor.
(4) The above-ground discharge, land application or disposal of any septage, sewage, sludge, animal wastes, animal remains or human excreta is prohibited, except for agricultural uses consistent with appropriate best management practices which have been endorsed by the board (see Schenectady Aquifer Schenectady Intermunicipal Watershed Rules and Regulations Administrative Procedures Manual filed at each municipal clerks office).
(5) The dumping or disposing of snow or ice collected offsite from roadways or parking areas into or within 100 feet of any water body is prohibited.
(6) The open storage of pesticides for wholesale, retail or commercial agricultural purposes is prohibited.
(7) The bulk storage of coal or chloride salts is prohibited except in structures designed to prevent the entrance of precipitation and constructed on low permeability pads which control seepage and runoff.
(8) The owner of any aboveground or underground storage facility existing on the effective date of this Part shall notify the appropriate municipal water purveyor and all other appropriate agencies of any leak or spill promptly on its discovery. The owner shall immediately undertake any such actions as may be necessary to prevent contamination of the groundwater. The municipal water purveyor shall send this information to the board and all other involved or interested agencies.
(9) The drilling, construction, installation, discontinuance and abandonment of all individual or private water supply wells shall comply with the requirements and standards of the Department of Health. (See Subpart 5-2 of this Title.)
(10) Any underground storage facility that is out of service for more than one year shall be removed. Any liquid residue shall be removed from the facility, and all connecting lines shall be securely capped or plugged.
(11) Sanitary sewer lines, pipes and mains shall not allow exfiltration or infiltration to exceed 200 gallons per inch of pipe diameter per mile per day for any section of the sewerage system. (See Recommended Standards for Wastewater Facilities, 1990 Edition, Great Lakes-Upper Mississippi River Board of State Public Health and Environmental Managers, section 33.9.)
(f) Specific regulations.
Zone II primary recharge zone. Except to the extent that broader prohibitions or more stringent limitations and requirements are set forth in this subdivision, all regulations and provisions applicable to Zones IV and III shall also apply to Zone II. In addition:
(1) Uses that pose a substantial risk to groundwater quality because of associated storage, use or handling of hazardous materials, as defined by 6 NYCRR Part 595 and Part 612, are prohibited. These uses include but are not limited to motor vehicle repair and body shops; trucking or bus terminals; coin or commercial laundries; dry cleaning and dyeing establishments; furniture stripping and refinishing operations; printing and photographic processing plants; salvage yards; and the storage for sale of gasoline, diesel fuel, heating oil, lubricants, anti-freeze, solvents or agricultural or industrial chemicals.
(2) The commercial excavation or extraction of soils, sands and gravels, except for those existing mining operations authorized by the Department of Environmental Conservation under article 23, title 27 of the Environmental Conservation Law, is prohibited.
(3) The introduction into an existing onsite disposal system of any hazardous material is prohibited.
(4) The establishment of any solid waste management or waste treatment facility, is prohibited.
(5) The installation of any underground storage facility is prohibited.
(6) The interment of human or animal remains is prohibited.
(7) The dumping or disposing of snow or ice collected offsite from roadways or parking areas is prohibited.
(8) Approval is required from the appropriate municipal building inspector before the installation of any new onsite disposal system or the replacement or expansion of any existing onsite disposal system. Conditions for approval shall include an approved engineering plan, a site specific soils analysis, verification of the site's percolation rate and inspection of the site before backfilling. A copy of the approval will be sent to the water purveyor.
(9) The appropriate municipal water purveyor must be notified before the spreading, application or use of any pesticide for commercial and agricultural purposes. Notification shall include a description of the area to be covered and identification of the type and volume of the material to be used.
(g) Specific regulation.
Zone I wellhead protection zone. Except to the extent that broader prohibitions or more stringent limitations and requirements are set forth in this subdivision, all regulations and provisions applicable to Zones IV, III, and II shall also apply to Zone I. In addition:
(1) All land uses and development activities other than those directly connected with the pumping and treatment of public water supplies, are prohibited, except for single-family residences and existing transportation corridors, to which the relevant restrictions of these regulations shall apply.
(2) The storage or handling of any septage, sewage, sludge, animal wastes, human excreta, hazardous material or radioactive material, except for existing single-family residences, to which the relevant restrictions of these regulations shall apply and except for fuels and chemicals necessary for pumping and treatment of water supply wells, is prohibited.
(3) The bulk storage of coal or chloride salts is prohibited.
(4) The use of pesticides for commercial/agricultural purposes is prohibited.
(5) No filling, excavation or dredging, other than those activities specifically referred to in paragraph (f)(2) of this subdivision, is permitted without prior approval of the appropriate municipal purveyor. An application for such an approval must be accompanied by a site plan. The approval shall not be granted unless the applicant can demonstrate that the proposed activity will not result in adverse water quantity impacts or the contravention of water quality standards set forth in 6 NYCRR Part 703.
(h) Inspections.
Each municipality which has protection zones, or portions of protection zones, within its municipal jurisdiction, shall make periodic inspections of all properties within the boundaries of such zones, consistent with all constitutional limitations, to verify conformance with this Part. These inspections shall be conducted by the municipal water purveyor, or designated municipal official, having jurisdiction, at least one time annually. Before January 1st of each year the municipal water purveyor shall make a report to the board describing the results of these inspections together with any other information relevant to the enforcement and administration of this Part. Information necessary to demonstrate compliance shall be submitted at the request of the municipal water purveyor. The aforesaid shall cause copies of any provisions violated to be served on the person violating same together with notices of such violations. If said person does not immediately comply, the municipal water purveyor shall promptly notify the board and the State Commissioner of Health of such violations. The board shall make annual reports to the State Commissioner of Health, before January 30th, including such information on number of inspections, violations found, notices served, violations abated, the general condition of the resource and any other information relevant to the enforcement and administration of this Part.
(i) Variances.
(1) Standards.
An owner who experiences practical difficulty or unnecessary hardship because of the literal interpretation of the provisions of this Part may request a hearing by the Commissioner of Health. The commissioner may grant a variance from the requirements of this Part if the commissioner finds that the health, welfare and safety of the consuming public will be protected. In making this determination, the commissioner shall consider the following factors and make findings regarding each:
(i) whether the use or activity to be authorized by the waiver or variance is in harmony with the purpose and intent of this Part;
(ii) whether a substantial change will be produced in the general condition of the resource or a substantial risk to groundwater quality or quantity will be created because of the variance;
(iii) whether the hardship or difficulty can be alleviated by some other method that is feasible for the applicant to pursue;
(iv) whether the variance requested is the minimum variance necessary to afford relief. To this end, the Health Department may grant a lesser variance than that applied for; or
(v) whether the hardship or difficulty has not been created by the applicant.
(2) Decision of the commissioner.
The commissioner may request the local water purveyor and the board to review any application for a variance before reaching a determination regarding the request. The commissioner may impose such conditions as it may deem necessary to serve the purpose and intent of this Part. The commissioner shall act on all requests within 60 days of a variance application. Failure to act within this 60-day period shall be deemed a denial of the application. Every decision of the Health Department to grant, grant with conditions or deny a variance request shall be made in writing and served on the applicant and shall include all findings made regarding the aforementioned factors. All conditions shall be expressly set forth and the reasons for such conditions specified. Violations of the conditions of a variance shall be a violation of this Part. The issuance of a variance shall not authorize the establishment or extension of any use nor the construction of any structure but shall merely authorize the filing of an application for any permit or approval that may be required by the municipality which such action is proposed.
(3) Variance application procedure.
Applications for a variance shall be submitted to the appropriate municipal water purveyor by registered mail and shall contain at least the following information:
(i) the applicant's name, address and his interest in the subject property; or the owner's name and address, if different from the applicant, and the owner's signed consent to file the application;
(ii) the protection zone location, along with the street address and legal description of the subject property;
(iii) a narrative description of the proposed use or action together with any other pertinent information that may be necessary to adequately review the application;
(iv) a sketch plan illustrating all proposed site alterations, all structures existing onsite, the existing uses and zoning of adjacent parcels, site contours and drainage patterns;
(v) a statement articulating the hardship or difficulty imposed by the enforcement and administration of this Part with specific reference to the factors listed in this Part;
(vi) a statement assessing the potential impact on groundwater quality of the use or activity to be authorized by the waiver or variance; and
(vii) a plan and annual report as described in subparagraphs (c)(6)(i) and (ii) of this section where applicable.
(j) Penalties for violations.
Any person, firm or corporation who violates, disobeys, refuses to comply with or resists the enforcement of this Part shall be subject to those penalties specified in section 1103 of the Public Health Law. Any such violation may be enjoined subject to sections 1102, 1104 and 1105 of the Public Health Law.
(k) Amendments.
The board, from time to time, on its own motion or on a recommendation from any communities in Schenectady County served by the Schenectady Aquifer, as specified in subdivision (a) of this section, may propose to amend, supplement or change the provisions of this Part. In proposing any amendment, supplement or change, the board shall, in writing, state the reasons for such action. No amendment, supplement or change proposed by the board shall be considered for adoption as a valid part of this Part until it is duly approved by resolution of the governing bodies of each of the communities in Schenectady County served by the Schenectady Aquifer, as specified in subdivision (a) of this section, adopted by the State Commissioner of Health, and filed in the Office of the Secretary of State. Nothing contained herein shall be construed to impair the authority of the State Commissioner of Health to make rules and regulations for the protection from contamination of any or all public supplies of potable waters and water supplies of this State.
(l) Separability.
If any section, paragraph or part of this Part is for any reason declared invalid or held unconstitutional by any court of last resort, every other section, paragraph and part shall continue in full force and effect.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.92 Equipment lubrication
Equipment containing bearings and gears requiring lubricants is to be designed and constructed so that the lubricant cannot leak, drip or be forced into the food or onto food-contact surfaces. Food-grade lubricants are to be used on or within food-contact surfaces.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.10 Nursing services
The operator, directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, must:
(a) evaluate the need of each registrant for nursing care on a periodic and continuing basis, but not less often than quarterly, and, when appropriate, provide or authorize such care;
(b) ensure that a registered professional nurse is on-site and performs a nursing evaluation of each registrant at the time of admission to the program, unless such nursing evaluation has been performed by the managed long term care plan or care coordination model prior to referring the registrant to the adult day health care program;
(c) ensure that for each registrant the findings of the nursing evaluation, the nursing care plan, and recommendations for nursing follow-up are documented, dated and signed in the registrant's clinical record;
(d) ensure that nursing services are provided to registrants under the direction of a registered professional nurse who is on-site in the adult day health care program during all hours of the program operation. Based on the care needs of the registrants, for a program located at the sponsoring licensed residential health care facility, a licensed practical nurse may provide the on-site services when a registered professional nurse is available in the nursing home or on the campus to provide immediate direction or consultation; and
(e) ensure that appropriate health education is provided to registrants and family members to provide support for the registrant and family in understanding and dealing with the registrant's health condition as it relates to his/her continued ability to reside in the community. With respect to registrants referred to the adult day health care program by a managed long term care plan or care coordination model, the managed long term care plan or care coordination model shall be responsible for compliance with the requirements of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY
10 CRR-NY 85.3 Deferrable surgery
(a) To be a covered benefit under medical assistance for the needy as provided in section 365-a(5)(c) of the Social Services Law, any surgery not coverable as emergency or urgent surgery under section 365-a(5)(a) or which does not meet standards for surgical intervention under section 365-a(5)(b) shall require a determination of coverability by a person designated by the Commissioner of Health prior to admission. A determination of coverability shall be based on the likelihood that deferral of the proposed surgery for six months or more may jeopardize life or essential function, or cause severe pain.
(b) A determination of coverability shall be for a specified period of time not to exceed the 50th percentile of length of stay norms for comparable patients which have been authorized by the commissioner or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in section 85.5(a) of this Part, such specified period of time shall not exceed the 40th day of stay. Subsequent to this initial determination of coverability, extensions of benefit coverability shall be subject to length of stay limitations of sections 85.5 and 85.7 of this Part.
(c) The required determination of coverability shall be initiated by written request from the proposing surgeon, with information adequate for making the determination. A determination of coverability shall be made by a designated physician or non-physician under supervision of a designated physician. A determination of non-coverability shall be made only by a physician.
(d) Prior to making a determination, the designated person may require a written second opinion from a qualified specialist designated by the Commissioner of Health. A written second opinion shall be based upon an examination of the patient and a review of information about the patient provided by the proposing surgeon. A second written opinion under this section shall in every instance by required for the following surgical procedures except when performed as urgent or emergency surgery as set forth in this Part, or when not required under the provisions of the children and youth with special health care needs support services program:
(1) tonsillectomy and/or adenoidectomy.
(2) herniorrhapy.
(3) hemorrhoidectomy.
(4) hysterectomy.
(5) cholecystectomy.
(6) spinal fusion or laminectomy.
(7) joint cartilage surgery.
(e) If, in any area, reasonable patient access to specialists designated to give second opinion is lacking, the Commissioner of Health may provide for other mechanisms to assist his designee in making deterination of coverability.
(f) A written second opinion may be required by the department for any deferrable surgery to be performed within specific hospitals or by specific surgeons when review reveals unusual, aberrant or questionable practices, or practices not in conformity with provisions of this section.
(g) Notice of determination shall be given to the proposing surgeon who shall, if coverability is determined, incorporate such notice in the hospital record at admission.
(h) The proposing surgeon may appeal any determination of non-coverability to a physician or physicians designated by the Commissioner of Health for such purpose. Notification of decision on appeal shall be given to the proposing surgeon who shall incorporate any notice of determination of coverability in the hospital record at admission.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.191 Preoperational review
It is the responsibility of the operator of a mobile food service establishment or pushcart to construct, equip, furnish, maintain and operate the mobile food service establishment or pushcart under his control in compliance with the requirements of this Subpart and other applicable laws, rules and regulations. Prior to constructing, major renovation, or commencing operation of a mobile food service establishment or pushcart, the permit-issuing official may require all mobile food service establishments and pushcarts under his control to submit sketches or plans showing the floor layout, equipment, plumbing, ventilation, refuse storage facilities, sewage disposal facilities and similar information. Submission and review of plans does not relieve the operator of a food service establishment or his successor from meeting all requirements of this code.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.12 Need methodology for acquisition of magnetic resonance imagers
(a) This methodology will be utilized to evaluate certificate of need applications, submitted by facilities other than general hospitals, involving the acquisition of magnetic resonance imagers (MRI). It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of magnetic resonance imagers. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate number of MRI units available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors and methodology for determining the public need for MRI units shall include, but not be limited to the following:
(1) The need for MRI units will be planned for on a Health Systems Agency (HSA) region basis using a formula based on the number of CT scans performed in the region as follows:
(i) The total CT scans performed in an HSA region is reduced by 15 percent to account for patients that are not suitable for MRI studies due to the presence of pacemakers and motion problems.
(ii) Of the remaining number of CT scans, 60 percent will be deemed to be studies of the central nervous system (CNS).
(iii) 55 percent of the patients that receive CT scans of the CNS will be deemed to be candidates for an MRI scan.
(iv) The resulting number is increased by 30 percent to account for MRI studies of areas other than the CNS.
(v) Each MRI has an annual capacity for 3,200 scans.
(vi) The estimated number of MRI scans for the HSA region is divided by 3,200 to determine the number of MRI units which are needed.
(2) In addition, each applicant applying to acquire an MRI unit must meet the following standards:
(i) Each applicant must demonstrate the availability of appropriate equipment in the areas of computed tomography, ultrasound, angiography, conventional radiography and nuclear medicine.
(ii) Each applicant must demonstrate the availability of neurologists, neurosurgeons, orthopedists, oncologists and radiologists who meet the definition of qualified specialists.
(iii) Each applicant must submit a plan to develop referral agreements with all facilities in the relevant service area.
(3) When public need is established, priority consideration will be given to applicants who agree to serve the medically indigent and patients regardless of source of payment.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.22 Spitting
Spitting on floors and in sinks shall be prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.3 Interest on capital debt
This functional reporting center must contain all interest on capital, mortgage rates and other loans for the acquisition of equipment.
(a) Standard unit of measure: total operating expenses.
The total operating expenses of the facility, less depreciation and lease costs for land, buildings and fixed equipment, and interest on capital debt.
(b) Data source.
The costs shall be determined from the general accounting records.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.113 Drainboards
Drainboards of adequate size are to be provided and used for the proper handling of solid items prior to washing and of clean items following sanitization. Drainboards are to be self-draining and to be located and constructed so that they do not interfere with the proper use of the dishwashing facilities. Use of easily movable tables for the storage of clean items following sanitization is allowed.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.2 Purpose and findings
(a) The quality of the drinking water supplied to the city and upstate communities which draw from the New York City water supply depends primarily on the quality of the source waters which feed the reservoirs. The source waters and reservoirs are vulnerable to degradation and contamination from various sources and activities, including, but not limited to:
(1) wastewater discharges to surface water and groundwater;
(2) urban, suburban, rural, mining, silvicultural and agricultural land use practices that result in nonpoint source runoff of pollution and/or in adverse changes in the natural rate at which water flows into and through a delineated drainage basin; and
(3) improper use, handling, storage, transport and/or disposal of substances, including but not limited to, hazardous substances, radioactive materials, pesticides, fertilizers, winter highway maintenance materials, solid wastes, and animal wastes.
(b) The department finds that such sources and activities, either alone or in conjunction with any other related activities, may constitute a source of contamination to or degradation of the water supply, may cause a contravention of the State water quality standards set forth in Parts 701-705 of Title 6 NYCRR, and Subpart 128-4 of this Part, and may result in the impairment of the use of the water supply for drinking, culinary or food processing purposes.
(c) In response to the Safe Drinking Water Act Amendments of 1986, the United States Environmental Protection Agency has begun implementing a significant expansion of regulatory requirements for public water systems. In order to protect the public health, and to satisfy the legislative mandates of the Safe Drinking Water Act Amendments and the rules and regulations in 40 CFR parts 141 and 142, the New York State Department of Health has amended the State Sanitary Code, Part 5 of this Title and Subpart 5-1 of this Title, Public Water Systems, which contains New York State's Surface Water Treatment Rule. Although both Federal and State law propose filtration as a method for water quality treatment for pathogen control, the effectiveness of the filtration process and complexity of plant operation is dependent upon the quality of the water entering the filtration plant. In addition, many contaminants are not removed by conventional filtration. Therefore, it is clear that enhancement of the city's existing watershed rules and regulations would be necessary even if the city were to build filtration plants to filter its entire water supply.
(d) It is the goal and intent of these rules and regulations to protect the public health by averting future contamination to and degradation of the water supply and by remediating existing sources of pollution or degradation of the New York City water supply. These rules and regulations implement the department's intention to minimize the discharge of pollutants into the source waters from both point and nonpoint sources, minimize the adverse impacts of erosion, limit the discharge of phosphorus to source waters which may accelerate the eutrophication process, and provide notification to the city of ongoing or proposed activities, which either alone or in conjunction with other existing and proposed regulated activities, may cause contamination to or degradation of the water supply.
(e) It is the purpose of these rules and regulations to insure compliance with the Federal and State standards by providing a comprehensive watershed protection program. Furthermore, these rules and regulations articulate an anti-degradation policy for the New York City water supply system. These rules and regulations are promulgated to govern those activities in the watershed that threaten the quality of the water supply of the numerous upstate communities and the City of New York. While bound by its responsibility to protect the public health, the city has also taken the needs of the communities and businesses in the New York City watershed into consideration in drafting and promulgating these rules and regulations.
(f) The city reserves the right to re-examine these rules and regulations periodically to insure that they continue to further the goal and intent referred to in subdivision (d) of this section and the purposes referred to in subdivision (e) of this section. Without limiting the foregoing, and without limiting the city's rights to continue, modify, amend, suspend, waive or revoke any or all of these rules and regulations at any time in accordance with applicable law, the city intends to re-examine these rules and regulations 10 years after the effective date hereof to ascertain whether, and to what extent, these rules and regulations should be modified or amended so that they continue to serve their intended purposes.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.21 Operator and operating records
(a) Each swimming pool shall be maintained by a pool operator familiar with its equipment. The pool operator shall comply with the regulations in this Subpart and any conditions of the permit.
(b) All pools larger than 3,000 square feet in surface area, or pools disinfected using gas chlorine, shall be maintained by a qualified swimming pool water treatment operator within one year of the effective date of this section [March 30, 1988].
(c) Complete daily operation records shall be kept of the operation of each swimming pool on forms approved or furnished by the State Commissioner of Health. Upon completion, a copy of such records shall be maintained at the facility for 12 months. The permit-issuing official may require submission of reports at periodic intervals.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 85.17 Notification of Department of Social Services
When a determination is made pursuant to paragraph (f)(1), (2) or (3) of section 85.16 of this Part, the area office shall notify the appropriate social services district official of the determination and forward a copy of the patient review forms (PRI and SCREEN), and the utilization review agent physician's statement of the change in the patient's or resident's medical condition or other circumstances justifying the transfer. The social services district office shall notify the patient or resident, the patient's or resident's attending physician, the facility administrator, and the patient's or resident's next of kin or designated representative, of the adverse decision and the patient's or resident's fair hearing rights.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.8 Withdrawals or abandonment of applications and failure to satisfy contingencies
(a) An application made to the Public Health Council in accordance with this Part may, on written request of the applicant, be withdrawn prior to decision by the council at any time without prejudice to resubmission. Such resubmission shall be subject to the provisions relating to amendments.
(b) The failure, neglect or refusal of an applicant to submit documentation or information, within a stated time frame, to satisfy a contingency imposed by the Public Health Council in conjunction with the council's proposal to approve an application shall constitute and be deemed on abandonment or withdrawl of the application by the applicant without the need for further action by the council.
(c) When an applicant submits documentation or information, within the stated time frame, in an attempt to satisfy a contingency imposed by the Public Health Council but the department, on behalf of the council, does not consider the documentation or information sufficient to satisfy the contingency, the application shall be returned to the council for whatever action the council deems appropriate.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 139 ROCKLAND COUNTY
COMPANIES COMPANIES
10 CRR-NY 139.17 Spring Valley Water Works and Supply Company (Suffern, Viola and Piermont)
(a) Application.
The following rules and regulations, enacted in accordance with the provisions of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 879 of the Laws of 1953 and numbered article 11 thereof, shall apply to all existing wells and such wells as may be developed in the future on the properties of the Spring Valley Water Works and Supply Company near Suffern and in Viola in the town of Ramapo and in Piermont in the town of Orangetown, Rockland County, New York, such wells being a source of public water supply of said corporation.
(b) Definitions of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Spring Valley Water Works and Supply Company in the towns of Ramapo and Orangetown, Rockland County, New York.
(2) The term wells means the wells now used as sources of this public water supply or any wells developed in the future as additional sources of this public water supply, which are located on land now owned by the corporation near Suffern and in Viola in the town of Ramapo and in Piermont in the town of Orangetown, Rockland County, New York.
(3) The term linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No human excreta shall be buried in the soil at a distance of less than 500 feet from any well.
(2) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(3) Every privy or receptacle for the storage or deposit of human excreta, located between the prescribed 100 feet and 200 feet from any well, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of so that no nuisance will be created.
(4) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged nor deposited on or beneath the surface of the ground within 200 feet of any well except into watertight receptacles, the contents of which shall be removed before overflowing in such a manner as to prevent the pollution of the ground about the receptacle, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be located within 50 feet of any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited on or beneath the surface of the ground within 200 feet of any well.
(e) Flooding.
Any person who, by reason of alteration in surface grading or by development of property upstream, permits a change in surface drainage resulting either in an increased rate or concentration of discharge of surface water onto the lands on which the wells are located or adjacent property or any person who permits the undue obstruction of any drainage outlet downstream from the said well property and causes flooding of the said property shall be deemed in violation of these rules.
(f) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited on or beneath the surface of the ground within 200 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the wells.
(g) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any well.
(h) Manure.
No manure or manure pile shall be maintained or allowed to remain within 200 feet of any well.
(i) Trespassing.
No trespassing shall be allowed upon the property of the Spring Valley Water Works and Supply Company upon which the wells of the public water supply of said corporation are located and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the Spring Valley Water Works and Supply Company.
(j) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 200 feet of any well.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(l) Inspections.
The Spring Valley Water Works and Supply Company, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid corporation to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Spring Valley Water Works and Supply Company to promptly notify the State Commissioner of Health of such violations. The aforesaid corporation shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(m) Increase in linear distance.
Any linear or limiting distance contained in these subdivisions may be increased where in the opinion of the duly designated enforcement representatives of the State Department of Health such increase is necessary for the protection of the wells against contamination or pollution.
(n) Penalty.
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.214 Newborn
(a) An inpatient newly born in the hospital and accepted for routine care and lodging in a newborn bed facility. Stillbirths are not to be considered newborn.
(b) The following should not be included as newborn patient days:
(1) boarder babies for nonmedical reasons;
(2) premature infants;
(3) infants born outside of hospital;
(4) newborn who, for medical reasons, remain in the hospital after the mother's discharge; and
(5) newborn who become sick and require general hospital care.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.1 Definitions
As used in this Subpart, the following words and terms shall have the stated meanings except as otherwise provided:
(a) Available means a certified operator must be on site or able to be contacted within one hour to initiate the appropriate action.
(b) Clarification means a treatment process that includes rapid mix, flocculation and sedimentation.
(c) Community water system (CWS) means a public water system which serves at least five service connections used by year-round residents or regularly serves at least 25 year-round residents.
(d) Continuing education unit (CEU) means 10 hours of personal participation in an organized continuing education course, training meeting, workshop, etc. approved by the New York State Department of Health.
(e) Department means the New York State Department of Health.
(f) Distribution system means any combination of pipes, tanks, etc. which delivers potable water from the source(s) and/or treatment plant(s) to the consumer's service connection.
(g) Distribution system operator means the certified person in responsible charge of the operation and maintenance of the distribution system at a community water system or a nontransient noncommunity water system.
(h) Dwelling unit means one or more rooms with provisions for living, sanitary and sleeping facilities arranged for the use of one family.
(i) Filtration means the process for removing particulate matter from water by the passage through porous materials or other processes determined to be acceptable under the provisions of section 5-1.22 of this Part.
(j) Grandparenting means an exemption for the existing system operator(s) in responsible charge, effective February 14, 2001, from meeting the initial education and/or examination requirements for the class of certification the system requires.
(k) Ground water directly influenced by surface water means any water beneath the surface of the ground which exhibits water characteristics such as turbidity, temperature, conductivity or pH that closely correlates to climatological or surface water conditions and/or which contain significant occurrence of macroorganisms, algae, organic debris, large-diameter pathogens, or insect parts of a surface water origin.
(l) Ground water source means a source of water supply taken from a ground water aquifer and developed in accordance with section 5-1.22 of this Part, but shall not include an admixture of surface water or water exposed to the ground surface.
(m) Noncommunity water system (NCWS) means a public water system that is not a community water system.
(n) Nontransient noncommunity water system (NTNC) means a public water system that is not a community water system but is a subset of a noncommunity water system that regularly serves at least 25 of the same persons, for hours or more per day, for four or more days per week, for 26 or more weeks per year.
(o) Operating experience means the time spent working at a water treatment plant in the satisfactory performance of operational duties or working on a distribution system in the satisfactory performance of operational and maintenance duties. Water plant design experience does not qualify as operating experience.
(p) Operation means the time during which the system (water treatment plant and/or distribution system) is functioning with the intent to produce potable water for human consumption.
(q) Operator in responsible charge means the person(s) designated by the owner of the system to be the certified water treatment operator(s) who makes decisions regarding the daily operational activities of a public water system, water treatment facility and/or distribution system that will directly impact the quality and/or quantity of drinking water.
(r) Public water system means either a community or noncommunity water system which provides piped water to the public for human consumption, if such system has at least five service connections or regularly serves an average of at least 25 individuals at least 60 days out of the year. Such term includes:
(1) collection, treatment, storage and distribution facilities under control of the supplier of water of such system and used with such system; and
(2) collection or pretreatment storage facilities not under such control which are used in connection with such system.
(s) Purchasing water system means a distribution system which purchases all or part of its water from another system, and which is wholly or partially outside of the normal service area or political jurisdiction of the other system, and neither provides additional treatment nor sells water to another system(s).
(t) Service connection means the pertinent pipes, valves and fittings that connect a distribution system to a consumer's facility.
(u) State means the State Commissioner of Health, or his/her designated representative.
(v) Surface water means all water open to the atmosphere and subject to surface runoff.
(w) Validated examination means an exam that is independently reviewed by subject matter experts to ensure that the exam is based on job analysis and related to the classification of the system or facility.
(x) Water treatment operator means the certified person responsible for the operation of the water treatment plant at a community or a nontransient noncommunity water system.
(y) Water treatment assistant operator means a person who, under the direction of a certified water treatment operator in responsible charge, is involved in the day to day operation of a water treatment plant or a major segment of a water treatment plant at a community water system or nontransient noncommunity water system.
(z) Water treatment plant means any plant or equipment which, through the addition of chemicals or through granular activated carbon, aeration, ion exchange, demineralization, coagulation, sedimentation or filtration, or through any other means or combinations of treatment, shall change the physical, chemical, radiological or microbiological quality of water.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.172 Improvement
(a) Betterment.
(b) The clearing, draining, grading, or other addition to the worth of a tract of land; any cost of developing real estate, whether paid for directly or through special assessment taxes.
(c) A betterment of leased property or plant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.30 Computation of rates for early intervention services provided to infants and children ages birth to three years old and their families or caregivers
(a) The commissioner shall annually determine the rates for approved early intervention services and evaluations provided to eligible children, subject to the approval of the Director of the Budget. For payments made pursuant to this section for early intervention services to Medicaid patients, reimbursement shall be based upon a uniform payment schedule with discrete prices as set forth in subdivision (d) of this section. To be eligible to receive reimbursement pursuant to this section, providers must be approved to provide early intervention services pursuant to article 25 of the Public Health Law.
(b) For purposes of this section, a billable visit shall mean a face-to-face contact for the provision of authorized early intervention services between a provider of early intervention services and the individual(s) receiving such services, except for service coordination as described in paragraph (c)(3) of this section. Duration shall mean the time spent by a provider of early intervention services providing direct care or client contact. Activities such as case recording, training and conferences, supervisory conferences, team meetings and administrative work are not separately billable activities.
(c) Reimbursement shall be available at prices established pursuant to this section for the following Early Intervention Program services:
(1) Screening as defined in section 69-4.1(an) of this Subpart and performed in accordance with section 69-4.8 of this Subpart. A provider shall submit one claim for a screening regardless of the number of visits required to perform and complete a screening. Reimbursement may be provided for up to two screenings of a child suspected of having a developmental delay in any 12-month period without prior approval of the early intervention official. The early intervention official shall approve any additional screenings provided to a child within the 12-month period. Reimbursement shall not be provided for screenings performed after a child has been found eligible for early intervention services.
(2) Multidisciplinary evaluation as defined in section 69-4.1(n) of this Subpart and performed in accordance with section 69-4.8 of this Subpart. Reimbursable evaluations shall include core evaluations and supplemental evaluations. A provider shall submit one claim for a core or supplemental evaluation regardless of the number of visits required to perform and complete the evaluation.
(i) A core evaluation shall include a developmental assessment, a review of pertinent records and a parent interview as specified in section 69-4.8(a)(4) of this Subpart, and may include a family assessment.
(a) A developmental assessment shall mean procedures conducted by qualified personnel with sufficient expertise in early childhood development who are trained in the use of professionally acceptable methods and procedures to evaluate each of the developmental domains: physical development, cognitive development, communication development, social or emotional development and adaptive development.
(b) A family assessment shall mean a voluntary, family-directed assessment conducted by qualified personnel who are trained in the use of professionally acceptable methods and procedures to assist the family in identifying their concerns, priorities and resources related to the development of the child.
(ii) Supplemental evaluations shall include supplemental physician or non-physician evaluations and shall be provided upon the recommendation of the multidisciplinary team conducting the core evaluation and agreement of the child's parent. A supplemental evaluation may also be provided in conjunction with the core evaluation by a specialist trained in the area of the child's suspected delay or disability who is present during the core evaluation as required by section 69-4.8(a)(3) of this Subpart and who provides an in-depth assessment of the child's strengths and needs in such area. Supplemental evaluations provided subsequent to the child's Individualized Family Service Plan (IFSP) must be required by and performed in accordance with the IFSP as specified in section 69-4.8(a)(13) of this Subpart.
(a) Supplemental physician evaluation shall mean an evaluation by a physician licensed pursuant to article 131 of the Education Law for the purpose of providing specific medical information regarding physical or mental conditions that may impact on the growth and development of the child and completing the required evaluation of the child's physical development as specified in section 69-4.8(a)(4)(i)( a ) of this Subpart, or assessing specific needs in one or more of the developmental domains in accordance with section 69-4.8(a)(4)(iv) of this Subpart.
(b) Supplemental non-physician evaluation shall mean an additional evaluation for assessing the child's specific needs in one or more of the developmental domains in accordance with section 69-4.8 of this Subpart. Information obtained from this evaluation shall provide direction as to the specific early intervention services that may be required for the child. Supplemental non-physician evaluations may be conducted only by qualified personnel as defined in section 69-4.1(al) of this Subpart.
(iii)
(a) A multidisciplinary evaluation consisting of a core evaluation and up to four supplemental evaluations (which may include any combination of physician and non-physician evaluations) may be reimbursed within a 12-month period without prior approval of the early intervention official to develop and implement the initial Individualized Family Service Plan (IFSP) and subsequent annual IFSPs. The early intervention official shall approve and notify the department of any additional core or supplemental evaluations provided to a child within the initial 12-month period. If additional core or supplemental evaluations are necessary, such notice shall be provided on a monthly basis on forms provided by the department. Additional core or supplemental evaluations provided subsequent to the child's initial IFSP must be required by and performed in accordance with the IFSP as specified in section 69-4.8(a)(13) of this Subpart.
(b) Certain evaluation and assessment procedures may be repeated if deemed necessary and appropriate by the early intervention official in conjunction with the required annual evaluation of the child's IFSP or more frequently in accordance with section 69-4.8(a)(12) of this Subpart. If additional evaluation or assessment procedures are necessary, the early intervention official shall approve up to one more core evaluation and two supplemental evaluations prior to the next annual IFSP. Such additional evaluations must be required by and performed in accordance with the child's IFSP as specified in section 69-4.8(a)(13) of this Subpart. Any additional evaluations within that period shall be based on the indicators specified in section 69-4.8(a)(12) of this Subpart, approved by the early intervention official and the Commissioner of Health of the New York State department of Health and required by and performed in accordance with the child's IFSP.
(3) Service coordination as defined in section 69-4.1(m)(2)(xii) of this Subpart. Service coordination shall be provided by appropriate qualified personnel and billed in 15 minute units that reflect the time spent providing services in accordance with sections 69-4.6 and 69-4.7 of this Subpart, or billed under a capitation or other rate methodology as may be established by the commissioner subject to the approval of the Director of the Budget and as specified in prior written notice provided by the Commissioner to Early Intervention Officials. Such written notice shall specify that any newly established rate methodology shall apply only to initial IFSPs and IFSP amendments made on or after the effective date of such written notice by the commissioner. The rate methodology may be established on a per month, per week, and/or service component basis for providing service coordination services. When units of time are billed, the first unit shall reflect the initial five to 15 minutes of service provided and each unit thereafter shall reflect up to an additional 15 minutes of service provided. Except for child/family interviews to make assessments and plans, contacts for service coordination need not be face-to-face encounters; they may include contacts with service providers or a child's parent, caregiver, daycare worker or other similar collateral contacts, in fulfillment of the child's IFSP.
(4) Assistive technology as defined in section 69-4.1(m)(2)(ii) of this Subpart.
(5) Home and community-based individual/collateral visit. This shall mean the provision by appropriate qualified personnel of early intervention services to an eligible child and/or parent(s) or other designated caregiver at the child's home or other natural setting in which children under three years of age are typically found (including day care centers, other than those located at the same premises as the early intervention provider, and family day care homes). Reimbursable home and community-based individual/collateral visits shall include basic and extended visits.
(i) A basic visit is less than one hour in duration. Up to three such visits provided by appropriate qualified personnel within different disciplines per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(ii) An extended visit is one hour or more in duration. Up to three such visits provided by appropriate qualified personnel within different disciplines per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(iii) Notwithstanding subparagraphs (i) and (ii) of this paragraph, no more than three basic and extended visits combined per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(iv) A provider shall not bill for a basic and extended visit provided on the same day by appropriate qualified personnel within the same discipline without prior approval of the early intervention official.
(6) Office/facility-based individual/collateral visit. This shall mean the provision by appropriate qualified personnel of early intervention services to an eligible child and/or parent(s) or other designated caregiver at an approved early intervention provider's site (including day care centers located at the same premises as the early intervention provider). Up to one visit per discipline and no more than three office/facility-based visits per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(7) Parent-child group visit. This shall mean the provision of early intervention services in a group comprised of parent(s) or other designated caregivers and eligible children, and a minimum of one appropriate professional qualified to provide early intervention services at an early intervention provider's site or a community-based site ( e.g. day care center, family day care, or other community settings). Up to one visit per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(8) Basic group developmental intervention visit. This shall mean the provision of early intervention services by appropriate qualified personnel to eligible children in a group which may also include children without disabilities, at an approved early intervention provider's site or in a community-based setting where children under three years of age are typically found.
(i) Up to one group developmental intervention visit per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(ii) For purposes of subparagraph (i) of this paragraph and subparagraphs (i) of paragraphs (9) through (11) of this subdivision, a group developmental intervention visit shall include a basic visit as described in this paragraph, an enhanced visit as described in paragraph (9) of this subdivision, a basic with one-to-one aide visit as described in paragraph (10) of this subdivision, or an enhanced with one-to-one aide visit as described in paragraph (11) of this subdivision.
(9) Enhanced group developmental intervention visit. This shall mean a group developmental intervention visit as defined in paragraph (8) of this subdivision provided to a child who, due to age, significant medical needs (such as major feeding difficulties, severe orthopaedic impairment), significant behavior management needs and/or level of developmental functioning, require significantly more time and attention from adults during group activities.
(i) Up to one group developmental intervention visit per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(10) Basic group developmental intervention with one-to-one aide visit. This shall mean the provision of early intervention services by appropriate qualified personnel to eligible children in a group which may also include children without disabilities, with attendance at the group developmental intervention session by an additional aide or appropriate qualified personnel. This visit must be provided at an approved early intervention provider's site or in a community-based setting where children under three years of age are typically found.
(i) Up to one group developmental intervention visit per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(11) Enhanced group developmental intervention with one-to-one aide visit. This shall mean a group developmental intervention with one-to-one aide visit as defined in paragraph (10) of this subdivision provided to a child who, due to age, significant medical needs (such as major feeding difficulties, severe orthopaedic impairment), significant behavior management needs and/or level of developmental functioning, require significantly more time and attention from adults during group activities.
(i) Up to one group developmental intervention visit per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official.
(12) Family/caregiver support group visit. This shall mean the provision of early intervention services by appropriate qualified personnel to a group of parents or other designated caregivers (such as foster parents, day care staff) and/or siblings of eligible children for the purposes of:
(i) enhancing their capacity to care for and/or enhance the development of the eligible child; and/or
(ii) provide support, education, and guidance to such individuals relative to the child's unique developmental needs. Up to two visits per day may be billed for each eligible child as specified in an approved IFSP without prior approval of the early intervention official (for example, one for parents or other designated caregivers and one for sibling[s] in a given day).
(13) ABA services. This shall mean services delivered by an ABA aide employed by and under the supervision of an agency provider approved in accordance with section 69-4.25 of this Subpart to deliver ABA services in accordance with requirements set forth in section 69-4.25 of this Subpart. The price established pursuant to this section shall include direct and indirect supervisory time, team meetings and training. ABA services shall be billed by the day and in increments of 60 minutes up to and in accordance with the hours of service as specified the child's IFSP.
(14) The early intervention official shall approve and notify the department of any visits provided in addition to those described in paragraphs (5) through (12) of this subdivision as may be required by and provided in accordance with the child's IFSP. If such additional visits are necessary, such notice shall be provided on a monthly basis on forms provided by the department.
(d) The prices established pursuant to this section shall provide full reimbursement for the following:
(1) physician services, nursing services, therapist services, technician services, nutrition services, psychosocial services, service coordination, and other related professional and paraprofessional expenses directly incurred by the approved provider;
(2) space occupancy, except as provided in subdivision (f) of this section, and plant overhead costs;
(3) all supplies directly related to the provision of early intervention services, except as provided in subdivision (g) of this section; and
(4) administrative, personnel, business office, data processing, recordkeeping, housekeeping, and other related provider overhead expenses.
(e) The price for each service shall be adjusted for regional differences in wage levels to reflect differences in labor costs for personnel providing direct care and support staff and shall include consideration of absentee data and child to professional to paraprofessional ratios.
(f) Assistive technology devices.
Reimbursement for approved assistive technology devices shall be at reasonable and customary charges approved by the commissioner or his designee.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.18 Security standards; public warehouse and common or contract carriers
(a) Licensees who store controlled substances in a public warehouse are responsible for utilizing a warehouse that will provide adequate security against theft or diversion. The licensee and not the warehouse is responsible for the security of the controlled substances. The department shall determine if the overall security is adequate. The licensee shall notify the department in writing within 30 days of any change in the warehouse inspected and approved by the department.
(b) The licensees are also responsible for utilizing a common or contract carrier that will provide adequate security of the controlled substances while they are in transit. If the licensee has substantial quantities of controlled substances lost or stolen in transit when utilizing the facilities of a particular common or contract carrier, steps shall be taken to obtain another carrier or means of transportation for shipping controlled substances. Precautions such as securely wrapping and sealing packages containing controlled substances or utilizing unmarked or coded boxes or shipping containers are required for guarding against losses in storage or in transit.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.41 Fee schedule
Effective upon adoption, the annual fees assessable shall be as prescribed in this section.
(a) Registration fees.
Except for entities exempt from fees under section 16.40(b)(1) of this Part, the annual registration fee for radiation installations required to be registered with the department pursuant to section 16.50(a) of this Part is $50.
(b) Fee categories for radiation installations required to be registered with the department.
For the purpose of assessing annual fees, all radiation installations required to be registered with the department pursuant to section 16.50(a) of this Part are categorized in one of the following six categories:
Category I: Radiation installations with any five or more of the modalities listed below.
Category II: Radiation installations with three or four of the modalities listed below.
Category III: Radiation installations with two of the medical modalities listed below.
Category IV: Radiation installations with one of the medical modalities listed below and annual patient workload of 750 examinations or more.
Category V: Radiation installations with one of the medical modalities listed below and annual patient workload of less than 750 examinations, and all other radiation installations with one or two of the non-medical modalities listed below except as listed under category VI.
Category VI: Dental, podiatric, bone densitometry or veterinary installations.
The modalities to be used in determining the fee category for radiation installations required to be registered with the department pursuant to section 16.50(a) of this Part are:
Medical Modalities: radiography, fluoroscopy, computed tomography, angiography, stereotactic breast biopsy systems, and Grenz/orthovoltage therapy, utilized in humans.
Non-medical Modalities: radiography, fluoroscopy, analytical equipment (including electron microscopes, fluorescence analysis and X-ray diffraction equipment), computed tomography and particle accelerators, not utilized on humans.
(c) Fee schedule for radiation installations routinely inspected by the department.
All radiation installations required to be registered with the department pursuant to section 16.50(a) of this Part that are not exempt from fees under section 16.40(b) of this Part and that are routinely inspected by the department shall, in addition to the registration fee prescribed in subdivision (a) of this section, be assessed annual fees according to the following schedule:
Category I radiation installations:
$1,370
Category II radiation installations:
$1,030
Category III radiation installations:
$ 690
Category IV radiation installations:
$ 275
Category V radiation installations:
$ 140
Category VI radiation installations:
$ 75
(d) Fee schedule for radiation installations routinely inspected by a county or part-county health officer or by a certified radiation equipment safety officer.
All radiation installations required to be registered with the department pursuant to section 16.50(a) of this Part that are not exempt from fees under section 16.40(b) of this Part and that are routinely inspected by a county or part-county health officer having jurisdiction, as the department shall direct, under a program certified by the department, or by a certified radiation equipment safety officer as directed by the department shall, in addition to the registration fee prescribed in subdivision (a) of this section, be assessed an annual fee according to the following schedule:
Category I radiation installations:
$425
Category II radiation installations:
$320
Category III radiation installations:
$210
Category IV radiation installations:
$ 85
Category V radiation installations:
$ 45
Category VT radiation installations:
$ 15
(e) Fee categories for radioactive material licensees and radiation installations that use accelerators in medical therapy.
For the purpose of assessing annual fees, all persons holding radioactive material licenses issued by the department and all radiation installations that are required to be registered with the department, pursuant to section 16.50(a) of this Part and that use accelerators in medical therapy are categorized in one or more of the following six categories:
Category I: Persons issued a broad scope medical license.
Category II: Persons issued a broad scope academic or broad scope research and development license.
Category III: Persons issued a specific license which allows the use of radioactive materials for both nuclear medicine and brachytherapy, or a license which authorizes the operation of a nuclear pharmacy at an institution or a pharmaceutical production cyclotron.
Category IV: Radiation installations operating a medical therapy accelerator and/or persons issued a specific license which authorizes the use of radioactive materials in nuclear medicine, brachytherapy, mobile nuclear medicine service, teletherapy (including Co-60 teletherapy and gamma knife), research and development, academic uses, veterinary medicine or large irradiators.
Category V: Persons issued a specific license which authorizes the use of radioactive materials in a clinical laboratory, lead paint analyzers, mobile nuclear medicine sites, leak tests, equipment calibration, self-shielded irradiators, diagnostic sealed sources, and any other use not included in categories I through VI as listed in this subdivision.
Category VI: Persons issued a specific license for use of radioactive materials in gas chromatographs.
(f) Radioactive materials/medical therapy accelerator fee schedule.
(1) Except for entities exempt from fees under section 16.40(b) of this Part, all persons that hold radioactive material licenses issued by the department and all radiation installations that are required to be registered with the department and that use accelerators in medical therapy shall be assessed annual fees according to the following schedule:
Category I: $5,265
Category II: $3,510
Category III: $1,400
Category IV: $ 880
Category V: $ 350
Category VI: $ 50
(2) When more than one fee category as described in subdivision (e) of this section applies the fee which corresponds to the highest applicable category will be assessed, provided, however, that separate category III fees will be assessed to any person that holds a license to operate a nuclear pharmacy or a pharmaceutical production cyclotron for each type of these uses that applies, in addition to any other categories of fees that apply; and radiation installations or licensees that provide teletherapy (Co-60, gamma knife or a medical therapy accelerator) services or veterinary medicine services, or use radioactive materials in large irradiators or, except for category I or II licensees, use radioactive materials in research and development, will be assessed category IV fees for each type of these uses that applies, in addition to any other categories of fees that apply. If a person that holds a radioactive material license is also the operator of a radiation installation that uses an accelerator in medical therapy and the licensed activities are conducted at such installation, the licensed radiation installation shall be considered as one and the same entity for purposes of assessing fees described under subdivision (e) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.5 Sterilization of instruments
Syringes, needles, lancets, or other phlebotomy or hematopoietic progenitor cell collection devices capable of transmitting infection from one person to another and licensed for single use by the Food and Drug Administration shall be appropriately discarded after such use. Reusable devices shall be heat-sterilized prior to each use. Heat sterilization shall be by autoclaving at 121.5°C for 15 minutes after the chamber of the autoclave has been evacuated and has reached that temperature, or by dry heat for two hours at 170°C, or by such other similarly acceptable procedure in accordance with current medical standards generally accepted by leading authorities in transplantation medicine.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
COMPANIES COMPANIES
10 CRR-NY 127.101 Long Island Water Corporation (Baldwin, Roosevelt, Hempstead Villa, Lakeview and Valley Stream)
(a) [Application.]
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such wells as may be developed in the future on the properties of the Long Island Water Corporation at Baldwin, Roosevelt, Hempstead Villa, Lakeview and Valley Stream in the town of Hempstead, Nassau County, New York, such wells being the sources of public water supply of said corporation.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Long Island Water Corporation in the town of Hempstead, Nassau County, New York.
(2) The term wells means the wells now used as sources of this public water supply or any wells developed in the future as additional sources of this public water supply, which are located on land now owned by the corporation at Baldwin, Roosevelt and Valley Stream in Nassau County, New York.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No human excreta shall be buried in the soil at a distance of less than 500 feet from any well.
(2) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any well.
(3) Every privy or receptacle for the storage or deposit of human excreta, located between the prescribed 50 feet and 150 feet from any well, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of so that no nuisance will be created.
(4) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged nor deposited on or beneath the surface of the ground within 150 feet of any well except into watertight receptacles, the contents of which shall be removed, before overflowing, in such a manner as to prevent the pollution of the ground about the receptacle, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be located within 50 feet of any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited on or beneath the surface of the ground within 75 feet of any well.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited on or beneath the surface of the ground within 100 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the wells.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 100 feet of any well.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 150 feet of any well.
(h) Trespassing.
No trespassing shall be allowed upon the property of the Long Island Water Corporation upon which the wells of the public water supply of said corporation are located and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the Long Island Water Corporation.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(k) Inspections.
The Long Island Water Corporation, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid corporation to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Long Island Water Corporation to promptly notify the State Commissioner of Health of such violations. The aforesaid corporation shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.6 Confidentiality and disclosure
(a) No person who obtains confidential HIV-related information in the course of providing any health or social service or pursuant to a release of confidential HIV-related information may disclose or be compelled to disclose such information, except to the following:
(1) the protected individual or, when the protected individual lacks capacity to consent, a qualified person under section 18 of the Public Health Law, a person the protected individual has authorized to access records relating to the provision of health care under General Obligations Law article 5, title 15, or person authorized pursuant to law to consent to health care for the individual;
(2) any person to whom disclosure is authorized pursuant to a release of confidential HIV- related information in accordance with section 63.5(a) of this Part;
(3) an agent or employee of a health facility or health care provider if:
(i) the agent or employee is authorized to access medical records;
(ii) the health facility or health care provider itself is authorized to obtain the HIV- related information; and
(iii) the agent or employee provides health care to the protected individual, or maintains or processes medical records for billing or reimbursement;
(4)
(i) a health care provider or health facility when knowledge of the HIV-related information is necessary to provide appropriate care or treatment to the protected individual or a child of the individual;
(ii) a health care provider or health facility when knowledge of HIV-related information is necessary to provide appropriate care or treatment to a contact or exposed individual, provided the requirements in section 63.8(m) of this Part are followed for disclosures involving exposures in risk situations;
(iii) in circumstances where consent for health care is necessary, disclosure may also be made to a person authorized to consent to health care for such contact or for such protected individual, provided that if disclosure is to a person authorized to consent to the health care of a contact or to a contact when such contact has been exposed to HIV under circumstances which present a risk of transmission, the requirements in section 63.8(m) of this Part must be followed;
(5) a health facility or health care provider, in relation to the procurement, or use of a human body or a human body part, including organs, tissues, blood, semen, or other body fluids, for use in medical education, research, therapy, or for transplantation to individuals;
(6) health facility staff committees, or accreditation or oversight review organizations authorized to access medical records, provided that such committees or organizations may only disclose confidential HIV-related information:
(i) back to the facility or provider of a health or social service;
(ii) to carry out the monitoring, evaluation, or service review for which it was obtained; or
(iii) to a Federal, State or local government agency for the purposes of and subject to the conditions provided in subdivision (e) of this section;
(7) a Federal, State, county or local health officer when such disclosure is mandated by Federal or State law, including reporting and contact notification processes authorized pursuant to article 21, title III, or pursuant to article 27-F;
(8) authorized agencies as defined by Social Services Law, section 371 and corporations incorporated or organized to receive children for adoption or foster care, in connection with foster care or adoption of a child. Such agency shall be authorized to redisclose such information only pursuant to the provisions of article 27-F of the Public Health Law or in accordance with the provisions of Social Services Law, section 373-A and regulations promulgated thereunder;
(9) third-party reimbursers or their agents to the extent necessary to reimburse health care providers, including health facilities, for health services, provided that, an otherwise appropriate authorization for such disclosure has been secured;
(10) an insurance institution, for other than the purpose set forth in paragraph (9) of this subdivision, provided the insurance institution secures a dated and written authorization that indicates that health care providers, health facilities, insurance institutions, and other persons are authorized to disclose information about the protected individual, the nature of the information to be disclosed, the purposes for which the information is to be disclosed and which is signed by:
(i) the protected individual;
(ii) if the protected individual lacks the capacity to consent, such other person authorized pursuant to law to consent for such individual; or
(iii) if the protected individual is deceased, the beneficiary or claimant for benefits under an insurance policy, a health services plan, or an employee welfare benefit plan as authorized in article 27-F of the Public Health Law;
(11) to a funeral director upon taking charge of the remains of a deceased person when such funeral director has access in the ordinary course of business to HIV-related information on the death certificate of the deceased individual, as authorized by Public Health Law, section 4142;
(12) any person to whom disclosure is ordered by a court of competent jurisdiction pursuant to Public Health Law, section 2785;
(13) an employee or agent of the Division of Probation and Correctional Alternatives, Division of Parole, Commission of Correction, or any local probation department, to the extent the employee or agent is authorized to access records containing such information in order to carry out functions, powers and duties with respect to the protected person and in accordance with regulations promulgated pursuant to Public Health Law, article 27-F;
(14) a medical director of a local correctional facility in accordance with regulations promulgated pursuant to article 27-F to the extent the medical director is authorized to access records to carry out his/her functions relating to the protected person. Redisclosure by the medical director is prohibited except as permitted under Public Health Law, article 27-F, article 21, title III and implementing regulations;
(15) an employee or agent of the New York City Board of Corrections so that the board may continue to access records of inmates who die while in the custody of the New York City Department of Corrections when necessary for the board to carry out its duties, functions, and powers with respect to the protected individual, pursuant to the New York City charter; or
(16) a law guardian, appointed to represent a minor pursuant to the Social Services Law or the Family Court Act, for the purpose of representing that minor. If the minor has the capacity to consent, the law guardian may not redisclose confidential HIV-related information without the minor's permission. If the minor lacks capacity to consent, the law guardian may redisclose confidential HIV-related information for the purpose of representing the minor;
(17) an executor or administrator of an estate of a deceased person as needed to fulfill his or her responsibilities/duties as an executor or administrator; or
(18) qualified researchers for medical research purposes upon the approval of a research protocol by a human research review committee established and approved under the provisions of article 24-A of the Public Health Law or by an institutional review board established and approved under applicable provisions of Federal law, for the purpose of reviewing and monitoring research involving human subjects, provided that in no event shall any qualified researcher disclose information tending to identify the subjects of the research.
(b) A State, county or local health officer may disclose confidential HIV-related information when:
(1) disclosure is specifically authorized or required by Federal or State law including, but not limited to, Public Health Law, article 21, title III and Public Health Law, article 27-F; or
(2) disclosure is made pursuant to a release of confidential HIV-related information; or
(3) disclosure of information regarding a contact is requested by a physician pursuant to section 63.8 of this Part; or if the contact resides outside the jurisdiction of the authorized public health official, the official shall inform the public health official in the contact's jurisdiction in order to confidentially inform such contact; or
(4) disclosure is authorized by court order pursuant to the provisions of Public Health Law, section 2785.
(c) A physician or his/her agent may disclose the confidential HIV-related information to a contact and to a public health officer for the purpose of making a disclosure to the contact.
(d) A physician or his/her agent may, upon the consent of a parent or guardian, disclose confidential HIV- related information to a State, county, or local health officer for the purpose of reviewing the medical history of a child to determine the fitness of the child to attend school.
(e) Confidential HIV-related information of a protected person may be disclosed to authorized employees or agents of a governmental agency pursuant to the regulations of the governmental agency when the person providing health or social services is regulated, supervised or monitored by the governmental agency or when the governmental agency administers the health program or a social service program and when such employees or agents have access to records in the ordinary course of business and when access is reasonably necessary for regulation, supervision, monitoring, administration or provision of services. Such authorized employees or agents may include attorneys authorized by a government agency when access occurs in the ordinary course of providing legal services and is reasonably necessary for supervision, monitoring, administration or provision of services. Such authorized employees or agents may also include public health officers as needed for conducting epidemiological or surveillance investigations pursuant to applicable law, rule or regulation. Such surveillance or investigational data shall also be disclosed by the public health officer to the State Department of Health as required by the State Sanitary Code or this Part.
(f) Confidential HIV-related information of a protected person may be disclosed to authorized employees or agents of a provider of health or social services when such provider is either regulated, supervised or monitored by a governmental agency or when a governmental agency administers the provider's health or social service program, and when such employees or agents have access to records in the ordinary course of business and when access is reasonably necessary for regulation, supervision, monitoring, administration or provision of services. Such authorized employees or agents may include attorneys authorized by persons providing health services when access occurs in the ordinary course of providing legal services and is reasonably necessary for supervision, monitoring, administration or provision of services.
(g) A physician or his/her agent may disclose confidential HIV-related information pertaining to a protected individual to a person, known to the physician or his/her agent, authorized pursuant to law to consent to the health care for the protected individual when the physician reasonably believes that:
(1) disclosure is medically necessary in order to provide timely care and treatment for the protected individual; and
(2) after appropriate counseling as to the need for such disclosure the protected individual will not inform a person authorized by law to consent to health care; provided, however, that the physician shall not make such disclosure if, in the judgment of the physician:
(i) the disclosure would not be in the best interest of the protected individual; or
(ii) the protected individual is authorized pursuant to law to consent to such care and treatment. A physician's decision to disclose pursuant to this paragraph, and the basis for that decision shall be recorded in the medical record.
(h) No person to whom confidential HIV-related information has been disclosed shall disclose the information to another person except as authorized by law, (including, but not limited to, disclosure authorized by PHL article 21, title III), except that this provision shall not apply to:
(1) the protected individual;
(2) a natural person who is authorized pursuant to law to consent to health care for the protected individual;
(3) a protected individual's foster parent, subject to Department of Social Services regulations, for the purpose of providing care, treatment or supervision to the protected individual; or
(4) a prospective adoptive parent, subject to Department of Social Services regulations, with whom a child has been placed for adoption.
(i) Nothing in this section shall limit a person's or agency's responsibility or authority to report, investigate, or redisclose child protective and adult protective services information in accordance with title 6 of article 6 and titles 1 and 2 of article 9-B of the Social Services Law, or to provide or monitor the provision of child and adult protective or preventive services.
(j) Confidential HIV-related information shall not be disclosed to a health care provider or health care facility for the sole purpose of implementing infection control precautions when such provider or facility is regulated under the Public Health Law and required to implement such precautions with all individuals pursuant to this Title. This restriction shall not limit access to HIV-related information by a facility's infection control personnel for purposes of fulfilling their designated responsibilities in the facility.
(k) Confidential HIV-related information shall not be released pursuant to a subpoena. A court order pursuant to Public Health Law, section 2785 is required for release of confidential HIV-related information.
(l) Confidential HIV-related information shall be disclosed upon the request of the Health Care Worker HIV/HBV Advisory Panel (see Public Health Law article 27-DD) to the panel or its designee(s) only when the panel considers the information reasonably necessary for the evaluation and monitoring of a worker who has voluntarily sought the panel's review.
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.10 Equivalence of prior training
(a) A person who has successfully completed one or more of the following may submit training and/or academic information to the Department of Health for a determination of training equivalency:
(1) an Environmental Protection Agency approved asbestos safety training program given in New York State prior to September 3, 1987 for asbestos handler, March 10, 1989 for inspector, and December 19, 1990 for other AHERA disciplines, provided the individual has maintained the certification through annual refresher training; or
(2) an approved asbestos safety training program accredited in a state which has an accreditation program that prior to April 4, 1994, met or exceeding the requirements of the Asbestos Hazard Emergency Response Act or, on or after April 4, 1994, met or exceeded the requirements of the Asbestos School Hazard Abatement Reauthorization Act model accreditation plan and which has the administrative capability to audit the training program, provided the individual has maintained all appropriate refresher training; or
(3) academic course work in environmental science, industrial hygiene, analytical chemistry or a closely related field. This shall not include any course work completed as part of an asbestos safety training program; or
(4) a combination of paragraphs (1), (2) and/or (3) of this section and/or a Department of Health approved asbestos safety training program and/or part of one or more Department of Health approved asbestos safety training programs. An individual may apply for a determination that the course and/or training program was substantially equivalent to an approved asbestos safety training program pursuant to this Part. Applications may be made to the department and at least the following information shall be submitted:
(i) date and location of the course or program attended;
(ii) name and address of the course or program provider;
(iii) a schedule or outline of the course or program indicating the subject matter that was presented and the amount of time devoted to each subject; and
(iv) a written indication by the course provider or program provider that the individual had satisfactorily completed all requirements of the course or program.
(b) The Department of Health shall determine whether the course and/or program substantially meets the criteria specified in sections 73.5 and/or 73.6 of this Part and may determine that the course and/or program is either:
(1) not equivalent to an approved program; or
(2) substantially equivalent.
The department may communicate directly with the course and/or program provider concerning any aspect of the applicant's prior training.
(c) A person who has successfully completed an asbestos safety training program for inspector and was certified as required by the New York City Department of Environmental Protection on or before September 1, 1989 is considered to have met training requirements equivalent to the training requirements for inspector contained in this Part.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.45 Hot storage
Enough conveniently located hot food storage facilities are to be provided and used to maintain potentially hazardous food at the required temperature during storage. Each potentially hazardous food storage facility is to have a numerically scaled indicating thermometer, accurate to plus or minus two degrees Fahrenheit (1.1 degrees Celsius) available and used to measure the temperature of food stored in the facility or installed to measure the air temperature in the coldest part of the facility.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.3 Outer interment receptacle price list
A funeral firm shall present for information and review a printed or typewritten price list to individuals who inquire in person about outer interment receptacles. The funeral firm may neither discuss nor show outer interment receptacles until an outer interment receptacle price list is offered to the customer. The list must contain at least the retail price of each outer interment receptacle which does not require special ordering; supplier name; model name or number; description of construction material; and the effective date of the prices listed. In immediate conjunction with the prices must be the following statement: "No New York State or local law requires you to buy a receptacle to surround the casket in the grave. However, many cemeteries require that you have such a receptacle so that the grave will not sink. Either a burial vault or grave liner will satisfy these requirements." The list must contain the true funeral firm name and address as registered with the department and a caption describing the list as an "Outer Interment Receptacle Price List." In lieu of a written list, the firm may use other formats, such as notebooks, brochures or charts, if they contain the same information as required in a printed or typewritten list and are displayed in a clear and conspicuous manner.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.4 Generally accepted accounting principles
The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the LTHHCP, unless the reporting instructions authorize specific variation in such principles.
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.3 Rates for providers of ICF/DD services
(a) There shall be one provider-wide rate for each provider, except that rates for ICF/DD services provided to individuals identified as specialized populations by OPWDD shall be determined under section 86-11.9 of this Subpart. Adjustments may be made to the rate resulting from any final audit findings or reviews.
(b) Rates shall be computed on the basis of a full 12 month base year CFR, adjusted in accordance with the methodology as provided in this section. The rate shall include operating cost components, and capital cost components as identified in applicable subdivisions. Such base year may be updated periodically, as determined by the department.
(c) Components of rates for ICF/DD services.
(1) The operating component shall be based on allowable costs identified in the consolidated fiscal reports. The operating component shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars for each provider in a Department of Health region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation-supportive IRA, day habilitation services and ICF/DD, divided by base year salaried direct care hours for each provider in a Department of Health region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation- supportive IRA, day habilitation services and ICF/DD services.
(ii) Regional average employee-related component , which shall mean the sum of vacation leave accruals and total fringe benefits for the base year for each provider of a Department of Health region, aggregated for all such providers in such region, such sum to be divided by base year salaried direct care dollars for each provider of a Department of Health region, aggregated for all such providers in such region, and then multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the sum of transportation related-participant staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider of a Department of Health region, aggregated by all such providers in such region. Such sum shall be divided by the total base year salaried direct care dollars of all providers in a Department of Health region, and then multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the sum of the insurance-general and agency administration allocation for the base year for each provider in a Department of Health region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider of a Department of Health region, aggregated for all providers in such region). The regional average direct care hourly rate-exclusive of general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (iv) of this paragraph shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage, as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional general and administrative component computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of base year salaried direct care dollars divided by the base year salaried direct care hours of a provider.
(viii) Provider average employee-related component , which shall mean the sum of vacation leave accruals and fringe benefits for the base year for each provider, divided by base year salaried direct care dollars of a provider, such quotient to be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for a provider. Such sum shall be divided by the base year salaried direct care dollars of such provider and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the sum of insurance-general and agency administration allocation for the base year for a provider, such sum to be divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for a provider) for the base year. The provider average direct care hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage, as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Provider direct care hours , which shall mean the sum of base year salaried direct care hours and base year contracted direct care hours, such sum to be divided by the rate sheet capacities for the base year. Such quotient to be multiplied by rate sheet capacities for the initial period.
(xiv) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider of a Department of Health region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider of a Department of Health region, aggregated for all such providers in such region.
(xv) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of such provider.
(xvi) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the rate sheet capacities for the base year, such quotient to be multiplied by the rate sheet capacities for the initial period for such provider.
(xvii) Regional average contracted clinical hourly wage , which shall mean the quotient of contracted clinical dollars divided by the base year contracted clinical hours for each provider of a Department of Health region, aggregated for all such providers in such region.
(xviii) Provider contracted clinical hours , which shall mean the quotient of a provider’s contracted clinical hours for the base year divided by the rate sheet capacities for the base year, such quotient to be multiplied by rate sheet capacities for the initial period.
(xix) Provider direct care hourly rate- adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph multiplied by 0.25.
(xx) Provider clinical hourly wage – adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xv) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xiv) of this paragraph multiplied by 0.25.
(xxi) Provider reimbursement from direct care hourly rate , which shall mean the product of the calculated direct care hours, as determined pursuant to subparagraph (xiii) of this paragraph, and the provider direct care hourly rate-adjusted for wage equalization factor, as computed in subparagraph (xix) of this paragraph.
(xxii) Provider reimbursement from clinical hourly wage , which shall mean the product of the provider salaried clinical hours, as determined pursuant to subparagraph (xvi) of this paragraph and the provider clinical hourly wage- adjusted for wage equalization factor, as determined pursuant to subparagraph (xx) of this paragraph.
(xxiii) Provider reimbursement from contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours, as determined pursuant to subparagraph (xviii) of this paragraph and the applicable regional average contracted clinical hourly wage, as determined pursuant to subparagraph (xvii) of this paragraph.
(xxiv) Provider facility reimbursement , which shall mean the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, housekeeping and maintenance staff, and program administration property the base year for a provider and such sum to be divided by provider rate sheet capacities for the base year. Such sum to be multiplied by rate sheet capacities for the initial period.
(xxv) Provider operating revenue , which shall mean the sum of provider reimbursement from direct care hourly rate, as determined pursuant to subparagraph (xxi) of this paragraph, the provider reimbursement from clinical hourly wage, as determined pursuant to subparagraph (xxii) of this paragraph, the provider reimbursement from contracted clinical hourly wage, as determined pursuant to subparagraph (xxiii) of this paragraph, and the provider facility reimbursement, as determined pursuant to subparagraph (xxiv) of this paragraph.
(xxvi) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of all provider rate sheets in effect on June 30, 2014, divided by provider operating revenue, as determined pursuant to subparagraph (xxv) of this paragraph, for all providers.
(xxvii) Total provider operating revenue- adjusted , which shall mean the product of the provider operating revenue, as determined pursuant to subparagraph (xxv) of this paragraph and the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (xxvi) of this paragraph.
The final daily operating rate shall be determined by dividing the total provider operating revenue-adjusted, as determined by subparagraph (xxvii) of this paragraph, by the applicable provider rate sheet capacity for the initial period and such quotient to be further divided by 365.
(2) Alternative operating component. For providers that did not submit a cost report or submitted a cost report that was incomplete for the base year, the final daily operating rate shall be a regional daily operating rate. This rate shall be the sum of:
(i) The product of the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (1)(vi) of this subdivision and the applicable regional average direct care hours , which shall mean the quotient of salaried and base year contracted direct care hours for each provider of a Department of Health region, aggregated for all such providers in such region, divided by the rate sheet capacities, pro-rated for partial year sites for the base year for each provider of a Department of Health region, aggregated for all such providers in such region; and
(ii) the product of the applicable regional average clinical hourly wage, as determined pursuant to subparagraph (1)(xiv) of this subdivision and the applicable regional average clinical hours , which shall mean the quotient of salaried and base year contracted clinical hours for each provider of a Department of Health region, aggregated for all such providers in such region, divided by the rate sheet capacities, pro-rated for partial year sites for the base year for each provider of a Department of Health region, aggregated for all such providers in such region; and
(iii) the applicable regional average facility revenue , which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance – property and casualty, housekeeping and maintenance staff, and program administration property for the base year divided by the rate sheet capacities, pro-rated for partial year sites for the base year for each provider of a Department of Health region, aggregated for all such providers in such region; and
Such sum shall then be multiplied by the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (1)(xxvii) of this subdivision.
(3) Day program services component. There shall be a day program services component for individuals who participate in either in-house day programming or day services , which shall equal the sum of the in-house day programming amount from the provider rate sheet in effect on June 30, 2014 plus the product of the units of service for the day services providers as was used in the calculation of the rate in effect on June 30, 2014 and the day service provider’s rate in effect on July 1, 2014.
(4) Capital component.
(i) For capital assets approved on or after July 1, 2014. OPWDD regulations under 14 NYCRR Subpart 635-6 establish standards and criteria for calculating provider reimbursement for the acquisition and lease of real property assets which require approval by the Office for People with Developmental Disabilities. The regulations also address associated depreciation and related financing expenses. The rate will include costs for actual straight line depreciation, interest expense, financing expenses, and lease cost. In no case will the total capital reimbursement associated with the capital asset exceed the total acquisition cost, renovation and financing cost associated with a capital asset. The asset life for building acquisitions shall be 25 years.
(ii) For capital assets approved prior to July 1, 2014. The State will identify each asset by provider, and provide a schedule of these assets identifying: total actual cost, reimbursable cost determined by the prior approval, total financing cost, allowable depreciation and allowable interest for the remaining useful life as determined by the prior approval, and the allowable reimbursement for each year of the remaining useful lives. In no case will the total reimbursable depreciation or principal amortization and total interest associated with the capital asset exceed the total acquisition cost, renovation and financing cost associated with a capital asset.
(iii) Notification to providers. 14 NYCRR Subpart 635-6 contains the criteria and standards associated with capital costs and reimbursement. Each provider will receive a schedule of “prior approved assets” that is being used to establish the real property capital component of the provider’s reimbursement rate.
(iv) Initial rate for capital assets approved on or after July 1, 2014. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease, and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date of certification of the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(v) Cost verified rates for capital assets approved on or after July 1, 2014. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Under no circumstances shall the amount included in the rate under this subparagraph exceed the amount authorized in the approval process. Capital costs shall be depreciated over a 25 year period for acquisition of properties or amortized over the life of the lease for leased sites. Capital improvements shall be depreciated over the life of the asset. The amortization of interest shall not exceed the life of the loan taken. Amortization or depreciation shall begin upon certification by the provider of such costs. Start-up costs may be amortized over a one year period beginning with site certification. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted.
(vi) Capital reimbursement reconciliation schedule. Beginning with the cost reporting period ending December 31, 2014, each provider shall submit to OPWDD, as part of the annual cost report, a capital reimbursement reconciliation schedule. This schedule will specifically identify the differences, by capital reimbursement item, between the amounts reported on the certified cost report, and the reimbursable items, including depreciation, interest and lease cost from the schedule of approved reimbursable capital costs. The provider’s independent auditor will apply procedures to verify the accuracy and completeness of the capital reimbursement reconciliation schedule. The department will retroactively adjust capital reimbursement based on the actual cost verification process as described in subparagraph (iv) of this paragraph.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.1 Application
This Subpart shall govern the functioning of medical access review committees established pursuant to Public Health Law, section 18 to hear appeals from the denial of access to patient information.
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.12 Continued ignition interlock device certification
(a) An ignition interlock device certification shall remain in effect until:
(1) the manufacturer files a written request for discontinuance;
(2) the department issues to the manufacturer a written notice of suspension or revocation of approval; or
(3) the manufacturer modifies the device so that it does not meet the Federal model specifications for breath alcohol ignition interlock devices in effect when it was certified.
(b) No manufacturer who makes an operational modification to a model of an ignition interlock device that has been certified pursuant to this Part shall release the modified device for use pursuant to Vehicle and Traffic Law, section 1198 without having obtained the express approval of the department. Manufacturers shall submit to the department a description of the intended operational modification(s), and the commissioner shall determine either that the existing certification shall continue in effect for the ignition interlock device as modified or that the manufacturer must apply for separate certification for the modified device. For purposes of this section, operational modification means any change to product design or function that would or could affect the device's anti-circumvention, anti-tampering or analytical features, as determined by the department.
(c) A manufacturer shall ensure that the department is provided with documentation of current insurance by notifying the department in writing of each renewal of coverage, each change of issuing company, and each change in liability limits.
(d) The department may require manufacturers whose devices are certified pursuant to this Part to periodically renew the certifications. Information required for renewal of certification shall minimally include:
(1) verification that information on file with the department, including, but not limited to, manufacturer's address and contact person, is current;
(2) an attestation that the department has been notified of any operational modification made to the certified model, or that no modification was made; and
(3) documentation of current insurance coverage.
(e) Each device shall be provided with a supply of disposable spit-trap mouthpieces, and the manufacturer shall ensure availability of additional mouthpieces.
(f) A manufacturer shall provide to installation/service providers that install its certified device(s) a sufficient number of labels to label each device installed and replace labels as needed. The label shall contain a notice printed in at least 10-point boldface type, reading as follows:
"WARNING – ANY PERSON TAMPERING, CIRCUMVENTING OR OTHERWISE MISUSING THE DEVICE IS GUILTY OF A MISDEMEANOR AND MAY BE SUBJECT TO CIVIL LIABILITY."
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.13 Adult day health-care programs
(a) This methodology will be utilized to evaluate certificate of need applications involving the initiation of adult day health-care programs. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of adult day health-care programs. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate number of adult day health-care programs are available to provide access to care and avoid the unnecessary duplication of resources. Additionally it is intended that the methodology provide sufficient flexibility to consider additional circumstances that reflect on the need for adult day health care.
(b) The factors and methodology for determining the public need for adult day health-care services in each county shall include, but not be limited to:
(1) An estimate of the capacity needed in adult day health-care programs to serve adult day health-care registrants. For purposes of this section, capacity means the number of registrants that an adult day health-care program can accommodate at one time based on factors such as availability of staff, furniture and equipment and the number and size of the rooms used for the program. This capacity is calculated using population estimates for each county projected five years in the future. This capacity shall be calculated using the following age cohorts and capacity measures:
(i) capacity for 0.04 registrants per 1,000 population aged 20-64;
(ii) capacity for 2.5 registrants per 1,000 population aged 65-74; and
(iii) capacity for 3.65 registrants per 1,000 population aged 75 and over.
(2) The estimates for each of the age cohorts shall be summed to derive the total capacity needed for adult day health-care services in a county.
(3)
(i) To determine unmet need for adult day health-care program capacity in a county, capacity of the approved programs in such county shall be subtracted from the total capacity needed for such county.
(ii) The capacity of approved adult day health-care programs shall be determined as follows:
(a) for a program that was approved with a specific capacity, such approved capacity shall be utilized;
(b) for a program that was approved for a total number of registrants without a specific capacity, such number shall be divided by two to determine the program's capacity;
(c) for a program that was not approved with a specific capacity or for a total number of registrants, the department will determine, based on the most recently received and processed data, the total number of current registrants of such program and such number shall be divided by two to determine the program's capacity.
(iii) The number of registrants is divided by two in order to determine an proved program's capacity under clauses (ii)( b ) and ( c ) of this paragraph, since it is estimated that each unit of adult day health-care program capacity will serve two registrants.
(4) In counties where the total capacity needed for adult day health-care services is less than the minimum capacity required in order to be approved under the operational standards set forth in Part 425 of this Title, one program may be approved despite such minimum capacity requirement, provided that all other criteria for approval are met.
(5) Notwithstanding that need may otherwise have been determined to be met under this section, additional adult day health-care program capacity may be approved within a county if:
(i) all existing programs within the county are operating at their approved capacities; and
(ii) there is evidence of further need for adult day health-care services as demonstrated by factors which include, but need not be limited to:
(a) waiting lists for adult day health-care services; and
(b) the number of people on alternate level of care in the county who could benefit from adult day health-care services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.39 Inpatient psychiatric services
Inpatient psychiatric services provided in general hospitals, or distinct units of general hospitals, specializing in such inpatient psychiatric services, with regard to patients admitted on and after October 20, 2010, shall be reimbursed on a per diem basis in accordance with the following, provided, however, that such rates applicable to inpatients otherwise subject to the provisions of Public Health Law section 2807-c(1)(a-2)(i) shall be effective with regard to patients admitted on and after January 1, 2011:
(a) Such reimbursement shall be based on the All Patient Refined Diagnostic Related Group (APR-DRG) patient classification system as defined in section 86-1.15(a) of this Subpart.
(b) The operating component of the rate shall be based on a statewide price, utilizing 2005 Medicaid fee-for-service (FFS) inpatient costs adjusted for case mix and the wage equalization factor (WEF) and excluding costs for direct GME, electroconvulsive therapy, and capital costs.
(c) The capital cost components of rates computed pursuant to this section shall be computed on the basis of budgeted capital costs allocated to the hospital, or to the distinct unit of a hospital, in accordance with the provisions of section 86-1.25 of this Subpart divided by the hospital or distinct unit patient days and reconciled to actual total expenses.
(d) The non-operating component of the rate shall reflect 2005 Medicaid fee-for-service direct GME costs.
(e) The statewide price shall be adjusted for each patient to reflect the following factors:
(1) a service intensity weight (SIW) associated with the case based on the grouper assigned APR-DRG, as described in subdivision (f) of this section, will be applied to the adjusted operating per diem;
(2) a rural adjustment factor of 1.2309 will be applied to the operating per diem for those hospitals designated as rural hospitals. For dates of service beginning on or after July 1, 2014, rural designation shall apply to hospitals located in an upstate region, as defined in subdivision (o) of this section, with population densities of 225 persons or fewer per square mile, based on the New York State 2010 Vital Statistics table of estimated population, land area, and population density;
(3) an age adjustment payment factor of 1.0872 will be applied to the per diem operating component for adolescents ages 17 and under;
(4) a payment adjustment factor of 1.0599 will be applied to the operating component for the presence of a mental retardation diagnosis;
(5) the payment methodology shall include one co-morbidity factor per stay and if more than one co-morbidity is presented, the co-morbidity that reflects the highest payment factor shall be used to adjust the per diem operating component;
(6) a variable payment factor will be applied to the operating per diem for each day of the stay, with the factor for days one through four established at 1.2, the factor for days 5 through 11 established at 1.0, the factor for days 12 through 22 established at 0.96 and the factor for stays longer than 22 days established at 0.92; and
(7) for dates of service beginning on or after July 1, 2014, a 10 percent increase will be applied for hospitals located in an upstate region, as defined in subdivision (o) of this section.
(f)
(1) The table of service intensity weights (SIW's) applicable to rates set pursuant to this section for each effective period is published on the New York State Department of Health website at http://www.health.ny.gov/nysdoh/hospital/drg/index.htmand reflects the cost weights assigned to each all patient refined (APR) diagnosis related group (DRG) patient classification category. The SIWs assigned to each DRG/APR indicates the relative cost variance of that DRG/APR classification from the average cost of all inpatients in all DRG/APRs. Such SIWs are developed using two years of Medicaid fee-for-service cost data as reported to the Statewide Planning and Research Cooperative System (SPARCS) for the years set forth in paragraph (2) of this subdivision. Costs associated with hospitals that do not have an ancillary charge structure and costs associated with statistical outliers shall be excluded from the SIW calculations.
(2) For rate periods on and after the effective date of this section the SIW shall be computed using SPARCS and reported cost data from the 2005 and 2006 calendar years, as submitted to the department by September 30, 2009.
(g) The table of co-morbidity factors applicable to the rate adjustments described in paragraph (e)(5) of this section is published on the New York State Department of Health website at http://www.health.state.ny.us/.
(h) The first day of a patient's readmissions to the same hospital within 30 days of discharge will be treated as day four for purposes of the variable payment factor computed pursuant to paragraph (d)(6) of this section, with subsequent days treated in a conforming manner with the provisions of such paragraph.
(i) Reimbursement for physician services shall not be included in rates set pursuant to this section and such services may be billed on a fee-for-services basis as otherwise provided by applicable provisions of law.
(j) Reimbursement for electroconvulsive therapy shall be established at a statewide fee of $281, as adjusted for each facility's WEF, for each treatment during a patient's stay.
(k) Reimbursement for days of alternative level of care for patients whose reimbursement is otherwise subject to this section shall be in accordance with section 86-1.22 of this Subpart.
(l) New inpatient psychiatric exempt hospitals or units established pursuant to article 28 of the Public Health Law shall be reimbursed at the statewide price plus budgeted capital and direct GME.
(m) For rate periods through December 31, 2014, reimbursement pursuant to this section shall include transition payments of up to $25,000,000 on an annualized basis, which shall be distributed in accordance with the following:
(1)
(i) Fifty percent of such payments shall be allocated to facilities that experience a reduction in Medicaid operating revenue in excess of threshold percentage set forth in subparagraph (ii) of this paragraph as a result of the implementation of rates set pursuant to this section. Such payments shall be allocated proportionally, based on each eligible facility's relative Medicaid operating revenue loss in excess of the threshold, as determined by the commissioner.
(ii) The threshold percentage described in subparagraph (i) of this paragraph shall be 6.02 percent.
(2)
(i) Fifty percent of such payments shall be allocated to facilities with regard to which it is determined by the commissioner that rates otherwise set pursuant to this section result in Medicaid revenue that is less than the facility's Medicaid costs by a threshold percentage in excess of the threshold percentage set forth in subparagraph (ii) of this paragraph. Such payments shall be allocated proportionally, based on the degree each facility Medicaid operating revenue shortfall exceeds such threshold percentage. For those facilities without available Medicaid fee-for-service cost data, computations pursuant to this paragraph shall be based on each such facility's total operating costs as determined by the commissioner.
(ii) The threshold percentage described in subparagraph (i) of this paragraph shall be 1.20 percent.
(n) For rate period after October 20, 2010 through March 31, 2011, reimbursement pursuant to this paragraph may include transition payments totaling, in aggregate, up to 12,000,000 and distributed to eligible hospitals in accordance with the following, provided, however, that if less than $12,000,000 is distributed in such rate period, then additional distributions of up to such $12,00,000 may be made in accordance with the provisions of this subdivision in subsequent rate periods:
(1) Eligible hospitals shall be those general hospitals which receive approval for certificate-of-need applications submitted to the Department of Health between April 1,2010 and March 31, 2011 for adding new behavioral health beds to their certified bed capacity as a direct result of the decertification of other general hospital behavioral health inpatient beds in the same service area, or which the Commissioner of Health, in consultation with the Commissioner of Mental Health, has determined have complied with Department of Health requests to make other significant behavioral health service delivery adjustments in direct response to such decertification.
(2) Eligible hospitals shall, as a condition of their receipt of such rate adjustments, submit to the Department of Health proposed budgets for the expenditure of such additional Medicaid payments for the purpose of providing behavioral health services and such budgets must be approved by the Department of Health, in consultation with the Office of Mental Health, prior to such rate adjustments being issued.
(3) Distributions made pursuant to this paragraph shall be made as add-ons to each eligible facility's inpatient Medicaid rate and shall be allocated proportionally, based on the proportion of each approved hospital budget to the total amount of all approved hospital budgets and such distributions shall be subsequently reconciled to ensure that actual aggregate expenditures are within available aggregate funding.
(o) For purposes of this section, the downstate region of New York State shall consist of the counties of Bronx, New York, Kings, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam and Dutchess, and the upstate region of New York State shall consist of all other counties.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.18 Ventilation
All indoor spray grounds shall be adequately ventilated, either by natural or mechanical means.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.12 Revocation
(a) The department may revoke, at any time, the certificate of public advantage, if any of the following occur:
(1) the department, after consultation with the Attorney General and, as appropriate, the mental hygiene agencies, determines that the parties to a certificate of public advantage have not complied with a condition or terms of such certificate of public advantage;
(2) the department, after consultation with the Attorney General and, as appropriate, the mental hygiene agencies, determines that the benefits or likely benefits of the cooperative agreement and the unavoidable costs of terminating the agreement do not continue to outweigh the disadvantages or likely disadvantages resulting from the agreement;
(3) the Attorney General or, as appropriate, the mental hygiene agencies, objects to the continuation of a certificate of public advantage and the department determines, after consultation with the Attorney General and, as appropriate, the mental hygiene agencies, that such objections are not overcome by modifying the cooperative agreement or planning process or changing the conditions imposed on the certificate of public advantage. Any modifications or changed conditions must be satisfied by a date set or agreed to by the department;
(4) the holder of a certificate of public advantage fails to file a report required by this Subpart or fails to provide information requested pursuant to a review under this Subpart, after notice of default; or
(5) a change in State or Federal law or regulations warrants revocation of the certificate of public advantage.
(b) Upon a decision to revoke the certificate of public advantage, the department shall notify the parties to the certificate of public advantage in writing of its determination, and any objections or concerns of the department that are part of the basis for the determination. The parties to the certificate of public advantage shall have 90 days to respond to such determination, and any objections or concerns. If the objections or concerns are not resolved to the satisfaction of the department based on its review of such response, the department may revoke the certificate.
(c) If the certificate is revoked, the parties shall be entitled to no benefits under article 29-F of the Public Health Law and this Subpart, beginning on the date of revocation.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.10 Computation of basic rate
(a) Definitions.
For purposes of this section, the following definitions shall apply:
(1) Direct price shall mean the monetary amount established for the direct component of the rate, based on the direct costs of all facilities after application of the regional direct input price adjustment factor, divided by patient days and the average statewide case mix index.
(2) Indirect price shall mean the monetary amount established for the indirect component of the rate, based on the indirect costs for each facility in a peer group, after application of a regional indirect price adjustment factor, divided by total peer group patient days.
(3) Peer group shall mean a set of facilities distinguished by like characteristics which are grouped for purposes of comparing costs and establishing payment rates using such criteria as affiliation ( i.e., hospital-based or freestanding) case mix index ( i.e., high intensity, case mix index greater than.83, or low intensity, case mix index less than or equal to.83), and size ( i.e., less than 300 beds or 300 or more beds).
(4) Cost center shall mean categories into which related costs are grouped in accordance with and defined in Part 455 of this Title.
(5) Case mix index shall mean the numeric weighting of each patient classification group in terms of relative resource utilization as specified in Appendix 13-A, infra.
(6) Rate shall mean the aggregate governmental payment to facilities per patient day as defined in section 86-2.8 of this Subpart, for the care of Medicaid payments which include a direct, indirect, noncomparable and capital component.
(7) Operating portion of the rate shall mean the portion of the rate consisting of the direct, indirect and noncomparable components after application of the roll factor promulgated by the department.
(8) Roll factor shall mean the cumulative result of multiplying one year's trend (inflation) factor times one or more other years trend factor(s) which is used to inflate costs from a base period to a rate period.
(9) Capital costs shall mean costs reported in the depreciation, leases and rentals, interest on capital debt and/or major movable equipment depreciation cost centers, as well as costs reported in any other cost center under the major natural classification of depreciation, leases and rentals on the facilities annual cost report (RHCF-4).
(10) Base shall mean, as applicable to cost or price, a minimum cost or price.
(11) Ceiling shall mean, as applicable to cost or price, a maximum cost or price.
(12) Corridor shall mean the difference between a base and a ceiling.
(13) Hospital-based shall mean as follows:
(i) For facilities receiving initial operating certificates prior to January 1, 1983, hospital- based shall mean those facilities that are considered by the Federal Health Care Financing Administration (HCFA) to be hospital-based or hospital-related (as pertaining to cost allocation) and which derive and report costs on the basis of a Medicare cost allocation methodology from an affiliated hospital.
(ii) For facilities receiving operating certificates after January 1, 1983, the commissioner shall review and determine whether or not such facilities are hospital-based utilizing the following criteria:
(a) the nature of any construction approval received pursuant to section 2802 of the Public Health Law;
(b) the nature of any establishment approval received pursuant to section 2801-a of the Public Health Law;
(c) the architectural configuration of the residential health care facility unit as related to the hospital physical plant;
(d) the method and amount of cost allocation;
(e) whether a determination that such a facility is hospital-based would result in the efficient and economic operation of such facility.
(b)
(1) The rate for 1986 and subsequent rate years shall:
(i) be computed on the basis of allowable fiscal and statistical data submitted by the facility for the fiscal year ending December 31, 1983 as contained in parts I, II, III and IV of the facility's annual cost report (RHCF-4) and for hospital-based facilities, the annual cost report (RHCF-2) and the institutional cost report of its related hospital;
(ii) consist of the following four separate and distinct components, as defined in this section:
(a) direct;
(b) indirect;
(c) noncomparable; and
(d) capital.
(2) The operation portion of the rate for 1986 and subsequent rate years shall consist of the sum of the direct, indirect and noncomparable components of the rate determined in accordance with this section trended to the rate year by the applicable roll factor promulgated by the department.
(3) Allocation and adjustments of reported costs.
(i) The computation of the rate for 1986 and for subsequent rate years shall incorporate the use of the single step-down method of cost allocation as defined in section 451.249 of this Title.
(ii) Individual discrete ceilings shall be applied to renumeration for the facility's administrator, assistant administrator and operator as specified in Appendix 13-A, infra.
(iii) Reported costs for 1983 shall be adjusted through the apportionment of retroactive adjustments due to operating appeals which were as a result of significant increases in staff specifically mandated by the commissioner. Such adjustments shall be limited to those related to staff hired subsequent to December 31, 1982 and those appeal requests received by the department prior to July 1, 1985.
(iv) In the determination of rates, reported costs shall be subject to the limitations and adjustments contained in sections 86-2.12, 86-2.17, 86-2.18, 86-2.25 and 86-2.26 of this Subpart.
(v) Salaries paid to related parties shall be subject to an initial maximum not to exceed $17,000. This limitation may be waived by the department pursuant to the provisions of section 86-2.14(a)(7) of this Subpart.
(c) Direct component of the rate.
(1) Allowable costs for the direct component of the rate shall include costs reported in the following functional cost centers on the facility's annual cost report (RHCF-4) or extracted from a hospital-based facility's annual cost report (RHCF-2) and the institutional cost report of its related hospital, after first deducting for capital costs and allowable items not subject to trending:
(i) nursing administration;
(ii) activities;
(iii) social service;
(iv) transportation;
(v) physical therapy;
(vi) occupational therapy;
(vii) speech and hearing therapy—(speech therapy portion only);
(viii) pharmacy;
(ix) central service supply; and
(x) residential health care facility.
(2) For purposes of calculating the direct component of the rate, the department shall utilize the allowable direct costs reported by all facilities with the exception of specialty facilities as defined in subdivision (i) of this section.
(3) The statewide mean, base and ceiling direct price for patients in each patient classification group shall be determined as follows:
(i) Allowable costs for the direct cost centers for each facility after first deducting capital costs and items not subject to trending, shall be multiplied by the appropriate Regional Direct Input Price Adjustment Factor (“RDIPAF”), as determined pursuant to paragraph (5) of this subdivision. The RDIPAF neutralizes the difference in wage and fringe benefit costs between and among the regions caused by differences in the wage scale of each level of employee.
(ii) The statewide distribution of patients in each patient classification group shall be determined for 1986 payments utilizing the patient data obtained in the patient assessment period, March 1, 1985 through September 30, 1985, conducted pursuant to section 86-2.30 of this Subpart.
(iii) A statewide mean direct case mix neutral cost, a statewide base direct case mix neutral cost and a statewide ceiling direct case mix neutral cost shall be determined as follows:
(a) Allowable direct costs for each facility, after first deducting capital costs and items not subject to trending and adjusted by applying the RDIPAF shall be summed to determine total statewide direct costs.
(b) The aggregate statewide case mix index shall be determined by multiplying number of patients on a statewide basis in each patient classification group by the case mix index for each patient classification group and the results summed.
(c) A statewide mean direct cost per day shall be determined by dividing total statewide direct costs by the aggregate number of statewide 1983 patient days.
(d) A statewide mean direct case mix neutral cost per day shall be determined by dividing the statewide mean direct cost per day by the ratio of the aggregate statewide case mix index to the number of patient review instruments received pursuant to section 86-2.30 of this Subpart.
(e) The statewide mean direct case mix neutral cost per day shall be the basis to establish a corridor between the statewide base direct case mix neutral cost per day and the statewide ceiling direct case mix neutral cost per day.
(f) The corridor shall be established by use of a base factor and a ceiling factor expressed as a percentage of the statewide mean direct case mix neutral cost per day.
(g) A statewide base direct case mix neutral cost per day shall be determined by multiplying the base factor times the statewide mean direct case mix neutral cost per day.
(h) A statewide ceiling direct case mix neutral cost per day shall be determined by multiplying the ceiling factor times the statewide mean direct case mix neutral cost per day.
(i) A statewide mean direct price per day for each patient classification group shall be determined by multiplying the statewide mean direct case mix neutral cost per day by the case mix index for each patient classification group, provided however that the index for reduced physical functioning A shall be.4414.
(j) A statewide base direct price per day for each patient classification group shall be determined by multiplying the statewide base direct case mix neutral cost per day by the case mix index for each patient classification group, provided however that the index for reduced physical functioning A shall be.4414.
(k) A statewide ceiling direct price per day for each patient classification group shall be determined by multiplying the statewide ceiling direct case mix neutral cost per day by the case mix index for each patient classification group, provided however that the index for reduced physical functioning A shall be.4414.
(l) The corridor referred to in clause ( e ) of this subparagraph shall be calculated as follows:
(1) The base factor referred to in clause ( f ) of this subparagraph shall be approximately 90 percent for the period January 1, 1986 through December 31, 1986. For the period January 1, 1987 through December 31, 1987, such factor shall be approximately 90 percent. For the period January 1, 1988 through June 30, 1989, such factor shall be increased to approximately 95 percent. For the period July 1, 1989 through March 31, 1990, such factor shall be reduced to approximately 88.25 percent. For the period April 1, 1990, and thereafter, such factor shall be increased to approximately 90 percent.
(2) The ceiling factor referred to in clause ( f ) of this subparagraph shall be approximately 115 percent for the period January 1, 1986 through December 31, 1986. For the period January 1, 1987 through December 31, 1987, such factor shall be reduced to approximately 110 percent. For the period January 1, 1988 through December 31, 1988, and thereafter, such factor shall be reduced to approximately 105 percent.
(3) For the period January 1, 1986 through December 31, 1986, the base factor and ceiling factor contained in the clause shall initially be determined to result in a 20-percent corridor. The ceiling factor shall then be increased by five percent. For the period January 1, 1987 through December 31, 1987, the application of the base factor and ceiling factor contained in this clause shall result in a 20-percent corridor. For the period January 1, 1988 through December 21, 1988, and thereafter, the base factor and ceiling factor contained in this clause shall result in a 10-percent corridor.
(4) The facility specific direct adjusted payment price per day shall be determined as follows:
(i) The facility specific mean direct price per day shall be determined by multiplying the statewide mean direct price per day for each patient classification group times the number of patients properly assessed and reported by the facility in each patient classification group pursuant to section 86-2.30 of this Subpart and dividing the sum of the results by the total number of patients properly assessed and reported by the facility pursuant to section 86-2.30 of this Subpart.
(ii) The facility specific base direct price per day shall be determined by multiplying the statewide base direct per day for each patient classification group times the number of patients properly assessed and reported by the facility in each patient classification group pursuant to section 86-2.30 of this Subpart and dividing the sum of the results by the total number of patients properly assessed and reported by the facility pursuant to section 86-2.30 of this Subpart.
(iii) The facility specific ceiling direct price per day shall be determined by multiplying the statewide ceiling direct price per day for each patient classification group times the number of patients properly assessed and reported by the facility in each patient classification group pursuant to section 86-2.30 of this Subpart and dividing the sum of the results by the total number of patients properly assessed and reported by the facility pursuant to section 86-2.30 of this Subpart.
(iv) The facility specific cost based direct price per day shall be determined by dividing a facility's adjusted allowable reported direct costs after first deducting capital costs and items not subject to trending and, after application of the RDIPAF, by the facility's 1983 total patient days.
(v) Except as contained in subparagraph (vi) of this paragraph, the facility specific direct adjusted payment price per day shall be determined by comparison of the facility specific cost based price per day with the facility specific base direct price per day and the facility specific ceiling direct per day pursuant to the following table:
| Facility Specific Cost Based Direct Price Per Day | Facility Specific Direct Adjusted Payment Price Per Day | | --- | --- | | Below Facility Specific Base Direct Price Per Day | Facility Specific Base Direct Price Per Day | | Between Facility Specific Base Direct Price Per Day and Facility | Facility Specific Cost Based Direct Price Per Day | | Specific Ceiling Direct Price Per Day | | | Above Facility Specific Ceiling Direct Price Per Day | Facility Specific Ceiling Direct Price Per Day |
(vi) The facility specific direct adjusted payment price per day shall be considered to be the facility specific cost based direct price per day when such price is below the facility specific base direct price per day subject to the provisions of paragraph (6) of this subdivision for the following operators of residential health care facilities:
(a) an operator who has had an operating certificate revoked pursuant to section 2806(5) of the Public Health Law and is operating a residential health care facility pursuant to an order of the Commissioner of this department; and
(b) an operator of a facility in which the Federal Health Care Financing Administration (HCFA) has imposed a ban on payment for all Medicare and Medicaid admissions after a specified date pursuant to section 1866(f) of the Federal Social Security Act until the lifting of the ban in writing by HCFA.
(vii) The direct component of a facility's rate shall be the facility specific direct adjusted payment price per day determined in subparagraph (v) or (vi) of this paragraph as applicable after applying the RDIPAF.
(5) The RDIPAF shall be based on the following factors:
(i) Residential health care facilities shall be grouped, by county, into 16 regions within the State as outlined in Appendix 13-A, infra.
(ii) The facility's staffing, based on case mix predicted staffing for registered professional nurses, licensed practical nurses, and aides, orderlies and assistants for each facility. The case mix predicted staffing shall be adjusted annually on January 1st of each rate year based on the PRI's submitted by each facility for the fourth quarter of the preceding calendar year, in accordance with sections 86-2.11(b) and 86-2.30 of this Subpart. Until such PRI's are available, the case mix predicted staffing shall be based on the most current PRI's available prior to calculation of the initial rate effective January 1st of each rate year. The case mix predicted staffing shall subsequently be revised based on more recent PRI submissions until such time as the PRI's for the fourth quarter of the preceding calendar year are available.
(iii) The proportion of salaries and fringe benefit costs for the direct care cost centers indicated in subdivision (c) of this section to the total costs of such direct care cost centers.
(6) Case mix adjustment. A facility shall receive an increase or decrease in the direct component of its rate if the facility has increased or decreased its case mix from one assessment period to the next and, in accordance with subparagraph (4)(v) of this subdivision, would not have received any change in the direct component of its rate from that determined as of January 1, 1986 to the current calculation date. The increases or decreases in the direct component of the rate shall be determined as follows:
(i) The facility specific mean price per day effective January 1, 1986 as determined in accordance with subparagraph (4)(i) of this subdivision shall be compared to the facility specific mean price per day determined as a result of the submissions required in accordance with section 86-2.11(b) of this Subpart. Any increase or decrease determined as a result of such comparison, shall be expressed as a percentage, positive or negative, of the facility specific mean price per day effective January 1, 1986.
(ii) This percentage shall be applied to the facility specific cost based direct price per day determined as of January 1, 1986, and an adjustment factor shall be determined.
(iii) This adjustment factor shall be added to or subtracted from the facility specific cost based direct price per day determined as of January 1, 1986, to arrive at an adjusted facility specific cost based direct price per day which shall become for a facility their facility specific adjusted payment price per day for the applicable rate period for which payment rates are adjusted pursuant to section 86-2.11 of this Subpart.
(d) Indirect component of the rate.
(1) Allowable costs for the indirect component of the rate shall include costs reported in the following functional cost centers on the facility's annual cost report (RHCF-4) or extracted from a hospital-based facility's annual cost report (RHCF-2) and the institutional cost report of its related hospital, after first deducting for capital costs and allowable items not subject to trending:
(i) fiscal services;
(ii) administrative services;
(iii) plant operations and maintenance (with the exception of utilities and real estate and occupancy taxes);
(iv) grounds;
(v) security;
(vi) laundry and linen;
(vii) housekeeping;
(viii) patient food services;
(ix) cafeteria;
(x) nonphysician education;
(xi) medical education;
(xii) housing; and
(xiii) medical records.
(2) For the purposes of establishing the allowable indirect component of the rate, facilities shall be combined into peer groups as follows:
(i) Size:
(a) less than 300 beds;
(b) 300 or more beds.
(ii) Affiliation:
(a) free-standing;
(b) hospital-based.
(iii) Case mix index:
(a) high intensity, case mix index greater than.83;
(b) low intensity, case mix index less than or equal to.83.
(3) If any peer group contains fewer than five facilities, those facilities shall be included in a peer group of a similar type.
(4) For each of the peer groups, the indirect component of the rate shall be determined as follows:
(i) A mean indirect price per day shall be computed as follows:
(a) Reported allowable costs for the indirect cost centers for each facility in the peer group, after first deducting capital costs and allowable items not subject to trending shall be adjusted by applying the Regional Indirect Input Price Adjustment Factor (RIIPAF), as determined pursuant to paragraph (7) of this subdivision.
(b) The results of the calculation in clause ( a ) of this subparagraph shall be aggregated and divided by total 1983 patient days of all facilities in the peer group.
(ii) The mean indirect price per day shall be the basis to establish a corridor between the base indirect price per day and the ceiling indirect price per day. The corridor shall be established by use of a base factor and a ceiling factor expressed as a percentage of the mean indirect price per day.
(a) The base factor shall be approximately 90 percent for the period January 1, 1986 through December 31, 1986. For the period January 1, 1987 through December 31, 1987, such factor shall be increased to approximately 95 percent. For the period January 1, 1988 through June 30, 1989, such factor shall be increased to approximately 97.5 percent. For the period July 1, 1989 through March 31, 1990 such factor shall be reduced to approximately 90.75 percent. For the period April 1, 1990, and thereafter, such factor shall be increased to approximately 92.5 percent.
(b) The ceiling factor shall be approximately 110 percent for the period January 1, 1986 through December 31, 1986. For the period January 1, 1987 through December 31, 1987, and thereafter, such factor shall be reduced to approximately 105 percent.
(iii) For the period January 1, 1986 through December 31, 1986, the base factor and ceiling factor contained in subparagraph (ii) of this paragraph, shall result in a 20-percent corridor. For the period January 1, 1987 through December 31, 1987, the base factor and ceiling factor contained in subparagraph (ii) of this paragraph shall result in a 10-percent corridor. For the period January 1, 1988 through December 31, 1988, and thereafter, the base factor and ceiling factor contained in subparagraph (ii) of this paragraph shall initially be determined to result in a five-percent corridor. The ceiling factor shall then be increased by 2.5 percent.
(iv) The base indirect price per day shall be determined by multiplying the base factor times the mean indirect price per day.
(v) The ceiling indirect price per day shall be determined by multiplying the ceiling factor times the mean indirect price per day.
(vi) The facility specific indirect adjusted payment price per day shall be determined by comparison of a facility's adjusted reported indirect costs after deducting capital costs and items not subject to trending and after application of the RIIPAF, divided by the facility's total 1983 patient days, with the base indirect price per day and the ceiling indirect price per day. Except as outlined in subparagraph
(vii) of this paragraph, the facility specific indirect adjusted payment price per day shall be established as presented by the following table:
| Facility Adjusted Costs | Facility Specific Indirect Adjusted Payment | | --- | --- | | Divided by Patient Days | Price Per Day | | Below Base Indirect Price Per Day | Base Indirect Price Per Day | | Between Base Indirect Price Per Day and Ceiling Indirect Price Per Day | Reported Adjusted Costs Per Day | | Above Ceiling Indirect Price Per Day | Ceiling Indirect Price Per Day |
(vii) The facility specific indirect adjusted payment price per day shall be considered to be the facility specific cost based indirect price per day when such price is below the facility specific base indirect price per day for the following operators of residential health care facilities:
(a) an operator who has had an operating certificate revoked pursuant to section 2806(5) of the Public Health Law and is operating a residential health care facility pursuant to an order of the commissioner of this department; and
(b) an operator of a facility in which the Federal Health Care Financing Administration (HCFA) has imposed a ban on payment for all Medicare and Medicaid admissions after a specified date pursuant to section 1866(f) of the Federal Social Security Act until the lifting of the ban in writing by HCFA.
(5) For each rate year, a facility's indirect costs shall be compared to the peer groups identified in paragraph (2) of this subdivision as follows:
(i) A facility's peer group established pursuant to subparagraphs (2)(i) and (ii) of this subdivision shall be based on that facility's affiliation status prior to the effective rate period, contingent upon the provisions of section 86-2.34 of this Subpart, and total certified bed capacity listed on the operating certificate.
(ii) Those facilities having 80 percent or more of all patients falling into patient classification groups with weights greater than.83 shall be compared to the peer group established pursuant to clause (2)(iii)( a ) of this subdivision.
(iii) Those facilities having 80 percent or more of all patients falling into patient classification groups with weights equal to or less than.83 shall be compared to the peer group established pursuant to clause (2)(iii)( b ) of this subdivision.
(iv) Those facilities who do not meet either of the above conditions identified in subparagraphs (ii) and (iii) of this paragraph, shall be compared to a blended peer group mean price per day. Such price shall be determined by blending the number of a facility's patients which have patient classification group weights above.83 at the high intensity peer group mean price and the number of a facility's patients at or below.83 at the low intensity peer group mean price as defined pursuant to paragraph (4) of this subdivision.
(v) The peer group mean price effective January 1st of each rate year shall be based on the PRI's submitted by each facility for the fourth quarter of the preceding calendar year in accordance with sections 86-2.11(b) and 86-2.30 of this Subpart. Until such PRI's are available, the peer group mean price shall be based on the most current PRI's available prior to calculation of the initial rate effective January 1st of each rate year. The peer group mean price shall subsequently be revised based on more recent PRI submissions until such time as the PRI's for the fourth quarter of the preceding calendar year are available.
(6) The indirect component of a facility's rate shall be the facility specific indirect adjusted payment price per day determined in accordance with subparagraphs (vi) and (vii), as applicable of paragraph (4) of this subdivision after application of the RIIPAF.
(7) The RIIPAF shall be based on the following factors:
(i) residential health care facilities shall be grouped by county, into 16 regions within the State as outlined in Appendix 13-A, infra.
(ii) the facility's staffing, based on case mix predicted staffing for registered professional nurses, licensed practical nurses, and aides, orderlies and assistants for each facility. The case mix predicted staffing shall be adjusted annually on January 1st, of each rate year based on the PRI's submitted by each facility for the fourth quarter of the preceding calendar year, in accordance with sections 86-2.11(b) and 86-2.30 of this Subpart. Until such PRI's are available, the case mix predicted staffing shall be based on the most current PRI's available prior to calculation of the initial rate effective January 1st of each rate year. The case mix predicted staffing shall subsequently be revised based on more recent PRI submissions until such time as the PRI's for the fourth quarter of the preceding calendar year are available; and
(iii) the proportion of salaries and fringe benefit costs for the indirect care cost centers indicated in paragraph (1) of this subdivision to the total costs of such indirect care cost centers.
(e) Gain or loss limitation for the direct and indirect component of the rate.
Gain or losses resulting from using the regional direct or indirect input price adjustment factors rather than individual facility specific direct or indirect input price adjustment factors shall be determined as follows:
(1) A facility's allowable direct costs divided by the facility's 1983 total patient days shall be compared to the facility's direct component and a direct gain or loss per day calculated.
(2) A facility's allowable indirect costs divided by the facility's 1983 total patient days shall be compared to the facility's indirect component and an indirect gain or loss per day calculated.
(3) The facility's direct gain or loss per day and indirect gain or loss per day shall be summed to arrive at a facility's net composite gain or loss per day.
(4) If a facility's net composite gain or loss per day is greater than $3.50, for the rate year 1986, a limitation shall be applied for rate years 1986 through 1988 as follows:
(i) For 1986 rates, if a facility has a net composite gain, then a facility's direct or indirect cost per day shall be determined by utilizing the regional or the individual facility specific input price adjustment factor, whichever factor, when applied would reduce the gain.
(ii) For 1986 rates, if a facility has a net composite loss, then a facility's direct or indirect cost per day shall be determined by utilizing the regional or the individual facility specific input price adjustment factor, whichever factor, when applied, would reduce the loss.
(iii) If a facility's direct or indirect cost per day is determined, pursuant to subparagraph (i) or (ii) of this paragraph, by utilizing the regional input price adjustment factor, such factor shall be utilized in all subsequent rate years.
(iv) If a facility's direct or indirect cost per day is determined, pursuant to subparagraph (i) or (ii) of this paragraph, by utilizing the individual facility specific input price adjustment factor, the following shall apply to subsequent rate years:
(a) For 1987 rates, a facility's direct or indirect costs per day shall be determined by using a composite of 50 percent of the regional and 50 percent of the facility specific input price adjustment factor.
(b) For 1988 rates, a facility's direct or indirect costs per day shall be determined by using a composite of 75 percent of the regional and 25 percent of the facility specific input price adjustment factor.
(c) For 1989 and subsequent rate years, a facility's direct costs per day shall be determined by using the regional input price adjustment factors.
(5) The limitations of this subdivision shall not be applicable to specialty facilities as defined in subdivision (i) of this section.
(f) Noncomparable component of the rate.
(1) The noncomparable component of the rate shall consist of costs which represent allowable costs reported by a facility which because of their nature are not subject to peer group comparisons.
(2) Allowable costs for the noncomparable component of the rate shall include the costs associated with supervision of facility volunteers and costs reported in the following functional cost centers as reported on the facility's annual cost report (RHCF-4) or extracted from a hospital-based facility's annual cost report (RHCF-2) and the institutional cost report of its related hospital, after first deducting capital costs and allowable items not subject to trending:
(i) laboratory services;
(ii) ECG;
(iii) EEG;
(iv) radiology;
(v) inhalation therapy;
(vi) podiatry;
(vii) dental;
(viii) psychiatric;
(ix) speech and hearing therapy—(hearing therapy only);
(x) medical director office;
(xi) medical staff services;
(xii) utilization review;
(xiii) other ancillary; and
(xiv) plant operations and maintenance—(cost for utilities and real estate and occupancy taxes only).
(3) The allowable facility specific noncomparable component of the rate shall be reimbursed at a payment rate equal to adjusted reported noncomparable costs, after first deducting capital costs and allowable items not subject to trending, divided by the facility's total 1983 patient days.
(g) Capital component of the rate.
The allowable facility specific capital component of the rate shall include allowable capital costs determined in accordance with sections 86-2.19, 86-2.20, 86-2.21 and 86-2.22 of this Subpart and costs of other allowable items determined by the department to be nontrendable divided by the facility's patient days in the base year determined applicable by the department.
(h) A facility's payment rate for 1986 and subsequent rate years shall be equal to the sum of the operating portion of the rate as defined in paragraph (b)(2) of this section and the capital component as defined in subdivision (g) of this section.
(i) Specialty facilities.
Facilities which provide extensive nursing, medical, psychological and counseling support services to children with diverse and complex medical, emotional and social problems shall be considered specialty facilities and shall not be subject to the provisions of paragraphs (c)(3), (c)(4), (d)(4), (d)(5) and (d)(6) of this section. The direct component of such facilities' rates shall be calculated based on allowable 1983 direct costs as defined in paragraph (c)(1) of this section, divided by the facilities' total 1983 patient days. The indirect component of such facilities' rates shall be calculated based on allowable 1983 indirect costs as defined in paragraph (d)(1) of this section, divided by the facilities' total 1983 patient days.
(j) Rates for residential health care facility services for nonoccupants for 1986 and subsequent rate years shall be calculated in accordance with section 86-2.9 of this Subpart, with any operating component of the rate trended from the 1983 base year, to the rate year by the applicable roll factor promulgated by the department.
(k) Receiverships and new operators.
(1) The appointment of a receiver or the establishment of a new operator of an ongoing facility shall require such receiver or operator of file a cost report for the first 12-month period of operation in accordance with section 86-2.2(e) of this Subpart. This report shall be filed and properly certified within 60 days following the end of the 12-month period covered by the report. Failure to comply with this subdivision shall result in application of the provisions of section 86-2.2(c) of this Subpart.
(2) The initial rate for facilities covered under this subdivision shall be the higher of:
(i) the rate in effect on the date of the appointment of a receiver or the date of transfer of ownership as applicable; or
(ii) the rate in effect on the date of appointment of a receiver or the date of transfer of ownership as applicable with the direct and indirect component of such rate calculated as follows:
(a) the direct component of the rate shall be equivalent to the facility-specific mean direct price per day after application of the RDIPAF as determined in subdivision (c) of this section. The PRIs used in the computation of the facility-specific mean direct price per day shall be the PRIs used to calculate the rate in effect on the date of appointment of a receiver or the date of transfer of ownership;
(b) the indirect component of the rate shall be equivalent to the mean indirect price per day, determined using the PRIs used to calculate the rate in effect on the date of appointment of a receiver or date of transfer of ownership, and adjusted by the RIIPAF as determined in subdivision (d) of the section.
(3) The facility shall perform an assessment of all patients, pursuant to section 86-2.30 of this Subpart, at the beginning of the fourth month of operation. The direct component of the rate shall be adjusted pursuant to this Subpart effective the first day of the assessment period based on the facility's case mix.
(4) The 12-month cost report referred to in paragraph (1) of this subdivision shall be used to adjust the direct, indirect, noncomparable and capital components of the rate effective on the first day of the 12-month cost report period.
(5)
(i) For purposes of this subdivision, and except as identified in paragraph (7) of this subdivision, the terms new operator and receiver shall not include any operator or receiver approved to operate a facility when:
(a) a stockholder, officer, director, sole proprietor or partner of such operator or receiver was also a stockholder, officer, director, sole proprietor or partner of the prior operator or receiver of such facility;
(b) the approved operator was the prior receiver of the facility;
(c) any prior corporate operator or receiver is a corporate member of the approved operator or receiver, is otherwise affiliated with the approved operator or receiver through direct or indirect sponsorship or control or when the approved operator or receiver and prior operator or receiver are subsidiaries of a common corporate parent; or
(d) a principal stockholder (owning 10 percent or more of the stock), officer, director, sole proprietor or partner of an approved proprietary operator or receiver is the spouse or child of a principal stockholder, officer, director, sole proprietor or partner of the prior operator or receiver of such facility, regardless of whether such relationship arises by reason of birth, marriage or adoption.
(ii) Rates of reimbursement for operators or receivers which are not considered new operators or receivers under this subdivision shall not be subject to adjustment under this subdivision.
(6) Notwithstanding the provisions of this subdivision, a receiver or new operator of a facility which has had an overall average utilization of at least 90 percent of bed capacity for a six-month period which began prior to April 1, 1993 but after the date on which the receiver was appointed or new operator became the operator shall submit a six-month cost report for that period. Such six-month cost report shall be utilized for the purposes of this subdivision in lieu of the 12-month cost report identified in paragraph (1) of this subdivision.
(7)
(i) Notwithstanding the provisions of this subdivision, when a receiver of a proprietary nursing facility is appointed or a new operator of a previously established proprietary nursing facility is established and a stockholder, sole proprietor, partner or limited liability company member of such receiver or new operator is the child of a stockholder, sole proprietor, partner or member of the limited liability company of the prior operator or receiver of the facility, such receiver or new operator shall receive rates of reimbursement adjusted pursuant to paragraphs (1)-(4) and (6) of this subdivision. For purposes of this paragraph, child shall mean a child or stepchild by birth, adoption, or marriage. Rates of reimbursement for any subsequent operator of such facility who is established within 10 years of the date of appointment or establishment of such child or stepchild shall not be subject to adjustment under this subdivision.
(ii) For purposes of this paragraph, the terms new operator and receiver shall not include any operator or receiver with a stockholder, sole proprietor, partner, or limited liability company member who was a stockholder, sole proprietor, partner or limited liability company member of the prior operator or receiver of such facility.
(iii) For purposes of this paragraph, new operator shall also mean an established operator which has undergone a total change in owners, stockholders, partners or limited liability company members.
(iv) This paragraph shall apply to appointments of receivers and/or the establishment of a new operator on or after the effective date of this paragraph.
(l) Adjustments to the operating component of the rate.
(1) Notwithstanding any other provision of this section, the department shall make available the sum of $10 million for rate year 1986 and $5 million for rate year 1987, based on total system costs and total patient days, herein referred to as the transfer amount, to facilities in those rate years, whose reimbursement for the indirect component of their rates is less than their 1983 allowable costs for the indirect component of the rate, herein referred to as indirect losses.
(2) To determine eligibility for such adjustments, facilities shall also have suffered an aggregate loss. For purposes of this subdivision, an aggregate loss shall exist when a facility's composite reimbursement for the direct and indirect components of the rate is less than such a facility's composite 1983 allowable costs for the direct and indirect components.
(3) The transfer amount referred to in paragraph (1) of this subdivision shall be made available by reductions in the operating components of facilities' rates whose composite reimbursement for the direct and indirect components of their rates is more than their composite 1983 allowable costs for the direct and indirect components, herein referred to as aggregate gains.
(4) The transfer amounts referred to in paragraph (1) of this subdivision shall be distributed, for the applicable rate years, to eligible facilities by a per diem adjustment in the operating component of their rates in accordance with the following procedure:
(i) The indirect losses of all eligible facilities shall be summed to arrive at total indirect losses.
(ii) The proportion of a facility's indirect loss to total indirect losses shall be expressed as a percentage, herein referred to as a sharing percentage.
(iii) The sharing percentage for an eligible facility shall be multiplied by the transfer amount to arrive at a facility's share of the transfer amount.
(iv) A facility's share of the transfer amount shall be divided by 1983 patient days to arrive at a per diem adjustment to the operating component of a facility' s rate.
(5) The transfer amounts referred to in paragraph (1) of this subdivision shall be accumulated from facilities referred to in paragraph (3) of this subdivision by a per diem adjustment to the operating component of their rates in accordance with the following procedure:
(i) The aggregate gains of a facility shall be expressed as a percentage of their composite 1983 allowable costs for the direct and indirect components. Such percentage shall be herein referred to as percentage gain.
(ii) The percentage gain for all facilities shall be ranked from highest to lowest.
(iii) A methodology shall be employed where, beginning with a set percentage, percentage gains in excess of such set percentage shall be noted, arrayed by facility and herein referred to as excess percentage gain.
(iv) The excess percentage gain shall be multiplied by each facility's allowable composite 1983 costs for the direct and indirect components and such total for all facilities accumulated as a funded amount. The excess percentage gain shall also then be subtracted from a facility's percentage gain and the net percentage gain utilized as a facility's percentage gain for subsequent calculations.
(v) Such process shall continue, decreasing the set percentage used as a standard against which percentage gains of facilities is compared and the funded amounts accumulated until the transfer amounts referred to in paragraph (1) of this subdivision are realized.
(vi) If in this process, moving to the next set percentage used as a standard against which percentage gains of facilities is compared shall result in a total transfer amount in excess of the transfer amounts referred to in paragraph (1) of this subdivision, the following procedure shall be utilized to determine the amounts necessary to be funded by each facility in the final step of this process to attain the transfer amounts referred to in paragraph (1) of this subdivision:
(a) A facility's percentage gain shall be compared to the next lower set percentage that would be utilized as a standard and an excess percentage gain determined.
(b) The excess percentage gain for a facility, at that time, shall be multiplied by the facility's allowable composite 1983 costs for the direct and indirect components and the result herein referred to as an interim funded amount.
(c) The interim funded amount for each facility, expressed as a percentage of the aggregate of the interim funded amounts for all facilities shall be multiplied by the remaining amount to be funded for a given rate year to arrive at a facility's portion of the final amount to be funded.
(vii) The funded amounts for a facility arrived at as a result of this paragraph shall be summed, divided by total 1983 patient days and deducted as a per diem adjustment from a facility's operating per diem in the appropriate rate year.
(m) Computation of regional input price adjustment factors applied for purposes other than determining, pursuant to this section, the statewide direct and peer group indirect prices.
(1) The regional direct input price adjustment factor (RDIPAF) as contained in subparagraphs (c)(4)(iv) and (vii) of this section, the regional indirect input price adjustment factor (RIIPAF), as contained in subparagraph (d)(4)(vi) and paragraph (d)(5) of this section and the regional input price adjustment factor as contained in subparagraph (e)(4)(iv) of this section, hereinafter referred to as factors shall, for rate years beginning on or after January 1, 1987, be based on the regional average dollar per hour (RAP) calculated using the financial and statistical data required by section 86-2.2 of this Subpart, reported solely for 1983 calendar year operations, adjusted as follows:
(i) RAP's shall be adjusted for the variation in wage and fringe benefit costs for each region relative to such variation for all other regions through the use of a variable corridor.
(ii) The measurement of the region's variation shall be accomplished by means of the statistical measure of variation, the coefficient of variation, in wage and fringe benefit costs.
(iii) The region with the smallest variation shall receive no corridor. The region with the highest variation shall receive a corridor no greater than a maximum percentage such that the average corridor for all regions in the State shall be approximately plus or minus 10 percent.
(iv) For rate years beginning on or after January 1, 1991, for those regions of the State described in Appendix 13-A, infra, whose Regional Average Dollar Per Hour (RAP), calculated using the financial and statistical data required by section 86-2.2 of this Subpart reported solely for 1987 calendar year operations (1987 RAP) expressed as a percentage of the Statewide RAP for such year is greater than the percentage calculated using the same data reported for 1983 calendar year operations, (1983 RAP), the factors shall be determined utilizing 1987 RAPs and adjusted pursuant to subparagraphs (i), (ii) and (iii) of this paragraph.
(a) Notwithstanding this subparagraph if the utilization of 1987 RAPs to determine the factors would, for any facility within a region described in this subparagraph, result in less reimbursement than the continued utilization of the 1983 RAPs to determine the factors, the factors utilized for such facility shall continue to be based on 1983 calendar year data.
(2) The corridor established in paragraph (1) of this subdivision shall be applied in each region as follows:
(i) The regional corridor percentage referred to in subparagraph (1)(iii) of this subdivision, shall be applied, both negatively and positively to the RAP to arrive at an amount which when added to or subtracted from the RAP shall represent the maximum and minimum regional dollar per hour for the region, hereinafter referred to as the maximum and minimum respectively.
(ii) The facility in each region with the highest facility wage and fringe benefit dollar per hour shall be assigned a facility RAP equivalent to the maximum.
(iii) The facility in each region with the lowest facility wage and fringe benefit dollar per hour shall be assigned a facility RAP equivalent to the minimum.
(iv) Facilities in a region with facility wage and fringe benefit dollars per hour between the highest and lowest facility wage and fringe benefit dollar per hour in such region shall be assigned a facility RAP on a sliding scale, based on the relativity of each such facility's labor costs to the RAP and to the highest or lowest labor costs in the region, as applicable.
(n) Long-term inpatient rehabilitation program for traumatic brain-injured residents (TBI).
Facilities which have been approved to operate discrete units for the care of patients under the long-term inpatient rehabilitation program for TBI patients established pursuant to section 415.36 of this Title shall have separate and distinct payment rates for such units calculated pursuant to this section except as follows:
(1) In determining the facility specific direct adjusted payment price per day pursuant to paragraph (c)(4) of this section for patients meeting the criteria for and residing in a TBI unit, the case mix index used to establish the statewide ceiling direct price per day for each patient classification group pursuant to subparagraph (c)(3)(iii) of this section for such residents shall be increased by an increment of 1.49. In determining the case mix adjustment pursuant to paragraph (c)(6) of this section, the case mix index used to calculate the facility specific mean price for each patient classification group shall be increased by an increment of 1.49.
(i) The increment established in paragraph (1) of this subdivision shall be audited and such increment shall be retrospectively or prospectively reduced on a proportional basis if the commissioner determines that the actual staffing reported in the facility's cost report submitted pursuant to this Subpart is less than the staffing pattern required by section 415.36 of this Title.
(2) In determining the indirect component of a facility's rate pursuant to paragraphs (d)(4), (5) and (6) of this section for residents meeting the criteria for and residing in a TBI unit, a facility's indirect costs shall be compared to the peer group established pursuant to clause (d)(2)(iii)( a ) of this section.
(3) The noncomparable component of such facilities' rates shall be determined pursuant to subdivision (f) of this section utilizing the cost report filed pursuant to section 86-2.2(e) of this Subpart including approved actual costs in such cost report for personnel required by section 415.36 of this Title that would be reported in the functional cost centers identified in subdivision (f) of this section.
(o)
(1) A per diem amount of $4 (subject to adjustment pursuant to the provisions of paragraph [2] of this subdivision) increased to the rate year by the projection factors determined pursuant to section 86-2.12 of this Subpart, adjusted by the RDIPAF determined pursuant to paragraph (c)(5) of this section, shall be added to each facility's payment rate for each patient whose primary medical problem, as reported in section V.29 of the patient review form (PRI) as contained in section 86-2.30(i) of this Subpart, is dementia, as defined in paragraph (4) of this subdivision, and who is properly assessed and reported by the facility in one of the following patient categories as listed in Appendix 13-A of this Title:
Clinically Complex A
Behavioral A
Reduced Physical Functioning A
Reduced Physical Functioning B
(2) Based on the most current 1986 PRI's filed with the department, the number of eligible dementia patient days for Medicaid patients admitted prior to December 31, 1987, is estimated to be 1,750,000. Aggregate changes in such number in excess of five percent shall be deemed to be attributable to factors other than changes in patient condition and shall result in the recalculation and proportionate, prospective reduction of the per diem amount referred to in paragraph (1) of this subdivision.
(3) Facilities to whom the additional amount is paid shall demonstrate and document positive outcomes from implementation or continuation of programs and/or operations and promulgation of policies designed to improve the care of eligible dementia patients. The additional amount shall be recouped from facilities in which such positive outcomes are not demonstrated.
(4) The per diem amount referred to in paragraph (1) of this subdivision shall be paid for any patients with the following dementia diagnoses. The dementia diagnoses and related codes and descriptions are taken from the International Classification of Diseases, 9th Revision, Clinical Modification, volume 3 (ICD-9-CM).
| ICD-9-CM Code | ICD-9-CM Diagnosis | | --- | --- | | 290.0 | Senile dementia | | | Uncomplicated senile dementia | | | NOS, simple type excludes memory disturbance | | 290.1 | Presenile dementia | | | Brain syndrome with presenile brain disease | | | Dementia in: | | | Alzheimer's disease | | | Jakob-Croutzfeldt disease | | | Pick's disease of the brain | | 290.10 | Presenile dementia | | | Uncomplicated presenile dementia | | | NOS, simple type | | 290.11 | Presenile dementia with delirium | | | Presenile dementia with acute confusional state | | 290.12 | Presenile dementia with delusional feature | | 290.13 | Presenile dementia with depressive features | | 290.2 | Senile dementia with delusional or depressive features | | 290.21 | Senile dementia with depressive features | | 290.4 | Multi-infarct dementia | | 290.40 | Arteriosclerotic dementia | | 290.41 | Arteriosclerotic dementia | | 290.42 | Arteriosclerotic dementia | | 290.43 | Arteriosclerotic dementia | | 294.0 | Wernicke-Korsakoff syndrome (nonalcoholic) | | 293.81 | Organic brain syndrome | | 294.8 | Other specified organic brain syndrome | | 294.9 | Unspecified organic brain syndrome | | 310.1 | Organic personality syndrome | | 310.8 | Other specified nonpsychotic mental disorders, following organic brain damage | | 310.9 | Unspecified nonpsychotic mental disorders following organic brain damage | | 331.0 | Alzheimer's disease | | 331.1 | Pick's disease | | 331.2 | Senile degeneration of the brain | | 331.3 | Communicating hydrocephalus | | 331.7 | Cerebral degeneration in diseases classified elsewhere | | 331.8 | Other cerebral degeneration | | 331.9 | Cerebral degeneration, unspecified | | 331.89 | Cerebral degeneration, NEC | | 333.4 | Huntington's Chorea | | 437.0 | Cerebral atherosclerosis |
(p) Acquired immune deficiency syndrome (AIDS).
(1) For rate year 1988 and thereafter, payment rates shall be adjusted, pursuant to this subdivision to provide additional payments to facilities for patients residing in a residential health care facility designated as an AIDS facility or having a discrete AIDS unit approved by the commissioner pursuant to Part 710 of this Title, or a facility which has received approval by the commissioner pursuant to Part 710 of this Title to provide services to a patient whose medical condition is HIV Infection Symptomatic. Such patients shall hereinafter be referred to as AIDS patients.
(2) Separate and distinct payment rates shall be calculated pursuant to this paragraph for AIDS facilities or discrete AIDS units approved by the commissioner pursuant to Part 710 of this Title.
(i) The facility specific direct adjusted payment price per day shall be determined pursuant to paragraphs (c)(3) and (4) of this section and further adjusted as follows:
(a) In determining the direct component of a facility's rate pursuant to paragraphs (c)(3) and (4) of this section for providing care for an AIDS patient in a residential health care facility designated as an AIDS facility or having a discrete AIDS unit, the case mix index for the AIDS patient shall be increased by an increment which shall be determined on the basis of the difference between allowable actual direct staffing levels and cost expenditures for the care of AIDS patients in specific patient classification groups and those of non-AIDS patients which are classified in the same patient classification groups based on data submitted by the facility. The increment to be included in a facility's rate shall be approved by the commissioner, but in no event shall the increment exceed 1.0. The facility's direct ceiling price shall be further increased by an occupancy factor of 1.089.
(b) For purposes of this paragraph, the allowable costs for the central service supply functional cost center as listed in paragraph (c)(1) of this section shall be considered a noncomparable cost.
(ii) Except as identified in subparagraph (iii) of this paragraph, in determining the indirect component of a facility's rate pursuant to paragraphs (d)(4), (5) and (6) of this section for providing care of an AIDS patient in a residential health care facility designated as an AIDS facility or having a discrete AIDS unit (an approved discrete AIDS unit), the peer group ceiling indirect price shall be increased by a factor of 1.20.
(iii) In determining the indirect component of a facility's rate pursuant to paragraphs (d)(4) and (5) of this section for a facility with a total bed complement of less than 40 beds all of which are approved by the commissioner pursuant to Part 710 of this Title solely for the care management of AIDS patients, the peer group ceiling indirect price shall be increased by a factor of 2.00 for those facilities that are less than or equal to 16 beds and such factor shall be decreased by 0.033 for every additional bed thereafter.
(3) For facilities which have received approval by the commissioner pursuant to Part 710 of this Title to provide services to a patient whose medical condition is HIV Infection Symptomatic, and the facility is not eligible for separate and distinct payment rates pursuant to paragraph (2) of this subdivision, the patient classification group case mix index for AIDS patients which is used to establish direct cost reimbursement shall be increased by an increment of 1.0.
(q) Long-term ventilator dependent residents.
Facilities which have been approved to operate discrete units for the care of long-term ventilator dependent residents as established pursuant to section 415.38 of this Title shall have separate and distinct payment rates for such units calculated pursuant to this section except as follows:
(1) The facility-specific direct adjusted price per day shall be determined as follows:
(i) In determining the facility specific direct adjusted payment price per day pursuant to paragraph (c)(4) of this section for residents meeting the criteria established in section 415.38 of this Title and residing in a discrete unit for the care of long-term ventilator dependent residents, the case mix index used to establish the statewide ceiling direct price per day for each patient classification group pursuant to subparagraph (c)(3)(iii) of this section for such residents shall be increased by an increment of 1.15. In determining the case mix adjustment pursuant to paragraph (c)(6) of this section, the case mix index used to calculate the facility specific mean price for each patient classification group shall be increased by an increment of 1.15.
(ii) The increment established in subparagraph (i) of this paragraph shall be audited and such increment shall be retrospectively or prospectively reduced on a proportional basis if the commissioner determines that the actual staffing reported in the facility's cost report submitted pursuant to this Subpart is less than the staffing pattern required by section 415.38 of this Title.
(iii) The allowable costs for the central service supply functional cost center as listed in paragraph (c)(1) of this section shall be considered a noncomparable cost reimbursed pursuant to subdivision (f) of this section.
(iv) The allowable costs for prescription drugs, specifically required by generally accepted standards of professional practice for long-term ventilator dependent residents, that are administered at a frequency and volume exceeding those of prescription drugs included in the direct component of the rate pursuant to subdivision (c) of this section shall be considered a noncomparable cost pursuant to subdivision (f) of this section.
(2) In determining the indirect component of a facility's rate pursuant to paragraphs (d)(4), (5) and (6) of this section for residents meeting the criteria established in section 415.38 of this Title and residing in a discrete unit for the care of long-term ventilator dependent residents, a facility's indirect costs shall be compared to the peer group established pursuant to clause (d)(2)(iii)(a) of this section.
(3) The noncomparable component of such facilities' rates shall be determined pursuant to subdivision (f) of this section utilizing the cost report filed pursuant to section 86-2.2(e) of this Subpart including approved actual costs in such cost report for personnel required by section 415.38 of this Title that would be reported in the functional cost centers identified in subdivision (f) of this section.
(r) Nursing salary adjustment.
(1) The adjustment to the operating portion of the rate to reflect the costs of retaining and recruiting nursing services shall be made as follows:
(i) A percentage figure shall be determined as follows:
(a) An average annual statewide increase in registered nurses and licensed practical nurses salaries between the calendar year ending 1987 and calendar year ending 1988 shall be determined based on the available ratified nursing contracts for general hospital services and an average annual regional increase in registered nurses and licensed practical nurses salaries between the calendar year ending 1987 and calendar year ending 1988 shall be determined based upon available information for residential health care facilities.
(b) The average annual regional and statewide increase in salaries shall be multiplied by the total number of nursing staff in the region and the total number of nursing staff statewide respectively to arrive at the total regional and statewide adjustment to be made to facilities. The total regional adjustments shall be determined using the regions contained in Appendix 13-A, infra.
(c) The adjusted base shall be determined by multiplying the facility specific mean price per day determined pursuant to subparagraph (c)(4)(i) of this section by total patient days for each facility and the result shall be summed on a regional and statewide basis.
(d) The total adjustment to be made for all facilities determined pursuant to clause ( b ) of this subparagraph shall be divided by the adjusted base determined pursuant to clause ( c ) of this subparagraph on a regional and statewide basis to determine the regional percentage increase and the statewide percentage increase.
(e) The facility specific percentage shall be determined by summing 40 percent of the statewide percentage and 60 percent of the corresponding regional percentage determined pursuant to clause ( d ) of this subparagraph.
(ii) The adjustment to the rate for a facility shall be determined by applying the facility specific percentage figure calculated in subparagraph (i) of this paragraph to a facility's adjusted base and added to the operating portion of the rate.
(s) Adjustment of rates pursuant to methodology changes effective October 1, 1990 and April 1, 1991.
(1) Rate changes resulting from the amendments to sections 86-2.1(a), 86-2.9(c), 86-2.10(a)(3), (c)(1)-(5), (d)(1) and (2), (p)(2) and (3) and 86-2.30(c)(3) of this Title effective October 1, 1990 and amendments to sections 86-2.10(a)(3), (c)(1), (3) and (5), (d)(1), (2) and (4)-(7), (p)(1)-(3), and (t)(1) and (2) of this Title effective April 1, 1991 shall be transitioned into the rates as follows:
(i) For rates with effective dates commencing between October 1, 1990 and June 30, 1992, the rate shall be computed using the rate methodology in effect on September 30, 1990, adjusted by the most recent PRI submissions applicable to the effective period of the rate, and the adjustment to the regional direct and indirect input price adjustment factors pursuant to subparagarph (m)(1)(iv) of this section.
(ii) For rates with effective dates commencing on or after July 1, 1992, the full impact of the rate changes cited in paragraph (1) of this subdivision shall be reflected in rates.
(iii) Those facilities with an initial budgeted rate or revised cost-based rate which reflects a change in base year and which is effective after April 1, 1991, shall receive the full impact of the methodology changes cited in paragraph (1) of this subdivision on the effective date of such rate.
(2) For facilities having multiple rates based on levels of care prior to October 1, 1990, such rates shall be combined for the establishment of rates effective October 1, 1990 to June 30, 1992 based on a weighted average of reported Medicaid days for each previous level of care for the latest available cost reporting period. Where the department is authorized expressly by statute to adjust rates retrospectively, for both positive and negative rate adjustments, such combined rate shall be adjusted by a reconciliation of reported Medicaid days to actual billed Medicaid days for the effective period, provided that such adjustment results in a combined direct and indirect component rate change of more than five percent. Such combined rate shall reflect the amendments referenced in paragraph (1) of this subdivision pursuant to the schedule set forth therein.
(3) Notwithstanding the provisions of paragraph (1) of this subdivision, residential health care facilities which have been identified by the department as requiring registered nurse staffing increases to provide seven days a week, eight hours per day of day shift registered nurse coverage shall receive rate changes effective October 1, 1990 at a level sufficient to compensate facilities for additional expenses of expanding registered nurse coverage based upon a survey of costs to be incurred by affected facilities.
(4) Nothing within this subdivision shall preclude the department from fully implementing rate adjustments on or after October 1, 1990, which are unrelated to methodology changes referenced in paragraph (1) of this subdivision.
(t) Base year adjustment for facilities who have bed conversions.
A facility shall be eligible for an adjustment to its base year costs if its proportion of beds identified as skilled nursing facility beds and health related facility beds as of the first day of its base period differs from the proportion of beds identified as skilled nursing facility beds and health related facility beds as of September 30, 1990. The adjustment shall be separately determined for the direct, indirect, and noncomparable components of a facility's allowable base period costs, and each adjustment shall be added to a facility's allowable direct, indirect and noncomparable costs, respectively, prior to group comparisons. The amount of the adjustment shall be determined as follows:
(1) Base period direct, indirect, and noncomparable costs per bed adjusted for occupancy level shall be separately calculated for both skilled nursing and health related facility beds. The changes in skilled nursing and health related facility beds for the period defined in the above paragraph shall be multiplied by the applicable cost per bed and added together to arrive at each adjustment amount.
(2) An adjustment to allowable days shall also be made for a facility whose total number of beds has changed for the period described in this subdivision to reflect the skilled nursing facility and health related facility occupancy levels used in the calculation of rates effective September 30, 1990. Base period days shall be adjusted by the proportion of total new beds as of September 30, 1990 to total base year beds prior to the determination of the facility-specific price per day for the facility's direct, indirect, and noncomparable cost components.
(u) Adjustment for additional Federal requirements.
A facility whose rate is based on allowable or budgeted costs for a period prior to April 1, 1991 shall be considered eligible to receive a per diem adjustment to its rate as follows:
(1) A per diem adjustment shall be incorporated into each facility's rate to take into account the additional reasonable costs incurred by facilities in complying with the requirements of subsection (b) (other than paragraph 3[F] thereof), (c) and (d) of section 1919 of the Federal Social Security Act effective October 1, 1990 as added by the Federal Omnibus Budged Reconciliation Act of 1987 (OBRA 1987). Additional reasonable costs resulting from such Federal requirements shall include additional reasonable costs in the following areas: the completion of resident assessments, the development and review of comprehensive care plans for residents, staff training for the new resident assessment tool, quality assurance committee costs, nurse aide registry costs, psychotropic drug reviews, and surety bond requirements.
(i) The per diem adjustment shall be 45 cents computed on a statewide basis and shall be regionally adjusted to reflect differences in registered nurse salary levels for calendar year 1987. Any costs over the per diem adjustment shall be deemed attributable to factors other than compliance with the Federal requirements referenced in this subdivision.
(ii) For purposes of inclusion in facility rates for 1991, the annual incremental per diem add-on shall be effective for the nine-month period beginning April 1, 1991 and further adjusted so that the nine months of incremental cost are reflected in a per diem adjustment for July 1, 1991 through December 31, 1991 rates.
(2) For rates years beginning on or after January 1, 1992 the annual incremental per diem add-on calculated pursuant to subparagraph (1)(i) of this subdivision shall be trended forward by the applicable facility trend factor.
(v) Extended care of residents with traumatic brain injury.
(1)
(i) Except as provided in subparagraph (ii) of this paragraph, effective April 1, 1993, a per diem amount of $25, adjusted by the RDIPAF determined pursuant to paragraph (c)(5) of this section, and increased in rate years thereafter, by the projection factors determined pursuant to section 86-2.12 of this Subpart shall be added to a facility's payment rate determined pursuant to this Subpart for each resident with traumatic brain injury identified as requiring extended care and receiving services pursuant to section 415.40 of this Title.
(ii) Effective with rates revised based upon patient review instrument (PRI) assessment data for an assessment period set forth in section 86-2.11(b) of this Subpart beginning on or after November 1, 1994, a TBI patient per diem amount shall be added to a facility's average Medicaid payment rate determined pursuant to this Subpart only for Medicaid residents with traumatic brain injury identified as requiring extended care and receiving services pursuant to section 415.40 of this Title. The TBI patient per diem amount shall be determined as follows: The total number of Medicaid traumatic brain injury (TBI) extended care residents shall be multiplied by $25 per patient day times 365 days to determine the annual TBI amount. The annual TBI amount shall then be adjusted by the facility RDIPAF, determined pursuant to subdivision (c)(5) of this section, to establish the allowable TBI dollars. The allowable TBI dollars shall be divided by the facility total annual Medicaid days to determine the facility TBI patient per diem amount. The TBI patient per diem amount shall be increased annually by the projection factor determined pursuant to section 86-2.12 of this Subpart. For purposes of this subdivision, a Medicaid resident is defined as a resident whose primary payor description is coded as Medicaid on the PRI assessment data.
(2) Residents reimbursed pursuant to this subdivision shall not be reimbursed pursuant to subdivisions (n) and (o) of this section.
(w) Specialized programs for residents requiring behavioral interventions.
Facilities which have been approved to operate discrete units specifically designated for the purpose of providing specialized programs for residents requiring behavioral interventions as established pursuant to section 415.39 of this Title shall have separate and distinct payment rates calculated pursuant to this section except as follows:
(1) In determining the facility specific direct adjusted payment price per day pursuant to paragraph (c)(4) of this section for residents meeting the criteria established in section 415.39 of this Title and residing in a discrete unit specifically designated for the purpose of providing specialized programs for residents requiring behavioral interventions, the case mix index used to establish the statewide ceiling price per day for each patient classification group pursuant to subparagraph (c)(3)(iii) of this section for such residents shall be increased by an increment of 1.40. In determining the case mix adjustment pursuant to paragraph (c)(6) of this section, the case mix index used to calculate the facility specific mean price for each patient classification group shall be increased by an increment of 1.40.
(i) The increment established in paragraph (1) of this subdivision shall be audited and such increment shall be retrospectively or prospectively reduced on a proportional basis if the commissioner determines that the actual staffing reported in the facility's cost report submitted pursuant to this Subpart is less than the staffing pattern required by section 415.39 of this Title.
(2) In determining the indirect component of a facility's rate pursuant to paragraphs (d)(4)-(6) of this section for residents meeting the criteria established in section 415.39 of this Title and residing in a discrete unit specifically designated for the purpose of providing specialized programs for residents requiring behavioral interventions, a facility's indirect costs shall be compared to the peer group established pursuant to clause (d)(2)(iii)( a ) of this section.
(3) The noncomparable component of such facilities' rates shall be determined pursuant to subdivision (f) of this section utilizing the cost report filed pursuant to section 86-2.2(e) of this Subpart including approved actual costs in such cost report for personnel required by section 415.39 of this Title that would be reported in the functional cost centers identified in subdivision (f) of this section.
(x) Specialized programs for residents with neurodegenerative disease providing care to patients diagnosed with Huntington’s disease and amyotrophic lateral sclerosis.
Facilities which have been approved to operate discrete units specifically designated for the purpose of providing care to residents with Huntington’s disease and amyotrophic lateral sclerosis, as established pursuant to section 415.41 of this Title, shall have separate and distinct payment rates calculated pursuant to this section. The noncomparable component of such facilities’ rates shall be determined pursuant to this section utilizing the cost report filed pursuant to section 86-2.2(e) of this Subpart.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.6 Time for answer
The respondent hospital governing body may, at least five days prior to the date specified in the notice of hearing, file a written verified answer to the complaint and serve a copy thereof upon the complainant personally or by mail addressed to the complainant at his address as set forth in the complaint.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.12 Plumbing fixtures
Plumbing fixtures shall be of impervious material and of a type which is readily cleanable. They shall be free from cracks and from parts which are not readily accessible for cleaning. They shall be of a type which does not constitute a hazard to a public water supply through back siphonage.
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.12 Reporting by others than physicians of cases of diseases presumably communicable
When no physician is in attendance, it shall be the duty of the head of a private household or the person in charge of any institution, school, hotel, boarding house, camp or vessel or any public health nurse or any other person having knowledge of an individual affected with any disease presumably communicable, to report immediately the name and address of such person to the city, county or district health officer.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.11 Application for renewal
(a) The parties to a certificate of public advantage issued for a definite term may renew such certificate. An application to renew the certificate of public advantage shall, no later than 120 days prior to the expiration of the certificate, be submitted to the department in a format determined by the department and shall be provided by the department to the Attorney General and, as appropriate, the mental hygiene agencies.
(b) The application for renewal shall include the information required pursuant to section 83-2.9(b) of this Subpart, unless waived by the department, and any other information requested by the department, and shall be accompanied by the fee set forth in section 83-2.4 of this Subpart.
(c) A certificate of public advantage may be renewed pursuant to the procedure set forth in section 83-2.10 of this Subpart for a period determined by the department, which shall be no less than two years in duration, and shall be subject to active state supervision pursuant to this Subpart.
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.39 Salaries or fees to officers or directors
No hospital shall pay any salaries or fees to any director or trustee, except that salaries or fees may be paid to officers of the board, directors or trustees for services actually performed.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.8 Appeals
(a) An applicant may appeal a final determination issued by the department under these rules and regulations by filing a petition in writing with the department and with the New York City Office of Administrative Trials and Hearings (OATH) within 30 days of the date the determination was mailed. The petition shall state the name and address of the petitioner and shall include a short and plain statement of the matters to be adjudicated, identifying the approval or variance sought by the petitioner with citation to the applicable provisions of these rules and regulations, the regulated activity for which the department issued the determination, the proposed location of the activity, and the date of the department's determination. The petition should also indicate whether the petitioner is requesting a hearing. A copy of the determination being appealed shall be attached to the petition. In addition, a completed OATH intake sheet shall be included with the petition. Blank intake sheets are available from the department.
(b) The following determinations are appealable:
(1) a denial of an application for approval of a regulated activity;
(2) a denial of an application for a variance;
(3) the imposition of a substantial condition in an approval of a regulated activity; and
(4) the imposition of a substantial condition in a grant of a variance.
(c) Petitions for appeal shall be referred to a city administrative law judge (ALJ) for hearing, where allowed by this section, and determination as defined in subdivision (g) of this section.
(d) The following issues are adjudicable on appeal:
(1) whether the regulated activity proposed by the petitioner will be in compliance with the requirements of these rules and regulations;
(2) whether the imposition of a substantial condition in an approval of a regulated activity is appropriate to ensure that the regulated activity will comply with the requirements of these rules and regulations;
(3) whether the commissioner or the first deputy commissioner abused his or her discretion in denying a request for a variance or in imposing a substantial condition in a grant of a variance; and
(4) except where the department has acted as lead agency, the ALJ shall not adjudicate any issues relating to compliance with the State Environmental Quality Review Act (SEQRA).
(e) Except for appeals from determinations relating to variances, the petitioner shall have the burden of proving by a preponderance of the evidence that the proposed regulated activity is in compliance with the requirements of these rules and regulations. For appeals from determinations relating to variances, the petitioner shall have the burden of proving that the commissioner or first deputy commissioner has abused his or her discretion.
(f)
(1) Appeals from determinations relating to individual sewage treatment systems or variances shall be decided on the record before the department in its review of the application and any other written submissions allowed by the ALJ.
(2) A petitioner may request an adjudicatory hearing on appeals from all other determinations issued by the department. If a petitioner does not request a hearing, the petition shall be decided on the record before the department in its review of the application and any other written submissions allowed by the ALJ.
(i) Unless otherwise agreed to by the parties and the ALJ, the hearing shall be held in the district of the department in which the regulated activity was proposed to be located, except that hearings may be held at the department's offices in Valhalla, New York for appeals relating to regulated activities in the east of Hudson watershed and at the department's offices in Kingston, New York for appeals relating to regulated activities in the west of Hudson watershed.
(g) The ALJ shall submit a report to the commissioner within 60 days after the record on appeal is closed with a recommendation as to whether the determination appealed from should be approved, modified or rejected. The commissioner shall issue a final decision approving, rejecting, or modifying the ALJ's recommendation within 30 days of receipt of the ALJ's report. If the commissioner does not act, the ALJ's recommendation shall be deemed approved.
(h) This section shall not apply to determinations made by local governments administering provisions of these rules and regulations pursuant to Subpart 128-7 of this Part.
(i) An applicant shall have the option whether to file an administrative appeal under this section and nothing in this section shall preclude an applicant from challenging a final determination issued by the department in a court of competent jurisdiction, including instituting a proceeding under article 78 of the Civil Practice Law and Rules, without first filing a petition for appeal pursuant to this section.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE OPERATION FOOD VENDING MACHINE OPERATION
10 CRR-NY 14-5.22 Definition of person
A person as used in this Subpart is an individual, firm, estate, partnership, company, corporation, trustee, association, or any public or private entity.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.1 Village of Brocton
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Slippery Rock Creek and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Village of Brocton, Chautauqua County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section in intended to mean and refer to all storage and impounding reservoirs on Slippery Rock Creek, which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the Village of Brocton.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the highwater mark of a reservoir or the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of Brocton.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of Brocton.
(3) No cesspool, pit or other receptacle of any kind used for the deposit or storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying and trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Brocton and in such a manner and at such a place as to effectively prevent its being washed over the surface of or through the ground in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Village of Brocton.
(6) Whenever, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or to other local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition to any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall be removed to such greater distance or to such a place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed sewage disposal plant approved by the State Commissioner of Health, as required by law, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface except into water-tight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c) of this section, within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Village of Brocton.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid [ continued ] or solid refuse or waste be thrown, discharged or allowed to escape, flow or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow or percolate into any reservoir or watercourse within a distance of 200 feet from any reservoir or within 75 feet from any watercourse tributary to the public water supply of the village of Brocton.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed on any reservoir or watercourse tributary to the public water supply of the village of Brocton.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall bathe nor shall any animal be allowed to stand, wallow, wade or swim nor be washed nor watered in any reservoir of the public water supply of the village of Brocton. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Brocton.
(2) No stable for cattle or horses, barnyards, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Brocton, and none of the above named objects or sources of pollution shall the so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet to any reservoir or 50 feet to any watercourse tributary to the public water supply of the village of Brocton.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Brocton, nor shall any such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir nor within 150 feet of any watercourse tributary to the public water supply of the village of Brockton,* and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 300 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of Brocton.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet before entering any reservoir or 50 feet before entering any watercourse tributary to the public water supply of the village of Brocton.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage, for a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of Brocton.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of Brocton.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or 250 feet from any watercourse tributary to time public water supply of Brocton.
(j) Inspections.
The board of trustees of the village of Brocton or such other board, body or person as may be charged with the maintenance of the public water supply of the village shall make or cause to be made regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.9 Water supply
(a) The water supply serving all plumbing fixtures, including drinking fountains, lavatories and showers, shall, after treatment, meet the provisions required for a public water system as defined in subpart 5-1 of the State Sanitary Code. A temporary residence with an on-site water supply that does not meet the definition of a public water system must comply with the standards established in subpart 5-1 for a non-community water system.
(b) Annual start-up.
The temporary residence operator must ensure that the following actions have been taken at least 15 days prior to the property’s occupancy for which the water supply is utilized each year. The following applies to each on-site potable water system that is not subject to continuous water use, and to each temporary residence potable water supply distribution system which receives water from an off-site public water system and is not subject to continuous water use.
(1) All water mains shall be disinfected by:
(i) completely filling the main to remove all air pockets, flushing the main to remove particulates, and filling the main with potable water. The potable water shall then be chlorinated by feeding liquid hypochlorite at a constant rate such that the water will not have less than a 25 mg/l free chlorine residual throughout the temporary residence water system. After a 24-hour holding period there must be a free chlorine residual of not less than 10 mg/l throughout the temporary residence water system; or
(ii) using a disinfection method the State Commissioner of Health has determined in writing to be as protective as the disinfection procedure described in subparagraph (i) of this paragraph.
(2) The water system shall then be flushed and free chlorine residual disinfection concentrations measured at representative points in the distribution system to ensure that no free chlorine is present if a waiver of disinfection has been issued, or that a free chlorine residual of greater than 0.2 mg/l and less than 4.0 mg/l is present in a system with continuous disinfection.
(3) Bacteriological samples shall then be collected from each water source at representative points in the distribution system and analyzed at a laboratory certified by New York State Department of Health.
(4) The facility operator must report sample results, if positive for total coliform or escherichia coli to the permit-issuing official as soon as possible but no later than 24 hours of being notified by the laboratory. Pre-operational water analysis reports must be submitted to the permit-issuing official prior to permit issuance. All other water analysis reports required to be made by this Subpart or requested or ordered by the permit-issuing official shall be submitted to the permit-issuing official within 10 days of the end of each quarter in which samples were collected.
(c) Water distribution and treatment.
Facilities shall be provided and maintained for the satisfactory treatment and distribution of water. In addition, such facilities shall meet the following requirement:
(1) Submission of plans; prior approval. A plan for a new or modified water source, or distribution and treatment facilities shall be submitted to the permit-issuing official at least 60 days prior to construction. No construction of new or modified water distribution and/or treatment facilities shall commence until plans and specifications have been submitted to and approved by the permit-issuing official. Construction shall be in accordance with the approved plans.
(d) Minimum standards.
Potable hot or tempered and cold running water shall be adequate in quantity and quality and shall be readily available to occupants of the temporary residence. Only potable water shall be easily accessible. Any non-potable water supply shall be conspicuously labeled as a non-potable supply. An adequate supply shall mean a minimum of 50 gallons per person per day or more dependant upon amenities provided at the facility, unless otherwise justified in writing by a professional engineer or registered architect licensed to practice in New York State and deemed acceptable by the permit-issuing official.
(e) Connections prohibited.
There shall be no physical connection between the potable water supply and any non-potable water supply. Any fixture, installation or equipment, which is subject to back-siphonage, shall be adequately installed and maintained to protect against contamination of the water system.
(f) A minimum pressure of 20 pounds per square inch, at peak demand, shall be maintained in all parts of the water distribution system.
(g) A common drinking utensil shall not be provided for individual consumption of potable water.
(h) Interruptions, changes in sources or treatments.
Any incident or condition, which affects the quantity or quality of the on-site potable water supply, shall be reported to the permit-issuing official within 24 hours of occurrence. There shall be no changes made to the source or method of treatment of a potable water supply, either temporary or permanent, without first receiving approval from the permit-issuing official. An adequate supply of potable water must be provided and maintained during all times of operation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.3 Claims assistance manager
Duties of the claims assistance manager shall include, but not be limited to, the following:
(a) answering questions regarding the information and documentation needed for completion of the application process;
(b) handling any issues raised about alleged delays by the fund administrator in processing applications, claims, reviews of claim denials, prior approval initial determinations, and prior approval reviews; and
(c) assisting in resolving any issues involving enrollees and case managers or the assignment of case managers.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.4 Village of Nunda
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the impounding reservoir and all watercourses tributary thereto or which may ultimately discharge into said impounding reservoir or which may be developed in the future to serve as sources of the water supply to the Village of Nunda, Livingston County.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir, or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal or agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Nunda public water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Nunda.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the Village of Nunda water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Nunda water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 500-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse, except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed, unless deposited in trenches or pits at a linear distance of not less than 300 feet from any reservoir or watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 500-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 500-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle, or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the places of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph, or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State or county agency and the village board having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State or county agency having jurisdiction over such facility, and subparagraph (v) of this paragraph, shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 5,000-foot linear distance of any reservoir or watercourse, and not within a 10,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State or county agency and the village board and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Nunda.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Nunda, except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Nunda within a 1,000-foot linear distance of the water supply intakes, except by duly authorized employees of the Village of Nunda in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyards shall be located within a 2,500-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 2,500-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 5,000-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 5,000-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Nunda.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State or county agency and the village board having jurisdiction over such facilities.
(e) Inspections.
The board of trustees of the Village of Nunda, or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 610 SPECIAL REQUIREMENTS FOR NONPROFIT CORPORATIONS
10 CRR-NY 610.4 Director voting and conflicting interests
(a)
(1) No director of a nonprofit corporation operating a hospital shall vote, or be counted in determining the quorum for any vote, on any transaction between such hospital corporation and another corporation, firm, association or other entity in which that director is an officer or director or has a direct or indirect substantial financial interest. Any such quality of interest shall be disclosed to the other directors of the hospital corporation and made a matter of record. Such disclosure shall be made by the director involved or, in his absence, by another director having knowledge of the facts. In addition to refraining from voting, such director shall not participate in the deliberations nor use personal influence in the matter and any such transaction shall be at least as fair and reasonable to the hospital corporation as would otherwise then be obtainable by such corporation.
(2) For the purposes of paragraph (1) of this subdivision, a director or officer shall be deemed to have a direct or indirect substantial financial interest in any corporation, firm, association or other entity in which such person together with such person's parents and spouse, and all descendants of either of such person's parents or such person's spouse, have an aggregate beneficial equity interest of 10 percent or more.
(3) This section shall not apply to such directors of a nonprofit corporation operating a hospital who also serves as an unsalaried officer or director of other nonprofit corporations which, having received all requisite approvals, exist for the purpose of raising funds for the operation and maintenance of, or to provide administrative, planning and research support services to the nonprofit corporation operating the hospital, with respect to transactions between the hospital corporation and such other nonprofit corporations.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.261 Pooled investments
Assets of two or more funds consolidated for investment purposes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-2 UMBILICAL CORD BLOOD TESTING
10 CRR-NY 69-2.1 Definitions
(a) Responsible physician means the physician or other licensed health care provider named on the specimen collection form, the infant's primary health care provider, if different, or the hospital staff physician as designated by the chief executive officer and identified to the approved laboratory.
(b) Birth attendant means the physician or licensed midwife who attends a nonhospital birth.
(c) Chief executive officer means the person who acts as the administrative officer of the institution and who is responsible to the licensed governing body for overall management of the institution providing birthing services.
(d) Responsible institution means the hospital or diagnostic and treatment center providing birthing services.
(e) Approved laboratory means a laboratory approved by the department, or in the City of New York by the department of Health of such city, for the purpose as herein provided.
(f) Standard serological tests for syphilis are tests generally recognized as such, as determined by the department, or in the City of New York by the department of Health of such city. All blood samples shall be tested initially by a quantitative nontreponemal test; any specimen reactive in the nontreponemal test shall also have a treponemal test performed on the same sample.
(g) Satisfactory specimen means a specimen received by the approved laboratory in a condition suitable for testing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.27 Quality assessment and assurance
The facility shall establish and maintain a coordinated quality assessment and assurance program which integrates the review activities of all nursing home programs and services to enhance the quality of life and resident care and treatment.
(a) Facility-wide quality assurance.
Quality assurance shall be the responsibility of all staff, at every level, at all times. Supervisory personnel alone cannot ensure quality of care and services. Such quality must be a part of each individual's approach to his or her daily responsibilities.
(b) Quality assessment and assurance committee.
The facility shall maintain a quality assessment and assurance committee consisting of at least the following:
(1) the administrator or his or her designee;
(2) the director of nursing services;
(3) a physician designated by the facility;
(4) at least one member of the governing body who is not otherwise affiliated with the nursing home in an employment or contractual capacity; and
(5) at least three other members of the facility's staff.
(c) Committee functions.
The quality assessment and assurance committee shall:
(1) meet at least quarterly to identify issues with respect to which quality assessment and assurance activities are necessary;
(2) have a written plan for the quality assessment and assurance program which describes the program's objectives, organization, responsibilities of all participants, scope of the program and procedures for overseeing the effectiveness of monitoring, assessing and problem-solving activities. Such plan shall also provide for the development and implementation of quality improvement initiatives designed to advance the quality of life, care and services in the facility;
(3) define methods for identification and selection of clinical and administrative problems to be reviewed. The process shall include but not be limited to:
(i) the establishment of review criteria developed in accordance with current standards of professional practice for monitoring and assessing resident care and clinical performance;
(ii) regularly scheduled reviews of clinical records, resident complaints and suggestions, reported incidents and other documents pertinent to problem identification;
(iii) consultation on at least a quarterly basis with the Resident Council to seek recommendations on quality improvements;
(iv) documentation of all quality assessment and assurance activities, including but not limited to the findings, recommendations and actions taken to resolve identified problems; and
(v) the timely implementation of corrective actions and periodic assessments of the results of such actions;
(4) ensure that the outcomes of quality assurance reviews are shared with appropriate staff to be used for the revision or development of facility policies and practices and in granting or renewing staff privileges, as appropriate;
(5) facilitate participation in the program by administrative staff and health-care professionals representing each professional service provided;
(6) report its activities, findings and recommendations to the governing body as often as necessary, but no less often than 4 times a year; and
(7) participate with the medical director in implementing Public Health Law, section 2805-k.
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.19 Withdrawal of equity or assets
(a) Definitions.
For purposes of this section, the following terms shall have the following meanings:
(1) The term equity means:
(i) any right or claim to assets;
(ii) any interest in property or in a business, subject to claims of creditors;
(iii) the difference between assets and liabilities;
(iv) net worth.
(2) The term asset means any owned physical object or any right having economic value to its owner or any item or source of wealth expressed, for accounting purposes, in terms of its cost, depreciated cost determined in accordance with the applicable provisions of Part 86 of this Title, or fair market value at date of donation.
(3) The term withdrawal shall include, but not be limited to, the following examples:
(i) any transfer of a facility's cash or other assets directly or indirectly to or for the benefit of its operator;
(ii) expenditures of the facility's assets or equity for personal items not recognized as reimbursable under the state's medical assistance program;
(iii) any liability incurred within any period of time required for financial reporting in accordance with Part 86 of this Title by a facility or its operator by reason of a mortgage, lease, borrowing or other transaction relating to such a facility that exceeds, in the aggregate, $50,000;
(iv) any non-arm's length or related party loans made by the facility or its operator, including loans to any individual, corporation, partnership, or other organization related to the facility within the meaning of “related organization” , as that term is defined in section 451.229 of this Title;
(v) payment to the operator or owner of a salary in excess of the maximum amount allowed for reimbursement purposes by the Department of Health.
(b)
(1) No medical facility operated for profit, or operator of such facility, may withdraw said facility's equity or assets, without the prior approval of the commissioner, if such a withdrawal would create or increase a negative net worth position for the facility or occur when the facility is in a negative net worth position.
(2) A withdrawal shall be considered to have taken place if it has occurred during any period of time required for financial reporting in accordance with Part 86 of this Title.
(3) Negative net worth shall be calculated without regard to any surplus created by revaluation of assets, or to receivables resulting from non-arm's length or related party loans.
(4) When calculating net worth under this section, only the equity or assets of the facility shall be considered, and not any other property owned by the facility's operator, nor any other business entities related to the facility. Appeals and audits made pursuant to Part 86 of this Title and Title 18 (Social Services) NYCRR, respectively, shall not be considered for purposes of calculating net worth unless finally determined.
(5) In any administrative hearing brought pursuant to section 2808(5) of the Public Health Law, this section and Part 51 of this Title it shall be prima facie evidence of a withdrawal of equity or assets in violation of section 2808(5) of the Public Health Law and this section if, at the close of the period of time required for financial reporting in accordance with Part 86 of this Title, a facility is in a negative equity or net worth position and the operator has withdrawn equity or assets from the facility during the period of time covered by the financial report.
(c)
(1) An application for approval shall be submitted on forms provided by the Department of Health at least 60 days prior to the proposed withdrawal and shall specify the necessity, purpose, and impact on patient care of the withdrawal and the details concerning such withdrawal including, but not limited to, the principal amount, interest rate, repayment terms, conditions of default, remedies upon default and obligee of any transaction to be consummated in a proposed withdrawal, unless such items are inapplicable. The application shall contain a current interim balance sheet and a description of the facility's cash position, including as cash such cash equivalents as certificates of deposit and treasury bills. Requests shall be made by certified or registered mail. Nothing herein shall be construed to prohibit the commissioner from considering applications submitted less than 60 days prior to the proposed withdrawal in an emergency situation that directly affects the health, safety or welfare of patients.
(2) The commissioner or his designee shall approve or disapprove a request for withdrawal of equity or assets within 60 days of the date of receipt of such a request. Any request not approved or disapproved within 60 days shall be considered approved.
(3) In reviewing an application for withdrawal, the commissioner shall consider:
(i) the necessity for the withdrawal;
(ii) whether such withdrawal would impair the facility's ability to render quality care;
(iii) any expense which such withdrawal would generate; and
(iv) the financial condition of the facility in general.
(d) If an analysis of a facility's financial reports indicates the violation of the provisions of this section, the commissioner may review all documents which may indicate a withdrawal of equity has occurred and the facility shall produce all data necessary for the completion of such review.
(e) In addition to any other remedy or penalty available, and after the operator has been granted the opportunity for an administrative hearing, the commissioner may require replacement of the withdrawn equity or assets and may impose a penalty for violation of this regulation in an amount not to exceed ten percent of any amount withdrawn without prior approval.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.4 Donor qualifications
(a) In addition to all the requirements of this Subpart, limited tissue procurement services and comprehensive tissue procurement services shall comply with the donor qualification requirements in Subpart 52-3 of this Part.
(b) Unless specifically authorized by the tissue bank medical director, ocular tissue shall not be released for transplant from donors with any of the following conditions or factors:
(1) evidence of disseminated malignant disease, such as lymphoma or leukemia;
(2) malignant disease of the eye;
(3) active hepatitis B or C, or hepatitis of unknown etiology;
(4) syphilis within the past 12 months;
(5) any disease of unknown etiology;
(6) congenital rubella;
(7) subacute sclerosing panencephalitis;
(8) Reye's syndrome; or
(9) bacterial or fungal endocarditis.
(c) The medical director of the comprehensive tissue procurement service shall be responsible for determining that donors and donated ocular tissue are acceptable based on medical history information, the tissue bank's established donor selection criteria and the factors specified in this Part.
(d) A written policy shall specify the range of acceptable donor age limits for eye donation. This policy shall be determined by the tissue bank medical director in consultation with the medical advisory committee of the comprehensive tissue procurement service.
(e) Unless intended for lamellar grafts or epikeratoplasty, corneal tissue shall not be released from donors with prior intraocular or anterior segment surgery affecting the corneal endothelium or from donors with intrinsic eye disease affecting the corneal endothelium.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.8 Inspection fee
(a) Prior to any on-site inspection, an out-of-state laboratory possessing or seeking a certificate of approval shall pay an inspection fee in addition to its approval fee. The purpose of the inspection fee is to offset the additional travel costs incurred by the department in sending inspectors out-of-state. Such fees will be credited to the environmental laboratory approval fee account. The inspection fee shall consist of the following components:
(1) a transportation expense, which shall be either the actual expense if travel is by common carrier, or a mileage expense at the rate negotiated between the State and the union representing the employees scheduled to conduct the inspection; and
(2) a per diem expense as specified by the New York State Comptroller for the inspecting employees, multiplied by the number of days estimated by the department to be necessary for travel and the actual inspection.
(b) In calculating this fee, the department shall estimate the total cost of the components specified in subdivision (a) of this section and divide it equally among the laboratories inspected on any trip.
(c) In the event the department underestimates any of the above expenses, the laboratory shall pay any difference between the estimate and the actual expense.
(d) In the event the department overestimates any of the above expenses, the laboratory shall be notified of the difference between the estimate and the actual expense, and its account shall be credited that amount unless a refund is requested.
(e) Failure to pay the fee for out-of-state inspection shall result in suspension or nonrenewal of the laboratory approval.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.69 Schedule III, IV and V substances
(a) In addition to the requirements set forth in sections 80.67 and 80.70 of this Part, substances in schedule III, IV or V shall be prescribed by a practitioner on an official New York State prescription or, subject to the following, an electronic prescription, in good faith, and in the course of his/her professional practice. Electronic prescriptions may be created, signed and transmitted electronically provided the practitioner complies with all other requirements for issuing controlled substance prescriptions in this Part, and with Federal requirements for electronic prescribing of controlled substances. A prescription generated on an electronic system that is printed out or transmitted via facsimile is not considered an electronic prescription and shall be manually signed.
(b) The prescription shall contain the following:
(1) name, address and age of the ultimate user for whom the substance is intended, or, if the ultimate user is an animal, the species of such animal and the name and address of the owner or person in custody of such animal;
(2) the printed name, address, Drug Enforcement Administration registration number, telephone number and handwritten signature or, in the case of an electronic prescription, the electronic signature of the prescribing practitioner. The printed name of the prescriber who has signed the prescription shall be imprinted or stamped legibly and conspicuously on the prescription, shall appear in an appropriate location on the prescription form and shall not be entered in or upon the space or line reserved for the prescriber's signature. The imprinted or stamped name shall not be a substitute for or fulfill any legal requirement otherwise mandating that the prescription be signed by the prescriber;
(3) specific directions for use, including but not limited to the dosage and frequency of dosage and the maximum daily dosage;
(4) the date upon which such prescription was actually signed by the prescribing practitioner. A prescription shall be dated as of, and signed on, the date when issued; and
(5) the quantity of dosage units prescribed and the number of times that the prescription may be refilled. On an official New York State prescription, the quantity of dosage units and the number of times that the prescription may be refilled shall be indicated in both numerical and written word form.
(6) An electronic prescription shall contain the requirements as provided in paragraphs (1)-(5) of this subdivision except such prescription shall contain an electronic signature and shall be transmitted and received by electronic means. Such electronic signature shall meet the signature requirements set forth in paragraph (2) of this subdivision.
(7) A section wherein prescribers may indicate whether an individual is limited English proficient, as defined in section 6829 of the Education Law; and if the patient is limited English proficient, a specification of the preferred language indicated by the patient. Failure to include such indication on the part of the prescriber shall not invalidate the prescription.
(c) Except as provided in subdivision (d) of this section, no such prescription shall be made for a quantity of substances which would exceed a 30-day supply if the substance were used in accordance with the directions for use, as specified on the prescription. No additional prescriptions for a controlled substance may be issued by a practitioner to an ultimate user within 30 days of the date of any prescription previously issued unless and until the ultimate user has exhausted all but a seven days' supply of that controlled substance provided by any previously issued prescription.
(d)
(1) A practitioner may issue a prescription for up to a three month supply of a controlled substance if used in accordance with the directions for use, provided that the prescription has been issued for the treatment of:
(i) panic disorders, designated as code A;
(ii) attention deficit disorder, designated as code B;
(iii) chronic debilitating neurological conditions characterized as a movement disorder or exhibiting seizure, convulsive or spasm activity, designated as code C;
(iv) relief of pain in patients suffering from conditions or diseases known to be chronic or incurable, designated as code D;
(v) narcolepsy, designated as code E; or
(vi) hormone deficiency states in males, gynecologic conditions that are responsive to treatment with anabolic steroids or chorionic gonadotropin, metastatic breast cancer in women, anemia and angioedema, designated as code F.
(2) Such prescription shall specify the condition being treated on the face of the prescription. The practitioner issuing such prescription shall either:
(i) specify the name of such condition on the face of the prescription; or
(ii) specify a code on the prescription to denote the condition for which the prescription has been issued, in accordance with codes issued by the department.
(3) Either the name of the condition or one of the designated codes shall fulfill the requirement in:
(i) section 3332(3) of the Public Health Law for the specific condition to be given on the face of the prescription; and
(ii) section 3333(1) of the Public Health Law for the statement that the controlled substance has been prescribed to treat one of the conditions that have been enumerated by the regulations of the commissioner as warranting the prescribing of greater than a 30 days' supply of a controlled substance.
(e) Such official New York State prescription or an out-of-state written prescription for a patient enrolled in a hospice program or for a patient residing in a residential health care facility (RHCF) may be transmitted by the practitioner, or a person authorized by the practitioner, to the dispensing pharmacy by facsimile, provided:
(1) the hospice program or RHCF is licensed or approved by the department;
(2) the dispensing pharmacy has a written agreement or contract with the hospice program or RHCF to dispense controlled substances to a patient of such program or facility;
(3) the practitioner shall note on the prescription that the patient is a "hospice patient" or "RHCF patient"; and
(4) within 72 hours, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or the original out-of-state written prescription. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(f) An official New York State prescription or an out-of-state written prescription for a schedule III, IV or V controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion may be transmitted by the practitioner, or a person authorized by the practitioner, to the dispensing pharmacy by facsimile. Within 72 hours, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or the original out-of-state written prescription. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(g) An official New York State prescription, an out-of-state written prescription, or an electronic prescription for a schedule III, IV, or V controlled substance, other than such substances as listed in section 80.67 of this Part, may be refilled, but not more than the number of times specifically authorized by the prescriber upon the prescription; provided, however, no such authorization shall be effective for longer than six months from the date the prescription is signed and that not more than five refills are made. When the initial prescription is issued for a quantity of substance in excess of a 30-day supply under the authority of subdivision (c) of this section, the prescription may only be refilled once.
(h) Unless an earlier refilling is authorized by the prescriber, no prescription shall be refilled earlier than seven days prior to the date the previously dispensed supply would be exhausted if used in conformity with the directions for use.
(i) On refills the dispensing pharmacist shall indicate on the prescription the amount dispensed, the date dispensed, and the signature of the dispensing pharmacist. When refills are recorded in an electronic recordkeeping system:
(1) the pharmacist shall ensure that the computer application used for such recordkeeping shall:
(i) provide online retrieval of original prescription information; and
(ii) provide online retrieval of the current refill history for schedule III, IV and V controlled substance prescriptions.
(2) each time an official New York State prescription or an out-of-state written prescription for a schedule III, IV or V controlled substance is refilled, the dispensing pharmacist shall document that the refill information entered into the computer has been reviewed and is correct by manually signing:
(i) a hard-copy printout of each day’s controlled substance prescription refill data; or
(ii) a bound log book containing a statement that the refill information entered into the computer that day has been reviewed and is correct as shown.
(3) When a prescription is received electronically, the prescription and all required annotations shall be retained electronically.
(4) The pharmacy shall employ a procedure to be used for documentation of refills of schedule III, IV and V controlled substance prescriptions in the event of system downtime. The procedure shall ensure that refills are authorized by the original prescription and that the maximum number of refills authorized has not been exceeded.
(j) Prescriptions which indicate pharmacy prescription numbers only of prior controlled substances prescriptions are not valid and shall not be refilled.
(k) Upon expiration of the authorization of the prescription to be refilled or the six month limitation of the prescription, the practitioner shall execute a new prescription if he desires the medication to be continued.
(l) When a prescription prepared by a practitioner is incomplete, the practitioner may orally furnish the missing information to the pharmacist and authorize him or her to enter the missing information on the prescription. The pharmacist shall write the date he or she received the oral authorization on the prescription and shall affix his or her signature. This procedure shall not apply to unsigned or undated prescriptions or where the name and/or quantity of the controlled substances is not specified or where the name of the ultimate user is missing. The pharmacist is not required to obtain authorization from the practitioner to enter the patient's address, sex or age if the pharmacist obtains the information through a good-faith effort.
(m) A practitioner may orally authorize a pharmacist to change information on a controlled substance prescription. This procedure shall not apply to the practitioner's signature, date the prescription was signed by the practitioner, drug name or name of the ultimate user. The pharmacist shall write the date he or she received the oral authorization on the prescription, reason for the change and his or her signature. The pharmacist shall also indicate the change on the prescription and initial the change.
(n) When a pharmacist fills a prescription in a manner that would require, under subdivision (l) or (m) of this section, the pharmacist to make a notation on the prescription if the prescription were written, the pharmacist shall make the same notation electronically when filling an electronic prescription and retain the annotation electronically in the prescription record.
(o) When a practitioner is notified that an electronic prescription was not successfully delivered, the practitioner shall ensure that any written or oral prescription issued as a replacement of the original electronic prescription indicates that the prescription was originally transmitted electronically, shall indicate which pharmacy the prescription was originally transmitted to, and that the transmission failed.
(p) If the content of any of the information required by this Part for a controlled substance prescription is altered during the transmission of an electronic prescription, the prescription is deemed to be invalid and the pharmacy may not dispense the controlled substance.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.3 Applicability of other laws, codes, rules and regulations
Shared health facility providers, purveyors, operators, administrators, managers and employees shall comply with all Federal, State and local laws, codes, rules, and regulations pertaining to participation in the Medical Assistance Program, including, but not limited to pertinent sections and provisions of title XIX of the Social Security Act, the New York State Social Services Law, the New York State Public Health Law and codes, rules and regulations enacted pursuant thereto; the New York State Medical Handbook, medical plans of local social services districts, and with local laws, ordinances, codes, rules and regulations having general application.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.9 Effective dates
(a) Until March 31, 1986, the following dates shall have the following meanings:
(1) In section 58-3.3(a), May 1st shall mean the effective date of this regulation.
(2) In section 58-3.3(b), May 15th shall mean a date 10 days after the effective date of this regulation.
(3) In section 58-3.3(c), June 1st shall mean a date 45 days after the effective date of this regulation.
(4) In section 58-3.4, June 30th, September 30th, December 31st and March 10th shall mean dates to be negotiated by the department and each laboratory for the payment of quarterly installments of the 1985-86 fee; provided, however, that full payment must be made by March 10, 1986.
(b) The provisions of this section shall expire on March 31, 1986.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.8 Submission of documentation to the department
Physicians, PAs and SAs must submit documentation of course completion to DOH, except that such persons holding privileges or affiliated with or employed by DOH regulated health care facilities, including home health care agencies, need not submit documentation of course completion to the department. DOH regulated health care facilities, including home health care agencies, shall maintain documentation in credentialing or employment files of such infection control training and education of physicians, PAs and SAs.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.28 Return on investment
(a) For rate year 1993, in computing the allowable cost of a proprietary residential health care facility, there will be included, after subtracting for current and noncurrent time deposits and equivalents, investments and construction in progress, a reasonable return on average equity capital invested for necessary and proper operation for patient care activities of a residential health care facility and related organizations, as defined in section 86-2.26(a) of this Subpart. For purposes of this section, average equity capital shall mean the difference between total assets less total liabilities averaged over the applicable cost report period, including assets and liabilities attributable to land, plant, fixed equipment and capital improvements thereto. It shall also include the average equity capital of related organizations proportionate with the percentage of a related organization's business with the residential health care facility, as calculated in the annual report forms filed in accordance with section 86-2.2 of this Subpart.
(b) The allowable average equity capital shall be further adjusted by subtracting the equity, as that term is defined in section 86-2.21(a)(4) of this Subpart, upon which a return is calculated pursuant to section 86-2.21(e)(6) of this Subpart. The return on investment for rate year January 1, 1993 shall be computed on the basis of allowable fiscal and statistical data submitted by the facility for the fiscal year ended December 31, 1991, or other applicable cost report period used to determine the capital component of the 1993 rate, in accordance with section 86-2.21 of this Subpart. The return on investment for subsequent rate years shall be based upon the annual cost report used by the department to determine the capital component of the rate in accordance with section 86-2.21 of this Subpart. The percentage to be used in computing the return on investment shall be equal to the 26-week United States Treasury Bill rate in effect on the second Wednesday of September of the year prior to the rate year.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.6 Adoption Information Registry
(a) All registrations, records and information of the Adoption Information Registry, as established pursuant to section 4138-c of the Public Health Law, shall be filed and stored within the department with the Adoption Information Registry. Such filing and storage areas shall be clearly set off and physically separate from other areas and, except to the extent necessary for the proper function of the registry, access thereto shall be restricted to employees designated by the commissioner.
(b) The records and information of the Adoption Information Registry, except to the extent necessary for the proper function of the registry, shall not be transported or removed from the designated area within the Department of Health assigned for the operation of the Adoption Information Registry.
(c) Where an adoptee registrant registers directly with the department and requests the department to have nonidentifying information released either by the department or the authorized agency involved in the adoption, such agency shall be entitled to a service fee not exceeding $50 to be paid by the adoptee registrant directly to such agency for the review, compilation and forwarding of the nonidentifying information. The authorized agency, upon receipt of such request from the department and fee from the adoptee registrant, shall provide the nonidentifying information to either the department or the adoptee registrant as directed by the department.
(d) An authorized agency which maintains a mutual-consent voluntary adoption registry shall be entitled to a registration/a service fee for the registration, and a registration/a service fee for the services related to the processing of requests for information, according to the following schedule:
(1) Where an adoptee, a biological sibling of an adoptee or biological parent is registered directly with an agency, the agency shall be entitled to a registration fee not exceeding $20.
(2) Where the agency which was involved in the adoption provides nonidentifying information to an adoptee or the biological sibling of the adoptee, the agency shall be entitled to a service fee not exceeding $50, in addition to the registration fee.
(e) The verified registration by an adoptee, the adoptive parents of an adoptee under the age of 18 for the purpose of receiving medical information updates, the biological sibling of an adoptee or the biological parents of an adoptee whose consent to the adoption was required at the time of the adoption, or whose signature was required on an instrument of surrender to an authorized agency, as specified in sections 4138-c and 4138-d of the Public Health Law, shall be in the form that shall be prescribed by the commissioner.
(f) The recording and forwarding of the nonidentifying information to the Adoption Information Registry, as specified in section 4138-c of the Public Health Law, shall be in the form that shall be prescribed by the commissioner.
(g) Any person who discloses any information in the adoption registry unlawfully shall be guilty of a class A misdemeanor pursuant to section 4138-c(7)(b) of the Public Health Law.
(h) Any authorized agency which establishes a mutual-consent voluntary adoption registry shall inform the Department of Health, Adoption Information Registry, by certified mail, of the establishment of such registry on the form prescribed by the commissioner.
(i) Any authorized agency which maintains a mutual-consent voluntary adoption registry, upon registering a person and making a determination that the agency was involved in such adoption, shall promptly forward a copy of the registration form to the Adoption Information Registry of the Department of Health, indicating on the face of the form that such agency was involved in the adoption and shall provide other information as requested by the department.
(j) Any authorized agency which maintains a mutual-consent voluntary adoption registry, upon registering a person and making a determination that the agency was not involved in the adoption, shall promptly forward a copy of the registration form to the Adoption Information Registry of the Department of Health, indicating on the face of the form that such agency was not involved in the adoption and shall provide other information as requested by the department.
(k) Any authorized agency which has not established a mutual-consent voluntary adoption registry, upon receipt of a request to register with such agency, shall refer such person to the Adoption Information Registry of the Department of Health.
(l) An authorized agency is an agency as defined by New York Social Services Law, sections 371(10)(a) and 371(10)(b).
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.6 Inpatient hospital and related care
Reimbursement for inpatient care rendered by hospitals shall be made at all-inclusive per diem rates not to exceed those established by the State of New York Joint Committee on Hospital Rates.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.13 Water supply
Every campground potable water supply meeting the definition of a public water system as defined in Subpart 5-1 of this Title shall, in addition to complying with subdivisions (d)-(l) of this section, comply with the applicable requirements of Subpart 5-1 of this Title. All other potable water supplies serving campgrounds not meeting the definition of a public water system shall comply with the following requirements:
(a) Treatment.
(1) Minimum treatment for a ground water source shall be disinfection by chlorination or other disinfection methods acceptable to the permit issuing official unless a waiver for disinfection has been issued based upon a satisfactory history of microbiological water quality and all sources of the water supply are properly located, constructed and effectively protected and maintained.
(2) Minimum treatment for surface water sources or ground water sources directly influenced by surface water shall be filtration and disinfection techniques, approved by the permit issuing official, capable of 99.9 percent removal and/or inactivation of viruses and giardia lamblia cysts.
(b) Maximum contaminant levels (MCL)
| Contaminant | MCL | | --- | --- | | Total coliform | Any positive sample | | Escherichia coli (E. coli) | Any positive sample | | Nitrate | 10 (as Nitrogen) mg/L | | Nitrite | 1 (as Nitrogen) mg/L | | Total nitrate and nitrite | 10 (as Nitrogen) mg/L |
(c) Monitoring requirements.
Samples shall be collected from the water system(s) for analysis as follows:
(1) At least one sample collected for microbiological analysis from each system prior to opening for the operating season and at least one additional sample collected from each system during the operating season. For those campgrounds operating more than 90 days in a calendar year microbiological samples shall be collected for each quarter the campground is in operation.
(2) A sample shall be collected for nitrate and nitrite analysis for new water sources.
(3) Additional monitoring may be required when determined by the permit-issuing official to be necessary to evaluate water quality.
(d) Submission of plans; prior approval.
A plan for proposed new or modified potable water supply systems shall be submitted to the permit-issuing official at least 30 days prior to beginning construction. No construction of new or modified potable water supply systems shall commence until plans and specifications have been submitted to and approved by the permit-issuing official. Construction shall be in accordance with the approved plans.
(e) Minimum standards.
(1) Potable water shall be adequate in quantity and quality and shall be readily available to occupants of the campground. Only potable water shall be easily accessible. An adequate supply shall mean at least 55 gallons per day per campsite which includes water use for toilets, hand washing, showers and individual campsite food preparation and clean-up. Additional available capacity for food services, bathing facilities, laundry and demand created by day use of these facilities shall be provided.
(2) Structures available for overnight occupancy other than those meeting the definition of a camping unit, shall be supplied with at least 150 gallons of water per unit per day.
(f) Source protection.
All potable water sources and distribution systems shall be designed, located, constructed and maintained to provide protection against contamination or pollution. All pumps, piping fixtures and appurtenances shall be adequately installed and maintained to protect against contamination of any water source.
(g) Connections prohibited.
There shall be no physical connection between the potable water supply and any nonpotable water supply. Any fixture, installation or equipment which is subject to back-siphonage shall be adequately installed and maintained to protect against contamination of the water source(s).
(h) A minimum pressure of 20 pounds per square inch, at peak demand, shall be maintained in all parts of the campground distribution system.
(i) Report on water treatment.
When a water treatment process is required to maintain adequate water quality, accurate and complete reports on the operation of the treatment system shall be maintained daily and submitted at least monthly, within 10 days of the end of each month, during periods of operation to the permit-issuing official on a form supplied for this purpose.
(j) Interruptions, changes in sources or treatments.
Any incident or condition which effects the quantity or quality of the on-site potable water supply shall be reported to the permit-issuing official within 24 hours of occurrence. There shall be no changes made to the source, or method of treatment of a potable water supply, either temporary or permanent, without first receiving approval from the permit-issuing official. An adequate supply of potable water must be provided and maintained during all times of operation.
(k) An adequate supply of potable water shall be provided within 250 feet of all campsites. One water spigot with a soakage pit or other disposal facilities shall be provided for each 10 campsites not provided with individual spigots on the campsites.
(l) A common drinking utensil shall not be provided. Drinking fountains shall be of adequate sanitary design and construction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.38 Nursing home incentive payment
(a) The commissioner shall make rate adjustments, subject to the availability of funds therefore, to certain residential health care facilities who demonstrate to the satisfaction of the commissioner that they can meet or exceed defined quality measures.
(b) Initial awards shall be based on a residential health care facility's performance for pressure ulcer quality of care for chronic care residents.
(c) The commissioner shall make two sets of awards as follows:
(1) an award shall be made for the best performers for the evaluation period;
(2) an award shall be made to residential health care facilities with the best improvement in pressure ulcer care between a base and evaluation period except that facilities in the bottom quarter percentile of all eligible residential health care facilities for this evaluation period shall not be eligible for such an award if, even after their improvement in pressure ulcer care, they still remain in the bottom quarter percentile of all eligible residential health care facilities; and
(3) residential health care facilities that qualify are eligible to receive an award in both categories of awards.
(d)
(1) The evaluation period for the award for best performers shall be January 1, 2007 through December 31, 2007.
(2) The base period for the award for best improvement shall be July 1, 2006 through June 30, 2007, which shall be compared to the period July 1, 2007 through June 30, 2008.
(e) The following factors shall be considered by the commissioner in making awards pursuant to this section:
(1) the quality measure of pressure ulcer care shall be risk adjusted using such patient health factors to include but not be limited to: coma, malnutrition, diseases and conditions related to pressure ulcer, low body mass index, and plegia (paraplegia or hemiplegia);
(2) pressure ulcer rates shall be considered only for chronic care residential health care facility residents;
(3) in order to be eligible to be considered for a rate enhancement, a residential health care facility must have averaged more than one prevented pressure ulcer per quarter of the evaluation period identified in subdivision (d) of this section as calculated by comparing the actual number of residents with a pressure ulcer to the expected number of residents with a pressure ulcer, based on the facility's risk adjusted pressure ulcer rate developed pursuant to this subdivision; and
(4) Any residential health care facility receiving a written deficiency for substandard quality of care, as defined in Federal regulation 42 C.F.R. § 488.301, during the evaluation periods contained in this section shall be excluded from receiving an award under this section.
(f) Rate adjustments made pursuant to this section for residential health care facilities receiving monetary awards shall be made based on the residential health care facility's percent of patient days of care attributable to patients eligible for medical assistance pursuant to title 11 of article 5 of the Social Services Law.
(g) Residential health care facilities chosen to receive rate enhancements pursuant to this section shall, prior to the rate enhancement, inform the commissioner in writing as to their proposed use of the additional monies to further improve quality and care of patients in the residential health care facility.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.6 Accounting control
The administrative procedures employed in maintaining the accuracy and propriety of transactions and the bookkeeping record thereof.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.16 Parents, persons in parental relation and surrogate parents
(a) The early intervention official shall make every effort to protect the right of parents, which includes persons in a parental relation, to make decisions about a child’s receipt of early intervention services.
(b) Where the parent’s availability to the child is limited due to life circumstances, including residing far from their child or the parent is residing in an institution, or the child's placement in the care and custody of the local social services commissioner, the early intervention official shall, as appropriate, facilitate the parent's involvement in early intervention services.
(c) The early intervention official shall be responsible for the determination of the need for a surrogate parent for eligible or potentially eligible children and make reasonable efforts, including contacting persons who might have information concerning the parent, or visit and/or send letters via regular and certified mail to addresses at which the parent may have lived, to discover the whereabouts of a parent before appointing a surrogate.
(1) The early intervention official shall establish agreements with local social services districts, Family Court and other relevant public agencies regarding procedures which will be used to identify eligible or potentially eligible children in need of surrogate parents.
(2) Upon receipt of a referral of an eligible or potentially eligible child who is in the care and custody or custody and guardianship of the local commissioner of social services, the early intervention official, in consultation with the local commissioner of social services or designee, shall determine the availability of the parent.
(3) In the event that the child is a ward of the State, or in the care and custody of the local social services commissioner, and his or her parents by birth or adoption are unavailable and the child has no person in parental relation, the early intervention official shall consult with the local commissioner of social services with care and custody or custody and guardianship of the child to promptly appoint a surrogate parent.
(d) The early intervention official shall appoint a qualified surrogate parent for any eligible child or potentially eligible child when the child is a ward of the State, or when the child is not a ward of the State but his or her parents by birth or adoption are unavailable after reasonable efforts to facilitate their participation. Such appointment shall be made within 30 days after making a determination of the child’s need for a surrogate parent.
(e) The early intervention official shall allow an available birth parent or adoptive parent to voluntarily appoint a surrogate parent upon written consent.
(f) The early intervention official shall select a surrogate parent who is qualified and willing to serve in such capacity and who:
(1) has no interest that conflicts with the interests of the child;
(2) has knowledge and skills that ensure adequate representation of the child;
(3) if available and appropriate, is a relative who has an ongoing relationship with the child or a foster parent with whom the child resides;
(4) is not an employee of the lead agency or any other public agency or provider involved in the provision of early intervention or education, care or other services to the child, provided however that a person who otherwise qualifies to be a surrogate parent is not considered an employee solely because he or she is paid by a public agency to serve as a surrogate parent;
(5) has been selected, for any child who is a ward of the State or for any child whose parent is unavailable and who is in the care and custody of the local social services commissioner, in consultation with the local commissioner of social services or designee; and
(6) in the case of a child who is a ward of the State, the early intervention official shall recognize the appointment of a surrogate parent by a judge overseeing the child’s case, for purposes of the Early Intervention Program.
(g) The early intervention official shall afford the surrogate parent the same rights and responsibilities as accorded to the parent by the Early Intervention Program and shall represent the child in all matters related to:
(1) screening, evaluation, and assessment of the child;
(2) development and implementation of the individualized family service plan, including annual evaluations and periodic reviews;
(3) the ongoing provision of early intervention services;
(4) the right to request mediation or an impartial hearing in the event of a dispute; and
(5) any other rights established in the Early Intervention Program.
(h) The surrogate parent shall maintain the confidentiality of all information regarding the child, including written records.
(i) A person appointed to serve as a surrogate parent shall be removed by the early intervention official in the event:
(1) the surrogate parent is no longer willing or available to participate in that capacity;
(2) the surrogate parent fails to fulfill his or her duties;
(3) the child is no longer a ward of the State; or
(4) a parent becomes available.
(j) The surrogate parent may request a hearing to challenge a determination by an early intervention official to remove the surrogate parent for failure to fulfill the duties of a surrogate parent. Upon request by the former surrogate parent, a hearing shall be conducted under the provisions of Part 51 of this Title.
(k) In the event that the surrogate parent is removed and the child continues to require the assistance of a surrogate parent, the early intervention official shall appoint a surrogate parent within no more than 10 working days of the removal.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 15.2 Application
(a) The requirements of this Part shall apply to migrant farmworker housing facilities occupied by five or more persons one or more of whom are employed to perform in farm activities. In determining whether a certain property constitutes a migrant farmworker housing facility within the intent of this Part, the property owner or other persons occupying the property on a continuous annual basis shall not be included in computing the number of persons occupying the property.
(b) The requirements of this Part shall not apply to:
(1) a private residence, a facility regulated by Subparts 7-1 and 7-2 of this Title, or other similar property which is primarily occupied or maintained for occupancy of persons other than migrant farmworkers; and
(2) any other type of operation, occupancy or use of a property determined by the State Commissioner of Health as not being within the intent of regulation by this Part.
(c) Variance.
In order to allow time to comply with a provision of this Part, an operator may submit a written request to the permit-issuing official for a variance. Such variance request shall not be granted unless the operator demonstrates that the health and safety of the housing occupants and the public will not be prejudiced by the variance, and there are practical difficulties or hardships in immediate compliance with the provisions. An operator must meet all terms of an approved variance including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the permit-issuing official specifies. A variance shall end one year from its date of issuance, unless it is granted for a lesser period of time.
(d) Waiver.
In order to accept alaternative arrangements that do not meet a provision of the Part, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Part. Such request shall not be granted unless the operator can demonstrate that circumstances exist that are beyond the control of the operator, compliance with the provision would present a hardship and that the public and housing occupants' health and safety will not be endangered by granting such a waiver. The permit-issuing official shall obtain and be guided by the recommendation of the State Department of Health prior to granting or denying a waiver. An operator must meet all terms of an approved waiver(s). A waiver will remain in effect indefinitely unless revoked by the permit-issuing official or the facility changes operators.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PLUMBING PLUMBING
10 CRR-NY 14-5.141 Definition of indirect drain
An indirect drain is a waste line which does not connect directly with the drainage system, but conveys and discharges liquid wastes through an air break into an approved plumbing fixture or receptacle directly connected to the drainage system.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.1 Definitions
(a) Primary care hospital (PCH) shall mean a general hospital serving rural area which:
(1) complies with the provisions of this Part and the provisions of Part 405 of this Title to the extent required by this Part;
(2) provides all services required by section 407.3 of this Part in a manner that safely and effectively meets patient needs;
(3) may provide one or more additional optional services authorized by section 407.14 of this Part in accordance with patient needs, the hospital's ability to meet these needs safely and effectively and the commissioner's approval to provide such services;
(4) may participate in a rural health network as defined in subdivision (c) of this section;
(5) has a formal affiliation with a general hospital that complies with all provisions of Part 405 of this Title; and
(6) is located in a rural area, defined as any county with less than 200,000 persons or any town which has a population of less than 200 persons per square mile, or if approved by the commissioner, any town which has a population of less than 250 persons per square mile.
(b) Critical access hospital (CAH) shall mean a PCH serving a rural area which:
(1) is designated by the Federal government as a CAH pursuant to the requirements of 42 CFR section 485.606; and
(2) complies with provisions of this Part that relate to PCHs as well as those applying only to be CAHs.
(c) Rural health network shall mean an affiliation of health care providers serving a rural area, pursuant to a contract, joint or cooperative agreement, or organized pursuant to the not-for-profit corporation law and approved pursuant to subdivision 14 of section 2801-a of the Public Health Law, which provides or arranges for the provision of health care services pursuant to a network plan to residents of a rural area or the provision of administrative or management services among such health care providers.
(d) Network plan shall mean a written plan prepared by a rural health network or rural providers planning to form a rural health network, with the involvement of consumers, describing the steps to be taken by such network and its participating providers to respond to the health care needs of the rural area, improve access to and the quality of care for residents of the community, promote the coordination of resources among providers and reduce duplication of services while achieving cost and other operational efficiencies.
(e) Medical control shall have the meaning set forth in subdivision 15 of section 3001 of the Public Health Law and includes advice and direction provided by or under the direction of a physician to certified first responders, emergency medical technicians or advanced emergency medical technicians who are providing medical care at the scene of an emergency or in route to a health care facility. For the purposes of this Part, medical control shall also involve the implementation of network emergency medical service plans developed in conjunction with the Regional Emergency Medical Advisory Committee(s) (REMACs) responsible for the hospital's service area.
(f) Professional shall mean a person practicing medicine as defined in article 131 of title 8 of the State Education Law, and may also mean other licensed and currently registered health care practitioners appointed by the governing body, in accordance with State law. The governing body shall determine which categories of health care practitioners are eligible candidates for appointment to the medical staff. The eligible categories may include qualified staff such as registered physician's assistants, registered specialists' assistants, registered professional nurses - nurse practitioners or clinical nurse specialists.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MOBILE FOOD SERVICE ESTABLISHMENTS MOBILE FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-4.34 Definition of frozen desserts
(a) Frozen desserts are ice cream, frozen custard, French ice cream, French custard ice cream, artificially sweetened ice cream, ice milk, artificially sweetened ice milk, fruit sherbet, non-fruit sherbet, water ices, non-fruit water ices, confection frozen without stirring, dairy confection frozen without stirring, manufactured dessert mix, frozen confection, melloream frozen dessert, parevine, frozen yogurt, freezer made shakes, freezer made milk shakes, dietary frozen dessert, whipped cream confection and bisque tortoni, as all such products are commonly known, together with any mix used in making such frozen desserts and any products which are similar in appearance, odor or taste to such products, or are prepared or frozen as frozen desserts are customarily prepared and frozen, whether made with dairy products or non-dairy products. Any operation producing chips or flakes of ice made from water with or without additives, served to the consumer with or without flavorings added by the operator or consumer, is included as a retail frozen dessert within this definition. This operation is commonly known as a slush operation.
(b) Retail frozen desserts are to be manufactured from ingredients and are to be identified in conformance with the applicable requirements of Part 39 of the rules and regulations of the State Department of Agriculture and Markets (1 NYCRR Part 39).
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
ENVIRONMENTAL HEALTH DIRECTOR ENVIRONMENTAL HEALTH DIRECTOR
10 CRR-NY 11.91 Qualifications
An environmental health director must possess:
(a) a baccalaureate degree from a regionally accredited or New York State registered college or university in sanitary, environmental, chemical, civil or public health engineering or a related engineering field; or a bachelor's degree from a regionally accredited or New York State registered college or university with 30 credit hours in the natural sciences, of which not more than 12 credit hours may be in the applied sciences; and
(b) two years of administrative and supervisory experience as a supervising engineer or supervising sanitarian as defined in this Part; or five years of environmental health experience, including two years of supervisory responsibility that demonstrates that the candidate has the technical and administrative skills necessary to manage programs that can anticipate, recognize and respond to environmental health challenges. A master's degree in public or environmental health or a related field that demonstrates the five core competencies of a public health education (biostatistics, environmental health services, epidemiology, health policy and management and social and behavior sciences) may be substituted for up to two years of the required environmental health experience.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT
10 CRR-NY 43-1.18 Violations by a provider
A violation of any provision of this Subpart as applied to a specific patient, shall be punishable by a denial of payment of State aid reimbursement to a local health official or a provider or the repayment thereof for tuberculosis health care services for such patient.
Subchapter D LABORATORIES
Part 57 CONDITIONS UNDER WHICH A DOG ACTIVELY IMMUNIZED AGAINST RABIES MAY BE AT LARGE IN DESIGNATED AREAS CERTIFIED FOR RABIES
10 CRR-NY 57.4 Requirements for designated area
(a) An area may be designated after at least 70 percent of the enumerated dogs have been vaccinated as defined in section 57.1(b) of this Part.
(b) An area may be designated upon receipt of a resolution from the board of supervisors of the county, requesting the State Commissioner of Health to permit all dogs vaccinated against rabies to run at large, whereupon the commissioner may grant such privilege subject to the limitations of section 57.2 of this Part and subject to the following conditions:
(1) that the board of supervisors shall have provided funds and made the necessary arrangements for giving dog owners the opportunity of having their dogs vaccinated;
(2) that every effort shall be made to permit only vaccinated dogs to run at large;
(3) that, if within four months of the date of granting this request, 70 percent or more of the enumerated dog population have not been vaccinated, the commissioner may revoke this privilege.
Designation may be revoked at any time for failure to enforce the provisions of the Public Health Law or Chapter I of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.1 Depreciation, Leases and Rentals
This functional reporting center must contain all depreciation and amortization expenses on buildings, fixed equipment and leasehold improvements recorded at their historical cost. In addition, the center must also contain all lease and rented expenses for land, buildings, fixed equipment and leasehold improvements.
(a) Standard unit of measure: gross square feet.
Gross square feet shall be determined using the outer dimensions of the facility. Measurement should be taken by floor, to account for structural irregularities that may exist on various floors. When changes have been made during the year as a result of new construction or expansion, or curtailment of service, statistical data should be maintained to allow for the development of “weighted” areas for the fractional part of the year.
(b) Data source.
Gross square feet shall be determined from the blueprints of the residential health care facility, or actual measurement if blueprints are not available.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.27 Reinfusion procedures
(a) All entities performing reinfusion procedures or any part thereof shall hold a valid department permit in the category of blood services – transfusion or be approved by the department as a limited reinfusion service. Such limited reinfusion services are subject to inspection by the department.
(b) All reinfusion procedures shall comply with written protocols approved by the director of transfusion services and the transfusion committee of the facility where the reinfusion is to be performed, the director of the hospital department where the product is reinfused, and the hospital department or facility where processing for the reinfusion procedure is performed, if different. These protocols shall include procedures for collection, labeling, handling, processing and reinfusion of the product. All reinfusion procedures performed in hospitals shall be reviewed by the hospital transfusion committee.
(c) The syringe, tube, bag, or other container into which the blood or component thereof is collected for reinfusion, shall be labeled at the time of collection with two forms of identification, one of which shall be the patient's name. The person drawing the blood or component shall initial or sign the records pertaining to the collection and certify that the identification on the blood or component and on the pertinent records is correct.
(d) During shipment, processing and storage, reinfusion products shall be maintained at a temperature between one and 38 degrees Celsius, except as otherwise required in a protocol approved by the director of the service performing the reinfusion. Red cell reinfusion products shall not be exposed to a temperature above six degrees Celsius for more than six hours. While in transit, the container and shipping box for such products shall be appropriately labeled as containing human blood products.
(e) Any container into which the blood or component is transferred from another container during reinfusion processing shall be labeled prior to the transfer with two forms of identification, one of which shall be the patient's name or identification code. The person performing the transfer shall initial or sign the records pertaining to reinfusion processing of the blood or component and shall certify that the container identification was transcribed correctly. All final containers shall be labeled with the patient's name, description of the contents, expiration date and dosage, if applicable.
(f) No reinfusion of a processed product shall be performed unless two individuals other than the patient have confirmed the identity of the recipient and the product to be reinfused as matching in name and in at least one additional identifier. This confirmation shall be documented in writing.
(g) All errors or accidents during processing or reinfusion procedures, that may pose a substantial risk to the patient shall be reported to the department's Wadsworth Center, with sufficient detail to facilitate evaluation and investigation, within seven calendar days of the error or accident, or its discovery.
(h) All records pertaining to reinfusion procedures shall be retained for a minimum of seven years.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.192 Separability
If any provision of this Subpart is held invalid, such invalidity shall not affect other provisions which shall be given effect without the invalid provisions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.2 Definitions
For the purpose of this Subpart:
(a) Committee means a medical record access review committee designated by the Commissioner of Health to hear appeals from the denial of access to patient information as provided in Public Health Law, section 18.
(b) Health care provider or provider shall have the same meaning as in section 18 of the Public Health Law.
(c) Patient information shall have the same meaning as in section 18 of the Public Health Law.
(d) API coordinator means the Department of Health employee responsible for administration, coordination and operation of the access to patient information program within the Department of Health.
(e) Qualified person shall have the same meaning as in section 18 of the Public Health Law.
(f) Personal notes and observations shall mean a practitioner's speculations, impressions (other than tentative or actual diagnosis) and reminders, provided such data is maintained by a practitioner. Handwritten notes and observations shall not be presumed to be personal notes and observations.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.8 Requirements for continued attendance
Prior to August 1, 1991, this Subpart shall not apply to part time students. This Subpart shall also not apply to any student who attended the institution he or she is attending prior to August 1, 1989.
Chapter I STATE SANITARY CODE
Part 19 CLINICAL LABORATORY DIRECTORS
10 CRR-NY 19.2 Clinical laboratory or blood bank; qualifications of laboratory director
A director and any assistant director of a clinical laboratory or blood bank shall possess training and/or experience acceptable to the department, obtained within the previous six years, in one or more categories. Additionally, the applicant must meet one of the following requirements:
(a) be a physician who is currently certified by:
(1) the American Board of Pathology in:
(i) clinical pathology; or
(ii) anatomic pathology; or
(iii) dermatopathology; or
(2) the American Osteopathic Board of Pathology in:
(i) laboratory medicine; or
(ii) anatomic pathology; or
(iii) dermatopathology; or
(b) be a physician in the State of New York who:
(1) is currently certified by the American Board of Pathology in blood banking and transfusion medicine; or
(2) is currently certified by the American Board of Pathology in clinical pathology or the American Board of Internal Medicine in hematology, and possesses six months of training and/or experience in transfusion services; or
(3) possesses four years of training and/or experience in an acceptable laboratory including two or more years of training and/or experience in transfusion services and in general laboratory management.
(c) be a dentist who is currently certified by the American Board of Oral and Maxillofacial Pathology; or
(d) be a physician, or hold an earned doctoral degree from an accredited institution with a relevant chemical, physical or biological science major, and:
(1) is currently certified by one of the following boards and meets any supplemental requirements for experience as specified by the department:
(i) the American Board of Bioanalysis as a High Complexity Laboratory Director, provided the applicant has obtained a minimum of four years of post-doctoral experience equivalent to paragraph (2) of this subdivision; or
(ii) the American Board of Clinical Chemistry in clinical chemistry; or
(iii) the American Board of Clinical Chemistry in toxicological chemistry; or
(iv) the American Board of Dermatology; or
(v) the American Board of Forensic Toxicology, provided the applicant has an earned doctoral degree; or
(vi) the American Board of Internal Medicine in hematology or hematology and medical oncology; or
(vii) the American Board of Medical Laboratory Immunology; or
(viii) the American Board of Medical Microbiology; or
(ix) dual certification by the American Board of Pathology in either anatomic pathology or clinical pathology, and molecular genetic pathology; or
(x) the American Board of Pathology in medical microbiology; or
(xi) the National Registry for Certified Chemists, provided the applicant has obtained a minimum of four years of post-doctoral experience equivalent to paragraph (2) of this subdivision; or
(2) subsequent to receiving a doctor of medicine, doctor of osteopathic medicine or earned doctoral degree has had, and has documented to the department, four years of training and/or experience in an acceptable laboratory, including two or more years of training and/or experience in methods and techniques currently in use in the certificate category or categories sought and in general laboratory management, or an equivalent combination of training and/or experience as verified by the department.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.8 Subsurface sewage treatment systems
(a) Minimum requirements.
(1) The design, treatment, construction, maintenance and operation of new subsurface sewage treatment systems, and the plans therefor, require the review and approval of the department, provided that the requirements of this section shall not apply to subsurface sewage treatment systems necessary for an agricultural activity that are designed, provide treatment and are constructed, maintained and operated in compliance with State and Federal law.
(2) All new individual sewage treatment systems shall comply with the requirements of Part 75 and Appendix 75-A of this Title except where a local government or agency has enacted, or these rules and regulations specify, more stringent standards, in which case, the more stringent standards shall apply.
(3) All new intermediate sized sewage treatment systems shall comply with the requirements set forth in Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities, New York State Department of Environmental Conservation (1988), except where a local government or agency has enacted, or these rules and regulations specify, more stringent standards, in which case, the more stringent standards shall apply.
(i) As a condition of approval the department may require evidence of financial security prior to construction, from any owner or operator of a new intermediate sized sewage treatment system or a substantial alteration or modification to an existing intermediate sized sewage treatment system. Such financial security shall consist of a bond, or an equivalent guaranty, to be deposited with the department, covering the full cost of the construction of such facility and an additional bond or an equivalent guaranty for the payment of labor and material furnished in the course of such construction. Upon completion of construction and payment of labor and materials, such bonds or other guaranties shall be released. Additionally, a bond or equivalent guaranty may be required for the maintenance and operation of the facility for a period of five years post-construction. No bond or guaranty is required where the owner or operator of such a facility is a village, town, county or city.
(4) All new subsurface sewage treatment systems, other than those covered by paragraphs (2) and (3) of this subdivision, shall comply with the applicable requirements of Part 75 and Appendix 75-A of this Title or the applicable published standards of the Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities, New York State Department of Environmental Conservation (1988), except where a local government or agency has enacted, or these rules and regulations specify, more stringent standards, in which case, the more stringent standards shall apply.
(i) As a condition of approval the department may require evidence of financial security prior to construction, from any owner or operator of a new subsurface sewage treatment system or a substantial alteration or modification to an existing subsurface sewage treatment system. Such financial security shall consist of a bond, or an equivalent guaranty, to be deposited with the department, covering the full cost of the construction of such facility and an additional bond or an equivalent guaranty for the payment of labor and material furnished in the course of such construction. Upon completion of construction and payment of labor and materials, such bonds or other guaranties shall be released. Additionally, a bond or equivalent guaranty may be required for the maintenance and operation of the facility for a period of five years post-construction. No bond or guaranty is required where the owner or operator of such a facility is a village, town, county or city.
(5) No part of any absorption field for a new conventional individual subsurface sewage treatment system, as described in Appendix 75-A of this Title, or for the types of sewage treatment systems described in paragraphs (3) and (4) of this subdivision, or for an Ulster County fill system, shall be located within the limiting distance of 100 feet of a watercourse or wetland or 300 feet of a reservoir, reservoir stem or controlled lake. For a new conventional individual subsurface sewage treatment system or for a new Ulster County fill system the department may recommend a greater limiting distance from an absorption field to a watercourse, wetland, reservoir, reservoir stem or controlled lake.
(6) Raised systems, as described in Part 75 and Appendix 75-A of this Title, are allowed on undeveloped lots not located in a subdivision or on undeveloped residential lots located in a subdivision which was approved prior to the effective date of these rules and regulations, where site conditions are not suitable for a conventional system provided that:
(i) the system shall be located at least 250 feet from any watercourse or wetland and 500 feet from any reservoir, reservoir stem or controlled lake provided that the greater limiting distance for raised systems does not preclude construction on the subject lot or lots of the use proposed by the applicant, and further provided that the site conditions and the subsurface sewage treatment system comply with the other provisions of these rules and regulations and other applicable Federal, State and local laws, as cited in paragraph (1) of this subdivision; or
(ii) raised systems which cannot meet the limiting distances set forth in subparagraph (i) of this paragraph due to size or location of the lot shall be located at the greatest limiting distance possible within the property lines and at least 100 feet from any watercourse or wetland and 300 feet from any reservoir, reservoir stem or controlled lake.
(7) Where a watershed county has adopted a subdivision code that allows a raised system, as described in Part 75 and Appendix 75-A of this Title, or where any system that has been modified from the standards outlined in Appendix 75-A of this Title has been approved by the New York State Department of Health as an alternative system, or where the New York State Department of Health approved such raised or modified alternative systems for use in subdivisions located in the watershed, such raised or alternative systems are allowed in subdivisions that are approved subsequent to the effective date of these rules and regulations, provided that no part of such systems shall be located within 250 feet of a watercourse or wetland or 500 feet of a reservoir, reservoir stem or controlled lake.
(8) Any proposed alteration or modification of any subsurface sewage treatment system, including a noncomplying regulated activity, requires the review and approval of the department, and shall also be subject to the following, where applicable:
(i) Any proposed alteration or modification of any individual sewage treatment system or any other kind of subsurface sewage treatment system described in paragraphs (3) and (4) of this subdivision located within the limiting distances set forth in this section shall be performed in accordance with the New York State Fire Prevention and Building Code, Executive Law, section 370 et seq.
(ii) Any proposed alteration or modification of any intermediate sized sewage treatment system is prohibited unless such alteration or modification complies with the requirements of this section.
(9) All existing subsurface sewage treatment systems, which are operating in accordance with their Federal, State, and local approvals on the effective date of these rules and regulations, but which do not comply with the additional requirements set forth in this section, shall be allowed to continue to operate and shall be considered noncomplying regulated activities. However, if at any time after the effective date of these rules and regulations such subsurface sewage treatment system fails or needs remediation, the owner or operator of the subsurface sewage treatment system shall comply with the following:
(i) any proposed remediation of any part of such existing subsurface sewage treatment system shall require the prior review and approval of the department, and if approved, shall be completed as soon as possible in accordance with a schedule approved by the department;
(ii) upon the failure of any subsurface sewage treatment system, it shall be remediated, to the extent possible, in accordance with the design standards set forth in this section, and shall require the prior review and approval of the department. However, if the department determines, based upon the application submitted by the owner or operator of the subsurface sewage treatment system, that such system cannot comply with this section, the owner or operator of the subsurface sewage treatment system shall cooperate with the department to determine the most suitable location and design for the system on the specific site. The department may require the owner to agree to a regular schedule for the pump-out of any failed subsurface sewage treatment system; and
(iii) the provisions of this paragraph shall not apply to the routine repair and maintenance of a subsurface sewage treatment system, including, but not limited to, the pump-out of a septic tank, the repair of a broken lateral, the leveling of a distribution box, or the removal of a blockage.
(10) Any approval of a subsurface sewage treatment system issued by the department shall expire and thereafter be null and void unless construction is commenced within five years of the date of issuance for systems located within approved subdivisions, or within two years of the date of issuance for all other subsurface sewage treatment systems. Following expiration of the approval, the plans for the subsurface sewage treatment system may be resubmitted to the department for consideration for a new approval.
(b) Design, operation, treatment, and maintenance requirements.
(1) All subsurface sewage treatment systems shall be designed, operated and maintained to prevent the exposure of sewage to the surface of the ground or the discharge of sewage to groundwater.
(2) Mound systems, intermittent sand filters, evapotranspiration/absorption systems and galley systems that did not have all discretionary approvals before June 30, 2002, are prohibited from use in the watershed.
(3) An additional area of at least 100 percent of the primary absorption field area shall be set aside as a reserve absorption field area for any subsurface sewage treatment system.
(4) Primary and reserve absorption fields may not be built under pavement or other impervious surfaces, and pavement and other impervious surfaces may not be built over such absorption fields after installation.
(5) At least one percolation test and at least one deep hole test shall be performed in the primary absorption field. At least one percolation test and at least one deep hole test shall be performed in the reserve absorption field area. An applicant shall notify the department in writing at least seven days prior to performance of such tests, and specify the location and the time of the tests. At the option of the department, a department representative may witness such tests.
(6) Proposed sites with soil percolation rates faster than three minutes per inch or slower than 60 minutes per inch shall not be approved by the department for locating a subsurface sewage treatment system.
(7) Whenever possible, gravity flow systems shall be used for subsurface sewage treatment systems. The use of pumping, mechanical dosing or other mechanical devices shall require a pump chamber equipped with an alarm to indicate malfunction and any other safety features required by the department to prevent sewage overflow. An intermediate sized sewage treatment system or any other kind of subsurface sewage treatment system as described in paragraphs (a)(3)-(4) of this section is required to have either a backup pump or a backup storage tank capable of holding two days flow. An individual sewage treatment system shall have a backup storage tank capable of holding one days flow.
(c) Application requirements.
(1) An application for review and approval of any subsurface sewage treatment systems shall include the following information:
(i) Soil investigation report including:
(a) percolation test results;
(b) deep hole test pit results or boring analysis;
(c) indication of surface water or ledge rock observed;
(d) design rate of flow; and
(e) delineation of United States Department of Agriculture Soil Conservation Service soil type boundaries.
(ii) Building permit number and tax map number where available.
(iii) Four sets of plans showing:
(a) site location, including distances to wells, watercourses, rock outcroppings, wetlands, controlled lakes and reservoirs;
(b) site/system plans;
(c) system profile;
(d) details of system components; and
(e) a report containing:
(1) a description of the project characteristics; and
(2) a detailing of the design process.
(2) An application for review and approval of an intermediate sized sewage treatment system and for any other subsurface sewage treatment system as described in paragraph (a)(4) of this section, shall include all of the information in this subdivision, and additionally shall contain:
(i) an Environmental Assessment form and State Environmental Quality Review Act determination, if applicable; and
(ii) a SPDES permit, if applicable.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.19 Infection control
The facility shall establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment in which residents reside and to help prevent the development and transmission of disease and infection.
(a) Infection control program.
The facility shall establish an infection control program with written policies and procedures under which it:
(1) investigates, controls and takes action to prevent infections in the facility;
(2) determines what procedures such as isolation and universal precautions should be utilized for an individual resident and implements the appropriate procedures;
(3) maintains a record of incidence and corrective actions related to infections; and
(4) collects documentation of vaccination against influenza, or requires wearing of a surgical or procedure mask during the influenza season, for personnel who have not received the influenza vaccine for the current influenza season, pursuant to section 2.59 of this Title;
(5) collects documentation of COVID-19 or documentation of a valid medical exemption to such vaccination, for all personnel pursuant to section 2.61 of this Title, in accordance with applicable privacy laws, and making such documentation immediately available upon request by the department, as well as any reasonable accommodation addressing such exemption.
(b) Preventing spread of infection.
(1) When the infection control program determines that isolation is needed to prevent the spread of infection, the facility shall isolate the resident.
(2) The facility shall assure that all equipment and supplies are cleaned and properly sterilized where necessary and are stored in a manner that will not violate the integrity of the sterilization.
(3) The facility shall prohibit persons, including but not limited to, staff, volunteers, and visitors known to have a communicable disease or infected skin lesions from direct contact with residents or their food, if direct contact will transmit the disease.
(4) The facility shall require physicians and staff to wash their hands after each direct resident contact for which handwashing is indicated by accepted professional practice.
(c) Linens.
Personnel shall handle, store, process, and transport linens so as to prevent the spread of infection.
(d) Reporting.
The facility shall report increased incidence of infections, including nosocomial infections as defined in section 2.2 of this Title, to the appropriate area office of the Office of Health Systems Management and shall report, immediately, the presence of any communicable disease as defined in section 2.1 of this Title to the city, county or district health officer.
(e) Notice to funeral directors.
If, at the time of death, a resident was diagnosed as having a specific communicable disease designated in Part 2 of this Title or an infectious disease, a written report of such disease shall accompany the body when it is released to the funeral director or his or her agent, except that no HIV-related information shall be disclosed to the funeral director unless the funeral director has access in the ordinary course of business to HIV-related information on the death certificate of the deceased individual.
(f)
(1) The nursing home shall possess and maintain a supply of all necessary items of personal protective equipment (PPE) sufficient to protect health care personnel, consistent with federal Centers for Disease Control and Prevention guidance, for at least 60 days, by August 31, 2021.
(2) The 60-day stockpile requirement set forth in paragraph (1) of this subdivision shall be determined by the department as follows for each type of required PPE:
(i) for single gloves, the applicable positivity rate, multiplied by the number of certified nursing home beds as indicated on the nursing home’s operating certificate, multiplied by 24;
(ii) for gowns, the applicable positivity rate, multiplied by the number of certified nursing home beds as indicated on the nursing home’s operating certificate, multiplied by 3;
(iii) for surgical masks, the applicable positivity rate, multiplied by the number of certified nursing home beds as indicated on the nursing home’s operating certificate, multiplied by 1.5; and
(iv) for N95 respirator masks, the applicable positivity rate, multiplied by the number of certified nursing home beds as indicated on the nursing home’s operating certificate, multiplied by 1.4;
(v) for the purposes of this paragraph, the term applicable positivity rate shall mean the greater of the following positivity rates:
(a) the nursing home’s average COVID-19 positivity rate, based on reports made to the department, during the period April 26, 2020 through May 20, 2020; or
(b) the nursing home’s average COVID-19 positivity rate, based on reports made to the department, during the period January 3, 2021 through January 31, 2021; or
(c) 20.15 percent, representing the highest regional economic development council average COVID-19 positivity rate, as reported to the department, during the periods April 26, 2020 through May 20, 2020 and January 3, 2021 through January 31, 2021.
(3) Failure to possess and maintain the required supply of PPE may result in the revocation, limitation, or suspension of the nursing home’s license; provided, however, that no such revocation, limitation, or suspension shall be ordered unless the department has provided the nursing home with a 14 day grace period, solely for a nursing home’s first violation of this section, to achieve compliance with the requirement set forth herein.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-4 REQUIREMENTS FOR ALTERNATIVE REGULATED MEDICAL WASTE TREATMENT SYSTEMS
10 CRR-NY 70-4.4 Recordkeeping
(a) Each facility shall document efficacy and validation testing, including testing protocols and results, and routine system monitoring, and shall retain such records for three years.
(b) Each facility shall document, in the personnel file of each employee, participation in system training and/or retraining, and retain such records for three years.
(c) Documentation of corrective action, including that required by section 70-4.2 of this Subpart, shall be retained for three years.
(d) Each facility shall document any modification to an approved operation plan and retain such records for three years from discontinuance of the modified plan.
(e) The facility in which the alternative treatment system is situated shall maintain a copy of the department's letter notifying the manufacturer of the alternative treatment technology approval and any appendices or amendments thereto for as long as the system is operational.
(f) All records required pursuant to this section shall be made available for inspection and copying by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.8 Operating revenue accounts—general
[ 3210 ]
(a) Hospital revenue consists mainly of the value, at the hospital's full established rates, of all hospital services rendered to patients, regardless of amounts actually paid to the hospital by or on behalf of patients. The objective of patient service revenue reporting is to compile complete and accurate information, on the accrual basis, of gross revenue, by revenue centers and by inpatient and outpatient classification, and a record of revenue deductions, classified by type.
(b) Patient service revenues must be reported in such a manner as to clearly identify these revenues with the functional ambulatory and ancillary services cost centers and the discrete daily hospital services cost centers of the hospital. Revenues of revenue producing cost centers are needed for comparison with the expenses of the center, so that operating performances can be evaluated.
(c) In addition to patient service revenue, hospitals obtain revenue from sources and activities only indirectly related to patient care. These “other” operating revenues typically consist of tuition revenue, parking lot revenue, nonpatient food sales, etc.
(d) Regardless of the source of hospital revenue, it is important that it be reported for on the accrual basis. This basis of reporting requires that revenue be recognized and reported in the time period it is earned, irrespective of the timing of the cash flow between the hospital and other parties. No other basis provides the necessary qualities of completeness, accuracy, and usefulness of financial data and/or the proper basis for matching revenues with expenses. The requirement for accrual reporting is only that the reports be prepared on the accrual basis and not that the books be maintained on that basis throughout the reporting period. Hospitals will be permitted two reporting periods in which to meet the accrual reporting requirements. The Health Care Financial Administration (HCFA) will consider requests for waivers where a State law requires other than full accrual accounting.
(e) The operating revenue accounts in the Listing of Accounts are classified into five categories.
Part 441 DEFINITIONS
10 CRR-NY 441.260 Plant replacement and expansion funds
Resources restricted by donor and other third parties for the acquisition or construction of plant assets or the reduction of related debt.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-10 STEM HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 52-10.1 Definitions
As used in this Part:
(a) Bone marrow means the human tissue filing cavities of bone, consisting of fully mature and precursor hematopoietic cells intended for hematopoietic reconstitution.
(b) Hematopoietic progenitor cells means human precursor hematopoietic cells derived from bone marrow, peripheral blood or other tissue sources.
(c) hematopoietic progenitor cell bank means hematopoietic progenitor cell procurement service, hematopoietic progenitor cell processing facility, hematopoietic progenitor cell storage facility or hematopoietic progenitor cell transplantation facility.
(d) Bone marrow transplantation service means a coordinated program of inpatient and outpatient care in a hospital approved by the commissioner as a provider of bone marrow transplantation services pursuant to section 709.8 of this Title. Such services may accept only stem cells collected in substantial compliance with the criteria established in this Part and Subpart 58-5 of this Title, except in documented emergencies.
(e) Department means the New York State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.6 Plant operation and maintenance
This functional reporting center must contain all the expenses associated with the maintenance, repair and service of buildings, fixed and movable equipment, and operating and utility systems, including minor renovation of buildings (including services of the building trades, i.e., carpentry, plumbing, electricity, painting, masonry, plastering and mechanical repairs); maintenance and repair of the following systems: domestic water supply, sewage treatment facility, domestic hot water storage and distribution; bulk oxygen distribution from entry into the buildings; biomedical equipment inspection, testing, maintenance and repair; electrical distribution; operation and maintenance of the boiler plant to include steam distribution piping up to and including PRV stations and the condensate return system from the receiving tanks to the boiler plant; emergency power system; air conditioning systems to include air handling equipment; incinerators and waste removal equipment; elevators and dumbwaiters. This center should include all similar services performed under contract. Additional activities include but are not limited to the following: technical assistance on equipment purchases and installations; coordinating construction; establishing priorities for repairs and utility systems and projects; service and maintenance of water and sewage treatment facilities; and maintenance of utilities such as heat, light, water, air conditioning and air treatment.
(a) Standard unit of measure: net square feet.
The number of net square feet shall be determined using the center of the exterior walls of the facility, by floor. Measurement should be taken by floor to account for structural irregularities that may exist on various floors. When changes have been made during the year as a result of new construction, expansion, or curtailment of service, statistical data should be maintained to allow for the development of weighted areas for the fractional part of the year.
(b) Data source.
Net square feet shall be determined from the blueprints of the residential health care facility, or actual measurement if blueprints are not available.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.9 Exemptions
The department may grant an exemption from such training and education to: physicians, PAs and SAs when the professional demonstrates to the department's satisfaction that:
(a) no need exists to complete the course work or training due to the nature of his/her practice; or
(b) he/she has completed equivalent course work or training.
No need to complete course work or training exists when health professionals are in settings where they do not provide direct patient care, do not have responsibility for supervising staff who provide direct patient care or reprocess used patient care equipment, or do not perform services to which these standards would be expected to apply, or when the professional does not practice in New York State. A physician, a PA or SA who has been granted an exemption shall notify the department in writing of any change in the nature of his or her practice within 30 days of the occurrence of such change. The physician, PA or SA shall then obtain necessary course work or training within 90 days of the change in practice.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.7 Village of Naples
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Eelpot Creek and Reservoir Creek and all watercourses tributary thereto or which may ultimately discharge into said Eelpot Creek and Reservoir Creek or which may be developed in the future to serve as sources of the water supply of the Village of Naples, Ontario County.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for the deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(4) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(5) Human excreta shall mean human feces and urine.
(6) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(7) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(8) Manure shall mean animal feces and urine.
(9) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(10) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(11) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial and municipal waste, and agricultural-and nonagricultural-associated animal waste.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(14) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(15) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(16) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Village of Naples.
(17) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(18) Sewage disposal system shall mean any system used for disposing of sewage.
(19) Toxic substance shall mean any toxic substance as so defined by section 4801(2) of the Public Health Law.
(20) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(21) Water supply shall mean the public water supply of the Village of Naples.
(22) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the water supply of the Village of Naples.
(23) Watershed shall mean the entire drainage area contributing water to the water supply of the Village of Naples.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste area.
No agricultural-associated animal waste area shall be located within a 250-foot linear distance of the lake or watercourse. Beyond that distance such area shall be maintained in such manner that surface runoff will not carry agricultural-associated animal waste directly into the lake or watercourse.
(2) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(3) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(4) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within 500 feet of, or to enter into, any reservoir or watercourse unless a permit to store or apply has been obtained from the appropriate State agency having jurisdiction.
(5) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its seepage and washing into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 100-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(6) Junkyards.
No junkyard shall be permitted within a 250-foot linear distance of the lake or watercourse.
(7) Manure.
Manure shall not be field-spread within 75 feet of the lake or watercourse unless it is plowed underground on the same day it is spread.
(8) Radioactive material.
No radioactive material shall be disposed of by burial in soil within the watershed area of the Village of Naples.
(9) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Naples.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Naples, except by duly authorized employees of the village in performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Naples, Ontario County, within a 1,000-foot linear distance of the water supply intakes, except by duly authorized employees of the Village of Naples in the performance of their duties of supervision and maintenance of the water supply.
(10) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(11) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(12) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Naples.
(13) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within the watershed of the Village of Naples.
(14) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
(1) The trustees of the village, superintendent of the department of waterworks, or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representatives make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid responsible authority to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid responsible authority to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law.
(2) The aforesaid responsible authority shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.2 Application
(a) The requirements of this Subpart shall apply to a temporary residence occupied by or maintained for occupancy by 11 people or more, except:
(1) temporary residences or portions of any such establishment which are occupied by the same persons in excess of 180 consecutive days in a calendar year as their domicile, while those portions of the temporary residence are so occupied. This exclusion of portions of a temporary residence occupied by the same persons in excess of 180 consecutive days shall not apply to worker housing;
(2) a hotel or motel located in a city with a population of 125,000 or more for which all water is derived from a public water supply system and from which all sewage is discharged to a public sewer system;
(3) a temporary residence consisting of a single occupancy unit rented in its entirety for common use by a group, provided it is not part or otherwise affiliated with a temporary residence as described in section 7-1.1(j) of this Subpart;
(4) a temporary residence or portion thereof, occupied by the owner or operator thereof, or his family;
(5) a temporary residence occupied for less than 60 cumulative hours in any calendar year;
(6) a temporary residence used as a jail, hospital, nursing or convalescent home, or otherwise offering residential or custodial care to individuals who are physically or mentally unable to completely care for themselves;
(7) a temporary residence used as a school or college dormitory, or a fraternity or sorority house that is affiliated with an academic institution approved under the Education Law;
(8) a temporary residence operated as a domestic violence shelter, homeless shelter or hospice residence;
(9) a temporary residence which the commissioner, based upon consideration of the nature, duration and continuity of its occupancy, the degree of occupant control over the use and nature of the property’s facilities, the purpose of the property’s occupancy and the extent to which the property may be subject to the regulation of other agencies, reasonably determines not to be within the intent of regulation under this Subpart.
(b) The requirements of this Subpart shall not apply to a children’s camp, campground, mass gathering, migrant farmworker housing or a mobile home park as defined in Subparts 7-2, 7-3, 7-4 of this Part and Parts 15 and 17 of this Title respectively.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-8 WATERSHED PROTECTION PLANS
10 CRR-NY 128-8.2 Watershed planning in the Croton system
(a) Notwithstanding the prohibitions set forth in section 128-3.6 of this Part on new or expanded wastewater treatment plants with surface discharges within the 60-day travel time to intake or within phosphorus restricted basins, the department shall allow for the preparation and implementation of a Comprehensive Croton System Water Quality Protection Plan (“Croton Plan”) and an accompanying phosphorus offset program and diversion credit program in accordance with this section. This section is independent of, does not govern, and is not governed by, section 128-8.1 of this Subpart.
(b)
(1) At the request of Dutchess, Putnam or Westchester County, and in partnership with Dutchess, Putnam or Westchester County, and the municipalities located in the Croton system watershed, the department shall prepare or assist in the preparation of a Croton Plan only in a participating county or counties which:
(i) identifies significant sources of pollution to the Croton system;
(ii) recommends measures to be taken by the department, the counties, and the municipalities which, in conjunction with other Federal, State, local and department water quality protection programs, will prevent degradation to, and improve, water quality, with the long term goal of attaining water quality standards in the Croton system; and
(iii) recommends measures to be taken to protect the character and special needs of communities located within the watershed.
(2) A county wishing to do so may, when joined by a majority of municipalities located within the county's watershed, choose to prepare the Croton Plan for the portion of the watershed located within the county. Such Croton Plan shall be prepared in partnership with the department.
(3) The Croton Plan shall be developed in the manner set forth in subdivisions (c), (d) and (e) of this section and may allow for new wastewater treatment plants with a surface discharge or for the expansion of existing wastewater treatment plants with a surface discharge, provided the additional flow is either offset by a diversion of wastewater off of the watershed pursuant to subparagraph (e)(4)(i) of this section, or the additional phosphorus load is offset pursuant to subparagraph (e)(4)(ii) of this section.
(4) Any data that would benefit the Croton Planning process that is in the possession of the department or one of the counties or municipalities participating in the development of a Croton Plan shall be shared among the participants and appropriately considered in developing a Croton Plan.
(c) The Croton Plan shall consist of the following three elements:
(1) Identification of water quality problems and community character needs. Such identification shall include the following elements:
(i) an identification of growth or development projected to occur under existing municipal zoning and master plans and allowed under existing land use controls, other than these rules and regulations, and including development necessary to maintain community character, public facilities and institutions and to serve local, regional or special needs;
(ii) an identification of specific existing water quality problem areas and specific sources of pollution to the Croton system, including areas of existing or imminent subsurface sewage treatment system failures, areas of concentrated point source discharges and substantial non-point source pollution, and areas in need of streambank stabilization;
(iii) an assessment of future water quality impacts related to growth or development identified in subparagraph (i) of this paragraph;
(iv) an identification of areas identified in subparagraph (i) of this paragraph where site constraints may prevent the siting of new subsurface sewage treatment systems in accordance with the requirements set forth in these rules and regulations; and
(v) an identification of areas identified in subparagraph (i) of this paragraph where these rules and regulations prohibit new surface discharges from wastewater treatment plants and site constraints prevent the siting of a new wastewater treatment plant with a subsurface discharge.
(2) Identification of investments to correct existing water quality problems in accordance with developed priorities. Such identification shall include the following elements:
(i) the identified investments may include investments ( i.e., capital projects and best management practices) implemented during the development of the Croton Plan, investments that the participating counties and municipalities commit to implement, and an identification of priorities for future investments, without any commitment on the part of the counties and municipalities to implement such investments; and
(ii) proposed measures to address water quality problems identified in subparagraph (1)(ii) of this subdivision. Such measures may include subsurface sewage treatment system maintenance, rehabilitation and replacement programs, installation of community septic systems, the construction of sewer extensions or new sewerage systems, stormwater controls, and the permanent diversion of wastewater to a discharge point outside of the watershed.
(3) Strategies for prevention of future water quality problems and the consideration of future community character needs in conjunction with the water quality goals of the Croton Plan. Such strategies shall include the following:
(i) an assessment of the economic, water quality, community character, and special needs impacts of directing growth away from areas identified in subparagraphs (1)(iv) and (v) of this subdivision;
(ii) an identification of the economic, water quality and community character impacts of allowing growth within those areas identified in subparagraphs (1)(i), (iv) and (v) of this subdivision, if directing growth in accordance with subparagraph (i) of this paragraph is not feasible or practical;
(iii) an identification of potential areas for the construction of new or expanded wastewater treatment plants, as provided for in subdivision (e) of this section, either under a future permanent phosphorus offset program or utilizing the 10 percent credit provision for an implemented diversion project and a statement of the reasoning for the selection of such potential areas;
(iv) an identification of land use and local laws and regulations that the participating counties and municipalities have already implemented and/or agree to implement in the future which are intended, in combination with other measures in the Croton Plan, to mitigate the water quality impacts identified in subparagraph (1)(iii) of this subdivision;
(v) with respect to future land use issues, identification of mechanisms to ensure the improvement and protection of water quality is taken into consideration by the local government and that the local government agrees to use best efforts to implement such mechanisms; and
(vi) at the option of the local government, designation of village centers as provided for in section 128-3.9(a)(7)(i) of this Part.
(d)
(1) If a county requests, pursuant to subdivision (b) of this section, that a Croton Plan be developed within five years of the effective date of these rules and regulations, the department, in partnership with the participating counties and municipalities, and in consultation with the New York State Department of Health, shall complete a draft Croton Plan and release such draft Croton Plan for public review and comment. If a Croton Plan has been prepared by a county and its municipalities, the county and municipalities, in partnership with the department and in consultation with the New York State Department of Health, shall complete a draft Croton Plan within five years of the effective date of these rules and regulations and release such draft Croton Plan for public review and comment. The department, the participating counties and municipalities shall consider and respond to comments received from the public in preparing the final Croton Plan.
(2) Within six months after the release of the draft Croton Plan, the final Croton Plan shall be agreed to by the department and the counties and municipalities which participated in the preparation of the Croton Plan, and in consultation with the New York State Department of Health. In determining whether to agree to the Croton Plan, the department will consider the Croton Plan, including the level of commitments therein, taken as a whole and consistent with this subdivision, meets the overall goals of the Croton Plan, set forth in subdivision (b) of this section. The department will not approve or disapprove individual components of the Croton Plan. The department and the participating counties and municipalities shall make a reasonable effort to resolve any and all issues which preclude their agreement to the Croton Plan. The five-year period referred to in paragraph (1) of this subdivision, and/or the six-month period referred to in this paragraph may be extended by agreement of the department and the participating counties and municipalities. In addition, the participating counties and municipalities may, at any time, agree to discontinue the development of the Croton Plan.
(3) A failure of any participating county or municipality to agree to the Croton Plan shall not affect the ability of another participating county or municipality to agree to the Croton Plan and to site new wastewater treatment plants or to expand existing wastewater treatment plants with a surface discharge in accordance with subdivision (e) of this section.
(4) Once the Croton Plan is agreed to by the department and the participating counties and municipalities, the Croton Plan shall be considered valid and effective. The participating counties and municipalities agreeing to the Croton Plan may, upon 60 days written notice to the city, modify the plan at any time after it has been agreed upon. If the Croton Plan is proposed to be modified, the department shall make a determination within 60 days of notice of the proposed modification, whether the Croton Plan, as modified, shall continue to be valid and effective. In making such a determination, the department shall consider whether the Croton Plan, as modified and taken as a whole, is consistent with this subdivision and meets the overall goals of the Croton Plan set forth in subdivision (b) of this section. Any approved Croton Plan remains in effect pending any determination on a proposed modification and shall remain in effect until and unless either the department agrees to a modification or a local government modifies it without the department's approval or ceases to implement it.
(5) Any Croton Plan agreed to shall be reviewed by the participants to the plan 15 years after the Croton Plan becomes effective in order to determine whether the Croton Plan has met and will continue to meet its goals, and to determine whether new goals are appropriate.
(6) The counties and the municipalities agreeing to the Croton Plan shall submit to the department an annual report each year the Croton Plan is in effect. The annual report shall be submitted on the anniversary of the date the Croton Plan became effective and shall include:
(i) a statement of the status of the development or implementation of measures proposed in the Croton Plan;
(ii) a statement of expenditures incurred by the counties and municipalities in implementing, and administering measures proposed in the Croton Plan; and
(iii) An identification of the financial, personnel and other resources needed to continue implementation and administration of the measures proposed in the Croton Plan.
(e) The Croton Plan may allow for the siting of a new wastewater treatment plant with a surface discharge or the expansion of an existing wastewater treatment plant with a surface discharge in the Croton System within a phosphorus restricted basin or a basin located within the 60-day travel time, but not within a coliform restricted basin, pursuant to the following conditions:
(1) site constraints prevent the proposed new wastewater treatment plant or the expanded existing wastewater treatment plant from discharging subsurface;
(2) the municipal government and the county in which the wastewater treatment plant would be sited, confirms in writing that the proposed new wastewater treatment plant or the expansion of an existing wastewater treatment plant is consistent with the Croton Plan;
(3) the department, in consultation with the New York State Department of Health, determines that the proposed new wastewater treatment plant or expansion of an existing wastewater treatment plant is consistent with the water quality objectives of the Croton Plan; and
(4) the discharge from the new wastewater treatment plant or the expansion of an existing wastewater treatment plant complies with one of the following conditions:
(i) the total volume (or flow) of surface discharge from such new wastewater treatment plant or expansion of an existing wastewater treatment plant, together with the total volume of surface discharges from all other new wastewater treatment plants and expansions of wastewater treatment plants which have been permitted in the subject county pursuant to this subparagraph, shall not, in the aggregate, exceed 10 percent of the total volume (or flow) of surface discharge from wastewater treatment plants located in the Croton system, within the subject county, which previously discharged into the Croton system but have been permanently diverted, since the effective date of these rules and regulations, to a discharge point outside of the watershed. The department may approve applications to construct new wastewater treatment plants with surface discharges pursuant to this subdivision prior to the permanent diversion of wastewater, and allow construction to begin on such new wastewater treatment plants, provided that the wastewater treatment plant may not commence operation until the diversion for which the credit is received has actually occurred; or
(ii) in phosphorus restricted basins located outside of the 60-day travel time, provided that the department has determined pursuant to section 128-8.4 of this Subpart, based upon the results of the pilot programs set forth in subdivision (g) of this section and section 128-8.3(a) of this Subpart, or of other studies conducted within the watershed, that the phosphorus offsets sought by the pilot programs have been achieved, the department may require that each one kilogram of projected increase in the phosphorus load resulting from the proposed new wastewater treatment plant, together with any accompanying non-point source runoff, is actually offset by at least three kilograms of reductions in phosphorus loading within the basin within which the proposed project is located, including reductions from measures identified in and implemented in accordance with the Croton Plan pursuant to paragraph (c)(8) of this section, and otherwise eligible for an offset hereunder, whether the source of the offsets is in the same basin or within an upstream, hydrologically connected phosphorus restricted basin; and
(5) with respect to any new or expanded wastewater treatment plant allowed pursuant to this subdivision, the department will not impose additional requirements on the siting of such new or expanded wastewater treatment plant other than the requirements specifically set forth in these rules and regulations applicable to all wastewater treatment plants, the requirements of this subdivision, and, with respect to new or expanded wastewater treatment plants in phosphorus restricted basins relying on phosphorus offsets, the requirements of any phosphorus offset program pursuant to subdivision (g) of this section, and sections 128-8.3(a) and 128-8.4 of this Subpart.
(f)
(1) A county or municipality wishing to participate in the preparation of the Croton Plan shall indicate its intention to participate by written notice to the department given within one year of the effective date of these rules and regulations. Such notice shall include a commitment by the subject county or municipality to cooperate with the department in generating and analyzing the data and information reasonably necessary to address the Croton Plan elements identified in subdivision (c) of this section, and an agreement to minimize the use of offsets as a basis for new wastewater treatment plants or expansions of existing wastewater treatment plants pursuant to subdivision (e) of this section, to the extent that the economic and social needs of such county or municipality can be reasonably addressed without the use of such offsets.
(2) Within 30 days after receipt of a notice as described in paragraph (1) of this subdivision, the department shall notify a county or municipality of its inclusion in the preparation of a Croton Plan.
(3) If a county and its municipalities wish to prepare a Croton Plan, in accordance with paragraph (b)(2) of this section, the department shall, within 30 days of receipt of a notice as described in paragraph (1) of this subdivision, authorize the county and municipalities to begin preparation of such a Croton Plan. Such authorization shall include a commitment by the department to cooperate with county and municipalities in generating the data and information reasonably necessary to address the Croton Plan elements identified in subdivision (c) of this section.
(4) The provisions of subdivision (e) of this section shall not apply in any county or municipality which fails to participate in the preparation of the Croton Plan, fails to cooperate with the department in the manner described in paragraph (1) of this subdivision in preparing the Croton Plan; fails or ceases to implement any water quality protection measures which such county or municipality has committed to implement as part of the final Croton Plan agreed upon by the county, municipality and the department; or where a previously agreed upon Croton Plan is no longer valid and effective.
(g) In Putnam County, provided that Putnam County has committed in writing to participate in the development of the Croton Plan pursuant to subdivision (d) of this section, the department shall allow for a pilot program to evaluate the effectiveness of phosphorus offsets as a potential basis for allowing construction of new wastewater treatment plants within phosphorus restricted basins in the Croton system. Such pilot program shall be limited to a term of five years, commencing on the effective date of these rules and regulations and expiring on the fifth anniversary thereof. During the term of the pilot program, the department may approve within a Putnam County municipality which has committed in writing to participate in development of the Croton Plan, the construction of a new wastewater treatment plant with a surface discharge within a phosphorus restricted basin in the Croton system provided that the following conditions are met:
(1) the applicant proposing a new wastewater treatment plant demonstrates that the county or municipality agrees to the plant's inclusion in the pilot program;
(2) the applicant demonstrates, and commits to take action to insure, that for every one kilogram of projected increase in the phosphorus load resulting from the new wastewater treatment plant and accompanying non-point source runoff, there will be an offset which achieves at least three kilograms of reduction in phosphorus within the basin in which the new wastewater treatment plant is located, whether the source of the offset is in the same basin or within an upstream hydrologically connected phosphorus restricted basin;
(3) all new wastewater treatment plants proposed to be constructed pursuant to this pilot program shall be reviewed and approved by the department in accordance with section 128-3.6 of this Part;
(4) no more than three wastewater treatment plants with surface discharges may be located in the Croton system in Putnam County pursuant to this pilot program. The total capacity, as constructed, for the three proposed wastewater treatment plants shall not exceed a maximum of 150,000 gpd aggregate surface discharge; and
(5) any wastewater treatment plant constructed pursuant to this pilot program shall be designed and operated to meet a total phosphorus effluent limit of.2 mg/l.
(h) Nothing in this Subpart is intended to constrain, limit or preclude an applicant from seeking, or the department from issuing, approval of or a variance for a proposed regulated activity under any other applicable provision of these rules and regulations.
(i) Nothing in this section or in the Croton Plan is intended to constrain or limit the authority of local governments under State law to make local land use and zoning decisions, and nothing in this section or the Croton Plan should be construed to have the effect of transferring such local land use and zoning authority from the participating local governments to the department or any other entity.
Part 153 WASHINGTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 153.4 Village of Argyle, (well supply)
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1110-1107 of the Public Health Law shall apply to the well, and to any future well developed, which comprise the primary source of the public water supply of the Village of Argyle. Said well is located on land owned by the Village of Argyle and is situated approximately 1 ½ miles southeast from the Village of Argyle, on Summit Lake Road.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the extension of the centerline of the well(s).
(7) Manure shall mean animal feces or urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal wastes and agricultural and nonagricultural-associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Village of Argyle.
(20) Well shall mean well(s) now used as a source of this water supply or any additional well(s) which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well except in weatherproof buildings or watertight vessels.
(3) Herbicides, pesticides and farming.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction. No milk house drain outlet, barn gutter, silo, sinkhole, cow yard, chicken yard, hog yard or other animal yard shall be constructed, maintained or allowed to remain within a 200-foot linear distance of the well.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the well, except in watertight pipes connected to a sewage disposal system for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the well.
(5) Junkyard.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the well unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the well.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the well.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the well.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Village of Argyle upon which the well is located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Argyle.
(e) Inspections.
The Board of Trustees of the Village of Argyle or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representatives, make regular and thorough inspections of the area surrounding the well to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of said violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law. The aforesaid village board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.5 Responsibilities of applicants
(a) Applicants to the department for approval of proposed actions shall include in their application documents, an environmental assessment form (EAF) prepared in a manner prescribed by the department which describes and analyzes the environmental impacts of the proposed action, documentation showing the application pertains to a type II action which has not been subject to a final EIS, or other documentation showing the application pertains to a project not subject to this Part. The EAF or other documentation shall contain sufficient information for the department to determine if the action may have a significant effect on the environment. An initial notice of determination will be prepared by the department citing the results of its review. If, in the judgment of the department, the information provided in the EAF or other documentation is insufficient to complete an adequate review under the State Environmental Quality Review Act (SEQR), the applicant will be required to furnish additional information on the proposed action as it is deemed necessary for compliance with this Part. A draft EIS may be submitted in lieu of an EAF.
(b) Each application to the department shall include:
(1) an identification of those other agencies, including Federal agencies, which to the best knowledge of the applicant, have jurisdiction by law over the action or any portion of it;
(2) documentation that the applicant has made his proposal known to those agencies; and
(3) copies of preliminary approval and/or review.
(c) Where appropriate, an applicant may append to the EAF a concise statement of reasons why, in the judgment of the applicant, the proposed action is one which will not require the preparation of an EIS under SEQR.
(d) Applicants shall consider the environmental impacts of proposed actions and alternatives at the earliest possible point in their planning processes and shall develop, wherever possible, measures to mitigate or avoid adverse environmental impacts.
(e) No application for funding or other department approval of an action shall be complete until, the applicant provides the documentation required by this section and such other documentation as may be required by any statute or regulation pertaining to consideration of that action.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.9 Village of Highland Falls
(a) Application.
The following rules and regulations enacted in accordance with the provisions of 1100 et seq. of the Public Health Law, formerly sections 70, 71 and 73 of chapter 45 of the Consolidated Laws, as amended, shall apply to the distributing reservoirs located at Bog Meadow Pond, located on Buttermilk Falls Brook above the junction of Stone* Lonesome Brook and to all natural and artificial reservoirs and watercourses entering or ultimately discharging into said distributing reservoirs which serve as sources of the public water supply furnished by the Village of Highland Falls to the Village of Highland Falls and parts of the Town of Highlands, Orange County, NY.
(b) Definition of terms.
Whenever used in this section:
(1) The term water supply means the public water supply furnished by the Village of Highland Falls, Orange County, NY.
(2) The term reservoir means the distributing reservoir at the intake of the aforesaid water supply on Buttermilk Falls Brook above the junction of Stoney Lonesome Brook.
(3) The term watercourse means every spring, pond (other than reservoir), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such waterflow.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the lake, reservoir or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from the reservoir or 300 feet from any watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be construced, placed, maintained or allowed to remain within 200 feet of the reservoir or within 75 feet of any watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta located between the distances of 300 feet and 200 feet from the reservoir or between the distances of 150 and 75 feet from any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the reservoir or any watercourse nor deposited on or beneath the surface of the ground within 300 feet of the reservoir or within 150 feet of any watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (c)(3) of this section. If such watertight receptacles are used, they shall be located not less than 200 feet from the reservoir or 75 feet of any watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes shall be allowed to flow into the reservoir of any watercourse, nor be deposited on or beneath the surface of the ground within 200 feet of the reservoir or within 50 feet of any watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or other material that pollutes water shall be deposited in the reservoir or any watercourse, nor on or beneath the surface of the ground within 250 feet of the reservoir or within 50 feet of any watercourse, nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into the reservoir or any watercourse.
(f) Bathing, boating, fishing, ice cutting.
(1) No person shall bathe or swim or be allowed to bathe or swim in the reservoir or any watercourse.
(2) No bathing, boating or fishing of any kind, ice cutting or any trespassing whatsoever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse of the public water supply of the Village of Highland Falls except by duly authorized employees of the Village of Highland Falls in the performance of their duties of supervision and maintenance of the water supply, except that fishing may be allowed upon permit issued by the water department of the Village of Highland Falls under regulations and rules for the proper use of such permits and under the supervision of the superintendent of said water department, such permits being revocable at any time by the water department.
(g) Places for animals.
(1) No animals or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in the reservoir, and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute the reservoir or any watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 300 feet of the reservoir or within 50 feet of any watercourse, nor in such a manner as to pollute said reservoir or watercourse.
(i) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of the reservoir or within 300 feet of any watercourse tributary to the water supply.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 400 feet of the reservoir.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any acts, though not heretofore specified, which may result in contamination of any portion of the water supply.
(l) Inspections.
The Village of Highland Falls or such others as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of the village shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said village to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said village to promptly notify the State Commissioner of Health of such violations. The Village of Highland Falls shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.338 Vested interest
An interest (as a title to an estate) carrying a legal right to present or future enjoyment and of present alienation.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 130 ONEIDA COUNTY
COMPANIES COMPANIES
10 CRR-NY 130.25 Deansboro Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to the springs located one-half mile west of the hamlet of Deansboro known as the Munsell and Bishop springs and all watercourses flowing therefrom and all watercourses entering or ultimately discharging into any streams to which the Munsell or Bishop springs are tributary, at any point above the intakes of the Deansboro Water Company, said springs being the sources of water supply of the Deansboro Water Company.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and distributing reservoirs on the stream rising in the Munsell or Bishop springs or to any additional reservoirs which may be constructed on these streams or these tributaries.
(2) The term watercourses wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel or permeable pipe or conduit of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the water supply of the said Deansboro Water Company.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any reservoir or watercourse of the water supply of the Deansboro Water Company.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 150 feet of any reservoir or watercourse of the water supply of the Deansboro Water Company.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta, which is constructed, located, maintained or allowed to remain between the limiting distances of 75 feet and 150 feet as provided by paragraphs (1) and (2) of this subdivision, from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents, while being transferred from the privy to the place of disposal (hereinafter specified), and that the contents while being transferred from the privy to the place of disposal shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of said water supply.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse of the water supply of the Deansboro Water Company, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground below the surface within 300 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the Deansboro Water Company; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the Deansboro Water Company within 100 feet of any such reservoir or within 75 feet of any such watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the Deansboro Water Company.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the Deansboro Water Company, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein; nor shall any animals be pastured or allowed to stand within such distance from any reservoir, spring or watercourse of the water supply of the Deansboro Water Company that the droppings or the drainage from the same shall run or be washed into any such reservoir, spring or watercourse and in no case shall such distance be less than 150 feet from any reservoir or spring and 75 feet from any watercourse.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the water supply of the Deansboro Water Company; and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excreta, compost or other matter containing the same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground or dug or buried in the soil, within a distance of 300 feet from any reservoir or 200 feet from any watercourse of the water supply of the Deansboro Water Company; and no manure or compost of any kind not containing human excreta shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the Deansboro Water Company without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the abovementioned drainage, leachings or washings shall have percloated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the Deansboro Water Company; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or from 100 feet before entering any such watercourse.
(g) Fishing, boating and ice cutting.
No fish shall be taken from any reservoir or watercourse nor shall any person fish in any reservoir or watercourse or through the ice upon the same nor trespass upon the waters of any reservoir or watercourse or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employes of the Deansboro Water Company in the exercise of their duties in the management and operation of the reservoirs; nor shall any ice cutting or other operations incident thereto be allowed on any of the reservoirs which form or are tributary to the sources of the public water supply furnished by the Deansboro Water Company except by permission and under rigid inspection and supervision of said water company.
(h) Temporary camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the Deansboro Water Company.
(i) Inspection.
The Deansboro Water Company shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules or regulations, it shall be the further duty of the said water company to promptly notify the State Commissioner of Health of such violations. The Deansboro Water Company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general sanitary condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.76 Consecutive public water systems
(a) When a public water system supplies water to one or more consecutive public water systems, the State may modify the monitoring requirements of this Subpart when the circumstances justify treating them as a single system for monitoring purposes. Any modified monitoring shall be conducted pursuant to a schedule approved by the State, in accordance with the provisions of section 5-1.52 of this Subpart.
(b) Consecutive systems must follow section 5-1.52 table 11B of this Subpart in the event of a total coliform positive sample from their distribution system. When a consecutive system that receives ground water from a wholesale system is notified of a positive total coliform sample result, the consecutive system must, within 24 hours, notify the State, the wholesale system and any other wholesale system that owns and/or operates groundwater sources that provides water used by the consecutive system. If all the water provided by the consecutive system has been subject to four-log virus treatment and process compliance monitoring, notification by the consecutive system about the total coliform sample is not required. After notification, the wholesaler must, within 24 hours, test its raw water source(s) for fecal indicator organism(s) in accordance with section 5-1.52 table 11B of this Subpart at the location(s) specified in the monitoring plan described in section 5-1.51 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.327 Treasury stock
Full-paid capital reacquired by the issuing company through gift, purchase or otherwise and available for resale or cancellation. Treasury stock is not a part of capital stock outstanding; and the term does not apply to unissued capital stock or to shares forfeited for nonpayment of subscriptions.
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.26 In-service education - nursing
[ 1660 ]
(a) Nursing in-service education activities are defined as educational activities conducted by the hospital for hospital nursing personnel. The cost of time spent by nursing personnel as students in such classes and activities must remain in the cost center in which their normal salary and wage costs are charged ( i.e., the cost center in which they work). However, the cost (defined as salary, wages and payroll-related fringe benefits) of time spent in such classes and activities by those instructing and administering the programs must be included in the Nursing Administration cost center (account 8750). For those hospitals that want to account for these costs separately, an In-service Education - Nursing sub-account (account 8751) has been provided.
(b) If instructors do not work full-time in the in-service programs, the cost (as defined above) of the portion of time they spend working in the in-service education program must be included in the Nursing Administration cost center. This may be accomplished by direct distribution of these costs (by natural classification of expense category) each payroll period based upon actual hours worked.
(c) The costs of nursing in-service education supplies (such as cassettes, books, medical supplies, etc.) and outside lecturers must also be reflected in the Nursing Administration cost center. Nursing in-service education does not include orientation of new employees. Such orientation costs must be charged to the cost center in which the new employees are, or will be, assigned.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.2 Techniques and methods for determining blood and urine alcohol
(a) All blood and urine alcohol determinations shall be made by quantitative methods and reported as whole blood alcohol concentration (BAC) to the second decimal place as found; for example, 0.137 percent found shall be reported as 0.13 percent weight per volume. If specimens other than whole blood are analyzed, the following conversions shall apply:
(1) three fourths of the determined concentration of alcohol in the urine shall be equivalent to the corresponding BAC; and
(2) nine tenths of the determined concentration of alcohol in the serum or plasma shall be equivalent to the corresponding BAC.
(b) Analytical procedures for blood and urine alcohol analysis shall include the following controls in conjunction with any sample or series of 10 samples analyzed sequentially or simultaneously:
(1) a blank analysis as appropriate; and
(2) analysis of a suitable reference sample of known alcoholic content greater than or equal to 0.08 percent weight per volume, the result of which analysis shall agree with the reference sample value within the limits of plus or minus 0.01 percent weight per volume or such limits as specified by the commissioner.
(c) An analysis of urine shall be made upon two specimens collected at least 30 minutes apart.
(d) If a blood specimen is to be collected for analysis, an aqueous solution of a nonvolatile antiseptic shall be used on the skin. Alcohol or phenol shall not be used as a skin antiseptic.
(e) Specimens shall be clearly identified at the time of collection.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.23 Leave for quarantine
If an employee who is not ill himself is required to remain absent because of quarantine and presents a written statement of the attending physician or local health officer proving the necessity of such absence, he shall be granted leave with pay for the period of his required absence, without charge against accumulated sick leave credits. Prior to return to duty, such employee may be required to submit a written statement from the local health officer having jurisdiction that his return to duty will not jeopardize the health of other employees.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.12 Appeals
(a) An applicant may request a reconsideration of an adverse decision within 60 days of a decision.
(b) The department shall review any additional submissions and issue a written decision within 30 days of an applicant's request and submission of additional documents.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.13 Floors
Floors shall be of such construction as to be easily cleaned and shall be kept clean and in good repair. If carpeting or similar material is used for floor covering, it shall be of a light color with a single loop pile or not more than one-quarter inch in height. Such floor covering shall be kept clean by vacuuming at least daily and shampooing at least annually and more frequently if the covering is not clean.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.5 Village of Milford
(a) Application.
The rules and regulations set forth in this section duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Goey's Pond and all watercourses tributary thereto or which may ultimately discharge into said Goey's Pond or which may be developed in the future to serve as sources of the water supply to the Village of Milford.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse diposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the water supply for the Village of Milford.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private, or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing, or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Milford.
(17) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flow or may flow into the Village of Milford water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Milford water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 250-foot linear distance of any reservoir or watercourse except ( a ) watertight receptacles; ( b ) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and ( c ) a properly designed, constructed, and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Milford.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Milford except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Milford within a 500-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Milford in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic substance.
No container used for storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structure. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Milford.
(ii) Other wastes. No pollutant of any kind shall be discharged or aloowed to flow into any reservoir or watercourse on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The board of trustees of the Village of Milford or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir or watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.10 Shared health facility report and audit requirements
(a) Each shared health facility shall establish and maintain a system of uniform reports and internal utilization review audits as prescribed by the commissioner.
(b) The information contained in the required reports and audits shall be made available from time to time in such manner and form as required by the department.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
MAKING OF CERTIFICATES MAKING OF CERTIFICATES
10 CRR-NY 36.5 Certificate made by attendant at birth
If the physician or licensed midwife who attended the birth is alive and can be located, the certificate shall be made by such physician or licensed midwife.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.11 Computation of individual hourly or per-visit service rate
(a) Individual service rates, except for rates established pursuant to section 861.46(b) of this Subpart, shall be computed on the basis of allowable fiscal and statistical data submitted by the LTHHCP. The computed rates shall be all-inclusive rates, taking into consideration total allowable costs.
(b) To the allowable basic rate based on actual LTHHCP cost, there shall be added a factor to adjust allowable costs during the effective period of the cost-based reimbursement rate. Such adjustments shall not be made to rates based on budgeted costs. This adjustment shall be determined as follows:
(1) The elements of a long-term home health care program's cost shall be weighted based upon data for the following categories:
(i) salaries;
(ii) employee health and welfare expense;
(iii) nonpayroll administrative and general expense;
(iv) nonpayroll housekeeping and maintenance expense; and
(v) nonpayroll professional care expense.
(2) Each weight shall be adjusted by the appropriate price index for each category noted in paragraph (1) of this subdivision.
(3) Geographic differentials may be established, where appropriate.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-5.52 Transport vehicles
Spaces used to carry food in transport vehicles are to be maintained in a sanitary condition to protect food from contamination. Spaces used for food are to be separate from spaces used to carry sanitizing and maintenance chemicals and supplies.
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.3 Notice of construction, enlargement, development, improvement or conversion required; prior approval
No person shall construct or enlarge for occupancy or use a mobile home park or any portion or facility thereof, or develop and improve a property for occupancy and use as a mobile home park, or convert a property for use or occupancy as a mobile home park, without giving notice in writing of his intent to do so to the permit-issuing official, at least 30 days before the proposed date of beginning of such construction, enlargement, development, improvement or conversion. The notice shall give the name of the city, village or town in which the property is located, the construction, enlargement, development, improvement or conversion, and the name and mail address of the person giving the notice and his telephone number, if any. The notice shall be supplemented by such further information, plans or specifications as may be required by the permit-issuing official. Such plans or specifications must be approved by the permit-issuing official prior to the commencement of any such construction, enlargement, improvement or conversion.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.229 Operating lease
A lease which fails to meet all of the following four criteria:
(a) The present value of the minimum lease payments is 90 percent of the fair value of the property to the lessor.
(b) The lease term is 75 percent or more of the leased property's estimated economic life.
(c) The lease contains a bargain (less than fair value) purchase option.
(d) Ownership is transferred to the lessee by the end of the lease term. (See FASB Statement No. 13 for further details.)
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.2 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) Allowable capital costs.
Capital costs that are allowable under 14 NYCRR Subpart 635-6.
(b) Allowable operating costs.
In the case of prevocational and respite services, operating costs that are allowable under 14 NYCRR section 635-10.4.
(c) Base year.
The consolidated fiscal report period from which the initial period rate will be calculated. Such period shall be January 1, 2013 through December 31, 2013 for providers reporting on a calendar year basis and July 1, 2012 through June 30, 2013 for providers reporting on a fiscal year basis.
(d) Base operating rate.
Reimbursement amount calculated by dividing annual reimbursement by applicable annual units of service, both in effect on June 30, 2015.
(e) Department of Health (DOH) regions.
Regions as defined by DOH, assigned to providers based upon the geographic location of the provider’s headquarters as reported on the consolidated fiscal report. Such regions are as follows:
(1) Downstate: Five boroughs of New York City, Nassau, Suffolk, Westchester.
(2) Hudson Valley: Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster.
(3) Upstate metro: Albany, Erie, Fulton, Genesee, Madison, Monroe, Montgomery, Niagara, Onondaga, Orleans, Rensselaer, Saratoga, Schenectady, Warren, Washington, Wyoming.
(4) Upstate non-metro: Any counties not listed in paragraph (1), (2) or (3) of this subdivision.
(f) Financing expenses.
Interest expense and fees charged for financing of costs related to the purchase/acquisition, alteration, construction, rehabilitation and/or renovation of real property.
(g) Free-standing respite.
Respite services provided in a free-standing respite facility under the home and community based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10.
(h) Hourly respite.
Respite services provided outside of a free-standing respite center under the home and community based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10.
(i) Individual.
Person receiving a service authorized by OPWDD.
(j) Initial period.
July 1, 2015 through June 30, 2016.
(k) Lease/rental and ancillary costs.
A provider’s annual rental payments for real property and ancillary outlays associated with the property such as utilities and maintenance.
(l) Office for People With Developmental Disabilities (OPWDD) regions.
OPWDD regions are as follows:
(1) Region 1: Bronx, Kings, New York, Queens and Richmond Counties.
(2) Region 2: Nassau, Putnam, Rockland, Suffolk, and Westchester Counties.
(3) Region 3: All other counties in New York State.
(m) Operating costs.
Provider costs related to the provision of prevocational services (site-based) and respite services (hourly and free-standing) identified in such provider’s cost reports.
(n) Prevocational services.
Prevocational services provided under the home and community based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10 are defined as follows:
(1) Site based prevocational services are habilitation services that assist individuals to develop employment readiness skills and that are provided in non-residential facilities certified by OPWDD. The services consist of learning and work experiences that are not job-task specific but contribute to an individual’s ability to attain paid employment in the community.
(2) Community prevocational services are habilitation services that assist the individual to develop employment readiness skills and that are provided in the most integrated setting appropriate to the needs of the individual receiving such services. The services consist of learning and work experiences, including volunteer work, that are not job-task specific but contribute to an individual’s ability to attain paid employment in the community.
(o) Provider.
An individual, corporation, partnership, or other organization to which OPWDD has issued an operating certificate or approval to operate a prevocational (site-based), prevocational (community-based), hourly respite, free-standing respite, residential habilitation (family care) or supported employment program, and for which DOH has issued a Medicaid provider agreement.
(p) Rate sheet units.
The number of units for which OPWDD authorizes a provider to deliver services in a specific program.
(q) Reimbursable cost.
The final allowable costs of the rate year after all audit and/or adjustments are made.
(r) Residential habilitation (family care).
Residential habilitation (family care) services that are:
(1) provided under the home and community based services waiver operated by OPWDD;
(2) provided pursuant to 14 NYCRR Subpart 635-10; and
(3) provided by a family care home issued an operating certificate by OPWDD.
(s) Start-up costs.
Those costs associated with the opening of a new program. Start-up costs include pre-operational rent, utilities, staffing, staff training, advertising for staff, travel, security services, furniture, equipment and supplies.
(t) Supported employment services.
Supported employment services provided under the home and community based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10.
(u) Target rate.
The final rate in effect at the end of the transition period for prevocational services (site-based) determined using the rate year final reimbursable cost for prevocational services (site-based) for each respective provider divided by the final total of actual units of service for all individuals, regardless of payor.
(v) Units of service.
The unit of measure for the following waiver services shall be:
(1) Prevocational (site-based) – daily.
(2) Prevocational (community-based) – hourly.
(3) Respite (hourly and free-standing) – hourly.
(4) Supported employment – hourly.
(5) Residential habilitation (family care) – daily.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.1 Definitions
For purposes of this Subchapter, unless the following context indicates otherwise, the following term shall have the following meaning:
(a) Central services facility rural health network shall mean a rural health network organized pursuant to the not-for-profit corporation law and established pursuant to subdivision 14 of section 2801-a of the Public Health Law which provides or arranges for the provision of health care services pursuant to a network operational plan to residents of a rural area, which health care services shall include, at a minimum, comprehensive primary care; emergency care; outpatient and inpatient care. Such network may offer any medical and health related service approved for practice, licensure or certification in accordance with state law and regulation for which it is able to provide appropriate technical and human resourses, respond to community need, and assure quality in the delivery of services.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-4 PROHIBITION OF FIREWORKS
10 CRR-NY 9-4.2 Penalties
A violation of this Subpart is subject to all civil and criminal penalties as provided for by law, including but not limited to Public Health Law section 12-b. For purposes of civil penalties, each use of fireworks shall constitute a separate violation under this Subpart. Individuals who violate this Subpart are subject to a maximum fine of $500 for the first violation of this Subpart; $1,000 for the second violation of this Subpart; and $2,000 for each additional violation of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.50 Public health threat; determination
(a) Public health threat of an arthropod vector-borne disease based on historical risk shall be determined by the documentation of a public health threat as described in subdivision (b) of this section, once in the previous three years, or two or more times in the previous 10 years, and by a finding, based upon the risk assessment considerations set forth in section 44.51 of this Part, that current conditions pose a substantial risk to human health.
(b) A public health threat of an arthropod vector-borne disease based on current activity shall be determined by the presence of human vector-borne disease or the presence of disease-specific etiologic agents in a known or suspected vector as specified below, and substantiated by information required by the risk assessment activities described in section 44.51 of this Part.
(1) The presence of human vector-borne disease includes, but is not limited to:
(i) a single human or equine case of EEE;
(ii) a single human case of St. Louis Encephalitis (SLE); or
(iii) epidemiologic evidence of clustering of human cases of:
(a) California Encephalitis (CE);
(b) Rocky Mountain Spotted Fever (RMSF);
(c) Lyme disease;
(d) Babesiosis;
(e) the occurrence of indigenous cases of other arthropod-borne etiologic agents which include, but are not limited to:
(1) dog heartworm;
(2) malaria;
(3) tularemia;
(4) powassan; or
(5) dengue.
(2) The presence of disease specific etiologic agents in a known or suspected vector includes, but is not limited to:
(i) isolation of EEE virus or SLE virus from mosquitoes or an avian host;
(ii) demonstration of vector infectivity rates in excess of 5 percent in known or suspected tick vectors of the rickettsia of the spotted fever group, or in excess of 30 percent in known or suspected tick vectors of the Lyme disease spirochete in association with documented human cases;
(iii) site specific, multiple isolations of the related alpha virus, the Highlands J (HJ) virus, from known or suspected mosquito vectors, indicative of potential EEE virus activity;
(iv) demonstration of an imminent potential for the transfer of the etiologic agent from the endemic cycle to the epidemic disease cycle, including but not limited to:
(a) the demonstration of a significant rise in antibody levels or significant IgM antibody levels in avian hosts of EEE virus or SLE virus during the recognized period of disease activity; or
(b) the demonstration of high levels of parasitemia (≥20 percent) in the mammalian reservoirs for human babesia; or
(c) in the case of established clustering of human cases of dog heartworm, malaria, powassan, dengue or tularemia, the demonstration of infective forms or etiologic agent isolation from known or suspected arthropod vectors.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH DIRECTOR PUBLIC HEALTH DIRECTOR
10 CRR-NY 11.181 Definition
The term public health director shall mean a person who, with appropriate medical consultation, administers and manages the public health programs within a county.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.285 Referred outpatient
An outpatient who is referred by his private physician to the institution for diagnosis or treatment on a ambulatory basis. The responsibility for medical care remains with the referring physician.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
CONSTRUCTION CONSTRUCTION
10 CRR-NY 6-3.8 Approval of plans and reports
(a) New construction.
(1) No municipality, school district, person, group of persons, firm, corporation, association, organization or institution shall install or construct a spray ground, or make any addition or modification to an existing spray ground, until plans and specifications receive the approval of the permit-issuing official. All plans shall be prepared by a person licensed by the State of New York to practice engineering or architecture. The permit-issuing official may require, when granting this approval, such modifications or conditions as the public health or safety may require.
(2) Design standards for spray grounds (see section 6-3.24 of this Subpart) shall be the basis upon which all plans for spray grounds shall be reviewed, approved and constructed.
(3) Plans for any potable water treatment or sewage treatment facilities to be constructed on-site at spray grounds shall be approved prior to construction, by the permit-issuing official or such agency having jurisdiction for such plan approval.
(b) Spray grounds constructed prior to the effective date of this Subpart.
(1) The owner/ operator of a spray ground constructed prior to the effective date of this Subpart must submit a report addressing all of the design criteria specified in section 6-3.24 of this Subpart. This report shall be prepared by a New York State licensed professional engineer and must be submitted to the permit-issuing official at least 90 days prior to the proposed opening date. The report must evaluate the spray ground's compliance with this Subpart and identify each aspect of non-compliance and include recommendations for compliance. The permit-issuing official shall obtain the approval of the State Department of Health prior to granting or denying approval of alternative provisions recommended by the professional engineer as providing an equivalent level of protection for compliance with design criteria in section 6-3.24 of this Subpart. Waivers for those alternative provisions shall be issued in accordance with section 6-3.6(b) of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.6 Tissue processing facilities
(a) A facility which processes musculoskeletal tissue shall be licensed by the department as a tissue processing facility. Such facilities shall make available to the department a statement of the procedures used in the preparation, testing and preservation of the tissue or tissues distributed, or offered for use. The premises, equipment, procedures, records, circulars of instruction and tissues shall be available for inspection and/or testing by the department as required. Copies of all brochures and other informational materials and instructions, including descriptions of methods of tissue handling, shall be available to the department. Each container of tissue shall be clearly labeled with the donor identification code or a unique tissue identification number, unit size, and expiration date, if applicable.
(b) Aseptic processing of musculoskeletal tissue shall be performed in separately defined work areas with:
(1) floors, walls and ceilings with nonporous smooth surfaces that are easily cleaned;
(2) temperature and humidity controls;
(3) an air supply filtered through high efficiency particulate air filters with positive pressure differentials between rooms;
(4) a system for monitoring environmental conditions;
(5) a system for cleaning and disinfecting a room and equipment to produce aseptic conditions; and
(6) adequate space for staff, and storage of garments and equipment.
(c) Processing of musculoskeletal tissue intended for viral inactivation shall occur in controlled work areas. These areas shall have an acceptable microbial and particulate quality to minimize contaminants in final tissue preparation prior to sterilization and to ensure effectiveness of sterilization. Air shall have a particulate (less than or equal to 0.05 micron) count of less than or equal to 100,000 per cubic foot in the vicinity of the exposed tissue during periods of processing activity, and no more than 25 bacterial colonies per 10 cubic feet. Air flow shall achieve 20 air exchanges per hour and a pressure differential greater than or equal to 0.05 inches of water relative to an adjacent less clean area. Compressed air shall be free of demonstrable oil vapors.
(d) Critical work areas in which sterile tissue containers or aseptically retrieved musculoskeletal tissue are exposed to the environment shall have an air quality of no more than 100 particles (less than or equal to 0.5 micron) per cubic foot of air and no more than one bacterial colony forming unit per 10 cubic feet of air. Critical work areas shall have a positive pressure gradient greater than or equal to 0.05 inches of water relative to an adjacent less clean area. Critical surfaces shall be sterile and shall not interact with the tissue so as to affect the quality of the tissue adversely.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.12 Building construction
(a) Notice of construction, modification or conversion required.
No person shall modify, develop or convert a property for use as a children's camp without first notifying the permit-issuing official at least 60 days before construction commences. The notices shall give the name and location of the property, a brief description of the facilities to be provided and the name, telephone number and mailing address of the person giving notice. The notice shall be supplemented by additional information, including plans or sketches as requested by the permit-issuing official. Construction shall not start prior to the required approval of the plans or sketches by the permit-issuing official and other appropriate regulatory official.
(b) Requirement for new construction.
(1) Except as otherwise provided in paragraph (2) of this subdivision, all new construction, including alterations, enlargements and improvements, shall be in accordance with the Uniform Code, and the provisions of the State Environmental Quality Review Act. The building permit and certificate of occupancy as issued by the local code enforcement official should be readily available for review and submission to the permit-issuing official. A written statement signed by a registered architect or professional engineer certifying construction compliance with the Uniform Code shall be submitted to the permit-issuing official prior to occupancy of all new construction. For a summer camp cabin (as that term is defined in paragraph [3] of this subdivision), the written certification of compliance to be submitted to the permit-issuing official shall certify compliance with all applicable Uniform Code requirements other than the automatic sprinkler system requirements specified in subparagraph (2)(i) of this subdivision.
(2) A summer camp cabin (as that term is defined in paragraph [3] of this subdivision) shall be exempt from the following Uniform Code requirements:
(i) the automatic sprinkler system requirements; and
(ii) the minimum floor area per occupant requirements.
(3) For the purposes of this subdivision, the term summer camp cabin shall mean a sleeping quarter which:
(i) is located in a children's overnight camp;
(ii) has a sleeping capacity of fewer than 25 occupants with a total combined sleeping room floor area of 1,200 square feet or less for all sleeping rooms;
(iii) is one story;
(iv) is used and occupied only between June 1st and September 14th;
(v) has no cooking facilities, no heating systems, and no solid fuel heating or burning systems;
(vi) has only sleeping rooms (including the necessary area for storing occupant belongings) and bathrooms;
(vii) has no interior corridors or separate common area rooms;
(viii) has at least two exits per sleeping room which are remote from each other and which discharge directly to the building's exterior;
(ix) has exit doors that open in the direction of, and are non-locking against egress; and
(x) has smoke alarms in each sleeping room that are interconnected such that the activation of one alarm will activate all of the alarms in the cabin.
An existing structure that is altered, enlarged or otherwise improved shall not be deemed to be a summer camp cabin (and shall not be subject to the exceptions set forth in paragraph [2] of this subdivision) unless such structure, as so altered, enlarged or otherwise improved, satisfies all of the criteria set forth in this paragraph.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.312 Specimen
Refers to the nature or source of material on which one or more laboratory tests may be carried out.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.10 Approved bathing waters
(a) Natural or artificially formed bathing areas must meet the following conditions:
(1) A sanitary survey verifies that the watershed for the beach water is free of sewage and untreated sewage discharges, or that known waste-water discharges or other contamination is determined to not adversely impact water quality or beach use based upon an historical water quality model for rainfall and bacteriological quality.
(2) A bathing beach located on the watershed of a lake, reservoir, stream or other body of water used as a source of public water supply shall be so operated as not to pollute or contaminate such supply and shall comply with all watershed rules or local regulations in effect.
(3) Water quality standards specified in section 6-2.15 of this Subpart.
(4) The swimming and bathing areas are provided with float lines to clearly designate the perimeter, the separation of shallow and deep areas, the wading area, the diving area and dropoffs, radical changes in slope or underwater obstructions. This requirement is not applicable at beaches located on the shore of Lake Erie, Lake Ontario, Long Island Sound or the Atlantic Ocean, unless required by the permit-issuing official.
(b) Use of impoundments less than four acres in area for bathing purposes shall be prohibited unless:
(1) the operator can document compliance with subdivision (a) of this section; or
(2) a minimum of 100 gallons per person per day of dilution water meeting the standards contained in section 6-2.15 of this Subpart is added to or flows through the swimming and bathing area.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 153 WASHINGTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 153.2 Village of Whitehall
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to Pine Lake, to all artificial reservoirs and to all watercourses tributary thereto or ultimately being diverted or discharged into said lake, these bodies of water being sources of the public water supply of the village of Whitehall, Washington County.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to Pine Lake and to all drainage and impounding reservoirs which serve as sources of this public water supply or to any additional reservoir which may be constituted or used for the purpose of this water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoir), stream, ditch, gutter or other channel of any kind the waters of which when running whether continuously or occasionally eventually flow or may flow or be diverted into Pine Lake or the impounding or storage reservoirs tributary to the public water supply of the village of Whitehall.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any watertight receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain with 150 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the village of Whitehall.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta which is not watertight shall be constructed, located, placed, maintained or allowed to remain within 250 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Whitehall.
(3) No privy, privy vault, pit, cesspool or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said privy, privy vault, pit, cesspool or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage will not overflow and is at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the receptacle or the prive* or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of final disposal hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision, shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Whitehall.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the village of Whitehall, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Whitehall nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 250 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Whitehall.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory, nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed, nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Whitehall; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the village of Whitehall.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Whitehall.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe nor shall any animal or poultry be allowed to stand, wallow, wade, swim or be washed or watered in any reservoir tributary to the public water supply of the village of Whitehall. This shall not, however, be construed to prohibit animals from being watered in any portion of the watercourse tributary to the public water supply of the village of Whitehall but no watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Village of Whitehall.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or within 50 feet of any watercourse tributary to the public water supply of the Village of Whitehall, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet of any reservoir or 50 feet from any watercourse tributary to the public water supply of the Village of Whitehall.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Whitehall nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Whitehall; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir nor within 50 feet from any watercourse tributary to the public water supply of the Village of Whitehall.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such a extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the Village of Whitehall.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish, or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the Village of Whitehall, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the Village of Whitehall.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatsoever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Village of Whitehall.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Whitehall.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Whitehall.
(j) Inspections.
The board of trustees of the Village of Whitehall or such other board as may be charged with the maintenance or supervision of the public water supply of the Village of Whitehall or its duly appointed representative shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with; and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees promptly to notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.18 Disinfection and sterilization
(a) Shared health facilities shall:
(1) assure proper cleaning, disinfection, sterilization and storage of all equipment and supplies that require such treatment;
(2) provide for monthly bacteriological tests of sterilization processes, and keep a record of the results of such tests; and
(3) assure proper cleaning and disinfection or sterilization of gas, oxygen, aspirating and vaporizing equipment.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.15 Loans
Any loan for the benefit of a referring health services purveyor or for the benefit of any immediate family member of such purveyor, which was secured or facilitated either directly or indirectly by or through the efforts of a clinical laboratory shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.51 Surrender and disposal of controlled substances
(a) As described in this section, the destruction of controlled substances shall mean that the substances have been rendered totally unrecoverable and beyond reclamation.
(b) Single-unit doses or partial doses remaining after the administration or attempted administration of a portion of a liquid or solid unit dose of a controlled substance may be destroyed on the premises of an institutional dispenser by a pharmacist or nurse provided that:
(1) a notation is made on the administration record sheet; and
(2) the destruction is witnessed by a second pharmacist or nurse or other responsible person designated by the administrator.
(c) A person holding a Federal registration number, or who is licensed by the department under article 33 of the Public Health Law, or a person with lawful temporary custody possessing controlled substances, which are undesired, deteriorated, obsolete, or for any reason no longer needed shall:
(1) return such controlled substances to the licensed distributor or manufacturer from whom the controlled substances were purchased provided, that a manufacturer or distributor is required to accept only those full packages of controlled substances still in the sealed containers but may accept partial containers if it wishes to do so; or
(2) surrender such controlled substances to such other person approved by the Bureau of Narcotic Enforcement to receive controlled substances for destruction; or
(3) destroy the controlled substances in the presence of a witness who shall be a New York State licensed practitioner, pharmacist or nurse, provided that:
(i) the person shall request from the department permission to destroy controlled substances at least two weeks prior to the intended destruction. Such requests must be made in writing and must include the following information:
(a) an inventory of controlled substances to be destroyed;
(b) the specific method of destruction to be employed;
(c) the date, time and location of intended destruction;
(d) the identity of at least two persons to conduct and witness the destruction. Such witnesses shall be New York State-licensed practitioners, pharmacists or nurses; and
(e) the reason for the destruction;
(ii) the department shall determine whether or not to grant approval for the destruction by considering factors that include, but are not limited to:
(a) the record of compliance with article 33 of the Public Health Law by the licensee, its employees, and the persons designated to witness the destruction;
(b) the type, nature and schedule of the drugs proposed for destruction, including the potential for diversion of such drugs during the destruction process;
(c) the licensee's pattern and frequency of requests for approval to destroy and of surrenders of controlled substances to the department;
(iii) a person may destroy controlled substances only after receiving the written approval of the department which will include specific protocols for and methods of destruction;
(iv) if the department does not grant approval for the person to destroy controlled substances, the person shall surrender the controlled substances to the department by following the requirements in paragraph (4) of this subdivision; or
(4) surrender the controlled substances to the New York State Department of Health, Bureau of Narcotic Enforcement in the following manner:
(i) the person shall request a surrender date from the bureau on which to surrender the controlled substances to the bureau. Such a request shall be made on forms provided by the bureau and must include the following information:
(a) an inventory of all controlled substances to be surrendered;
(b) the identity of at least two persons who conducted the inventory of the controlled substances to be surrendered. Such persons shall be New York State licensed practitioners, pharmacists or nurses;
(c) the reason for the surrender of each controlled substance; and
(d) the proposed date of surrender and an alternative date;
(ii) a person may surrender controlled substances only after receiving a surrender date in writing from the bureau. The controlled substances must be shipped to the bureau no later than five days from the date the bureau has set as the surrender date. The bureau may set a date different than the date requested by the applicant;
(iii) all controlled substances to be surrendered to the bureau must be packaged in the following manner:
(a) all solid dosage forms of controlled substances must be packaged by placing each controlled substance in separate, individual, paper packaging only. The package must be properly labeled with the name of the licensee, DEA registration number and the name, strength and quantity of the controlled substance;
(b) all liquids, including injectable preparations and prefilled syringes, shall be emptied into individual plastic containers. A label shall be affixed to the container with the name of the licensee, DEA registration number and the name, strength and quantity of the controlled substance. Glass containers are prohibited;
(c) no needles or syringes shall be surrendered to the department for destruction; or
(5) surrender the controlled substances to the Federal Drug Enforcement Administration, or its successor agency; or
(6) transfer such controlled substances into an authorized collection receptacle, located at the residential health care facility and maintained by a properly licensed and registered pharmacy, no longer than three business days after discontinuation.
(d) Recordkeeping requirements.
(1) Any person disposing of a controlled substance by returning it to the distributor or to the manufacturer, by destroying the controlled substance in the presence of a witness, or by surrendering it to the department, must maintain a written record containing:
(i) date of return or destruction;
(ii) name, form, quantity of the substance returned or destroyed;
(iii) name, address, registry number of the person making the return;
(iv) name, address, registry number of the supplier or manufacturer to whom the substances are returned or the name and license number of the persons performing and witnessing the destruction.
(2) Any distributor or manufacturer receiving such controlled substances shall keep a record of those controlled substances received and include:
(i) name, address, registry number of the person making the return;
(ii) name, form and quantity of the substance returned; and
(iii) date substance was received.
(3) Any person surrendering controlled substances to the Drug Enforcement Administration shall maintain records of such surrenders as may be required by that agency.
(4) Any record required to be kept under this section shall be kept for a period of five years.
(e) Persons licensed under article 33 of the Public Health Law as manufacturers or distributors may destroy controlled substances on their premises providing that Federal Drug Enforcement Administration approval is obtained and a copy of such approval is filed with the department within 30 days of the receipt of such approval.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.21 Leave for subpoenaed appearance and jury attendance
On proof of the necessity of jury service or appearance as a witness pursuant to subpoena or other order of a court or body, an employee shall be granted a leave of absence with pay with no charge against leave credits; provided, however, that this section shall not apply to any absence by an employee occasioned by such an appearance if he is a party.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.6 Space
(a) The rental of space by a clinical laboratory from a referring health services purveyor, or an immediate family member of such purveyor, for more than fair market value, or under circumstances where the rental amount is affected by the volume or value of tests ordered by the health services purveyor shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(b) The rental of space by a clinical laboratory from a referring health services purveyor for storage of supplies provided by the laboratory to the health services purveyor shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(c) The location of a PSC by a clinical laboratory, within or sharing space in any part of the practice, administrative, office or waiting area of any health services purveyor that refers specimens to the clinical laboratory, shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(d) A PSC may be located in a building in which a health services purveyor that refers specimens to the clinical laboratory operating the PSC has a direct or indirect ownership, investment or leasehold interest, under the following circumstances:
(2) the PSC is the subject of a signed written lease, available to the department, which conforms to the requirements of Public Health Law, section 238-a(5)(b)(i)(A) and implementing regulations; and
(2) the PSC is open to and actually serves the general public and operates independently from the health services purveyor, and meets all of the following criteria:
(i) the PSC actually collects a substantial number of specimens from patients of other health services purveyors which do not have a direct or indirect financial relationship with a referring health service purveyor who has an ownership, investment or leasehold interest in the building;
(ii) the PSC has its own entrance, exit, and waiting area, except that the PSC may use a waiting area that is generally shared by all tenants or occupants of the building or an entire floor of the building, provided there are two or more tenants renting separate office spaces who are not referring health services purveyors;
(iii) the PSC is identified on signs, consistent with signage of other tenants or occupants, on the outside of the building and within the building;
(iv) the PSC has its own telephone line, separate and distinct from that of any referring health services purveyor, and telephone listings for the clinical laboratory include the PSC's telephone number;
(v) advertisements and other public notices by the clinical laboratory list the address and telephone number of the PSC;
(vi) the hours the PSC is open are independent and not restricted to the hours of one or more referring health services purveyors in the building; and
(vii) the PSC patients of health services purveyors not located in the building have access to a restroom other than those of health services purveyors in the building.
(e) A clinical laboratory shall, within 60 days from the effective date of this Subpart, bring any PSC which it operates at locations as described in subdivision (d) of this section, into compliance with the requirements of paragraphs (d)(1) and (2) of this section, or shall cease operation of the PSC. However, a clinical laboratory may request in writing to the department an extension of time for complying with this Subpart with respect to a PSC. Such request shall be made within 30 calendar days from the effective date of this Subpart, shall state the reason(s) that the PSC cannot be brought into compliance with the requirements of this Subpart, and shall document a plan of correction acceptable to the department. The department may extend the grace period granted pursuant to this subdivision for a period not to exceed 180 days from the effective date of this Subpart.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.50 Public water supply protection; performance standards
The local health department shall maintain a program that ensures public water systems are operated pursuant to Part 5 (State Sanitary Code) of this Title, and applicable Federal Safe Drinking Water Act (SDWA) requirements.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS
10 CRR-NY 80.86 Records and reports of treatment programs
(a) All persons approved pursuant to article 32 of the Mental Hygiene Law to operate a chemical dependence program, other than authorized physicians and pharmacists as defined in section 80.84 of this Part who are registered with the department to prescribe, administer or dispense approved controlled substances for the treatment of narcotic addiction, and who possess a Federal registration by the Drug Enforcement Administration, United States Department of Justice to purchase, possess and use controlled substances shall keep the following records:
(1) records of controlled substances received by approved persons including date of receipt, name and address of distributor, type and quantity of such drugs received and the signature of the individual receiving the controlled substance. A duplicate invoice or separate itemized list furnished by the distributor will be sufficient to satisfy this record requirement provided it includes all required information and is maintained in a separate file. In addition, duplicate copies of Federal order forms for schedule II controlled substances must be retained; and
(2) records of controlled substances administered or dispensed including date of administration or dispensing, name of patient, signature of person administering or dispensing, type and quantity of drug and such other information as may be required by this Part.
(b) By the 10th day of each month, a person other than an authorized physician as defined in section 80.84(b) of this Part, approved to conduct a maintenance program pursuant to article 32 of the Mental Hygiene Law, shall file with the department a report summarizing its controlled substances activity in the preceding month. Such a report shall be on forms provided by the department and shall include:
(1) an inventory of the quantity of controlled substances on hand at the commencement and at the conclusion of such month's activity;
(2) the date of the inventory;
(3) the signature of the persons performing the inventory;
(4) the total quantity of controlled substances received, the distributor from whom each order was received, and the form and dosage unit in which such substance was received;
(5) a separate listing of the total quantity of controlled substances prescribed, dispensed and administered during such month;
(6) total quantity of methadone surrendered to the department for destruction;
(7) total number of patients treated during the month; and
(8) each incident or alleged incident involving the theft, loss or possible diversion of controlled substances.
(c) Each incident or alleged incident involving the theft, loss or possible diversion of controlled substances shall also be reported to the department immediately.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.114 Equity
(a) Any right or claim to assets.
(b) An interest in property or in a business, subject to claims of creditors.
(c) The difference between assets and liabilities.
(d) Net worth.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.11 Individualized family service plan
(a) Individualized family service plan (IFSP) participation.
(1) If the evaluator determines that the infant or toddler is an eligible child, the early intervention official shall convene a meeting of the IFSP team within 45 days of the receipt of the child's referral, to develop the initial IFSP, provided however that such timeline does not apply for any period when:
(i) the child or parent is unavailable to complete the initial evaluation and assessment of the child and family or is unavailable for the initial IFSP meeting due to exceptional family circumstances that are documented in the child’s early intervention records and the multidisciplinary evaluation, and the initial evaluation and assessment and the initial IFSP meeting are completed as soon as possible after the exceptional family circumstances no longer exist; or
(ii) the parent has not provided timely consent for the initial evaluation and assessment of the child despite documented repeated attempts by the evaluator to obtain parental consent, and the initial evaluation and assessment and the initial IFSP meeting are completed as soon as possible after parental consent has been obtained for the initial evaluation and assessment of the child.
(2) A multidisciplinary IFSP team shall be convened by the early intervention official to develop and annually evaluate the IFSP. Such multidisciplinary IFSP team shall include two or more individuals from separate disciplines or professions, one of whom shall be the service coordinator, and the following participants:
(i) the parent or parent(s) of the child;
(ii) other family members, as requested by the parent, if feasible to do so;
(iii) an advocate or person outside of the family, as requested by the parent;
(iv) the early intervention official, provided that the early intervention official may participate in the meeting via conference call if he or she is unable to attend the meeting;
(v) the initial or ongoing service coordinator responsible for assisting in the development of the IFSP or implementation of the IFSP, as applicable;
(vi) the person or persons directly involved in conducting the evaluations and assessments of the child; provided, however, that if such a person is unable to attend a meeting, arrangements shall be made for his or her involvement through other means, including participation through a conference call, having a knowledgeable authorized representative attend the meeting, or making pertinent records available at the meeting;
(vii) as appropriate, the person or persons who will be delivering early intervention services to the child or family; and
(viii) any other persons, such as the child's primary health care provider or child care provider, who the parent or the initial or ongoing service coordinator, with the parent's consent, invite.
(3) The six-month review of the IFSP pursuant to subdivision (b) of this section shall provide for the participation of persons in subparagraphs (2)(i)-(v) of this subdivision and, if conditions warrant, provisions shall be made for participation of other representatives identified in paragraph (2) of this subdivision.
(4) The IFSP meeting must be conducted:
(i) in settings and at times that are convenient to the parent; and
(ii) in the dominant language of the parent or other mode of communication used by the parent, unless it is clearly not feasible to do so.
(5) Meeting arrangements must be made with, and written notice provided to, the family and other participants early enough before the meeting date to ensure that they will be able to attend.
(i) The notice to the child's parent of the IFSP meeting shall also inform the parent of the following:
(a) parents are required to furnish their social security numbers and the social security number of their child to the early intervention official, in accordance with subdivision four of section 2552 of the Public Health Law, for purposes of administration of the Early Intervention Program;
(b) parents shall provide their social security numbers and the social security number for their child at the time of the IFSP meeting; and
(c) social security numbers of the child and parent will be maintained in a confidential manner, will be used solely for the purpose of administration of the Early Intervention Program, and will not be re-disclosed to any party other than the department.
(6) The early intervention official, initial service coordinator, parent, and evaluator or designated contact from the evaluation team shall jointly develop an IFSP for a parent who requests services.
(7) If the IFSP team members, including the early intervention official and the parent agree on the initial or subsequent IFSPs, the IFSP shall be deemed final and the ongoing service coordinator shall be authorized to implement the plan.
(i) The early intervention official shall request, and the parent shall supply, the parent's social security number and the social security number for their child at the time of the IFSP meeting; provided, however, that if the parent refuses to furnish such information to the early intervention official, early intervention services contained within the IFSP must still be provided and such refusal by the parent shall be documented in the child's record.
(ii) The evaluator who conducts an evaluation of a child or an approved agency which employs or contracts with the evaluator shall not be prohibited from providing early intervention services authorized by the early intervention official and included in the child’s individualized family service plan, unless it is documented by the early intervention official that this course of action is not in the best interest of the child and family. Such documentation must include justification for prohibiting the evaluator from providing early intervention services to such child.
(8) The contents of the IFSP must be fully explained to the parent and informed written consent from the parent must be obtained prior to the provision of early intervention services described in the plan. If the parent does not provide consent with respect to a particular early intervention service, or withdraws consent after first providing it, that service may not be provided. The early intervention services to which parental consent is obtained must be provided.
(9) If the IFSP team members, including the early intervention official and the parent do not agree on an IFSP, the service coordinator shall implement the sections of the proposed IFSP that are not in dispute, and the parent may exercise his or her due process rights to resolve the dispute.
(10) The IFSP shall be in writing and include the following:
(i) a statement, based on objective criteria, of the child's present levels of functioning in each of the following domains: physical development, including vision and hearing; cognitive development; communication development; social or emotional development; and adaptive development;
(ii) a physician's or nurse practitioner's order pertaining to early intervention services which require such an order and which includes a diagnostic statement and purpose of treatment;
(iii) with parental consent, a statement of the family's strengths, priorities and concerns that relate to enhancing the development of the child;
(iv) a statement of the measurable results or measurable outcomes expected to be achieved for the child and the family (including pre-literacy and language and numeracy skills, as developmentally appropriate for the child), including timelines, and the criteria and procedures that will be used both to determine whether progress toward achieving the outcomes is being made and whether modifications or revisions of the outcomes or services is necessary;
(v) a statement of specific early intervention services based on peer-reviewed research, to the extent practicable, including transportation and the mode thereof, necessary to meet the unique strengths and needs of the child and the family, including the frequency, intensity, length, duration, location and the method of delivering services. If ABA services using ABA aides are to be provided to the child, the IFSP shall specify the number of hours of intervention to be delivered by such aides in accordance with section 69-4.25 of this Subpart. For purposes of this subparagraph frequency, intensity, length, duration, location and method shall be defined as follows:
(a) frequency shall mean the number of days or sessions the service will be provided;
(b) intensity shall mean whether the service is provided on an individual or group basis in accordance with the service model option in section 69-4.10 of this Subpart and reimbursed in accordance with section 69-4.30 of this Subpart;
(c) length shall mean the number of minutes of actual time spent delivering services during each session;
(d) duration shall mean the start date and end date the service is to be provided;
(e) location shall mean the actual place or places where the service will be delivered;
(f) method shall mean how a service is provided; and
(vi) a statement of the natural environments in which early intervention services shall appropriately be provided, including, if applicable, a justification of the extent, if any, to which early intervention services will not be provided in a natural environment;
(a) the determination of the appropriate setting for providing early intervention services to an infant or toddler with a disability must be:
(1) made by the participants of the IFSP meeting, including the parent;
(2) consistent with the definition of natural environment in section 69-4.1(ag) of this Subpart; and
(3) based on the child's outcomes that are identified by the IFSP meeting participants;
(4) if the IFSP meeting participants together determine that a particular early intervention service is to be delivered at a location that is not the natural environment for the child or service, the IFSP shall set forth in detail the justification for not delivering the service in a natural environment.
(vii) when the child is in day care and when appropriate, a plan for qualified professionals to train the day care provider to accommodate the needs of the child;
(viii) to the extent appropriate, a statement of other services, including medical services, that the child and family needs or is receiving through other sources, but that are neither required nor funded by the program. If such services are not currently being provided, the IFSP shall include a description of the steps the service coordinator or family may take to assist the child and family in securing those other services;
(ix) a statement of other public programs under which the child and family may be eligible for benefits, and a referral, where indicated;
(x) the projected dates for initiation of services as soon as possible after the IFSP meeting and the anticipated duration of these services;
(xi) the name of the ongoing service coordinator, who may be different from the initial service coordinator, selected by the parent who will be responsible for the implementation of the IFSP and coordination with other agencies, services and persons;
(xii) if applicable, a statement of any supplemental evaluations, including the type, and the date and evaluator if known; and
(xiii) if applicable, establishment of a transition plan with the steps and services to be taken supporting the potential transition of the toddler with a disability to services provided under section 4410 of the Education Law, or to other services, including:
(a) discussions with and education of parents regarding potential options and other matters related to the child's transition, including:
(1) if the child is potentially eligible for services under section 4410 of the Education Law, the service coordinator shall notify the Committee on Preschool Special Education (CPSE) of the local school district in which the child resides of the child's potential transition for services under section 4410 of the Education Law, unless the parent objects to such notification orally or in writing. The service coordinator shall explain to the parent the procedures by which the parent may object to notification of the CPSE of the child's potential transition and the deadline for such objection;
(2) if the child is potentially eligible for services under section 4410 of the Education Law, the parent must timely refer, or provide consent for the service coordinator to refer, the child to the CPSE of the local district in which the child resides for an evaluation to determine the child's eligibility for such services;
(3) the child's eligibility for services under section 4410 of the Education Law must be determined by the CPSE prior to the child's third birthday in order to continue receiving services in the Early Intervention Program after the child's third birthday. If the CPSE has not made a determination of eligibility prior to the child's third birthday, early intervention services will end the day before the child turns three years of age;
(4) the requirement for the service coordinator to convene, with the approval of the parent, a conference among the early intervention official, the parent, and the chair or designee of the CPSE no fewer than 90 days before the child's third birthday or the date on which the child is first eligible for services under section 4410 of the Education Law, and at the discretion of all parties, no more than nine months prior to the child’s third birthday, to discuss any services the child may receive under the Education Law, review the child's program options and establish a transition plan; and
(5) with parental consent, such conference may be combined with:
(i) the initial meeting of the CPSE, provided that the combined conference and meeting are convened within timeframes specified in section 69-4.20(b) of this Subpart; or
(ii) the IFSP review meeting that occurs closet to the child's second birthday;
(b) procedures to prepare the child for changes in service delivery, including steps to help the child adjust to, and function in, a new setting;
(c) with parental consent, procedures to prepare program staff or individual qualified personnel who will be providing services to the child to facilitate a smooth transition;
(d) with parental consent, the transmission of information about the child to the committee on preschool special education, to ensure continuity of services, if appropriate, including evaluation and assessment information or a copy of the individualize family service plan; and
(e) identification of transition services and other activities that the IFSP participants determines are necessary to support the transition of the child.
(b) The IFSP shall be reviewed at six month intervals and shall be evaluated annually to determine the degree to which progress toward achieving the outcomes is being made and whether or not there is a need to amend the IFSP to modify or revise the services being provided or anticipated outcomes. Upon request of the parent, or if conditions warrant, the IFSP may be reviewed at more frequent intervals.
(1) IFSP reviews shall be conducted by an in-person meeting or other means agreed to by the parent which may include a telephone or video conference call or record review and written correspondence.
(2) An IFSP meeting shall be conducted at least annually to evaluate the IFSP for the child and the child's family, and, as appropriate, to revise its provisions. The results of any current evaluations conducted under section 69-4.8 of this Subpart and any other information available from the ongoing assessment of the child and family, must be used in determining the services that are needed and will be provided.
(3) When a request is made to review an IFSP prior to the six-month review period, for the purposes of increasing the frequency or duration of an approved service, including service coordination, the early intervention official may require and additional multidisciplinary evaluation or supplemental evaluation at public expense by an approved evaluator other than the current provider of service, with parent consent. The early intervention official may consider parent input when selecting the evaluator.
(4) If the parent does not consent to the evaluation or partial evaluation, the early intervention official may determine that an increase in frequency or duration of an approved service is not warranted and may deny such request. A parent who disagrees with the determination of the early intervention official shall have the due process rights set forth in section 2549 of the Public Health Law.
(c) Interim services.
(1) The initial service coordinator shall inform the parent of the availability of interim services for the child and/or family in immediate need of early intervention services.
(2) Interim early intervention services for an eligible child and the child's family may commence before the completion of the evaluation and assessment, if the following conditions are met:
(i) parental consent is obtained;
(ii) the parent and the early intervention official agree to an interim IFSP that includes:
(a) the name of a service coordinator who will be responsible for implementation of the interim IFSP and coordination with other agencies and persons;
(b) a physician's or nurse practitioner's order pertaining to those early intervention services which require such an order and which includes a diagnostic statement and purpose of treatment; and
(c) the early intervention services needed immediately by the child and the child's family, including the location, frequency, and intensity and providers of such services;
(iii) the evaluation and assessment are completed and an individualized family service plan meeting is convened within 45 days of referral to the early intervention official.
(3) The costs that an approved provider of early intervention services incurs in providing such interim services shall be approved costs to the extent they are otherwise consistent with section 2555 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.331 Trust
A right, enforceable in courts of equity, to the beneficial enjoyment of property, the legal title to which is in another.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.9 Completed works
Within 30 days of the completion of water well construction, the applicant or his agent shall:
(a) pump the well until the water is clear;
(b) disinfect the well in accordance with the requirements of the permit issuing official; and
(c) submit a well log to the permit issuing official. Such well log shall specify the well location, depth and diameter, formations penetrated, casing length, extent and nature of grouting, well output tests and associated water levels, and any other information required by the permit issuing official. In addition, analytical data of the water quality associated with such well shall be submitted when available.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.21 Reimbursement of municipal administrative costs
(a) Municipalities shall be eligible for reimbursement for administrative costs. exclusive of due process costs, incurred during the preceding year pursuant to this Title.
(b) The costs of direct early intervention services are not considered administrative costs. Administrative costs shall include personnel and operating expenses incurred for administration of the program.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.10 Primary care related inpatient and outpatient services
(a) Definition.
Primary care related inpatient and outpatient services are those non-critical or special care services that are provided to patients on a short term inpatient or outpatient basis to protect and promote the health and well being of the patients. Such services shall be provided to inpatients who are in need of clinical preventive services and/or the continuous management of non-critical medical conditions and to members of the community on an outpatient basis.
(b) General provisions.
Primary care related inpatient and outpatient services shall be organized to meet the needs of patients and provided to patients requiring such care on a short term basis. PCH/CAH primary care services shall be provided through medical and professional staff and support services appropriate to the scope of services offered and consistent with the primary health care needs of the patients.
(c) Organization and direction.
Primary care related inpatient services shall be directed by a physician member of the medical/professional staff, who shall be responsible for the administrative and clinical aspects of all such inpatient care services. The director shall have received specialized training in and have demonstrated competence in the organization and delivery of, primary care services, and may also be responsible for the administrative and clinical aspects of all outpatient primary care services.
(1) The provision of all primary care related inpatient and outpatient services shall be in accordance with generally accepted standards of medical practice and other licensed health care practitioner standards of practice.
(2) The PCH shall ensure that written policies and procedures are developed for the provision of all inpatient and out patient primary care services, and implemented by the medical and professional staff.
(3) Such policies shall set forth procedures for ensuring that all patients are provided with information necessary for their selection of or referral to community based primary care providers, and for the ongoing management of a patient's primary health care needs.
(d) If the PCH/CAH has an organized outpatient service, the service shall be operated in accordance with the provision of section 405.20(a)-(c) of this Title and organized in a manner that supports and augments other primary care services available in the rural area being served by the PCH/CAH.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.63 Chart of accounts
A systematically arranged list of accounts applicable to a specific concern, giving account names and numbers. A chart of accounts, accompanied by descriptions of their use and of the general operation of the books of account, becomes a classification or manual of accounts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.7 Retention of price lists
Copies of all price lists shall be retained on file at the funeral firm for a period of at least four years from the date of their last distribution to customers and shall be available for review during normal business hours by the designated representative of the commissioner.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.19 Transportation
(a) The municipality shall ensure that transportation is available beginning the first day of service as agreed upon in the individualized family service plan when transportation is necessary to enable the child and the child's family to receive early intervention services.
(1) Transportation may be provided directly, by contract, or through reimbursement of the parent at a mileage rate authorized by the municipality for the use of a private vehicle or for other reasonable transportation costs, including public transportation, tolls, and parking fees.
(b) In developing the IFSP, consideration shall first be given to provision of transportation by a parent of a child to early intervention services.
(c) If the parent has demonstrated an inability to provide or access transportation, the municipality in which an eligible child resides shall arrange and provide payment for suitable transportation services necessary for the child and parent participation in early intervention services contained within the individualized family service plan.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 111 DELAWARE COUNTY
VILLAGES VILLAGES
10 CRR-NY 111.1 Village of Delhi
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Village of Delhi. Said wells are located on land owned by the Village of Delhi and are situated approximately 225 feet southerly of New York State Route 10 in and around the Village of Delhi pump house and garage.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste, and agricultural- and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that is shall not include the land used for depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of see.
(19) Water supply shall mean the public water supply of the Village of Delhi.
(20) Wells shall mean any well now used as a source of water supply for the Village of Delhi, or any additional wells which may be constructed or developed in the future as a source for such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 500-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells, except in weatherproof buildings or watertight vessels acceptable to the village.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells, unless:
(i) a permit is obtained from the appropriate State agency having jurisdiction; or
(ii) if there are no permit requirements, then storage only may be permitted in a facility acceptable to the Village of Delhi which shall provide containment in the event of damage to the storage containers.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 500-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 500-foot linear distance of the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Junkyards.
No junkyards shall be located within a 500-foot linear distance of the wells.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 1,000-foot linear distance of the wells.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 500-foot linear distance of the wells.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells, except as otherwise permitted under the provisions of subparagraph (4)(iii) of this subdivision.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Village of Delhi upon which the wells are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Delhi.
(11) Other wastes.
No pollutant of any kind shall be discharged or deposited upon the property of the Village of Delhi upon which the wells are located, except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(e) Inspections.
The Village of Delhi, by its trustees and its duly appointed representatives, or any person or persons charged with the maintenance or supervision of the public water supply system, shall make regular and thorough inspections of the area surrounding the wells to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid trustees of the Village of Delhi to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the Village of Delhi to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees of the Village of Delhi shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.190 Emergency occurrences, reporting of foodborne disease
(a) In the event of an occurrence such as fire, flood, power outage, or similar event which might result in the contamination of food, or which might prevent potentially hazardous food from being held at required temperatures, the person in charge of the food vending commissary or food vending operation is to immediately notify the permit-issuing official.
(b) Any food service operator having actual or constructive knowledge of the occurrence of illness allegedly due to the consumption of food served at the establishment, shall report the same within 24 hours by telephone, telegram, or in person to the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.5 Selection of contractors
(a) Process.
Contractors shall be selected based on the criteria described in subdivisions (b) and (c) of this section to the extent funds are available for contracts; however, a practitioner who is not eligible to enroll in the medical assistance program as a Medicaid provider or who is under suspension, exclusion or involuntary withdrawal from participation in the medical assistance program shall not be eligible for a contract under this Part.
(b) Preference.
Preference shall be given to practitioners in the following categories in the order of listing:
(1) An additional service obstetric practitioner who has had a contract, satisfactorily met the contract's terms and conditions, and is requesting a second contract.
(2) A new pediatric practitioner who has a new pediatric practitioner contract, satisfactorily met the contract's terms and conditions, and is requesting a second contract.
(3) An additional service obstetric practitioner applying for an initial contract.
(4) A new pediatric practitioner applying for an initial contract.
(5) A disproportionate share obstetric practitioner applying for an initial or additional contract.
(c) Selection criteria.
If funds available for the program are not sufficient to cover all eligible applicants within a category listed in subdivision (b) of this section, then applicants within that category shall be reviewed competitively using the following criteria:
(1) the extent of the practitioner's potential contribution towards increasing covered services available to the target population;
(2) the need for covered services to the target population in the designated area or location;
(3) in the case of an obstetric practitioner, the extent of participation in the New York State Department of Health Prenatal Care Assistance Program;
(4) the extent of participation in a Medicaid managed care program if there is a New York State Department of Social Services approved program in the social services district; and
(5) the demonstrated commitment of the applicant to serve the target population and the education, training or other experience of the applicant to provide obstetric or pediatric services to the target population.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.6 Fair hearings for applicants and participants
(a) A fair hearing shall be scheduled within 21 days from the date the department receives the request for a hearing.
(b) A written notice of hearing shall be sent by certified mail to the petitioner, his/her representative, if any, and the local agency at least 10 days prior to the scheduled date of the hearing.
(c) The notice of hearing shall:
(1) specify the date, time and place of the hearing;
(2) state briefly the issues which are to be the subject of the hearing;
(3) explain the manner in which the fair hearing will be conducted;
(4) apprise the petitioner of the right to be represented by an attorney, parent or guardian, relative, friend or other spokesperson; to testify, present documentary evidence, advance arguments, produce witnesses, and question or refute any testimony or evidence, including an opportunity to cross-examine adverse witnesses; and to examine prior to and during the hearing the documents and records supporting the determination or action under appeal;
(5) state that failure to appear at the hearing shall constitute waiver of the petitioner's right to a hearing; and
(6) as appropriate pursuant to sections 60-1.2(b)(8) and 60-1.5(b) of this Subpart, advise a petitioner participant that WIC program benefits may be continued pending the fair hearing decision.
(d) A fair hearing shall be conducted under the provisions of Part 51 of this Title by an administrative law judge who has not been involved previously in any way with the matter under appeal. The administrative law judge may order, when relevant and necessary, an independent medical assessment or professional evaluation.
(e) A copy of the fair hearing decision shall be sent to the petitioner, his/her representative, if any, and the local agency within 45 days from the date on which the request for the hearing was received by the department, except that such time may be extended if the petitioner has requested and been granted a postponement of his/her hearing. A fair hearing decision unfavorable to the petitioner shall contain a statement informing the petitioner of the availability of judicial review as provided in the Civil Practice Law and Rules.
(f) WIC program benefits shall not continue during an appeal by a denied applicant or participant of an adverse hearing decision made by an administrative law judge or the commissioner. Retroactive benefits may not be ordered as a result of the fair hearing.
(g) When a local agency receives a copy of a fair hearing decision, it shall comply with the decision immediately and shall notify the department in writing of such compliance. The department shall review the compliance statement to assure that the local agency has complied correctly.
(h) A record of each fair hearing shall be maintained as provided in Part 51 of this Title and shall be retained for at least three years from the date of the decision. The record of each fair hearing shall be available for public inspection and copying.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.96 Use of liquid nitrogen and dry ice
For the purposes of this section, liquid nitrogen shall mean nitrogen in its cryogenic liquid form, which comes in direct contact with food or is used as a food additive. Dry ice shall mean carbon dioxide in its solid form, which comes in direct contact with food or is used as a food additive.
(a) Only food-grade liquid nitrogen or dry ice may be added to food.
(b) Liquid nitrogen, used in the preparation of food, shall be evaporated completely or the operator shall ensure that all residual liquid nitrogen is drained prior to service.
(c) Dry ice, used in the preparation of food, shall be sublimated completely prior to service or the operator shall ensure no residual dry ice is served to the patrons.
(d) Liquid nitrogen or dry ice shall not be added to any food before service, such that a fog or smoke effect remains at time of service or is created during eating.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.50 Minimum security standards for institutional dispensers, institutional dispensers limited, treatment programs, license holders engaging in research, instructional activities and chemical analysis
(a) Reserve or main stocks of controlled substances shall be securely kept as follows:
(1) Schedule I and II controlled substances shall be kept in one of the following secure storage areas:
(i) A GSA class 5 rated steel cabinet or equivalent safe approved by the Bureau of Narcotic Enforcement of the Department of Health. Any cabinet or safe weighing less than 750 pounds shall be bolted or cemented to the floor or wall in such a way that it cannot be removed. The door of the cabinet or safe shall contain a multiple position combination lock, a relocking device or the equivalent, and steel plate having a thickness of at least one-half inch.
(ii) A vault, constructed of substantial masonry and having a multiple position combination lock, a relocking device or the equivalent, and a door having a thickness of steel plate of at least one-half inch. For new construction, floor, walls and ceiling shall not be less than eight inches of reinforced concrete, but less may be accepted where there are compensating extra safeguards.
(2) Schedule III, IV and V controlled substances shall be stored in a securely locked cabinet of substantial construction.
(b) Working stocks of controlled substances of a registered pharmacy may be dispersed throughout the stocks of noncontrolled substances in such a manner as to obstruct theft or diversion provided the conditions of section 80.6 of this Part are met and the pharmacy is locked when not in operation. If not dispersed, controlled substances in schedules II, III and IV shall be kept in a stationary, securely locked cabinet of substantial construction.
(c) Working stocks of controlled substances for institutional dispensers without a registered pharmacy, treatment programs, license holders engaging in research, instructional activities, and chemical analysis shall be securely kept as follows:
(1) Schedule I, II, III and IV controlled substances shall be kept in stationary, locked double cabinets. Both cabinets, inner and outer, shall have key-locked doors with separate keys; spring locks or combination dial locks are not acceptable. For new construction, cabinets shall be made of steel or other approved metal.
(2) Schedule V controlled substances shall be stored in a stationary, securely locked cabinet of substantial construction.
(3) Limited supplies of controlled substances for use in emergency situations may be stocked in sealed emergency medication kits.
(d) Patient care units of institutional dispensers or institutional dispensers limited shall safeguard substances as follows:
(1) Controlled substances kept as floor stocks on patient care units for general patient use and quantities prescribed or ordered for a specific patient which would exceed a 72-hour supply shall be stored as specified in subdivision (c) of this section.
(2) Controlled substances prescribed or ordered for a specific patient in quantities which would not exceed a 72-hour supply may be stored with the patient's other medications at the patient care unit, provided that they are kept in a securely locked medication cart or other storage unit approved by the department.
(3) Medication carts. schedule II controlled substances may not be stocked in medication carts.
(i) Medication carts may be utilized to stock schedule III, IV and V controlled substances as provided in paragraph (2) of this subdivision, provided they are equipped with the following:
(a) double-keyed locks;
(b) when not in use, anchored to a floor or wall device or maintained in another secure location;
(c) locked drawer system; and
(d) independent locking device.
(ii) Access to medication carts shall be limited to an identified individual at all times. Such carts are to be used only in conjunction with a pharmacy-maintained patient profile summary.
(4) Records.
The following records shall be maintained of controlled substances stocked, dispensed or administered in medication carts:
(i) An order, signed by a person authorized to prescribe under the provisions of this Part, specifying the controlled substances medication for an indicated person or animal.
(ii) A separate record, at the main point of supply for controlled substances, showing the type and strength of each drug, in the form of a running inventory indicating the dates and amounts of such drugs compounded by them or received from other persons and their distribution or use.
(iii) A record of authorized requisitions for such drugs and the distribution to substations or wards should be maintained. Such records shall show delivery to substation or ward by the authorized signature of dispensing personnel.
(iv) A record in the patient's chart indicating administration of the controlled substance, including the name of the administering attendant and the date and hour of administration.
(e) Except as provided in paragraph (1) of this subdivision, institutional dispensers limited may only possess controlled substances prescribed for individual patient use, pursuant to prescriptions filled in a registered pharmacy. These controlled substances shall be safeguarded as provided in subdivision (d) of this section.
(1) Except for adult care facilities subject to the provisions of 18 NYCRR Parts 487, 488 and 490, institutional dispensers limited may possess limited supplies of controlled substances in sealed emergency medication kits for use as provided in section 80.49(d) of this Part. Each kit may contain up to a 24-hour supply of a maximum of 10 different controlled substances in unit dose packaging, no more than three of which may be in an injectable form. Each kit shall be secured in a stationary, double-locked system or other secure method approved by the department.
(f) Only controlled substances shall be stored within the storage facilities described in this section, except in an automated dispensing system and as noted in subdivision (b) and paragraph (d)(2) of this section.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.21 Siting requirements
Before a person shall enter a financial commitment for or initiate construction of a public water system, such person shall notify the State and, to the extent practicable, avoid locating part or all of the public water system at a site which:
(a) is subject to a significant risk from earthquake, floods, fires or other disasters; or
(b) except for intake structures, is within the floodplain of a 100-year flood or is lower than any recorded high tide.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.14 Reporting of certain communicable diseases
(a) The commissioner shall designate those communicable diseases, as defined by section 2.1 of the Sanitary Code, that require prompt action, and shall make available on the department’s website a list of such communicable diseases.
(b) Laboratories performing tests for screening, diagnosis or monitoring of communicable diseases requiring prompt action pursuant to subdivision (a) of this section, for New York State residents and/or New York State health care providers, shall:
(1) immediately report to the commissioner all positive results for such communicable diseases in a manner and format as prescribed by the commissioner; and
(2) report all results, including positive, negative and indeterminate results, to the commissioner in a time and manner consistent with Public Health Law section 576-c.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.8 Exception, construction standards
The standards set forth in this Subchapter, to the extent they constitute construction standards, shall not apply. Medical facilities shall comply with the construction standards contained in Article 2 of Subchapter C of this Chapter (State Hospital Code).
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.143 Fund balance sheet
A balance sheet divided into self-balancing sections, each of which shows the assets and liabilities of a single fund or group of related funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.9 Adult day health care in residential health care facilities
(a) Except as specifically identified in subdivision (g), rates for residential health care facility services for adult day health care registrants shall be computed on the basis of the allowable costs, as reported by the residential health care facility, and the total number of visits by adult day health care registrants, as defined in Part 425 of this Title, for which services were delivered pursuant to Article 6 of Subchapter A of Chapter V of this Title subject to the maximum daily rate provided for in this section.
(b) For adult day health care programs without adequate cost experience, rates will be computed based upon annual budgeted allowable costs, as submitted by the residential health care facility and the total estimated annual number of visits by adult day health care registrants, as defined in Part 425 of this Title, for which services were delivered pursuant to Article 6 of Subchapter A of Chapter V of this Title subject to the maximum daily rate provided for in this section.
(c) Allowable costs shall include, but are not limited to, the following:
(1) applicable salary and nonsalary operating costs;
(2) cost of transportation; and
(3) appropriate portion of capital costs, allocated according to instructions accompanying the RHCF-4 report;
(i) notwithstanding any provision to the contrary, effective January 1, 2015, for leases originating prior to December 31, 2018 and being renewed beyond such date, residential health care facilities that lease property from a non-related organization in order to operate an adult day health care program consistent with this section shall receive reimbursement from the department related to the cost of such lease. In the event that there is no historic cost, the department shall reimburse such adult day health care program for the lesser of the aggregate lease costs reported to the department during calendar year 2013, or the amount actually paid to the lessor for such lease in the calendar year two years prior to the claim for reimbursement pursuant to this subdivision, provided that such reimbursement shall not exceed any applicable maximum daily rate as provided for in this section. If the lease reported for that year does not span the calendar year, the first 12 months of the lease shall constitute the amount paid for such lease in a calendar year for the calculation above;
(ii) beginning January 1, 2019, any residential health care facility that seeks to be reimbursed for costs related to newly leased property from a non-related organization in order to operate an adult day health care program consistent with this section shall, prior to entering into the lease, demonstrate to the satisfaction of the commissioner that: the adult day health care program meets a public need; such program would enable participants to remain in the community, in the least restrictive setting, and avoid institutionalization; and the leased property is the most cost effective option for the facility to operate the adult day health care program. Upon determination that the proposed or existing program satisfactorily meets each of these requirements, the commissioner may grant reimbursement for the lease payment. In the event that no historic cost is available, such adult day health care program will receive the lesser of the lease cost reported during the calendar year 2013 or the actual lease payment for the first 12 months of operation, regardless of any subsequent changes or renewals to such lease or ownership of the facility operations or the leased premises, provided that such reimbursement shall not exceed any applicable maximum daily rate as provided for in this section. If the lease reported for that year does not span the calendar year, the first 12 months of the lease shall constitute the amount paid for such lease in a calendar year for the calculation above.
(d) The maximum daily rate, excluding the allowable costs of transportation, for services provided to a registrant in a 24-hour period as described in Part 425 of this Title shall be 75 percent of the sponsoring facility's former skilled nursing facility rate in effect on January 1, 1990, with the operating component trended forward to the rate year by the sponsoring facility's trend factor.
(e) Notwithstanding subdivision (d) of this section or any other regulations to the contrary, for the period July 1, 1992 to March 31, 1993 and annual periods beginning April 1st, thereafter, the maximum daily rate, excluding the allowable costs of transportation, for services provided to a registrant in a 24-hour period as described in Part 425 of this Title shall be 65 percent of the sponsoring facility's former skilled nursing facility rate in effect on January 1, 1990 with the operating component trended forward to the rate year by the sponsoring facility's trend factor. The provisions of this subdivision shall be contingent upon extension of section 1 of chapter 41 of the Laws of 1992, or upon the enactment of permanent statutory authority.
(f) For facilities without a skilled nursing facility rate, computed in accordance with section 86-2.10 or 86-2.15 of this Subpart, in effect on January 1, 1990, a weighted average rate for each region listed in Appendix 13-A of this Title shall be used as the proxy for the facility's January 1, 1990 skilled nursing facility rate in determining the maximum daily rate for such facilities as set forth in subdivisions (d) and (e) of this section. The weighted average rate for each region shall be equal to the statewide weighted average 1990 skilled nursing facility rate with the statewide average direct component and indirect component of the rate adjusted respectively by the regional direct and indirect input price adjustment factors described in section 86-2.10 of this Subpart. The statewide weighted average rate shall be computed by multiplying each residential health care facility's 1990 skilled nursing facility rate times its 1990 skilled nursing facility patient days, summing the result statewide, and dividing by the statewide total 1990 skilled nursing facility patient days. The 1990 rate used in computing the statewide weighted average rate shall be the latest 1990 rate in effect on July 1, 1992 for the former skilled nursing level of care which is contained in the rate which has been certified by the commissioner pursuant to section 2807(3) of the Public Health Law.
(g) Effective April 1, 1994 and thereafter reimbursement for adult day health care services that are provided to registrants with acquired immune deficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) related illnesses and, effective April 1, 2017, that are provided to registrants who are otherwise considered at the discretion of the commissioner to be part of a high-need population that, regardless of their HIV status, would benefit from receiving these adult day health care services shall be established pursuant to this subdivision. The services to be provided to such registrants shall be the same as those listed in Part 759 of this Title. Reimbursement to a residential health care facility shall be established as follows:
(1) The rate of payment shall consist of a single price per visit to include the operating component, transportation, and the capital cost component of the rate. Payment shall be based upon a per visit rate of $160 with not more than one reimbursable visit per 24-hour period per registrant.
(2) To be eligible to receive reimbursement pursuant to this section, a residential health care facility must be certified by the department pursuant to Part 710 of this Title to provide adult day health care services for AIDS/HIV registrants and, effective April 1, 2017, other high-need registrants.
(3) The price established pursuant to this section shall be full reimbursement for the following:
(i) physician services, nursing services, and other related professional expenses directly incurred by the licensed residential health care facility;
(ii) administrative personnel, business office, data processing, recordkeeping, housekeeping, food services, transportation, plant operation and maintenance and other related facility overhead expenses;
(iii) all other services described in Article 6 of this Title appropriate to the level of general medical care required by the patient;
(iv) all medical supplies, immunizations, and drugs directly related to the provisions of services except for those drugs used to treat AIDS patients for which fee-for-service reimbursement is available as determined by the Department of Social Services.
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.9 Severability
If any provision of this Subpart or its application to any person or circumstance is held to be invalid, the remainder of this Subpart and the application of that provision to other persons or circumstances will not be affected.
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.23 Research
(a) All research costs shall be excluded from allowable costs in computing reimbursement rates.
(b) Research includes those studies and projects which have as their purpose the enlargement of general knowledge and understanding, are experimental in nature and hold no prospect of immediate benefit to the hospital or its patients.
10 CRR-NY 86-2.34 Affiliation changes
(a) A hospital-based residential health care facility as defined in section 86-2.10(a)(13) of this Subpart whose affiliated hospital closes its acute care beds shall notify the department within 30 days of actual complete closure of such beds. Such residential health care facility shall have its affiliation status changed to free-standing effective as of the date of actual complete closure.
(b) For purposes of establishing the allowable indirect component of the rate pursuant to section 86-2.10(d) of this Subpart, a hospital-based residential health care facility whose affiliation changes to free-standing under circumstances described in subdivision (a) of this section may apply to the department at the same time notice of closure is given pursuant to subdivision (a) of this section for a three-year phase in of its free-standing affiliation for reimbursement purposes effective the beginning of the next calendar year following actual complete closure of its acute care beds.
(1) For the rate effective January 1st of the calendar year following actual complete closure of the affiliated hospital's acute care beds, the mean indirect price per day determined pursuant to section 86-2.10(d)(4)(i) of this Subpart shall be determined by summing the product of multiplying the mean indirect price per day of the appropriate hospital-based peer group by.75 and the product of multiplying the mean indirect price per day of the appropriate free-standing peer group by.25.
(2) For the rate effective January 1st of the second calendar year following actual complete closure of the affiliated hospital's acute care beds, the mean indirect price per day determined pursuant to section 86-2.10(d)(4)(i) of this Subpart shall be determined by summing the product of multiplying the mean indirect price per day of the appropriate hospital-based peer group by.50 and the product of multiplying the mean indirect price per day of the appropriate free-standing peer group by.50.
(3) For the rate effective January 1st of the third calendar year following actual complete closure of the affiliated hospital's acute care beds, the mean indirect price per day determined pursuant to section 86-2.10(d)(4)(i) of this Subpart shall be determined by summing the product of multiplying the mean indirect price per day of the appropriate hospital-based peer group by.25 and the product of multiplying the mean indirect price per day of the appropriate free-standing peer group by.75.
(c) For purposes of establishing the factor determined pursuant to section 86-2.12(a) of this Subpart, a hospital-based residential health care facility whose affiliation changes to free-standing under circumstances described in subdivision (a) of this section and has applied for a three-year phase in of the free-standing indirect component pursuant to subdivision (b) of this section shall continue to be classified as hospital-based for a period of three calendar years following the actual complete closure of the affiliated hospital's acute care beds.
(d) A hospital-based residential health care facility whose affiliation changed to free-standing under the circumstances described in subdivision (a) of this section that fails to notify the department within 30 days from the date of actual complete closure of the acute care beds shall not be eligible for the provisions of subdivisions (b) and (c) of this section. Such facilities shall be designated free-standing, for rate calculation purposes, pursuant to this Subpart retroactive to the date of actual complete closure of the acute care beds of the affiliated hospital.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.5 Long-term inpatient rehabilitation programs for head-injured patients
The factors and methodology to be considered by the Public Health Council for determining the public need for long-term inpatient rehabilitation program beds and services for head-injured patients shall include, but not be limited to, the substantive criteria and methodology set forth in section 709.11 of this Chapter.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.2 Priority of admissions
Preference in admission shall be given to those cases most in need of the type of service the institution can provide; otherwise, so far as practicable, patients shall be admitted within priority categories established by each disability center chief. Admissions of nonresidents shall be made so as not to deny significantly postpone the admission or care at the hospital of residents of New York.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.8 Approval of plans
(a) No municipality, person, group of persons, firm, corporation, association, organization or institution shall establish or construct or physically modify a bathing beach until plans and specifications are submitted to, and receive the approval of, the permit-issuing official. All plans shall be prepared by a person licensed by the State of New York to practice engineering or architecture.
(b) Bathing beach design standards, as contained in section 6-2.19 of this Subpart, shall be the basis upon which all plans for bathing beaches are reviewed and approved.
(c) Plans for any potable water treatment or sewage treatment facilities to be constructed at a bathing beach shall be approved prior to construction by the permit-issuing official or such agency having jurisdiction for such plan approval.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.4 Circumstances entitling applicants and participants to a fair hearing
(a) The following persons shall, upon request, be entitled to a fair hearing:
(1) applicants or participants who are determined during certification procedures to be ineligible to participate in the WIC program;
(2) participants who are disqualified or terminated from the WIC program for any reason at any time after certification;
(3) applicants with a special nutritional risk condition who have not been notified of their eligibility or ineligibility for WIC program benefits within 10 days of application, and all other applicants who have not been notified within 20 days of application;
(4) persons with a special nutritional risk condition who have not been determined eligible for WIC program benefits and who have not received food instruments within 10 days of application, and all other persons determined eligible who have not received food instruments within 20 days of application; and
(5) a person aggrieved by any other adverse action affecting his/her benefits or participation in the WIC program.
(b) A person who is categorically ineligible and whose status is documented by the local agency shall not be entitled to a fair hearing.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 350 ALL PAYER DATABASE (APD)
10 CRR-NY 350.4 APD advisory group
(a) The department may establish an advisory group to provide recommendations on any or all of the following areas: submission specifications, patient privacy and confidentiality, data release, data aggregation, and security.
(b) The department may accept, reject, or amend recommendations, in whole or in part, from the advisory group.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
LOCAL HEALTH OFFICER LOCAL HEALTH OFFICER
10 CRR-NY 11.3 Conferences
As required by section 324(1)(f) of the Public Health Law, every local health officer, as defined in section 11.1 of this Part, shall, when so requested, attend conferences called by the commissioner or his authorized representative. A failure to attend, without good cause, shall be deemed just cause for removal of such local health officer pursuant to applicable provisions of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.24 Disposal of untransfused blood units
Units deemed unsuitable for transfusion, those not transfused for any reason, and those designated for disposal for any reason, shall be disposed of by an appropriate method in accordance with all applicable regulations and requirements. All expired blood components shall be transferred to a separate storage location within 24 hours of expiration. All such components shall be destroyed, discarded, or removed for non-transfusion purposes within 72 hours of expiration, or returned to the collection facility within one week of expiration.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.26 Radiology
This functional reporting center must contain all the expenses associated with the provision of diagnostic radiology services under the direction of a radiologist as required for the examination and care of patients. Additional activities include but are not limited to the following: taking and processing fluorographs and radiographs; examining and interpreting results; consulting with patients and attending physicians; disposing of radioactive waste; and storing and retrieving film and radioactive materials.
(a) Standard unit of measure: relative value units.
Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies, pages 142-155, California Medical Association, 44 Gough Street, San Francisco, CA 94103. Copies of this publication are available from the Office of Health Systems Management, Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237. Relative value units for unlisted and “BR” (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. Count “Total Unit Value,” not “PC Unit Value.”
(b) Data source.
The number of relative value units shall be the actual count maintained by the radiology department. Copies of the California Relative Value Scales can be obtained from the Office of Health Systems Management by requesting a copy of Health Facilities Memorandum No. 78-72, dated August 7, 1978.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED
10 CRR-NY 5-1.51 Maximum contaminant levels, maximum residual disinfectant levels and treatment technique requirements
(a) The maximum contaminant levels, maximum residual disinfectant levels and treatment technique requirements are listed in section 5-1.52 tables 1 through 7 of this Subpart. In the case where an MCL, MRDL or treatment technique requirement is exceeded, notwithstanding anything to the contrary contained in section 5-1.12 of this Subpart, the supplier of water will take the necessary steps to comply with this section, to ensure the protection of the public health, including the undertaking of remedial feasibility studies and the installation of a suitable treatment process. Compliance with the MCLs, MRDLs and treatment technique requirements shall be determined by the procedures contained in section 5-1.52 tables 1 through 7 of this Subpart.
(b) The minimum monitoring requirements for each contaminant are listed in section 5-1.52 tables 8A through 12 and 15A of this Subpart, except for public water systems with fewer than 15 service connections and which serve fewer than 25 persons, where monitoring will be at State discretion. For this section, State discretion shall mean requiring monitoring when the State has reason to believe an MCL, MRDL or treatment technique requirement has been violated, the potential exists for an MCL, MRDL or treatment technique violation or a contaminant may present a risk to public health.
(c) Each system shall develop and implement a monitoring plan that includes all monitoring requirements specified in this Subpart. The system shall maintain the plan and make it available for inspection by the State and the general public. After review, the State may require changes in any plan elements. Failure to monitor in accordance with the monitoring plan is a monitoring violation. Systems may only use data collected in accordance with the monitoring plan to qualify for reduced monitoring. The monitoring plan shall include at least the following elements, as applicable:
(1) specific locations and schedules for collecting samples for all applicable parameters listed in section 5-1.42, section 5-1.43, tables 8A-12, 15 and 15A of section 5-1.52, section 5-1.61, and section 5-1.81 of this Subpart;
(2) how the system will calculate compliance with MCLs, MRDLs, and treatment techniques;
(3) if the system is a consecutive system, or it is providing water to a consecutive system, and has been approved for modified monitoring under the provisions of section 5-1.76 of this Subpart, the sampling plan must reflect the entire distribution system for any analytes approved for modified monitoring;
(4) consecutive ground water systems must define and implement a protocol for notifying the system from which they receive water of any total coliform positive samples so the source can be tested for fecal contamination, unless the wholesale ground water system provides four-log virus treatment at peak flow before or at the first customer as confirmed through process compliance monitoring.
(5) Disinfection byproduct monitoring.
(i) The following requirements of this subdivision apply to community and nontransient noncommunity water systems that use or deliver water that has been treated with a primary or residual disinfectant other than ultraviolet light, provided they serve 15 or more service connections or serve 25 or more persons:
(a) if a new community or nontransient noncommunity water system begins operation, or an existing community or nontransient noncommunity water system begins using a disinfectant other than ultraviolet light, the system shall consult with the State to identify compliance monitoring locations for disinfection byproducts to include in the system’s monitoring plan, consistent with the requirements in 40 CFR 141.601 and 141.602, and for new systems that need an Initial Distribution System Evaluation (IDSE), consistent with 40 CFR 141.605; and
(b) if a community or nontransient noncommunity water system adds or removes compliance monitoring locations, the system shall identify additional locations by alternating selection of locations representing high TTHM levels and high HAA5 levels until the required number of compliance monitoring locations have been identified, as specified in section 5-1.52 table 9A. Systems shall also provide the rationale for identifying the locations as having high levels of TTHM or HAA5.
(ii) Systems shall revise monitoring plans to reflect changes in treatment, distribution system operations and layout (including new service areas), other factors that may affect TTHM or HAA5 formation or upon consultation with the State.
(a) If a system changes monitoring locations, it shall replace existing compliance monitoring locations with the lowest LRAA with new locations that reflect the current distribution system locations with expected high TTHM or HAA5 levels.
(b) The State may require modifications in the monitoring plan.
(c) Surface water or GWUDI systems serving more than 3,300 people shall submit a copy of their modified monitoring plan to the State prior to the date they are required to comply with the revised monitoring plan.
(iii) A system is in violation of the monitoring requirements for each quarter that a monitoring result would be used in calculating a LRAA if the system fails to monitor.
(d) The notification requirements for each contaminant are listed in section 5-1.52 table 13 of this Subpart.
(e) The CT values for inactivation of Giardia lamblia cysts by free chlorine at various pH and temperature levels are listed in section 5-1.52 tables 14A through 14F of this Subpart. The CT values for inactivation of Giardia lamblia cysts by chlorine dioxide and ozone at various temperature levels are listed in section 5-1.52 table 14G of this Subpart. The CT values for inactivation of Giardia lamblia cysts by chloramines at various temperature levels are listed in section 5-1.52 table 14H of this Subpart. The CT values for inactivation of Cryptosporidium by chlorine dioxide at various temperature levels are listed in section 5-1.52 table 14I of this Subpart. The CT values for inactivation of Cryptosporidium by ozone at various temperature levels are listed in section 5-1.52 table 14J of this Subpart. The UV doses for Cryptosporidium, Giardia lamblia, and virus inactivation credit are listed in section 5-1.52 table 14K of this Subpart.
(f) The alternative disinfection monitoring frequency requirements using grab samples instead of continuous chlorine concentration monitoring is listed in section 5-1.52 table 15 of this Subpart.
(g) Monitoring and reporting frequencies for specific contaminants may be established at State discretion whenever the State believes that a potential exists for an MCL or MRDL violation or a contaminant may present a risk to public health.
(h) Notwithstanding anything to the contrary in subdivision (a) of this section, the commissioner may recommend values lower than the MCL's if sufficient valid information based on commonly accepted scientific standards and principles demonstrates an increased public health concern. Within one year from the date of such recommendation, the State shall hold a public hearing regarding the justification for the lower value, and whether a new MCL is warranted.
(i) Notwithstanding anything to the contrary in section 5-1.52 table 3 of this Subpart, the commissioner may in specific cases except specific organic chemicals from the MCL's for general organic chemicals if the supplier of water can demonstrate that sufficient valid scientific information exists to show that the organic chemical does not pose an unreasonable risk to human health, the organic chemical is present at a level and under circumstances not indicative of contamination, and the cost of compliance is unreasonable in light of the risk to human health.
(j) Notwithstanding anything to the contrary in section 5-1.52 table 3 of this Subpart, the commissioner may, based on receipt and review of a justification submitted by the supplier of water, allow a higher MCL for a period of up to 60 days following application of a paint or lining to a potable water structure, if he determines that an unreasonable risk to human health does not exist.
(k) Notwithstanding anything to the contrary in section 5-1.52 table 3A of this Subpart, systems may increase residual disinfectant levels of chlorine or chloramines (but not chlorine dioxide) in the distribution system to a level and for a time necessary to protect public health, to address specific microbiological contamination problems caused by circumstances such as, but not limited to, distribution line breaks, storm run-off events, source water contamination events, or cross-connection events.
(l) A system that is installing granular activated carbon (GAC) or membrane technology to comply with the trihalomethane and haloacetic acid MCLs listed in section 5-1.52 table 3 of this Subpart may apply to the State for an extension of up to 24 months past the compliance dates for those MCLs. Systems must comply with any interim measures and schedules of compliance set by the State.
(m) Each public water system must certify annually in writing to the State that when Acrylamide and Epichlorohydrin are used in drinking water systems, the combination (or product) of dose and monomer level does not exceed the levels specified as follows:
Acrylamide = 0.05% dosed at 1 ppm (or equivalent)
Epichlorohydrin = 0.01% dosed at 20 ppm (or equivalent)
Certification can rely on manufacturers or third parties, as approved by the State.
(n) For microbiological analysis, a standard sample size of 100 milliliters shall be used.
(o) Disinfection byproduct monitoring.
The requirements of this subdivision apply to community and nontransient noncommunity water systems that use a primary or residual disinfectant other than ultraviolet light, or deliver water that has been treated with a primary or residual disinfectant other than ultraviolet light in accordance with monitoring requirements in table 9A of section 5-1.52 of this Subpart.
(1) Systems required to conduct quarterly monitoring shall calculate compliance at the end of each quarter or earlier if the LRAA calculated based on fewer than four quarters of data would cause the MCL to be exceeded regardless of the monitoring results of subsequent quarters in accordance with table 3 of section 5-1.52 of this Subpart.
(2) Systems required to conduct monitoring at a frequency that is less than quarterly shall monitor in the calendar month identified in the monitoring plan developed under subdivision (c) of this section. Compliance calculations shall be made beginning with the first compliance sample taken after the compliance date.
(p) A system implementing corrective actions to comply with the MCL for Perfluorooctanesulfonic acid (PFOS), Perfluorooctanoic acid (PFOA), and 1,4-dioxane listed in table 3 of section 5-1.52 of this Subpart may request that the State defer actions for determining MCL violations prescribed in table 3 of section 5-1.52 of this Subpart for up to 24 months past the effective date of the PFOS, PFOA or 1,4-dioxane MCL. The system shall make such requests in writing within 90 days of the effective date of such MCL. Requests shall document that a deferral period is necessary for a system to implement corrective actions to achieve compliance with the MCL for PFOS, PFOA or 1,4-dioxane and include a timeline with specific milestones for State review and approval. A public notice shall be distributed within 30 days of receiving notification from the State that a deferral has been granted. Systems operating with a deferral approved by the State shall comply with any interim monitoring, public notification or other conditions required by the State, including but not limited to a timeline for implementation of a corrective action plan. Deferrals granted under this subdivision may be renewed, upon request, for up to an additional 12 months if the system establishes to the satisfaction of the State that it is taking all practical steps to meet the corrective action plan on which the initial deferral was conditioned. Failure to meet any deferral conditions shall constitute a violation of this section and may result in immediate deferral revocation. Notice of revocation of a deferral shall will be issued in writing by the State.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH TECHNICIAN PUBLIC HEALTH TECHNICIAN
10 CRR-NY 11.121 Entry level qualifications
A public health technician must possess an associate degree from a regionally accredited or New York State-registered college or university or have completed 60 credit hours, with a minimum of 15 credit hours in the natural sciences, of which not more than six credit hours may be in the applied sciences, and have satisfactory completed a public health training course approved by the State Health Department within two years of appointment.
PUBLIC HEALTH EPIDEMIOLOGIST PUBLIC HEALTH EPIDEMIOLOGIST
10 CRR-NY 11.197 Minimum qualifications
A local public health epidemiologist must possess:
(a) a master's degree from a regionally accredited or New York State-registered college or university in epidemiology, or in public health with a concentration in epidemiology, or a health-related field with a minimum of six credits in epidemiology and six additional credits in epidemiology or biostatistics; or
(b) a bachelor's degree or higher from a regionally accredited or New York State-registered college or university and two years experience conducting data collection, analysis and reporting in support of surveillance and epidemiologic investigations; or
(c) a bachelor's degree or higher from a regionally accredited or New York State-registered college or university and one year of experience conducting data collection, analysis and reporting in support of surveillance and epidemiologic investigations and successful completion of a principles of epidemiology course for health professionals given by the Centers for Disease Control, U.S. Public Health Service.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.13 Requirements for audit committees
(a) The audit committee shall be directly responsible for the appointment, compensation and oversight of the work of any CPA (including resolution of disagreements between management and the CPA regarding financial reporting) for the purpose of preparing or issuing the audited financial report or related work pursuant to this Subpart. Every CPA shall report directly to the audit committee.
(b) Every member of the audit committee shall be a member of the board of directors, a member of the board of directors of a member of the holding MCO system or, for a United States branch of an alien MCO, a member of the audit committee of the person that controls the branch.
(c) In order to be considered independent for purposes of this section, a member of the audit committee may not, other than in the member’s capacity as a member of the audit committee, the board of directors, or any other board committee, accept any consulting, advisory or other compensatory fee from the MCO or be an affiliated person of the MCO or any subsidiary thereof, except to the extent that any law may require board participation by otherwise non-independent members, and, in such case, the member may participate in the audit committee and be designated as independent for audit committee purposes, unless the member is an officer or employee of the MCO or one of its affiliates.
(d) If a member of the audit committee ceases to be independent for reasons outside the member’s reasonable control, that person may remain an audit committee member of the responsible MCO until the earlier of the next annual meeting of the responsible MCO or one year from the occurrence of the event that caused the member to be no longer independent, provided that the MCO promptly notifies the commissioner.
(e) The MCO shall give written notice to the commissioner of the selection of its audit committee within 30 days of the effective date of this Subpart and within 30 days of any change in membership of the audit committee. The notice shall include a description of the reason for the change.
(f)
(1) The audit committee shall require the CPA that performs any audit for a MCO that is required by this Subpart to timely report to the audit committee:
(i) all significant accounting policies and material permitted practices;
(ii) all material alternative treatments of financial information within statutory accounting principles that have been discussed with management officials of the MCO, ramifications of the use of the alternative disclosures and treatments, and the treatment preferred by the CPA; and
(iii) other material written communications between the CPA and the management of the MCO, such as any management letter or schedule of unadjusted differences.
(2) If a MCO is a member of a group of MCOs, the reports required by paragraph (1) of this subdivision may be provided to the audit committee on an aggregate basis for the group, provided that any substantial differences among MCOs in the system are identified to the audit committee.
(g) The proportion of independent audit committee members for a MCO shall meet or exceed the following minimum criteria:
(1) if the MCO’s prior calendar year direct written and assumed premiums are equal to or less than $300,000,000, no members of the audit committee shall be required to be independent;
(2) if the MCO’s prior calendar year direct written and assumed premiums are greater than $300,000,000 but not more than $500,000,000, 50 percent or more of the members of the audit committee shall be independent, unless otherwise provided by law as for a MCO; or
(3) if the MCO’s prior calendar year direct written and assumed premiums are more than $500,000,000, 75 percent or more of the members of the audit committee shall be independent.
(h) This section shall not apply to:
(1) A MCO that is a SOX compliant MCO or a directly or indirectly wholly-owned subsidiary of a SOX compliant MCO.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.32 Ancillary services
Diagnostic or therapeutic services performed by specific facility departments as distinguished from general or routine patient care such as room and board. Ancillary services generally are those special services for which charges are customarily made in addition to routine charges and include such services as laboratory, radiology, surgical services, etc.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.7 Reportable levels of heavy metals in blood and urine
For purposes of section 22.6 of this Part, the following levels of heavy metals in blood and urine samples are reportable to the State Commissioner of Health:
| Metal | Sample | Reportable at or above | | --- | --- | --- | | Lead | Blood | 25 ug/dl | | Cadmium | Blood | 10 ng/ml | | | Urine | 5 ug/l | | Mercury | Blood | 5 ng/ml | | | Urine | 20 ng/ml | | Arsenic | Urine | 50 ug/l |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.7 Participant violations of the WIC program and penalties
(a) A person who applies for or is receiving WIC benefits shall be considered in violation of the WIC program if that person or any individual acting on his or her behalf:
(1) knowingly and deliberately misrepresents circumstances to obtain benefits;
(2) sells supplemental foods or food instruments to, or exchanges them with, other individuals or entities;
(3) receives from food vendors unauthorized food, cash or credit towards purchase of unauthorized food or other items of value in lieu of authorized supplemental foods;
(4) physically or verbally abuses or threatens physical abuse of State, local agency, food vendor staff or other participants;
(5) uses WIC food instruments outside of valid dates;
(6) participates in the WIC program with more than one local agency;
(7) alters the food package quantity or period of issue on the check;
(8) falsely reports food instruments lost or stolen;
(9) steals WIC food instruments;
(10) redeems WIC food instruments at non-WIC food vendors; or
(11) countersigns the check before the food price is entered on the check.
(b) When a participant or an individual acting on the participant's behalf is found in violation of the WIC program, the department or local agency shall determine what penalty, if any shall be imposed, depending on the severity of the violation. One or more of the following penalties may be imposed:
(1) a warning to discontinue the violation;
(2) disqualification for up to three months;
(3) a requirement to reimburse the State agency for the amount of food instruments which were used as described in subdivision (a) of this section; and/or
(4) other sanctions as may be defined by the department.
(c) Prior to imposition of a penalty, other than a warning, the local agency must notify the participant of the intended adverse action and the right to a fair hearing as provided in sections 60-1.2, 60-1.4 and 60-1.5 of this Subpart.
(d) The imposition of penalties pursuant to this section does not preclude any other penalties provided for under State, Federal or local law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.5 Discharge planning
The hospital administration shall implement procedures governing discharge planning as set forth in Part 405 of this Title and as also required for participation in the Medicaid program in coordination with the hospital's utilization review plan and policies governing length of stay applicable to the swing bed program in order to ensure that each patient has a planned program of continuing care that meets his or her post-discharge needs.
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.31 Living donor transplantation services
Hospitals performing living donor transplants shall comply with the requirements of this section, section 405.30 and with section 405.22(a) of this Part. In addition, the following standards apply to all living donor transplant services:
(a) Definition.
(1) Donor advocate is a person or a team responsible for ensuring that the rights and interests of the living donor and the prospective living donor are protected.
(b) Donor advocate responsibilities.
A donor advocate shall be established for any living donor transplantation program. The transplant program shall, as appropriate, consult with an ethicist, and a psychiatrist or other qualified mental health professional, as defined in section 405.30(a)(6) of this Part. The donor advocate’s primary responsibility is to support the donor, beginning with the donor evaluation process and continuing through donation, the postoperative period, and discharge, and to ensure that there are appropriate referrals for post discharge care. The advocate shall assist the donor in making informed decisions and balancing external/family pressures to donate. The advocate must evaluate the donor and make a recommendation concerning donor suitability and ensure that the needs of the donor are fulfilled promptly and in accordance with best medical practice. The advocate shall:
(1) advocate for the interests and well-being of the donor;
(2) explain the evaluation process, what to expect, what it means to be a donor;
(3) verify that such living donor is at least 18 years of age at the time of such donor’s initial evaluation related to the transplant procedure or is a parent donating to his or her child;
(4) ensure all decisions made by the donor are informed and not coerced by:
(i) evaluating whether there is monetary or property enrichment for the donor, and ensuring the donor signs an attestation as specified in paragraph (4) of this subdivision;
(ii) evaluating whether there is overt coercion to donate by family or others;
(iii) assessing the donor’s intellectual and emotional capability of participating in a balanced discussion of potential risks and benefits;
(iv) providing information to the donor about the medical, psychosocial, and financial implications of the living donation for the potential donor and about the recipient’s options for deceased donation transplant, including risks and outcomes;
(v) ensuring the donor understands that he or she may decline to donate at any time prior to his or her surgery; and
(vi) if requested by the donor, assisting the donor in the preparation of a general, medically accurate statement of unsuitability for donation.
(5) consult with the surgical team regarding donor suitability before issuing a formal recommendation;
(6) transmit donor advocate findings in writing to the surgical team. The transmittal shall include the reasons for the donor advocate’s recommendation. The final determination of donor suitability rests with the attending surgeons of the surgical team;
(7) the potential donor will be advised of the donor advocate’s recommendation. At least one attending surgeon and the donor advocate shall make themselves available to the potential donor upon his or her request to discuss the donor advocate’s recommendation; and
(8) assure there is continuity of care during hospitalization and assure that there are appropriate referrals for post-discharge care.
(c) Donor advocate requirements.
(1) Such donor advocate or, in the case of multiple members of a donor advocate team at least one member of such team, must not participate in the care of transplant recipients. The advocate’s interests shall be centered on the well-being of the living donor.
(2) The donor advocate shall not receive any direct or indirect benefit from recommending continuation of the donor’s participation.
(3) The status of the donor advocate at the transplant center may not be affected by recommending for or against donation.
(4) The donor advocate shall be medically sophisticated in transplantation and aware of relevant statistics such as center volume and outcome data, and be able to explain such information to the potential donor.
(5) The donor advocate shall have sufficient preparation in his or her role to recommend that a specific donor is or is not a candidate for living donation.
(6) The donor advocate shall have a comprehensive working knowledge of living donor transplantation.
(d) Education of the donor.
In order to ensure that the potential donor has the knowledge and capacity to exercise informed consent, the advocate shall do the following:
(1) consider the intellectual and emotional capacity of the potential donor to exercise legally and ethically adequate informed consent as described in subdivision (e) of this section;
(2) inform him or her orally and in writing about the risks and benefits of medical interventions;
(3) evaluate whether there is a thorough understanding of the elements of the decision;
(4) evaluate whether the potential donor’s decision is voluntary;
(5) inform the potential donor that the donor advocate may recommend against donation and that the advocate’s recommendation will be given significant consideration in the surgical team’s decision. The reasons for the advocate’s decision shall be explained to the donor; and
(6) advise the potential donor of the opportunity to discuss donation with others who have donated in the past and assist in making arrangements to do so, if requested by the donor.
(e) Informed consent.
A person who gives consent to be a living donor shall be competent, willing to donate, free from coercion, medically and psychosocially suitable, fully informed of the risks and benefits as a donor, fully informed of the risks, benefits and any alternative treatments available to the recipient, at least 18 years of age at the time of the donor’s initial evaluation related to the transplant procedure unless the person is a parent seeking to donate to their own child, and be likely to benefit in a way not involving the transfer of money or property in connection with the donation, other than reimbursement of donation-related expenses as allowed by law. The informed consent process must include:
(1) informed understanding:
(i) presentation of all information to the potential donor in a language or manner understandable to him or her, consistent with his or her education level;
(ii) the potential donor shall be given the opportunity and adequate time to assimilate the information provided, ask questions and have questions answered;
(iii) the donor shall identify the family and loved ones who shall be given the opportunity to discuss openly with the donor advocate and the surgical team their concerns in a safe and non-threatening environment; and
(iv) the potential donor shall be informed with regard to the need for postoperative, long-term follow-up and testing by the transplant center. The donor shall also be provided with information regarding the need and importance for long term follow-up and annual primary care.
(f) Disclosure requirements.
(1) The donation process shall be explained to the potential donor. This explanation shall address, at a minimum:
(i) donor evaluation procedure;
(ii) surgical procedure;
(iii) recuperative period;
(iv) short and long term follow-up care;
(v) alternative donation and transplant procedures;
(vi) potential psychological benefits and detriments to the donor;
(vii) transplant center and surgeon specific statistics of donor and recipient outcomes;
(viii) confidentiality of the donor’s information and decision;
(ix) donor’s ability to opt out at any point in the process up to the time of surgery; and
(x) information about how the transplant center will follow the health of the donor for at least two years post donation.
(2) The transplant team and the donor advocate shall disclose their institutional affiliations to the potential donor.
(g) Risks.
Risks shall be fully explained to the potential donor. The explanation shall include:
(1) physical:
(i) potential for surgical complications including risk of donor death;
(ii) potential for organ failure and the need for transplantation;
(iii) potential for other medical complications including long-term complications;
(iv) scars;
(v) pain;
(vi) fatigue;
(vii) abdominal and/or bowel symptoms such as bloating and nausea;
(2) psychosocial:
(i) potential for problems with body image;
(ii) possibility of recipient death;
(iii) possibility of recipient rejection and need for retransplantation;
(iv) possibility of recurrent disease in the recipient;
(v) possibility of adjustment disorder post-surgery;
(vi) possible impact on donor’s family;
(vii) possible impact on recipient’s family; and
(viii) potential impact of donation on the donor’s lifestyle.
(3) Financial:
(i) out of pocket expenses;
(ii) possible loss of employment;
(iii) potential impact on ability to obtain future employment;
(iv) potential for disability benefits and need for assistance completing relevant paperwork; and
(v) possible impact on ability to obtain health and life insurance.
(h) Documentation.
The entire disclosure and consent process, including the attestation required by section 405.30(b)(8) of this Part shall be documented in the donor’s medical record, which shall be maintained separate and distinct from the recipient’s medical record.
(i) Primary medical evaluation.
A medical evaluation of the potential donor shall be made by an appropriate medical physician. Appropriate laboratory and imaging studies shall be done. Additionally, the following shall also be assessed:
(1) compatibility of the potential donor to the recipient;
(2) general health of, and surgical risk for, the potential donor;
(3) co-morbidities and significant medical conditions that impact the potential donor’s suitability;
(4) the potential donor’s vulnerability to infection, blood loss, or delayed wound healing; and the potential donor’s personal and family medical history.
(j) Psychosocial.
(1) A psychosocial evaluation of the potential donor shall be made by the qualified mental health professional, as defined in section 405.30(a)(6) of this Title. The evaluation shall include, but not be limited to: consideration of the donor’s current and past history of: any psychiatric illness, physical abuse, sexual abuse, alcohol abuse, and substance abuse.
(2) Social services shall be provided in accordance with section 405.28 of this Part as well as any additional requirements established in this Part.
(k) Recipient criteria.
The transplant center must establish written policies and procedures governing recipient eligibility for living donation. At a minimum, such policies and procedures shall:
(1) ensure the patient meets the center’s written eligibility criteria as specified in section 405.30(b)(5) and (e) of this Part;
(2) ensure the recipient has received information regarding specific risks and benefits, alternative treatments and expected outcome of the transplantation;
(3) establish conditions which require recipient exclusion; and
(4) ensure that the benefits to both the donor and the recipient outweigh the risks before any living transplant is performed.
(l) Donor management.
(1) The donor surgeon shall have the primary responsibility for the donor’s care and welfare throughout his or her hospital stay.
(i) The donor surgeon is responsible for making the final determination regarding a donor’s suitability after reviewing and considering the donor’s medical, psychological, and social history; the donor’s current medical, psychological and social status; the recommendation of the donor advocate, all consultative reports; and the standards set forth in this subdivision.
(ii) If the donor surgeon decides to proceed with a donation after receiving an adverse recommendation from the donor advocate, the surgeon shall document the reasons for doing so in the patient’s medical record.
(m) Imaging service requirements.
Hospitals performing living donor transplantation shall have adequate imaging services and staff support appropriate to evaluate recipients and living donors. Radiologists with experience in interventional procedures (angiography) and ultrasound imaging studies in the living donor and recipient, must be available at all times including weekends and holidays. If there is an emergent complication requiring imaging services, these patients should be prioritized for access to such imaging services by the hospital.
(n) Discharge planning requirements.
The hospital shall comply with the discharge planning requirements contained in section 405.9 of this Part as well as the following:
(1) The donor advocate shall be available to the donor from pre-admission to post-discharge.
(2) A detailed, written discharge plan shall be developed, given to the donor and provided to all health care professionals involved in the donor’s care, including the donor’s primary care physician.
(3) This plan shall be reviewed with the donor by a health care professional such as a registered professional nurse, qualified social worker or transplant coordinator.
(4) The plan shall include, at a minimum, instructions on:
(i) activities;
(ii) diet;
(iii) medication for pain; and
(iv) wound care.
(5) The patient shall be provided with a 24-hour contact number that he/she can call with questions. The responder shall be available when needed and knowledgeable about living donation.
(6) Information shall include the name, address and telephone number of the surgeon and instructions for the follow-up visit.
(7) Instructions for family members or caregivers shall be provided.
(o) Post-discharge requirements.
(1) Medical follow-up shall meet generally accepted standards for someone who has undergone a major transplant procedure. This follow-up shall include:
(i) postoperative visits with the donor’s surgeon(s);
(ii) follow-up coordinated with the donor’s primary care physician to assess wound healing and to monitor for signs/symptoms of infection;
(iii) laboratory studies as appropriate; and
(iv) a written summary of the donor’s condition, which shall be provided to the donor and his or her primary care physician upon the donor’s discharge from the hospital.
(2) The hospital shall provide or arrange for follow-up social/psychological supports directly related to the donation as needed, which may include measures such as:
(i) visits with a social worker familiar with organ transplantation issues;
(ii) visits with a psychologist or psychiatrist familiar with organ transplantation issues;
(iii) participation in a professionally run support group;
(iv) participation in a center sponsored computer donor listserve or bulletin board to share patient concerns; and
(v) invitation to a donor recognition event, such as an annual recognition ceremony or presentation of a donor medal.
(3) Donors shall be informed of the option to discuss financial/insurance concerns with the transplant center’s financial coordinator.
(4) Hospitals shall report to the department such information as the department shall require to assist the department in assessing the quality of care provided; determining routine or unusual complications or outcomes, and identifying potential improvements to donor education, screening, consent, preoperative, surgical and postoperative care and follow-up. Such information shall include, but not be limited to:
(i) donor demographics;
(ii) preoperative medical and psychosocial information;
(iii) surgical information and complications;
(iv) hospital staff training and experience;
(v) recipient outcome; and
(vi) immediate and long-term postoperative care, complications, and impact on quality of life.
(5) Hospitals shall track the donor and his or her condition for at least two years post donation in accordance with the provisions set forth in section 405.30(b)(9) of this Part.
(p) Living adult donor to adult recipient liver transplantation services.
(1) Surgical team requirements:
(i) At least two liver transplant attending surgeons with experience as established in subparagraph (v) of this paragraph shall participate in the surgery of the donor. These two surgeons shall be present for the critical parts of the surgery including the live parenchymal transection. They both shall be available and scrubbed if needed for complications, however, only one surgeon need be present for the remainder of the donor operation.
(ii) A third liver transplant attending surgeon shall be present in the recipient operating room. This surgeon must have experience in deceased liver transplantation.
(iii) All three surgeons shall be board certified or board admissible in general surgery or have foreign certification determined to be equivalent by the New York State Department of Health.
(iv) All three surgeons shall have demonstrated experience in liver transplant surgery.
(v) One of the two surgeons must demonstrate experience as the primary surgeon or first assistant in 20 major hepatic surgeries (to include living donor hepatectomies or major hepatic resections), seven of which must have been live donor hepatectomies within the prior five year period. The other of the two surgeons must be either a liver transplant surgeon or hepatobiliary surgeon practicing at a transplant hospital and must have performed at least 20 major liver resections within the prior five year period. Both of the surgeons must be available during the donor hepatic resection.
(2) Anesthesia requirements:
(i) there shall be two separate attending anesthesiologists; one each for the living adult liver transplantation donor and recipient operations. These anesthesiologists shall be present for the critical anesthetic and surgical portions of the procedures and immediately available at all other times. As one case is completed, either anesthesiologist may take responsibility for the ongoing case. The anesthesiologists shall have experience in liver transplant anesthesia and/or major hepatic resection surgery and/or cardiac surgery anesthesia;
(ii) there shall be two separate anesthesia teams in two operating rooms (one for the donor, one for the recipient); and
(iii) these teams shall each be directed by a separate attending anesthesiologist for the living donor and the recipient procedure. In addition to the attending anesthesiologist who shall be present as specified in subparagraph (i) of this paragraph, at least one member of the anesthesia team who is an anesthesiologist, chief resident, fellow (postgraduate year 3, 4, or 5), or qualified certified registered nurse anesthetist shall be present and responsible, under the direction of the attending anesthesiologist, for the evaluation and care of the patient through all phases of the procedure pertaining to the administration of, and recovery from, anesthesia. All team members shall have ongoing education and training in liver and/or cardiac surgery and have had anesthesia responsibility for major liver resections.
(3) Postoperative care requirements. Donors shall receive postoperative care consistent with the following:
(i) day 0-1. Living adult liver donors shall receive intensive care (ICU or PACU) for at least 24 hours, at a minimum;
(ii) day 2. If stable and cleared for transfer by the transplant team after the first 24 hour period, donors shall be cared for in a hospital unit that is dedicated to the care of transplant recipients or a hospital unit in which patients who undergo major hepatobiliary resectional surgery are cared for. Living liver donors may be cared for on another unit if a specific medical condition of the donor warrants such a transfer and the transfer is documented in the donor’s medical record;
(iii) the donor shall be evaluated at least daily by one of the qualified liver transplant attending physicians with documentation in the medical record;
(iv) the transplant team shall be responsible for the pain management of the donor. In institutions where a pain management team is available, the transplant team may delegate its responsibility to this team. However, there shall be a written protocol in place for assessment and management of donor pain;
(v) the patient care staff shall be familiar with the common complications associated with the donor and recipient operations and have appropriate monitoring in place to detect these problems should they arise; and
(vi) if there is an emergent complication requiring reoperation, these patients shall be prioritized by the hospital for access to the operating room by the institution.
(4) Minimum Medical Staffing Requirements.
(i) There shall be 24-hour, seven day-a-week continuous coverage of the transplant service by general surgery residents at the postgraduate year two level or higher, transplant fellows, nurse practitioners or physician assistants. Between the hours of 6 p.m. and 8 a.m. on weekdays and at all times on the weekends and holidays, the covering residents, fellows, nurse practitioners, or physician assistants should be dedicated to the transplant service and not covering other surgical or nonsurgical patients. An attending transplant surgeon shall be available immediately as a resource for the residents, fellows, nurse practitioners or physician assistants at all times.
(ii) Any patient with abnormal vital signs or unusual symptoms shall be evaluated immediately. Notification to the appropriate senior medical staff member (fellow, chief resident, attending) shall be made in accordance with written hospital policy and procedures and in no case no more than 30 minutes after abnormal vital signs or unusual symptoms were first observed.
(5) Nursing minimum staffing requirements.
(i) Nursing staff shall have ongoing education and training in live donor liver transplantation nursing care (donor and recipient). This shall include education in the pain management issues particular to the donor. The registered professional nursing ratio shall be at least one registered professional nurse for every two patients (1:2) in the ICU/PACU level setting, increased as appropriate for the acuity level of the patients.
(ii) After the donor is transferred from the ICU/PACU, the registered professional nursing ratio shall be at least 1:4 on all shifts, increased as appropriate for the acuity level of the patients.
(iii) The same registered professional nurse shall not take care of both the donor and the recipient.
(iv) The nursing service shall verify that the potential donor received appropriate pre-surgical information.
(v) The names and contact numbers of the transplant team shall be posted on all units receiving transplant donors.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.19 Ambulatory services expenses description
[3260]
(a) 6710
EMERGENCY SERVICES
6711
Emergency Room
6712
Observation
6719
Other Emergency Services
(1) Function. Emergency Services provides emergency treatment to the ill and injured who require immediate medical or surgical care on an unscheduled basis. Additional activities include, but are not limited to, the following: Comforting patients; maintaining aseptic conditions; assisting physicians in performance of emergency care; monitoring of vital life signs; applying or assisting physician in applying bandages; coordinating the scheduling of patient through required professional service functions; administering specified medications; and infusing fluids, including I.V.'s and blood.
(2) Description. This cost center contains the direct expenses incurred in providing emergency treatment to the ill and injured. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of visits. A visit is each registration of a patient in the emergency services unit of the hospital. Multiple services performed in the emergency services unit during a single registration ( e.g., encounters with two or more physicians, two or more occasions of service, any combination of one or more encounters and occasions of service) are recorded as one visit. Services provided to emergency patients in ancillary cost centers are not included here, but are included in the applicable ancillary cost center.
(4) Data source. The number of visits shall be the actual count maintained by Emergency Services.
(b) 6720 CLINIC SERVICES
(1) Function. Clinics provide organized diagnostic, preventive, curative, rehabilitative and educational services on a scheduled basis to ambulatory patients. The cost of therapy services such as physical therapy, speech-language pathology, occupational therapy and respiratory therapy must be reported in the appropriate ancillary cost centers. Additional activities include, but are not limited to, the following:
Participating in community activities designed to promote health education; assisting in administration of physical examinations and diagnosing and treating ambulatory patients having illnesses which respond quickly to treatment; referring patients who require prolonged or specialized care to appropriate other services; assigning patients to doctors in accordance with clinic rules; assisting and guiding volunteers in their duties; making patients' appointments through required professional service functions.
(2) Description. These cost centers contain the direct expenses incurred in providing clinic services to ambulatory patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of visits. A visit is each registration of a patient in a formally organized clinic of the hospital. Multiple services performed in the clinical unit during a single registration ( e.g., encounters with two or more physicians, two or more occasions of service, any combination of one or more encounters and occasions of service) are recorded as one visit. Visits made by clinic patients to ancillary cost centers are not included here but are accumulated in the appropriate ancillary cost center.
(4) Data source. The number of visits shall be the actual count maintained by the formally organized clinic within the hospital.
(c) 6810
HOME PROGRAM DIALYSIS EQUIPMENT—100%
(1) Function.
This cost center provides medically necessary dialysis equipment for dialysis patients capable of administering their own treatment in their homes. The cost center provides, obtains, or arranges for the provision of:
(i) artificial kidney and automated peritoneal dialysis machines, including supportive equipment such as blood pumps, heparin pumps, bubble detectors and other alarm systems. (Supportive equipment does not include items not used in conjunction with delivery systems, such as scales, blood pressure apparatus and other diagnostic devices);
(ii) dialysis equipment installation, maintenance and repair; and
(iii) dialysis equipment reconditioning for subsequent use.
Hospitals so electing will be reimbursed by the Medicare program 100 percent of the reasonable costs incurred by the provision of such home dialysis equipment. Additional activities include, but are not limited to, the following: Water testing; making minor plumbing and electrical changes to accommodate the equipment; delivering the equipment; replacing water filters on reverse osmosis devices; providing minor parts to the patient for patient-performed maintenance; transporting equipment for installation and reconditioning.
(2) Description. This cost center contains the direct expenses incurred in providing dialysis equipment, for patients dialyzing at home, for which the hospital will be reimbursed 100 percent of the reasonable cost. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. As an exception to the requirement to report all equipment maintenance expense in the Plant Operations and Maintenance cost center, dialysis equipment maintenance expense must be reported in this cost center.
(3) Standard Unit of Measure: number of patient months. Count as one, each month or major portion thereof, each home dialysis patient who is in the 100 percent reimbursement home dialysis program.
(4) Data source. Departmental records.
(5) Effective date. Reporting periods beginning in 1980 and thereafter.
(d) 6820
HOME PROGRAM DIALYSIS—OTHER
(1) Function. The Home Program Dialysis—Other cost center provides home dialysis support services for dialysis patients capable of administering their own treatment in their home. This program obtains or arranges for the provision of:
(i) medically necessary dialysis equipment as prescribed by the attending physician;
(ii) dialysis equipment installation, maintenance and repair services;
(iii) all necessary medical supplies; and
(iv) the services of trained home dialysis aides, where necessary. Additional activities include, but are not limited to, the following: Periodic monitoring of patient's home adaption to self-dialysis in accordance with patient care plans; home visits by qualified provider personnel; testing and appropriate treatment of water.
(2) Description. This cost center contains the direct expenses incurred in providing home program dialysis services to self-care home dialysis patients other than such expenses included in account 6810, Home Program Dialysis Equipment—100%. As an exception to the requirement to report all patient-chargeable supplies in the Medical Supplies Sold cost center (account 7110), home program dialysis patient-chargeable supplies are to be included in this cost center.
(3) Standard Unit of Measure: number of patient months. Count as one, each month or major portion thereof, each home dialysis patient who is in the home dialysis program. These patients are those not in the 100 percent reimbursement home dialysis program.
(4) Data source. Departmental records.
(5) Effective date. Reporting periods beginning in 1980 and thereafter.
(e) 6830 AMBULATORY SURGERY SERVICES
(1) Function. Ambulatory Surgery Services are those surgical services provided to outpatients in a discrete outpatient surgical suite by specially trained nursing personnel who assist physicians in the performance of surgical and related procedures both during and immediately following surgery. Additional activities include, but are not limited to, the following:
Comforting patients in the operating room; maintaining aseptic techniques; scheduling operations in conjunction with surgeons; assisting surgeon during operations; preparing for operations; cleaning up after operations to the extent of preparation for pickup and disposal of used linen, gloves, instruments, utensils, equipment and waste; arranging sterile setup for operation; assisting in preparing patients for surgery; inspecting, testing and maintaining special equipment related to this function; preparing patient for transportation to recovery room; counting sponges, needles and instruments used during operation; enforcing safety rules and standards; monitoring patient while recovering from anesthesia.
(2) Description. This cost center contains the direct expenses associated with a separately identifiable outpatient surgery room. When a common operating room is used for both inpatients and outpatients, the direct costs for both must be accumulated in the “Operating Room” (account 7040). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of surgery minutes. Surgery minutes are the difference between starting time and ending time, defined as follows:
Starting time is the beginning of anesthesia administered in the room in which the procedure is to be performed (or surgery if anesthesia is not administered or if anesthesia is administered in other than the operating room). Ending time is the end of surgery.
(4) Data source. The number of surgery minutes shall be an actual count obtained from the surgery room operating log.
(f) 6840 PSYCHIATRIC DAY AND NIGHT CARE SERVICES
(1) Function. The Psychiatric Day and Night Care Services provides intermittent care to patients, either during the day with the patient returning to his home each night, or during the evening and night hours with the patient performing his usual daytime functions.
(2) Description. This cost center contains all the direct expenses of maintaining Psychiatric Day and Night Care Services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of visits. A visit is each registration of a patient in a formally organized Psychiatric Day and Night Care unit of the hospital. Multiple services performed in the Psychiatric Day and Night Care unit during a single registration ( e.g., encounters with two or more physicians, two or more occasions of service, any combination of one or more encounters and occasions of service) are recorded as one visit.
(4) Data source. The number of visits shall be the actual count maintained by the Psychiatric Day and Night Care Services unit.
(g) 6850 AMBULANCE SERVICES
(1) Function. This cost center provides ambulance service to the ill and injured who require medical attention on a scheduled and an unscheduled basis. Additional activities include, but are not limited to, the following:
Lifting and placing patient into and out of an ambulance; transporting patients to and from the hospital; first aid treatment administered by a physician or paramedic prior to arrival at the hospital.
(2) Description. The cost center contains the direct expenses incurred in providing ambulance service to the ill and injured. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of occasions of service. Ambulance service provided a patient is counted as one occasion of service regardless of special services rendered at the point of pickup or during transport. For example, the administration of oxygen and first aid during the pickup and delivery of the patient would not be counted as a separate occasion of service.
(4) Data source. The number of occasions of service shall be the actual count maintained by Ambulance Services.
(h) 6860 OTHER AMBULATORY SERVICES
(1) Description. This cost center contains the direct expenses incurred in maintaining ambulatory services not specifically required to be included in Emergency Services, Clinic Services, Home Program Dialysis, Ambulatory Surgery Services, Psychiatric Day and Night Care Services, Ambulance Services, Free Standing Clinics Services, or Home Health Services cost centers. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(2) Standard Unit of Measure: none required. Not applicable.
(i) 6870
FREE STANDING CLINIC I
6880
FREE STANDING CLINIC II
6890
FREE STANDING CLINIC III
(1) General. Three zero level accounts have been established for this function to provide for the reporting of up to three discrete Free Standing Clinics. The designations I, II and III do not indicate the level of care. The function, description, standard unit of measure and date source below apply to each Free Standing Clinic.
(2) Function. Free Standing Clinics provide organized diagnostic, preventive, curative, rehabilitative and educational services on a scheduled basis to ambulatory patients at locations other than on the hospital grounds. The cost of therapy services such as physical therapy, speech-language pathology, occupational therapy and respiratory therapy must be reported in the appropriate ancillary cost centers. Additional activities include, but are not limited to, the following:
Participating in community neighborhood activities designed to promote health education; assisting in administration of physical examinations and diagnosing and treating ambulatory patients having illnesses which respond quickly to treatment; referring patients who require prolonged or specialized care to appropriate other services; assigning patients to doctors in accordance with clinic rules; assisting and guiding volunteers in their duties; making patients' appointments through required professional service functions.
(3) Description. This cost center contains the direct expenses incurred in providing clinic services to ambulatory patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other expenses, and transfers.
(4) Standard Unit of Measure: number of visits. A visit is each registration of a patient in a free standing clinic of the hospital. Multiple services performed in a free standing clinic during a single registration ( e.g., encounters with two or more physicians, two or more occasions of service, any combination of one or more encounters and occasions of service) are recorded as one visit.
(5) Data source. The number of visits shall be the actual count maintained by the free standing clinics.
(6) Effective date. The reporting of Free Standing Clinic II (account 6880) and Free Standing Clinic III (account 6890) is optional for cost reporting periods beginning in 1980. For cost reporting periods beginning in 1981 and thereafter, reporting these cost centers separately is required.
(j) 6910 HOME HEALTH—SKILLED NURSING CARE
(1) Function. Home Health—Skilled Nursing Care is part-time or intermittent nursing care provided by or under the direct supervision of a licensed nurse (R.N., L.P.N. or L.V.N.) to patients in their residence on the basis of physician's orders and an approved plan of care established and periodically reviewed by the physician. It consists of care in which the patients require convalescent and/or major restorative services at a level less intensive than institutional requirements. Activities include, but are not limited to, the following: Administration of parentera1 medication ( e.g., intravenous and intramuscular injections or insertion of catheter); changing of dressings and cleansing of wounds; irrigations; enemas; colostomy care; urethral catheter care; administration of oxygen and certain drugs through inhalation of positive pressure; vital signs; observing and recording psychiatric symptoms.
(2) Description. This cost center contains the direct expenses incurred in the provision of skilled nursing care to patients normally at their place of residence. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses.
(3) Standard Unit of Measure: number of home visits. A home visit is a personal contact in the place of residence of a patient made for the purpose of providing a service by a member of the staff of the home health agency or by others under contract or arrangement with the home health agency. Visits by therapists are not included here but in the appropriate ancillary cost center. If a visit is made simultaneously by two or more persons from the home health agency to provide a single service, for which one person supervises or instructs the other, it is counted as one visit (see Example 1). If one person visits the patient's home more than once during a day to provide services, each visit is recorded as a separate visit (see Example 2). If a visit is made by two or more persons from the home health agency for the purpose of providing separate and distinct types of services, each is recorded— i.e., two or more visits (see Example 3).
(i) Example 1. If two nurses visit the patient together to provide nursing services and one is there to supervise the other, one visit is counted.
(ii) Example 2. If a nurse visits the patient in the morning to dress a wound and later must return to replace a catheter, two visits are counted. However, if the nurse visits the patient in the morning to dress a wound and to replace a catheter, one visit is counted.
(iii) Example 3. If a nurse visits the patient to replace a catheter and at the same time the patient is visited by a home health aide to provide home health aide services, two visits are counted.
(4) Data source. Departmental records.
(5) Effective date. Reporting periods beginning in 1980 and thereafter.
(k) 6920 HOME HEALTH SERVICES—MEDICAL SOCIAL SERVICES
(1) Function. Home Health—Medical Social Services is the provision of counseling and assessment activities which contribute meaningfully to the treatment of a patient's condition. These services must be under the direction of a physician and must be given by or under the supervision of a qualified medical or psychiatric social worker. Such services include, but are not limited to, the following: assessment of the social and emotional factors related to the patient's illness, his need for care; his response to treatment and his adjustment to care; appropriate action to obtain casework services to assist in resolving problems in these areas; assessment of the relationship of the patient's medical and nursing requirements to his home situation, his financial resources, and the community resources available to him.
(2) Description. This cost center contains the direct expenses incurred in the provision of Medical Social Services within the context of Home Health Care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses.
(3) Standard Unit of Measure: number of home visits. A home visit is a personal contact in the place of residence of a patient made for the purpose of providing a service by a member of the staff of the home health agency or by others under contract or arrangement with the home health agency. Visits by therapists are not included here but in the appropriate ancillary cost center. If visit is made simultaneously by two or more persons from the home health agency to provide a single service, for which one person supervises or instructs the other, it is counted as one visit (see Example 1). If one person visits the patient's home more than once during a day to provide services, each visit is recorded as a separate visit (see Example 2). If a visit is made by two or more persons from the home health agency for the purpose of providing separate and distinct types of services, each is recorded— i.e., two or more visits (see Example 3).
(i) Example 1. If two nurses visit the patient together to provide nursing services and one is there to supervise the other, one visit is counted.
(ii) Example 2. If a nurse visits the patient in the morning to dress a wound and later must return to replace a catheter, two visits are counted. However, if the nurse visits the patient in the morning to dress a wound and to replace a catheter, one visit is counted.
(iii) Example 3. If a nurse visits the patient to replace a catheter and at the same time the patient is visited by a home health aide to provide home health aide services, two visits are counted.
(4) Data source. Departmental records.
(5) Effective date. Reporting periods beginning in 1980 and thereafter.
(l) 6930 HOME HEALTH SERVICES—HOME HEALTH AIDES
(1) Function. Home Health Aides Services is the provision of personal care services under the supervision of a registered professional nurse and, if appropriate, a physical, speech or occupational therapist or other qualified person. This function is performed by specially trained personnel who assist individuals in carrying out physicians' instructions and established plans of care. Additional services include, but are not limited to, the following: assisting the patient with activities of daily living (helping to bathe, to get in and out of bed, to care for hair and teeth, to exercise, to take medications specially ordered by a physician which are ordinarily self-administered); assisting the patient with necessary self-help skills.
(2) Description. This cost center contains the direct expenses incurred in the provision of Home Health Aide services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses.
(3) Standard Unit of Measure: number of home visits. A home visit is a personal contact in the place of residence of a patient made for the purpose of providing a service by a member of the staff of the home health agency or by others under contract or arrangement with the home health agency. Visits by therapists are not included here but in the appropriate ancillary cost center. If visit is made simultaneously by two or more persons from the home health agency to provide a single service, for which one person supervises or instructs the other, it is counted as one visit (see Example 1). If one person visits the patient's home more than once during a day to provide services, each visit is recorded as a separate visit (see Example 2). If a visit is made by two or more persons from the home health agency for the purpose of providing separate and distinct types of services, each is recorded— i.e., two or more visits (see Example 3).
(i) Example 1. If two nurses visit the patient together to provide nursing services and one is there to supervise the other, one visit is counted.
(ii) Example 2. If a nurse visits the patient in the morning to dress a wound and later must return to replace a catheter, two visits are counted. However, if the nurse visits the patient in the morning to dress a wound and to replace a catheter, one visit is counted.
(iii) Example 3. If a nurse visits the patient to replace a catheter and at the same time the patient is visited by a home health aide to provide home health aide services, two visits are counted.
(4) Data source. Departmental records.
(5) Effective date. Reporting periods beginning in 1980 and thereafter.
(m) 6990 HOME HEALTH SERVICES—OTHER HOME HEALTH
(1) Description. This cost center is used to report home health patient care services not specifically required to be reported in Home Health—Skilled Nursing Care (account 6910), Home Health—Medical Social Services (account 6920) and Home Health Aides (account 6930). Such services include nutritional services, homemaker services and private duty nursing. The cost of therapy services such as physical therapy, speech-language pathology, occupational therapy and respiratory therapy must be reported in the appropriate ancillary cost centers. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses.
(2) Standard Unit of Measure: number of home visits. A home visit is a personal contact in the place of residence of a patient made for the purpose of providing a service by a member of the staff of the home health agency or by others under contract or arrangement with the home health agency. Visits by therapists are not included here but in the appropriate ancillary cost center. If visit is made simultaneously by two or more persons from the home health agency to provide a single service, for which one person supervises or instructs the other, it is counted as one visit (see Example 1). If one person visits the patient's home more than once during a day to provide services, each visit is recorded as a separate visit (see Example 2). If a visit is made by two or more persons from the home health agency for the purpose of providing separate and distinct types of services, each is recorded— i.e., two or more visits (see Example 3).
(i) Example 1. If two nurses visit the patient together to provide nursing services and one is there to supervise the other, one visit is counted.
(ii) Example 2. If a nurse visits the patient in the morning to dress a wound and later must return to replace a catheter, two visits are counted. However, if the nurse visits the patient in the morning to dress a wound and to replace a catheter, one visit is counted.
(iii) Example 3. If a nurse visits the patient to replace a catheter and at the same time the patient is visited by a home health aide to provide home health aide services, two visits are counted.
(3) Data source. Departmental records.
(4) Effective date. Reporting periods beginning in 1980 and thereafter.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.40 Limitation on State aid
(a) State aid may be limited, in whole in or part, if the commissioner determines, upon review of a local health department’s State aid application, that the local health department will not deliver a core public health service required by Subpart 40-2 of this Part. In that event, the commissioner may use the proportionate share that is not granted to the local health department to contract with agencies, associations, or organizations to provide such services, or expend such share to provide such services upon approval of the Director of the Division of Budget, as authorized by section 605 of the Public Health Law.
(b) Partial service counties . The commissioner may approve a State aid application that seeks funding for fewer than all core public health services required pursuant to Subpart 40-2 of this Part, provided that:
(1) a community health assessment is completed by the municipality pursuant to section 40-2.40 of this Part;
(2) the selected core services meet all standards for those services set forth in this Part; and
(3) the State aid application identifies the availability of core public health services not provided by the local health department, who will provide those services and the manner in which the services will be provided and financed.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.148 Funds held in trust by others
Funds held and administered, at the direction of the donor, by an outside trustee for the benefit of an institution or institutions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.37 Readmissions
(a) For discharges occurring on and after July 1, 2010, Medicaid rates of payment to hospitals that have an excess number of readmissions as defined in accordance with the criteria set forth in subdivision (c) of this section, as determined by a risk adjusted comparison of the actual and expected number of readmissions in a hospital as described by subdivision (d) of this section, shall be reduced in accordance with subdivision (e) of this section.
(b) Definitions.
For purposes applicable to this section the following terms shall be defined as follows:
(1) Potentially preventable readmission (PPR) shall mean a readmission to a hospital that follows a prior discharge from a hospital within 14 days, and that is clinically-related to the prior hospital admission.
(2) Hospital shall mean a general hospital as defined pursuant to section 2801 of the Public Health Law.
(3) Observed rate of readmission shall mean the number of admissions in each hospital that were actually followed by at least one PPR divided by the total number of admissions.
(4) Expected rate of readmission shall mean a risk adjusted rate for each hospital that accounts for the severity of illness, APR-DRG, and age of patients at the time of discharge preceding the readmission.
(5) Excess rate of readmission shall mean the difference between the observed rates of potentially preventable readmissions and the expected rate of potentially preventable readmissions for each hospital.
(6) Behavioral health shall mean an admission that includes a primary or secondary diagnosis of a major mental health related condition, including, but not limited to, chemical dependency and substance abuse.
(7) Managed care encounter data shall mean claims-like data that describes services provided by managed care plans to their enrollees.
(c) Readmission criteria.
(1) A readmission is a return hospitalization following a prior discharge that meets all of the following criteria:
(i) The readmission could reasonably have been prevented by the provision of appropriate care consistent with accepted standards in the prior discharge or during the post discharge follow-up period.
(ii) The readmission is for a condition or procedure related to the care during the prior discharge or the care during the period immediately following the prior discharge and including, but not limited to:
(a) The same or closely related condition or procedure as the prior discharge.
(b) An infection or other complication of care.
(c) A condition or procedure indicative of a failed surgical intervention.
(d) An acute decompensation of a coexisting chronic disease.
(iii) The readmission is back to the same or to any other hospital.
(2) Readmissions, for the purposes of determining PPRs, excludes the following circumstances:
(i) The original discharge was a patient initiated discharge and was against medical advice (AMA) and the circumstances of such discharge and readmission are documented in the patient's medical record.
(ii) The original discharge was for the purpose of securing treatment of a major or metastatic malignancy, multiple trauma, burns, neonatal and obstetrical admissions.
(iii) The readmission was a planned readmission or one that occurred on or after 15 days following an initial admission.
(iv) For readmissions occurring during the period up through March 31, 2012, the readmission involves an original discharge determined to be behavioral health related.
(d) Methodology.
(1) Rate adjustments for each hospital shall be based on such hospital's 2007 Medicaid paid claims data and managed care encounter data for discharges that occurred between January 1, 2007 and December 31, 2007.
(2) The expected rate of readmissions shall be reduced by 24 percent for each hospital for periods prior to September 30, 2010; 38.5 percent for the period October 1, 2010 through December 31, 2010; and 33.3 percent on and after January 1, 2011.
(3) Excess readmission rates are calculated based on the difference between the observed rate of PPRs and the expected rate of PPRs for each hospital.
(4) In the event the observed rate of PPRs for a hospital is lower than the expected rate of PPRs, the excess number of readmissions shall be set at zero.
(e) Payment calculation.
(1) For the excess readmissions identified in paragraph (d)(3) of this section, each hospital's projected payment rate for the 2010 rate period, as otherwise computed in accordance with this Subpart, will be used to compute the relative aggregate payments, excluding behavioral health, associated with the risk adjusted excess readmissions in each hospital.
(2) For each hospital, a hospital specific readmission adjustment factor shall be computed as one minus the ratio of the hospital's relative aggregate payments associated with the excess readmissions from paragraph (d)(3) of this section and the hospital's relative aggregate payments for all non-behavioral health Medicaid discharges as determined pursuant to this subdivision.
(3) Non-behavioral health related payments to hospitals shall be reduced by applying the hospital readmission adjustment factor from paragraph (2) of this subdivision to the applicable case payment or per-diem payment amount for all non-behavioral health related Medicaid discharges to the hospital.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.47 Boarder baby
(a) A baby receiving lodging in the institution and who is not an institution patient.
(b) A newborn infant whose mother is discharged but the newborn does not occupy a patient bed but is retained in the nursery.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.39 Computation of basic rates for methadone maintenance treatment services provided by free-standing ambulatory care facilities and hospital outpatient clinic services
(a) For payments made pursuant to this section and pursuant to section 86-1.11(h)(5) of this Part, for methadone maintenance treatment services reimbursement shall be based upon a fixed weekly payment per recipient.
(b) To be eligible to receive reimbursement pursuant to this section, facilities must have an operating certificate issued pursuant to Part 401 of this Title, and be certified to provide outpatient methadone maintenance treatment services.
(c) The clinic services which shall be provided to be eligible for reimbursement according to the price as established by this section includes: urinalysis drug testing, dispensing of methadone, medical supervision and arranging for appropriate laboratory tests for the initial and annual physical examinations, preparation and monitoring of treatment plans, maintenance of patient medical histories, prescribing methadone dosage, counseling as prescribed in the patients' individual treatment plan, and maintenance of records.
(d) The weekly price established pursuant to this section shall be reimbursement for the following, as required by New York State Office of Alcoholism and Substance Abuse Services in 10 NYCRR Part 1040:
(1) physician services, nursing services, therapist services, technician services, nutrition services, health education services, psychosocial services, care coordination services and other related professional expenses directly incurred by the licensed facility;
(2) space occupancy and plant overhead costs;
(3) all ancillary procedures directly related to the provision of services with the exception of laboratory and diagnostic tests other than urinalysis testing;
(4) all medical supplies and drugs directly related to the provision of services; and
(5) administrative personnel, business office, data processing recordkeeping, housekeeping, and other related facility overhead expenses.
(e) The methadone maintenance treatment service weekly price shall be established using 1986 cost and statistical data for the factors listed in subdivision (d) of this section reported by diagnostic and treatment centers and hospital-based outpatient programs. Weekly visit utilization shall be based upon the average daily census information compiled by the New York State Office of Alcoholism and Substance Abuse Services. The price shall be trended forward in accordance with subdivision (f) of this section in a manner consistent with the rate period of the facility's other basic services. After the price has been trended forward, the price shall be increased by adding the product of the estimated statewide number of urinalysis tests per week per patient multiplied by the current Medicaid reimbursement fee for urinalysis toxicology screening.
(f) The commissioner shall establish trend factors to project increases in the price during the effective period of the reimbursement rates. The trend factors shall be developed using available price indices including elements of the United States Department of Labor consumer and producer price indices and special price indices developed by the commissioner for this purpose. The projected trend factors shall be updated on an annual basis, based upon current and available data.
(g) The commissioner, in consultation with the New York State Office of Alcoholism and Substance Abuse Services, may add or delete health services from the methadone maintenance treatment services contained in subdivision (c) of this section, if the commissioner finds that the inclusion or deletion of such services is appropriate based upon commonly accepted medical standards, current scientific or medical literature, or the results of properly conducted medical or scientific research. The commissioner shall notify participating providers of such changes at least 60 days before such changes shall be effective.
(h) When such an addition or deletion is made pursuant to subdivision (g) of this section, the price established pursuant to subdivision (e) of this section shall be adjusted based upon an estimate of the costs of such added or deleted services efficiently and economically provided by general hospitals or diagnostic and treatment services.
(i) For financial reporting purposes and statistical reporting purposes, facilities which provide services pursuant to subdivision (c) of this section must comply as appropriate with the standards established for said reporting in section 86-1.3 or 86-4.3 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.9 Responsibilities of providers; required notifications
(a) Recordkeeping.
(1) Each provider shall establish, maintain, and keep current, a record of:
(i) a roster of current employees who were reviewed pursuant to this Part and a list of their staffing assignments; such roster shall be submitted by April 1st of each year or upon written request of the department in a form and format specified by the commissioner;
(ii) the names of each person for whom a request for a criminal history information was submitted to the department;
(iii) for each such name recorded pursuant to subparagraph (ii) of this paragraph, a copy of the signed informed consent form required pursuant to section 402.5 of this Part;
(iv) for each such name recorded pursuant to subparagraph (ii) of this paragraph, the results of the criminal history record check and determination of the department with regard to the employment;
(v) for certified home health care agencies, licensed home care services agencies or long term home health care programs licensed or certified under article 36 of the Public Health Law, the onsite supervision and alternate week contacts made for assessment of temporary employees as set forth in section 402.4(b)(2)(ii) of this Title;
(vi) for adult homes, enriched housing programs, and residences for adults licensed under article 7 of the Social Services Law, the onsite supervision of temporary employees as set forth in section 402.4(b)(2)(iv) of this Part; and
(vii) for hospice programs certified under article 40 of the Public Health Law, the onsite supervision and alternate week contacts made for assessment of temporary employees as set forth in section 402.4(b)(2)(v) of this Part.
(2) Such record shall be maintained in a manner that ensures the security of the information contained therein, but which also assures the department of immediate and unrestricted access to such information upon its request, for the purpose of monitoring compliance with this Part.
(b) Notifications.
A provider must immediately, but within no later than 30 calendar days after the event, notify the department, and document such notification occurred, when:
(1) any prospective employee who is subject to a criminal history record check in accordance with this Part withdraws an application for employment or is no longer being considered as a prospective employee as defined in this Part; or
(2) any employee who was subject to, and underwent, a criminal history record check in accordance with this Part is no longer employed by the provider; or
(3) any employee once subject to, and underwent, a criminal history record check in accordance with this Part but is no longer working in a position defined in section 402.3(i) of this Part for the provider.
(c) Retention and disposal of information.
(1) Each provider subject to the provisions of this Part shall maintain information necessary to demonstrate compliance with this Part, as set forth in subdivision (a) of this section, for at least six years after the person ceases to be a subject individual, unless otherwise directed by the department.
(2) If directed to do so by the department, a provider subject to this Part shall dispose of the summary of the criminal history information and/or any other information related to criminal history record checks in accordance with such direction.
(3) Disposal of the criminal history information and records of department determinations shall be performed in a manner that ensures the confidentiality of the information.
(d) Policies and procedures.
Each provider subject to the provisions of this Part shall have policies and procedures designed to implement the provisions of this Part. Amendment of existing personnel policies and procedures to reflect these new requirements is sufficient compliance with this subdivision.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.11 Reporting cases of communicable disease diagnosed after death
If a pathologist, coroner, medical examiner, or other person determines from examination of a corpse or from history of the events leading to death that at the time of death this individual apparently was affected with a communicable disease, he/she shall report the case within 24 hours to the proper health authority according to the manner indicated in section 2.10 of this Part as if the diagnosis had been established prior to death.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.11 Food and nutrition services
The operator must:
(a) provide nutritional services for each registrant;
(b) provide meals and nutritional supplements, including modified diets when medically prescribed, to registrants who are on the premises at scheduled meal times and, where appropriate, to registrants in their homes in accordance with the identified needs included in registrant care plans;
(c) ensure that the quality and quantity of food and nutrition services provided to registrants are in conformance with section 415.14 of this Subchapter, exclusive of the requirements specified in section 415.14(f);
(d) ensure that nutrition services are under the direction of a qualified dietitian, as defined in section 415.14 of this Subchapter; and
(e) ensure that dietary service records for the adult day health care service are maintained in conformance with section 415.14(c)(1) and (2) of this Subchapter.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.4 Certification of external appeal agents
(a) External appeal agents shall be certified jointly by the commissioner and superintendent pursuant to section 4912 of the Public Health Law, section 4912 of the Insurance Law and the following:
(1) the applicant has demonstrated to the satisfaction of the commissioner and the superintendent that it has access to a pool of clinical peer reviewers sufficient to reasonably assure that appropriately qualified reviewers will be available on a timely basis for all appeals allowed by section 4910 of the Public Health Law and section 4910 of the Insurance Law and to avoid or minimize conflicts of interest pursuant to section 98-2.6 of this Subpart; and
(2) the applicant has demonstrated its capability to comply with all applicable laws, rules, regulations, contractual terms, policies and standards as set forth in section 4912 of the Public Health Law and section 4912 of the Insurance Law and as required by the commissioner and superintendent.
(b) Applicants for certification as external appeal agents shall submit two originals and seven copies of the application to the commissioner in the form and manner prescribed jointly by the commissioner and the superintendent. Upon receipt of the application for certification, the commissioner shall transmit copies of such application to the superintendent for review.
(c) No applicant shall be certified as an external appeal agent unless the applicant's proposed fees for external appeals are determined to be reasonable by the commissioner and superintendent.
(d) In order to be certified as an external appeal agent, an applicant shall consent to cooperate in court proceedings relevant to its role as a certified external appeal agent.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.154 Generally accepted
Given authoritative recognition; said of accounting principles or audit standards, and the pronouncements concerning them, particularly, in recent years, those of the American Institute of Certified Public Accountants and the Financial Accounting Standards Board.
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.13 Forms (Hospital/Community Patient Review Instrument)
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NEW YORK STATE DEPARTMENT OF HEALTH
DIVISION OF HEALTH CARE FINANCING
INSTRUCTIONS: HOSPITAL AND COMMUNITY PATIENT
REVIEW INSTRUMENT (H/C-PRI)
GENERAL CONCEPTS
1. PURPOSE: Preadmission review to a Residential Health Care Facility (RHCF) from the hospital and community based residences and facilities, such as personal dwelling, domicillary care facility/adult home and congregate housing.
2. ASSESSORS: As qualified through the N.Y.S. Department of Health PRI Training Program - hospital discharge planners, certified home health care agency registered nurses, RHCF registered nurses, county public health nurses and other utilization review personnel as designated.
3. USING THESE INSTRUCTIONS: These instructions should be read before completing the H/C-PRI and should be kept with the H/C-PRIs as they are being completed. FREQUENT REFERENCE TO THE INSTRUCTIONS WILL BE NEEDED TO COMPLETE THE H/C-PRI ACCURATELY.
4. ANSWER ALL QUESTIONS Answer all questions using the numeric codes provided. DO NOT LEAVE ANY QUESTIONS TOTALLY BLANK. UNUSED BOXES FOR A QUESTION SHOULD REMAIN BLANK. For example, Medical Record Number: // 9 / 6 / 2 / 1 / 0 /. If there are unused boxes, they should be on the left side of the number as shown in the example.
5. QUALIFIERS: Many of the PRI questions contain multiple criteria which are labeled qualifiers. All qualifiers must be met for a question to be answered “yes”. These qualifiers take the following forms:
• TIME PERIOD - The time period for the questions is the past week. For the patients who have been in the hospital less than one week use the time from admission to H/C-PRI completion as the timeframe. If the community assessor (e.g., certified home health care agency, RHCF assessor) does not have any history on the patient, then the day of the H/C-PRI assessment is the timeframe. See “Sources of Information” below.
• FREQUENCY - The frequency specifies how often something needs to occur to meet the qualifier. For example, suctioning needs to occur daily for at least one week or the PRI cannot be checked for this patient as receiving this care.
• DOCUMENTATION - Some of the questions require specific medical record documentation to be present. Otherwise, the question cannot be answered “yes” for the patient.
• EXCLUSIONS - Some of the questions specifically state to omit certain types of care or behavior when answering the question. For example, inhalators are excluded from oxygen therapy.
6. SOURCES OF INFORMATION: For community based referred patients, the sources of information may not be as accessible as in the hospital. Discussion with the patient's family members, other caregivers and personal physician(s) will help provide more accurate information. The patient may be recieving community services or may have in the past.
7. ACTIVITIES OF DAILY LIVING (ADLs): The approach to measuring ADLs is slightly different from other PRI questions. Measure how capable the patient is in completing each ADL 60% or more of the time it needs to be performed. CAPABILITY - Reviewing the patient's physical and mental status, measure the present capability of the patient to perform each ADL. This is in contrast to how the patient may be actually performing the ADLs in the hospital/facility or in the community. Read the specific instructions on ADLs to understand the CHANGED CONDITION RULE, the specific ADL definitions and the measurement of capability.
8. CORRECTIONS: Cross out any responses which you wish to change and reenter clearly to the right of the original response. Example: /3/4
INSTRUCTIONS: H/C-PRI QUESTIONS
I. ADMINISTRATIVE DATA
1. OPERATING CERTIFICATE NUMBER: Enter the seven or eight character identifier stated on the facility's/agency's operating certificate. For a hospital there will always be seven (7) numbers followed by an “H” in the eighth box. For a certified home health agency and a county Department of Health, there will only be seven (7) numbers with no letters. This means the first answer box to the left will remain blank. For a residential health care facility, there will be seven (7) numbers followed by an “N” which indicates a nursing facility.
2. SOCIAL SECURITY NUMBER: Do not leave blank; enter zero in far right hand box if patient does not have a number.
3. OFFICIAL FACILITY NAME: Print the formal name of the hospital/community agency, etc.
4. PATIENT NAME: When completing the H/C-PRI do not use nicknames. Print last name first (e.g., Brant, Diana C).
6. MEDICAL RECORD NUMBER/CASE NUMBER: Enter the unique number assigned by the hospital/agency to identify each patient. It is not the Medicaid, Medicare or Social Security number, unless that is the number used to identify patients. If there is no assigned case number for the community based patient, leave this question blank.
7. HOSPITAL ROOM NUMBER: Enter the numbers and/or letters which identify the patient's room in the hospital or other applicable community facility. If the patient is residing in the community when the H/C-PRI review is completed, then print the address in question 4., “Patient Name.” (Community is defined as a personal dwelling, Adult Home, congregate housing, or other domicillary type facilities/dwellings.)
8. NAME OF HOSPITAL UNIT/BUILDING/DIVISION: Print the name of the hospital unit, such as “med-surgery,” where the patient was reviewed. Include any other unique hospital location identifiers, such as specific building names where the unit is located. However, if the patient has changed units or buildings or will be moving, then print instead where the patient can be located in the future (if known). If the patient is reviewed in the community, then this question is not applicable and can be left blank.
11A. DATE OF HOSPITAL ADMISSION OR INITIAL AGENCY VISIT: Enter in numerical format the month, day and year the patient was admitted to this hospital for the purposes of this review. (Use most recent hospitalization date for multiple hospitalizations.) Do not include the date of Alternate Level of Care status (ALC), rather enter this date, if applicable, in Question 11B. If the patient is being reviewed in the community, enter the date of the initial patient visit by the certified home health care agency, nursing home or any other qualified agency/organization. This visit may be a followup to a referral made by the patient, the patient's family, the patient's physician, etc.
11B. DATE OF ALTERNATE LEVEL OF CARE STATUS: Enter in numerical format the day, month and year the patient went onto Alternate Level of Care status (ALC) in the hospital. If the patient has entered ALC status more than once during this hospital stay, enter the most recent ALC admission date. (That is, this patient was on ALC status, but was discharged because of an acute episode and then went back to ALC status.) If the patient is not on ALC status or is in the community during this review, enter a zero (0) in far right hand box.
12. MEDICAID NUMBER: Enter these numbers if patient has such coverage.
13. MEDICARE NUMBER: available, whether or not the coverage is being used. If not, enter only one zero in the far right hand box.
14. PRIMARY PAYOR: Enter the one source of coverage which pays for most of the patient's current hospitalized stay; for patients in the community enter what is covering the patient's community health care needs. Code “other” only if the primary payor is not Medicaid or Medicare. “Other” includes self-pay and private insurance.
15. REASON FOR PRI COMPLETION: Select the one reason why the PRI is being completed. This is for preadmission review purposes.
# 1 RHCF Application from Hospital means the patient resides in the hospital at the time of this H/C-PRI review and is applying for admission into a residential health care facility (RHCF, HRF or SNF). This H/C-PRI is being completed by a qualified hospital assessor or another qualified assessor (i.e., RHCF assessor, certified home health care agency assessor) who enters the hospital to review the patient.
# 2 RHCF Application for Community means the patient resides in the community during this H/C-PRI review. Include Adult Homes and other domicillary care facilities.
II. MEDICAL EVENTS
16. DECUBITUS LEVEL: Enter the level of skin breakdown (located at pressure points) using the qualifiers stated below:
Documentation For a patient to be coded as level 4, documentation by a licensed clinician must exist which describes the following three components: • A description of the patient's decubitus. • Circumstances or medical condition which led to the decubitus. • An active treatment plan.
Definition
LEVELS:
#0 No reddened skin or breakdown.
#1 Reddened skin, potential breakdown.
#2 Blushed skin, dusty colored, superficial layer of broken or blistered skin.
#3 Subcutaneous skin is broken down.
#4 Necrotic breakdown of skin and subcutaneous tissue which may involve muscle, fascia and bone.
#5 Patient is at level 4, but the documentation qualifier has not been met.
17. MEDICAL CONDITIONS: For a YES to be answered for any of these conditions, all of the following qualifiers must be met:
Time Period Condition must have existed during the past week.
Documentation Written support exists that the patient has the condition.
Definitions See chart below. (Examples are for clarification and are not intended to be all-inclusive.)
| DEFINITION | EXAMPLES OF CAUSES | EXAMPLES OF TREATMENTS | | --- | --- | --- | | 17A. COMATOSE: Unconscious, cannot be aroused, and at most can respond only to powerful stimuli. The coma must be present for at least four days. | Brain insult Hepatic encephalopathy Cardiovascular accident | Total ADL Intake & output Parenteral feeding | | 17B. DEHYDRATION: Excessive loss of body fluids requiring immediate medical treatment and ADL care. | Fever Acute urinary tract infections Pneumonia Vomiting Unstable diabetes | Intake & output Electrolyte lab tests Parental hydration Nasal feedings | | 17C. INTERNAL BLEEDING: Blood loss stemming from a subacute or chronic condition ( e.g., gastrointestinal, respiratory or genito-urinary conditions) which may result in low blood pressure and hemoglobin, pallor, dizziness, fatigue, rapid respiration. | Use only the causes presented in the definition. Exclude external Hemorrhoids and other minor blood loss which is not dangerous and requires only minor intervention. | Critical monitoring of vital signs Transfusion Use of blood pressure elevators Plasma expanders Blood every 60 days likely to be needed | | 17D. STASIS ULCER: Open lesion, usually In lower extremities, caused by decreased blood flow from chronic venous insufficiency. | Severe edema Diabetes PVD | Sterile dressing Compresses Whirlpool Leg elevation | | | End stages of: | ADL Care | | 17E. TERMINALLY ILL: Professional prognosis (judgment) is that patient is rapidly deteriorating and will likely die within three months. | Carcinoma, Renal disease, and Cardiac diseases | Social/ emotional support | | 17F. CONTRACTURES: Shortening and tightening of ligaments and muscles resulting in loss of joint movement. Determine whether range of motion loss is actually due to contractures and not only due to spasticity or paralysis or in joint pain. | Comatose, Bedbound High dependence with ADLs Low physical tolerance for exercise. Exclude range of motion loss due to spasticity or paralysis only. | Range of Motion Ambulation Splint care PT/OT regimen | | It is important to observe the patient to confirm whether a contracture exists and check the chart for confirmatory documentation. To qualify as "YES" on the H/C PRI the following qualifiers must be met: | | | | 1. The contracture must be documented by a physician, physical therapist or occupational therapist. | | | | 2. The status of the contracture must be reevaluated and documented by the physician, physical therapist or occupational therapist on an annual basis. | | | | There does not need to be an active treatment plan to enter "YES" to contractures. | | | | 17G. DIABETES MELLITUS: A metabolic disorder in which the ability to oxidize carbohydrates is compromised due to inadequate pancreatic activity resulting in disturbance of normal insulin production. This may or may not be the primary problem (Q.29) or primary diagnosis. It should be diagnosed by a physician. Include any degree of diabetes, stable or unstable, and any manner it is controlled. | Destruction/ malfunction of the pancreas Exclude hypoglycemia or hyperglycemia which may be a diabetic condition, but by itself does not constitute diabetes mellitus. | Special diet Oral agents Insulin Exercise | | 17H. URINARY TRACT INFECTION: During the past week, signs and symptoms of a UTI have been exhibited or it has been diagnosed by lab tests. | Exclude if symptoms are present, but the lab values are negative | Antibiotics Fluids | | Symptoms may include frequent voiding, foul smelling urine, voiding small amounts, cloudy urine, sediment and an elevated temperature. May or may not be the primary problem under Q.29. Include as a UTI if it has not been confirmed yet by lab tests, but the symptoms are present. Include patients who appear asymptomatic but whose lab values are positive ( e.g., mentally confused or incontinent patients). | | |
| 18. MEDICAL TREATMENTS: For a "YES" to be answered for any of these, the following qualifiers must be met: | | | --- | --- | | Time Period | -Treatment must have been given during the past week and is still required. | | Frequency | -As specified in the chart below. | | Documentation | -Physician order specifies that treatment should be given and includes frequency as cited below, where appropriate. | | Exclusions | See chart below. |
| DEFINITION | SPECIFIC FREQUENCY | EXCLUSIONS | | --- | --- | --- | | 18A. TRACHEOSTOMY CARE: Care for a tracheostomy, including suctioning. Exclude any self-care patients who do not need daily staff help. | Daily for the past week (7 days) or will continue to be required for 7 days. | Self-care patients | | 18B. SUCTIONING: Nasal or oral techniques for clearing away fluid or secretions. May be for a respiratory problem. | Daily for the past week (7 days) or will continue to be required for 7 days. | Any tracheostomy Suctioning | | 18C. RESPIRATORY CARE: Care for any portion of the respiratory tract, especially the lungs (for example COPD, pneumonia.) This care may include one or more of the following: percussion or cupping, postural drainage, positive pressure machine, possibly oxygen to administer drugs, etc. | Daily for the past week (7 days) or will continue to be required for 7 days. | Suctioning | | 18D. OXYGEN THERAPY: Administration of oxygen by nasal catheter, mask (nasal or oronasal), funnel/cone, or oxygen tent for conditions resulting from oxygen deficiency ( e.g., cardiopulmonary condition). | Daily for the past week (7 days) or will continue to be required for 7 days. | Inhalators Oxygen in room, but not in use | | 18E. NASAL GASTRIC FEEDING: Primary food intake is by a tube inserted into nasal passage; resorted to when it is the only route to the stomach. | None | None Gastrostomy not applicable | | 18F. PARENTERAL FEEDING: Intravenous or subcutaneous route for the administration of fluids used to maintain fluid, nutritional intake, electrolyte balance (for example, comatose, damaged stomach). | None | None Gastrostomy not applicable | | 18G. WOUND CARE: Subcutaneous lesion(s) resulting from surgery, trauma, or open cancerous ulcers. | Care has been provided or is professionally judged to be needed for at least 3 consecutive weeks | Decubiti Stasis ulcers Skin tears Feeding tubes | | 18H. CHEMOTHERAPY: Treatment of carcinoma through IV and/or oral chemical agents, as ordered by a physician. (Community-based patient may have to go to a hospital for treatment.) | None | None | | 18I. TRANSFUSIONS: Introduction of whole blood or blood components directly into the bloodstream. (Community-based patient may have to go to a hospital for treatment.) | None | None | | 18J. DIALYSIS: The process of separating components, as in kidney dialysis ( e.g., renal failures, leukemia, blood dyscrasia). (Community-based patient may have to go to a hospital for treatment.) | None | None | | 18K. BOWEL AND/OR BLADDER REHABILITATION: The goal of this treatment is to gain or regain optimal bowel and/or bladder function and to reestablish a pattern. It is much more than just a toileting schedule or a maintenance/ conditioning program. Rather it is an intense treatment which to very specific and unique for each patient and is of short term duration (i.e., usually not longer than six weeks). NOT all patients at level 5 under Toileting Q.22 may be a "YES" with this question. The specific definition for bladder rehabilitation differs from bowel rehabilitation; refer below: | Very specific and unique for each patient | Maintenance toileting schedule Restorative toileting program but does not meet the treatment requirements specified in the definitions | | Bladder rehabilitation: Will generally include these step-by-step procedures which are closely monitored, evaluated and documented: (1) mental and physical assessment of the patient to determine training capacity; (2) a 24-hour flow sheet or chart documenting voiding progress; (3) possibly increased fluid intake during the daytime; (4) careful attention to skin care; (5) prevention of constipation; (6) in the beginning may be toileted 8 to 12 times per day with decreased frequency with progress. | | | | Bowel rehabilitation: A program to prevent chronic constipation/impaction. The plan will generally include: (1) assessment of past bowel movements, relevant medical problems, medication use; (2) a dietary regimen of increased fluids and bulk ( e.g., bran, fruits); (3) regular toileting for purposes of bowel evacuation; (4) use of glycerine suppositories or laxatives; (5) documentation on a worksheet or Kardex. | | Exclude a bowel maintenance program which controls bowel incontinence by development of a routine bowel schedule. | | 18L. CATHETER: During the past week, an indwelling or external catheter has been needed. Indwelling catheter has been used for any duration during the past week. The external catheter was used on a continuous basis (with proper removal and replacement during this period) for one or more days during the past week; a physician order is required. | | Exclude catheters used to empty the bladder once, secure a specimen or instill medication | | 18M. PHYSICAL RESTRAINTS: A device was used during the daytime during the past week to limit, restrict or keep under control patient movement. To qualify as a "YES" on the PRI, the restraints must have been given for at least two continuous hours and provided during the daytime. There must be a physician order for the daytime restraints restraints. Daytime includes all the time from when the patient wakes up in the morning to when the patient goes to sleep at night. Include belts, cuffs, mitts, geriatric chairs, harnesses, locked doors/gates, nets, bedrails and domes as restraints. (Include bedrails only for hospitalized patients, if there is a physician's order.) | Two continuous hours anytime during the past week (7 days) | Exclude chemical restraints Application only at night Application for less than two continuous hours Use only for transportation Devices which the patient can manipulate and loosen/remove, such as velcro seatbelts |
III. ACTIVITIES OF DAILY LIVING: EATING, MOBILITY, TRANSFER, TOILETING
Use the following qualifiers in answering each ADL question:
| Time Period | - Past week (7 days). | | --- | --- | | Frequency | - Assess the capability level of the patient to perform each ADL 60% or more of time performed since the ADL status may fluctuate during a 24-hour period. | | | CHANGED CONDITION RULE: When a patient's ADL has improved or deteriorated during the past week (7 days) and this course is unlikely to change, measure the ADL according to its present status. |
MEASUREMENT APPROACH: Measure the present capability of the patient to complete each ADL. This may be in contrast to what the patient may actually be doing. The reason why you are assessing capacity, rather than actual performance, is so that only patient characteristics are taken into account when measuring ADLs. Omit nonpatient considerations when assessing ADLs. For example, physical barriers, such as stairs or no ramps, may prevent the patient from performing ADLs at the level s/he is actually capable. Or a facility safety policy or clinical order, such as bedrest, may prevent the patient from performing ADLs. Or informal supports in the community or hospital staff may be providing more assistance with ADLs ( e.g., toileting) that the patient actually needs.
Definitions -
• SUPERVISION means verbal encouragement and observation, not physical hands-on care.
• ASSISTANCE means physical hands-on care.
• INTERMITTENT means that a staff person does not have to be present during the entire activity, nor does the help have to be on a one-to-one basis.
• CONSTANT means one-to-one care that requires a staff person to be present during the entire activity. If the staff person is not present, the patient will not complete the activity.
Note how these terms are used together in the ADLs. For example, there is intermittent supervision and intermittent assistance.
CLARIFICATION OF ADL RESPONSES
19. EATING:
#3 “Requires continual help...” means that the patient requires a staff person's continual presence and help for reasons such as: patient tends to choke, has a swallowing problem, is learning to feed self, or is quite confused and forgets to eat.
#5 “Tube or parenteral feeding...” means that all food and drink is given by nursing staff through the means specified.
20. MOBILITY:
#3 “Walks with constant supervision and/or assistance. . .” may be required if the patient cannot maintain balance, has a history of falls, has stress fracture potential, or is relearning to ambulate.
21. TRANSFER: Exclude transfers to bath or toilet.
#4 “Requires two people. . .” may be required for reasons such as: the patient is obese, has contractures, has fractures (or stress fracture potential), has attached equipment that makes transfer difficult (for example, tubes). There must be logical medical reasons why the patient needs the help of two people to transfer. This reason should be documented in the medical record.
#5 “Bedfast. . .” may refer to a patient with acute dehydration, severe decubitus, or terminal illness.
22. TOILETING:
Definition - INCONTINENT 60% or more of the time the patient loses control of his/her bladder or bowel functions, with or without equipment.
#1 “Continent. . . Requires no or intermittent supervision” and
#2 “. . . and/or assistance” can refer to the continent patient or the incontinent patient who needs no/little help with his/her toileting equipment (for example, catheter).
#3 “Continent. . . Requires constant supervision/total assistance...” refers to a patient who may not be able to balance him/her self and transfer, has contractures, has a fracture, is confused or is on a rehabilitation program. In addition this level refers to the patient who needs constant help with elimination/incontinence equipment (for example, colostomy, ileostomy).
#4 “Incontinent. . . Does not use a bathroom” refers to the patient who does not go to a toilet room, but instead may use a bedpan or continence pads. This patient may be bedbound or is mentally confused to the extent that a scheduled toileting program is not beneficial.
#5 “Incontinent. . . Taken to a Bathroom. . .” refers to a patient who is on a formal toileting schedule; this should be documented in the medical record. This patient may be on a formal bowel and bladder rehabilitation program to regain or maintain control, or the toileting pattern is known and it is better psychologically and physically for the patient to be taken to the toilet (for example, prevent decubiti).
A patient may have different levels of toileting capacity for bowel and bladder function. To determine the level of such a patient, note that level four and five refer to incontinence of either bladder or bowel. Thus if a patient receives the type of care described in one of these levels for either type of incontinence, enter that level.
Example 1:
A patient needs constant assistance with a catheter (level 3) and is incontinent of bowel and is taken to the bathroom every four hours (level 5). In this instance, enter level 5 on the PRI because they are receiving the type of care described in this question for bowel incontinence.
Example 2:
The patient requires intermittent supervision for bowel function (level 2), and is taken to the toilet every two hours as part of a bladder rehabilitation program. Enter level 5, as the patient is receiving this type of care for bladder incontinence.
IV. BEHAVIORS VERBAL DISRUPTION, PHYSICAL AGGRESSION; DISRUPTIVE INFANTILE/SOCIALLY INAPPROPRIATE BEHAVIOR AND HALLUCINATIONS
The following qualifiers must be met:
Time Period - Past week (7 days).
Frequency - As stated in the responses to each behavioral question.
Documentation - To qualify a patient as LEVEL 4 or to qualify the patient as a “YES” to HALLUCINATIONS, the following conditions must be met:
• Active treatment plan for the behavioral problem must be in current use.
• Psychiatric assessment by a recognized professional with psychiatric training/education must exist to support the fact that the patient has a severe behavioral problem. This assessment must still be exhibited by the patient.
Definitions - The terms used on the PRI should be interpreted only as they are defined below:
• PATIENT'S BEHAVIOR: Measure it as displayed with the behavior modification and treatment plan in effect during the past week.
• DISRUPTION: Through verbal outbursts and/or physical actions, the patient interferes with the staff and/or other patients. This interference causes the staff to stop or change what they are doing immediately to control the situation. Without this staff assistance, the disruption would persist or a problem would occur.
• NONDISRUPTION: Verbal outbursts and/or physical actions by the patient may be irritating, but do not create a need for immediate action by the staff.
• UNPREDICTABLE BEHAVIOR: The staff cannot predict when (that is, under what circumstances) the patient will exhibit the behavioral problem. There is no evident pattern.
• PREDICTABLE BEHAVIOR: Based on observations and experiences with the patient, the staff can discern when a patient will exhibit a behavioral problem and plan appropriate responses in advance. The behavioral problem may occur during activities of daily living (for example, bathing), specific treatments (for example, contracture care, ambulation exercises), or when criticized, bumped into, etc.
CLARIFICATION OF RESPONSES TO BEHAVIORAL QUESTIONS
23. VERBAL DISRUPTION: Exclude verbal outbursts/expressions/utterances which do not create disruption as defined by the PRI.
24. PHYSICAL AGGRESSION: Note that the definition states “with intent for injury.”
25. DISRUPTIVE, INFANTILE OR SOCIALLY INAPPROPRIATE BEHAVIOR: Note that the definition states this behavior is physical and creates disruption.
EXCLUDE the following behaviors:
• Verbal outbursts
• Social withdrawal
• Hoarding
• Paranoia
26. HALLUCINATIONS: For a “YES” response, the hallucinations must occur at least once per week during the past week (7 days) (in addition to meeting the other qualifiers noted above for an active treatment plan and psychiatric assessment.)
V. SPECIALIZED SERVICES
27. PHYSICAL AND OCCUPATIONAL THERAPIES:
• For each therapy these three types of information will be entered on the PRI: “Level,” “Days” and “Time” (hours and minutes).
• For a patient not receiving a therapy at all, the “Level” will always be entered in the answer key as #1 (“does not receive”), the “Days” will be entered 0 (zero) and the “Time” will be 0 (zero).
• Use the chart on the following page to understand the qualifiers for each of the three types of information that will be entered. Whether patient is receiving maintenance or restorative therapy will make a difference in terms of the qualifiers to be used.
27. LEVEL QUESTION: QUALIFIERS
| Qualifiers for Level | Maintenance Therapy | Restorative Therapy | Qualifier Not Met | | --- | --- | --- | --- | | | Level 2 | Level 3 | Level 4 | | DOCUMENTATION QUALIFIERS: | | | | | POTENTIAL FOR INCREASED FUNCTIONAL/ ADL ABILITY | No potential for increased functional ADL ability. Therapy is provided to maintain and/or retard deterioration of current functional /ADL status. Therapy plan of care and progress notes should support that patient has no potential for further or any significant improvement. | There IS positive potential for improved functional status within a short and predictable period of time. Therapy plan of care and progress notes should support that patient has this potential/is improving. | Enter level 4 if any one of the qualifiers under qualifiers for level 2 or 3 is not met. | | PHYSICIAN ORDER QUALIFIER | Yes | Yes, monthly | | | PROGRAM DESIGN AND EVALUATION QUALIFIER | Licensed professional person with a 4-year, specialized therapy degree evaluates program on a monthly basis. | Licensed professional person with a 4-year, specialized therapy degree evaluated program on a monthly basis. | | | TIME PERIOD QUALIFIER | Treatments have been provided during the past week. | Treatments have been provided during the past week. | | | NEW ADMISSION QUALIFIER | Not applicable | New admissions of less than one week can be marked for restorative therapy if: | | | | | • There is a physician order for therapy and patient is receiving it. | | | | | A new admission includes readmissions to a residential health care facility. | | | | | • The licensed therapist has documented in the care/plan that therapy is needed for at least one week. | |
27. DAYS AND TIME PER WEEK QUESTION: QUALIFIERS
| Qualifiers for Days and Time * | Maintenance Therapy | Restorative therapy | | --- | --- | --- | | | (i.e., level 2 or 4 under "Level" question) | (i.e., if level 3 or 4 under "Level" question) | | TYPE OF THERAPY SESSION | Count only one-to-one care. Exclude group sessions ( e.g., PT exercise session, OT cooking session). | Count only one-to-one care. Exclude group sessions ( e.g., PT exercise session, OT cooking session). | | SPECIALIZED PROFESSIONAL ON-SITE (ON-SITE MEANS WITHIN THE FACILITY) | A certified (2-year) or licensed (4-year) specialized professional is on-site supervising or providing therapy. | A licensed (4-year) specialized professional is on-site supervising or providing care. (Do not include care provided by PT or OT aides.) |
*
Qualifiers not met: Do not enter on the PRI any days and time of therapy which do not meet both these qualifiers under each type of therapy.
28. NUMBER OF PHYSICIAN VISITS: Enter “0” (zero) unless the patient need qualifiers stated below are met. If, and ONLY if, the patient meets all the patient need qualifiers, then enter the number of physician visits that meet the physician visit qualifiers.
• Do not answer this question for hospitalized patients, unless an alternate level of of care status. Enter “0” (zero).
• PATIENT TYPE/NEED QUALIFIERS: The patient has a medical condition that (1) is unstable and changing or (2) is stable, but there is high risk of instability. If this patient is not closely monitored and treated by medical staff, an acute episode or severe deterioration can result. Documentation must support that the patient is of this type (for example, terminally ill, acute episode, recent hospitalization, post-operative).
• PHYSICIAN VISIT QUALIFIER: If, and only if, the patient meets the PATIENT TYPE/NEED QUALIFIER, then enter the number of physician visits during the past week that meets the following qualifications:
• A visit qualifies only if there is physician documentation that s/he has personally examined the patient to address the pertinent medical problem. The physician must make a notation or documentation in the medical record as to the result of the visit for the unstable medical condition ( e.g., change medications, renew treatment orders, nursing orders, order lab tests).
• Do not include phone calls as a visit nor visits which could have been accomplished over the phone.
• For community-based patient, the physician visit may occur in the patient's own home, physician's office, outpatient clinic or hospital.
VI. DIAGNOSIS
29. PRIMARY MEDICAL PROBLEM: Follow the guidelines stated below when answering this question.
• NURSING TIME The primary medical problem should be selected based on the condition that has created the most need for nursing time during the past week (7 days). A review of the medical record for nursing and physician notes during the past week may be necessary. For community-based patients review what is requiring the most care time from informal supports and health care professionals if any.
• JUDGMENT This decision may require the assessor to use her/his own professional judgment in deciding upon the primary problem.
• ICD-9 Refer to the ICD-9 codes for common diagnoses (attached at the end of these instructions) for easy access to the most frequently used numbers. An ICD-9 code book containing the complete ICD-9 listing should be available in the nursing and/or medical records office of a facility.
• NO ICD-9 NUMBER - Enter “0” zero in the far right box if no ICD-9 number can be found for the patient's primary problem (or if the patient does not have a primary medical problem). If you cannot locate the ICD-9 code for the primary medical problem, PRINT THE NAME OF THE PRIMARY MEDICAL PROBLEM in the space provided on the PRI.
QUALIFIED ASSESSOR NUMBER:
31. QUALIFIED ASSESSOR: The individual who has completed and/or reviewed the PRI. To be complete, each assessment must be signed by the qualified nurse assessor.
ICD-9 CODES FOR COMMON DIAGNOSES
(Listed alphabetically within body system category)
| Blood and Blood-forming Organ Disorders | | | --- | --- | | Anemia, NOS* | 285.9 | | Circulatory Diseases | | | Angina pectoris, NOS | 413.9 | | Atherosclerosis, generalized & unspecified | 440.9 | | Atherosclerotic cardiovascular disease (ASCVD) | 429.2 | | Arteriosclerotic heart disease (ASHD) | 414.0 | | Cardiac dysrnythmias, unspecified | 427.9 | | Chronic ischemic heart disease, NOS | 414.9 | | Congestive heart failure | 428.0 | | Congestive heart failure with acute pulmonary edema | 428.1 | | Hypertension, essential, NOS | 401.9 | | Hypertensive heart disease without congestive heart failure NOS | 402.90 | | Peripheral vascular disease, NOS | 443.9 | | Endocrine and Metabolic Disorders | | | Diabetes, non-insulin dependent, adult onset or NOS | 250.00 | | Diabetes, insulin dependent, adult onset or NOS | 250.01 | | Genitourinary Disorders | | | Urinary tract infection, site not specified | 599.0 | | Mental Problems | | | Alcoholism, chronic | 303.9 | | Alzheimer's disease | 331.0 | | Arteriosclerotic dementia | 290.40 | | Chronic organic brain syndrome, NOS | 294.9 | | Depression, NOS | 311 | | Mental disorder (non-psychotic) following organic brain damage | 310.9 | | Mental retardation, NOS | 319 | | Organic personality syndrome | 310.1 | | Presenile dementia, NOS | 290.10 | | Psychosis, NOS | 298.9 | | Schizophrenia, NOS | 295.9 | | Senile dementia, NOS | 290.0 | | Senility without psychosis | 797 | | Musculoskeletal Disability | | | Arthritis, excluding osteoarthrosis, site unspecified | 716.90 | | Fracture, neck of femur | 820.09 | | Fracture, other unspecified part of femur | 821.00 | | Fracture, vertebra, closed NOS | 805.8 | | Hip fracture, NOS | 820.0 | | Osteoarthritis, generalized, NOS | 715.00 | | Osteoarthritis, unspecified whether generalized or localized | 715.90 | | Osteoporosis | 733.00 | | Rheumatoid arthritis | 714.0 | | Traumatic amputation, late effect | 905.9 | | Neoplasms | | | Carcinoma of female breast, NOS (if removed, use V10.3) | 174.9 | | Carcinoma of colon, NOS | 153.9 | | Carcinoma of lung and bronchus, NOS | 162.9 | | Carcinomatosis, generalized cancer, unspecified site | 199.0 | | Neurological Motor Dysfunction | | | Cerebral arteriosclerosis | 437.0 | | Cerebral degeneration, unspecified | 331.9 | | Cerebral infarction, NOS | 434.9 | | Cerebral palsy, NOS | 343.9 | | Cerebral thrombosis | 434.0 | | Cerebrovascular accident, NOS, acute phase (CVA) | 436 | | Cerebrovascular disease, late effects | 438 | | Convulsions | 780.3 | | Hemiplegia | 342 | | Huntington's chorea | 333.4 | | Multiple sclerosis | 340 | | Parkinson's disease | 332.0 | | Quadriplegia | 344.0 | | Transient ischemic attack (TIA) | 435.9 | | Pulmonary Disease | | | Chronic obstructive pulmonary disease, (COPD) | 496 | | Pneumonia, organism unspecified | 486 | | Upper respiratory infection, acute, NOS | 465.9 | | Sensory Disorders | | | Blindness and low vision, unspecified | 369.9 | | Cataract, unspecified | 366.9 | | Glaucoma, unspecified | 365.9 | | Hearing loss, unspecified | 389.9 | | Skin Disorders | | | Chronic skin ulcer, NOS | 707.9 | | Decubitus ulcer | 707.0 | | SEE ICD-9 CODING BOOK FOR DIAGNOSES NOT LISTED HERE. | |
*
Not otherwise specified
Note: ICD-9 codes sometimes have two digits after the decimal, sometimes one, and sometimes none. Write the codes exactly as shown.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
TOXIC MATERIALS TOXIC MATERIALS
10 CRR-NY 14-5.60 Poisonous and toxic materials; restrictions; labeling
(a) Poisonous and toxic materials required to maintain sanitary conditions, which includes pest control and sanitization, used in vending machine operations are restricted to those prominently labeled and lawfully permitted under State and Federal regulations.
(b) Bactericides, cleaning compounds or other materials used on food-contact surfaces are not to leave toxic residues on such surfaces.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.22 Leave for civil service examinations
Employees shall be allowed leave with pay to take New York State Civil Service examinations at the appropriate center provided that due notice is given by the employee to the department.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.4 Retrieval and acquisition of nontransplant anatomic parts
(a) The retrieval of nontransplant anatomic parts shall only be performed on:
(1) the premises of a general hospital;
(2) the premises of a whole body acquisition service licensed in accordance with this Subpart; or
(3) for nontransplant anatomic parts other than whole bodies and body segments, the premises of a comprehensive tissue procurement service licensed in accordance with Subpart 52-2 of this Part.
(b) No body, body segment, or other nontransplant anatomic part shall be retrieved, acquired, distributed, transported, or used for a purpose not authorized by Public Health Law section 4302. For the purposes of this Subpart, the term research as used in Public Health Law section 4302 shall be limited to research conducted in accordance with accepted research protocols designed to improve the public health, safety and welfare.
(c) Whole body acquisition services.
(1) A whole body acquisition service shall employ the following staff:
(i) a nontransplant anatomic bank director who holds a graduate degree in anatomy or the health sciences, or who has been serving as director of a nontransplant anatomic bank licensed by the department prior to the adoption of this provision;
(ii) an appropriately trained technician, morgue attendant, diener, or licensed funeral director responsible for the preparation, care and maintenance of whole bodies and body segments; and
(iii) at least one support staff person, other than the nontransplant anatomic bank director, but who may be the technician, morgue attendant, diener, or licensed funeral director, who shall be responsible for recordkeeping.
(2) Facilities requirements. A whole body acquisition service shall have a dedicated, secure and restricted space for preparation of whole bodies and body segments for research and/or education purposes. Access to such space shall be limited to individuals directly associated with receipt and preparation of whole bodies or body segments. Preparation and storage space shall include:
(i) a working sink and adequate counter space for preparation of whole bodies or body segments;
(ii) suitable space for storage of chemicals/materials used in preparation of whole bodies or body segments, as applicable;
(iii) counters, tables, and cabinetry built of material that may be easily disinfected and cleaned;
(iv) a refrigerated storage room, walk-in cooler, or cadaver drawer cooler, dedicated solely to storage of whole bodies or body segments. Such storage areas shall have lockable access doors, and alarms to signal intrusion or unacceptable temperature deviation;
(v) a U.S. Occupational Safety and Health Administration (OSHA)-approved device for handling, lifting, and internal transportation of whole bodies or body segments;
(vi) OSHA-approved eye wash stations;
(vii) if embalming is performed, a morgue compliant with Federal and State standards; and
(viii) if cremation is performed, a crematory compliant with Federal and State standards.
(3) Records. In addition to the records required in section 52-2.9(i) of this Part, a whole body acquisition service shall maintain complete and accurate records of all donations, including:
(i) identification of the whole body, and, in the case of a body segment, a description and source of the body segment;
(ii) documentation of unclaimed acquisitions, death certificates, and burial transit permits associated with receipt and use of whole bodies or body segments;
(iii) facilities/institutions to which the whole bodies or body segments are transferred, or documentation of any other disposition; and
(iv) a copy of any contract or letter of agreement between the whole body acquisition service and the whole body user, and documentation of the method of intended final disposition of the whole body or body segment.
(d) Transfer.
(1) Any transfer of whole bodies, body segments or other nontransplant anatomic parts shall be conducted in compliance with existing state standards for such transfer. The burial transit permit(s) issued by the registrar of vital statistics (in the case of a whole body transfer), or written documentation of the source and a description of the body segment(s) or anatomic parts, shall accompany whole bodies, body segments, or nontransplant anatomic parts.
(2) In the case of a whole body transfer, a copy of the properly executed burial transit permit shall be maintained by the whole body acquisition service.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.5 Collection receptacles
(a) Every collection receptacle maintained at participating pharmacies and residential health care facilities shall comply with all applicable State and Federal laws and regulations; and
(1) be securely fastened to a permanent structure so that it cannot be removed;
(2) be a securely-locked, substantially-constructed container with a permanent outer container and a removable inner liner;
(3) feature an outer container which shall include a small opening that allows contents to be deposited into the inner liner, but which does not allow removal of the inner liner's contents; and
(4) display signage describing items eligible and not eligible for deposit in the collection receptacle.
(b) Inner liners shall meet the following requirements:
(1) be accessible only to employees of the pharmacy;
(2) be waterproof, tamper-evident, and tear-resistant;
(3) be removable and sealable immediately upon removal without emptying or touching the contents;
(4) the contents of the inner liner shall not be viewable from the outside when sealed;
(5) the size of the inner liner shall be clearly marked on the outside of the liner ( e.g. , 5-gallon, 10-gallon, etc.);
(6) the inner liner shall bear a permanent, unique identification number that enables the inner liner to be tracked;
(7) immediately upon removal from the permanent outer container, be sealed by two pharmacy employees, except that in a residential health care facility it may be sealed by one pharmacy employee and one supervisory level New York State-licensed healthcare professional employed by the residential health care facility;
(8) shall not be opened, x-rayed, analyzed, or otherwise penetrated;
(9) if at a pharmacy, be removed from a collection receptacle and retrieved by the reverse distributor or common or contract carrier on the same business day whenever possible. If not possible, it must be safely secured and stored at the pharmacy until retrieved by the reverse distributor or common or contract carrier; and
(10) if at a residential healthcare facility, be removed from a collection receptacle and retrieved by the reverse distributor or common or contract carrier on the same business day whenever possible. If not possible, it must be safely secured and stored. Such storage shall not exceed three business days.
(c) Any pharmacy authorized by DEA to be a collector shall maintain a record that includes the date of sealing, the names of the two employees who performed the sealing, the date of removal, and the unique identification number of the liner.
(d) Pharmacy employees may not handle drugs for disposal, review contents of the collection receptacle, remove, count, weigh, consume, repurpose, restock, redispense, resell, or touch items placed in the collection receptacle.
(e) Installation, removal, transfer, and storage of inner liners must be performed in compliance with all applicable State and Federal laws and regulations.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 78 STATEMENT TO BE FURNISHED BY EVERY PERSON LICENSED PURSUANT TO ARTICLE 34 OF THE PUBLIC HEALTH LAW
10 CRR-NY 78.1 Contents of statement
(a) Every person licensed pursuant to article 34 of the Public Health Law, including funeral directors and funeral firms, shall furnish at the time funeral arrangements are made for the care and disposition of the body of a deceased person, to the person or persons making such arrangements, a written statement which shall include, but not be limited to, the price of the funeral, including an itemized list of the services and merchandise to be furnished for such price, as required by paragraph (b)(4) of this section. No reference to the Public Health Law or administrative rules and regulations promulgated pursuant thereto shall appear on the front or back of such statement except as required by the public notice in section 78.2 of this Part.
(b) Such statement shall include the following:
(1) true firm name and address as registered with the department;
(2) the signature and printed or typed name of the funeral director or undertaker making funeral arrangements and the date such statement was furnished to the customer;
(3) name of deceased together with the place and date of death;
(4) the price of the funeral together with the price of each item of service and merchandise actually to be furnished. The itemization of prices shall be contained in a written statement similar in form to that contained in section 78.2 of this Part, and shall be limited to the statements, language, titles, and the numerical order contained in said section. The itemization shall be completed as follows:
(i) The charging of expenses related to the overall cost of doing business under "overhead", "administrative costs" or any similar title, is prohibited.
(ii) The statement of "cash advances" shall be in compliance with subdivision (k) of section 77.12 of this Title in regard to those services or merchandise required to be listed as cash advances.
(iii) Charges for additional services and merchandise selected by the customer, which the funeral firm purchases for the customer, such as hairdressing, flowers, death notices, pallbearers, clothing or burial garments, musicians and watcher, catering services, food, and nonalcoholic beverages, shall be specifically described and may be made either as a "Funeral Home Charge" under the section "Additional Services and Merchandise Selected," if the funeral firm charges for its services in purchasing these items, or as a "Cash Advance," if the funeral home does not charge the customer in excess of the amount advanced to a third party. If the funeral firm charges more than it advances to a third party or receives and retains a rebate, commission, trade or volume discount or other benefit, the items must be listed under the heading "Additional Services and Merchandise Selected."
(iv) Under the heading "Cash Advances," the price for each cash advance item selected shall be listed to the extent known or ascertainable at the time the itemization form is completed. If prices are not known or ascertainable, a good faith estimate shall be listed. The actual charges for any estimated prices shall be provided in writing to the person making the arrangements before the final bill is paid.
(v) Items listed under the heading "Additional Services and Merchandise Selected" shall be the actual charge and shall not be an estimate even when the item is to be purchased by the funeral firm from a third party.
(vi) Charges for preparation of the remains. The charge for embalming shall include all items of service incidental to the disinfection and preservation of the remains. Charges for "other preparation (excluding embalming)," that is cosmetology, dressing/casketing and restoration, shall be listed if selected. If a charge is incurred for "other," the service provided must be specifically listed. A charge for topical disinfection may only be listed when the remains are not to be embalmed and this service is selected. The charge for "custodial care" shall be listed, if applicable. A separate charge for the use of the preparation room shall not be listed as the use of this facility is incidental to the "preparation of remains." A separate charge for "hairdressing" may be made under either the heading "Additional Services and Merchandise Selected," if it is a "Funeral Home Charge," or under the heading "Cash Advances," if the funeral director does not charge the customer in excess of the amount advanced to a third party.
(vii) Items listed under "Funeral Home Charges" shall not be estimated and the term estimate shall only appear on the statement in reference to cash advance items.
(5) Under the heading "Explanation of Charges," a clear, concise written description of the reasons for an embalming charge or any other charge made necessary by cemetery requirements, crematory requirements or other selections made by the person making arrangements.
(6) The dated signature of the person making arrangements acknowledging receipt of the itemization statement. This must be signed unless the person making arrangements refuses to sign it or signs and dates a contractual statement on the same form.
(c) Nothing contained herein shall be interpreted to prohibit the addition of legal contractual language on the itemized statement form provided that no such additional language, if any, shall be inconsistent with the provisions of this Part. Such language shall appear after the required information in section 78.2 of this Part. The customer shall be required to sign either the acknowledgment required by this section or a binding contractual agreement, which includes the itemized statement, proposed by the funeral director.
(d)
(1) True copies of the statement required by this Part shall be consecutively numbered and maintained in numerical order at the funeral establishment.
(2) The following documents shall be retained at the funeral home for a period of not less than four years following the funeral and shall, during normal business hours within such period, be open to inspection by the commissioner or his representatives:
(i) itemized statements;
(ii) funeral bills rendered to customers indicating funeral charges and service/merchandise provided. Bills for past due balances need not be retained;
(iii) casket invoices or delivery copies;
(iv) outer interment receptacle invoices or delivery copies;
(v) receipts or cancelled checks for cash advance items, except for gratuities paid in cash. Wholesale prices of funeral home merchandise need not appear on casket and/or outer interment receptacle invoices; and
(vi) customer's designation of intentions.
(e) Itemization of social services and other governmental cases shall be in compliance with the rules of the department or agency having jurisdiction; provided, however, that the requirements of this Part are also met. True copies of documents pertaining to all such cases shall be consecutively numbered and maintained at the funeral establishment for a period not less than four years following the funeral and shall during normal hours within such period be open to inspection by the commissioner or his representatives. Where any portion of the payment for such cases is not provided for by such department or agency, itemization shall be governed by this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 138 RENSSELAER COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 138.10 Berlin Water District, Town of Berlin
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such additional wells as may be developed in the future on the property of the Berlin Water District, Town of Berlin, Rensselaer County, New York, such wells being the sources of public water supply of the Berlin Water District.
(b) Definitions.
Definition of terms wherever used in this section:
(1) The term water supply means the public water supply of the Berlin Water District.
(2) The term well means either of the wells now serving as sources of water supply for the Berlin Water District and also any wells which may be developed to serve as sources of water supply for the Berlin Water District.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(4) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(5) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No privy, cesspool, septic tank, subsurface leaching tile or receptacle of any kind for the storage, deposit or disposal of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(2) No human excreta or sewage shall be so stored, disposed of or discharged onto the surface of the ground so that the material will drain or be washed by rain or melting snow to points within 200 feet of any well.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Bath water, wastes, garbage.
No cesspool, pit or receptacle of any kind for the storage, deposit or disposal of bath water, sink or laundry wastes, garbage, refuse, manure, putrescible matter shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(e) Animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any well.
(f) Trespassing.
No trespassing shall be allowed upon the property of the Berlin Water District upon which the wells of the public water supply are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said district.
(g) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(h) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Berlin Water District.
(i) Inspections.
The Berlin Water District, its officers or their duly appointed representatives shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid district to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the district to promptly notify the State Commissioner of Health of such violations. The aforesaid district shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PLUMBING PLUMBING
10 CRR-NY 14-1.141 Definition of indirect drain
An indirect drain is a waste line which does not connect directly with the drainage system, but conveys and discharges liquid wastes through an air break into an approved plumbing fixture or receptacle, directly connected to the drainage system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.1 Applicability
The requirements and standards set forth in this Part shall apply to shared health facilities as defined.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.3 Electronic registration and reporting
(a) Registration.
All owners of cooling towers shall register such towers with the department, using a statewide electronic system designated by the department, prior to initial operation, and whenever any owner of the cooling tower changes. Such registration shall include, at a minimum, the following information:
(1) street address of the building at which the cooling tower is located, with building identification number, if any;
(2) name(s), addresses(es), telephone number(s), and email address(es) of the owner(s) of the cooling tower;
(3) name of the manufacturer of the cooling tower;
(4) model number of the cooling tower;
(5) specific unit serial number of the cooling tower, if available;
(6) cooling capacity of the cooling tower;
(7) cooling tower system volume, inclusive of all piping, basin(s), and sump;
(8) intended use of the cooling tower;
(9) whether the cooling tower operates year-round or seasonally and, if seasonally, start and end date of operation;
(10) whether systematic disinfection in accordance with section 4-1.7 of this Subpart is maintained manually, through timed injection, or through continuous delivery;
(11) whether maintenance is performed by in-house personnel, by a contractor, or by other parties; and
(12) year the cooling tower was placed into service.
(b) Reporting.
Effective upon adoption of the regulation, at intervals of no more than 90 days while a cooling tower is in use, the owner of the cooling tower shall report to the department using the statewide electronic system:
(1) date of last bacteriological culture sample collection, the analysis result(s), and date of any required remedial action, pursuant to section 4-1.4(b)(1) of this Subpart;
(2) date of last Legionella culture sample collection, the analysis result(s), and date of any required remedial action, pursuant to section 4-1.4(b)(2)-(4) of this Subpart;
(3) date of last inspection, pursuant to section 4-1.8 of this Subpart;
(4) date of last certification, pursuant to section 4-1.8 of this Subpart;
(5) date of removal or permanent discontinued use of the cooling tower, if applicable; and
(6) such other information as shall be determined by the department.
(c) The department shall make data in the statewide electronic system publicly available, as appropriate. The statewide electronic system shall be made fully accessible and searchable to any local health department. Nothing in this Subpart shall preclude a local health department from requiring registration and reporting with a local system or collecting fees associated with the administration of such system.
(d) Where both a landlord and a tenant are considered “owners” of a cooling tower pursuant to section 4-1.2 of this Subpart, either the owner or the tenant shall register the cooling tower. However, both parties are obligated to ensure that registration and reporting are completed as required by this Subpart.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
SEWAGE SEWAGE
10 CRR-NY 14-5.130 General
All sewage, including liquid waste, is to be disposed of in a public sewer or in a manner which protects the premises, personnel and contents within the establishment and does not create a nuisance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.303 Revenue-producing cost centers
Health facility activities providing direct services to patients (such as nursing, physical therapy and laboratory) and thereby generating revenue.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.111 Manual facilities
The preferred manual method of cleaning and sanitizing equipment and utensils is to use a three-compartment sink; to wash in the first compartment with hot water and a detergent; rinse in clean hot water in the second compartment; and sanitize in the third compartment using an accepted procedure. Other methods acceptable to the State Commissioner of Health may be used. The procedure must clean and sanitize the article so as to produce an average plate count of not more than 100 colonies on the surface of utensils examined and free from coliform bacteria.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.3 Applicability
The provisions of this Part shall apply and take effect as prescribed in article 8 of the Environmental Conservation Law.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.71 Protection and supervision of public water systems
(a) The supplier of water and the person or persons operating a public water system shall exercise due care and diligence in the maintenance and supervision of all sources of the public water systems to prevent, so far as possible, their pollution and depletion.
(b) The supplier of water and the person or persons operating a water treatment plant or distribution system shall exercise due care and diligence in the operation and maintenance of these facilities and their appurtenances to ensure continued compliance with the provisions of this Subpart. Facilities approved by the State shall be operated in general accordance with their design unless otherwise authorized under the provisions of section 5-1.22, 5-1.23 or 5-1.24 of this Subpart.
(c) If the State notifies the supplier of water that a significant deficiency exists, the supplier of water shall consult with the State within 30 days regarding corrective action. Within 120 days of being notified that a significant deficiency exists (or earlier if the State determines that action is necessary to protect public health), the supplier of water shall correct the significant deficiency or be in compliance with a corrective action plan to correct the deficiency. The corrective action plan must specify appropriate modifications and/or improvements to the existing system or facility as may be necessary to fully conform to the requirements of this Subpart.
(d) Any significant deficiency that is not corrected or where correction has not begun according to a corrective action plan prepared to meet the requirements of this code, within 120 days, or as directed by the State, is a treatment technique violation and must be addressed in accordance with the requirements in section 5-1.12 of this Subpart. If the deficiency is a public health hazard, the deficiency must be addressed as directed or approved by the State and tier 1 notification is required.
(e) Public water systems shall correct sanitary defects found through a Level 1 or 2 assessment. For corrections that have not been completed at the time that the assessment form is submitted the system shall complete the corrective action(s) within 120 days of identifying the sanitary defect or be in compliance with a timeframe approved by the State in consultation with the system. The system shall notify the State when each scheduled corrective action is complete.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.8 Adverse event reporting
(a) Any adverse event required to be reported pursuant to subdivision (b) of this section shall be reported to the department. Hospitals shall report such adverse events, as defined in subdivision (b) of this section, within 24 hours or one business day of when the adverse event occurred or when the hospital has reasonable cause to believe that such an adverse event has occurred. This report to the department shall be submitted in a format specified by the department and shall at a minimum include: the date, the nature, classification and location of the adverse event; and medical record numbers of all patients directly affected by the adverse event.
(b) Adverse events to be reported are:
(1) patients' deaths in circumstances other than those related to the natural course of illness, disease or proper treatment in accordance with generally accepted medical standards;
(2) injuries and impairments of bodily functions, in circumstances other than those related to the natural course of illness, disease or proper treatment in accordance with generally accepted medical standards that necessitate additional or more complicated treatment regimens or that result in a significant change in patient status;
(3) equipment malfunction or equipment user error during treatment or diagnosis of a patient which results in death or serious injury of a patient;
(4) patient elopements resulting in death or serious injury;
(5) abduction of a patient of any age;
(6) sexual abuse/sexual assault on a patient or staff member within or on the grounds of a general hospital;
(7) physical assault of a patient or staff member within or on the grounds of a general hospital;
(8) discharge or release of a patient of any age, who is unable to make decisions, to other than an authorized person;
(9) patient or staff death or serious injury associated with a burn incurred from any source in the course of a patient care process;
(10) patient suicide, attempted suicide or self harm resulting in serious injury;
(11) poisoning occurring within the hospital;
(12) fires or other internal disasters in the hospital which disrupt the provision of patient care services or cause harm to patients or staff members;
(13) disasters or other emergency situations external to the hospital environment which affect hospital operations;
(14) termination of any services vital to the continued safe operation of the hospital or to the health and safety of its patients and staff members, including but not limited to the termination of telephone, electric, gas, fuel, water, heat, air conditioning, rodent or pest control, laundry services, food, or contract services; and
(15) strikes by staff members.
(c) The hospital shall conduct an investigation of adverse events described in paragraphs (1)-(10) of subdivision (b) of this section. Such investigations shall be thorough and credible and occur within 30 days of when the adverse event occurred or when the hospital has reasonable cause to believe that such an adverse event occurred or upon determination by the department that an investigation is warranted in order to protect patient health and safety. If the hospital reasonably expects such investigation to extend beyond the 30 day period, the hospital shall notify the department electronically of such expectation and the reason(s) and shall inform the department of the expected date of completion, not to exceed 60 days. For adverse events described in paragraphs (1)-(10) of subdivision (b) of this section, the hospital shall submit its investigative report electronically, in a format prescribed by the department. The investigative report shall document all hospital efforts to identify and analyze the circumstances surrounding the adverse event and to develop and implement appropriate measures to prevent recurrence and improve the overall quality of patient care. This report shall be credible and thorough and contain all information in a format specified by the department.
(d) The requirements of this section shall be in addition to and shall not replace other reporting required by this Part.
(e) Nothing in this section shall prohibit the department from investigating any adverse event occurring in general hospitals.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.7 Consistency
[ 1160 ] Consistency refers to continued uniformity, during a period and from one period to another, in methods of accounting, mainly in valuation bases and methods of accrual, as reflected in the financial statements of an accounting entity, e.g., change from FIFO inventory method to the LIFO method. Consistency is very important to the development and analysis of trends on a year-to-year basis and as a means of forecasting. However, consistency does not require continued adherence to a method of procedure that is incorrect or no longer useful, nor does it preclude a justifiable and desirable change in accounting and reporting methods or procedures unless otherwise specified in this manual. Any such change must be highlighted in submitting reports to HCFA by appropriate footnotes on all schedules which are affected by the change.
Chapter I STATE SANITARY CODE
Part 13 TRANSPORTATION OF DEAD BODIES
10 CRR-NY 13.2 Transportation of dead human bodies by other than common carrier
In the transportation of dead human bodies by every mode of transportation including air, other than by common carrier in the State of New York, and including such transportation which originates outside the State of New York, the dead body shall be encased in a casket or container or shall be enclosed in a waterproof pouch and secured in a rigid litter or stretcher, and however encased or enclosed, the dead body shall be obscured from public view and:
(1) the funeral director or his agent assuming responsibility for the transportation of the dead body must take the steps necessary to prevent leakage of body fluids from the container in which the remains are encased; and
(2) the interior of the vehicle and equipment used for transportation must be maintained in a clean and sanitary manner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.9 Health care provider and health facility policy and procedures
Each health care provider and health facility employing persons or contracting with persons to perform any activity related to such provider's or facility's rendering of health services shall develop and implement policies and procedures to maintain the confidentiality of confidential HIV-related information. Such policies and procedures shall assure that such information is disclosed to employees or contractors only when appropriate under this Part. Such policies and procedures shall include:
(a) initial employee education inservice education of employees regarding the legal prohibition against unauthorized disclosure in Public Health Law article 27-F and provisions of article 21, title III. Updates should be provided to all employees in cases of changes to relevant laws or regulations. A list of all employees who have had such training must be maintained by health care providers and health facilities. Health care providers and health facilities contracting with others for services in which HIV-related information may be disclosed to such contractors, must document evidence that such contractors have been informed of the confidentiality and disclosure requirements of this Part;
(b) maintenance of a list of job titles and the specific employee functions within those titles for which employees are authorized to access such information. This list shall describe the limits of such access to information and must be provided to the employees during employee education sessions;
(c) a requirement that only full-time or part-time employees, contractors and medical, nursing or health-related students who have received such education on HIV confidentiality, or can document that they have received such education or training, shall have access to confidential HIV-related information while performing the authorized functions listed under paragraph (2) of this subdivision;
(d) protocols for ensuring that records, including records which are stored electronically, are maintained securely and used for the purpose intended;
(e) procedures for handling requests by other parties for confidential HIV-related information;
(f) protocols prohibiting employees/agents/contractors from discriminating against persons having or suspected of having HIV infection; and
(g) review of the policies and procedures on at least an annual basis.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
ENHANCED TREATMENT FOR CRYPTOSPORIDIUM ENHANCED TREATMENT FOR CRYPTOSPORIDIUM
10 CRR-NY 5-1.82 Requirements when making a significant change in disinfection practice
(a) Following the completion of initial source water monitoring under section 5-1.81(a)(1) of this Subpart, a system that plans to make a significant change to its disinfection practice, as defined in subdivision (b) of this section, shall develop disinfection profiles and calculate disinfection benchmarks for Giardia lamblia and viruses, in accordance with 40 CFR 141.709. Prior to changing the disinfection practice, the system shall notify the State and shall include in this notice the following information:
(1) a completed disinfection profile and disinfection benchmark for Giardia lamblia and viruses prepared as described in 40 CFR 141.709;
(2) a description of the proposed change in disinfection practice;
(3) an analysis of how the proposed change will affect the current level of disinfection.
(b) Significant changes to disinfection practice are defined as follows:
(1) changes to the point of disinfection;
(2) changes to the disinfectant(s) used in the treatment;
(3) changes to the disinfection process; or
(4) any other modification identified by the State as a significant change to disinfection practice.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.11 Failure to obtain required immunization
Barring a valid medical contraindication or religious exemption from hepatitis B immunization, if the parent or legal guardian of a child born to a woman with a positive HBsAg test result is unwilling to have the infant immunized, the health care provider attending the child, or the local health officer if vaccine is to be administered under section 3.8 of this Subpart, shall make a report of suspected child abuse or maltreatment (see section 415 of the Social Services Law).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.297 Restricted funds
Funds restricted by donors or grantors for specific purposes. Restricted funds generally fall into three categories: plant replacement and expansion fund, specific purpose fund, and endowment fund. The accounts within each restricted fund are self-balancing, as each fund constitutes a separate accounting entity.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.181 Preoperational review
(a) It is the responsibility of the operator of a food vending operation to construct, equip, furnish, maintain and operate the food vending operation under his control in compliance with the requirements of this Subpart and other applicable laws, rules and regulations. Prior to construction, major renovation, or commencing operation of a food vending operation, the permit-issuing official may require all food vending operations under his control to submit sketches or plans showing the floor layout, equipment, plumbing, ventilation, refuse storage facilities, sewage disposal facilities and similar information.
(b) Submission and review of plans does not relieve the operator or his successor from meeting all requirements of this code.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.324 Third-party payor
An agency such as Blue Cross or the Medicare program which contracts with hospitals and patients to pay for the care of covered patients.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.171 Walls and ceilings
(a) Walls and ceilings, including doors, windows, skylights and similar closures, are to be maintained clean and in good repair.
(b) Walls, including nonsupporting partitions, wall coverings and ceilings of walk-in refrigerating units, food preparation areas, equipment washing and utensil areas, toilet rooms and vestibules, are to be easily cleanable, light-colored, smooth and nonabsorbent. Concrete or pumice blocks used for interior wall construction in these areas are to be finished and sealed to provide an easily cleanable surface.
(c) Exposed utility service lines and pipes are to be installed in a way that does not obstruct or prevent cleaning of the walls and ceilings.
(d) Light fixtures, vent covers, wall-mounted fans, decorative materials and similar equipment attached to walls and ceilings are to be maintained clean and in good repair and are to be installed to be easily cleanable.
(e) Wall and ceiling covering materials are to be attached and sealed to be easily cleanable and to prevent insect harborage.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.6 Notice and demand
Whenever the commisioner or his designated representative determines that a condition conducive to lead poisoning exists in a dwelling, a written notice and demand for discontinuance of such may be issued in accordance with section 1373(2) of the Public Health Law.
(a) No person shall commence lead paint abatement in any designated area of high risk prior to the issuance of a written notice and demand. Risk reduction efforts may proceed prior to receipt of a notice and demand.
(b) Upon receipt of a notice and demand for discontinuance of conditions conducive to lead poisoning, the owner of a dwelling is required to abate such conditions. The extent of abatement and method(s) used shall be determined by the commissioner or his designated representative, in accordance with applicable laws or rules and regulaions.
(c) It shall be the responsibility of the owner of the dwelling to comply with all Federal, State and local laws governing building construction, housing, worker health and safety, and disposal of lead-containing wastes. The owner of the dwelling must provide, upon request, to the commissioner or his designated representative, such documentation as shall show that the owner has fully complied with these laws.
(d) Any vacancy or change in occupancy of the dwelling before abatement has been completed shall not relieve the owner of that dwelling from compliance with the notice or demand.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.5 Applications
Applications for a permit to construct or abandon a water well shall be directed to the permit issuing official by the applicant or his agent and shall be on a form prescribed by the State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.67 Consistency
Continued uniformity, during a period or from one period to another, in methods of accounting, mainly in valuation bases and methods of accrual, as reflected in the financial statements of an accounting entity.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.46 Use of liquid nitrogen and dry ice
For the purposes of this section, liquid nitrogen shall mean nitrogen in its cryogenic liquid form, which comes in direct contact with food or is used as a food additive. Dry ice shall mean carbon dioxide in its solid form, which comes in direct contact with food or is used as a food additive.
(a) Only food-grade liquid nitrogen or dry ice may be added to food.
(b) Liquid nitrogen, used in the preparation of food, is to be drained or allowed to evaporate completely prior to vending.
(c) Dry ice, used in the preparation of food, shall be sublimated completely or removed prior to vending.
(d) Liquid nitrogen or dry ice shall not be added to any food before service, such that a fog or smoke effect remains at time of service or is created during eating.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
USE OF ANIMALS USE OF ANIMALS
10 CRR-NY 55-1.5 Care and treatment of animals
(a) The laboratory or institution shall give careful consideration to the humane treatment of animals wherever located. This includes any off-premises locations which are not considered part of the laboratory or institution. The food given to the animals shall be wholesome and in sufficient quantity for the type of animal and scientific tests. The animals' quarters shall be kept clean, well lighted and ventilated and be maintained at a proper temperature. Quarters or cages of suitable size shall be provided so that each animal may stand, sit and lie in a normal position and turn around with ease. All quarters and cages shall be kept clean, and after they are vacated and before they are reoccupied shall be cleaned by procedures suitable to prevent spread of communicable diseases.
(b) Laboratories and institutions providing transportation for animals must arrange for their humane handling during their transportation to and from the laboratory or institution.
(c) Pain and discomfort shall be minimized by proper use of tranquilizers, analgesics and anesthetics. Exceptions may be made when provisions for maximum comfort, including the use of tranquilizers, analgesics and anesthetics, would defeat the purpose of the experiment. Any exceptions are to be made only after having received the recommendations of the person in charge of animal care.
(d) If animals are to be killed, they must be killed humanely.
(e) Humane methods for killing animals shall include, but not be limited to, the following:
(1) inhalant agents such as carbon dioxide for small rodents;
(2) noninhalant pharmacological agents such as:
(i) barbituric acid derivatives; and
(ii) a combination of chloral hydrate, magnesium sulfate and sodium pentabarbital for large animals;
(3) physical methods such as decapitation for small animals.
(f) Inhumane methods which are prohibited shall include but not limited to the following:
(1) noninhalant pharmacological agents such as:
(i) chloral hydrate alone;
(ii) strychnine;
(iii) magnesium sulfate alone; or
(iv) curariform drugs or agents with curariform activity;
(2) physical methods such as:
(i) drowning; or
(ii) exsanguination without causing prior unconsciousness.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.20 Hearings
(a) On disapproval of applications.
If the department disapproves any application filed pursuant to section 16.102 of this Part:
(1) The department will conduct a hearing if the applicant files with the department a written petition within 30 days after receipt of such notice of disapproval, and the petition:
(i) asserts that such disapproval was, and the respect in which it was, improper; and
(ii) requests a hearing.
(2) Having determined to conduct a hearing on the issues raised in an applicant's petition, the department will give written notice by personal delivery or by certified or registered mail to the applicant at least 20 days prior to such hearing, informing that person that he/she may be present and heard at the hearing.
(b) On amendment, suspension or revocation of licenses; imposition of additional requirements; transfer or surrender of radioactive material.
Except in any case of willfulness or in which the public health or safety requires otherwise, or in which an administrative correction is required, the department shall not amend, suspend or revoke any license pursuant to section 16.107 of this Part, or impose additional requirements on the possessor of a radiation source or require the transfer or surrender of radioactive material pursuant to section 16.18 of this Part, unless the prior consent of the licensee or person involved has first been obtained, without first:
(1) notifying in writing such licensee or person of the facts or conduct which may warrant such amendment, suspension, revocation, additional requirement, transfer or surrender, and giving such licensee or person a reasonable opportunity to demonstrate or achieve compliance with all lawful requirements; and
(2) conducting a hearing if the licensee or person files with the department a written petition within 30 days after receipt of such notice, and the petition:
(i) asserts that such amendment, suspension, revocation. additional requirement, transfer or surrender would be, and the respects in which it would be improper; and
(ii) requests a hearing;
(3) giving written notice by personal delivery or by certified or registered mail to the licensee or person at least 20 days prior to any hearing ordered pursuant to paragraph (2) of this subdivision. Such notice will inform the licensee or person that he/she may be present and heard at the hearing.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.12 Toilet facilities
Toilet facilities serving temporary food service establishments are to include warm running water, soap and individual paper towels for handwashing by employees.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.6 Insurance
(a) A nursing home company shall make provision for and obtain insurance and bonds in accordance with the requirements of the State Department of Health and of the insurance requirements for nursing homes and hospitals under article 28-A of the Public Health Law.
(b) The amount, extent and endorsements of the insurance maintained, and the custody of the insurance policies, shall be in accordance with the requirements of the State Department of Health.
(c) A nursing home company shall provide and maintain such additional insurance as may from time to time be required by the State Department of Health.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.3 Surrogacy program owner information
(a) The surrogacy program shall provide, as a condition of licensure, business and owner information to the department such as:
(1) the business name, each business address, tax ID number, and date of incorporation if applicable;
(2) the true full legal name, date of birth, driver license number, social security or tax identification number, and home address of all owners;
(3) degrees, certifications and licenses or other professional designation of the primary owner for the business and for all owners; and
(4) each business or occupation engaged in by all owners during the five years immediately preceding the date of the application, including place of employment and the location thereof.
(b) Any material change in the information set forth in this section following date of licensure and prior to the annual renewal of licensure shall be reported to the department.
(c) Any failure to disclose a material change of information within 30 days of the change shall constitute grounds for the department to revoke the license of such surrogacy program pursuant to section 69-11.10 of this Part.
(d) When such change causes a new person to acquire a controlling interest in the surrogacy program, such person must submit an initial application for licensure before such purchase or acquisition may take place.
(e) The owner of a licensed surrogacy program is responsible for designating staff to regularly monitor and update, as needed, the surrogacy program’s business and owner information.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 412 REPORTING INFORMATION FOR INSPECTIONS
10 CRR-NY 412.1 Facility-supplied information required
(a) As a part of the inspection process, each residential health care facility operating under the provisions of article 28 of the Public Health Law shall complete and file a report with the appropriate area office of the New York State Department of Health, Office of Health Systems Management. Such report shall be in a form as prescribed by the commissioner and may include, but not be limited to, a reporting of information concerning the facility in the following areas:
(1) administration and management;
(2) staffing;
(3) structure and functions of facility committees;
(4) facility policies and procedures; and
(5) physical environment.
(b) The report shall indicate the appropriate area office of the New York State Department of Health, Office of Health Systems Management, to which the report shall be returned. A facility possessing operating certificates to provide both nursing home and health-related services may submit one such report to the appropriate area office.
(c) Each residential health care facility shall complete and file such form within 30 days of receipt of the report. An extension of time for filing such report may be granted upon application received by the appropriate area office prior to the due date of the report, and only in those circumstances where the residential health care facility establishes, by documentary evidence, that the report cannot be filed by the due date for reasons beyond the control of the facility.
(d) In the event that any information or data which a residential health care facility has submitted in this report is inaccurate or incorrect, whether by reason of subsequent events or otherwise, such facility shall correct such information or data. Such correction may be made by submitting to the appropriate area office of the New York State Department of Health, Office of Health Systems Management, the accurate information or data on a form which meets the same certification requirements as the report being corrected, or the facility may correct such information or data at the time of the inspection.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.7 Village of Sinclairville
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Village of Sinclairville. Said wells are located on land owned by the Village of Sinclairville and are situated approximately 280 feet south of Sinclair Drive and 215 feet west of Bloomer Street.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area when two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(6) Pesticide shall mean any substance used to destroy or inhibit pests, such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter, from a domestic, commercial, private or industrial establishment, which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Village of Sinclairville.
(16) Wells shall mean wells now used as a source of this water supply, or any additional wells which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act, or grant any permit or approval, which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 200-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 150-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 150-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 150-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 150-foot linear distance of the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells, nor within a 500-foot to a 1000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the wells.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Village of Sinclairville upon which the wells are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Sinclairville.
(e) Inspections.
The Village of Sinclairville board of trustees, or any person or persons charged with the maintenance or supervision of the public water supply system, shall by its officers or their duly appointed representative make regular and thorough inspections of the area surrounding the wells to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid Village of Sinclairville board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Village of Sinclairville board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid Village of Sinclairville board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter S LAND ACQUISITION
Part 99 PAYMENTS TO AN OWNER OR TENANT OF RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY UPON APPLICATION FOR ALLOWANCE OF MOVING EXPENSES IN VACATING PROPERTY ACQUIRED BY THE DEPARTMENT OF HEALTH
10 CRR-NY 99.4 Fixed moving expenses for residential individuals and families
(a) A flat fixed sum will be allowed for moving expenses (provided application therefor is made within six months of completion of move), based upon the terms and conditions of this Part, to eligible persons which shall cover all items and incidentals necessary to the vacating of the premises acquired or being acquired by the State, according to the following number of counted rooms from which the individual or family moves:
| Number of counted rooms | Amount | | --- | --- | | 1 | $ 45 | | 1½ | 54 | | 2 | 63 | | 2½ | 72 | | 3 | 81 | | 3½ | 88 | | 4 | 95 | | 4½ | 102 | | 5 | 108 | | 5½ | 115 | | 6 | 122 | | 6½ | 129 | | 7 | 135 | | 7½ | 142 | | 8 | 149 | | 8½ | 156 | | 9 | 162 | | 9½ | 169 | | 10 | 176 | | 10½ | 183 | | 11 | 189 | | 11½ | 196 | | 12 | 203 | | 12½ | 210 | | 13 | 216 | | 13½ | 223 | | 14 | 230 | | 14½ | 237 | | 15 | 243 | | 15½ | 250 | | 16 | 257 | | 16½ | 264 | | 17 | 270 | | 17½ | 277 | | 18 | 284 | | 18½ | 291 | | 19 | 297 | | 19½ and over | 300 |
(b) Tenants in furnished rooms, furnished apartments, and housetrailers where the principal household furniture and equipment is owned by the operator of such a facility and when such tenant furnishes and uses in such facilities a nominal amount of his own household equipment; under such circumstances an individual upon proper application and verification of the claim will be paid $10 upon vacating the premises and two or more persons occupying such facilities as a family and who own and use a nominal amount of their own furniture and household equipment will be paid $20 upon vacating the facility.
(c) When a trailer is owner occupied and it is affixed to the ground and determined to be real property and compensated for in the acquisition as such, the owner will be allowed the fixed sum of $50 for vacating and removing all of his personal effects that are not considered part of the realty.
(d) In the case of a typical trailer park, where a trailer is attached to the local water and electric supply and the trailer owner occupies space on a weekly, monthly or term lease rental basis, such a trailer owner when orderd to remove to clear the site of the project will be eligible to collect the flat sum of $50 to move his entire trailer, equipment and appurtenances from the premises.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.6 Certificate of completion
Persons or organizations engaged in training and education pursuant to this Subpart shall supply each participant who has completed a course with a certificate of completion, as specified by the commissioner, within 21 days and shall maintain a record for six years of participants who complete the work or training.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.12 Misconduct
Misconduct in the business and practice of funeral directing within the meaning of paragraph (f) of subdivision (1) of section 3450 of the Public Health Law, shall include, but is not limited to, the following:
(a) failing to comply with the provisions of law, rules and regulations relating to the funeral directing, undertaking and embalming;
(b) exercising undue influence on a customer, misleading a customer, or misrepresenting to a customer the sale of services or merchandise and thereby taking unfair advantage of the customer, under the circumstances which existed during the course of the sale;
(c)
(1) making or filing a false report or inducing another person to do so; or
(2) failing to file a report required by law, rules and regulations relating to funeral directing, undertaking and embalming, or willfully obstructing such filing or inducing another person to do so;
(d) revealing the personally identifiable facts, data or information about a decedent or customer, obtained in the business or practice of funeral directing without the prior consent of the customer, except as:
(1) authorized and/or required by law or regulation; or
(2) as necessary to complete the performance of the contract between the customer and the funeral director;
(e) delegating funeral directing responsibilities to a person when the licensee delegating such responsibilities knows, or has reason to know, that such person is not qualified by training, experience or licensure, to perform them;
(f) harassing, abusing, intimidating or otherwise threatening a customer;
(g) abandoning, neglecting, abusing or failing to treat with dignity and respect, a dead human body entrusted to the licensee;
(h) charging for services not contracted for or failing to provide or making substitution for services contracted for without the authorization of the customer;
(i) charging for any item of merchandise:
(1) not required by law, which is not authorized by the customer; or
(2) which is not actually furnished;
(j) making a substitution for merchandise arranged and contracted for when such substitution is not authorized by the customer;
(k) charging in excess of the amount advanced, paid or owed to third parties on behalf of the customers, or not passing along to the customer any discount, rebate or other benefit received from third parties for any items of service or merchandise described as cash advances. Cash advances shall include, but are not limited to the following services or merchandise:
(1) cemetery or crematory charges;
(2) clergy honoraria;
(3) death certificate transcripts;
(4) escorts;
(5) chevra kadisha (Tahara);
(6) public transportation (common carrier);
(7) gratuities;
(8) bridge and road tolls; and
(9) telephone and telegraph charges;
(l) suggesting, or implying in any manner, that the customer's expressed concern about prices, inexpensive services or merchandise, or desire to save money, is improper or inappropriate;
(m) verbally disparaging to a customer the quality or appearance of merchandise or services which the licensee or funeral firm has advertised or offered for sale;
(n) failing to display the less expensive items of merchandise advertised or offered for sale in the same manner and condition as the more expensive items of merchandise;
(o)
(1) misrepresenting the law or public health necessity, including but not limited to representing that State or local law requires that a deceased person be embalmed, or that a casket is required for direct cremations, or that outer interment receptacles are required, or that any purchase of goods or services is required when such is not the case; or
(2) misrepresenting cemetery or crematory regulations or requirements, including but not limited to representing that such regulations or requirements require that a deceased person be embalmed, or that a casket is required for direct cremations, or that outer interment receptacles are required when such is not the case, or that any purchase of goods or services is required when such is not the case; or
(3) misrepresenting religious requirements; however, this shall not include differences in interpretation of religious requirements when due diligence has been exercised to determine those requirements on behalf of the customer; or
(4) misrepresenting that a deceased person is required to be embalmed for direct cremation, for direct burial, for a funeral using a sealed casket or for a funeral without viewing or visitation when there is to be a closed casket and refrigeration is available; or
(5) misrepresenting that a casket (other than an unfinished wooden box) is required for direct cremation, or misrepresenting that any other container is required by the crematory when such is not the case;
(p) obtaining custody of a deceased human body without having first received from a customer explicit written or oral authorization;
(q) failing to promptly release a body and/or give information in regard to the release, care and whereabouts of a body upon the request of a customer;
(r) embalming or furnishing other services or merchandise, without having first obtained from the customer explicit written or oral authorization;
(s) making false, misleading or unsubstantiated claims directly, or by implication, as to the benefits or quality of funeral merchandise or services, including but not limited to:
(1) misrepresenting that funeral merchandise or services will delay the natural decomposition of human remains for a long-term or indefinite time; or
(2) misrepresenting that funeral goods have protective features or will protect the body from gravesite substances, when such is not the case;
(t) indicating interest charges or finance charges unless written disclosure is contained in the statement of itemization. Such disclosure shall include the payment due date after which interest charges or finance charges will be assessed, and the annual percentage rate of interest or charge, and, where repayment is on the basis of a fixed periodic repayment schedule, such disclosure shall include the interest or finance charge in dollars;
(u)
(1) failing to conspicuously and legibly display the actual retail price on each casket, outer interment or entombment receptacle, or other item of funeral merchandise offered for sale (in regard to the particular items of casket and outer interment receptacle, the actual retail price printed in half-inch numbers or larger will be considered as legible); or
(2) failing to legibly display the actual retail price with each picture, when pictures are used for the presentation of merchandise for sale;
(v) displaying with caskets, outer interment or entombment receptacles, or any other funeral merchandise, any price other than the actual retail price of that particular item;
(w) inducing the customer to consent to delay or otherwise change the desired day or time of the funeral by misstating facts or circumstances relating to such funeral, burial or cremation:
(1) resulting in an increase in charges for the funeral to the customer; or
(2) depriving the customer of his desire to have the funeral at a particular time, when such particular time has been expressed by the customer as an essential element of the funeral;
(x) procuring or soliciting, or attempting to procure or solicit, funeral patronage through the use of door-to-door or telephone solicitation methods unless specifically requested by a potential customer;
(y) representing, permitting a representative to be made, or describing any funeral firm or entity as a society, fund, trust, or in any other way which might indicate that such funeral firm or entity is not-for-profit, unless such funeral firm or entity is not-for-profit, or unless such description includes a statement that such funeral firm or entity is for-profit;
(z) requiring that a casket other than an unfinished wooden box be purchased for direct cremations or failing to make an unfinished wooden box or alternative container available for direct cremations if direct cremations are arranged;
(aa) conditioning the furnishing of any funeral merchandise or services to a person arranging a funeral upon the purchase of any other funeral merchandise or services, except as required by law or as permitted by this Part. Failing to comply with a request for a combination of merchandise or services that would be impossible, impractical or excessively burdensome to provide or not regularly offered by the funeral firm shall not be misconduct.
(bb)
(1) charging additional fees for topical disinfection when embalming was selected or necessary because of other selections made as set out in Item I-C of section 78.2 of this Title.
(2) charging additional fees for custodial care for a time period during which a charge was incurred for embalming, or for other preparation, or for visitation or for the funeral service.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.197 Suspension of permits
Permits may be suspended temporarily by the permit-issuing official, after notice and an opportunity to be heard, for failure of the permit holder to comply with the requirements of this Subpart or with any lawful notice or order issued by the permit-issuing official or his designated representative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.7 Service obligation: deferrals and waivers
(a) Service deferral.
The commissioner may delay or defer the reporting date, the service obligation and/or the repayment obligation incurred by a recipient due to extreme hardship, or the commissioner may defer the reporting date for a recipient who is unavailable because the recipient is completing the program of study for which a scholarship award was given. Extreme hardship includes, but is not limited to: serious illness or injury of the recipient or a member of the recipient's immediate family and other circumstances beyond the control of the recipient that would make it extremely difficult or impossible for the recipient to fulfill the service obligation or repayment requirements.
(b) Waiver.
The commissioner may waive all or part of the service obligation and/or any repayment obligation incurred by a recipient because of extreme hardship.
(c) Evidence of hardship.
A request for deferral or waiver shall be submitted on forms prescribed by the Department of Health. The commissioner may require that sworn statements and appropriate documentation be submitted to support the recipient's claim.
(d) The commissioner will notify the president of any service and/or repayment obligation deferrals or waivers.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.3 Definitions
For purposes of this Part, the following terms shall have the following meanings.
(a) Authorized person means each individual designated by a provider who is authorized to request, receive and review criminal history information in accordance with this Part.
(b) Commissioner means the Commissioner of the New York State Department of Health.
(c) Criminal history information means a record of pending New York State criminal charges, New York State criminal convictions which have not been vacated or reversed, information from the Federal Bureau of Investigation (FBI) obtained as a result of a national criminal history record check, and certificates of relief from disabilities or certificates of good conduct filed pursuant to subdivision (2) of section 705 of the Correction Law and which the division is required to maintain pursuant to subdivision (6) of section 837 of the Executive Law.
(d) Criminal conviction means a judgment or sentence for a charge of a felony or misdemeanor under New York State law or a comparable crime under any other jurisdiction.
(e) Department means the New York State Department of Health.
(f) Determination means the decision made by the department after reviewing criminal history information to approve or disapprove a prospective employee's eligibility for employment by a provider.
(g) Division means the New York State Division of Criminal Justice Services.
(h) Permanent record means a permanent, written record of a determination and the criminal history information maintained by the department.
(i) Employee in direct care and supervision means:
(1) any unlicensed person employed by or used by a nursing home, licensed pursuant to article 28 of the Public Health Law, who has physical access to a resident's living quarters, or any unlicensed person providing face-to-face care following the resident's care plan in accordance with section 410.2(h) of this Title;
(2) any unlicensed person employed by or used by a certified home health agency, licensed home care services agency, or long term home health care program pursuant to article 36 of the Public Health Law, providing face-to-face care following the professional or paraprofessional plan of care developed for the individual patient in accordance with section 766.3 or 763.6 of this Title;
(3) any unlicensed person employed by or used by an adult home, enriched housing program, or residence for adults who provides residents face-to-face care or has physical access to a resident’s living quarters; or
(4) any unlicensed person employed by or used by a hospice program certified under article 40 of the Public Health Law who provides patients face-to-face care following the professional or paraprofessional plan of care developed for the individual patient in accordance with section 793.4 of this Title.
(j) Prospective employee means any person to be employed or used by a provider, including those persons provided by a temporary employment agency, to provide direct care or supervision to patients, residents or clients, and whom the provider reasonably expects to hire, employ or use, where such person is hired, employed or used by:
(1) a residential health care facility on or after September 1, 2006;
(2) a certified home health agency, licensed home care services agency, or long term home health care program on or after September 1, 2006;
(3) an adult home, enriched housing program, or residence for adults on or after January 1, 2015; or
(4) a hospice program on or after April 1, 2018.
Persons licensed pursuant to title 8 of the Education Law or article 28-D of the Public Health Law are excluded from the meaning of the term. Such term shall not include volunteers.
(k) Provider means any entity subject to this Part as enumerated in section 402.2 of this Part.
(l) Subject individual means a person for whom a provider is authorized to request a check of criminal history information pursuant to section 845-b of the Executive Law, article 28-E of the Public Health Law, and this Part.
(m) Temporary employee means a prospective employee who has been temporarily approved by a provider for employment after a request for a criminal history record check and pending a determination by the department.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.43 Physician cost
(a) Please refer back to section 440.6(e)(4)(vii)(c)(3) of this Article.
(b) The requirements indicated there for Blue Cross apply equally to Medicaid.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.4 Quarterly payments
At least quarterly payments must be made. If the laboratory elects to make quarterly payments, equal quarterly payments must be made by June 30th, September 30th, December 31st and March 10th of the State fiscal year to which the billing relates. Nothing herein precludes full payment from being made before these dates.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 84.3 Suspension of rules
These rules may be suspended in whole or in part, in an emergency, for the duration of same and to the extent made necessary by the nature of the emergency, on approval by the New York State Civil Service Commission of a written request by the department.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.6 Notification
(a) The owner of a cooling tower shall notify the local health department within 24 hours of receipt of a Legionella culture sample result that exceeds 1,000 colony forming units per milliliter (CFU/mL). The local health department shall notify the State Department of Health with 24 hours of receipt of such a report.
(b) The owner shall notify the public of such test results in a manner determined by the local health department or, in the event that the department elects to determine the manner of public notification, by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.316 Straight-line method of depreciation
This method of allocating depreciation is a function of the passage of time and recognizes equal periodic charges over the useful life of the asset. The depreciation charge calculated by the straight-line method is not affected by asset productivity, efficiency, or degree of use. The periodic charge is computed by relating the cost of the asset, less any salvage, to the useful life of the asset.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.25 Disinfection/start-up of facilities
(a) No spring basin, collecting basin, well, infiltration gallery, water main, pumping station, standpipe or reservoir shall be placed in service following cleaning or repairs until it has been disinfected in a manner approved by the State.
(b) For each operational period, before serving water to the public, all seasonal systems must demonstrate completion of a State approved start-up procedure.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.173 Cleaning of floor cleaning tools
In new or extensively remodeled establishments, at least one utility sink or curbed cleaning facility with a floor drain is to be provided and used for cleaning mops, similar wet floor cleaning tools, disposal of mop water and similar liquid waste. The use of lavatories or utensil, equipment or food preparation sinks for this purpose is prohibited.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.107 Amendment, suspension or revocation of licenses
Specific and general licenses shall be subject to amendment, suspension or revocation by reason of amendment of the State Public Health Law, enactment or amendment of any other applicable law, amendment of the State Sanitary Code [Chapter I of this Title] or amendment or promulgation of any other applicable rule, regulation, or order. The department may amend, revoke or suspend any license in whole or in part, for:
(a) any material misstatement in the application therefor or in any supplementary statement thereto;
(b) any condition revealed by such application, supplementary statement, report, record, inspection or other means, which would warrant the department to refuse to grant a license on an original application; or
(c) any violation or failure to observe any of the applicable terms or provisions of such license, the State Public Health Law, this Part, or any other applicable rule, regulation, code or order now or hereafter in effect.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PROGRAM SERVICES FOR SUPPLEMENTAL DATA PROGRAM SERVICES FOR SUPPLEMENTAL DATA
10 CRR-NY 446.44 Program services for supplemental data
(a) In an effort to standardize the reporting categories for the supplemental data required in this Part and to be consistent with the other sections of this Article, the Program Service Areas for which the supplemental data must be reported are being specified in this section. Subdivision (b) of this section specifies these Program Service Areas for the Daily Hospital Services accounts. Subdivision (c) of this section specifies these Program Service Areas for the Ambulatory Services accounts.
(b) Program Service Areas for Daily Hospital Services.
| Account number | Account name | | --- | --- | | (1) ACUTE CARE | | | 6010 | Medical/Surgical | | 6170 | Pediatric | | 6210 | Psychiatric | | 6250 | Obstetrics | | 6280 | Definitive Observation | | 6290 | Other Acute Care | | (2) INTENSIVE CARE SERVICES | | | 6310 | Medical/Surgical | | 6330 | Coronary | | 6350 | Pediatric | | 6370 | Neo-Natal | | 6380 | Burn | | 6390 | Psychiatric | | 6410 | Other Intensive Care I | | 6420 | Other Intensive Care II | | 6430 | Other Intensive Care III | | (3) NURSERY SERVICES | | | 6510 | Newborn Nursery | | 6520 | Premature Nursery | | (4) SUBACUTE CARE SERVICES | | | 6610 | Skilled Nursing Care—Medicare/Medicaid Certified | | 6620 | Skilled Nursing Care—Medicaid Certified | | 6630 | Psychiatric Long-Term | | 6640 | Tuberculosis Long-Term Care | | 6660 | Intermediate Care—Other | | 6670 | Residential Care | | 6680 | Other Sub-Acute Care Services | | 6710 | Emergency Services | | 6720 | Clinic Services | | 6810 | Home Program Dialysis Equipment—100% | | 6820 | Home Program Dialysis Equipment—Other | | 6830 | Ambulatory Surgery | | 6840 | Psychiatric Day/Night | | 6850 | Ambulance Services | | 6860 | Other Ambulatory Services | | 6870 | Free Standing Clinic I | | 6880 | Free Standing Clinic II | | 6890 | Free Standing Clinic III | | 6910 | Home Health Services—Skilled Nursing Care | | 6920 | Home Health Services—Medical Social Services | | 6930 | Home Health Services—Home Health Aides | | 6990 | Home Health Services—Other Home Health | | None | Referred Ambulatory Services | | None | Sold Services | | None | Outpatient Renal Dialysis |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.19 Rates for facilities without adequate cost experience
(a) A facility shall be deemed to be without adequate cost experience when fiscal and statistical data necessary for setting a rate are unavailable through no fault of the operator or his or her agents, and due to circumstances beyond his or her control, or in the instance of a newly licensed facility or in the instance of a new service for which certificate of need (CON) approval has been received as required by law. The rates certified for a facility without adequate cost experience shall be determined on the basis of:
(1) the rates established for comparable services or facilities in the geographic area;
(2) reasonable and complete cost projections based on estimated costs and statistics contained in a proposed annual budget for the new service or newly licensed facility, reviewed for adequacy and reasonableness of the proposed operation, including but not limited to utilization, as compared to standards established in section 86-4.10 of this Subpart, staffing, and salaries;
(3) actual allowable expenditures and statistics for prior or subsequent cost reporting periods; and/or
(4) existing ceilings.
(b) Rates for new services or facilities established pursuant to this section shall be retroactively adjusted using actual costs and statistics for the first full fiscal period of operation of the new facility or service.
(c) Notwithstanding the above, rates of payment for licensed free-standing ambulatory surgery centers shall be determined pursuant to section 86-4.40 of this Subpart.
(d) All rates of reimbursement certified pursuant to this section, exclusive of those for licensed free-standing ambulatory surgery centers, shall be subject to audit. After audit, the facility rate shah be revised based upon actual allowable costs incurred during the rate period, consistent with the provisions of this Subpart.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-4.171 Walls and ceilings
(a) Walls and ceilings, including doors, windows, skylights and similar closures of mobile food service establishments are to be maintained clean and in good repair.
(b) Light fixtures, vent covers, wall-mounted fans, decorative materials and similar equipment attached to walls and ceilings are to be maintained clean and in good repair.
(c) Wall and ceiling covering materials are to be attached and sealed to be easily cleanable and to prevent insect harborage.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.5 Procedure for filing application
Prospective patients should be referred by a physician, hospital, clinic, or appropriate public agency, and pertinent professional information should be submitted for the guidance of the hospital staff in determining suitability for admission and subsequently in the evaluation and treatment of the patient. No specific form is required for this purpose. Referrals should be addressed to the director of the hospital, who will notify the referring source of action taken.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Eye donor means a human being, living or dead, who is the source of ocular tissue intended for transplantation.
(b) Enucleation means the removal of the whole eye globe.
(c) Corneal excision means the in situ or laboratory removal of the cornea or corneal-scleral rim.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.10 Escrow funds
(a) A nursing home company will submit annually to the State Department of Health a schedule detailing those amounts that it is required to fund in the operating escrow account.
(b) The operating escrow account shall be opened in a federally insured commercial bank that agrees to the uniform custodial agreement of the State Department of Health.
(c) From the financial occupancy date, a nursing home company shall deposit monthly in the operating escrow account, one-twelfth of its annual required funding.
(d) A nursing home company will establish a separate mortgage repayment escrow account and make deposits and withdrawals into and from the account as required by the martgage and the mortgagee.
(e) A nursing home company shall invest excess fund in the operating escrow account in a manner specifically approved by the State Department of Health. Copies of the records of all transactions shall be promptly submitted to the State Department of Health.
(f) The deposited reserves for replacements shall be available to provide purchase money for necessary material replacements of furnishing and/or equipment and major repairs.
(g) To obtain the disbursement of operating escrow account funds, other than in the case of imminent peril, a nursing home company shall submit in advance to the State Department of Health such documentation as may be necessary for its approval.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 630 SPECIAL REQUIREMENTS FOR LOCAL GOVERNMENTAL APPLICANTS
10 CRR-NY 630.1 Application for approval for the establishment of hospitals, public home infirmaries or other facilities for inpatient care of the sick by a county, city, town, village or other governmental subdivision
(a) An application to the Public Health Council for approval for the establishment of a public general hospital, public home infirmary or other facility for inpatient care shall comply with the provisions of Part 600 of this Title. Such application shall include:
(1) A request for the council's approval for the establishment of the proposed facility or for the establishment of an agency concerned with the establishment of any such facility which request shall be made on the forms supplied therefor, be properly executed by one or more authorized persons and contain the prescribed information.
(2) All other data and documents required or submitted as part of the application.
(b) The application shall provide the information and data necessary for the council to refer the application to and obtain the recommendations and advice from the sources required by law, and to enable the council properly to consider and act on the application. It shall also indicate the name of the county, city, town, village or other governmental subdivision; purpose for which the request is made (creation of an agency “concerned with the establishment of”, the proposed facility and/or establishment of a facility); type of facility proposed to be established (public general hospital, public hospital for the chronically ill, public home infirmary or other); name and location of proposed facility and the territory to be served; and bed capacity, appropriately classified (single, semiprivate, ward, free).
(c) The application shall provide the information and data with reference to:
(1) The public need for the existence of the proposed facility at the time and place sad under the circumstances proposed.
(2) The financial resources and sources of future revenue of the facility that is proposed to be established and of the applicant.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.19 Food service
(a) Kitchens, dining areas and food service shall comply with Part 14 of this Title.
(b) When food is provided by the camp, it shall be of sufficient quantity and quality for the nutritional needs of each child.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
COMMISSIONER OF HEALTH COMMISSIONER OF HEALTH
10 CRR-NY 11.11 Qualifications
(a) A commissioner of health of a county, or a city having a population of 50,000 or more and having an established department of health, shall be a physician who is currently registered to practice medicine in New York State and possesses two years' of experience in administrative practice that demonstrates that the candidate possesses the knowledge and skills to administer public health programs including workforce and budget management, effective communications, effective establishment and implementation of policy or business goals, and compliance with legal requirements and:
(1) certification by the American Board of Preventive Medicine; or
(2) a master's degree in public health from a regionally accredited or New York State-registered college or university that demonstrates the core competencies of a masters in public health (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavior sciences) or a masters degree in a related field from a regionally accredited New York State-registered college or university.
(b) All appointments to the position of commissioner of health must be approved by the State Commissioner of Health.
(c) Candidates who do not meet the education or experience requirements of this section may be conditionally approved by the State Commissioner of Health for an appointment of two years, with an opportunity for two additional one-year conditional renewals. Final approval of these candidates shall be contingent on satisfactory progress in meeting a public health education or experience plan developed in conjunction with and approved by the State Commissioner of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 413 CONSUMER INFORMATION SYSTEM
10 CRR-NY 413.1 Consumer information
(a) The department shall issue to each nursing home consumer information based on the findings from any on-site regulatory visit.
(b) Consumer information shall include as a minimum the residential health care facility (RHCF) survey profile which summarizes the results of a regulatory visit; any statement of deficiencies issued since the last certification survey; the enforcement poster, if applicable; and other information relating to the facility available through the consumer information system.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.14 Electrical safety
The electrical service, wiring and fixtures shall be in good repair and safe condition. Where conditions indicate a need for inspection, the electrical service and wiring shall be inspected by a qualified electrical inspector, and a copy of the inspection report and certificate of approval submitted to the permit-issuing official.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 456 COST-FINDING PRACTICES AND PROCEDURES
10 CRR-NY 456.5 Compilation of statistical data
The cost allocation process utilizes statistics in distributing costs among the various residential health care facilities services. In order to facilitate the development of appropriate statistical data, set forth below is a definition and source of the required statistic for each nonrevenue-producing department. The statistical bases for cost allocation for ancillary services are the same as the standard units of measure except that such statistics must be segregated by program level of patients served.
| Statistic | Definition or method of computation | Source | | --- | --- | --- | | (a) Square feet, net | The number of net square feet in each department should be determined either by a physical measurement of the facility or by a measurement from blueprints. Floor area measurements should be taken from the center of walls to the center of adjoining corridors if a hallway services more than one department. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only one department should be included in that department. When changes in assigned areas have been made during the year as a result of new construction, departmental relocation, expansion or curtailment of service, statistical data should be maintained to allow for the development of weighted areas for the fractional part of the year. Where the same area serves more than one function, this area must be apportioned between functions. Where costs applicable to a particular building are identifiable, e.g., depreciation, the costs should be distributed by the square feet in that building alone, and to the corresponding department. | Blueprints of the residential health care facility or actual measurement if blueprints are not available. | | (b) Square feet, gross | The number of gross square feet in each department should be determined by a physical measurement of the residential health care facility or by a measurement from blueprints. Measurement should be taken from the exterior wall or railing to the center of adjoining interior corridors if a hallway services more than one department. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only one department should be included in that department. When changes in assigned areas have been made during the year as a result of new construction, departmental relocation, expansion or curtailment of service, statistical data should be maintained to allow for the development of weighted areas for the fractional part of the year. Where the same area serves more than one function, this area must be apportioned between or among the appropriate functions. Where costs applicable to a particular building are identifiable, e.g., depreciation, the costs should be distributed by the square feet of that building alone, and to the corresponding department. | Blueprints of the residential health care facility or actual measurement if blueprints are not available. | | (c) Major movable equipment depreciation, by department | Depreciation on major movable equipment allocated to departments, based on the department where the equipment is physically located and utilized. For acquisitions prior to 1/1/78, allocation may be based on square feet, net. | General accounting records and blueprints of the residential health care facility or actual measurement. | | (d) Square feet of building for which debt incurred and actual depreciation of major movable equipment | The interest expense related to the building and fixed equipment must be allocated to departments in the building based upon gross square feet. The interest expense related to the major movable equipment will be allocated based upon actual department depreciation of major movable equipment. | General accounting records and blueprints of the residential health care facility or actual measurement. | | (e) Depreciation by building, by department | The depreciation expense for each building distributed through gross square feet to departments in that building. | General accounting records and blueprints of the residential health care facility or actual measurement. | | (f) Accumulated costs | The direct costs of each reporting center and indirect costs previously allocated. inversion process.) | Stepdown report. (For) other than the matrix | | (g) Hours of service | Accumulated hours of service to departments or by program. | Departmental records. | | (h) Dietary meals served | Number of meals served shall include only regularly scheduled meals and exclude snacks and fruit juices served between regularly scheduled meals. Also includes tube feeding at the rate of three meals for each day so fed. | Actual count maintained by dietary department. | | (i) Average number of employees | The average number of employees in each department. This average should be computed by using at least one pay period per quarter. | Payroll records. | | (j) Total hours of direct nursing service | Hours of nurses providing direct patient care for which administration is provided. | Payroll records. | | (k) Assigned time of students | Hours of students enrolled in programs by assigned department. | Education records. | | (l) Assigned time—interns and residents | Number of full-time equivalent interns and residents in approved teaching programs, by assigned departments. | Education records. | | (m) Time spent | Number of minutes/hours utilized by a department. | Departmental log. | | (n) Dry and clean pounds distributed | Statistic shall include the weight of linen distributed for the residential health care facility's use (including linen of personnel quarters and employee housing). Also shall include equivalent weight of disposable linens distributed. | Actual count maintained in the laundry and linen department. | | (o) Number of rooms occupied by department assigned | Where housing is provided, a count of the number of rooms occupied by physicians and employees, totaled by the departments they are assigned to, regardless of whether or not the facility receives income. | Personnel records and general accounting records. | | (p) Costed requisitions | The aggregate cost of goods supplied to departments. For the Pharmacy cost center, the prices shown in the Red Book or Blue Book reference manuals may be utilized rather than actual invoice. price. Such reference manuals are published annually (the Red Book one half of the year; the Blue Book the other half). | General accounting records. | | (q) Number of cases reviewed, by program area | Number of patient cases reviewed by Utilization Review personnel, by program area. | Department records. | | (r) Number of users, by program area | Number of patients using transportation, by program area. | Department log. | | (s) Assigned time | The hours (or other unit of time) assigned to service each department. Exclude common or unused areas. Time assigned to shared areas is to be allocated to the reporting centers sharing those areas on an equitable basis. | Department log. |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.21 Capital cost reimbursement for proprietary residential health care facilities
(a) Definitions.
As used in this section, the following terms shall be defined as follows:
(1) Capital indebtedness.
The term capital indebtedness shall mean all debt obligations of a facility that are:
(i) evidenced by a mortgage note or bond and secured by a mortgage on the land, building or nonmovable equipment of a facility or evidenced by a note incurred in accordance with subparagraph (ii) of this paragraph;
(ii) incurred for the purpose of financing the acquisition, construction or renovation of land, building or nonmovable equipment (hereinafter called the “authorized purpose”); and
(iii) found by the commissioner to be reasonable, necessary and in the public interest with respect to the facility in accordance with standards set forth in section 86-2.21(e)(3)(ii) of this Subpart. Refinancing of capital indebtedness shall be recognized only to the extent of the then unpaid balance of the debt being refinanced.
(2) Commissioner.
The term commissioner shall mean the Commissioner of Health of the State of New York.
(3) Department.
The term department shall mean the Department of Health of the State of New York.
(4) Equity.
The term equity shall mean all cash or other assets, net of liabilities, invested by a facility or its operator in land, building and nonmovable equipment, and found by the commissioner to be reasonable, necessary and in the public interest with respect to the facility. Equity shall not include any change in the book value of a facility resulting from revaluation of assets or from the amortization of capital indebtedness resulting from payments made pursuant to subdivision (e), paragraph (3) of this section.
(5) Facility.
The term facility shall mean a proprietary residential health care facility, as the term residential health care facility is defined in article 28 of the Public Health Law and in regulations of the department.
(6) Initial allowed facility cost.
The term initial allowed facility cost shall mean the portion of certified costs approved by the commissioner or, in the case of facilities granted operating certificates prior to April 15, 1973, the costs of the facility as verified by audit to the satisfaction of the commissioner or, in the case of facilities not able to comply with either of the foregoing standards, costs imputed pursuant to subdivision (g) of this section, in or prior to the first year of useful facility life attributable to the acquisition of land and the construction, acquisition or renovation of building and nonmovable equipment. The commissioner shall disregard any costs relating to prior transactions involving the facility which he finds were not bona fide or the terms of which are found to be other than fair and reasonable.
(7) Useful facility life.
The term useful facility life shall mean a period of 40 years measured from the calendar year in which a facility commences operations as determined by the commissioner.
(8) Rate of return.
The term rate of return shall mean the annual rate of return on equity invested, and said rate for a rate year shall be equal to the yield on 30-year United States Treasury bonds in effect on the second Wednesday of September of the year prior to the rate year.
(9) Capital improvement.
The term capital improvement shall mean any addition to, replacement of, or improvement of a capital item of plant or nonmovable equipment approved by the commissioner as reasonable, necessary and in the public interest.
(10) Capital improvement cost.
The term capital improvement cost shall mean the actual expenditure or portion thereof attributable to a capital improvement approved by the commissioner as reasonable, necessary and in the public interest.
(11) Hospital-based residential health care facility.
The term hospital-based residential health care facility shall mean a facility holding a certificate of operation as a residential health care facility which is wholly owned by a hospital as that term is defined in Subpart 86-1 of this Title, and is physically located in a building or buildings, part of which building or buildings are also used for provision of acute care hospital services.
(12) Effective term.
The term effective term shall mean the number of years and months required, pursuant to the term of the note or mortgage, to fully amortize the principal of the debt, predicated upon the regular principal payments required by the mortgage or note, but determined without regard to any provision for making the balance all due and payable at a given date or upon a stated event, and without regard to any provision for acceleration of the debt or any original or subsequent agreement for the suspension or moratorium of principal payments.
(b) Subject to subdivision (f) of this section, the reimbursement rate of every facility certified by the commissioner and approved by the State Director of the Budget pursuant to article 28 of the Public Health Law shall, in each year of useful facility life, include a capital cost component determined in accordance with the provisions of subdivision (c), (d) or (e) of this section applicable to the facility in such year.
(c)
(1) The provisions of subdivision (e) of this section shall not apply for the term prescribed by paragraph (3) of this subdivision to any facility which, as of the effective date of this section, is located in and operated from leased space pursuant to a lease:
(i) which was entered into and approved for reimbursement prior to March 10, 1975; and
(ii) which the commissioner finds to be bona fide, valid and noncancelable; and
(iii) the payments, or a portion thereof, made pursuant to such lease are found by the commissioner to have been the proper basis for reimbursement of capital cost paid to such facility pursuant to article 28 of the Public Health Law prior to March 10, 1975.
(2) The capital cost component of a facility within the provisions of paragraph (1) of this subdivision shall, for the term prescribed by paragraph (3) of this subdivision, consist of a payment factor sufficient to reimburse the facility for the total payments required under its lease to the extent approved by the commissioner pursuant to paragraph (1) of this subdivision, and subject to the historical limitations set forth by the commissioner.
(3) Capital cost reimbursement for leased facilities shall be made pursuant to this subdivision for the balance of the lease term (computed without regard to any future extension or option to renew authorized by the lease) remaining as of the effective date of this subdivision. Upon the expiration of such balance of the lease term provided in an approved lease (as said lease so provides as of August 1, 1977) or such earlier expiration date as may be agreed to by the parties to an approved lease, capital cost reimbursement shall be made pursuant to subdivision (e) of this section notwithstanding any extension or renewal of such lease or the execution of a new lease by or on behalf of the facility; provided, however, that the commissioner may, in his discretion, continue capital cost reimbursement for such leased facilities pursuant to this subdivision, at a rental amount approved by the commissioner prior to such extension or renewal, and not pursuant to subdivision (e), upon his finding that there is a public need for such facility at the time and place and under the circumstances proposed and that the continued operation of such facility would be jeopardized by a limitation of reimbursement pursuant to subdivision (e).
(4) A lease with a related organization described in subdivision (a) or (d) of section 86-2.26 of this Subpart shall be deemed to be a non-arms length lease.
(5) Any capital expenditures associated with non-arms length leases shall be approved and certified to, if required, pursuant to article 28 of the Public Health Law. In the computation of reimbursement for non-arms length leases, the capital cost shall be included in allowable costs only to the extent that it does not exceed the amount which the facility would have included in allowable costs if it had legal title to the asset (the cost of ownership), such as straight-line depreciation, insurance, and interest. Accelerated depreciation on these assets may not be included in allowable costs under any circumstances.
(d) The provisions of subdivision (e) of this section shall not apply to hospital-based residential health care facilities. Such facilities will be reimbursed pursuant to capital cost regulations in Subpart 86-1 of this Part.
(e)
(1) Subject to the provisions of subdivisions (c), (d) and (f) of this section, the capital cost component for every facility shall consist of the payment factors provided in this subdivision that, in any year of useful facility life, are applicable to the facility.
(2) Interest.
The capital cost component shall, in each year of useful facility life, include a payment factor sufficient to reimburse, at a rate which the commissioner finds to be reasonable under the circumstances prevailing at the time of the placing of the capital indebtedness, interest on capital indebtedness.
(3) Amortization.
(i) Subject to the limitations of paragraph (5) of this subdivision, the capital cost component shall, in each year of useful facility life, include a payment factor sufficient to reimburse the amortization component of capital indebtedness pursuant to the terms of the mortgage note or bond.
(ii) The capital indebtedness of a facility, to the extent that the original principal of such debt does not exceed the initial allowed facility cost of the facility, shall be recognized as follows:
(a) For capital indebtedness with an effective term of 10 years or less, amortization expense will be recognized for the purpose of reimbursement only, if the schedule of debt amortization is within the limitation set forth in section 86-2.21(e)(5) of this Subpart for each of the years of debt amortization.
(b) For capital indebtedness with an effective term in excess of 10 years, amortization expense will be recognized for the purpose of reimbursement upon a determination by the commissioner that the following standards are met:
(1) the debt is incurred for authorized purposes;
(2) the interest rate is reasonable for the time and place in which the capital indebtedness is committed, and for the type of indebtedness associated with the interest rate;
(3) the amortization schedule is reasonable (amortization must be required in each year of the mortgage in accordance with the established financial practices);
(4) the effective term is consistent with customary commercial practices in the geographic area of the facility; and
(5) the effective term is in accordance with efficient production of services.
(c) For capital indebtedness other than first mortgages, the amortization expense will be recognized for the purpose of reimbursement upon a determination by the commissioner that the debt, complies with the standards set forth in section 86-2.21(e)(3)(ii)( b ) of this Subpart, and the following additional standards:
(1) they must be incurred for the purpose of financing either an approved purchase or construction of a facility; and
(2) the effective term of financing for a capital improvement is reasonable when compared to the estimated useful life of the improvement.
(d) Capital indebtedness for any unauthorized purpose will not be recognized for any reimbursement purpose.
(4) Return of equity.
Subject to the limitations of paragraph (5) of this subdivision, the capital cost component shall include a payment factor sufficient to return equity. A facility shall be eligible for the return of equity commencing in the first year following the department's determination, among other factors, that the facility has the ability to meet current capital indebtedness (including principal and interest) over the balance of useful facility life. This shall mean that within the confines of the regulations expressed in this Subpart, capital reimbursement will be sufficient to provide for the remaining amortization of capital indebtedness. The commissioner's determination shall also take into account such factors as the age, size, location and condition of the facility, and the financial condition of the facility.
(5) Limitation.
(i) Annual reimbursement payments for capital cost under paragraphs (3) and (4) of this subdivision shall not at any time result in a cumulative average payment in excess of three and three one-hundredths percent of initial allowed facility cost. For years prior to 1981, actual amortization or depreciation paid by Medicaid will be used in the computation of the limitation. For years prior to Medicaid or in years when Medicaid payments did not include an expense equivalent of depreciation or amortization, a three and three one-hundredths percent payment will be imputed.
(ii) This limitation may be waived by the commissioner where a facility applies to the commissioner for approval to refinance an existing mortgage because its recognized amortization expense exceeds the amount of allowable reimbursement for amortization of principal and interest expense (including credit from prior amortization reimbursement). In those instances where the commissioner determines that it would be more expensive to reimburse the debt service that would be incurred if the facility refinanced the remaining principal, than it would be to continue to reimburse the debt service on the existing mortgage, the commissioner may reimburse up to the actual debt service incurred by the facility under the existing mortgage, plus return on equity in accordance with the provisions of paragraph (6) of this subdivision.
(6) Return on equity.
The capital cost component for every facility shall include a payment factor sufficient to pay an annual rate of return on average equity, as such average annual equity shall be determined by the commissioner in each year of useful facility life.
(7) Residual reimbursement.
After the expiration of useful facility life, the commissioner may approve a payment factor for any facility for which he determines that continued capital cost reimbursement is appropriate; provided, however, that such payment factor shall not exceed one half of the capital cost reimbursement received by such facility in the final year of useful facility life.
(8) Capital improvement cost reimbursement.
(i) The capital improvement cost shall be reimbursed by adjusting the initial allowed facility cost, capital indebtedness, equity determinations and limitations as stated in paragraph (5) of this subdivision, to include the capital improvement cost.
(ii) Adjustments in accordance with subparagraph (i) of this paragraph shall be made in the following manner:
(a) if the cost of an improvement is $100,000 or more, and certificate of need approval has been granted by the commissioner, then component useful life for the improvement will be permitted. Such component useful life will be equivalent to the estimated asset life in accordance with the Medicare Provider Reimbursement Manual or the remaining useful life of the facility, whichever is less. Where a capital improvement adjusts the expected useful life of the facility beyond the remaining portion of the original useful facility life, the limitation set forth in section 86-2.21(e)(5) of this Subpart, will be increased to allow for the reimbursement of the amortization component of the debt obtained to finance the improvement.
(b) If the cost of an improvement is less than $100,000, then the cost will be reimbursed over the remaining portion of the expected useful life. In such instances the reimbursement will commence with either the reporting of such costs on an annual certified cost report or, upon submission of a cost report, certified by an independent public accountant, whichever is submitted first. In either event, the reporting of such costs must be accompanied by a sworn statement by the administrator or the chief fiscal officer of the facility to the effect that the improvements made are not part of a number of planned related projects which, in the aggregate, total $100,000 or more.
(c) If the cost of an improvement is less than $100,000 and:
(1) is undertaken as the result of an emergency situation;
(2) affects the health and safety of the patients; and
(3) the facility can demonstrate dire financial condition; then the limitation set forth in section 86-2.21(e)(6) of this Subpart will be modified to allow for the reimbursement of the debt service associated with the financing of the approved capital improvement over the effective term of the obligation or five years, whichever is greater. Any contribution to the improvement by the facility and not financed by the debt obligation will be considered an equity contribution and an adjustment to the facility's total capital equity will be made.
(d) If a facility undertakes an authorized improvement without incurring additional debt, then the facility will receive a return on equity and, when a determina tion has been made in accordance with section 86-2.21(e)(4) of this Subpart, a return of equity, for the funds invested in the improvement.
(f)
(1) With respect to facilities granted operating certificates prior to March 10, 1975, the commissioner may modify or provide exceptions to subdivision (c) or (e) of this section in circumstances where he finds that application of the provisions of either subdivision would result in (1) excessive reimbursement to the facility, or (ii) severe economic hardship to the facility not caused by circumstances reasonably under the control of the facility. In determining severe economic hardship, the commissioner shall consider such factors as debt service required on capital indebtedness, prior withdrawal of assets from the facility, and the financial condition of the facility in general. In such cases where the commissioner makes a finding of severe economic hardship, the capital cost component of the rate shall not exceed the debt service on capital indebtedness.
(2) The commissioner may revise the capital cost component of the reimbursement rate applicable to any facility which he determines is based upon previous error, deceit or any other misrepresentation or misstatement by the facility.
(3) The capital cost component shall not be affected by any sale, lease or transfer occurring after March 10, 1975.
(g) In lieu of determining initial allowed facility cost pursuant to subdivision (a) of this section, the commissioner may estimate the original fair and reasonable cost of the facility with due regard for the fair and reasonable cost of facilities of comparable age, size, location and condition, and impute an initial allowed facility cost to:
(1) every facility for which records on the historical cost or book value of land, building or nonmovable equipment are not available or not verifiable to the satisfaction of the commissioner;
(2) every leased facility which, as of the effective date of this section, is not eligible for reimbursement pursuant to subdivision (c) of this section;
(3) every facility which, after the effective date of this section, ceases to be eligible for reimbursement pursuant to subdivision (c) of this section and becomes eligible for reimbursement pursuant to subdivision (e) of this section; or
(4) every facility whose construction was completed prior to the calendar year in which this section becomes effective and whose initial facility year occurs in or after the calendar year in which this section becomes effective.
(h) In the event that a facility fails to submit information necessary for the implementation of this section, after notification pursuant to subdivision (f) of section 86-2.2 of this Subpart, the capital cost component of the rate shall consist of interest, if reported, and amortization not in excess of the lesser of the amortization payment required under capital indebtedness, or 2<< percent of initial allowed facility cost.
(i)
(1) The limitation provision of paragraph (e)(5) of this section may be waived for certain qualifying facilities. In order to be considered a qualifying transaction, all of the following conditions must be met:
(i) A sale or transfer between nonrelated parties must take place.
(ii) The purchaser must assume the seller's remaining mortgage repayment schedule at the associated fixed rate of interest.
(iii) The difference between the unpaid principal balance of the seller's mortgage (first mortgage) and the Medicaid-allowable transfer price must be generated either from second mortgage proceeds or contributed equity capital or both.
(iv) The annual amount of allowable interest expense incurred as described in this section, under the terms of the first and second mortgage, plus the annual principal debt amortization must be less than that which would otherwise be reimbursed pursuant to this section, if no assumption of the existing first mortgage were made. (This comparison is hereinafter referred to as the comparative analysis test.) For purposes of this subdivision, the loan-financed portion of the Medicaid-allowable transfer price shall be held constant and the comparative analysis test shall be applied to each year of the effective term of the first and second mortgages. In instances where more than one facility is involved in the transaction, the facilities may be combined for purposes of the comparative analysis test.
(2) Qualifying facilities shall be reimbursed principal debt amortization, interest and return of equity in the following manner:
(i) Principal debt amortization. In each year, during the effective term of the mortgage, the capital cost component of the rate shall include a payment factor sufficient to reimburse the principal debt amortization component of the allowable portion of the mortgage.
(ii) Interest. The capital cost component shall include a payment factor sufficient to reimburse interest associated with the allowable portion of the mortgage as defined by paragraph (e)(2) of this section.
(iii) Return of equity. The equity portion of the Medicaid-allowable transfer price shall be reimbursed in equal annual amounts beginning in the first year following the expiration of the term of the mortgages over the remaining useful facility life.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.16 Receptacle for used towels
A covered receptacle which can be readily emptied and cleansed shall be provided exclusively for soiled towels or linen.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
TOXIC MATERIALS TOXIC MATERIALS
10 CRR-NY 14-1.60 Poisonous and toxic materials; restrictions; labeling and storage
Poisonous and toxic materials are restricted to those required to maintain sanitary conditions, which include pest control and sanitization, and when so used in food establishments are to be prominently labeled and lawfully permitted under State and Federal regulations, and are to be used in accordance with label directions.
(a) Poisonous and toxic materials are to be stored in areas designated for such use and for no other purpose, or in a storage area outside the food, equipment and utensil storage area. Bactericides and cleaning compounds are not to be stored with insecticides, rodenticides or other poisonous materials. Insecticides and rodenticides are to be kept in their original containers. Insecticide spraying is prohibited in food preparation and service areas while food is being processed, prepared or served, or where unprotected food, clean utensils or containers are displayed or stored.
(b) Bactericides, cleaning compounds or other compounds used on food-contact surfaces are not to leave toxic residues on such surfaces.
(c) Phenolic compounds may not be used for sanitizing food-contact surfaces.
(d) First-aid supplies and personal medications are restricted to designated locations.
(e) The use of unprotected bait stations in food storage, service and preparation areas and in utensil washing and storage areas is forbidden.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.19 Water quality
(a) Sample collection and analysis.
Microbiological samples shall be collected from spray pad treatment tanks when determined by the permit-issuing official to be necessary to evaluate water quality, and be examined in laboratories approved by the New York State Department of Health.
(b) Microbiological quality.
Total coliform bacteria levels should not exceed 4 per 100 milliliters in more than one sample examined each month. When the membrane filter technique is used, or when the fermentation tube method is used, coliform bacteria shall not be present in more than 10 percent of portions analyzed in any month; also, total bacteria (heterotrophic plate count or standard plate count) shall not exceed 200 per milliliter.
(c) Chemical quality.
(1) The chemical quality of the spray feature water shall not cause irritation to the eyes or skin of the patrons or have other objectionable physiological effects on patrons.
(2) The total alkalinity of the spray pad treatment tank water shall be maintained within the range of 80 to 120 mg/l.
(3) The spray pad treatment tank water shall be chemically balanced. The permit-issuing official may require that the operator determine the saturation index monthly or at any other frequency required to maintain water clarity, proper disinfection, alkalinity, and pH levels.
(d) Cleanliness.
The spray pad and features shall be kept free of sediment and visible soil, and the treatment tank water surface shall be kept free of visible floating matter.
(e) Turbidity.
The turbidity in the spray pad treatment tank shall not exceed three nephelometric turbidity units (NTU) at any time during use. If this turbidity level is exceeded, the spray pad shall be closed for use until the spray pad treatment system reduces the turbidity to less than three NTU.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 112 DUTCHESS COUNTY
INSTITUTIONS INSTITUTIONS
10 CRR-NY 112.30 Harlem Valley State Hospital, Wingdale
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs, watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, serving as sources of the water supply of the Harlem Valley State Hospital at Wingdale, Dutchess County, New York.
(b) Definition of terms.
(1) The term water supply means the water supply of the Harlem Valley State Hospital, Wingdale, Dutchess County, New York.
(2) The term reservoir means any natural or artificially impounded body of water serving as the source of the aforesaid water supply and to any additional reservoir which may be constructed or used for this water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any reservoir or 75 feet from any watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or 25 feet of any watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the distances of 200 feet and 100 feet from any reservoir or 50 feet and 25 feet from any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 200 feet of any reservoir or 50 feet of any watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall be located not less than 100 feet from any reservoir or 25 feet from any watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans, which shall first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes shall be allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or 25 feet of any watercourse.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir or 25 feet of any watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in any reservoir.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may directly pollute any reservoir.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir or 25 feet of any watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Fishing, boating and ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir except by duly authorized employees of the Harlem Valley State Hospital in the performance of their duties of supervision and maintenance of the water supply.
(j) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the water supply.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or 25 feet of any watercourse tributary to the water supply.
(l) General clause.
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, not heretofore specified, which may result in contamination of any portion of the water supply of the Harlem Valley State Hospital.
(m) Inspections.
The superintendent of the Harlem Valley State Hospital or such other person or persons as may be charged with the maintenance or supervision of the water supply of the Harlem Valley State Hospital or the duly appointed representatives of such superintendent shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said superintendent to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said superintendent to promptly notify the State Commissioner of Health of such violations. The superintendent shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(n) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.13 Isolation and quarantine procedures
(a) Duty to issue isolation and quarantine orders.
(1) Whenever appropriate to control the spread of a highly contagious communicable disease, the State Commissioner of Health may issue and/or may direct the local health authority to issue isolation and/or quarantine orders, consistent with due process of law, to all such persons as the State Commissioner of Health shall determine appropriate.
(2) Paragraph (1) of this subdivision shall not be construed as relieving the authority and duty of local health authorities to issue isolation and quarantine orders to control the spread of a highly contagious communicable disease, consistent with due process of law, in the absence of such direction from the State Commissioner of Health.
(3) For the purposes of isolation orders, isolation locations may include home isolation or such other residential or temporary housing location that the public health authority issuing the order determines appropriate, where symptoms or conditions indicate that medical care in a general hospital is not expected to be required, and consistent with any direction that the State Commissioner of Health may issue. Where symptoms or conditions indicate that medical care in a general hospital is expected to be required, the isolation location shall be a general hospital.
(4) For the purposes of quarantine orders, quarantine locations may include home quarantine, other residential or temporary housing quarantine, or quarantine at such other locations as the public health authority issuing the order deems appropriate, consistent with any direction that the State Commissioner of Health may issue.
(b) Any isolation or quarantine order shall specify:
(1) the basis for the order;
(2) the location where the person shall remain in isolation or quarantine, unless travel is authorized by the State or local health authority, such as for medical care;
(3) the duration of the order;
(4) instructions for traveling to the isolation or quarantine location, if appropriate;
(5) instructions for maintaining appropriate distance and taking such other actions as to prevent transmission to other persons living or working at the isolation or quarantine location, consistent with any direction that the State Commissioner of Health may issue;
(6) if the location of isolation or quarantine is not in a general hospital, instructions for contacting the State and/or local health authority to report the subject person’s health condition, consistent with any direction that the State Commissioner of Health may issue;
(7) if the location of isolation or quarantine is a multiple dwelling structure, that the person shall remain in their specific dwelling and in no instance come within six feet of any other person, and consistent with any direction that the State Commissioner of Health may issue;
(8) if the location of isolation or quarantine is a detached structure, that the person may go outside while remaining on the premise, but shall not leave the premise or come within six feet of any person who does not reside at the premise, or such other distance as may be appropriate for the specific disease, and consistent with any direction that the State Commissioner of Health may issue;
(9) such other limitations on interactions with other persons as are appropriate, consistent with any direction that the State Commissioner of Health may issue;
(10) notification of the right to request that the public health authority issuing the order inform a reasonable number of persons of the conditions of the isolation or quarantine order;
(11) a statement that the person has the right to seek judicial review of the order;
(12) a statement that the person has the right to legal counsel, and that if the person is unable to afford legal counsel, counsel will be appointed upon request.
(c) Whenever a person is subject to an isolation or quarantine order, the State Department of Health or local health authority, or the local health authority at the State Department of Health’s direction shall, consistent with any direction issued by the State Commissioner of Health:
(1) monitor such person to ensure compliance with the order and determine whether such person requires a higher level of medical care;
(2) whenever appropriate, coordinate with local law enforcement to ensure that such person comply with the order; and
(3) the extent such items and services are not available to such person, provide or arrange for the provision of appropriate supports, supplies and services, including, but not limited to: food, laundry, medical care, and medications.
(d) If the location of an isolation or quarantine order is owned by a landlord, hotel, motel or other person or entity, no such landlord or person associated with such hotel, motel or other person or entity shall enter the isolation or quarantine location without permission of the local health authority, and consistent with any direction that the State Commissioner of Health may issue.
(e) No article that is likely to be contaminated with infective material may be removed from a premise where a person is isolated or quarantined unless the local health authority determines that such article has been properly disinfected or protected from spreading infection, or unless the quarantine period expires and there is no risk of contamination. Such determinations shall be made pursuant to any direction that the State Commissioner of Health may issue.
(f) Any person who violates a public health order shall be subject to all civil and criminal penalties as provided for by law. For purposes of civil penalties, each day that the order is violated shall constitute a separate violation of this Part.
(g) Duty of attending physician.
(1) Every attending physician shall immediately, upon discovering a case or suspected case of a highly contagious reportable communicable disease, cause the patient to be appropriately isolated and contact the State Department of Health and the local health authority where the patient is isolated and, if different, the local health authority where the patient resides.
(2) Such physician shall advise other members of the household regarding precautions to be taken to prevent further spread of the disease, consistent with any direction that the State Commissioner of Health may issue.
(3) Such physician shall furnish the patient, or caregiver of such patient where applicable, with detailed instructions regarding the disinfection and disposal of any contaminated articles, consistent with any direction that the State Commissioner of Health may issue.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.7 Facility participation in title XVIII program
Every facility that provides a service which is reimbursable under the provisions of title XVIII of the Social Security Act shall make application to be an approved provider of such services pursuant to such title. If approved, the facility shall participate in such program and make appropriate claims for payment in any instance in which a patient is eligible for benefits under such program.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.106 Pharmacies
(a) Pharmacies shall keep records of all controlled substances received and delivered or disposed of by them.
(1) The records of controlled substances received by pharmacies shall include date of receipt, name and address of vendor, and kind and quantity of such drug received. A duplicate invoice or separate itemized list furnished by the vendor will be sufficient to satisfy this record requirement for schedule III, IV, and V controlled substances provided it includes all required information and is maintained in a separate file. Duplicate copies of Federal order forms for schedule II controlled substances shall be retained.
(2) The records of all controlled substances delivered or disposed of shall consist of the prescriptions filled for such drugs. The prescription shall indicate the name and address of the prescriber, Drug Enforcement Administration registration number, signature of the prescriber, name and address of the patient, date of issue, date of dispensing by pharmacist, serial number, type and quantity of drug and such other information as may be required by this Part or provisions of article 33 of the Public Health Law.
(b)
(1) Schedule II controlled substances prescriptions shall be maintained together in a separate file.
(2) Schedule III, IV and V controlled substances prescriptions shall be maintained together in a separate file.
(c) If a prescription for a schedule II, III, IV or V controlled substance is created, signed, transmitted and received electronically, all records related to that prescription shall be retained electronically. These records shall be readily retrievable from all other records, and shall be easily readable or easily rendered into a format that a person can read.
(d) If a pharmacy ceases to use an application service provider, the pharmacy shall ensure that the application service provider transfer any records subject to this Part to the pharmacy in a format that can be displayed, read, and printed, and in a manner readily accessible to, and readable by, representatives of the department.
(e) Pharmacies shall keep a separate record of all controlled substances distributed to an automated dispensing system and returned to the pharmacy from such system.
(f) Pharmacies shall keep a separate record for an automated dispensing system for all records required by this Part.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.2 Construction
Terms not defined in this Subpart are defined in Subpart 52-1 of this Part. Cardiovascular tissue banks shall apply for licensure and otherwise comply with Subpart 52-2 of this Part, and shall meet all general technical standards for tissue banks specified in Subpart 52-3 of this Part.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.13 Audits by local health officials
Local health officials shall audit a sufficient number of provider reports, medical records, and if necessary, interview physicians and other personnel to determine whether a provider has furnished or is furnishing tuberculosis health care services in accordance with the requirements of this Subpart.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 360 SURGE AND FLEX HEALTH COORDINATION SYSTEM ACTIVATION DURING A STATE DISASTER EMERGENCY DECLARATION
10 CRR-NY 360.1 Administrative purpose, application and scope
(a) Administrative purpose.
As of July 2020, there are 213 hospitals - public, private, and independent - across New York State, each operating as essentially a private entity in a highly competitive environment. Prior to the COVID-19 pandemic, these individual institutions and hospital networks rarely worked together or coordinated as a unified healthcare system. But a pandemic on the scale of the COVID-19 crisis demonstrated that our health care facilities could not meet the demand of the moment unless a new and innovative system was put into place requiring unprecedented coordination, cooperation, and agility. No one situation best encapsulates this lack of coordination than what transpired at Elmhurst Hospital, a facility in the New York City-operated Health & Hospitals (H&H) system, during the third week of March. Elmhurst Hospital was overwhelmed with patients at a time when there were just 4,000 total COVID-19 hospitalizations statewide, nearly 900 available beds across the eleven hospitals in the H&H system, and more than 3,500 open beds across all public and private hospitals in New York City. In other words, the problem the Elmhurst situation exposed was not one of hospital capacity, but one of patient load management across all hospitals and hospital systems. As the Elmhurst situation demonstrated, the COVID-19 crisis demanded a new coordinated approach to ensure no one hospital was overwhelmed by COVID-19 patients or needed more ventilators, while a hospital nearby had capacity for more patients and excess equipment. There was an immediate realization that if peak projections actually materialized in New York, it was imperative for government to coordinate and organize all hospitals under the umbrella of one unified system, and efficiently use all the resources available in the State to attempt to meet the significant demands of the crisis. This approach was operationalized in late March when Governor Andrew M. Cuomo directed the New York State Department of Health (NYSDOH) to create a new and innovative Surge and Flex system, designed to create for the first time one singular coordinated statewide public healthcare system to prevent the virus from overwhelming any one hospital in the State. The approach was literally a life-saver—it helped New York at our peak of hospitalizations in April to facilitate the transfer of thousands of patients. The purpose of this NYSDOH regulation is to institutionalize the Surge and Flex operation to both allow the State to quickly activate Surge and Flex in the event of a resurgence of coronavirus, while also giving hospitals the time and guidance to adequately prepare for a potential future activation of Surge and Flex. The Surge and Flex system operation launched in March 2020 included four key elements which this regulation will institutionalize, in this subdivision.
(1) First, the State quickly built unprecedented hospital capacity.
Health experts modeled that New York State could potentially need as many as 140,000 COVID-only hospital beds when there were only 53,000 hospital beds total in the entire State. As a result, New York State had to quickly build unprecedented bed capacity including requiring all hospitals to delay non-life-threatening elective procedures and increase their number of beds by at least 50 percent (by turning single rooms into doubles and freeing meeting rooms and other areas for patient care among other measures) and preferably 100 percent. In addition, the State worked with local and Federal government partners to deploy and stand up temporary hospitals and create contingency plans with large-scale venue operators, hotels, and college dormitory operators, to ensure we were prepared for a worst-case scenario - a projected need for as many as 140,000 COVID patients hospitalized at one time. In total, this approach enabled New York State in a matter of weeks to expand hospital capacity from 53,000 total beds to more than 90,000.
(2) Second, more beds require more staff.
Staffing was a major issue. In many cases, health care staff were becoming sick with COVID and unable to work. This put tremendous strain on the system. To address staffing shortages, New York State established a web portal to recruit and connect health care professionals from across the nation willing to serve, an effort that enlisted the support of nearly 100,000 health care workers. New York State connected these healthcare heroes with housing as needed and provided support to hospital human resource offices to expedite the onboarding process. Further, New York State facilitated transfers of healthcare staff from upstate hospitals that had few COVID-19 patients to hospitals in New York City in need of staffing support. In the case of another wave of COVID-19 or another infectious disease it is critical that extra staffing capacity be available to meet the emergency.
(3) Third, more beds require more supplies and equipment.
Access to life-saving supplies and materials was a scramble for every state in the nation because our country is reliant on an international supply chain. There was a dire need for ventilators and there was a literal hunger games scenario among states and nations to purchase enough to meet the demand under the crisis. But purchasing alone wasn’t enough. There simply weren’t enough supplies. To address any potential supply and equipment shortages, New York State used data and a daily reporting system to build a statewide inventory of personal protective equipment (PPE), ventilators, medications and other critical items. Using a reporting system, New York State could take limited resources and distribute them to the hospitals and other institutions that needed them the most. For example, a hospital in New York City may have had only a few ventilators while other facilities nearby had more than 100. The Surge and Flex system allowed for the overburdened hospital to get unused ventilators from a nearby facility. New York State distributed more than 13,000,000 pieces of PPE and other equipment, including thousands of ventilators. To ensure no hospital lacked supplies and equipment while others had excess, the State built an operational system that could quickly transport supplies and equipment from a hospital with excess to a hospital in need.
(4) Fourth, the State had to coordinate all aspects of the Surge and Flex operation.
For this operational undertaking, the State convened a Hospital Capacity Coordination Committee (HCCC), an around the clock command center with representatives from each of the State’s hospital systems to serve as the central hub for operations related to patient transfers, supply and equipment deployment, and staffing support. Guided by online data dashboards that tracked hospital capacity, equipment use, and supply stockpiles by institution in real time, and provided a 24/7 hotline accessible to every hospital in the State, the HCCC had a dedicated desk and assigned leader for every aspect of the operation: patient management, supply and equipment deployment, staffing deployment, and for each supporting function including transportation, legal, and intergovernmental relations.
Taken together, the Surge and Flex strategy enabled New York during our apex in late March and through the month of April to save lives and avoid the type of catastrophic failure of the healthcare system that Italy and other nations experienced. This regulation provides the Department of Health with the necessary tools to enact each of these four critical parts of NYS Surge and Flex operation during a second wave of COVID-19, or a future public health emergency. Further, this regulation is designed to help each hospital and healthcare system prepare for this contingency in order to ensure a straightforward transition from standard operating procedures to Surge and Flex.
(b) Application and scope.
In the event of a State disaster emergency declared pursuant to section 28 of the Executive Law, the commissioner may exercise the authorities granted in this Part, thereby maximizing the efficiency and effectiveness of the State’s health care delivery systems and mitigating the threat to the health of the people of New York. Further, this Part establishes certain ongoing emergency planning requirements, called the Surge and Flex Health Care Coordination System, for facilities and agencies regulated by the department. To the extent that any provision of this Part conflicts with any other regulation of the department, this Part shall take precedence. All authorities granted to the commissioner shall be subject to any conditions and limitations that the commissioner may deem appropriate. The commissioner may delegate activation of the authorities provided by this Part to appropriate executive staff within the department. In the event that there are inconsistent statutes, which would preclude effectiveness of such regulation, such regulation shall be effective upon the suspension of such inconsistent statute by the Governor pursuant to authority in article 2-B of the Executive Law, and such regulation shall immediately be effective.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.3 Medical record access review committee
(a) Every reasonable effort will be made to include on the committee a professional in the same or related field as the health care provider who is the subject of the appeal.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.1 Definitions
As used in this Subpart, the following terms shall have the following meanings.
(a) Hospice shall mean a hospice as defined in article 40 of the Public Health Law possessing a valid certificate of approval issued by the State Commissioner of Health.
(b) A routine home care day is a day on which an individual who has elected to receive hospice care is at home and is not receiving continuous care as defined in subdivision (f) of this section.
(c) A routine home care day for AIDS patients is a day on which an individual who has been diagnosed with Acquired Immune Deficiency Syndrome (AIDS) has elected to receive hospice care, is at home and is not receiving continuous home care as defined in subdivision (f) of this section.
(d) A routine home care day with an escort is a day as defined in subdivision (b) of this section, when the nurse providing care requires the use of an escort for security when visiting the patient's home.
(e) A routine home care day for AIDS patients with an escort is a routine home care day as defined in subdivision (b) of this section when the individual who has elected to receive hospice care has been diagnosed with Acquired Immune Deficiency Syndrome (AIDS) and the nurse providing care requires the use of an escort for security when visiting the patient's home.
(f) A continuous home care day is a day on which an individual who has elected to receive hospice care is not in an inpatient facility and receives hospice care consisting predominantly of nursing care on a continuous basis at home. Home health aide or homemaker services or both may also be provided on a continuous basis. Continuous home care is only furnished during brief periods of crisis, and only as necessary to maintain the terminally ill patient at home. A period of crisis is a period in which the individual requires continuous care to achieve palliation or management of acute medical symptoms.
(g) A continuous home care day for AIDS patients is a day as defined in subdivision (f) of this section when the patient receiving care has been diagnosed as having Acquired Immune Deficiency Syndrome (AIDS).
(h) An inpatient respite care day is a day on which the individual who has elected hospice care receives care in an approved facility on a short-term basis for respite.
(i) A general inpatient care day is a day on which an individual who has elected hospice care receives general inpatient care in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings.
(j) A general inpatient care day for AIDS patients is a day as defined in subdivision (i) of this section, when the patient receiving care has been diagnosed as having Acquired Immune Deficiency Syndrome (AIDS).
(k) Supplemental financial assistance program means the program as established pursuant to section 4012-a of the Public Health Law to provide additional payments to hospices which provide care to patients with special needs, which shall include patients diagnosed with acquired immune deficiency syndrome or patients in environment situations which require the use of escort services for delivery of routine home care in accordance with approved plans required by section 86-6.6(b) of this Subpart, or persons receiving care in a hospice residence.
(l) Room and board services shall mean the provision of personal care services, including assistance in activities of daily living, socializing activities, administration of medications, maintaining the cleanliness of a resident's room and supervising and assisting in the use of durable medical equipment and prescribed therapies by a nursing facility to an individual who has elected to receive hospice care. Room and board services shall also include the services, activities and allowable costs as set forth in section 86-2.10(d) and (g) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.319 Tangible assets
A capital asset having physical existence.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.9 Issuance of blood, blood components and derivatives
(a) Unless they are needed to meet a medical emergency, blood and blood components shall be transported in a leak-resistant, crush-resistant and puncture-resistant container featuring a prominent label which:
(1) identifies the contents as "human blood" or "biomedical product";
(2) describes the contents, the packing agent, if any, and any special precautions necessary in handling such blood; and
(3) contains the name, address and 24-hour telephone number of the person or entity to be contacted in the event that the container is found to be leaking or damaged or to have been misdirected.
(b) Except in an emergency or except as indicated in section 58-2.3(c) or (d) of this Subpart, blood and blood components shall not be made available for allogeneic transfusion, unless a donor blood sample reacts negatively to tests required in section 58-2.3(a) of this Subpart, and testing specified in section 58-2.3(f) of this Subpart has been completed. Untested or incompletely tested blood, including blood from directed donations and cytapheresis collections, shall not be issued if a fully tested blood component is available, except in the case of autogeneic donations, as specified in section 58-2.3(a) of this Subpart. Cytapheresis units for which testing has not been completed may be distributed to a hospital by the facility collecting the units, but such components may not be issued by a transfusion service until testing is complete, except in the case of a life-threatening emergency or when the clinically useful shelf life of the component precludes completion of testing prior to issuance. The release of cytapheresis components from a donor found to have a positive result for anti-HBc may be permitted upon the authorization of the health care provider ordering the transfusion and the written authorization of the medical director or designee who is a physician, provided that such authorization documents the indication and justification for such release. Such components shall be labeled with all positive test results. Blood from a donor whose blood specimen reacts positively in testing for syphilis and is nonreactive in confirmatory testing shall be appropriately labeled and may be used for plasma fractionation. Blood from a donor whose blood specimen reacts positively in testing for anti-HBc shall be appropriately labeled and may be used for plasma fractionation. Blood from a donor whose blood specimen reacts positively in testing for HBsAg, HIV nucleic acid, HCV nucleic acid, or antibodies to HCV, HIV-1, HIV-2, or HTLV-I/II shall be appropriately labeled and may not be used for allogeneic transfusion or for fractionation. Blood from a donor whose blood specimen reacts positively in testing for HBsAg, HIV nucleic acid, HCV nucleic acid, or antibodies to HCV, HIV-1 and/or HIV-2 may not be used for autogeneic transfusion without the written authorization of the patient's physician and, if drawn by another facility, the director of the transfusion service receiving the unit.
(c) Blood, blood components and derivatives shall be issued only if ordered by a licensed physician or other person authorized by law. Recipients shall receive whole blood of the same ABO group or compatible red blood cells. Rho (D)-negative recipients shall receive Rho (D)-negative blood, except for reasonable exempting circumstances as determined by the director of transfusion services. Rho (D)-positive recipients may receive Rho (D)-positive or Rho (D)-negative whole blood or red blood cells. In an emergency, appropriately documented in the records, blood may be released for transfusion prior to the completion of compatibility tests. Any transfusion service which issues blood components for transfusion by a limited transfusion service or ambulance transfusion service shall perform the required tests on its own premises.
(d) Whole blood, red blood cells, plasma and other blood components shall be inspected visually immediately prior to issuance. If the color or physical appearance is abnormal or there is indication or suspicion of microbial contamination, the unit of whole blood or blood components shall not be issued for transfusion.
(e) Blood, blood components or derivatives may not be made available for transfusion beyond the designated expiration date, except that whole blood may be used to prepare plasma within nine days after the designated expiration date, provided that it meets the inspection standards required in subdivision (d) of this section.
(f) An established protocol for processing or pooling of blood components prior to issuance must be in place.
(g) The director of transfusion services shall establish a written policy that specifies the circumstances under which more than one unit of red blood cells for a particular patient may be issued simultaneously for transfusion within a hospital without documented approval of the director of transfusion services or designee who is a physician.
(h) If an unused, unopened unit is returned to the blood bank, the time, date and condition of the unit must be recorded.
(i) A sample of red cells or whole blood from each red cell product issued for transfusion shall be retained for a minimum of seven days after the transfusion for further testing in the event of an adverse reaction.
(j) After issuance, red blood cells may be stored at room temperature for up to one hour or by refrigerating at one to six degrees Celsius. Red blood cells kept at room temperature for more than one hour may not be returned to the blood bank and later reissued for transfusion unless the temperature of the component is documented not to have risen above 10 degrees Celsius. If refrigerated, red blood cells shall be stored in a refrigerator designed for the purpose of storing blood, except that a cooler with suitable coolant may be used for refrigeration, provided that the temperature of the blood is maintained at one to 10 degrees Celsius.
(k) Blood or blood components shall not be identified or labeled or preferentially distributed according to the donor's membership in a category based on age, race, color, creed, national origin, sex, marital status or social organization, except for purposes of phenotyping of blood units. The sequence of issuance by a transfusion service of blood donated for designated recipients shall not be based on factors other than medical considerations.
(l) Blood or blood components from a donor who had been determined in the past to be unsuitable for subsequent donation shall not be released for transfusion unless the donor has been approved for reentry into the donor pool by the director of the blood bank.
(m) Blood components issued to a limited transfusion service shall be transported in a leak-resistant, crush-resistant and puncture-resistant container that has been validated to maintain the appropriate temperature for the anticipated duration of storage and that has a label indicating the issuing transfusion service.
(n) Blood components issued to an ambulance transfusion service shall be transported in a leak-resistant, crush-resistant and puncture-resistant container that has been validated to maintain the appropriate temperature for the anticipated duration of transport and that has a label indicating the intended receiving hospital’s blood bank.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.325 Trade discount
The discount allowed to a class of customers on a list price before consideration of credit terms; as a rule, invoice prices are recorded in the books of account net after the deduction of trade discounts. Trade discounts are not to be confused with cash or purchase discounts which are other operating revenues.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.23 Sanitary services
(a) A towel shall not be used for more than one person without being properly laundered before each use.
(b) The head rest of the chair shall be covered by a properly laundered towel or paper for each customer before the customer is permitted to recline in such chair.
(c) A sanitary paper strip shall be placed completely around the neck of each customer before any apron or hair cloth or any other protective device is fastened around the neck.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.4 Vacancies
The director shall have authority to maintain such a number of vacancies as in his judgment will make adequate provision for immediate admission of possible emergency cases.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.9 Distribution of tissue products
(a) Except as specified in section 52-3.4 of this Part, ocular tissue shall not be made available for transplantation if the donor's blood tests repeatedly reactive in approved screening tests for HBsAg or antibodies to HIV-1, HIV-2 or HCV.
(b) The eye bank shall distribute tissue for transplantation only to another eye bank or to a licensed tissue transplantation facility in possession of a written order by a licensed physician.
(c) Tissue shall be transported by the eye bank or its agents, or by staff or agents of the tissue transplantation facility. A signed form shall be kept on file at the eye bank documenting the identification of tissue distributed, including the names of both the person(s) releasing the tissue and the person(s) receiving the tissue.
(d) Tissue in transit from a tissue processing or storage facility to a tissue transplantation facility shall be maintained at the appropriate storage temperature specified in section 52-7.8 of this Subpart. Tissue stored at a transplantation facility shall be maintained at the appropriate storage temperature until immediately prior to transplantation.
(e) Tissue shall be visually inspected prior to use by the transplant surgeon who shall determine the suitability of the tissue for transplantation.
(f) Tissue shall be issued by the tissue transplantation facility only upon a written order by a licensed physician or other person authorized by law to order tissue for transplant. Documentation of such order shall be on a dedicated tracking record or on the recipient's medical record. Documentation shall allow accurate tracking of tissue to each recipient.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
WATER SUPPLY WATER SUPPLY
10 CRR-NY 14-1.122 Steam
Culinary-quality steam is to be used for contact with food or food-contact surfaces. All additives to such steam must be approved by the permit-issuing official tor such use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.8 Revocation or suspension of permits
(a) The commissioner or the training agencies may at any time and from time to time require breath analysis instrument operators or technical supervisors to demonstrate their ability to operate properly the breath analysis instrument(s) for which they hold a permit.
(b) The operator's permit may be revoked by the commissioner based on information acquired by the commissioner, or a training agency, that the operator does not conduct breath tests in accordance with techniques and methods as instructed by the training agency, that the operator's performance is unreliable, or the operator is incompetent. Upon revocation, the operator shall return any and all permits to the commissioner.
(c) The training agency may suspend the permit of any operator under its supervision when, in its judgment, the operator does not conduct breath tests in accordance with techniques and methods as established by the training agency, the operator's performance is unreliable or the operator is incompetent. The training agency shall immediately notify the commissioner in writing of any such suspension and furnish a copy of such notice to the suspended operator, who shall not be permitted to operate the breath analysis instrument until such time as the suspension is removed.
(d) An operator whose permit has been suspended by the training agency may appeal to the commissioner who shall decide whether suspension shall be affirmed or set aside. The commissioner may reinstate the permit of the operator making such appeal under such conditions as the commissioner deems necessary.
(e) An operator whose permit has been revoked shall not be eligible for a new permit within 12 months from the date of revocation or at such other time as may be determined by the commissioner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.224 Occasion of service
(a) A specific identifiable act of service involved in the medical care of the patient which does not require the assessment of the patient's condition nor the exercising of independent judgment as to the patient's care. An example of an occasion of service is a technician administering an injection.
(b) An examination, a consultation or a treatment in any of the services or facilities of the hospital.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-5 APPROVAL OF ALTERNATIVE TREATMENT TECHNOLOGIES FOR USE IN NEW YORK STATE
10 CRR-NY 70-5.1 Treatment technology approval
(a) No alternative regulated medical waste treatment system shall be used in New York State unless the Commissioner of Health has approved the system's technology pursuant to this Subpart. The system manufacturer, as applicant for technology approval, shall:
(1) submit an application on forms prescribed by the Commissioner of Health;
(2) demonstrate that the system's operation does not pose a threat to public health or safety, including documentation that any chemical used in the system has been registered and approved by the New York State Department of Environmental Conservation for use in New York State;
(3) provide documentation that any chemical used in system to treat regulated medical waste has been registered with the Federal Environmental Protection Agency;
(4) establish the system's operating parameters through efficacy testing, and demonstrate that the system effectively treats regulated medical waste. Unless precluded by system design:
(i) efficacy testing shall be conducted on an actual full-scale working model of the system, rather than a simulation, or other substitution in scale or in kind; and
(ii) such testing shall employ surrogate test loads, varying in organic to non-organic and solid to liquid compositions. Such surrogate test loads shall include mycobacterium species and/or other appropriate indicators as determined by the department, that has been strategically placed throughout the test loads; and
(5) agree to provide all facilities in New York State that use the alternative treatment system with a copy of the department's technology approval letter, and any appendices or amendments thereto for the period in which the system is in use in New York State.
(b) Whenever mycobacterium species is used as a biological indicator, effective treatment shall be demonstrated by a 6 log10 reduction in viable cell concentrations; Bacillus atrophaeus or Geobacillus stearothermophilus are used as a biological indicator, effective treatment shall be demonstrated a 4 log10 reduction in viable spores concentration. No alternative treatment system that fails to attain such reductions or fails to demonstrate that the waste has been treated shall be used to treat regulated medical waste.
(c) The department may require that the system undergo supplemental efficacy testing using organisms or agents other than those identified in subdivision (b) of this section, and may require the manufacturer to demonstrate that the technology meets manufacturer's claims for effective treatment of non-typical bioloads or materials, for example, new and emerging pathogens or pathological waste.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.13 Rehabilitation therapy services
The operator, either directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, must:
(a) provide or arrange for rehabilitation therapy services to registrants determined through the comprehensive assessment to need such services; and
(b) ensure that the rehabilitation therapy services provided are in conformance with section 415.16 of this Subchapter.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.45 Reimbursement for language assistance services in hospital inpatient settings
For hospital inpatient services, in addition to the inpatient rates of payment computed in accordance with this Subpart, a separately billable rate of payment shall be available for providing language assistance services, if applicable, in accordance with the following:
(a) A discrete rate of payment for language interpretation services provided to patients with limited English proficiency (LEP) and communication services provided for patients who are deaf and hard of hearing will be established as follows:
(1) Payment will be established on a per unit basis with the unit of payment determined based on the number of minutes of language assistance service provided.
(2) A maximum of two billable units of language assistance services will be allowable per patient per day with the billable units defined as follows:
(i) 1st billable unit – for encounters providing up to and including the first 22 minutes of language assistance service.
(ii) 2nd billable unit – for encounters providing additional minutes (23+) beyond the initial 22 minutes of language assistance services during the given patient day.
(b) The rate of payment will be established at $11 per unit of language assistance service provided, with a maximum allowable payment per inpatient day of care of $22.
(c) To be reimbursable, the language assistance service must be provided by an independent third party, a dedicated hospital employee or a third party vendor ( e.g., telephonic interpretation service) whose sole function is to provide interpretation services for individuals with LEP and communication services for people who are deaf and hard of hearing.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.14 Housing maintenance
A building or structure of a children's camp shall be safe, adequate in size for its use, clean, and have watertight roof and sides. However, a lean-to or an open recreational facility, which excludes rain from occupied portions of the structure, may be used as a shelter.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
VILLAGES VILLAGES
10 CRR-NY 127.3 Village of Old Westbury
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such wells as may be developed in the future on the property of the village of Old Westbury, Nassau County, Long Island, New York, such wells being the sources of public water supply of said village.
(b) Definitions of terms.
Whenever used in this section:
(1) The term water supply means the public water supply of the village of Old Westbury, Nassau County, Long Island, New York.
(2) The term wells means the wells now used as sources of this public water supply or any wells developed in the future as additional sources of this public water supply, which are located on land now owned by said village.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(2) Every privy or receptacle for the storage or deposit of human excreta located between the prescribed 100 feet and 200 feet from any well shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of so that no nuisance will be created.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(4) No human excreta shall be buried in the soil at a distance of less than 500 feet from any well.
(d) Sewage.
(1) No sewage shall be discharged nor deposited nor allowed to be discharged or deposited on or beneath the surface of the ground within 200 feet of any well except into watertight receptacles, the contents of which shall be removed, before overflowing, in such a manner as to prevent the pollution of the ground about the receptacle, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be located within 50 feet of any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited or allowed to be discharged or deposited on or beneath the surface of the ground within 100 feet of any well.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited or allowed to be deposited on or beneath the surface of the ground within 100 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the wells.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 100 feet of any well.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 150 feet of any well.
(h) Trespassing.
No trespassing shall be allowed upon the property of the village of Old Westbury upon which the wells of the public water supply of said village are located and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said village.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the village of Old Westbury.
(l) Inspections.
The village of Old Westbury, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid village to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the village of Old Westbury to promptly notify the State Commissioner of Health of such violations. The aforesaid village shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.22 Approval of plans and completed works
(a) No supplier of water shall make, install or construct, or allow to be made, installed or constructed, a public water system or any addition or deletion to or modification of a public water system until the plans and specifications have been submitted to and approved by the State. Materials used in the design, construction and repair of a public water system shall be lead-free. For this Subpart, lead-free shall mean:
(1) solder or flux which contains no more than 0.2 percent lead;
(2) pipes, pipe fittings, plumbing fittings and fixtures which contain no more than a weighted average of 0.25 percent lead with respect to the wetted surfaces.
The weighted average lead content of a pipe, pipe fitting, plumbing fitting, or fixture shall be calculated by using the following formula: For each wetted component, the percentage of lead is multiplied by the ratio of the wetted surface area of that component to the total wetted surface area of the entire product to arrive at the weighted percentage of lead of the component. The weighted percentage of lead of each wetted component is added together, and the sum of these weighted percentages constitutes the weighted average lead content of the product. The lead content of the material used to produce wetted components is used to determine compliance with paragraph (2) of this subdivision. For lead content of materials that are provided as a range, the maximum content of the range must be used for calculating the weighted average lead content.
(b) Approval of plans and specifications for public water systems shall be based on the following standards in their entirety. The State may allow deviations from these standards in accordance with procedures established by the commissioner.
(1) Recommended Standards for Water Works, (Appendix 5-A).
(2) Standards for Water Wells (Appendix 5-B).
(3) Special Requirements for Wells Serving Public Water Systems (Appendix 5-D).
(c) The State may approve such plans or may require such modification which is deemed necessary to protect public health or safety. Application for plan approval shall be made on a form prescribed by the department.
(d) A supplier of water shall receive the approval of the State before placing into service any public water system constructed under the requirements of this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.286 Refund
An amount paid back or a credit allowed on account of an overcollection; rebate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.2 Definitions
For the purposes of this Subpart, the following definitions shall apply:
(a) AICPA means the American Institute of Certified Public Accountants.
(b) Affiliate of , or person affiliated with another person means a person that directly, or indirectly, controls, or is controlled by, or is under common control with, the other person specified.
(c) Audit committee means a committee (or equivalent body) established by the board of directors of a MCO for the purpose of overseeing the accounting and financial reporting processes of a MCO or group of MCOs, and audits of financial statements of the MCO or group of affected MCOs; provided that:
(1) for a holding company that controls a group of MCOs, the audit committee of the holding company may be deemed to be the audit committee for one or more of those controlled MCOs solely for the purposes of this Subpart even if all members of the holding company audit committee are not residents of this State;
(2) for a United States branch of an alien MCO, the audit committee may be comprised of the audit committee of the person that controls the United States branch; and
(3) for a MCO that does not otherwise designate an audit committee, the MCO’s entire board of directors shall constitute the audit committee.
(d) Audited financial report means and includes those items specified in section 98-3.4 of this Subpart.
(e) CPA means:
(1) an independent certified public accountant or accounting firm, who or that meets requirements established by the PCAOB and is also a registrant in good standing with the AICPA and every state in which the accountant or the firm is licensed to practice; or
(2) for a United States branch of a Canadian or British insurer, “CPA” also includes a Canadian-chartered or British-chartered accountant.
(f) Group of MCOs means those MCOs that are:
(1) part of a holding company system;
(2) a MCO and its subsidiaries that are not part of a holding company system; or
(3) a subset of a group of MCOs described in either paragraph (1) or (2) of this subdivision, which the MCO identifies for aggregation to implement and assess internal control over financial reporting.
(g) Indemnification means an agreement of indemnity or a release from liability where the intent or effect is to shift or limit in any manner the potential liability of the CPA for failure to adhere to applicable auditing or professional standards, whether or not resulting in part from knowing of other misrepresentations made by the MCO or its representatives.
(h) Independent audit committee member has the meaning described in section 98.13(c) of this Subpart.
(i) Internal control over financial reporting means a process effected by a MCO’s board of directors, management and other personnel designed to provide reasonable assurance regarding the reliability of those items specified in section 98-3.4 of this Subpart and includes those policies and procedures that:
(1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of assets;
(2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of the financial statements, and that receipts and expenditures are being made only in accordance with authorizations of management and directors; and
(3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of assets that could have a material effect on the financial statements.
(j) For purposes of this Subpart, MCO means a Prepaid Health Services Plans, HIV Special Needs Plans and Managed Long-Term Care Plans (PHSP, HIV SNP and MLTCP).
(k) NAIC means the National Association of Insurance Commissioners.
(l) PCAOB means the Public Company Accounting Oversight Board, which was established by the Sarbanes-Oxley Act of 2002, 15 U.S.C. section 7201 et seq .
(m) Prior calendar year direct written and assumed premiums means the MCO’s combined total of direct premiums and assumed premiums from non-affiliates.
(n) SEC means the United States Securities and Exchange Commission.
(o) SOX means the Sarbanes-Oxley Act of 2002, 15 U.S.C. section 7201 et seq .
(p) SOX compliant MCO means a MCO that either is required to be compliant with, or voluntarily is compliant with, all of the following provisions of the Sarbanes-Oxley Act of 2002:
(1) the preapproval requirements of section 201 (section 10A[i] of the Securities Exchange Act of 1934, 15 U.S.C. section 78j-1[i]);
(2) the audit committee independence requirements of section 301 (section 10A[m][3] of the Securities Exchange Act of 1934, 15 U.S.C. section 78j-1[m][3]); and
(3) the internal control over financial reporting requirements of section 404 (item 308 of SEC Regulation S-K).
(q) SOX section 404 means section 404 of the Sarbanes-Oxley Act of 2002 titled “management assessment of internal controls” and any rules and regulations promulgated thereunder.
(r) SOX section 404 report means “management’s report on internal control over financial reporting” as defined by SOX section 404 and any rules or regulations promulgated thereunder.
(s) Work papers mean the records kept by the CPA of the procedures followed, the tests performed, the information obtained, the conclusions reached pertinent to the CPA’s audit of the financial statements of a MCO, and any communication between the CPA and the MCO relating to the CPA’s audit of the MCO. Work papers include audit planning documentation, work programs, analyses, memoranda, letters of confirmation and representation, abstracts of MCO documents and schedules or commentaries prepared or obtained by the CPA in the course of the CPA’s audit of the financial statements of a MCO and that support the CPA’s opinion.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.5 Duties and qualifications of clinical laboratory technical personnel
(a) Duties of technologist.
The laboratory shall employ a sufficient number of qualified medical technologists, or where appropriate, cytotechnologists, to perform proficiently under general supervision the clinical laboratory tests which require the exercise of independent judgment as follows:
(1) The medical technologists shall perform tests which require the exercise of independent judgment and responsibility, with a minimal supervision by the director or supervisor, in only those specialties or subspecialties in which they are qualified by education, training and experience.
(2) With respect to specialties in which the medical technologist is not qualified by education, training or experience, he shall function only under direct supervision and perform only tests which require limited technical skill and responsibility.
(3) Clinical laboratory technologists shall be sufficient in number to adequately supervise the work of technicians and trainees.
(4) An individual who qualifies as a cytotechnologist under subdivision (c) of this section may supervise technicians and trainees only in the specialty of cytology.
(b) Qualifications of medical technologist.
A medical technologist must meet one of the following requirements:
(1) Successful completion of a full course of study which meets all academic requirements for a bachelor's degree in medical technology from an accredited college or university.
(2) Successful completion of three academic years of study (a minimum of 90 semester hours or equivalent) in an accredited college or university which met the specific requirements for entrance into, and the successful completion of a course of training of at least 12 months in a school of medical technology approved by the Council on Medical Education of the American Medical Association.
(3) Successful completion in an accredited college or university of a course of study which meets all academic requirements for a bachelor's degree in one of the chemical, physical or biological sciences and, in addition, at least one year of pertinent laboratory experience and/or training covering the specialty(ies) or subspecialty(ies) in which he performs tests, provided the combination has given the individual the equivalent in such specialty(ies) or subspecialty(ies) of the education and training described in paragraph (1) or (2) of this subdivision.
(4) Successful completion of three years (90 semester hours or equivalent) in an accredited college or university with a distribution of courses as shown below, and, in addition, successful experience and/or training covering several fields of medical laboratory work of such length (not less than one year), and of such quality that this experience or training, when combined with the education, will have provided the individual with education and training in medical technology equivalent to that described in paragraph (1) or (2) of this subdivision. Distribution of course work: (Where semester hours are stated, it is understood that the equivalent in quarter hours is equally acceptable. The specified courses must have included lecture and laboratory work. Survey courses are not acceptable.)
(i) for those whose training was completed prior to September 15, 1963: At least 24 semester hours in chemistry and biology courses of which not less than nine semester hours must have been in chemistry and must have included at least six semester hours in inorganic chemistry, and not less than 12 semester hours must have been in biology courses pertinent to medical sciences;
(ii) for those whose training was completed after September 15, 1963: 16 semester hours in chemistry courses, which included at least six semester hours in inorganic chemistry and are acceptable toward a major in chemistry; 16 semester hours in biology courses which are pertinent to the medical sciences and are acceptable toward a major in the biological sciences; and three semester hours of mathematics.
(5) With respect to individuals first qualifying prior to April 1, 1972, an exception to the requirements in paragraph (1), (2), (3) or (4) of this subdivision may be made if:
(i) the technologist was performing the duties of a medical technologist at any time between July 1, 1961 and September 1, 1971;
(ii) the technologist has had at least 10 years of pertinent clinical laboratory experience prior to September 1, 1971: provided, that a minimum of 30 semester hours credit toward a bachelor's degree from an accredited institution with a chemical, physical, or a biological science as his major subject; or 30 semester hours in an approved school of medical technology shall reduce the required years of experience by two years, with any additional hours further reducing the required years of experience at the rate of 15 hours for one year; and
(iii) he has performed the duties of a clinical laboratory technologist for at least two years during the qualifying 10 years:
(a) in a clinical laboratory having a director at the doctoral level, of a hospital, university, health department or medical research institution; or
(b) in a laboratory approved under the supplementary medical insurance program: Provided also, that where qualifying years in a laboratory described in clause ( a ) of this subparagraph are obtained after January 30, 1969, the laboratory meets applicable conditions under the Federal health insurance program, or under title 42, Code of Federal Regulations, part 74, the latter being the regulations issued pursuant to the Federal Clinical Laboratories Improvement Act of 1967.
(c) Qualifications of cytotechnologists:
(1) have successfully completed two years in an accredited college or university with at least 12 semester hours in biology courses pertinent to the medical sciences; and:
(i) must have received 12 months of training in a school of cytotechnology approved by the American Medical Association; or
(ii) received six months formal training in a school of cytotechnology approved by the American Medical Association and six months of full-time experience in cytotechnology in a laboratory acceptable to the pathologist who directed such formal six months of training; or
(2) prior to September 1, 1971, shall have been graduated from high school, completed six months of training in cytotechnology in a laboratory directed by a pathologist or other physician recognized as a specialist in cytology, and completed two years of full-time experience in cytotechnology.
Chapter I STATE SANITARY CODE
Part 13 TRANSPORTATION OF DEAD BODIES
10 CRR-NY 13.1 Transportation of dead human bodies by common carrier
The transportation of dead bodies by common carrier, defined for the purposes of this Part as a carrier licensed or authorized to transport cargo by any of the following: New York State Department of Transportation; Interstate Commerce Commission; Federal Aviation Administration; or United States Coast Guard, shall be conducted in such manner as not to be a menace to health and shall conform to the following requirements:
(a) Burial-transit permit required.
A burial-transit permit issued by the local registrar of vital statistics must accompany each dead body transported by a common carrier.
(b) Transportation of dead human bodies by common carrier.
Transportation of dead bodies by common carrier shall be permitted only under the following conditions:
(1) dead bodies shall be encased in a rigid container which is so constructed as to withstand hazards associated with the methods of transportation used. In order to prevent the leakage of body fluids either the dead body must be placed in a leak-proof pouch within the container, or the container must be leakproof or the container must be placed in a leak-proof container; and
(2) all dead bodies shall be clothed or covered by a shroud or other body covering, all external body orifices shall be closed with absorbent cotton and a name tag affixed to the dead body giving the name of the deceased as it appears on the death certificate.
(c) Exceptions.
Notwithstanding any other provisions of this section, a permit for the burial or cremation of human remains issued by the authorized agency of any municipality or county within the United States, of any State, territory or possession of the United States, the District of Columbia, or of any foreign state within whose jurisdiction the death or fetal death occurred, which specifies the cemetery or crematory, may be accepted by the person in charge of the cemetery or crematory in lieu of a permit issued by a registrar of vital statistics of this State. If a permit issued in another jurisdiction does not specify the cemetery or crematory, or if the cemetery or crematory specified is not the actual place of intended burial or cremation, it shall not be accepted by the person in charge of a cemetery or crematory, but shall be exchanged for a permit issued by the registrar of vital statistics in the registration district where the burial or cremation of the remains was originally intended.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.15 Medical services
The nursing home shall develop and implement medical services to meet the needs of its residents.
(a) Medical director.
The facility shall designate a full-time or part-time physician to serve as medical director. The medical director shall be responsible for:
(1) implementation of resident medical care policies;
(2) the coordination of physician services and medical care in the facility;
(3) coordinating the review, prior to granting or renewing professional privileges or association, of any physician, dentist or podiatrist as required by Public Health Law, section 2805-j. Hospital-based nursing homes may utilize the hospital's medical staff membership review system to facilitate this review. Such review shall be coordinated with the activities of the Quality Assessment and Assurance Committee established in section 415.27 of this Part and shall:
(i) provide for the maintenance and continuous collection of information concerning the facility's experience with negative health care outcomes and incidents injurious to residents, resident grievances, professional liability premiums, settlements, awards, costs incurred by the facility for resident injury prevention and safety improvement activities;
(ii) periodically reconsider the credentials, physical and mental capacity and competency in delivery of health care services of all physicians, dentists or podiatrists who are employed or associated with the facility;
(iii) gather information concerning individual physicians, dentists and podiatrists within the individual physician's, dentist's or podiatrist's personnel file maintained by the facility; and
(iv) prior to renewal of privileges of physicians, dentists, or podiatrists, solicit and consider information provided by the Resident Council about each such practitioner; and
(4) assuring that each resident's responsible physician attends to the resident's medical needs, participates in care planning, follows the schedule of visits maintained in accordance with subdivision (b) of this section, and complies with facility policies. When a physician fails to provide services which meet generally accepted standards of practice, the medical director shall take necessary corrective measures and refer the matter to the Office of Professional Medical Conduct of the department as appropriate.
(b) Physician services.
The facility shall ensure that a physician personally approves a recommendation that an individual be admitted to a nursing home. Each resident shall remain under the care of a physician and shall be provided care that meets prevailing standards of medical care and services.
(1) Physician supervision. The facility shall ensure that:
(i) the medical care of each resident is supervised by a physician who assumes the principal obligation and responsibility to manage the resident's medical condition and who agrees to visit the resident as often as necessary to address resident medical care needs; and
(ii) another physician supervises the medical care of residents when the resident's attending physician is unavailable.
(2) Physician visits and responsibilities. The facility shall ensure that the responsible physician:
(i) participates as a member of the interdisciplinary care team in the development and review of the resident's comprehensive care plan with the understanding that the minimum level of physician participation in interdisciplinary development and review of the care plan shall be a person-to-person conference with the registered professional nurse who has principal responsibility for development and implementation of the resident's care plan;
(ii) visits the resident whenever the resident's medical condition warrants medical attention and establishes and maintains a schedule of visits appropriate to the resident's medical condition. The frequency of visits shall be no less often than once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter;
(iii) reviews the resident's total program of care, including medications and treatments, at each regularly scheduled visit;
(iv) prepares, authenticates and dates progress notes at each visit;
(v) authenticates and dates all orders;
(vi) provides residents and designated representatives with his or her name, office address and telephone number and responds to calls from residents to discuss the resident's medical care;
(vii) participates in facility training programs to familiarize him or herself with State regulations and facility policies;
(viii) is informed of the results of all Department of Health surveys related to medical service deficiencies and is involved in resolving such problems; and
(ix) at the option of the physician and the facility, scheduled visits after the initial visit may alternate between personal visits by the responsible physician and visits by a registered physician's assistant or certified nurse practitioner in accordance with paragraph (4) of this subdivision.
(3) Availability of physicians for emergency care.
The facility shall provide or arrange for the provision of physician services 24 hours a day, in case of an emergency.
(4) Physician delegation of tasks.
(i) Except as specified in subparagraph (ii) of this paragraph, a facility may permit a physician to delegate tasks to a registered physician's assistant or certified nurse practitioner who:
(a) meets the applicable requirements of Part 94 of this Title or is certified as a nurse practitioner, respectively;
(b) is acting within the scope of practice as defined by State law; and
(c) is under the supervision of the physician.
(ii) The facility shall not permit a physician to delegate a task when the regulations specify that the physician must perform it personally or when the delegation is prohibited by the facility's own policies.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-2 STATE FUNDING FOR HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-2.2 Computation of grants
The amount of any grant made to a health systems agency pursuant to this Subpart shall be determined by the Commissioner of Health, in accordance with appropriations made pursuant to law.
(a) Base support.
The Commissioner of Health shall allocate at least $250,000, contingent upon appropriation level, as base support for each health systems agency and shall distribute any base support according to an equitable formula.
(b) Matching support.
Matching support shall be provided based on the level of appropriation and shall be calculated based on a ratio of the appropriation and funds raised and received during the previous calendar year from other qualified sources including grants by local and county governments, interest income, and grants or contributions made by individuals or private entities excluding grants or contributions made by individuals, private entities, or health maintenance organizations having a financial, fiduciary, or other direct interest in the development, expansion, or support of health resources. The calendar year shall be applied to promote consistency and uniformity in measuring funds raised notwithstanding any overlap that may occur in the initial year in measuring funds raised on which state matching funds are calculated. For purposes of this paragraph, an individual or entity shall not be considered to have such an interest solely on the basis of (1) providing, directly or indirectly, health care for their employees, nor (2) engaging in issuing any policy or contract of individual or group health insurance or hospital or medical service benefits. Further, for purposes of this paragraph, association of health facilities or providers of health care shall not be considered to have such an interest. The funds raised and received from other qualified sources on which state matching funds are calculated and allocated shall be used solely for the purposes specified in section 82-1.6 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 440 APPLICABILITY AND PURPOSE
10 CRR-NY 440.2 Purpose
(a) The purpose of this Article is to provide a common standard of measure and communication through the use of uniform:
(1) reporting principles;
(2) classification system which identifies cost by functional cost center by the nature of costs incurred, and revenues by revenue center by patient classification; and
(3) statistical and service data definitions.
(b) This Article presents the definitions, principles, statistics, and listing of accounts to be employed for reporting and reimbursement purposes. This Article has been developed to provide the data base necessary to support reimbursement regulations.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.14 Fertilizers
(a) The requirements of this section shall not apply to the application or storage of fertilizers for:
(1) an agricultural activity performed in compliance with State or Federal law; and
(2) non-commercial application by an individual on residential premises.
(b) No fertilizer activity shall be considered to be a noncomplying regulated activity.
(c) Discharge from the washing of fertilizer application equipment into any watercourse, wetland, reservoir, reservoir stem or controlled lake is prohibited.
(d) Use of water directly from a reservoir, reservoir stem or controlled lake for fertilizer make-up is prohibited.
(e) Use of water directly from a watercourse for fertilizer make-up without the use of an anti-siphon device is prohibited.
(f) Open storage of fertilizer is prohibited.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-3 HEALTH MAINTENANCE ORGANIZATIONS
10 CRR-NY 86-3.2 Applicability of Subpart
The purpose of this Subpart is to implement the legislative requirement that the Commissioner of Health approve rates to be paid by article 44 HMO's to hospitals for inpatient services.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.111 Windsor Oaks Property Owners Association, Village of Croton-on-Hudson, Westchester County
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the well which comprises the source of the public water supply of the Windsor Oaks Property Owners Association located in the Village of Croton-on-Hudson, Westchester County, NY. Said well is located on land owned by the Windsor Oaks Property Owners Association and is situated easterly of Oak Place and southerly of Mount Airy East in the Town of Cortland.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the extension of the centerline of the well.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal and agricultural- and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage, and includes treatment works.
(17) Toxic substance shall mean any toxic substance, as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Windsor Oaks Property Owners Association, Westchester County, NY.
(20) Well shall mean the well now used as a source of water supply for the Windsor Oaks Property Owners Association of any additional wells which may be constructed or developed in the future as a source for such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well, except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the well, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facilities. No such watertight pipe shall be located within a 25-foot linear distance of the well.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the well.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the well unless authorization has been obtained from the appropriate State agency, and such burial is in accordance with provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the well.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the well.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the well, except as otherwise permitted under the provisions of subparagraph (4)(iii) of this subdivision.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Windsor Oaks Property Owners Association upon which the well is located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Windsor Oaks Property Owners Association.
(11) Other wastes.
No pollutant of any kind shall be discharged or deposited on or beneath the surface of the ground on the watershed within 250 feet of the well except as otherwise permitted by subparagraph (4)(iii) of this subdivision.
(e) Inspections.
The duly appointed representative of the Windsor Oaks Property Owners Association shall make regular and thorough inspections of the area surrounding the well to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid association to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid association to promptly notify the State Commissioner of Health of such violations. The aforesaid association shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified in section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
STATISTICAL DATA STATISTICAL DATA
10 CRR-NY 446.11 Service classification
(a) The following data is to be reported:
(1) discharges;
(2) patient days (census); and
(3) certified bed capacity.
(b) Please refer to section 446.44(b) of this Part for all program services for which these statistics are to be reported.
Part 441 DEFINITIONS
10 CRR-NY 441.195 Live births
A live birth is the complete expulsion or extraction from its mother in a hospital facility, of a product of conception, irrespective of the duration of pregnancy, which after such separation breathes or shows any evidence of life such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.55 Amagansett Water Company, Inc., Amagansett
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land owned by the Amagansett Water Company, Inc., and situated in the unincorporated village of Amagansett in the town of Easthampton on the south side of the Montauk division of the Long Island Railroad, about one-half mile west of the Amagansett railroad station and about 500 feet north of the Montauk Highway, which form the source of the public water supply of the Amagansett Water Company, Inc. of Amagansett, Suffolk County, N.Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Whenever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the Amagansett Water Company, Inc.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Amagansett Water Company, Inc., and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the Amagansett Water Company, Inc.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Amagansett Water Company, Inc. upon which the wells of the public water supply of the Amagansett Water Company, Inc. are located and no person or persons shall enter in or upon such property except the duly authorized representative of the Amagansett Water Company, Inc. or any such other person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the Amagansett Water Company, Inc.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Amagansett Water Company, Inc.
(j) Inspections.
The Amagansett Water Company, Inc. of Amagansett, N. Y. or such other company, person or persons as may be charged with the maintenance or supervision of the public water supply of the unincorporated village of Amagansett or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Amagansett Water Company, Inc. to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Amagansett Water Company, Inc. to promptly notify the State Commissioner of Health of such violations. The Amagansett Water Company, Inc. shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRENATAL CARE SERVICES PRENATAL CARE SERVICES
10 CRR-NY 85.42 Catastrophic health care expense program
(a) The Expanded Health Care Coverage Act of 1988 (chapter 703 of the Laws of 1988) establishes, under the jurisdiction of the New York State Department of Social Services, the Catastrophic Health Care Expense Program (CHCEP). The Department of Social Services will permit authorized counties to make available assistance with cost sharing to eligible county individuals and families for the purpose of assisting such individuals and families with catastrophic health care expenses. The CHCEP program requires participants eligible for cost sharing to receive such assistance in accordance with a schedule that sets forth the cost sharing shares between the participant and the program.
(b) The following schedule entitled “Cost Sharing Proportional Schedule” shall be used by the New York State Department of Social Services in determining a beneficiary's fiscal responsibility for catastrophic health care expenses covered under the CHCEP assistance with cost sharing program:
Cost Sharing Proportional Schedule
| Category of Service | Recipient Cost Share Responsibility | | --- | --- | | Hospital Emergency Room | 75 percent | | Selected Optional Services | 50 percent | | Podiatry | | | Clinical Psychology | | | Optometry/Eye Care Services | | | Transportation | | | Inpatient Hospitalization | 30 percent | | Physician, Dental & Clinic Services, | 25 percent | | Health Maintenance Organization, Home Health Care | | | (freestanding and hospital-based) including ordered diagnostic and treatment services: | | | Pharmacy | | | Durable Medical Equipment | | | Laboratory | | | Radiology | | | Referred Ambulatory | | | Audiology (Hearing Aid) | | | Ambulatory Surgery and Outpatient Surgery | 15 percent |
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.7 Safety
A nontransplant anatomic bank shall implement written safety and infection control policies and procedures to ensure protection from unnecessary physical, chemical and biological hazards.
(a) Decontamination and disposal techniques for regulated medical waste shall be utilized. All hazardous and regulated waste materials shall be handled, stored and discarded pursuant to Part 70 of this Title and/or 6 NYCRR Subpart 360-10 as appropriate, or in the case of out-of-state banks, in accordance with the hazardous waste disposal requirements of the state in which the disposal occurs.
(b) If autoclave equipment is used for sterilization, the pressure, temperature, and duration of each cycle shall be recorded, and such records maintained for one year. For each run, these parameters shall be within the manufacturer's recommended operating procedures. If any one or more of these parameters fall outside the manufacturer's standards, all material shall be reautoclaved. Chemical, biological, and physical detection systems shall be used in conjunction with these other measurements of autoclave performance.
(c) Eating, drinking, smoking, and the application of cosmetics or contact lenses shall not be permitted in work areas. Refrigerators and freezers used for storing nontransplant anatomic parts, specimens, or reagents shall not be used for any other purpose.
(d) Gloves and laboratory coats, gowns or other protective clothing shall be worn while handling nontransplant anatomic parts or specimens, sufficient to protect against the transmission of disease and exposure to toxic substances. Such protective clothing shall not be worn outside the work area and shall be disposed of in an appropriate receptacle.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.17 Electrical safety
All existing electrical service, wiring and fixtures shall be in good repair and safe condition.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.262 Premature infant
An infant born at any time through the 37th week of gestation (259 days).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.8 Specialized template populations
Notwithstanding any other provisions of this Subpart, rates for individuals identified by OPWDD as qualifying for specialized template populations funding shall be as follows. As used in this section, downstate shall mean the counties of New York, Kings, Bronx, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, Orange Sullivan, Putnam and Dutchess, and upstate shall mean all other counties in New York State.
(a) For individuals initially identified as qualifying for specialized template populations funding between November 1, 2011 and March 31, 2014:
| Prevocational – specialized level of care | | | | --- | --- | --- | | Region | Gross annual funding allocation per individual – operating only | | | Downstate | $41,730 | | | Upstate | $37,562 | |
| Prevocational – highly complex level of care | | | | --- | --- | --- | | Region | Gross annual funding allocation per individual – operating only | | | Downstate | $46,433 | | | Upstate | $43,063 | |
(b) For individuals initially identified as qualifying for specialized template populations funding after March 31, 2014:
| Prevocational – highly complex level of care | | | | --- | --- | --- | | Region | Gross annual funding allocation per individual – operating only | | | Downstate | $46,433 | | | Upstate | $43,063 | |
(c) January 1, 2015 increase.
The fees for specialized template populations funding will be revised to incorporate funding for compensation increases to direct support professional employees. Such fee increases will be effective January 1, 2015. The compensation increase funding will be included in the provider’s fee issued for January 1, 2015 or in a subsequent fee with the inclusion of funding in the amount necessary to achieve the same funding impact as if the fee had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(d) April 1, 2015 increase.
In addition to compensation funding effective January 1, 2015, the fees for specialized template population funding will be revised to incorporate funding for a compensation increase to direct support professional and clinical employees to be effective April 1, 2015. The April 1, 2015 direct support compensation funding will be compounded on the amount which was calculated for the January 1, 2015 compensation increase and will be an augmentation to the January 1, 2015 increase.
(e) Calculations.
(1) The portion of the fee that is identified as direct care and support will be increased by 2 percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional direct support compensation increases for January 1, 2015 and April 1, 2015.
(2) The portion of the fee that is identified as clinical will be increased by 2 percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional clinical compensation increase for April 1, 2015.
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.1 Definitions
(a) Adequate means sufficient to accomplish the purpose for which something is intended, and to such a degree that no reasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(b) Department means the New York State Department of Health.
(c) Disinfect means adequate antimicrobial treatment by a disinfectant capable of destroying pathogenic non-spore forming bacteria, viruses, fungi, parasites and protozoa on treated surfaces.
(d) FDA means United States Food and Drug Administration.
(e) Permit issuing official (PIO) shall mean the State Commissioner of Health, or where authorization is requested and received from the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law. The PIO may designate additional persons to act in his/her behalf to issue permits or perform inspections as required by this Subpart.
(f) Permit means a license issued to a tanning facility operator pursuant to these rules.
(g) Person means an individual, corporation, partnership, joint venture or any business entity.
(h) Protective eyewear means any adequate equipment designed to be worn by users of an ultraviolet radiation-emitting device to reduce exposure of the eyes to radiation emitted by the product.
(i) Qualified health care professional means a physician licensed by the State of New York to practice medicine, or a physician assistant or nurse practitioner licensed to practice in New York in collaboration with and under the supervision of a licensed physician.
(j) Sanitize means adequate antimicrobial treatment by a disinfectant capable of reducing the number of pathogenic non-spore forming bacteria on treated surfaces. Exposure to the ultraviolet radiation produced by the ultraviolet radiation device itself is not considered an adequate sanitizing agent.
(k) Tanning facility means any establishment where one or more ultraviolet radiation devices are used, offered, or made available for use by any human being, whether or not a fee is charged, directly or indirectly, excluding a facility where such device is used by a qualified health care professional for treatment of medical conditions.
(l) Ultraviolet radiation device means any product which is designed to emit electromagnetic radiation in the wavelength interval of 200 nanometers to 400 nanometers in air, and which is intended to induce tanning of the human skin through irradiation, including but not limited to, a sunlamp, tanning booth, or tanning bed.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.92 Free-standing vending machines
(a) Free-standing vending machines are to:
(1) be light enough to be manually moved with ease by one person;
(2) be elevated on legs or extended sidewalls to afford, with or without kickplates, an unobstructed vertical space of at least six inches under the machine;
(3) be mounted on rollers or casters which permit easy movement; or
(4) be sealed to the floor.
Where used, kickplates are to be easily removable or be capable of being rotated.
(b) Counter-type machines are to be:
(1) sealed to the counter;
(2) mounted on four-inch legs or the equivalent; or
(3) easily movable for cleaning with service connections in place.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.13 Engineering and maintenance
(a) Water supplies of shared health facilities shall be operated in conformance with the following requirements:
(1) water shall be adequate in volume and pressure for all medical purposes;
(2) the water system shall not be operated with physical connections to other piping systems or connections to fixtures that may permit contamination of the water supply;
(3) the water system shall be operated with a hot water system adequate for all medical purposes; and
(4) the hot water supply shall be regulated by thermostatic or other control devices which shall be either locked or located in places not accessible to patients or the general public so that the hot water used by patients and the public is maintained at an even temperature which cannot cause personal injury.
(b) Plumbing and plumbing fixtures shall be properly maintained.
(c) Ventilation, heating, air conditioning and air changing systems shall be:
(1) sufficient to provide for patient health and comfort;
(2) sufficient to assure that relative humidity is maintained at a minimum of 50 percent in those areas where conductive floors are required; and
(3) maintained in good repair and operated in a manner to prevent the spread of infection.
(d) Grounds and buildings shall be maintained:
(1) in a clean condition free of safety hazards;
(2) in such manner as will prevent standing water, flooding or leakage; and
(3) free of excessive noise, odors, pollens, dusts or other environmental pollutants and such nuisances as may adversely affect the health or welfare of patients.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.14 Operator responsibility
The operator of the bathing beach shall be responsible for:
(a) sample collection and analysis of bathing waters, when required by the permit-issuing official, and assuring a safe water quality;
(b) controlling the decorum and activities at the bathing site;
(c) supplying adequate supervisory personnel;
(d) reporting injuries, deaths and communicable disease; and
(e) maintaining physical facilities.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.54 Burn center
A burn unit (see section 444.18[b][5] of this Article for the definition of a burn care unit ) with an emphasis on research and teaching, where the intensive care environment serves as a classroom for teaching the complexities of burn care and a laboratory for research.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 15.4 Permit to operate required; application, issuance, revocation, posting, inspections, access
(a) Permit required.
No individual, group of individuals, partnership, firm, corporation, or association shall operate any migrant farmworker housing facility as defined by this Part or cause or allow the same to be occupied without a permit to do so from the permit issuing official.
(b) Application for permit.
Application for a permit to operate a migrant farmwork or housing facility shall be made by the camp operator using forms provided by the Health Department at least 30 days before the first day of proposed operation of such housing facility. Following the revocation of a permit a new application for permit must be filed at least 72 hours before resuming operation. Operating permits shall not be transferable or assignable and cannot be issued for a term greater than 12 consecutive months.
(c) Permit issuance.
The permit issuing official shall issue a permit when the migrant farmworker housing facility conforms, or will conform, to the requirements of this Part, and does not present a danger to the health or safety of the housing occupants. The operator to whom the permit is issued shall comply with the requirements of this Part and with any additional conditions stated in the permit. An application for a permit may be denied when the applicant has exhibited a history of noncompliance with the requirements of this Part.
(d) Revocation, suspension.
A permit may be revoked, or suspended by the permit issuing official if the migrant farmworker housing facility for which the permit was requested or issued was found to have been maintained, operated or occupied in violation of the Public Health Law, or this Chapter. Before suspension, or revocation of a permit, or after receipt of a Notice of Violation, the permittee, or applicant, shall be given the opportunity to be heard by the permit-issuing official or his designated officer to appeal the revocation, or suspension of the permit to operate. A permit may be revoked upon request of the permittee or upon abandonment of operation.
(e) Posting.
Posters supplied by the permit-issuing official which list the responsibilities of the operator and occupants for operation and maintenance of the housing facilities and environs must be placed in locations readily visible to the occupants.
(f) Inspections.
Any property that is operated, or suspected of being operated as a migrant farmworker housing facility as defined by this Part is subject to inspection by the permit-issuing official or their representative.
(g) Pre-occupancy inspection required.
No occupancy shall be allowed until after the required inspection has been made and a permit is issued, or permission to occupy is granted by the permit-issuing official.
(h) Operational inspections.
A facility may be exempted from inspections, other than inspections based upon a complaint or an injury or illness investigation, during occupancy by migrant farmworkers if the permit-issuing official determines the operator has operated the facility for at least two consecutive years without any violations of this Part, and in a manner demonstrating such operation does not present an unreasonable risk to the health or safety of the occupants. The exemption applies only during the term of the permit and its renewal will be based upon continued documented compliance with the provisions of this Part.
(i) Access.
The permit issuing official or their representative shall be allowed entry for the purposes of inspection to any property operated or suspected of being operated as a migrant farmworker housing facility as defined by this Part.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.110 Licensure and inspection of radioactive materials; fees authorized
Provided that a written schedule of the licensing and inspection fees to be charged has been submitted to and approved by the State Commissioner of Health, any county, part-county or city health district having a population of more than 2,000,000 which has established substitute licensure requirements acceptable to the State Department of Health pursuant to the provisions of paragraph (3) of subdivision (b) of section 16.1 of this Part is authorized to charge adequate and reasonable fees for the licensing and inspection of radioactive materials not exceeding the estimated cost of such services except that, with the approval of the State Commissioner of Health, one or more of such services may be rendered without charge.
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.26 Alum or other astringents
Alum or other material used to stop the flow of blood shall be applied in powdered or liquid form only.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.8 Food vendor violations of the WIC program
(a) Any food vendor, who, in the course of a transaction involving a food instrument (WIC check) commits any of the following acts shall be liable for disqualification from the WIC program for a period of up to three years in addition to being liable for civil penalties of up to $1,000 per violation under the authority of section 12 of the Public Health Law:
(1) the vendor charges the State or local agency for foods not received by the participant;
(2) the vendor charges the State or local agency prices in excess of those charged to other customers;
(3) the vendor provides cash in exchange for WIC checks;
(4) the vendor provides cash for the return of items purchased with a WIC check;
(5) the vendor fails to verify the signature on the customer's WIC identification card against the required signature on the customer's WIC check for all foods delivered or sold to the customer;
(6) the vendor provides unwholesome items in exchange for a WIC check, such as but not limited to, items provided past their expiration date and/or spoiled foods;
(7) the vendor provides unauthorized items and/or items not specified on the face of the WIC check in exchange for a WIC check;
(8) the vendor issues a document (rain check) to a person utilizing a WIC check purporting to give that person the right to buy, at a later date, a particular WIC item which the vendor does not have in stock at the time the document is issued;
(9) the vendor forges a customer's signature onto a WIC check;
(10) the vendor stamps a WIC vendor number onto a WIC check redeemed by any other vendor;
(11) the vendor accepts WIC checks without being a WIC food vendor;
(12) the vendor discriminates against or harasses any person utilizing a WIC check;
(13) the vendor fails to ensure that the amount of purchase is written in the space provided on the WIC check in the customer's presence at the time of purchase;
(14) the vendor accepts WIC checks before or after the dates indicated on the checks during which the checks are valid;
(15) the vendor fails to maintain, for a minimum of three years, all invoices and purchase slips for WIC food items, for inspection by authorized Federal, State or local agencies;
(16) the vendor fails to allow unobstructed examination of all WIC food instruments, invoices and purchase slips for WIC food items;
(17) the vendor fails to have invoices and purchase slips for WIC food items equal to the type and volume of WIC food sold;
(18) the vendor fails to surrender WIC stamps upon disqualification or suspension;
(19) the vendor fails to maintain, on premises of the authorized location, a State-issued WIC vendor authorization stamp; or
(20) the vendor deposits WIC checks into a bank account different than the vendor's sole authorized bank account listed on the vendor's contract; or
(21) the vendor stamps a check that was accepted at a location other than the sole authorized location contained in the vendor's contract.
(b) A food vendor shall be liable for any violation of subdivision (a) of this section by his/her employees.
(c) A food vendor who accepts or redeems WIC checks in violation of this section, in addition to being liable for any civil penalties assessed pursuant to section 12 of the Public Health Law, may be required to reimburse the State agency for funds obtained as result of the transactions.
(d) The imposition of civil penalties pursuant to this section, does not preclude the imposition of any fines or other penalties prescribed by applicable State, Federal or local law.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-2 REQUIRED SIGNAGE
10 CRR-NY 9-2.1 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) The terms electronic cigarette and e-cigarette mean an electronic device that delivers vapor which is inhaled by an individual user, and shall include any refill, cartridge and any other component of such a device; provided, however, that electronic cigarette and e-cigarette shall not mean any product approved by the United States Food and Drug Administration as a drug or medical device, or manufactured and dispensed pursuant to title 5-A of article 33 of the Public Health Law.
(b) The terms electronic liquid and e-liquid means the solution, substance or material used in an e-cigarette and heated to produce an aerosol or emission to be inhaled by the user, whether the liquid contains nicotine or not.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.7 Required examination
(a) Each individual who has attended an approved asbestos safety training program must pass a written multiple choice examination appropriate for the program which includes topics from all aspects of the training.
(b) The examination will be one provided by the Department of Health, or if one is not provided by the Department of Health, one approved by the Department of Health as part of the program provider's application.
(c) Closed book written examinations shall be administered at the completion of each initial and refresher training program by the training provider. The training provider will insure that the integrity of examination process is not compromised by actions of the trainee. The Department of Health may require the training provider to grade the examinations, record the grades and submit a copy of the examination, including the answer sheet, and a list of those who successfully completed each training program to the Department of Health.
(d) The written examination required for the asbestos handler training program shall cover the topics listed under section 73.5(a) and (b) of this Part. The examination shall include at least 50 questions. A minimum score of 70 percent is required to pass the examination.
(e) The written examination required for the operations and maintenance training program shall cover the topics listed under section 73.5(a) and (c) of this Part. The examination shall include at least 25 questions. A minimum score of 70 percent is required to pass the examination.
(f) The written examination required for the allied trades training program shall cover the topics listed under section 73.5(a) and (d) of this Part. The examination shall include at least 50 questions. A minimum score of 70 percent is required to pass the examination.
(g) The written examination required for the asbestos project air sampling technician training program shall cover the topics listed under section 73.5(a) and (e) of this Part. The examination shall include at least 50 questions. A minimum score of 70 percent is required to pass the examination.
(h) The written examination required for the inspector training program shall cover the topics listed under section 73.5(a) and (f) of this Part. The examination shall include at least 50 questions. A minimum score of 70 percent is required to pass the examination.
(i) The written examination required for the management planner training program shall cover the topics listed under section 73.5(g) of this Part. The examination shall include at least 50 questions. A minimum score of 70 percent is required to pass the examination.
(j) The written examination required for the abatement project designer training program shall cover the topics listed under section 73.5(a) and (h) of this Part. The examination shall include at least 100 questions. A score of 70 percent is required to pass the examination.
(k) The written examination required for the asbestos abatement contractors and supervisors training program shall cover the topics listed under section 73.5(a) and (i) of this Part. The examination shall include at least 100 questions. A minimum score of 70 percent is required to pass the examination.
(l) The written examination required for the asbestos project monitor shall cover the topics listed under section 73.5(a) and (j) of this Part. The examination shall include at least 100 questions. A minimum score of 70 percent is required to pass the examination.
(m) The examinations for all refresher training programs must include a minimum of 25 questions. A minimum score of 72 percent is required to pass the examination. Examination questions must be specific to the topic areas required for the discipline under section 73.6 of this Part.
(n) Notwithstanding anything to the contrary contained in this section, an oral examination may be administered instead of a written examination if an individual demonstrates that he/she is unable to read or write and provided such skills are not required to perform the functions of the discipline for which the individual is being tested. The individual administering the examination shall record the answers of the individual taking the examination on an answer sheet.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.19 Water quality
(a) Sample collection and analysis.
Microbiological samples shall be collected from swimming pools when determined by the permit-issuing official to be necessary to evaluate water quality, and be examined in laboratories approved by the New York State Department of Health.
(b) Microbiological quality.
Coliform bacteria levels should not exceed 4 per 100 milliliters in more than one sample examined each month. When the membrane filter technique is used, or when the fermentation tube method is used, coliform bacteria shall not be present in more than 10 percent of portions analyzed in any month; also, total bacteria shall not exceed 200 per milliliter.
(c) Chemical quality.
(1) The chemical quality of water in the pool shall not cause irritation to the eyes or skin of the bathers or have other objectionable physiological effects on bathers.
(2) The total alkalinity of the pool water shall be maintained within the range of 80 to 120 mg/l.
(3) The pool water shall be chemically balanced. The permit-issuing official may require that the operator determine the saturation index (see section 6-1.30 of this Subpart) monthly or at any other frequency required to maintain pool clarity, proper disinfection, alkalinity, and pH levels.
(d) Cleanliness.
(1) The bottom and sidewalls of swimming pools shall be kept free of sediment and visible soil, and the pool water surface shall be kept free of visible floating matter.
(2) The water in a swimming pool shall be sufficiently clear to permit a white and black object four inches in diameter, placed at any location on the bottom of the swimming pool, to be clearly visible from the sides of the swimming pool at all times.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.108 Emergency services category 1—comprehensive emergency medical services
Comprehensive emergency medical services provide immediate, complete and advanced care for all patients, including those requiring the most complex and specialized techniques. In addition to meeting the qualifications of a category 2 facility, a category 1 facility should have an anesthesiologist, internist, surgeon and, if applicable, an obstetrician or pediatrician, all of whom are specially trained in resuscitation and are available 24 hours a day to the emergency department. Continuous 24-hour laboratory support should be available, including such services as the determination of blood gases, blood pH, cardiac output, oxygen consumption, oxygen content, plasma protein, serum electrolytes, blood volume, hematologic determination and blood sugar. Capability for hemodialysis and extracorporeal oxygenation must also be present.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.5 Administrative rate appeals
(a) Administrative rate appeals of rates of payment issued pursuant to this Subpart must be submitted to the department in writing within 120 days of the date such rates are published by the department to the facility. Such rate appeals must set forth in detail the basis for such appeal and be accompanied by any relevant documentation. thereafter the department shall respond to such rate appeals in writing and shall either affirm the original rates, revise such rates or request additional information. A failure to respond to the department’s request for additional information within 30 days shall be deemed to constitute the withdrawal, with prejudice, of the facility’s rate appeal, provided, however, that the department may extend that time period upon a request by the facility and for good cause shown. Upon its receipt of the requested additional information the department shall issue a written determination of such rate appeal.
(b) The department’s written determination of a facility’s rate appeal shall be deemed final unless the facility submits a written request for further consideration of the rate appeal within 30 days of the date the department issued such written determination, provided, however, that if such written determination advises the facility that its rate appeal is being denied on the ground that the appeal constitutes a challenge to the rate-setting methodology set forth in this subpart such denial shall be deemed to be the department’s final administrative determination with regard to such appeal and there shall be no further administrative review available. the department shall otherwise respond in writing to the facility’s request for further consideration and either affirm or revise its original rate appeal determination and this response by the department shall be deemed its final administrative determination with regard to such rate appeal.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.13 Anesthesia services
If anesthesia services are provided within a hospital, the hospital shall develop, implement and keep current effective written policies and procedures regarding staff privileges consistent with provisions set forth in section 405.4 of this Part, the administration of anesthetics, the maintenance of safety controls and the integration of such services with other related services of the hospital to protect the health and safety of the patients in accordance with generally accepted standards of medical practice and patient care. Such policies and procedures shall be reviewed and updated as necessary, but at a minimum biennially. Hospitals providing living liver donor transplants shall also comply with the provisions contained in section 405.31(p)(2) of this Part.
(a) Organization and direction.
Anesthesia services shall be directed by a physician who has responsibility for the clinical aspects of organization and delivery of all anesthesia services provided by the hospital. That physician or another individual qualified by education and experience shall direct administrative aspects of the service.
(1) The director shall be responsible, in conjunction with the medical staff, for recommending to the governing body privileges to those persons qualified to administer anesthetics, including the procedures each person is qualified to perform and the levels of required supervision as appropriate. Anesthesia shall be administered in accordance with their credentials, competencies and privileges by the following:
(i) anesthesiologists;
(ii) physicians granted anesthesia privileges;
(iii) dentists, oral surgeons, or podiatrists who are qualified to administer anesthesia under State law;
(iv) certified registered nurse anesthetists (CRNA's) under the supervision of an anesthesiologist who is immediately available as needed or under the supervision of the operating physician who has been found qualified by the governing body and the medical staff to supervise the administration of anesthetics and who has accepted responsibility for the supervision of the CRNA; or
(v) a student enrolled in a school of nurse anesthesia accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs may administer anesthesia as related to such course of study under the direct personal supervision of a certified registered nurse anesthetist or an anesthesiologist.
(2) Anesthesia service policies shall clearly outline requirements for orientation and continuing education programs for all staff, and staff compliance with such requirements shall be considered at the time of reappointment or performance evaluation. Such training, clinical competencies and continuing education programs shall be established that are relevant to care provided but must, at a minimum, include instruction in safety precautions, equipment usage and inspections, infection control requirements and any patients' rights requirements pertaining to surgical/anesthesia consents.
(3) The director shall, in conjunction with the medical staff, monitor the quality and appropriateness of anesthesia related patient care and ensure that identified problems are reported to the quality assurance committee and are resolved.
(b) Operation and service delivery.
Policies governing anesthesia services shall be designed to ensure the achievement and maintenance of generally accepted standards of medical practice and patient care.
(1) All anesthesia machines shall be numbered and reports of all equipment inspections and routine maintenance shall be included in the anesthesia service records. Policies and procedures shall be developed and implemented regarding notification of equipment disorders/malfunctions to the director, to the manufacturer and, in accordance with section 405.8 of this Part, to the department.
(2) Written policies regarding anesthesia procedures shall be developed and implemented which shall clearly delineate pre-anesthesia and post-anesthesia responsibilities. These policies shall include, but not be limited to, the following elements:
(i) Pre-anesthesia physical evaluations shall be performed by an individual qualified to administer anesthesia and recorded within 48 hours, prior to surgery.
(ii) Routine checks shall be conducted by the anesthetist prior to every administration of anesthesia to ensure the readiness, availability, cleanliness, sterility when required, and working condition of all equipment used in the administration of anesthetic agents.
(iii) All anesthesia care shall be provided in accordance with generally accepted standards of practice and shall ensure the safety of the patient during the administration, conduct of and emergence from anesthesia. The following continuous monitoring is required during the administration of general and regional anesthetics. Such continuous monitoring is not required during the administration of anesthetics administered for analgesia or during the administration of local anesthetics unless medically indicated.
(a) An anesthetist shall be continuously present in the operating room throughout the administration and the conduct of all general anesthetics, regional anesthetics, and monitored anesthesia care. If there is a documented hazard to the anesthetist which prevents the anesthetist from being continuously present in the operating room, provision must be made for monitoring the patient.
(b) All patients must be attended by the anesthetist during the emergence from anesthesia until they are under the care of qualified post-anesthesia care staff or longer as necessary to meet the patient's needs.
(c) During all anesthetics, the heart sounds and breathing sounds of all patients shall be monitored through the use of a precordial or esophageal stethoscope. Such equipment or superior equipment shall be obtained and utilized by the hospital.
(d) During the administration and conduct of all anesthesia services the patient's oxygenation shall be continuously monitored to ensure adequate oxygen concentration in the inspired gas and the blood through the use of a pulse oximeter or superior equipment that is age and size appropriate. During every administration of general anesthesia using an anesthesia machine, the concentration of oxygen in the patient's breathing system shall be measured by an oxygen analyzer with a low oxygen concentration limit alarm.
(e) All patients' ventilation shall be continuously monitored during the conduct of anesthesia. During regional anesthesia, monitored anesthesia care and general anesthesia with a mask, the adequacy of ventilation shall be evaluated through the continual observation of the patient's qualitative clinical signs. For every patient receiving general anesthesia with an endotracheal tube, the quantitative carbon dioxide content of expired gases shall be monitored through the use of endtidal carbon dioxide analysis or superior technology. In all cases where ventilation is controlled by a mechanical ventilator, there shall be in continuous use an alarm that is capable of detecting disconnection of any components of the breathing system.
(f) The patient's circulatory functions shall be continuously monitored during all anesthetics. This monitoring shall include the continuous display of the patient's electrocardiogram, from the beginning of anesthesia until preparation to leave the anesthetizing location, and the evaluation of the patient's blood pressure and heart rate at least every five minutes.
(g) During every administration of anesthesia, there shall be immediately available a means to continuously measure the patient's temperature.
(iv) All equipment and services provided shall be age and size appropriate.
(v) Intraoperative anesthesia records shall document all pertinent events that occur during the induction, maintenance, and emergence from anesthesia. These pertinent events shall include, but not be limited to, the following: intraoperative abnormalities or complications, blood pressure, pulse, dosage and duration of all anesthetic agents, dosage and duration of other drugs and intravenous fluids, and the administration of blood and blood components. The record shall also document the general condition of the patient.
(vi) With respect to inpatients a post-anesthetic follow-up evaluation and report by the individual who administered the anesthesia or by an individual qualified administer anesthesia shall be written not less than three or more than 48 hours after surgery and shall note the presence or absence of anesthesia related abnormalities or complications, and shall evaluate the patient for proper anesthesia recovery and shall document the general condition of the patient.
(vii) With respect to outpatients, a post-anesthesia evaluation for proper anesthesia recovery performed in accordance with policies and procedures approved by the medical staff shall be documented for each patient prior to hospital discharge.
(3) Safety precautions shall be clearly identified in written policies and procedures specific to the department and include, but not be limited to:
(i) safety regulations posted;
(ii) routine inspection and maintenance of equipment;
(iii) use and maintenance of shockproof equipment;
(iv) proper grounding; and
(v) infection control.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.298 Retained earnings (or income)
Accumulated net income, less distributions to stockholders and transfers to paid-in capital accounts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.3 Board of examiners; officers and duties
(a) The term of office of the members of the board shall be three years and shall expire on June 30th three years from the year of the appointment. No more than three board members may be appointed for a term that expires during the same year.
(b) The board shall select from among its members a chair and vice-chair at least one of which shall be a licensed and currently registered New York State nursing home administrator.
(c) The chair shall preside at all meetings of the board and shall sign all official documents of the board.
(d) In addition to the duties imposed by law, the secretary shall attend all meetings of the board; keep a full and complete record of the minutes of said meetings; notify the members of the board of the time and place fixed for meetings of the board; maintain the records pertaining to licenses and this Part; countersign all licenses and certificates of registration and official certification of approval and certification issued by the board.
(e) The secretary shall conduct all correspondence for the board, shall issue all notices of meetings and hearings, shall have custody of all books, records and property of the board and shall perform all duties pertaining to the office of the secretary.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.45 Source water treatment requirements
A water system that exceeds the lead or copper action level based on first draw tap water samples collected in accordance with section 5-1.42 of this Subpart shall complete the applicable source water monitoring and treatment requirements and operate appropriate treatment to maintain lead and copper below levels specified by the State in accordance with the following requirements.
(a) Source water treatment requirements.
(1) A water system exceeding the lead or copper action level shall complete required lead and copper source water monitoring in accordance with section 5-1.44(b)(1) of this Subpart and make an appropriate treatment recommendation to the State no later than 180 days after the end of the monitoring period during which the system exceeds the lead or copper action level. A system may recommend that no treatment be installed based upon a demonstration that source water treatment is not necessary to minimize lead and copper levels at users' taps.
(2) Based on an evaluation of the results of all required source water sampling, the State shall make a determination if source water treatment is necessary and may require:
(i) source water treatment as recommended by the system; or
(ii) alternative source water treatment that would minimize lead and copper levels at user’s taps. Completion of proper installation and operation of the State specified source water treatment shall occur within 24 months of State determination and notification of the specified treatment to the water system.
(3) The water system shall complete standard monitoring for tap water in accordance with section 5-1.42(b) of this Subpart and source water in accordance with paragraph (b)(2) of this section following installation of source water treatment.
(4) Based on a review of the source water samples taken by the water system both before and after the system installs source water treatment, the State shall:
(i) determine whether the system has properly installed and operated the source water treatment designated by the State; and
(ii) specify maximum permissible source water concentrations for water entering the distribution system. Such levels shall reflect the contaminant removal capability of the treatment when properly operated and maintained.
(b) Operation and maintenance requirements.
(1) Each water system shall operate in a manner that minimizes lead and copper levels at user’s taps by maintaining lead and copper levels below State-specified maximum permissible concentrations at each of the required source water sampling locations in accordance with section 5-1.44 of this Subpart. The system is out of compliance with this paragraph if the level of lead or copper at any sampling point is greater than the State-specified maximum permissible concentration.
(2) The State may modify its determination of the source water treatment under paragraph (a)(2) of this section, or maximum permissible lead and copper concentrations for finished water entering the distribution system under paragraph (a)(4) of this section where it concludes that such change is necessary to ensure that the system continues to minimize lead and copper concentrations in source water.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.215 Nine-C (IX-C) corporation
As defined in article IX-C of the Insurance Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 40-2.2 State aid eligibility; clinic services
The cost of public health clinic services is allowable for only the following:
(a) clinic health services identified in section 40-1.51(b) of this Part, including clinics for sexually transmitted diseases, consistent with Public Health Law section 2304; HIV counseling, testing, diagnosis and prevention; family planning; immunization; primary care for children less than 21 years of age, provided that such services are only eligible for State aid to the extent that the local health department makes good faith efforts to assist such persons with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective; and prenatal and postpartum care, provided that such services are only eligible for State aid to the extent that the local health department makes good faith efforts to assist such women with Medicaid or insurance enrollment, as applicable, and only until such time as insurance coverage becomes effective;
(b) tuberculosis control;
(c) rabies control;
(d) dispensing countermeasures in the event of an actual or threatened public health emergency;
(e) other services consistent with section 602 of the Public Health Law and approved by the commissioner for State aid reimbursement.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.9 Review of demonstration project data
The commissioner and the technical advisory groups shall review and analyze the reports and data submitted with respect to the demonstration projects and evaluate the medical efficacy, cost effectiveness and efficiency of, the need for, and the quality of care and safety associated with the innovation in medical technology being evaluated and shall report their findings and recommendations to the State Hospital Review and Planning Council and Public Health Council. Upon completion of a demonstration project and a determination by the commissioner that the subject of the demonstration meets an identifiable need, is cost effective and efficient and meets generally accepted medical standards for safety and effectiveness, applicants participating in the demonstration, as well as other medical facilities, must apply in order to acquire, operate or provide the innovation in technology that was the subject of the demonstration pursuant to section 2802 of the Public Health Law and Part 710 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.48 Records and reports of institutional dispensers
(a) Hospitals and other facilities licensed and authorized by the department to purchase, possess and use controlled substances shall keep the following records:
(1) An order, signed by a person authorized to prescribe under the provisions of this Part, specifying the controlled substances medication for an indicated person or animal.
(2) A separate record, at the main point of supply for controlled substances showing the type and strength of each drug in the form of a running inventory indicating the dates and amounts of such drugs compounded by them or received from other persons and their distribution or use.
(3) A record of authorized requisitions for such drugs for distribution to substations or wards. Such records shall show receipt at substation or ward by the signature of a person authorized to control such substation or ward; and:
(i) with each substock of schedule II controlled substances, an administration sheet shall be furnished;
(ii) the administration sheet shall list the type of controlled substances, dose and number of doses furnished to the substock; and
(a) date and hour of administration;
(b) name of patient;
(c) name of prescribing physician or practitioner;
(d) quantity of administration;
(e) balance on hand after each administration; and
(f) signature of administering nurse.
(4) A record in the patient's chart indicating administration of the controlled substance including the name of the administering attendant and the date and hour of administration.
(b) Records of controlled substances received shall include the date of receipt, name and address of vendor, type and quantity of such drugs received. A duplicate invoice or separate itemized list furnished by the vendor will be sufficient to satisfy this record requirement provided it includes all required information and is maintained in a separate file. In addition, duplicate copies of Federal order forms for schedule II controlled substances must be retained.
(c) Records of controlled substances administered shall include date of administration, name of patient, prescriber's signature, signature of person administering, type and quantity of drug and such other information as may be required by regulation provisions of article 33 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.27 Alcohol and drug unit
A unit for the care of alcohol and/or drug rehabilitation inpatients. The hospital must also employ specially trained personnel to staff this unit, and at least one psychiatrist must be on the medical staff.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.5 Lead screening and follow-up of pregnant women by prenatal care providers
(a) Prenatal health care providers shall provide each pregnant woman anticipatory guidance on lead poisoning prevention during pregnancy, and shall assess each pregnant woman at the initial prenatal visit for high dose lead exposure using a risk assessment tool. A risk assessment tool shall be recommended by the State Commissioner of Health.
(b) Prenatal health care providers shall screen or refer for blood lead screening each pregnant woman found to be at risk for current high dose lead exposure.
(c) Prenatal health care providers shall provide each pregnant women, who has a confirmed blood lead level equal to or greater than 10 micrograms per deciliter of whole blood, risk reduction counselling in accordance with guidelines recommended by the State Commissioner of Health.
(d) Prenatal care providers shall refer each pregnant woman, who has a confirmed blood lead level equal to or greater than 10 micrograms per deciliter of whole blood and who may have been occupationally exposed to lead, to an occupational health clinic for individual guidance.
(e) Prenatal care providers shall provide anticipatory guidance to each woman at her postpartum visit on the prevention of childhood lead poisoning.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.10 Medical records
The hospital shall have a department that has administrative responsibility for medical records. An accurate, clear, and comprehensive medical record shall be maintained for every person evaluated or treated as an inpatient, ambulatory patient, emergency patient or outpatient of the hospital.
(a) General requirements.
(1) Medical records shall be legibly and accurately written, complete, properly filed, retained and accessible in a manner that does not compromise the security and confidentiality of the records.
(2) The hospital shall establish, implement and monitor an effective system of author identification for medical records and/or medical orders to ensure the integrity of the authentication and protect the security of all transmissions, records and record entries. This system shall identify those categories of practitioners and personnel who are authorized to utilize electronic or computer authentication systems.
(3) The hospital shall ensure that all medical records are completed within 30 days following discharge.
(4) Medical records shall be retained in their original or legally reproduced form for a period of at least six years from the date of discharge or three years after the patient's age of majority (18 years), whichever is longer, or at least six years after death.
(5) The hospital shall have a system of coding and indexing medical records. The system shall allow for timely retrieval by diagnosis and procedure, in order to support quality assurance studies.
(6) The hospital shall ensure the confidentiality of patient records. Original medical records, information from or copies of records shall be released only to hospital staff involved in treating the patient and individuals as permitted by Federal and State laws.
(7) The hospital shall allow patients and other qualified persons to obtain access to their medical records and to add brief written statements which challenge the accuracy of the medical record documentation to become a permanent part of the medical record, in accordance with the provisions of Part 50 of Chapter II of this Title and the provisions of Public Health Law, section 18(4).
(b) Content.
(1) The medical record shall contain information to justify admission and continued hospitalization, support the diagnosis, and describe the patient's progress and response to medications and services.
(2) All records shall document, as appropriate, at least the following:
(i) evidence of a physical examination, including a health history, performed no more than 30 days prior to admission or within 24 hours after admission and a statement of the conclusion or impressions drawn;
(ii) admitting diagnosis;
(iii) results of all consultative evaluations of the patient and findings by clinical and other staff involved in the care of the patient;
(iv) documentation of all complications, hospital acquired infections, and unfavorable reactions to drugs and anesthesia;
(v) properly executed consent forms for procedures and treatments;
(vi) all practitioners' diagnostic and therapeutic orders, nursing documentation and care plans, reports of treatment, medication records, radiology, and laboratory reports, vital signs and other information necessary to monitor the patient’s condition;
(vii) discharge summary with outcome of hospitalization, disposition of case and provisions for follow-up care; and
(viii) final diagnosis.
(c) Authentication of medical records, record entries and medical orders.
(1) Upon completion of ordering or providing or evaluating patient care services, each such action shall be recorded and promptly entered in the patient medical record. All entries shall be legible and complete and shall be authenticated by the person entering, ordering or completing such action. Legible and signed facsimile orders may be accepted and shall be filed in the patient medical record.
(2) Written signatures, or initials and electronic signatures or computer generated signature codes shall be acceptable as authentication when utilized in accordance with hospital policy.
(3) Each electronic or computer entry, order or authentication shall be recorded in the medical record as to date, time, category of practitioner, mode of transmission and point of origin.
(4) Safeguards to ensure security and confidentiality shall include but not be limited to:
(i) the assignment, as appropriate, of a unique identifier that is assigned in a confidential manner;
(ii) the certification in writing by the hospital’s designee and the user that each identifier assigned is confidential and is available and accessible only to the person authorized to use the electronic or computer authentication system;
(iii) policies and procedures to ensure the security of electronic or computer equipment from unwarranted access;
(iv) policies and procedures that restrict access to information and data to those individuals who have need, reason and permission for such access; and
(v) the implementation of an audit capability to track access by users.
(5) Hospitals shall implement an ongoing verification process to ensure that electronic communications and entries are accurate, including but not limited to:
(i) protocols for ensuring that incomplete entries or reports or documents are not accepted or implemented until reviewed, completed and verified by the author; and
(ii) a process implemented as part of the hospital’s quality assurance activities that provides for the sampling of records for review to verify the accuracy and integrity of the system.
(6) Written notice from the author shall be required should the author/user wish to terminate participating in the electronic or computer authentication system.
(7) The hospital shall have procedures in place to modify or terminate use of any assigned identifier in cases of abuse or misuse or if practice privileges are suspended, restricted, terminated or curtailed or employment or affiliation ends.
(8) The hospital shall implement policies and procedures regarding the use and authentication of verbal orders, including telephone orders. Such policies and procedures must:
(i) specify the process for accepting and documenting such orders;
(ii) ensure that such orders will be issued only in accordance with applicable scope of practice provisions for licensed, certified or registered practitioners, consistent with Federal and State law; and
(iii) specify that such orders must be authenticated by the prescribing practitioner, or by another practitioner responsible for the care of the patient and authorized to write such orders and the time frame for such authentication.
(9) All orders for controlled substances shall be carried out in accordance with provisions of Part 80 of this Title.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.33 COVID-19 confirmatory testing
(a) Any resident with symptoms of COVID-19 who has been exposed to COVID-19 shall be tested for the COVID-19 virus, along with any other clinically appropriate testing.
(b) Whenever a person expires while in a nursing home, where in the professional judgment of the nursing home clinician there is a clinical suspicion that COVID-19 was a cause of death, but no such test was performed in the 14 days before death, the nursing home shall administer a COVID-19 test within 48 hours after death, along with any other clinically appropriate testing. Such COVID-19 test shall be performed using rapid testing methodologies to the extent available. The facility shall report the death to the department immediately after and only upon receipt of such test results through the Health Emergency Response Data System (HERDS). Notwithstanding the foregoing, no test shall be administered if the next of kin objects to such testing. Should the nursing home lack the ability to perform such testing expeditiously, the nursing home should request assistance from the State Department of Health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 100.16 Latham Water District, town of Colonie (reservoir)
(a) Application.
The following rules and regulations enacted in accordance with the provisions of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 879 of the Laws of 1953, and numbered article 11 thereof, shall apply to the reservoir and drainage areas tributary thereto which serve as a source of the public water supply of the Latham Water District in the town of Colonie, Albany County, New York, and to any future reservoirs which may be constructed to serve as part of the source of supply.
(b) Definitions.
(1) The term water supply whenever used in this section refers to the public water supply of the Latham Water District in the town of Colonie, Albany County, New York.
(2) The term reservoir refers to the reservoir on land owned by the Latham Water District in the town of Clifton Park, Saratoga County, New York.
(3) The term tributary refers to Stony Creek or any stream discharging to the reservoir.
(4) The term linear distance refers to the shortest horizontal distance from the nearest point of the structure or object to the tributaries or the high-water mark of the reservoirs.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into the reservoir or any tributary.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 300 feet from the reservoir or within 200 feet of any tributary and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of the reservoir or within 100 feet of any tributary, except a properly constructed and operated sewage disposal plant as hereinafter set forth in subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from the reservoir or tributary and especially constructed of concrete, masonary or metal to form a watertight receptable from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from the reservoir or any tributary. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the town board of the town of Colonie acting for, and on behalf of, the Latham Water District.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the reservoir or any tributary nor deposited on or beneath the surface of the ground within 300 feet of the reservoir or within 200 feet of any tributary except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within 100 feet of the reservoir, provided, however, that the property on which the receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for the* paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and aproved by the State Commissioner of Health and/or the Water Pollution Control Board.
(e) Bath water, wastes.
No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by subdivision (d), shall be discharged or allowed to flow into the reservoir or any tributary nor be deposited on or beneath the surface of the ground within 100 feet of the reservoir or within 50 feet of any tributary.
(f) Garbage, refuse.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in the reservoir or tributaries nor on or beneath the surface ground within 100 feet of the reservoir or within 50 feet of any tributary nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into the reservoir or any tributary.
(g) Swimming.
No person or persons shall bathe or swim or be allowed to bathe or swim in the reservoir.
(h) Boating, fishing.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir, except by duly authorized employees of the Latham Water District in the performance of their duties of supervision and maintenance of the water supply.
(i) Animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in the reservoir, and no watering place shall be maintained in such a way as to pollute any water course with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute the reservoir or any tributary.
(j) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 200 feet of the reservoir or within a distance of 100 feet of any tributary.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of the reservoir or within a distance of 100 feet of any tributary.
(l) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(m) Inspections.
The town board of the Town of Colonie acting for and on behalf of the Latham Water District or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the district shall make thorough monthly inspections of the lake, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said town board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said town board to promptly notify the State Commissioner of Health of such violations. The town board of the Town of Colonie acting for, and on behalf of, the Latham Water District shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(n) Penalty.
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.12 Additional requirements for importers and exporters
(a)
(1) All persons acting as importers of controlled substances shall first obtain a class 9 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(2) Persons conducting activities as importer broker of controlled substances within New York State where there is no physical possession of controlled substances are required to obtain a class 9a license from the department and wherever necessary, proper license from the appropriate Federal agency.
(b)
(1) All persons exporting controlled substances shall first obtain a class 10 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(2) Persons conducting activities as exporter broker of controlled substances within New York State where there is no physical possession of controlled substances are required to obtain a class 10a license from the department and wherever necessary, proper license from the appropriate Federal agency.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.75 Critical care units
A discrete inpatient unit within the hospital providing maximum surveillance/support of vital functions; definitive therapy for patients with acute but reversible life-threatening impairments; patient monitoring; cardiopulmonary resuscitation; other life support techniques; and a staff of health professionals who have received specialized training in the provision of these services.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.33 Milk and milk products and substitutions; fresh and frozen shellfish; eggs; pasteurization, packaging and labeling
(a) When fluid and dry mllk, fluid and dry milk products, and fluid or dry milk substitutes are used or served, they are to be pasteurized and are to meet the standards established by law.
(b) When fresh and frozen shellfish or shucked shellfish (oysters, clams or mussels) are used, they must be identified with the name and address of the original shell-stock processor, shucker-packer, or repacker, and the foreign, intrastate and interstate certification number issued according to law. Tags are to be retained for 90 days after use of shellfish.
(c) Only clean, whole eggs, with shell intact and free from cracks or checks, or pasteurized liquid, frozen or dry eggs or pasteurized dry egg products arm to be used. All containers in which shell eggs are received in a food service establishment must identify the source.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.1 Compliance with FDA regulations and manufacturers' instructions
(a) All antisera, reagents, devices, methods and procedures for tissue processing or transplantation-related testing shall be approved by the FDA, if such approval is available for the particular class or type of antiserum, reagent, device, method or procedure.
(b) All reagents shall be stored in labeled containers under conditions appropriate for each reagent as directed by the manufacturer and shall be removed from use after the expiration date. The reactivity, specificity and potency of each reagent shall be determined whenever a new lot is employed. All methods shall conform to the manufacturer's instructions unless otherwise approved by the department upon submission of evidence that another method is equal or superior to the method described in the manufacturer's instructions.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 84.2 Applicability
(a) Except as otherwise expressly provided in any rule or rules, these attendance rules shall apply to the following employees in the department who are employed in positions the principal duty of which is the teaching or instruction of patients or the direct supervision of such teaching or instruction, who are employed on the basis of a calendar year similar to the school calendar year of public school teachers in New York State, and who are compensated in accordance with section 136 of the New York State Civil Service Law.
(1) Institution Teachers, G-12
(2) Institution Teachers (T.B.S.), G-13
(3) Senior Institution Teachers, G-15
(4) Senior Institution Teachers (T.B.S.), G-16
(5) Institution Education Supervisors (group of classes), G-17
(b) These rules shall not be construed to require or allow extension of leave with pay except for periods during which the employee is normally paid his regular salary.
Chapter I STATE SANITARY CODE
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.2 Equipment requirements for an emergency health care facility
Any emergency health care facility at a public function must contain at minimum the following equipment:
(a) Patient transfer equipment:
(1) A device equipped with two two-inch-wide web straps to secure a patient which will enable emergency medical service personnel to move the patient from the incident site to the emergency health care facility.
(2) In an auditorium, stadium or similar physical setting with seats in steep tiers, a stair chair-type stretcher.
(b) Airway, ventilation, oxygen and suction equipment:
(1) Manually operated, self-refilling bag-valve-mask ventilation device with a high concentration oxygen enrichment or portable manually triggered oxygen-powered resuscitation device, either of which shall include adult and pediatric-size face masks.
(2) Oropharyngeal airways, in adult, pediatric and infant sizes.
(3) Two commercially prepared bite sticks.
(4) A portable oxygen system with one medical “D” size cylinder including a regulator consisting of a yoke, pressure gauge, flow meter and a spare cylinder.
(5) Four disposable oxygen masks and four nasal cannulae.
(6) A portable suction device capable of providing an adjustable flow of over 30 liters/minute at the end of the delivery tube and a vacuum of over 300mm mercury when the tube is clamped, including wide bore tubing, a plastic, rigid pharyngeal suction tip and various size flexible suction catheters.
(7) One pocket face mask with oxygen inlet.
(8) Miscellaneous items for oral use which shall be kept clean and be individually wrapped.
(c) Immobilization equipment:
(1) One full-size backboard (72 inches long) with a minimum of two-inch by nine-foot web straps for securing the patient to the device.
(2) One padded board splint, 54 inches by 3 inches by 3/8 inch thick with a minimum of one-half inch foam padding on one side covered with a nonporous material.
(3) Two padded boards, 36 inches by 3 inches by 3/8 inch thick (cardboard, other malleable or inflatable splints are acceptable substitutes) with a minimum of one-half inch foam padding on one side covered with a nonporous material.
(4) Two padded boards, 15 inches by 3 inches by 3/8 inch thick (padded wire, cardboard or inflatable splints are acceptable substitutes) with a minimum of one-half inch foam padding on one side covered with a nonporous material.
(5) A head immobilization device (commercially manufactured device), blanket collar, two five-pound sandbags or other device providing equivalent immobilization of the head.
(6) One large, one medium and one small extrication collar.
(d) Wound dressings:
(1) Twenty-four sterile gauze pads, four inches by four inches.
(2) Three rolls adhesive tape in assorted sizes.
(3) Six rolls conforming gauze bandages in assorted sizes, but including three-inch.
(4) Two universal dressings approximately 10 inches by 30 inches.
(5) Ten large sterile dressings, five inches by eight inches minimum.
(6) One pair bandage shears.
(7) Six triangular bandages.
(8) Two liquid glucose or equivalent.
(9) Sterile normal saline in plastic containers (1,000cc minimum).
(10) Two occlusive dressings.
(11) Two sterile burn sheets.
(e) Miscellaneous equipment:
(1) Spare pillow, four sheets, two pillow cases, one blanket, in addition to linen and pillow on cot(s) or litter(s).
(2) Six cloth hand towels.
(3) One box facial tissues.
(4) Two emesis containers.
(5) Portable blood pressure cuff and stethoscope.
(6) One male urinal and one bedpan.
(7) Potable water, minimum five gallons.
(8) Sterile O.B. kit.
(9) Carrying case with compartments for essential emergency care equipment (jump kit).
(10) One flashlight in operable condition.
(11) One battery lantern in operable condition.
(12) Communication equipment—two-way radio or telephone between the emergency health care facility and an outside medical facility(s).
(13) Six chemical ice packs.
(f) Other miscellaneous requirements:
(1) an ambulance used to meet the requirements of an emergency health care facility must be certified and equipped pursuant to sections 800.21, 800.22, 800.23 and 800.24 of this Title and must remain onsite at all times during the event except when transporting patients;
(2) an emergency health care facility shall place a placard or sign of such size and design at such location as will assure notice to the public of the emergency health care facility's identity as such; and
(3) an emergency health care facility shall be maintained at such temperature as will not endanger its ability to care for or will not further compromise the condition of either hypothermic or hyperthermic patients requiring emergency care.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.7 Hearings
(a) Hearings are open to the public, presided over by a tribunal or tribunal representative, and are to proceed with reasonable expedition and order and, insofar as practicable, shall be held at a place and time that will minimize postponements and adjournments.
(b) Each party to a proceeding has the right to be represented by counsel, to present evidence, to examine and cross-examine witnesses (subject to the requirement contained in subdivision [c] of this section), and shall have all rights essential to a fair and impartial hearing.
(c) If requested by the respondent, the department will ensure the appearance of the departmental employee who has signed the finding of violation. Such employee shall testify and produce for examination and consideration any written evidence deemed relevant to the allegations.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.3 Standard description of the external appeal process
(a) Health care plans shall provide enrollees, and upon request, health care providers, with a copy of the standard description of the external appeal process developed jointly by the commissioner and superintendent, including a form and instructions for enrollees to request an external appeal. The standard description, request form and instructions for the external appeal process developed jointly by the commissioner and superintendent shall include, but not be limited to:
(1) a statement of the enrollee's right to an external appeal of health care services denied pursuant to a utilization review determination by the enrollee's health care plan on the basis that the services are not medically necessary or that the services are experimental or investigational;
(2) a description of the eligibility criteria for an external appeal pursuant to section 4910 of the Public Health Law and Insurance Law and the following:
(i) Medicare cannot be the enrollee's only source of health services; and
(ii) enrollees receiving benefits under both Medicaid and Medicare are eligible for the external appeal process only for denials of benefits that are covered under Medicaid;
(3) notification that enrollees receiving benefits under Medicaid may also file a complaint through the fair hearing process and that the determination in the fair hearing process will be the one that controls;
(4) notification of the time frames within which the certified external appeal agent must make a determination on expedited and nonexpedited external appeals;
(5) notification that enrollees requesting an expedited external appeal or an external appeal of a health care plan's denial because the requested health care service is considered to be experimental or investigational should forward the attending physician's attestation to the enrollee's attending physician to complete;
(6) notification that requests for external appeal must be accompanied by the appropriate fee, as determined by the enrollee's health care plan, or a statement that a waiver of the fee has been requested, in order to be eligible for an external appeal;
(7) a description of the responsibility of the enrollee's health care plan to send the enrollee's medical and treatment records to the certified external appeal agent, provided that the certified external appeal agent may request additional information from the enrollee, the enrollee's health care provider or the enrollee's health care plan at any time;
(8) a description of the right of the enrollee and the enrollee's health care provider to submit information to the certified external appeal agent, regardless of whether the agent has requested any information, within 45 days from when the enrollee received notice that the health care plan made a final adverse determination or within 45 days from when the enrollee received a letter from the health care plan affirming that both the enrollee and the enrollee's health care plan jointly agreed to waive the internal appeal process, provided that the external appeal agent has not yet rendered a determination on the appeal;
(9) a description of the process for notifying the enrollee and the enrollee's health care plan of the certified external appeal agent's determination;
(10) instructions for submitting the request for external appeal to the superintendent;
(11) instructions for contacting the State if the enrollee or health care provider has questions;
(12) notification that an enrollee or a person authorized pursuant to law to consent to health care for the enrollee must sign the request and consent to the release of medical and treatment records for an enrollee to be eligible for an external appeal; and
(13) a signature line for the enrollee's consent to the release of his or her medical and treatment records, including HIV, mental health and alcohol and drug abuse records, to the certified external appeal agent assigned to review the enrollee's external appeal, and the expiration date of the authority to release the enrollee's medical and treatment records in accordance with section 2782 of the Public Health Law for confidential HIV related information and sections 33.13 and 33.16 of the Mental Hygiene Law for mental health related information.
(b) The commissioner and superintendent shall develop a separate form and instructions for an enrollee's health care provider to request an external appeal in connection with a retrospective adverse utilization review determination pursuant to section 4904 of the Public Health Law. The form must include notification that an enrollee or a person authorized pursuant to law to consent to health care for the enrollee must sign the request and consent to the release of medical and treatment records for the health care provider to be eligible for an external appeal.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.4 Disclosure: clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services
(a) An ownership interest or investment interest shall not be subject to section 238-a(1)(a) of the Public Health Law or to section 34-1.3 of this Subpart if:
(1) the health care provider authorized to provide clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services is in a rural area and the referring practitioner or the patient is in such rural area; or
(2) the clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services are provided by a general hospital, the referring practitioner is authorized to perform services at such general hospital, and the ownership or investment interest is in the general hospital itself and not merely in a subdivision thereof; or
(3) the clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services are provided by an ambulatory surgical center issued an operating certificate pursuant to Part 401 of this Title in conjunction with a surgical procedure performed by the referring practitioner at the ambulatory surgical center; and
(4) if each practitioner who is an interested investor in a health care provider within a category specified in paragraph (1), (2) or (3) of this subdivision discloses to the patient the practitioner's, or family member's, ownership interest or investment interest in the health care provider and the patient's right to utilize a specifically identified alternative health care provider if any such alternative is reasonably available, in the disclosure form specified in section 34-1.6 of this Subpart. Such form shall also be posted prominently in the practitioner's office.
(b) A practitioner shall maintain documentation of each instance of disclosure to a patient pursuant to this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.2 Application
(a) Prior to operation of an adult day health care program, the proposed operator must apply for and receive department approval in accordance with Part 710 of this Chapter. Such application must include a description of the proposed program, including but not limited to:
(1) the need for the program, including a statement on the philosophy and objectives of the program;
(2) the range of services to be provided;
(3) the method(s) of delivery of services;
(4) physical space to be utilized and planned use thereof;
(5) number and expected characteristics of registrants to be served;
(6) a description of a typical registrant's program;
(7) personnel to be employed in the program, including qualifications;
(8) intended use of and coordination with existing community resources;
(9) financial policies and procedures;
(10) program budget;
(11) methods for program evaluation; and
(12) proximity to an identified number of potential registrants.
(b) A residential health care facility operator that has been approved by the department to operate an adult day health care program at its primary site may provide adult day health care services at an extension site only when such use of an extension site has first been approved by the department under the provisions of Part 710 of this Chapter.
(c) A residential health care facility operator that does not operate an adult day health care program at its primary site may provide such a program at an extension site approved by the department for such use in accordance with section 710.1 of this Chapter if there is not sufficient suitable space within the residential health care facility to accommodate a full range of adult day health care program activities and services. The department may conduct an on-site survey of the residential health care facility to determine whether the facility lacks suitable space for an adult day health care program.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.26 Special-purpose pools
Pools for persons with physical disabilities shall provide safe entry and exit from the pool. All surfaces shall be free of sharp edges. These pools shall be operated and maintained in accordance with the requirements specified in section 6-1.29, item 15.3, of this Subpart.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.14 Toilets and lavatories
(a) The agricultural fairground owner shall ensure that toilets and lavatories comply with the following requirements:
(1) adequate toilet and handwash facilities shall be provided;
(2) adequate handwash facilities shall be located at any petting zoo and within 100 feet of all areas where the general public is allowed to come in contact with animals. These facilities shall be constructed of easily cleanable materials, and maintained in a sanitary condition and in good repair and adequate signs shall be conspicuously posted indicating the location of handwash facilities; and
(3) at campgrounds, a minimum of four toilets, two per sex, shall be provided within 500 feet of each campsite;
(i) for every two toilers, one handwash facility shall be provided. Handwash facilities shall be located in close proximity to the toilets.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.10 Religious exemption from immunization
The provisions of this Subpart regarding immunizations shall not apply in the case of any child whose parent or legal guardian holds genuine and sincere religious beliefs which prohibit immunization and who notifies the person charged with administering such immunization of the religious objection hereto. The health care provider attending the child shall document the religious objection exemption in the child's medical record, including a statement signed by the parents or legal guardian stating that they hold genuine and sincere religious beliefs which prohibit immunization and that they acknowledge that they have been informed about the risk to the child's health by withholding hepatitis B immunization.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 152 WARREN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 152.8 North Creek Water District, Town of Johnsburgh
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs, watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, serving as sources of the public water supply of the North Creek Water District, Town of Johnsburgh, Warren County, New York.
(b) Defintions of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the North Creek Water District.
(2) The term reservoir means any natural or artificially impounded body of water serving as the source of the aforesaid water supply and to any additional reservoir which may be constructed or used for this water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta and sewage.
(1) No human excreta or sewage shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta or sewage shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta or sewage shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any reservoir or watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse.
(5) No privy or receptacle of any kind for the storage of human excreta shall be constructed, placed, maintained or allowed to remain within any mine or mine shaft, the drainage from which, either by gravity or by pumping, flows directly or indirectly into reservoir or watercourse.
(6) Every privy or receptacle for the storage or deposit of human excreta located between the limiting distances of 200 feet and 500 feet from any reservoir or watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(8) No garbage, refuse or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 200 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(d) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse.
(e) Fishing, boating and ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply, except by duly authorized employees of the North Creek Water District in the performance of their duties of supervision and maintenance of the water supply.
(f) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the water supply. All provisions of Part 7 of the State Sanitary Code [Chapter I of this Title] relating to camps shall be complied with.
(g) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act though not heretofore specified which may result in contamination of any portion of the water supply of the North Creek Water District.
(h) Inspections.
The board of supervisors of the town of Johnsburg or such other person or persons as may be charged with the maintenance or supervision of the public water supply of the North Creek Water District or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said board to promptly notify the State Commissioner of Health of such violations. The board of supervisors shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.9 Severability
If any provisions of this Subpart or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Subpart or the application thereof to other persons, entities, and circumstances.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.8 Policies and procedures
An integrated services provider shall have written policies, procedures, and methods governing the provision of services to patients, including a description of each service provided. These policies, procedures, and methods shall be reviewed annually and revised as necessary. They shall address, at a minimum, the following:
(a) admission criteria;
(b) evaluations and treatment plans;
(c) screening for substance use disorder, mental health, and/or physical health issues;
(d) the provision of medical services, including screening and referral for associated physical or behavioral health conditions;
(e) how to ensure prompt follow-up action on patients with abnormal test results or physical findings;
(f) identification of specific support and ancillary providers, where appropriate, and methods for coordinating such service delivery;
(g) appropriate transfer and referral procedures to and from other services;
(h) discharge criteria;
(i) procedures for handling patient emergencies and identification of available off-hour emergency services 7 days per week, 24 hours per day, including, but not limited to, detoxification, withdrawal and acute psychiatric services;
(j) how to ensure that staff are prepared to care for emergencies in accordance with the services provided at the host site, and necessary emergency equipment is maintained in working order;
(k) the continuity of care, including regular participation of all integrated care services staff in case conferences, in-service training and staff meetings;
(l) the prescription and administration of medication which shall be consistent with applicable Federal and State laws and regulations;
(m) for providers providing primary care, policies and procedures for investigating, controlling and preventing infections in the host site. The policies and procedures shall include those for:
(1) isolating patients with communicable or infectious diseases or patients suspected of having such diseases;
(2) training all personnel rendering care to such patients in the employment of standard infection control techniques;
(3) obtaining periodic reports of health care associated infections (health care associated infections shall include an increased incidence or outbreak of disease due to biological, chemical or radioactive agents or their toxic products occurring in patients or persons working in the host site); and
(4) reporting immediately to the department, in a manner specified by the commissioner, the presence of health care associated infections; and to the city, county or district health officer where the host site is located, the presence of any communicable disease as defined in section 2.1 (State Sanitary Code) of this Title;
(n) public health education and screening with regard to tuberculosis, sexually transmitted diseases, hepatitis, and HIV/AIDS prevention and harm reduction; and
(o) the requirement of the mandatory offer of HIV testing in accordance with section 2781-a of article 27-F of the Public Health Law.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.13 Accrued liability
An amount of interest, wages, or other expense recognized or incurred on and before a given date but not paid; sometimes referred to as accrued expense.
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.1 General provisions
(a) Medical facilities shall be planned to achieve efficiency and economy of operation and care of high quality.
(b)
(1) For purposes of this Part, total project cost(s) means total costs for construction, including but not limited to costs for demolition work, site preparation, design and construction contingencies, total costs for real property, for fixed and movable equipment, architectural and/or engineering fees, construction manager and/or consultant fees, construction loan interest costs, and other financing, professional and ancillary fees, charges and allowances. Such costs shall include the cost of all capital items associated with an acquisition, lease arrangement and/or construction. If any acquisition is to be financed through a leasing arrangement, the relevant cost shall be the cost of the asset, not the lease amount.
(2) For purposes of this Part, total basic cost(s) of construction means total project cost(s) less capitalized amounts of construction loan interest cost(s), and other financing fees and charges.
(3) For purposes of this Part, general hospital means a general hospital as defined in subdivision 10 of section 2801 of the Public Health Law.
(4) [ Reserved ]
(5) For purposes of this Part, cardiac catheterization laboratory center, PCI capable cardiac catheterization laboratory center, diagnostic cardiac catheterization service, and cardiac electrophysiology (EP) laboratory program shall have the same meanings as in section 405.29(a)(4) of this Title.
(c) The erection, building, acquisition, alteration, reconstruction, improvement, extension or modification of a medical facility, including its equipment and services, shall be governed by the following:
(1) Proposals requiring a certificate of need application. Any proposal which involves any of the following shall be the subject of an application submitted for review pursuant to the requirements of this Part and article 28 of the Public Health Law:
(i) the addition, modification or decertification of a licensed service other than the addition of a service or a decertification of a facility's services as provided for in paragraph (5) of this subdivision, or the addition or deletion of approval to operate part-time clinics, regardless of cost. The addition or deletion of part-time clinic services operated by the State Department of Health (other than as an extension of an article 28 hospital operated by the State Department of Health) or by the health department of a city or county as such terms are defined in section 614 of the Public Health Law shall not be subject to approval pursuant to this Part;
(ii) a change in the method of delivery of a licensed service, regardless of cost;
(iii) the initial acquisition or addition of any equipment, regardless of cost, utilized in the provision of a service listed in paragraph (2) of this subdivision, other than the acquisition or addition of equipment subject to paragraph (6) of this subdivision. A proposal for the replacement of existing equipment, regardless of cost, which meets the criteria contained therein, shall not require an application but shall be processed pursuant to paragraph (4) of this subdivision;
(iv) [ Reserved ]
(v) a conversion of beds, except as provided for in paragraph (5) of this subdivision or a change in the certified bed capacity of a facility, regardless of cost, other than a decertification of a facility's beds as provided for in paragraph (5) of this subdivision; or
(vi) any other construction, addition or replacement proposal involving a total project cost in excess of $15 million for a general hospital or $6 million for all other facilities, except non-clinical and health information technology projects subject to paragraph (4) of this subdivision.
(2) Proposals requiring a full review, including a recommendation of the State Hospital Review and Planning Council.
(i) Any proposal involving any of the activities set forth in paragraph (1) of this subdivision that falls within any of the following categories shall require a full review pursuant to the requirements of this Part and article 28 of the Public Health Law:
(a) the addition of beds, other than beds designated for patients with acquired immune deficiency syndrome (AIDS) which are eligible for administrative review under paragraph (3) of this subdivision, or the conversion of beds which establish a different level of care, regardless of cost;
(b) any proposal for the addition, modification or change in the method of delivery of the following services, including the initial acquisition of any equipment relating thereto, regardless of cost;
(1) therapeutic radiology other than the replacement of a cobalt unit with a linear accelerator by a facility which has been deemed appropriate to provide therapeutic radiology or radiation oncology pursuant to section 708.5 of this Title which may be eligible for administrative review under paragraph (3) of this subdivision;
(2) adult or pediatric cardiac surgery;
(3) cardiac catheterization, including the relocation of any cardiac catheterization laboratory center service within a network or to another site in a multi-site facility, as defined in section 401.1 of this Title, and the addition of a PCI capable cardiac catheterization laboratory center at a facility that is not already approved to provide cardiac catheterization services; provided however that the addition of a PCI capable cardiac catheterization laboratory center or cardiac EP laboratory program at a facility approved to provide cardiac catheterization services shall be reviewed pursuant to paragraph (3) of this subdivision, and the addition of a cardiac EP laboratory program services at a facility approved to provide cardiac surgery shall be reviewed pursuant to paragraph (6) of this subdivision;
(4) kidney, heart, liver and bone marrow transplantation;
(5) burns care;
(6) acquired immune deficiency syndrome (AIDS) centers except as provided in paragraph (3) of this subdivision; and
(7) epilepsy service;
(c) any proposal involving total project cost in excess of $30 million for a general hospital or $15 million for all other facilities, except as otherwise provided under paragraph (3) of this subdivision;
(d) any other proposal not eligible for administrative review under this section;
(e) any proposal which would otherwise be eligible for administrative review but which exceeds a facility's administrative review limitation; or
(f) any proposal which would otherwise be eligible for administrative review but which is recommended for disapproval.
(ii) The addition of equipment utilized in the provision of a service set forth in subparagraph (i) of this paragraph by a medical facility already approved to provide such service shall be reviewed as follows:
(a) the addition of equipment utilized in the provision of cardiac catheterization laboratory center services shall be eligible for limited review pursuant to paragraph (6) of this subdivision, to the extent that it does not otherwise require an administrative or a full review under this Part;
(b) the addition of equipment utilized in the provision of all other services set forth in subparagraph (i) of this paragraph shall be eligible for administrative review pursuant to paragraph (3) of this subdivision, to the extent that it does not otherwise require a full review under this Part.
(iii) For any application subject to full review for which the total basic cost of construction does not exceed $15 million the commissioner may, in lieu of requiring some or all of the architectural information and documentation required by this Part, accept a written certification by an architect or engineer licensed by the State of New York that such project complies with Part 711 of this Title. The certification shall be attached to and made a part of the application. The costs of any subsequent corrections necessary to achieve compliance with the requirements of Part 711 of this Title, when the prior work was not completed properly and was not accurately certified, shall not be considered allowable costs for reimbursement under Part 86 of this Title. This subparagraph does not waive any of the requirements of section 5-1.22 of this Title.
(3) Proposals eligible for administrative review.
(i) The commissioner may administratively approve applications submitted pursuant to article 28 of the Public Health Law and this Part without the recommendation of the Public Health and Health Planning Council when an application has not been recommended for disapproval by the health systems agency having jurisdiction, and where the total project cost does not exceed $30 million for a general hospital or $15 million for all other facilities. An application shall be eligible for administrative review even though total project costs exceed $30 million for a general hospital or $15 million for all other facilities, if:
(a) total project costs do not exceed 10 percent of the total operating costs of the facility for the fiscal year ended two years prior to the submission of the application; and
(b) total project costs do not exceed $100 million for a general hospital or $25 million for all other facilities. Notwithstanding anything in this Part to the contrary, any cost increase of a project in excess of $30 million for general hospitals or $15 million for all other facilities that is administratively reviewed under the subparagraph, resulting in total project costs in excess of the $100 million for general hospitals or $25 million for all other facilities, or in excess of 10 percent of the total operating costs of the facility for the fiscal year ended two years prior to the submission of the application, shall subject the application to full review. The following types of proposals are eligible for administrative review:
(1) the addition of a licensed service or the modification or change in the method of delivery of a licensed service, other than those set forth in paragraph (2) of this subdivision which require full review;
(2) the conversion of a diagnostic cardiac catheterization service as described in section 405.29(a)(4)(ii) of this Title into a PCI capable cardiac catheterization laboratory center as described in section 405.29(a)(4)(i) of this Title; and the addition of cardiac EP laboratory program services at a facility approved to provide cardiac catheterization laboratory center services that is not also approved to provide cardiac surgery services;
(3) the conversion of beds other than a conversion which would establish a different level of care which proposal would require a full review, including the approval of the Public Health Council, and except as provided for in paragraph (5) of this subdivision;
(4) additions to existing services not involving an additional site or beds;
(5) the correction of patient safety deficiencies, ordinary repairs and maintenance, energy conservation measures, or modernization in a medical facility or portion of a medical facility. Projects for the modernization (which may include new construction and/or renovation) of a medical facility or portion of a medical facility will be eligible for administrative review only if it will not substantively change the capacity or type of the service(s) involved and does not involve issues of public need;
(6) the addition, updating or modification of equipment utilized in the provision of a service listed in paragraph (2) of this subdivision, by a medical facility already approved to provide such service, except for the addition of equipment utilized in cardiac catheterization laboratory center services by a facility already approved to provide such service, which shall be subject to limited review pursuant to paragraph (6) of this subdivision;
(7) the addition or deletion of approval to operate part-time clinic services;
(8) the operation or relocation of an extension clinic as defined in section 401.1 of this Title, when such relocation is to a site outside the current service area of the extension clinic, as defined in paragraph (5) of this subdivision, and does not entail an increase in scope of services or clinical capacity;
(9) the expansion or the modernization of an emergency room;
(10) [ Reserved ]
(11) a change in bed capacity of an acquired immune deficiency syndrome (AIDS) center which does not result in a net increase in the certified bed capacity of the facility;
(12) the acquisition of magnetic resonance imagers (MRIs), provided that acquisitions of MRIs by a general hospital as defined in section 2801 of the Public Health Law may be reviewed under paragraph (5) of this subdivision;
(13) the addition of adult day health care services provided either in a residential health care facility or offsite by a residential health care facility that has been approved to provide the services onsite or the expansion of an existing adult day health care service;
(14) the addition of skilled nursing facility beds specifically designated for persons suffering with acquired immune deficiency syndrome (AIDS) by a residential health-care facility without any limitation of total project cost as set forth above;
(15) the addition of a methadone maintenance treatment program at either its main site or an extension clinic;
(16) the acquisition of CT scanners, provided that acquisitions of CT scanners by a general hospital as defined in article 28 of the Public Health Law may be reviewed under paragraph (5) of this subdivision;
(17) [ Reserved ]
(18) the replacement of a cobalt unit with a linear accelerator by a facility which has been deemed appropriate to provide therapeutic radiology and radiation oncology pursuant to section 708.5(a) of this Title;
(19) the temporary addition of beds to a facility's certified capacity, for a period of time not to exceed one year, required to address high priority health care needs for which there is a demonstrated acute shortage;
(20) the addition of ventilator dependent service;
(21) Swing Bed Demonstration Program;
(22) the addition of chronic renal dialysis stations by a facility approved and operating dialysis stations. A facility approved to provide only chronic renal dialysis shall be deemed approved to provide:
(i) all modalities of chronic renal dialysis; and
(ii) chronic renal dialysis services to patients at home, provided that a facility shall give the appropriate area office of the department at least 15 days' written notice prior to commencing or terminating the facility's program for the provision of chronic renal dialysis services to patients at home; and
(23) the addition of primary care sites meeting the following criteria:
(i) primary care services are comprehensive in nature and are developed consistent with section 85.44 of this Title; and
(ii) total project costs do not exceed $15 million; and
(iii) the proposed location is designated by the department and the health systems agency having jurisdiction as a low access to primary care area and access to primary care by residents will be enhanced. The local health systems agency, however, may provide the department with other relevant information addressing the unmet need for additional primary care capacity; and
(iv) the number of projected new visits represents residents who are not currently receiving primary health care services from an existing designated preferred primary care provider (PPCP); and
(v) the proposed addition would not substantially adversely impact existing PPCPs relative to duplication of services and proximity of the proposed site; and
(vi) existing PPCPs have achieved optimal utilization based on their physical plant and ability to retain an appropriate supply of practitioners; and
(vii) neither the facility nor any part thereof, nor the project is currently or is proposed to be financed by bonds or other debt instruments insured, enhanced or guaranteed by any state or municipal agency or public benefit corporation. Notwithstanding anything in this Part to the contrary, any cost increase of a primary care services project resulting in total project costs in excess of the $30 million threshold for general hospitals or the $15 million threshold for all other facilities shall subject the application or amendment, as the case may be, to full review.
(ii)
(a) Each medical facility shall be limited in the total amount of, or extent to which, applications may be approved administratively, and such limit shall be based on the anticipated annual operating costs, including capital costs, generated by the activities which are the subject of the applications. Except with respect to an application under clause (i)( a ), ( c ), ( h ) or ( j ) of this paragraph, or clause ( b ) of this subparagraph, a medical facility's application shall not be eligible for administrative review if, for any calendar year, the total anticipated annual increase in total operating costs, including capital costs, generated by the facility's applications that have already been approved administratively in the current calendar year exceeds or, including the subject application under review, would exceed an amount equal to one percent of the total allowable operating and capital costs of the base year used trended to determine the facility's Medicaid reimbursement rate pursuant to Part 86 of this Title for the year in which the application is expected to be acted on. For facilities which do not participate in the Medicaid program, the limitation imposed herein shall be an amount equal to one half of one percent of the facility's total annual operating and capital costs, incurred during the fiscal year utilized by Part 86 for participating facilities. Any unused portion of a facility's administrative review cap for any calendar year shall be carried forward to the following calendar year to be applied to any application(s) eligible for administrative review which has not been acted on, which is deemed complete and which was submitted on or before October 1st of the preceding year.
(b) Notwithstanding the administrative review limitation imposed by clause ( a ) of this subparagraph, the commissioner may, pursuant to the requirements and limitations of this clause, administratively approve an application for the correction of nonwaiverable requirements of construction under this Title or the replacement of existing equipment which has not exhausted at least 90 percent of the higher of its useful life pursuant to Part 86 of this Title or its estimated useful life according to the tables of estimated useful lives in the American Hospital Association's Estimated Useful Lives of Depreciable Hospital Assets, 2008 edition, as incorporated by reference in this clause, the total project cost of which does not exceed $15 million, when such correction or replacement proposal is essential for the continued operation of the facility in compliance with the requirements of this Title or the provision of necessary medical care and services. Equipment replacement proposals involving equipment which no longer meets the generally accepted operational standards for such equipment or has exhausted at least 90 percent of the higher of its useful life reported pursuant to Part 86 of this Title or its estimated useful life according to the tables of estimated useful lives in the American Hospital Association's Estimated Useful Lives of Depreciable Hospital Assets, 2008 edition, may be processed under paragraph (4) of this subdivision. Copies of the foregoing publication are available from the American Hospital Association, One North Franklin, Chicago, IL 60606-3421, www.aha.org and a copy is available for inspection and copying at the Regulatory Affairs Unit of the Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237. The anticipated annual increase in total operating costs, including capital costs, generated by an application eligible for administrative review under this clause, shall be charged against any unused portion of the applicant's administrative review limitation imposed by clause ( a ) of this subparagraph; however, an application eligible for administrative review under this clause may be processed administratively despite the fact that the administrative review limitation has been exhausted or may be exceeded as a result of approving the subject application.
(iii) Where an application is being processed administratively and consistency with applicable statutes, codes, rules and regulations relating to the structural, architectural, engineering, environmental, safety and sanitary requirements of a licensed medical facility is required:
(a) the applicant shall submit to the Bureau of Architectural and Engineering Review such information and documentation as is required under this Part to determine the acceptability of the proposal; or
(b) the commissioner may, as an alternative to the above, accept a written certification by an architect or engineer licensed by the State of New York that such project complies with Part 711 of this Title. The certification will be made available for review at the next onsite survey conducted by the department in accordance with article 28 of the Public Health Law. The costs of any subsequent corrections necessary to achieve compliance with the requirements of Part 711 of this Title when the prior work was not completed properly and was not accurately certified shall not be considered allowable costs for reimbursement under Part 86 of this Title. This clause does not waive any of the requirements of section 5-1.22 of this Title.
(4) Proposals not requiring an application.
(i) The following types of construction projects shall not require prior approval under this Part, regardless of cost, provided that a written notice has been submitted to the department prior to commencement of construction, together with, where indicated in this paragraph, a written certification by a New York State licensed architect or engineer that the project meets all applicable statutes, codes and regulations; and provided that the hospital shall implement a plan to protect patient safety during construction projects that implicate patient safety, consistent with section 711.2 of this Title and other applicable standards, and as otherwise required by the department:
(a) Any proposal for the correction of cited deficiencies, consistent with a plan of correction approved by the department; provided that the construction is limited to the correction of the deficiencies.
(b) Any proposal for the repair or maintenance of a medical facility, including routine purchases and the acquisition of minor equipment undertaken in the course of a medical facility's inventory control functions, provided that for proposals under this clause with a total cost of up to $6 million, including separate proposals which are programmatically related, no written notice shall be required. This subparagraph shall not apply to activities requiring a limited review under Article 28 of the Public Health Law pursuant to paragraph (5) of this subdivision.
(c) Any proposal to discontinue a part-time clinic site of a medical facility already authorized to operate part-time clinics pursuant to this Part shall not require the submission of an application pursuant to this Part, but compliance is required with the applicable notice provisions of section 703.6 of this Title.
(d) Any proposal for the replacement of existing equipment, regardless of cost, with another piece of equipment used for similar purposes but employing substantially equivalent current technology which, if subject to approval by the U.S. Food and Drug Administration, has received such approval. The facility’s written notice to the department shall include a written certification by a New York State licensed architect or engineer that the project meets the applicable statutes, codes and regulations; and a plan to protect patient safety during replacement projects that implicate patient safety, consistent with section 711.2 of this Title and other applicable standards, and as otherwise required by the department. Upon completion of the project, the facility shall, where applicable, submit written certification by a New York State licensed architect, engineer and/or physicist that the replacement equipment as installed meets applicable statutes, codes and regulations; and such other close-out documents as may be required by the department.
(e) Subject to clause (5)(ii)( d ) of this subdivision, any proposal for a nonclinical infrastructure project, with total project costs in excess of $6 million, including but not limited to replacement of heating, ventilating and air conditioning, fire alarm and call bell systems or components thereof, roofs, elevators, parking lots and garages, dietary, and solid waste and/or sewage disposal and upgrades of the exterior building envelope. The facility’s written notice to the department shall include a written certification by a New York State licensed architect or engineer that the project meets the applicable statutes, codes and regulations; and shall include a plan to protect patient safety during construction consistent with section 711.2 of this Title and other applicable standards, and as otherwise required by the department. Upon completion of the project, the facility shall, where applicable, submit written certification by a New York State licensed architect, engineer and/or physicist that the project as constructed or installed meets applicable statutes, codes and regulations; and such other close-out documents as may be specified by the department.
(f) Notwithstanding anything in this section to the contrary, from time to time the commissioner may, at the commissioner's discretion, approve capital expenditures that may be required in response to new State, municipal, or Federal code requirements. Such approval may only be considered when such code changes affect large numbers of hospitals (as such term is defined in article 28 of the Public Health Law) and where the commissioner finds that the capital expenditure is unlikely to create any risk to patient safety. Upon such determination, the commissioner shall notify affected hospitals of the opportunity to proceed with such capital expenditures based on a letter of notice to the department. The commissioner may impose a cap on anticipated individual project capital expenditures for such a waiver.
(g) Any proposal that relates to health information technology regardless of cost. For health information technology proposals involving the implementation of clinical information systems, electronic medical records, computerized physician order entry, radiology systems, lab ordering systems or other health information systems impacting patient care, the facility’s written notice to the department shall include a certification of the technology's interoperability with other systems and conformance with State and Federal guidelines and regulations governing the use and exchange of information, including privacy and security, that is acceptable to the department.
(ii) Proposals for a nonclinical infrastructure project, including but not limited to replacement of heating, ventilating and air conditioning, fire alarm and call bell systems or components thereof, roofs, elevators, parking lots and garages, dietary, and solid waste and/or sewage disposal and upgrades of the exterior building envelope, where total project costs do not exceed $6 million, shall not require prior approval or written notice to the department under this Part, except as required by clause (5)(ii)( d ) of this subdivision.
(5) Proposals requiring a limited review. Proposals where total project cost does not exceed $15 million for a general hospital or $6 million for all other facilities, and for which a certificate of need is not otherwise required under this Part, shall be reviewed under this paragraph, except for proposals covered by paragraph (4) of this subdivision.
(i)
(a) Applicants shall submit all such requests for approval of proposals described in this paragraph through the electronic application submission process at the address posted on the department's website, including such information and documentation as the department requires to determine whether the proposal is acceptable.
(b) If the proposal involves the addition or decertification of a service or the conversion or decertification of beds subject to review under subparagraph (iv) of this paragraph, a copy shall also be sent to the health systems agency (HSA) having jurisdiction, if any. The HSA will have 10 days to respond to the department.
(c) If the department determines that the proposal complies with all pertinent statutory and regulatory requirements, the department shall notify the applicant, in writing, that the proposal is acceptable and, if applicable, an amended operating certificate will be issued.
(d) If the department determines that the proposal is not acceptable, the applicant shall be notified in writing of such determination and the bases thereof. If the applicant disagrees with the commissioner's determination, the applicant may submit a certificate of need application to be processed for full review in accordance with this Part.
(e) Applicants that submit proposals subject to review under clause (ii)( e ) of this paragraph, or under subparagraph (iv) of this paragraph that do not require an architecture and engineering certification, shall be notified of the department's determination within 30 days of submission of all necessary information.
(ii) A review shall be conducted of the proposal's compliance with applicable statutes, codes, rules and regulations relating to the structural, architectural, engineering, environmental, safety and sanitary requirement of licensed medical facilities, where the proposal relates to the acquisition, relocation, installation or modification of:
(a) medical equipment involving ionizing radiation or magnetic resonance, including magnetic resonance imagers (MRIs) and CT scanners by a general hospital as defined in article 28 of the Public Health Law;
(b) facility areas relating to clinical services or surgical or other invasive procedures, not otherwise requiring approval under this section;
(c) inpatient units, including resident rooms in a residential health care facility and other spaces used by residents of residential health care facilities on a daily basis, relating to other than routine maintenance and repairs or routine purchase of equipment;
(d) heating, ventilating, air conditioning, plumbing, electrical, water supply and fire protection systems that involve modification or alteration of clinical space, services or equipment such as operating rooms, treatment and procedure rooms, and intensive care, cardiac care and other special care units (such as airborne infection isolation rooms and protective environment rooms), laboratories and special procedure rooms, and patient or resident rooms or other spaces used by residents of residential health care facilities on a daily basis. Projects involving routine maintenance or repairs or routine purchases affecting such systems shall not be subject to this subparagraph.
(e) the relocation of an extension clinic within the same service area, defined as:
(1) one or more postal zip code areas in each of which 25 percent or more of the extension clinic's patients reside; or
(2) the area within one mile of the current location of such extension clinic, which does not entail an increase in services or clinical capacity; and
(f) notwithstanding anything in this Title to the contrary, the reallocation, relocation or redistribution of linear accelerators as replacements for cobalt units and related services from one hospital to another hospital within the same established article 28 network.
(iii) The commissioner may, as an alternative to the submission of architectural and engineering documentation referenced above, accept a written certification by an architect or engineer licensed by the State of New York that such project complies with Part 711 of this Title. The certification will be made available for review at the next onsite survey conducted by the department in accordance with article 28 of the Public Health Law. The costs of any subsequent corrections necessary to achieve compliance with the requirements of Part 711 of this Title, when the prior work was not completed properly and was not accurately certified, shall not be considered allowable costs for reimbursement under Part 86 of this Title. This subparagraph does not waive any of the requirements of section 5-1.22 of this Title.
(iv) The following proposals shall also be subject to limited review under this paragraph for programmatic and/or public need purposes:
(a) Any proposal to decertify a facility's beds, for which a certificate of need application is not otherwise required under this Part. The applicant shall submit information indicating the number of beds to be decertified, where the beds to be decertified are physically located in the facility and what, if any, alternate use will be made of the space. Such proposed alternate use may require review pursuant to subparagraph (ii) of this paragraph.
(b) Any proposal solely to decertify services, other than those set forth in clause (2)(i)( b ) of this subdivision. The applicant shall submit information indicating the services to be decertified, where the services to be decertified are physically provided in the facility and what, if any, alternate use will be made of the space. Such alternate use may require review pursuant to subparagraph (ii) of this paragraph.
(c) Any proposal to add services, other than those set forth in clause (2)(i)( b ) and subparagraph (3)(i) of this subdivision, for which a certificate of need application is not otherwise required under this Part. The applicant shall submit information indicating the services to be certified, the additional staffing requirement, if any, where the services to be certified are physically provided in the facility and what, if any, construction will be required in the facility. If construction is required, the request may require review pursuant to subparagraph (ii) of this paragraph.
(d) Any proposal to convert beds from one category to another in the categories listed in this clause and for which the acute care inpatient facility is already a certified provider. The applicant shall submit information indicating the number of beds to be converted and the categories from which and to which the beds will be converted. This clause applies to beds in the following categories:
(1) medical/surgical;
(2) intensive care;
(3) coronary care;
(4) pediatric;
(5) pediatric intensive care;
(6) neonatal intensive care;
(7) neonatal intermediate care;
(8) neonatal continuing care;
(9) maternity; and
(10) chemical dependence-detoxification.
(e) Any proposal to operate, change services offered, change hours of operation, or relocate a part-time clinic site. Requests for approval shall be consistent with the provisions of section 703.6(b) of this Title. Notwithstanding any inconsistent provision of this section, if the proposal is acceptable to the department, the applicant shall be notified in writing within 45 days of acknowledgment of receipt of the request. If the proposal is not acceptable, the applicant shall be notified in writing within 45 days of such determination and the bases thereof. If the applicant disagrees with the commissioner's determination, the applicant may submit a certificate of need application to be processed for full review in accordance with this Part. If a proposal requests approval for an arrangement or services that are not permissible for a part-time clinic, the proposal will not be accepted for processing under this section.
(f) Notwithstanding anything in this Title to the contrary, any proposal for the reallocation, relocation or redistribution of acute care beds from one general hospital to another general hospital within the same established article 28 network shall be subject to a limited review under this section. The applicant shall submit information indicating the current and proposed certified bed capacity for each service and facility for which the reallocation, relocation or redistribution of beds is proposed.
(g) [ Reserved ]
(6) Cardiac catheterization proposals requiring a limited review.
(i) The following proposals related to the expansion or modification of cardiac catheterization laboratory center services and equipment shall be subject to review pursuant to this paragraph, provided that they do not involve a total project cost in excess of the amount set forth in paragraph (5) of this subdivision or otherwise require a certificate of need under this Part:
(a) any proposal to add or modify cardiac catheterization laboratories, facility areas or equipment to be utilized in the provision of approved cardiac catheterization laboratory center services by a facility already approved to provide PCI capable cardiac catheterization laboratory center services;
(b) any proposal to add or modify equipment in approved space by a facility already approved to provide diagnostic cardiac catheterization services; and
(c) any proposal to add cardiac EP laboratory program services at a facility that is already approved to provide cardiac surgery services.
(ii)
(a) Reviews under this paragraph shall include, but not be limited to, the proposal's compliance with applicable statutes, codes and rules and regulations relating to the structural, architectural, engineering, environmental, safety and sanitary requirements of licensed medical facilities and with Part 405.29 of this Title.
(b) Requests for approval of proposals described in this subparagraph shall be made through the electronic application submission process at the address posted on the department’s website or any other means approved by the department, including information indicating the services to be provided, the facility areas to be utilized, and such other information as the department may require. If construction is required, the request should include the cost of such construction and other information required by the Bureau of Architectural and Engineering Facility Planning under this Part. If the proposal involves the addition of cardiac EP laboratory program services, the applicant shall also submit a copy to the local health systems agency (HSA) having jurisdiction, if any. The HSA shall have 10 days to make a recommendation to the department.
(c) If the proposal is acceptable to the department, the applicant will be notified in writing and, if appropriate, an amended operating certificate will be issued. If the proposal is not acceptable, the applicant shall be notified in writing of such determination and the basis thereof. If the applicant has not submitted an acceptable proposal within 30 days of such determination, then the proposal shall be deemed an application subject to full or administrative review pursuant to section 2802 of the Public Health Law.
(7) Medical facilities which will undertake during their fiscal year a number of construction and/or acquisition projects related programmatically, the aggregate total project cost of which during said period will exceed $6 million, shall submit for review a single application encompassing all such projects pursuant to the requirements of this Part and article 28 of the Public Health Law. If a subsequent audit reveals that during any such period a medical facility has undertaken several projects or submitted several proposals or applications, related programmatically, the total aggregate project cost of which exceeds $6 million, the facility's reimbursement rate may not reflect, or may be reduced to the extent it includes, the cost of the related projects. For the purposes of this paragraph, no such audit shall consider costs incurred in proposals or applications acknowledged or received prior to the effective date of this subdivision.
(8) Medical facilities shall maintain a record of all additions to property, plant and equipment made during the appropriate 12-month period reflected in their capital budget. Each addition, which is subject to paragraph (1) of this subdivision, must be supported by an application approved pursuant to article 28 of the Public Health Law and this Part. Each medical facility shall, as a matter of routine, submit with the annual certified cost reimbursement reporting forms required by the Office of Health Systems Management, beginning with the effective date of this section, identification of its annual capital expenditures, as provided for in the section entitled “Changes in financial positions,” indicating separately the total amounts thereof involving projects in the following categories: below $6 million and over $6 million, which have received appropriate approvals pursuant to this Part, and the nature of each approval. The facilities shall also provide to the department annually, on forms provided by the department, a list of projects between $1 million and $6 million, which have been undertaken by the facility, although such projects do not require certificate of need approval.
(d) All drawings and specifications shall bear the seal and signature of an architect or engineer licensed to practice in New York State. The commissioner, at his discretion, may waive the above requirement when the construction is less than $10,000 in value, unless otherwise provided for in this Part.
(e) All construction in or of a medical facility shall have competent and adequate architectural and/or engineering inspection at the construction site to ensure that the completed work conforms with the approved plans and specifications.
(f) As a part of the application required for approval of the project, the applicant shall give the following assurances:
(1) that the applicant has or will have a fee simple or such other estate or interest in the site, including necessary easements and rights-of-way sufficient to assure use and possession for the purpose of the construction and operation of the facility;
(2) that the applicant will obtain the approval of the commissioner of all required submissions, which shall conform to the standards of construction and equipment of this Subchapter;
(3) that the applicant will submit to the commissioner final working drawings and specifications, which shall conform to the standards of construction and equipment of this Subchapter, prior to contracting for construction, unless otherwise provided for in section 710.7 of this Part;
(4) that the applicant will cause the project to be completed in accordance with the application and approved plans and specifications;
(5) that the applicant will provide and maintain competent and adequate architectural and/or engineering inspection at the construction site to insure that the completed work conforms with the approved plans and specifications;
(6) that if the project is an addition to a facility already in existence, upon completion of construction all patients shall be removed from areas of the facility which are not in compliance with sections 711.4 through 711.8 of this Title, or other pertinent provisions of this Subchapter, unless a waiver is granted to specific provisions by the commissioner, under section 711.9 of this Title;
(7) that the facility will be operated and maintained in accordance with the standards prescribed by law; and
(8) that the applicant will comply with the provisions of the Public Health Law and the applicable provisions of this Title with respect to the operation of all established, existing medical facilities in which the applicant has a controlling interest.
(g) The applicant shall be required to adequately equip the facility to assure its proper operation.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
GARBAGE AND REFUSE GARBAGE AND REFUSE
10 CRR-NY 14-4.150 Garbage and refuse storage and disposal
Within a mobile food service establishment, garbage and refuse is to be stored, handled and disposed of in a manner that protects food and food-contact surfaces from contamination and the premises from litter.
(a) Garbage and refuse is to be kept in durable, easily cleanable, insect-proof and rodent-proof containers.
(b) Adequate refuse containers are to be made available for customer use to dispose of refuse, wrapping materials, single-service items and uneaten food resulting from the operation of the mobile establishment.
(c) The operator is responsible to maintain, empty and clean all refuse containers furnished as part of the operation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.272 Psychiatric day care
A program offering treatment including a planned program of recreational, social and vocational activities in a therapeutic environment under the direction of a psychiatrist or a physician with specialized knowledge in the field. Treatment services may be provided by a staff which may include psychiatrists, psychologists, social workers, nurses, educators, occupational and recreational therapists, psychiatric aides and volunteers. Treatment may include individual or group therapy, patient-staff meetings, drug therapy, occupational therapy, recreational therapy and other activity.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.8 Mobile home stands
The mobile home stand shall be improved to provide adequate support for the placement and anchoring of the mobile home in accordance with generally accepted standards. The stand shall not heave, shift or settle unevenly under the weight of the mobile home due to frost action, inadequate drainage, vibration, wind or other forces acting on the structure. The stand shall inhibit the ponding of water under and around the home.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.39 Funded depreciation waiver
(a) If funding requirement is not met, do you wish to apply for a waiver?
(b) If so, the following information must be provided:
(1) A narrative of the reasons for your request.
(2) Provide the status of your unrestricted resources:
(i) Does the hospital have unrestricted funds temporarily serving as specific purpose funds, plant replacement and expansion funds, or endowment funds?
(ii) Does the hospital have restricted funds temporarily serving as specific purpose funds, plant replacement and expansion funds, or endowment funds?
(iii) If any question is answered yes, the amounts must be reported.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
VILLAGES VILLAGES
10 CRR-NY 127.5 Village of Williston Park
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land owned by the village, and situated on a plot of ground in the northeast corner of the village, south of the Long Island Motor Parkway and west of the Long Island Railroad, which form the source of the public water supply of the village of Williston Park, Nassau County, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the village of Williston Park.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Williston Park.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removal container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the village of Williston Park.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health) within 200 feet of any well of the public water supply of the village of Williston Park. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the village of Williston Park.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the village of Williston Park.
(e) Animals, manure, compost, etc.
(1) No manure pile or compost heap shall be located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Williston Park and no such manure pile or compost heap shall be located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the village of Williston Park.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the village of Williston Park.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the village of Williston Park.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Williston Park upon which the wells of the public water supply of the village of Williston Park are located within 50 feet of such wells and no person or persons shall enter in or upon such property within said limits except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Williston Park.
(h) Inspections.
The board of trustees of the village of Williston Park or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Williston Park or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.82 Cooking of potentially hazardous foods
All parts of potentially hazardous foods requiring cooking are to be heated to at least 140 degrees Fahrenheit (60 degrees Celsius), except:
(a) poultry, poultry stuffing, stuffed meats and stuffing containing meat are to be heated so all parts are at least 165 degrees Fahrenheit (73.9 degrees Celsius) with no interruption of the cooking process;
(b) pork and food containing pork is to be heated so all parts of the food are at least 150 degrees Fahrenheit (65.6 degrees Celsius);
(c) rare roast beef and/or rare beef steaks are to be heated to an internal temperature of 130 degrees Fahrenheit (54.4 degrees Celsius), unless otherwise ordered by the consumer. When meat or fish is served raw, the consumer is to be notified;
(d) shell eggs or foods containing shell eggs are to be heated to 145 degrees Fahrenheit (62.8 degrees Celsius) or greater unless an individual consumer requests preparation of a shell egg or food containing shell eggs in a style such as raw, poached or fried which must be prepared at a temperature less than 145 degrees Fahrenheit in order to comply with the request;
(e) every part of ground meat or foods containing ground meat are to be heated to at least 158 degrees Fahrenheit (69.4 degrees Celsius), unless a consumer requests preparation of a single order of ground meat or food containing ground meat which must be prepared at a temperature less than 158 degrees Fahrenheit in order to comply with the request.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
OFFENSES, VIOLATIONS AND ENFORCEMENT OFFENSES, VIOLATIONS AND ENFORCEMENT
10 CRR-NY 80.121 Rules and regulations
Rules, regulations and determinations, when made and promulgated by the commissioner, shall be the rules and regulations and determinations of the department, and, until modified or rescinded, shall have the force and effect of law.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.110 Cleaning frequency
(a) Tableware is to be washed, rinsed and sanitized after each use and whenever subjected to contamination.
(b) Food-contact surfaces are to be washed, rinsed and sanitized after each use and following any interruption of operations when contamination may have occurred. When eggs are processed in a blender or similar mixing machinery, the food container shall be disassembled, cleaned, rinsed, and sanitized after each use.
(c) Equipment and utensils used for the preparation of potentially hazardous foods on a continuous or production-line basis are to be washed, rinsed and sanitized at intervals throughout the day on a schedule based on food temperature, type of food, and the amount of food particle accumulation. The food-contact surfaces of grills, griddles and similar cooking devices and the cavities and door seals of microwave ovens are to be cleaned at least once a day. This does not apply to hot oil cooking equipment and hot oil filtering systems. Food-contact surfaces of all cooking equipment are to be kept free of encrusted grease deposits and other accumulated soil.
(d) Non-food-contact surfaces of equipment are to be cleaned as often as necessary to keep the equipment free of accumulations of dust, dirt, food particles and other debris.
(e) Clean and sanitized equipment and utensils, including single-service articles, are to be handled, transported and stored so they are protected from contamination.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.15 Village of Warwick
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Village of Warwick, Orange County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs which are tributary to or which serve as sources of this public water supply to or any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel or every kind of waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Warwick.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at some point off the watershed tributary to the public water supply of the Village of Warwick.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal of the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Village of Warwick, nor shall any such matters by thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (c)(4) of this section, within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged to allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the Village of Warwick is prohibited; nor shall any such watering be allowed in any watercourse tributary to this water supply within 1,000 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the Village of Warwick.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or watercourse tributary to the public water supply of the Village of Warwick and none of the above-named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(3) No human excreta, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Warwick; nor shall such human excreta, compost or other matter containing the same be dug or buried in the soil at any point on the watershed tributary to the public water supply of Warwick, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet from any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 250 feet from any reservoir or watercourse tributary to the public water supply for the Village of Warwick.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatsoever shall be allowed in or upon the waters or ice of the reservoirs tributary to the public water supply of Warwick. Neither shall any ice cutting be allowed from said reservoirs.
(h) Camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of Warwick.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the Village of Warwick.
(j) Inspections.
The board of water commissioners of the Village of Warwick shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.23 HIV-1 and HIV-2 antibody testing results
No blood bank shall inform any blood or plasma donor or his/her heath care provider of the results of HIV-1, HIV-2 or HIV-1/HIV-2 combination antibody screening tests unless such results are negative, with the exception of autogeneic donors, whose heath care provider may be informed of screening test results if there is insufficient time prior to surgery for completion of supplemental testing, provided that such heath care provider is instructed that the donor may not be informed that he or she is positive for HIV-1 or HIV-2 antibodies based on the incomplete results. Initial reactive screening tests shall be repeated in duplicate. If two of three screening tests are reactive, the sample shall be considered repeatedly reactive, and supplemental testing shall be performed. Notification that a donor is positive shall be made only if the results have been reactive for more than one screening test, and the supplemental HIV antibody test result has been unequivocally positive. Appropriate counseling of donors regarding the significance of all test results must be available. HIV results must be reported to donors if the results are substantiated as positive, or upon supplemental testing show an increased likelihood of representing seroconversion to positive, as determined by the director of the laboratory performing the supplemental testing. This report must be made in person unless repeated efforts to encourage a donor to come in have failed, in which case notification may be made by certified restricted delivery mail. HIV results that are substantiated as negative, or upon supplemental testing are indeterminate but do not show an increased likelihood of representing seroconversion to positive, as determined by the director of the laboratory performing the supplemental testing, may be reported to donors by mail, provided that such donors are not informed that they are seropositive. Any notification of HIV results to donors who were repeatedly reactive on initial screening tests, regardless of the results of supplemental testing, must include an offer of appropriate counseling.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.20 Workmen's compensation leave
(a) Leave for absence necessitated by occupational injury or disease.
Except as otherwise provided in subdivision (b) and (c) hereof, an employee necessarily absent from duty because of occupational injury or disease as defined in the Workmen's Compensation Law, upon giving notice to the department that he is absent on account of such injury or disease and that he claims benefits under such law, shall be allowed leave from his position for the period of absence necessitated by such injury or disease, up to cumulatively one year including any periods of such absence during which the employee draws sick leave credits. Such leave may be extended for further periods in the discretion of the appointing authority.
(b) Controverted cases.
If the employee's claim for benefits under the Workmen's Compensation Law is controverted by the State Insurance Fund (at the request of the department or on its own initiative) and the department is so notified, the employee shall not be entitled to leave under this section. This shall not, however, adversely affect the employee's eligibility for leave under other provisions of these rules. If final determination of the controverted claim is in favor of the employee, he shall be entitled to leave under this section, and all absences before such final determination, to the extent that the same were necessitated by his occupational injury or disease, shall be deemed to have been pursuant to leave under this section.
(c) Permanent incapacity.
Leave under this section may be withheld or terminated if the department determines that the occupational injury or disease suffered by the employee is of such a nature as to permanently incapacitate him for the performance of the duties of his position.
(d) Pay during leave.
An employee on leave under this section may receive pay, as follows:
(1) The department upon finding that the employee is in fact disabled from the performance of his duties, may grant the employee full pay during such leave not exceeding cumulatively six months. Such full pay may be granted irrespective of the employee's accrued credits under these rules.
(2) Except when on full pay status under paragraph (1) of this subdivision, the employee may draw accrued sick leave credits, subject to the provisions of these rules pertaining thereto.
(3) If not drawing full pay under paragraph (1) or paragraph (2) of this subdivision, an employee may, in the discretion of the department, be allowed to draw sick leave at half pay for which he may be eligible under these rules.
(e) Accrual of leave credits.
An employee who receives full pay for any period of leave under this section shall earn sick leave credits during such period.
(f) Award credited to State.
An award by the Workmen's Compensation Board of compensation for any period for which the employee receives or received pay from the State shall be credited to the State as reimbursement of wages paid.
(g) Restoration of leave credits.
Sick leave credits, including sick leave at half pay, used by an employee during a period of absence for which an award of compensation has been made and credited to the State as reimbursement for wages paid shall be restored to him in full; provided, however, that no restoration shall be made for any absence of less than a full day. Credits so restored may not again be used for future absences attributable to the same injury. An employee restored to service after absence on leave under this section shall have one year from the date of such restoration to reduce his accrued leave credits to the limits prescribed in these rules.
(h) Reinstatement.
Upon request of the employee for reinstatement at or prior to the expiration of the maximum period of allowed leave, the department, if in doubt as to whether the employee is physically and mentally fit to perform the duties of his position, may require the employee to undergo medical examination, by a physician designated by the department, before the employee may be reinstated. If reinstatement is denied, the employee may make application therefor in the manner prescribed by section 71 of the Civil Service Law. If an employee continues absent after the expiration of the maximum period of allowed leave, his eligibility for reinstatement shall be governed by section 71 of the Civil Service Law.
(i) Medical examination.
In order to enable the department to make such determinations as are authorized or required under this section, the department may require an employee at any time to be examined by a physician designated by the department.
(j) Where the department has refused to grant the employee pay during leave pursuant to subdivision (d) above or has withheld or terminated a leave of absence on the ground that the occupational injury or disease is of such a nature as to permanently incapacitate the employee for the performance of the duties of his position, the employee may request the Civil Service Commission to review the determination of the department. If the commission finds that such determination of the department is arbitrary or unreasonable, it may reverse or modify such determination.
(k) Construction.
This section shall not be construed to require extension of any employment beyond the time at which it would otherwise terminate.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.29 Dental
This functional reporting center must contain all the expenses associated with the provision of preventive and emergency dental care under the supervision of a dentist or other licensed dental personnel. Additional activities include but are not limited to the following: examination and treatment of patients; consulting with patients and attending physician.
(a) Standard unit of measure: number of visits.
A visit is defined as dental attention provided by the dentist and/or dental staff, regardless of whether the patient visits the dental department or the patient is visited by the dentist and/or dental staff.
(b) Data source.
The number of visits shall be an actual count maintained by the dental office.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.17 Recoupment of overpayments
Overpayments determined to have been made pursuant to this section and section 43-2.16 of this Subpart shall be recovered by billing the provider for reimbursement, withholding the provider's current or withholding future payments on claims submitted or a percentage of payments otherwise payable on such claims, or such other remedies as may be available through a court of law.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.14 Default avoidance method
(a) A nursing home company which fails to or has failed to make any monthly payment as required by its mortgage with the New York State Housing Finance Agency or the New York State Medical Care Facilities Finance Agency within five days after such payment is due, shall become subject to the default avoidance method as set forth in this section.
(b) On the sixth day after a payment as set forth in subdivision (a) of this section becomes due, the trustee of the mortgage repayment escrow account, or the agency, shall notify the State Commissioner of Health that a nursing home company has not made a required payment.
(c) Upon receipt by the State Commissioner of Health of such notice from the trustee, or the agency, the State Commissioner of Health shall communicate with the nursing home company to determine if the payment will be forthcoming.
(d) If by no later than the 15th day following the date the payment was due it has not yet been received by the trustee and/or the agency, the trustee and/or the agency shall on the same day notify the State Commissioner of Health of such failure to make the required payment and the State Commissioner of Health shall advise the Department of Social Services of the name of the nursing home company which has not made a monthly payment as required by its mortgage. The Department of Social Services shall then advise the local social services districts with respect to which the nursing home company has filed medicaid claims that the next medicaid payment to be made to the respective nursing home company which has failed to make the required mortgage payment shall be made by means of a check payable to the operating escrow reserve account of the nonpaying nursing home company.
(e) Such Medicaid payment shall remain on deposit in the operating escrow reserve account until the nursing home company draws checks as required pursuant to the mortgage. Such checks shall be transmitted to the State Department of Health forthwith.
(f) Upon receipt of the checks the State Commissioner of Health shall countersign each check and forward same to the appropriate payee.
(g) To avoid undue hardship to a nursing home company which is more than one month in arrears in its payments at the time these regulations, as embodied in this section, become effective, the State Commissioner of Health is authorized to establish special payment schedules for payment of a portion of the sum then due as specified in subdivision (e) of this section. These schedules shall require the approval of the agency.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Cardiovascular tissue donor means a human being, living or dead, who is the source of cardiovascular tissue for transplantation, including autogeneic tissue.
(b) Critical work area means an area where sterile tissue containers or aseptically retrieved tissue are exposed to the environment.
(c) Critical surface means a surface which comes into contact with aseptically retrieved tissue, sterile tissue containers or sterile container covers.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.115 Microwave ovens
The cavities and door edges of microwave ovens are to be cleaned at least once a day, and are to be kept free of encrusted grease deposits and other accumulated soil.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.61 Monitoring requirements for disinfection byproduct precursors
Monitoring for Disinfection byproduct precursors shall be in accordance with the following table.
)
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.14 Enrollee services and grievance procedures
(a) The MCO shall supply enrollee handbooks to each enrollee, and upon request to each prospective enrollee, which explain the operation of the plan. The MCO shall also provide information as required by section 4408 of the Public Health Law. Except where precluded by applicable law or regulation, changes in operations that affect the enrollee shall be communicated to the enrollee prior to the effective date of the change via the enrollee handbook or by other direct means of communication.
(1) For MLTCPs, the enrollee handbook and complete provider network directory shall be provided to individuals who have expressed a desire for enrollment. MLTCPs shall also comply with the provisions of section 98-1.16(i) of this Subpart.
(2) Information disclosed in the enrollee handbook and changes made thereto shall be approved prior to use of the handbook by:
(i) for programs authorized by title XIX, the commissioner and, when such approval is required, the Federal agency with oversight responsibility for programs authorized by title XIX;
(ii) for programs authorized by title XXI, the commissioner;
(iii) for commercial and private pay insurance products, the commissioner; and
(iv) for MLTCPs, the superintendent in consultation with the commissioner and director of the State Office for Aging and, as appropriate, the Federal agencies with oversight responsibility for programs authorized by titles XIX and XVIII of the Social Security Act.
(b) The MCO shall establish written policies regarding the rights of enrollees and shall list these rights in the enrollee handbook. Enrollee rights shall include the following:
(1) to obtain complete current information concerning a diagnosis, treatment and prognosis from a physician or other provider in terms the enrollee can be reasonably expected to understand. When it is not advisable to give such information to the enrollee, the information shall be made available to an appropriate person acting on the enrollee's behalf;
(2) to receive information from a physician or other provider necessary to give informed consent prior to the start of any procedure or treatment; and
(3) to refuse treatment to the extent permitted by law and to be informed of the medical consequences of that action.
(c) The MCO shall have written grievance and complaint procedures, including an appeals procedures consistent with section 4408-a of the Public Health Law and/or in the case of an entity participating in federally sponsored programs, consistent with Federal law and regulation. Such procedures shall be approved by the commissioner and/or, as appropriate, the Federal agency with oversight responsibility for programs authorized by titles XIX and XVIII of the Social Security Act prior to the start of enrollment.
(d) The MCO shall document the receipt and disposition of each grievance or complaint, comply with all applicable reporting requirements of section 210 of the Insurance Law, and retain these records for not less than three years.
(e) Within 15 business days of receipt, the MCO shall provide written acknowledgement to the complainant or grievant of grievances, written complaints, or verbal complaints that are not immediately resolved. Such acknowledgement shall include the name, address and telephone number of the individual or department designated by the MCO to respond. In addition, the MCO shall provide either a written explanation of the determination resulting from the investigation, without releasing protected peer review information, including detailed reasons for the determination for all grievances and for complaints related to quality of care, access to care and billing, including the clinical rationale for the determination when the determination has a clinical basis, or a written statement that insufficient information was presented or available to reach a determination. When the complainant or grievant is dissatisfied with a determination made by the MCO, other than determinations subject to the provisions of article 49 of the Public Health Law, the appeal provisions of article 4408-a of the Public Health Law apply. In the case of an entity participating in a federally sponsored program, the requirements for written acknowledgement of grievances, written or verbal complaints and MCO determinations shall be consistent with Federal law and regulations. For purposes of this Subpart, a complaint is any issue of dissatisfaction with the MCO's operations other than those grievances identified in article 4408-a of the Public Health Law.
(f) With respect to its responsibilities to the enrollee, the MCO shall comply with all provisions of section 700.5 (Advance directives) of this Title. For purposes of this section, the term facility/agency as used in section 700.5 of this Title shall be deemed to mean MCO and the term patient shall be deemed to mean enrollee. The phrase admission as an inpatient or outpatient shall be deemed to mean enrollment in an MCO and medical record shall be deemed to mean the medical record maintained by the primary care provider in an MCO or care management record in an MLTCP.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.20 Personnel
(a) Local health department personnel must meet the entry and supervisory level qualifications established by Part 11 (State Sanitary Code) of this Title, as applicable.
(b) All public health services shall be supervised by a local commissioner of health or public health director, to ensure that such services are provided in accordance with the approved State aid application. Such supervising official shall devote his or her entire time to public health duties, provided that:
(1) such official may serve as the head of a merged agency or multiple agencies if the approval of the commissioner is obtained; or
(2) such official may serve as the local commissioner of health or public health director of additional counties when authorized pursuant to section 351 of the Public Health Law.
(c) All local health departments referred to herein shall not be in violation of the Civil Rights Act of 1964 (42 USCA 2000 et seq .) and the regulations promulgated by the United States Department of Health and Human Services (45 CFR part 80). The purpose of such statute and regulations is to assure that no person in the United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program activity receiving Federal financial assistance from the Department of Health and Human Services. The local health department shall submit to the commissioner, in triplicate, the assurance of compliance form required by the Department of Health and Human Services. Such form must be submitted by present recipients of State aid as well as by all future applicants.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.129 Financial Accounting Standards Board (FASB)
A quasi-independent organization established in 1973 by the AICPA-sponsored Financial Accounting Foundation for the purpose of developing principles for financial reporting by business enterprises.
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.2 Acute care facilities
The factors and methodology to be considered by the Public Health Council for determining the public need for acute care facilities, beds and services, shall include, but not be limited to, the substantive criteria and methodology set forth in section 709.2 of this Chapter.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
ISOLATION, QUARANTINE AND RESTRICTION ISOLATION, QUARANTINE AND RESTRICTION
10 CRR-NY 2.32 Reports of gonorrhea, chlamydia trachomatis infection and syphilis cases confidential
Records of the State Department of Health or of any local department of health or local health authority having custody of such records or of any laboratory, clinic or other institution relating to cases of gonorrhea, chlamydia trachomatis infection or syphilis shall be confidential, except that access to such records by representatives of official public agencies concerned with the control of such diseases may be permitted at the discretion of the State or local health authority having custody of such reports.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.1 Definitions
As used in this Part:
(a) Client means any person seeking or receiving the services of a rape crisis counselor for the purpose of securing counseling or assistance concerning any sexual offense, sexual abuse, incest or attempt to commit a sexual offense, sexual abuse, or incest, as defined in the Penal Law.
(b) Governing authority means the entity or individual responsible for the quality of services and the operation of the rape crisis program.
(c) Rape crisis counselor means any person certified by an approved rape crisis program as having satisfied the training standards set forth in section 206 of the Public Health Law, and who is acting under the direction and supervision of an approved rape crisis program.
(d) Rape crisis program means any office, institution or center, which has been approved, pursuant to subdivision 15 of section 206 of the Public Health Law, to offer counseling and assistance to clients concerning sexual offenses, sexual abuse or incest.
(e) Training coordinator means the individual, designated by the governing authority who is responsible for overseeing the training and certification of rape crisis counselors.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.5 Correction and supplementation of reports
(a) In the event that any information or data which a facility has submitted to the department for use in establishing rates is found by the facility to be incorrect or incomplete for any reason, the facility shall submit corrected and complete information or data to the department within 30 days of such finding and prior to certification of the rate.
(b) If the financial and statistical reports required by this Subpart are determined by the department or its agent to be incomplete or incorrect, the facility shall provide additional or corrected data within 30 days from the date of receipt of notice of the determination. Should the facility fail to file the corrected or additional data within that period or by a later date specified by the commissioner, the provisions of subdivision (h) of section 86-4.3 of this Subpart shall apply.
(c) All corrected or completed data or information must meet the certification requirements of section 86-4.4 of this Subpart.
(d) Specific additional data related to the rate setting process may be required by the commissioner. The commissioner shall supply each facility with a preliminary listing of the data that will be required prior to the start of each rate period. Such data shall be submitted by the facility within 30 days from the date of receipt of a request for such information or by a later date specified by the commissioner. Failure to submit the additional data shall result in the application of the provisions of section 86-4.3(h), unless the facility documents that the requested data does not exist or cannot reasonably be produced.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.2 Applicability
(a) With the prior approval of the commissioner pursuant to Part 710 of this Title and upon certification by the Health Care Financing Administration (HCFA), general hospitals located in a rural area including all areas not delineated as urbanized areas by the U.S. Census Bureau and licensed, exclusive of bassinets for newborns, distinct part psychiatric and rehabilitation unit beds and beds in intensive care inpatient units, for fewer than 100 inpatient beds or for 100 or more inpatient beds but consistently utilizing and staffing fewer than 100 beds shall be permitted to participate in the swing bed demonstration program. Participation in the program shall be for a period of three years and in accordance with the requirements of this Part. The program shall be conducted so as to show the extent and effect of the program on the availability and effective and economical provision of long-term care services in rural areas.
(b) The swing bed program shall utilize inpatient facilities and available beds in a manner which assures the provision of services to patients in accord with their assessed needs and shall be subject to the following:
(1) the swing bed program shall provide care throughout the period such patients require the nursing home level of care and in accord with the program's utilization review plan and policies governing length of stay; and
(2) patients may be admitted to the swing bed program for respite care in accord with nursing home medical eligibility criteria for admission so as to provide temporary relief to primary care givers; and
(3) reimbursement for patients whose length of stay exceeds 60 days shall be in accordance with alternate level of care payments (ALC) as set forth by section 861.56 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.15 Effect of consultation or recommendations
The response and recommendations of the Attorney General, the mental hygiene agencies as appropriate, and the public health and health planning council, when sought or required pursuant to any provision of this Subpart, shall be considered by the department; provided however that such recommendations or the result of such consultation shall not be binding on the department.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.13 Out-of-state providers
(a) Rates for services specified in section 86-8.1(a) of this Subpart provided in outpatient facilities located outside New York state shall be as follows:
(1) rates in effect for similar services for providers located in the downstate region of New York State shall apply with regard to services provided by out-of-state providers located in the New Jersey Counties of Sussex, Passaic, Bergen, Hudson, Essex, Union, Middlesex and Monmouth, in the Pennsylvania County of Pike, and in the Connecticut Counties of Fairfield and Litchfield; and
(2) rates in effect for similar services for providers located in the upstate region of New York State shall apply with regard to all other out-of-state providers.
(b) Notwithstanding any inconsistent provision of this section, in the event the department determines that an out-of-state provider is providing services which are not available within New York State, the department may negotiate payment rates and conditions with such a provider. Prior approval by the department shall be required with regard to services provided by such providers.
(c) For the purposes of this section, the downstate region of New York State shall consist of the New York Counties of Bronx, New York, Kings, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, orange, Putnam and Dutchess, and the upstate region of New York State shall consist of all other New York counties.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.61 South Bay Consolidated Water Company, Inc. at Bay Shore
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, Suffolk County, New York.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid watertight receptacles shall be removed and the receptacles cleansed and disinfected as often as may be found necessary in order to maintain the privy or receptacle in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or receptacle to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such a manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, then the said privy or receptacle for excreta or the trench or place of disposal, shall after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 100 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health. It is provided, however, that no such watertight receptacle shall be within 75 feet nor any such watertight iron pipe shall be within 50 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon or percolate into or through the ground below the surface within a distance of 75 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, except into watertight receptacles, the contents of which are removed and disposed of in the manner provided by paragraphs (4) and (5) of subdivision (c).
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 50 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to remain upon the surface of the ground nor shall such human excreta or compost or other matter containing human excreta be buried in the soil within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or maintained or allowed to remain upon the surface of the ground or beneath the surface within 300 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore nor shall any such matters be so placed or maintained that the washings therefrom may reach any well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(g) Trespassing.
No trespassing shall be allowed upon the property upon which the wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore are located and no person or persons shall enter in or upon such property except the officers or employees of the company in the official performance of their duties of supervision and maintenance of the public water supply or except authorized public officials or except such other persons as may be authorized to enter said property by the officials of the South Bay Consolidated Water Company, Inc.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(j) [General clause.]
In addition to observing the foregoing requirements all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the South Bay Consolidated Water Company, Inc. at Bay Shore.
(k) Inspections.
The duly authorized officials of the South Bay Consolidated Water Company, Inc. or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.9 Transfer and affiliation agreements
Effective January 1, 1970 the admission, discharge or transfer of any patient or resident from each facility having an operating certificate under the provisions of any Article of Subchapter C of this Chapter to a facility issued an operating certificate under any other Article of Subchapter C of this Chapter or to a certified home health agency shall conform to the following provisions:
(a) The governing authority or operator of each such facility shall have in effect a transfer and/or affiliation agreement acceptable to the department with:
(1) one or more facilities having a valid operating certificate under Articles 2, 4 and 5 of this Subchapter and located in or near the same community; and
(2) one or more home health agencies certified by the department and serving a geographic area of coverage appropriate to the area of coverage of this facility.
(b) The governing authority or operator of each such facility shall:
(1) maintain in the administrator's office and available to the department a written copy of each transfer or affiliation agreement;
(2) include in such agreement reasonable assurance that there will be transfer of the patient or resident whenever deemed medically appropriate and mutually agreed upon by the physician responsible for the medical care in the referring facility, or by the midwife responsible for the medical care in the case of a referring midwifery birth center, and by the physician who will become responsible for the medical care in the receiving facility, or, in the case of a certified home health agency, by the physician who will become responsible for the medical care when such patient or resident is to receive services from the certified home health agency;
(3) include in such agreement reasonable assurance that the originating facility will transfer promptly such medical and other information as is relevant to proper care by the receiving facility or home health agency including medical, social, nursing and other care plans; and
(4) include in the agreement reasonable assurance that there is sharing of diagnostic and other services when the department finds that such sharing is in the interest of efficiency, economy and quality of care.
(c) For each admission to or transfer or discharge from each such facility, the governing authority or operator shall assure that:
(1) the personal, alternate or staff physician requests or agrees to the admission, transfer or discharge unless the patient or resident signs out or is signed out against medical advice;
(2) admission information is obtained and transfer and discharge information is furnished as required by the provisions of this Chapter;
(3) the method of physically transporting the patient or resident is safe and medically approved by the responsible physician; and
(4) the patient's or resident's personal effects, especially his monies and valuables, are transported and stored safely in a place known and reasonably accessible to the patient or resident or to a person or agency legally authorized to act in his behalf and full information about same is on file and readily available in the administrator's office or other site acceptable to the department.
(d) If the personal, alternate or staff physician or the director or acting or assistant director of nursing approves an emergency or unusual admission, transfer or discharge, the requirements of paragraph (c)(1) of this section may be waived providing the circumstances and reasons are recorded in the medical record.
(e) The governing authority or operator of each facility having a valid operating certificate under the provisions of Article 6 of Subchapter C of this Chapter shall have an affiliation agreement with at least one facility having an operating certificate under the provisions of Article 2, 4 or 5 of this Subchapter which includes assurance that:
(1) the affiliating facility has the capability of providing strong backup support, including but not limited to medical, diagnostic, emergency and other services; and
(2) the affiliating facility furnishes such backup support by providing, as needed, medical, medically related and other supportive services to enhance the effectiveness of operation of the treatment center and diagnostic center.
(f) Where it is in the interest of the community and where it is essential to assure that inpatient or resident care will continue to be available for those requiring such care, the department may except the governing authority or operator from specific requirements of this section when the operator or governing authority provides documented verification acceptable to the department that all reasonable attempts have been made in good faith to make such an agreement.
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.4 Amendments
(a) An application made to the Public Health Council pursuant to this Part may be amended while the matter is pending before the council. Such amendments shall be made on appropriate forms supplied by the department.
(b) Any amendment to an application which constitutes a substantial change in the information contained in the original application, or any prior amendments thereto, must be accompanied by a satisfactory written explanation as to the reason such information was not contained in the original application.
(c) Prior to the issuance of final council approval, any change as set forth in this subdivision shall constitute an amendment to the application and the applicant shall submit appropriate dovumentation as may be required in support of such amendment. The amended application shall be referred to the State Hospital Review and Planning Council for their comments. The approval of the Public Health Council must be obtained for any amended application. Any change in the principals of the applicant as considered by the council shall be considered an amendment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.3 Enforcement, public health hazards and other violations
(a) Enforcement.
(1) Operation of a tanning facility without a permit is a violation of this Subpart. The PIO may order any tanning facility operating without a permit to close and remain closed until the facility obtains and displays a valid permit.
(2) Operators in violation of these regulations are subject to the enforcement provisions delineated in the Public Health Law. Where a public health hazard is found, the tanning facility or portion of the facility constituting the hazard shall be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of the patrons. When a placard is used, it shall be conspicuously posted at each entrance to the tanning facility or portion of the facility constituting the hazard. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the PIO shall constitute a violation of this Chapter and the Public Health Law.
(3) Within 15 days of placarding of a facility or portion of the facility, the operator shall be provided with an opportunity to be heard and present proof that continued operation of the facility does not constitute a danger to the public health.
(4) The PIO or his/her designated representative may inspect the premises, within two working days of notification that the hazard has been eliminated to remove the placards after verifying the correction, or upon notification of correction, may provide verbal authorization for the operator to remove the placard and resume use.
(b) Public health hazards.
Any of the following violations are public health hazards, which require the PIO or a designated representative to order immediate correction or to immediately institute action as provided in the law and/or in this Subpart:
(1) the condition of the wiring or electrical system components of tanning equipment is such that an imminent fire or shock hazard exists;
(2) an ultraviolet radiation device does not have an adequate label;
(3) failure to operate an ultraviolet radiation device in accordance with the label;
(4) failure to maintain the accuracy of ultraviolet radiation device timers;
(5) failure to ensure that patrons possess adequate protective eyewear;
(6) failure to provide adequate protective eyewear at no additional charge to patrons not possessing their own adequate protective eyewear;
(7) inadequate sanitizing of tanning beds, tanning booths, pillows, or headrests; inadequate disinfection of reusable protective eyewear;
(8) failure to provide timer lockout or remote timer controls; or
(9) any other condition determined by the PIO to be an imminent risk to the public's health and safety.
(c) Other violations.
Failure to comply with other sections of this Subpart or other parts of this Title may be subject to a penalty.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.11 Assessment of long-term care patients
(a)
(1) For patients who require placement or continued stay in a nursing home or health- related facility, the Hospital/Community PRI or the PRI, as appropriate, shall be completed by a registered professional nurse who has successfully completed a training program in patient case mix assessment approved by the department to train individuals in the completion of the patient review form (PRI) as contained in section 86-2.30(i) of this Title, or the Hospital/Community patient review form (Hospital/Community PRI) as contained in section 400.13 of this Part, and for patients who require placement or continued stay in a nursing home or a health-related facility, the SCREEN shall be completed by a professional with demonstrated skills in assessing psychosocial situations, including but not limited to social work and discharge planning professionals, who has successfully completed a training program in patient case mix screening approved by the department to train individuals in the completion of the patient screening form (SCREEN), as contained in section 400.12 of this Part.
(2) Each general hospital shall have on staff trained and qualified screener(s) and assessor(s) in such numbers as specified in section 85.8(c)(1)(ii) of this Title, who shall be responsible for and attest to the accuracy of Hospital/Community PRI's, PRI's, and SCREEN's, as contained in sections 400.13, 86-2.30(i) and 400.12 of this Title, respectively. Each residential health care facility shall have on staff trained and qualified screener(s) and assessor(s) who shall be responsible for and attest to the accuracy of PRI's and SCREEN's.
(b) The commissioner may waive the requirements of this section or any part thereof for recognized demonstration projects to effect the development of additional knowledge and experience in different types of assessments for long-term care patients.
(c) The patient, and/or the patient's designated representative shall be given an explanation of the information contained on the SCREEN, including the determination of setting for care for that particular patient.
(d) Residential health care facilities not participating in the Medicare and Medicaid programs (titles XVIII and XIX of the Federal Social Security Act) are required to complete the PRI and SCREEN forms for prior to admission and admission review purposes pursuant to sections 415.1(a), 420.1(a), 416.9(a) and 421.13(a) of this Title. The continued stay review requirements of sections 416.9(b), (f) and 421.13(b), (f) of this Title shall not apply. An alternate schedule for completion and submission of the forms may be established by the commissioner for such continued stay review requirements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.42 Residential health care facility quality pool
(a) For the calendar year 2013 and thereafter, the commissioner shall establish a residential health care facility quality pool for the purpose of making quality incentive payments to facilities meeting the criteria set forth in this section. This program shall be referred to as the Nursing Home Quality Pool (NHQP). The amount of the NHQP shall be $50 million or as determined by the commissioner. The financial awards to facilities shall be determined by their performances in the Nursing Home Quality Initiative (NHQI). The measures on which facilities will be evaluated in the NHQI are described below.
(1) The NHQI shall contain measurement components comprised of quality measures, compliance measures, efficiency measures, and satisfaction measures, if and when satisfaction data becomes available. Each measure shall be awarded points based on the facility’s performance in the measure. The points from each measure shall be summed to create an overall score. Nursing homes shall be categorized into quintile placements based on the distribution of the overall scores.
(b) From the NHQI, the commissioner shall exclude:
(1) Non-Medicaid facilities, special focus facilities as designated by the Centers for Medicare and Medicaid Services (CMS), continuing care retirement communities, transitional care units, specialty facilities, and specialty units within facilities. Specialty facilities and specialty units shall include AIDS facilities or discrete AIDS units within facilities, facilities or discrete units within facilities for residents receiving care in a long-term inpatient rehabilitation program for traumatic brain injured persons, facilities or discrete units within facilities that provide specialized programs for residents requiring behavioral interventions, facilities or discrete units within facilities for long-term ventilator dependent residents, and facilities or discrete units within facilities that provide services solely to children.
(2) A facility that is excluded from the NHQI shall not be subject to the Medicaid rate reduction or the fund redistribution methodology of the NHQP.
(c) Each facility that is not excluded from the NHQI shall be subject to a Medicaid rate reduction to fund the NHQP. The Medicaid rate reduction shall be calculated as follows:
(1) The Medicaid revenue for each facility shall be calculated by multiplying the facility’s promulgated Medicaid rate as of January 1st of the payment year by the facility’s total Medicaid patient days, as reported in the facility’s cost report from the measurement year on which the NHQI is based. The facility’s Medicaid revenue shall be divided by the sum of the Medicaid revenues from all facilities in the NHQI. The result shall be multiplied by the pool amount, and divided by each facility’s Medicaid patient days as described above. If a facility failed to submit a cost report for the measurement year on which the NHQI is based, the number of Medicaid patient days from the most recent cost report shall be used.
(d) The pool amount shall be redistributed to facilities as follows:
(1) Facilities shall be categorized into quintile placements based on the distribution of the overall scores in the NHQI. The pool money shall be redistributed to facilities based on their quintile placements. Facilities in the top three quintiles shall receive distributions, with facilities in the first quintile receiving a proportion larger than facilities in the second and third quintiles, and facilities in the second quintile receiving a proportion larger than facilities in the third quintile. To determine the proportions awarded to facilities in the first, second, and third quintiles, the total Medicaid revenue for facilities in such quintiles shall be multiplied by award factors of 3, 2.25, and 1.5, or as determined by the commissioner, respectively. Facilities in the fourth and fifth quintiles shall not receive a redistribution. Additionally, if a facility receives a health inspection survey deficiency of a letter J, K, or L between July 1st of the measurement year and June 30th of the payment year, the facility shall not be eligible to receive a redistribution, regardless of its quintile placement. Payments shall be paid as per diem adjustments for the payment year. The payment formula for facilities in the top three quintiles is shown in the table below.
| Distribution of NHQP Payments | | | | | --- | --- | --- | --- | | Facilities Grouped by Quintile | A Facility’s Medicaid Revenue Multiplied by Award Factor | B Share of Pool Allocated to Facility | C Facility Per Diem Payment | | Quintile 1 | Each facility’s Medicaid patient days from the measurement year multiplied by the Medicaid Rate as of January 1 of the payment year= Total Medicaid Revenue, multiplied by an award factor of 3, or an award factor as determined by the commissioner | Each facility’s column A divided by sum of Total Medicaid Revenue for all facilities, multiplied by the pool amount | Each facility’s column B divided by the facility’s Medicaid patient days from the measurement year | | Quintile 2 | Each facility’s Medicaid patient days from the measurement year multiplied by the Medicaid Rate as of January 1 of the payment year= Total Medicaid Revenue, multiplied by an award factor of 2.25, or an award factor as determined by the commissioner | Each facility’s column A divided by sum of Total Medicaid Revenue for all facilities, multiplied by the pool amount | Each facility’s column B divided by the facility’s Medicaid patient days from the measurement year | | Quintile 3 | Each facility’s Medicaid patient days from the measurement year multiplied by the Medicaid Rate as of January 1 of the payment year= Total Medicaid Revenue, multiplied by an award factor of 1.5, or an award factor as determined by the commissioner | Each facility’s column A divided by sum of Total Medicaid Revenue for all facilities, multiplied by the pool amount | Each facility’s column B divided by the facility’s Medicaid patient days from the measurement year | | Total | Sum of Total Medicaid Revenue for all facilities | Sum of column B = pool amount | -- |
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.22 Weed control
Ragweed, poison ivy, poison oak, poison sumac and other noxious weeds shall be controlled to minimize contact by camp occupants.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.7 Screening of requests for external appeal
(a) Requests for external appeals shall be submitted to the superintendent. Upon receipt of such requests completed in the form and manner prescribed by the commissioner and superintendent, the requests shall be screened by the superintendent to determine eligibility for external appeal pursuant to the criteria detailed in section 4910(2) of the Public Health Law and section 4910(b) of the Insurance Law and the following:
(1) The enrollee submitting the request or on whose behalf a request for external appeal was submitted, or in the case of a retrospective adverse determination, on whose behalf a health care service is delivered, is not covered exclusively by title XVIII of the Federal Social Security Act.
(2) If the enrollee submitting the request or on whose behalf a request for external appeal was submitted, or in the case of a retrospective adverse determination, on whose behalf a health care service is delivered, is receiving benefits under both titles XVIII and XIX of the Federal Social Security Act, the health care service being requested is a covered benefit under title XIX.
(3) The request is substantially complete as appropriate for the type of determination to be appealed and contains the following:
(i) a copy of the final adverse determination letter from the health care plan notifying the enrollee that their request for health care services was denied on appeal; or
(ii) a copy of a letter from the health care plan to the enrollee indicating a joint agreement to waive any internal appeal offered by the health care plan; or
(iii) in the case of a retrospective adverse determination, a copy of the final adverse determination letter from the health care plan;
(iv) payment of a fee, if applicable, or a statement that a waiver of the fee has been requested;
(v) the signature of the enrollee, or a person authorized pursuant to law to consent to health care for the enrollee, authorizing release of medical and treatment information; and
(vi) in the case of a retrospective adverse determination, if the enrollee's health care provider is requesting an external appeal and the enrollee's acknowledgment of the external appeal request and consent for release of the enrollee's medical records to a certified external appeal agent is obtained at the time health care services are provided, a copy of a letter sent by the enrollee's health care provider to the enrollee notifying the enrollee that an external appeal of a retrospective adverse determination has been requested and that the enrollee's medical records will be released to a certified external appeal agent.
(4) As applicable, the enrollee's attending physician attestation is fully and appropriately completed by the attending physician in the form and manner prescribed by the commissioner and superintendent, or the enrollee has indicated that the attending physician attestation has been transmitted to the enrollee's attending physician. An application shall not be considered incomplete or untimely solely on the basis of failure by the attending physician to submit such documentation within the enrollee's 45-day time frame for initiation of an external appeal request pursuant to section 4914(2)(a) of the Public Health Law, provided however, the application will not be forwarded to an external appeal agent until the attestation is submitted.
(5) If the attending physician is recommending that the enrollee participate in a clinical trial, the attending physician attests that:
(i) the enrollee has a life-threatening or disabling condition or disease, as defined in subdivision 7-a of section 4900 of the Public Health Law;
(ii) the enrollee meets the eligibility criteria for the clinical trial;
(iii) the clinical trial is open to the enrollee; and
(iv) the enrollee has been or will likely be accepted into the clinical trial.
(6) The external appeal request was submitted, in the form and manner prescribed by the commissioner and superintendent, to the superintendent within 45 days from the date the enrollee or, for provider initiated retrospective appeals, the enrollee's health care provider, received notice that the health care plan made a final adverse determination or within 45 days from when the enrollee received a letter from the health care plan affirming that both the enrollee and the enrollee's health care plan jointly agreed to waive the internal appeal process. Unless otherwise demonstrated, it shall be presumed that the enrollee, or the enrollee's health care provider for provider initiated retrospective appeals, received the notice of final adverse determination or letter agreeing to waive the internal appeal process within eight days of the date on the notice of final adverse determination or the date on the letter agreeing to waive the internal appeal process.
(b) Screening of expedited appeals shall be initiated by the superintendent within 24 hours of receipt of the request. Screening of standard appeals shall be initiated by the superintendent within five business days of receipt of the request.
(c) In the event that additional information is required to process a request, the superintendent shall contact the initiator of the request, the enrollee's health care plan or the enrollee's attending physician, as appropriate, by the most efficient means available, to request the necessary information.
(d) A copy of appropriately completed requests for appeals of final adverse utilization review determinations made by entities certified under article 44 of the Public Health Law that are determined to be eligible for external appeal shall be transmitted to the commissioner immediately after assignment to a certified external appeal agent.
(e) The superintendent shall notify the enrollee and the enrollee's health care plan if a request is determined to be eligible for external appeal within seven days of receipt of a complete request for a standard appeal and within 48 hours of receipt of a complete request for an expedited appeal. Such notification shall include:
(1) identification of the certified external appeal agent assigned to the appeal;
(2) notification to the enrollee of any unavoidable material affiliations concerning the certified external appeal agent assigned to the appeal, including a brief explanation of the nature of the material affiliation(s) pursuant to section 98-2.6(e)(1) of this Subpart;
(3) for purposes of notifying the enrollee's health care plan, a copy of the enrollee's signed release of medical and treatment information, completed in a manner as prescribed jointly by the commissioner and superintendent and in accordance with section 2782 of the Public Health Law for confidential HIV related information and sections 33.13 and 33.16 of the Mental Hygiene Law for mental health related information; and
(4) for purposes of notifying the enrollee's health care plan, as applicable, a copy of the attending physician's attestation.
(f) If a fee is submitted and the health care plan's determination is upheld by the external appeal agent, the superintendent shall forward the fee to the health care plan within seven days of receipt of the external appeal agent's determination.
(g) If a fee is submitted and the health care plan's determination is overturned in whole or in part by the external appeal agent, the superintendent shall return the fee to the enrollee or, in the case of a provider initiated retrospective appeal, the enrollee's health care provider, within seven days of receipt of the external appeal agent's determination.
(h) Those requests determined to be ineligible for external appeal shall be returned to the enrollee or, in the case of a provider initiated retrospective appeal, the enrollee's health care provider, by the superintendent, with notification to the enrollee's health care plan and attending physician, as appropriate, accompanied by an explanation as to why the request was determined to be ineligible for external appeal within seven days of receipt of a complete request for a standard appeal and within 48 hours of receipt of a complete request for an expedited appeal.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.300 Retirement of indebtedness funds
Funds required by external sources to be used to meet debt service charges and the retirement of indebtedness on plant assets. The term sinking funds is sometimes used to describe these funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.5 Award rescission and deferrals
(a) Award rescission.
An award may be rescinded by the Commissioner of Health if:
(1) the recipient fails to execute a student payment application (form HE8030) with the Higher Education Services Corporation or fails to follow the Higher Education Services Corporation or Department of Health reporting requirements;
(2) the recipient withdraws from school or otherwise fails to maintain full-time enrollment;
(3) the recipient is convicted of any felony;
(4) the recipient fails to maintain good academic standing; or
(5) the recipient is found to have provided fraudulent or willfully misrepresented information in the application or supporting documents.
(b) Award deferral.
An award may be postponed or deferred temporarily by the Commissioner of Health because of one or more of the conditions described in subdivision (a) of this section if it is determined that the condition will be corrected in a reasonable time or if the circumstances warrant a deferral rather than a rescission.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.13 Assisted reproductive service provider informed consent and applicability of reproductive tissue bank regulations
All assisted reproduction service providers shall adhere to all applicable tissue bank regulations set forth in Part 52 of this Title, including but not limited to the informed consent requirements therein.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.13 Nursing administration
This functional reporting center must contain all the expenses associated with the overall administration and supervision of all nursing services, including all nursing in-service training, scheduling and transferring of nurses between services and units, nursing staff supervision, evaluation and discipline. It includes the work of the director, assistants and/or associates, secretaries, clerks, and all nursing personnel who are responsible for conducting in-service education of nursing personnel, and the following specific job titles: RN Supervisor (supervising two or more units and/or areas), Health Services Supervisor, Director of Nursing Services, and Assistant Director of Nursing Services. Note that nursing in-service education is subject to special rules rather than the reclassification criteria (section 452.4[g]). Additional activities include but are not limited to the following: recommendation of appointments to the nursing staff; definition and execution of the philosophy, objectives, policies and standards for nursing care of patients; participation in community education health programs; participation in patient care review committees; inspection of patient areas to verify that patient needs are met; and coordination of all nursing activities and functions with other residential health care facility functions.
(a) Standard unit of measure: average number of nursing department employees.
The sum of the average number of nursing service personnel working in the various departments throughout the residential health care facility under the direction of nursing administration.
(b) Data source.
The average shall be determined by adding the number of nursing service personnel who worked for at least four pay periods during the year and dividing the total by the number of pay periods used. Payroll records should be used to obtain this information.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.8 Consent of the city
Nothing in this Subpart shall be construed to allow the designated administrative or enforcement personnel of a certified local government, or any representative or attorney of a certified local government, to appear in any court proceeding or before any administrative tribunal on behalf of the city or the department, for the purpose of enforcing violations of these rules and regulations or defending against any claim or action arising from these rules and regulations without the written consent of the city.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.2 Depreciation on major movable equipment
This functional reporting center must contain all depreciation on major movable equipment of the residential health care facility. Note the special rules shown in section 452.4(a)(1)(iii) of this Article for assignment of major movable depreciation to departments.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.1 Purpose and intent
Due to the frequent development of new medical technologies involving in both medical equipment and health services, it is necessary and appropriate in order for the department to carry out its responsibilities under article 28 of Public Health Law and to assure that such equipment and services will be of a high quality, of adequate safety, efficiently provided at a reasonable cost and properly utilized, to evaluate the medical efficacy, cost effectiveness and efficiency of and need for such equipment and services before such equipment and services may be considered as usual, customary and generally accepted modalities of providing patient diagnosis, care, treatment or other health services in medical facilities.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.112 Fingerprinting and criminal background check requirements
(a) Applicability.
This section applies to any licensee who possesses, or is authorized to possess, radioactive material that is:
(1) listed in Table 1 ("Radionuclides of Concern") of this section; and
(2) in a quantity equal to or exceeding that listed in Table 1 of this section.
(b) Definitions.
(1) Trustworthiness and Reliability (T&R) Official means an individual appointed by the licensee who is responsible for determining the trustworthiness and reliability of another individual requiring unescorted access to one or more radioactive materials identified in Table 1 of this section.
(2) Affected individual means an individual who has or is seeking unescorted access to radioactive material identified in Table 1 of this section in a quantity equal to or exceeding that listed in Table 1 of this section.
(3) Unescorted access means access without an escort to radioactive material identified in Table 1 of this section which is in a quantity equal to or exceeding that listed in Table 1 of this section.
(c) The T&R official, if he/she does not require unescorted access, must be deemed trustworthy and reliable by the licensee in accordance with its increased controls license conditions before making a determination regarding the trustworthiness and reliability of another individual. If the T&R official requires unescorted access, the licensee must consider the results of the Federal Bureau of Investigation (FBI) identification and criminal history records check before approving a T&R official.
(d) Prior to requesting fingerprints from any individual, the licensee shall provide a copy of this section to that person.
(e) Upon receipt of the results of FBI identification and criminal history records checks, the licensee shall control such information as specified in subdivision (i) of this section and its increased controls license conditions.
(f) Specific requirements pertaining to fingerprinting and criminal history records checks.
(1) Each licensee subject to the provisions of this section shall fingerprint each affected individual.
(2) For affected individuals employed by the licensee for three years or less, and for affected individuals who are nonlicensee personnel, such as physicians, physicists, house-keeping personnel, and security personnel under contract, trustworthiness and reliability shall be determined, at a minimum, by verifying employment history, education, personal references, and fingerprinting and the review of an FBI identification and criminal history records check.
(3) The licensee shall also, obtain independent information to corroborate that provided by the employee ( e.g., seeking references not supplied by the individual). For an affected individual employed by the licensee for longer than three years, trustworthiness and reliability shall be determined, at a minimum, by a review of the employees' employment history with the licensee and fingerprinting and an FBI identification and criminal history records check.
(4) Service provider licensee employees who are affected individuals shall be escorted unless they are determined to be trustworthy and reliable by a NRC-required background investigation. Written verification attesting to or certifying the person's trustworthiness and reliability shall be obtained by the licensee from the licensee providing the service.
(5) The licensee must submit one completed, legible standard FBI fingerprint card (Form FD-258,ORIMDNRCOOOZ)1 for each affected individual, to the NRC's Division of Facilities and Security. The name and address of the individual (T&R official) to whom the criminal history records should be returned must be included with the submission.
(6) The licensee shall review and use the information received from the FBI identification and criminal history records check as part of its trustworthiness and reliability determination required by its increased controls license conditions.
(7) The licensee shall notify each affected individual that his/her fingerprints will be used to secure a review of his/her criminal history record and inform the affected individual of the procedures for revising the record or including an explanation in the record, as specified in subdivision (h) of this section.
(8) Fingerprints for unescorted access need not be taken if an employed individual ( e.g., a licensee employee, contractor, manufacturer, or supplier) is:
(i) an employee of the United States (U.S.) Nuclear Regulatory Commission (NRC) or of the Executive Branch of the U.S. Government who has undergone fingerprinting for a prior U.S. Government criminal history check;
(ii) a member of Congress;
(iii) an employee of a member of Congress or congressional committee who has undergone fingerprinting for a prior U.S. Government criminal history check;
(iv) the Governor or his or her designated State employee representative;
(v) Federal, State, or local law enforcement personnel;
(vi) State Radiation Control Program directors and State homeland security advisors or their designated State employee representatives;
(vii) representatives of the International Atomic Energy Agency (IAEA) engaged in activities associated with the U.S./IAEA safeguards agreement who have been certified by the NRC; or
(viii) documentation is provided which demonstrates that the employed individual has been favorably-decided by a U.S. Government program involving fingerprinting and an FBI identification and criminal history records check within the last five calendar years of the effective date of this regulation, or documentation is provided which demonstrates that any person has an active Federal security clearance. Written confirmation from the agency/employer which granted the Federal security clearance or reviewed the FBI criminal history records results based upon a fingerprint identification check must be provided. The licensee must retain this documentation for a period of three years from the date the employed individual no longer requires unescorted access associated with the licensee's activities.
(9) All fingerprints obtained by the licensee pursuant to this section must be submitted to the NRC. Additionally, the licensee shall submit a certification of the trustworthiness and reliability of the T&R official as determined in accordance with subdivision (c) of this section to the NRC with each submission of fingerprints.
(10) The licensee shall review and use the information received from the FBI identification and criminal history records check and consider it as part of its trustworthiness and reliability determination, in conjunction with the trustworthiness and reliability requirements set forth in its increased controls license conditions, in making a determination whether to grant an affected individual unescorted access. The licensee shall use any information obtained from a criminal history records check solely for the purpose of determining an affected individual's suitability for unescorted access.
(11) The licensee shall document the basis for its determination whether to grant, or continue to allow, an affected individual unescorted access.
(12) Licensees shall notify the department and the U.S. NRC headquarters operations office by telephone within 24 hours if the results from a FBI identification and criminal history records check indicate an individual is listed on the FBI terrorist screening data base.
(g) Prohibitions.
(1) A licensee shall not base a final determination to deny an affected individual unescorted access solely on the basis of information received from the FBI involving:
(i) an arrest more than one year old for which there is no information regarding the disposition of the case; or
(ii) an arrest that resulted in dismissal of the charge or an acquittal.
(2) A licensee shall not use information received from a criminal history records check obtained pursuant to this section in a manner that would infringe upon the rights of any individual under the First Amendment to the Constitution of the United States or article 1 of the New York State Constitution, nor shall the licensee use the information in any way which would discriminate among individuals on the basis of race, religion, national origin, sex, or age.
(h) Right to correct and complete information.
Prior to any final adverse determination, the licensee shall make available to the affected individual the contents of any criminal records obtained from the FBI for the purpose of assuring correct and complete information. Written confirmation by the individual of receipt of this notification must be maintained by the licensee for a period of one year from the date of the notification. If, after reviewing the record, an affected individual believes that it is incorrect or incomplete in any respect and wishes to change, correct, or update the alleged deficiency, or to explain any matter in the record, the individual may initiate challenge procedures. These procedures include either a direct application by the individual challenging the record to the agency ( i.e., law enforcement agency) that contributed the questioned information, or a direct challenge as to the accuracy or completeness of any entry on the criminal history record to the FBI Identification Division.2 The licensee must provide at least 10 days for an individual to initiate an action challenging the results of a FBI criminal history records check after the record is made available for his/her review. The licensee may make a final unescorted access determination based upon an individual's criminal history record only upon receipt of the FBI's confirmation or correction of the record. Upon a final adverse determination on unescorted access the licensee shall provide the individual its documented basis for denial. Unescorted access shall not be granted to an individual during the review process.
(i) Protection of information.
(1) Each licensee who obtains a criminal history record on an affected individual pursuant to this section shall establish and maintain a system of files and procedures for protecting the record and the personal information in the record from unauthorized disclosure.
(2) The licensee may not disclose the record or personal information collected and maintained to persons other than the affected individual, his/her representative, or to those who have a need to access the information in performing assigned duties in the process of determining unescorted access. No individual authorized to have access to the information may disseminate the information to any other individual whose job duties do not require such information.
(3) The personal information obtained on an affected individual from a criminal history record check may be transferred to another licensee if the licensee holding the criminal history record check receives the affected individual's written request to provide the information contained in his/her file, and the receiving licensee verifies information such as the affected individual's name, date of birth, social security number, sex, and other applicable physical characteristics for identification purposes.
(4) The licensee shall make criminal history records, obtained under this section, available for examination by an authorized representative of the department to determine compliance with this section.
(5) The licensee shall retain all fingerprint and criminal history records from the FBI, or a copy if the affected individual's file has been transferred, for three years after termination of employment or determination of unescorted access (whether unescorted access was approved or denied). After the required three-year period, these documents shall be destroyed by a method that will prevent reconstruction of the information in whole or in part.
Table 1: Radionuclides of Concern
| Radionuclide | Quantity of | Quantity of | | --- | --- | --- | | | Concern1 (TBq) | Concern2 (Ci) | | Am-241 | 0.6 | 16 | | Am-241/Be | 0.6 | 16 | | Cf-252 | 0.2 | 5.4 | | Cm-244 | 0.5 | 14 | | Co-60 | 0.3 | 8.1 | | Cs-137 | 1 | 27 | | Gd-153 | 10 | 270 | | Ir-192 | 0.8 | 22 | | Pm-147 | 400 | 11,000 | | Pu-238 | 0.6 | 16 | | Pu-239/Be | 0.6 | 16 | | Ra-226 | 0.4 | 11 | | Se-75 | 2 | 54 | | Sr-90 (Y-90) | 10 | 270 | | Tm-170 | 200 | 5,400 | | Yb-169 | 3 | 81 | | Combinations of radioactive materials listed above3 | See footnote below4 | |
1 The aggregate activity of multiple, collocated sources of the same radionuclide should be included when the total activity equals or exceeds the quantity of concern. 2 The primary values used for compliance with this Order are tera becquerel (TBq). 3 Radioactive materials are to be considered aggregated or co-located if breaching a common physical security barrier ( e.g., a locked door at the entrance to a storage room) would allow access to the radioactive material or devices containing the radioactive material. 4 If several radionuclides are aggregated, the sum of the ratios of the activity of each source, i of radionuclide, n, A (i,n), to the quantity of concern for radionuclide n, Q (n) , listed for that radionuclide equals or exceeds one. That is:
)
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED PUBLIC WATER SYSTEMS; MAXIMUM CONTAMINANT LEVELS; MONITORING REQUIREMENTS; NOTIFICATIONS REQUIRED
10 CRR-NY 5-1.50 Applicability and responsibility
The provisions of this section and sections 5-1.51—5-1.52 of this Subpart shall apply to all public water systems. The supplier of water of a public water system is responsible for completion of the monitoring requirements set forth in such sections and for performing all analyses in accordance with the analytical requirements set forth in Appendix 5-C of this Subpart. At the discretion of the State, analyses performed by the State may be used for monitoring purposes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.8 Results of tests to be reported only to physicians or other authorized persons
No person shall report the result of any test, examination or analysis of a specimen submitted for evidence of human disease or medical condition except to a physician, his agent, or other person authorized by law to employ the results thereof in the conduct of his practice or in the fulfillment of his official duties. Upon request by a patient or the patient’s personal representative, clinical laboratories may provide a patient access to completed test reports that can be identified as belonging to that patient as provided in section 34-2.11 of this Title.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 68 POISON CONTROL NETWORK
10 CRR-NY 68.3 Standards for operation of a regional poison control center
(a) Services provided.
A regional poison control center shall receive or have a reasonable expectation of receiving not less than 4,000 poison control calls per year and shall perform the following functions:
(1) serve the population of the designated service area;
(2) provide expert information and consultation services to professional personnel in the region on the diagnosis, treatment and management of any suspected or actual poisoning(s);
(3) provide information, emergency care, and referral services to the general public;
(4) assure that tertiary referral treatment centers willing to accept poison patients are identified for the region;
(5) coordinate, develop and monitor poison prevention and medical management programs for medical professionals and the general public in the region;
(6) periodically report and/or conduct investigations of new toxic risks and injuries, as indicated; and
(7) collect uniform data and engage in research activity to enhance poison prevention and control management.
(b) Staffing.
Regional poison control centers shall be staffed by a physician medical director, qualified poison information specialists, an administrator or administrative director, a health educator, and other personnel deemed necessary to operate the poison control center within the requirements of this Part. The following personnel standards and qualifications shall be met:
(1) The medical director shall have completed sufficient training to qualify for certification in a medical primary care specialty, have certification or appropriate experience in medical toxicology and have a medical staff appointment at the hospital designated as the poison control center.
(i) The medical director shall provide training to and supervision of poison information specialists; be responsible for medical decisions and treatment protocols: and provide direct patient care, telephone supervision, or case consultation to the hospitalized poison patient, either as the attending physician or as a consultant.
(ii) The medical director shall spend not less than 20 hours per work week in poison control center activities.
(2) Poison information specialists shall be qualified to read, understand and interpret standard poison information resources and transmit that information in a logical, concise and understandable way to both health care professionals and consumers and to communicate information from standardized poison center treatment protocols approved by the medical director.
(3) An administrator or administrative director shall be employed who is qualified by training and experience to supervise operations, finance, personnel, data collection and analysis and other administrative functions of the poison control center.
(4) A health educator shall be employed who is qualified by training and/or experience to conduct outreach and to develop and provide training for both professional and public groups and organizations in basic elements of poison prevention and treatment, especially to underserved populations of the region.
(c) Operations.
(1) Poison control center services shall be available to both the general public and health professionals 24 hours per day, 365 days per year.
(2) The center shall be easily accessible by telephone at no charge to the public from all areas within the designated region. The availability of poison control information by telephone shall be widely publicized throughout the region to both the public and health care providers.
(3) [ Reserved ]
(4) The following services shall be available at the telephone answering site:
(i) current toxicology information;
(ii) a comprehensive set of current texts covering both general and specific aspects of acute poisoning management;
(iii) primary information resources and access to a major medical library or information system;
(iv) poison control center specialty consultants available on an on-call basis; and
(v) a list of general hospitals in the region capable of delivering comprehensive care for poison victims and willing to accept such patients for care.
(5) The center shall develop and maintain written policies and protocols for responding to calls from the public and health professionals that provide consistent prehospital evaluation and treatment of toxic exposures. The center shall also develop operational guidelines prepared in conjunction with the medical director of the regional emergency medical system. These policies, protocols and guidelines shall be approved in writing by the medical director of the center and shall be available at the central telephone answering site.
(6) The center shall function as a source of comprehensive toxicology information and consultation to health professionals in the region, and shall report and/or conduct investigations of new toxic risks and injuries, as indicated.
(d) Regional coordination of poison control activities.
The designated regional poison control center shall function as the focal point for the coordination of all poison control activities in a region.
(1) All medical care treatment facilities in the region shall be evaluated by the center for participation in and contribution to the regional poison control treatment program. This information shall be available for the regional poison control center staff as a guide to the facilities' capabilities in managing the poison patient.
(2) One or more tertiary treatment centers for the management of pediatric, adolescent and adult poisoning victims shall be identified for the region. A formal relationship shall be established between such treatment centers and the regional poison control center for the treatment of poison victims and to improve management of the poisoned patient.
(3) Comprehensive analytical toxicology services from laboratories approved as required by law shall be identified and available within the region 24 hours a day, 365 days a year so that required emergency analysis can be performed within a time frame appropriate to the needs of patients. There shall be a written poison control center protocol describing the available tests and the process for submission of specimens and interpretation of results.
(4) The regional poison control center shall have a protocol for interacting with the transport service(s) and communication capability with the prehospital transport service(s) where this is available and needed for acute management of patients. Such services shall be available to all emergency patients.
(e) Health professional education, public education and public outreach programs.
The regional poison control center shall provide the following educational services:
(1) instruction and programs in the prevention, care and management of poisonings for health care professionals involved directly in the regional treatment system, and to other professionals with an interest or involvement in care of poison patients; and
(2) public and professional outreach programs to promote or provide education on concepts related to poison prevention or control.
(f) Regional data collection system.
Each regional program shall utilize a data collection system that includes recording of all inquiries and cases handled or admitted by the center. The center shall complete a record containing data elements prescribed by the commissioner for all poison-related calls or admissions. Such data elements shall include origin of call, type of call, substance involved, description of the victim, designation as an accidental or intentional incident, management and final disposition, and medical outcome, if any. The center shall assure the confidentiality of such data as required by section 405.25(a)(9) of this Title.
(g) Reporting and evaluation.
(1) Regional poison control centers shall submit semiannually to the department a report which shall include, but not be limited to, a statement or regional program goals and specific objectives for each year and progress toward meeting the stated goals and objectives, and statistical data regarding the effectiveness of the regional poison prevention and control activities.
(2) Regional poison control centers shall submit to the department an annual report which shall include. but not be limited to the number and percentage of total calls received from each county, narrative information on program operations, the extent and type of targeted outreach and education to professional and public groups in the region, the relationship of center expenditures to program accomplishments, estimated cost savings, if any, evaluation of poison patient outcomes, and other overall findings and recommendations related to the program.
(3) The department shall conduct periodic onsite program reviews to determine whether each regional poison control center is in compliance with the standards set forth in this Part. A report summarizing the findings of each review shall be made available in writing to the center within 30 days of such review.
(i) If the review report identifies areas in which the center is out of compliance with the standards of this Part, the center shall submit to the commissioner, within 30 days of issuance of the report, a plan detailing steps to be taken for corrective action and a timetable for bringing the center into compliance with the applicable standards.
(ii) After receiving and accepting such a plan for corrective action, the department may conduct a follow-up onsite review to determine whether the plan has been implemented and whether the center has come into compliance with applicable standards.
(iii) Failure to submit an acceptable plan for corrective action shall constitute grounds for revocation of poison control center designation.
10 CRR-NY 68.4 Revocation of designation as a regional poison control center
(a) If a facility designated by the commissioner as a regional poison control center is determined by the department to be out of compliance with the standards set forth in this Part and such center remains out of compliance after follow-up review of any plan of correction approved by the department, the commissioner may revoke the designation of the facility as a regional poison control center.
(b) The facility shall be notified by the department in writing when revocation of the designation is proposed.
(c) Within 15 days of the receipt of the notice of proposed revocation, a facility wishing to contest the proposed revocation shall submit to the department written documentation demonstrating that the department's determination of noncompliance with standards is in fact erroneous or that extraordinary conditions have existed which have made compliance not feasible or not in the best interests of the population of the region.
(d) The facility shall be advised in writing of the department's decision on the proposed revocation. The facility may appeal a decision revoking its designation by submitting to the commissioner a written request for a hearing, within 15 days of receipt to the department's decision on the proposed revocation.
(e) If the commissioner does not receive a request for a hearing as provided herein, the facility shall be advised in writing that its designation is revoked.
(f) If the commissioner receives a written request for a hearing within the 15-day period established herein, a hearing shall be held in accordance with the provisions of Part 51 of this Title. Issues at the hearing shall be limited to the findings of the original onsite review, the center's plan for corrective action, if any, follow-up onsite reviews and any additional information pertinent to center compliance presented by either party to the action.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.56 Huntington Water Works Company, Huntington
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all wells and reservoirs of the public water supply of the Huntington Water Works Company of Huntington, Suffolk County, N. Y.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refers to the pressure equalizing reservoir now used for the storage of water of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well or reservoir is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge of such well.
(c) Privies adjacent to any well or reservoir.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any well of the public water supply of the Huntington Water Works Company.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Huntington Water Works Company.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the Huntington Water Works Company.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the Huntington Water Works Company, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the Huntington Water Works Company, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable tight sewer pipes connected to a sewage disposal plant, a permit for which has been granted by the State Commissioner of Health.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or into the ground beneath the surface within 100 feet of any well of the public water supply of the Huntington Water Works Company.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any well of the public water supply of the Huntington Water Works Company and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well of the public water supply of the Huntington Water Works Company.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well or reservoir, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of any well of the public water supply of the Huntington Water Works Company and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the Huntington Water Works Company.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any well or reservoir of the public water supply of the Huntington Water Works Company nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any well of the public water supply of the Huntington Water Works Company.
(g) Trespassing.
No trespassing shall be allowed upon the property upon which the reservoir of the public water supply of the Huntington Water Works Company is located and no person or persons shall enter in or upon such reservoir except the duly authorized employees of the Huntington Water Works Company in the official performance of their duties of supervision and maintenance of the public water supply.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Huntington Water Works Company.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Huntington Water Works Company.
(j) Inspections.
The duly authorized officials of the Huntington Water Works Company or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells and reservoir for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 133 ORANGE COUNTY
CITIES CITIES
10 CRR-NY 133.2 City of Newburgh
(a) [Application.]
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to Washington Lake, Brown Pond, Lockwood Basin and/or to any reservoirs which may be constructed to serve as sources of the public water supply of the city of Newburgh, Orange County, and to all watercourses, the water from which is tributary to or discharged into Washington Lake, Brown Pond, Lockwood Basin or said reservoirs.
(b) Definitions.
(1) The term water supply means the public water supply of the city of Newburgh.
(2) The term reservoir means Washington Lake, Brown Pond and Lockwood Basin serving as the source of the water supply and any reservoir which may be constructed to serve as sources of the water supply of the city of Newburgh.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The term watershed means any area naturally draining into any watercourse tributary to any reservoir of the water supply of the city of Newburgh.
(5) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(6) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy.
(7) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into any reservoir or any tributary watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any reservoir or any tributary watercourse and covered with not less than 18 inches of soil in such a manner as to effecually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or any tributary watercourse except a properly constructed and operated sewage disposal plant, as hereinafter set forth in subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or tributary watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided they shall be located as far as practicable from any reservoir or tributary watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the water department of the city of Newburgh and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 50 feet and 250 feet of any reservoir or within 50 feet and 125 feet of any tributary watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or tributary watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the lake or any tributary watercourse nor upon the surface of the ground at any point on the watershed of the supply nor deposited beneath the surface of the ground within 250 feet of any reservoir or within 125 feet of any tributary watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within 50 feet of any reservoir or any tributary watercourse, provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse, garbage.
(1) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by subdivision (d), shall be discharged or allowed to flow into any reservoir or any tributary watercourse nor be deposited on or beneath the surface of the ground within 250 feet of any reservoir or any tributary watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in any reservoir or tributary watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir or any tributary watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or tributary watercourse.
(3) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or in any tributary watercourse.
(f) Boating, fishing, ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse of the public water supply, except by duly authorized employees of the city of Newburgh in the performance of their duties of supervision and maintenance of the water supply, except that fishing may be allowed upon permit issued by the water department of the city of Newburgh, such permit being revocable at any time by the water department.
(g) Animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir or any tributary watercourse and no watering place shall be maintained in such way as to pollute any tributary watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may pollute any reservoir or any tributary watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 75 feet of any reservoir or any tributary watercourse.
(i) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or any tributary watercourse.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or any tributary watercourse.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(l) Inspections.
The water department of the city of Newburgh or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the city shall make regular and thorough inspections of all reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water department to cause copies of any rules and regulations violated to be served upon persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said water department to promptly notify the State Commissioner of Health of such violations. The water department shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.4 Health officer to report to State Commissioner of Health
Within 48 hours after the entry of any decision of the board declaring the conditions not to be a nuisance affecting health, or if within five days of the filing of the report of the health officer with the local board of health, said board fails to take action provided by section 8.3, supra, the health officer shall forward a copy thereof to the State Commissioner of Health, together with the original or copies of his report and other papers filed by him with the local board, as required in section 8.2, supra.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.189 Irrevocable trust
A trust that cannot be set aside by its creator.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.27 Adequacy of distribution system
The public water system shall be maintained and operated by the supplier of water to assure a minimum working pressure of 20 pounds per square inch at ground level at all points in the distribution system. Measurement of pressure may be obtained from representative points of use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.7 Rate corrections
(a) Arithmetic or calculation errors will be adjusted accordingly in instances that would result in a change of $5,000 or more in a provider’s annual reimbursement for either residential habilitation services provided in community residences and/or day habilitation services.
(b) In order to request a rate correction in accordance with subdivision (a) of this section, the provider must send to the Department of Health its request by certified mail, return receipt requested, within 90 days of the provider receiving the rate computation or with 90 days of the first day of the rate period in question, whichever is later.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.17 Pharmaceutical services
The hospital shall provide pharmaceutical services that are available at all times on the premises to meet the needs of the patients. The hospital shall have a pharmacy that is registered and operated in accordance with article 137 of the New York State Education Law and is directed by a registered pharmacist trained in the specialized functions of hospital pharmacy.
(a) Organization and direction.
The pharmacy shall be responsible, in conjunction with the medical staff, for ensuring the health and safety of patients through the organization, management and operation of the service in accordance with generally accepted professional principles and the proper selection, storage, preparation, distribution, use, control, disposal and accountability of drugs and pharmaceuticals.
(1) The director shall be employed on a full-time or part-time basis based on the needs of the hospital.
(2) The director, in conjunction with designated members of the medical staff, shall ensure that:
(i) for patients of all ages weight shall be measured in metric units. Up-to-date drug information reference systems relating to drug interactions, drug therapies, side effects, toxicology, dosage, indications for use, and routes of administration are available to the professional staff. Pediatric dosing resources shall include age and size appropriate fluid and medication administration and dosing. Pediatric dosing must be weight based, should include the calculated dose, the dosing determination, such as the dose per weight ( e.g. , milligrams per kilogram) or body surface area, to facilitate an independent double-check of the calculation, and should not exceed adult maximum dosage, or in emergencies, length based;
(ii) a formulary is established and reviewed at least annually and updated as necessary to meet the needs of the patients for use in the hospital to assure quality pharmaceuticals at reasonable costs;
(iii) standards are established concerning the use and control of investigational drugs and research in the use of recognized drugs;
(iv) clinical data are evaluated concerning new drugs or preparations requested for use in the hospital; and
(v) the list of floor stock medication is reviewed and recommendations are made concerning drugs to be stocked on the nursing unit floors and by other services.
(3) The director shall be responsible for developing and implementing written policies and procedures for the intrahospital distribution of drugs.
(4) Effective October 1, 1990, each hospital shall have implemented a unit-dose distribution system.
(5) The pharmaceutical service shall have an adequate number of registered pharmacists and other qualified personnel to ensure the availability of quality services including emergency services, 24 hours per day, seven days per week.
(6) All drug storage, preparation and dispensing shall be under the supervision of the director and shall be monitored for adherence to hospital policies and procedures. Monitoring reports shall be documented and available for inspection.
(7) The director shall ensure that current and accurate records are kept of the transactions of the pharmacy, including but not limited to:
(i) a system of records and bookkeeping in accordance with the policies of the hospital for:
(a) maintaining adequate control over the requisitioning and dispensing of all drugs and pharmaceutical supplies; and
(b) charging patients for drugs and pharmaceutical supplies;
(ii) a record of inventory and dispensing of all controlled substances maintained in accordance with article 33 of the Public Health Law and Part 80 of this Title; and
(iii) the labeling of all inpatient and outpatient medications in accordance with article 137 of the State Education Law and 8 NYCRR section 29.7.
(8) The director shall ensure that drug monitoring services are provided appropriate to each inpatient's needs. This shall include, but not be limited to, the maintenance of a medication record or drug profile for each inpatient which is based on available drug history and current therapy.
(9) The director will ensure that there is a quality assurance program to monitor personnel qualifications, training, performance, equipment and facilities.
(i) The director shall require and document the participation of pharmacy personnel in relevant education programs, including orientation of new employees as well as inservice and outside continuing education programs.
(ii) The quality assurance program shall include policies, procedures and monitoring and improvement activities to identify, measure, prevent, minimize and/or mitigate adverse drug events, adverse drug reactions and medication errors in accordance with generally accepted standards and practices in the field of medication safety and quality improvement.
(iii) The director in conjunction with the medical staff shall ensure the monitoring and evaluation of the quality and appropriateness of patient services provided by the pharmaceutical service.
(10) The director shall participate in those aspects of the hospital's overall quality assurance program that relate to drug utilization and effectiveness.
(b) Operation and service delivery.
All drugs and biologicals shall be controlled and distributed in accordance with written policies and procedures to maximize patient safety and quality of care.
(1) The compounding, preparation, labeling or dispensing of drugs shall be performed by a licensed pharmacist or pharmacy intern in accordance with applicable State and Federal laws, rules and regulations.
(2) All packing and repacking of medications shall be performed in the pharmacy by or under the direct supervision of a pharmacist in accordance with article 137 of the State Education Law.
(i) Written policies and procedures shall indicate how such packages shall be labeled to identify the lot number or reference code and manufacturer's or distributor's name for proper identification and safety.
(ii) Repacking and inventory records shall be maintained by the pharmacy.
(iii) Written policies and procedures shall specify those medications which will not be obtained from manufacturers or distributors in single unit packages and those which will not be repackaged as single units in the facility.
(3) Policies and procedures for the unit-dose drug distribution system shall be developed and implemented and shall include, but not be limited to:
(i) each patient shall have his or her own receptacle, such as a tray, bin, box cassette, drawer or compartment, appropriately labeled as to patient, and containing his or her own medications. Each single unit package of medication shall be labeled in accordance with requirements set forth in article 137 of the State Education Law;
(ii) delivery and exchange of patient medications shall occur as scheduled and as specified in the service's written policies and procedures. Not more than a 72-hour supply of prescribed medications shall be delivered to or available in the patient care area at any time;
(iii) methods for procuring drugs on a routine basis, in emergencies and in the event of disaster shall be identified in the service's written policies and procedures; and
(iv) written policies and procedures shall be developed and implemented regarding emergency kits and emergency carts including provisions for ensuring that emergency kits are secure and accessible and are specific to service locations, but are not kept under lock and key;
(a) locations and contents shall be identified and approved by the pharmaceutical service and the medical staff;
(b) frequency of checking contents and expiration dates shall be specified in written policies and procedures.
(4) Outdated, mislabeled, discontinued, expired or otherwise unusable drugs and biologicals shall not be available for patient use.
(5) A procedure shall be developed to provide for the availability of drugs and biologicals during periods of time when a pharmacist may not be immediately available.
(6) Drugs and biologicals not specifically prescribed as to time or number of doses shall automatically be stopped after a time that is specified in the service's policies and procedures as determined by the medical staff.
(7) Policies and procedures shall be developed and implemented for documenting, reviewing and, as appropriate, reporting dispensing errors, adverse drug reactions and drug defects.
(c) Physical facilities.
The hospital shall provide facilities for the storage, safeguarding, preparation, and dispensing of drugs.
(1) Floor stock medications shall be issued to floor units in accordance with the facility's written policies and procedures:
(i) all floor stocks must be properly controlled and shall be limited to those medications identified on an approved floor stock list;
(ii) floor stock will be checked at least monthly by or under the direct supervision of a pharmacist for outdated and unauthorized medications.
(2) All drugs and biologicals shall be stored in locked storage areas and all controlled substances shall be stored in accordance with the storage requirements set forth in article 33 of the Public Health Law and Part 80 of this Title.
(3) All abuses and losses of controlled substances shall be reported to the director, and to the medical staff, as appropriate, in accordance with applicable Federal and State laws.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.9 Revocation, suspension and modification of accredited training programs
(a) Provisional accreditation. The department may immediately terminate provisional accreditation if the department finds any of the following:
(1) submission of false information;
(2) providing program completion certificates to individuals who did not complete any or all of the required training;
(3) failure to present the required topics set forth in these regulations in a manner such that students would be able to comprehend the required subject matter;
(4) failure to submit required information or notifications in a timely manner;
(5) failure to allow a representative of the Department of Health or the Department of Labor to audit any phase of the program, whenever requested;
(6) failure to allow the Department of Health or Department of Labor to access program records;
(7) failure to properly and fairly administer the required examination;
(8) failure to maintain requisite records;
(9) falsification of accreditation records, instructor qualifications, or other accreditation information;
(10) failure to adhere to the training standards and requirements of this Part;
(11) misrepresentation of the extent of a training provider's approval by the State;
(12) failure to submit written notification to the Department of Health of any changes to the program; and
(13) any other good cause.
(b) Full accreditation. The department may after notice and an opportunity for hearing, suspend or revoke full accreditation or change full accreditation to provisional accreditation if a training provider, training director, or other person with supervisory authority over the training program has:
(1) submitted false information;
(2) failed to submit required information or notification in a timely manner;
(3) failed to submit written notification to the Department of Health of any changes to the program;
(4) failed to maintain required records;
(5) falsified program records, instructor qualifications, or other accreditation information;
(6) failed to properly and fairly administer the required examinations;
(7) failed to present the program in accordance with the application materials submitted to the department and in a manner such that the students would be able to comprehend the required subject matter;
(8) failed to allow a representative of the Department of Health or the Department of Labor to audit any phase of the course, whenever requested;
(9) failed to adhere to the standards and requirements of this Part;
(10) provided program completion certificates to individuals who did not complete any or all of the required training;
(11) misrepresented the extent of a training provider's approval by the State;
(12) failed to allow the Department of Health or Department of Labor to access program records; and
(13) any other good cause.
Part 70 REGULATED MEDICAL WASTE
Subpart 70-1 APPLICATION AND DEFINITIONS
10 CRR-NY 70-1.2 Definitions
Whenever used in this Part, unless the context of this Part clearly requires otherwise, the following terms shall have the following meanings:
(a) Alternative regulated medical waste treatment system shall mean a device, method, and/ or technology approved by the Commissioner of Health pursuant to Subpart 70-5 of this Part for the treatment of regulated medical waste.
(b) Autoclave shall mean a device for decontaminating and/or sterilizing materials through exposure to steam under pressure for periods of time prescribed in Subpart 70-3 of this Part.
(c) Biologicals shall mean any preparations derived from a living organism and/or its products including, but not limited to, sera, nonviable vaccines, vaccines attenuated in a manner that prevents propagation, antigens, toxins and antitoxins, for use in diagnosis, immunization, or treatment of human beings or animals.
(d) Certificate of treatment shall mean a form prescribed by the Commissioner of Health to document treatment of regulated medical waste, signed by a person authorized by an on-site or off-site treatment facility to attest to such treatment.
(e) Challenge testing shall mean monitoring testing or procedures periodically conducted at the installation site of a treatment system to demonstrate continued operation under conditions established by efficacy testing for an alternative regulated medical waste treatment system, or, for an autoclave, to verify continued effective treatment of regulated medical waste.
(f) Clinical laboratory shall have the same meaning as in section 571 of the Public Health Law.
(g) Cultures and stocks shall mean materials and/or systems supporting in vitro growth or maintenance of infectious agents, including, but not limited to, the infectious agents themselves, nutrient agars, gels, broths, human and primate cell lines, impure animal cell lines, live vaccines, and attenuated vaccines capable of propagation.
(h) Culture and dishes and devices for transferring, inoculating and mixing cultures shall mean any plates, flasks, tubes, beakers, vials, bottles, jars or inoculation loops of any material; manual or mechanical stirring or mixing devices; stoppers or plugs of any material; filtering devices of natural and artificial substances; and any other items or devices for growing and/or maintaining infectious agents in vitro.
(i) Cycle shall mean total operating time required for a device to treat regulated medical waste, and, for an autoclave, shall include warm-up, residence and cool down time.
(j) Decontamination shall mean reduction or inactivation of potentially infectious agents' bioload in waste, so that such waste, including any waste residual in or on a container, no longer constitutes a threat to public health and safety.
(k) Destroyed shall mean torn apart or mutilated through incineration, melting, shredding, grinding, tearing, breaking or other process; to render unusable and unrecognizable as the item that underwent destruction. Destroyed shall not mean compacted or compacted following treatment. As used in this Part pertaining to sharps, unrecognizable shall mean that 100 percent of the sharps must be rendered not identifiable as intact sharps devices.
(l) Efficacy testing shall mean testing of an autoclave or alternative regulated medical waste treatment system, conducted by a laboratory independent of the system manufacturer that is generally recognized within the scientific community as having the capability for conducting, in conformance with generally recognized scientific principles, microbiologic examinations and/or other pertinent assessments of waste material to establish operating parameters for the system's effective treatment of regulated medical waste.
(m) Hazardous waste shall have the same meaning as in 6 NYCRR, section 360-1.2.
(n) Toxic drug waste shall mean waste contaminated by or mixed with a chemotherapeutic, cytotoxic and/or antineoplastic agent, and/or a biotechnological material ( e.g. , infectious nanoparticles), not otherwise regulated as hazardous waste under 6 NYCRR Part 371.
(o) Household medical waste shall have the same meaning as in 6 NYCRR, section 360-1.2 and shall include residential sharps ( i.e. , lancets, hypodermic needles and syringes) generated in a household in the course of medical self-management.
(p) Incinerator shall mean an enclosed device using controlled flame combustion to effect thermal breakdown of solid waste, including refuse-derived fuel, to ash residue containing little or no combustible material, as defined in 6 NYCRR, section 200.1 and regulated under 6 NYCRR, Parts 200, 201, 211, 212, 219 and 257.
(q) Infectious agent shall mean any organism or agent that causes disease or an adverse health impact in humans, and shall include any agent listed in Part 2 of this Title and any agent designated as requiring Biosafety Level 2, 3 or 4 processing in the U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institutes of Health publication, "Biosafety in Microbiological and Biomedical Laboratories," 4th ed., May, 1999 and any biological agents listed in 42 CFR Part 73 (Vol. 70, March 18, 2005): Possession, Use and Transfer of Select Agents and Toxins. Federal regulations are published by the Office of the Federal Register, National Archives and Records Administration and may be purchased from the Superintendent of Documents, Government Printing Office, Washington, DC 20402. Copies are available for inspection and copying in the New York State Department of Health, Bureau of Hospital and Primary Care Services, Hedley Park Place, 433 River Street, Troy, NY 12180.
(r) Leakproof shall mean designed and maintained to prevent the escape of contained liquids or other materials from sides or bottom, when appropriately closed regardless of container orientation ( i.e. , upright, tipped over).
(s) Monitoring shall mean periodic assessment and quality control of the operation of a regulated medical waste treatment system.
(t) Operating parameters shall mean the specific conditions of pressure, temperature, residence time, chemical concentration, and other physical or engineering condition established through efficacy testing of an alternative regulated medical waste treatment system, or verified through validation testing of an autoclave for effective treatment of regulated medical waste.
(u) Operation plan shall mean documented policies and procedures for a facility's operation of an on-site autoclave, incinerator or alternative regulated medical waste treatment system.
(v) Parametric control shall mean an electronic or other device designed to monitor accurately the performance of a regulated medical waste treatment system and/or regulate continuously the system's operation to achieve and maintain pre-set operating parameters.
(w) Patient care area shall mean a room or location at which a hospital, nursing home or clinical laboratory engages in medical services and/or specimen collection that results in the generation of regulated medical waste. For purposes of this Part, a patient service center ( i.e. , collection station) and a health fair operated by a clinical laboratory are patient care areas.
(x) Primary container shall mean the containment system in direct contact with, holding and securing regulated medical waste, i.e. , a red bag or sharps container.
(y) Radiological medical waste shall mean regulated medical waste contaminated by or mixed with radioisotopes that are emitting ionizing radiation at a level distinguishable from natural background level.
(z) Regulated medical waste shall mean waste generated in diagnosis, treatment or immunization of humans or animals in research pertaining thereto, or in production and testing of biologicals; provided, however, that regulated medical waste shall not include hazardous waste and household medical waste except as prescribed in paragraph (4) of this subdivision, and hazardous waste. Regulated medical waste shall include:
(1) cultures and stocks; culture dishes and devices used to transfer, inoculate and mix cultures that have come into contact with cultures and stocks; and biologicals;
(2) human pathological waste, including: tissue; organs; body parts, excluding teeth and contiguous structures of bone and gum; body fluids removed during surgery, autopsy or other medical procedures; specimens of body fluids and their containers; and discarded materials saturated with body fluids other than urine. Human pathological waste shall not include urine or fecal material submitted for purposes other than diagnosis of infectious diseases;
(3) human blood and blood products, including their components ( e.g. , serum and plasma); containers with free-flowing blood; discarded blood products as defined in Subpart 58-2 of this Title; and materials saturated with flowing blood (except feminine hygiene products);
(4) sharps whether used or unused including residential sharps accepted by a facility regulated under article 28 of the Public Health Law pursuant to section 1389-dd(4) of the Public Health Law;
(5) animal waste, including animal carcasses, body parts, body fluid, blood, and bedding originating from animals known to be contaminated with infectious agents ( i.e. , zoonotic organisms) or from animals inoculated with infectious agents for purposes including, but not limited to, research, production of biologicals, or drug testing; and
(6) any other waste materials containing infectious agents designated by the Commissioner of Health as regulated medical waste.
(aa) Residence time shall mean the time necessary for effective treatment of regulated medical waste at a specific temperature, pressure and/or chemical concentration, the duration of which:
(1) for an autoclave, begins when the autoclave's coldest area, as determined by the manufacturer, attains the temperature and pressure established by validation testing as effective for treatment of regulated medical waste, and continues for at least the minimum time established by validation testing as effective for treatment of such waste;
(2) for an incinerator, begins when the incinerator attains operating temperature in both the ignition and combustion (secondary) chambers, and continues for the time necessary to achieve a complete burn down as determined by inspection through a view port of the waste bed; and
(3) for an alternative regulated medical waste treatment system, begins when the temperature, chemical concentration or other condition established through efficacy testing has been attained, and continues for the time established through such testing, as required for effective treatment of regulated medical waste.
(ab) Secondary container shall mean the containment system used to hold and secure a primary container. A secondary container ( e.g. , outer container) shall be a disposable or reusable rigid pail, carton, drum or portable bin that is, under normal conditions of use, leak-resistant; has leak-proof sides and bottom; has a tight-fitting cover or is otherwise closeable; and is in good repair.
(ac) Sharp shall mean an item capable of causing percutaneous injury, including, but not limited to, hypodermic, intravenous or other medical needles; hypodermic or intravenous syringes to which a needle or other sharp is attached; Pasteur pipettes; scalpel blades; blood vials; and broken and unbroken glass and plastic ware, including microscope slides and cover slips, in contact with infectious agents. Sharps shall not include those parts of syringes specifically designed to allow easy removal of a hypodermic, intravenous or other medical needle, and are intended for recycling or other disposal, provided the needle has been removed and such syringe has not been in contact with infectious agents.
(ad) Solid waste shall have the same meaning as in 6 NYCRR, section 360-1.2.
(ae) Sterilize shall mean to inactivate all microbial forms of life.
(af) Storage shall mean temporary containment of regulated medical waste in such a manner as not to constitute disposal of such waste. Storage area shall mean a room, delineated area or designated space designed for storage of regulated medical waste in accordance with this Part, within a building, or on any permanent structure attached or unattached to a building, including a loading dock, situated on property owned by or under management of the facility operator. Storage area shall not include a trailer, bulk container or other transportable container or vehicle not owned by the facility but situated on facility property.
(ag) Transport shall mean shipment or conveyance of regulated medical waste from the point of generation to any intermediate point, including a treatment facility, and finally to the point of ultimate disposal.
(ah) Treatment shall mean any method, technology or process designed to change the character or composition of any regulated medical waste so that it no longer constitutes a threat to public health and safety. Treatment shall not include compaction.
(ai) Universal warning sign shall mean a symbol design that conforms to the design shown by illustration at 29 CFR section 1910.1030(g)(l)(i)(A) (Vol. 6, July 1, 2003). Federal regulations are published by the Office of the Federal Register, National Archives and Records Administration and may be purchased from the Superintendent of Documents, Government Printing Office, Washington, DC 20402. Copies are available for inspection and copying in the New York State Department of Health, Bureau of Hospital and Primary Care Services, Hedley Park Place, 433 River Street, Troy, NY 12180.
(aj) Validation testing shall mean procedures conducted at the installation site of an alternative regulated medical waste treatment system, an incinerator, or an autoclave prior to initial operation for waste treatment, the purpose of which is to demonstrate, under pre-established operating parameters, the effective treatment of regulated medical waste at the installation site.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.68 Emergency oral prescriptions for schedule II substances and certain other controlled substances
(a) In an emergency, a practitioner may orally prescribe and a pharmacist may dispense, to an ultimate user, controlled substances in schedule II and those controlled substances listed in section 80.67 of this Part; provided, however, the pharmacist shall:
(1) contemporaneously reduce such prescription to writing or, to the extent authorized by Federal requirements to an electronic record;
(2) dispense the substance in conformity with the labeling requirements applicable to the type of prescription which would be required but for the emergency; and
(3) make a good-faith effort to verify the identity of both the practitioner and the ultimate user.
(b) No oral prescription shall be filled for a quantity of controlled substances which would exceed a five-day supply if the substance were used in accordance with the directions for use.
(c) Within 72 hours after authorizing an emergency oral prescription, the prescribing practitioner shall cause to be delivered to the pharmacist a written or an electronic prescription. Such prescription shall, in addition to the information otherwise required, also have written or typed upon its face the words: “Authorization for emergency dispensing.” If the pharmacist fails to receive such prescription, he shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(d)
(1) The pharmacist filling the prescription shall endorse upon the prescription the date of delivery, and his/her signature.
(2) The endorsed prescription shall be retained by the proprietor of the pharmacy for a period of five years. The prescription information shall be filed electronically with the Bureau of Narcotic Enforcement, utilizing a transmission format acceptable to the department, not later than 24 hours after the substance was delivered. A waiver allowing a pharmacy to make such filings within a longer period of time may be issued by the commissioner based upon a showing of economic hardship, technological limitations that are not reasonably within the control of the pharmacy; or other exceptional circumstance demonstrated by the pharmacy. Such waiver and any subsequent waiver shall be applied for in the same manner and shall be subject to the same requirements as specified in section 80.63(c)(2)(x) of this Part and, if granted, such waiver shall not provide for a filing period longer than the 15th day of the next month following the month in which the substance was delivered. The information filed with the department shall include but not be limited to:
(i) pharmacy prescription number;
(ii) pharmacy's national identification number;
(iii) patient name, in the case of an animal, the patient name field shall be filled with the name of the animal’s owner;
(iv) patient address, including street, city, state, ZIP code;
(v) patient date of birth;
(vi) patient's sex;
(vii) date prescription filled;
(viii) metric quantity;
(ix) national drug code number of the drug;
(x) number of days supply;
(xi) prescriber's Drug Enforcement Administration (DEA) number;
(xii) date prescription issued;
(xiii) serial number of official prescription form or an identifier designated by the department;
(xiv) payment method;
(xv) species code; and
(xvi) name of animal, if applicable.
(e) Emergency means that the immediate administration of the drug is necessary for proper treatment, that no alternative treatment is available and it is not possible for the practitioner to provide a written or electronic prescription for the drug at the time.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.33 Screening mammography services
(a) Applicability.
This section shall apply to any general hospital or extension clinic that is certified as a mammography facility pursuant to the Mammography Quality Standards Act (MQSA).
(b) Extended service hours.
Any general hospital or extension clinic certified as a mammography facility pursuant to the MQSA shall provide extended hours, i.e., in the early morning, evening, or weekend hours, for screening mammography services. Extended hours for screening mammography services shall be provided on at least two days each week, for at least two hours each day offered, for a total of at least four hours each week, including but not limited to the following times:
(1) Monday through Friday, between the hours of 7:00 a.m. and 9:00 a.m.;
(2) Monday through Friday, between the hours of 5:00 p.m. and 7:00 p.m.; or
(3) Saturday or Sunday, between the hours of 9:00 a.m. and 5:00 p.m.
(c) Waiver.
(1) A facility may submit an application for a waiver from the requirements of this section, in whole or in part, if it can demonstrate, to the department’s satisfaction, that the facility:
(i) does not have sufficient staff to provide extended hours for screening mammography services in accordance with this section, and that it is making diligent efforts to obtain staffing such that it can provide extended hours;
(ii) is in the process of discontinuing screening mammography services, as part of a consolidation or similar change; or
(iii) is subject to such other hardships as the department deems appropriate.
(2) The department may deny, grant or extend a waiver for 90 days, or more if the department determines appropriate, in its sole discretion.
Subchapter B HOSPITAL ESTABLISHMENT
Part 650 DISSOLUTION OF CORPORATIONS
10 CRR-NY 650.1 Applications for dissolution of corporations
Corporations seeking the approval of the Public Health Council of voluntary dissolution shall file information, documents and data as follows:
(a) the public need for such dissolution;
(b) the proposed disposition of the assets of the corporation;
(c) the proposed certificate of dissolution which shall in all respects conform with the applicable provisions of the Not-for-Profit Corporation Law and all other pertinent laws of the State of New York;
(d) the proposed plan of dissolution and distribution of assets which shall in all respects conform with the applicable provisions of the Not-for-Profit Corporation Law and all other pertinent laws of the State of New York;
(e) the petition proposed to be submitted to the court in support of the application for judicial approval of the proposed plan of dissolution and distribution of assets; and
(f) such additional pertinent information and documents which are deemed necessary for the council's consideration, as requested.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.37 Skilled nursing facility
This functional reporting center must contain all the expenses associated with providing skilled nursing care to patients on the basis of physicians' orders and approved nursing care plans, when patients require convalescent rehabilitative and/or restorative services at a level less intensive than that of the usual medical acute care. Additional activities include but are not limited to the following: monitoring vital life signs; operating specialized equipment; preparing equipment and assisting physicians during patient examinations and treatments; changing dressings and cleansing wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping them in and out of bed; observing patients for reaction to drugs; administering specified medication; serving food to patients in their rooms, and feeding patients regardless of location; assisting patients with daily hygiene; answering patient calls; stripping and making beds; and keeping patients' rooms in order.
(a) Standard unit of measure: number of patient days.
Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASE CONTROL
10 CRR-NY 40-2.23 Immunization; performance standards
The local health department shall maintain a program designed to minimize the occurrence and transmission of vaccine-preventable diseases. The program shall include, at a minimum, activities to ensure:
(a) compliance with all statutes and regulations concerning immunization applicable to local health departments, including but not limited to:
(1) Public Health Law section 613, concerning programs of immunization for children;
(2) Public Health Law section 2164, concerning vaccination of school children against certain diseases;
(3) Public Health Law section 2165, concerning vaccination of post-secondary students against certain diseases;
(4) Public Health Law section 2168 concerning the New York Statewide Immunization Information System (NYSIIS);
(5) Subpart 69-3 of this Title, concerning pregnant women, testing for Hepatitis B, and follow-up care;
(b) disease surveillance for vaccine preventable diseases, in accordance with Part 2 of this Title;
(c) assistance with and follow-up on school immunization surveys;
(d) educational efforts in the community, including:
(1) collaboration and communication with healthcare providers and schools to maintain required immunization levels in schools; and
(2) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials or campaigns, to increase awareness of diseases and the control measures required to prevent the spread of disease;
(e) coordination with medical providers and laboratories to encourage and advise them to conduct recommended diagnostic testing in the event of a disease outbreak; and
(f) engagement in quality assurance activities with providers in the community to improve immunization practices, including but not limited to, improving compliance with the NYSIIS reporting requirements, as applicable.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.4 Direction and medical direction
(a) Medical direction of a reproductive tissue bank shall be provided by the medical director in consultation with the medical advisory committee, if applicable.
(b) Except for insemination/implantation sites, the reproductive tissue bank director, in consultation with the medical director, if not the same person, and the medical advisory committee shall monitor the efficacy of the reproductive tissue banking program and shall, as a minimum, develop:
(1) medical criteria for donor participation;
(2) quality standards for sperm, oocytes, embryos and other reproductive tissue, as applicable; and
(3) guidelines for determining a maximum number of offspring per donor to minimize the probability of consanguinity.
(c) The reproductive tissue bank director shall be responsible for selection of donors who meet the medical criteria and for the technical/scientific operation of the reproductive tissue bank, and shall make available to the physician performing each artificial insemination or assisted reproductive procedure the donor's medical history and other pertinent non-identifying characteristics of the donor, so that recipient counseling may be provided.
(d) Artificial insemination and all assisted reproductive procedures shall be ordered only by a licensed physician, physician's assistant or nurse practitioner. Artificial insemination procedures shall be performed only by:
(1) a licensed physician;
(2) a licensed physician's assistant;
(3) a licensed nurse practitioner; or
(4) a licensed registered nurse who has been trained in the technical aspects of artificial insemination by a licensed physician, licensed physician's assistant or licensed nurse practitioner employed by the insemination/implantation site, and is supervised by such a physician, physician's assistant or nurse practitioner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.66 Comprehensive inpatient rehabilitation service
A program of care providing mltidisciplinary physician and restorative services; including skilled rehabilitation nursing, physical therapy, occupational therapy, activities of daily living, speech therapy, and prosthetic-orthotic services; and having a physician director whose primary activity is supervision and coordination of the various rehabilitation modalities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.6 Trend factor, increases to compensation and other adjustments
(a) Trend factor.
For years in which the department does not update the base year, subject to the approval of the Director of Budget, the department may use a compounded trend factor to bring base year costs forward to the appropriate rate period. The trend factor shall be taken from applicable years from consumer and producer price indices, including, but not limited to the Medical Care Services Index; U.S. city average, by expenditure category and commodity and service group for the period April to April of each year.
(b) Increases to compensation.
(1) Applicability. On or after January 1, 2015, rates of reimbursement for providers that operate eligible programs as defined in this section will be revised to incorporate funding for compensation increases to their direct support professional employees. Such rate increases will be effective January 1, 2015. The compensation increase funding will be included in the provider's rate issued for January 1, 2015 or in a subsequent rate with the inclusion of funding in the amount necessary to achieve the same funding impact as if the rate had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(2) Definitions. As used in this section, the following terms shall have the following meanings:
(i) Direct support professionals are those defined as direct care and support per consolidated fiscal report (CFR) appendix R and reported on the CFR under the position title code identifiers of 100 or 200. Contracted staff salary information will not be utilized.
(ii) Clinical staff are those defined as clinical per CFR appendix R and reported on the CFR under the position title code identifier of 300. Contracted staff salary information will not be utilized.
(iii) Eligible rate based programs shall mean intermediate care facility for persons with developmental disabilities (ICFs/DD).
(3) Increases for eligible rate based programs.
(i) January 1, 2015 increase. Rates for eligible rate based programs will be revised to incorporate funding for compensation increases to direct support professional employees. Such rate increases will be effective January 1, 2015. The compensation increase funding will be included in the provider’s rate issued for January 1, 2015, or in a subsequent rate with the inclusion of funding in the amount necessary to achieve the same funding impact as if the rate had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(ii) April 1, 2015 increase. In addition to the compensation funding effective January 1, 2015, providers that operate ICFs/DD will receive a compensation increase targeted to direct support professional and clinical employees to be effective April 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits. The April 1, 2015 direct support professionals compensation funding will be compounded on the amount which was calculated for the January 1, 2015 compensation increase and will be an augmentation to the January 1, 2015 increase.
(iii) Calculations. The basis for the calculation of provider and regional direct care, support and clinical salary averages and associated fringe benefit percentages will be the data in providers’ CFRs for July 1, 2010 through June 30, 2011 for providers reporting on a fiscal year basis or January 1, 2011 through December 31, 2011 for providers reporting on a calendar year basis.
(a) The January 1, 2015 and April 1, 2015 direct support professionals compensation increase funding formula will be as follows:
(1) The annual impact of a two percent increase to 2010-11 or 2011 salaried direct care dollars, salaried support dollars and associated fringe benefits will be calculated.
(2) The annual impact of the two percent increase for salaried direct care dollars, salaried support dollars and associated fringe will be added to the appropriate operating components in the rate methodology. This will result in a recalculation of provider and regional average direct care wages, provider and regional average employee-related components, provider and regional average program support components, and provider and regional average direct care hourly rates.
(3) The provider direct care hourly rate – adjusted for wage equalization factor will be recalculated to utilize the provider average direct care hourly rate and regional average direct care hourly rate, as calculated in subclause ( 2 ) of this clause.
(4) An identification will be made of the dollar difference between the provider direct care hourly rate – adjusted for wage equalization factor, which is in the rate in effect on December 31, 2014, and the provider direct care hourly rate – adjusted for wage equalization factor, as calculated in subclause ( 3 ) of this clause.
(5) The rate difference identified in subclause ( 4 ) of this clause will be multiplied by the calculated direct care hours in the rate in effect on December 31, 2014 to calculate the additional funding generated by the direct care compensation adjustment.
(6) The rate add-on for the compensation increase shall be determined by dividing the additional funding, as calculated in subclause ( 5 ) of this clause by the rate sheet units in effect on January 1, 2015.
(b) The April 1, 2015 clinical compensation increase funding formula will be as follows:
(1) The annual impact of a two percent increase to 2010-11 or 2011 salaried clinical dollars and associated fringe benefits will be calculated.
(2) The annual impact of the two percent increase for salaried clinical dollars and associated fringe will be added to the appropriate operating components in the rate methodology. This will result in a recalculation of provider and regional average employee-related components, provider and regional average clinical hourly wages.
(3) The provider clinical hourly wage – adjusted for wage equalization factor will be recalculated to utilize the provider average clinical hourly wage and regional average clinical hourly wage, as calculated in subclause ( 2 ) of this clause.
(4) An identification will be made of the dollar difference between the provider clinical hourly wage – adjusted for wage equalization factor, which is in the rate in effect on December 31, 2014, and the provider clinical hourly wage – adjusted for wage equalization factor, as calculated in subclause ( 3 ) of this clause.
(5) The rate difference identified in subclause ( 4 ) of this clause will be multiplied by the provider salaried clinical hours in the rate in effect on December 31, 2014 to calculate the additional funding generated by the clinical compensation adjustment.
(6) The rate add-on for the compensation increase shall be determined by dividing the additional funding, as calculated in subclause ( 5 ) of this clause by the rate sheet units in effect on January 1, 2015.
(c) Occupancy adjustment.
(1) Definitions. As used in this section, the following terms shall have the following meanings:
(i) Occupancy adjustment. An adjustment to the calculated daily rate of a provider operating an ICF/DD to account for days when Medicaid billing cannot occur because an individual has passed away or has moved to another site.
(2) For the initial rate period beginning July 1, 2014 and thereafter, providers will receive an occupancy adjustment to the operating component of their rate for vacancy days. The occupancy adjustment percentage is calculated by dividing the agency’s rate period service days by 100 percent of the agency’s certified capacity. The certified capacity is calculated taking into account capacity changes throughout the year, multiplied by 100 percent of the year’s days. This adjustment will begin on July 1, 2016 and be recalculated on an annual basis based on the previous year’s experience. The occupancy adjustment calculation will be agency specific and will be the higher of the agency’s actual occupancy percentage or at 95 percent occupancy. The occupancy percentage will be used to adjust the operating component of the rate for the rate year.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 78 STATEMENT TO BE FURNISHED BY EVERY PERSON LICENSED PURSUANT TO ARTICLE 34 OF THE PUBLIC HEALTH LAW
10 CRR-NY 78.3 Customer's designation of intentions
(a) Every person licensed pursuant to article 34 of the Public Health Law, including funeral directors and funeral firms, shall furnish at the time funeral arrangements are made for the cremation of the body of a deceased person, to the person or persons making arrangements, a written statement which shall include the following:
(1) true firm name and address as registered with the department;
(2) the signature and printed or typed name of the funeral director or undertaker making funeral arrangements, and the date such statement was furnished to the customer;
(3) name of deceased, together with the place and scheduled date of cremation;
(4) a statement, by the person making the arrangements, indicating the manner of disposition of the cremains;
(5) the dated signature, address and phone number of the person making the arrangements; and
(6) a disclosure statement by the funeral director or undertaker making the arrangements, indicating the manner of disposition of the cremains if unclaimed after 120 days from the date of cremation.
(b) The funeral firm's copy of the customer's designation of intentions shall include he following:
(1) the actual date of cremation, and the name and location of crematory;
(2) the date, location and manner of disposition of cremains; and
(3) the dated signature and printed or typed name of person making disposition of cremains.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.3 Scope of service
(a) PCHs and CAHs shall provide initial diagnostic services, a limited range of therapeutic services, resuscitation and stabilization services, and shall have the ability to arrange transport to other more appropriate facilities for patients in need of services not offered at the PCH/CAH.
(b) A PCH/CAH shall provide a minimum set of core services to meet patient needs, including:
(1) primary care: inpatient and ambulatory services;
(2) inpatient non-surgical clinical services;
(3) emergency services sufficient to handle a range of urgent and limited emergent care needs;
(4) laboratory services;
(5) imaging services; and
(6) pharmacy services.
(c) PCHs and CAHs may provide, subject to the approval of the commissioner, one or more of the optional services listed in section 407.14 of this Part.
(d) PCHs and CAHs shall:
(1) participate in the development and implementation of an emergency medical services plan that is suitable to meet the needs of the rural area in which the hospital is located. If the PCH or CAH is a member of a rural health network, such plan shall be a component of the network plan. The emergency medical services plan shall be developed in conjunction with the existing local EMS system and service delivery providers. In the event that the PCH or CAH is a member of a rural health network, the plan shall reflect the agreement of all appropriate providers in the network;
(2) install and maintain a radio operated or dedicated phone line (call box) outside the PCH/CAH to provide continuous contact with medical control and appropriate providers of advice and/or emergency transport for patients that may arrive after hours;
(3) develop written policies and protocols for medical control. Such protocols shall be developed in conjunction with appropriate area or network providers, entities providing medical control services, be consistent with area and regional EMS protocols and be approved by the area Regional Emergency Medical Advisory Committee (REMAC);
(4) educate the community about the role of the hospital in meeting community health and health related needs including, but not limited to:
(i) the types of services provided at the hospital and, if applicable, within the network;
(ii) the hours of operation, which shall be posted publicly in the rural area served by the hospital and made available to the designated medical control facility for the area in which the hospital operates; and
(iii) changes in hours of operation, which shall be publicly posted and implemented only after a reasonable notification period to insure the rural area has had ample warning of the changes; and
(5) support and participate in any communication system that may be available for the area served by the PCH/CAH and the general hospital(s) with which it has a formal affiliation pursuant to section 407.1 of this Part. Such communication system may include but shall not be limited to electronic sharing of patient data, telemetry, and medical records as well as cellular and other radio transmission devices for providing immediate communication links with medical control, back-up services and transport systems;
(6) CAHs shall have the following additional agreements:
(i) patient referral and transfer with its supporting hospital(s);
(ii) the provision of emergency and non-emergency transportation between the CAH and its supporting hospital(s) pursuant to the provisions of section 407.12 of this Part; and
(iii) credentialing and quality assurance activities with the CAH's support hospital(s) pursuant to the provisions of section 407.6 of this Part.
(e) PCHs and CAHs shall comply with construction standards contained in Article 2, Subchapter C (Medical Facility Construction) of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.34 Rehabilitation services
(a) Provision of care.
Rehabilitation services shall be made available, only at the direction of a physician, to eligible persons as medically needed and as an integral part of a comprehensive medical care program. Such services include not only service to the patient but also instructions to responsible members of the family in follow-up procedures necessary for the care of the patient.
(b) Where care may be provided.
Rehabilitation services may be provided in the patient's own home, in a hospital outpatient department, in an approved clinic or outpatient medical facility not part of a hospital, in an approved medical institution or facility, in an approved home health agency, or in the office of a qualified private practicing therapist or speech pathologist.
(c) Who may provide care.
Rehabilitation services shall be provided by:
(1) qualified professional personnel employed by:
(i) an approved home health agency;
(ii) a hospital; or
(iii) an approved clinic or outpatient medical facility not part of a hospital;
(2) a qualified private practicing therapist or speech pathologist.
(d) Definitions.
(1) Qualified professional shall mean:
(i) an occupational therapist, physical therapist or speech pathologist who is licensed and currently registered with the New York State Education Department;
(ii) an occupational therapist or physical therapist who possesses a limited permit and practices under the supervision of the appropriate professional in accordance with requirements of section 7905 and section 6735, respectively, of the State Education Law, book 16, McKinney's Consolidated Laws of New York. Copies are available from West Publishing Co., St. Paul, MN, and copies of both sections are available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY;
(iii) a speech pathologist who is in the process of obtaining a license and has on file a “Notification of Approval of the Supervisory Plan” in accordance with requirements of the State Education Law; or
(iv) an out-of-state occupational therapist, physical therapist or speech pathologist meeting the certification requirements of the appropriate agency of the state in which they practice.
(e) Use of rehabilitation resources.
(1) In the provision of necessary occupational therapy, physical therapy and speech pathology, full and primary use shall be made of qualified rehabilitation therapists employed on the staff of an approved home health agency or approved rehabilitation clinic as part of a rehabilitation team under the overall direction of a qualified physician.
(2) Service of a qualified occupational therapist, physical therapist or speech pathologist, provided on a private practitioner basis, may be rendered to a patient in his or her own home, in an approved medical facility or in the office of the therapist or speech pathologist, only under the following conditions:
(i) when there is no approved home health agency available to provide the service needed by the patient; or
(ii) when the patient is in need of individual rehabilitation service beyond, or in addition to, that which is available from an approved home health agency.
(f) Prior approval and prior authorization.
(1) Prior approval by the local professional director and prior authorization of the local social services official shall be required for the following:
(i) rehabilitation services provided by a private practicing occupational therapist, physical therapist or speech pathologist; and
(ii) all out-of-state rehabilitation services.
(2) Authorization to a private practicing occupational therapist, physical therapist and speech pathologist shall not exceed three months.
(g) Physician's written order required.
(1) All rehabilitation services shall be supported by a written order of a qualified physician and shall be carried out under his or her medical direction. The written order shall constitute medical direction of the physician.
(2) Such written order shall include a diagnostic statement and purpose of treatment.
(3) Such written order is required prior to treatment.
(4) In extraordinary circumstances and for valid reasons which must be documented, a rehabilitation evaluation in the home may be initiated by a home health agency without a written order of a physician. Reimbursement shall not be made for more than one such rehabilitation evaluation visit to a patient in his own home before a physician's specific written order for treatment is obtained.
(h) Reimbursement.
Reimbursement for rehabilitation services shall be made in accordance with rates and fees developed by the New York State Department of Health and approved by the New York State Division of the Budget.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.2 Eligibility for an award
(a) To be eligible for Primary Care Service Corps scholarship award, an individual must:
(1) show evidence of enrollment or acceptance for full-time study or part-time study in a primary care practitioner program. The Commissioner of Health may permit individuals who are not enrolled or who have not been accepted for enrollment to apply for an award, but an award will not be made until the individual provides evidence of enrollment or acceptance into a primary care practitioner program;
(2) be within 24 months of completing the program of study on a full-time basis or be within 48 months of completing the program of study on a part-time basis;
(3) be eligible to apply for licensure, registration or certification, as appropriate, in the profession of study after completion of the primary care practitioner program;
(4) be a United States citizen or resident alien who is holding a valid I-551 card or a valid I-151 card issued by the U.S. Immigration and Naturalization Service;
(5) be a New York State resident;
(6) meet the character and moral standards required for licensure registration or certification, as appropriate; and
(7) complete, sign and file an application with the Department of Health on such forms as are specified by the department at least 90 days prior to the beginning of the semester for which an award is sought or by a later date specified by the commissioner. All required supplementary documentation shall be filed as directed. Incomplete, illegible or vague applications may be rejected. Applications filed after the deadlines specified may be rejected.
(b) An individual may be determined to be ineligible to receive a Primary Care Service Corps scholarship award if:
(1) the individual is already receiving any other scholarship or fellowship award that requires the fulfillment of a service obligation;
(2) the individual is identified by Higher Education Services Corporation as having defaulted on the repayment of a guaranteed student loan or as being in default under the terms of any other governmentally administered scholarship or financial aid program.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.57 North Fork Water Company, Inc., Southold
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land, owned by the North Fork Water Company, Inc. and situated approximately one and one-quarter miles west of Southold and 1,000 feet south of the Greenport Road on South Harbor Lane, which form the source of the public water supply of the North Fork Water Company, Inc., of Southold, Suffolk County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to any of the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the North Fork Water Company, Inc.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the North Fork Water Company, Inc.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the North Fork Water Company, Inc.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which shall have been granted by the State Commissioner of Health) within 200 feet of any well of the public water supply of the North Fork Water Company, Inc. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the North Fork Water Company, Inc.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the North Fork Water Company, Inc.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the North Fork Water Company, Inc. and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the North Fork Water Company, Inc.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the North Fork Water Company, Inc.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well of the public water supply of the North Fork Water Company, Inc.
(g) Trespassing.
No trespassing shall be allowed upon the property of the North Fork Water Company, Inc. upon which the wells of the public water supply of the North Fork Water Company, Inc. are located and no person or persons shall enter in or upon such property except the duly authorized representative of the North Fork Water Company, Inc. or any such other person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the North Fork Water Company, Inc.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the North Fork Water Company, Inc.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the North Fork Water Company, Inc.
(j) Inspections.
The North Fork Water Company, Inc., of Southhold, N. Y., or such other company, person or persons as may be charged with the maintenance or supervision of the public water supply of the unincorporated village of Southold or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said North Fork Water Company, Inc. to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the North Fork Water Company, Inc. to promptly notify the State Commissioner of Health of such violations. The North Fork Water Company, Inc. shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 401 ALL FACILITIES—OPERATING CERTIFICATES
10 CRR-NY 401.1 Issuance of operating certificates
(a) For new facilities, an establishment/construction application will contain the information necessary for automatic issuance of the initial operating certificate following final approval of the establishment/construction application. For purposes of this subdivision, final approval of the establishment/construction application shall consist of all final approvals, surveys and satisfaction of any contingency conditions.
(b) An operating certificate issued pursuant to subdivision (a) of this section shall remain in force until revised, annulled, revoked or surrendered, unless an expiration date is specified in the operating certificate as a result of a determination that a subsequent evaluation is necessary to ensure that the facility is operating in compliance with Public Health Law, article 28 and the rules and regulations promulgated thereunder.
(c) Upon the death of any person, party or member of a partnership to whom an operating certificate has been issued, the commissioner may permit the facility to continue operating under the existing operating certificate for such time as in his or her discretion shall be required for the transfer of such decedent's interest in the facility, for the processing of an application to the State Public Health Council for approval of establishment of a transferee of such decedent's interest and for the processing of an operating certificate on behalf of such transferee.
(d) Medical facilities not under the direction of the same governing authority, with each facility separately incorporated or owned and each operated by separate governing authorities, even though located on the same premises, shall each require a separate operating certificate.
(e) In addition to the operating certificate issued to each municipal hospital in a municipality having more than one such hospital, the municipality operating such hospital system shall have a separate operating certificate.
(f) Notwithstanding the limitations of this section, the commissioner upon a showing that efficiency of operations and services will result, may issue one operating certificate to a hospital when the facility is operated by one governing authority. A determination of efficiency of operation shall be based upon the following:
(1) Operational elements:
(i) existence of a single medical staff organization;
(ii) existence of a single credentialing, appointment, and privileges process for medical staff;
(iii) one chief executive officer accountable to the governing body;
(iv) uniform hospital policies;
(v) uniform patient care policies; and
(vi) uniform medical education and allied health programs, if applicable.
(2) Economic elements:
(i) demonstrable long-term economies in construction;
(ii) demonstrable long-term economies in volume purchasing;
(iii) demonstrable long-term economies resulting from an enhanced ability to afford specialized management and related expertise;
(iv) demonstrable long-term economies resulting from standardization of hotel-type services, supplies and equipment; or
(v) demonstrable long-term economies resulting from improved utilization of services and programs, staffing and financial viability of the hospital.
(g) Extension clinic shall mean a clinic which is a component of a general hospital sponsored ambulatory care program, or a diagnostic and treatment center sponsored ambulatory care program, offering services of a nonemergent nature and located on premises other than those of the hospital or diagnostic and treatment center which operates it. An extension clinic of a hospital or diagnostic and treatment center may be certified to provide services, authorized to be provided by a diagnostic and treatment center, other than or in addition to the services provided at the sponsoring hospital or center.
(h) A multi-site facility shall mean two or more general hospitals operated by a single governing authority or operator and located in separate premises.
(i) Except for part-time clinic sites as defined in section 700.2(a)(22) of this Title, an operating certificate shall be issued to each certified site of health care delivery, including extension clinics and shall indicate the specific services approved to be provided at that site.
(j) An established article 28 network shall mean any arrangement in which operating authority, including, but not necessarily limited to, any of the functions listed under section 405.1(c) of this Title, is legally delegated to a corporation or other entity by hospitals participating in such arrangement and in which the corporation or other entity has received establishment approval by the Public Health Council under article 28 of the Public Health Law as operator or co-operator of the participating hospitals. An established article 28 network may, but need not, be a multi-site facility, as such term is defined in subdivision (h) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.5 Answer or responsive pleading
(a) A party may serve on the department an answer, or responsive pleading, signed by the party or the party's attorney. The answer or responsive pleading shall specify which allegations are admitted, which allegations are denied and which allegations a party has insufficient information upon which to form an opinion.
(b) The answer or responsive pleading shall be served no later than three days before the initial hearing date.
(c) An answer or responsive pleading is required if there are affirmative defenses.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.20 Maximum permissible bather use
(a) The maximum number of bathers permitted in a swimming pool at one time shall not exceed the design bather capacity. This capacity is calculated based on section 6-1.29, item 3.0, of this Subpart.
(b) The pool operator shall be responsible for controlling the number of bathers so that the maximum capacity is not exceeded.
(c) A sign shall be conspicuously posted in the pool area stating:
(1) the maximum number of bathers who may use the swimming pool at one time;
(2) the hours that a swimming pool is open; and
(3) that pool use is prohibited at any other time.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.6 Quality assurance and utilization review
(a) The governing body shall require the establishment and maintenance of a written coordinated quality assurance program which integrates the review activities of all PCH/CAH services to enhance the quality of patient care. This program shall be designed to identify and prevent potential malpractice issues, shall incorporate the minimum standards for a quality assurance program delineated in section 405.6 of this Title and shall require at least quarterly quality assurance reports to be submitted to the governing body. For purposes of this Part, the quality assurance program may be developed and implemented for all services in accordance with the ongoing quality assurance program of the affiliated full service hospital.
(b) Where a PCH/CAH is a member of a rural health network and there is a network-wide quality assurance program and/or health information system, the PCH/CAH shall coordinate its assessment and improvement activities with such program or system.
(c) The PCH's/CAH's quality assurance program shall support a care delivery continuum and may utilize a performance measurement system for the analysis of care provided which includes, but need not be limited to:
(1) a permanent patient record; and
(2) an indicator measurement system for analysis of undesired outcomes related to:
(i) access to and availability of cares;
(ii) variations from generally accepted standards of professional practice; and
(iii) if the PCH/CAH is a member of a rural health network, any departures within the network from established medical/professional standards delineated in section 405.4(a)(1) of this Title, and generally accepted practice guidelines.
(d) In addition to implementing the activities required by the quality assurance provisions of this Part and section 405.6(b) of this Title, the PCH/CAH shall:
(1) review admissions made under exceptional circumstances;
(2) review cases involving an unanticipated transfer to a more service intensive facility;
(3) review cases involving a readmission within two days of discharge; and
(4) review cases that exceed a length of stay determined by the governing body to be in excess of what is appropriate for the PCH/CAH.
(e) A PCH's/CAH's utilization review program shall provide for prospective, concurrent and retrospective review processes.
(1) The prospective review process shall be locally developed by clinicians from the PCH/CAH and from the facility or facilities providing hospital support services to the service area within which the PCH/CAH operates, and shall be based upon the service capabilities of those facilities.
(2) The concurrent review process shall provide for a review of patients admitted to the PCH/CAH under exceptional circumstances ( i.e. , emergency or other life threatening situations, weather, availability of transport, equipment or staff prohibits transfer to a more appropriate facility) and patients whose service needs have changed after admission and may exceed the service capacity or capabilities of the PCH/CAH.
(3) The retrospective review process shall include case level assessments for patients as set forth in section 405.6(b) of this Title and subdivision (d) of this section and, in cases involving the transfer or referral of a patient to another facility, shall involve a facility level assessment.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 450 APPLICABILITY
10 CRR-NY 450.1 Applicability and relationship to reimbursement
(a) This Article is applicable to all residential health care facilities except those that are hospital-based, unless said residential health care facility was organized under article 28-A of the Public Health Law, in which case this Article applies regardless of whether or not such facility is hospital-based.
(b) This Article has been designed so that a uniform report for financial disclosure could be developed. This Article has not been designed to conform to or reflect reimbursement regulations, since they have and will continue to change. It is anticipated that an omnibus annual Medicaid cost report will reflect both the uniform reporting concepts and reimbursement regulations.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.6 Review criteria
The technical advisory groups in reviewing applications and making recommendations, and the commissioner in making his determinations, shall consider pertinent factors including, but not limited to, the following:
(a) the extent to which an applicant's proposal meets the goals of the demonstration as set by the commissioner;
(b) the adequacy of the methodology proposed for the demonstration;
(c) the ability of the proposed demonstration to collect data required for an analysis of the project;
(d) the adequacy and appropriateness of the plan for organizing and carrying out the project;
(e) the technical qualifications of the principal investigator and the proposed project staff;
(f) the reasonableness of the proposed budget in relation to the proposed project;
(g) the adequacy of the facility and resources available to the applicant;
(h) where an application involves activities which could have an adverse health effect upon individuals participating in the demonstration, the adequacy of the proposed means for protecting against or minimizing such effects;
(i) the relevance and status of any approvals required by the Federal Food and Drug Administration for the subject of the demonstration project; and
(j) the number of applications to be approved.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH TECHNICIAN PUBLIC HEALTH TECHNICIAN
10 CRR-NY 11.122 Supervisory level qualifications
A supervisory public health technician must meet the qualifications of the public health technician and have two years' experience as a public health technician.
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.6 Reporting heavy metal levels in blood and urine
Every physician, clinical laboratory and health facility in attendance of a person with a blood or urine test resulting in a value at or above those listed in section 22.7 of this Part, shall report such occurrence to the State Commissioner of Health within 10 days of the receipt of the results of such test. The report shall be on such forms as prescribed by the State Commissioner of Health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.8 Patient visits/hourly rate
(a) A patient visit or an hourly rate are the units of measure by which an LTHHCP may bill for services provided.
(b) Nursing, therapeutic and related services will be billed per visit.
(c) Home health aides, personal care aides, homemaker and housekeeper services will be billed on an hourly basis.
(d) The hourly/visit rate will include an amount for the indirect costs of the LTHHCP as defined in section 86-5.17 of this Subpart.
(e) No provider of an LTHHCP shall establish charges for such program in excess of the higher of those rates established pursuant to section 3614 of the Public Health Law and rules and regulations adopted pursuant to section 3612 of the Public Health Law (Medicaid) or subchapter XVIII of the Federal Social Security Act (Medicare).
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.2 Definitions
As used in this Subpart, the following words and terms shall have the indicated meanings:
(a) Data subject means any natural person about whom personal information has been collected by an agency.
(b) Personal information means any data concerning a data subject which, because of name, number, symbol, mark or other identifier, can be used to identify that data subject.
(c) Records access officer means the records access officer or his/her authorized representative and shall be the person from whom records may be obtained, as listed in section 50-1.4 of this Part.
(d) Records access appeals officer means the Director, Department of Health. Public Affairs Group, whose business address is: Empire State Plaza, Corning Tower, Albany, NY 12237.
(e) Records means any item, collection or grouping of personal information about a data subject which is maintained and is retrievable by use of name or other identifier of the data subject. The term record shall not include personal information not used to make a determination about a data subject, such as:
(1) a telephone book or directory;
(2) a card catalog, book or other resource material in any library;
(3) a compilation of information containing names and addresses used exclusively for mailing agency information;
(4) personal information required by law to be maintained, and required by law to be used only for statistical research or reporting purposes;
(5) correspondence files; or
(6) information requested by the Department of Health which is necessary to answer unsolicited requests by the data subject for information.
(f) System of records means any group of records under the actual or constructive control of the department pertaining to one or more data subject from which personal information is retrievable by use of the name or other identifier of a data subject.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.5 Obligation of local health officer
If any student is unable to pay for the services of a private health practitioner, such student may present himself or herself to the health officer of the county in which such student resides, or the county in which the institution is located who shall then administer the immunization without charge.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Skin donor means a human being, living or dead, who is the source of skin tissue including autogeneic tissue for transplantation.
(b) Transplantation means the grafting of skin from a donor to a recipient, including the grafting of skin that has been manipulated and integrated into an artificial skin substitute, and the grafting of skin from an autogenic donor.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.6 Issuance of a certificate of authority
Prior to issuance of a certificate of authority to an MCO, the commissioner, and in the case of an HMO or MLTCP, the superintendent where applicable, must be satisfied that the following conditions have been met:
(a) The applicant has demonstrated its capability to organize, market, manage, promote and operate the proposed MCO in order to provide comprehensive health services to a proposed enrolled population that is identified in the application, the manner in which the applicant will comply with the requirements of section 98-1.11(g) of this Subpart, that the governing authority shall assemble to conduct the business of the MCO at least four times annually, once in each quarter, and that the governing authority shall for each such assembly provide prior notice to and shall include in each such assembly each enrollee or consumer representative and/or enrollee advisory council member elected or appointed to represent the MCO's enrollees.
(b) Except for PCPCPs, the applicant has demonstrated, to the satisfaction of the commissioner and, except for entities certified pursuant to sections 4403-a and 4403-c of the Public Health Law, the superintendent, that it is capable of assuming full financial risk for covered services. The applicant may make risk sharing arrangements for the provision of comprehensive health services to the population to be enrolled within the area to be served by the plan as prescribed by regulations and guidelines of the commissioner. When such an arrangement includes risk sharing as defined in this Subpart, such an arrangement shall be approved by the superintendent pursuant to the requirements of 11 NYCRR Part 101 (Regulation 164), where applicable, or the commissioner pursuant to regulations and guidelines. In making a determination of financial soundness, the commissioner and the superintendent shall consider financial information, contracts and agreements required as part of the application for a certificate of authority, and any other materials that the commissioner or the superintendent shall deem necessary to make that determination.
(c) The applicant has demonstrated, to the satisfaction of the commissioner, that it will retain full responsibility for the operation of the MCO and the protection of its enrollees in compliance with article 44 of the Public Health Law and this Subpart, including protection for enrollees from billing by providers for services covered under the enrollee contract during the operation of the MCO or in the event of insolvency.
(d) Except for PCPCPs, the applicant has demonstrated, to the satisfaction of the commissioner, that the medical director and the members of the board and officers, controlling persons of a corporation or holding company or the owners, or all the partners of a partnership, or the members and managers of a limited liability company are of such character, experience, competence and standing in the community as to give reasonable assurance of their ability to conduct the affairs of the proposed MCO in the best interest of the MCO and in the public interest, and to provide proper care for the enrollees. In the case of an applicant that is controlled, the commissioner must be satisfied that the holding company has conducted itself in a manner that is consistent with the public interest. In determining the character and competence of applicants and holding companies, the commissioner shall consider criminal convictions, bankruptcy proceedings, and the quality of health-related services provided by any facility or organization owned or operated by the applicant or its holding company or other persons in the holding company system or with which an officer, member of the board, controlling person, member or manager of a limited liability company, owner, partner or medical director has been affiliated. PCPCPs must provide the information prescribed in section 4403-e(2)(b) of the Public Health Law.
(e) Except for PCPCPs, the applicant demonstrates that there are adequate finances and sources of future revenue to properly establish and operate the proposed MCO. In the case of a PCPCP, the applicant demonstrates financial responsibility pursuant to section 4403-e(3)(e) of the Public Health Law.
(f) The applicant demonstrates that the arrangements for health care services assure the availability and accessibility of those services to the proposed enrolled population, and are conducive to the appropriate and efficient use of ambulatory care and hospital services, and that utilization review procedures, if applicable, have been developed consistent with article 49 of the Public Health Law and/or, in the case of an entity participating in federally sponsored programs, consistent with Federal law and regulation.
(g) The applicant demonstrates that an effective program has been developed to monitor and assess the quality of care provided by the MCO, together with a performance improvement program, approved prior to issuance of its certificate of authority, consistent with section 98-1.12 of this Subpart, pursuant to which, actual and potential problems will be identified and corrections accomplished promptly. In the case of an entity participating in federally sponsored programs, quality of care monitoring and quality improvement programs shall be consistent with Federal law and regulations.
(h) The applicant demonstrates that an acceptable mechanism has been developed, consistent with sections 4403(1)(g) and 4408-a of the Public Health Law and/or, in the case of an entity participating in federally sponsored programs, consistent with Federal law and regulation, to receive and resolve complaints and grievances initiated by enrollees of the MCO.
(i) The applicant demonstrates that acceptable contracts between the potential enrollee or anyone on behalf of the enrollee and the MCO have been developed. Such contracts shall be approved by the superintendent pursuant to section 4406 of the Public Health Law. In the case of contracts for services provided pursuant to title XIX, such contracts shall require prior approval by the commissioner and, as required by Federal law or regulation, the Federal agency with oversight responsibility for programs authorized by such title.
(j) The applicant demonstrates that the proposed premium rates have been submitted to and approved by the superintendent or, in the case of services provided pursuant to title XIX, the commissioner.
(k) Except for PCPCPs, the applicant demonstrates that it has established a system which appropriately accounts for costs and a uniform system of reports and audits meeting the requirements of the commissioner and/or the superintendent, as appropriate.
(l) Demonstration by the HMO applicant of a willingness to provide community services that include at least the following: a willingness to enter into a contract with the local social services district to enroll individuals eligible for benefits under title XIX, including the steps and a time frame for entering into such contract; a willingness to provide coverage to Medicare beneficiaries; and demonstration that the HMO offers open enrollment, pursuant to articles 32 and 43 of the Insurance Law, including steps and a time frame for offering such coverage. For the purpose of this section, open enrollment shall mean offering enrollment throughout the year to individuals and groups consisting of two or more eligible members who elect to enroll, subject to such reasonable limitations as an affiliation or waiting period not to exceed two months from the date of the enrollee's application until the commencement of coverage, provided that coverage may not be excluded based upon a preexisting condition for groups of more than 50.
(m) Requirements and conditions for issuance of a certificate of authority for an MLTCP shall be as set forth in section 4403-f of the Public Health Law and subdivisions (a) through (k) of this section.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.4 Emergency procedures
(a) Notwithstanding any other provision of this Subpart, where an expedited review and approval of a regulated activity is necessary to respond to an imminent threat to the health and safety of humans or animals, or to respond to a substantial imminent threat to property, an applicant seeking such review and approval shall notify the department by telephone at the office of the local representative listed in section 128-1.5 of this Part, and shall meet with the department within 24 hours. At the meeting the applicant shall present to the representative of the department such available information regarding the regulated activity as would otherwise be required in a written application for review and approval of the regulated activity. Additionally, the applicant shall provide an explanation of the nature of the imminent threat that necessitates the expedited review. The department shall review the information supplied by the applicant and shall issue a temporary determination to approve or disapprove the application within 24 hours of receipt of the information required by this subdivision.
(1) An applicant shall not be required to notify the department before undertaking the routine repair and maintenance of a subsurface sewage treatment system, including, but not limited to, the pump-out of a septic tank, the repair of a broken lateral, the leveling of a distribution box, or the removal of a blockage.
(b) An approval granted by the department pursuant to the emergency expedited review procedure shall be a temporary approval only, and shall not be considered to be a final approval of the department. The temporary approval may contain conditions and time limitations and shall be limited to whatever actions are necessary to abate the imminent threat. A final approval shall be issued by the department only after review and approval of a complete written application submitted in accordance with the procedures and standards set forth in subdivision (c) of this section, and any other applicable provisions of this Part.
(c) An applicant who has received a temporary approval for a regulated activity pursuant to the emergency expedited review procedure shall, within 20 days of such approval, submit a written application to the department containing all of the information required to be provided by these rules and regulations for the particular regulated activity.
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.8 Village of Otego
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 110-1107 of the Public Health Law shall apply to the wells which comprise the source of the public water supply of the Village of Otego. Said wells are located on land owned by the Village of Otego and are situated approximately one mile north of the village along Otsdawa Road in the west end of the village south of Meadow Street between the Susquehanna River and the Delaware and Hudson railroad tracks.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial and municipal and agricultural- and nonagricultural-associated animal wastes.
(11) Radiation shall mean ionizing radiation; that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or leasee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(18) Water supply shall mean the public water supply of the Village of Otego.
(20) Wells shall mean wells now used as a source of this water supply or any additional wells which may be constructed at this point as a source for this water supply.
(c) General prohibition.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the wells.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the wells.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Village of Otego upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Otego.
(e) Inspections.
The board of trustees of the Village of Otego or any person or persons charged with the maintenance or supervision of the public water supply system shall make regular and thorough inspections of the area surrounding the wells to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of said violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. If the commissioner finds such rule or regulation to have been violated, further steps will be taken in accordance with the provision of section 1102 of the Public Health Law. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.10 Town of Carroll
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Town of Carroll. Said wells are located on land owned by the Town of Carroll, as follows:
(1) Wells 1 and 2 are situated on County Road 317 (Falconer-Frewsburg Road), approximately 1.1 miles north of the intersection of Routes 60 and 62 in the Town of Carroll. Well 3 is situated on County Road 317 (Falconer-Frewsburg Road), approximately 1.4 miles north of the intersection of Routes 60 and 62 in the Town of Carroll. Well 4 is situated on Route 60 in the Town of Kiantone, approximately 1.3 miles west of its intersection with Route 62.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the extension of the centerline of the wells.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural- and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Town of Carroll.
(20) Wells shall mean any well now used as a source of water supply for the Town of Carroll, or any additional wells which may be constructed or developed in the future as a source for such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells, except in weatherproof buildings or watertight vessels acceptable to the town.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells, unless a permit is obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained, or allowed to reaimn with a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facilities. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the wells.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency, and such burial is in accordance with provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the wells.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 250-foot linear distance of the wells.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells, except as otherwise permitted under the provisions of subparagraph (4)(iii) of this subdivision.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Town of Carroll upon which the wells are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Town of Carroll.
(11) Other wastes.
No pollutant of any kind shall be discharged or deposited upon the property of the Town of Carroll upon which the wells are located, except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(e) Inspections.
The Town of Carroll, by its town supervisor or its duly appointed representative, or any person or persons charged with the maintenance or supervision of the public water supply system, shall make regular and thorough inspections of the area surrounding the wells to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town supervisor to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town supervisor to promptly notify the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general conditions of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified in section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH EDUCATOR PUBLIC HEALTH EDUCATOR
10 CRR-NY 11.150 Definitions
The term local public health educator shall mean a person who applies the principles of behavioral sciences in public health programs to foster the voluntary adaptation of behavior to improve or maintain health.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.6 Occupational dose limits
(a) Occupational dose limits for adults.
(1) Except for planned special exposures pursuant to subdivision (f) of this section, no person shall transfer, receive, possess or use any radiation source so as to cause any individual adult to receive an occupational dose from all sources of radiation that exceeds any of the following limits:
(i) The annual limit, which is the more limiting of:
(a) the total effective dose equivalent being equal to 0.05 Sv (5 rem); or
(b) the sum of the deep dose equivalent and the committed dose equivalent to any individual organ or tissue other than the lens of the eye being equal to 0.50 Sv (50 rem).
(ii) The annual limits to the lens of the eye, to the skin, and to the extremities which are:
(a) an eye dose equivalent of 0.15 Sv (15 rem); and
(b) a shallow dose equivalent of 0.50 Sv (50 rem) to the skin or to any extremity.
(2) Doses received in excess of the annual limits, including doses received during accidents, emergencies, and planned special exposures must be subtracted from the limits for planned special exposures that the individual may receive during the current year and during the individual's lifetime. (See paragraph [f][6] of this section).
(3) The assigned deep dose equivalent and shallow dose equivalent shall be for the portion of the body receiving the highest exposure determined as follows:
(i) The deep dose equivalent, eye dose equivalent and shallow dose equivalent may be assessed from surveys or other radiation measurements for the purpose of demonstrating compliance with the occupational dose limits, if the individual monitoring device was not in the region of highest potential exposure, or the results of individual monitoring are unavailable.
(ii) When a protective apron is worn pursuant to section 16.58(b)(3) of this Part by physicians during X-ray fluoroscopic procedures and monitoring is conducted as specified in section 16.11(b)(1) of this Part, the effective dose equivalent for external radiation may be determined for these individuals as follows:
(a) when only one individual monitoring device is used and it is located at the neck outside the protective apron, the reported deep dose equivalent value multiplied by 0.3 shall be the effective dose equivalent for external radiation; or
(b) when individual monitoring devices are worn, both under the protective apron at the waist and outside the protective apron at the neck, the effective dose equivalent for external radiation shall be assigned the value of the sum of the deep dose equivalent reported for the individual monitoring device located at the waist under the protective apron multiplied by 1.5 and the deep dose equivalent reported for the individual monitoring device located at the neck outside the protective apron multiplied by 0.04.
(4) Derived air concentration (DAC) and annual limit on intake (ALI) values are presented in Appendix 16-C, Table 1, infra, and may be used to determine the individual's dose and to demonstrate compliance with the occupational dose limits.
(5) Notwithstanding the annual dose limits, the licensee shall limit the soluble uranium intake by an individual to 10 milligrams in a week. (See footnote 3 of Appendix 16-C.)
(6) The licensee or registrant shall reduce the dose that an individual may be allowed to receive in the current year by the amount of occupational dose received while employed by any other person. (See subdivision [e] of this section.)
(b) Compliance with requirements for summation of external and internal dose.
(1) If the licensee or registrant is required to monitor pursuant to both subdivisions (a) and (d) of section 16.11 of this Part, the licensee or registrant shall demonstrate compliance with the dose limits by summing external and internal doses. If the licensee or registrant is required to monitor only pursuant to section 16.11(a) of this Part or only pursuant to section 16.11(d) of this Part, then summation is not required to demonstrate compliance with the dose limits. The licensee or registrant may demonstrate compliance with the requirements for summation of external and internal doses by meeting one of the conditions specified in paragraph (2), and the conditions in paragraphs (3) and (4) of this subdivision. The dose equivalents for the lens of the eye, the skin, and the extremities are not included in the summation, but are subject to separate limits.
(2) intake by inhalation.
the only intake of radionuclides is by inhalation, the total effective dose equivalent limit is not exceeded if the sum of the deep dose equivalent divided by the total effective dose equivalent limit, and one of the following, does not exceed unity:
(i) the sum of the fractions of the inhalation ALI for each radionuclide; or
(ii) the total number of derived air concentrations-hours (DAC-hours) for all radionuclides divided by 2,000; or
(iii) the sum of the calculated committed effective dose equivalents to all significantly irradiated organs or tissues (T) calculated from bioassay data using appropriate biological models and expressed as a fraction of the annual limit. For purposes of this requirement, an organ or tissue is deemed to be significantly irradiated if, for that organ or tissue, the product of the weighting factors, WT, and the committed dose equivalent, H T,50, per unit intake is greater than 10 percent of the maximum weighted value of H50, that is, WH,50 per unit intake for any organ or tissue.
(3) Intake by oral ingestion.
If the occupationally exposed individual also receives an intake of radionuclides by oral ingestion greater than 10 percent of the applicable oral ALI, the licensee or registrant shall account for this intake and include it in demonstrating compliance with the limits.
(4) Intake through wounds or absorption through skin.
The licensee or registrant shall evaluate and account for intakes through wounds or skin absorption. The intake through intact skin has been included in the calculation of DAC for hydrogen-3 and does not need to be evaluated or accounted for pursuant to this paragraph.
(c) Determination of external dose from airborne radioactive material.
(1) Licensees shall, when determining the dose from airborne radioactive material, include the contribution to the deep dose equivalent, eye dose equivalent, and shallow does equivalent from external exposure to the radioactive cloud (see Appendix 16-C, footnotes 1 and 2 infra ).
(2) Airborne radioactivity measurements and DAC values shall not be used as the primary means to assess the deep dose equivalent when the airborne radioactive material includes radionuclides other than noble gases or if the cloud of airborne radioactive material is not relatively uniform. The determination of the deep dose equivalent to an individual shall be based upon measurements using instruments or individual monitoring devices.
(d) Determination of internal exposure.
(1) For purposes of assessing dose used to determine compliance with occupational dose equivalent limits, the licensee shall, when required under section 16.11 of this Part, take any of the following measurements as may be necessary for timely and appropriate detection and assessment of intake of radioactivity by individuals:
(i) concentrations of radioactive materials in air in work areas; or
(ii) quantities of radionuclides in the body; or
(iii) quantities of radionuclides excreted from the body; or
(iv) combinations of these measurements.
(2) Unless respiratory protective equipment is used, as provided in section 16.26 of this Part, or the assessment of intake is based on bioassays, the licensee or registrant shall assume that an individual inhales radioactive material at the airborne concentration in which the individual is present.
(3) When specific information on the physical and biochemical properties of the radionuclides taken into the body or the behavior of the material in an individual is known, the licensee or registrant may:
(i) use that information to calculate the committed effective dose equivalent, and, if used, the licensee or registrant shall document that information in the individual's record; and
(ii) upon prior approval of the department, adjust the DAC or ALI values to reflect the actual physical and chemical characteristics of airborne radioactive material, for example, aerosol size distribution or density; and
(iii) separately assess the contribution of fractional intakes of Class D, W, or Y compounds of a given radionuclide to the committed effective dose equivalent.
(4) If the licensee chooses to assess intakes of Class Y material using the measurements given in subparagraph (1)(ii) or (iii) of this subdivision, the licensee or registrant may delay the recording and reporting of the assessments for periods up to seven months, unless otherwise required by section 16.15(b) or 16.15(c) of this Part. This delay permits the licensee or registrant to make additional measurements basic to the assessments.
(5) If the identity and concentration of each radionuclide in a mixture are known, the fraction of the DAC applicable to the mixture for use in calculating DAC-hours shall be either:
(i) the sum of the ratios of the concentration to the appropriate DAC value, that is, D, W, or Y, from Appendix 16-C infra, for each radionuclide in the mixture; or
(ii) the ratio of the total concentration for all radionuclides in the mixture to the most restrictive DAC value for any radionuclide in the mixture.
(6) If the identity of each radionuclide in a mixture is known, but the concentration of one or more of the radionuclides in the mixture is not known, the DAC for the mixture shall be the most restrictive DAC of any radionuclide in the mixture.
(7) When a mixture of radionuclides in air exists, a licensee may disregard certain radionuclides in the mixture if:
(i) the licensee uses the total activity of the mixture in demonstrating compliance with the dose limits in subdivision (a) of this section and in complying with the monitoring requirements in section 16.11(d) of this Part; and
(ii) the concentration of any radionuclide disregarded is less than 10 percent of its DAC; and
(iii) the sum of these percentages for all of the radionuclides disregarded in the mixture does not exceed 30 percent.
(8) When determining the committed effective dose equivalent, the following information may be considered:
(i) In order to calculate the committed effective dose equivalent, the licensee or registrant may assume that the inhalation of one ALI, or an exposure of 2,000 DAC-hours, results in a committed effective dose equivalent of 0.05 Sv (five rem) for radionuclides that have their ALIs or DACs based on the committed effective dose equivalent.
(ii) For an ALI and the associated DAC determined by the nonstochastic organ dose limit of 0.50 Sv (50) rem), the intake of radionuclides that would result in a committed effective dose equivalent of 0.05 Sv (five rem), that is, the stochastic ALI, is listed in parentheses in Appendix 16-C, Table 1, infra. The licensee or registrant may, as a simplifying assumption, use the stochastic ALIs to determine committed effective dose equivalent. However, if the licensee or registrant uses the stochastic ALIs, the licensee or registrant shall also demonstrate that the limit in clause (a)(1)(i)( b ) of this section is met.
(e) Determination of prior occupational dose.
(1) For each individual who may enter the licensee's or registrant's restricted area and is likely to receive, in a year, an occupational dose requiring monitoring pursuant to section 16.11 of this Part, the licensee or registrant shall:
(i) determine the occupational radiation dose received during the current year; and
(ii) request in writing the records of lifetime cumulative occupational radiation dose.
(2) Prior to permitting an individual to participate in a planned special exposure, the licensee or registrant shall determine:
(i) the internal and external doses from all previous planned special exposures; and
(ii) all doses in excess of the limits, including doses received during accidents and emergencies, received during the lifetime of the individual.
(3) In complying with the requirements of paragraph (1) of this subdivision, a licensee or registrant may:
(i) accept, as a record of the occupational dose that the individual received during the current year, a written signed statement from the individual, or from the individual's most recent employer for work involving radiation exposure, that discloses the nature and the amount of any occupational dose that the individual received during the current year; and
(ii) accept, as the record of lifetime cumulative radiation dose, an up-to-date department form “Cumulative Occupational Radiation Exposure History”, or equivalent, signed by the individual and countersigned by an appropriate official of the most recent employer for work involving radiation exposure, or the individual's current employer, if the individual is not employed by the licensee or registrant; and
(iii) obtain reports of the individual's dose equivalent from the most recent employer for work involving radiation exposure, or the individual's current employer, if the individual is not employed by the licensee or registrant, by telephone, telegram, facsimile, or letter. The licensee or registrant shall request a written verification of the dose data if the authenticity of the transmitted report cannot be established.
(4) The licensee or registrant shall record the exposure history, as required by paragraph (1) of this subdivision, on department form “Cumulative Occupational Radiation Exposure History”, or other clear and legible record, of all the information required on that form.
(i) The form or record shall show each period in which the individual received occupational exposure to radiation or radioactive material and shall be signed by the individual who received the exposure. For each period for which the licensee or registrant obtains reports, the licensee or registrant shall use the dose shown in the report in preparing department form “Cumulative Occupational Radiation Exposure History”. For any period in which the licensee or registrant does not obtain a report, the licensee or registrant shall place a notation on department form “Cumulative Occupational Radiation Exposure History” indicating the periods of time for which data are not available.
(ii) Licensees or registrants are not required to reevaluate the separate external dose equivalents and internal committed dose equivalents or intakes of radionuclides assessed under the regulations in this Part in effect before the effective date of these regulations. Further occupational exposure histories obtained and recorded on department form “Cumulative Occupational Radiation Exposure History” before the effective date of these regulations, would not have included effective dose equivalent, but may be used in the absence of specific information on the intake of radionuclides by the individual.
(5) If the licensee or registrant is unable to obtain complete records of an individual's current and previously accumulated occupational dose, the licensee or registrant:
(i) when establishing administrative controls under paragraph (a)(6) of this section for the current year, shall assume that the allowable dose limit for the individual is reduced by 12.5 mSv (1.25 rem) for each quarter for which records were unavailable and the individual was engaged in activities that could have resulted in occupational radiation exposure; and
(ii) shall not authorize the individual to receive any planned special exposures.
(6) The licensee or registrant shall retain the records on department form “Cumulative Occupational Radiation Exposure History” or equivalent until the department authorizes their disposition. The licensee or registrant shall retain records used in preparing department form “Cumulative Occupational Radiation Exposure History” for three years after the record is made.
(f) Planned special exposures.
A licensee or registrant may authorize an adult worker to receive doses in addition to and accounted for separately from the doses received under the limits specified in subdivision (a) of this section provided that each of the following conditions is satisfied:
(1) The licensee or registrant authorizes the planned special exposure only in an exceptional situation when alternatives that might avoid the higher exposure are unavailable or impractical.
(2) The licensee or registrant, and employer if the employer is not the licensee or registrant, specifically authorizes the planned special exposure, in writing, before the exposure occurs.
(3) Before a planned special exposure, the licensee or registrant ensures that each worker involved is:
(i) informed of the purpose of the planned operation; and
(ii) informed of the estimated doses and associated potential risks and specific radiation levels or other conditions that might be involved in performing the task;, and
(iii) instructed in the measures to be taken to keep the dose ALARA considering other risks that may be present.
(4) Prior to permitting an individual to participate in a planned special exposure, the licensee or registrant ascertains prior doses as required by paragraph (e)(2) of this section.
(5) Subject to paragraph (a)(2) of this section, the licensee or registrant shall not authorize a planned special exposure that would cause an individual to receive a dose from all planned special exposures and all doses in excess of the limits to exceed:
(i) the numerical values of any of the dose limits in paragraph (a) (1) of this section in any year; and
(ii) five times the annual dose limits in paragraph (a)(1) of this section during the individual's lifetime.
(6) The licensee or registrant maintains records of the conduct of a planned special exposure in accordance with section 16.14(e) of this Part and submits a written report in accordance with section 16.15(d) of this Part.
(7) The licensee or registrant records the best estimate of the dose resulting from the planned special exposure in the individual's record and informs the individual, in writing, of the dose within 30 days from the date of the planned special exposure. The dose from planned special exposures shall not be considered in controlling future occupational dose of the individual pursuant to paragraph (a)(1) of this section but shall be included in evaluations required by paragraphs (4) and (5) of this subdivision.
(g) Occupational dose limits for minors.
The annual occupational dose limits for minors are 10 percent of the annual occupational dose limits specified for adult workers in subdivision (a) of this section.
(h) Dose to an embryo/fetus.
(1) The licensee or registrant shall ensure that the dose to an embryo/fetus during the entire pregnancy, due to occupational exposure of a declared pregnant woman, does not exceed five mSv (0.5 rem). (See section 16.14[f] of this Part for recordkeeping requirements.)
(2) The licensee or registrant shall review past exposure history and adjust working conditions so as to avoid a monthly total effective dose equivalent of more than 50 mrem to the embryo/fetus of a declared pregnant woman.
(3) The dose to an embryo/fetus shall be taken as the sum of:
(i) the deep dose equivalent to the declared pregnant woman during the entire pregnancy period; and
(ii) the dose to the embryo/fetus from radionuclides in the embryo/fetus and radionuclides in the declared pregnant woman during the entire pregnancy period.
(4) If by the time the woman declares pregnancy to the licensee or registrant, the dose to the embryo/fetus exceeded 4.5 mSv (0.45 rem), the licensee or registrant shall be deemed to be in compliance with paragraph (1) of this subdivision if the additional dose to the embryo/fetus does not exceed 0.50 mSv (0.05 rem) during the remainder of the pregnancy.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.7 Initial occupancy
(a) A nursing home company shall obtain timely final inspections of construction and medicaid approvals. Requests for such, and the submission of an application for an operating certificate to the State Department of Health, shall be instituted six months prior to scheduled initial occupancy.
(b) A nursing home company shall forward to the State Department of Health a final proposed schedule of estimated annual expenses and income and a supporting schedule for all entries therein no later than three months prior to initial occupancy.
(c) A nursing home company shall establish and maintain a separate special patient register setting forth the income of patients and the source of payment for patient care as required by the State Department of Health.
(d) A nursing home company shall maintain a uniform system of accounts as required by the accounting manual of the State Department of Health.
(e) The following reports for the operational period from initial occupancy to discharge of the mortgage lien shall be submitted promptly to the State Department of Health:
(1) Quarterly uncertified reports during each calendar or fiscal year commencing with the date of admission of the first patient, to and including the last day of March, June, September and December, no later than 30 days following the end of the reporting period.
(2) An annual report for the period ending December 31 containing the opinion and certificate of an independent licensed or certified public accountant, no later than 90 days following the end of the reporting period.
(f) A nursing home company shall submit to the State Department of Health for approval for each budget year a schedule of estimated annual expenses and income and a supporting schedule of expenses no later than 60 days preceding the effective date of the schedule.
(g) A nursing home company shall obtain the prior approval of the State Department of Health for all written contracts except those included in the approved budget of the company.
(h) A nursing home company shall establish and maintain an inventory register of all equipment in accordance with the requirements of the State Department of Health.
(i) Any change in or addition to the services provided by a company shall require prior approval as set forth in the State Hospital Code.
(j) Such other reports as may be required by the State Department of Health shall be submitted promptly.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.6 Part-time clinics
(a) Applicability.
In lieu of Parts 702, 711, 712 and 715 of this Title, this section shall apply to part-time clinic sites, except for those operated by the State Department of Health (other than those part-time clinics which are operated as an extension of article 28 hospitals operated by the State Department of Health) or by the health department of a city or county as such terms are defined in section 614 of the Public Health Law. Such cities and counties shall submit to the State Department of Health information which lists the location(s), hours of operation and services offered at each part-time clinic operated by or under the authority of the city or county health department. This information shall be submitted annually, by January 30th of each year, as an update to the Municipal Public Health Services Plan (MPHSP) submitted by the city or county pursuant to section 602 of the Public Health Law, and shall provide such information for each part-time clinic operated by or under the authority of the city or county health department in the previous calendar year. Consistent with the definition of part-time clinic site in section 700.2(a)(22) of this Title, a part-time clinic shall:
(1) provide services which shall be limited to low-risk (as determined by prevailing standards of care and services) procedures and examinations which do not normally require backup and support from the primary delivery site of the operator or other medical facility. Such services may include health screening (such as blood pressure and HIV screening), preventive health care and other public health initiatives (such as HIV services), procedures and examinations (such as well child care, the provision of immunizations and screening for chronic or communicable conditions which are treatable or preventable by early detection or which are of public health significance);
(2) be located at a site that has adequate and appropriate space and resources to provide the intended services safely and effectively and is located in proximity to the primary delivery site to ensure that supervision and quality assurance are not compromised; and
(3) not be located at a private residence or apartment, an intermediate care facility, an individualized residential alternative, congregate living arrangements (not including a shelter for adults or other group shelter operated by governmental or other organizations to provide temporary housing accommodations in a safe environment to at-risk populations), an area within an adult home, a residence for adults or enriched housing program as defined in section 2 of the Social Services Law, unless the part-time clinic is operated as part of an approved State Department of Health public health initiative. A part-time clinic also shall not be located in space which is part of another facility licensed under article 28 of the Public Health Law, unless such part-time clinic is operated as part of an approved State Department of Health public health initiative, or in space which is part of the private office of a health care practitioner or group of practitioners licensed by the State Education Department.
(b) Department approval and/or notification.
(1) An operator of part-time clinics may initiate patient care services at a specific site only upon written approval from the department in accordance with the department's limited review process set forth at section 710.1(c)(5)(iv)( e ) of this Title. To request such approval, the operator shall submit to the department, for each such site, information and documentation in a format acceptable to the department and in sufficient detail to enable the commissioner to make a decision, including the following:
(i) the location, type and nature of the building, days and hours of operation, expected duration of operation (specified limited period of time, for example, seasonally), staffing patterns and objectives of the part-time clinic;
(ii) the leasing or other arrangement for gaining access to the site's real property, (including a copy of the agreement which grants the applicant the right to use and occupy the space for the part-time clinic site);
(iii) the plans and strategies for meeting the operational standards set forth in this section and an explanation of how the operator will provide adequate supervision and ensure quality of care;
(iv) a listing of all part-time clinic sites already operated by the applicant;
(v) a description of the services to be provided and the populations to be served;
(vi) procedures or strategies for advising patients on making arrangements for follow-up care; and
(vii) the annual aggregate number of part-time clinic services (based on the number of visits) already provided by the applicant and the percentage such visits represent of all outpatient visits provided by the applicant, the number of visits anticipated to be provided at the new part-time clinic and the impact such new site will have on the percentage of the applicant's total annual outpatient visits that will be part-time clinic visits.
(2) After initiating patient care services, an operator of part-time clinics may relocate a part-time clinic or change a category of service only upon written approval from the department in accordance with the department's limited review process as set forth in section 710.1(c)(5)(iv)( e ) of this Title. To request approval, the operator shall submit to the department, for the site of relocation, change in hours of operation or change in services, information concerning:
(i) the location, type and nature of the building, days and hours of operation, and expected duration of operation (specified limited period of time, for example, seasonally);
(ii) the leasing or other arrangement for gaining access to the site's real property (including a copy of the agreement which grants the applicant the right to use and occupy the space for the part-time clinic site);
(iii) a description of the services to be provided and the populations to be served; and
(iv) the type of information concerning the volume of visits as required under subparagraph (i)(vii) of this subdivision.
(3) After initiating patient care services, the operator shall give written notification, including a closure plan acceptable to the department, to the Director of the Bureau of Hospital and Primary Care Services of the department at least 15 days prior to the discontinuance of a part-time clinic site other than a scheduled discontinuance as indicated in accordance with subparagraph (1)(i) of this subdivision. No part-time clinic site shall discontinue operation without first obtaining written approval from the department.
(4)
(i) The operator of any part-time clinic that was in operation on August 15, 2000, and in conformance with all pertinent statutes and regulations in effect prior to that date, and has submitted request(s) to the department for approval to continue providing services for each such site by November 13, 2000, in accordance with requirements in effect at that time shall be permitted to operate until and unless the department issues a written denial of approval to continue operation. If a request to continue operation of a part-time clinic site is denied, the operator shall, within 30 days of receipt of such denial submit to the department and obtain written approval of a closure plan consistent with the provisions of paragraph (3) of this subdivision for the expeditious termination of services at the site. Notwithstanding any other provision of this section, the operator of such part-time clinic site shall cease providing services at and close such site within 60 days of receipt of the notice of denial to continue operation regardless of whether a plan of closure has been approved by the department.
(ii) The operator of any part-time clinic site for which an application to continue providing services at such site was not submitted to the department by November 13, 2000, shall cease operations by December 31, 2000.
(c) Policies and Procedures.
(1) The operator shall ensure the development and implementation of written policies and procedures specific to each part-time clinic site, which shall include, but need not be limited to:
(i) security, confidentiality, maintenance, access to and storage of medical records for each patient, including documentation of any diagnoses or treatments;
(ii) handling and storage of drugs in accordance with state law and regulation;
(iii) standards for maintaining asceptic conditions including the provision and storage of sterile supplies; sterilization equipment as necessary; disposal of contaminated supplies, equipment and medical waste; sharps disposal; and hand washing;
(iv) the prohibition of smoking within the facility;
(v) handling of patient emergencies, including written transfer agreements with hospitals within the service area;
(vi) a fire plan consistent with local laws;
(vii) training and education of staff in fire safety, evacuation and emergency procedures specific to each site, including those policies established by the building owner or operator;
(viii) credentialing of staff by the governing authority of the operator and assurance that only appropriately licensed and/or certified staff perform functions that require such licensure or certification;
(ix) quality assurance/improvement initiatives coordinated with such activities at the operator's primary delivery site(s);
(x) utilization review;
(xi) community outreach efforts designed to ensure that community members are aware of the availability of and the range of clinic services and hours of operation; and
(xii) assurance that patients can access necessary services without regard to source of payment.
(2) The following services shall not be provided at a part-time clinic site:
(i) services that require specialized equipment such as radiographic equipment, computerized axial tomography, magnetic resonance imaging or that required for renal dialysis;
(ii) services that involve invasion or invasive treatment procedures or disruption of the integrity of the body that normally require a surgical operative environment; and
(iii) services other than those available at the primary delivery site(s) listed on the primary facility's operating certificate.
(d) Services and personnel.
The operator shall ensure that all health care services and personnel provided at the part-time clinic site shall conform with generally accepted standards of care and practice and with the following:
(1) part-time clinics operated by hospitals shall comply with pertinent standards established in Part 405 of this Title including, but not limited to, sections 405.7 (Patients' rights) and 405.20 (Outpatient services), which cross-references the outpatient care provisions of sections 752.1 and 753.1 of this Title; and
(2) part-time clinics operated by diagnostic and treatment centers shall comply with the pertinent provisions of Parts 750, 751, 752 and 753 of this Title including, but not limited to, section 751.9 (Patients' rights).
(e) Environment.
The operator shall ensure that:
(1) the site is located in a building that complies with all applicable building construction and fire safety regulations and is acceptable to the local authority having jurisdiction, as evidenced by a valid certificate of occupancy or other written documentation;
(2) exits and access routes to exits are readily identified and accessible to patients and staff during all hours of occupancy or operation;
(3) continuous lighting, including provisions for emergency lighting in the event of electrical power interruptions, is provided for all exit route components and signage, during all hours of occupancy or operation;
(4) passageways, corridors, doorways and other means of exit are kept unobstructed; and
(5) all water used at the part-time clinic site is provided from a water supply which meets all applicable standards set forth in Part 5 of this Title.
(f) Limitation on the size of part-time clinic programs.
An operator of part-time clinic sites shall limit the size and scope of its total part-time clinic program and operations so that the annual aggregate number or amount of outpatient services (based on the number of visits) provided by an operator at all of its part-time clinic sites in the aggregate does not exceed 20 percent of all outpatient services visits provided by such operator at all of its article 28 sites, so that at least 80 percent of all outpatient visit services provided by such operator must be provided at its main site of operation and/or approved extension clinics. Operators of part-time clinics who are not in compliance with the requirements of this subdivision on the effective date of this subdivision shall have 90 days from such effective date within which to come into full compliance with such requirements.
(g) Waivers.
The commissioner, upon a request from the operator, may waive one or more provisions of this section upon a finding that such waiver would:
(1) enable at risk or medically underserved patients to obtain needed care and services, which are otherwise unavailable or difficult to access;
(2) contribute to attaining a generally recognized public health goal;
(3) not jeopardize the health or safety of patients or clinic staff; and
(4) not conflict with existing Federal or State law or regulation.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH EDUCATOR PUBLIC HEALTH EDUCATOR
10 CRR-NY 11.152 Supervisory level qualifications
A supervising public health educator must meet the qualifications for local public health educator and have two years of experience as a public health educator or have a master's degree in public health or health education from a regionally accredited or New York State registered college or university and one year experience as a public health educator.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.29 Payments to receivers
(a) The commissioner may make noninterest-bearing payments to receivers, appointed pursuant to Public Health Law, section 2810, according to the terms set forth in this section and subject to the availability of moneys therefor.
(b) No such payments shall be made unless the commissioner reasonably anticipates that repayment shall be made prior to or upon termination of the receivership.
(c) Any such payment to a receiver shall be pursuant to a written agreement between such receiver and the commissioner. The amount of such payment shall not exceed the facility's anticipated Medicaid revenue for a four-week period. When the commissioner is the receiver, no written agreements shall be required, but the commissioner shall comply with all other provisions of this section.
(d) A receiver may request a payment upon a showing that:
(1) there is a need for such funds based on the financial condition of the facility;
(2) there are debts that were incurred prior to the receivership, which must be paid by the receiver to assure uninterrupted patient care; or
(3) funds are not otherwise available to correct serious or life-threatening structural deficiencies other than alterations prohibited in Public Health Law, section 2810(2)(c).
(e) The criteria to be considered in determining the reasonableness of anticipating repayment by a receiver of any payment made pursuant to this section shall be:
(1) assignment to the commissioner by the receiver of anticipated revenues not less than the amount of the payment, payable upon demand by the commissioner; and
(2) a signed confession of judgment by the receiver to the commissioner for the full amount of said payment.
(f) Repayment by a receiver of any payment made pursuant to this section shall be applied to reimburse any special revenue fund appropriations made for the purposes of this section and chapter 1021 of the Laws of 1981.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.28 Ambulance calls
The number of trips made in response to a request for assistance.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.11 Recall letters and reporting of test results
(a) A clinical laboratory shall not communicate to a patient of a referring health services purveyor that a clinical laboratory test, including, but not limited to a Pap smear, is or will be due to be performed, or that a visit to the health services purveyor for diagnosis or treatment is or will be due. A clinical laboratory shall not prepare such communication for the health services purveyor to send, or otherwise facilitate the preparation or sending of such communication by the health services purveyor. Such communication or its facilitation shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(b) A clinical laboratory shall not communicate to a patient of a referring health services purveyor the results of a clinical laboratory test, including, but not limited to, a Pap smear. A clinical laboratory shall not prepare such communication for the health services purveyor to send, or otherwise facilitate the preparation or sending of such communication by the health services purveyor. Such communication or its facilitation shall be deemed consideration given for referral of specimens for performance of clinical laboratory services and is prohibited, except that:
(1) a clinical laboratory may communicate in writing to the patient (by mail or electronically) an accurate and complete account of the result of the laboratory test along with information required to be included in a report of test results pursuant to Subpart 58-1 of this Title under the following circumstances:
(i) the laboratory test results have already been, or are simultaneously being communicated to the referring health services purveyor authorized by law to order and use the results of laboratory tests;
(ii) the clinical laboratory advises the patient that the referring health services purveyor authorized by law to order and use the results of laboratory tests has received or is receiving the test results;
(iii) the clinical laboratory shall include, in the communication to the patient, a clear statement, presented in a prominent manner, to the effect that the communication should not be viewed as medical advice and is not meant to replace direct communication with a physician or other health service purveyor;
(iv) the clinical laboratory directs the patient's inquiries regarding the meaning or interpretation of the test results to the referring health services purveyor; and
(v) the communication to the patient does not include any information which would be consideration given for referral of specimens, including, but not limited to, medical advice specifically directed at the patient concerning the patient's condition, including diagnosis or treatment of the patient's condition.
(2) nothing in this subdivision shall prohibit a licensed physician from communicating with a patient:
(i) when requested by the referring health services purveyor;
(ii) when requested by the patient; or
(iii) when the referring health services purveyor, or other health services purveyor responsible for using the test results, cannot be reached and a critical value needs to be communicated to the patient.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.17 Programmatic or generic environmental impact statements
(a) A programmatic or generic environmental impact statement may be used to assess the environmental effects of:
(1) a number of separate actions in a given geographic area which, if considered singly may have minor effects, but if considered together may have significant effects;
(2) a sequence of actions, contemplated by a single agency or individual;
(3) separate actions having generic or common impacts; or
(4) programs or plans having wide application or restricting the range of future alternatives policies or projects.
(b) Generic or programmatic statements should set forth specific conditions or criteria under which future actions will be undertaken or approved, and shall include procedures and criteria for amendments or supplements to reflect impacts, such as site-specific impacts, which cannot be adequately addressed or analyzed in the initial statement. Such procedures shall include provision for public notice of amendments or supplements which allow for comment thereon in the same manner as was provided in respect to the original statement.
(c) When an individual action is proposed which was encompassed in a programmatic EIS and the action is to be carried out in conformance with the conditions discussed in the programmatic statement, a subsequent EIS should be prepared only if there are site-specific impacts to be addressed.
(d) In connection with projects that are to be developed in phases or stages, the department should address not only the site-specific impacts of the individual project under consideration, but also, in more general or conceptual terms, the cumulative effects on the environment and existing natural resource base of subsequent phases of a larger project or series of projects that may be developed in the future, and that are under the ownership or control of the same project sponsor. In these cases, this part of the EIS shall discuss the important elements and constraints present in the natural and man-made environment, that may bear on the conditions of an agency decision on the immediate project.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.11 Village of Monroe
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Mombasha Reservoir and all watercourses tributary thereto or which may ultimately discharge into said Mombasha Reservoir or which may be developed in the future to serve as sources of the water supply to the Village of Monroe.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir, or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that spontaneously emits radiation. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Monroe water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Monroe.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the Village of Monroe water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Monroe water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 300 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 75-foot linear distance of any reservoir or watercourse.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 300-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Monroe.
(ii) Boating. No gasoline-powered engines will be permitted on Mombasha Reservoir. Launching of boats may only take place at a point designated by the Village of Monroe water superintendent. A permit must be obtained for boating by the Village of Monroe water superintendent. Boats must meet standards acceptable to the Village of Monroe water superintendent.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Monroe within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Monroe in the performance of their duties of supervision and maintenance of the water supply. Permits for fishing in other areas of Mombasha Reservoir must be obtained by the Village of Monroe water superintendent. No fishing shall be allowed from the shoreline of Mombasha Reservoir.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 500-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 500-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 1,000-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 1,000-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Monroe.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 1,000 feet of any reservoir or watercourse.
(iii) Motorized equipment. No motor-driven equipment shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Monroe, except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(e) Inspections.
The commissioner of water supply or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the provisions of this section are being complied with. It shall be the duty of the aforesaid commissioner of water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid commissioner of water supply to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of water supply shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH TECHNICIAN PUBLIC HEALTH TECHNICIAN
10 CRR-NY 11.120 Definition
The term public health technician shall mean a person who assists sanitarians and engineers in carrying out the various elements of prevention and control programs affecting the public's health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.62 South Bay Consolidated Water Company, Inc. at Bellport
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport, Suffolk County, New York.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such a manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport, except into watertight receptacles, the contents of which are removed and disposed of in the manner provided by paragraphs (4) and (5) of subdivision (c).
(e) [Animals.]
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any well of the public water supply of the South Bay Considated Water Company, Inc. at Bellport, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(f) [Human excreta and compost.]
No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to remain upon the surface of the ground, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(g) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or beneath the surface within 300 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport; nor shall any such matters be so placed or maintained that the leachings or washings therefrom may reach any well without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Bellport.
(j) Inspections.
The duly authorized officials of the South Bay Consolidated Water Company, Inc. or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company at Bellport or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceeding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation or of noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 134 ORLEANS COUNTY
10 CRR-NY 134.2 Village of Lyndonville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law) as heretofore set forth shall apply to that portion of Lake Ontario within one mile of the intake of the public water supply of the village of Lyndonville, Orleans County, New York, and to all watercourses tributary to Lake Ontario within the above specified limits.
(b) [Definitions.]
(1) The term intake wherever used in this section is intended to mean and refer to the point or points at which water is or may be admitted into the suction line or lines of the pump or pumps which obtain or may obtain water from Lake Ontario for the public water supply of the village of Lyndonville.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), streams, ditch, gutter or any channel of every kind, the waters of which, when running whether continuously or occassionally, eventually flow or may flow into Lake Ontario within the above specified limits.
(3) Wherever a linear distance of a structure or object from Lake Ontario or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to Lake Ontario or tributary watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of Lake Ontario or tributary watercourse within the limiting distances from the intake of the public water supply of the village of Lyndonville, as previously defined, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d).
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of Lake Ontario or tributary watercourses within the limiting distance from the intake of the public water supply of the village of Lyndonville, as previously defined, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d).
(3) Every privy, privy vault, pit or other receptacle of any kind, used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, unless said pit or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such a manner that all such excreta shall be received in suitable watertight receptacles and shall be at all times disposed of as hereinafter set forth in paragraphs (4) and (5) of this subdivision.
(4) The exereta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain these receptacles or the privy or the place in which they are kept in a proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape in being transferred from the privy or place of temporary storage to the place of disposal hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be cause to the occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth not less than 18 inches below the ground surface in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from Lake Ontario or any tributary watercourse within the limiting distances of the intake of the public water supply of the village of Lyndonville as previously defined.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into Lake Ontario or tributary watercourse within the limiting distance of the public water supply of the village of Lyndonville as previously defined, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry, garbage or stable wastes or sewage or excremental matter from any water closet, privy, receptacle or other source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided under paragraph (2) of this subdivision, shall be thrown, placed, led, discharged or allowed to escape or flow into Lake Ontario or tributary watercourse within the limiting distance of the intake of the public water supply of the village of Lyndonville, nor shall the same be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 100 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville, as previously defined.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined, shall be constructed, enlarged, altered or put in operation until plans for the same shall have been submitted to and approved by the State engineer and a permit issued by the State Commissioner of Health allowing the discharge of such effluent as required by law and a copy of the plans, as approved, filed with the board of trustees of the village of Lyndonville.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 50 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in Lake Ontario or any tributary watercourse within 500 feet of the intake of the public water supply of the village of Lyndonville, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in the lake nor be washed therein within this distance. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 25 feet from Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined, and none of the above named objects or sources of pollution shall be constructed, placed or allowed to remain where or in such manner that the drainings, leachings or washings therefrom may enter Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a less distance than 25 feet from Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village Lyndonville as previously defined.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville, as previously defined, nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Lyndonville within the limiting distance of the intake, as previously defined, nor shall such human excreta or compost of other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within the prohibited distance of 100 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville, as previously defined, and no manure or compost of any kind shall be thrown, placed, piled or spread upon the ground within a distance of 25 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into said lake or tributary watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines drainage for a distance of not less than 50 feet from Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed or discharged into Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville, nor shall the same be thrown, placed, discharged, maintained or allowed to remain on the surface of the ground or beneath the surface of the ground within 100 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(g) Fishing, boating and ice cutting.
No boating of any kind, or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Lake Ontario within 400 feet of the intake of the public water supply of the village of Lyndonville.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 100 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 100 feet of Lake Ontario or tributary watercourse within the limiting distance from the intake of the public water supply of the village of Lyndonville as previously defined.
(j) Inspections.
The board of trustees of the village of Lyndonville or such other board as may be charged with the maintenance or supervision of the public water supply of the village shall make regular and thorough inspections of Lake Ontario or tributary watercourses within the limiting distance of the intake of the public water supply as previously defined and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the reservoir, watercourses and drainage areas tributary to the public water supply of the village of Lyndonville at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of Chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 111 DELAWARE COUNTY
COMPANIES COMPANIES
10 CRR-NY 111.21 Stamford Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs and to all water courses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply furnished by the Stamford Water Company to the village of Stamford, Delaware County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Stamford.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the village of Stamford.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of Stamford.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Stamford.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Stamford, nor shall any such matter be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of Stamford.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the village of Stamford.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Stamford is prohibited. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Stamford.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or within 50 feet of any watercourse tributary to the public water supply of the village of Stamford, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Stamford.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Stamford, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir nor within 150 feet of any watercourse tributary to the public water supply of the village of Stamford, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or within 25 feet from any watercourse tributary to the public water supply of the village of Stamford.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage. leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the village of Stamford.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Stamford.
(g) Fishing, boating and ice cutting.
No boating of any kind, fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the village of Stamford.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the village of Stamford.
(j) Inspections.
The Stamford Water Company shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Stamford Water Company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the Stamford Water Company to promptly notify the State Commissioner of Health of such violations. The Stamford Water Company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.7 Other environmental factors
Upon request the developer shall provide the commissioner or his authorized representative with a report and such plans as may be needed, covering the following environmental factors:
(a) the method of solid waste collection and disposal;
(b) the extent to which proposed land uses and structures may cause air pollution;
(c) the methods for grading to prevent changes in soil percolation capacity and to provide for adequate collection and disposal of surface and ground water;
(d) the methods to prevent contravention of surface and ground water quality standards;
(e) the effect on the subdivision of environmental pollutants or hazards either on the property or from surrounding areas, resulting from such facilities, activities or conditions as industrial or commercial structures or operations, highways, solid waste disposal sites, swamps, quarries, sink holes, limestone deposits, gravel pits, airports, watercourses, agricultural uses, flood plains and unstable soil condition; and
(f) the potential effect of the subdivision on environmental factors in surrounding areas.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.13 Waiver
(a) The permit-issuing official may, upon written application and after review, grant a waiver from the specific provision of this Part in a specific case subject to the following conditions.
(1) The park, or portion thereof, was operated as a park prior to, and continuously since the effective date of the requirement being waived.
(2) Failure to comply with the specific provisions will not have any adverse effect on the health and safety of the park occupants or any other person.
(3) The waiver shall prescribe the terms, requirements or conditions for operation of the park under which the waiver is being issued.
(4) A waiver shall not be transferable or assignable.
(b) A waiver shall remain in effect until revoked by the permit-issuing official. Failure of the operator to comply with the terms, requirements or conditions for operating specified in the waiver shall constitute sufficient basis for revocation of the waiver.
(c) A copy of every waiver shall be submitted to the State Commissioner of Health at the time of issuance.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 109 COLUMBIA COUNTY
VILLAGES VILLAGES
10 CRR-NY 109.3 Village of Philmont
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 695 of the Laws of 1911, and as heretofore set forth, shall apply to Forest Pond and to all water courses entering or ultimately discharging into Forest Pond.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to Forest Pond and to the distributing reservoir of the Philmont water supply system and to any additional reservoirs that may be constructed in connection with the said water supply system.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than Forest Pond or the distributing reservoir), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the water supply of the said village of Philmont.
(3) Wherever a linear distance of structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 100 feet of any reservoir or watercourse of the water supply of the village of Philmont.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 200 feet of any reservoir or watercourse of the water supply of the village of Philmont.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances of 100 feet and 200 feet as provided by paragraphs (1) and (2) of this subdivision from which privy or other receptable the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacle permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances not less than 400 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 300 feet from the edge, margin or precipitous bank of any watercourse of said water supply.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow or subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse of the water supply of the village of Philmont, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow on to the surface of the ground or into the ground beneath the surface within 300 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed, rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the village of Philmont, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the village of Philmont within 100 feet of any such reservoir or within 75 feet of any such watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacle, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the village of Philmont.
(e) Bathing animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the village of Philmont, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the water supply of the village of Philmont; and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excreta, compost or other matter containing the same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 400 feet from any reservoir or 300 feet from any watercourse of the water supply of the village of Philmont; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, maintained, piled or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the village of Philmont without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the village of Philmont; not shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Forest Pond within 500 feet of the water supply intake of the village of Philmont, except that boating, fishing or ice cutting may be allowed on other parts of Forest Pond upon written permit issued by the board of trustees and in direct compliance with conditions of the permit issued by such board for the protection from contamination of said supply. Notices relative to the foregoing restriction shall be posted conspicuously by the village of Philmont.
(h) [Temporary housing.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the village of Philmont.
(i) [Cemeteries.]
No interment of a human body shall be made within 100 feet of any watercourse or within 200 feet of any reservoir of the public water supply of the village of Philmont.
(j) Inspection.
The board of water commissioners of the village of Philmont shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules or regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.4 Donor qualifications
(a) Except in the case of an autogeneic donation, a complete donor history shall be obtained prior to hematopoietic progenitor cell donation. A summary of the donor history obtained by a hematopoietic progenitor cell procurement service shall be provided to the physician performing the transplant for a determination of the cells' suitability for transplantation. The donor history, or in the case of cord blood donation, the history of the donor's biologic mother and, if available, the donor's biologic father, shall include, but not be limited to, information concerning:
(1) any acute respiratory disease;
(2) any infectious skin disease that creates a risk of contamination of the hematopoietic progenitor cells;
(3) any disease transmissible by hematopoietic progenitor cells insofar as can be determined by donor history;
(4) active tuberculosis or history of therapy therefor;
(5) history of malaria or travel to or residence in malarially endemic areas for periods of time considered to bear increased risks for malaria exposure, as determined by criteria established by the procurement or collection facility, consistent with criteria developed by the United States Public Health Service;
(6) known coagulation of platelet disorders;
(7) any medical condition, which may be affected adversely by the collection procedure;
(8) any medical condition, including a malignancy, that would adversely affect the quality of the hematopoietic progenitor cells collected;
(9) receipt of an organ transplant or a transfusion of blood or blood components within the past 12 months;
(10) indications of drug or alcohol abuse; and
(11) other medical conditions or circumstances as determined by the medical advisory committee and medical director of the procurement service.
(b) Except in the case of an autogeneic donation or cord blood donation, a complete physical examination of the donor shall be performed by the medical director of the procurement service or another qualified physician.
(c) For autogeneic donations, testing for syphilis, hepatitis B surface antigen (HBsAg), antibody to human immunodeficiency virus type 1 (anti-HIV-1) and antibody to human immunodeficiency virus type 2 (anti-HIV-2) shall be performed, unless already performed within the previous 30 days, or unless the hematopoietic progenitor cells are collected, processed and transfused at the same facility and a system is in place to ensure disposition to the intended recipient.
(d) For allogeneic hematopoietic progenitor cell donations in New York State, specimens of blood shall be collected from the donor, or in the case of umbilical cord blood, from the donor's mother, and the following tests shall be performed in a clinical laboratory under permit by the department. For out-of-state donations, all required clinical laboratory testing shall be performed by a laboratory which is approved by the regulatory authority in the state or jurisdiction where the laboratory is located, or by the department:
(1) within 30 days prior to or 72 hours after donation, and prior to initiation of the transplant conditioning regimen in the recipient:
(i) direct tests for indicators of infection with syphilis and cytomegalovirus (CMV);
(ii) HbsAg;
(iii) antibody to hepatitis B core antigen (anti-HBc), antibody to hepatitis C virus (anti- HCV), anti HIV-1, anti-HIV-2, and antibody to human T-cell lymphotropic virus type 1 (anti-HTLV-1); and
(iv) except for cord blood donation, peripheral blood cell enumeration (red, white and platelet) and differential blood smear evaluation;
(2) prior to ablation of the recipient, major histocompatibility antigens (HLA-A,B and DR) and other minor histocompatibility antigens, including mixed lymphocyte culture or DNA typing, as indicated.
(e) Except for allogeneic donors confirmed positive for any indicator of HIV infection, the decision as to the acceptability of hematopoietic progenitor cells shall be made by the hematopoietic progenitor cell transplantation service director. Hematopoietic progenitor cells from allogeneic donors confirmed positive for any indicator of HIV infection may not be used in any case.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.18 Service intensity weights (SIW) and average length-of-stay (LOS)
(a) The table of SIWs and statewide average LOS for each effective period is published on the New York State Department of Health website at: http://www.health.state.ny.us/and reflects the cost weights and LOS assigned to each all-patient refined (APR) diagnosis related group (DRG) patient classification category. The SIWs assigned to each APR/DRG indicates the relative cost variance of that APR/DRG classification from the average cost of all inpatients in all APR/DRGs. Such SIWs are developed using three years of Medicaid fee-for-service cost data, Medicaid managed care data and commercial third party payor data as reported to the Statewide Planning and Research Cooperative System (SPARCS) for the years set forth in subdivision (b) of this section. Costs associated with hospitals that do not have an ancillary charge structure or associated with hospitals and services exempt from the case payment methodology, and costs associated with statistical outliers are excluded from the SIW calculations.
(b) For periods on and after December 1, 2009, the SIW and statewide average LOS table shall be computed using SPARCS and reported cost data from the 2005, 2006 and 2007 calendar years as submitted to the department by September 30, 2009.
(c) For periods on and after January 1, 2011, the SIW and statewide average LOS table shall be computed using SPARCS and reported cost data from the 2006, 2007 and 2008 calendar years as submitted to the department by June 30,2010.
(d) For each calendar year thereafter, the SIW and statewide average LOS table shall be updated by dropping the earliest year of SPARCS data and including the next subsequent calendar year data as submitted to the department by September 30th of the year prior to the rate year.
(e) For the period beginning January 1, 2014 and ending, at the discretion of the commissioner, no sooner than April 1, 2014, but no later than July 1, 2014, the SIWs and statewide average LOS utilized for the 2013 calendar year will be utilized by the department.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.11 Inpatient rehabilitation programs for traumatic brain-injured patients
(a) This methodology will be utilized to evaluate certificate of need applications involving the initiation of inpatient rehabilitation programs for traumatic brain-injured patients. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of inpatient rehabilitation programs for traumatic brain-injured patients. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate number of inpatient traumatic brain-injured rehabilitation programs and beds are available to provide access to care and avoid the unnecessary duplication of resources.
(b) Inpatient rehabilitation programs for traumatic brain-injured patients are intensive rehabilitation programs designed to prevent and/or minimize chronic disabilities while restoring the individual to the optimal level of physical, cognitive, and behavioral functioning. These programs are applicable to those individuals who have severe disabling impairments of recent onset and are able to participate daily (at least five days per week) in multi-disciplinary programs for a minimum of three hours per day.
(c) The factors and methodology for determining the public need for inpatient rehabilitation programs for traumatic brain-injured patients shall include, but not be limited to, the following:
(1) The service area for determining the public need for inpatient rehabilitation programs for traumatic brain-injured patients shall be the designated health systems agency regions.
(2) The maximum number of inpatient rehabilitation beds for traumatic brain-injured patients in each health systems agency region required to meet the public need shall be determined by dividing the projected annual patient days for the service by 365, and dividing the result by 0.90 to allow for 90-percent occupancy. The projected inpatient rehabilitation patient days for traumatic brain-injured patients used in this calculation shall be determined as follows:
(i) The diagnostic categories used in computing the need for inpatient rehabilitation beds for traumatic brain-injured patients shall be: brain dysfunction, traumatic brain dysfunction and skull fracture.
(ii) The annual number of potential candidates for inpatient rehabilitation programs for the traumatic brain-injured shall be determined by calculating the total numbers of annual general hospital discharges from the categories considered, plus an additional 10 percent, and multiplying the resulting figure by 0.155.
(iii) The number of potential candidates for inpatient rehabilitation programs for the traumatic brain-injured shall be multiplied by an 85-day rehabilitation length-of-stay to project the annual number of inpatient rehabilitation days for traumatic brain-injured patients.
(iv) A traumatic brain-injured rehabilitation program that is organized as a specialized unit within a comprehensive inpatient physical medicine and rehabilitation program shall have a minimum of 10 beds. A traumatic brain-injury rehabilitation program that is organized as a freestanding inpatient rehabilitation program shall have a minimum of 20 beds.
(v) The Health Systems Agencies may make adjustments to these bed need estimates to address patient migration patterns and other regional planning issues.
(3) Where public need is established herein, and in addition to meeting the operating requirements of either section 405.18(e) of this Title (traumatic head-injury programs of general hospitals) or section 415.36 of this Title (long-term inpatient rehabilitation program for head-injured residents in nursing homes), priority consideration will be given to applicants that:
(i) Demonstrate a commitment to developing and participating in an area-wide network of service organizations which provide and coordinate a full array of rehabilitation, support, education, vocational rehabilitation, recreation, housing, case management and social services for persons with traumatic brain injuries.
(ii) Have a coma recovery care program for brain-injured patients who are unable to participate in an active rehabilitation program or have a transfer agreement with a facility that has a coma recovery care program for traumatic brain-injured patients. The number of coma recovery care beds needed in each health systems agency region shall be determined by the ratio of six beds per 1.5 million population.
(iii) Have an extended care program for traumatic brain-injured patients who are unable to participate in an active rehabilitation program or a transfer agreement with a facility that has an extended care program for traumatic brain-injured patients.
(iv) Will provide access to New York State Medicaid recipients or to patients or residents who are likely to become Medicaid-eligible.
(v) Demonstrate a commitment to serve the medically indigent and patients regardless of the source of payment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-8 HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING
10 CRR-NY 58-8.2 HIV testing and recordkeeping requirements
In addition to other applicable requirements in this Part, and Parts 52 and 63 of this Title, clinical laboratories, blood banks and tissue banks with a New York State clinical laboratory permit to perform HIV testing shall meet the following requirements:
(a) Specimens for testing patients, donors and insurance applicants shall be only of the type approved by the FDA or acceptable to the department for use with the particular method or test kit.
(b) All tests shall employ reagents, methods, techniques and procedures approved by the FDA or acceptable to the department in conformance with generally accepted laboratory principles.
(c) If the test result is to be communicated to the test subject or other person legally authorized to receive the result, results for specimens found reactive in accordance with the test manufacturer's interpretation of HIV antibody screening test results shall be confirmed with HIV confirmatory testing.
(d) Confirmatory testing shall be performed as soon as practicable in all cases when notification of a preliminary finding of HIV infection is made.
(e) A standard operating procedure manual (SOPM) shall be developed and maintained current, and shall include, in addition to documentation required elsewhere in this Part and Part 52 of this Title, algorithms for use of each HIV test method or test kit, and policies and processes for accepting specimens, reporting results, and ensuring compliance with confidentiality requirements and, as applicable, reporting requirements of article 21, title III and article 27-F of the Public Health Law and New York State Insurance Law, section 2611(c).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.81 Food-contact surface construction
Food-contact surfaces are to be constructed of safe materials which will not contaminate or otherwise affect food. Such materials are to be resistant to denting, buckling, pitting, chipping, distortion, cracking and crazing, and are to be smooth, easily cleanable, and free from breaks, open seams, cracks, chips, pits and similar imperfections. Food-contact surfaces are to be free from difficult-to-clean internal corners and crevices. and are to be readily accessible for cleaning.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.131 Prescription, sale and possession of hypodermic syringes and hypodermic needles
(a) For purposes of this section, prescription shall have the same meaning as provided in section 3302 of the Public Health Law, as supplemented by the meaning provided in section 3381 of the Public Health Law. It shall be unlawful for any person to sell or furnish, to any other person or persons, or to possess, a hypodermic syringe, hypodermic needle, or a hypodermic syringe or hypodermic needle pre-filled with a non-controlled substance, except:
(1) pursuant to a prescription; or
(2) such sale, furnishing or possession has been authorized by the commissioner; or
(3) pursuant to section 80.137 of this Part.
(b) Subject to the provisions of this section, a practitioner may orally prescribe or authorize a refill, and an employee of the prescribing practitioner, or a health care professional in a Residential Health Care Facility (RHCF) who is licensed by the State Education Department pursuant to the Education Law, may orally communicate a prescription or refill for, one or more hypodermic syringes or hypodermic needles. Subject to the provisions this section, a pharmacist may dispense, to an ultimate user, such hypodermic syringes or hypodermic needles; provided, however, the pharmacist shall:
(1) contemporaneously reduce such oral prescription to a written or electronic memorandum indicating the name, address and telephone number of the prescriber, the name, address, and age of the ultimate user, date on which the hypodermic syringe or hypodermic needle was ordered, quantity prescribed, directions for use, the name and strength of the drug, if applicable, number of refills authorized, the signature or readily identifiable initials of the pharmacist accepting the oral memorandum and documenting the fact that it is a telephone order;
(2) indicate on the memoranda the date filled and the number of the prescription under which it is recorded in the pharmacy prescription file, and sign or electronically sign the memorandum; and
(3) make a good faith effort to verify the identity of the practitioner and the practitioner's employee or RHCF professional, if applicable, and the ultimate user, if not known to the pharmacist.
(c) A prescription for one or more hypodermic syringes or hypodermic needles shall include:
(1) the name, address and age of the ultimate user;
(2) the name, address, telephone number and signature or electronic signature of the practitioner;
(3) the date on which it was issued; and
(4) the name, and strength of the drug, if applicable, the directions for use, the quantity of the hypodermic syringes or hypodermic needles prescribed, and the number of authorized refills.
(d) Any pharmacist selling or furnishing a hypodermic syringe or hypodermic needle pursuant to a prescription shall record upon the prescription, his or her signature or, as applicable, electronic signature, and the date of the sale or furnishing of the hypodermic syringe or hypodermic needle. Prescriptions and oral prescription memorandums shall be retained on file for a period of five years and be readily accessible for inspection by any public officer or employee engaged in the enforcement of this section. A prescription may be refilled not more than the number of times specifically authorized by the prescriber upon the prescription; provided, however, no such authorization shall be effective for a period longer than two years from the date the prescription is signed.
(e) A pharmacist receiving an oral authorization for the refill of a prescription for one or more hypodermic syringes or hypodermic needles shall enter on the original prescription or electronic record maintained on an electronic data processing system, the date, time, and name of the authorizing practitioner and the name of the practitioner’s employee or RHCF professional, if applicable, and shall sign or electronically sign such record.
(f) Pharmacists at registered pharmacies may, at the express request and approval of a patient or a person authorized to act on behalf of the patient, and subject to the requirements of 8 NYCRR section 63.6(a)(8), transfer information relating to a prescription for one or more hypodermic syringes or hypodermic needles, including a prescription for one or more hypodermic syringes or hypodermic needles pre-filled with a non-controlled substance, or accept a transfer of such information from another registered pharmacy or a pharmacy authorized to do business in another jurisdiction for the exclusive purpose of providing one authorized refill per transfer.
(g) Any prescription for one or more hypodermic syringes or hypodermic needles prefilled with a controlled substance shall be issued and dispensed according to the requirements as set forth in sections 80.67, 80.68, 80.69, 80.70, 80.73 and 80.74 of this Part.
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.75 Institutional dispensers
(a) Institutional dispensers licensed by the department may cause controlled substances to be administered or dispensed for use on the premises only pursuant to a written order by a practitioner for such medication. A prescription is not required for inpatient use. In an emergency situation in which a physician determines that it is necessary to transfer a critically ill patient from one hospital to an alternative medical facility, an institutional dispenser may cause a single dose of a controlled substance to be dispensed to the medical attendant accompanying the patient if the duration of the transfer may reasonably be expected to exceed three hours.
(b) An institutional dispenser may dispense controlled substances for use off its premises only pursuant to a prescription issued by a practitioner. All such prescriptions for outpatient use shall be filled only in a hospital pharmacy or other registered pharmacy. However, a practitioner in the emergency room of a hospital without a full-time pharmacy and when the services of a registered pharmacy are not available may dispense controlled substances to a patient in an emergency situation. For the purposes of this subdivision, an emergency means that the immediate dispensing of the controlled substance is necessary and no alternative treatment is available. The practitioner may dispense no more than a 24-hour supply in accordance with directions for use and must conform with the applicable labeling requirements of section 80.71 of this Part.
(c) Official New York prescription forms are available for use by institutional dispensers. Institutional dispensers shall register with the department to be issued official prescriptions.
(1) The registration application for an institutional dispenser shall include but not be limited to the requesting institution's name, primary or other practice site address(s), the Federal registration number or exemption certificate, where applicable, a State agency license number, if applicable, and shall be signed by a person authorized by the institution to request such forms.
(2) An institutional dispenser's registration shall be without fee and subject to approval by the department. Such registration shall be valid for a period of two years.
(3) An institutional dispenser registered to be issued official prescription forms shall order such forms in the manner required by the department. The number of prescriptions requested by the institution shall be subject to approval by the department and shall be issued free of charge in the manner and quantity approved by the department.
(4) Official prescription forms shall be sent to the institutional dispenser's primary address. Primary address is the address of a registered institution's Federal Drug Enforcement Administration (DEA) registration or, if such facility is not required to be registered with DEA, an address designated as the primary address in the facility's registration with the department.
(d) Staff practitioners are required to use such forms to prescribe controlled substances for outpatient use, indicating the practitioner's Drug Enforcement Administration registration number on the form. Staff practitioners may create, sign and transmit electronic prescriptions for controlled substances for outpatient use provided the practitioner complies with all other requirements for issuing controlled substance prescriptions in this Part and with Federal requirements for electronic prescribing of controlled substances. A prescription generated on an electronic system that is printed out or transmitted via facsimile is not considered an electronic prescription and shall be manually signed.
(e) Interns or residents are required to use the Drug Enforcement Administration registration number of the institution and the code number assigned by the institution for such purpose. Any practitioner who is an intern, resident or foreign physician may dispense and prescribe controlled substances under the registration of the hospital or other institution which is registered and by whom the physician is employed, provided that:
(1) the dispensing or prescribing is in the usual course of his professional practice;
(2) the practitioner is authorized or permitted to do so by the laws of New York State;
(3) the hospital or institution has determined that the practitioner is permitted to dispense or prescribe drugs in New York State;
(4) the practitioner acts only within the scope of his employment in the hospital or institution; and
(5) the hospital or institution authorizes the intern, resident, or foreign physician to dispense or prescribe under its registration number and assigns a specific code number for each practitioner so authorized.
(f) It is the responsibility of the dispensing institution to obtain all official prescriptions for outpatient use and to assign such prescriptions to staff practitioners and interns and to insure the security of all such official prescriptions. Institutions obtaining official New York State prescriptions shall establish a system of control and security which will include the following:
(1) A record of all such prescriptions received.
(2) A record of all such prescriptions assigned to staff practitioners.
(3) A system requiring that such prescriptions be kept under lock and key when not in use.
(4) A system whereby official prescriptions are surrendered to the institution if the practitioner to whom they were assigned terminates his affiliation with the institution.
(5) A system whereby the Bureau of Narcotic Enforcement, New York State Department of Health, is notified immediately of the loss, destruction or theft of any such official prescriptions assigned to the institution.
(6) A system whereby the institution has a sufficient number of official prescriptions in reserve for use by the institution.
(g) Staff practitioners, interns, residents, or foreign physicians who are authorized to dispense or prescribe controlled substances in a hospital or other institution and use the institution's official New York State prescription forms, other hospital or institutional forms, or the institution’s electronic prescribing application must conform to the requirements of sections 80.67, 80.69 and 80.71 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.126 Fellow
A graduate of a medical/osteopathic/dental school who has had an advanced period of graduate training and is in a fellowship program in a subspecialty or in a clinical research program.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 453 MANDATORY REPORTING LEVELS
10 CRR-NY 453.2 Mandatory sublevels
In addition to the basic listing, the following additional sublevels of detail are mandated in certain areas. The circumstances under which such additional sublevels are required are outlined in subdivision (f) of this section.
(a) Financial Classification.
(1) Self-Pay.
(2) Medicare Part A.
(3) Medicare Part B.
(4) Medicaid.
(5) Other.
(b) Patient Service Category.
(1) Residential Health Care Facility.
(2) Domiciliary Care Facility.
(3) Adult Day Health Care.
(4) Outpatient Clinic.
(5) Home Health Services.
(6) Homemaker.
(7) Meals on Wheels.
(8) Intermediate Care Facility—Mental Retardation.
(9) Independent Living.
(10) Specialty Pediatric.
(11) Head Injury.
(12) Acquired Immune Deficiency Syndrome.
(13) Respite Care.
(14) Long-term Ventilator Dependent.
(c) Natural Classification of Expenses.
(1) Salaries and Wages.
(i) Management and Supervision.
(ii) Technicians, Specialists, and Non-Physician Medical Practitioners.
(iii) Registered Nurses.
(iv) Licensed Practical Nurses.
(v) Aides, Orderlies and Assistants.
(vi) Clerical and Other Administrative Employees.
(vii) Environment, Hotel and Food Service Employees.
(viii) Physicians.
(ix) Interns, Residents and Fellows.
(2) Employee Benefits.
(i) Employee Uniform Allowance.
(ii) FICA.
(iii) State Unemployment and Federal Unemployment Insurance.
(iv) Group Health Insurance.
(v) Pension and Retirement—Union.
(vi) Workers' Compensation Insurance.
(vii) Pension and Retirement—Nonunion.
(viii) Disability.
(ix) Other Employee Benefits.
(x) Union Health and Welfare.
(xi) Employee Meal Allowance.
(3) Fees.
(i) Administrative Fees—Long-Term Debt.
(ii) Physicians Fees.
(iii) Therapists and Other (Non-Physicians).
(iv) Consulting and Management Services.
(v) Legal Services.
(vi) Auditing Services.
(vii) Registered Nurses.
(viii) Licensed Practical Nurses.
(ix) Private Duty Nurses Fees.
(x) Other Fees.
(4) Supplies and Materials.
(i) Disposable Linen.
(ii) Prescription Drugs.
(iii) Medicine Cabinet Drugs.
(iv) Other Medical Care Materials and Supplies.
(v) Dietary—Food.
(vi) Dietary—Other.
(vii) Linen and Bedding.
(viii) Cleaning Supplies.
(ix) Office and Administrative Supplies.
(x) Employee Wearing Apparel.
(xi) Instruments and Minor Medical Equipment.
(xii) Minor Nonmedical Equipment.
(xiii) Other Supplies and Materials.
(5) Purchased and Contracted Services.
(i) Repairs and Maintenance—Purchased Services—Nonassignable.
(ii) Medical—Purchased Services.
(iii) Repairs & Maintenance—Purchased Services—Directly Assignable.
(iv) Management Services.
(v) Collection Services.
(vi) Other Purchased Services.
(vii) Contracted Services.
(6) Depreciation, Rentals and Leases.
(i) Depreciation and Amortization.
(ii) Rental or Lease—Land.
(iii) Rental or Lease—Buildings.
(iv) Rental or Lease—Fixed Equipment.
(v) Rental or Lease—Movable Equipment.
(7) Other Direct Expenses.
(i) Electricity.
(ii) Gas.
(iii) Water and Sewer.
(iv) Fuel Oil #2.
(v) Fuel Oil #4.
(vi) Fuel Oil #6.
(vii) Other Utilities.
(viii) Insurance.
(ix) Interest.
(x) Licenses and Taxes (Other than Income Taxes).
(xi) Telephone and Telegraph.
(xii) Dues to Nursing Home Association.
(xiii) Printing, Duplicating, Microfilming.
(xiv) Travel, Conferences, Workshops.
(xv) Books, Periodicals, etc.
(xvi) Other Direct Expenses.
(8) Assessments.
(i) Assessments from Municipalities or Religious, Educational, Foundations or Other Associations.
(d) Charges by type.
(1) Routine, representing room and board charges.
(2) Ancillary, by type.
(i) Laboratory.
(ii) Electrocardiology.
(iii) Electroencephalogy.
(iv) Radiology.
(v) Inhalation Therapy.
(vi) Podiatry.
(vii) Dental.
(viii) Psychiatric.
(ix) Physical Therapy.
(x) Occupational Therapy.
(xi) Speech and Hearing Therapy.
(xii) Pharmacy.
(xiii) Central Service Supply.
(xiv) Medical Staff Services.
(xv) Other.
(e) Fund Classification.
(1) Unrestricted Operating Fund.
(2) Unrestricted Board-Designated Fund.
(3) Plant Replacement and Expansion Fund.
(4) Specific Purpose Fund.
(5) Endowment Fund.
(6) Other.
(f) Application of preceding sublevels of detail.
(1) For Patient Service Revenues, the following sublevels are mandated:
(i) Where a facility records patient charges on a fee-for-service basis, such charges must be reported by type (subdivision [d] of this section) in accordance with the functional reporting center descriptions in Part 455 of this Article.
(ii) Where a facility records patient charges on an all-inclusive or flat-rate basis, such charges would all be reported as Routine Patient Service Revenue.
(iii) Regardless of a facility's charge structure, charges must also be reported by Patient Service Category, subdivision (b) of this section.
(2) For Deductions From Revenue, the following sublevels are mandated:
(i) Financial Classification, subdivision (a) of this section.
(ii) Patient Service Category, subdivision (b) of this section.
(3) For Expenses, the sublevel of natural classification of expense, subdivision (c) of this section, is mandated. Such Natural Classification of Expenses is described in detail in Part 458 of this Article.
(4) For Assets, Liability and Fund Balances/Equity Accounts, the sublevel of Fund Classification, subdivision (e) of this section, is mandated.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.70 Use of body scanning
(a) This section shall not apply in cities having a population of two million or more.
(b) Practitioners licensed under article 35 of the Public Health Law and unlicensed personnel employed at a local correctional facility may utilize body imaging scanning equipment that applies ionizing radiation to humans for purposes of screening inmates committed to such facility, solely in connection with the implementation of such facility's security program and in accordance with the provisions of this Part.
(c) Definitions.
(1) Body imaging scanning equipment or equipment means equipment that is specifically manufactured for security screening purposes and utilizes a low dose of ionizing radiation, with a maximum exposure per scan equal to or less than 10 µSv (1 mrem), to produce an anatomical image capable of detecting objects placed on, attached to or secreted within a person's body. The utilization of body imaging scanning equipment is for purposes of screening inmates committed to such facility, in connection with the implementation of such facility's security program.
(2) Local correctional facility shall mean a local correctional facility as defined in Correction Law section 2(16).
(3) Equipment operator or operator means personnel employed at the local correctional facilities that have successfully completed a training course approved by the department.
(4) Screening means the sum of radiation exposures or scans necessary to image objects concealed on all sides of the body as intended by the system design under normal conditions.
(d) Equipment use and installation requirements.
(1) Prior to the equipment’s first use on humans at a specific physical location or upon any major repairs that could influence image quality or exposure:
(i) body imaging scanning equipment purchased or installed at a local correctional facility must be registered with the department, in accordance with section 16.50 of this Part; and
(ii) radiation protection survey, shielding evaluation and verification of image usefulness for detecting foreign objects must be completed by a licensed medical physicist.
(2) Equipment must have a clearly marked restricted area and one or more indicators when a scan is in process that is clearly visible to all security screening system operators and anyone approaching the restricted area.
(3) Equipment must be periodically inspected by the department as described in section 16.10 of this Part.
(4) Equipment must be tested by a licensed medical physicist annually to verify the equipment is operating as designed.
(5) The facility must maintain a policy and procedure manual describing equipment operations, body scanning procedures, records and associated facility policies shall be maintained and available upon request by the department. The policy and procedure manual must include the following items:
(i) operating procedures appropriate for the specific equipment and intended scan types;
(ii) policy prohibiting the use of the equipment on individuals who are not inmates;
(iii) policy regarding the determination of pregnancy that has been approved by the jail physician;
(iv) emergency contact information in the event the equipment overexposes any individual or there is equipment related failure that potentially requires service prior to scanning other inmates;
(v) requirements for exposure records to be provided to an inmate upon release or transfer to another facility; and
(vi) exposure per scan for each scan protocol used.
(6) Records and documentation of the program operation shall be maintained in accordance with section 16.14 of this Part and shall include, at a minimum, the following:
(i) the number of times the equipment was used on inmates upon intake, after visits, and upon the suspicion of contraband, as well as any other event that triggers the use of such equipment;
(ii) the average, median, and highest number of times the equipment was used on any inmate, with corresponding exposure levels;
(iii) the number of times the use of the equipment detected the presence of drug contraband, weapon contraband, and any other illegal or impermissible object or substance; and
(iv) the number of times an inmate has been scanned.
(e) Exposure limits and reporting requirements.
(1) No person other than an inmate of a local correctional facility shall be exposed to the useful beam and then only by an individual that has met the provisions of subdivision (f) of this section.
(2) Limits on the use of equipment and exposure to inmates are:
(i) no more than 50 percent of the annual exposure limits for non-radiation workers as specified by applicable regulations, not to exceed 0.5 mSv (50 mrem);
(ii) inmates under the age of 18 shall not be subject to more than 5 percent of such annual exposure limits, not to exceed 0.05 mSv (5 mrem); and
(iii) pregnant women shall not be subject to scanning at any time.
(3) The following events shall be reported to the department in writing within 30 days:
(i) incidents or any injuries or illness resulting from the use of such equipment or reported by persons scanned by such equipment; and
(ii) exposure that exceeds the limits set forth in this Part.
(f) Training requirements.
(1) Every equipment operator shall receive initial operator training, to be provided by the equipment manufacturer or their approved representative, or another source approved by the department.
(2) The contents of the initial operator training must include radiation safety, equipment operations, exposure and exposure limits for occupational exposed staff and inmates; applicable regulations; and facility policies and procedures.
(3) Initial operator training must be documented and available for review by the department upon request. Such documentation must include the names of the presenter or sources, attendees, dates and contents of the training.
(4) Every equipment operator shall receive refresher training, to be provided by the equipment manufacturer or their approved representative, or another source approved by the department. Such training shall meet the requirements listed in paragraphs (1), (2) and (3) of this subdivision and include any changes to the policies and procedures manual or updates to the regulations.
10 CRR-NY 16.103 General requirements for issuing specific licenses
The department will approve an application for, and issue in response thereto, a specific license to transfer, receive, possess and use any radioactive material, if the department determines that the following requirements have been met:
(a) the applicant's proposed use, equipment, facilities and procedures will protect public health and safety, and will minimize danger to life and property, from radiation hazards;
(b) the applicant's radiation detection and measuring instrumentation is appropriate for the uses of radioactive materials requested in the application;
(c) the applicant, (or the applicant's personnel if the applicant is not an individual), is qualified by training and experience to use such radioactive material for each purpose covered by the application so as to protect public health and safety and to minimize danger to life and property from radiation hazards; and
(d) the applicant submits sufficient information to support a determination that the requirements of this section are satisfied.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY
10 CRR-NY 85.4 One-day presurgical stay limitation
(a) To be a covered benefit under medical assistance for the needy, provided in section 365-a(5)(d) of the Social Services Law, any presurgical hospital stay of more than one day for surgical benefits covered by sections 365-a(5)(b) and 365-a(5)(c) shall require a determination of coverability prior to admission by a person designated by the Commissioner of Health. Such determination of coverability shall be for a specified maximum period of presurgical stay. A written request for such determination shall be made by the patient's surgeon, proposing the total length of presurgical stay, and citing conditions requiring such exceptional stay. A determination of coverability shall be based upon existence of conditions which require inpatient preparation of more than one day to improve operative risk status such as:
(1) correction of significant fluid or electrolyte imbalance.
(2) transfusion to correct significant anemia.
(3) stabilization of congestive heart failure.
(4) improvement of pulmonary function or drainage.
(5) hyperalimentation to correct significant malnutrition.
(6) gastro-intestinal preparation before gastrointestinal surgery.
(7) stabilization of significant endocrine disorder.
(8) hematologic and immunologic preparation for organ transplant.
(9) management of infection.
(10) essential preliminary studies and procedures performable only on an inpatient basis.
(b) Determination of coverability shall be made by a designated physician or non-physician under physician supervision. A determination of non-coverability shall be made only by a designated physician. Notice of determination shall be given to the patient's physician who shall, in case of extended coverability, incorporate such notice in the patient's medical record at admission. No presurgical stay of more than one day will be a covered benefit without such prior determination of coverability and its incorporation in the patient's medical record.
(c) The patient's physician may appeal any determination of non-coverability to a physician or physicians designated by the commissioner for such purpose. Notification of decision on appeal shall be given to the patient's physician, who shall incorporate such notification in the patient's medical record at admission.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.14 Dietary services
The facility shall provide each resident with a nourishing, palatable well-balanced diet that meets the daily nutritional and special dietary needs of each resident.
(a) Direction.
The facility shall employ a qualified dietitian either full-time, part-time or on a consultant basis who shall be responsible for the nutrition services in the nursing home.
(1) The facility shall designate a qualified dietitian or a dietetic service supervisor qualified on the basis of education, training and experience in food service management to serve as the director of food service. If the director of food service is not a qualified dietitian, such individual shall receive frequently scheduled consultation from a qualified dietitian.
(2) A qualified dietitian is one who is qualified based upon:
(i) registration by the Commission on Dietetic Registration of the American Dietetic Association;
(ii) education, training, and experience in identification of dietary needs, planning and implementation of dietary programs; or
(iii) certification as a certified dietitian or certified nutritionist in accordance with article 157 of the Education Law.
(b) Sufficient staff.
The facility shall employ sufficient professional and support personnel competent to carry out the functions of the dietary service.
(1) The availability of qualified dietitian services shall be related to the number of beds in the nursing homes, the amount and type of dietary supervision required, and the complexity of resident needs and additional full- or part-time qualified dietitians shall be utilized commensurate with such factors. Each resident's nutritional care shall be under the direction of a qualified dietitian.
(2) The facility shall utilize one or more dietetic service supervisor(s) with consultation by a qualified dietitian to manage the food service in the absence of the qualified dietitian.
(c) Menus and nutritional adequacy.
(1) Menus shall meet the nutritional needs of residents in accordance with dietary allowances that meet generally recognized standards of care and shall take into account the cultural background and food habits of residents.
(i) The facility shall have an effective means of recording and transmitting to the food service diet orders and changes; and
(ii) The facility shall maintain a current list of residents identified by name, location and diet order and such identification shall accompany each resident' s meal when it is served.
(2) Menus shall be prepared in advance in accordance with a diet manual acceptable to the medical, nursing and dietary services and retained for one year from the date of serving.
(3) Menus shall be followed.
(d) Food.
Each resident shall receive and the facility shall provide:
(1) food prepared by methods that conserve nutritive value, flavor and appearances;
(2) food that is palatable, attractive, and at the proper temperature;
(3) food prepared in a form designed to meet individual needs; and
(4) substitutes offered of similar nutritive value to residents who refuse food served.
(e) Therapeutic diets.
Therapeutic diets shall be prescribed by the attending physician, when indicated, based on the findings of the comprehensive resident assessment.
(f) Frequency of meals.
(1) Each resident shall receive and the facility shall provide at least three substantial meals daily, at regular times comparable to normal mealtimes in the community.
(2) There shall be no more than 14 hours between a substantial evening meal and breakfast the following day, except as provided in paragraph (4) of this subdivision.
(3) The facility shall offer snacks at bedtime daily.
(4) If a nourishing snack as determined by a qualified dietitian in accordance with generally accepted standards of care, is provided at bedtime, up to 16 hours may elapse between a substantial evening meal and breakfast the following day provided that a resident group agrees to this meal span and a nourishing snack is served.
(g) Assistive devices.
The facility shall provide assistance with eating and special eating equipment and utensils for residents who need them.
(h) Sanitary conditions.
The facility shall store, prepare, distribute and serve food under sanitary conditions; and in accordance with the sanitary requirements of Part 14 (Service Food Establishments) of Chapter I (State Sanitary Code) of this Title.
(i) Kosher food.
The facility shall provide, as part of the basic services, kosher food or food products prepared in accordance with the Hebrew Orthodox religious requirements when the resident, as a matter of religious belief, desires to observe Jewish dietary laws; and shall:
(1) establish a plan and procedure for obtaining, preparing and serving kosher foods and food products in accordance with Hebrew Orthodox religious requirements;
(2) incorporate the provision of kosher food and food products prepared in accordance with Hebrew Orthodox religious requirements into the resident's comprehensive care plan; and
(3) assure that employees who are involved with such plan of care are trained in the procedures that satisfy Hebrew Orthodox dietary requirements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.15 Waiver of rules
Any of the foregoing rules may be waived by agreement of the parties or, if a hearing has convened, by agreement of the parties and with consent of the hearing officer.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 711 GENERAL STANDARDS OF CONSTRUCTION
10 CRR-NY 711.1 Applicability
(a) This Part sets forth minimum construction and physical environment standards applicable to all health facilities subject to Public Health Law article 28, including but not limited to, general hospitals, nursing homes and ambulatory care facilities.
(b) An applicant seeking approval to construct a new health facility or alter or renovate an existing health facility shall submit to the department a completed application and functional program. The applicant shall ensure that all terms and acronyms are clearly defined and consistently used in the application and functional program. The functional program, which is a detailed architectural and design plan for the health facility, shall include a description of the following:
(1) the scope and purpose of the proposed construction project and other basic information relating to fulfillment of the applicant's objectives;
(2) the services necessary for the complete operation of the health facility, the size and function of each space, any special design features, the projected occupant load, and numbers and types of staff, patients, residents, visitors and vendors;
(3) the types and projected numbers of procedures to be performed in each treatment area and circulation patterns for staff, patients or residents, and the public;
(4) the projected demand or utilization, staffing patterns, departmental relationships, space requirements, and circulation patterns that are a function of infection control requirements and for clean and soiled materials;
(5) equipment requirements, including building service equipment and fixed and moveable equipment; and
(6) potential future expansion that may be needed to accommodate increased demand.
(c) Once approved by the department, the functional program and the approved plans and specifications developed from it shall be used in the development, design and construction of the project and serve as the basis for all subsequent construction approvals regarding the specific project. The applicant or health facility operator shall retain and make available to the department, upon the department's request, the functional program, all government approved plans and specifications developed from it and any other design data to facilitate alterations, and program changes.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.117 Estimated useful life
Expected operating or service life of an asset or asset group in terms of utility to the institution.
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.2 Definitions
For purposes of this Part, the following terms shall have the following meanings:
(a) Advanced home health aide is a certified home health aide who has satisfied all requirements to perform advanced tasks set forth in subdivision (2) of section 6908 of the Education Law and regulations issued by the State Education Department thereunder and who is currently listed in the home care services worker registry maintained by the department pursuant to subdivision (9) of section 3613 of the Public Health Law as having satisfied all applicable requirements for performing advanced tasks as an advanced home health aide. An advanced home health aide shall have successfully completed a training program for advanced home health aides that is approved by the department or the State Education Department.
(b) Commissioner means the Commissioner of Health of the State of New York.
(c) Department means the New York State Department of Health.
(d) Home care services entity or entity means:
(1) a home care services agency or other entity providing home care services subject to article 36 of the Public Health Law or exempt under section 3619 of such law;
(2) for purposes of compliance with the home care worker registry, an enhanced assisted living residence licensed under article 7 of the Social Services Law and certified under article 46-B of the Public Health Law and providing enhanced assisted living services; and
(3) for purposes of compliance with the home care worker registry, a hospice program certified under article 40 of the Public Health Law and providing hospice care.
(e) Home care services worker or worker means any person engaged in or applying to become engaged in providing home health aide services, as defined in Public Health Law section 3602(4); or personal care aide services, as defined in Public Health Law section 3602(5); or advanced home health aide services, as defined in subdivision (a) of this section.
(f) Home care services worker registry or registry means the home care services worker registry established by Public Health Law section 3613.
(g) Home care services worker trainee or trainee means an individual who has applied for and been accepted into a State approved education or training program.
(h) State approved education or training program or program means a program that provides education or training for persons to meet any requirement established by the department for providing home health aide services or personal care services, or advanced home health aide services, which program is approved by the department or the New York State Education Department.
(i) Successfully completed or successful completion means, in connection with home health aide training, compliance with section 700.2(b)(9) of this Title; in connection with personal care aide training, it means compliance with section 700.2(b)(14) of this Title; in connection with advanced home health aide training, it means compliance with 10 NYCRR section 700.2(b)(54) of this Title.
(j) Senior official means an individual with responsibility for oversight of a training program and who is authorized to execute a legally binding instrument on behalf of the operator of the program. The senior official may be the operator if the operator is a natural person.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.44 Packaged food handling and protection
All food, other than fresh fruit, is to be stored or packaged in clean protective containers, or dispensed into clean single-use containers; and all food is to be handled and vended in a sanitary manner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.4 Donor qualifications
(a) In addition to all the requirements of this Subpart, limited tissue procurement services and comprehensive tissue procurement services shall comply with the donor qualification requirements in Subpart 52-3 of this Part.
(b) Unless specifically authorized by the tissue bank medical director, cardiovascular tissue shall not be released for allogeneic transplant from donors with any of the following conditions:
(1) a disease of unknown etiology;
(2) malaria within the last three years or travel to a malarially endemic area within the last six months;
(3) active or untreated tuberculosis;
(4) history or presence of bacterial endocarditis or semilunar valvular heart disease, except for mitral valve prolapse;
(5) previous cardiac valvular surgery, if donation of the affected valve is considered;
(6) insulin-dependent diabetes mellitus;
(7) death due to drowning, if immersion was for longer than six hours; or
(8) history of rheumatic fever.
(c) In addition to the exclusions outlined in subdivision (b) of this section, saphenous veins shall not be released from donors with any of the following conditions:
(1) varicose veins or other conditions of chronic venous stasis;
(2) trauma to saphenous veins; or
(3) significant phlebitis.
(d) Social history as recorded in the medical chart of the donor, or as provided by a friend or family member shall be considered in the donor selection process.
(e) The medical director of the comprehensive tissue procurement service shall be responsible for determining that the donor and the donated cardiovascular tissue are acceptable based on medical history information and established donor selection criteria as specified in this Part, and a physical examination.
(f) A written policy shall specify the range of acceptable donor age limits for allogeneic cardiovascular tissue donation. This policy shall be determined by the tissue bank medical director in consultation with the medical advisory committee of the comprehensive tissue procurement service.
(g) Written criteria for acceptance of donors of autogeneic tissue shall be specified by the transplantation service director of the tissue transplantation facility, unless such criteria have been specified already by the medical director of a comprehensive tissue procurement service.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.1 Purpose
This Subpart requires all school districts and boards of cooperative educational services, including those already classified as a public water system under Subpart 5-1 of this Title, to test potable water for lead contamination and to develop and implement a lead remediation plan, where applicable.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.5 Retrieval of tissue
(a) Prior to enucleation, eyes shall be maintained in accordance with procedures approved by the tissue bank medical director. Eyes shall be kept moist during the interval between cessation of circulatory function and enucleation.
(b) Enucleation and corneal excision shall be performed in a clean surgical field using standard operating room technique.
(c) Enucleation and/or corneal excision shall occur within 12 hours after cessation of circulatory function unless otherwise specifically authorized by the tissue bank medical director.
(d) Eyes shall be stored and transported to the tissue processing facility at a temperature between two and six degrees Celsius.
(e) If an ante mortem blood sample is not available from a cadaveric donor, a post mortem sample of sufficient quantity to perform required laboratory testing shall be drawn via a cardiac insertion or from a large vein or artery.
(f) Tissue specimen containers and storage solutions shall be sterile and nontoxic.
(g) Each tissue and blood specimen container shall be labeled legibly at the time of retrieval with the tissue bank identification, and donor identification code or unique tissue identification number. The date, time and anatomic site of retrieval shall be recorded on accompanying documents.
(h) Tissue and blood specimen containers shall be labeled so as to maintain tissue identification throughout all phases of processing, storage and distribution, in a manner not subject to significant deterioration under conditions of transport and storage.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.4 Reporting of occupational lung disease
Every physician, health facility and clinical laboratory in attendance on a person with clinical evidence of occupational lung disease, as categorized in section 22.5 of this Part, shall report such occurrence to the State Commissioner of Health within 10 days. Such report shall be on such forms as prescribed by the State Commissioner of Health.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-1.50 Transportation
During transportation, including transportation to another location for service or catering operations, food is to meet the requirements of this Subpart relating to food protection, temperature, handling and storage. Food, utensils, equipment and tableware are to be protected from contamination during transportation by use of covered containers, complete wrappings or packaging. Original individual packages do not need to be overwrapped or covered if the original package has not been torn or broken.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.20 Utilization review
This functional reporting center must contain all the expenses associated with providing utilization review. Reference: section 416.9 of this Subchapter. Additional activities include but are not limited to the following: conducting ongoing evaluation of the quality of care provided. This includes periodic review of utilization of bed facilities and of the diagnostic, nursing and therapeutic resources of the residential health care facility with respect to availability of these resources to all patients according to their medical needs, and recognition of the medical practitioner's responsibility for the costs of health care. This review should cover necessity of admission (including concurrent review of admission), length of stay, level of care, quality of care, utilization of ancillary services, professional services furnished, and availability and alternative use of facilities and services. The review committee should include two or more physicians with participation of other professional personnel, or a group outside the facility which is similarly composed and which is established by the local medical society and some or all of the residential health care facilities in the locality, or a group established and organized in a manner approved by the Department of Health that is capable of performing such function.
(a) Standard unit of measure: number of cases reviewed.
The total number of patient cases reviewed by the Utilization Review Committee. If a case is reviewed more than once, it should be counted as a case reviewed, each time reviewed.
(b) Data source.
The number shall be determined from an actual count maintained in the Utilization Review Committee.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.33 Development period records and reports
(a) A hospital shall establish and maintain a separate uniform system of accounts during the development period for all items of project cost designed to conform with the State Department of Health requirements and regulations.
(b) The following reports as required by the regulatory agreement during the development period after mortgage closing shall be submitted promptly.
(1) Quarterly reports commencing with the date of inception to and including the last day of March, June, September and December.
(2) An annual report for the period ending December 31, or the fiscal year ending date if different, which shall contain the opinion and certificate of an independent licensed or certified public accountant.
(c) Quarterly reports to the State Department of Health required by this Part shall be submitted within 60 days following the end of the reporting period and annual reports required by this Part shall be submitted within 90 days following the end of the reporting period or as otherwise specified by the regulatory agreement.
(d) A hospital shall submit promptly such special reports as may from time to time be required by the State Department of Health.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.6 Tissue processing facilities
(a) A facility which processes cardiovascular tissue shall be licensed by the department as a tissue processing facility. Such facilities shall make available to the department a statement of the procedures used in the preparation, testing and preservation of the tissue or tissues distributed, or offered for use. The premises, equipment, procedures, records, circulars of instruction and tissues shall be available for inspection and/or testing by the department as required. Copies of all brochures and other informational materials and instructions, including descriptions of methods of tissue handling, shall be available to the department. Each container of tissue shall be clearly labeled with the donor identification code or a unique tissue identification number, unit size and expiration date, if applicable.
(b) Aseptic processing of cardiovascular tissue shall be performed in separately defined work areas with:
(1) floors, walls and ceilings with nonporous smooth surfaces that are easily cleaned;
(2) temperature and humidity controls;
(3) an air supply filtered through high efficiency particulate air filters with positive pressure differentials between rooms;
(4) a system for monitoring environmental conditions;
(5) a system for cleaning and disinfecting a room and equipment to produce aseptic conditions; and
(6) adequate space for staff, and storage of garments and equipment.
(c) Critical work areas in which sterile tissue containers or aseptically retrieved cardiovascular tissue are exposed to the environment shall have an air quality of no more than 100 particles (less than or equal to 0.5 micron) per cubic foot of air and no more than one bacterial colony forming unit per 10 cubic feet of air. Critical work areas shall have a positive pressure gradient greater than or equal to 0.05 inches of water relative to an adjacent less clean area. Critical surfaces shall be sterile and shall not interact with the tissue so as to affect the quality of the tissue adversely.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
SUPPORTING DOCUMENTS SUPPORTING DOCUMENTS
10 CRR-NY 36.11 Proof required in support of application for delayed registration of an unrecorded birth
The following supporting proof, or such proof as may in the opinion of the commissioner be considered the equivalent thereof, shall be submitted by an applicant for delayed registration of birth:
(a) Persons under 12 years of age.
If the person whose birth it is desired to register is under 12 years of age, the supporting proof shall consist of one document, such as a hospital record of the birth, a baptismal certificate, a church or synagogue record, a school entrance certificate, or a census record, provided that such document shows the name of the person whose birth is to be registered, the date of birth, place of birth and the names of the parents. In the event that such document is not available, the supporting proof may consist of an affidavit by a competent person who has personal knowledge of the date and place of birth and the names of the parents of the person whose birth it is desired to record. If the certificate of birth submitted for delayed registration is signed by a parent, and an affidavit is submitted as supporting proof, such affidavit shall be made by some person outside the immediate family of the person whose birth it is desired to register.
(b) Persons over 12 but under 18 years of age.
If the person whose birth it is desired to register is over 12 but under 18 years of age, the application for such delayed registration shall be supported by two written records or certified copies thereof, other than affidavits, made at least five years prior to the date of application, showing the name, date and place of birth and the names of the parents of such person.
(c) Persons over 18 years of age; certificate signed by parent.
If the person whose birth it is desired to register is 18 years of age or over, and if the certificate of birth submitted for delayed registration is signed by one of the parents, the application shall be supported by two written records or certified copies thereof, as follows:
(1) At least one of these records shall show the name, date of birth, place of birth, and names of the parents of such person, which record shall have been originally made when the person was a minor upon information furnished by a person other than the person whose birth it is desired to register.
(2) The other written record, not an affidavit, shall have been made at least five years prior to the date of application and shall show the name, the place of birth, the date of birth, and the names of the parents of such person.
(d) Persons over 18 years of age; certificate signed by such person.
If the person whose birth it is desired to register is 18 years of age or over, and if the certificate of birth submitted for delayed registration is signed by such person, the application shall be supported by three written records, or certified copies thereof, as follows:
(1) At least one written record shall show the name, date of birth, place of birth, and names of the parents of such person, which record shall have been originally made when the person was a minor upon information furnished by a person other than the person whose birth it is desired to register.
(2) The other two written records shall have been made at least five years prior to the date of application and shall show the name, the place of birth, the date of birth, and the names of the parents of such person; only one of these may be an affidavit by a competent person who was old enough at the time the birth occurred to have personal knowledge of the date and place of birth and the names of the parents.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 640 PROCEDURES FOR APPROVAL OF THE DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES AND THE ESTABLISHMENT OF SUCH FACILITIES
10 CRR-NY 640.2 Applications for approval of planning for comprehensive health services
Any person, partnership or corporation interested in planning for comprehensive health services, not having sufficient information necessary to determine whether the establishment of such facilities is feasible at the time and place and under the circumstances proposed, should file an application in accordance with the applicable provisions of Part 600 of this Title for approval by the Public Health Council of the conduct of studies and any other research and informational gathering techniques intended to provide information as to the feasibility of the comprehensive health services proposed.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.156 Goodwill
The excess of the price paid for a business as a whole over the book value or over the computed or agreed value of all tangible net assets purchased. Normally, goodwill thus acquired is the only type appearing on books of account and in financial statements.
Subchapter B HOSPITAL ESTABLISHMENT
Part 640 PROCEDURES FOR APPROVAL OF THE DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES AND THE ESTABLISHMENT OF SUCH FACILITIES
10 CRR-NY 640.3 Applications for authority for nonprofit corporations to solicit or apply for funds for development and establishment of comprehensive health services facilities
Any person, partnership or corporation which does not have the finances necessary to support the development of comprehensive health services and the establishment of such facilities shall make application to the Public Health Council for its approval of the solicitation of or application for funds to be used for such development and establishment. Such application shall be made in accordance with the provisions of Parts 600 and 610 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.5 Fees for copying records
(a) Fees for certification of copies and supplying transcripts of all documents and records under the seal of the State Commissioner of Health shall be the fees as prescribed by the Public Health Law or applicable regulation of the department.
(b) Fees for photocopies or data printouts of records available pursuant to this Subpart shall be 25 cents per page or $60 for transfer of a computer file to a requestor's computer tape.
(c) Except where fees are established by law, rule or regulation, no fee shall be charged for:
(1) inspection of a record;
(2) record searches;
(3) certification pursuant to this Subpart; and
(4) amendment or correction of an agency record found to be in error.
(d) Fees shall be paid in full or a valid offer made to pay established fees prior to issuance of copies, transcripts or certification of records.
(e) Payment shall be made in the form of a check, bank draft, or money order payable to the New York State Department of Health, or if personally delivered. may be made in cash for which a receipt shall be given.
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.9 Distribution of tissue products
(a) Except as provided in section 52-3.4 of this Part, a cardiovascular tissue shall not be made available for allogeneic transplantation if:
(1) The donor's blood tests repeatedly reactive in approved screening tests for HBsAg, or antibodies to HIV-1, HIV-2, HTLV-I, or HCV; or
(2) the donor's blood reacts positively to approved tests for syphilis, unless confirmatory testing is negative.
(b) Cardiovascular tissue shall be transported by the tissue bank or its agents, or by staff or agents of the tissue transplantation facility. A signed form shall be kept on file at the tissue bank documenting the identification of tissue distributed, including the names of both the person(s) releasing the tissue and the person(s) receiving the tissue.
(c) Frozen cardiovascular tissue in transit from a tissue processing or storage facility to a tissue transplantation facility shall be maintained at a temperature of minus 70 degrees Celsius or lower. Tissue stored at a tissue transplantation facility shall be maintained at the appropriate storage temperature until immediately prior to transplantation.
(d) Cardiovascular tissue and its labeling and packaging shall be visually inspected prior to its distribution by the tissue processing facility. The tissue shall be inspected by the tissue transplantation facility immediately upon receipt and again after thawing, if frozen. If the physical appearance is abnormal, or there is indication or suspicion of overt microbial contamination, the tissue shall not be utilized for transplantation. In the case of frozen tissue, the period of time between thawing and use shall not exceed 24 hours if tissue is refrigerated at between one and 10 degrees Celsius, or four hours if not refrigerated.
(e) Cardiovascular tissue shall be issued by the tissue transplantation facility only upon a written order by a licensed physician, or person authorized by law to order such issuance pursuant to section 52-4.11(b) of this Subpart. Documentation of such order shall be on a dedicated tracking record or on the recipient's medical record. Issuance of cardiovascular tissue shall be recorded in a disposition log and shall allow accurate tracking of tissue to each recipient.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.12 Order of commissioner
If the hearing officer shall find that a respondent has engaged in an unlawful discriminatory practice as defined in section 206-a of the Public Health Law, the commissioner shall issue and cause to be served on the respondent an order requiring the respondent to cease and desist from the unlawful discriminatory practice. If the hearing officer shall find that a respondent has not engaged in an unlawful discriminatory practice, the commissioner shall issue and cause to be served on the complainant and respondent an order dismissing the complaint as to such respondent.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.6 Potable water
(a) All on-site potable water supplies shall comply with the provisions of this section and, in addition, those on-site water systems meeting the definition of a public water system as defined in Subpart 5-1 of this Title, shall also comply with the requirements of Subpart 5-1 of this Title.
(b) A children's camp that utilizes an off-site public water supply must comply with subdivisions (i) through (n) of this section and, when determined necessary to ensure the satisfactory quality of the potable water, the permit-issuing official may require a children's camp operator to implement the annual start-up procedure contain in subdivision (d) of this section.
(c) Treatment.
(1) Minimum treatment for a ground water source shall be disinfection by chlorination in a manner which destroys harmful microorganisms or other disinfection methods acceptable to the permit-issuing official.
(2) For facilities utilizing disinfection by chlorination, the free chlorine residual disinfection concentration in the water distribution system shall be at least 0.2 milligram per liter (mg/1).
(3) Minimum treatment for surface water sources or ground water sources directly influenced by surface water shall be filtration and disinfection techniques, approved by the permit issuing official, capable of 99.9 percent removal and/or inactivation of giardia lamblia cysts and 99.99 percent removal and/or inactivation of viruses.
(4) A waiver from disinfection shall not be permitted.
(d) Annual start-up.
The children's camp operator must ensure that the following actions have been taken 15 days prior to the property's occupancy for which the water supply is utilized each year. The following applies to each on-site potable water system that is not subject to continuous water use and to each children's camp potable water supply distribution system, which receives water from an off-site public water system and is not subject to continuous water use, when due to the seasonal use of the water system, the water may be hazardous to health:
(1) All water mains shall be disinfected by:
(i) completely filling the main to remove all air pockets, flushing the main to remove particulates, and filling the main with potable water. The potable water shall then be chlorinated by feeding liquid hypochlorite at a constant rate such that the water will not have less than a 25 mg/l free chlorine residual throughout the children's camp water system. After a 24-hour holding period there must be a free chlorine residual of not less than 10 mg/l throughout the children's camp water system; or
(ii) using a disinfection method the State Commissioner of Health has determined in writing to be as protective as the disinfection procedure described in subparagraph (i) of this paragraph.
(2) All water mains shall be flushed and free chlorine residual disinfection concentrations shall be measured for the two days immediately following the completion of the main disinfection, as prescribed in paragraph (1) of this subdivision, at representative points in the distribution system, to ensure chlorine residuals of not less than 0.2 mg/l.
(3) Total coliform samples shall be collected in accordance with paragraph (f)(1) of this section following the two-day flushing and chlorine monitoring period prescribed by paragraph (2) of this subdivision and when a free chlorine residual of not more than 4.0 mg/1 is present.
(e) Maximum contaminant levels (MCL):
| Contaminant | MCL | | --- | --- | | Total coliform | Any positive sample | | Escherichia coli (E. coli) | Any positive sample | | Nitrate | 10 (as nitrogen) mg/L | | Nitrite | 1 (as nitrogen) mg/L | | Total Nitrate and Nitrite | 10 (as nitrogen)mg/L |
(f) Monitoring requirements.
Samples shall be collected from each water source at a representative point in the distribution system for each source and analyzed at a laboratory certified by New York State Department of Health as follows:
(1) At least one sample collected for total coliform analysis from each water source prior to opening for the operating season and at least one additional sample collected from each water source during the operating season. For those children's camps operating more than 30 days in a calendar year. Total coliform samples shall be collected for each month the camp is in operation. When a water supply serving a children's camp is operated continuously year round with total coliform analysis performed monthly, the total coliform analysis prior to the children's camp's operation is not required.
(2) Nitrate and nitrite analysis shall be conducted for new water sources. Nitrate analysis shall be conducted annually for each system.
(3) Additional monitoring may be required when determined by the permit-issuing official as necessary to evaluate water quality.
(4) The camp operator must report sample results that are positive for total coliform or Escherichia coli to the permit-issuing official as soon as possible but no later than 24 hours of being notified by the laboratory. Pre-operational water analysis reports must be submitted to the permit-issuing official prior to permit issuance. All other water analysis reports required to be made by this Subpart or requested or ordered by the permit-issuing official shall be submitted to the permit-issuing official within 10 days of the end of each month in which samples were collected.
(g) Report on water treatment.
Accurate and complete water treatment operation reports shall be maintained daily and submitted to the permit-issuing official within 10 days of the end of each month of operation. Reports must be made on forms provided or approved by the department.
(h) Source protection.
All potable water sources and distribution systems shall be designed, located, constructed and maintained to provide protection against contamination or pollution. All pumps, piping fixtures and appurtenances shall be installed and maintained to protect against contamination of any water source.
(i) Submission of plans; prior approval.
(1) A plan for proposed new or modified potable water supply systems shall be submitted to the permit-issuing official at least 60 days prior to beginning construction. No construction of new or modified potable water supply systems shall commence until plans and specifications have been submitted to and approved by the permit-issuing official. Construction shall be in accordance with the approved plans.
(2) Recommended Standards for Water Works, (See Appendix 5-A, infra. ) 1997 edition published by Health Research, Inc., P.O. Box 7126, Albany, NY 12224 available for public inspection at the offices of the records access officer of the New York State Department of Health, Empire State Plaza, Coming Tower, Albany, NY 12237, shall, in their entirety, be the basis on which all plans and specifications for children's camp water systems will be reviewed and approved. The permit-issuing official may allow deviations from these standards when it can be shown that the deviations will provide adequate protection of the health and safety of the children's camp occupants and public.
(j) Minimum standards.
Potable water shall be adequate in quantity and quality as set forth in this Subpart and shall be readily available to occupants of the children's camp. Only potable water shall be easily accessible. Any non-potable water supply shall be conspicuously labeled as a non-potable supply.
(k) Connections prohibited.
There shall be no physical connection between the potable water supply and any non-potable water supply. Any fixture, installation or equipment which is subject to back-siphonage shall be installed and maintained to protect against contamination of the water source(s).
(l) A minimum pressure of 20 pounds per square inch, at peak demand, shall be maintained in all parts of the children's camp water distribution system.
(m) Interruptions, changes in sources or treatments.
Any incident or condition which affects the quantity or quality of the on-site potable water supply shall be reported to the permit-issuing official within 24 hours of occurrence. There shall be no changes made to the source or method of treatment of a potable water supply, either temporary or permanent, without first receiving approval from the permit-issuing official. An adequate supply of potable water must be provided and maintained during all times of operation.
(n) A common drinking utensil shall not be provided. Drinking fountains shall be of sanitary design and construction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.2 Financial and statistical data required
(a) Each residential health care facility shall complete and file, with the New York State Department of Health and/or its agent, annual financial and statistical report forms supplied by the department and/or its agent. Residential health care facilities certified for title XVIII of the Federal Social Security Act (Medicare) shall use the same fiscal year for title XIX of the Federal Social Security Act (Medicaid) as is used for title XVIII. All residential health care facilities must report their operations from January 1, 1977 forward on a calendar-year basis.
(1) Hospital-based residential health care facilities whose affiliation changes to free- standing pursuant to section 86-2.34(a) of this Subpart shall complete and file the free-standing annual cost report (RHCF-4) supplies by the department and/or its agent for the first full calendar year following actual complete closure of the acute care beds of its affiliated hospital.
(b) Federal regulations require the submission of cost reports to the State agency no later than three months after the close of the cost reporting year. State agencies requiring certified reports may grant an extension of 30 days. Since the reports from all residential health care facilities are required to be certified, an extension of 30 days is automatically provided in this subdivision so that all required financial and statistical reports shall be submitted to the department no later than 120 days following the close of the fiscal period. Further extensions of time for filing reports may be granted upon application received prior to the due date of the report and only in those circumstances where the residential health care facility established, by documentary evidence, that the report cannot be filed by the due date for reasons beyond the control of the facility.
(c) In the event a residential health care facility fails to file the required financial and statistical reports on or before the due dates, or as the same may be extended pursuant to subdivision (b) of this section, the State Commissioner of Health shall reduce the current rate paid by State governmental agencies by two percent for a period beginning on the first day of the calendar month following the original due date of the required reports and continuing until the last day of the calendar month in which the required reports are filed.
(d) In the event that any information or data which a residential health care facility has submitted to the State Department of Health, on required reports, budgets or appeals for rate revisions intended for use in establishing rates, is inaccurate or incorrect, whether by reason of subsequent events or otherwise, such facility shall forthwith submit to the department a correction of such information or data which meets the same certification requirements as the document being corrected.
(e) Except as identified in sections 86-2.10(k)(6) and 86-2.15(e) of this Part, a cost report shall be filed in accordance with this section by each new facility for the first 12-month period during which the facility has had an overall average utilization of at least 90 percent of bed capacity. This report shall be filed and properly certified within 60 days following the end of the 12-month period covered by the report. Failure to comply with this subdivision shall result in application of subdivision (c) of this section.
(f) If the financial and statistical reports required by this Subpart are determined by the department to be incomplete, inaccurate or incorrect, the residential health care facility will have 30 days from date of receipt of notification to provide the corrected or additional data. Failure to file the corrected or additional data within 30 days, or within such period as extended by the commissioner, will result in application of subdivision (c) of this section. Lack of the respective certifications by both the operator and accountant, as required pursuant to sections 86-2.5 and 86-2.6 of this Subpart, shall render a financial and statistical report incomplete.
(g) Specific additional data related to the rate setting process may be requested by the State Commissioner of Health. These data, which include and are limited to those for use in a wage geographic differential survey, a peer grouping data survey, a medical supplies survey and a malpractice insurance survey, must be provided by the residential health care facility within 30 days from the date of receipt of notification to supply such information. The commissioner must supply to each facility prior to the start of each rate period, a preliminary listing of the data that will be required. Failure to submit the additional data shall result in application of subdivision (c) of this section, unless the residential health care facility can prove by documentary evidence that the data being requested is not available.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.91 Product thermometers
Metal stem-type numerically scaled indicating thermometers accurate to plus or minus 2°F (1.1°C) are to be provided and used to determine that proper internal cooking, holding or refrigeration temperatures of all potentially hazardous foods are obtained and maintained.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-7 ASSISTED LIVING PROGRAM
10 CRR-NY 86-7.2 Computation of the rate of payment
(a) For each region, a rate of payment shall be established for each of the 16 patient classification groups. The rate of payment shall be established for the calendar year 1992. For each subsequent calendar year, the 1992 rate of payment shall be increased by a roll factor as determined pursuant to section 86-7.3 of this Subpart.
(b)
(1) For purposes of this Subpart, the rate of payment shall be related to an average residential health care facility rate consisting of two components:
(i) direct component; and
(ii) other than direct component.
(2) Direct component of the rate of payment:
(i) The direct component of the rate of payment shall be composed of costs incurred in providing care directly to patients as set forth in section 86-2.10(c)(1) of this Part.
(ii) The direct component for each patient classification group shall be equal to the statewide mean direct case mix neutral cost, as determined in section 86-2.10(c)(3) of this Part, times the case mix index for the patient classification group divided by a regional direct input price adjustment factor for the patient classification group as identified in subparagraph (iii) of this paragraph and trended to 1992 by the applicable weighted average regional roll factor as determined pursuant to section 86-7.3 of this Subpart. The case mix index for each patient classification group shall be as identified in Appendix 13-A, infra, however, the case mix index for reduced physical functioning A shall be.4414 as identified in section 86-2.10(c)(3)(iii)(i) of this Part.
(iii) The regional direct input price adjustment factor (RDIPAF) shall adjust for differences in wage and fringe benefit costs between and among the regions caused by differences in the wage scale of each level of employee. Within each region, a RDIPAF shall be calculated for each patient classification group. The RDIPAF shall be based upon the following factors:
(a) Sixteen regions within the State as identified in Appendix 13-A, infra.
(b) Case mix predicted staffing for registered professional nurses, licensed practical nurses and aides, orderlies and assistants for each patient classification group.
(c) The proportion of residential health care facility salaries and fringe benefit costs for the direct care cost centers identified in section 86-2.10(c)(1) of this Part to the total costs of the direct care cost centers.
(d) A regional average dollar per hour and proportion of regional direct salaries and fringe benefits to total direct costs as identified in clause (c) of this subparagraph based upon either 1983 or 1987 residential health care facility financial and statistical data in accordance with section 86-2.10(m)(1)(iv) of this Part.
(3) Other than direct component of the rate of payment:
(i) The other than direct component shall be equal to the mean indirect price per day set forth in section 86-2.10(d)(4) of this Part for the freestanding, low intensity, less than 300 beds peer group divided by the regional indirect input price adjustment factor for the patient classification group as identified in subparagraph (ii) of this paragraph and trended to 1992 by the applicable weighted average regional roll factor as determined pursuant to section 86-7.3 of this Subpart plus a 1992 regional weighted average per diem for other than direct and indirect components of the RHCF rate as set forth in section 86-2.10(f), (g) and (r) of this Part, computed using the first January 1, 1992 rate promulgated following the 30-day period established for correcting errors in the initial January 1, 1992 rate issued at least 60 days prior to January 1, 1992.
(ii) The regional indirect input price adjustment factor (RIIPAF) shall adjust for differences in wage and fringe benefit costs between and among the wage equalization factor regions caused by differences in the wage scale of each level of employee. Within each region, a RIIPAF shall be calculated for each patient classification group. The RIIPAF shall be based upon the following factors:
(a) Sixteen regions within the State, as identified in Appendix 13-A, infra.
(b) Case mix predicted staffing for registered professional nurses, licensed practical nurses and aides, orderlies and assistants for each patient classification group.
(c) The proportion of regional RHCF salaries and fringe benefit costs for the indirect cost centers identified in section 86-2.10(d)(1) of this Part to the total costs of the indirect care cost centers.
(d) A regional average dollar per hour and proportion of regional indirect salaries and fringe benefits to total indirect costs as identified in clause ( c ) of this subparagraph based upon either 1983 or 1987 residential health care facility financial and statistical data in accordance with section 86-2.10(m)(1)(iv) of this Part.
(c) For calendar year 1992, for each patient classification group in each region, the direct and other than direct components shall be summed and multiplied by 50 percent. For subsequent calendar years, the 1992 rate of payment shall be increased by the applicable roll factor determined pursuant to section 86-7.3(b) of this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 131 ONONDAGA COUNTY
COMPANIES COMPANIES
10 CRR-NY 131.50 Onondaga County Water Authority
Public Health Law, § 1100
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Otisco Lake and its tributaries which now serve or which may be developed in the future to serve as sources of public water supply of the Onondaga County Water Authority, Onondaga County, New York, and to all watercourses tributary thereto or ultimately discharging into said lake.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc., unless a permit has been obtained to sell used cars.
(5) Lake shall mean Otisco Lake.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(7) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(12) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(13) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(14) Treatment works shall mean any plant, subsurface disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(15) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the Onondaga County Water Authority water supply.
(16) Watershed shall mean the entire drainage area contributing water to Otisco Lake.
(17) Water supply shall mean the public water supply of the Onondaga County Water Authority, Onondaga County, New York from Otisco Lake.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York (10 NYCRR Part 170).
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within 250 feet of the lake or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500 foot linear distance of the lake or watercourse except in weather-proof buildings or watertight vessels.
(3) Herbicides, pesticides and toxic chemical.
No herbicides, pesticides or toxic chemical shall be discharged, applied or allowed to enter into the lake, its tributaries or any watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta shall be deposited or allowed to escape into the lake or any watercourse on the watershed.
(ii) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy, cesspool or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of the high water mark of Otisco Lake, its tributaries or any watercourses. Existing privies used for the deposit or storage of human excreta shall be replaced by other methods for the disposal of said excreta acceptable to the Commissioner of Health within three years after the date of adoption of this section. Properly designed holding tanks to receive the human excreta, wash water, and sink wastes from the sanitary and plumbing facilities within a building will be acceptable (under permit from local health departments) where feasible, provided safeguards are built into the system to eliminate overflowing of the holding tank.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed, or rebuilt within 50 feet of the lake or watercourse. These restrictions shall not apply to existing subsurface sewage disposal works installed in accordance with plans submitted to and approved by the appropriate State agency or officer or other official health agency or officer having jurisdiction. All unexercised construction permits over three years old shall be invalidated.
(vi) Every watertight holding tank referred to in subparagraphs (iv) and (ix) of this paragraph shall be emptied when filled within six inches of the top of the holding tank.
(vii) In emptying either a septic tank or holding tank, and transferring its contents to a transportable receptacle, such as a tank truck, all necessary care shall be exercised to prevent contamination of the lake or watercourse. All such transportable receptacles shall be provided with drip-proof connections and tight fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the tank trucks shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction.
(viii) Subsurface disposal.
(a) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system. Where rapid percolation is indicated, such as in rock fissures, the site may be rejected.
(b) When an existing subsurface sewage disposal system fails, the entire system must be inspected and the site thoroughly evaluated in a manner acceptable to the Commissioner of Health, prior to designing alterations, or modifications, to the existing system.
(c) The maximum interval for inspection of sewage disposal facilities serving year- round residences shall not exceed three years. All new or replacement septic tanks should have a fresh air inlet pipe visible above ground to readily make their location known to the watershed inspector.
(ix) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into the lake or watercourses, nor on, or beneath the surface of the ground on the watershed (except into watertight pipes connected to a sewage disposal system or holding tank approved by the appropriate State agency, in accordance with subparagraph [v] of this paragraph).
(5) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of the lake, its tributaries or watercourses.
(6) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, infra Part 16, Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York (10 NYCRR Part 16) shall be disposed of by burial in soil within 250 feet of the lake, its tributaries or watercourses.
(7) Recreation.
(i) Bathing, swimming and fishing. Bathing, swimming and fishing are prohibited within 500 feet of any water supply intake owned by the Onondaga County Water Authority.
(ii) Boating. No boating shall be allowed in or upon the waters of Otisco Lake within 500 feet of the water supply intake owned by the Onondaga County Water Authority except by duly authorized employees of the Onondaga County Water Authority in the performance of their duties of supervision and maintenance of the water supply.
(8) Solid waste.
(i) Junkyards. No junkyards shall be located within 100 feet of the lake, its tributaries or watercourses.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250 foot linear distance of the lake or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within 250 feet of the lake, its tributaries or watercourses. No refuse disposal operation will be permitted unless approved by the appropriate State agency having jurisdiction.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a water works structure, shall be permitted on the water or ice within 500 feet of any water supply intake owned by the Onondaga County Water Authority.
(e) Inspections.
The Onondaga County Water Authority, shall make regular and thorough inspections of the lake, watercourses and watershed to ascertain whether this section is being complied with. It shall be the duty of the aforesaid Onondaga County Water Authority to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with this section, it shall be the further duty of the aforesaid Onondaga County Water Authority to promptly notify the State Commissioner of Health of such violations. The aforesaid Onondaga County Water Authority shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. This inspection report shall state the number of violations found, the number of violations abated and the condition of the watershed which shall include:
(1) An annually updated land use inventory of all structures, facilities, sewage and waste disposal systems, and other solid and liquid waste disposal practices.
(2) Census of residents, both full and part-time, and domestic animals.
(3) Survey and inventory of users of pesticides, fertilizers, road salts and any other potential polluting material.
(4) Survey of water use, including public water supply, private water supply, bathing and swimming (private or public), water skiing, and power boat use, fishing, agricultural water supply and any other reasonable water use.
(5) Surveillance program which can measure and quantify the physical, bacteriological, microscopic, biological, chemical and radiological quality of the lake and its tributary streams.
(f) Penalties for violations.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.203 Medical staff classification—attending
Have full admitting privileges in accordance with their abilities and qualifications, and also participate as members of the medical staff committees, serve as officers of the medical staff and serve as directors or chiefs of departments. They are required to attend meetings of the general staff and departmental staff, and may be required to devote time to the education programs and supervise residents in outpatient clinics or emergency departments.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.2 Eligibility for an award
(a) To be eligible for a State Health Service Corps award, an individual must:
(1) show evidence of enrollment or acceptance for full-time study in a professional study program in an institution approved by the Board of Regents. The Commissioner of Health may permit individuals who are not enrolled or who have not been accepted for enrollment to apply for an award, but an award will not be made until the individual provides evidence of acceptance into an institution approved by the Department of Health pursuant to standards established in this Title, or the Board of Regents. The Commissioner of Health may permit individuals who submit satisfactory medical statements substantiating a serious illness or disability that precludes full-time attendance to attend part-time;
(2) be pursuing a program of continuous undergraduate or graduate education in a health care profession as defined in section 47.1(a) of this Part;
(3) be within 24 months of completing the program of study and becoming eligible to apply for licensure, registration or certification in the profession of study;
(4) be a United States citizen or resident alien who is holding a valid I-551 card or a valid I-151 card issued by the U.S. Immigration and Naturalization Service;
(5) meet the character and moral standards required for licensure under section 6524, subsection 7 of the State Education Law; and
(6) complete, sign and file an application using prescribed forms which must be filed within specified time frames. All required supplementary documents must be filed as directed. Incomplete, illegible or vague applications may be rejected. Applications filed after the deadlines specified may be rejected.
(b) An individual may be determined to be ineligible to receive a State Health Service Corps scholarship or fellowship award if:
(1) the individual is already receiving any other scholarship or fellowship award that requires the fulfillment of a service obligation;
(2) the individual is employed by the State of New York and is granted educational leave with pay from the position held except in the instance of extreme hardship as determined by the Commissioner of Health;
(3) the individual is identified by Higher Education Services Corporation as having defaulted in the repayment of a guaranteed student loan; or
(4) the individual is not a resident of New York State and plans to attend or attends an educational institution located out of state.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.6 Variance and waivers
(a) Variance.
In order to allow time to comply with certain provisions of this Subpart, an operator may submit a written request to the permit-issuing official for a variance from a specific provision(s) when the health and safety of the public will not be prejudiced by the variance, and where there are practical difficulties or hardships in immediate compliance with the provision. An operator must meet all terms of an approved variance including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the permit-issuing official specifies.
(b) Waiver.
In order to obtain a waiver permitting alternative arrangements that do not meet the provisions of this Subpart but do protect the health and safety of the occupants and the public, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Subpart. Such request must demonstrate that the alternate arrangements provide adequate protection of the health and safety of the patrons and public. The permit-issuing official shall obtain and be guided by the recommendation of the State Department of Health prior to granting or denying a waiver. An operator must meet all terms of an approved waiver. A waiver will remain in effect indefinitely unless revoked by the permit-issuing official or the facility changes operators.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.32 Social work
(a) Social work services may be provided by a social worker, practicing under the direct supervision of a qualified psychiatrist in private practice as part of a course of treatment provided by the supervising psychiatrist.
(b) For purposes of this section, the term social worker shall mean a person authorized pursuant to the Education Law to use the title “certified social worker.”
(c)
(1) A social worker may provide services only under the continuing direct supervision of a qualified psychiatrist. Such supervision must include regular communication and consultation between the social worker and the supervising psychiatrist, but shall not be construed as requiring the physical presence of the supervising psychiatrist at the time the services are being performed by the social worker. The number of social workers supervised by the supervising psychiatrist shall not exceed four.
(2) Duties and responsibilities performed by the social worker must be assigned to him by the supervising psychiatrist, within the scope of practice of the supervising psychiatrist, and appropriate to the education, training and experience of the social worker.
(3) The provision of services by a social worker must be preceded by the completion of a diagnostic evaluation of the patient by the supervising psychiatrist.
(4) The supervising psychiatrist shall be responsible for developing an overall treatment plan which integrates the social worker's study of the patient, and describes the services to be provided by the social worker.
(5) When enrolling in the medical assistance program, a supervising psychiatrist must provide the Department of Social Services with the names of any social workers for whose services he may bill.
(d) The services provided by the social worker may include the following:
(1) the taking of a social history, if taken during an office visit, which shall include all relevant information useful to the patient's treatment;
(2) making relevant visits to the patient's home and family to assure the efficacy of the supervising psychiatrist's treatment plan;
(3) counselling the patient, if counselling is done during an office visit;
(4) conducting group therapy sessions, if conducted during an office visit;
(5) submitting regular reports to the supervising psychiatrist which will keep him informed of any changes in the patient's circumstances or condition which may influence the outcome of the patient's treatment. The reports shall be retained by the supervising psychiatrist and incorporated into the patient's medical record as required to be maintained pursuant to section 85.29 of this Part.
(e) Payment and reimbursement.
(1) Payment for social work services performed by a social worker shall be made only to the supervising psychiatrist. Social workers may not bill independently for their services.
(2) State reimbursement for social work services performed by a social worker shall be limited by the maximum reimbursable fees for such services.
(3) Claims submitted by a supervising psychiatrist for social work services performed by a social worker must include the name of the social worker providing such services.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 131 ONONDAGA COUNTY
CITIES CITIES
10 CRR-NY 131.1 City of Syracuse, Onondaga County
(a) Application.
The rules and regulations set forth in this section duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the source of the public water supply of the City of Syracuse. Said water supply is Skaneateles Lake located approximately 19 miles southwest of the City of Syracuse along NYS Route 20. It is situated within parts of Onondaga, Cayuga, and Cortland Counties. The lake is one of the Central New York Finger Lakes and is a multiple use lake/reservoir with a lake surface area of 13.6 square miles and a watershed land drainage area of 58.9 square miles. The watershed drainage area appears on the 7.5-minute quadrangle maps (revised in 1951) for Marcellus, Skaneateles, Owasco, Spafford, Homer, Sempronius and Otisco Valley. The location of the watershed drainage boundary as it applies to these rules and regulations is determined by Geographic Information System maps maintained by the City of Syracuse. Where there is a discrepancy between the maps and field observations, a site evaluation by designated supplier of water personnel will be the method of verifying this boundary. Their determination shall be final. Maps delineating this boundary can be reviewed at the City of Syracuse Water Treatment Plant, 20 West Genesee Street, Skaneateles, NY, or New York State Department of Health, Bureau of Public Water Supply, Flanigan Square, 547 River Street, Troy, NY 12180-2216.
(b) Definitions.
(1) AA is the water quality classification of Skaneateles Lake as described in 6 NYCRR Part 703 and designated in 6 NYCRR Part 896.
(2) Accessory structure shall mean a detached structure located on or partially on the premises which is not used or not intended to be used for living, sleeping, cooking or eating quarters by human occupants.
(3) Agricultural associated animal waste shall mean manure, including liquid or solid mixtures containing manure, obtained from agricultural activities.
(4) Agricultural activities shall include, but are not limited to, practices that contribute to the production, preparation and marketing of crops, livestock and livestock products as a commercial enterprise, including manure processing and handling, and practices of a commercial horse boarding operation, as defined in section 301(2) and (13) of the Agriculture and Markets Law as amended through November 1, 1998.
(5) Aquifer shall mean a consolidated or unconsolidated geologic formation, group of formations or part of a formation capable of yielding a significant amount of groundwater to wells, springs, or infiltration galleries.
(6) Chloride salt shall mean any bulk quantities of chloride compounds or other deicing compounds intended for application to roads, including mixtures of sand and chloride compounds in any proportion where the chloride compounds constitute eight percent or more of the mixture. A bulk quantity of chloride compounds means a quantity of 1,000 pounds or more, but does not include any chloride compounds in a solid form, including granules, which are packaged in waterproof bags or containers which do not exceed 100 pounds each.
(7) Commercial building shall mean a structure which is wholly or partially used or intended to be used for commercial or municipal purposes, including, but not limited to, municipal highway departments and fire departments buildings, marinas, gas stations, stores, markets or shops or any kind, clubs, and car dealerships.
(8) Commissioner of Health unless otherwise noted, shall mean the Commissioner of Health of the State of New York.
(9) Designated representative means the health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, the state regional health director, or district director having jurisdiction; a public health director or public health engineer qualified as duly appointed pursuant to part 11 of the State Sanitary Code; or a county health commissioner, or county health director having the powers and duties prescribed in section 352 of the Public Health Law, or any other individual so designated by the Commissioner of Health of the State of New York.
(10) Developer shall mean a person, partnership, corporation, or other legal entity undertaking or participating in any development. Development shall refer to the construction of any dwellings, commercial buildings or site improvements.
(11) Disposal shall mean the discharge, deposit, injection, dumping, spilling, leaking, or placing of any solid waste, radioactive material, hazardous waste, or wastewater into or on any land or water so that such solid waste, radioactive material, hazardous waste, or wastewater shall remain on the land or water and will not be removed.
(12) Dwelling shall mean any building or structure which is wholly or partly used or intended to be used for living, sleeping, cooking, or eating quarters by human occupants.
(13) Environmental assessment form (EAF) shall mean the form used by an agency to assist it in determining the environmental significance of actions as defined in 6 NYCRR Part 617.
(14) Farm is defined as land used in a single operation for the production for sale of crops, livestock or livestock products of an average (over the past two years) gross sales value of $10,000 or more.
(15) Fertilizer shall mean any commercially produced mixture generally containing phosphorous, nitrogen, or potassium, and which is applied to the ground to increase nutrients to plants.
(16) Flood plain (100-year) shall mean the land contiguous to streams, ponds, estuaries, and lakes which would be inundated by a flood having a one percent chance of being equaled or exceeded in any given year.
(17) Groundwater shall mean any water beneath the land surface in the saturated zone.
(18) Hazardous material shall mean any substance listed in or exhibiting characteristics identified in either 6 NYCRR Part 371 or 6 NYCRR Part 597.
(19) Herbicides shall mean any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any vegetation, and being those substances defined as herbicides pursuant to section 33-0101 of the Environmental Conservation Law.
(20) Human excreta shall mean human feces and urine.
(21) Junkyard is a solid waste management facility as defined in 6 NYCRR section 360-1.2(b)(15) and (16).
(22) Lake shall mean Skaneateles Lake.
(23) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of the lake, which is City of Syracuse datum 863.27 feet above sea level, or to the edge, margin, or steep bank forming the ordinary high water mark of the lake or watercourse.
(24) Manure shall mean animal feces and urine.
(25) Non-agricultural associated animal waste shall mean manure obtained from non- agricultural sources.
(26) Non-point discharge shall mean any source of water pollution or pollutants which is not a discrete conveyance or point source permitted pursuant to title 7 or 8 of article 17 of the Environmental Conservation Law.
(27) NYSDEC shall mean the New York State Department of Environmental Conservation.
(28) NYSDOH shall mean the New York State Department of Health.
(29) Open storage shall mean the holding of any material in such a way that the material is exposed to the elements of nature.
(30) Pail service. This service has been in existence since approximately 1916 to service those residences that were limited by physical constraints from installing onsite wastewater treatment works. Pail service shall mean the collection of containerized human waste from privies. This service is provided by the City of Syracuse. Steel containers are supplied to residences that are currently receiving service. The containers, when full, are collected by City personnel and emptied into a concrete holding tank on City owned property in the Town of Sempronius, Cayuga County. The storage and transport of this waste are permitted by the NYS Department of Environmental Conservation under 6 NYCRR Parts 360 and 364. Pumping of the holding tank is done as needed by a licensed waste hauler as required by 6 NYCRR Part 364.
(31) Pesticide shall mean any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any pest, and any substance or mixture of substances intended for use as a plant regulator, defoliant, or desiccant, and being those substances defined as pesticides pursuant to section 33-0101 et seq. of the Environmental Conservation Law.
(32) Point source discharge shall mean pollutants discharged from a point source as defined in section 17-0105 of the Environmental Conservation Law.
(33) Privy shall be as defined in the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996).
(34) Protection zone shall mean any of the watershed management zones, zones I, II and III as described in paragraphs (54)-(56) of this subdivision.
(35) Radioactive material shall mean any material in any form that emits radiation spontaneously, excluding those radioactive materials or devices containing radioactive materials whose receipt, possession, use, and transfer are exempt from licensing and regulatory control pursuant to regulations of the New York State Department of Labor or United States Nuclear Regulatory Commission.
(36) Radiation shall mean ionizing radiation; that is, any alpha particle, beta particle, gamma ray, x-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(37) Recyclables handling and recovery facility shall mean a solid waste management facility, other than a pickup or transfer vehicle, at which recyclables are separated from the solid waste stream, or at which previously separated recyclables are collected for storage, or off-site shipment as defined in section 27-0701 et seq. of the Environmental Conservation Law and 6 NYCRR Part 360.
(38) Septage shall mean the contents of a septic tank, cesspool, or other individual wastewater treatment work, which receives domestic sewage wastes.
(39) Silviculture shall mean the art, science and practice of controlling the establishment, growth, composition, health and quality of forests and woodlands to meet the diverse needs and values of landowners and society on a sustainable basis.
(40) Sludge shall mean the solid, semi-solid, or liquid waste generated from a waste processing facility, but does not include the liquid stream of effluent.
(41) Solid waste shall mean all putrescible and nonputrescible materials or substances discarded or rejected as being spent, useless, worthless or in excess to the owners at the time of such discard or rejection, including but not limited to garbage, refuse, industrial and commercial waste, sludges from air or water control facilities, rubbish, ashes, contained gaseous material, incinerator residue, demolition and construction debris, discarded automobiles and offal but not including sewage and other highly diluted water carried materials or substances and those in gaseous form, and being those wastes defined as solid waste pursuant to section 27-0701 et seq. of the Environmental Conservation Law and 6 NYCRR Part 360.
(42) Solid waste management facility shall mean any facility employed beyond the initial waste collection process, including, but not limited to, transfer stations, bailing facilities, rail haul or garbage haul facilities, processing systems, including resource recovery facilities or other facilities for reducing solid waste volume, sanitary landfills, facilities for the disposal of construction and demolition debris, plants and facilities for compacting, composting, or pyrolization of solid wastes, incinerators, and other solid waste disposal, reduction, or conversion facilities, as defined in section 27-0701 et seq. of the Environmental Conservation Law and 6 NYCRR Part 360.
(43) Spill shall mean any escape of a substance from the containers employed in storage, transfer, processing, or use.
(44) State Pollutant Discharge Elimination System (SPDES) shall mean the system established pursuant to article 17, title 8 of State Environmental Conservation Law for issuance of permits authorizing discharges to the waters of the State of New York.
(45) Stormwater runoff recharge basin shall mean a man-made device capable of retaining surface water runoff to induce groundwater infiltration.
(46) Subdivision shall mean any tract of land which is divided, after the effective date of this Part, into two or more lots, plots, sites or other division of land for the purpose of sale or rent, or development regardless of whether the lots, plots or sites to be sold or offered for sale, or leased or rented for any period of time, are described by metes and bounds or by reference to a map or survey of the property or by any other method of description.
(47) Supplier of water shall mean the City of Syracuse, a municipal corporation, organized and existing under the laws of New York State, and having offices at City Hall, Syracuse, NY 13202. The City of Syracuse is the owner and operator of the public water supply facilities located within the watershed protection zones as described in paragraphs (55)-(57) of this subdivision.
(48) USDA NRCS shall mean the United States Department of Agriculture Natural Resources Conservation Service.
(49) Wastewater shall mean aqueous carried waste including, but not limited to, dredge spoil, solid waste, hazardous waste, incinerator ash residue, septage, garbage, refuse, sludge, chemical waste, infectious waste, biological material, radioactive materials, heat, and industrial, municipal, and agricultural waste.
(50) Wastewater treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, collection or distribution pipe, on-site disposal system and seepage unit, or other work installed for the purpose of transport, treatment, neutralization, stabilization, storage, or disposal of wastewater.
(51) Watercourse shall be considered "waters" or "waters of the state" as defined in section 17-0105 of the Environmental Conservation Law and further described as being annual or perennial, influent or effluent, continuously or intermittently flowing and include those classified in 6 NYCRR Part 896. The banks of such watercourse shall be identifiable, i.e., defined bed, banks, gullies, ravines, etc., that are capable of, and do under normal conditions, carry water in a manner described above. Road ditches and shallow land depressions generally referred to as grassed waterways, swales, etc., that carry water only immediately (a few to several hours) after a runoff producing event are not considered a watercourse. A map delineating the watercourses of the watershed can be reviewed at the City of Syracuse Water Treatment Plant at 20 West Genesee St., Skaneateles, NY, and the New York State Department of Health, Bureau of Public Water Supply, Flanigan Square, 547 River Street, Troy, NY 12180-2216. Where there is a discrepancy between the maps and field observations, a site evaluation by designated supplier of water personnel will be the method of verifying whether or not a particular channel is a watercourse. Their determination shall be final.
(52) Watershed shall mean that land area which contributes water to the lake, watercourse, aquifer, or aquifer recharge area and shall include the three designated protection zones known as zone I, zone II, and zone III as described in paragraphs (57)-(59) of this subdivision.
(53) Watershed protection zone shall mean the land area, known as zone III, which is tributary to zones I and II described in paragraph (59) of this subdivision and is the tributary surface area from which the lake, watercourse, and aquifer are replenished by runoff. Maps delineating this zone can be reviewed at the City of Syracuse Water Treatment Plant, 20 West Genesee Street, Skaneateles, NY, New York State Department of Health, Bureau of Public Water Supply, Flanigan Square, 547 River Street, Troy, NY 12180-2216.
(54) Water supply shall mean the public water supply of the City of Syracuse.
(55) Water supply protection zones shall mean the lake surface areas known as zones I and II described in paragraphs (57)-(58) of this subdivision. Maps delineating these zones can be reviewed at the City of Syracuse Water Treatment Plant, 20 West Genesee Street, Skaneateles, NY, and, New York State Department of Health, Bureau of Public Water Supply, Flanigan Square, 547 River Street, Troy, NY 12180-2216.
(56) Whole Farm Planning Program, established by the Supplier of Water and known as the Skaneateles Lake Watershed Agricultural Program (SLWAP), shall mean that program designed to implement management practices on farms (farms as described in paragraph [14] of this subdivision) in order to eliminate or minimize sources of non-point source pollution. Under this program a specific plan is developed for each farm by SLWAP in accordance with the USDA - NRCS Conservation Practice Standard code NY312 (January 8, 1999) and the plan is accepted by the farmer. A copy of the plan is on file at the SLWAP office, 2571 Route 11, Suite 3, Lafayette, NY 13084.
(57) Zone I shall mean the area within a 500-foot radius of the water supply intakes.
(58) Zone II shall mean the entire lake surface area excluding zone I.
(59) Zone III shall mean the entire tributary watershed to the lake, watercourse, aquifer or aquifer recharge area.
(c) General provisions.
(1) The manufacture, use, storage, disposal, or discharge of any product, material, or byproduct, including, but not limited to, wastewater, solid waste, or any pollutant within the identified protection zones must conform to the requirements of these rules.
(2) Copies of permit applications and notices of intent for proposed building activities that involve land or shoreline disturbance within the watershed shall be forwarded to the supplier of water, by the applicant, at the same time it is submitted to the agency having jurisdiction. Notification shall be at the earliest stages of the application process including a informal or formal pre-application review stage ( i.e., preliminary sketches, drawings, proposals, etc.) for any proposed activities so as to allow the supplier of water to be included in the review of any proposed activities within the watershed at the initial planning stages. Where applicable, any comments by the supplier of water must be submitted within the statutory or procedural time frames of the permitting agency. Copies of all permits issued shall be sent to the supplier of water by the applicant.
(3) Point source discharges are prohibited as described in section 17-1709 of the Environmental Conservation Law.
(4) Any person, agency, or entity preparing an environmental impact statement (draft and final) for a project or activity in zone I, II or III shall file a copy with the Commissioner of Health, the Onondaga County Health Department, the health department of the county within which the project or activity is proposed, and the supplier of water.
(5) Spills. Within any of the herein defined protection zones, any person who is the owner of, or in actual or constructive possession or control of a hazardous material, petroleum, or radioactive material, or any agent or employee thereof, or any person who has knowledge of any spill, as defined in subdivision (b) of this section, of any hazardous material, petroleum, or radioactive material to the ground surface or any watercourse, shall notify the supplier of water, the New York State Department of Environmental Conservation, Onondaga County Department of Health, and the health department of the county in which the spill occurred. Notwithstanding any of the foregoing provisions, all spills shall be reported pursuant to article 12 of the Navigation Law and section 17-1743 of the Environmental Conservation Law.
(6) Transportation of hazardous materials is prohibited except under permit of the New York State Department of Transportation pursuant to section 14-F of the Transportation Law and 17 NYCRR Part 507.
(7) Disposal of snow or ice from the plowing of public or private roads, driveways, parking lots, etc., into the lake or watercourse is prohibited except for incidental deposition from plowing operations.
(d) Specific regulations: zone I.
(1) Water use.
(i) All recreational use including boating, swimming, and fishing is prohibited within 500 feet of water supply intakes. Notification of the public of these restrictions shall be made by the posting of signs in appropriate places.
(ii) No solid or liquid waste, hazardous material, herbicide, pesticide, or other material that may have a detrimental impact on water quality shall be discharged, placed, applied, or thrown into waters in this zone.
(iii) Waste disposal systems for watercraft shall be designed, installed and maintained in accordance with standards established in section 33-a of the Navigation Law. Said facilities are to be modified to prevent any discharge to the waters of Skaneateles Lake. Servicing and pump-out of holding tanks on watercraft shall be performed at facilities permitted by NYSDEC and county health departments having jurisdiction.
(e) Specific regulations: zone II.
(1) No solid or liquid waste, hazardous material, herbicide, pesticide, or other material that may have a detrimental impact on water quality shall be discharged, placed, applied or thrown into waters in this zone except as determined necessary by the supplier of water for preservation of water quality subject to approval by the Commissioner of Health or his/her designated representative and the NYSDEC.
(2) Waste disposal systems for watercraft shall be designed, installed and maintained in accordance with standards established in section 33-a of the Navigation Law. Said facilities are to be modified to prevent any discharge to the waters of Skaneateles Lake. Servicing and pump-out of holding tanks on watercraft shall be performed at NYSDEC permitted facilities.
(f) Specific regulations: zone III.
(1) Wastewater treatment works.
(i) All individual household wastewater treatment works receiving domestic wastewater without the admixture of industrial or other wastes, as those terms are defined in section 17-0701 of the Environmental Conservation Law, in quantities of less than 1000 gallons per day shall be designed, installed, and maintained in accordance with the standards established in Part 75 (Appendix 75-A) of this Title, and the NYSDOH publication: Individual Residential Wastewater Treatment Systems Design Handbook (1996). Room for a 50 percent expansion of the leaching component of wastewater treatment works shall be provided for conventional and alternative systems. Room for a 100 percent expansion of the leaching component of the wastewater treatment works is recommended for alternative systems. In both cases, lineal separation distance requirements shall be met based upon the actual leaching area plus the expansion area. The authority to approve individual household treatment works shall rest with the NYSDOH or the county health department having jurisdiction. Approval may be denied when rapid percolation, as defined in Part 75 (Appendix 75-A) of this Title is found.
(ii) The absorptive component of all wastewater treatment works shall be a minimum of 100 feet linear distance from the lake or watercourse.
(iii)
(a) Land-based holding tanks shall not be installed for new construction ( i.e., full- time or part-time occupancy). Land-based holding tanks may be permitted as replacements for existing failing land-based holding tanks, as replacement systems for pail service, or for those cases where a land-based holding tank is the only possible repair or replacement alternative for an existing onsite wastewater treatment system where conditions preclude the replacement of onsite wastewater treatment systems due to parcel size limitations, poor soil conditions, or insufficient depth to bedrock or groundwater. All holding tanks shall be designed, installed, and maintained in accordance with the standards established in the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996). The authority to approve the installation of land-based holding tanks shall rest with the NYSDOH or the county health department having jurisdiction.
(b) Land-based holding tanks shall not be placed within a 50-foot lineal distance of the lake or a watercourse.
(c) Land-based holding tanks shall be equipped with audio or visual alarms indicating that the tank is 80 percent full. Pumping of all tanks shall be accomplished by a licensed waste hauler as described in 6 NYCRR Part 364. A log of dates when the tank was pumped shall be maintained by the owner of said dwelling indicating when the tank was pumped. The log shall include receipts submitted to the property owner by the waste hauler for the pumping. The log and receipts shall be made available upon request of the NYSDOH or county health department having jurisdiction or the supplier of water.
(d) If site conditions, including but not limited to proximity to the lake or watercourse, steep slopes, erodible or unstable soils or high groundwater indicate that the installation of a new land-based holding tank, or the continued use of an existing land-based holding tank would pose an immediate potential for contamination to the lake or watercourse if it were to leak, additional safeguards will be required. These safeguards may include, singly or in combination, such mitigating measures as runoff and groundwater diversion structures, structural supports to prevent movement, secondary containment structures around the land-based holding tank and system components, or mandatory pumping intervals.
(e) The term continued use in clause ( d ) of this subparagraph shall pertain to those situations where the tank has failed and remedial action is necessary.
(iv) New construction of privies shall be allowed if constructed as outlined in the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996), and where approval from the NYSDOH or county health department having jurisdiction is obtained, and they are not within a 100-foot lineal distance from a watercourse or 300 foot lineal distance from the lake, and one of the following criteria are met:
(a) pumping of a self-contained vault-type privy shall be done by a licensed waste hauler as described in 6 NYCRR Part 364 when the contents are within 18″ from the top of the vault, and a log (including receipts for pumping services) are maintained and made available to the supplier of water as outlined in clause (iii)( c ) of this paragraph; or
(b) for a sanitary pit privy, a test hole of not less than six feet is dug and witnessed by a City of Syracuse watershed inspector prior to construction to ensure a minimum of a two foot separation from the bottom of the proposed pit to seasonal high groundwater and/or bedrock, and the pit shall be cleaned, pumped, or material buried in place when the contents are within 18″ of ground level provided:
(1) if cleaned, the material shall be buried no less than 300 feet from the lake or 100 feet from a watercourse with no less than 18″ of soil cover; or
(2) if pumped, the pumping and disposal shall be effected by a licensed waste hauler as described in clause (iii)( c ) of this paragraph; or
(3) the privy can be moved in accordance with this section, and the pit filled to ground surface level with no less than 18″ of soil and tamped down.
(v) The alteration, addition or repair of existing privies shall be allowed if constructed as outlined in the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996) and the criteria set forth in clause (iv)( a ) or ( b ) of this paragraph is met, and where approval from the NYSDOH or county health department having jurisdiction is obtained. An existing privy may be allowed to remain within 300 lineal feet of the lake and/or within 100 lineal feet of the watercourse if the bottom of the pit is at least two feet above bedrock and/or maximum high groundwater and grading is such that surface water is prevented from entering the pit.
(vi) The use of wastewater treatment works, other than individual household systems, with design flows greater than 1000 gallons per day are subject to the approval and enforcement authority of the NYSDEC and the county health department having jurisdiction.
(vii) Any alteration, addition or repair of an existing wastewater treatment works shall conform to Part 75 (Appendix 75-A) of this Title and the NYSDOH publication Individual Residential Wastewater Treatment Systems Design Handbook (1996). If conformance is not possible for reasons including, but not limited to insufficient or limited available area on the parcel, or limiting soil conditions, a specific waiver may be granted, pursuant to Part 75 of this Title by the NYSDOH or county health department having jurisdiction subject to the review, recommendation and comment by the supplier of water. This waiver may include such requirements as deemed necessary to assure the protection of the source of water. The granting of this waiver is subject to the applicant demonstrating that the alternatives have been investigated and the design alternative selected is one that minimizes the risk of contamination to the lake or watercourse and maximizes the utilization of the usable area and conditions of the site. Prior to the alteration, addition or repair, notification of the proposed action shall be made to, NYSDOH or county health department having jurisdiction and to the supplier of water. Approval from the NYSDOH or county health department having jurisdiction for the alteration, addition or repair shall be obtained.
(viii) No new construction or alteration, addition or change of use (for example, conversion from seasonal to year-round residence) of existing dwellings or commercial buildings shall be undertaken, until such time as the supplier of water and the NYSDOH or county health department having jurisdiction has been notified, and the NYSDOH or county health department having jurisdiction has:
(a) issued an approval for the construction of a new wastewater treatment works; or
(b) issued an approval for the alteration, addition or repair of the existing wastewater treatment works; or
(c) issued a written notice indicating acceptance of the existing treatment works for the proposed construction, alteration, addition or change in use.
(ix) All proposed installations for new construction of wastewater treatment works, excluding privy installation, shall be designed by a design professional as defined in Part 75 (Appendix 75A) of this Title. The health department having jurisdiction may require that the alteration, addition or repair of existing wastewater treatment works be designed by a design professional where determined necessary to assure conformance with provisions of subparagraph (vii) of this subdivision. Approval from the NYSDOH or county health department having jurisdiction for the construction or alteration, addition or repair must be obtained.
(x) All site and soil appraisals for new construction or alteration, addition or repair of existing treatment works, as described in Part 75 (Appendix 75-A) of this Title and the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996) shall be witnessed by a City of Syracuse watershed inspector.
(xi) Required soil analyses should be conducted during the season of highest groundwater levels to insure proper design. This interval is generally between March 15th and June 30th. If the soil analysis is conducted at a time other than specified above, soil mottling and discoloration readings shall be used to establish the highest groundwater levels and, if questions arise as to the suitability of the site for system installation, observation of groundwater levels during a period of seasonal wetness may be required.
(xii) Pail service shall be replaced by other methods as described in Part 75 (Appendix 75-A) of this Title and the NYSDOH publication, Individual Residential Wastewater Treatment Systems Design Handbook (1996) subject to the approval of the NYSDOH or county health department having jurisdiction.
(xiii) Review by supplier of water. All applications and design drawings for the construction of new or alteration, addition or repair of existing wastewater treatment works, including privies, shall be submitted by the applicant, to the supplier of water for review, recommendation, or comment as outlined in paragraph (c)(2) of this section. Copies of all approvals issued shall be sent to the supplier of water by the NYSDOH or county health department having jurisdiction.
(2) Septage and sludge.
(i) Storage of septage, sludge, or human excreta, other than storage associated with the operation of an individual wastewater treatment works or as pertains to the City of Syracuse pail service is prohibited.
(ii) The land application of septage, sludge, or human excreta is prohibited.
(iii) Burial of human excreta is prohibited except as described in subparagraphs (1)(iv) and (v) of this subdivision.
(3) Animal waste storage and disposal. Areas used for the storage, stockpiling, or disposal of non-agricultural or agricultural associated animal waste shall:
(i) be in conformance with the publication Agricultural Management Practices Catalogue for Nonpoint Source Pollution Prevention and Water Quality Protection in New York State May 1996, published by the Bureau of Water Quality Management, Division of Water, NYSDEC, 625 Broadway, Albany, NY 12233. The publication is available for public inspection and copying from The Bureau of Public Water Supply Protection, Flanigan Square, 547 River Street, Troy, NY 12180-2216; or
(ii) conform to the plan developed by the Whole Farm Planning Program.
(4) Fertilizer and manure use.
(i) Open storage of fertilizers is prohibited.
(ii) Use of fertilizers and land application of manure shall:
(a) be in conformance with the publication defined in paragraph (3) of this subdivision; or
(b) conform to the plan developed by the Whole Farm Planning Program.
(iii) Fertilizer shall not be applied in a manner or at a rate which contravenes the water quality standards set forth in 6 NYCRR Parts 700-705.
(5) Pesticide storage and use.
(i) Pesticide storage and use are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation.
(ii) Pesticides shall not be applied in a manner or at a rate which contravenes the water quality standards set forth in 6 NYCRR Parts 700-705.
(iii) Use of streams as a source of water or for make-up water or washing of equipment used in conjunction with pesticides without the use of an anti-siphoning device in accordance with 6 NYCRR Part 325 is prohibited.
(6) Sediment generation and control.
(i) Farm tillage practices shall:
(a) be in conformance with the publication defined in paragraph (3) of this subdivision; or
(b) conform to the plan developed by the Whole Farm Planning Program.
(ii) Pertaining to this paragraph, the term environmentally sensitive area shall be defined as those areas that meet any or all of the following criteria:
(a) land within 300 feet of the lake or watercourse;
(b) areas with slopes greater than 15 percent;
(c) within 300 feet of or within areas defined by the NYSDEC as wetlands;
(d) soils that are highly erodible, where highly erodible is defined as: areas with soils that pose a high risk of erosion, or severe limitations on structure or sewage disposal system construction, and are identified as lands with some or all of the following conditions:
(1) shallow soils: <2 foot depth to bedrock or fragipan;
(2) high seasonal groundwater table (<3) feet;
(3) soils that are either poorly drained and/or slowly permeable;
(4) soils that are either excessively drained and/or highly permeable soils;
(5) soils underlain or intersected by easily softened and mobile layers, especially silts and clays, which may be evidenced by outcrop or recent instability; and
(6) the soils and conditions thereof discussed in subclauses ( 1 ) to ( 4 ) of this clause, are as defined in the Soil Survey of Onondaga County, New York (January 1977), Soil Survey of Cayuga County, New York (May 1971), and Soil Survey of Cortland County, New York (May 1961) prepared by the USDA Natural Resources Conservation Service (NRCS) (previously the Soil Conservation Service) in cooperation with the Cornell University Agricultural Experimental Station. These publications are available for public inspection at the NRCS office, 441 South Salina Street, Syracuse, NY 13202. If an onsite investigation indicates soil conditions other than described in the above referenced publications, the onsite investigation results will take precedence.
(iii) Land disturbing activities, including, but not limited to, general construction, highway construction and maintenance, and silviculture, and which expose 5,000 or more square feet of soil ( i.e., vegetation has been removed, or the landscape has been graded or filled resulting in bare soil surfaces) are prohibited within an environmentally sensitive area as defined in subparagraph (ii) of this paragraph, except where measures have been put in place to prevent erosion and sediment production as outlined in the various publications:
(a) New York State Stormwater Management Design Manual (August 2003) prepared by the Center for Watershed Protection, 8391 Main St., Ellicott City, MD 21043 for the NYSDEC, 625 Broadway, Albany, NY 12233 and distributed by Soil and Water Conservation Society, Empire State Chapter, c/o Cayuga County Soil and Water Conservation District, 7413 County House Rd., Auburn, NY 13021;
(b) New York Guidelines for Urban Erosion and Sediment Control (April 1997), published by the Soil and Water Conservation Society, Empire State Chapter, c/o Cayuga County Soil and Water Conservation District, 7413 County House Rd., Auburn, NY 13021;
(c) Construction Management Practice Catalogue for Nonpoint Source Pollution Prevention and Water Quality Protection in New York State 2nd Edition, March 1999, published by the Bureau of Water Quality Management, Division of Water, NYSDEC, 625 Broadway, Albany, NY 12233;
(d) Silviculture Management Practice Catalogue for Nonpoint Source Pollution Prevention and Water Quality Protection in New York State (October 1993) published by the Bureau of Water Quality Management, Division of Water, NYSDEC, 625 Broadway Albany, NY 12233;
(e) the publications defined in paragraph (3) of this subdivision; and
(f) all publications are available for public inspection and copying from The Bureau of Public Water Supply Protection, Flanigan Square, 547 River Street, Troy, NY 12180-2216.
(iv) The proposed erosion control measures shall be in the form of a written description and site plan showing the design criteria, location and type of proposed control structures, sequence of actions, maintenance and construction details. Copies of the erosion/stormwater control plans must be submitted to the supplier of water, by the applicant at least 10 business days prior to undertaking any land disturbing activity.
(v) If a municipality through local regulation requires such erosion/stormwater control plans, the proposed erosion control measures shall be submitted, by the applicant to the municipality as required by local regulation.
(vi) Public highway construction activities shall be performed so as to preclude erosion and sediment production. Generic mitigation practices pertaining to general road maintenance, road ditch clearing, etc., shall be submitted to the supplier of water for review and comment and kept on file. For road re-construction or new construction, mitigation plans specific to that activity shall be developed by the highway department proposing the action and submitted to the supplier of water for review and comment.
(7)
(i) New solid waste management facilities, whether regulated or exempt from regulation under 6 NYCRR Part 360 or any other local laws or regulations are prohibited within the watershed except for the following:
(a) composting facilities as described in 6 NYCRR section 360-5.1(b), provided that the solid waste is generated and stored/located within the property boundaries of a single family residence or farm as described in 6 NYCRR section 360-1.7(b)(1) and (3);
(b) liquid storage facilities for the storage of leachate or waste water from any abandoned landfill as regulated in 6 NYCRR Subpart 360-6 excluding surface impoundments as described in 6 NYCRR section 360-6.5;
(c) construction and demolition debris landfills as described in 6 NYCRR section 360-7.1(b)(1)(i) when such debris is generated within the property boundaries of a single family residence or farm as described in 6 NYCRR section 360-1.7(b)(1), and 6 NYCRR section 360-7.1(b)(1)(ii);
(d) regulated medical waste and waste storage and transfer facilities as exempted from regulation under 6 NYCRR section 360-10.1(b). Disposal of said waste is prohibited;
(e) permitted transfer stations as described in 6 NYCRR Subpart 360-11, and including clean-up days or similar events described in 6 NYCRR section 360-1.7(b)(6);
(f) recyclables handling and recovery facilities exempted under 6 NYCRR section 360-12.1(b) and (c), however, disposal of the recyclables or by-products of any handling or recovery processes, or waste generated from any of those processes is prohibited. Storage of used automobiles, trucks, etc., which are not being dismantled for sale or re-use, is prohibited;
(g) temporary waste tire storage facilities as described in 6 NYCRR section 360-13.1(b).
(h) used oil as regulated by 6 NYCRR sections 360-14.1(d)(2) and 360-14.4 and 360-14.5 where only storage is allowed if the appropriate permit is obtained; and
(i) construction and demolition debris processing facility as described in 6 NYCRR section 360-16.1(b) and registered as outlined in 6 NYCRR section 360-16.1(c) as long as the processed materials are not disposed of within the watershed, and are not allowed to enter the lake or watercourse.
(ii) The minimum linear distance separation for the location of the facilities described in subparagraph (i) of this paragraph are:
(a) clause (i)( a ) of this paragraph is 100 feet; and
(b) clauses (i)( b )-( i ) of this paragraph is 300 feet.
(iii) Solid waste facilities existing at the time of adoption of this Part can remain if in compliance with 6 NYCRR Part 360.
(8) Hazardous material.
(i) Storage and use of hazardous materials is subject to regulation by the State Department of Environmental Conservation pursuant to article 27 of the Environmental Conservation Law and 6 NYCRR Parts 370-376 and all other agencies having jurisdiction.
(ii) Disposal of hazardous material is prohibited.
(9) Radioactive material. Disposal of radioactive waste is prohibited.
(10) Petroleum storage.
(i) Installation, operation, use, maintenance, and closure of aboveground and underground bulk petroleum storage tanks, is subject to the approval and enforcement authority of 6 NYCRR Parts 612-614 or within Cortland County under the authority of the Cortland County Health Department.
(ii) Whenever mandatory notification to the NYSDEC is required regarding inventory monitoring, leak detection test reports, or discovery of a leak, etc., notification to the supplier of water is also required. This notification shall be made at the same time notification to the NYSDEC is made.
(iii) Facility inventory records and previous leak detection reports shall also be made available to the supplier of water personnel upon request.
(iv) All permit applications for the installation of new or the modification of existing facilities shall be forwarded to the supplier of water for review and comment as outlined in paragraph (c)(2) of this section.
(11) Stockpiles.
(i) Storage of chloride salts is prohibited except in structures designed to minimize contact with precipitation and built on low permeability pads which control seepage and runoff, and is located at a lineal distance of no less than 500 feet from the lake or a watercourse.
(ii) Storage of coal is prohibited except in structures as defined in subdivision (i) of this section.
(12) Chloride salt application. Chloride salt use for deicing shall be restricted to the minimum amount needed for public safety.
(13) Construction and closure of wells.
(i) Oil and gas well construction, maintenance, and abandonment is subject to the approval and enforcement authority of the New York State Department of Environmental Conservation.
(ii) Water supply well construction, maintenance, and abandonment is subject to the regulations established by section 15-1502 of the Environmental Conservation Law and section 206 of the Public Health Law.
(14) Cemeteries. All cemeteries shall be operated to prevent contamination of the public water supply.
(g) Inspections.
(1) The officials of the City of Syracuse or any persons charged with the maintenance or supervision of the public water supply system by its officers or their duly appointed representative, shall make regular and thorough inspections of the identified protection zones to enforce the rules and regulations set forth in this section. It shall be the duty of the aforesaid officials to serve a notice of such violation, together with copies of any rules and regulations violated, upon persons violating the same. If such persons served do not immediately comply with the rules and regulations violated, it shall be the further duty of the aforesaid officials to promptly notify, in writing, the Commissioner of Health or his or her authorized representative, which official may enter property for the purpose of causing such violations to be abated.
(2) The City of Syracuse shall report to the State Commissioner of Health in writing annually, on or prior to the 30th day of April, the results of regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number and type of violations both cited and abated, and the general conditions of the protection zones at the time of the last inspection.
(3) With the authority granted by section 1101 of the New York State Public Health Law, an inventory and census shall be conducted and updated on an ongoing basis by the supplier of water of all systems, facilities, and activities in the protection zones that may contribute to water supply source contamination including, but not limited to, wastewater treatment system surveys and dye testing, hazardous materials inventory and agricultural materials surveys.
(h) Remedies for violation.
Remedies for violation of these rules and regulations shall be those specified by sections 1102 and 1103 of the Public Health Law and/or article 71 of Environmental Conservation Law and any other law where applicable.
(i) Variances.
(1) The Commissioner of Health or his/her designated representative may, upon written application from the owner, operator, or person in charge of a site, grant a variance from the requirements of these regulations, provided that a variance shall be granted only if the regulated activity, alone or cumulatively with other proposed activity, will not contravene the water quality standards described in 6 NYCRR Parts 700-705. The issuance of a variance shall not authorize any use or extension of use in zone I, II, or III for which a permit is required by any local, State or Federal authority.
(2) An application for a variance must:
(i) include the applicant's name, address, and his interest in the subject property; and the owner's name and address if different from the applicant;
(ii) include the owner's signed consent to the application if made by any person or entity other than the owner of the site;
(iii) include the street address and legal description of the subject site;
(iv) include a sketch plan illustrating all proposed site alterations, all structures existing on site both above and below ground, the existing uses and zoning of adjacent parcels, site contours and drainage patterns;
(v) demonstrate that the regulated activity will not cause an increased risk of contamination or degradation of the water supply;
(vi) identify the specific provision of these rules and regulations from which the variance is sought;
(vii) demonstrate that due to conditions unique and peculiar to the applicant's situation, compliance with these rules and regulations would be unduly burdensome or result in substantial hardship that cannot be otherwise mitigated;
(viii) demonstrate that any undue burden or substantial hardship was not created by the applicant, and cannot be avoided except by a variance;
(ix) demonstrate that alternatives to the regulated activity have been considered and that there is no available alternative, which would not require a variance;
(x) demonstrate the regulated activity as proposed includes adequate mitigation measures to justify such variance; and
(xi) be submitted to the supplier of water and the commissioner.
(3) Review by the supplier of water. Within 90 days of the receipt of an application for variance, the supplier of water shall make a written recommendation to the commissioner as to whether the applicant has met the standards for a variance. In order to make its recommendation, the supplier of water may request additional information from the applicant. The supplier of water may also hold a public hearing on the application, upon 30 days' notice. The supplier of water's written recommendation shall be forwarded by the supplier of water to the commissioner and served on the applicant.
(4) Decision of the commissioner.
(i) The commissioner or his/her designated representative may solicit the views of the supplier of water on a variance application. After reviewing the application and any recommendations provided by the supplier of water, the commissioner will render a decision to grant, grant with conditions or deny a variance application. The requirements of paragraph (2) of this subdivision shall be used as the basis for each decision. The commissioner may hold a public hearing on the application, if deemed necessary, to seek further information prior to rendering a final decision.
(ii) The commissioner shall impose such conditions as he or she may deem necessary or prudent to preserve the quality of the water supply. All conditions shall be expressly set forth and the reasons for such conditions specified. Violations of the conditions of a variance shall be a violation of this Part.
(iii) The issuance of a variance from a requirement imposed by this section shall not act as a variance from any regulation or requirement of any other Federal, State or local agency, or any other regulation or requirement of the Department of Health.
(iv) In granting a variance or a conditioned variance, the commissioner may require financial security, impose time limitations or limit transfer of the approval.
Part 113 ERIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 113.4 Village of North Collins
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on land owned by the Village of North Collins and situated approximately one mile south of the village near the highway bridge over Sister Creek on the Fenton Road which form the source of the public water supply of the Village of North Collins, Erie County, New York.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the wells.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Village of North Collins.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well of the public water supply of this Village of North Collins.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removal, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the Village of North Collins.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any well of the public water supply of the Village of North Collins.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of any well of the public water supply of the Village of North Collins.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the village of North Collins, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any well of the public water supply of the Village of North Collins.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any well of the public water supply of the Village of North Collins.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the Village of North Collins.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village upon which the wells of the public water supply of the Village of North Collins are located and no person or persons shall enter in or upon such property, except the village board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the Village of North Collins.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Village of North Collins.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Village of North Collins.
(j) Inspections.
The board of trustees of the Village of North Collins or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of North Collins or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.94 Display and service of food
(a) Food placed on display is to be protected against contamination. The quantity of food displayed is to be limited to immediate needs.
(b) All artificial lighting fixtures located over, by or within food storage, preparation, service or display facilities and facilities where utensils and equipment are cleaned and stored are to be protected to prevent broken glass from falling into food or onto food-contact surfaces.
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.32 Definition of hermetically sealed container
An hermetically sealed container is a container which is designed and intended to be secure against the entry of microorganisms and to maintain the safety and quality of its contents after processing.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.4 Response
If the lead concentration of water at an outlet exceeds the action level, the school shall:
(a) prohibit use of the outlet until:
(1) a lead remediation plan is implemented to mitigate the lead level of such outlet; and
(2) test results indicate that the lead levels are at or below the action level;
(b) provide building occupants with an adequate supply of potable water for drinking and cooking until remediation is performed;
(c) report the test results to the local health department as soon as practicable, but no more than one business day after the school received the laboratory report; and
(d) notify all staff and all persons in parental relation to children or students of the test results, in writing, as soon as practicable but no more than 10 business days after the school received the laboratory report; and, for results of tests performed prior to September 6, 2016, within 10 business days after September 6, 2016, unless such written notification has already occurred.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.3 General requirements for administration of the Infant Hearing Screening Program
(a) The administrative officer of each facility caring for infants or their contractor(s) shall designate a program manager responsible for management and oversight of the Infant Hearing Screening Program.
(1) The program manager shall be a licensed audiologist, physician, physician's assistant, registered nurse or nurse practitioner.
(2) If the program manager is not an audiologist, infant hearing screening procedures and training shall be established and monitored in consultation with an audiologist.
(b) The program manager shall be responsible for ensuring:
(1) training and supervision of the individuals performing the screening;
(2) review, recording and documentation of screening results;
(3) data reporting;
(4) staff and parent education; and
(5) coordination of services and follow-up including referrals for re-screening or diagnostic audiologic evaluation as appropriate.
(c) All personnel performing infant hearing screening must be supervised and trained in the performance of infant hearing screening.
(d) Training shall include the following:
(1) the performance of infant hearing screening;
(2) the risks including psychological stress for the parent;
(3) infection control practices;
(4) the general care and handling of infants in hospital settings according to established hospital policies and procedures;
(5) the recording and documentation of screening results as directed; and
(6) procedures for communicating screening results to parents.
(e) Personnel other than licensed audiologists may perform infant hearing screening provided that:
(1) the screening equipment and protocol used are fully automated;
(2) equipment parameters are not accessible for alteration or adjustment by such personnel; and
(3) the results of the screening are determined without clinical decisionmaking and are reported as pass or fail.
(f) Equipment that requires clinical decisionmaking shall be used to conduct infant hearing screenings only by personnel licensed under State Education Law and authorized to perform infant hearing screening.
(g) Equipment used for infant hearing screening shall be maintained and calibrated in accordance with section 405.24(c)(2) of this Title.
(h) The facility shall provide adequate physical space for equipment and supplies and an environment suitable to obtain reliable infant hearing screening results.
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.10 Financial investigators
(a) Definition.
A financial investigator is a person employed under a county’s children and youth with special health care needs support services program for the purpose of:
(1) conducting financial investigations of families of children for whom care has been requested under the program; and
(2) detecting problems in families which may have a bearing on the utilization or outcome of services provided under the program, and referring families to appropriate agencies for help regarding these problems.
(b) Qualifications.
The financial investigator shall meet one of the following qualifications:
(1) graduation from a recognized college or university with a bachelor's degree;
(2) satisfactory completion of training leading to nursing registration, and one year of satisfactory full-time experience as a registered professional nurse;
(3) four years of satisfactory full-time paid experience either in financial investigations or in casework with a social work agency adhering to acceptable standards or in supervised teaching in an accredited school;
(4) a satisfactory combination of the training and experience described in paragraphs (1)-(3) of this subdivision; or
(5) full-time employment specifically in the performance of financial investigations under the children and youth with special health care needs support services program as of April 1, 1964.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.257 Physician, attending
The physician who has legal responsibility for the care of a patient in a hospital.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.55 Podiatric radiographic installations
(a) Equipment.
(1) The protective tube housing shall be of diagnostic type.
(2) Collimating devices capable of restricting the useful beam to the area of clinical interest shall be used and shall provide the same degree of protection as is required of the tube housing.
(3) The X-ray films used as the recording medium during the X-ray examination shall show substantial evidence of cut-off (beam delineation).
(4) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(5) A device shall be provided which terminates the exposure after a preset time interval or exposure. The exposure switch shall be of the dead-man type and where protective barriers are required shall be so arranged that it cannot be operated outside the shielded area.
(6) Each installation shall be arranged so that the operator can stand at least six feet from the patients, the X-ray tube and the useful beam during exposure. A protective barrier shall be provided when the operator cannot stand at least six feet away from the patient, the X-ray tube and useful beam during exposures.
(b) Conditions for operation of equipment.
(1) No person shall hold film during the exposure.
(2) Only persons required for the radiographic procedure shall be in the radiographic room during exposure.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 151 ULSTER COUNTY
CITIES CITIES
10 CRR-NY 151.1 City of Kingston
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to those portions of Sawkill and Mink Hollow creeks, to Cooper's Lake and to all other artificial reservoirs and to all watercourses and drainage areas tributary thereto, which serve as sources of the public water supply of the City of Kingston, Ulster County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to any natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter into the public water supply of the City of Kingston.
(2) The term watercourse wherever used in this section is intended to mean and refer to any spring, stream, ditch, gutter or other channel, permeable pipe, conduit or watercourse of every kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Kingston.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse as mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the City of Kingston, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (d)(2) of this section.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 150 feet of any watercourse tributary to the the public water supply of the City of Kingston.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with [ continued ] not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the city of Kingston.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant, as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir of or any watercourse tributary to the public water supply of the city of Kingston, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the city of Kingston.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir or watercourse tributary to the public water supply of the city of Kingston, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the board of water commissioners of the city of Kingston.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant, as heretofore provided under paragraph (2) of this subdivision, shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the city of Kingston nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the city of Kingston.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the city of Kingston.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir of the public water supply of the city of Kingston. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the city of Kingston.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Kingston, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the city of Kingston.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the city of Kingston, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the city of Kingston; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Kingston.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Kingston.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the city of Kingston.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir of the public water supply of the city of Kingston, except by duly authorized employees of the city of Kingston in the performance of their duties of supervision and maintenance of the public water supply of the city of Kingston.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the city of Kingston.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 100 feet of any reservoir or watercourse tributary to the public water supply of the city of Kingston.
(j) Inspections.
The board of water commissioners of the city of Kingston or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the city of Kingston or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 132 ONTARIO COUNTY
10 CRR-NY 132.1 City of Canandaigua, Villages of Palmyra and Newark in Wayne County, and Village of Rushville in Ontario and Yates Counties
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as last amended by chapter 879 of the Laws of 1953, shall apply to Canandaigua Lake and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the City of Canandaigua, Ontario County, the Villages of Palmyra and Newark in Wayne County, and the Village of Rushville in Ontario and Yates Counties, New York, and to all watercourses tributary thereto or ultimately discharging into said Canandaigua Lake.
(b) Definition of terms.
(1) The term water supply means the public water supplies of the City of Canandaigua in Ontario County, the Villages of Palmyra and Newark in Wayne County, and the Village of Rushville in Ontario and Yates Counties, New York.
(2) The term lake means Canandaigua Lake.
(3) The term watercourse means every spring, pond, stream, marsh, road ditch or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure, tank, pit or object from the lake or watercourse is the shortest horizontal distance from the nearest point of the structure, tank or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of a watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter, waste liquids from bathrooms, kitchens or laundries, or polluted liquids of any kind in or from the drainage system or sewer of a dwelling or any structure occupied for commercial purposes.
(7) The term receptacle means septic tanks, privy pits, cesspools, leaching cesspools, filter beds or other containers used for the storage or processing of excreta, sewage or waste matter.
(8) The minimum capacity for any septic tank to be installed either new or as a replacement on the watershed shall be 500 gallons.
(9) For the purpose of graduating the severity of the subdivisions in application to different parts of the drainage areas, so as to conform to the varying degrees of danger to the water supply, the drainage area is divided into the following zones:
(i) Zone I shall include all the shores of the lake together with all the drainage areas tributary to the lake except that portion of the drainage area consisting of the West River and its tributaries.
(ii) Zone II comprises the drainage area of the West River and its tributaries.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the lake or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta, either raw or partially decomposed, such as may be dipped, pumped or shoveled from a privy, septic tank, cesspool or other receptacle, shall be buried in the soil on the watershed of the water supply, unless deposited in trenches or pits at a distance of not less than 500 feet from the lake or any watercourse in zone I or not less than 200 feet from any watercourse in zone II and covered with not less than 18 inches of soil in such a manner as to effectively prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed or maintained or allowed to remain within 100 feet of the lake or any watercourse in zone I, nor within 50 feet of any watercourse in zone II, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (8) of this subdivision; provided, however, that the property which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta built or to be built on property which is so located, bounded or otherwise placed that the distances in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from the lake or any watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from the lake or any watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the duly authorized representative of the officers or boards having the management and control of the potable water supplies defined above and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta, within 100 feet of the lake or any watercourse in zone I or within 50 feet of any watercourse in zone II, built or to be built according to the provisions of paragraph (5) of this subdivision, shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision. In the case of properties occupied only during the summer season, the said receptacles shall be emptied when necessary and also at the end of the summer season, disinfected and left empty during the winter. The work of emptying these receptacles shall be done in such manner as to effectually prevent any pollution of the public water supply.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench, or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into the lake or any watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(8) No sewage, as defined under the term sewage above, nor any industrial waste, so classified by the Water Pollution Control Board under the State Department of Health, shall be discharged or allowed to flow into the lake or any watercourse nor deposited on or beneath the surface of the ground within 100 feet of the lake or any watercourse in zone I or within 50 feet of any watercourse in zone II except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of this subdivision, provided, however, that the property on which the receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of this subdivision. The restrictions and limiting distances shall not apply to sewage treatment plants or waste treatment systems installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(d) Sewage.
No privy or receptacle of any kind for the storage, deposit or treatment of excreta, sewage or other waste matter shall be installed, repaired or replaced on any property situated on the watershed where such installations are or will be more than 100 feet from the lake or any watercourse in zone I or more than 50 feet from any watercourse in zone II unless written permission has first been granted by the authorized representative of the officers or boards having the management and control of the Canandaigua Lake watershed. Prerequisites for such permission shall be rough plans and specifications for the structure or installation and a soil percolation test taken on the site of the installation or leaching area. The provisions and restrictions of this subdivision shall not apply to any property or installation subject to more stringent or restrictive laws or regulations of the State Department of Health or other State agency.
(e) Garbage, refuse and dead animals.
No garbage, refuse, putrescible matter, decomposed fruits and vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in the lake or any watercourse nor on or beneath the surface of the ground within 100 feet of the lake or any watercourse in zone I nor within 50 feet of any watercourse in zone II in such manner that it can be washed by rain or melting snow or otherwise over the surface or through the ground into the lake or any watercourse.
(f) Bottles and cans.
In the interest of public safety, no bottles, jars, jugs, metal cans, drums or similar objects shall be deposited in the lake or any watercourse nor on or beneath the surface of the ground within 50 feet of the lake or any watercourse in zone I or within 25 feet of any watercourse in zone II nor in such a manner that the object or material can be washed by rain or melting snow or otherwise over the surface of the ground into the lake or any watercourse.
(g) Place for animals.
(1) No animal or poultry shall be allowed to stand, wade, swim or be washed or watered in the water of the lake within 300 feet of a public water supply intake, and no watering place shall be maintained in such a way as to pollute the lake or any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute the lake or any watercourse.
(3) No manure pile shall be maintained or allowed to remain within 100 feet of the lake or any watercourse in zone I or within 50 feet of any watercourse in zone II nor in such a condition as to pollute the lake or any watercoure.
(h) Bathing, boating, fishing, etc.
No person shall bathe, and no boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the lake within 300 feet of the water supply intakes. All ice cutting on the lake beyond the above specified distance shall be done only with the written permission of the officers or boards having the management and control of the potable water supplies defined above or their duly authorized representative and in strict accordance with the regulations to be adopted by said officers or boards and under the rigid inspection and supervision of such officers or boards or their authorized representatives.
(i) Refuse from boats.
No excreta, garbage, slops nor decomposable matter of any kind nor any bottles or metal cans of any kind shall be thrown, discharged, or allowed to escape or pass into the lake from any power boat, steamer, launch, yacht, sailboat, houseboat, rowboat, canoe or raft. Any boat of any type or description having water closets, permanent or temporary toilet accommodations or galley facilities shall be provided with removable watertight receptacles, which shall be regularly emptied, cleaned and deodorized each day when in use, under the same restrictions as those which are imposed under paragraphs (3) and (7) of subdivision (c).
(j) Camps, tents and trailers.
(1) No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction or agricultural work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 100 feet of the lake or any watercourse in zone I or within 50 feet of any watercourse in zone II.
(2) No camp, tent, trailer or other structure for the personal use of the owner or the personal use of family, friends or tenants shall be located, placed or maintained within a distance of 100 feet of the lake or any watercourse in zone I or within 50 feet of any watercourse in zone II without first complying with the provisions of paragraphs (4) through (8) of subdivision (c) and subdivision (d) for the proper disposal of excreta, sewage and waste matter.
(k) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of Canandaigua Lake or its tributaries.
(l) Inspections.
The officers or boards having the management and control of the public water supplies defined above or such boards or person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of such boards or persons shall make regular and thorough inspections of the lake, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the officers or boards having the management and control of the public water supplies defined above to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons do not immediately comply with the rules and regulations, it shall be the further duty of said officers or boards having the management and control of the public water supplies defined above to promptly notify the State Commissioner of Health of such violations. The officers or boards having the management and control of the public water supplies defined above shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the inspections which have been made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
(1) In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
(2) The penalty for each and every violation of or noncompliance with any of these rules and regulations which does not relate to a permanent source or act of contamination is hereby fixed at $25.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.13 Nursing services
The facility shall have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care. The facility shall assure that each resident receives treatments, medications, diets and other health services in accordance with individual care plans.
(a) Sufficient staff.
(1) The facility shall provide services by sufficient numbers of each of the following types of personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans:
(i) registered professional nurses or licensed practical nurses;
(ii) certified nurse aides; and
(iii) other nursing personnel.
(2) The facility shall designate a registered professional nurse or licensed practical nurse to serve as a charge nurse on each tour of duty who is responsible for the supervision of total nursing activities in the facility. Alternatively, as necessitated by resident care needs, the facility may designate one charge nurse for each tour of duty on each resident care unit or on proximate nursing care units in the facility provided that each nursing care unit in the facility is under the supervision of a charge nurse.
(b) Registered professional nurse.
(1) The facility shall use the services of a registered professional nurse for at least eight consecutive hours a day, seven days a week.
(2) The facility shall designate a registered professional nurse to serve as the director of nursing on a full-time basis.
(3) The director of nursing may serve as a charge nurse only when the facility has an average daily occupancy of 60 or fewer residents.
(c) Nurse aide.
(1) For the purpose of this section and section 415.26(d) of this Part, nurse aide shall mean any person who provides direct personal resident care and services including, but not limited to, safety, comfort, personal hygiene or resident protection services, for compensation, under the supervision of a registered professional nurse or licensed practical nurse in the facility, except for those individuals who furnish services to residents only as feeding assistants as defined in section 415.13(d) of this Part. Certification of such nurse aide shall be in accordance with the provisions of section 415.26(d) of this Part.
(2) Only individuals who meet the following qualifications may be assigned to perform nurse aide functions, as defined in paragraph (1) of this subdivision:
(i) a person who, as verified by the facility, is listed in the New York State RHCF Nurse Aide Registry developed and maintained as set forth in section 2803-j of the Public Health Law and as described in section 415.31 of this Part;
(ii) a graduate of a nursing program approved by the New York State Commissioner of Education or by the licensing authority in another state, territory or possession of the United States as preparation for practice as a licensed nurse who has taken and passed the New York State competency examination;
(iii) a nurse aide trainee who has successfully completed a State approved RHCF nurse aide training program as described in section 415.26(d) of this Part or a program designed for such purpose and approved by the State Commissioner of Education and who is waiting to take the RHCF clinical skills and written or oral nurse aide competency examination at the next scheduled opportunity, such competency examinations to be passed within three consecutive attempts within four months of the date of the initial RHCF nurse aide trainee employment or of the completion of the State approved RHCF nurse aide training program, whichever occurs first;
(iv) a nurse aide trainee who has taken the competency examinations and is waiting for the official results of the examination;
(v) a certified nurse aide who is currently listed in another state's nursing home nurse aide registry, as verified by the facility, and who has applied to the department to obtain State certification and has not been denied; and
(vi) a nurse aide trainee provided the individual is concurrently enrolled in a State approved residential health care facility nurse aide training program which meets all requirements set forth in this section and completes such training program and competency examinations within 120 days of employment, in accordance with the following:
(a) the nurse aide trainee may assume specific duties involving direct resident care and services as training and successful demonstration of competencies in the specific duties/skills are completed, but not before completing at least 16 hours of classroom instructions in the following areas:
(1) communication and interpersonal skills;
(2) infection control;
(3) safety/emergency procedures, including the Heimlich maneuver;
(4) promoting residents' independence;
(5) respecting residents' rights; and
(6) resident abuse, mistreatment and neglect reporting requirements as set forth in section 2803-d of the Public Health Law; and
(b) the nurse aide trainee shall be under the direct supervision of a nurse when the trainee is providing direct resident care or services and identifiable as a nurse aide trainee.
(vii) If the facility has reason to believe that the individual has worked as a nurse aid in any state(s) other than New York, the facility must request information from the nurse aide registry of such other state(s) before permitting the individual to serve as a nurse aide.
(d) Feeding assistant.
(1) Feeding assistant shall mean an individual who meets the requirements of this section and who is paid by the facility or provided to the facility under contract with another entity to feed residents or assist residents with eating or hydration.
(2) The feeding assistant shall:
(i) be under the supervision of a nurse;
(ii) only feed or assist with feeding only those residents who do not have complicated feeding problems. Complicated feeding problems include, but are not limited to, difficulty swallowing, recurrent lung aspirations, and tube or parenteral/IV feedings;
(iii) have successfully completed a State-approved feeding assistant training program, such program shall meet the requirements as described in section 415.26(k) of this Part.
(3) The charge nurse's selection of residents who can safely be fed or assisted by a feeding assistant shall be based upon a registered professional nurse's assessment and the resident's latest assessment and plan of care.
(4) The feeding assistant may only provide eating and hydration assistance to residents in congregated dining rooms, not in a resident's room.
(5) In an emergency, the feeding assistant must call a supervisory nurse for help on the resident call system, when the supervisory nurse is not on the scene.
(6) The facility must maintain records of all individuals used by the facility as feeding assistants. For each individual, such records shall include, but not be limited to:
(i) a copy of the feeding assistant training program certificate of completion;
(ii) the dates and results of evaluations of the feeding assistant; and
(iii) the dates and subject topics of any additional training related to the individual's role as a feeding assistant, and a record of the individual's demonstrated competency in the activities and/or skills toward which the training was focused.
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.32 Observation services
(a) General.
(1) Observation services are post-stabilization services appropriate for short-term treatments, assessment, and re-assessment of those patients for whom diagnosis and a determination concerning inpatient admission, discharge, or transfer can reasonably be expected within 48 hours.
(2) If observation services are provided, the services shall be provided in a manner which protects the health and safety of the patients in accordance with generally accepted standards of medical practice.
(3) Direct referral is defined as a patient referred to the hospital for observation services by a nursing home, hospital outpatient clinic, diagnostic and treatment center, private practice physician or appropriately licensed practitioner, without receiving emergency room or critical care services on the day observation care begins. The referring practitioner must be a licensed physician or appropriately licensed practitioner and must have conducted a physical assessment of the patient within the previous eight hours from the referral.
(4) Patients may be assigned to observation services only by order of a physician or appropriately licensed practitioner.
(5) Patients may be assigned to observation services only through the emergency department or by direct referral in accordance with hospital policies, procedures and bylaws, in conformance with applicable statutes and regulations.
(b) Organization and notice.
(1) The medical staff shall develop and implement written policies and procedures, approved by the governing body, that are based on the clinical needs of the patient, that shall specify:
(i) the organizational structure for providing observation services, including the specification of authority and accountability of the services;
(ii) the proper clinical location for the care of a patient requiring observation services;
(iii) the appropriate medical and administrative oversight of observation services;
(iv) clinical criteria for observation assignment and discharge;
(v) assignment of a physician, nurse practitioner, or physician assistant who will be responsible for the care of the patient and timely discharge from observation services; and
(vi) integration with related services and quality assurance activities of the hospital.
(2) The hospital, in conjunction with the discharge planning program of the hospital, shall establish and implement written criteria and guidelines specifying the circumstances, the actions to be taken, and the appropriate contact agencies and individuals to accomplish adequate discharge planning for persons in need of post observation treatment or services but not in need of inpatient hospital care.
(3) Patients in observation shall be cared for by staff appropriately trained and in sufficient numbers to meet the needs of the patients.
(4) Patients being assigned to the observation services, or the patient representative, shall be provided with an oral and written notice within 24 hours of such placement that the patient is not admitted to the hospital and is under observation status. The hospital shall make a good faith effort to obtain written acknowledgment of receipt of the notice by the patient or the patient representative, and if not obtained, document its good faith efforts to obtain such acknowledgment and the reason why the acknowledgment was not obtained. Such written notice shall include, but not be limited to the following information:
(i) a statement that observation status may affect the patient’s Medicare, Medicaid and/or private insurance coverage for the current hospital services, including medications and other pharmaceutical supplies, as well as coverage for any subsequent discharge to a skilled nursing facility or home and community based care; and
(ii) that the patient should contact his or her insurance plan to better understand the implications of being placed in observation status.
(c) Locations.
Hospitals may provide observation services in the following locations:
(1) inpatient beds;
(2) distinct observation units; or
(3) in a hospital designated as a critical access hospital pursuant to subpart F of part 485 of title 42 of the Code of Federal Regulations or a sole community hospital pursuant to section 412.92 of title 42 of the Code of Federal Regulations, or any successor provisions, observation services may be provided in the emergency department.
(d) Distinct observation units.
(1) Physical standards:
(i) The observation unit shall comply with the applicable provisions of Part 711 and Subpart 712-2 and section 712-2.4 of this Title for construction projects approved or completed after January 1, 2011, except that the unit need not be adjacent to the emergency department.
(ii) Observation unit beds shall not be counted within the State certified bed capacity of the hospital and shall be exempt from the public need provisions of Part 709 of this Title.
(iii) The observation unit shall be marked with a clear and conspicuous sign that states: “This is an observation unit for visits of up to 48 hours. Patients in this unit are not admitted for inpatient services.”
(2) Any hospital seeking to establish a distinct observation unit shall, not less than 90 days prior:
(i) if no construction, as defined in subdivision 5 of section 2801 of the Public Health Law, will be needed, no construction waivers are being requested, and no service will be eliminated, notify the department in writing of the general location of the unit and the number of beds; and submit a certification from a licensed architect or engineer, in the form specified by the department, that the space complies with the applicable provisions of Part 711 and Subpart 712-2 and section 712-2.4 of this Title for construction projects approved or completed after January 1, 2011; or
(ii) if construction, as defined in subdivision 5 of section 2801 of the Public Health Law, will be needed, or construction waivers are being requested, or a service will be eliminated:
(a) submit a request for limited review under section 710.1(c)(5) of this Title, provided that for purposes of Part 710 of this Title, a construction project involving only the creation of an observation unit and the addition of observation unit beds shall not be subject to review under section 710.1(c)(2) or (3) of this Title, unless the total project cost exceeds $15 million or $6 million respectively; and
(b) comply with the applicable provisions of Part 711 and Subpart 712-2 and section 712-2.4 of this Title for construction projects approved or completed after January 1, 2011.
(3) Any hospital operating an observation unit pursuant to a waiver granted by the department shall be required to comply with the provisions of this subdivision within 12 months of its effective date.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.12 Village of Port Jervis
(a) Privies adjacent to any reservoir or watercourse.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir, pond, spring, stream, ditch or watercourse of any kind, the water in which, when running, flows eventually into a reservoir of the public water supply of the Village of Port Jervis.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any pond or reservoir or within 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit, reception or storage of human excreta which is constructed, located or maintained between the aforesaid limits of 50 and 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any pond or reservoir or -between the aforesaid limits of 50 and 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid, and from which privy or place the said excreta is not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of disposal beyond the maximum aforesaid limit, shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limit.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or upon the foundation or floor of said privy. In effecting this removal, the utmost care shall be exercised that none of the contents of the receptacles be allowed to escape while being transported from the privy to the place of ultimate disposal hereinafter specified and that the least possible annoyance or inconvenience be caused to occupants of the premises or of adjoining premises.
(5) Unless otherwise specifically ordered or permitted in writing by the board of health of the Village of Port Jervis, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging into the soil at such places and in such manner as to effectually prevent their being washed over the surface of the ground by rain or melted snow and at distances not less than 500 feet, horizontal measurement, from the high-water mark of any pond or reservoir and not less than 300 feet horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse of any kind, the water of which, when running, flows into a reservoir of the public water supply of the Village of Port Jervis.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle or from any trench or place of disposal may be washed over the surface or through the subsoil into a pond or reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a pond or reservoir or into any spring, stream, ditch or watercourse aforesaid nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any reservoir, pond, spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any pond, reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any pond, reservoir, spring, stream, ditch or watercourse aforesaid nor shall any cattle, horses, sheep, swine or other animals be allowed to enter, wallow or stand in any reservoir, spring, stream, ditch or watercourse aforesaid.
(c) Garbage and refuse.
No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be placed upon or below the surface of the ground where they may be washed into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark or precipitous bank thereof.
(d) Manures, composts and similar matter.
(1) No stable, cattle pen, pigsty, henhouse, stable yard, barnyard, hogyard, duckyard, hitching or standing place for horses or cattle nor any compost or manure heap nor other place where animal manure accumulates shall be located or maintained within 100 feet of any reservoir, spring, stream, ditch or watercourse aforesaid. These and also watering places for horses or cattle or other animals must be so arranged that the polluted drainings therefrom shall not flow into any such reservoirs, springs, streams, ditches or watercourses without having undergone proper purification. Such drainings shall not be allowed to flow through open or covered drains nearer than 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse as aforesaid without having undergone proper purification.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a pond or reservoir or within 130 feet of the high-water mark or precipitous bank of any stream, spring, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so as to be washed a less distance than 50 feet over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any pond, reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface or less than 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(f) Cemeteries.
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any pond, reservoir, spring, stream, ditch or watercourse aforesaid.
(g) Penalty.
In accordance with section 70 of the Public Health Law of the State of New York, a penalty of $50 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above-given mandatory rules or regulations, to be recovered under the said act.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.7 Recoveries of expense
Operating costs shall be reduced by the cost of services and activities which are not properly chargeable to patient care. In the event that the State Commissioner of Health determines that it is not practical to establish the costs of such services and activities, the income derived therefrom maybe substituted for costs of these services and activities. Examples of activities and services covered by this provision include:
(a) drugs and supplies sold for use outside the medical facility;
(b) telephone and telegraph services for which a charge is made;
(c) discount on purchases;
(d) living quarters rented to employees;
(e) employee cafeterias;
(f) meals provided to special nurses or patients' guests;
(g) operation of parking facilities for community convenience;
(h) lease of office and other space of concessionaires providing services not related to medical service;
(i) tuitions and other payments for educational service, room and board and other services not directly related to medical service.
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.1 Purpose
To provide for expeditious administrative proceedings to correct and to impose penalties for violations of the State Sanitary Code, Public Health Law and pertinent provisions of the administrative rules and regulations of the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 401 ALL FACILITIES—OPERATING CERTIFICATES
10 CRR-NY 401.4 Review of operating certificate determinations
(a) To review a determination of the department made pursuant to the provisions of this Subchapter relating to an operating certificate, an applicant shall forward such request in writing to the commissioner, specifying the relief sought, within 30 days following the determination.
(b) The commissioner may, in his discretion, grant or deny the request; or, prior to making a determination, direct that a hearing be held to recommend whether the relief sought by the applicant shall be granted.
(c) The findings, conclusions and recommendations of the hearing officer may be referred by the commissioner to the council for review and recommendations; the council shall not act upon any such referral until the regional hospital planning councils concerned have had a reasonable time to submit their recommendations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.1 Statement of purpose
The rules contained in this Part have been promulgated to protect the health and safety of those persons who must use an individual onsite water supply system, an individual onsite wastewater treatment system, or both, when a municipal or communal system is not available.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.118 Expenditure
(a) The incurring of a liability, the payment of cash, or the transfer of property for the purpose of acquiring an asset or service or settling a loss.
(b) The amount of cash or property paid or to be paid for a service rendered, or an asset purchased.
(c) Any cost, the benefits of which may extend beyond the current accounting period.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.9 Diagnostic coding and rate computation
(a) Facilities shall assign ICD-9 diagnostic codes and HCPCS/CPT procedure codes to each claim as appropriate and shall submit such information to the department or the department’s designee in accordance with written billing and reporting instructions issued by the department. the department shall utilize such claim coding information to assign each the applicable APG or APGs for each patient visit identified on the claim, utilizing the APG software system to determine the significant procedure APG or the medical visit APG, the applicable ancillary services APGs and the final APG weight applicable to each such visit. the APG software system shall incorporate methodologies for consolidation, packaging and discounting to be reflected in the final APG weight to be assigned to each visit on the claim.
(b) The operating component of the payment rate for each patient shall be computed by multiplying the final APG weight for each visit, as computed in accordance with subdivision (a) of this section, by the applicable base rate, as determined in accordance with section 86-8.7 of this Subpart. A capital component shall then been added to each such payment rate in accordance with the provisions of section 86-8.4 of this Subpart.
(c) Drugs purchased under the 340B drug benefit program and billed under the APG reimbursement methodology shall be reimbursed at a reduced rate comparable to the reduced cost of drugs purchased through the 340B drug benefit program.
(d) In cases where the only reimbursable APGs for a visit are one or more of the following APGs, there shall be no reimbursement for capital costs included in the payment for that visit.
94 CARDIAC REHABILITATION
274 PHYSICAL THERAPY, GROUP
275 SPEECH THERAPY AND EVALUATION, GROUP
322 MEDICATION ADMINISTRATION AND OBSERVATION
414 LEVEL I IMMUNIZATION AND ALLERGY IMMUNOTHERAPY
415 LEVEL II IMMUNIZATION
416 LEVEL III IMMUNIZATION
428 PATIENT EDUCATION, INDIVIDUAL
429 PATIENT EDUCATION, GROUP
451 SMOKING CESSATION TREATMENT
(e) The following APGs shall be designated as “no blend APGs” and shall have their payments calculated solely under the APG reimbursement methodology.
94 Cardiac Rehabilitation
310 Developmental & Neuropsychological Testing
312 Full Day Partial Hospitalization for Mental Illness
321 Crisis Intervention
414 Level I Immunization and Allergy Immunotherapy
415 Level II Immunization
416 Level III Immunization
426 Medication Management
428 Patient Education, Individual
429 Patient Education, Group
448 After Hours Services
451 Smoking Cessation Treatment
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 452 BASIC CONCEPTS, REPORTING PRINCIPLES AND SPECIALIZED REPORTING AREAS
10 CRR-NY 452.2 Basic concepts
(a) Accounting entity.
A fundamental accounting concept is that of the accounting entity or unit. For the purposes of this Article, a residential health care facility is presumed to be an accounting entity, the boundaries of which may not be the same as those of the legal entity. The residential health care facility is the primary unit for which the accounting records are maintained.
(b) Going concern.
An accounting entity is viewed as continuing in operation in the absence of evidence to the contrary. The results of operation of an accounting entity are recognized and measured based on this concept.
(c) Reporting period.
The economic activities of an accounting entity are measured and accounted for in incremental time periods that are shorter than the life of the entity. The basic reporting period for this Article is one year, commencing on January 1st and ending on December 31st of each year.
(d) Substance over form.
Financial accounting is concerned with the economic substance of transactions rather than the legal form of such transactions. Generally, economic substance agrees with legal form. However, in those instances where substance and form differ, the financial treatment for such transactions should be accounted for based on their economic substance to provide more meaningful information of the economic activities of the accounting entity.
(e) Consistency.
Consistency refers to continued uniformity, during a period and from one period to another, in methods of accounting, mainly in valuation bases and methods of accrual, as reflected in the financial statements of an accounting entity. However, consistency does not require continued adherence to a method or procedure that is incorrect or no longer useful, nor does it preclude a justifiable and desirable change in accounting and reporting methods or procedures.
(f) Materiality.
Materiality is an elusive concept, with the dividing line between material and immaterial amounts subject to various interpretations. It is clear, however, that an amount is material if its exclusion from the financial statements would cause misleading or incorrect conclusions to be drawn by users of the statements.
(g) Functional vs. responsibility accounting.
(1) Normally, financial data is accumulated for operating departments that are identified with specific managerial responsibility. This information provides management with the tools necessary to evaluate the performance of various departments. Recording and reporting financial data in this manner is known as responsibility accounting.
(2) Functional accounting is the process of recording and reporting revenues and expenses on the basis of activities performed without regard to organizational framework. Thus, costs related to a specific activity, normally charged to the organizational unit (department) responsible for that activity, would instead be charged to the cost center whose function is to perform the activity.
(3) Since facilities vary in basic organizational structure and the way responsibilities are organized within departments, this Article mandates reporting on a functional basis in accordance with defined activities of each department to achieve a level of compatibility.
(h) Objective evidence.
(1) Information produced by the accounting process should be based, to the extent possible, on objectively determined facts. A record of an addition to inventory, for example, should be supported by properly executed business documents such as the purchase order, the receiving report, the supplier's invoice, and the check issued in payment of the invoice. Such documents serve as objective evidence of the transaction, and permit reliable determination of the cost of the asset, the amount of the liability, and the appropriateness of the resulting cash disbursement. Retention of these documents for a suitable period makes it possible to verify data in the accounting records.
(2) The requirement of objective evidence, however, cannot always be met by financial data in accounting reports. Although various computations and analyses can provide some evidence, it is often necessary to make estimates. Determination of depreciation and anticipated bad debts, for example, are based to a large extent on past experience and expected future conditions. In those instances requiring estimates, the judgment of the accountant and of management must be exercised.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.11 Funeral director business practices
Every funeral director, undertaker or funeral firm shall give customers, unless otherwise agreed upon in writing at the time arrangements are made, documents which have been procured for or supplied by the customer within one week after the funeral. If the funeral director, undertaker or funeral firm does not have possession of such documents within that time, he shall give them to the customer when he obtains possession of them.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.4 Responsibilities of the birth attendant
Whenever a newborn is born outside of a hospital, the birth attendant shall be responsible for the collection of a satisfactory specimen and shall ensure compliance with the following procedures:
(a) The birth attendant shall inform the parent(s) of each newborn, of the purpose and need for newborn screening, and shall provide newborn screening educational materials made available by the department.
(b) Specimen collection forms shall be properly stored in a cool and dry environment prior to use.
(c) The birth attendant shall collect a satisfactory specimen from every newborn between 24 and 36 hours after birth, and shall submit the satisfactory specimen to the testing laboratory within 24 hours of collection, except under the following circumstances:
(1) If a newborn is transferred to a hospital before 24 hours of age, the birth attendant shall collect an initial satisfactory specimen from the newborn prior to transfer, submit the satisfactory specimen to the testing laboratory, and provide written and/or electronic notification to the receiving hospital that a specimen was collected. The receiving hospital shall collect a repeat specimen from the newborn between 48 and 72 hours after birth.
(d) All specimens shall be air dried thoroughly on a flat nonabsorbent surface for a minimum of three hours prior to forwarding to the testing laboratory. All specimens, including repeat specimens, shall be forwarded to the testing laboratory within 24 hours of collection using the testing laboratory's delivery service or an equivalent arrangement designed to ensure delivery of specimens to the testing laboratory no later than 48 hours after collection.
(e)
(1) When notified by the testing laboratory that a repeat specimen is required, the birth attendant shall notify the parent(s) and responsible provider within one business day that a repeat specimen is required from the newborn. The birth attendant shall collect the repeat specimen, pursuant to guidance issued by the testing laboratory, and submit it to the testing laboratory as soon as practicable.
(2) If the responsible provider documented on the initial specimen collection form is no longer responsible for the newborn’s care, the birth attendant shall identify a new provider, notify the new provider of the need for a repeat specimen, and submit the contact information for the new provider to the testing laboratory.
(3) If the birth attendant is unable to obtain a repeat specimen, the birth attendant shall submit written and/or electronic documentation to the testing laboratory describing the steps by the birth attendant to notify the parent(s) and responsible provider that a repeat specimen(s) was required. The birth attendant shall submit this documentation to the testing laboratory no later than 90 days after receiving notification from testing laboratory that a repeat specimen was required.
(f) If a satisfactory specimen or a repeat specimen is not collected due to newborn mortality, the birth attendant shall submit a written and/or electronic notification to the testing laboratory within five days after death.
(g) The birth attendant shall submit all information required by the testing laboratory using an electronic format determined by the department, provided that:
(1) specimen collection forms shall be submitted as directed by the testing laboratory; and
(2) the birth attendant may request an exemption from electronic submission by demonstrating, to the department’s satisfaction, that the requirement imposes an undue burden.
(h) The birth attendant shall document on the newborn’s health record the LAB I.D., as it appears on the specimen collection form, the date and time of specimen collection, and all screening results.
(i) The birth attendant shall document the LAB I.D., as it appears on the specimen collection form, on any discharge summary, and shall transmit a copy of screening results or a copy of the discharge summary to the responsible provider.
(j) Before performing any tasks relating to collection of specimens, the birth attendant, and any staff under the birth attendant’s supervision performing specimen collection, shall complete comprehensive specimen collection training, and shall complete such training annually thereafter. The birth attendant shall retain documentation of all such training.
(k) The birth attendant shall establish written policies and procedures, which shall be available for the department’s review, for:
(1) the collection, storage, and shipping of specimens; and
(2) the tracking and disposition of test results.
(l) The birth attendant shall comply with the following additional requirements for HIV testing:
(1) the birth attendant shall obtain written documentation of any HIV testing and treatment during the current pregnancy and include such documentation in the mother’s health record. The birth attendant shall counsel the mother consistent with such testing;
(2) the birth attendant shall maintain in the newborn’s health record the newborn’s HIV test result in accordance with article 27-F of the Public Health Law;
(3) the birth attendant shall transmit a copy of the newborn's HIV test result to the responsible provider. For any HIV exposed newborn, the birth attendant shall coordinate with the responsible provider to arrange appointments for follow up care with a provider experienced in the treatment of HIV; and
(4) the birth attendant shall collect and provide authorized department staff with such data as the department may require for program evaluation and, in the case of HIV exposed newborns, for patient follow-up.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT LOCATION EQUIPMENT LOCATION
10 CRR-NY 14-5.100 Vending machine location
(a) Vending machines, ovens and other equipment used in connection with a food vending operation are to be located in a room, area or space which is maintained in a clean condition and which is protected from overhead leakage or condensation from water, waste or sewer piping. The immediate area in which the equipment is located is to have adequate ventilation to remove odors and fumes. Each vending machine is to be located so that the space around and under the machine is easily cleaned and maintained, and so that insect and rodent harborage is not created.
(b) The floor area where vending machines are located is to be cleanable and capable of withstanding repeated cleaning operations. This space and the immediate surroundings of each vending machine are to be maintained in a clean condition.
(c) Handwashing facilities, including hot and cold or tempered running water, soap and individual towels, are to be convenient to the machine location and available for use by employees servicing or loading food vending machines.
(d) The immediate area in which a food vending machine operation is located is to have at least 20 foot-candles of lighting during times of operation at vending machine operating surfaces, condiment dispensing tables, ovens, and at least 10 foot-candles at tables furnished for eating.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.17 Inventories
[ 1370 ]
(a) Inventories reflect the cost of unused hospital supplies. Any generally accepted cost method ( e.g., FIFO, LIFO, Average, etc.) may be used as long as it is consistent with that of the preceding accounting period. Cost of inventories based on the last invoice price is not an acceptable method for determining such cost.
(b) Inventory accounting record systems are required, consistent with the method of the inventory valuation employed. Perpetual inventory records are recommended but not required. Physical valuations must be made at least once a year and the accounting records, if applicable, adjusted to such valuations.
(c) Inventory usage records are required to be maintained for all inventories that are distributed and used by more than one cost center in the hospital. It is recommended that a formal requisition system be used for this purpose. In all cases, the cost of non-billable supplies used during the period must be distributed to the user cost centers, preferably on a monthly basis.
Part 441 DEFINITIONS
10 CRR-NY 441.216 Nonoperating expense
The expenses of a hospital which are not directly related to patient care, related patient services, or the sale of related goods. For example, nonoperating expenses includes losses on sale of hospital property and retail operations expenses.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.15 Reporting of food poisoning
(a) Every physician, visiting nurse, public health nurse or any other person having knowledge of the occurrence of illness believed to have been due to the consumption of spoiled or poisonous food, shall report the same immediately, by telephone, facsimile, other electronic communication, or in person to the city, county or district health officer in whose jurisdiction it occurred.
(b) Provided that if the cases occur in a State institution, said cases shall be reported to the State Department of Health and to the city, county or district health officer in whose jurisdiction such institution is located.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-3 REQUIREMENTS FOR AUTOCLAVES USED TO TREAT REGULATED MEDICAL WASTE
10 CRR-NY 70-3.2 Operational requirements
(a) Each facility seeking to operate an autoclave shall develop an operation plan, and shall submit such plan to the department for review and approval prior to using the autoclave to treat regulated medical waste. Any change in procedures related to the operation of the autoclave shall be reflected in a modified plan, which shall be dated with each revision.
(b) No autoclave shall be used to treat regulated medical waste without department approval of the facility's operation plan and any modifications made to such plan on or after the effective date of this regulation.
(c) The operation plan shall be designed to promote safe and effective operation of the autoclave. The operation plan shall include, minimally, procedures to ensure:
(1) the autoclave meets department criteria for effective treatment of regulated medical waste ( i.e. , the protocol for validation testing and a summary of the results);
(2) loads contain only those items or types of waste for which effective treatment has been demonstrated by validation testing; and exclude waste materials for which effective treatment by the system has not been demonstrated and/or is prohibited pursuant to section 70-2.3 of this Part, and, as applicable, materials expressly excluded in the commissioner's notice of approval;
(3) each load is treated using residence time, temperature and pressure that have been validated as effective for the treatment of regulated medical waste, and conditions of treatment are monitored and documented for each load;
(4) the effectiveness of treatment is maintained, by including, as applicable, procedures for and frequency of: calibration verification and recalibration of parametric controls; monitoring by challenge testing or other demonstration that treatment has been attained; and preventative maintenance of engineering controls ( e.g. , charcoal and/or HEPA filters) and diagnostic procedures for electronic controls ( e.g. , integrated computers and mechanical components);
(5) occupational exposure is minimized, and physical injury to operators is prevented during loading, the cycle, and unloading the autoclave; and
(6) personnel are knowledgeable about routine operation of the autoclave, are kept current with manufacturer recommendations for operation, and have been instructed in emergency procedures for handling malfunctioning systems and untreated waste. Training programs shall mandate initial training and retraining at least once per calendar year and as necessary for presenting updates on operational information.
(d) Any modification of an approved operation plan with potential to substantially alter treatment efficacy shall be submitted to the department for approval. Prior to approving a modified plan, the department may require that validation testing be conducted again by the facility, and the results submitted for department review.
(e) Whenever an autoclave fails to operate in accordance with pre-established operating parameters, the facility shall:
(1) discontinue use of the autoclave, using emergency shutdown procedures if appropriate until corrective action has been taken and validation testing has verified that effective treatment can resume;
(2) handle as untreated all regulated medical waste processed by the system since the last previous run under documented compliance with such requirements;
(3) document the failure, including date and autoclave identifier;
(4) document the facility response, including corrective action; and
(5) whenever a facility has reason to believe untreated waste certified as treated waste has left the facility, notify the waste transporter as soon as practicable, and notify the department within 72 hours of the waste's leaving the facility.
(f) Monitoring autoclave operator.
(1) parametric controls shall be employed to monitor operating parameters automatically and continuously throughout the entire cycle, and generate a record of operating parameters for each cycle.
(2) In the absence of parametric controls, routine operational performance of an autoclave shall be monitored by:
(i) challenge testing, conducted every 40 hours of autoclave operation or once a week, whichever occurs first, using the same protocol as was approved by the department for validation testing; and
(ii) time/temperature-sensitive materials used in each load.
No autoclave that fails to attain 4 log10 reduction in viable spores concentration upon challenge testing shall be used to treat regulated medical waste. Whenever time/temperature-sensitive materials fail to show expected results ( i.e. , a color change), the load shall be handled as untreated waste, and the facility shall demonstrate, through a repeat of validation testing, that the autoclave effectively treats regulated medical waste before resuming its use for treatment purposes.
(g) Containment of regulated medical waste for treatment by autoclaving shall be by a container or containment system designed to withstand the temperature and pressure of autoclaving, and may, except for sharps, consist soley of a red bag.
(h) If the container or containment system does not, by design, allow steam to come into direct contact with waste material, the operator shall take action to ensure such contact.
(i) Sharps treated by autoclaving shall be destroyed prior to disposal.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.241 Paid staff
See medical staff classification.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.177 Locker area
Enough lockers or other suitable facilities are to be provided and used for the orderly storage of employee clothing and other belongings.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.23 Depreciation
(a) Allowable depreciation shall be limited to those assets which are used for purposes of providing or supporting direct patient care. Reported depreciation based on historical cost is recognized as a proper element of cost. Useful lives for assets purchased after 1991 shall be the higher of the reported useful life or those useful lives from the Estimated Useful Lives of Depreciable Hospital Assets, 1988 edition, American Hospital Association, consistent with title XVIII provisions. Useful lives for assets purchased prior to 1991 shall be determined by use of the 1983 edition. Copies of these publications are available from the American Hospital Association, 840 North Lake Shore Drive, Chicago, IL 60611, and copies are available for inspection and copying at the offices of the Records Access Officer of the Department of Health, Corning Tower Building, Empire State Plaza, Albany, NY 12237.
(b) In the computation of rates for voluntary facilities, depreciation shall be included on a straight-line method on plant and nonmovable equipment. Depreciation on movable equipment may be computed on a straight-line method on accelerated under a double declining balance or sum-of-the-years' digits method.
(1) Voluntary facilities shall fund depreciation unless the commissioner determines, upon application by the facility and after inviting written comments from interested parties, that a waiver of the requirement for funding is necessary and in the public interest. Funding shall mean the transfer of monies to the funded accounts. Board-designated funds and the accrual of liabilities to the funded depreciation accounts shall not be recognized as funding of depreciation. Deposits to the funded depreciation accounts must remain in such accounts for six months or more to be considered as valid funding transactions unless expended for the purposes for which the account was funded.
(2) Funding for plant and fixed equipment shall mean that the transfer of monies to the funded accounts shall occur by the end of the fiscal period in which the depreciation is recorded.
(3) Depreciation on major movable equipment shall be funded in the year revenue is received from the reimbursement of each expense and in the amount included in reimbursement for that year.
(4) Such funds may be used only for capital expenditures with approval as required for the amortization of capital indebtedness.
(c) In the computation of rates for public facilities, depreciation shall be included on a straight-line method on plant and nonmovable equipment. Depreciation on movable equipment may be computed on a straight-line method or accelerated under a double declining balance or sum-of-the-years' digits method.
(d) In the computation of reimbursement rates for proprietary facilities, depreciation shall be computed on a straight-line basis on plant and nonmovable equipment. Depreciation on movable equipment may be computed on a straight-line method or accelerated under a double declining balance or sum-of-the-years' digits method.
(e) Facilities financed by mortgage loans pursuant to the Hospital Mortgage Loan Construction Law shall conform to the requirements of this Subpart. In lieu of depreciation and interest, on the loan-financed portion of the facilities, the commissioner shall allow level debt service on the mortgage loan, together with such required fixed charges, sinking funds and reserves as may be determined by the commissioner as necessary to assure repayment of the mortgage indebtedness.
(f) Article 43 corporations may elect to include in their reimbursement rates depreciation computed by a method other than that used in subdivisions (b), (c) and (d) of this section, subject to approval of the commissioner.
(g) An amount for rent will be reimbursed as capital cost in lieu of depreciation, provided the following conditions are met:
(1) if required, the lease is reviewed and approved by the department;
(2) the applicant has no interest, direct or indirect, beneficial or of record, in the ownership of the building or any overlease;
(3) the rental per square foot, in the judgment of the department, is the same as or is comparable to other rentals in the building in which the facility is to be located, and the rental per square foot is comparable to the rental of similar space in other comparable buildings in the area when such comparisons can be made; and
(4) the rent, if the lease is a sublease, is the same as or less than rent in comparable leases in the geographic area.
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.8 Base rates
Base rates shall be developed by the department for each category of providers set forth in section 86-8.1(a) of this Subpart, in accordance with the following:
(a) Separate base rates for each category of provider shall be established based on the location of such providers in the upstate region or the downstate region and such base rates shall reflect differing regional cost factors as determined by the department.
(b) Additional discrete base rates may be developed by the department for such peer groups as may be established by regulation in this Subpart. Such base rates shall include a MR/DD/TBI peer group for hospital clinics for periods commencing on and after July 1, 2010 and a MR/DD/TBI peer group for free-standing clinics which may be established for rate periods commencing on or after January 1, 2011.
(c) Such base rates shall be established based on estimated historical per visit payment amounts, as adjusted to reflect the level of State appropriations made available for such purposes. Such adjustments shall be calculated on a per visit basis, utilizing the same historical visit volume used to calculate the estimated per visit payment amounts.
(d) Such base rates shall be peer group specific and shall reflect the estimated case mix index for each peer group and any projected changes in provider coding patterns for each peer group.
(e) Such base rates may be periodically adjusted to reflect changes in provider coding patterns and case mix.
(f) For hospital clinics operating under a Mental Hygiene Law license and instituting utilization of the APG reimbursement methodology, the applicable blend rate calculation shall be determined on a licensure-specific and provider-specific basis and shall be based on the most recent 12-month period for which accurate and complete billing information exists, as determined by the commissioner of the Mental Hygiene Law agency having jurisdiction over that class of provider. Such clinics shall have the blend rate otherwise computed and applied on the same schedule as applies to Public Health Law article 28 – licensed hospital clinics pursuant to paragraph (a) of subdivision 2-a of section 2807 of the Public Health Law.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.4 Application/reapplication for rape crisis program approval
(a) Application for approval shall be made on forms provided by the department. Information required from the applicant shall include:
(1) a description of services provided to victims of sexual offenses, sexual abuse or incest;
(2) a description of the program's community prevention education, training of professionals and outreach services;
(3) the program's curriculum for training rape crisis counselors, or confirmation of intent to use a curriculum approved by the department;
(4) a description of the program's training program, referred to in section 69-5.3 of this Subpart; and
(5) a description of the program's procedures to evaluate and monitor program services, including the performance of rape crisis counselors.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-5.170 Premises
Food vending operations, and all parts of the property used in connection with the operations, are to be kept clean and free from litter.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.144 Fund liability
A liability of a fund which is to be met out of its existing resources.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.13 Village of Tuxedo Park
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as last amended by chapter 879 of the Law of 1953, shall apply to Tuxedo Lake, Pond No. 3 and Wee Wah and its tributaries which now serve or which may be developed in the future to service as sources of the public water supply of the Village of Tuxedo Park and the hamlet of Tuxedo and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definitions.
(1) The term water supply means the public water supply of the Village of Tuxedo Park and the hamlet of Tuxedo.
(2) The term either lake whenever used in this section is intended to mean the above-mentioned Tuxedo Lake, Pond No. 3 and Wee Wah and means said body of water serving as the source of the water supply of the Village of Tuxedo Park and the hamlet of Tuxedo.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, including ditches, gutters or artificial underdrains, the waters of which may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into either lake or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or shall be allowed to remain with its nearest point less than 250 feet, horizontal measurement, from the high-water mark on either lake or from the edge, margin or precipitous bank of any watercourse of the Tuxedo water supply, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (d)(1) of this section; provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of ths subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of trustees of the Village of Tuxedo Park and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta, which is constructed, located or maintained within the aforesaid limit of 250 feet, horizontal measurement, of the high-water mark of either lake or watercourse, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which shall be emptied when filled within six inches of the top and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(7) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(8) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, wastes, garbage.
(1) No sewage shall be discharged or allowed to flow into the lake or any watercourse nor deposited beneath the surface of the ground within 250 feet, horizontal measurement, from the high-water mark of either lake or from the edge, margin or precipitous bank of any watercourse of the Tuxedo water supply except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (c)(7) of this section. If such watertight receptacles are used, they shall not be located within 250 feet of the watercourse; provided, however, when the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (c)(5) of this section. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by paragraph (1) of this subdivision, shall be discharged or allowed to flow into the lake or any watercourse nor be deposited on or beneath the surface of the ground within 250 feet of the watercourse.
(3) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in the lake or watercourse nor on or beneath the surface of the ground within 250 feet of the watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(e) Bathing.
No person or persons shall bathe or swim or be allowed to bathe or swim in Tuxedo Lake.
(f) Animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in either lake or any tributary and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house and yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with the nearest point less than 250 feet, horizontal measurement, from the high-water mark of either lake nor less than 250 feet, horizontal measurement, from the edge, margin or precipitous bank of any watercourse of the Tuxedo water supply, unless such stable for cattle or horses, hogpen or poultry house shall have cemented watertight floors connected wih the sewers and in which all manure shall be temporarily kept in covered cemented pits or compartments, draining into sewers, and protected from the wash of surface water, and unless such barnyard, poultry yard, hitching place or standing place for horses or other animals shall be paved with cemented watertight material, protected from the wash of roof water and surface water, and connected with the sewers.
(g) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(h) Inspections.
The board of trustees of the Village of Tuxedo Park or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the village shall make regular and thorough inspections of the lake, watercourse and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(f) Penalty.
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
USE OF ANIMALS USE OF ANIMALS
10 CRR-NY 55-1.7 Applicability
This Subpart shall not apply to elementary or secondary schools under the jurisdiction of the State Education Department.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.96 Other hazards
(a) Food vending machines requiring electrical power are to be grounded or double-insulated to protect anyone contacting or touching the machine from shock.
(b) Food vending machines are to be constructed and installed so that they are stable and resist tipping under normal conditions of use and service.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.2 Exemptions
(a) Pursuant to section 3305 of the Public Health Law, the provisions of this Part restricting the possession of controlled substances shall not apply to:
(1) common carriers or warehousemen while engaged in lawfully transporting or storing such substances or to any employee of the same acting within the scope of his employment;
(2) public officers or their employees in the lawful performance of their official duties requiring possession of controlled substances;
(3) temporary incidental possession by employees or agents of persons lawfully entitled to possession or by persons whose possession is for the purpose of aiding public officers in performing their official duties;
(4) a person in the employ of the United States government, its territories, districts or insular governments by reason of his official duties;
(5) a master of a ship or a person in charge of any aircraft upon which a physician is not regularly employed; or
(6) a duly authorized agent of an incorporated society for the prevention of cruelty to animals or a municipal animal control facility for the limited purpose of purchasing, possessing and dispensing sodium pentobarbital to registered and certified personnel, to euthanize animals and ketamine hydrochloride to anesthetize animals prior to euthanasia.
(b) The provisions of article 33 with respect to the payment of fees and costs shall not apply to the State of New York or any political subdivision thereof or any agency or instrumentality of either.
(c) The following exemptions are granted to the possession and use of schedule III or IV substances as part of an industrial process or manufacture of substances other than drugs: None.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.207 Medicare
A third-party reimbursement program administered by the Health Care Financing Administration that underwrites the medical costs of persons 65 and over, and some qualified persons under 65. “Part A” covers hospital services and “Part B” covers physicians' services.
10 CRR-NY 441.238 Ownership
The right to and enjoyment of services or benefits flowing from an asset, usually evidenced by the possession of legal title or by a beneficial interest in the title.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.8 Renewal/recertification requirements
(a) Renewal requirements.
(1) A request for renewal of a certificate must be submitted, by each operator, to the department, on a form prescribed by the department, at least one month before the certificate expiration date. All operators will have a fixed renewal cycle of three years.
(2) All renewal requests from grandparented operators may be approved after the operator has completed the required renewal training, as set forth in Table 5-4.8 of this section; satisfactorily operated his/her facility during each three-year grandparenting period; and all other renewal conditions prescribed by the department.
(3) To qualify for renewal, a grade A, B, C or D water treatment operator, water treatment assistant operator, or distribution system operator must have successfully completed the following equivalent continuing education unit (CEU) training requirements, as set forth in Table 5-4.8 of this section, within the previous three years. All renewal training courses must be approved by the department.
(4) The department may require any person applying for renewal of certification as a water treatment operator, water treatment assistant operator or distribution system operator to take a written, oral and/or practical skills validated examination to determine the applicant's skills, knowledge, ability and judgement. The results of the examination, and the requirements of this section, will serve as the basis for approval or disapproval of such application.
Table 5–4.8 — Renewal Requirements
| Grade | CEU equivalent | Type of training | | --- | --- | --- | | IA and IIA | 3.0 | • .5 CEU's required from a laboratory course • Remaining 2.5 CEU's must come from the following list of acceptable training: • Science of water • Source water protection • Mathematics • Treatment • Operation & maintenance • Regulations • Safety | | IB and IIB | 3.0 | • All CEU's must come from the following list of acceptable training: • Laboratory • Science of water • Source water protection • Mathematics • Treatment • Operation & maintenance • Regulations • Safety | | C | 1.5 | • All CEU's must come from the following list of acceptable training: • Laboratory • Science of water • Source water protection • Mathematics • Treatment • Operation & maintenance • Distribution systems • Regulations • Safety | | D | 1.5 | • The following is a list of acceptable training: • Distribution systems • Mathematics • Operation & maintenance • Regulations • Safety |
(5) If dual certification is held, then the operator must obtain the number of CEU's corresponding to the highest grade of certification held, as outlined in Table 5-4.8 of this section.
(b) Recertification requirements.
(1) An individual that allows his or her certification renewal to lapse after the expiration date is no longer certified to operate a water treatment plant and/or distribution system. When the individual meets the requirements outlined in subdivision (a) of this section, the certification will be reinstated.
(2) An individual who allows his or her certification renewal to lapse, for more than one year, will be required to repeat the type and amount of experience, training and validated examination as contained in sections 5-4.3(b) and 5-4.5 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.2 Requirements for approval
(a) The application must be complete and in proper form. It shall provide all the information essential for the Public Health Council's consideration.
(b) The applicant must satisfactorily demonstrate to the council:
(1) that there is a public need for the facility or the proposed new facility;
(2)
(i) if a nonprofit corporation, that the members of the board of directors and the officers of the corporation are of such character, experience, competence and standing as to give reasonable assurance of their ability to conduct the affairs of the corporation in its best interests and in the public interest and so as to provide proper care for the patients or residents to be served by the facility or the proposed facility;
(ii) if a proprietary business, that the owner, or all the partners, if a partnership, are persons of good moral character who are competent to operate the business so as to provide proper care for the patients or residents to be served by the proposed facility;
(iii) if a business corporation, that the members of the board of directors, the officers and the stockholders of the corporation are of such character, experience, competence and standing as to give reasonable assurance of their ability to conduct the affairs of the corporation so as to provide proper care for the patients or residents to be served by the proposed facility;
(3) that there are adequate finances to properly establish and conduct the proposed facility;
(4) that, with respect to an applicant who is already or within the past 10 years has been an incorporator, director, sponsor, principal stockholder, or operator of any facility as specified in paragraph (b) of subdivision (3) of section 2801-a of the Public Health Law, a substantially consistent high level of care has been rendered in each such facility with which the applicant is or has been affiliated during the past 10 years or during the period of affiliation, as appropriate. In reaching this determination, the Public Health Council shall consider findings of facility inspections, including but not limited to the title XVIII and XIX (of the Social Security Act) and article 28 survey findings, as such pertain to violations of this Chapter, periodic medical review/independent professional review (PMR/IPR) findings, routine and patient abuse complaint investigation results, and other available information. The Public Health Council's determination that a substantially consistent high level of care has been rendered shall be made after reviewing the following criteria: the gravity of any violation, the manner in which the applicant/operator exercised supervisory responsibility over the facility operation, and the remedial action, if any, taken after the violation was discovered.
(i)
(a) In reviewing the gravity of the violation, the Public Health Council shall consider whether the violation threatened, or resulted in direct, significant harm to the health, safety or welfare of patients/residents.
(b) In reviewing the manner in which the applicant/operator exercised supervisory responsibility over the facility operation, the Public Health Council shall consider whether a reasonably prudent applicant/operator should have been aware of the conditions which resulted in the violation.
(c) In reviewing any remedial action taken, the Public Health Council shall consider whether the applicant/operator investigated the circumstances surrounding the violation, and took steps which a reasonably prudent applicant/operator would take to prevent the reoccurrence of the violation.
(ii) When violations were found which either threatened to directly affect patient/resident health, safety or welfare, or resulted in direct, significant harm to the health, safety or welfare of patients/residents, there shall not be a determination of a substantially consistent high level of care if the violations reoccurred or were not promptly corrected.
(c)
(1) The applicant must supply any additional documentation or information requested by the department acting on behalf of the Public Health Council within 30 days, or any other stated time frame, of such request, or must obtain from the department acting on behalf of the council an extension of the time in which to provide such documentation or information which is requested during the review of the application. Any request for an extension of time shall set forth reasons why such documentation or information could not be obtained within the prescribed time. The granting of a request for an extension shall be at the discretion of the department acting on behalf of the council. Failure to provide such documentation or information within the time prescribed or as extended by the department acting on behalf of the council shall constitute an abandonment or withdrawal of the application without any further action by the council or department.
(2) The applicant must supply any authorization the council or the department requests in order to verify any documentation or information contained in the application or to obtain any additional documentation or information which the council or department finds is pertinent to the application. Failure to provide such authorization shall constitute an abandonment or withdrawal of the application without any further action by the council or department.
(d) Whenever any applicant proposes to lease premises in which the operation of a hospital as defined in article 28 of the Public Health Law is to be conducted, the lease agreement shall include the following language:
“The landlord acknowledges that his rights of reentry into the premises set forth in this lease do not confer on him the authority to operate a hospital as defined in article 28 of the Public Health Law on the premises and agrees that he will give the New York State Department of Health, Tower Building, Empire State Plaza, Albany, NY 12237, notification by certified mail of his intent to reenter the premises or to initiate dispossess proceedings or that the lease is due to expire, at least 30 days prior to the date on which the landlord intends to exercise a right of reentry or to initiate such proceedings or at least 60 days before expiration of the lease.
“Upon receipt of notice from the landlord of his intent to exercise his right of reentry or upon the service of process in dispossess proceedings and 60 days prior to the expiration of the lease, the tenant shall immediately notify by certified mail the New York State Department of Health, Tower Building, Empire State Plaza, Albany, NY 12237, of the receipt of such notice or service of such process or that the lease is about to expire.”
(e) No lease covering the premises in which the operation of a hospital as defined in article 28 of the Public Health Law is to be conducted may contain any provision whereby rent, or any increase therein, is based upon the Consumer Price Index, or any other cost of living index, except:
(1) leases for outpatient facilities and premises leased solely for administrative purposes may contain cost of living index rent determination or adjustment provisions, provided the following conditions are met:
(i) the lease is reviewed and approved by the department;
(ii) the space rented is in a multi-purpose, multi-use building not constructed specifically for the purpose of housing an outpatient facility;
(iii) the rental, if the lease is a sublease, is the same or less than the rental in the overlease;
(iv) the applicant has no interest, direct or indirect, beneficial or of record, in the ownership of the building or any overlease; and
(v) the rental per square foot, in the judgement of the department, is the same as or is comparable to other rentals in the building in which the outpatient service or administrative space is to be located, and the rental per square foot is comparable to the rental of similar space in other comparable buildings in the area when such comparisons can be made;
(2) in addition to the exception set forth in paragraph (1) of this subdivision, in the event the lease covering hospital premises contains provisions whereby it is the lessor's responsibility to pay necessary expenses associated with such premises, such as real estate taxes, utilities, heat, insurance, maintenance and operating supplies, such lease may contain provisions which allow adjustments to the rent only to the extent necessary to compensate for changes in such expenses.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.6 Department and Operational Unit Protocols
(a) The Department will promulgate, for use and implementation by all its operational units, standard confidentiality protocols which meet the requirements of this section.
(b) The supervisor of each operational unit, in which employees have access to personal health-related information, shall prepare protocols for ensuring confidentiality of such information. The protocols shall include as necessary:
(1) measures to ensure that letters, memoranda and other documents containing personal health-related information are accessible only by authorized personnel;
(2) measures to ensure that personal health-related information stored electronically is protected from access by unauthorized persons;
(3) measures to ensure that only personal health-related information necessary to fulfill authorized functions is maintained in the unit;
(4) measures to ensure that staff working with personal health-related information secure such information from casual observance or loss and that such documents or files are returned to confidential storage on termination of use;
(5) measures to ensure that personal health-related information is not inappropriately copied or removed from control of the Department;
(6) measures to provide safeguards to prevent discrimination, abuse or other adverse actions directed toward persons to whom personal health-related information applies;
(7) measures to ensure that personal health-related information is adequately secured after working hours;
(8) measures to ensure that transmittal of personal health related information outside of the unit is authorized only by the director of the unit, other persons designated by the director or in accordance with such protocol;
(9) measures to protect the confidentiality of personal health-related information being transferred within the unit and to other units in the Department;
(10) measures to ensure that documents or files that contain personal health-related information that are obsolete or no longer needed are promptly disposed of in such a manner so as to not compromise the confidentiality of the documents.
(c) Unit protocols for ensuring confidentiality of personal health-related information are to be updated whenever a program activity change renders the established protocol obsolete or inadequate.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.3 Uniform system of accounting and reporting
(a) Medical facilities shall maintain their records in accordance with:
(1) Accounting and reporting. Hospitals shall maintain their accounts and records in accordance with the Healthcare Financial Management Association's (HFMA) Introduction to Hospital Accounting, 5th edition, written by Michael Nowicki and published by the Health Administration Press. Such accounts and records are to be maintained on an accrual basis except where an alternate system is mandated by law. Hospitals shall also submit to the department or its authorized agent a certified institutional cost report within five months after the close of each hospital's fiscal year. The data shall be reported as follows:
(i) In accordance with the policies and instructions in the following:
(a) The Financial Management of Hospitals and Healthcare Organizations, 4th edition, written by Michael Nowicki and published by the Health Administration Press;
(b) HFMA, Glossary of Terms;
(c) Health Care Entities—American Institute of Certified Public Accountants (AICPA) Audit and Accounting Guide published by the AICPA; and
(d) Medicare Provider Reimbursement Manual, Part 1.
(ii) All government subsidies shall be reported on the income statement of the institutional cost report on the line provided and such amounts shall be itemized on the notes to financial statements by payor and purpose. Such grants shall not be used to reduce allowances as indicated in the American Institute of Certified Public Accountants manual, Audit and Accounting Guide .
(iii) Investments, other than donations, shall be reported on the balance sheet of the institutional cost report at cost. The notes to the financial statements shall describe the assets and indicate the quoted market value and cost for each category of investment.
(iv) Fixed assets, other than donations, shall be reported on the balance sheet of the institutional cost report at cost.
(v) Discounts, allowances and bad debts shall be reported and broken out on the institutional cost report by hospital service.
(vi) Copies of HFMA's Introduction to Hospital Accounting and The Financial Management of Hospitals and Healthcare Organizations are available from the Health Administration Press, American College of Healthcare Executives, One North Franklin, Suite 1700, Chicago, IL 60606-3529 and at
http//:www.ache.org/PUBS/redesign/productcatalog.cfm?pc=WWW1-2060and
http//:www.ache.org/PUBS/redesign/productcatalog.cfm?pc=WWW1-2087,respectively.
Copies of HFMA's Glossary of Terms are available from HFMA, Two Westbrook Corporate Center, Suite 700, Westchester, IL 60154 and at
http//:www.hfma.org/site/store/hfmaglossaryorderform.cfm.Copies of Health Care Entities—AICPA Audit and Accounting Guide are available from the AICPA, CPA2 Biz Corporate Headquarters, 100 Broadway, 6th Floor, New York, NY 10005 and at
http//:www.cpa2biz.com/AST/Main/CPA2BIZ Primary/AuditAttest/IndustryspecificGuidance/HealthCare/PRDOVR~PC-012615/PC-012615.jsp. In addition, a copy of each publication is available for inspection at the offices of the Bureau of Primary and Acute Care Reimbursement, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237; and
(2) Article 8 of Subchapter A of Chapter V of this Title.
(b) Failure of a medical facility to file the reports required pursuant to this section will subject the medical facility to a rate reduction as set forth in section 86-1.2(c) of this Subpart.
(c) For purposes of rate setting, medical facilities shall submit to the department, or its authorized agent, a certified institutional cost report in accordance with the policies and instructions as set forth in subdivision (a) of this section.
(d) The institutional cost report and supplementary schedule form as adopted by the department shall be used to report financial and statistical data in order to establish rates of payment for title 19 providers.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
CAPITAL PLANT CAPITAL PLANT
10 CRR-NY 446.24 Patient accommodations
(a) Patient accommodations—certified beds (excluding newborn).
(1) In accordance with Department of Health Operating Certificate.
(i) Number of certified beds at the beginning of the reporting period.
(ii) Number of certified beds at the end of the reporting period.
(2) Please refer to section 446.44(b) of this Part for all program services for which these statistics are to be reported.
(b) Patient accommodations—bed complement (excluding newborn).
(1) Number of beds at the beginning of the reporting period.
(2) Number of beds at the end of the reporting period.
(3) Please refer to section 446.44(b) of this Part for all program services for which these statistics are to be reported.
(c) Patient accommodations—changes in certified beds or bed complement (excluding newborn).
(1) Indicate type of change:
(i) Complement.
(ii) Certified beds.
(2) Indicate clinical service affected.
(3) Indicate date of change.
(4) Indicate number of beds gained.
(5) Indicate number of beds lost.
(6) Indicate pavilion/building and rooms affected.
(7) Indicate, for each change, the final number of beds at the end of the reporting period.
(8) Indicate an explanation of the change.
(d) Patient accommodations—regular newborn bassinets.
(1) Number of bassinets at the beginning of the reporting period.
(2) Number of bassinets at the end of the reporting period.
(3) Specific data required:
(i) Total bassinets.
(ii) Normal bassinets.
(iii) Observation bassinets.
(iv) Isolation bassinets.
(v) Premature bassinets.
(vi) Other bassinets.
(e) Patient accommodations—changes in regular newborn bassinets.
(1) Type of bassinet changed:
(i) Normal.
(ii) Observation.
(iii) Isolation.
(iv) Premature.
(v) Other.
(2) Date of change.
(3) Number of bassinets gained.
(4) Number of bassinets lost.
(5) The number of bassinets at the end of the reporting period.
(6) An explanation of the change.
(f) Patient accommodations—specialized beds.
(1) Number of specialized beds at the beginning of the reporting period.
(2) Number of specialized beds at the end of the reporting period.
(3) Types of specialized beds:
(i) Kidney Dialysis Unit (not in a discrete unit).
(ii) Recovery room.
(iii) Other (specify).
(g) Capital plant—real property owned.
(1) Data required:
(i) Location of real property.
(ii) Description of real property.
(iii) Use of real property.
(2) Categories of real property:
(i) Land and buildings (hospital owns both).
(ii) Land only (hospital owns; is it vacant, are you renting/leasing any structures on this land).
(iii) Building only (hospital owns building and does not own land).
(h) Capital plant—real property leased by provider.
(1) Data required:
(i) Location of real property.
(ii) Description of real property.
(iii) Use of real property.
(2) Categories of real property:
(i) Land and buildings (hospital leases both).
(ii) Land only (hospital leases and keeps it vacant).
(iii) Building only (leases building and does not own the land).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.2 Definitions
Whenever used in this Subpart, unless the context of this Subpart clearly requires otherwise, the following terms shall have the following meanings:
(a) Clinical laboratory services shall mean the microbiological, immunological, chemical, hematological, biophysical, cytological or pathological, genetic or other examination of materials derived from the human body, for the purposes of obtaining information for the diagnosis, prevention, or treatment of disease or the assessment of a health condition.
(b) Fair market value shall mean the value in arms length transactions, consistent with the general market value, and, with respect to rentals or leases, the value of rental property for general commercial purposes, not taking into account its intended use, and, in the case of a lease of space, not adjusted to reflect the additional value the prospective lessee or lessor would attribute to the proximity or convenience to the lessor where the lessor is a potential source of patient referrals to the lessee.
(c) Financial relationship shall mean an ownership interest, investment interest or compensation arrangement.
(d) General hospital shall mean a hospital engaged in providing medical or medical and surgical services primarily to in-patients by or under the supervision of a physician on a 24-hour basis with provisions for admission or treatment of persons in need of emergency care and with an organized medical staff and nursing service, including facilities providing services relating to particular diseases, injuries, conditions or deformities. The term general hospital shall not include a residential health care facility, public health center, diagnostic center, treatment center, out- patient lodge, dispensary and laboratory or central service facility serving more than one institution.
(e) Group practice shall mean a group of two or more practitioners organized as a partnership, professional corporation, foundation, not-for-profit corporation, faculty practice plan or similar association; and
(1) in which each practitioner who is a member of the group provides substantially the full range of services which the practitioner routinely provides, including medical care, consultation, diagnosis or treatment, through the joint use of shared office space, facilities, equipment and personnel; and
(2) for which substantially all of the services of the practitioners who are members of the group are provided through the group and are billed in the name of the group and amounts so received are treated as receipts of the group; and
(3) in which the overhead expenses of the income from the practice are distributed in accordance with methods previously determined by members of the group; and
(4) provided, however, in the case of a faculty practice plan associated with a hospital with an approved residency training program in which practitioner members may provide a variety of different specialty services and provide professional services both within and outside the group, as well as perform other tasks such as research, the provisions of paragraphs (1)-(3) of this subdivision shall be applied only with respect to the services provided within the faculty practice plan.
(f) Health care provider shall mean a practitioner in an individual practice, group practice, partnership, professional corporation or other authorized form of association, a hospital or other health care institution issued an operating certificate pursuant to the Public Health Law or the Mental Hygiene Law, a certified home health agency or a licensed home care services agency, and any other purveyor of health or health related items or services including but not limited to a clinical laboratory, a physiological laboratory, a pharmacy, a purveyor of X-ray or imaging services, a purveyor of physical therapy services, a purveyor of health or health related supplies, appliances or equipment, or an ambulance service.
(g) Health or health related items or services shall include, but not be limited to, items and services available under the medical assistance program pursuant to title 11 of article 5 of the Social Services Law.
(h) Immediate family member shall include spouse; natural and adoptive parents, children and siblings; stepparents, stepchildren and step-siblings; fathers-in-law, mothers-in-law, brothers-in- law, sisters-in-law, sons-in-law and daughters-in-law; and grandparents and grandchildren.
(i) Interested investor shall mean, with respect to a health care provider, an investor who is a practitioner in a position to make or to influence referrals or business to the health care provider, or who is an immediate family member of such an investor.
(j) Investor shall mean, with respect to a health care provider, a person with a financial relationship with the health care provider, subject to the exceptions provided in paragraph (b) of subdivision 3, subdivision 4 and paragraph (b) of subdivision 5 of section 238(a) of the Public Health Law.
(k) Ownership interest or investment interest shall mean an interest through equity, debt, or other means, but shall not include ownership of investment securities, including shares or bonds, debentures, notes or other debt instruments, which were purchased on terms generally available to the public and which are in a corporation that is listed for trading on the New York Stock Exchange or on the American Stock Exchange, or is a national market system security traded under an automated interdealer quotation system operated by the national association of securities dealers, and had, at the end of the corporation's most recent fiscal year, total assets exceeding $100 million.
(l) Pharmacy services shall mean the preparing, compounding, preserving or, the dispensing of drugs, medicines and therapeutic devices on the basis of prescriptions or other legal authority.
(m) Practitioner shall mean a licensed or registered physician, dentist, podiatrist, chiropractor, nurse, midwife, physician assistant or specialist assistant, physical therapist, or optometrist.
(n) Rural shall mean a county with population of 200,000 persons or less, or a town with a population density of 150 persons or less per square mile.
(o) X-ray or imaging services shall mean diagnostic imaging techniques which shall include but not be limited to the following:
(1) conventional X-ray or radiology;
(2) fluoroscopy;
(3) digital radiography;
(4) computed tomography;
(5) magnetic resonance imaging;
(6) nuclear imaging;
(7) ultrasonography; and
(8) angiography.
(p) Radiation therapy services shall mean the use of high-energy X-rays, particles, or radiation materials for the treatment of cancer and other diseases or conditions.
(q) Effective December 8, 2002, physical therapy services shall mean physical therapy as defined by section 6731 of the Education Law.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.24 Spray ground design standards
(a) Submission of plans.
(1) General. All plans shall be prepared by a person licensed by the State of New York to practice engineering or architecture. All construction shall comply with the requirements of the Uniform Code. Plans, specifications and reports submitted for formal approval must contain sufficient information to demonstrate to the permit-issuing official or his/her designated representative that the proposed spray ground, or improvements thereto, will meet the standards contained herein and shall include, but not be limited to, those factors hereinafter set forth in paragraph (2) of this subdivision.
(2) Basis of design report:
(i) spray pad shape and area;
(ii) number and type of spray features and drains;
(iii) spray pad treatment tank volume;
(iv) feature and filter flow rates, turnover and filtration rate;
(v) patron use (daily maximum and average);
(vi) source, quality, quantity available and characteristics of the water supplied to a spray ground and spray pad, including alkalinity, pH, iron and manganese;
(vii) detailed description of filtration, recirculation equipment and chemical feed equipment;
(viii) hydraulic computations including head loss in all piping and recirculation equipment; and
(ix) pump curves, showing that the proposed recirculation pump can adequately pump proposed flows.
(3) Plans and specifications.
(i) General layout plan:
(a) name and address of the proposed facility and the name and address of the owner;
(b) scale, north point and direction of prevailing wind;
(c) date, address, name, professional seal and signature of the design engineer or architect; and
(d) a plot plan of the property to be used, indicating the topography, the arrangement and location of present and proposed structures, and the location of present and proposed spray ground.
(ii) Detailed plans. All detailed plans shall be drawn to a suitable scale and include the following information:
(a) complete construction details, including dimensions, elevations and appropriate cross-sections;
(b) schematic diagrams and plan and elevation views of the spray pad water treatment and recirculation system;
(c) size and location of all piping, including elevations; and
(d) specifications. Complete, detailed specifications for the construction of the spray ground/spray pad, bathhouse, recirculation system, filtration facilities, disinfection equipment and all other appurtenances shown on detailed plans shall be submitted.
(b) Construction material.
(1) Materials. Spray pads shall be constructed of materials which are inert, stable, nontoxic, watertight and enduring. Sand or earth surfaces are not permitted.
(2) Finish. Spray pad surface must be slip resistant and easily cleanable.
(c) Design detail.
(1) Spray pad. The spray pad shall be sloped to drain(s). The slope shall be sufficient to prevent water from collecting on the pad.
(i) Drain systems. The size, number and locations of the spray pad drains shall be determined and specified so as to assure water does not accumulate on the spray pads. Flow through the drains to the spray pad treatment tank shall be under gravity, direct suction outlets from the spray pad are prohibited.
(a) Valves and piping shall be provided in the spray pad drain system to allow for discharging spray pad water to waste prior to returning to the spray pad treatment tank.
(b) Grating. Openings in the grates covering the drains shall not be over one-half inch wide. Gratings shall not be removable without the use of tools.
(2) Decks. A continuous clear deck shall surround the entire spray pad perimeter. It shall be not less than five feet wide. The deck shall be of a uniform, easily cleaned, impervious material and be protected from surface runoff.
(i) Slope. The deck shall be sloped at least one-fourth inch per foot to deck drains or grade.
(ii) Drainage. Deck drains, when used, shall be spaced and arranged so that not more than 400 square feet of area is tributary to each drain, and drains shall not be spaced more than 25 feet apart. There shall be no direct connection between the spray pad deck drains and the sanitary sewer system, or the treatment tank or recirculation system.
(iii) Carpeting. Carpeting shall not be permitted on the spray pad or decks.
(iv) Hose bibbs. Hose bibbs shall be provided to facilitate flushing of the spray pad and deck areas and shall be provided with antisiphonage devices.
(3) Foot showers. Showers shall be provided at the entry to the spray pad to allow for rinsing debris from patrons' feet prior to entering the spray pad except such showers are not required at indoor spray grounds or those within the enclosure of an aquatic amusement park. The use of foot baths is prohibited.
(i) Waste water from the foot showers shall be discharged to an approved waste disposal system to prevent standing water on the ground surface, and/or contamination of ground water, surface water or the spray ground.
(4) Fencing. All spray pads shall be provided with an enclosure to prevent access by patrons and animals when the spray pad is not supervised.
(5) Spray features. Spray features shall be designed and installed so as not to pose a tripping hazard, a hazard to patrons due to water velocity from the spray feature discharge, or other safety hazards.
(d) Lighting, electrical, ventilation requirements.
(1) Lighting. Artificial lighting shall be provided at all spray pads which are used at night, or which do not have adequate natural lighting, so that all portions of the spray pad and deck may be readily seen.
(i) Equipment rooms. All spray pad equipment and chemical storage rooms shall be provided with artificial lighting sufficient to illuminate all equipment and supplies.
(2) Electrical.
(i) Wiring shall conform to the Uniform Code and the requirements of the appropriate regulatory agency. A certificate of electrical compliance shall be submitted for all new electrical work.
(ii) Overhead clearance. No electrical wiring shall pass overhead within a 20-foot horizontal distance of the spray pad.
(iii) Electrical receptacles. Ground-fault circuit interrupters shall be provided on all spray pads, for all lighting and other electrical circuits in the area of the spray pad. These devices may be required in an existing spray pad, when the permit-issuing official determines it is necessary to protect the safety of patrons.
(3) Ventilation.
(i) Room ventilation. Bathhouses, mechanical equipment rooms, storage areas and indoor spray pad enclosures shall be ventilated, either by natural or mechanical means in accordance with requirements contained in the Uniform Code. Fuel-burning heating equipment shall be installed and vented to the outdoors in accordance with the Uniform Code.
(e) Water supply and wastewater disposal.
(1) Water supply. The water supply serving all plumbing fixtures, including drinking fountains, lavatories and showers, shall, after treatment, meet the provisions required for a public water system as defined in the State Sanitary Code (Subpart 5-1 of this Title). A spray ground with an on-site water supply that does not meet the definition of a public water system must comply with the standards established in Subpart 5-1 of this Title for a non-community water system.
(2) Cross-connection control. All portions of the water distribution system serving the spray pad and auxiliary facilities shall be protected against backflow and back-siphonage. Water introduced into the spray pad, either directly or to the recirculation system, shall be supplied through an air gap or by another method which will prevent backflow and back- siphonage.
(3) Sanitary wastes. Sanitary sewage shall be disposed of through a municipal sanitary sewerage system. If a private subsurface sewage disposal system or other system must be used, approval of the system must be obtained from the appropriate regulatory agency.
(4) Spray pad waste water. Water used to flush the spray pad shall be discharged to an approved waste disposal system through a suitable air gap so as to preclude the possibility of backup of sewage or waste water into the spray pad piping system. Approval of the system must be obtained from the appropriate regulatory agency.
(f) Spray pad treatment system design.
(1) The water from the spray pad treatment system cannot be combined/circulated with water from other aquatic facilities such as swimming pools, water slides, or wave pools unless:
(i) all the water from the spray pad is treated by ultraviolet (uv) light disinfection prior to combining/circulating with water from the other aquatic facilities; or
(ii) UV light disinfection must be provided to treat all of the water in the other aquatic facilities. The minimum flow rate through the treatment system shall be calculated using the two techniques described below. The larger flow rate resulting from the two calculations shall be the minimum flow rate used for the treatment system design. All recirculated water must pass through both the ultraviolet light unit(s) and filters;
(a) minimum flow for ultraviolet light disinfection:
)
Q is in gallons per minute through the ultraviolet disinfection/filtration system V is in gallons and is the volume of the pool.
Number of turnovers = 14.8-ln(V) The term ln(V) is the natural log of the volume;
(b) minimum filtration rate for a combined pool/spray pad system: The minimum filtration rate for a pool that shares water with a spray pad is specified in clause (3)(ii)( c ) of this subdivision. The minimum filtration flow rate shall be at least the sum of the flow rate for the pool type specified in Subpart 6-1 of this Title and one third of the spray feature flow rate.
(2) When water supplying the spray features is removed from the spray pad treatment tank by a pump separate from the filtration/recirculation pump system, the ratio of the flow rate of water supplied to the spray features directly from the treatment tank must not exceed three times the design filtered water flow rate.
(3) Recirculation systems and equipment. A recirculation system consisting of pumps, piping, filters, water conditioning and disinfection equipment, and other accessory equipment, shall be provided which will clarify, chemically balance and disinfect the spray pad water. The spray pad treatment tank filtration, circulation and spray pad chemical disinfection equipment must operate 24 hours a day.
(i) Equipment approval. Equipment used or proposed for use in spray pad water treatment shall be of proven design and construction and other than ultraviolet light units be tested and listed by the National Sanitation Foundation (NSF) or another testing laboratory under standards promulgated by NSF.
(ii) Turnover rate.
(a) When water is supplied to the spray features by a pump which removes water directly from the spray pad treatment tank independent from the spray pad treatment tank filter pump, the turnover rate for filtration will be determined by the feature flow rate. The filtration flow rate for the spray pad treatment tank must be at least one-third of the design spray feature flow rate.
(b) When all of the water supplied to the spray features is filtered upon removal from the spray pad treatment tank before being supplied to the spray features, a reduced pumping rate for filtration/treatment of the spray pad treatment tank water can be used when the spray features are not in operation. However, a minimum four-hour turnover rate is required.
(c) The minimum flow rate through the filtration system for combined pool/spray pad systems shall be equal to or greater than the sum of the flow rate for the specific type pool as required by Subpart 6-1 of this Title, plus one third of the spray feature flow rate.
(4) Spray pad treatment tank. The spray pad treatment tank that receives the effluent water from the spray pad shall conform to the following specifications.
(i) The volume of the water in the spray pad treatment tank shall be sufficient to assure continuous operation of the filtration system. The capacity shall be measured from six inches above the uppermost pump inlet to the bottom of the overflow waste outlet.
(ii) The spray pad treatment tank must be designed to provide ready access for cleaning and inspections, and be capable of complete draining. An overflow pipe to convey excess water to waste through a suitable air gap must be provided.
(iii) The spray pad treatment tank shall be constructed of materials which are inert, corrosion resistant, nontoxic, and watertight such as concrete, fiberglass, stainless steel, etc., which can withstand all anticipated loadings under full and empty conditions.
(iv) An automatic water level controller shall be provided for the spray pad treatment tank.
(v) The makeup water shall be introduced into the spray pad treatment tank through an air gap or by another method which will prevent back flow and back-siphonage.
(vi) A screen or similar device shall be provided through which all water from the spray pad shall pass before entering the spray pad treatment tank or another method/process described to provide for removal of debris on the surface layer of the spray pad treatment tank water.
(vii) Spray pad treatment tank filtered/treated water inlets.
(a) Number and location. An adequate number of filtered/treated water inlets shall be provided and located for complete mixing and circulation of treated water within the spray pad treatment tank.
(viii) Spray pad treatment tank drain. At least one main drain suction outlet supplying water to the spray pad treatment tank filtration system shall be provided at the deepest point in the spray pad treatment tank.
(5) Piping.
(i) Materials. The recirculation piping and fittings shall be of nontoxic material, resistant to corrosion, and able to withstand operating pressures suitable for water supply use.
(ii) Velocities. The pipes, fittings and valves of the recirculation system shall be sized so that velocities do not exceed six feet per second under suction, 10 feet per second under pressure and three feet per second in gravity flow. The velocities may be exceeded when hydraulic computations indicate higher velocities will not adversely affect the spray pad treatment system.
(6) Drainage and installation. All equipment and piping shall be designed and fabricated to drain completely by use of drain plugs, drain valves or other means. All piping shall be supported continuously or at sufficiently close intervals to prevent sagging. All suction piping shall be sloped in one direction, preferably toward the pump. All supply and return pipelines to the spray pad shall be provided with insertable plugs or valves to allow the piping to be drained to a point below the frost line. Provision shall be made for expansion and contraction of pipes.
(7) Pumps and strainers.
(i) Strainers. Strainers shall be provided through which all water shall pass before entering the pump. The strainers shall be of rigid construction, fabricated of corrosion-resistant material and sufficiently strong to prevent collapsing when clogged. The openings shall be no greater than one-eighth inch in any dimension. The total clear area of all openings shall be at least four times the area of the connecting pipe. The strainer shall have a quick-opening cover. Spare strainer baskets shall be provided. In systems where the filter is located on the suction side of the pump, strainers are not required.
(ii) Pumping equipment. The recirculation pump shall have adequate capacity to meet the design requirements of the spray pad treatment tank, including filter backwashing. It shall be of a self-priming type if installed above the hydraulic gradient. A gauge that indicates both pressure and vacuum shall be installed on the pump suction header and a pressure gauge shall be installed on the discharge side of the pump.
(8) Flow measurement and control.
(i) Flow measurement. A means of continuously measuring rate of flow shall be provided in the recirculation system. For sand filters, the flow-measuring equipment shall be located where the backwash flow rate can also be determined. The indicator shall be capable of measuring at least 1½ times the design flow rate and shall be accurate within 10 percent of true flow. The indicator shall have a range of readings appropriate for the anticipated flow rates, and be installed where it is readily accessible for reading and maintenance, and with straight pipe upstream and downstream of any fitting or restriction in accordance with the manufacturer's recommendation.
(ii) Flow regulation. Automatic devices are required for regulating the rate of flow through the filtration system and flow to the spray features.
(g) Filtration (general).
A spray pad treatment tank treatment system shall have one or more filters. It shall be installed with adequate clearance and facilities for ready and safe inspection, maintenance, disassembly and repair.
(1) Sand filters. The design filtration rate of high-rate sand filters (pressure or vacuum) shall not exceed a filtration rate of 15 gallons per minute per square foot of filter area. The sand filter system shall be equipped to backwash each filter at a rate of 12 to 15 gallons per minute per square foot of filter bed area, or as recommended by the manufacturer. The backwash water shall be discharged to waste through a suitable air gap.
(i) Filter media. Sand or other media shall be carefully graded and meet the manufacturer's recommendation for pool use.
(ii) Accessories shall include influent pressure gauge, effluent pressure gauge, backwash sight glass and air relief valve.
(2) Diatomaceous earth. The design filtration rate for pressure or vacuum filters shall be no greater than 1.5 gallons per minute per square foot of effective filter area, except that a maximum filtration rate of 2.0 gallons per minute per square foot may be allowed where continuous "body feed" is provided. The filter and all component parts shall be of such materials, design and construction to withstand normal continuous use without significant deformation, deterioration, corrosion or wear which could adversely affect filter operation.
(i) Precoating. The filter piping shall be designed to refilter or waste the effluent until a uniform body coat is applied. For pressure-type filters, precoat feed equipment shall be provided to apply not less than 0.1 pound of diatomaceous earth per square foot of filter area.
(ii) Body feed equipment. Body feed equipment capable of applying not less than 0.1 pound of diatomaceous earth per square foot of filter area per 24 hours should be provided.
(iii) Regenerative-type filters. Regenerative type of filters shall meet the same standards as pressure filters. Pumping by air or manual means must be provided for, and provision for visual inspection of elements shall be provided.
(iv) Accessories. Accessories for vacuum filters shall include a vacuum gauge and a vacuum limit switch interconnected with the pump. Pressure filters require a backwash sight glass, effluent pressure gauge, influent pressure gauge and air relief valve.
(v) Backwash. Diatomaceous earth filter backwash water must discharge to the sewer system through a separation tank and a suitable air gap. The separation tank sludge shall be disposed of in an approved solid waste disposal facility.
(3) Cartridge filters: filter rate. The design filtration rate for cartridge filters shall not exceed 0.375 gallon per minute per square foot of filter media.
(i) Cartridges. A complete extra set of filter cartridges must be on hand at user's location.
(ii) Accessories shall include influent pressure gauge, effluent pressure gauge and air relief valve.
(h) Disinfection.
Spray pad treatment tanks shall be designed to provide for continuous disinfection of the spray pad water with a chemical which is an effective disinfectant and which imparts an easily measured, active residual. An automatic controller shall be provided for continuously monitoring and adjusting the level of free residual disinfectant in the spray pad treatment tank.
(1) Disinfectant feeders. An automatic feeder which is easily adjustable shall be provided for the application of disinfectant.
(i) Construction. Feeders shall be of sturdy construction and materials which will withstand wear, corrosion or attack by disinfectant solutions or vapors, and which are not adversely affected by repeated, regular adjustments or other normal use conditions.
(ii) Maintenance. Feeders shall be capable of being easily disassembled for cleaning and maintenance.
(iii) Operation. The design and construction shall minimize stoppage from chemicals intended to be used or foreign materials that may be contained therein.
(iv) Safeguards. The feeders shall incorporate antisiphon safeguards so that the disinfectant cannot continue to feed into the spray pad treatment tank, the spray pad piping system or the spray pad enclosure if any type of failure of the spray pad equipment occurs.
(v) Capacity. Feeders shall be capable of supplying disinfectant to the spray pad treatment tank in the range up to 10 mg/l chlorine or equivalent.
(2) Hypochlorinators. Where hypochlorinators are used, the following requirements shall apply:
(i) Feed. Feed shall be continuous under all conditions of pressure in the recirculation system without constriction of the recirculation pump suction.
(ii) Solution tanks. If calcium hypochlorite is used, two solution tanks, each with minimum capacity of one-day supply, should be provided. All chemical containers, including those used with chemical feeders, must be clearly labeled regarding their contents.
(3) Ultraviolet light disinfection units.
(i) Treatment systems shall include ultraviolet light disinfection systems unless another treatment process is provided that has been determined by the State Department of Health to be capable of providing the equivalent level of reduction of cryptosporidium as the ultraviolet light disinfection system specified in this section. All water that is provided to the spray pad shall be treated with ultraviolet light during spray pad operation. The ultraviolet light unit validated dosage shall be equivalent to 40mJ/cm2 or greater at the end of lamp life.
(a) All ultraviolet light units must be validated. The validation process must determine the ultraviolet light unit's disinfection performance by indicating that a dose of 40mJ/cm2 (at end of lamp life) is achieved at a flow rate equal to or greater than the design flow rate at the setpoint intensity. Validation testing must be performed by an independent agency. The validation procedure used must have been determined by the State Department of Health to be capable of demonstrating the disinfection performance described above.
(b) For systems utilizing quartz sleeves to separate the water passing through the chamber from the ultraviolet source, the system shall be designed to permit cleaning of the lamp jackets and the sensor window or lens without mechanical disassembly. For systems utilizing polytetrafluoroethylene (PTFE) surface materials to separate the water that flows through the ultraviolet chamber from the lamps, the ultraviolet unit shall be designed to be readily accessible to the interior and exterior of the PTFE. The ultraviolet unit shall be designed to permit use of either physical or chemical cleaning methods.
(c) An accurately calibrated ultraviolet light intensity meter, properly filtered to restrict its sensitivity to the disinfection spectrum shall be installed in the wall of the disinfection chamber at the point of greatest water depth from the tube or tubes.
(d) An automatic system shall be installed to prevent flow to the features in the event the ultraviolet light intensity decreases below the validated setpoint.
(e) An automatic, audible alarm shall be installed to warn of ultraviolet light disinfection system malfunction or impending shutdown.
(f) The unit shall be designed to protect the operator against electrical shock or excessive radiation.
(g) Installation of the unit shall be in a protected enclosure not subject to extremes of temperature.
(h) A spare ultraviolet lamp and other necessary equipment to effect prompt repair by qualified personnel properly instructed in the operation and maintenance of the equipment shall be provided on-site.
(i) The ultraviolet light unit shall be located between the spray pad treatment tank pump discharge and the spray features or as approved in accordance with paragraph (f)(1) of this section.
(4) Disinfection with bromine. Where bromine is used as a disinfectant, the permit-issuing official shall first approve use of solid stick-type bromine and the equipment provided for feeding on a continuous basis.
(5) Ozone generating equipment (OGE) is acceptable only as a supplement to a chlorine or bromine disinfection system. When OGE is installed, the following design performance standards must be met:
(i) Ozone concentration in the spray pad treatment tank water shall not exceed 0.1 mg/l. Off-gassing of ozone shall not result in ozone levels in the equipment room or in the spray pad area exceeding 0.1 ppm. At the time the OGE is installed and annually thereafter the air space within six inches of the spray pad treatment tank water level and air in the equipment room shall be tested to determine compliance with this requirement.
(ii) All corona discharge OGEs must be vacuum systems.
(iii) Backflow of spray pad water into the OGE shall not occur.
(6) pH adjustment. Positive feed equipment for the purpose of adding a chemical for pH adjustment shall be provided. An automatic controller shall be provided for continuously monitoring and adjusting the level of pH in the spray pad treatment tank.
(i) Where carbon dioxide (CO2) is used as a method of pH control, the following features shall be provided:
(a) CO2 shall be injected into the recirculation pipe at the same point where pH adjustment solutions ( i.e., acid) would normally be added. The recirculation pipe shall be of sufficient size and length to provide a minimum of five seconds contact time prior to bather contact.
(b) CO2 cylinders shall be anchored to prevent damage. Cylinders shall be inaccessible to the general public.
(c) The manufacturer's instructions shall be followed for installation and operation of cylinders. The units shall be operated by the designated persons listed in the safety plan.
(d) CO2 cylinders should be stored in a protective enclosure at the exterior of occupied structures. If CO2 cylinders are provided in the interior of occupied structures, they shall be placed in a ventilated enclosure. A louvered fresh air intake shall be provided near the ceiling. Mechanical exhaust ventilation shall be provided at the rate of one air change every three minutes and take suction near the floor as far as practical from the door and fresh air intake. Exhausted air shall be ducted to the exterior of the building through a continuous pipe of at least 1½ inches in diameter with the point of discharge so located as not to contaminate air inlets to any rooms or structures.
(7) Chemical feed equipment. Equipment and piping used to apply chemicals to the water shall be of such size, design and material that they may be cleaned. All material used for such equipment and piping shall be resistant to action of chemicals to be used therein.
(8) An automatic device shall be provided to deactivate chemical feeders when there is no flow in the spray pad treatment tank recirculation system.
(9) Test kit. Colorimetric test kits shall be provided for the determination of free disinfectant residual, pH of the pool water and, where necessary, total alkalinity and calcium hardness. FAS-DPD test kits are also acceptable. A supply of appropriate reagents for making each type of test shall be provided. When colorimetric tests are used, color standards shall be furnished for each of the tests, that allow an accurate comparison of the sample to be tested, both from the standpoint of color and density, and shall be reasonably permanent and nonfading. Electronic residual and pH monitoring devices may be used in addition to the test kit.
(i) Standards. A DPD (Diethyl-P-Phenylene Diamine) test kit with the following increments: 0.2, 0.4, 0.6, 0.8, 1.0, 1.5, 2.0, 3.0, 5.0, 10 ppm as a minimum, shall be provided to measure the chlorine residual. If other halogens are used, an appropriate scale shall be provided.
(ii) A pH kit. A pH test kit with a range from 6.8 to 8.2, accurate to the nearest 0.2 pH unit, shall be provided.
(i) Bathhouse.
(1) General. Adequate sanitary facilities shall be provided for all spray grounds.
(2) Diaper changing stations. Diaper changing stations shall be provided.
(3) Bathhouse design. Floors of the bathhouse shall be of smooth-finished material with nonslip surfaces, impervious to moisture, easily cleanable and sloped at least one-fourth inch per foot to drains. Carpeting shall not be permitted in shower and toilet areas. Junctions between walls and floors shall be coved and of smooth, impervious materials, free from cracks or open joints. Partitions between dressing cubicles shall terminate at least 10 inches above the floor, or shall be placed on continuous raised masonry or concrete bases at least four inches high. Lockers shall be set either on solid masonry or concrete bases at least four inches above the floor. Lockers shall be vented.
(4) Fixture requirements. An adequate number of toilet and handwashing facilities shall be provided.
(i) Fixtures. Plumbing fixtures and installations shall be in accordance with the Uniform Code.
(5) Hose bibbs. Hose bibbs shall be provided within the bathhouse to enable the entire area to be flushed. Hose bibbs shall be provided with antisiphonage devices.
(j) Miscellaneous.
(1) Manual. A manual(s) for operation and maintenance of the spray pad equipment shall be provided. It shall include instructions for each filter, pump, disinfection or other piece of equipment, drawings, illustrations, charts, operating instructions and parts list, to permit service, operation, winterization and maintenance.
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.16 Control of beach and water use
(a) All areas of an operator's property that are adjacent to the designated public beach area and are accessible to the public for entry into the water for bathing shall be supervised or patrolled during hours of operation. Bathing shall be prohibited where required supervision is not provided.
(b) Operators must maintain signs stating the hours during which public bathing is allowed, and that bathing at other times is prohibited.
(c) No motorized vehicles except emergency and maintenance vehicles shall be permitted on the beach.
(d) No boating, water skiing, fishing or surfboarding shall be permitted in the bathing area during the hours bathing is allowed. Separate areas for the above activities may be designated by floating lines and buoys.
(e) Bathing at night or during electrical thunderstorms is prohibited.
(f) Clearly visible depth markings shall be provided at all diving boards, platforms, piers, floats and similar facilities. Warning signs stating “No Diving” shall be provided where water depths are less than eight feet.
(g) Diving shall not be permitted unless minimum depths in accordance with provisions in section 6-2.19, item 4.8.2, of this Subpart are provided.
(h) All plug-in electrical devices, such as portable announcing systems and radios, are prohibited within 20 feet of the water.
(i) Bather use.
(1) The maximum number of bathers permitted in the bathing waters of a bathing beach shall not exceed one bather per 25 square feet of water surface. In areas of water depth greater than four feet, at least 75 square feet per bather shall be provided.
(2) The operator shall be responsible for restricting usage so that the maximum capacity is not exceeded.
(3) A sign stating the maximum number of persons who may use the bathing beach at any one time shall be posted in a conspicuous place.
(j) Glass containers shall not be permitted on the beach.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
VILLAGES VILLAGES
10 CRR-NY 127.2 Village of Hempstead
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all wells forming the source of the public water supply of the village of Hempstead, Nassau County, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional wells which may be constructed for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary or permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Hempstead.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well of the public water supply of the village of Hempstead, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the village of Hempstead except into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be within 50 feet of any well of the public water supply of the village of Hempstead.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged or allowed to escape or remain upon or percolate into or through the ground beneath the surface within a distance of 100 feet from any well of the public water supply of the village of Hempstead, except into watertight iron pipes as hereinbefore provided.
(e) Manure, compost, etc.
No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well of the public water supply of the village of Hempstead and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the village of Hempstead.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well of the public water supply of the village of Hempstead nor shall any such matters be so placed or maintained that the washings therefrom may reach any well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed, or maintained within a distance of 500 feet of any well of the public water supply of the village of Hempstead.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the village of Hempstead.
(i) Inspections.
The board of trustees of the village of Hempstead or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Hempstead o*their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45, of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-4 COVID-19 NURSING HOME AND ADULT CARE FACILITY VACCINATION PROGRAM
10 CRR-NY 66-4.3 Penalties
(a) A violation of any provision of this Subpart shall be subject to penalties in accordance with sections 12 and 12-b of the Public Health Law.
(b) For adult care facilities, failure to arrange for the vaccination of every facility resident and personnel as set forth in section 66-4.2 of this Part constitutes a “failure in systemic practices and procedures” under Social Services Law 460-d(7)(b)(2)(iii) and pursuant to 18 NYCRR 486.5(a)(4)(v).
(c) In addition to any monetary penalties or referral for criminal investigation to appropriate entities, the Department shall be empowered to immediately take custody and control of such vaccine at a nursing home and re-allocate to another provider.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.4 Operator responsibilities and reporting requirements
(a) The operator of a campground shall provide an individual to be in charge of the property and to maintain the facilities as required by this Subpart and who shall be on or available to the property at all times when the property is occupied or open for occupancy. A telephone number or other method for summoning the individual in charge shall be posted in an area readily accessible to the campground occupants.
(b) The operator shall report the following to the permit-issuing official within 24 hours of occurrence:
(1) injury or illness occurring at a swimming pool or bathing beach as required by section 6-1.7 and/or 6-2.7 of this Title;
(2) a condition suspected of affecting the quantity or quality of the on-site potable water supply or constituting a public health hazard as specified by section 5-1.1(ar) of this Title; and
(3) illness suspected of being food-borne due to consumption of food from a food service establishment in the campground as required by section 14-1.200 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.1 General requirements
(a) The term nursing home company or company as used in this Part shall mean a corporation organized under the provisions of article 28-A of the Public Health Law and the Not-For-Profit Corporation Law.
(b) A nursing home company is required to comply with all applicable provisions of law, including but not limited to articles 28 and 28-A of the Public Health Law and the State Hospital Code.
(c) A nursing home company shall apply for establishment of the proposed project, and approval of the certificate of incorporation by the Public Health Council in accordance with the provisions of section 2801-a of the Public Health Law and this Title.
(d) A nursing home shall apply for the prior approval of construction of the facility in accordance with the provisions of section 2802 of the Public Health Law and the State Hospital Code.
(e) A nursing home company shall apply for a mortgage loan by setting forth in the applications for establishment and construction the amount of the proposed mortgage loan requested for development of the project.
(f) A nursing home company shall comply with the terms and conditions set forth in the mortgage loan of the New York State Housing Finance Agency.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.40 Fees
(a) General requirement.
Unless exempt under subdivision (b) of this section, no person shall establish, maintain or operate a radiation installation with radiation equipment, that is subject to the registration requirements of section 16.50 of this Part, or hold a radioactive materials license as required pursuant to the licensing requirements of section 16.100 of this Part, except upon payment of the applicable fees prescribed in this section and section 16.41 of this Part.
(b) Exemptions.
(1) Agencies of the State of New York and its political subdivisions, except for hospitals and higher education academic institutions operated by such agencies, are exempt from the payment of any of the fees prescribed in this section and section 16.41 of this Part.
(2) Any operator of a radiation installation that is registered with the New York City Department of Health or any person that holds a radioactive material license issued by the New York City Department of Health, pursuant to sections 16.50(j) and 16.l(b)(3), respectively, of this Part is exempt from paying the fees prescribed in this section and section 16.41 of this Part, unless they also hold a registration certificate or a radioactive material license issued by the department for which fees are applicable. In the latter case, the applicable fees for the activities registered or licensed by the department shall be assessed.
(c) Payment of fees.
(1) Each application for a radiation installation registration or for a new radioactive material license, shall be accompanied by a remittance of the full amount of the applicable annual fees prescribed in section 16.41 of this Part. Annual fees for each subsequent year shall become due on each anniversary date thereafter, determined by the date of original registration or license issued.
(2) Any operator of a radiation installation who holds a current radiation installation registration certificate issued pursuant to this Part or any person who holds a current radioactive material license issued pursuant to this Part, shall pay the prescribed annual fee as billed by the department. Payment of fees shall be made within the 30 day period immediately following the billing date. A late payment charge will be assessed at the rate of 1½ percent for each 30 day late period or part thereof.
(3) The payment of all fees prescribed by this Part shall be by check or money order made payable to the New York State Department of Health.
(d) Prorating fees.
For administrative purposes, the department may alter the fee due date and charge a fee for a period greater or less than one year. In such case the amount of the fee due will be prorated to correspond to the length of the period covered by the bill.
(e) No refund policy.
Except in those cases where the department has determined that a payment of fees is not required, no fees, or portions thereof, paid to the department pursuant to this Part shall be refundable.
(f) Failure to pay prescribed fee.
If an applicant for a license or registration fails to remit with such application the full amount of the fees as prescribed by this Part, the department will not process the application and will notify the applicant that the application will not be processed unless fees are first paid. The department may revoke, suspend or amend a registration or radioactive material license in whole or in part for failure to pay all prescribed annual fees due.
(g) Registration fees charged by New York City Department of Health.
Provided that a written schedule of the registration fees to be charged by the New York City Department of Health, not to exceed $50 per year per installation, has been submitted, in the manner prescribed, to, and approved by, the State Commissioner of Health, the New York City Department of Health is authorized to charge within its jurisdiction registration fees as so approved. The State of New York or any political subdivision thereof or any agency or instrumentality of either are exempt from the payment of such fees.
(h) Fees charged by local health departments.
Provided that a written schedule of the fees to be charged, together with a written analysis of the estimated costs of its radiation protection regulatory program, has been submitted to and approved by the State Commissioner of Health, the New York City Department of Health or, as the department shall direct, the appropriate county or part-county health officer having jurisdiction that inspects installations with radiation equipment under a program of inspection certified by the State Department of Health, or any county, part-county or city health district that licenses and inspects radioactive materials in accordance with section 16.1(b)(3) of this Part, is authorized to charge adequate and reasonable fees for inspection, licensing and/or other radiation protection services rendered, as applicable, not exceeding the estimated costs of such services, except that, with the approval of the State Commissioner of Health, one or more of such services may be rendered without charge. The State of New York or any political subdivision thereof or any agency or instrumentality of either are exempt from the payment of such fees.
(i) Fees charged by certified radiation equipment safety officers.
A certified radiation equipment safety officer shall not charge, or propose to charge, a fee for an inspection in excess of a fair and reasonable amount as determined by the department. Such officer shall furnish to the department, upon request, information as to fees charged or proposed to be charged by the officer. Such fees shall not exceed the estimated cost of services.
(j) Fees paid prior to the effective date of this section.
Facilities that had paid fees which cover a period that extends beyond the effective date of this section, shall be responsible for the difference between the prorated amount of any fee previously paid for such period and that due under this section for such period.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.11 Village of Peekskill
L. 1909, ch. 49; L. 1915, ch. 665; L. 1911, ch. 695, as amd.
(a) [Application.]
The following rules and regulations shall apply to all natural and artificial reservoirs on the Peekskill Hollow Creek and all watercourses tributary thereto or ultimately discharging into said reservoirs, those bodies of water being sources of the public water supply of the village of Peekskill in Westchester County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Peekskill Hollow Creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch gutter or other channel of every kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Peekskill.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse at any point within two miles upstream from the intake of the Peekskill waterworks; nor shall any such privy, privy vault, pit, cesspool or other receptacle for the deposit of human excreta be constructed, placed, located, maintained or allowed to remain within 25 feet of any reservoir or any watercourse at points distant more than two miles upstream from the intake of the Peekskill waterworks.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta and sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed or by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, washings from the bodies of human beings or animals, sewage or other excretal matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed sewage disposal plant approved by the State Department of Health, as required by law, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Peekskill, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 100 feet of any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into the ground or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 50 feet from any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any of the streams, lakes, ponds or reservoirs tributary to the water supply of the village of Peekskill except in Oscawana Lake, Mohegan Lake, Osceola Lake, Brant Lake, Clear Lake, Mud Lake, Barger Pond and tributaries thereof, nor shall any person be allowed to bathe in Oscawana Lake, Mohegan Lake, Osceola Lake, Brant Lake and Barger Pond within 500 feet of the outlets thereof. No animal or poultry shall be allowed to stand, wallow, wade or swim in any stream, lake, pond or reservoir tributary to said water supply nor allowed to be washed therein. No watering place shall be maintained in such a way as to pollute by muddy leachings or excretal matters any streams tributary to the public water supply of the village of Peekskill.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet of any reservoir or 50 feet of any watercourse at any point within two miles upstream from the intake of the Peekskill waterworks; nor shall any such structures or places be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or any watercourse at points distant more than two miles upstream from the intake of the Peekskill waterworks, except in the case of islands in Oscawana Lake where no such structures or places shall be constructed, placed, maintained or allowed to remain within 25 feet of the high-water mark in the lake. None of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having been passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for distances not less than those specified in the foregoing part of this paragraph.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground at any point on any watershed tributary to the public water supply of the village of Peekskill; nor shall human excreta, compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below surface nor within a distance of 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Peekskill, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 25 feet from any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Peekskill.
(g) Fishing, boating and ice cutting.
No boating of any kind nor fishing from boats or through the ice nor any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir of the village of Peekskill or of Oscawana Lake, Mohegan Lake, Osceola Lake, Brant Lake or Barger Pond within 50 feet of the outlets thereof nor shall any fishing, boating or ice cutting be done in any manner that may pollute the waters of this public water supply.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Peekskill.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Peekskill.
(j) [Inspections.]
The board of water commissioners of the village of Peekskill shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.28 Adding or deleting hospital services or units
(a) Notification of the elimination of a general hospital inpatient service or identifiable unit of such a service in instances in which the costs of such service are reflected in the rate calculated pursuant to this Subpart shall be submitted in writing by the facility to the department within 60 days of the elimination of such service or unit. If a rate is modified by the department as a result of such service or unit elimination, such rate shall be effective as of the date of the elimination of the service or unit.
(b) Notification of the establishment of a new hospital or of a new exempt unit of an existing hospital shall be submitted in writing by the facility to the department within 60 days of the establishment of such new hospital or such new unit. Thereafter the department shall establish inpatient rates for such new hospital or such new exempt unit in accordance with section 86-1.29 of this Subpart. Such rates shall be effective the first day of the month following 30 days after such notification or the date of the approved certificate of need (CON) certification, whichever is later.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 153 WASHINGTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 153.3 Village of Argyle
(a) Application.
The rules and regulations set forth in this section duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Summit Lake and all watercourses tributary thereto or which may ultimately discharge into said Summit Lake or which may be developed in the future to serve as sources of the water supply to the Village of Argyle, Washington County, New York.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or second-hand motor vehicles are being accumulated for purposes of disposal, resale or used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, garbage, sewage sludge, chemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that is shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant, or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond, which is tributary to or serves as a source of the Village of Argyle public water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including, but not limited to, gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Argyle, Washington County, New York.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the Village of Argyle public water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Argyle public water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be make within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed or reconstructed within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designated, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such a facility.
(viii) Before any existng sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such a facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed disposal system.
(ix) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within a 50-foot linear distance of any reservoir or watercourse. The restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
No bathing, swimming, boating, fishing and trespassing shall be allowed on the lake within 50 feet from the intake of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Manure. No manure pile shall be maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Argyle.
(e) Inspections.
The village board of the Village of Argyle or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representatives make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the State Commissioner of Health of such violations. The aforesaid village board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.16 Statewide base price
(a) For periods on and after December 1, 2009, a statewide base price per discharge shall be established based on targeted statewide Medicaid inpatient hospital expenditures and case-mix and wage neutral reimbursable Medicaid acute operating costs derived from the base period identified in subdivision (b) of this section, and as adjusted for inflation between the base period and the rate period in accordance with trend factors determined pursuant to applicable provisions of section 2807-c(10) of the Public Health Law, but excluding costs related to graduate medical education, exempt units, patient transfers, high-cost outliers, alternate level of care, and non-comparables. Such trended operating costs shall then be divided by Medicaid inpatient discharges in the base period identified in subdivision (b) of this section to establish the average statewide base price per discharge for the applicable rate period.
(b) For periods on and after December 1, 2009, the "base period" shall be the 2005 calendar year and "operating costs" shall be those reported by each facility to the department prior to July 1, 2009.
(1) For those hospitals operated by the New York City Health and Hospitals Corporation, the base period shall be for the period which ended June 30, 2005, and for those hospitals operated by New York State, excluding the hospitals operated by the State University of New York, the base period shall be the 12-month period which ended March 31, 2006.
(2) Discharges, as defined in section 86-1.15(n) of this Subpart, used for direct graduate medical education adjustments shall be based on reported 2007 data.
(3) Discharges, as defined in section 86-1.15(n) of this Subpart, but excluding the factors set forth in section 86-1.15(n)(3) of this Subpart, as used for non-comparable adjustments shall be based on reported 2007 data.
(c)
(1) For the period effective July 1, 2011 through March 31, 2012, the statewide base price shall be adjusted such that total Medicaid payments are decreased by $24,200,000.
(2) For the period May 1, 2012 through March 31, 2013 and for State fiscal year periods on and after April 1, 2013, the statewide base price shall be adjusted such that total Medicaid payments are decreased for such period and for each such State fiscal year period by $19,200,000.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.222 Nursing services
Services pertaining to the curative, rehabilitative and preventive aspects of nursing care that are planned, performed, supervised and/or directed by a registered professional nurse.
10 CRR-NY 441.223 Obsolescence
The loss in usefulness of an asset, occasioned by the approach to the stage of economic uselessness through programs of the arts; economic inutility arising from external causes; disappearing usefulness resulting from invention, change of style, legislation, or other causes having no physical relation to the object affected. It is distinguished from exhaustion, wear and tear, and deterioration, in that these terms refer to a functional loss arising out of a change in physical condition.
10 CRR-NY 441.74 Cost center
A cost center is an accounting device for accumulating items of cost that have common characteristics. A cost center may or may not be a department within the institution. A cost center such as Depreciation and Amortization, is an example where the cost center would not be a department of the institution. A cost center may be a function within the health facility, as opposed to a department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.15 Multiple storage area; schedule I-V controlled substances
Where necessary for licensees (nonpractitioner category) to handle several classes of controlled substances separately, for example, damaged goods, returned goods and goods in process, the controlled substances may be stored apart from the main stock of controlled substances, provided that each storage area complies with the security requirements set forth in this Part.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 610 SPECIAL REQUIREMENTS FOR NONPROFIT CORPORATIONS
10 CRR-NY 610.3 Annual statement
(a) Each corporation operating a facility shall file annually, upon forms provided by the State Department of Health, a statement identifying the members of the board of directors and the officers of the corporation.
(b) If any change has occurred in the members of the board of directors or officers of the corporation, the corporation shall file, for evaluation by the department which shall report to the council, information and data with reference to:
(1) the character, experience, competency and standing in the community of such director or officer on forms provided by the department;
(2) such additional pertinent information or documents as requested.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.239 Oxygen therapy minutes
The number of minutes oxygen has been administered to a patient. Consideration should be given to volume of oxygen used.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.7 Transition to new methodology
The reimbursement methodology described in this Subpart will be phased-in over a three-year period, with a year for purposes of the transition period meaning a 12-month period from July 1st to the following June 30th, and with full implementation in the beginning of the fourth year. During this transition period, the base operating rate will transition to the target rate as determined by the reimbursement methodology described in this Subpart, according to the phase-in schedule outlined below. The base operating rate will remain fixed and the target rate, as determined by the reimbursement methodology in this Subpart, will be updated to reflect rebasing of cost data, trend factors and/or other appropriate adjustments.
| | Phase-in percentage | | | --- | --- | --- | | Transition year | Base operating rate | Target rate | | Year One (July 1, 2014 – June 30, 2015) | 75% | 25% | | Year Two (July 1, 2015 – June 30, 2016) | 50% | 50% | | Year Three (July 1, 2016 - June 30, 2017) | 25% | 75% | | Year Four (July 1, 2017 – June 30, 2018) | 0% | 100% |
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.5 Nursing services
The governing body shall ensure that the hospital has an organized nursing service that provides 24-hour services and that meets the care needs of all patients in accordance with established standards of nursing practice. The nursing services for all patients shall be provided or supervised by a registered professional nurse who is on duty and available at all times.
(a) Organization and staffing.
(1) The hospital shall have a written nursing service plan of administrative authority and delineation of responsibilities. The director of the nursing service shall be a licensed registered professional nurse who is qualified by training and experience for such position. He or she shall be responsible for the operation of the service, including developing a plan to be approved by the hospital for determining the types and numbers of nursing personnel and staff necessary to provide nursing care for all areas of the hospital.
(2) The hospital shall employ licensed and currently registered professional nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. The hospital shall provide supervisory and staff personnel for each department or nursing unit to ensure, when needed in accordance with generally accepted standards of nursing practice, the immediate availability of a registered professional nurse for bedside care of any patient.
(3) Job descriptions for each position classification of registered professional nurses and ancillary nursing personnel shall specify standards of performance and delineate the functions, responsibilities, and specific qualifications of each classification.
(4) A written evaluation of the performance, credentials, and competence of registered professional nurses and ancillary nursing personnel shall be conducted on at least a biennial basis.
(5) When nursing services are provided by nursing students, nurses with limited permits, or by personnel from outside sources, the hospital shall retain full responsibility for the quality of nursing care rendered in the hospital.
(i) Nursing students, nurses with limited permits, and registered professional nurses from outside sources who are working in the hospital shall adhere to the policies and procedures of the hospital.
(ii) The director of nursing services shall provide for the supervision and evaluation of the clinical activities of all nursing personnel.
(6) All nursing services personnel, including nursing students and nonemployee licensed nurses who are working in the hospital, shall receive a basic orientation to prepare them for their specific duties and responsibilities prior to performing any nursing functions within a patient care area. For employee nurses and nursing students, the hospital shall provide or arrange for the provision of training programs to augment their knowledge of pertinent new developments in patient care. The hospital shall also require that nonemployee licensed nurses obtain education and training pertinent to the clinical duties to which they are assigned.
(7) Nursing services personnel employed in specialty areas, including, but not limited to, emergency services, must complete training and education specific to the specialty area. Nursing services personnel must be periodically reevaluated for competency and ongoing education and training provided to maintain competency in the specialty area.
(b) Delivery of services.
(1) There shall be working relationships among medical staff, nursing staff and staff of other departments or services to assure that all patient care needs are met.
(i) Nursing services personnel shall execute the orders of physicians and other practitioners, authorized by the governing body to order such services.
(ii) Registered professional nurses shall confer with the responsible practitioner relative to patient care on an ongoing basis and relative to significant changes in the patient's condition as necessary.
(iii) The hospital shall develop and implement policies and procedures for prompt review and correction, as necessary, of health care practitioner orders which have, or have the likely potential for having, negative impact on patient care and safety and which should not be carried out.
(2) There shall be continuous review and evaluation of the adequacy and appropriateness of nursing care provided for patients.
(i) Nursing care policies and procedures shall be written and consistent with generally accepted standards of nursing practice.
(ii) A registered professional nurse shall plan, supervise, and evaluate the nursing care for each patient. A registered professional nurse shall assign the nursing care of each patient to other nursing personnel in accordance with the patient's needs and the preparation and competence of such other nursing personnel.
(3) Written nursing care plans shall be kept current. Such plans shall indicate what nursing care is needed, how it is to be provided, and the methods, approaches and mechanisms for ongoing modifications necessary to ensure the most effective and beneficial results for the patient. Patient education and patient/family knowledge of care requirements shall be included in the nursing plan. The nursing care plan may be integrated into the overall interdisciplinary plan of care.
(4) Nursing documentation shall describe the nursing care given and include information and observations of significance so that they contribute to the continuity of patient care. Nursing interventions and patient responses shall be documented.
(c) Administration of drugs.
All drugs and biologicals shall be administered in accordance with the orders of the practitioner or practitioners responsible for the patient's care as specified under section 405.2 of this Part, and generally accepted standards of practice. They shall be administered by a licensed physician or a registered professional nurse, or other personnel in accordance with applicable licensing requirements of title 8 of the New York State Education Law, except for the self-administration of medications as set forth in paragraphs (4) and (5) of this subdivision, and in accordance with hospital policies and procedures. For purposes of this subdivision, self-administration means administration by the patient or the patient’s caregiver, including but not limited to a caregiver pursuant to section 2994-ii(3) of the Public Health Law, or a designated caregiver pursuant to section 3360(5) of the Public Health Law.
(1) All orders for drugs and biologicals shall be authenticated by the practitioner or practitioners responsible for the care of the patient as specified under section 405.2 of this Part.
(2) Blood transfusions and intravenous medications shall be administered in accordance with approved medical staff and nursing service policies and procedures. If blood transfusions and intravenous medications are administered by personnel other than physicians, such personnel shall have completed specific training to prepare them for this duty.
(3) There shall be a hospital procedure and nursing policies and procedures for the reporting and review of transfusion reactions, adverse drug reactions, and errors in administration of drugs.
(4) Hospitals, in accordance with hospital policies and procedures, may authorize hospital-issued prescription and non-prescription medications to be self-administered, provided that:
(i) a practitioner responsible for the care of the patient in the hospital has issued an order permitting self-administration;
(ii) the capacity of the patient or the patient’s caregiver to administer the medication has been assessed;
(iii) the patient or the patient’s caregiver has been given instructions for the safe and accurate administration of the medication;
(iv) the security of the medication is addressed; and
(v) documentation is made of the administration of each medication in the patient’s record, as reported by the patient or the patient’s caregiver.
(5) Hospitals, in accordance with hospital policies and procedures, may authorize a patient to bring in his or her own medications, including prescription medications, non-prescription medications and medical marihuana as defined in section 3360(8) of the Public Health Law, and self-administer such medications, provided that:
(i) a practitioner responsible for the care of the patient in the hospital has issued an order permitting self-administration of the medication the patient brought into the hospital, and in the case of medical marihuana, upon presentation of the patient or designated caregiver’s registry identification card issued pursuant to section 3363 of the Public Health Law;
(ii) the capacity of the patient or the patient’s caregiver to administer the medication has been assessed;
(iii) a determination is made concerning whether the patient or the patient’s caregiver needs instruction on the safe and accurate administration of the medication;
(iv) the medication is identified and visually evaluated for integrity;
(v) the security of the medication is addressed;
(vi) documentation is made of the administration of each medication in the patient’s record, as reported by the patient or the patient’s caregiver; and
(vii) if a patient dies in the hospital, any unused prescription medication shall be destroyed or disposed of in accordance with all applicable State and Federal laws and regulations. Such prescription medications may not be turned over to the patient’s caregiver. In the case of medical marihuana, it may be turned over to the deceased patient’s designated caregiver or to appropriate law enforcement for destruction or disposal.
(d) Nasogastric tube feedings.
Following consideration of possible alternatives for short-term nutritional therapy, nasogastric tubes and feeding formulations may be used for feeding purposes when determined clinically appropriate by the attending practitioner. Nasogastric tube feedings shall be used to promote a therapeutic program to maintain adequate nutrition and hydration and include a plan to help the patient develop or regain eating skills.
(1) Nasogastric tube feeding formulations shall be given in accordance with the manufacturer's instructions or at a rate appropriate to the physical size of the resident and the amount of fluid and nutrients necessary to meet the assessed caloric and fluid needs of the patient.
(2) To minimize patient discomfort, nasogastric tubes used for patient feeding purposes shall:
(i) be the smallest gauge appropriate for the patient and shall not exceed 3.96 millimeters (#12 French) in outside diameter unless medically indicated;
(ii) be made of a soft, flexible material such as medical grade polyurethane or silicone; and
(iii) be specifically manufactured for nasogastric feeding purposes.
(3) Patients receiving nasogastric tube feedings shall be periodically evaluated for the ability to return to normal feeding function. If nasogastric feedings are to be continued longer than three months, permanent enteral feeding procedures such as surgical gastrostomy or jejunostomy shall be considered. If the nasogastric feeding is continued, the reasons for continuation shall be documented in the patient's medical record.
(4) The facility shall develop and implement policies and procedures for inpatient nasogastric tube feedings which are written in accordance with prevailing standards of professional practice and in consultation with the medical, nursing, dietary and pharmacy services of the facility. Medical practitioners shall be informed of such policies and procedures governing the use of nasogastric tubes for patient feeding. The policies and procedures shall address as a minimum:
(i) types and sizes of nasogastric tubes and the various types of feeding formulations available at the facility;
(ii) the need to assess each patient's clinical and nutritional status to determine the size of the nasogastric tube and type of feeding appropriate for that individual;
(iii) standard techniques for inserting a nasogastric tube and confirming the correct placement of the tube;
(iv) procedures for administering nasogastric feedings including positioning the patient and the need for patient observation and monitoring before, during and following the feeding; and
(v) infection control practices related to tube feedings.
(e) Quality assurance.
The nursing service shall monitor and evaluate the quality and appropriateness of patient care and the resolution of identified problems. This process shall be integrated with the quality assurance committee in accordance with hospital policies and procedures.
(1) Nursing service personnel shall meet as often as necessary to identify and resolve problems and potential problems in the provision of nursing care, taking into consideration the findings from relevant nursing care monitoring and evaluation activities.
(2) Documentation of such reviews shall include findings, conclusions, recommendations and actions taken in conjunction with the hospital-wide quality assurance program and shall be maintained for review and analysis.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.9 Stormwater Pollution Prevention Plans and impervious surfaces
(a) Impervious surfaces.
(1) The construction of an impervious surface within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem, or controlled lake, is prohibited.
(2) Paragraph (1) of this subdivision shall not apply to the following activities:
(i) construction of a new individual residence, which shall comply with paragraph (5) of this subdivision, or non-commercial ancillary improvements or additions to an individual residence;
(ii) agricultural activities;
(iii) construction of bridges or crossings of watercourses or wetlands constructed pursuant to a valid permit from the appropriate regulatory agencies. If a permit from a regulatory agency other than the department is not required, the applicant shall comply with paragraph (9) of this subdivision;
(iv) creation of an impervious surface to alter or modify a wastewater treatment plant approved by the department;
(v) creation of an impervious surface that is made necessary by the construction of a new facility or alteration or modification of an existing facility used in connection with the operation of a public water supply system; or
(vi) creation of an impervious surface, such as a culvert, needed as an integral component of diversion or piping of a watercourse, but only with the review and approval of the department and only if the department determines that such impervious surface will not have an adverse impact on water quality.
(3) Paragraph (1) of this subdivision shall not apply to creation of an impervious surface in the west of Hudson watershed within a village, hamlet, village extension, or area zoned for commercial or industrial uses, which complies with paragraph (8) of this subdivision or to the creation of an impervious surface in the east of Hudson watershed within a designated main street area, which complies with paragraph (11) of this subdivision.
(4) Paragraph (1) of this subdivision shall not apply to the creation of an impervious surface in connection with the following activities occurring in the east of Hudson watershed outside a designated main street area or in the west of Hudson watershed outside a village, hamlet, village extension, or an area zoned for commercial or industrial uses:
(i) construction of a new road or driveway, or widening of an existing road, which shall comply with paragraph (6) of this subdivision;
(ii) creation of an impervious surface within a designated village center, which shall comply with paragraph (7) of this subdivision; or
(iii) expansion of an existing impervious surface within the limiting distance of 100 feet of a watercourse or wetland, at an existing commercial or industrial facility, provided that the total area of all expanded impervious surfaces does not exceed 25 percent of the area of the existing impervious surface at that commercial or industrial facility, which shall comply with subdivisions (b), (c) and (d) of this section.
(5) The following requirements are applicable to construction of a new individual residence:
(i) whether or not a new individual residence will be located in a subdivision, construction of a new individual residence within the limiting distance of 300 feet of a reservoir, reservoir stem, or controlled lake is prohibited;
(ii) construction of a new individual residence in a subdivision within the limiting distance of 100 feet of a watercourse or wetland is prohibited where:
(a) the subdivision plat received preliminary approval on or after October 16, 1995; or
(b) the subdivision plat received preliminary approval before October 16, 1995, the person who owned the subdivision on October 16, 1995 was the same person, or a principal or affiliate of the person, who owned the subdivision at the time the subdivision plat received preliminary approval, and construction activity related to infrastructure improvements for the subdivision had not begun as of October 16, 1995;
(iii) construction of a new individual residence not in a subdivision, or in a subdivision approved before October 16, 1995 and not prohibited by clause (ii)( b ) of this paragraph, within the limiting distance of 100 feet of a perennial stream or wetland requires an individual residential stormwater permit from the department, pursuant to subdivision (e) of this section.
(6) The following requirements are applicable to construction of an impervious surface for a new road or driveway or the widening of an existing road:
(i) Construction of an impervious surface for a new road or driveway within the limiting distance of 300 feet of a reservoir, reservoir stem or controlled lake is prohibited, except paving an existing dirt or gravel road is permitted. Construction of a new impervious surface by paving an existing dirt or gravel road requires a Stormwater Pollution Prevention Plan which complies with subdivisions (b), (c) and (d) of this section.
(ii) Construction of an impervious surface for a new road within the limiting distance of 50 feet of an intermittent stream or wetland, or within the limiting distance of 100 feet of a perennial stream is prohibited, except for paving an existing dirt or gravel road or where necessary to provide an access road to two or more parcels or to a subdivision. Construction of an impervious surface for paving such existing dirt or gravel road or for such a new access road requires a Stormwater Pollution Prevention Plan which complies with the requirements of subdivisions (b), (c) and (d) of this section. Any access road constructed pursuant to this paragraph shall be constructed as far as practicable from all watercourses and wetlands.
(iii) Construction of an impervious surface for a new road between the limiting distances of 50 feet and 100 feet of an intermittent stream or wetland requires a Stormwater Pollution Prevention Plan which complies with the requirements of subdivisions (b), (c) and (d) of this section.
(iv) Construction of an impervious surface for a driveway within the limiting distance of 50 feet of an intermittent stream or wetland, or within the limiting distance of 100 feet of a perennial stream is prohibited except where necessary to provide access to an existing home or a new individual residence allowed to be constructed within such limiting distances pursuant to paragraph (5) of this subdivision. If construction of the individual residence served by the driveway would require a Stormwater Pollution Prevention Plan or an individual residential stormwater permit, construction of the impervious surface for the driveway shall also require a Stormwater Pollution Prevention Plan or an individual residential stormwater permit, respectively.
(v) Widening of an existing road located within the limiting distance of 50 feet of an intermittent stream or wetland, within the limiting distance of 100 feet of a perennial stream, or within the limiting distance of 300 feet of a reservoir, reservoir stem or controlled lake shall be performed on the side of such existing road furthest from the watercourse, wetland, reservoir, reservoir stem or controlled lake, to the extent practical.
(7) The following requirements are applicable to creation of an impervious surface within a designated village center:
(i) A local government in the Croton System may delineate an area within the local government's boundaries to be a designated village center in a Comprehensive Croton Water Quality Protection Plan prepared and agreed to in accordance with section 128-8.2 of this Part. Such designated village center shall comply with the requirements of this paragraph with regard to the construction of impervious surfaces.
(ii) Within a designated village center the construction of a new impervious surface within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem, or controlled lake requires the review and approval of the department. An approval issued by the department pursuant to this subparagraph shall contain a determination by the department that there is no reasonable alternative to the creation of the proposed new impervious surface within the applicable limiting distance and that the best available measures have been taken to prevent adverse impacts on the quality of the drinking water supply.
(8) The following requirements are applicable to creation of an impervious surface in the west of Hudson watershed within a village, hamlet, village extension or area zoned for commercial or industrial uses:
(i) Creation of any new impervious surface within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem or controlled lake, within a village, hamlet, village extension or area zoned for commercial or industrial uses as of the effective date of these rules and regulations, requires a Stormwater Pollution Prevention Plan which complies with the requirements of subdivisions (b), (c) and (d) of this section, except that the foregoing requirements of this subparagraph shall not apply to the creation of a new impervious surface for an activity set forth in paragraph (2) of this subdivision which complies with the provisions of paragraph (2) of this subdivision.
(ii) If a local government in the west of Hudson watershed adopts a zoning ordinance designating additional areas for commercial or industrial use after the effective date of these rules and regulations, it may apply to the department to allow construction of new impervious surfaces in the newly zoned commercial or industrial areas located within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem, or controlled lake. The department shall approve such application if the department determines that allowing new impervious surfaces in such newly zoned commercial or industrial area is consistent with the objectives of these rules and regulations and with previously approved zoning ordinances. If approved by the department, creation of new impervious surfaces within such newly zoned commercial or industrial areas within the aforesaid limiting distances shall be allowed subject to the requirements of subparagraph (i) of this paragraph.
(9) Construction of a bridge or crossing of a watercourse or wetland which does not require a permit from a regulatory agency other than the department shall require the review and approval of the department. Such bridge or crossing shall be constructed to prevent adverse impacts on the quality of the water supply.
(10) Maintenance of an existing impervious surface that is a noncomplying regulated activity shall not require the review and approval of the department.
(11) The following requirements are applicable to creation of an impervious surface in the east of Hudson watershed within a designated main street area:
(i) Creation of any new impervious surface within a designated main street area requires a Stormwater Pollution Prevention Plan which complies with the requirements of subdivisions (b), (c), and (d) of this section, except that the foregoing requirements of this subparagraph shall not apply to the creation of a new impervious surface for an activity set forth in paragraph (2) of this subdivision which complies with the provisions of paragraph (2) of this subdivision.
(ii) Within 30 days of the effective date of these rules and regulations, a local government may define by metes and bounds, tax maps or other geographic boundaries a proposed designated main street area within its boundaries, and apply to the department for approval of such proposal. Within 30 days of such application the department may approve, disapprove, or approve with modifications, such designated main street area. If the department disapproves the application, the local government shall have an additional 30 days in which to submit a revised application for approval of the proposed designated main street area, and the department shall approve or disapprove the application within 30 days of receipt of such revised application. The department will approve only a limited number of designated main street areas and local governments may not designate all areas of population concentrations in the east of Hudson watershed as designated main street areas. The approved boundary description of a designated main street area shall be made available by the department for public inspection at its field offices in the east of Hudson watershed.
(b) Stormwater Pollution Prevention Plans.
(1) Stormwater Pollution Prevention Plans shall not be required to be prepared pursuant to this section for agricultural and silvicultural activities.
(2) Stormwater Pollution Prevention Plans shall not be required to be prepared pursuant to this section for clear cutting and mining activities, provided, however, that such activities shall be subject to the requirements set forth in the applicable New York State Department of Environmental Conservation SPDES permit which may be required pursuant to Environmental Conservation Law, section 17-0808.
(3) Stormwater Pollution Prevention Plans shall be prepared for the activities listed in this paragraph. Such plans shall be prepared and implemented in accordance with the requirements of Part III of the New York State Department of Environmental Conservation General Permit No. GP-93-06. Such plans shall also be subject to the prior review and approval of the department. The activities are:
(i) plans for development or sale of land that will result in the disturbance of five or more acres of total land area as described in General Permit No. GP-93-06;
(ii) construction of a subdivision;
(iii) construction of a new industrial, municipal, commercial, or multi-family residential project that will result in creation of an impervious surface totaling over 40,000 square feet in size;
(iv) a land clearing or land grading project, involving two or more acres, located at least in part within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem or controlled lake or on a slope exceeding 15 percent;
(v) construction of a new solid waste management facility or alteration or modification of an existing solid waste management facility within 300 feet of a watercourse or wetland or 500 feet of a reservoir, reservoir stem or controlled lake;
(vi) construction of a gasoline station;
(vii) construction of an impervious surface for a new road, as required by paragraph (a)(6) of this section;
(viii) construction of an impervious surface in the west of Hudson watershed within a village, hamlet, village extension or area zoned for commercial or industrial uses, as required by paragraph (a)(8) of this section;
(ix) up to a 25 percent expansion of an existing impervious surface at an existing commercial or industrial facility which is within the limiting distance of 100 feet of a watercourse or wetland, as required in subparagraph (a)(4)(iii) of this section; or
(x) construction of an impervious surface in the east of Hudson watershed in a designated main street area.
(4) If the owner or operator of any activity which is subject to a Stormwater Pollution Prevention Plan pursuant to paragraph (3) of this subdivision, alters or modifies such activity in a manner which would require an amended Stormwater Pollution Prevention Plan pursuant to Part III.C of the New York State Department of Environmental Conservation General Permit No. GP-93-06, if such activity were governed by General Permit No. GP-93-06, such amended Stormwater Pollution Prevention Plan shall be submitted to the department for prior review and approval and shall comply with the requirements of this section.
(5) Any approval of a Stormwater Pollution Prevention Plan issued by the department shall expire and thereafter be null and void unless construction is completed within five years of the date of issuance or within any extended period of time approved by the department upon good cause shown. Following expiration of the approval, the application for the Stormwater Pollution Prevention Plan may be resubmitted to the department for consideration for a new approval.
(6) As a condition of approval the department may require evidence of financial security prior to construction from any owner or operator of a stormwater management system pursuant to a Stormwater Pollution Prevention Plan. Such financial security shall consist of a bond, or an equivalent guaranty, to be deposited with the department, covering the full cost of the construction of such facility and an additional bond or an equivalent guaranty for the payment of labor and material furnished in the course of such construction. Upon completion of construction and payment of labor and materials, such bonds or other guaranties shall be released. Additionally, a bond or equivalent guaranty may be required for the maintenance and operation of the facility for a period of five years post-construction. No bond or guaranty is required where the owner or operator of such a facility is a village, town, county or city.
(c) Additional requirements for Stormwater Pollution Prevention Plans.
(1) When any activity listed in paragraph (b)(3) of this section is proposed to be undertaken in a phosphorus restricted basin, the Stormwater Pollution Prevention Plan shall include an analysis of phosphorus runoff, before and after the land disturbance activity. Such plan shall require measures to capture and treat the two-year, 24-hour storm runoff from the disturbed area created by such activity.
(2) When any activity listed in paragraph (b)(3) of this section is proposed to be undertaken in the drainage basin of a terminal reservoir, as identified on the watershed maps in section 128-10.1 of this Part, the Stormwater Pollution Prevention Plan shall include analysis of coliform runoff, before and after the land disturbance activity.
(i) If such proposed activity causes or contributes to the contravention of the coliform standard set forth in section 128-4.1(b)(1) of this Part, the Stormwater Pollution Prevention Plan shall not be approved by the department, unless the measures required by the Stormwater Pollution Prevention Plan in conjunction with any other controls to be imposed that limit future land disturbance at the site, including but not limited to property easements, restrictive covenants, zoning laws and development by-laws, will prevent the contribution of additional coliform.
(3) When any activity listed in paragraph (b)(3) of this section is proposed to be undertaken in a coliform restricted reservoir basin, the Stormwater Pollution Prevention Plan shall include an analysis of coliform runoff, before and after the land disturbance activity. Such plan shall require measures to capture and treat the two-year, 24-hour storm runoff from the disturbed area created by such activity.
(4) All Stormwater Pollution Prevention Plans prepared pursuant to this section shall include an analysis of the 25-year storm.
(d) Application requirements and procedures.
(1) An application for approval of a Stormwater Pollution Prevention Plan shall include:
(i) the Pollution Prevention Plan;
(ii) the information required in a Notice of Intent under New York State Department of Environmental Conservation SPDES General Permit No. GP-93-06; and
(iii) A phosphorus and/or coliform analysis when required by this section.
(2) When the department notifies an applicant that an application for approval of a Stormwater Pollution Prevention Plan is complete pursuant to section 128-2.3(d)(2) and (3) of this Part, the department shall also issue a written notification to the Stormwater Project Review Committee (committee) for the town(s) or village in which the activity requiring preparation of the Stormwater Pollution Prevention Plan is proposed to be located, of the department's receipt of a complete application.
(i) If requested by one or more members of the committee, the department shall submit a copy of the complete application to the committee for its review and shall convene a meeting, in person or by telephone, of the committee.
(ii) The department shall not be required to meet with or otherwise further consult with a member of the committee concerning an application where the committee member declines to review the application or fails to attend a meeting of the committee convened to consider the application.
(3) Upon completion of their review of the application, and upon a majority vote of the committee members, including the department's committee member, who reviewed the application, the committee may recommend to the department that an application for approval of a Stormwater Pollution Prevention Plan be approved, approved with conditions or disapproved.
(i) If the department's committee member agrees with the majority recommendation of the committee, the department may proceed to issue its determination to the applicant.
(ii) If the department's committee member disagrees with the majority recommendation of the committee, the application, together with the written recommendation of the committee, shall be submitted to the first deputy commissioner of the department for review and a determination. The first deputy commissioner shall issue a written record of decision setting forth the basis for the determination and responding to any contrary written recommendations submitted by any member of the committee.
(iii) If the committee fails to make a recommendation to the department at least 15 days prior to the date the department is required to notify an applicant in writing of its determination pursuant to section 128-2.3(d)(5) of this Part, the department may proceed to issue its determination and the department shall not be required by these rules and regulations to further consult with or consider the comments of the committee or any member of the committee.
(4) Failure of any committee member, other than the department committee member, to act in accordance with the procedures or within the time frames set forth in these rules and regulations, shall relieve the department of any obligation to consult with or consider the comments of the committee member. Failure of any committee member, other than the department committee member, to act in accordance with the procedures or within the time frames set forth in these rules and regulations, shall not invalidate any determination issued by the department.
(5) A committee may only make recommendations to the department and shall have no authority to make decisions on behalf of the department. For purposes of SEQRA, the department's determination on an application, not the committee's recommendation to the department, shall be considered a final decision.
(e) Individual residential stormwater permits.
(1) An individual residential stormwater permit is required for:
(i) construction of a new individual residence, not located within a subdivision, and located within the limiting distance of 100 feet of a perennial stream or wetland;
(ii) construction of a new individual residence located within a subdivision approved before October 16, 1995, and not prohibited by clause (a)(5)(ii)( b ) of this section, and located within the limiting distance of 100 feet of a perennial stream or wetland; and
(iii) construction of an impervious surface for a driveway located within the limiting distances of 50 feet of an intermittent stream or wetland or within 100 feet of a perennial stream, provided that the driveway is necessary for access to an individual residence which is not located within a subdivision and where the individual residence accessed by the driveway would be required to obtain an individual residential stormwater permit pursuant to this section.
(2) Application requirements. An application for issuance of an individual residential stormwater permit shall include:
(i) a plan of the proposed individual residence and/or driveway;
(ii) a plan or map identifying the location of any watercourses, wetlands, reservoirs, reservoir stems or controlled lakes on or adjacent to the property;
(iii) a plan showing the approximate area of site disturbance;
(iv) a description and depiction of proposed erosion controls sufficient to prevent sedimentation of the receiving watercourse or wetland during construction. Erosion controls typically consist of sediment barriers, such as hay bales and silt fencing, and temporary stormwater diversions;
(v) a schedule for construction, including grading and site stabilization; and
(vi) a description and depiction of proposed stormwater best management practices designed to filter, detain, or filtrate runoff from the individual residence or driveway, thereby minimizing the post-construction increase in pollutant loading to the receiving perennial stream or wetland.
(3) An individual residential stormwater permit issued by the department shall expire and thereafter be null and void unless construction is completed within two years of the date of issuance of the permit, or within any extended period of time approved by the department upon good cause shown. Following expiration of the permit, the application for the individual residential stormwater permit may be resubmitted to the department for consideration for a new permit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.9 Hearing officer
(a) No hearing officer shall preside who has any bias with respect to the matter involved in the proceeding. Any party may file with the department a request, together with a supporting affidavit, that a hearing officer be removed on the basis of personal bias or other good cause.
(b) The hearing officer shall conduct the hearing in a fair and impartial manner.
(c) The hearing officer shall have the power to:
(1) rule upon requests, including all requests for adjournments;
(2) set the time and place of hearing;
(3) administer oaths and affirmations;
(4) issue subpoenas requiring the attendance and testimony of witnesses and the production of books, records, contracts, papers and other evidence;
(5) summon and examine witnesses, including the authority to direct a party, without necessity of subpoena, to appear and to testify;
(6) admit or exclude evidence;
(7) limit the number of times any witness may testify, repetitious examination or cross-examination, and the amount of corroborative or cumulative testimony;
(8) hear argument on facts or law;
(9) order the parties to appear for a prehearing conference to consider matters which may simplify the issues or expedite the proceeding;
(10) order that opening statements be made; and
(11) do all acts and take all measures necessary, but not otherwise prohibited by this Part, for the maintenance of order and the efficient conduct of the hearing.
(d) The hearing officer shall not have the power to:
(1) remove testimony from the transcript by deletion, expungement or otherwise; and
(2) dismiss the charges unless otherwise authorized by designation.
(e) Upon being notified that a hearing officer declines or fails to serve, or in the case of death, resignation or removal of the hearing officer, or upon the initiative of the commissioner, or the appropriate board or council, a successor hearing officer shall be designated to continue the proceeding.
(f) The designation of a hearing officer shall be in writing and filed with the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.12 Staffing
(a) Personnel.
The governing authority shall ensure the employment of personnel without regard to age, race, color, sexual orientation, religion, sex or national origin. A personnel file shall be maintained for each employee.
(b) Integrated services programs that are providing primary care services shall ensure that:
(1) the health status of each employee is examined prior to the beginning of employment, which is sufficient in scope to ensure that the employee is free from a health impairment which is of potential risk to patients or which may interfere with the performance of his/her duties;
(2) a record of the following tests, procedures and examinations is maintained for all employees:
(i) a certificate of immunization against rubella which means:
(a) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of rubella antibodies;
(b) a document indicating one dose of live virus rubella vaccine was administered on or after the age of 12 months, showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization; or
(c) a copy of a document described in clause (a) or (b) of this subparagraph which comes from a previous employer or the school which the employee attended as a student; and
(ii) a certificate of immunization against measles, for all personnel born on or after January 1,1957, which means:
(a) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of measles antibodies; or
(b) a document indicating two doses of live virus measles vaccine were administered with the first dose administered on or after the age of 12 months and the second dose administered more than 30 days after the first dose but after 15 months of age showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization; or
(c) a document, indicating a diagnosis of the employee as having had measles disease, prepared by the physician, physician's assistant/specialist's assistant, licensed midwife or nurse practitioner who diagnosed the employee's measles; or
(d) a copy of a document described in clause ( a ), ( b ) or ( c ) of this subparagraph which comes from a previous employer or the school which the employee attended as a student;
(iii) if any licensed physician, physician’s assistant/specialist's assistant, licensed midwife or nurse practitioner certifies that immunization with measles or rubella vaccine may be detrimental to the employee's health, the requirements of subparagraph (i) and/or (ii) of this paragraph relating to measles and/or rubella immunization shall be inapplicable until such immunization is found no longer to be detrimental to such employee's health. The nature and duration of the medical exemption must be stated in the employee's employment medical record and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the American Academy of Pediatrics and the Immunization Practices Advisory Committee of the U.S. Department of Health and Human Services); and
(iv) for all personnel prior to employment or affiliation, except for personnel with no clinical or patient contact responsibilities who are located in a building or site with no patient care services, an initial individual tuberculosis (TB) risk assessment, symptom evaluation, and TB test (either tuberculin skin test or Food and Drug Administration [FDA] approved blood assay for the detection of latent tuberculosis infection), and annual assessments thereafter. Positive findings shall require appropriate clinical follow-up. The medical staff shall develop and implement policies regarding positive findings, including procedures for facilitating and documenting treatment for latent TB infection where indicated. Annual TB assessment shall include education, individual risk assessment, and follow-up tests as indicated;
(v) an annual, or more frequent if necessary, health status reassessment to assure freedom from a health impairment which is a potential risk to the patients or might interfere with the performance of duties; and
(vi) documentation of vaccination against influenza, or wearing of a surgical or procedure mask during the influenza season, for personnel who have not received the influenza vaccine for the current influenza season, pursuant to section 2.59 of this Title.
(3) each person delivering health care services wears identification indicating his/her name and title.
(c) Medical director.
(1) Integrated services providers providing primary care services shall have a medical director. The governing authority shall be responsible for appointing a medical director who:
(i) is qualified by training, experience, and administrative ability;
(ii) is a physician licensed by and currently registered with the New York State Education Department;
(iii) develops and recommends to the governing authority policies and procedures governing patient care, medical staff and clinical privileges; and
(iv) is responsible for the supervision of the quality assurance program and reporting to the governing authority.
(2) Integrated services providers providing substance use disorder services, shall have a medical director who, unless such medical director was in place on July 1, 2011:
(i) holds at least one of the following certifications:
(a) a subspecialty board certification in addiction psychiatry from the American Board of Medical Specialties;
(b) an addiction certification from the American Society of Addiction Medicine; or
(c) a certification by the American Board of Addiction Medicine (ABAM); or
(d) a subspecialty board certification in Addiction Medicine from the American Osteopathic Association; and
(ii) possesses a Federal DATA 2000 waiver (buprenorphine-certified).
In lieu of employing a medical director meeting these requirements, the integrated services provider providing substance use disorder services may have a consultation agreement with a full- or part-time physician who meets the requirements of this paragraph.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.113 Drying
All equipment and utensils are to be air-dried after sanitizing.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.6 Reporting by providers
(a) When a tuberculosis case or suspect is accepted for care by a provider, the provider shall notify by telephone within 24 hours the local health official where the provider is located, and also the local health official where the person resides. The provider shall then submit a written case report within five working days to the same local health official or officials. The written report shall include the person's name, date accepted for care, age, address, telephone number, name and address of employer, county of residence, diagnosis, clinical evidence of disease and diagnostic procedures completed. If the person has been admitted as an inpatient, a written statement shall also be submitted by the hospital indicating the reasons for inpatient admission, rather than ambulatory care.
(b) When a tuberculosis case or suspect accepted into care by a provider is or may be a local charge, as defined by article 22, section 2200 of the Public Health Law, the provider shall, within five working days, notify the local health official where the person resides of the person's name, address, potential status as a local charge, and the names and addresses of any third-party payers, along with all other information stated in subdivision (a) of this section.
(c) When a tuberculosis case or suspect accepted for care by a provider is or may be a State charge, as defined by article 22, section 2200 of the Public Health Law, the provider shall, within five working days, notify the local health official where the provider is located of the person's name, address, potential status as a State charge, and the names and addresses of any third-party payers, along with all information stated in subdivision (a) of this section. The health official will immediately inform the person designated by the State Health Commissioner for such purpose.
(d) A monthly patient status report on each person with tuberculosis disease shall be submitted by each provider to the local health officials where the person resides and where the provider is located, which shall include a medical and social history and, if applicable, a discharge summary. Reports shall be submitted within two weeks of the end of each month.
(e) Providers shall submit to such health official additional reports as the State Commissioner of Health may provide.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.1 Definitions
(a) Adequate shall mean sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of the Subpart.
(b) A mass gathering shall mean one which is likely to attract 5,000 people or more and continue for 24 hours or more but shall not include a temporary residence under permit.
(c) Permit-issuing official (PIO) shall mean the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law.
(d) Person shall mean an individual, group of individuals, partnership, firm, corporation, association, political subdivision, government agency, municipality, estate or any other legal entity.
(e) Potable water shall mean water provided or used for human consumption, food preparation, or for lavatory, culinary, bathing or laundry purposes.
(f) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanup, dead animals, offal and solid commercial waste.
(g) Sewage shall mean excreta and the waste from a flush toilet, bath, sink, lavatory, dish washing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.10 Stipulations and consent orders
(a) At any time prior to issuance of the final order or determination, parties may enter into a stipulation for the resolution of any or all issues.
(b) The commissioner, or the appropriate board or council, may issue a consent order upon agreement or stipulation of the parties. A consent order shall have the same force and effect as an order issued after a hearing.
(c) In matters governed by Public Health Law, sections 230, 230-a, 230-b and 230-c, a licensee, who is under investigation or against whom a determination has been made that a hearing is warranted, as a condition for the satisfaction of all charges and potential charges, shall admit guilt to at least one of the acts of misconduct alleged, or shall agree not to contest the allegations, or shall assert that he or she cannot successfully defend against at least one of the acts of misconduct alleged, and shall either surrender his or her license or agree to a penalty. The signators to such an agreement shall be the licensee, his or her counsel, if the licensee is represented, the attorney for the department, the director of the Office of Professional Medical Conduct and the chairperson of the State Board for Professional Medical Conduct. The chairperson of the State Board for Professional Medical Conduct shall issue a surrender or consent order based upon said agreement. The order shall have the same force and effect as an order issued after a hearing.
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.5 Water facilities
(a) A community water system is required when:
(1) the subdivision is located in an existing water district or service area;
(2) the subdivision is reasonably accessible to an existing water district or service area. This requirement shall apply in the absence of proof satisfactory to the department that the developer cannot effect arrangements for the installation and/or connection of the water system to the existing water district or service area facilities;
(3) individual wells cannot provide an average yield of five gpm;
(4) the subdivision consists of 50 lots or more;
(5) the subdivision consists of 200 or more residents in the aggregate;
(6) ground waters are nonpotable; or
(7) an approved comprehensive study exists.
(b)
(1) Community water systems shall be capable of delivering water at an average rate of 100 gal/capita/day when service connections are unmetered, or 75 gal/capita/day when service connections are metered.
(2) Community water systems shall be designed to deliver water meeting the requirements of Part 5 of this Title.
(3) Community water systems shall provide for continuity of water service. Ground water shall not be relied on unless at least two sources are available.
(4) Community water systems shall have at least one day's available storage at design average consumption.
(c) Individual wells shall assure an average yield of five gpm of potable water.
(d) The relevant provisions of department Bulletin 42 *Bulletins 1, 42 and Rural Water Supply have not been filed with the Department of State; however, for informational purposes they have been published as Appendixes 72-A, 5-A and 5-B, respectively, infra. entitled Recommended Standards for Water Works will be the basis upon which all plans, specifications and reports for community water systems will be reviewed for approval by the department, and the department bulletin Rural Water Supply *Bulletins 1, 42 and Rural Water Supply have not been filed with the Department of State; however, for informational purposes they have been published as Appendixes 72-A, 5-A and 5-B, respectively, infra. will be the basis upon which individual water supply systems will be reviewed for approval.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.284 Reporting principles
The body of doctrine associated with accounting, serving as an explanation of current practices and as a guide in the selection of conventions and procedures.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.5 Permit for operation
(a) No municipality, person, group of persons, firm, corporation, association, organization or institution shall operate or maintain or permit the use of any bathing beach without a permit from the permit-issuing official issued subject to the provisions of this Chapter and such additional sanitary or safety safeguards as may be required by the permit-issuing official. The permit shall be posted conspicuously at the facility.
(b) Application for a permit shall be made to the permit-issuing official at least 30 days before the expiration of a prior permit or at least 30 days before the opening of any bathing beach.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.3 HIV-related testing
(a) Except as noted in subdivision (c) of this section, no physician or other person authorized pursuant to law may order an HIV-related test without first having advised the individual, or, when the individual lacks capacity to consent, a person authorized to consent to health care for such individual, that an HIV-related test will be performed. The physician, or other person authorized pursuant to law, may not order the HIV-related test over the objection of the individual, or person authorized to consent to health care for such individual, except as authorized or required by law. A physician or other person authorized pursuant to law to order an HIV-related test to be used for the individual’s care shall provide to the laboratory the name, addresses, and date of birth of the individual who is the source of the specimen and other such information as specified by the commissioner except in the case of anonymous testing as provided for in this Part. Certification of consent does not have to be provided to the laboratory.
(b) The advisement, and any objection to testing, shall be noted in the individual’s medical record. Before ordering an HIV-related test, the physician or other person authorized by law to order such test, or such person’s representative, shall make the following information available:
(1) HIV causes AIDS and can be transmitted through sexual activities and by needle-sharing, by pregnant women to their fetuses, and through breastfeeding infants;
(2) there is treatment for HIV that can help an individual stay healthy;
(3) individuals with HIV or AIDS can adopt safe practices to protect infected and uninfected people in their lives from becoming infected or multiply infected with HIV;
(4) testing is voluntary and can be done anonymously at a public testing center;
(5) the law protects the confidentiality of HIV-related test results;
(6) the law prohibits discrimination based on an individual's HIV status and services are available to help with such consequences; and
(7) the law requires that an individual be advised before an HIV-related test is performed, and that no test shall be performed over the individual’s objection except as authorized or required by law.
(c) Advising that an HIV-related test is being performed is not required in the following situations:
(1) for court-ordered testing pursuant to Civil Practice Law and Rules, section 3121;
(2) when testing without consent is otherwise specifically authorized or required by State or Federal law, including under Public Health Law section 2994-g;
(3) for testing related to procuring, processing, distributing or use of a human body or human body part, including organs, tissues, eyes, bones, arteries, blood, semen or other body fluids for use in medical education, medical research or therapy, or for transplantation to persons, provided that if the test results are communicated to the tested person, post-test information for negative results or counseling for positive, indeterminate/inconclusive and preliminary positive results is required;
(4) for research if the testing is performed in a manner by which the identity of the test subject is not known and may not be retrieved by the researcher;
(5) for testing of a deceased person to determine cause of death or for epidemiological purposes;
(6) for comprehensive newborn testing pursuant to PHL section 2500-f; and
(7) for anonymous testing of a person who is the source of an occupational exposure under section 63.8(n) of this Part, who is deceased, comatose, or otherwise unable to provide consent, and no person authorized to consent on behalf of the source patient is immediately available, as provided in Public Health Law section 2781(6)(e).
(d) The commissioner may appoint and designate, from time to time, persons to review regulated facilities to determine compliance with this Part.
(e) With respect to positive and indeterminate/inconclusive results, and for preliminary positive results obtained pursuant to Subpart 58-8 of this Title, in addition to explaining the test result to the person lawfully authorized to consent to health care, the person who orders the test shall be responsible, directly or through a representative, for ensuring post-test counseling, referrals and linkage to care as appropriate. Blood banks and tissue banks may report results as specified in Subparts 58-2 and 52-3 of this Title, respectively. When confirmed positive results are being provided, with the consent of a person who tests positive, or if such person lacks the capacity to consent, with the consent of the person authorized to consent to health care for such person, the person ordering the test or his or her representative shall provide or arrange for an appointment for follow-up care for HIV. In situations in which a person other than the test subject is lawfully authorized to consent to health care, results, post-test counseling and referrals should also be provided to the test subject, to the extent the person responsible for ordering the test deems that the test subject will benefit from counseling. For persons who test positive, post-test counseling shall address:
(1) strategies for coping emotionally with the test results;
(2) discrimination issues relating to employment, housing, public accommodations, health care, public benefits and social services;
(3) the importance of taking precautions to prevent HIV transmission to others;
(4) the ability to release or revoke the release of confidential HIV-related information;
(5) HIV reporting requirements for the purposes of epidemiologic monitoring of the HIV/AIDS epidemic;
(6) the importance of contacts' being notified to prevent transmission, and allowing early access of exposed persons to HIV testing, health care, and prevention services, and a description of notification options and assistance available to the protected individual;
(7) an assessment of the risk of domestic violence in conformance with a domestic violence screening protocol developed by the commissioner pursuant to law;
(8) the requirement that known contacts, including a known spouse, will be reported and that protected persons will also be requested to cooperate in contact notification efforts of known contacts and may name additional contacts they wish to have notified with the assistance of the provider or authorized public health officials;
(9) non-disclosure of the protected individual's name or other information about them during the contact notification process;
(10) the provider's responsibility for making an appointment for newly diagnosed persons to receive follow-up HIV medical care;
(11) the availability of medical services and the location and telephone numbers of treatment sites, information on the use of HIV chemotherapeutics for prophylaxis and treatment and peer group support, access to prevention, education and support services and assistance, if needed, in obtaining any of these services;
(12) prevention of perinatal transmission; and
(13) the importance of remaining in care to maintain good health and reduce the likelihood of transmission to others, and that if protected individuals appear not to be receiving HIV medical care, health care providers, entities engaged in care coordination or local and State health departments may contact them to help address any challenges or barriers that may be affecting their ability to initiate and remain in care.
(f) In the case of a test not indicating evidence of HIV infection, the person who orders the test shall be responsible, directly or though a representative, for providing the result to the subject of the test, or for a person lacking capacity to consent, the person authorized to consent for the health care for the subject. The person ordering the test or his or her representative must also provide, in a manner that may consist of oral or written reference to materials previously provided, information concerning the risks of participating in high risk sexual or needle-sharing behavior. The negative result and required information may be provided in-person, by mail, electronic messaging, or telephone provided that patient confidentiality is reasonably protected.
(g) Every individual age 13 and older (or younger than 13 if there is evidence or indication of risk activity) who receives health services as an inpatient or in the emergency department of a general hospital defined in section 2801(10) of the Public Health Law or who receives primary care services in an outpatient department of such hospital or in a diagnostic and treatment center licensed under article 28 of the Public Health Law or from a physician, physician assistant, nurse practitioner, or midwife providing primary care in any office, clinic, facility or other setting shall in accordance with subdivision (a) of this section be offered an HIV-related test unless the health care practitioner providing such services reasonably believes that:
(1) the individual is being treated for a life threatening emergency; or
(2) the individual has previously been offered or has been the subject of an HIV-related test (except that a test shall be offered if otherwise indicated); or
(3) the individual lacks capacity to consent to an HIV-related test.
(h) Nothing in this Part or Part 58 of this Title shall be construed to prohibit a person from directly ordering an HIV test on a specimen taken from his/her own body and directly receiving the results of such HIV test. The test must be performed by a New York State licensed laboratory using a specimen collection kit which has been approved for home HIV specimen collection by the U.S. Food and Drug Administration and which is available without a prescription, or as provided by section 576-b of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.75 Additional sampling requirements
(a) Additional water samples for any contaminant shall be collected and analyzed from any public water system by the supplier of water as may be required by the State, to assure control of the quality of the public water system.
(b) The State may collect and analyze water samples from any public water system at any time, either by its own personnel or by contract with others.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 93 IMPROPER PRACTICES IN HOSPITAL STAFF APPOINTMENTS AND EXTENSION OF PROFESSIONAL PRIVILEGES
10 CRR-NY 93.2 Contents of complaint
The complaint shall set forth:
(a) the name and address of the complainant;
(b) his or her professional qualifications;
(c) the name and address of the hospital whose governing body is alleged to have committed the improper practice identified in the complaint;
(d) the staff appointment or professional privileges which are the subject of the complaint; and
(e) a detailed statement of the alleged improper practice.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.50 Handling of food forbidden in certain cases
(a) No person who suffers from cholera, amebiasis, shigellosis, superficial staphylococcal infection, streptococcal sore throat (including scarlet fever), salmonellosis, giardiasis, infectious hepatitis, poliomyelitis, diphtheria, tuberculosis, yersinosis, or typhoid, or is a carrier of the organism causing amebiasis or shigellosis, salmonella infection or typhoid, or who, in the judgement of the local health officer, is suffering from acute infectious diarrhea shall serve or handle in any manner whatsoever, food intended for sale.
(b) No person shall engage in the handling of milk, dairy products or other foods until clinical recovery from salmonella or shigella infection and until two successive specimens of intestinal discharges, passed not less than one week after the week of onset and at intervals not less than 24 hours, shall have been examined in an approved laboratory or in the laboratory of the State Department of Health and on salmonella or shigella organisms shall have been found.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
LICENSURE LICENSURE
10 CRR-NY 89.10 General provisions
(a) To qualify for a license to practice as a radiologic technologist, an applicant shall fulfill the following requirements in a manner acceptable to the department:
(1) file an application on a form prescribed by the department along with a nonrefundable license fee of $120;
(2) submit documentation that the applicant has successfully completed an education program in radiologic technology that is registered with the department, the State Education Department, or an accrediting organization approved by the department;
(3) submit evidence that the applicant has passed an examination administered by an accrediting organization approved by the department with a passing grade, as determined by the department;
(4) be at least 18 years of age; and
(5) be of good moral character. In accordance with Correction Law article 23-A, a person previously convicted of one or more criminal offenses shall not be found to lack good moral character based upon these conviction(s) unless:
(i) there is a direct relationship between one or more of the previous criminal offenses and the duties required of the license; or
(ii) licensing the applicant would involve an unreasonable risk to property or the safety or welfare of a specific individual or the general public. In determining these questions, the department will look at all the factors listed under Correction Law section 753.
(b) Nothing in this Part shall be construed to apply to the practice of nuclear medicine technology prior to January 1, 2009.
(c) Notwithstanding any provision herein to the contrary, any individual practicing as a nuclear medicine technologist prior to July 26, 2007 may be licensed to practice nuclear medicine technology provided that he or she has completed an education program in nuclear medicine technology acceptable to the department and has five years of verifiable and satisfactory employment within the previous 10 years as a nuclear medicine technologist, or possesses certification by the Nuclear Medicine Technology Certifying Board or registration with the American Registry of Radiologic Technology in nuclear medicine technology.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.7 Responsibility for prompt determination of eligibility
The decision to accept or deny the application shall be made as soon as sufficient information to make a determination about eligibility is obtained.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.89 Condensation water disposal; food container opening devices
(a) The food storage compartment and other compartments in refrigerated vending machines which are subject to condensation or cooling water retention are to be self-draining or equipped with a drain outlet which permits complete draining. In vending machines designed to store cartoned beverages, diversion devices and retention pans or drains for leakage are to be provided. All such drains, devices and retention pans are to be easily cleanable.
(b) Opening devices which come into contact with food or the food-contact surfaces of the containers are to be constructed of corrosion-resistant, nonabsorbent and safe materials. Unless the opening device is of a single-service type, it is to be readily removable for cleaning, and is to be kept clean. Parts of multi-use opening devices which come into contact with the food or food-contact surface of containers are to be readily removable for cleaning.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.7 Registrant care plan
The operator must ensure that:
(a) An adult day health care program care plan based on the comprehensive assessment required by this Part, and, when applicable, a transfer or discharge plan, is developed for each registrant and is in place within five visits or within 30 days after registration, whichever is earlier. The adult day health care program and the referring managed long term care plan or care coordination model must be sure to coordinate with each other regarding the development of a registrant’s care plan.
(b) Each registrant's care plan must include:
(1) designation of a professional person to be responsible for coordinating the care plan;
(2) the registrant's pertinent diagnoses, including mental status, types of equipment and services required, case management, frequency of planned visits, prognosis, rehabilitation potential, functional limitations, planned activities, nutritional requirements, medications and treatments, necessary measures to protect against injury, instructions for discharge or referral if applicable, orders for therapy services, including the specific procedures and modalities to be used and the amount, frequency and duration of such services, and any other appropriate item;
(3) the medical and nursing goals and limitations anticipated for the registrant and, as appropriate, the nutritional, social, rehabilitative and leisure time goals and limitations;
(4) the registrant's potential for remaining in the community; and
(5) a description of all services to be provided to the registrant by the program, informal supports and other community resources pursuant to the care plan, and how such services will be coordinated;
(c) Development and modification of the care plan is coordinated with other health care providers outside the program who are involved in the registrant's care.
(d) The responsible persons, with the appropriate participation of consultants in the medical, social, paramedical and related fields involved in the registrant's care, must:
(1) record in the clinical record changes in the registrant's status which require alterations in the registrant care plan;
(2) modify the care plan accordingly;
(3) review the care plan at least once every six months and whenever the registrant's condition warrants and document each such review in the clinical record; and
(4) promptly alert the registrant's authorized practitioner of any significant changes in the registrant's condition which indicate a need to revise the care plan.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.13 Distribution facilities
A blood bank may operate a distribution facility, provided the department is notified, in advance, of the location and activities to be performed at the site.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.8 Follow-up review, tracking and educational activities
The testing laboratory may:
(a) request case follow-up information from hospitals, birth attendants, responsible providers and specialty care centers;
(b) record diagnoses and case follow-up information;
(c) maintain tracking records on identified cases; and
(d) provide educational activities and materials.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.21 Admission
The formal acceptance by an institution of a patient who is to be provided with room, board, continuous nursing service, and other institutional services while lodged in the institution.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.7 Environmental intervention and abatement
The commissioner or his designated representative shall require in the notice and demand, where necessary, pre-abatement and clean up actions as specified in subdivisions (a) and (b) of this section and any one or more of the actions listed in subdivisions (c) through (j) of this section as part of an abatement of a dwelling:
(a) Pre-abatement actions:
(1) furniture, rugs, carpets, bedding, drapes, disware and food shall be either removed or covered with plastic sheets a minimum thicknes of six mils and sealed;
(2) room openings must be sealed with plastic sheets that have a minimum thickness of six mils; and
(3) floors or in place carpet must be covered with twosheets of plastic a minimum thicknes of six mil thick, secured to the wall or baseboard with duct tape.
(b) Clean-up shall be performed daily and consist of misting debris with water and carefully sweeping and placing it in double four mil or six mil plastic bags, followed by wet dusting or wet mopping of all surfaces in the work area. Final clean-up shall be performed a minimum of 2 hours after completion of active abatement and shall include, but not be limited to, an HEPA filtered vacuuming of all interior surfaces, including window sills, followed by a weet mopping of all surfaces with a heavy duty household cleaning solution, followed by a second HEPA filtered vacuuming. In some instances the commissioner or his designated representative may determine that an alternative wet vacuum system may be used in place of the HEPA filter.
(c) When necessary, relocation of occupants to temporary housing until the abatement work specified has been completed.
(d) Placarding of the dwelling with the statement that human habitation is prohibited until the commissioner or his designated representative determines that the dwelling has been abated.
(e) Prohibition of the presence of children and pregnant woman in part or all of a dwelling during abatement activities.
(f) Encapsulation of lead painted surfaces with materials approved as an encapsulant of lead paint by the United States Environmental Protection Agency or the United States Department of Housing and Urban Development, or the American Society for Testing and Materials or the Commissioner:
(1) after repair of water leaks caused by structures or plumbing deficiencies;
(2) in accordance with manufacturer's instructions; and
(3) after the removal of any chipping, peeling of flaking paint in accordance with subdivision (i) of this section.
(g) Enclosure of lead containing surfaces with drable materials applied as follows:
(1) After repair of water leaks caused by structural or plumbing deficiencies;
(2) with materials that are fire resistant which may include gypsum board, aluminum, vinyl, plywood paneling a minimum of 5/32 inch thick good (1) grade, Formica, acrylic sheets, fiberglass, durable carpet, tile, Plexiglass; and
(3) after the removal of any chipping, peeling or flaking paint in accordance with subdivision (i) of this section.
(h) Replacement of building components with lead-free materials.
(i) Removal of lead-containig surface coating materials by one or more of the following methods after which a lead-free surface coating material shall be applied to the surface:
(1) wet wire brushing or hand scraping with or without the aid of non-flamable solvent or wet abrasive compound;
(2) machine sanding, using a sander equipped with a high efficiency particle air filter device, to feather the edges and prepare surfaces for repainting or sealing;
(3) when used with appropriate respiratory protection, a heat gun, which produces a temperature not exceeding 1,100° F with hand scraping;
(4) off-site paint removal; and
(5) other procedures acceptable to the commissioner.
(j) Abatement of exterior surfaces by any of the methods described in subdivisions (a)-(i) of this section or by confined abrasive blasting using a wet misting technique or simultaneous vacuuming system. In addition, plastic sheets, a minimum thickness of six mils, must be placed on the ground as close to the dwelling foundation as obstructions will allow a minimum of six feet for each stary in height before blasting begins, and left in place until cleanup is complete. All seams must be sealed with tape and outer edges raised to trap liquid waste.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.30 Definition of food
Food is any edible substance, ice, beverage or ingredient used or intended for use or for sale in whole or in part for human consumption.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.4 Lead screening status of children who enroll in preschool or child care
(a) Prior to or within three months of initial enrollment, each child care provider, public and private nursery school and preschool, licensed, certified or approved by any State or local agency shall obtain a written statement signed by a health care provider that documents lead screening for any child at least one year of age but under six years of age, and retain such documentation until one year after the child is no longer enrolled.
(b) When no documentation of lead screening exists, the child shall not be excluded from attending nursery school, preschool or child care, however, the child care provider, principal, teacher, owner or person in charge of the nursery school or preschool shall provide the parent or guardian of the child with information on lead poisoning and lead poisoning prevention and refer the parent or guardian to the child's primary health care provider or, if the child's primary care provider is unavailable or the child has no primary health care provider, to another primary care provider or to the local health unit to obtain a blood lead test.
(c) Each child care provider, public and private nursery school and pre-school licensed, certified or approved by any State or local agency is exempt from the requirement to obtain, prior to or within three months of initial enrollment of children under six years of age, evidence that said children have been screened for elevated blood lead levels until April 1, 1994.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.8 Retaliation
(a) No residential health care facility or officer of employee thereof shall discharge or in any manner discriminate or retaliate against any person in any residential health care facility or any relative or sponsor thereof, or against any employee of the facility, or against any other person because such person, relative, legal representative, sponsor, or employee has made, or is about to make, a report in good faith pursuant to this section, or has testified or is about to testify in any proceeding relating to physical abuse, mistreatment or neglect of a person receiving care or services in a residential health care facility.
(b) Any violation of this section may be punishable pursuant to section 12 of the Public Health Law.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.1 Definitions
As used in this Subpart:
(a) Blood bank means a facility for the collection, processing, storage or distribution of human blood, human blood components or derivatives, or the performance of reinfusion procedures. A blood bank shall employ a qualified director for administrative purposes and, if blood collection is performed, a qualified medical director.
(b) Blood donation center means a fixed satellite location operated by a blood bank and used for the collection of whole blood and/or blood components.
(c) Donor or blood donor means a person who provides his/her blood or plasma for transfusion of whole blood, blood components or derivatives.
(d) Blood components means those preparations separated from a single donation of whole blood, or collected by apheresis, intended for direct use in transfusion, including but not limited to plasma, fresh frozen plasma, plasma frozen within 24 hours after phlebotomy (FP24), red blood cells, washed red blood cells, leukocyte-reduced red blood cells, platelets, granulocytes, and cryoprecipitate, but does not include lymphocytes collected from a donor of hematopoietic progenitor cells, as defined in Subpart 58-5 of this Part.
(e) Derivatives means those preparations separated from plasma derived from multiple donors, including but not limited to albumin, immune globulin, plasma protein fraction and clotting factor concentrates.
(f) Blood products means whole blood, blood components or derivatives.
(g) Plasmapheresis means the withdrawal of blood to obtain plasma with subsequent or simultaneous reinfusion into the donor of his/her own red blood cells.
(h) Serial plasmapheresis program means a program of individual donor donations on a regular basis by plasmapheresis yielding three liters or more of plasma per consecutive four-week period.
(i) Cytapheresis means the separation and collection of blood cells or other formed elements by hemapheresis for the purpose of obtaining a transfusable blood component.
(j) Intraoperative blood recovery means recovery of blood from a surgical field, and processing of recovered blood for direct reinfusion, storage or infusion into a cardiopulmonary bypass pump. Intraoperative blood recovery does not include performance of perioperative normovolemic hemodilution procedures. Postoperative blood recovery means recovery of blood from a wound following surgery, and processing of recovered blood for direct reinfusion or storage. Intraoperative blood recovery was formerly termed intraoperative blood salvage.
(k) F.D.A. means the Food and Drug Administration of the United States Department of Health and Human Services.
(l) Limited transfusion service means a facility, home care services agency, physician's office, or other entity which administers blood or blood components, and may temporarily store blood or blood components, and distribute them within its own organization, but relies on a blood bank holding a permit in blood services-transfusion to perform laboratory tests required under section 58-2.17 of this Subpart.
(m) Distribution facility means a facility at which blood and blood components are temporarily stored prior to distribution.
(n) Transfusion service means a service that issues blood or blood components for administration into a person, but does not include a limited transfusion service or an ambulance transfusion service.
(o) Institution means a hospital or other facility operating a transfusion service under a permit issued by the department.
(p) Allogeneic collection means the removal and storage of blood or blood components from a donor for transfusion into another person, and includes blood donated for directed donation to another person, or donated for autogeneic use and subsequently crossed-over in hole or in part for use by others. Allogeneic collection was formerly termed homologous collection.
(q) Autogeneic collection means the removal and storage of blood or blood components from a donor for subsequent reinfusion into that same person, and includes preoperative hemodilution procedures if at any time the blood leaves the operating room in which surgery is performed. Autogeneic collection was formerly termed autologous collection.
(r) Directed donation means an allogeneic collection in which blood from a particular donor is designated for use by a specified recipient.
(s) Medical director means a qualified physician who is employed by a blood bank, and is responsible for donor selection and safety.
(t) Department means the New York State Department of Health.
(u) Reinfusion procedure means the withdrawal of blood or a component thereof from a patient, its processing and administration of the product so obtained, in whole or in part, into the same patient for diagnostic or therapeutic purposes. Such processing may include, but is not limited to separation ( e.g. , into platelet-rich plasma or fibrin glue), radioisotopic tagging, and genetic and immunologic manipulation. Reinfusion procedures shall not include presurgical autogenic collection, normovolemic hemodilution, intraperative blood recovery or postoperative blood recovery.
(v) Normovolemic hemodilution means the collection of blood prior to surgery, and includes fluid replacement and reinfusion during or after surgery for purposes of reducing red cell loss during surgery.
(w) Limited reinfusion service means a facility, home care services agency, physician's office or other non-hospital entity that performs reinfusion procedures.
(x) Clinical laboratory technician means a clinical laboratory practitioner who performs clinical laboratory procedures and examinations, pursuant to established and approved protocols of the department, which require limited exercise of independent judgment, and are performed under the supervision of a clinical laboratory technologist, laboratory supervisor, or director of a clinical laboratory.
(y) Clinical laboratory technologist means a clinical laboratory practitioner who, pursuant to established and approved protocols of the department, performs clinical laboratory procedures and examinations and any other tests or procedures conducted by a clinical laboratory, including maintaining equipment and records, and performing quality assurance activities related to examination performance, which required the exercise of independent judgment and responsibility.
(z) Health care provider , for the purposes of this Subpart, means a physician, physician assistant or nurse practitioner.
(aa) Nurse practitioner means a registered professional nurse licensed and currently registered, under the Laws of the State of New York, to diagnose illness and physical conditions, and perform therapeutic and corrective measures, in accordance with a collaborative agreement with a physician qualified to collaborate in the specialty involved.
(ab) Physician means an allopathic or osteopathic physician licensed and currently registered, under the Laws of the State of New York or in the state of practice, to practice medicine.
(ac) Physician assistant means a person licensed and currently registered, under the Laws of the State of New York, to practice medicine under the supervision of a physician.
(ad) Physician designee means a physician designated by the medical director to be responsible for one or more routine or special tasks.
(ae) Ambulance transfusion service means an ambulance service certified by the department that administers blood components during transport from one hospital to another hospital.
(af) Hospital , for the purposes of this Subpart, means a general hospital.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 456 COST-FINDING PRACTICES AND PROCEDURES
10 CRR-NY 456.1 Introduction
(a) Cost finding is the apportionment or allocation of the costs of the nonrevenue-producing centers to each other and to the revenue-producing centers and final program centers on the basis of statistical data reflective of the amount of service rendered by each center to the other centers.
(b) In general, each nonrevenue, ancillary revenue or program revenue center a total expense of operation which can be described in an algebraic equation comprised of its own direct expense plus some fraction of the total expense of the operation of each of the other centers.
(c) Also, each center has a relationship to each of the other centers that can be described by a statistical allocation basis which is reflective of the relative amount of service rendered.
(d) Cost finding is a mathematical process used to solve the problem of allocating expenses to each center and subtotal expense in each ancillary or program center after the allocation of nonrevenue centers has been accomplished.
(e) While there are a number of methods that can be and have been used (direct allocation, single step down, multiple step down, matrix inversion, etc.), the matrix inversion process which solves equations simultaneously is the most accurate. This process recognizes all the services provided by one reporting center to all other centers. The complete recognition of services is not possible to the same degree in the other cost-finding processes. Although it is anticipated that the matrix inversion process will be used, the uniform system of statistical allocation is applicable to any process.
(f) This Part discusses the segregation of costs, the source for the compilation of data and other information pertinent to the cost allocation process.
(g) When the single step-down method of cost allocation is employed, the cost centers involved in the step down shall be arrayed in the following sequence:
Depreciation, Leases and Rentals
Depreciation on Major Movable Equipment
Interest on Capital Debt
Fiscal Services
Administrative Services
Plant Operation and Maintenance
Grounds
Security
Laundry and Linen
Housekeeping
Patient Food Service
Cafeteria
Nursing Administration
Activities Program
Non-Physician Education
Medical Education
Medical Director's Office
Medical Records
Utilization Review
Social Service
Transportation
Laboratory Service
Electrocardiology
Electroencephalogy
Radiology
Inhalation Therapy
Podiatry
Dental
Psychiatric
Physical Therapy
Occupational Therapy
Speech and Hearing Therapy
Pharmacy
Central Service Supply
Medical Staff Service
Ancillary Other - A
Ancillary Other - B
Ancillary Other - C
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 151 ULSTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 151.2 Village of New Paltz
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of section 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as heretofore set forth, shall apply to all natural and artificial reservoirs and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of New Paltz, Ulster County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow into the public [water] supply of the village of New Paltz.
(3) Whenever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(3) Every privy, privy vault, pit or other receptacle or place, used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal of the aforesaid garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of New Paltz, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of New Paltz is prohibited, nor shall any such watering be allowed in any watercourse tributary to this water supply within 1000 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of New Paltz.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz. None of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not cencentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(3) No human excreta, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on any watershed tributary to the public water supply of the village of New Paltz; nor shall such human excreta, compost or other matter containing the same be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs except by written permission and in strict compliance with the regulations to be adopted by the board of trustees of the village of New Paltz. All ice cutting shall be done under rigid inspection and supervision of the board of trustees of the village of New Paltz.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of New Paltz.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet from any reservoir or from any watercourse tributary to the public water supply of the village of New Paltz.
(j) [Inspections.]
The board of trustees shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.6 Issuance of a certificate of public advantage
(a) The department shall not issue a certificate of public advantage without first consulting with the Attorney General and, as appropriate, the mental hygiene agencies, and consulting with, and receiving a recommendation from, the public health and health planning council.
(b) After consulting with the Attorney General, the mental hygiene agencies as appropriate, and the public health and health planning council, and receiving a recommendation from the public health and health planning council, the department may issue a certificate of public advantage for the cooperative agreement or planning process, if it determines that the benefits likely to result from the agreement or planning process outweigh the disadvantages.
(c) The certificate shall include any conditions that the department, in consultation with the Attorney General, the mental hygiene agencies as appropriate, and the public health and health planning council, and receiving a recommendation from the public health and health planning council, determines to be appropriate in order to ensure that the cooperative agreement or the planning process and the activities conducted under it are consistent with article 29-F of the Public Health Law and its purpose to improve health care quality, access, efficiency and clinical outcomes. Such conditions shall be related to the proposed activities and goals of the cooperative agreement or the planning process and may include, but need not be limited to:
(1) implementation of a clinical integration plan;
(2) achievement of quality benchmarks, implementing evidence-based practices and clinical protocols, reducing preventable admissions and readmissions and sub-optimal emergency department use, and achieving other outcomes as identified by the department;
(3) maintaining or expanding certain services or levels of access by under-served populations;
(4) investment in primary care and population health activities;
(5) improvement in population health benchmarks;
(6) measures to prevent unwarranted price increases and achieve savings;
(7) measures to promote efficiencies and achieve savings, including reductions in duplication of services, unnecessary or preventable utilization, capital expenditures, and administrative overhead;
(8) improvement in recruitment and retention of needed health care professionals; and
(9) conditions reasonably necessary to ameliorate likely disadvantages, including potential disadvantages identified in section 83-2.5(d) of this Subpart.
(d) A certificate of public advantage may be issued for a period to be determined by the department, which shall be no less than two years in duration, and shall be subject to active supervision as provided in this Subpart and renewal, as applicable, pursuant to the procedure set forth in sections 83-2.10 and 83-2.11 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.235 Outstanding
(a) Uncollected or unpaid: said of an account or note receivable or payable, or of a check sent to the payee but not yet cleared against the drawee bank.
(b) In the hands of others: said of the units of funded debt of a corporation or of the certificates representing issued shares of capital stock in the hands of the public; treasury stock is defined in terms of shares issued but not outstanding.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.65 Best available technologies (BATs) for disinfection byproduct control
The following is a table of the best available technology, treatment techniques, or other means available for achieving compliance with the maximum contaminant levels for Bromate, Chlorite, TTHM and HAA5, for public water systems that disinfect their source water.
)
)
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.10 Stenographic record
A stenographic record shall be made by the hearing. Upon request, a transcript will be made available for examination. Copies may be procured upon payment of the charge therefor.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.1 Applicability and inapplicability of this Part
(a) Applicability.
Except as otherwise provided in subdivision (b) of this section, this Part applies to any person who transfers, receives, possesses or uses any radiation source in this State.2
(b) Inapplicability.
(1) This Part does not apply to any person with respect to any radiation source to the extent that such radiation source is subject to regulation as provided for by law by the State Department of Labor. This exclusion does not apply to persons with respect to radiation sources used at industrial or commercial establishments for the application of radiation to human beings.
(2) This Part does not apply to any common or contract carrier operating within this State to the extent that such carrier is subject to regulation as provided for by law by the United States Department of Transportation or other agencies of the United States or agencies of the State of New York, other than the Department of Health, having jurisdiction.
(3) The licensure requirements contained in sections 16.100 through 16.110 and sections 16.120 through 16.123 of this Part shall not apply in a county, part-county or city health district having a population of more than 2,000,000, provided that such health district has established its own substitute licensure requirements with respect to radiation sources located within such health district and transferred, received, possessed or used by persons other than the State and its institutions or other facilities and provided that such substitute licensure requirements are submitted to the State Department of Health prior to their effective date and are acceptable to the state Department of Health as consistent with the corresponding requirements of this Part.
(c) Communications.
Except as otherwise provided for in this Part or authorized by the department, all applications, notifications or other communications filed pursuant to this Part shall be addressed to the New York State Department of Health, Bureau of Environmental Radiation Protection, Empire State Plaza, Albany, NY 12237, or by telephone (518) 402-7550. Registrants and licensees that are authorized pursuant to article 28 of the Public Health Law to operate a hospital may comply with adverse event reporting required by this Part by electronic filing with the department via the New York Patient Occurrence and Tracking System (NYPORTS).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.6 Qualifications of CPA
(a) A MCO may utilize a CPA for the purposes specified in this Subpart provided that the CPA:
(1) meets the definition of a CPA set forth in section 98-3.2(e) of this Subpart;
(2) has not either directly or indirectly entered into an agreement of indemnity or release from liability (collectively referred to as indemnification) with respect to the audit of the MCO;
(3) acts in conformity with the standards of the accounting profession, such as set forth in the Code of Professional Ethics of the AICPA and Rules and Regulations and Code of Ethics of Professional Conduct of the New York Board of Public Accountancy, or similar code; and
(4) utilizes its staff consistent with the standard prescribed by generally accepted auditing standards.
(b) A MCO may enter into an agreement with a CPA to have disputes relating to an audit resolved by mediation or arbitration. However, in the event of a proceeding commenced under Insurance Law article 74 against the MCO, the mediation or arbitration provisions shall apply only with the permission of the statutory successor.
(c)
(1) A MCO shall not utilize the same lead or coordinating CPA as an audit partner who has primary responsibility for the audit for more than five consecutive years. The person shall be disqualified from acting in that or a similar capacity for the same MCO or its insurance subsidiaries or affiliates for a period of five consecutive years.
(2) A MCO may make application to the commissioner for relief from the rotation requirement contained in paragraph (1) of this subdivision on the basis of unusual circumstances. The application shall be made at least 30 days before the end of the calendar year and include the following details:
(i) number of partners, expertise of the partners or the number of insurance clients in the currently registered firm;
(ii) premium volume of the MCO; and
(iii) number of jurisdictions in which the MCO transacts business.
(3) If relief is granted from the requirements of this subdivision, the MCO shall file a copy of each grant of relief received by the MCO with each state in which it is licensed or doing business and with the NAIC.
(d) A MCO may not utilize for any purpose of this Subpart any work performed or prepared by a CPA who:
(1) has been convicted of fraud, bribery, a violation of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. sections 1961 to 1968, or any dishonest conduct or practices under Federal or State law; or
(2) has demonstrated a pattern or practice of failing to detect or disclose material information in previous reports filed under the provisions of this Subpart.
(e)
(1) A MCO may not utilize for any purpose of this Subpart any work performed or prepared by a CPA if that CPA also contemporaneously provides any of the following non-audit services:
(i) bookkeeping or other services related to the accounting records or financial statements of the MCO;
(ii) financial information systems design and implementation;
(iii) appraisal or valuation services, fairness opinions, or contribution-in-kind reports;
(iv) actuarial advisory services involving the determination of amounts recorded in the financial statements. However, the CPA may assist a MCO in understanding the methods, assumptions and inputs used to determine amounts recorded in the financial statement, but only if it is reasonable to conclude that those amounts will not be subject to question during an audit of the MCO’s financial statements. A CPA’s actuary may also issue an actuarial opinion or certification (“opinion”) on a MCO’s reserves if the following conditions have been met:
(a) neither the CPA nor the CPA’s actuary has performed any management functions or made any management decisions;
(b) the MCO has competent personnel (or engages a third party actuary) to estimate the reserves for which management takes responsibility; and
(c) the CPA’s actuary tests the reasonableness of the reserves after the MCO’s management has determined the amount of the reserves;
(v) internal audit outsourcing services;
(vi) management functions or human resources;
(vii) broker or dealer, investment adviser, or investment banking services; or
(viii) legal services or expert services unrelated to the audit.
(2) The MCO shall attach a statement to its audited annual financial statement, when filed, that the CPA does not function in the role of management, does not audit his or her own work, and does not serve in an advocacy role for the MCO.
(f) A MCO may permit a CPA who performs the audit to engage in non-audit services, including tax and other services, which are not prohibited by paragraph (e)(1) of this section, but only if the activity is approved in advance by the audit committee, in accordance with subdivision (h) of this section.
(g) A MCO having direct written and assumed premiums of less than $100,000,000 in any calendar year may request an exemption from paragraph (e)(1) of this section. The MCO shall file with the commissioner a written statement discussing the reasons why the MCO should be exempt from these provisions. The commissioner may grant the exemption upon a finding that compliance would constitute a financial or organizational hardship upon the MCO.
(h) The MCO’s audit committee shall preapprove all auditing services and non-audit services provided to the MCO by a CPA of the MCO except that a MCO need not preapprove non-audit services if:
(1) the MCO is a SOX compliant MCO or a direct or indirect wholly-owned subsidiary of a SOX compliant MCO; or
(2)
(i) the aggregate amount of all such non-audit services provided to the MCO constitute five percent or less of the total amount of fees paid by the MCO to its CPA during the fiscal year in which the non-audit services are provided;
(ii) the services were not recognized by the MCO at the time of the engagement to be non-audit services; and
(iii) the services are promptly brought to the attention of the audit committee and approved prior to the completion of the audit by the audit committee or by one or more members of the audit committee who are the members of the board of directors to whom authority to grant such approvals has been delegated by the audit committee.
(i) The audit committee may delegate to one or more designated members of the audit committee the authority to grant the preapprovals required by subdivision (h) of this section. The decisions of any member to whom this authority is delegated shall be presented to the full audit committee at each of its scheduled meetings.
(j)
(1) A MCO shall not utilize a CPA if a member of the board, president, chief executive officer, controller, chief financial officer, chief accounting officer, or any person serving in an equivalent position for that MCO, was employed by the CPA and participated in the audit of that MCO during the one-year period preceding the date that the most current statutory opinion is due. This section shall only apply to partners and senior managers involved in the audit. A MCO may make application to the commissioner for relief from the above requirement on the basis of unusual circumstances.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.9 Tests prescribed by the commissioner for signs of death
The embalmer or funeral director, before proceeding either to embalm, remove, cremate or bury the body, shall determine that life is extinct by ascertaining that:
(a) pulsation has ceased in the radial or other arteries;
(b) heart and respiratory sounds are not heard with the use of a stethoscope or with the ear applied directly over the heart.
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.10 Training agencies; administration, organization and faculty
(a) An accredited academic institution applying for approval of the course of study, degree program or course work in nursing home administration shall supply all data necessary for a complete evaluation of the administration, organization, faculty, physical facilities, student policies, curriculum and instruction and such other information, data and records as the board may require which pertain to the course of study, degree program or course work.
(b) The board shall be notified promptly of any proposed substantial changes in the approved degree program, course work or course of study, including on-line or correspondence courses, to obtain continued approval by the board.
(c) A site inspection of a and academic institution or training agency or its affiliate may be made by an officer of the board or a representative acceptable to the board.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 410 SCHEDULED SHORT-TERM CARE IN A NURSING HOME
10 CRR-NY 410.1 Definitions
(a) Scheduled short-term care in a nursing home shall mean scheduled short-term nursing home care provided on a temporary basis to an individual who needs this level of care but who is normally cared for in the community. The goal of scheduled short-term care is to provide relief for the caregiver(s) while providing nursing home care for the individual. Schedules for scheduled short-term care are generally pre-arranged and shall be limited to one or more periods of from one to 30 days and shall not exceed 42 days in any one year except in extraordinary circumstances, such as sudden illness of the primary caregiver or temporary unfitness of the individual's principal residence.
(b) A caregiver shall mean a family member or other person who routinely provides the daily care or supervision of the individual in the home.
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.9 Integrated care services
(a) Primary care services.
(1) General principles. Integrated services providers of primary care services shall effectively meet patient physical health needs by:
(i) providing patient care in a continuous manner by the same health care practitioner, whenever possible;
(ii) appropriately referring to other health care facilities or health care practitioners for services not available;
(iii) identifying, assessing, reporting and referring cases of suspected or confirmed child abuse or maltreatment;
(iv) identifying, assessing, reporting and referring cases of suspected or confirmed domestic violence;
(v) ensuring that all staff receive education in the identification, assessment, reporting and referral of cases of suspected child abuse or maltreatment or domestic violence; and
(vi) developing a written plan of treatment which shall be periodically revised, as necessary, in consultation with other health care professionals.
(2) Provision of primary care services.
(i) All primary care services shall be provided in a manner that safely and effectively meets the needs of the patients served in the integrated care services program.
(ii) Integrated care services programs delivering primary care services must have sufficient staff and appropriate equipment to deliver primary care services.
(iii) Integrated services providers delivering primary care services shall conduct periodic reviews of its integration of primary care services with behavioral health services as part of its overall quality assurance program.
(iv) Integrated services providers delivering primary care services shall assign a medical director to be responsible for the primary care services.
(v) Primary care services provided within the specialty of OB/GYN are limited to routine gynecologic care and family planning provided pursuant to Part 753 of this Title.
(vi) Primary care services shall not include prenatal care, dental services or ambulatory surgery which includes any procedure that requires more than minimal sedation or local anesthesia, unless specifically authorized by the Department of Health.
(vii) For integrated services providers providing primary care, practitioners, or their delegate, shall provide their patient complete and current information concerning his or her diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand, and necessary for the patient to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, at a minimum, the provision of information concerning the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision. A patient also may refuse treatment to the extent permitted by law, and if so, shall be fully informed of the medical consequences of his/her action.
(b) Mental health services.
(1) General principles.
(i) For adult patients, integrated services providers of mental health care shall effectively meet patient mental health care needs by diagnosing and treating an individual’s mental illness, working with the individual in developing a plan of care designed to minimize symptoms and adverse effects of illness, maximize wellness, and promote recovery toward the achievement of life goals such as, but not limited to, education and employment.
(ii) For integrated services providers of mental health care that serve children, effective care includes early assessment and identification of childhood emotional disturbances, and engagement of the child and family in the development of a plan of care designed to minimize the symptoms and adverse effects of illness, maximize wellness, assist the child in developing a resilient and hopeful approach to school, family, and community, and maintain the child in his or her natural environment.
(2) Provision of mental health services.
Integrated services providers of mental health care shall offer each of the following mental health services, to be provided consistent with patients’ conditions and needs, and which include:
(i) outreach;
(ii) crisis intervention:
(a) mental health crisis intervention services must be available 24 hours a day/7 days per week;
(b) after hours coverage may be provided directly by the integrated services provider or pursuant to a clinical services contract, as defined in 14 NYCRR section 599(f), which must require, at a minimum, that in the event of a crisis, the nature of the crisis and any measures taken to address such crisis are communicated to the primary care clinician or other designated clinician involved in the individual’s treatment in the primary care component of the integrated services provider on the next business day;
(iii) psychotropic medication treatment, including injectable psychotropic medication administration for adult patients;
(iv) psychotherapy services, including but not limited to:
(a) individual psychotherapy;
(b) family/collateral psychotherapy;
(c) group psychotherapy; and
(d) complex care management.
(3) The following optional services may be offered:
(i) developmental testing (for children and adolescents);
(ii) psychological testing;
(iii) psychiatric consultation; or
(iv) injectable psychotropic medication administration for patients who are minors;
(4) integrated services providers delivering mental health services shall conduct periodic reviews of the integration of primary care and/or substance use disorder services as part of its overall quality assurance program.
(c) Substance use disorder services.
(1) General principles. Integrated services providers of substance use disorder treatment shall effectively meet patient substance use disorders needs by diagnosing and treating an individual’s substance use disorders, working with the individual in developing a plan of care to achieve goals identified in the individual’s treatment plan and promote recovery.
(2) Provision of substance use disorder services. For purposes of this subdivision, the term clinical staff shall mean staff who provide services directly to patients as prescribed in the treatment plan; including licensed medical staff, credentialed or licensed staff, non-credentialed staff, non-licensed staff and student interns.
(3) Integrated services providers of substance use disorder services shall offer, at a minimum, each of the following services, to be provided consistent with patients’ conditions and needs:
(i) assessments;
(ii) counseling, which can be delivered via two distinct methods:
(a) individual counseling, which is a face-to-face service between a clinical staff member and a patient focused on the needs of the patient to be delivered consistent with the treatment/recovery plan, its development, or emergent issues. Individual counseling must be provided with a frequency and intensity consistent with the individual needs of each unique patient, as prescribed by the responsible clinical staff member; and
(b) group counseling, which is a face-to-face service between one or more clinical staff member and multiple patients at the same time, to be delivered consistent with patient treatment/recovery plans, their development, or emergent issues. Group counseling must contain no more than 15 patients in each group counseling session;
(iii) education about, orientation to, and the opportunity for participation in, available and relevant peer support and mutual assistance groups; and
(iv) chemical abuse and dependence awareness and relapse prevention.
(4) An integrated services provider of substance use disorder services shall:
(i) promote the achievement and maintenance of recovery from substance use disorder and abuse;
(ii) improve functioning and development of necessary recovery management skills so the patient can be treated in the least intensive environment; and
(iii) develop individualized treatment/recovery plans to support the achievement and maintenance of recovery from substance use disorder and abuse, the attainment of economic self-sufficiency (including, where appropriate, the ability to sustain long-term productive employment), and improvement of the patient's quality of life.
(5) Integrated services providers of substance use disorder services may offer:
(i) collateral services;
(ii) complex care coordination;
(iii) medication administration and management;
(iv) outreach; and
(v) peer support services.
(6) Integrated services providers delivering substance use disorder services shall conduct periodic reviews of the integration of primary care and/or mental services as part of its overall quality assurance program.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.9 Village of Forestville
(a) Application.
The rules set forth in this section duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the springs which comprise the sources of public water supply of the Village of Forestville. Said springs are located on land owned by the Village of Forestville and are situated approximately 200 feet off the north side of Shaw Road, one mile from County Road 307, five miles from the Village of Forestville (Hall Springs); 300 feet off the east side of Putnam Road, 0.6 mile from County Road 307, five miles from the Village of Forestville (Henry Springs) and on the east side of Rider Road, one mile from County Road 307, 2 1/2 miles from the Village of Forestville (Bradigan Springs). These rules shall also apply to all watercourses and tributaries thereto or which may be developed in the future to serve as sources of water supply of the Village of Forestville.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the springs, (including any part of the radial collectors of the springs), or, to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat wrecked or discarded equipment, rock, sand cellar dirt and industrial, municipal and agricultural- and nonagricultural-associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Forestville water supply; and its finished water storage reservoir.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage.
(18) Springs shall mean springs now used as a source of this water supply or to any additional spring(s) which may be constructed as a source from this water supply.
(19) Toxic substance shall mean any toxic substance as so defined by statute (see subdivision 2 of section 4801 of the Public Health Law).
(20) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(21) Water supply shall mean the public water supply of the Village of Forestville.
(22) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the Village of Forestville water supply.
(23) Watershed shall mean the entire drainage area contributing water to the Village of Forestville water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir, watercourse or spring.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir, watercourse or spring except in weather-proof buildings or watertight vessels.
(3) Herbicides, pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the spring or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed or deposited beneath the surface of the ground within a 250-foot linear distance of the springs.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground and no privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 500-foot linear distance of any reservoir or watercourse or within a 250-foot linear distance of any spring except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse or within a 250-foot linear distance of any spring.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal systems is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate state agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any spring, reservoir or watercourse and not within a 1,000-foot linear distance of any spring, reservoir or watercourse unless authorization has been obtained from the appropriate state agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Forestville.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Forestville except by duly authorized employees of the Village of Forestville in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Forestville within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Forestville in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid Waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir, watercourse or spring.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir, watercourse or spring.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir, watercourse or spring.
(8) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir, watercourse or spring.
(9) Miscellaneous.
(i) Trespassing. No trespassing shall be allowed upon the property of the Village of Forestville upon which the springs are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Forestville.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir, watercourse or spring. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to an approved by the appropriate state agency having jurisdiction over such facilities.
(iii) Gas and oil well drilling. Oil or natural gas wells shall not be drilled on the watershed unless any necessary permit or other authorization has been issued by the appropriate state agency. A copy of the application to obtain such permit or other authorization shall be submitted to the Chautauqua County Health Department at the time the application is submitted to the state agency having authority to authorized drilling of the gas or oil well.
(e) Inspections.
The Mayor and Trustees of the Village of Forestville and the Water Superintendent or any person or persons charged with the maintenance of supervision of the public water supply system shall be its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being compiled with. It shall be the duty of the aforesaid Mayor, Trustees and Water Superintendent to promptly notify the state Commissioner of Health of such violations. Further steps to abate the said violations shall be in accordance with provisions of statute (see section 1102 of the Public Health Law). The aforesaid Mayor, Trustees and the Water Superintendent shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations abated and the general condition of the watershed and area surrounding the springs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by law (see section 1103 of the Public Health Law).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.320 Teaching program (approved)
A medical internship or residency training approved by the Council of Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry must have the approval of the Council on Dental Education of the American Dental Association.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.6 Service obligation
(a) Service obligation.
A State Health Service Corps award recipient is required to work full-time in a designated facility or agency for 18 months in the profession he/she has received an award. A recipient will be required to complete his/her service obligation by working from the reporting date to completion of his/her service obligation without interruption.
(b) Reporting date.
A State Health Service Corps recipient is required to begin his/her service obligation within 60 days of either completing the education for which he/she has received a State Health Service Corps award, or receiving a license in that profession whichever comes later, except that the reporting date shall not exceed:
(1) 30 months from the effective date of the first scholarship award if the recipient has received two awards; and
(2) 18 months if the recipient has received one award.
(i) In the case of a recipient whose award has been deferred, the period of time of the approved deferral shall not be included in the calculation of the reporting date described in this section.
(ii) If no appropriate position exists in any designated facilities or agencies for the recipient, the reporting date shall be extended until such a position becomes available.
(c) Alternative service.
In the event a recipient fails to qualify for licensure or is unable to fulfill the service obligation in the profession for which the State Health Service Corps scholarship award is given, the Commissioner of Health, in consultation with the State Health Service Corps advisory committee, may permit the individual to provide alternative service which would meet the intent of the public service obligation.
(d) Service performance.
Each recipient while employed in a designated facility or agency shall abide by all of the performance rules or requirements of that agency. Loss of employment due to unsatisfactory performance will result in default.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.162 Health-related beds
Beds in facilities providing institutional care and services with nursing services available, but not continuous. Refer to the definition of residential care in section 444.18(d)(7) of this Article.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.2 Definitions
Whenever used in this Part:
(a) Commissioner means the Commissioner of Health of the State of New York, or his duly authorized representative.
(b) CPLR means the Civil Practice Law and Rules.
(c) Department means the Department of Health of the State of New York.
(d) Hearing officer means the person duly designated for the purpose of conducting or participating in a hearing pursuant to the Public Health Law, including an administrative officer or an administrative law judge assigned by the department to the hearing.
(e) Party means the department and all persons designated as petitioner, respondent, or intervenor in any adjudicatory proceeding subject to this Part.
(f) Report means the hearing officer's summary of the hearing record, including his findings of fact, conclusions and recommendation or the findings, conclusions and recommendation of the hearing committee or hearing panel pursuant to Public Health Law, section 230.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.52 Electrical hazards
(a) All radiation equipment, except equipment used solely in research and development, installed in a radiation installation shall, where applicable, be listed by the Underwriters Laboratories Inc., or shall comply with the National Electrical Code of the National Fire Protection Association or an equivalent safety standard.
(b) Existing equipment employing uninsulated or bare overhead conductors moved to a new location or registered as a new installation under section 16.50 of this Part shall be certified as being free of electrical hazards.
(c) Certification by a duly constituted local authority that the installation is free of electrical hazards shall be acceptable.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.10 Certificate or letter of compliance
Upon satisfactory completion of the requirements of the permit issuing official as contained in sections 5-2.9 and 5-2.13 of this Subpart, a certificate of compliance will be issued to the applicant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.0 Applications for State aid
(a) To be eligible for State aid, local health departments shall annually submit to the department a detailed application for State aid in a form specified by the commissioner.
(b) Each local health department shall submit its application for State aid to the department no later than two months after the commencement of the fiscal year for which it is seeking State aid.
(c) The application for State aid shall include:
(1) an organizational chart of the local health agency and a list of the number of employees by job title providing public health services;
(2) a budget of proposed expenditures;
(3) a description of how the local health department will provide public health services in a form determined by the commissioner;
(4) an attestation by the chief executive officer of the municipality that sufficient local funds have been appropriated to provide the public health services for which the local health department is seeking State aid;
(5) an attestation by the public health commissioner or director that the local health department has exercised due diligence in reviewing the State aid application and that the application seeks State aid only for eligible public health services;
(6) a list of public health services provided by the local health department that are not eligible for State aid, and the cost of each service;
(7) a projection of the fees and revenues to be collected for public health services eligible for State aid; and
(8) any other information or documents required by the commissioner.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
DUTIES OF PERMITTEE, RESPONSIBILITIES OF OCCUPANTS DUTIES OF PERMITTEE, RESPONSIBILITIES OF OCCUPANTS
10 CRR-NY 15.14 Responsibilities of occupants
All occupants are responsible for maintaining their dwelling unit and common use areas in a reasonably clean and sanitary condition; for exercising safe practices and proper care when using the facilities and equipment provided; for the sanitary storage and disposal of garbage and refuse which they generate using the facilities provided; for not using any unapproved heating or cooking device; and, for occupancy of the property in accordance with the permitted capacity.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.32 Administrative rate appeals
(a) Administrative rate appeals of rates of payment issued pursuant to this Subpart must be submitted to the department in writing within 120 days of the date such rates are issued by the department to the facility. Such rate appeals must set forth in detail the basis for such appeal and be accompanied by any relevant documentation. Thereafter the department shall respond to such rate appeals in writing and shall either affirm the original rates, revise such rates or request additional information. A failure to respond to the department's request for additional information within 30 days shall be deemed to constitute the withdrawal, with prejudice, of the facility's rate appeal, provided, however, that the department may extend that time period upon a request by the facility and for good cause shown. Upon its receipt of the requested additional information the department shall issue a written determination of such rate appeal.
(b) The department's written determination of a facility's rate appeal shall be deemed final unless the facility submits a written request for further consideration of the rate appeal within 30 days of the date the department issued such written determination, provided, however, that if such written determination advises the facility that its rate appeal is being denied on the ground that the appeal constitutes a challenge to the rate-setting methodology set forth in this Subpart, such denial shall be deemed to be the department's final administrative determination with regard to such appeal and there shall be no further administrative review available. The department shall otherwise respond in writing to such further appeal and either affirm or revise its original rate appeal determination and this response by the department shall be deemed its final administrative determination with regard to such rate appeal.
(c) Rate appeals which are rejected or precluded on the grounds of being untimely may be considered in connection with subsequent audits conducted pursuant to section 86-1.4 of this Subpart.
(d) The department shall consider only those rate appeals that reflect one or more of the following bases:
(1) mathematical or clerical errors in the financial and/or statistical data originally submitted by the medical facility, including information reported to the New York State Statewide Planning and Research Cooperate System (SPARCS) in accordance with section 400.18 of this Title, or mathematical or clerical errors made by the department. Revised data submitted by a facility must meet the same certification requirements as the original data and the department may require verification of revised SPARCS data by an independent review agent at the cost of the facility; and
(2) any errors regarding a medical facility's capital cost reimbursement;
(3)
(i) direct medical education (DME) and indirect medical education (IME) costs, as defined in sections 86-1.15(f)(1) and (f)(2) of this Subpart, for hospitals where the teaching status has changed from non-teaching to teaching;
(ii) the effective date of the initial rate adjustment shall be the later of the first of the month following 60 days from the department’s receipt of the written notification with documentation requesting a rate adjustment or July 1st of the program year.
(e) The department may refuse to accept or consider a rate appeal from a facility that:
(1) is providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council; or
(2) is operated by the same management that operates a facility with regard to which a determination of an unacceptable level of care has been made in accordance with paragraph (1) of this subdivision; or
(3) has been determined by the department as being operated by a person or persons not properly established or licensed pursuant to the Public Health Law; or
(4) is delinquent in the payment of a fine or penalty imposed on the facility pursuant to the Public Health Law.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.3 Selection of award recipients
(a) Process.
The Commissioner of Health in consultation with the State Health Service Corps advisory committee shall select award recipients based on the criteria and preferences described in subdivisions (b) and (c) of this section; however, no award shall be given to an applicant unless a designated facility or agency has expressed a willingness to employ the applicant upon completion of the applicant's education.
(b) Preference.
Preference shall be given to persons in the following categories, in the order of priority stated:
(1) holders of a prior State Health Service Corps award who have maintained an acceptable academic performance, provided they meet all requirements of chapter 355 of the Laws of 1985 and regulations of the Commissioner of Health. Recipients are limited to one award annually and are eligible for annual awards for two consecutive academic years. Holders of awards may be required to submit such supplemental data as required by the department;
(2) a New York State resident attending or planning to attend a New York State educational institution;
(3) a New York State resident attending or planning to attend an educational institution located out of state; and
(4) persons who are not residents of New York State attending or planning to attend a New York State educational institution.
(c) Selection criteria.
All eligible applications will be reviewed competitively using the following criteria:
(1) the need, as determined by the Commissioner of Health and the State Health Service Corps advisory committee, for the profession for which a scholarship is being sought in the designated facilities or agencies and region(s) where the applicant is willing to work;
(2) academic performance and academic awards or honors;
(3) special training and education relevant to the needs of the population to be served;
(4) work experience in the chosen health profession;
(5) work or volunteer experience with the population to be served;
(6) demonstrated commitment to working with the population to be served;
(7) civic or community awards and honors; and
(8) special skills or abilities or background or experience which will facilitate working with the population to be served.
(d) Number of awards.
The Commissioner of Health shall make as many awards as permitted by statute and for which there is available funding. The Commissioner of Health may make fewer awards than permitted by statute if, in consultation with the State Health Service Corps advisory committee, it is determined that no eligible applicants meet minimum qualifications, based on such criteria as those listed in the selection criteria in subdivision (c) of this section.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.2 Definitions
As used in this Part, unless the context otherwise requires:
(a) Commissioner means the Commissioner of the New York State Department of Health.
(b) Department means the New York State Department of Health.
(c) Region means that geographical area under the jurisdiction of the department's Albany, Buffalo, Rochester, Syracuse or New Rochelle regional or area health offices or its office for New York City health services.
(d) Applicant means any person making an application for approval or funding of a proposed action.
(e) Person means any agency, individual, corporation, governmental entity, partnership, association, trustee or other legal entity.
(f) State agency means any State department, agency, board, public benefit corporation, public authority or commission.
(g) Local agency means any local agency, board, district, commission or governing body, including any city, county and other political subdivision of the State.
(h) Agency means any State or local agency.
(i) Action means any project or activity directly undertaken by the department; or supported in whole or part through contracts, grants, subsidies, loans or other forms of funding assistance; or involving the issuance to a person or facility of a lease, permit, license, certificate approval or conditional approval or other entitlement for use or permission to act by the department; or any policy, regulation and procedure-making by the department. Actions are identified as type I, type II, exempt and unlisted actions.
(j) Exempt action means any one of the following:
(1) enforcement or criminal proceedings or the exercise of prosecutorial discretion in determining whether or not to institute such proceedings;
(2) ministerial actions;
(3) maintenance or repair involving no substantial change in an existing structure or facility;
(4) actions deemed by the commissioner to be immediately necessary on a limited emergency basis for the protection or preservation of life, health, property or natural resources;
(5) actions of the Legislature of the State of New York or of any court;
(6) actions subject to the jurisdiction of local governments pursuant to section 808 of the Executive Law or subject to the jurisdiction of the Adirondack Park Agency pursuant to section 809 of the Executive Law; and
(7) actions undertaken, funded or approved by the department prior to the effective date(s) specified in article 8 of the Environmental Conservation Law.
(k) Ministerial action means an action performed upon a given state of facts in a prescribed manner imposed by law, code, rule or regulation without the exercise of any judgment or discretion as to the propriety of the action, although such law, code, rule or regulation may require, to a limited degree, a construction of its language or intent.
(l) Environment means physical conditions, including land, air, water, minerals, flora, fauna, noise, objects of historic or aesthetic significance, existing patterns of population concentration, distribution or growth and existing community or neighborhood character.
(m) Environmental assessment form (EAF) means a form, describing a proposed action, its location, its purposes and its potential impacts on the environment, used to assist the department in determining the environmental significance or nonsignificance of an action. The term short form EAF means a simplified EAF used to determine whether sufficient information hs been presented on which to determine the environmental significance or nonsignificance of an unlisted action.
(n) Complete application means an application, including and environmental assessment which, in the judgment of the department, contains sufficient information on which to make a decision whether or not to proceed, approve or tentatively approve a proposed action. In the case of an action involving an applicant, it shall include the filing of all applications and documents associated with the proposed action that are required pursuant to any statute, rule or regulation unless in the judgment of the department and relevant regulatory agencies such filing is not feasible or appropriate given the nature of the proposed action or that the failure to file all such applications or documents at the same time will not preclude adequate review by the department.
(o) Application date means that date on which the department acknowledges the receipt of a complete application.
(p) Notice of determination means a formal notification issued by the department, informing the public and other interested parties of a decision affecting a proposed action. An initial notice of determination will consist of a negative declaration or a requirement to prepare an EIS. A final notice of determination will indicate the final department decision concerning a proposed action.
(q) Negative declaration means a written statement prepared by the department which announces that the department has determined that an action will not have a significant effect on the environment.
(r) Conditional approval means a general and preliminary expression of department assent that a project proposed by an applicant is feasible in light of environmental and statutory constraints. A conditional approval does not automatically assure the issuance of necessary permits and approvals for a project which is subject to final department determination based on more complete engineering and other planning details provided by the applicant at a later time.
(s) Environmental impact statement (EIS) means a written report prepared by the department or submitted to the department by an applicant which identifies and analyzes in detail the environmental impacts of the proposed action and feasible alternatives. The form and content follows section 97.12 of this Part and 6 NYCRR 617.14. An environmental impact statement may be either a “draft” or “final”.
(t) Notice of completion means a formal notification, issued by the department, informing the public and other interested parties that either the draft environmental impact statement or a final environmental impact statement has been prepared and is now available for public and department review.
(u) Notice of hearing means a formal notification, issued by the department, that establishes the date, time and location of a public hearing called to review a proposed action of the department or an applicant. This notice shall be published in a newspaper selected by the department and/or the Environmental Notice Bulletin at least 14 calendar days before the hearing date.
(v) Type I action means an action such as listed in either 6 NYCRR 617.12 or in section 97.14 of this Part likely to require the preparation of an environmental impact statement in order to adequately review the possible environmental consequences of the action.
(w) Type II action means an action such as listed in either 6 NYCRR 617.13 or in section 97.14 of this Part determined not to have a significant adverse impact on the environment.
(x) Unlisted action means an action not excluded or exempt, which is not listed as a type I or type II action in this Part.
(y) Residential means a realty subdivision or any facility used for permanent or seasonable habitation, including but not limited to apartments, mobile home parks, and campsites offering any utility hookups for recreational vehicles. It shall not include such facilities as hotels, hospitals, nursing homes, dormitories or prisons.
(z) Coastal area means the State's coastal waters and the adjacent shorelands, as defined in article 42 of the Executive Law, the specific bondaries of which are shown on the coastal area map on file in the Office of the Secretary of State, as required by section 914(2) of the Executive Law.
(aa) Funding means any financial support given by an agency, including contracts, grants, subsidies, loans or other forms of direct or indirect financial assistance, in connection with a proposed action.
(bb) Involved agency means an agency that has jurisdiction by law to fund, approve or directly undertake a given action.
(cc) Lead agency means an agency principally responsible for carrying out, funding or approving an action, and therefore responsible for determining whether an environmental impact statement is required in connection with an action, and for the preparation and filing of the statement if one is required.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.14 Ceilings on payments
(a) Reimbursement rate ceilings for the administrative cost center, the patient transportation cost center and for comparable patient care cost centers shall be established for facilities. Comparable patient care cost centers shall include, but not be limited to, the following:
(1) ancillary services cost center (clinical laboratory, pharmacy and diagnostic radiology services);
(2) medical services cost center;
(3) dental services cost center; and
(4) therapy services cost centers.
For a facility which provides limited primary medical care services as defined in section 86-4.13(b)(2) of this Subpart, the administrative and patient care costs incurred by the facility to provide such limited primary medical care services shall be excluded from the costs used to determine the ceilings for the facility's peer group. Reimbursement specific to limited primary medical care services will be established for the facility. The ceilings on costs related to limited primary medical care services will be determined based on the cost experience of facilities which provide limited primary medical care services.
(b) The ceilings shall be established prior to the addition of the trend factor and after the exclusion of desk-audit disallowances and capital costs from total reported costs. The costs of facilities with costs less than 75 percent or over 125 percent of the group average will be raised or lowered to fall within the 75-percent to 125-percent limits.
(c) Ceilings for each cost center shall be computed at 105 percent of the adjusted weighted average base year costs of the facilities in the cost center group.
(d) For the purpose of grouping facilities to establish cost center group ceilings, comprehensive primary medical care facilities will be grouped taking into consideration geographical differences such as upstate/downstate regions and urban/rural locations; family planning facilities will be grouped taking into consideration upstate/downstate regions; all other facilities will be grouped on a statewide basis. If upstate/downstate regions and/or urban/rural locations have not already been taken into account, the ceilings for facilities grouped in accordance with Subpart 86-4.13(b) will be adjusted by wage adjustment factors to recognize differences due to regional economic factors.
(e) The wage adjustment factors will be established by the commissioner based on examination of the salary and employee health and welfare cost experience of the facilities grouped in accordance with section 86-4.13(b) and the methodology described section 86-1.54(j)(2). The wage adjustment factors will be updated on an annual basis based upon then current and available data.
(f) Ceilings for operating costs of ungrouped facilities shall be established at the lower of reported base-year operating costs trended to the rate period or the operating cost component of the existing published rate trended forward by a one-year trend factor.
(g) A change in a facility's group or a revision in cost after ceilings have been established shall not cause a recalculation of ceilings for other facilities in the original or new groups, unless the change was occasioned by an error by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.5 Requirements before submitting a request for a criminal history record check
(a) To the extent permitted by law, a provider shall request from a prospective employee a certification disclosing any prior finding of patient or resident abuse, or a criminal conviction in this State or any other jurisdiction. Providers shall evaluate such statements in all hiring decisions, including any temporary employment allowed under this Part.
(b) The provider shall inform the subject individual in writing that:
(1) the provider is required to request a check of his or her criminal history information and review the results of such criminal history record check; and
(2) the subject individual has the right to obtain, review and seek correction of his or her criminal history information pursuant to rules and regulations established by the division and the FBI.
(c) The provider shall obtain the signed, informed consent of the subject individual in the form and format specified by the department which indicates that the subject individual has:
(1) been informed of the right and procedures necessary to obtain, review and seek correction of his or her criminal history information;
(2) been informed of the reason for the request for his or her criminal history information;
(3) consented to the request for a criminal history record check; and
(4) supplied on the form a current mailing or home address.
(d) A subject individual may withdraw his or her application for employment, without prejudice, at any time before employment is offered or declined, regardless of whether the subject individual or provider has reviewed the summary of the subject individual's criminal history information.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.10 Specimens: identification and examination
(a) Every specimen received for testing shall be numbered or otherwise appropriately identified and listed in an accession book, or another system acceptable to the department.
(b) Every tissue specimen shall be examined and reported upon by a qualified pathologist who is certified or eligible for certification for pathologic anatomy by the American Board of Pathology or whose qualifications, in the opinion of the Public Health Council pursuant to Part 19 of this Title, are equivalent of such certification. Preliminary examination or “screening” of specimens for cytopathology may be made only by an individual who has had special training in cytology acceptable to the department.
(c) A clinical laboratory or blood bank shall at any time during its regular working hours permit the inspection of its premises and records by a representative of the department and shall examine and report promptly on all specimens submitted by the department for the purpose of determining the competency of the laboratory.
(d) If the component to be tested for in a specimen is perishable, labile, or otherwise subject to deterioration, such specimen shall be tested as promptly as possible after collection. If a specimen is transported or stored, it shall be properly preserved, refrigerated, frozen or otherwise appropriately treated to maintain it in as close to its original state as is possible by then current technics.
(e) A specimen received by a laboratory shall not be tested or reported on if:
(1) the apparent condition of the specimen indicates that it is unsatisfactory for testing or that it is inappropriate for the test requested;
(2) it has been collected, labeled, preserved or otherwise handled in such a manner that it has become unsatisfactory or unreliable as a test specimen;
(3) it is perishable and the time lapse between the collection of the specimen and its receipt by the laboratory is of such duration that the test finding may no longer be reliable; or
(4) the date and, in the case of tests specified by the department, the hour when the specimen was taken by the physician or other authorized person is not furnished with the specimen.
(f) When a specimen is not tested for any of the reasons specified in subdivision (e) of this section the laboratory shall promptly notify the sender and give the reason therefor.
(g) All technical procedures employed in a laboratory shall be of proven reliability and generally accepted by leading authorities in the specialties of laboratory medicine and/or approved by the department.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-1.10 Guarantee of expense
Adequate guarantee of payment of the charges for hospitalization shall be required in each instance. This may consist of a statement of personal financial responsibility to be signed by the patient or a member of his family; or payment of charges incurred at the end of each treatment day in the case of outpatients; or financial coverage in appropriate form from another public agency, a recognized private or voluntary agency, or an insurance company.
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.6 Admissions and hospital stays
(a) Inpatient hospital admissions which do not require a determination of benefit coverability under sections 85.1 through 85.4 of this Part and except for admissions under subdivision (f) of this section shall be deemed a covered benefit under medical assistance for the needy as provided in section 365-a(2)(b) of the Social Services Law for the first three days of inpatient hospital care. To be a covered benefit after the third day of inpatient hospital care, there shall be a determination of benefit coverability prior to the end of the third day by a person designated by the Commissioner of Health. Such determination shall be for a specified period of time not to exceed the 50th percentile of length of stay norms for comparable patients which have been authorized by the Commissioner of Health or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in subdivision (a) of section 85.5 of this Part, such specified period of time shall not exceed the 40th day of stay. Determination of coverability shall be based upon existence of medical conditions which can be treated only on an inpatient hospital basis, as documented in the patient's medical record. Subsequent to this initial determination of coverability, extensions of benefit coverability shall be subject to length of stay limitations of sections 85.5 and 85.7 of this Part.
(b) A determination of benefit coverability under this section shall be made by a designated physician or nonphysician under a designated physician's supervision. A determination of noncoverability shall be made only by a designated physician. If such determination of noncoverability is made, any inpatient hospital care, supplies or services provided beyond three days shall not be a covered benefit under medical assistance for the needy.
(c) Notice of determination shall be given to the patient's physician, the hospital administrator and, if there is a determination of noncoverability, to the patient.
(d) The patient's physician or hospital administrator may, within three days of the date of such notification, appeal a determination of noncoverability in writing to the physician or physicians designated by the commissioner for such purpose. Notification of the decision on appeal shall be given to the patient's physician, the hospital administrator and the patient. If determination of noncoverability is affirmed on appeal, any inpatient hospital care, supplies or services provided beyond three days shall not be a covered benefit under medical assistance for the needy.
(e) If the person designated by the Commissioner of Health decides in the course of making determinations of coverability under this section or it is determined from other sources that a physician, physicians or the hospital are admitting patients for medical conditions which can be treated on other than an inpatient hospital basis, the designated person shall give written notification to the physician(s) and the hospital that if such admissions continue, the initial three-day period of stay will no longer be deemed a covered benefit. If patients are thereafter admitted for medical conditions which can be treated on other than an inpatient hospital basis, the designated person shall notify the physician(s) and the hospital that to be a covered benefit, the first three days of inpatient stay will be subject to a determination of coverability. Such determination of coverability shall be made prior to the end of the third day of inpatient hospital stay in accordance with the procedures in subdivisions (a) through (d) of this section. If there is a determination of noncoverability, any inpatient hospital care, supplies or services provided shall not be a covered benefit under medical assistance for the needy.
(f)
(1) During such period of time as sections 85.2 and 85.3 of this Part do not apply, all surgery, other than emergency or urgent surgery, within “medical assistance” as defined in section 365-a of the Social Services Law, shall require a determination of coverability by a person designated by the Commissioner of Health prior to admission. A determination of coverability shall be based on a finding that the proposed surgery can be performed properly only on an inpatient hospital basis.
(2) A determination of coverability shall be for a specified period of time not to exceed the 50th percentile of length of stay norms for comparable patients which have been authorized by the commissioner or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in section 85.5(a) of this Part, such specified period of time shall not exceed the 40th day of stay. Subsequent to this initial determination of coverability, extensions of benefit coverability shall be subject to length of stay limitations of sections 85.5 and 85.7 of this Part.
(3) The required determination of coverability shall be initiated by written request from the proposing surgeon, with information adequate for making the determination. A determination of coverability shall be made by a designated physician or nonphysician under supervision of a designated physician. A determination of noncoverability shall be made only by a physician.
(4) Notice of determination shall be given to the proposing surgeon who shall, if coverability is determined, incorporate such notice in the hospital record at admission.
(5) The proposing surgeon may appeal any determination of noncoverability to a physician or physicians designated by the Commissioner of Health for such purpose. Notification of decision on appeal shall be given to the proposing surgeon who shall incorporate any notice of determination of coverability in the hospital record at admission.
(6) Admissions and hospital stays solely for the purpose of performing any procedure which may be performed on an outpatient basis, as defined in paragraph (7) of this subdivision, shall not be included as inpatient care in a hospital or care in a hospital-based ambulatory surgery service or a free-standing ambulatory surgery center for purposes of coverability of benefits except that a determination of coverability may be made by a person designated by the Commissioner of Health when the medical condition of the individual patient requires that such procedure be performed on an inpatient basis in a hospital or as care in a hospital-based ambulatory surgery service or a free-standing ambulatory surgery center. For inpatient hospital, hospital-based ambulatory surgery service and free-standing ambulatory surgery center admissions for certain surgical procedures, as defined in paragraph (7) of this subdivision there shall be a determination prior to admission of the specified period of coverability as provided for in this subdivision, except for emergency admissions for which the determination of the period of coverability shall be made as soon after admission as feasible.
(7) A procedure which may be performed on an outpatient basis (“outpatient procedure”), is a diagnostic test or treatment, including certain surgical procedures, that carries a low patient risk, requires minimal preand post-procedure observation and treatment, is not likely to be time consuming or followed by complications, and is not associated with a condition which would require hospitalization. Column (1) lists “The International Classification of Diseases, 9th Revision, Clinical Modification” (ICD-9 CM) procedure codes for outpatient surgery and column (2) below lists the outpatient surgical (ICD-9-CM) procedure names. Such outpatient procedures include, but are not limited to, the following:
| (1) | (2) | | --- | --- | | ICD-9-CM Procedure Code | ICD-9-CM Procedure Name | | (i) 3.31 | Spinal tap | | (ii) 8.09 | Other eyelid incision | | (iii) 8.11 | Eyelid biopsy | | (iv) 8.20 | Removal of lesion of eyelid, NOS | | (v) 8.21 | Excision of chalazion | | (vi) 8.22 | Excision of other minor lesion of eyelid | | (vii) 8.41 | Repair entrop/ectro-thermocauterization | | (viii) 8.42 | Repair entrop/ectro. by suture tech. | | (ix) 8.52 | Blepharorrhaphy | | (x) 18.09 | Other incision of external ear | | (xi) 18.21 | Excision of preauricular sinus | | (xii) 18.29 | Excis./destruct. of other lesion ext. ear | | (xiii) 20.09 | Other myringotomy | | (xiv) 21.21 | Rhinoscopy | | (xv) 21.22 | Biopsy of the nose | | (xvi) 21.30 | Excis./destruct. of lesion-nose, NOS | | (xvii) 21.31 | Local excsn./destruct.-intranasal lesion | | (xviii) 21.32 | Local excsn./destruct.-other lesion of nose | | (xix) 21.61 | Turbinectomy by diathermy or cryosur | | (xx) 21.69 | Other Turbinectomy | | (xxi) 23.01 | Forceps extraction of deciduous tooth | | (xxii) 23.09 | Forceps extraction of other tooth | | (xxiii) 23.11 | Surgical removal of residual root | | (xxiv) 23.19 | Other surgical extraction of tooth | | (xxv) 23.20 | Restoration of tooth by filling | | (xxvi) 23.30 | Restoration of tooth by inlay | | (xxvii) 23.41 | Application of crown | | (xxviii) 23.42 | Insertion of fixed bridge | | (xxix) 23.43 | Insertion of removable bridge | | (xxx) 23.49 | Other dental restoration | | (xxxi) 23.50 | Implantation of tooth | | (xxxii) 23.60 | Prosthetic dental implant | | (xxxiii) 23.70 | Root canal, NOS | | (xxxiv) 23.71 | Root canal therapy with irrigation | | (xxxv) 23.72 | Root canal therapy with apicoectomy | | (xxxvi) 23.73 | Apicoectomy | | (xxxvii) 24.00 | Incision of gum or alveolar bone | | (xxxviii) 24.11 | Biopsy of gum | | (xxxix) 24.12 | Biopsy of alveolus | | (xl) 24.19 | Other diag. proc. on teeth, gums | | (xli) 24.20 | Gingivoplasty | | (xlii) 24.31 | Excision of lesion of tissue of gum | | (xliii) 24.32 | Suture of laceration of gum | | (xliv) 24.39 | Other operations on gum | | (xlv) 24.40 | Excision of dental lesion of jaw | | (xlvi) 24.50 | Alveoloplasty | | (xlvii) 24.60 | Exposure of tooth | | (xlviii) 24.70 | Application of orthodontic appliance | | (xlix) 24.80 | Other orthodontic operation | | (l) 24.91 | Extension or deepening of buc. sulcus | | (li) 24.99 | Other dental operations | | (lii) 25.02 | Open biopsy of tongue wedge biopsy | | (liii) 25.10 | Excisn./destuctn lesion/tissue tongue | | (liv) 27.43 | Other excision of lesion/tissue lip | | (lv) 27.49 | Other excision of mouth | | (lvi) 27.59 | Other plastic repair of mouth | | (lvii) 31.42 | Laryngoscopy and other tracheoscopy | | (lviii) 45.24 | Flexible sigmoidoscopy | | (lix) 48.23 | Rigid Proctosigmoidoscopy | | (lx) 48.25 | Open biopsy of rectum | | (lxi) 49.23 | Anal biopsy | | (lxii) 49.30 | Loc. excsn./dest. oth. lesion/tissue of anus | | (lxiii) 49.45 | Hemorrhoid ligation | | (lxiv) 49.47 | Evacuation of thrombosed hemorrhoid | | (lxv) 56.91 | Ureteral meatus dilation | | (lxvi) 57.19 | Other cystostomy | | (lxvii) 57.32 | Other cystoscopy | | (lxviii) 57.33 | Closed (transur) biopsy of bladder | | (lxix) 57.94 | Insertion of indwelling urinary cath | | (lxx) 57.95 | Replacement-indwelling urinary cath | | (lxxi) 58.10 | Urethral meatotomy | | (lxxii) 59.80 | Urethral catheterization | | (lxxiii) 83.21 | Biopsy of soft tissue | | (lxxiv) 86.04 | Other incsn w/drainage of skin/ subcu. tissue | | (lxxv) 86.11 | Biopsy of skin & subcutaneous tissue | | (lxxvi) 86.22 | Excision debrid of wound infection or burn | | (lxxvii) 86.23 | Removal of nail, nailbed, nail fold | | (lxxviii) 86.25 | Dermabrasion | | (lxxix) 86.59 | Suture skin/subcut. tissue of other sites | | (lxxx) 88.66 | Phlebography-femoral, other lower extrm vein c. material | | (lxxxi) 89.26 | Gynecological examination | | (lxxxii) 97.71 | Remove intrauterine contraceptive device |
(8) Admissions and hospital stays solely for the purpose of performing any procedure which may be performed on an ambulatory surgery basis as defined in paragraph (9) of this subdivision, shall not be included as inpatient care in a hospital for purposes of coverability of benefits except that a determination of coverability may be made by a person designated by the Commissioner of Health when the medical condition of the individual patient requires that such procedure be performed on an inpatient basis in a hospital. For inpatient hospital admissions for procedures listed in paragraph (9) of this subdivision, there shall be a determination prior to admission of the specified period of coverability as provided for in this subdivision, except for emergency admissions for which the determination of the period of coverability shall be made as soon after admission as feasible.
(9) A procedure which may be performed on an ambulatory surgery basis (“ambulatory surgery procedure”), is a diagnostic test, treatment, or procedure which shall be performed for safety reasons in an operating room on anesthetized patients requiring a stay of less than 24 hours' duration. These procedures do not include outpatient office or outpatient treatment room procedures as defined in and covered by paragraph (7) of this subdivision. Column (1) below lists the “The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure names for ambulatory surgical procedures and Column (2) lists the ICD-9-CM procedure codes for ambulatory surgical procedures for which prior approval is necessary for inpatient hospital admission, except for emergency admissions for which the determination of the period of coverability shall be made as soon after admission as feasible. Such ambulatory surgery procedures include, but are not limited to the following:
| | (1) | (2) | | --- | --- | --- | | | ICD-9-CM Procedure Names | ICD-9-CM Procedure Codes | | (i) | spinal tap | 03.31 | | (ii) | other excision or avulsion of cranial and peripheral nerves | 04.07 | | (iii) | release of carpal tunnel | 04.43 | | (iv) | other peripheral nerve or ganglion decompression or lysis of adhesion | 04.49 | | (v) | excision of pterygium | 11.39 | | (vi) | intracapsular extraction of lens by temporal inferior route | 13.11 | | (vii) | other intracapsular extraction of lens | 13.19 | | (viii) | extracapsular extraction of lens by simple aspiration (and irrig.) technique | 13.3 | | (ix) | extracapsular extraction of lens by temporal inferior route | 13.51 | | (x) | other extracapsular extraction of lens | 13.59 | | (xi) | insertion of pseudophakos, NOS | 13.70 | | (xii) | insertion of intraocular lens prosthesis at cataract extraction, 1-stage | 13.71 | | (xiii) | secondary insertion of intraocular lens prosthesis | 13.72 | | (xiv) | recession of one extraocular muscle | 15.11 | | (xv) | advancement of one extraocular muscle | 15.12 | | (xvi) | resection of one extraocular muscle | 15.13 | | (xvii) | other operation on one extraocular muscle involving temporary detachment from globe | 15.19 | | (xviii) | lengthening procedure on one extraocular muscle | 15.21 | | (xvix) | shortening procedure on one extraocular muscle | 15.22 | | (xx) | other operations on one extraocular muscle | 15.29 | | (xxi) | operations on two or more extraocular muscles involving temporary detachment from globe, one or both eyes | 15.3 | | (xxii) | excision or destruction of other lesion of ext. ear | 18.29 | | (xxiii) | myringotomy with insertion of tube | 20.01 | | (xxiv) | other myringotomy | 20.09 | | (xxv) | submucous resection of nasal septem | 21.5 | | (xxvi) | closed reduction of nasal fracture | 21.71 | | (xxvii) | revision rhinoplasty | 21.84 | | (xxviii) | other rhinoplasty | 21.87 | | (xxix) | other septoplasty | 21.88 | | (xxx) | other excision or destruction of lesion or tissue of larynx | 30.09 | | (xxxi) | laryngoscopy and other tracheoscopy | 31.42 | | (xxxii) | biopsy of larynx | 31.43 | | (xxxiii) | bronchoscopy through artificial stoma | 33.21 | | (xxxiv) | fiber-optic bronchoscopy | 33.22 | | (xxxv) | other bronchoscopy | 33.23 | | (xxxvi) | biopsy of lymphatic structure | 40.11 | | (xxxvii) | simple excision of other lymphatic structure | 40.29 | | (xxxviii) | biopsy of bone marrow | 41.31 | | (xxxix) | esophagoscopy through artificial stoma | 42.22 | | (xl) | other esophagoscopy | 42.23 | | (xli) | biopsy of esophagus | 42.24 | | (xlii) | gastroscopy through artificial stoma | 44.12 | | (xliii) | other gastroscopy | 44.13 | | (xliv) | other endoscopy of small intestine | 45.13 | | (xlv) | flexible fiberoptic colonoscopy | 45.23 | | (xlvi) | other endoscopy of large intestine | 45.24 | | (xlvii) | local excision of rectal lesion or tissue | 48.35 | | (xlviii) | incision or excision of perianal tissue | 49.01 | | (xlix) | local excision or destruction of other lesion or tissue of anus | 49.3 | | (l) | other procedures on hemorrhoids | 49.49 | | (li) | laparoscopy | 54.21 | | (lii) | other cystoscopy | 57.32 | | (liii) | urethral meatotomy | 58.1 | | (liv) | release of urethral stricture | 58.5 | | (lv) | dilation of urethra | 58.6 | | (lvi) | bilateral endoscopic ligation and crushing of fallopian tubes | 66.21 | | (lvii) | bilateral endoscopic ligation and division of fallopian tubes | 66.22 | | (lviii) | other bilateral endoscopic c destruction or occulsion of fallopian tubes | 66.29 | | (lix) | other cervical biopsy | 67.12 | | (lx) | dilation and curettage for termination of pregnancy | 69.01 | | (lxi) | other dilation and curettage | 69.09 | | (lxii) | aspiration curettage of uterus for termination of pregnancy | 69.51 | | (lxiii) | other aspiration curettage of uterus | 69.59 | | (lxiv) | marsupialization of Bartholin's gland (cyst) | 71.23 | | (lxv) | other bunionectomy | 77.59 | | (lxvi) | removal of internal fixation device | 78.6 | | (lxvii) | arthroscopy (knee) | 80.26 | | (lxviii) | excision of lesion of tendon sheath of hand | 82.21 | | (lxix) | excision of lesion of other soft tissue | 83.39 | | (lxx) | other biopsy of breast | 85.12 | | (lxxi) | local excision of lesion of breast | 85.21 | | (lxxii) | incision w/removal of foreign body from skin and subcutaneous tissue | 86.05 | | (lxxiii) | application of other cast | 93.53 |
(10) Nothing contained in either paragraph (8) or (9) of this subdivision shall prevent any of the procedures listed in, or otherwise covered by, paragraph (9) of this subdivision from being performed on an outpatient basis.
(g) Inpatient hospital care, services and supplies for admissions beginning on a Friday or Saturday shall include as a covered benefit under medical assistance for the needy only those inpatient days beginning with and following the Sunday after such admission unless a person designated by the Commissioner of Health makes a determination of coverability for such Friday or Saturday while making the determinations required in subdivision (a) of this section and section 85.7 of this Part. A determination of coverability shall be based upon a finding that:
(1) such care, services and supplies commencing with a Friday or Saturday admission are furnished for a medical emergency;
(2) such care, services and supplies commencing with a Friday or Saturday admission are required because of the necessity of emergency or urgent surgery for the alleviation of severe pain or the necessity for immediate diagnosis or treatment of conditions which threaten disability or death if not promptly diagnosed or treated; or
(3) the care, services and supplies commencing with a Friday or Saturday admission are for preoperative care for surgery which has been determined to be a covered benefit under section 85.4 of this Part.
(h) Inpatient days beginning on a Friday or Saturday shall not be subject to the limitations of subdivision (g) of this section in hospitals determined by the commissioner or his designee to be rendering full service on a seven-day-a-week basis. A determination of “full service” shall be made after taking into consideration such factors as the routine availability and use of operating room services, diagnostic services and consultants, laboratory services, radiological services, pharmacy services, staff patterns consistent with full services and such other factors as the commissioner or his designee deems necessary and appropriate.
(i) A determination of coverability of admissions to general hospitals for psychiatric care for persons 16 years of age and older requires that the following shall be met:
(1) The patient's hospital medical record shall contain one or more of the following as documentation for the necessity for admission:
(i) evidence of behavior or thought by the patient, described in the patient's medical record, that is likely to lead to consequences which are a significant danger to the patient or others;
(ii) evidence of deviant behavior exhibited by the patient and described in the patient's medical record, which is no longer tolerable to the patient or to society and is likely to be ameliorated by treatment at this level of care;
(iii) the finding that ambulatory treatment has been unsuccessful in halting or reversing the course of the mental illness, and that inpatient treatment at this level of care is needed in order to prevent or manage behavior or thought described in subparagraph (i) or (ii) of this paragraph;
(iv) the finding that the patient requires a type of therapy which cannot be initiated or continued unless in a supervised setting at this level of care; or
(v) the finding that the patient has a condition other than mental disorder which requires hospital care, but psychological components cannot be handled as well on other units.
(2) A specific treatment plan shall be developed and shall have been implemented within three days following admission.
(3) The patient's response to treatment must be observed and shall be recorded in the patient's medical record.
(4) An anticipated discharge plan shall be developed by the medical staff and shall be recorded in the patient's medical record no later than the fifth day following admission.
(5) A review of the necessity for continued stay shall be carried out in accordance with the provisions of subdivision (b) of section 85.5 of this Part. The patient's hospital medical record shall contain one or more of the following as documentation for the necessity for continued hospital stay:
(i) evidence that there is an immediate physical danger to the patient or others and this level of care is appropriate;
(ii) evidence that the magnitude of the abnormal behavior of the patient remains intolerable to the patient or society, and clinical evidence recorded in the medical chart justifies an extension of stay at this level of care under treatment;
(iii) a finding that if the patient were to be discharged, subparagraph (i) or (ii) of this paragraph; would be likely to recur soon and continued hospitalization would be likely to prevent this. The medical record must document the reason why it is believed likely to recur soon and why continued hospitalization would be likely to prevent the recurrence;
(iv) a finding that the patient's care requires the use and regulation of a specific modality, but the patient lacks motivation and refuses, or is unable, to cooperate under a program of care at another level;
(v) evidence suggests that the patient can improve sufficiently to be treated in an ambulatory setting or other level of care only after additional hospitalization because a major revision of treatment plan has occurred such as ( a ) change in treatment regimen or ( b ) patient relapsed unexpectedly; or
(vi) a condition other than mental disorder requires this level of care, but psychological component cannot be handled as well on other services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.51 Book inventory
(a) An inventory which is not the result of actual stocktaking but of adding the units and the cost of incoming goods to previous inventory figures and deducting the units and cost of outgoing goods.
(b) The balances of materials or products on hand in quantities, dollars, or both, appearing in perpetual-inventory accounts.
Chapter I STATE SANITARY CODE
Part 19 CLINICAL LABORATORY DIRECTORS
10 CRR-NY 19.1 Definitions
(a) Director means the individual responsible for administration of the technical and scientific operation of a clinical laboratory or blood bank, including supervision of test procedures the reporting of results, and the duties and responsibilities specified in section 19.3 of this Part. If a clinical laboratory or blood bank employs more than one director, the laboratory owner(s) shall designate in writing one such individual as the director of record for the laboratory.
(b) Assistant director means a director who has been designated by the owner(s) of the laboratory as having shared responsibility with a director for the technical and scientific operation of the clinical laboratory or blood bank in one or more categories and/or subcategories.
(c) Acceptable laboratory means a facility, operating lawfully, that meets the definition of a clinical laboratory or blood bank as defined in section 571 of the Public Health Law and which has a director who meets or would meet the requirements of this Part, including the anatomic and clinical pathology facilities of a hospital or health department, a clinical testing unit of a university or medical research institution, an independent clinical laboratory or blood bank, a privately operated forensic testing laboratory, or a facility providing training and/or experience in the testing of human specimens.
(d) Accredited means having the approval (accreditation) conferred on schools, institutions or programs by an accrediting agency or association recognized by the United States Secretary of Education and verified as such by the department.
(e) Physician means a physician who is licensed and currently registered to practice medicine in New York State or in the state or the country in which he or she practices and is not subject to any disciplinary or non-disciplinary order by the applicable state or country except as otherwise allowed by the department.
(f) Dentist means a dentist who is licensed and currently registered to practice dentistry in New York State or in the state or the country in which he or she practices and is not subject to any disciplinary or non-disciplinary order by the applicable state or country except as otherwise allowed by the department.
(g) Certificate of qualification means a credential issued by the department to applicants determined by the department to meet the requirements set forth in this Part.
(h) Grandfathered laboratory director means a laboratory director who qualified for and received a certificate of qualification in one or more categories of testing prior to the amendment of this regulation which became effective January 25, 1988.
(i) Category means an area, field, or discipline of laboratory medicine or laboratory science in which a certificate of qualification is issued. The department may issue certificates of qualification in a specified subpart of a category, including, but not limited to, a subcategory, technology, method, or specific procedure, based on the applicant’s education, training, and experience and the applicant’s ability to demonstrate that tests performed under their direction generate reliable results. The department shall make available a list of: categories and subcategories in which certificates of qualification are issued; minimum qualifications for each category; and the corresponding categories of testing authorized by a laboratory permit.
(j) Department means the New York State Department of Health.
(k) Board certified means having completed all requirements set forth by an accrediting board acceptable to the department, including a passing score on any qualifying examination and completion of all the requirements for recertification whenever the certifying board mandates recertification, provided such requirements are determined by the department to provide the applicant with the ability to effectively discharge the responsibilities described in Parts 10 and 58 of this Title.
(l) Earned doctoral degree means a doctor of philosophy, doctor of science, or equivalent degree as determined by the department.
(m) Training includes participation in a residency, fellowship, or post-doctoral position, or participation in a training course approved by a board acceptable to the department.
(n) Experience includes post-doctoral employment or voluntary participation in an acceptable laboratory where the applicant performed, supervised or directed testing of human clinical specimens. Teaching experience directly related to a medical technology program, clinical laboratory sciences program, or a clinical laboratory section of a residency program is also considered acceptable experience.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 68 POISON CONTROL NETWORK
10 CRR-NY 68.5 Reimbursement
(a) A hospital which has been designated as a regional poison control center shall submit an annual budget indicating the costs of operating such center and shall identify those costs associated with the provision of this service which are presently reflected in the hospital base year cost report. The hospital shall keep separate cost and statistical data related to the center for annual reporting under general hospital accounting and reporting provisions of this Title. Costs determined by the commissioner to be necessary and reasonable in order to comply with the requirements of this Part shall be reimbursable and shall be considered a specialized service eligible for a waiver of the maximum allowable payment for emergency services as authorized pursuant to the Public Health Law. Hospitals will be reimbursed based upon budget and cost data until the first full year of expenditures is experienced.
(b) Regional poison control centers requesting additional reimbursement for the operation of such centers shall submit rate appeals and supporting documentation in accordance with the provisions of Part 86 of this Chapter.
(c) The reasonable and necessary costs of the following items related directly to operation of the poison control center shall be considered by the commissioner to be reimbursable: personnel, computer and data services, telephone services, travel, printing and publication, audio-visual aids, outreach activities, plant and overhead, toxicology testing, supplies and equipment, contractual services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.1 Title and applicability
(a) This Subchapter shall be known and may be cited as “Medical Facilities—Minimum Standards,” and shall apply to medical facilities defined as hospitals within article 28 of the Public Health Law. The standards within a particular article shall constitute the minimum standards for the identified medical facility in addition to those standards that may apply to such facilities as set forth in Articles 1 and 3 of this Subchapter as applicable.
(b) During the period of a State disaster emergency declared pursuant to section 28 of the Executive Law, the State Commissioner of Health or their designee may suspend or modify any provision, of parts thereof, of this Subchapter, that is not otherwise required by State statute or Federal law, if compliance with such provisions, or parts thereof, would prevent, hinder, or delay action necessary to cope with the State disaster emergency, or if necessary to assist or aid in coping with such disaster. Such suspension or modifications may include any modifications of regulation, exceptions, limitations or other conditions as the commissioner or their designee deems appropriate and necessary to respond to the disaster emergency. Provided, further, that should the Governor declare a State disaster emergency pursuant to section 28 of the Executive Law, which suspends or otherwise modifies State statutes pursuant to his authority under section 29-a of the Executive Law, the commissioner or their designee may suspend or modify any provision of any regulation that is consistent with the statutory authority as modified or suspended, for the period of such suspension or modification.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.108 Stamford Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made an enacted in accordance with the provisions of sections 70, 71 and 72 of the Public Health Law heretofore set forth shall apply to Trinity Lake, Mud Pond or Mead Pond and to all those portions of Mill River, otherwise called Rippowan River, which are situated within the State of New York (Westchester County) lying above the reservoir and intake of the Stamford Water Company, as well as to every spring, stream, ditch, gutter, drain or watercourse of any kind, the waters of which when running eventually flow into Mud Pond, Trinity Lake or Mill River within the said State above such intake.
(b) Privies adjacent to ponds, lakes, reservoirs or watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the deposit, reception or storage of human excreta shall be constructed, located, placed or maintained with its nearest point within 50 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse of any kind, the waters of which comprise or, when running, flow eventually into Trinity Lake, Mud Pond or Mill River within the said State.
(2) Every privy, privy vault, pit or cesspool or other receptacle or place used for the deposit, reception or storage of human excreta which is constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind whose waters comprise or, when running, flow into Trinity Lake, Mud Pond or Mill River within the said State, and from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition, and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(3) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually and strictly prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal none of the contents shall be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified, so that the least possible annoyance and inconvenience shall be caused to the occupants of the premises or of adjacent premises.
(4) Unless otherwise specifically ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 250 feet, horizontal measurement, from the high-water mark of any lake, pond or reservoir or from the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind, the waters of which comprise or, when running, flow into Trinity Lake, Mud Pond or Mill River within the said State.
(5) Whenever it shall be found that, owing to the character of the soil or to the surface of the ground or owing to the height or flow of subsoil or surface water or through special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Department of Health, be washed over the surface of the ground or through the soil into any lake, pond or reservoir, spring, stream, ditch or gutter, drain or other watercourse, the waters of which comprise or, when running, flow into the aforesaid Trinity Lake, Mud Pond or Mill River within the said State, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Department of Health.
(c) House slops, sink waste, laundry water, garbage, refuse, etc.
(1) No sewage, garbage, putrescible matter, house slops, bath water, kitchen or sink waste, refuse or waste water from creameries, cheese factories or laundries or water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid shall be thrown or discharged directly into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse comprising or flowing into Trinity Lake, Mud Pond or Mill River within the said State, nor shall any such liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid within 100 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse aforesaid.
(2) No clothing, bedding, carpets, harness, vehicles, tanks, barrels, receptacles, utensils nor animals nor anything that pollutes water shall be washed or rinsed in, nor shall any person bathe in any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse comprising or flowing into Trinity Lake, Mud Pond or Mill River within the State of New York.
(d) Manures, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, poultry yard, cattle pen, pigsty, henhouse, hitching place or standing place for horses or other animals and no manure pile, compost heap, piles of fermented or decayed fruit, apple pumice, cider mill waste, vegetables, roots, grain, leaves or other vegetable substances shall be located, placed or maintained or allowed to remain in such place or manner that the washing or draining therefrom may flow in open, blind or covered drains or channels of any kind into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid without first having passed over or through such an extent of soil as to have become properly purified and in no case shall the above named sources or causes of pollution be so located or allowed to remain that their nearest point is less than 100 feet, horizontal measurement, from the high-water mark of any lake, pond, reservoir or the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind which comprises or, when running, flows into Trinity Lake, Mud Pond or Mill River within the State of New York.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet, horizontal measurement, of the high-water mark of any lake, pond, reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind whose waters comprise or, when running, flow into Trinity Lake, Mud Pond or Mill River in the said State, and no manure or compost of any kind shall be spread or deposited upon the ground so as to be washed a less distance than 100 feet over the surface or through the soil before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse.
(e) Dead animals, offal, manufacturing wastes, etc.
(1) No dead animal, bird, fish nor any part thereof nor any offal nor putrescible matter nor any polluted waters or refuse from any slaughterhouse, dairy, creamery, cheese factory, cider mill or other manufactory shall be thrown or allowed to run into any lake, pond, reservoir, spring, stream, ditch, gutter drain or other watercourse whose waters comprise or, when running, flow into Trinity Lake, Mud Pond or Mill River in the said State, nor shall any such refuse or polluted material aforesaid be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed over or through the soil a less distance than 100 feet before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse.
(2) No dead animal, bird, fish, fowl or reptile nor any part thereof shall be buried in the ground within 250 feet of the high-water mark of any aforesaid lake, pond or reservoir or the high-water mark or precipitous bank of any such aforesaid spring, stream or watercourse.
(3) No live sheep or other animals shall be washed in any lake, pond or reservoir or in any such aforesaid spring, stream or watercourse; neither shall any person swim, bathe or wash in any said lakes, ponds or reservoirs, streams or watercourses.
(4) The waste liquids which may be polluted with putrescible or deleterious organic matter from any of the operations above indicated shall be all thoroughly filtered or otherwise properly purified before being allowed to escape into any lake, pond or reservoir or into any spring, stream or watercourse tributary thereto.
(f) Cemeteries.
No interment shall be made in any cemetery or other place of burial within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any lake, pond or reservoir or of any spring, stream or watercourse whose waters comprise or, when running, flow into Trinity Lake, Mud Pond or Mill River within the aforesaid State.
(g) Penalties.
In accordance with section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 484 of the Laws of 1904, the penalty of each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.9 Inapplicability of this Subpart
The testing requirements of this Subpart shall not apply if the chief executive officer of a hospital providing care to the newborn or the newborn’s birth attendant determines that the newborn’s parent(s) hold genuine and sincere religious beliefs contrary to the testing required by this Subpart, and the parent(s) have provided satisfactory written documentation of such religious beliefs. In such instances, within five days of a newborn’s birth the chief executive officer or birth attendant shall submit such documentation to the testing laboratory, along with an attestation that the parent(s) received education regarding the benefits of newborn screening.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.27 AIDS home care programs
Payment for services provided by LTHHCPs certified as AHCPs shall be at rates established pursuant to this Subpart provided, however, that nursing services provided by any LTHHCP to patients diagnosed with Acquired Immune Deficiency Syndrome (AIDS) as defined by ICD-9 codes 042, 043 and 044 shall be reimbursed pursuant to section 86-1.46(b) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.199 Medicaid (Title XIX)
A federally aided, State-operated and administered program which provides medical benefits for certain low-income persons in need of health and medical care. The program, authorized by title XIX of the Social Security Act, is basically for the poor. It does not cover all of the poor, however, but only persons who are members of one of the categories of people who can be covered under the welfare cash payment programs—the aged, the blind, the disabled, and members of families with dependent children where one parent is absent, incapacitated or unemployed. Subject to broad Federal guidelines, states determine the benefits covered, program eligibility, rates of payment for providers, and methods of administering the program.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.41 Additional requirements for localities applying for State aid
(a) Nonchemical control measures.
Localities applying for nonchemical control of insect vectors must include in the plan a discussion of methods of habitat modification and biological control in terms of feasibility, manpower, equipment and target species in conjunction with a comprehensive delineation of the target area and anticipated shorthand long-term benefits.
(b) Chemical control measures.
Localities which anticipate a need for chemical control measures must submit detailed plans for such measures. Plans for pesticide application must discuss the target vector, its anticipated geographic location, manpower/equipment required, chemicals/application procedures, and pertinent safeguards which will be followed.
(c) Miscellaneous responsibilities.
(1) Localities anticipating the submission of vector surveillance or vector surveillance and control activities should review the response protocols available from the New York State Department of Health.
(2) Approval of a vector control program for the purpose of State aid shall not relieve any locality of its obligation to comply with all applicable laws or regulations, including article 8 of the Environmental Conservation Law and implementing regulations. Each application for State aid for vector control shall include a statement indicating the applicant's acknowledgment of the obligation.
(3) Counties shall submit proposals directly to the New York State Department of Health. Other municipalities shall submit plans through their respective counties. Plans must be submitted to the Department of Health by January 15th of the calendar year for which State aid will be requested. Exceptions to this deadline may be allowed by the State Department of Health if a public health threat occurs and/or in other compelling unanticipated circumstances.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.6 Certification by operator or officer
(a) The financial and statistical reports shall be certified by the operator of a proprietary medical facility, an officer of a voluntary medical facility or the public official responsible for the operation of a public medical facility.
(b) The form of the certification required in subdivision (a) of this section shall be as prescribed in the annual fiscal and statistical report forms provided by the State Commissioner of Health.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.59 Prevention of influenza transmission by healthcare and residential facility and agency personnel
(a) Definitions.
(1) Personnel , for the purposes of this section, shall mean all persons employed or affiliated with a healthcare or residential facility or agency, whether paid or unpaid, including but not limited to employees, members of the medical and nursing staff, contract staff, students, and volunteers, who engage in activities such that if they were infected with influenza, they could potentially expose patients or residents to the disease.
(2) Healthcare and residential facilities and agencies , for the purposes of this section, shall include:
(i) any facility or institution included in the definition of hospital in section 2801 of the Public Health Law, including but not limited to general hospitals, nursing homes, and diagnostic and treatment centers;
(ii) any agency established pursuant to article 36 of the Public Health Law, including but not limited to certified home health agencies, long term home health care programs, acquired immune deficiency syndrome (AIDS) home care programs, licensed home care service agencies, and limited licensed home care service agencies; and
(iii) hospices as defined in section 4002 of the Public Health Law.
(3) Influenza season , for the purposes of this section, shall mean the period of time during which influenza is prevalent as determined by the commissioner.
(4) Patient or resident, for the purposes of this section, shall mean any person receiving services from a healthcare or residential facility or agency, including but not limited to inpatients and outpatients, overnight residents, adult day health care participants, and home care and hospice patients, as well as any person presenting for registration or admission at a healthcare or residential facility or agency.
(5) Influenza vaccine or vaccine, for the purposes of this section, means a vaccine currently licensed for immunization and distribution in the United States by the Food and Drug Administration (FDA), for active immunization for the prevention of influenza disease caused by influenza virus(es), or authorized for such use by the FDA pursuant to an Emergency Use Authorization (EUA) or as an Emergency Investigational New Drug (EIND).
(b) All healthcare and residential facilities and agencies shall determine and document which persons qualify as personnel under this section.
(c) All healthcare and residential facilities and agencies shall document the influenza vaccination status of all personnel for the current influenza season in each individual’s personnel record or other appropriate record. Documentation of vaccination must include:
(1) a document, prepared by the licensed healthcare practitioner who administered the vaccine, indicating that one dose of influenza vaccine was administered, and specifying the vaccine formulation and the date of administration; or
(2) for personnel employed by a healthcare employer other than the healthcare or residential facility or agency in which he or she is providing service, an attestation by the employer that the employee(s) named in the attestation have been vaccinated against influenza for the current influenza season, and that the healthcare employer maintains documentation of vaccination of those employees, as described in paragraph (1) of this subdivision; or
(3) for student personnel, an attestation by the professional school that the student(s) named in the attestation have been vaccinated against influenza for the current influenza season, and that the school maintains documentation of vaccination of those students, as described in paragraph (1) of this subdivision.
(d) During the influenza season, all healthcare and residential facilities and agencies shall ensure that all personnel not vaccinated against influenza for the current influenza season wear a surgical or procedure mask while in areas where patients or residents are typically present, except that:
(1) when personnel provide services outside the home of a patient or resident, and not inside a healthcare or residential facility, mask wear shall not be required by this section, provided that this paragraph shall not be interpreted as eliminating any requirement that personnel wear a mask pursuant to standard and transmission-based precautions not addressed by this section;
(2) personnel required to wear a mask by this subdivision, but who provide speech therapy services, may remove the mask when necessary to deliver care, such as when modeling speech; and
(3) for any person who lip reads, personnel required to wear a mask by this subdivision may remove the mask when necessary for communication.
(e) Upon the request of the department, a healthcare or residential facility or agency must report the number and percentage of personnel that have been vaccinated against influenza for the current influenza season.
(f) All healthcare and residential facilities and agencies shall develop and implement a policy and procedure to ensure compliance with the provisions of this section. The policy and procedure shall include, but is not limited to, identification of those areas where unvaccinated personnel must wear a mask pursuant to subdivision (d) of this section.
(g) Healthcare and residential facilities and agencies shall supply surgical or procedure masks required by this section at no cost to personnel.
(h) Nothing in this section shall be interpreted as prohibiting any healthcare or residential facility or agency from adopting policies that are more stringent than the requirements of this section.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.100 Licensing requirements for use of radioactive materials
(a) A person may manufacture, produce, acquire, receive, possess, prepare, use or transfer any radioactive materials only in accordance with a specific license issued by the department or as allowed in subdivision (b) or (c) of this section.
(b) A specific license is not required for persons who comply with all applicable requirements for a general license as set forth in section 16.101 of this Part.
(c) A specific license is not required for persons who comply with all applicable requirements to qualify for an exemption as set forth in section 16.4 of this Part or other exemptions provided for in this Part or for the removal of source material from its place of deposit in nature.
Part 12 MATERNAL AND CHILD HEALTH
PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS
10 CRR-NY 12.13 Determination of blood group and Rh type and administration of Rh immune globulin
(a) It shall be the duty of the physician, licensed midwife or nurse practitioner attending a pregnant woman to take or cause to be taken a sample of her blood at the time of first examination or if this has not been done, as soon thereafter as practicable and prior to the time of delivery or other termination of pregnancy, whether induced or spontaneous. If the sample has not been taken and the pregnancy terminates as a result of an emergency, it shall be taken at the time of termination of pregnancy. Such sample shall be submitted to an approved laboratory for the determination of blood group and Rh type.
(b) It shall further be the duty of the attending physician, licensed midwife or nurse practitioner to evaluate every such patient for the risk of sensitization to Rho (D) antigen and if the use of Rh immune globulin is indicated, and the patient consents, to cause an appropriate dosage thereof to be administered to her as soon as possible within 72 hours after delivery or other termination of pregnancy, whether induced or spontaneous.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.78 Current assets
Unrestricted cash, or other assets held for conversion within one year into cash or other readily convertible asset, or currently useful goods or services. The five customary subdivisions of current assets are cash, temporary investments, receivables, inventory, and prepaid expenses.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.9 Units of service
(a) The unit of service used to establish rates of payment shall be the threshold visit, except for dialysis, abortion, sterilization services and free-standing ambulatory surgery, for which rates of payment shall be established for each procedure. For methadone maintenance treatment services, the rate of payment shall be established on a fixed weekly basis per recipient.
(b) A threshold visit, including all part-time clinic visits, shall occur each time a patient crosses the threshold of a facility to receive medical care without regard to the number of services provided during that visit. Only one threshold visit per patient per day shall be allowable for reimbursement purposes, except for transfusion services to hemophiliacs, in which case each transfusion visit shall constitute an allowable threshold visit.
(c) The following shall not constitute threshold visits within the meaning of subdivisions (a) and (b) of this section:
(1) visits solely for the purpose of receiving ordered ambulatory services;
(2) visits solely for the purpose of receiving pharmacy services;
(3) visits solely for the purpose of receiving nutrition services;
(4) visits solely for the purpose of receiving respiratory therapy;
(5) visits solely for the purpose of receiving recreation therapy;
(6) visits solely for the purpose of receiving medical social services, except for clinical social worker psychotherapy services as defined in subdivision (g) of this section;
(7) visits solely for the purpose of receiving group services, except for clinical group psychotherapy services in accordance with the provisions of subdivision (h) of this section;
(8) offsite services, defined as medical services provided by a facility's clinic staff at locations other than those operated by and under the licensure of the facility, or visits related to the provision of such offsite services, except in accordance with the provisions of subdivision (i) of this section.
(d) A procedure shall include the total service, including the initial visit, preparatory visits, the actual procedure and follow-up visits related to the procedure. All visits related to a procedure, regardless of number, shall be part of one procedure and shall not be reported as a threshold visit.
(e) Rates for separate components of a procedure may be established when patients are unable to utilize all of the services covered by a procedure rate. No separate component rates shall be established unless the facility includes in its annual financial and statistical reports the statistical and cost apportionments necessary to determine the component rates.
(f) Ordered ambulatory services may be covered and reimbursed on a fee-for-service basis in accordance with the State medical fee schedule. Ordered ambulatory services are specified services provided to nonregistered clinic patients at the facility, upon the order and referral of a physician, physician's assistant, dentist or podiatrist who is not employed by or under contract with the clinic, to test, diagnose or treat the patient. Ordered ambulatory services include laboratory services, diagnostic radiology services, pharmacy services, ultrasound services, rehabilitation therapy, diagnostic services and psychological evaluation services.
(g) For purposes of this section, clinical social worker psychotherapy services are defined as individual psychotherapy services provided in a federally qualified health center, by a licensed clinical social worker or by a licensed master social worker who is working in a clinic under qualifying supervision in pursuit of licensed clinical social worker status by the New York State Education Department.
(h) Clinical group psychotherapy services provided in a federally qualified health center, ( FQHC ) are defined as services performed by a clinician qualified as in subdivision (g) of this section, or by a licensed psychiatrist or psychologist to groups of patients ranging in size from two to eight patients. Clinical group psychotherapy shall not include case management services. Reimbursement for these services shall be made on the basis of a FQHC group rate which will be calculated by the department for this specific purpose, payable for each individual up to the limits set forth herein, using elements of the resource based relative value system (RBRVS) promulgated by the Centers for Medicare and Medicaid Services (CMS), and approved by the State Division of Budget.
(i) Federally qualified health centers will be reimbursed for the provision of offsite primary care services to existing FQHC patients in need of professional services available at the FQHC, but, due to the individual's medical condition, is unable to receive the services on the premises of the center.
(1) FQHC offsite services must:
(i) consist of services normally rendered at the FQHC site;
(ii) be rendered to an FQHC patient with a pre-existing relationship with the FQHC ( i.e., the patient was previously registered as a patient with the FQHC) in order to allow the FQHC to render continuous care when their patient is too ill to receive on-site services, and only to patients expected to recover and return to become an on-site patient again. Off-site services may not be billed for patients whose health status is expected to permanently preclude return to on-site status;
(iii) be rendered only for the duration of the limiting illness, with the intent that the patient return to regular treatment as an on-site patient as soon as their medical condition allows;
(iv) be an individual medical service rendered to an FQHC patient by a physician, physician assistant, midwife or nurse practitioner;
(v) not be rendered in a nursing facility or long-term care facility, to any patient expected to remain a patient in that facility or at that level of care;
(vi) not be billed in conjunction with any other professional fee for that service, or on the same day as a threshold visit.
(2) Reimbursement for these services shall be made on the basis of an FQHC offsite professional rate, which will be calculated by the department using elements of the resource based relative value system (RBRVS) promulgated by the Centers for Medicare and Medicaid Services (CMS) and approved by the State Division of Budget.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.20 Operator and operating records
(a) Each spray ground shall be maintained by an operator familiar with its equipment. The operator shall comply with the regulations in this Subpart and any conditions of the permit.
(b) All spray grounds shall be maintained by a qualified swimming pool water treatment operator.
(c) Complete daily operation records shall be kept of the operation of each spray pad on forms approved or furnished by the State Commissioner of Health. Upon completion, a copy of such records shall be maintained at the facility for 12 months. The permit-issuing official may require submission of reports at periodic intervals.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.10 Operating revenue—ambulatory services
[3212] This group of accounts (3710 - 3990) is used to report the gross revenue, measured in terms of the hospital's full established rates, earned from ambulatory services. The essential characteristic distinguishing ambulatory services is that patients arrive at a facility of the hospital for a purpose other than admission as an inpatient. For reporting purposes, ambulatory services also include ambulance, free-standing clinic, and home health services.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 454 FUNCTIONAL REPORTING
10 CRR-NY 454.4 Listing of functional reporting centers and standard units of measure
(a) The listing which follows shows each functional center and related standard unit of measure that are mandated levels of reporting for this Article. The standard units of measure are required to be reported for all functional reporting centers in which direct costs are reported. The specific definitions of each reporting center and related standard unit of measure, and the data source for its collection, are indicated in Part 455 of this Article.
(1) Non-Revenue Support Services
| | Functional Reporting Centers | Standard Unit of Measure | | --- | --- | --- | | (i) | Depreciation, Leases and Rentals | Square feet, gross | | (ii) | Depreciation on Major Movable Equipment | None | | (iii) | Interest on Capital Debt | Total operating expenses | | (iv) | Fiscal Services | Total operating expenses | | (v) | Administrative Services | Total operating expenses | | (vi) | Plant Operation and Maintenance | Square feet, net | | (vii) | Grounds | Square feet serviced | | (viii) | Security | None | | (ix) | Laundry and Linen | Dry and clean pounds processed | | (x) | Housekeeping | Square feet serviced | | (xi) | Patient Food Services | Dietary meals served | | (xii) | Cafeteria | Equivalent cafeteria meals served | | (xiii) | Nursing Administration | Average number of nursing department employees | | (xiv) | Activities Program | Total number of participants in program | | (xv) | Non-Physician Education | Number of students | | (xvi) | Medical Education | Number of students | | (xvii) | Medical Director's Office | None | | (xviii) | Housing | Average number of persons housed | | (xix) | Medical Records | None | | (xx) | Utilization Review | Number of cases reviewed | | (xxi) | Social Services | None | | (xxii) | Transportation | Number of trips |
(2) Ancillary Service Revenue Centers
| | Functional Reporting Center | Standard Unit of Measure | | --- | --- | --- | | (i) | Laboratory Services | CAP workload measurement unit | | (ii) | Electrocardiology | CAP workload measurement unit | | (iii) | Electroencephalogy | CAP workload measurement unit | | (iv) | Radiology | Relative value units | | (v) | Inhalation Therapy | Number of treatments | | (vi) | Podiatry | Number of visits | | (vii) | Dental | Number of visits | | (viii) | Psychiatric | Number of visits | | (ix) | Physical Therapy | Number of treatments | | (x) | Occupational Therapy | Number of treatments | | (xi) | Speech and Hearing Therapy | Number of treatments | | (xii) | Pharmacy | None | | (xiii) | Central Service Supply | None | | (xiv) | Medical Staff Services | None |
(3) Program Service Revenue Centers.
| (i) Inpatient. | | | --- | --- | | (a) Residential Health Care Facility | Patient days | | (b) Adult Care Facility | Patient days | | (c) Intermediate Care Facility Mental Retardation | Patient days | | (d) Independent Living | Patient days | | (e) Specialty Pediatric | Patient days | | (f) Head Injury | Patient days | | (g) Acquired Immune Deficiency Syndrome | | | (h) Long-Term Ventilator Dependent | Patient days | | (ii) Ambulatory and Other Care. | | | (a) Outpatient Clinics | Visits | | (b) Adult Day Health Care | Visits | | (c) Home Health | Number of home health visits | | (d) Homemaker | Number of homemaker visits | | (e) Meals on Wheels | Number of meals | | (iii) Research and Auxiliary Services. | | | (a) Research | None | | (b) Physicians' Offices and Other Rentals | None | | (c) Gift Shop | None | | (d) Public Restaurant | None | | (e) Fund Raising | None | | (f) Barber and Beauty Shop | | | (g) Sold Services | None |
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 150 TOMPKINS COUNTY
CITIES CITIES
10 CRR-NY 150.1 City of Ithaca
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs on Six Mile Creek and its tributaries which serve as sources of the public water supply of the city of Ithaca, Tompkins County, and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the city of Ithaca.
(2) The term reservoir means the 30 foot dam reservoir and the 60 foot dam reservoir, said bodies of water serving as sources of water supply of the city of Ithaca and shall include any additional reservoir which may be constructed or used for said water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry systems as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(7) For the purpose of graduating the severity of the subdivisions in their application to different parts of the drainage area so as to conform to the varying degrees of danger to the water supply, the drainage area is divided into the following zones:
(i) Zone I shall include all reservoirs of the public water supply of the city of Ithaca on Six Mile Creek and the drainage area tributary to said reservoirs and the streams entering them between the crest of the 30 foot dam and the intersection of Six Mile Creek with the western boundary of the town of Caroline west of the hamlet of Brooktondale.
(ii) Zone II shall include that portion of the drainage area tributary to the Six Mile Creek not included in zone I as above defined.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 300 feet from any reservoir or at a distance of not less than 150 feet from any watercourse in zone I or 100 feet from any watercourse in zone II and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse in zone I or within 25 feet of any watercourse in zone II, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the department of public works of the city of Ithaca and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 100 feet and 200 feet of any reservoir, between 50 feet and 100 feet of any watercourse in zone I or between 25 feet and 50 feet of any watercourse in zone II shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 150 feet of any reservoir or within 100 feet of any watercourse in zone I or within 50 feet of any watercourse in zone II, except into watertight receptacles, contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within 75 feet of any reservoir, within 50 feet of any watercourse in zone I or within 25 feet of any watercourse in zone II, provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Waste, refuse and garbage.
(1) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir, 40 feet of any watercourse in zone I or 20 feet of any watercourse in zone II.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir, 35 feet of any watercourse in zone I nor 20 feet of any watercourse in zone II nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or any watercourse in zone I.
(g) Fishing, boating or ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply, except by duly authorized employees of the city of Ithaca in the performance of their duties of supervision and maintenance of the water supply.
(h) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir and no watering place shall be maintained in such way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may pollute any reservoir or watercourse.
(3) No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir nor within 50 feet of any watercourse in zone I nor within 25 feet of any watercourse in zone II.
(i) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or within a distance of 150 feet of any watercourse in zone I or within 50 feet of any watercourse in zone II.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act though not heretofore specified which may result in contamination of any portion of the water supply.
(l) Inspections.
The department of public works of the city of Ithaca or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the city shall make regular and thorough inspections of the reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said department of public works to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violation. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said department of public works to promptly notify the State Commissioner of Health of such violations. The department of public works shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.11 Decisions, determinations and orders
(a) Unless precluded by statute, disposition of any finding of violation may be made by agreed settlement.
(b) Findings of fact shall be based upon the evidence, any matters officially noticed, and any oral or written explanations received.
(c) A written decision sustaining or dismissing the finding of violation shall be rendered by the tribunal representative promptly after the conclusion of a hearing. The decision, a copy of which will be served without delay on the respondent personally or by certified or registered mail, shall contain the findings of fact and, as applicable, orders issued and penalty assessed. The respondent shall also be notified in writing of the right to appeal the decision, as provided in section 76.13 of this Part.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.10 Surface drainage
An agricultural fairground owner shall ensure that an agricultural fairground is maintained so that adequate surface drainage is provided during its operation.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
VILLAGES VILLAGES
10 CRR-NY 148.2 Village of Monticello
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 72 of the Public Health Law heretofore set forth shall apply to the drainage areas of Kiamesha Lake and of all streams tributary thereto, and to Kiamesha Lake and to all streams and bodies of water which form or are tributary to the source of water supply of the village of Monticello, Sullivan County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to any natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter the public water supply of the village of Monticello.
(2) The term watercourse wherever used in this section is intended to mean and refer to any spring, stream, ditch, gutter or other watercourse of any kind, the waters of which when running, whether constantly or occasionally, eventually flow or may flow into the public water supply of the village of Monticello.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet of any reservoir or watercourse of the public water supply of the village of Monticello.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 150 feet of any reservoir or watercourse of the public water supply of the village of Monticello.
(3) Every privy, privy vault, pit, cesspool or other receptacle or place, used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 150 feet, horizontal measurement, of the water line of any reservoir or the edge, margin or precipitous bank of any watercourse of the public water supply of the village of Monticello, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 500 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 500 feet from the edge, margin or precipitous bank of any watercourse of the public water supply of the village of Monticello.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal of the garbage or wastes from any dump may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage nor excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the public water supply of the village of Monticello, nor shall any such matters be placed, led, discharged or allowed to escape onto the surface of the ground or into the ground below the surface within 500 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, house slops, bath water, kitchen or sink wastes, refuse or waste water from creameries, cheese factories, laundries nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the public water supply of the village of Monticello; nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the public water supply of the village of Monticello within 100 feet of any such reservoir or within 75 feet of any such watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the public water supply of the village of Monticello.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the public water supply of the village of Monticello, nor shall any animals or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor shall be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the public water supply of the village of Monticello; and none of the above named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 500 feet from any reservoir or watercourse of the public water supply of the village of Monticello; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the public water supply of the village of Monticello without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the public water supply of the village of Monticello; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(g) Fishing and boating and ice cutting.
(1) No fish shall be taken from any reservoir, nor shall any person fish in any reservoir or through the ice upon the same nor trespass upon the waters of any reservoir or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the board having charge of the public water supply of the village of Monticello in the exercise of their duties in the management and operation of the reservoirs.
(2) No person or persons shall cut or remove any ice from any of the reservoirs which form or are tributary to the sources of the public water supply of the village of Monticello, except as hereinafter provided. Upon written application to the board of water commissioners of Monticello or their duly authorized agents, a permit for the cutting of ice may be issued by said water commissioners or their duly authorized agents, provided the following conditions shall be stated in the permit and enforced by the water commissioners or their duly authorized agents.
(i) This permit shall allow ice cutting to be carried on at the lower or outlet end of Kiamesha Lake only, and no ice shall be cut at any point up the lake from a line which shall be marked out at right angles to the longer axis of the lake and 300 feet down stream from a point in the center line of the lake opposite the intake of the Monticello water supply nor within 500 feet of said intake.
(ii) No horses or other animals shall be allowed on the ice for the purpose of ice cutting or for other reasons.
(h) Cemeteries.
No interment of a human body shall be made within 50 feet of any watercourse or within 200 feet of any reservoir of the public water supply of the Village of Monticello.
(i) Inspections.
The board of water commissioners of the Village of Monticello, through its superintnedent or other duly authorized official, shall maintain systematic and thorough inspection of the reservoirs, streams and of the entire drainage area tributary thereto, for the purpose of determining whether the above rules are being complied with. At least six such inspections shall be made each year, and such others as may be directed by the State Commissioner of Health. A full and detailed report of each such inspection, including a statement of each violation or noncompliance with the rules, shall be submitted in writing to the State Commissioner of Health within 10 days of the completion of such inspection, and a duplicate copy of each report shall at the same time be furnished to the board of health of the Village of Monticello.
(j) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.7 Noncomplying regulated activities
(a) General requirements.
(1) A noncomplying regulated activity may be continued except where specifically prohibited from continuing by these rules and regulations.
(2) A noncomplying regulated activity shall come into compliance with these rules and regulations where specifically required to do so by these rules and regulations.
(3) Except where otherwise provided in these rules and regulations, no noncomplying regulated activity shall be substantially altered or modified without the prior review and approval of the department. The department shall review and approve such an alteration or modification in accordance with the standards and procedures set forth in Subpart 128-6 of this Part. However, a noncomplying regulated activity may be reduced in size or extent without such review and approval provided that such reduction does not cause any increase in any existing discharge or any increase in the potential for contamination to or degradation of the water supply. An application for a regulated activity to be located on a site with a noncomplying regulated activity, which does not involve a substantial alteration or modification of a noncomplying regulated activity, shall be reviewed in accordance with the standards for that regulated activity.
(4) In the event that any noncomplying regulated activity is discontinued for a period of one year or more, it shall permanently desist. However, a noncomplying regulated activity shall not be deemed discontinued in the following situations:
(i) seasonal use of a residence or business;
(ii) destruction of 75 percent or more of the market value of a noncomplying regulated activity and its related property, by flood, fire, or other natural disaster, provided that any replacement of a noncomplying regulated activity shall be identical in capacity, intensity, volume and type to the former noncomplying regulated activity and provided that such replacement shall take place within two years of such destruction, and provided further that such replacement shall comply with these rules and regulations, where possible; or
(iii) transfer, sale, or lease of a residence or business provided further that the noncomplying regulated activity is not changed to a different noncomplying regulated activity, unless approved by the department, and provided that such transfer, sale or lease occurs within three years of the offering for sale or lease of the residence or business.
(5) Should any noncomplying regulated activity cause contamination to or degradation of the water supply, such that the activity is a threat to the life, health, or safety of water supply users, the commissioner may order that such noncomplying regulated activity conform either in whole or in part to the requirements of these rules and regulations, immediately or within a limited period of time at the commissioner's discretion, or be discontinued immediately. Any person who receives such an order may request a hearing on such order in the manner provided in section 128-2.9 of this Subpart.
(6) Any owner or operator of a noncomplying regulated activity who was not required by these rules and regulations to notify the department pursuant to paragraph (b)(1) of this section, may request, in writing, a determination from the department that such property or activity is a noncomplying regulated activity. The written request shall include all of the information required in such paragraph. The department shall determine, based upon the submission, whether the property or activity is a noncomplying regulated activity, and shall notify the owner or operator of such determination in writing.
(b) Commercial, industrial, institutional or governmental noncomplying regulated activities.
(1) Commercial, industrial, institutional or governmental owners or operators of a noncomplying regulated activity shall notify the department, in writing, of the existence of the noncomplying regulated activity within one year of the effective date of these rules and regulations. The notification shall include a description of the noncomplying regulated activity and its location, and the name and telephone number of a contact person.
(2) The department shall publish a directory of all commercial, industrial, institutional or governmental noncomplying regulated activities located in the watershed based upon the information submitted pursuant to paragraph (1) of this subdivision, and any additional information available to the department.
(3) The directory shall be published in a newspaper of general circulation for two consecutive weekdays in each of two consecutive weeks.
(4) Within 60 days of the last date of such publication, any commercial, industrial, institutional, or governmental owner or operator of a noncomplying regulated activity shall notify the department in writing of any objection to the information set forth in the directory. Furthermore, any owner or operator of a noncomplying regulated activity shall notify the department in writing of the omission from the directory of his or her noncomplying regulated activity.
(5) Within 120 days of the last date of publication of the directory, the department shall publish a revised directory, in accordance with the procedures provided for in paragraph (3) of this subdivision.
(6) If, within five years of the effective date of these rules and regulations, a commercial, industrial, institutional or governmental owner or operator of a noncomplying regulated activity discovers that his or her property should have been included in the final directory and was not included, such owner or operator shall write to the department and request that the property be added to the directory. The request shall include all of the facts surrounding the omission from the listing and the reason why the property should be designated a noncomplying regulated activity, as well as all supporting documentary evidence, such as title searches, deeds, etc. Based upon the submission, the department shall determine whether to add the property to the directory and shall notify the petitioner in writing of its decision.
(7) Upon written notification by the department, a commercial, industrial, institutional, or governmental owner or operator of a noncomplying regulated activity may be required to submit any results of local, State or federally mandated or conducted tests or environmental audits. In addition, such owner or operator may be required to provide to the department copies of any reports or applications submitted to local, State and Federal agencies relating to the noncomplying regulated activity.
(8) Upon written notification by the department, a commercial, industrial, institutional, or governmental owner or operator of a noncomplying regulated activity may be required to submit, within 90 days of receipt of mailing, for review and approval by the department, a plan to protect the water supply from the potential for contamination or degradation posed by such activity. Such plan may include, but shall not be limited to, restriction or management of activities, use of best management practices, drainage control, development of procedures to address the potential contamination or degradation (including disposal procedures) and training of employees.
(i) The decisions whether to require submission of a plan and whether to approve a plan shall be based upon the risk of potential for contamination to or degradation of the water supply based upon such factors as: location, intensity of use, record of adequate maintenance and operation of any existing structure or facility, compliance with existing local, State, and Federal laws and rules and regulations, and the burden upon the noncomplying regulated activity.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.51 Environmental radiation protection; performance standards
The local health department shall maintain a program to conduct environmental radiation surveillance activities, if the department has authorized the local health department to conduct such a program. Such program shall, at a minimum, maintain appropriate equipment and supplies, ensure that personnel are properly trained, and collect environmental samples for radiological analysis.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.63 South Bay Consolidated Water Company, Inc. at Oakdale
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale, Suffolk County, New York.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid watertight receptacles shall be removed and the receptacles cleansed and disinfected as often as may be found necessary in order to maintain the privy or receptacle in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or receptacle to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such a manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health. It is provided, however, that no such watertight receptacle shall be within 100 feet nor any such watertight iron pipe shall be within 50 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale, except into watertight receptacles, the contents of which are removed and disposed of in the manner provided by paragraphs (4) and (5) of subdivision (c).
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, deposited or allowed to remain upon the surface of the ground nor shall such human excreta or compost or other matter containing human excreta be buried in the soil within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the South Bay Consolidated Water Company at Oakdale.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or maintained or allowed to remain upon the surface of the ground or beneath the surface within 300 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale nor shall any such matters be so placed or maintained that the washings therefrom may reach any well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Oakdale.
(i) Inspections.
The duly authorized officials of the South Bay Consolidated Water Company, Inc. or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.1 Telephone price disclosure
A funeral firm shall inform persons who call the firm's place of business and inquire about the terms, conditions or prices at which funeral goods or funeral services are offered, that price information is available over the telephone. A firm shall also inform such persons, who ask by telephone about the offerings or prices, of any accurate information from the price lists (general, casket or outer interment receptacle) or other readily available source which reasonably answers the question.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.84 Dry milk and dry milk products
Dry milk and dry milk products, if used, must be reconstituted in the establishment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.10 Severability
If any provision of this Subpart or its application to any person or circumstance is held to be invalid, the remainder of this Subpart and the application of that provision to other persons or circumstances will not be affected.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 620 INCORPORATIONS AND TRANSFERS OF PROPRIETARY BUSINESSES
10 CRR-NY 620.3 Transfers of stock
(a) An applicant who proposes to purchase stock in a business corporation, the transfer of the stock of which requires the approval of the Public Health Council, shall file an application for such approval in accordance with the requirements of Part 600 of this Subchapter, and in addition, the following documents:
(1) A copy of the document giving approval for the incorporation of the hospital business.
(2) An affidavit from each applicant setting forth:
(i) that he is to be the sole beneficial owner of the voting shares of the corporation of which he is to be the holder of record; and
(ii) the number of voting shares of the corporation of which he is to be the holder of record.
(3) An affidavit from the seller of the stock setting forth his name and address and stating that:
(i) He was authorized by the aforesaid document to own 10 percent or more of the stock of the corporation or that he was authorized by the Public Health Council to acquire ownership of 10 percent or more of the stock of the corporation.
(ii) The number of voting shares of the corporation which he proposes to transfer to the applicant.
(iii) The purchase price of the shares to be transferred to the applicant.
(4) The financial resources available for the acquisition of the stock to be transferred, or the basis on which such transfer is to be financed.
(5) If such transfer of stock is to be by gift, a statement of the relationship between the donor and donee.
(6) Such additional pertinent information or documents necessary for the council's consideration, as requested.
(7) Any transfer, assignment or other disposition of 10 percent or more of the stock or voting rights thereunder to the corporation, or any transfer, assignment or other disposition of the stock or voting rights thereunder which results in the ownership or control of more than 10 percent of the stock or voting rights thereunder by the corporation, or any transfer, assignment or other disposition of 10 percent or more of the stock or voting rights thereunder by the corporation shall be subject to approval by the Public Health Council in accordance with the requirements of Part 600 of this Subchapter and the requirements of this section.
(b) In addition to meeting the applicable requirements of subdivision (a) of this section, an application, requiring Public Health Council approval, which involves a transfer of less than 20 percent of the stock of a corporation shall be processed follows:
(1) The local health systems agency may waive review, but, if such review is not waived, it shall make its recommendation within 90 days from the date a complete application is received by the department.
(2) The department shall process an application subject to this subdivision and submit it to the State Hospital Review and Planning Council for a recommendation and to the Public Health Council for a decision within 150 days from the date a complete application is received by the department, provided that such time period may be extended for a time not to exceed the time the department awaited a response from the applicant to requests for additional documentation and information. The Public Health Council shall act on the application within the same such time period. If the Public Health Council defers the application, the council shall advise the applicant in writing of the reasons for such deferral. A deferred application shall be returned to the Public Health Council, and the council shall propose to approve or disapprove such application no later than the second council meeting following the meeting at which the application was deferred.
(3) In accordance with subdivision (4) of section 2801-a of the Public Health Law, an application solely for a transfer of stock in an existing established corporation shall not be subject to a public need review.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.7 Grounds
This functional reporting center must contain all the expenses associated with the maintenance of grounds of the facility, including landscaped and paved areas, streets on the property, sidewalks, fenced areas and fencing, external recreation areas and parking facilities ( e.g., lawn care, repairs and snow removal).
(a) Standard unit of measure: square feet serviced.
Measurement should be of the outer dimensions of the residential health care facility property and should only include grounds which are maintained. Wooded grounds which are not maintained would not be included. When changes occur during the year as a result of purchase, sale or receipt of donated property, data should be maintained to allow for the development of weighted areas for the fractional part of the year.
(b) Data source.
Square feet of grounds shall be determined from the deeds held by the residential health care facility or actual measurement. Square feet serviced should then be determined by the grounds department.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 111 DELAWARE COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 111.11 Bloomville Water District, Town of Kortwright
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the wells which comprise the source of the public water supply of the Bloomville Water District. Said springs are located on land utilized but not necessarily owned by the Bloomville Water District and are situated between Delaware County Road 33 and Bloomville Hill Road in the Town of Kortwright. Said well is located along Bloomville Hill Road approximately 200 feet north of Gregory Hill Road in the Town of Kortwright.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the well or springs.
(7) Manure shall mean animal feces and urine.
(8) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(9) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(10) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(11) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(12) Refuse disposal area shall mean land used for the depositing of refuse, except that is shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(13) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(14) Sewage disposal system shall mean any system used for disposing of sewage.
(15) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(16) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(17) Water supply shall mean the public water supply of the Bloomville Water District.
(18) Well or springs shall mean the well and springs now used as a source of this water supply or any additional well or spring which may be constructed at these locations as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title, or which may otherwise result in a significant deleterious effect on the water quality of the well or springs.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well or springs.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well or springs except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well and 220-foot linear distance of the springs. Pesticides and herbicides shall not be applied in the area beyond a 220-foot linear distance of the springs but within a 500-foot linear distance of the springs unless such application is first approved by the Town of Kortwright for such use.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the well or springs.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the well or springs.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the well or springs, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipes shall be located within a 15-foot linear distance of the well or springs.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the well or springs.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well or springs and not within a 500-foot to 1,000-foot linear distance of the well or springs unless authorization has been obtained from the appropriate State agency and such burial is in accordance with Part 16 of this Title.
(7) Refuse.
No refuse, including manure, shall be deposited on or beneath the surface of ground within a 220-foot linear distance of the well or springs.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the well or springs.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the well or springs, except as otherwise permitted under the provisions of subparagraph (4)(iii) of this subdivision.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Bloomville Water District upon which the well and springs are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Kortwright Town Board.
(e) Inspections.
The Kortwright Town Board or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representatives, make regular and thorough inspections of the area surrounding the well and springs to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with the provisions of section 1102 of the Public Health Law. The aforesaid town board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the well and springs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.7 Injury and illness incident reporting
A full report of any injury or illness incident occurring at a swimming pool shall be reported by the pool owner/operator to the permit-issuing official within 24 hours of its occurrence, and a notation recorded in a log book. This shall include all incidents occurring at a bathing facility which: (a) result in death; (b) require resuscitation; (c) require referral to a hospital or other facility for medical attention; or (d) is a bather illness associated with bathing water quality.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.6 Denial of applications for registration; suspension or revocation of registrations
(a) The department may deny the issuance of a registration, revoke or suspend the registration of a shared health facility upon one or more of the following grounds:
(1) a finding by the department that false information was submitted as part of the application;
(2) a finding of fraudulent practices on the part of any of the facility's providers or purveyors;
(3) a finding by the department that the facility is not in substantial compliance with the minimum physical or environmental standards for shared health facilities as set forth in this Part, provided, however, that a provisional registration may be issued to a facility operating prior to September 1, 1977, which is not in substantial compliance with these regulations when the condition of the premises does not constitute an immediate danger to the public health; the physical deficiencies are capable of correction within a set period of time; and the applicant or applicants warrant that the specified deficiencies will be corrected within that period;
(4) a finding by the department that the facility has failed to comply with the rules and regulations set forth in this Part;
(5) a finding by the department that any individual having a direct or indirect interest in the facility operation or business, or the manager or administrator of such facility is not of the requisite good moral character:
(i) no application for registration shall be denied solely on the basis that an individual has been convicted of a crime without consideration having been given to:
(a) the public policy of the State to encourage the licensure and employment of persons previously convicted of one or more criminal offenses;
(b) the specific duties and responsibilities necessarily related to the operation of a shared health facility;
(c) the bearing, if any, the criminal offense or offenses for which the person was previously convicted will have on his fitness or ability to perform one or more of such duties and responsibilities;
(d) the time which has elapsed since the occurrence of the criminal offense or offenses;
(e) the age of the person at the time of occurrence of the criminal offense or offenses;
(f) the seriousness of the offense or offenses;
(g) any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct; and
(h) the legitimate interest of the department in preventing abuses in shared health facilities and in ensuring the quality, continuity and coordination of medical care provided in such facilities.
(ii) In making a determination as to the moral character of any such person, the department shall also give consideration to a certificate of relief from disabilities or a certificate of good conduct issued to such person, which certificate shall create a presumption of rehabilitation in regard to the offense or offenses specified therein.
(b) Upon denial of an application for registration, the applicant will be notified by the department of the denial, the basis for the denial, and will be afforded an opportunity for a hearing. A request for a hearing must be made within 15 days of the notice of denial. All hearings under this section will be conducted in accordance with the procedures set forth in paragraphs (2) and (3) of this subdivision:
(1) The registration of a shared health facility shall be suspended or revoked, pursuant to a hearing as further described in paragraphs (2) and (3) of this subdivision; provided, however, that a registration may be suspended or limited for a period not in excess of 30 days upon written notice to the shared health facility operator following a determination by the commissioner that the public health or safety is in imminent danger.
(2) A notice of hearing which sets forth the time, place and nature of the hearing; the legal authority and jurisdiction under which the hearing is to be held; a reference to the particular sections of the statutes and rules involved; and a short and plain statement of the matters asserted shall be served in person or mailed by certified mail to the facility at least 21 days before the date fixed for the hearing. The shared health facility shall file with the department, not less than eight days prior to the hearing, a written answer to the charges.
(3) Hearings shall be conducted in accordance with section 12-a of the Public Health Law and pursuant to the provisions of the State Administrative Procedure Act by the commissioner or by a hearing officer appointed by the commissioner. The hearing officer shall not determine, but shall submit his report to the commissioner setting forth his findings of facts, his conclusions and his recommendations.
(4) Final appropriate action shall be taken upon waiver of the right to a hearing by the shared health facility operator or upon failure by the operator of a shared health facility to appear at a hearing
(5) All orders or determinations hereunder shall be subject to review as provided in article 78 of the Civil Practice Law and Rules. Application for such review must be made within 60 days after service in person or by certified mail of a copy of the order or determination upon the applicant.
(6) Any shared health facility provider or purveyor who violates any provision of article 47 of the Public Health Law pertaining to shared health facilities or of this Part may, subject to the review and hearing procedures specified in 18 NYCRR Part 515, be barred from collecting any payments under the program from the date such violation occurs.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.7 Engineering report
All applications for a permit to conduct a mass gathering shall be accompanied by an engineering report containing the following information:
(a) The name, age, residence, mailing address and telephone number of the applicant; a statement of the applicant's legal status, such as individual, partnership, corporation, etc. If the applicant is a partnership, state the names and addresses, etc. of all partners; and if a corporation, the names and addresses of all corporate officers and stockholders, together with a certified copy of the articles of incorporation and a list of the names and addresses of all persons directly in charge of the activity.
(b) The location and legal description of the property where the activity is proposed, including all lands to be used directly, indirectly or incidental to the proposed activity or any part thereof; attaching to the application certified copies of documents disclosing the nature of the interest of the applicant relating to such property.
(c) The date or dates and the hours during which the activity, including travel time, is to be conducted and the total time period.
(d) The program and plans of the activity in its entirety, specifying:
(1) detailed plans for parking facilities off public roadways able to serve all reasonable anticipated requirements at a rate of up to 100 passenger cars per acre or 30 buses per acre;
(2) detailed plans for transportation arrangements from noncontiguous parking facilities to the site to fully serve all reasonably anticipated requirements at a rate of no less than 20,000 persons per hour; including a statement from the county sheriff, State police, New York State Department of Transportation or other law enforcement agency certifying that the traffic control plan is satisfactory;
(3) an outline map of the area to be used, to an appropriate scale, showing the location of all privies or toilets and handwashing facilities, all water supply sources (lakes, ponds, streams, wells, storage tanks, etc.), all areas of assemblage, including separate overnight camping areas for sleeping, all food service areas and all refuse storage handling and disposal areas, and emergency access and egress roads;
(4) the total number of persons permitted at the event, including performers, staff members and audience, which shall be determined by providing a net assembly area of at least 50 square feet per person in addition to providing at least 50 square feet per person in a separate camping area for 50 percent of the population;
(5) a plan for limiting attendance, including methods of entering the area, number and location of ticket booths and entrances, and provisions for keeping nonticket holders out of the area;
(6) a statement agreeing to complete all construction and installation of services and facilities including water supply, toilet and handwashing facilities, sewage disposal, roads, food service equipment and refuse handling facilities, and all work for noxious weed and insect control, at least 48 hours prior to the commencement of the event;
(7) a detailed plan for food service, including a description of food sources, menu, mandatory use of single-service dishes and utensils, refrigeration, food handling and dispensing in compliance with Part 14 of this Title;
(8) a detailed plan for use of signs to locate all facilities and roadways;
(9) a statement from local fire authorities having jurisdiction over the area verifying that they are aware of the event and are willing to cooperate if needed;
(10) a detailed plan for emergency situations, including:
(i) food supplies;
(ii) medical supplies, facilities and personnel;
(iii) an evacuation plan; and
(iv) emergency access roads;
(11) a statement from the local civil defense director indicating that he/she has been advised of the event and has approved the plan from a civil defense standpoint;
(12) a command post to be used by State Department of Health personnel and/or the permit-issuing official and his lawful representatives, consisting of a minimum of one building or trailer equipped with a communication system satisfactory to the permit-issuing official;
(13) a statement that, if adult mosquito and biting fly populations are found to be in excess of 15 specimens per trap/night, the applicant agrees to arrange for proper adult mosquito control measures to be instituted no earlier than 72 hours nor later than 48 hours before the advertised start of the gathering in order to reduce such populations to a satisfactory level;
(14) a detailed plan for elimination of noxious weeds 48 hours before commencement of the mass gathering;
(15) detailed plans for security enforcement, including prevention of the unlawful use of alcohol, narcotics or dangerous drugs at the site, methods for limiting the size of the proposed function to the number of participants for which the facilities are designed, and external as well as internal crowd control, including sufficient guards for crowd control and security enforcement; and
(16) a letter or other written document from the appropriate municipal official certifying that the proposed mass gathering site conforms with applicable municipal zoning and planning regulations.
(e) The location and construction of toilet and handwashing facilities designed to serve fully all reasonably anticipated requirements at a rate of no more than 100 persons per toilet seat and 750 persons per handwashing facility, 50 percent of the male toilets to be urinals, and plans for construction and reports, including copies of all rental and service contracts, showing that the construction and operation constitute no threat of pollution to surface or underground water locations, to be attached.
(f) The location and construction of water supply facilities, designed to serve fully all reasonably anticipated requirements at a rate of one pint of potable water per person, per hour, for the maximum estimated hourly attendance. One tap and one drinking fountain shall be provided per 1,000 persons and shall be separately located with adequate soakage pits or drainage. Detailed plans for approval by the permit-issuing official, showing that the water supply meets Part 5 of this Title and laboratory results of both bacteriological and chemical analyses of all new water supply sources, shall be attached.
(g) Detailed plans for internal storage and collection of refuse, including provisions for disposal and cleaning the property and immediate surrounding properties within 48 hours after the event.
(h) Detailed plans for emergency first aid to serve fully all reasonably anticipated requirements. Such plans shall state the arrangements made with hospitals and ambulances in the area, including names and locations, the number of doctors and nurses at the site and on call, and arrangements made with all other medical personnel and facilities, either at the site or on call.
(i) Detailed plans for amplifying equipment designed to control the noise level at the perimeter of the site to no more than 70 decibels on the A scale of a sound level meter which meets the specifications of the American National Standards Institute.
(j) Detailed plans for lighting designed to illuminate the public areas of the site at all times and demonstrating that the lighting will not reflect on any area beyond the boundary of said site.
(k) A plan showing that the proposed activity is adequately buffered from all residential areas within 500 feet.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.25 Distribution of free samples
(a) It shall be unlawful to distribute free samples of controlled substances except by licensees licensed under this Part to persons licensed by the department for research, instructional activities or chemical analysis.
(b) No such distribution shall be made without giving prior notice to the department regarding the proposed manner of distribution and the names of those persons to whom such distribution will be made. A record of all such distributions shall be made.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.19 Timing differences
[ 1390 ]
(a) Timing differences result when accounting policies and practices used in an organization's accounting differ from those used for reporting operations to governmental units collecting taxes or to outside agencies making payments based upon the reported operations. These differences must be recorded on the hospital's records when they arise. The references relative to their acceptable accounting treatment are as follows:
—Income tax allocation— Accounting Principles Board Opinions Nos. 11, 23 and 24.
(b) The following condensed income statement illustrates a timing difference attributable to different methods of calculating depreciation expense for financial accounting versus tax or third-party reimbursement purposes.
(1) Assumptions:
(i) Depreciation for accounting purposes is calculated on the straight-line method and amounts to $10 for the current year.
(ii) Depreciation for tax and third-party reimbursement purposes is calculated on a declining balance method and amounts to $20 for the current year.
(iii) The tax rate is 40 percent.
(iv) The third-party utilization is 50 percent.
(v) The only deduction from revenue is the contractual allowance.
(2) Income statement.
| | Accounting records | Tax/third-party cost report | | --- | --- | --- | | Revenue | $180 | $180 | | Deductions from Revenue | 30 | 25 | | Net Revenue | $150 | $155 | | Expenses (excluding depreciation) | 110 | 110 | | Depreciation | 10 | 20 | | Total Expenses before Taxes | $120 | $130 | | Income before Taxes | 30 | 25 | | Taxes | 12 | 10 | | Net Income | $ 18 | $ 15 |
(3) The income tax expense is comprised of three components:
$10 currently payable and $4 payable in future periods representing the tax effect of the difference between depreciation expense for accounting and tax purposes (40% × $10 = $4), and $2 to be applied against tax liabilities in future periods, representing the tax effect relative to reimbursement caused by the difference between depreciation for accounting purposes and cost report purposes, computed as follows: 40% (tax effect) × 50% (third-party utilization) × $10 (difference between depreciation for accounting and cost report purposes) = $2 or, stated another way, it is the difference between the deductions from revenue per the accounting records ($30) and the Tax/Cost Report Records ($25) times the tax rate of 40%.
(4) The journal entry to record these items is:
| | Account | Dr. | Cr. | | --- | --- | --- | --- | | Provision for income taxes-Federal-current | 9411 | $10 | | | Provision for income taxes-Federal-deferred | 9412 | 2 | | | Income taxes payable | 2090 | | $10 | | Deferred income taxes payable | 2120 | | 2 |
(5) The deduction from revenue (contractual adjustments) is calculated as follows:
(i) Calculation.
| | Accounting records | Tax/cost report | | --- | --- | --- | | Medicare revenue ($180 × 50%) | $90 | $90 | | Reimbursable costs: | | | | $120 × 50 | 60 | | | $130 × 50% | | 65 | | Contractual Adjustment | $30 | $25 |
(ii) Of the $30 contractual adjustment for accounting purposes, $25 is the current portion and $5 is the deferred portion.
(6) The journal entry to record this expense is:
| | Account | Dr. | Cr. | | --- | --- | --- | --- | | Contractual adjustment-Medicare | 5910 | $30 | | | Allowance for contractual adjustments-Medicare | 1042 | | $25 | | Deferred revenue-Medicare | 2131 | | 5 |
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 700 GENERAL
10 CRR-NY 700.5 Commissioner authority to suspend and modify regulations
During the period of a State disaster emergency declared pursuant to section 28 of the Executive Law, the State Commissioner of Health or their designee may suspend or modify any provision, of parts thereof, of this subdivision, that is not otherwise required by State statute or Federal law, if compliance with such provisions, or parts thereof, would prevent, hinder, or delay action necessary to cope with the State disaster emergency, or if necessary to assist or aid in coping with such disaster. Such suspension or modifications may include any modifications of regulation, exceptions, limitations or other conditions as the commissioner or their designee deems appropriate and necessary to respond to the disaster emergency. Provided, further, that should the Governor declare a State disaster emergency pursuant to section 28 of the Executive Law, which suspends or otherwise modifies State statutes pursuant to the Governor's authority under section 29-a of the Executive Law, the commissioner or their designee may suspend or modify any provision of any regulation that is consistent with the statutory authority as modified or suspended, for the period of such suspension or modification.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.9 Materiality
[ 1180 ] Materiality is an elusive concept with the dividing line between material and immaterial amounts subject to various interpretations. It is clear, however, that an amount is material if its exclusion from the financial statements would cause misleading or incorrect conclusions to be drawn by users of the statements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.4 Qualifications of laboratory supervisor
The laboratory supervisor must meet one of the following requirements:
(a) The supervisor is a physician licensed to practice medicine or osteopathy in the State of New York or an individual who has earned a doctoral degree from an accredited institution with a chemical, physical or biological science as his major subject ( accredited, as used herein, refers to accreditation by a nationally recognized accrediting agency or association, as determined by the United States Commissioner of Education). The supervisor shall, subsequent to graduation, have had at least two years' experience in one of the laboratory specialties in a clinical laboratory or blood bank having a director at the doctoral level. The clinical laboratory or blood bank shall be part of a hospital, a health department, university, medical research institution, or other institution which provides equivalent training.
(b) The supervisor holds a degree of master of arts or master of science from an accredited institution with a major in one of the chemical, physical or biological sciences and, subsequent to graduation, has had at least four years of pertinent laboratory experience of which not less than two years have been spent working in the designated laboratory specialty in a clinical laboratory having a director at the doctoral level. The clinical laboratory or blood bank shall be part of a hospital, a health department, university, medical research institution or other institution which provides equivalent training.
(c) The supervisor is qualified as a medical technologist pursuant to the provisions of section 58-1.5(b) of this Subpart and has had at least six years of pertinent clinical laboratory experience subsequent to qualifying of which at least two years have been spent working in a clinical laboratory having a director at the doctoral level. The clinical laboratory or blood bank shall be part of a hospital, university, health department, medical research institution or other institution which provides equivalent training.
(d) The supervisor is qualified as a cytotechnologist pursuant to the provisions of section 58-1.5(c) of this Subpart and subsequent to qualifying, has had at least four years of pertinent clinical laboratory experience in cytotechnology in a laboratory having a doctoral level director qualified in cytopathology. The clincial laboratory shall be part of a hospital, health department, university, medical research institution, or other institution which provides equivalent training.
(e) With respect to individuals first qualifying prior to April 1, 1972, an exception to the requirements in subdivision (a), (b) or (c) of this section may be made if:
(1) the supervisor was performing the duties of a clinical laboratory supervisor at any time between July 1, 1961 and September 1, 1971; and
(2) the supervisor has had at least 15 years of pertinent clinical laboratory experience prior to September 1, 1971: provided, that a minimum of 30 semester hours of credit toward a bachelor's degree with a chemical, physical or a biological science as his major subject; or 30 semester hours in an approved school of medical technology shall reduce the required years of experience by two years, with any additional hours further reducing the required years of experience at the rate of 15 hours for one year; and
(3) he has performed the duties of a supervisor for at least two years during the qualifying 15 years in:
(i) a clinical laboratory having a director at the doctoral level, of a hospital, university, health department or medical research institution; or
(ii) in a laboratory approved under the Medicare supplementary medical insurance program, provided also, that where qualifying years in a laboratory described in subparagraph (i) of this paragraph are obtained after January 30, 1969, the laboratory meets applicable conditions under the Medicare health insurance program, or, under title 42, Code of Federal Regulations, part 74, the latter being the regulations issued pursuant to the Federal Clinical Laboratories Improvement Act of 1967.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.1 Standards for regulated activities
(a) The following general standards apply to all regulated activities unless specifically noted otherwise, whether or not the regulated activity also requires the review and approval of the department. In addition, certain regulated activities must meet additional standards or procedures where specifically set forth in this Subpart or in other Subparts:
(1) All regulated activities shall be planned, designed, scheduled and conducted in such manner as to not constitute a source of contamination to or degradation of the water supply.
(2) The department shall base its review and approval of any regulated activity on compliance with these rules and regulations, including the water quality standards set forth in Subpart 128-4 of this Part, and shall additionally take into consideration the system specific water quality characteristics set forth in section 128-10.2 of this Part.
(3) The burden of demonstrating compliance with the requirements of these rules and regulations shall be on the person proposing to engage in a regulated activity. In the event that any person finds that compliance with any standard set forth in these rules and regulations is not possible, then she or he may apply for a variance in accordance with the provisions of Subpart 128-6 of this Part. Variances may be granted provided that the department makes the findings required by Subpart 128-6 of this Part.
(4) Failure to comply with the conditions of any approval issued by the department under these rules and regulations shall be a violation of these rules and regulations.
(5) The department may order that a regulated activity cease, and/or a facility where such regulated activity is taking place be closed or removed, if such regulated activity is causing contamination to or degradation of the water supply, such that the activity is a threat to the life, health, or safety of water supply users that requires immediate corrective action. Any person who receives such an order may request a hearing on such order in the manner provided in section 128-2.9 of this Subpart.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SANITARIAN PUBLIC HEALTH SANITARIAN
10 CRR-NY 11.111 Entry level qualifications
A public health sanitarian:
(a) must possess a baccalaureate degree from a regionally accredited or New York State-registered college or university with 30 credit hours in the natural sciences of which not more than 12 credit hours may be in the applied sciences, and have satisfactorily completed a public health training course approved by the State Health Department within two years of appointment; or
(b) may be a public health technician who possesses five years of experience as a public health technician deemed satisfactory by the local commissioner of health or public health director and have satisfactorily completed a public health training course approved by the State Health Department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
BALANCE SHEETS BALANCE SHEETS
10 CRR-NY 444.4 UNRESTRICTED FUND LIABILITIES
[ 3130 ]
(a) CURRENT LIABILITIES.
[ 3131 ]
(1) 2010
NOTES AND LOANS PAYABLE
2011
Notes and Loans Payable — Vendors
2012
Notes and Loans Payable — Banks
2013
Current Portion of Long-Term Debt
2019
Other Notes and Loans Payable
These accounts reflect liabilities of the hospital to vendors, banks and others, evidenced by promissory notes due and payable within one year.
(2) 2020
ACCOUNTS PAYABLE
2021
Trade Payables
2029
Other Accounts Payable
The balance of these account must reflect the amounts due trade creditors and others for supplies and services purchased.
(3) 2030
ACCRUED COMPENSATION AND RELATED
LIABILITIES
2031
Accrued Payroll
2032
Accrued Vacation, Holiday and Sick Pay
2033
Other Accrued Salaries and Wages Payable
2034
Non-Paid Workers Services Payable
2035
Federal Income Taxes Withheld
2036
Social Security Taxes Withheld and Accrued
2037
State Income Taxes Withheld
2038
Local Income Taxes Withheld
2039
Unemployment Taxes Payable
2041
Accrued Hospitalization Insurance Premiums
2042
Union Dues Payable
2049
Other Payroll Taxes and Deductions Payable
The balances of these accounts reflect the actual or estimated liabilities of the hospital for salaries and wages payable, as well as related amounts payable for payroll taxes withheld from salaries and wages, payroll taxes to be paid by the hospital, and other payroll deductions, such as hospitalization insurance premiums. Non-Paid Worker Services Payable (account 2034) refers to amounts payable to Motherhouses, etc., for the services of nonpaid workers.
(4) 2050
OTHER ACCRUED EXPENSES
2051
Interest Payable
2052
Rent Payable
2053
Property Taxes Payable
2054
Fees Payable — Medical Specialists
2055
Fees Payable — Other
2059
Other Accrued Expenses Payable
These accounts include the amounts of those current liabilities that have accumulated at the end of the month or accounting period because of expenses, incurred up to that time.
(5) 2060
ADVANCES FROM THIRD-PARTY PAYORS
2061
Advances — Medicare
2062
Advances — Medicaid
2063
Advances — Blue Cross
2069
Advances — Other
Include in these accounts liabilities to third-party payors for current financing and other types of advances due and payable within one year.
Do not include liabilities to third-party payors arising from reimbursement settlements. Such liabilities must be included in account 2070 — Payable to Third-Party Payors.
(6) 2070
PAYABLE TO THIRD-PARTY PAYORS
2071
Reimbursement Settlement Due — Medicare
2072
Reimbursement Settlement Due — Medicaid
2073
Reimbursement Settlement Due — Blue Cross
2079
Reimbursement Settlement Due — Other
These accounts reflect reimbursement settlements due to third-party payors. Separate sub-accounts may be maintained within each account for each year's settlement included.
(7) 2080
DUE TO OTHER FUNDS
2082
Due to Board-Designated Assets
2083
Due to Plant Replacement and Expansion Fund
2084
Due to Specific Purpose Fund
2085
Due to Endowment Fund
These accounts reflect the amounts due to other funds by the Operating Fund. Under no circumstances should these accounts be construed as payables in the sense that an obligation external to the hospital exists.
(8) 2090
INCOME TAXES PAYABLE
2091
Federal Income Taxes Payable
2092
State Income Taxes Payable
2093
Local Income Taxes Payable
Include in these accounts the amount of current income taxes payable.
(9) 2110
OTHER CURRENT LIABILITIES
2111
Deferred Income — Patient Deposits
2112
Deferred Income — Tuition and Fees
2113
Deferred Income — Other
Deferred income is defined as income received or accrued which is applicable to services to be rendered within the next accounting period and/or the current year's effect of deferred income items classified as non-current liabilities. Deferred income applicable to accounting periods extending beyond the next accounting period should be included in accounts 2120-2140 (Deferred Credits and Other Liabilities) or in account 2270 (Other Non-Current Liabilities).
2114
Dividends Payable
2115
Current Maturities of Long-Term Debt
2116
Intercompany Indebtedness, Current
2117
Construction Retention Payable
2118
Construction Contracts Payable
2119
Other Current Liabilities
Include in these accounts the amount of Operating Fund current liabilities for which special accounts have not been provided elsewhere, including bank overdrafts.
(b) DEFERRED CREDITS AND OTHER LIABILITIES.
[ 3132 ]
(1) 2120
DEFERRED INCOME TAXES
2121
Deferred Taxes Payable — Federal
2122
Deferred Taxes Payable — State
2123
Deferred Taxes Payable — Local
(2) 2130
DEFERRED THIRD-PARTY REVENUE
2131
Deferred Revenue — Medicare
2132
Deferred Revenue — Medicaid
2133
Deferred Revenue — Blue Cross
2139
Deferred Revenue — Other
These accounts reflect the effects of any timing differences between book and tax or third-party reimbursement accounting.
(3) 2140
OTHER DEFERRED CREDITS
This account should reflect all deferred credits not specifically identified elsewhere.
(c) LONG-TERM DEBT.
[ 3133 ]
2210
Mortgages Payable — FHA
2220
Mortgages Payable — Other
2230
Construction Loans
2240
Notes Under Revolving Credit
2250
Capitalized Lease Obligations
2260
Bonds Payable — Taxable
2270
Bonds Payable — Tax Exempt
2280
Intercompany Indebtedness, Non-current
2280
Other Non-current Liabilities
These accounts reflect those liabilities that have maturity dates extending more than one year beyond the current year-end.
(d) BOARD-DESIGNATED LIABILITIES.
[ 3134 ]
(1) 2480
DUE TO OTHER FUNDS
2483
Due to Plant Replacement and Expansion Fund
2484
Due to Specific Purpose Fund
2485
Due to Endowment Fund
These accounts reflect the amounts due to other funds by Board-Designated Assets.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.17 Right to expedited review of denials of requests for prior approval
(a) An expedited review will be provided upon an enrollee showing that:
(1) he or she submitted a written statement from a physician, physician assistant, or nurse practitioner on the practitioner’s letterhead or on the letterhead of the supervising or collaborating physician, if applicable, that the enrollee had an emergency need for the medical service(s) or item(s) in issue and the reason the service or item was needed on an expedited basis; and
(2) the fund administrator denied the request for expedited prior approval.
Such reviews must be conducted within 10 business days from receipt of the request for expedited review and all documentation supporting the request.
(b) The hearing officer shall make a written recommendation to the commissioner consistent with the recommendation requirements set forth in section 69-10.16 of this Subpart within five business days of the document based review or hearing.
(c) The commissioner or his or her designee shall issue a written decision consistent with the decision requirements set forth in section 69-10.16 of this Subpart within five business days of receiving the hearing officer's written recommendation.
(d) As set forth in section 69-10.15 of this Subpart, the service or item may be provided to the enrollee in such a situation pending the expedited prior approval determination and any review of the determination; and a claim for the provision of the service or item during the time period while the prior review decision was pending or, in the event of a review, pending issuance of the review determination can be submitted to the fund administrator for payment, provided that there are no delays as the result of an untimely submission of supporting documentation or a request for an extension of time on the part of the enrollee or any person acting on the enrollee's behalf.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 620 INCORPORATIONS AND TRANSFERS OF PROPRIETARY BUSINESSES
10 CRR-NY 620.5 Limitation on transfer
Any transfer pursuant to section 620.2 or section 620.3 of this Part shall be completed within 90 days of issuance by the Public Health Council of its approval for such transfer unless extended by the council and the council notified of the transfer within 10 days thereafter. Any request for an extension of time shall set forth reasons why such transfer could not be completed within the prescribed time. Failure to complete a transfer within the time prescribed or as extended by the council or failure to notify the council within the time prescribed shall constitute a withdrawal of the application.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.188 Closure
When action is taken to order closure and cessation of operations, the permit-issuing official or his designated representative is to:
(a) conspicuously post a notice or placard at each entrance of the food vending commissary, food vending operation or on the food vending machine, stating the existence of such order and the authority for such order. This order is not to be concealed, mutilated or altered by any person, or removed without permission of the permit-issuing official; and
(b) publish notice of the order, with the reasons for the order, in one or more newspapers in the county or city in which the food vending commissary or food vending operation is located.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.7 Out-of-state care
Out-of-state care will not be approved for State aid reimbursement unless specific exception is made by an authorized representative of the commissioner for just cause.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.133 Fixed capital
The investment in capital assets.
10 CRR-NY 441.247 Payroll
(a) A record showing the wage or salary earned by employees for a certain period and the various deductions for withholding tax, health benefits, and so on.
(b) Total wages and salaries accrued or payable for a given period.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.20 General cleanliness
The licensed owner of every barber shop or beauty parlor shall keep it at all times in a clean and sanitary condition.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.23 Debt financing for plant replacement and expansion purposes
[ 1440 ]
(a) Debt financing for plant replacement and expansion programs may take many forms. Under the terms of most debt financing agreements the debtor is required to perform or is prohibited from performing certain acts. In many instances, debt financing gives rise to special accounting treatment because of discounts and premiums on bond issues, financing charges, formal restrictions on debt proceeds, and sinking and other required funds.
(b) Discounts and premiums on bond issues.
[ 1441 ] Discounts and premiums arising from the issue of bonds must be amortized over the life of the related issue(s). Bond discounts must be recorded as a reduction of the related debt (Bonds Payable - Net of Unamortized Discount). Bond premium must be recorded as Other Deferred Credits (account 2140).
(c) Financing charges.
[ 1442 ] Costs of obtaining debt financing other than discounts ( e.g., legal fees, underwriting fees, special accounting costs) must be recorded as deferred costs and amortized over the life of the related debt.
(d) Accounting for debt proceeds.
[ 1443 ]
(1) Debt agreements for financing plant replacement and expansion programs may or may not require formal segregation of debt proceeds prior to their use. Proceeds which are not required to be formally segregated prior to their use must be recorded as other noncurrent assets in the Unrestricted Fund.
(2) For the purposes of this Part, all funds received under covenant agreement arrangements which require formal segregation and/or separate accountability shall be recorded in the Plant Replacement and Expansion Fund until such time as the project is completed. Upon completion, the asset and related debt must be transferred to the Unrestricted Fund.
(e) Sinking and other required funds.
[ 1444 ]
(1) These funds are usually established to comply with loan provisions whereby specific deposits are to be used to insure that adequate funds are available to meet future payments of:
(i) interest and principal (retirement of indebtedness funds); or
(ii) property insurance, related taxes, repairs and maintenance costs, equipment replacement (escrow funds).
(2) Funds of this nature may also be required to be held by trustees outside the hospital. Income generated from the investment of such funds may be immediately available to the hospital or such income may be held by the trustee for some future designated purpose.
(3) For the purposes of this Part, all sinking and other required funds will be accounted for in the following manner:
(i) All fund assets, whether trusteed or otherwise, must be recorded in the Unrestricted Fund as a long-term investment. The only exception is when the funds are restricted by covenant agreement.
(ii) All income generated from the investment of such funds must be recorded as nonoperating revenue in the Unrestricted Fund, except as required under number 1386. Income generated from funds under covenant agreement may be accounted for as an addition to the appropriate restricted fund balance account.
(f) Early debt retirement.
[ 1445 ]
(1) Many bond contracts provide for the calling of any portion or all of the issue at the option of the company at a stated price, usually above par, for the purpose of enabling the corporation to reduce its indebtedness before maturity as occasion arises, or to take advantage of opportunities to borrow on more favorable terms. Bonds are often retired piecemeal through sinking fund operations.
(2) Costs incidental to the recall of bonds before their date of maturity are considered debt cancellation costs. Such costs include bond recall penalties, unamortized bond discounts and expenses, legal and accounting fees, etc. These costs must be reduced by any unamortized bond premiums and recorded in the Unrestricted Fund in accordance with generally accepted accounting practices.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.43 Monitoring requirements for water quality parameters
All systems serving over 50,000 persons and systems that exceed the lead or copper action level shall monitor water quality parameters in addition to lead and copper in tap water in accordance with this section.
(a) Sample requirements.
(1) Sample collection method.
(i) Distribution system (tap) samples shall be representative of water quality throughout the distribution system, taking into account the number of persons served, the different sources of water, the different treatment methods employed by the system, and seasonal variability. Distribution system sampling under this section is not required to be conducted at taps targeted for lead and copper sampling under section 5-1.42(a) of this Subpart.
(ii) Entry point samples to the distribution system shall be from locations representative of each source after treatment. If a system draws water from more than one source and the sources are combined before distribution, the system shall sample at entry point(s) representative of normal operating conditions.
(2) Number of samples.
(i) A water system conducting standard monitoring shall collect two samples for applicable water quality parameters during each monitoring period specified in subdivision (b) of this section from the number of distribution system sampling sites listed in the table below under Standard Monitoring. A water system conducting reduced monitoring shall collect two samples for applicable water quality parameters during each monitoring period specified in subdivision (c) of this section from the number of distribution system sampling sites listed in the table below under Reduced Monitoring. Such reduced monitoring sites shall be representative of the sites required for standard monitoring
| | STANDARD MONITORING | REDUCED MONITORING | | --- | --- | --- | | Population served | (Sample sites) | (Sample sites) | | >100,000 | 25 | 10 | | 10,001 to 100,000 | 10 | 7 | | 3,301 to 10,000 | 3 | 3 | | 501 to 3,300 | 2 | 2 | | 101 to 500 | 1 | 1 | | <101 | 1 | 1 |
(ii) A water system conducting monitoring in accordance with paragraph (b)(1) of this section shall collect two entry point samples for each applicable water quality parameter at each entry point to the distribution system during each six-month monitoring period. A water system conducting monitoring in accordance with paragraphs (b)(2), (3), and subdivision (c) of this section shall collect one entry point sample for each applicable water quality parameter at each entry point to the distribution system, or each applicable entry point in accordance with subparagraph (b)(2)(iii) of this section, at the frequency specified in subparagraph (b)(2)(ii) of this section.
(b) Standard monitoring.
Required samples shall be collected during six-month monitoring periods, beginning January 1st or July 1st of each calendar year.
(1) Initial sampling. All systems serving more than 50,000 persons shall measure the applicable water quality parameters during each six-month monitoring period specified in section 5-1.42(b)(1) of this Subpart. All systems serving 50,000 or fewer persons shall measure the applicable water quality parameters during each six-month monitoring period during which the system exceeds the lead or copper action level. Applicable water quality parameters at taps and entry points include: pH; alkalinity; conductivity; water temperature; calcium; and orthophosphate or silica, as appropriate to the corrosion control treatment used.
(2) Monitoring after installation of corrosion control. Any system which installs optimal corrosion control treatment shall measure the water quality parameters at the locations and frequencies specified below during each six-month monitoring period specified in section 5-1.42(b)(2) of this Subpart.
(i) Two samples shall be collected at taps in the distribution system for the following parameters: pH; alkalinity; calcium; and orthophosphate or silica, as appropriate to the corrosion control treatment used.
(ii) One sample shall be collected at each entry point: Except as provided in subparagraph (iii) of this paragraph, at least one sample no less frequently than every two weeks (biweekly) for pH; alkalinity (and a reading of the dosage rate of the chemical used to adjust alkalinity, when alkalinity is adjusted); calcium; orthophosphate or silica, as appropriate to the corrosion control treatment used; and a reading of the dosage rate of the corrosion control treatment chemical used.
(iii) A ground water system may limit entry point sampling described in subparagraph (ii) of this paragraph to those entry points that are representative of water quality and treatment conditions throughout the system. If water from untreated ground water sources mixes with water from treated ground water sources, the system shall monitor for water quality parameters both at representative entry points receiving treatment and representative entry points receiving no treatment. Prior to the start of any monitoring under this paragraph, the system shall provide to the State written information identifying the selected entry points and documentation, including information on seasonal variability, sufficient to demonstrate that the sites are representative of water quality and treatment conditions throughout the system.
(3) Monitoring after State specifies water quality parameter values for optimal corrosion control. After the State specifies the values for applicable water quality control parameters reflecting optimal corrosion control treatment, all systems serving more than 50,000 persons and any system serving 50,000 or fewer persons that has optimal corrosion control treatment installed shall measure the applicable water quality parameters during each six-month monitoring period specified in section 5-1.42(b)(3) of this Subpart, in accordance with subparagraphs (2)(i)-(iii) of this subdivision, and determine compliance with the requirements of section 5-1.41(g) of this Subpart during each six-month monitoring period specified in section 5-1.42(b)(3) of this Subpart.
(c) Reduced monitoring.
(1) Reducing the number of sampling sites. Any water system that maintains the range of State specified values for the water quality parameters reflecting optimal corrosion control treatment during each of two consecutive six-month monitoring periods under paragraph (b)(3) of this section shall continue monitoring at the entry point(s) to the distribution system as specified in subparagraphs (b)(2)(ii)-(iii) of this section. Such system may collect two distribution system samples for applicable water quality parameters from the reduced number of sites in accordance with subparagraph (a)(2)(i) of this section during each six-month monitoring period.
(2) Reducing sampling frequency.
(i) Any water system that maintains the range of State-specified values for the water quality parameters reflecting optimal corrosion control treatment during three consecutive years of monitoring in accordance with paragraph (1) of this subdivision may reduce the frequency with which it collects the number of distribution system samples for applicable water quality parameters specified in paragraph (1) of this subdivision from every six months to annually. This sampling shall begin during the calendar year immediately following the end of the monitoring period in which the third consecutive year of six-month monitoring occurs. Any water system that maintains the range of State-specified values for the water quality parameters reflecting optimal corrosion control treatment during three consecutive years of annual monitoring under this paragraph may reduce the frequency with which it collects the number of distribution system samples for applicable water quality parameters specified in paragraph (1) of this subdivision from annually to every three years.
(ii) A water system may reduce the frequency with which it collects the number of distribution system samples for applicable water quality parameters specified in subdivision (c)(1) of this section to every three years if it demonstrates during two consecutive monitoring periods that its tap water lead level at the 90th percentile is less than or equal to the PQL for lead specified in section 5-1.40(b)(1) of this Subpart, that its tap water copper level at the 90th percentile is less than or equal to 0.65 mg/L for copper, and that it also has maintained the range of values for the water quality parameters reflecting optimal corrosion control treatment specified by the State under section 5-1.41(f) of this Subpart.
(iii) Monitoring conducted every three years shall be done no later than every third calendar year.
(3) A water system that conducts reduced sampling frequency shall collect these samples evenly throughout monitoring period in which samples are taken so as to reflect seasonal variability.
(4) Any water system subject to the reduced monitoring frequency that fails to operate at or above the minimum value or within the range of values for the water quality parameters specified by the State under section 5-1.41(f) of this Subpart for more than nine days in any six-month period shall resume distribution system tap water sampling in accordance with the number and frequency requirements in paragraph (b)(3) of this section. The water system may resume annual monitoring for water quality parameters at the tap at the reduced number of sites specified in subparagraph (a)(2)(i) of this section after it has completed two subsequent consecutive six-month rounds of monitoring that meet the criteria of that subdivision and/or may resume triennial monitoring for water quality parameters at taps in the distribution system at the reduced number of sites after it demonstrates through subsequent rounds of monitoring that it meets the criteria of either subparagraph (2)(i) or (ii) of this subdivision.
(d) Additional monitoring by systems.
The results of any monitoring conducted in addition to the minimum requirements of this section shall be considered by the system and the State in making any compliance determinations ( i.e. , determining concentrations of water quality parameters).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.7 General
[ 3200 ]
(a) An Income Statement is an accounting statement which reflects the financial results of a hospital during a reporting period.
(b) Hospitals are required to report all revenue and expense accounts in this section when such a function as defined in this manual exists, even though the activity is not separately organized within the hospital. The only circumstances under which the hospital need not report a revenue or expense account is when the patient services provided in a daily hospital services cost center is not provided in a discrete unit. For example, if pediatric patients receive care in the Medical/Surgical acute cost center, no reclassification of expense from the Medical/Surgical cost center to the Pediatric Acute cost center is required. No functional reporting of revenue and expense is required for daily hospital service cost centers.
(c) Where a function required by the reporting system is not separately organized within the hospital, but combined with one or more functions required by the reporting system, an analysis will be required to determine the gross revenue and direct expenses applicable to each required function. For instance, some hospitals may be combining the function of Electrocardiography (accounts 4290/7290) and Neurology-Diagnostic (accounts 4460/7460). In such cases, it is necessary to determine the total direct revenue and direct expenses relative to the two different types of services rendered, and if significant, as defined below, reclassification is required.
(d) The gross revenue reported in each required revenue account must be the actual gross revenue attributable to such identified functions. The expenses reported in each required expense account must represent the direct expenses related to each identified function. The direct expenses related to such functions may be determined based upon analysis.
(e) It should be noted that reclassification must be made for significant amounts of misplaced costs or revenue. Significant is defined, for the purposes of this Article, as an amount equivalent to an aggregate amount of misplaced costs or revenue in excess of the lesser of:
(1) three percent of the direct costs of the functional center transferred to or from; or
(2) one quarter of one percent of the total annual operating expenses.
(f) However, in no case is a reclassification necessary if the aggregate amount of misplaced cost per cost center is less than $1,000.
(g) Since the zero level accounts presented in this manual are required, all zero level accounts presented herein, except as noted above, must be reported by the hospital where the related item or function exists in that hospital. A hospital will not be granted an exception to the reporting of an account solely because of accounting difficulty.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter S LAND ACQUISITION
Part 99 PAYMENTS TO AN OWNER OR TENANT OF RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY UPON APPLICATION FOR ALLOWANCE OF MOVING EXPENSES IN VACATING PROPERTY ACQUIRED BY THE DEPARTMENT OF HEALTH
10 CRR-NY 99.1 Purpose
The law stated above provides that the Commissioner of Health, with the approval of the Director of the Budget, shall establish and may amend rules and regulations authorizing the payment of reasonable and necessary moving expenses of occupants of property acquired pursuant to such law and may provide for a schedule of payments in fixed amounts, in lieu of payments of reasonable and necessary actual moving expenses. The following rules and regulations shall apply to making relocation payments to eligible persons for their moving expenses caused by their displacement from real property acquired pursuant to such law.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.8 Processing and storage of tissue
(a) Fresh skin shall be stored in a sealed, sterile container with an isotonic solution or nutrient medium demonstrated to maximize tissue viability, at a temperature between one and 10 degrees Celsius for a period not to exceed 14 days from retrieval. Storage shall take place in a refrigerator reserved for skin or other tissue intended for transplantation, or blood intended for transfusion, equipped with a thermometer calibrated at least annually against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer. The temperature shall be visually monitored daily unless the refrigerator is equipped with a calibrated mechanical temperature monitor and alarm system to detect an increase in temperature to above 10 degrees Celsius or a decrease in temperature to below one degree Celsius.
(b) If performed, skin processing for cryopreservation shall occur under aseptic conditions within three days of retrieval. Until processing, skin shall be stored at between one and 10 degrees Celsius. Once processed, skin shall be stored frozen at a target temperature of minus 40 degrees Celsius or lower with a suitable cryoprotectant in labeled containers until released for use, in either:
(1) a freezer reserved for skin or other tissue intended for transplantation, or blood intended for transfusion, equipped with an audible alarm to detect an increase in temperature to above the limit established by the director and a thermometer calibrated at least annually against a NIST-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer; or
(2) a liquid nitrogen tank reserved for skin or other tissue intended for transplantation.
(c) If performed, skin processing for freeze-drying shall take place within seven days of tissue procurement and in a manner that meets the minimum standards of the manufacturer of the freeze-drier. If sterilized by ethylene oxide, testing for ethylene oxide, ethylene glycol and ethylene chlorhydrin residue shall be performed on each batch of skin sterilized. Freeze-dried skin shall be stored at between one and 30 degrees Celsius.
(d) Storage devices shall have clearly defined and labeled areas for all skin stored, and untested tissue shall be maintained in a quarantine area segregated from tissue awaiting distribution.
(e) Thermometers shall be visually monitored daily, or temperatures shall be continuously monitored mechanically, and, if applicable, liquid nitrogen levels shall be checked at least twice a week for fluctuations potentially affecting the quality of the skin. Storage shall be at a target temperature of minus 40 degrees Celsius or lower. Temperature records and, if applicable, liquid nitrogen level records shall be available for inspection by the department for the entire period of storage and for one year afterwards.
(f) Skin from two or more donors shall not be pooled.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 36.1 Definitions
(a) Delayed registration of birth is the registration of a birth one year or more after its occurrence.
(b) A supporting affidavit is a sworn statement substantiating the facts entered on the birth certificate.
(c) A written record is one which confirms the facts entered on the birth certificate.
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.1 Definition of medical service
Medical service, as it relates to children and youth with special health care needs, means such diagnostic, therapeutic and rehabilitative care by medical and paramedical personnel, including hospital and related care, and drugs, prostheses, appliances, equipment and devices, as necessary.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.8 Inspection and certification
(a) Inspection.
(1) All owners of cooling towers shall ensure that such towers are inspected prior to seasonal start-up and at intervals not exceeding every 90 days while in use. Year-round towers shall be inspected at intervals not exceeding every 90 days and prior to start-up, following maintenance.
(2) All inspections shall be performed by a: New York State licensed professional engineer; certified industrial hygienist; certified water technologist; environmental consultant or water treatment professional with training and experience performing inspections in accordance with current standard industry protocols including, but not limited to ASHRAE 188-2015 , as incorporated by section 4-1.4 of this Subpart.
(3) Each inspection shall include an evaluation of the:
(i) cooling tower and associated equipment for the presence of organic material, biofilm, algae, debris and other visible contaminants;
(ii) general condition of the cooling tower basin, remote sump, packing material, and drift eliminators;
(iii) water make-up connections and control, including backflow protection and/or airgaps as needed;
(iv) proper functioning of the conductivity control; and
(v) proper functioning of all water treatment equipment, including, but not limited to, pumps, timers, valves, and strain gauges.
(4) Any deficiencies found during inspection shall be reported to the owner for immediate corrective action. A person qualified to inspect pursuant to this subdivision shall document all deficiencies, and all completed corrective actions.
(b) Certification.
By November 1, 2016, and by November 1st of each year thereafter, the owner of a cooling tower shall obtain a certification from a person identified in subdivsion (a) of this section, that such cooling tower has a maintenance program and plan, and that all activities within that plan or required by this Subpart were implemented, including but not limited to:
(1) all bacteriological culture sampling and analysis;
(2) all Legionella culture sampling and analysis, including any immediate Legionella culture sampling and analysis performed pursuant to section 4-1.4(b)(3) and (4) of this Subpart;
(3) any disinfection performed pursuant to section 4-1.7 of this Subpart; and
(4) all inspections performed pursuant subdivision (a) of this section.
(c) Reporting.
All inspection findings, deficiencies, and corrective actions, and all certifications, shall be reported to the owner, who shall retain such information, in accordance with section 4-1.9 of this Subpart.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.18 Operator and operating records
(a) Each bathing beach shall be under the supervision of a competent operator who shall require the careful observance of sanitary regulations prescribed in this Part and the requirements of the permit issued for such bathing beach.
(b) The bathing beach operator shall maintain daily records indicating the daily number of bathers using the beach, number of lifeguards on duty, weather conditions, water clarity, the results of any water quality laboratory reports, and reported rescues, injuries and illnesses. Upon completion, the records shall be maintained at the facility for 12 months. The permit-issuing official may require submission of reports at periodic intervals.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.17 Actuarial basis
A basis compatible with principles followed by actuaries: said of computations involving compound interest, retirement and mortality estimates, and the like.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.6 Program administration and process
(a) Applicants shall apply to the New York State Department of Health on such forms and provide such information as the department determines is necessary to administer the program.
(b) Applicants who are practitioners in an obstetric group practice must submit an application as a group.
(c) To obtain a subsidy, applicants who are selected and approved must enter into a contract with the department. The contract will include the minimum level of services to be provided, recording requirements, payment schedule and other requirements.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.41 Dispensing of potentially hazardous food
Potentially hazardous food is to be dispensed to the consumer in the individual, original container or wrapper in which it was packaged at the commissary or food-processing establishment. Potentially hazardous food is not to be dispensed from bulk supplies.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 143 SCHOHARIE COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 143.8 Central Bridge Water District, Towns of Esperance and Schoharie, Schoharie County
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the upper and lower reservoirs, located off Voege Road, and all watercourses tributary thereto or which may ultimately discharge into said reservoirs or which may be developed in the future to serve as sources of the water supply to the Central Bridge Water District.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Agricultural-associated animal waste storage area shall mean land for the temporary or permanent deposition of agricultural-associated animal waste where said deposition is not directly for the purpose of fertilization.
(4) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(5) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(6) Human excreta shall mean human feces and urine.
(7) Junkyard shall mean an area where two or more unregistered, old or second-hand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(8) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(9) Manure shall mean animal feces and urine.
(10) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(11) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(12) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal, agricultural- and nonagricultural-associated animal wastes.
(13) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(14) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(15) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(16) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(17) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Central Bridge Water District's water supply.
(18) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(19) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(20) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(21) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(22) Water district shall mean Central Bridge Water District in the Towns of Esperance and Schoharie.
(23) Water supply shall mean the public water supply of the Central Bridge Water District.
(24) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flow or may flow into the water supply of the Central Bridge Water District.
(25) Watershed shall mean the entire drainage area contributing water to the water supply of the Central Bridge Water District.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste area.
Agricultural-associated animal waste areas shall be maintained such that surface run-off will not carry agricultural-associated animal waste directly into any reservoir or watercourse.
(2) Agricultural-associated animal waste storage area.
No agricultural-associated animal waste storage area shall be located within a 250-foot linear distance of any reservoir or watercourse.
(3) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(4) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings or watertight vessels.
(5) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(6) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 100-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such a facility; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works which are published from time to time by the appropriate State agency having jurisdiction over such facility, and subparagraph (v) of this paragraph shall comprise the criteria for designing any proposed sewage disposal system.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Water District.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the water district within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the water district in the performance of their duties of supervision and maintenance.
(iii) Fishing and trespassing. No trespassing shall be allowed in or upon any reservoir or watercourse owned by the Central Bridge Water District except for the purpose of fishing with the written permission of the Central Bridge Water District and by duly authorized employees of the Central Bridge Water District in the performance of their duties of supervision and maintenance of the water supply; however, no fishing shall be allowed by boat or within a 200-foot linear distance of the water supply intake of the lower reservoir.
(8) Radioactive material.
No radioactive material shall be disposed of by burial in soil within 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir, or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(9) Junkyards.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(10) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(11) Refuse disposal area.
No refuse disposal area shall be located within 500-foot linear distance of any reservoir or watercourse.
(12) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the water district.
(13) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(14) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground or watershed within a 500-foot linear distance of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The governing body of the water district or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representatives make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid governing body to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid governing body to promptly notify the State Health Commissioner of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1100 of the Public Health Law. The aforesaid governing body shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.52 Community environmental health and food protection; performance standards
The local health department shall maintain a program that ensures that facilities operated pursuant to Parts 6, 7, 14, 15 and 17 of this Title comply with all relevant provisions of the State Sanitary Code and the Public Health Law.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.3 Initial investigation
The complaint shall be investigated promptly by a deputy commissioner or other officer of the department delegated by the commissioner or his duly authorized representative. If the investigating officer shall determine that the complaint does not state facts sufficient to constitute a charge of unlawful discriminatory practice or, after investigation, that probable cause does not exist for crediting the allegations of the complaint, he shall so advise the commissioner who, in his discretion, may issue and cause to be served on the complainant and the respondent hospital governing body a notice of dismissal of the complaint.
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.2 Definitions
(a) Medical care for cystic fibrosis means such diagnostic, therapeutic and rehabilitative care by medical and paramedical personnel, including hospital and related care, drugs, prostheses, appliances, procedures, equipment and devices, as necessary for the treatment of cystic fibrosis and any conditions demonstrated to result from the progress or treatment of cystic fibrosis.
(b) Net annual income means gross income of the patient and/or patient's spouse, less State, local and Federal income taxes, and social security deductions.
Chapter I STATE SANITARY CODE
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.6 Unexpected attendance
In the event that actual attendance at a public function shall exceed the estimate used for determining the required sanitary facilities, medical equipment, supplies and personnel by more than 20 percent, it shall be the responsibility of the permit holder to immediately provide the additional equipment, supplies and personnel required.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.76 Critical care units (type I)
(a) Intensive medical care.
(b) Medical director who has completed residency training in one of the major clinical specialties and has acquired advanced skills and knowledge in life support and patient monitoring techniques.
(c) The medical director devotes the majority of his time to the unit.
(d) An MD (attending or senior resident) physically present within the unit 24 hours a day.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.3 Village of Fredonia
(a) [Application.]
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs which serve as sources of the public water supply of the village of Fredonia, Chautauqua County, New York, and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definition of terms.
Definitions of terms wherever used in this section:
(1) The term water supply means the public water supply of the village of Fredonia.
(2) The term reservoir means any natural or artificially impounded body of water on the west branch of Canadaway Creek and tributaries thereto serving as sources of water supply of the village of Fredonia and shall include any additional reservoir which may be constructed or used for said water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind on the west branch of Canadaway Creek and tributaries thereto, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any reservoir or at a distance of not less than 100 feet from any watercourse and covered with 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (1) of subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above-named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval of the board of trustees of the village of Fredonia and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 100 feet and 200 feet of any reservoir, between 50 feet and 100 feet of any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle, or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed after due notice to the owner thereof to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 300 feet of any reservoir or within 200 feet of any watercourse except in watertight sewers and sewer appurtenances constructed or installed with the approval and under the supervision of the board of trustees of the village of Fredonia. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or within 50 feet of any watercourse.
(3) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof of any other matter that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir nor within 35 feet of any watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface of the ground into any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir.
(2) No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir except by duly authorized employees of the village of Fredonia in the performance of their duties of supervision and maintenance of the water supply.
(3) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir and no watering place shall be maintained in such way as to pollute any watercourse with excremental matter.
(4) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute any reservoir or watercourse.
(5) No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir nor within 50 feet of any watercourse.
(f) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or within a distance of 150 feet of any watercourse.
(g) General.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(h) Inspections.
The board of trustees of the village of Fredonia or such other person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violation. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number* inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.11 Hearings involving food vendors for violations of section 60-1.8 of this Subpart and local agencies for violation of section 60-1.9 of this Subpart where a monetary penalty is sought
(a) Any food vendor or local agency which the department seeks to fine or fine and disqualify from the WIC program for violations of section 60-1.8 or section 60-1.9 of this Subpart shall be afforded a right to a hearing under the terms of this section. A disqualification without a contemporaneous monetary penalty is governed by the provisions of section 60-1.12.
(b) A written notice of hearing shall be sent by certified mail to the applicant and other parties involved at least 15 days prior to the scheduled date of the hearing. Such notice shall:
(1) specify th date, time and place of the hearing;
(2) state briefly the issues which are to be the subject of the hearing;
(3) explain the manner in which the hearing will be conducted;
(4) apprise the respondent of its right to be represented by an attorney, to testify, present documentary evidence, produce witnesses, cross-examine adverse witnesses, and to examine the case record prior to the hearing; and
(5) state that failure to appear at the hearing shall constitute waiver of the respondent's right to a hearing and that a default order may be issued against the respondent, fining the respondent up to a maximum of $1,000 per violation and/or disqualifying the vendor from participating in the WIC program for up to three years and permanently terminating the local agency from participating in the WIC program.
(c) The provisions of section 60-1.6(d) and (h) of this Subpart concerning hearings, administrative law judges, and record of hearings shall apply to hearings for food vendors and local agencies under this section.
(d) A copy of the hearing decision shall be sent to the respondent, his/her attorney, if any, and other parties involved within 60 days following the date on which the department issued a notice of hearing.
(e) Nothing in this section shall prevent the department from immediately disqualifying any vendor or local agency from participating in the WIC program provided that written notice of disqualification is given to the vendor at least 15 days before the effective date of the disqualification and to the local agency at least 60 days before the effective date of disqualification, respectively. The disqualification may not be stayed during the pendency of the hearing by the administrative law judge without the consent of the department's representative at the hearing. The disqualification shall remain in effect unless an order is issued at the conclusion of the hearing which reinstates the vendor or local agency.
(f) The department has the burden of proof to establish a violation of section 60-1.8 or section 60-1.9 of this Subpart by substantial evidence.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.14 Additional requirements for laboratories engaged in testing for critical agents in environmental samples using autonomous detection systems
(a) For purposes of this Subpart:
(1) autonomous detection system shall mean a fixed or portable self-contained analytical system that: automatically, continuously or periodically samples the environment; analyzes sample(s); and triggers an alert that a critical agent, as defined in section 55-2.13 of this Subpart, has been detected. For purposes of this Subpart, signal and alert shall have the same meaning, i.e., a visual and/or audio alert triggered whenever an organism, its product or component, or a chemical, any of which exhibits characteristics or properties consistent with those of a critical agent has been detected by the detection system;
(2) deploy and operate shall mean to engage the system in real time collection and analysis of environmental samples for purposes of detecting incidental release of a critical agent as defined in section 55-2.13 of this Subpart;
(3) autonomous detection system shall not mean a device for environmental sampling and/or analysis of environmental samples deployed for a purpose other than detecting incidental release of a critical agent as defined in section 55-2.13 of this Subpart. Accordingly, the provisions of this Subpart shall not be applicable to:
(i) carbon monoxide detectors;
(ii) radon detectors;
(iii) hand-held detectors, personal dosimeters or Geiger counters designed and intended for use by individuals, or, when used in an academic setting, for instruction or research;
(iv) detectors deployed within hospitals or other health care facilities;
(v) detectors deployed by utility companies or in an industrial setting for the purpose of monitoring internal air quality or detecting leakage of hazardous materials;
(vi) detectors deployed by certified industrial hygienists, labor unions and other individuals or entities responsible for or engaging in testing or monitoring of workplace or environmental safety, including such testing or monitoring in the aftermath of a possible accident or bioterrorism incident involving critical agent(s); and
(vii) an environmental sampling and/or testing device deployed for a purpose other than detecting the incidental release of a critical agent, and determined by the Commissioner of Health to not require department oversight pursuant to Public Health Law, section 502.
(b) In addition to meeting the requirements stipulated elsewhere in this Subpart, including the department's Quality System Standards as referenced in section 55-2.1(f) of this Subpart, a laboratory engaged in the analysis of environmental samples using an autonomous detection system shall:
(1) ensure that the system is operated in a secure and safe manner to prevent accidental or deliberate tampering that could compromise the integrity of its operation;
(2) establish and validate the minimum concentration(s) of specified critical agent(s) that would trigger a signal;
(3) develop a laboratory response plan acceptable to the department, to be immediately implemented whenever a signal is triggered, that at a minimum includes procedures for: notification of a signal to the client(s) on whose property an autonomous detection system is situated; notification of a signal to State and local public health and emergency preparedness authorities responsible for confirming, responding to and remediating an incident involving critical agent(s); emergency shutdown of any autonomous detection system suspected to be malfunctioning; communication between the laboratory's technical director and authorities responding to a signal; timely verification that any signal triggered was neither a false positive nor false negative signal, including review of results of any supplemental testing; and remediation for any false signal;
(4) retain documentation that the response plan has been developed in collaboration with:
(i) State public health and emergency preparedness authorities, and comparable local authorities whenever applicable, responsible for confirming, responding to and remediating an incident involving critical agent(s); and includes documentation of approval by State and/or local public health and emergency preparedness authorities. Such documentation shall include a valid permit or certificate authorizing deployment of an autonomous detection system within an area under the authority's jurisdiction; and
(ii) the client(s) on whose property an autonomous detection system is situated and other party(ies) situated at or controlling right of access at that location; and includes an attestation of agreement to follow response plan protocols, signed by the client and any party(ies) situated at or controlling right of access at the location at which the autonomous detection system is deployed;
(5) document, in its standard operating procedures manual:
(i) the laboratory's process for selecting locations in which autonomous detection systems are to be situated, or, if a system is portable, a description of the types of locations in which a system may be deployed;
(ii) procedures to ensure adequate oversight by the technical director of each autonomous detection system deployed by the laboratory, including, but not limited to, review of quality assurance and quality control data and, as available, the results of any postsignal confirmatory testing;
(iii) protocols for monitoring multiple systems or monitoring from a remote location;
(iv) protocols for timely communication between the system's operator and the technical director, and between the client and the laboratory; and
(v) the laboratory's response plan;
(6) for each autonomous detection system in operation: maintain records on its location, including street address, and a description of its exact placement within a building or area; and
(7) whenever the system triggers an alert:
(i) immediately follow procedures prescribed in the laboratory's response plan;
(ii) as soon as practicable, but no later than one hour after a signal has been triggered, notify the department or an authority designated by the department, via telephone using a number designated by the department or the department's designee; and document the date and time of the telephone call, and the name(s) of the responsible person(s) contacted; and
(iii) request for review records of any supplemental testing conducted in response to the triggered signal. Whenever the results of such supplemental testing are inconsistent with the expected reason for a signal, the laboratory shall render inoperable the autonomous detection system that triggered the signal until the cause of the discrepancy is determined and remediated.
(c) The laboratory shall maintain a fixed-base location at which all records required by this Subpart, including but not limited to, calibration, test, quality assurance, quality control, operator training, and client notification protocols and supplemental testing are retained for periods stipulated in this Subpart. The laboratory shall also retain records demonstrating compliance with Federal, State, and local rules for registration, use and disposal of any material that meets the definition of a biological or chemical critical agent, including radioactive material, in its possession.
(d) A laboratory may operate one or more autonomous detection systems under the direction of one technical director. Procedures for direct oversight by the technical director of one or more systems and their operator(s) shall be acceptable to the department.
(e) An autonomous detection system, while in operation, shall be continuously monitored by an autonomous detection system operator who functions under the direction of the technical director. The technical director may also serve as the operator. Prior to designating a person as an autonomous detection system operator, the laboratory owner and technical director shall ensure compliance with applicable personnel requirements stipulated in the department's Quality System Standards as referenced in section 55-2.1(f) of this Subpart, as well as ensure that the operator:
(1) receives adequate training specific to the operation of each specific make and model of autonomous detection system in use by the laboratory;
(2) provides written attestation to reading and understanding the general policies and procedures of the laboratory, and those specific to the autonomous detection system(s) in use, including the laboratory's response plan and the operator's responsibilities under that plan; and
(3) undergoes a successful demonstration of capability that includes participation in the mock implementation of each specific response plan for each autonomous detection system deployed by the laboratory.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.12 Water supply
The water supply serving all plumbing fixtures, including drinking fountains, lavatories and showers, shall, after treatment, meet the provisions required for a public water system as defined in the State Sanitary Code (Subpart 5-1 of this Title). A spray ground with an on-site water supply that does not meet the definition of a public water system must comply with the standards established in Subpart 5-1 of this Title for a non-community water system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
MAKING OF CERTIFICATES MAKING OF CERTIFICATES
10 CRR-NY 36.6 Certificate made by parent
If the physician or midwife who attended the birth has died or cannot be located, or if the birth was not attended professionally, the certificate of birth shall be made by one of the parents.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.17 Linen and laundry
(a) Shared health facilities shall:
(1) provide a sufficient quantity of clean linen to meet the requirements of patients;
(2) separately bag or enclose used linens from infectious patients in readily identified containers distinguishable from other laundry; and
(3) transport and store clean linen in a manner to prevent its contamination.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.4 Enforcement
(a) Permits and placarding.
(1) Operation of a spray ground without a permit is a violation of this Subpart. The permit-issuing official may order any spray ground operating without a permit to close and remain closed until the facility has obtained and displays a valid permit.
(2) The enforcement procedures delineated in sections 12, 12-a, 12-b, 16, 308, 309, 1303-1305 and 1308 of the Public Health Law may be used, as appropriate. Where a public health hazard is found, the spray ground shall be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of the patrons. When a placard is used, it shall be conspicuously posted at each entrance leading to the spray ground. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law.
(3) Within 15 days of placarding of a facility, the operator of such facility shall be provided with an opportunity to be heard and present proof that continued operation of the facility does not constitute a danger to the public health.
(4) The permit-issuing official or his/her designated representative shall inspect the premises, within two working days of notification that the hazard has been eliminated, to remove the placards after verifying correction.
(b) Public health hazards.
Any of the following violations are public health hazards which require the permit-issuing official or his/her designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(1) failure to provide adequate supervision of the spray ground as prescribed in section 6-3.22 of this Subpart;
(2) failure to provide the minimum ultraviolet light dosage and/or absence of a residual of the required chemical disinfectant;
(3) failure to continuously operate the spray ground's filtration and disinfection equipment;
(4) use of an unapproved or contaminated water supply source for potable water use;
(5) overhead electrical wires within 20 feet horizontally of the spray pad;
(6) unprotected electrical circuits or wiring within 10 feet of the spray pad;
(7) plumbing cross-connections between the drinking water supply and spray pad treatment system or between sewerage system and the spray pad's filter backwash facilities;
(8) use of unapproved chemicals or the application of chemicals by unapproved methods to the spray pad water;
(9) broken or missing drain grates on the spray pad;
(10) glass or sharp objects on the spray pad or deck area;
(11) apparent contamination of the spray pad and/or spray pad treatment tank by a potentially toxic chemical or a bacteriological substance that could present a hazard to patrons; or
(12) any other condition which the permit-issuing official determines creates an immediate threat to public health.
(c) Other violations.
Failure to comply with other sections of this Subpart or of other Parts of this Chapter are also subject to a penalty.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.19 Actuarial calculations for the fund
(a) Following the annual deposit set forth in section 2999-i(5) of the Public Health Law, and quarterly thereafter, the superintendent shall conduct an actuarial calculation of the estimated liabilities of the fund for the year following such annual deposit, resulting from qualified plaintiffs enrolled in the fund.
(b) The analysis pursuant to subdivision (a) of this section shall include a review of the various elements contributing to the amount of benefits paid by the fund and to the expenses of administration of the fund, including:
(1) the number of qualified plaintiffs admitted in the fund, and estimates of the number of qualified plaintiffs not yet admitted;
(2) the mortality experience of the qualified plaintiffs admitted to the fund;
(3) the amounts of benefits paid by the fund by types of services provided;
(4) the patterns of utilization by types of services provided;
(5) the inflationary patterns by types of services provided;
(6) the expenses of administration of the fund;
(7) the impact available health insurance has on the benefits paid by the fund; and
(8) the investment earnings on the assets held by the fund.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.9 Enforcement
(a) Upon reasonable notice to the school, an officer or employee of the department or local health department may enter any building for the purposes of determining compliance with this Subpart.
(b) Where a school does not comply with the requirements of this Subpart, the department or local health department may take any action authorized by law, including but not limited to assessment of civil penalties as provided by law.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.86 Thawing of potentially hazardous foods
Potentially hazardous foods are to be thawed:
(a) in refrigerated facilities at a temperature not to exceed 45 degrees Fahrenheit (7.2 degrees Celsius); or
(b) under potable running water at a temperature of 70 degrees Fahrenheit (21.1 degrees Celsius) or below, with sufficient water velocity to agitate and float off loose particles into the overflow; or
(c) in a microwave oven when the food will be immediately transferred to conventional cooking facilities as part of a continuous cooking process, or when the entire uninterrupted cooking process takes place in a microwave oven; or
(d) as part of the conventional cooking process. Whole frozen poultry or poultry breasts, other than a single portion, must be completely thawed prior to conventional cooking, except for a single portion intended for service to an individual consumer.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.16 Less expensive alternatives
Reimbursement for the cost of providing services may be the lesser of the actual costs incurred or those costs which could reasonably be anticipated if such services had been provided by the operation of joint central services or use of facilities or services which could have served effective alternatives or substitutes for the whole or any part of such service.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PLUMBING PLUMBING
10 CRR-NY 14-1.142 Toilet facilities
(a) Each food establishment is to have adequate, conveniently located, and properly installed toilet facilities for its employees. Such facilities are to be accessible at all times. Toilet fixtures are to be of sanitary design and readily cleanable. Toilet rooms are to be completely enclosed and to have tight-fitting, self-closing doors.
(b) Toilet facilities are to be kept clean, in good repair and free from objectionable odors. A supply of toilet tissue is to be provided at all times at each toilet. Easily cleanable receptacles for waste paper and other refuse are to be provided. One receptacle, in toilet rooms used for women, is to be covered. Employee handwashing signs are to be posted in each employee toilet room area.
(c) All food service establishments with a seating capacity of 20 or more, except those in operation on or before December 5, 1977, are to provide toilet facilities for their patrons as required by chapter 774 of the Laws of 1977.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED
10 CRR-NY 40-2.60 Authorized radioactive materials licensing and inspection program; performance standards
Where a local health department has received authorization to maintain a radioactive materials licensing and inspection program pursuant to Part 16 of this Title, the municipality shall conduct such program consistent with that Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.182 Internal control
(a) The general methodology by which management is carried on within an organization; also, any of the numerous devices for supervising and directing an operation or operations generally.
(b) Internal control, a management function, is a basic factor operating in one form or another in the administration of every organization, business or otherwise. Although sometimes identified with the administrative organism itself, it is often characterized as the nervous system that activates overall operating policies and keeps them within practicable performance ranges. The principles contributing to internal control are usually these:
(1) recognition that within every organizational unit there are one or more functional or action components known as activities, costs, or responsibility centers, or management units;
(2) delegated operating authority in each organizational unit permitting freedom of action within defined limits;
(3) the linking of expenditures—their incurrence and disposition—with specified individual authority;
(4) end product planning by means of (i) a budget fitted to the organizational structure and to its functional components, thus maintaining dual forward operating disciplines; and (ii) the adoption of standards of comparison and other performance measurements such as standard costs, quality controls and timing goals;
(5) an accounting process that provides organizational and functional administrators with prompt, complete, and accurate information on operating performance, and comparisons with predetermined performance standards;
(6) periodic reports, consonant with accounting and related records, by activity heads to supervisory management; reports serving as feedbacks of informative pictures of operations, and as displays of favorable and unfavorable factors that have influenced performance;
(7) internal check, built into operating procedures, and providing maximum protection against fraud and error;
(8) frequent professional appraisals, through internal audit, of management and its policies and operations generally, as a protective and constructive management service, its emphasis varying with the quality of operating policies and their administration; and
(9) the construction of the above controls in such a manner as to stimulate and take full advantage of those natural attributes of individual employees the recognition and exercise of which may obviate the need for some internal controls and determine the extent and rigidity of others.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
CONSTRUCTION CONSTRUCTION
10 CRR-NY 6-1.8 Approval of plans
(a) No municipality, school district, person, group of persons, firm, corporation, association, organization or institution shall install or construct a swimming pool, or make any addition or modification to an existing swimming pool, until plans and specifications receive the approval of the permit-issuing official. All plans shall be prepared by a person licensed by the State of New York to practice engineering or architecture. The permit-issuing official may require, when granting this approval, such modifications or conditions as the public health or safety may require.
(b) Design standards for swimming pools (see section 6-1.29 of this Subpart) shall be the basis upon which all plans for swimming pools shall be reviewed, approved and constructed.
(c) Plans for any potable water treatment or sewage treatment facilities to be constructed onsite at swimming pools shall be approved, prior to construction, by the permit-issuing official or such agency having jurisdiction for such plan approval.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.10 Continuation of surrogacy program licensure
(a) Licenses are not transferable or assignable.
A licensee may invalidate any license by delivering it to the department, in the form and manner prescribed by the department, but such delivery does not affect any civil or criminal liability or the authority to enforce this Subpart for acts committed in violation thereof.
(b) A licensee who is the subject of a voluntary or involuntary bankruptcy filing must report such filing to the department within seven business days after the filing date.
(c) A surrogacy program’s license may be revoked, suspended, limited or annulled by the department upon a finding that:
(1) the owner misrepresented or failed to disclose information required to be provided by this Subpart;
(2) the owner, or any employees, contractors, or other personnel under the direction and control of the surrogacy program, failed to adhere to any requirements of article 44 of the General Business Law or this Part; or
(3) the owner, or any employees, contractors, or other personnel under the direction and control of the surrogacy program, through action or act of omission, placed parties to a surrogacy agreement or the child intended to be born under the surrogacy agreement in danger of harm of any kind, or otherwise violated the requirements of this Subpart or any guidelines or standards required to be issued by the department pursuant to law.
(d) No surrogacy program’s license may be revoked, suspended, limited or annulled by the department without affording the surrogacy program an opportunity to request a hearing pursuant to Part 51 of this Title.
(e) Any person or entity that is required to be licensed as a surrogacy program under this Subpart that continues to operate after the effective date of this Subpart without obtaining a license from the department, or that continues to operate following the revocation, suspension, or annulment of their license, or that operates contrary to limitations placed on their license pursuant to this section, shall be considered to be operating a fraudulent business, and the names of the owner or owners associated therewith shall be referred by the department to the Office of the Attorney General for investigation and possible prosecution.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.138 Functional reporting
Reporting of the revenues and expenses according to type of activity performed.
10 CRR-NY 441.60 Certified bed capacity
The total number of beds for which the facility has approval from the Commissioner of Health to operate. This is the number of beds that appears on the operating certificate.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.13 Location; grounds
A children's camp shall be so located that adequate surface drainage can be provided during the period of operation, and so that adequate soil and space will permit the installation and operation of a proper sewage disposal system and/or water system, unless other provisions are made acceptable to the permit issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.6 Physical facilities
No specimen shall be examined unless the portion of the laboratory premises and the equipment used therein have been approved by the department as adequate for proper performance of the type of tests for which the laboratory is authorized.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.13 Purchases and contracts
(a) Purchases and contracts for materials and services will be limited to those items needed for company operation. Such purchases and contracts are subject to budgetary limitations except where the expenditure is necessary to protect life or property from imminent danger.
(b) Purchases and contracts will be awarded by a nursing home company only after every reasonable effort has been made to obtain the lowest possible cost commitment consistent with prudent operation. Substantial construction contracts, as defined in the State Hospital Code, shall require verification of cost by competitive bidding acceptable to the State Department of Health.
(c) Prior to permitting any supplier or contractor to perform, a company will require the contractor to submit satisfactory evidence of any insurance coverages and performance and payment bonds that may be required by the contract or purchase documents.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.7 Acceptance of specimens
(a) No establishment other than a clinical laboratory under permit shall accept specimens for the purpose of obtaining information for the diagnosis, prevention, or treatment of a disease or the assessment of a health condition. This subdivision shall not be deemed to prohibit the acceptance of specimens solely for teaching and research purposes.
(b) Except as otherwise provided in section 58-1.9 of this Subpart, a clinical laboratory shall examine specimens only at the request of licensed physicians or other persons authorized by law to use the findings of laboratory examinations in their practice or the performance of their official duties.
(1) If the request is oral, the physician or other authorized person shall submit a written request to the laboratory within 48 hours. If the laboratory does not receive the written request within that period, it shall note that fact in the record of daily accession.
(2) Other persons authorized by law to request the examination of specimens shall include but not be limited to:
(i) dentists and podiatrists, provided such examination is within the scope of practice of dentistry or podiatry;
(ii) chiropractors, provided such examination is within the scope of practice of chiropractic, as determined by the executive secretary of the State Board of Chiropractic, Cultural Education Center, Empire State Plaza, Albany, NY 12201;
(iii) physician's assistants, provided such examination is authorized by the supervising physician, and licensed midwives in accordance with their written protocols;
(iv) nurse practitioners, provided such examination is authorized under article 139 of the State Education Law;
(v) police officers, provided such examination is incident to arrest charges for alcohol or drug impairment; and
(vi) judges ordering paternity tests under the Family Court Act.
(c)
(1) A clinical laboratory under permit may operate one or more collecting or transfer stations, provided that it first obtains written approval from the commissioner for each proposed station.
(2) A collecting station is a facility, fixed or mobile, operated by a clinical laboratory under permit, for the collection, drawing and/or temporary storage of materials derived from the human body, until forwarded to the clinical laboratory for testing.
(3) A transfer station is a fixed facility or a mobile courier service, operated by a clinical laboratory under permit, for the acceptance and/or temporary storage and/or transfer of materials derived from the human body, until forwarded to the clinical laboratory for testing.
(4) A temporary collecting station is a one-time, one-site facility, operated by a clinical laboratory under permit, with the prior approval of the department, which collects, draws and/or temporarily stores materials derived from the human body, as part of a health fair, health assessment or health risk reduction program, for the purpose of screening for health risks under a general order from a licensed physician-in-charge.
(5) A temporary collecting station may perform specific tests onsite with the prior approval of the department, including approval for testing, storage, transportation, recordkeeping, and reporting protocols, provided that:
(i) all testing is performed under the active supervision of a clinical laboratory with a permit in the specific category of testing, provided that:
(a) such testing be limited to treatable diseases or those of public health significance and preventable by early detection; and
(b) the risks of erroneous results do not outweigh the benefits of testing.
(ii) the clinical laboratory can document that the testing method/technique is accurate, reliable, reproducible, and suitable for onsite use;
(iii) the clinical laboratory is responsible for adherence to all quality control/quality assurance procedures;
(iv) the physician-in-charge is responsible for assuring that participants with abnormal/at-risk results are counseled appropriately and/or referred to a physician with pertinent materials for test interpretation;
(v) procedures exist to refer for follow-up those participants without a personal physician;
(vi) the screening is conducted to ensure an orderly flow of activities so that discussion of test results, under the direction of the physician-in-charge, takes place in an area suitable for confidential counseling without distraction; and
(vii) suitable procedures for safe collection and disposal of specimens are in place.
(6) Departmental approval to operate a collecting or transfer station must be renewed annually on July 1st in conjunction with the clinical laboratory's permit. Such application for approval must include the name and address of the permit laboratory and a protocol for operation of the station and for ensuring the security and integrity of the specimens collected. The department will conduct annual inspections of collecting stations.
(d) A collecting station or temporary collecting station shall:
(1) create and maintain a record of the daily accession of specimens containing the following information, except that a fixed station which accepts specimens from a mobile station may use a copy of the mobile station's accession record in lieu of creating its own for specimens provided by the mobile station:
(i) the name and address of the person from whom the specimen was taken;
(ii) the name and address or other identifier of the licensed physician or other authorized person who requested the test;
(iii) the date and hour when the specimen was taken;
(iv) the date and if the test must be performed within 24 hours, the time the specimen was received in the collecting station;
(v) the type of test requested; and
(vi) the date and hour when each specimen was forwarded to the clinical laboratory for testing;
(2) forward a copy of the accession record to the clinical laboratory together with the specimens.
(e) Collecting stations, temporary collecting stations and transfer stations shall:
(1) have on their premises an operating refrigerator which:
(i) maintains a temperature range of 4 to 10 degrees Centigrade;
(ii) is equipped with an accurate thermometer; and
(iii) shall be used exclusively for the storage of patient specimens for clinical laboratory testing;
(2) store each specimen requiring refrigeration in the refrigerator at all times until removed for forwarding to the clinical laboratory;
(3) store each specimen so as to maintain its original condition as much as possible, and assure that it will not become unsatisfactory as a patient specimen;
(4) forward specimens only to the clinical laboratory by which they are operated;
(5) transport, or arrange for the transportation of, each specimen which requires refrigeration, in a manner that will assure that its temperature will remain at between 4 and 10 degrees Centigrade until it reaches the clinical laboratory;
(6) transport, or arrange for the transportation of, all specimens not requiring refrigeration, so as to maintain their original condition as much as possible, and assure that they will not become unsatisfactory as patient specimens; and
(7) transport. or arrange for the transportation of all specimens in a manner designed to minimize the likelihood of exposing personnel or the public to any source of infection or hazard.
(f)
(1) A mobile collecting station shall, in addition to complying with all requirements for fixed facilities, provide the department upon request with a monthly schedule in advance.
(2) A mobile collecting station, temporary collecting station or transfer station may use an alternative system of refrigerating specimens, provided that specimen temperatures are maintained at between 4 and 10 degrees Centigrade and the system's temperature is monitored and recorded periodically whenever in use.
(g)
(1) No tests on specimens, whether human, veterinary, environmental or other, shall be performed in a collecting or transfer station, except for:
(i) the screening for glucose and/or ketones in a collecting station, which must be performed prior to the administration of glucose for a glucose tolerance test. If sugar or ketones are present, the physician ordering such a test must be advised and the collection of blood for the tests may not be performed without his or her approval. Such approval must be documented in the accession record; and
(ii) tests performed in temporary collecting stations pursuant to paragraph (c)(4) of this section.
(2) Processing of specimens in a collecting, temporary collecting or transfer station shall be restricted to the preparation of specimens for transport solely to preserve their integrity and reliability. Such preparation shall include, but not be limited to, centrifugation, separation of serum, freezing, refrigeration of specimens, and air drying, fixing and/or freezing of smears.
(h) A clinical laboratory shall, at any time when a collecting station, temporary collection station or transfer station it operates is open, permit the inspection of said station by a representative of the department.
(i) The collecting station, temporary collecting station or transfer station shall be identified by the name of the clinical laboratory. The collection station temporary collecting station or transfer station must post conspicuously, in the waiting area or other place visible to all visitors, a sign which states:
(1) the services at the site are limited to collection of specimens and/or preparation of the specimens for transport;
(2) the name and address of the laboratory which will test the specimens; and
(3) information on billing practices, including the name and address of the establishment from which bills will originate and to which billing questions can be directed.
(j) Collecting stations, temporary collecting stations and transfer stations shall be operated in such a way that no violation of article 38 of the General Business Law takes place.
(k) The aforesaid written approval of the commissioner may be revoked, suspended, limited or annulled as to any or all of the collecting stations, temporary collecting stations or transfer stations operated by a clinical laboratory under permit on proof that any one of said stations has been operated in violation of this Subpart, the Sanitary Code contained in Chapter I of this Title, or article 38 of the General Business Law. The enforcement provisions applicable to laboratory permits in subdivisions 2, 3 and 4 of section 577 of the Public Health Law shall also apply to such proceedings. In addition, in the event of a violation, the laboratory permit of the clinical laboratory operating the collecting station, temporary collecting station or transfer station may be revoked, suspended, limited or annulled pursuant to paragraph (g) of subdivision 1 of section 577 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
BALANCE SHEETS BALANCE SHEETS
10 CRR-NY 444.6 FUND BALANCES
[ 3150 ]
(a) NON-PROFIT
[ 3151 ]
(1) UNRESTRICTED FUND BALANCE
(i) 2290
FUND BALANCE
2292
Depreciation Funds
2294
Transfers from Restricted Funds for Capital Outlay
2296
Value of Donated Property, Plant and Equipment
(ii) Unrestricted Fund balances represent the difference between the total of Unrestricted Fund Assets and Unrestricted Fund Liabilities, i.e., the net assets of the Unrestricted Fund.
(iii) Separate sub-accounts may be maintained for the above when applicable.
(iv) The Transfers from Restricted Funds for Capital Outlay account should be credited for the cost of capital items purchased directly by the Unrestricted Fund with funds from the Plant Replacement and Expansion Fund. The fair market value of donated property, plant and equipment (at the date of donation) should be credited to the Donated Property, Plant and Equipment account. At the end of the year these accounts should be closed out to the Fund Balance account.
(v) Depreciation Funds (account 2292) represents amounts restricted by third-party payors for replacement of specified assets.
(2) PLANT REPLACEMENT AND EXPANSION FUND BALANCE
(i) 2690
FUND BALANCE
2691
Restricted Project Funds
2692
Depreciation Funds
2693
Donor-Restricted Funds
2695
Transfers to Unrestricted Fund for Capital Outlay
2696
Value of Donated Property, Plant and Equipment
2697
Transfers to Operating Fund for Operating Purposes
(ii) The credit balances of these accounts represent the net amount of this restricted fund's assets available for its designated purpose. These accounts must be credited for all income earned on restricted fund assets, as well as gains and losses on the disposal of such assets. If, however, such items are to be treated as Unrestricted Fund income (considering legal requirements and donor intent), the Restricted Fund Balance account should be charged, and the Due to Unrestricted Fund account credited, for such income.
(iii) Depreciation Funds (account 2692) represents amounts restricted by third-party payors for replacement of specified assets.
(iv) Accounts 2695 and 2697 are debit balance accounts and during the year the balance of the accounts would reflect the amounts transferred to the Unrestricted Fund for capital outlay and operating purposes. At the end of the year the balances of these sub-accounts should be closed out to the Fund Balance account.
(v) Account 2696 reflects the fair market value, at the date of donation, of donor-restricted property, plant and equipment.
(3) SPECIFIC PURPOSE FUND BALANCE
(i) 2790
FUND BALANCE
2791
Restricted Project Funds
2793
Donor-Restricted Funds
2795
Transfers to Unrestricted Fund for Capital Outlay
2796
Value of Donated Property, Plant and Equipment
2797
Transfers to Operating Fund for Operating Purposes
(ii) The credit balances of these accounts represent the net amount of this restricted fund's assets available for its designated purpose. These accounts must be credited for all income earned on restricted fund assets, as well as gains on the disposal of such assets. If, however, such items are to be treated as Unrestricted Fund income (considering legal requirements and donor intent), the Restricted Fund Balance account should be charged, and the Due to Operating Fund account credited, for such income.
(iii) Accounts 2795 and 2797 are debit balance accounts and during the year the balance of the accounts would reflect the amounts transferred to the Unrestricted Fund for capital outlay and operating purposes. At the end of the year the balances of these sub-accounts should be closed out to the Fund Balance account.
(iv) Account 2796 reflects the fair market value at the time of donation of donor-restricted property, plant and equipment.
(4) ENDOWMENT FUND BALANCE
(i) 2890
FUND BALANCE
2893
Donor-Restricted Funds
2895
Transfers to Unrestricted Funds for Capital Outlay
2896
Value of Donated Property, Plant and Equipment
2897
Transfers to Operating Fund for Operating Purposes
(ii) The credit balances of these accounts represent the net amount of this restricted fund's assets available for its designated purpose. These accounts must be credited for all income earned on restricted fund assets, as well as gains on the disposal of such assets. If, however, such items are to be treated as Operating Fund income (considering legal requirements and donor intent), the Restricted Fund Balance account should be charged, and the Due to Operating Fund account credited, for such income.
(iii) Accounts 2895 and 2897 are debit balance accounts and during the year the balance of the accounts would reflect the amounts transferred to the Unrestricted Fund for capital outlay and operating purposes. At the end of the year the balance of these sub-accounts should be closed out to the Fund Balance account.
(iv) Account 2896 reflects the fair market value at the time of donation of donor-restricted property, plant and equipment.
(b) INVESTOR-OWNED CORPORATION.
[ 3152 ]
2350
STOCKHOLDER's EQUITY
2351
Preferred Stock
2352
Common Stock
2353
Treasury Stock
2360
Additional Paid-in Capital
2370
Retained Earnings
The total of these equity accounts reflects the difference between the total assets and the total liabilities of the Investor-Owned Corporation.
(c) INVESTOR-OWNED PARTNERSHIP OR SOLE PROPRIETOR.
[ 3153 ]
2380
CAPITAL—PARTNERSHIP OR SOLE PROPRIETOR
2381
Capital
2382
Partner's Draw
The total of these accounts represents the net assets of the Partnership or Sole Proprietor.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
VILLAGES VILLAGES
10 CRR-NY 100.5 Village of Ravena
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all natural and artificial reservoirs on Hannacroix Creek and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Ravena, Albany County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs used for the collection or storage of the flow from the above named creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), brook, stream, ditch, gutter or channel of any kind the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Ravena.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Ravena.
(2) No privy, privy vault, pit or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Ravena.
(3) Every privy, privy vault, pit or other receptacle of any kind placed or used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal, hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Ravena.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the village, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Ravena, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Ravena.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply, nor shall any liquid or solid matter be thrown or discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface except into watertight receptacles, the contents of which are to be removed within 100 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Ravena.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the village of Ravena.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or tributary thereof, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Ravena is prohibited. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excremental matters any streams tributary to the public water supply of the village of Ravena.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet from any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Ravena, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washing from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Ravena.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Ravena, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 200 feet of any reservoir nor within 75 feet of any watercourse tributary to the public water supply of the village of Ravena, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Ravena.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the village of Ravena.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of Ravena, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Ravena.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice shall be allowed in or upon the waters or ice of the reservoir. No ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir without a permit from the board of trustees of the village of Ravena, and strict sanitary supervision shall be maintained by the village over all ice cutting operations on the reservoir in order to prevent polluton of the supply from the workmen or horses engaged in the ice cutting.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Ravena.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Ravena.
(j) Inspections.
The board of trustees of the village of Ravena or such other board as may be charged with the maintenance or supervision of the public water supply or its duly appointed representative shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.1 Definitions
(a) State Health Service Corps professional shall mean a health professional in any one of the professions listed below or any other health professional, excluding physician or dentist, determined by the Commissioner of Health, in consultation with the State Health Service Corps advisory committee to be needed in designated facilities or agencies:
(1) a registered professional nurse;
(2) a registered physician's assistant;
(3) a dental hygienist;
(4) an occupational therapist;
(5) a physical therapist;
(6) a speech-language pathologist;
(7) an audiologist;
(8) a pharmacist;
(9) a midwife; and
(10) any other health profession identified by participating agencies as being difficult to recruit. Scholarships in these occupations will be offered on a limited basis for no more than two years.
(b) State Health Service Corps advisory committee shall mean a committee composed of the Commissioners of the Departments of Health, Education and Correctional Services, the Commissioners of the Office of Mental Health and the Office of Mental Retardation and Developmental Disabilities and the Presidents of the Civil Service Commission and the Higher Education Services Corporation or their designees, established to advise the Commissioner of Health on issues related to the State Health Service Corps.
(c) Designated facility or agency shall mean a facility or institution designated by the Commissioner of Health, in consultation with the State Health Service Corps advisory committee that is:
(1) operated by:
(i) the Office of Mental Health;
(ii) the Office of Mental Retardation and Developmental Disabilities;
(iii) the Department of Correctional Services; or
(2) not-for-profit and licensed by the Office of Mental Retardation and Developmental Disabilities or the Office of Mental Health or under contract with the Commission for the Blind and Visually Handicapped;
(3) a not-for-profit diagnostic and treatment center, with an operating certificate issued pursuant to section 401.1 of this Title, which has a critical shortage of health personnel, as determined by the commissioner, and which serves the medically indigent and Medicaid-eligible persons;
(4) a health care facility or nonprofit or public agency which provides care or treatment to persons infected with the human immunodeficiency virus or who have acquired immunodeficiency syndrome and which are currently experiencing a shortage of health personnel to specifically serve such persons; or
(5) in the case of midwives, a not-for-profit facility with an operating certificate issued pursuant to section 401.1 of this Title, which serves the medically indigent and Medicaid-eligible women.
(d) Licensure shall mean possession of a license, registration or certificate to practice in one of the professions listed in subdivision (a) of this section issued by the appropriate governing agency.
(e) Academic year shall mean the period between July 1st and June 30th of the following year.
(f) Full-time enrollment shall mean matriculation as a college or university student taking at least 12 credits or their equivalent, except that in the final semester of study in which the student must take sufficient credits or their equivalent in order to complete training, but not fewer than six credits.
(g) Scholarship or fellowship award shall mean the sum of the State Health Service Corps funds paid to or on behalf of a State Health Service Corps recipient during one academic year. The award shall not exceed the cost of attendance which shall mean tuition, required fees, books, transportation, and room and board.
(h) Effective date of award shall mean the beginning date of the first semester for which the scholarship or fellowship recipient has received a State Health Service Corps award.
(i) Service obligation shall mean the period of time a State Health Service Corps scholarship or fellowship recipient is required to work a basic workweek as an employee of a designated facility or agency.
(j) Alternative service shall mean working a basic workweek as a paraprofessional or in a profession other than the one for which the award was given in fulfillment of the service obligation.
(k) State Health Service Corps recipient shall mean an individual who has signed a service agreement to receive a scholarship or fellowship award under the State Health Service Corps program in return for a service obligation.
(l) Service agreement shall mean the written agreement to be signed by a State Health Service Corps recipient specifying the terms of the award and the service obligation required prior to issuance of an award.
(m) Reporting date shall mean the date upon which a State Health Service Corps recipient is required to begin employment in fulfillment of his/her service obligation.
(n) Rescission shall mean the withdrawal of an award after the signing of the service agreement but before full payment for an award is made to an educational institution.
(o) Waiver shall mean full or partial release by the Commissioner of Health, of the service obligation and/or any financial obligation for repayment of scholarship or fellowship award monies incurred by a State Health Service Corps award recipient.
(p) Deferral shall mean a delay or temporary suspension of the award payment and/or service obligation and/or any financial obligation for repayment of award monies incurred by the State Health Service Corps award recipient, with no resulting reduction in service or financial obligation.
(q) Default shall mean the failure to complete program of study, or the failure to begin the service obligation on the reporting date, or the failure of a State Health Service Corps recipient to complete his/her service obligation within the time prescribed by the Commissioner of Health.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.4 Project construction
(a) All payments made by a nursing home company after mortgage closing for construction and development costs require the written approval of the State Department of Health. Payments may only be made for expenditures authorized in the development cost and capital requirement budget approved by the State Department of Health. Payments may be permitted monthly from either mortgage loans or capital contribution funds in accordance with procedures approved by the State Department of Health. Any capital or development costs determined by the State Department of Health to be ineligible will not be approved for payment. All payment approvals shall be subject to and conditioned upon audit by the State Department of Health.
(b) Acceptable surveys and title reports, or satisfactory updates of such acceptable to the State Department of Health, free and clear of all exceptions not approved by the State Department of Health, shall be required prior to approval of payments after mortgage closing.
(c) Any project materials to be stored off the site of the project shall require satisfactory evidence of identification of the materials and insurance coverage in a form and amount acceptable to the State Department of Health.
(d) All contract changes require prior written State Department of Health approval except changes that must be started immediately to correct emergency field conditions. Requests for change orders from contingency funds may only be approved if required to meet emergency and life safety requirements, unforeseen field conditions or errors and omissions in contract documents. Requested changes of scope or of quality or type of functions, materials or equipment may only be approved if the cost is reasonable, if funds are available and if the change will not result in an increase in operating cost. All change orders proposed must contain a statement specifying if the contract time is to be changed. The State Department of Health will limit all change order approvals from contingency funds to those necessary for completion of the project in order to protect the adequacy of the contingency budget.
(e) Acceptance of a restricted donation or a donation in kind which may result in an increase in operational costs requires the prior approval of the State Department of Health.
(f) The equity funds of a company not currently required shall be invested. Such investments shall have the prior approval of the State Department of Health.
(g) Equipment may only be purchased by projects after approval of an equipment list by the State Department of Health. Such list shall be in accordance with the requirements set forth in the State Department of Health Manual for the Preparation of Equipment Lists. Unit and total cost approval for all items shall be approved by the State Department of Health.
(h) Final payment for the completion of any contract shall require satisfactory evidence of payment of all subcontractors, the submission of all releases required by the State Department of Health, and such affidavits or certifications of the company, the architect, and the contractor as the State Department of Health may require.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.81 Daily inpatient census
The number of inpatients present at the census-taking time each day, plus any inpatients who were both admitted and discharged after the census-taking time the previous day. Generally the inpatient census is taken each midnight. However, a facility may designate and consistently use any other specified hour for census taking.
10 CRR-NY 441.113 Endowment funds
Funds in which a donor has stipulated, as a condition of his gift, that the principal of the fund is to be maintained inviolate and in perpetuity, and that only income from investments of the fund be expended (see also term endowment funds ).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.4 Approval criteria
(a) In such form as may be prescribed by the department, the environmental laboratory owner(s) and technical director(s) shall attest to the following:
(1) the laboratory will be operated in accordance with section 502 of the Public Health Law, the provisions of this Title and/or section 3-0119 of the New York State Environmental Conservation Law;
(2) the laboratory will employ approved methods and will document information pertinent to the approval, demonstration of capability, and use of each method;
(3) records will be maintained for not fewer than five years and shall identify precisely the samples collected, accepted and examined; and procedures used and personnel involved; and shall document test conditions, observations and results of analyses, except that records of chemical analyses related to potable water supplies shall be maintained for not fewer than 10 years and records of analyses related to critical agents shall be maintained as required in section 55-2.13 of this Subpart;
(4) the technical director(s) will develop, implement and document a quality system as defined in this Subpart; and
(5) the owner shall notify the department if the laboratory is found to be in violation of any Federal, State or local law related to the provision of environmental laboratory services or reimbursement for such services, by the Federal, State or local agency enforcing that law.
(b) Approval shall be granted to an environmental laboratory for the analytes by categories sought in the application for approval, provided:
(1) the laboratory submits a complete application, including the attestation specified in subdivision (a) of this section and any additional information required by the department to support the application, and remits to the department the approval fee pursuant to Subpart 55-3 of this Part, unless otherwise expressly authorized by the department.
(2) each proposed technical director submits documentation of his or her qualifications for evaluation by the department, and the department finds such individual(s) qualified pursuant to section 55-2.10 of this Subpart;
(3) the laboratory provides documentation of a quality system in compliance with this Subpart;
(4) pursuant to section 55-2.8 of this Subpart, the laboratory participates and performs satisfactorily in proficiency testing for the analytes for which it seeks approval;
(5) except as provided in subdivision (c) of this section, the laboratory undergoes an on-site assessment conducted by the department or by a State regulatory program recognized by the department pursuant to section 55-2.9 of this Subpart; the findings of the on-site assessment(s) confirm compliance with the staffing, methodological and other requirements of this Subpart; and the laboratory demonstrates effective implementation of its quality system for planning and assessing the work performed by the laboratory, and for conducting required quality assurance and quality control procedures to promote and maintain the accuracy and reliability of test results;
(6) the laboratory provides entry to representatives of the department and/or of a State regulatory program recognized by the department, for on-site assessments during normal business hours; and
(7) the department finds the owner(s) and technical director(s) to be of good character and competence after evaluation of factors including, but not limited to:
(i) prior sustained charges of administrative violations of State or Federal laws, rules and regulations related to the provision of environmental laboratory services or reimbursement for such services, against the owner or a technical director listed on the application, individually or jointly, or against any laboratory owned or directed by an owner or a technical director listed on the application, or findings by a municipality that a laboratory owned or directed by an owner or technical director listed on the application has violated a local ordinance relating either to collection and analysis of samples, or to reporting of results for the examination of said samples;
(ii) conviction of any crime, including, but not limited to, any offense related to furnishing of, or billing for, environmental laboratory services, which is considered an offense involving theft or fraud;
(iii) consideration of whether any environmental laboratory directed by a technical director listed on the application has demonstrated a pattern of repetitive unsatisfactory performance in required proficiency testing in one or more proficiency testing categories, excluding an unsatisfactory score for administrative reasons such as late result submission;
(iv) consideration of whether any laboratory owned or directed by an owner or a technical director listed on the application has misrepresented any material fact pertinent to obtaining or retaining approval including, but not limited to, falsification of any report on or related to laboratory analysis, or submission of any reports on laboratory work, including work both on samples and proficiency testing, actually performed in another laboratory, without disclosing the fact that the examinations or procedures were performed in another laboratory;
(v) evidence of aiding and/or abetting in the violation of any of the provision of this Subpart; and
(vi) any other factor having a direct bearing on the ability of the owner(s) and technical director(s) listed on the application to provide, direct or supervise the provision of high quality environmental laboratory services, or to ensure compliance with applicable statutory and regulatory requirements.
(c) Interim approval.
(1) A laboratory that has not undergone an on-site assessment may be granted interim approval, for a period not to exceed 12 months, provided all other requirements for approval in subdivision (b) of this section are met.
(2) A laboratory with interim approval shall be granted full approval in the categories and analytes for which it seeks approval provided the findings of on-site assessment(s) described in section 55-2.7 of this Subpart confirm compliance with the staffing, methodological and other requirements of this Subpart, and the laboratory demonstrates effective implementation of tis quality system for planning and assessing work performed by the laboratory, and for conducting required quality assurance and quality control procedures to promote and maintain the accuracy and reliability of test results.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.184 Inventory valuation
The determination of the cost or the portion of cost assignable to on-hand raw materials, merchandise, merchandise held for resale, and supplies based on any generally accepted method consistently applied.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.3 Definitions
As used in this Subpart:
(a) Abandoned well means a well whose use has been permanently discontinued. A well shall be deemed abandoned if it is in such a state of disrepair that continued use for the purpose of obtaining a satisfactory ground water supply is impracticable.
(b) Applicant means the owner, lessee or other person having the possession and control of property on which a well is to be constructed or abandoned.
(c) Construction of water wells means all acts necessary to obtain ground water by wells, including the location and excavation of the well.
(d) Permit-issuing official means the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, or such grade I or grade II public health administrator or county health director may designate the director of environmental health of such district; and the State regional health director or area director may designate the district sanitary engineer as additional persons authorized to issue the permits required by this Part.
(e) Installation of pumps and pumping equipment means the procedure employed in the placement, protection and preparation for operation of pumps and pumping equipment, including all construction involved in making entrance to the well and establishing seals.
(f) Person means any individual, public or private corporation, political subdivision, government agency, municipality, industry, copartnership, association, firm, trust, estate or any other legal entity.
(g) Pumps and pumping equipment means any equipment or materials utilized or intended for use in withdrawing or obtaining ground water for any use; including, without limitation, seals and tanks, together with fittings and controls.
(h) Yield means the quantity of water per unit of time which may flow or be pumped from a well at a stabilized drawdown water level.
(i) Specific capacity means the rate of yield of well per unit drawdown expressed either as gallons per minute per foot or as liters per minute per meter.
(j) Water well contractor means any person, firm, or corporation engaged in the business of constructing water wells.
(k) Well means any excavation that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed when the intended use of such excavation is for the location or acquisition of ground water, but such term does not include an excavation made for the purpose of obtaining or for prospecting for oil, natural gas, minerals, or products of mining or quarrying, or for inserting media to repressure oil or natural gas-bearing formation or for storing petroleum, natural gas or other products.1
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.136 Full-time equivalent employees (FTE)
An objective measurement of the personnel employment of an institution in terms of full-time labor capability. To calculate the number of full-time equivalent employees, sum all hours for which employees were paid (whether worked or not) during the year and divide by 2080.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.83 Reheating
(a) The entire mass of all precooked, refrigerated, potentially hazardous food that is to be reheated must be heated to 165 degrees Fahrenheit (73.9 degrees Celsius) or above within two hours and held above 140 degrees Fahrenheit (60 degrees Celsius) until served.
(b) Precooked potentially hazardous foods from commercially processed hermetically sealed containers and precooked potentially hazardous foods in intact packages from commercial food processing establishments that are to be heated for the first time within the food service establishment must be heated to 140 degrees Fahrenheit (60 degrees Celsius) within two hours and held above 140 degrees Fahrenheit (60 degrees Celsius) until served.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 350 ALL PAYER DATABASE (APD)
10 CRR-NY 350.2 APD data submission
(a) Third-party health care payers shall submit complete, accurate, and timely APD data to the department, pursuant to the submission specifications.
(b) The department shall consult with the Department of Financial Services and third-party health care payers before issuing any submission specifications.
(c) The department shall set a compliance date of at least 120 days from the date that new or revised submission specifications are issued.
(d) Third-party health care payers shall submit APD data in an electronic, computer-readable format through a secure electronic network of the department or its designated administrator on a monthly basis, or more frequently, as specified in the submission specifications.
(e) Third-party health care payers shall submit at least 95 percent of APD data within 60 days from the end of the month that the adjudicated claims were paid.
(f) Third-party health care payers shall submit 100 percent of APD data within 180 days from the end of the month of the adjudicated claims being submitted for payment.
(g) The department may audit APD data submitted by third-party health care payers to evaluate the quality, timeliness, and completeness of the data. The department may issue an audit report or statement of deficiencies listing any inadequacies or inconsistencies in the APD data submitted and requiring corrective actions. Any third-party health care payer that receives an audit report or statement of deficiencies shall submit a plan of correction to the department within 30 days from the date of receipt of the audit report or statement of deficiencies. Third-party heath care payers shall be in full compliance with APD data submission specifications and the plan of correction within 90 days from the date of submission of the plan of correction.
(h) A third-party health care payer may submit a written request to the department for an extension, variance, or waiver of APD data submission specifications requirements. The written request shall include: the specific requirement to be extended, varied, or waived; an explanation of the reason or cause; the methodology proposed to eliminate the need for future extension, variance, or waiver; and the time frame required to come into compliance. The department shall respond to such requests as soon as practicable.
(i) Any third-party health care payer that violates this section shall be liable pursuant to the provisions of the Public Health Law, including, but not limited to, sections 12 and 12-d of the Public Health Law, and applicable sections of New York State Insurance Law and regulations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-6 TESTING OF NEWBORNS FOR HUMAN IMMUNODEFICIENCY VIRUS
10 CRR-NY 69-6.1 Approval of providers
Notwithstanding any other regulation, the department may approve providers which have medically acceptable protocols to screen blood of newborns, or with consent, the mother's blood, for human immunodeficiency virus antibodies and to communicate the results of such screening test to the mother or, if the mother lacks capacity to consent to health care for the newborn, to the person authorized by law to give such consent.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 708 APPROPRIATENESS REVIEW
10 CRR-NY 708.1 General provisions
The commissioner shall review, at least every five years, those hospital services and home care services with respect to which goals have been established in the State Health Plan, and, after consideration of the recommendations submitted by health systems agencies and the State Hospital Review and Planning Council, make public his findings as to the appropriateness of such services within one year after receipt of the health systems agency recommendations. The commissioner's reviews shall follow the procedures and utilize the criteria set forth in this Part. Such criteria shall relate to need, accessibility and availability, financial viability, cost effectiveness, and the quality of the service provided, except that criteria adopted for review may vary according to the type of service being reviewed and the purpose of the review.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.13 Tissue storage facilities
(a) A facility which stores cardiovascular tissue shall be licensed by the department as a tissue storage facility. The cardiovascular tissue bank shall keep the department fully informed of the number and type of tissue storage facilities operating under its direction.
(b) All cardiovascular tissue shall be stored and monitored in accordance with the provisions of sections 52-4.8 and 52-4.9(b), (c) and (d) of this Subpart.
(c) Temperature records or liquid nitrogen level records shall be available for inspection by the department for the entire period of cardiovascular tissue storage and for one year afterwards.
(d) Cardiovascular tissue products shall be distributed in accordance with the requirements of this Part, and all records related to the inspection, distribution and transport of tissues shall be open to inspection by the department and shall be kept for at least seven years or six months after the expiration date of the tissue, whichever is the longer time.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 5 HIV/AIDS HEALTH SERVICES
Part 420 COMPREHENSIVE AMBULATORY HIV PROGRAMS
10 CRR-NY 420.4 Program administration
(a) The CAHP shall have an administrator responsible for the organization, equipment and staffing of the CAHP, consistent with the scope of services offered and patient care needs. The administrator shall:
(1) establish and implement administrative policies and procedures for the CAHP; and
(2) maintain a functional organization chart of the CAHP which delineates lines of authority, both administratively and clinically.
(b) The CAHP shall develop and implement a quality of care management program which includes a review of the appropriateness of HIV services and functions as an integral part of the Comprehensive Ambulatory HIV Program.
(1) Specific quality of care assessment protocols for HIV-infected patients shall be developed and monitored as an integrated part of the facility's quality management system.
(2) The quality management program shall promote continuous quality improvement of patient care as well as identification of target areas for continuing education programs.
(c) The CAHP shall develop and implement policies and procedures for infection control, occupational exposure to HIV and for employment of HIV infected health care workers based on currently available scientific evidence about HIV and its transmission.
(d) The CAHP shall develop and implement specific policies and procedures for the prevention of HIV and other infectious disease transmission and to further such prevention shall comply with pertinent Federal and State law and regulations and generally accepted public health practice for the prevention of infectious disease.
(1) Such policies and procedures shall require that all patients are:
(i) instructed regarding the transmission of HIV and other infectious diseases and risk reduction measures;
(ii) routinely screened and treated for sexually transmitted diseases and hepatitis B; and
(iii) screened and immunized against preventable infections.
(2) All newly diagnosed cases of AIDS or suspected cases of AIDS shall be reported to the department as required by Part 24 of this Title.
(3) The CAHP shall counsel patients regarding the importance of notifying sex and needle sharing pertners of the potential exposure to HIV and the need for counseling and testing for HIV antibodies. Partner notification shall be promoted as an effective intervention by all members of the patient's care team. Partner notification and counseling assistance shall be integrated across the continuum of services offered by the program.
(4) The CAHP shall develop and implement specific policies for the management of tuberculosis, including the management and containment of multiple drug resistant tuberculosis, consistent with generally accepted standards of medical care and treatment.
(e) A CAHP which does not have a closed patient population such as a substance abuse treatment program shall sponsor programs that promote access to HIV-related services offered by the facility and other providers within the community, and which are designed to increase community awareness of the modes of HIV transmission and the means of HIV prevention. The program shall be designed to strengthen provider linkages across the continuum of HIV care.
(f) Ongoing educational and support programs shall be provided to all regular staff of the CAHP. Inservice education programs shall address at least the following:
(1) medical and psychosocial needs of culturally diverse patients;
(2) confidentiality and legal issues with regard to HIV infection;
(3) the impact of HIV disease on the family unit; and
(4) stress management, psychosocial support and ongoing crisis counseling.
(g) The CAHP shall have an information management program with the capacity for monitoring and analyzing case-specific records that include, at a minimum, basic demographic information.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 100.18 Water District No. 1, Town of Bethlehem
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 1100, 1101, 1102, 1103, 1104 and 1105 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 879 of the Laws of 1953, shall apply to the springs and the spring-fed reservoirs and future drainage areas tributary thereto which serve as a source of the public water supply of Water District No. 1, Town of Bethlehem, Albany County, New York, and to any future reservoirs which may be constructed to serve as part of the source of supply.
(b) Definitions.
(1) The term water supply wherever used in this section refers to the public water supply of Water District No. 1, town of Bethlehem, Albany County, New York.
(2) The term springs refers to those springs located on the watershed and elsewhere and which are tributary to or contribute to the Water District No. 1 water supply.
(3) The term reservoirs refers to the impounding reservoir located on tributaries of Vly and Onesquethaw creeks in the town of New Scotland, in the valley between Clipp Road and Rock Hill Road on land owned by Water District No. 1, together with the two distribution reservoirs located on New Scotland Road in the town of New Scotland also located on land owned by Water District No. 1.
(4) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(5) The linear distance of a structure or object from the reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(6) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy.
(7) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into the reservoirs or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of water supply unless deposited in trenches or pits at a distance of not less than 200 feet from the reservoirs or any watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of the springs, streams or reservoirs, except a properly constructed and operated sewage disposal plant as hereinafter set forth in subdivision (d) of this section; provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above-named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of commissioners of Water District No. 1, and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 100 feet and 200 feet of the springs, streams or reservoirs shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the reservoir or any watercourse nor deposited beneath the surface of the ground within 200 feet of the springs, streams or reservoirs except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c) of this section. If such watertight receptacles are used, they shall not be located within 100 feet; provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above-named [ continued ] can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Bath water, wastes.
No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by subdivision (d), shall be discharged or allowed to flow into the reservoirs or any watercourse or spring nor be deposited on or beneath the surface of the ground within 200 feet of the reservoirs or any watercourse or spring.
(f) Garbage, refuse.
No garbage, refuse, putrescrible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in the reservoirs or watercourse nor on or beneath the surface of the ground within 200 feet of the reservoirs or of any watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(g) Bathing.
No person or persons shall bathe or swim or be allowed to bathe or swim in the reservoirs or in any watercourse.
(h) Boating, fishing.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs or any tributary to the public water supply, except by duly authorized employees of the Water District No. 1 in the performance of their duties of supervision and maintenance of the water supply.
(i) Animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in the reservoirs or any tributary and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute the reservoirs or any watercourse.
(j) Manure.
No manure pile shall be maintained or allowed to remain within 200 feet of the reservoirs or any watercourse.
(k) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintaned by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 250 feet of the reservoirs or any watercourse.
(l) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet of the reservoirs or any watercourse.
(m) General clause.
In addition to observing the foregoing reuirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(n) Inspections.
The board of commissioners of Water District No. 1 or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the town shall make thorough periodic inspections of the reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of commissioners to promptly notify the State Commissioner of Health of such violations. The board of commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(o) Penalty.
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of, or noncompliance with, any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.13 Operating revenue—deductions from revenue
[3215] This group of accounts (5900 - 5990) is used to report reductions in gross revenue arising from bad debts, contractual adjustments, uncompensated care, administrative, courtesy, policy discounts, and adjustments and other revenue deductions.
Part 447 STANDARD UNIT OF MEASURE REFERENCES
10 CRR-NY 447.5 Occupational therapy services
(a) ACCOUNT NUMBER
COST CENTER TITLE
7530
Occupational Therapy
(1) The standard unit of measure will be the relative value units developed by the American Occupational Therapy Association. Relative value units should be counted during a patient visit for all assessment, treatment or other activities which use the resources of the occupational therapy department, and for which a charge is made. Fifteen minutes is the smallest increment of time for which a unit of service should occur. After the initial 15 minutes, patient contact for less than 15 minutes should be rounded to the nearest whole 15-minute period.
(2) For patient groups of two or more, the appropriate relative value units listed in the schedule should be counted for each patient in the group. Different codes should be used to indicate the same treatment given to different size groups.
(3) Since a charge for only one treatment for a 15-minute period can be made, concurrent or combination treatments should be handled by selecting the most significant or longest treatment determined by the the therapist.
(4) Occupational therapy services provided in the home will have a unit value equivalent to that shown in the schedule for the service provided, plus the applicable unit value for travel time to and from the home.
(5) Relative value units for unlisted procedures should be reasonably estimated on the basis of other comparable procedures, or estimated by qualified personnel. If your facility has a standard set of treatments that all patients receive unique to your facility, using the system as a guide, relative value units should be developed.
(6) The system includes several definitions of activities not listed on the Relative Value Schedule, as the schedule is designed only for direct treatment.
| RVU's per 15 minutes Patient Group Categories | | | | | | | --- | --- | --- | --- | --- | --- | | Code number* | Service category | 1 pt. | 2-4 pts. | 5-8 pts. | 9 or more pts. | | | (b) Occupational Therapy Assessment. | | | | | | | (1) Screening | 11 | 5.5 | 3.3 | | | 98004 | (2) Patient Related Consultation | 14 | | | | | | (3) Evaluation | | | | | | 98055-06 | (i) Independent Living/Daily Living Skills and Performance | 18 | 9.0 | | | | 98010-00 | (ii) Sensorimotor Skill and Performance Components | 21 | 10.5 | | | | 98015-16 | (iii) Cognitive Skill and Performance Components | 20 | 10.0 | | | | 98020-21 | (iv) Psychosocial Skill and Performance Components | 18 | 9.0 | | | | 98025-26 | (v) Therapeutic Adaptations | 19 | | | | | 98030-32 | (vi) Specialized Evaluation | 23 | 11.5 | 6.9 | | | | (4) Reassessment | 18 | 9.0 | | | | | (c) Occupational Therapy Treatment. | | | | | | | (1) Independent Living/Daily Living Skills and Performance | | | | | | 98040-42 | (i) Physical Daily Living Skills | 13 | 6.5 | 3.9 | | | 98045-47 | (ii) Psychosocial/Emotional motional Daily Living Skills | 13 | 6.5 | 3.9 | | | | (iii) Work | | | | | | 98050-52 | (a) Homemaking | 15 | 7.5 | 4.5 | | | 98055-57 | (b) Child Care/Parenting | 18 | 9.0 | 5.4 | | | 98060-62 | (c) Employment Preparation | 19 | 9.5 | 5.7 | | | 98065-67 | (iv) Play/Leisure | 14 | 7.0 | 4.2 | | | | (2) Sensorimotor Components | | | | | | | (i) Neuromuscular | | | | | | 98070 | (a) Reflex Integration | 18 | | | | | 98075-78 | (b) Range of Motion | 13 | 6.5 | 3.9 | 1.3 | | | (c) Gross and Fine Coordination | 13 | 6.5 | 3.9 | 1.3 | | 98085-88 | (d) Strength and Endurance | 13 | 6.5 | 3.9 | 1.3 | | 98090-92 | (ii) Sensory Integration | 16 | 8.0 | 4.8 | | | | (3) Cognitive Components | | | | | | 98095-98 | (i) Orientation | 10 | 5.0 | 3.0 | 1.0 | | 98100-01 | (ii) Conceptualization/Comprehension | 14 | 7.0 | | | | 98105-06 | (iii) Cognitive Integration | 14 | 7.0 | | | | | (4) Psychosocial Components | | | | | | 96110-13 | (i) Self Management | 14 | 7.0 | 4.2 | 1.4 | | 96115-16 | (ii) Dyadic Interaction | 14 | 7.0 | | | | 98120-23 | (iii) Group Interaction | 10 | 5.0 | 3.0 | 1.0 | | | (5) Therapeutic Adaptation | | | | | | 98125 | (i) Orthotics | 20 | | | | | 98130-31 | (ii) Prosthetics | 16 | 8.0 | | | | 98135-36 | (iii) Assistive/Adaptive Equipment | 16 | 8.0 | | | | 98140-43 | (6) Prevention | 13 | 6.5 | 3.9 | 1.3 | | 98145 | (d) Patient/Client-Related Conferences | 14 | | | | | 98150-53 | (e) Travel: Patient Treatment-Related | 12 | 6.0 | 3.6 | 1.2 |
(f) Only one code number may be used for a given category. Thus, where a series of code numbers are listed, each code number in the series is to be used for a different patient group category. For example, code numbers 98001 through 98003 are given for screening: 98001 would be used for screening one patient, 98002 for screening a group of two to five patients, and 98003 for screening a group of six to eight patients.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.13 Audits and examinations
(a) The commissioner or superintendent or their representative(s) may examine at any time each certified external appeal agent, including any entities under contract with the certified external appeal agent for the purpose of carrying out the requirements of title II of article 49 of the Public Health Law or title II of article 49 of the Insurance Law and this Subpart, as to compliance with such requirements and the quality of services offered.
(b) All external appeal case records shall be subject to audit and examination for a period of six years from the date of the certified external appeal agent's final determination on the appeal. All documentation relating to the case shall be kept and maintained by the certified external appeal agent for no less than six years from the date of the certified external appeal agent's final determination on the appeal. Such documentation shall include, but not be limited to:
(1) procedures for credentialing clinical peer reviewers;
(2) procedures for selecting clinical peer reviewers for the case, including procedures for ensuring the absence of any prohibited material affiliation relative to clinical peer reviewers;
(3) enrollee's medical and treatment records;
(4) any other documentation received by the certified external appeal agent relative to the case;
(5) notes, comments and determinations of each clinical peer reviewer assigned to the case;
(6) written justification when more than three clinical peer reviewers are assigned to a particular case;
(7) letter of notification to the enrollee and the enrollee's health care plan and, as applicable, the enrollee's health care provider of the final determination;
(8) the names and qualifications of the clinical peer reviewer(s) that reviewed the external appeal; and
(9) a signed and notarized attestation from each clinical peer reviewer assigned to an external appeal that no prohibited material affiliation exists with respect to such external appeal.
(c) The commissioner or superintendent or their representative(s) may examine at any time each health care plan to determine compliance with the requirements of title II of article 49 of the Public Health Law or title II of article 49 of the Insurance Law and this Subpart.
(d) All external appeal case records shall be subject to audit and examination for a period of six years from the date of the certified external appeal agent's final determination on the appeal. All documentation relating to the case shall be kept and maintained by the health care plan for no less than six years from the date of the certified external appeal agent's final determination on the appeal. Such documentation shall include, but not be limited to:
(1) record of fees collected and waived;
(2) all correspondence and any other documentation received by and submitted to the certified external appeal agent assigned to the case;
(3) a copy of the notice provided by the health care plan to the enrollee or, as applicable, the enrollee's health care provider regarding the final utilization review adverse determination and the enrollee's right to request an external appeal; and
(4) a copy of the letter or other documentation of agreement between the health care plan and the enrollee to waive the health care plan's internal utilization review processes.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.5 Trend factor
For years in which the department does not update the base year, subject to the approval of the Director of Budget, the department may use a compounded trend factor to bring base year costs forward to the appropriate rate period. The trend factor shall be taken from applicable years from consumer and producer price indices, including, but not limited to the Medical Care Services Index; U.S. city average, by expenditure category and commodity and service group for the period April to April of each year.
Subpart 86-12 OUTPATIENT SERVICES LICENSED UNDER THE MENTAL HYGIENE LAW
10 CRR-NY 86-12.1 Utilization limits on OPWDD licensed clinics
For periods on and after April 1, 2011 Medicaid reimbursement rates for clinics licensed by the Office for People With Developmental Disabilities (OPWDD) shall be subject to the following:
(a) Definitions.
As used in this section:
(1) Clinic shall mean a clinic treatment facility licensed by OPWDD pursuant to 14 NYCRR Part 679.
(2) Clinic visit. For services provided by a clinic for the period on and after April 1, 2011 through June 30, 2011, clinic visit shall have the same meaning such term has in 14 NYCRR Part 679 as in effect for such period, and for services provided by a clinic for the period on and after July 1, 2011, clinic visit shall have the same meaning such term has in 14 NYCRR Part 679 as in effect for such period.
(3) Monthly utilization threshold shall be a monthly utilization standard defined in terms of an average monthly visit per patient served, as established by OPWDD based on peer norms.
(4) Reimbursement rate. For the period from April 1, 2011 through June 30, 2011, reimbursement rate shall mean the applicable fee as set forth in 14 NYCRR Part 679 as in effect for such period, and for any period on and after July 1, 2011, reimbursement rate shall mean the rate established in accordance with 14 NYCRR Part 679 for such period or periods.
(5) Utilization review period shall mean the 2009 calendar year.
(b) Service categories and corresponding monthly utilization thresholds are:
(1) Nutrition/dietetics: 2.08
(2) Speech language pathology: 4.33
(3) Occupational therapy: 4.08
(4) Physical therapy: 5.25
(5) Rehabilitation counseling: 3.25
(6) Individual psychotherapy: 3.08
(7) Group psychotherapy: 3.17
(c) For each service category identified in subdivision (b) of this section, OPWDD will annually calculate a monthly utilization rate for each clinic based on paid Medicaid claims for services rendered during the utilization review period. Service categories shall be identified by the procedure codes and clinician identifiers submitted on paid Medicaid claims. Visits associated with patients who received fewer than four visits within a service category shall be excluded from monthly utilization rate calculations. For utilization review periods beginning prior to July 1, 2011, OPWDD will use only the initial procedure code reported on the claim to calculate monthly utilization rates.
(d) When a clinic's calculated monthly utilization rate exceeds the monthly utilization threshold, OPWDD will calculate excess visits based on the following formula:
Excess Visits = (Clinic monthly utilization rate - Threshold Value) * Recipient Months
(e) OPWDD will sum a clinic's excess visits across all service categories. OPWDD will calculate excess visits as a percentage of total paid visits during the utilization review period. The reimbursement rates of clinics with excess visits shall be reduced by a uniform percentage in accordance with the following:
| Excess Visits as a percentage of Total Paid Visits | Reduction | | --- | --- | | 15.1% or more | 5.00% | | Between 10.1% and 15% | 4.25% | | Between 5.1% and 10% | 3.50% | | Between 1% and 5% | 2.75% | | Less than 1% | 0.00% |
(f) For the period April 1, 2011 through March 31, 2012, OPWDD may waive the reimbursement rate reductions in this section in accordance with the provisions of section 26 of part H of chapter 59 of the Laws of 2011, provided, however, that the waiver shall be subject to retroactive revocation upon a determination by OPWDD, in consultation with the department, that the clinic has not complied with the terms of such waiver.
(g) The issuance of waivers as described in subdivision (f) of this section shall be subject to the following:
(1) In order to receive a waiver a clinic must submit to OPWDD a request for a waiver and a utilization reduction plan. OPWDD’s decision on the waiver shall be based on whether the clinic’s utilization reduction plan shows a reduction in the clinic’s planned State fiscal year 2011-2012 Medicaid visits by an amount equal to the paid visits in excess of the utilization thresholds and whether the clinic is operating in conformance with all applicable statutes, rules and regulations. For purposes of this section, a clinic's planned State fiscal year 2011-2012 visits cannot exceed its paid Medicaid visits in calendar year 2010.
(2) OPWDD will compare the actual paid and planned State fiscal year 2011-2012 visits for each clinic granted a waiver. If a clinic fails to achieve the reduction in utilization in accordance with its utilization reduction plan, OPWDD will revoke the waiver and reduce the clinic’s reimbursement rates for State fiscal year 2011-12 as computed in accordance with the provisions of subdivisions (a) through (e) of this section, provided, however, that such reduction computation shall incorporate and reflect any utilization reduction that the clinic did achieve while operating under the waiver.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.9 Overnight transient occupancy
Structures at an agricultural fairground not meeting the definition of a camping unit which are available for overnight transient occupancy shall meet the requirements of Subpart 7-1 of this Part.
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.16 Showers
(a) If showers are provided, they shall be constructed of cleanable materials and maintained in a sanitary condition and good repair and provided with hot and cold running water.
(b) Hot water shall mean water heated or tempered to provide a temperature of 90° to 110°F at the point of use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.21 Rates of payment
(a) Physicians shall be paid at the 80th percentile of the usual and customary charges for services provided in private physician practices, as reported by FAIR Health, Inc. in its Usual, Customary and Reasonable (URC) database at the time of billing. Payment of these charges shall constitute payment in full for any such services provided to an enrollee of the fund.
(b) Emods, vehicle modifications and assistive technology will be paid at an amount established by the prior approval process pursuant to sections 69-10.7, 69-10.8, 69-10.9 and 69-10.10 of this Subpart.
(c) Services, supplies, and equipment for which there is a Medicaid fee or rate available will be paid at that fee or rate.
(d) Medications will be paid at the Medicaid rate, provided however, if the Department of Health determines that Medicaid rates are not available due to technological issues and related administrative costs, a pharmacy benefits manager designated by the fund administrator and approved by the Department of Health may be used to price medications.
(e) Any other service will be paid at a reasonable rate for that type of service in that geographic area as determined by the fund administrator. Rates shall be deemed reasonable if they are sufficient to provide the enrollee with access to services and are not in excess of the prevailing rates paid by other payers in the region. When Fair Health, Inc.’s UCR database specifies a rate for a particular service, the fund administrator shall pay at the 80th percentile of such rate.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.10 Supervision
It shall be the responsibility of the operator of the mobile home park to see that all facilities are kept in good working order and in good repair. This includes water supply facilities, sewage treatment and disposal facilities, grounds, roadways, and any other facility, appliances, or equipment pertinent to the normal operation of the mobile home park.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.8 Patient days
(a) A patient day is the unit of measure denoting lodging provided and services rendered to one patient between the census-taking hour on two successive days.
(b) In computing patient days, the day of admission shall be counted but not the day of discharge. When a patient is admitted and discharged on the same day, this period shall be counted as one patient day.
(c) For reimbursement purposes residential health care facility days shall be determined by using the higher of the minimum utilization factor of 90 percent of certified beds or the actual patient days of care as furnished by the facility.
(d) Reserved bed patient days shall be computed separately from patient days. A reserved bed patient day is the unit of measure denoting an overnight stay away from the residential health care facility for which the patient, or patient's third-party payor, provides per diem reimbursement when the patient's absence is due to hospitalization or therapeutic leave.
(e) In computing reserved bed patient days, the day of discharge from the residential health care facility shall be counted, but not the day of readmission.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.6 Grandparenting
(a) Water systems which will be required to have an operator for the first time because of the requirements of this Subpart dated February 5, 2001, may be granted a transition period to continue to retain their currently employed operators in responsible charge through grandparenting. Grandparenting will be based on factors such as system compliance history, operator experience and knowledge, system complexity, and level of treatment.
(b) Grandparenting is permitted only to existing operator(s) in responsible charge of existing systems. Operators that are New York State Department of Health certified before February 5, 2001 will retain his/her certification as originally granted.
(c) The system owner must apply for grandparenting for the operator(s) in responsible charge within two years of the effective date of this regulation or by February 5, 2003. Applications must be submitted to the department on forms prescribed by the department. Applications will be approved based on system compliance history, operator experience and knowledge, system complexity, and level of treatment. Upon approval, the operator in responsible charge will be grandparented.
(d) The certification for grandparented operators will be site-specific and nontransferable to other operators.
(e) Each grandparented operator must meet the renewal requirements outlined in section 5–4.8 of this Subpart no later than three years after his/her effective date of certification for grandparenting.
(f) The certification for a grandparented operator will no longer be valid if the classification of the plant or distribution system changes to a higher level.
(g) Grandparented operators that choose to work for a different water system must meet the initial certification requirements for that system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.20 Interest expense for all residential health care facilities
(a) Necessary interest on both current and capital indebtedness is an allowable cost for all residential health care facilities.
(b) To be considered as an allowable cost, debt generating interest shall be incurred to satisfy a financial need, and interest expense shall be at a rate not in excess of what a prudent borrower would have had to pay in the money market at the time the loan was made. Also, the interest shall be paid to a lender not related through control, ownership, affiliation or personal relationship to the borrower, except in instances where the prior approval of the Commissioner of Health has been obtained. Financial need for capital indebtedness relating to a specific project shall exist when all available restricted funds designated for capital acquisition of that type have been considered for equity purposes.
(c)
(1) Interest expense shall be reduced by investment income with the exception of income from funded depreciation, qualified pension funds, trusteed malpractice insurance funds, or in instances where income from gifts or grants is restricted by donors. Interest on funds borrowed from a donor-restricted fund or funded depreciation is an allowable expense. Investment income shall be defined as the aggregate net amount realized from dividends, interest, rental income, interest earned on temporary investment of withholding taxes, as well as all gains and losses. If the aggregate net amount realized is a loss, the loss is not allowable.
(2) For rate years beginning prior to January 1, 1994, investment income reported for the fiscal year ending December 31, 1983, (or for a subsequent fiscal year if that subsequent year's report is being used by the department to establish the basic rate pursuant to section 86-2.10 of this Subpart) shall reduce the interest expense allowed for reimbursement as follows:
(i) for all residential health care facilities, investment income shall first reduce the interest expense allowed each year for operational cost reimbursement; and
(ii) the amount of any remaining investment income, after application of subparagraph (i) of this paragraph, shall reduce the interest expense reimbursed each year as capital cost for residential health care facilities; and
(iii) the amount of any remaining investment income after application of subparagraph (ii) of this paragraph, shall not be considered in the computation of the rate.
(3) For rate years beginning on or after January 1, 1994, for all residential health care facilities, investment income reported for the same year used to compute capital cost reimbursement for a facility's rate shall reduce the interest expense allowed for reimbursement.
(d)
(1) Interest on current indebtedness shall be treated and reported as an operating, administrative expense for rate years beginning prior to January 1, 1994. For rate years beginning on or after January 1, 1994, interest on current indebtedness, reported for the same cost report period used to compute capital cost reimbursement for a facility's rate, shall be reported as an administrative expense and reimbursed as a nontrendable expense.
(2)
(i) Approval by the commissioner shall be required for reimbursement of interest expense on current indebtedness incurred on or after January 1, 1994 when such interest expense exceeds the threshold established for that calendar year. The threshold for each calendar year shall be equal to the interest charges that would be generated by current indebtedness with an interest rate equal to the prime lending rate as published in the first issue of the Wall Street Journal for the calendar year plus 200 basis points on a loan principal of $270,000 for facilities with 120 or less beds or $270,000 plus an additional $2,250 for each bed over 120 for facilities with more than 120 beds. Approval shall be granted in accordance with the standards set forth in subdivision (b) of this section. Prior approval shall not be required.
(ii) New facilities without adequate cost experience whose rates are calculated pursuant to section 86-2.15 of this Subpart shall be exempt from the requirements in subparagraph (i) of this paragraph until January 1st of the first calendar year used as the basis for computing capital cost reimbursement and for which a cost report is filed subsequent to the cost report described in section 86-2.2(e) of this Subpart. This exemption shall not apply to operating facilities that open new discrete units providing services reimbursed in accordance with the provisions of paragraphs (5), (6) and/or (7) of section 86-2.15(b) of this Subpart or other similar discrete units providing care to residents with special needs that receive a separate and distinct payment rate under section 86-2.15 of this Subpart.
(iii) The interest expense threshold for facilities operated by receivers or new operators who are required to file a cost report for the first 12-month period of operation pursuant to section 86-2.10(k) of this Subpart shall be established for that cost report period in accordance with subparagraph (i) of this paragraph, using the prime lending rate in effect on January 1st of the year in which the cost report period begins.
(e) Interest on capital indebtedness, as defined in section 86-2.21(a)(1) of this Subpart, except as provided for in subdivision (c) of this section for rate year beginning January 1, 1986 and thereafter. is an allowable cost if the debt generating the interest is approved by the commissioner, incurred for authorized purposes, and the principal of the debt does not exceed either the approval of the commissioner or the cost of the authorized purposes. Interest related to refinancing indebtedness shall be considered an allowable cost only to the extent that it is payable with respect to an amount equal to the unpaid principal of the indebtedness then being refinanced. However, interest incurred on refinanced debt in excess of the previously unpaid balance of the refinanced indebtedness will be allowable on acceptable demonstration to the Commissioner of Health that such refinancing will result in a debt service savings over the life of the indebtedness.
(f) Where a public finance authority has established a mortgage rate of interest such that sufficient cash flows exist to retire the mortgage prior to the stated maturity, the amount of the mortgage to be forgiven, at the time of such forgiveness, shall be capitalized as a deferred asset and amortized over the remaining mortgage life, as a reduction to the facility's capital expense.
(g) Voluntary facilities shall report mortgage obligations financed by public finance authorities for their benefit and which they are responsible to repay, as liabilities in the general fund when such mortgage obligations are incurred.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.38 Average life
The arithmetic mean of the estimated useful-life expectancies of a group of assets subject to depreciation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-1 DEFINITIONS
10 CRR-NY 52-1.1 Definitions
For purposes of this Part, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Acquisition means any activity, including solicitation, retrieval, and donor selection and testing, which is necessary to obtain tissue for transplantation, transfer, artificial insemination or implantation, or to obtain nontransplant anatomic parts for research or education.
(b) Allogeneic tissue collection means the retrieval of tissue from a donor for the purpose of transplantation or transfer into another individual, including tissue provided by a donor for transplantation, artificial insemination, implantation or transfer into a designated recipient.
(c) Aseptic processing means the handling, preservation and packaging of tissue not intended for viral inactivation, using methods designed to prevent contamination with pathogenic organisms.
(d) Aseptic retrieval means the recovery of tissue in a clean surgical field, using standard operating room techniques.
(e) Autogeneic tissue collection means the retrieval of tissue from a donor for subsequent reimplantation into that same donor.
(f) Clinical laboratory means a laboratory operating under a permit issued pursuant to article V, title 5 of the Public Health Law and/or which meets the requirements of the state in which it is located and of the Federal government (see clinical laboratory improvement amendments of 1988), and is acceptable to the commissioner as specified herein.
(g) Clinical use means the use of tissue for allogeneic or autogeneic transplantation, transfer, artificial insemination or implantation.
(h) Commissioner means the Commissioner of the New York State Department of Health.
(i) Controlling interest means the ability to direct or control the operation or management of a tissue bank, tissue processing facility or tissue storage facility (herein referred to as a facility), including, but not limited to, the ability or authority, expressed or reserved, to:
(1) amend or change the corporate or operating identity ( e.g., joint venture agreement or unincorporated business status) of the facility;
(2) approve operating and capital budgets of the facility;
(3) adopt, approve or direct facility fiscal operating policies and procedures;
(4) approve debt necessary to finance the facility's costs of compliance with operational or plant standards required by law;
(5) approve contracts for management of facility services;
(6) hire or dismiss the medical director or tissue bank director and nontechnical personnel;
(7) maintain and control the books and financial records of the facility;
(8) control any of the assets of the facility;
(9) encumber the assets of the facility by way of mortgage or other indebtedness; and
(10) dissolve the facility or arrange for the sale or transfer of the facility to new ownership or control.
(j) Department means the New York State Department of Health.
(k) Direct ownership interest means the possession of stock, equity in the capital, or any interest in the profits of the facility.
(l) Distribution means any activity necessary to distribute tissue for transplantation, transfer, artificial insemination or implantation from the tissue bank to the transplantation facility, or insemination/implantation site, including allocation and transportation, but shall not include transportation within the transplantation facility. Distribution shall also include distribution of nontransplant anatomic parts from the bank to the research or education facility.
(m) Donor means, except as otherwise defined in this Part, a human being, living or dead, who is the source of tissue or nontransplant anatomic parts, for transplantation, transfer, artificial insemination, implantation, education or research purposes.
(n) FDA means the Food and Drug Administration of the United States Department of Health and Human Services.
(o) Indirect ownership interest means the possession of stock, equity in the capital, or any interest in the profits of an entity with a direct or indirect ownership interest in the facility. For example, if an entity owns 10 percent of the stock in a corporation that owns 80 percent of the stock in a facility, that entity's interest equates to an eight percent indirect ownership interest.
(p) Medical advisory committee means a panel composed of at least five members with experience and expertise in the fields specified in the Subpart specific to the category or categories of tissue services provided, who are responsible for monitoring the medical efficacy of the tissue bank and setting operating policies and procedures. At least one member of the medical advisory committee shall possess expertise in microbiology, clinical pathology or infectious disease.
(q) Medical director means a physician who meets the requirements of section 52-2.5(a)(3) of this Part.
(r) Nontransplant anatomic bank means any person or facility that solicits, retrieves, performs donor selection and/or testing, preserves, transports, allocates, distributes, acquires, processes, stores or arranges for the storage of nontransplant anatomic parts, including whole bodies, body segments, organs or tissues from living or deceased donors, for education and/or research purposes specifically authorized by Public Health Law, section 4302. The following shall not constitute a nontransplant anatomic bank:
(1) any person or entity that stores nontransplant anatomic parts, except whole bodies and body segments, solely for purposes of research and/or education conducted by such person, provided the person or entity maintains on its premises a properly executed anatomical gift consent document consistent with section 52-11.3 of this Part; and
(i) such person or entity is a legal donee pursuant to Public Health Law, section 4302 and obtains all organs/tissues from a tissue bank or nontransplant anatomic bank licensed by the department; or
(ii) is a general hospital conducting pathology services or research on nontransplant anatomic parts including whole bodies, recovered from within the facility from a living or deceased source;
(2) any person or entity whose activities within the State of New York are limited to distribution of nontransplant anatomic parts to a tissue bank or nontransplant anatomic bank licensed by the department;
(3) any person or entity that uses prepared slides and/or human-derived cell lines for purposes of education and/or research; and
(4) an employee of the Federal government, provided an anatomical gift consent document has been executed in accordance with Public Health Law, section 4301 and section 52-11.3(d) of this Part.
(s) Owner means a person, persons, or an entity with direct or indirect ownership interest in a facility.
(t) Person means an individual, corporation, government or governmental subdivision or agency, business trust, estate trust, partnership or association, or any other legal entity, other than the Office of Mental Health.
(u) Principal stockholder means any person who owns (whether of record or as beneficiary), holds or has the power to vote, 10 percent or more of any class of securities issued by a corporation.
(v) Processing means any activity necessary to prepare, preserve for storage, remove from storage and/or conduct laboratory testing to assure the potency, quality or sterility of bodies, body parts, organs or tissue for research and/or education purposes, or tissue for transplantation, transfer, artificial insemination or implantation.
(w) Procure means to perform any activity which is necessary for the procurement of organs or tissue for transplantation, artificial insemination, implantation, research, education, therapy, fertilization, or autogeneic purposes, including solicitation, retrieval, donor selection and testing, clinical laboratory testing, including typing, preservation, transportation, allocation, distribution, storage, and payment activities.
(x) Recipient means a patient who receives tissue through transplantation, artificial insemination, transfer or implantation.
(y) Service area means a geographic area for acquisition and/or distribution services approved by the United States Secretary of Health and Human Services or, in the absence of such approval, by the department pursuant to the standards established in this Subpart.
(z) Storage means any activity necessary to store tissue for transplantation, transfer, artificial insemination or implantation, or nontransplant anatomic parts for research and/or education purposes.
(aa)
(1) Tissue bank means any person or facility which solicits, retrieves, performs donor selection and/or testing, preserves, transports, allocates, distributes, acquires, processes, stores or arranges for the storage of human tissues for transplantation, transfer, therapy, artificial insemination or implantation, including autogeneic procedures. Tissue banks shall be issued a license in the specific category of tissue and type of tissue services provided as described in subdivision (ad) of this section, and shall be required to comply with the standards applicable to the category or categories of tissue acquired, processed, stored and/or distributed. Categories of tissue and their definitions are:
(i) Cardiovascular tissue means human heart valves, aorta, great vessels, pericardium, saphenous vein, umbilical vein, or any other cardiovascular tissue for transplantation.
(ii) Musculoskeletal tissue means human bone, tendon, ligament, muscle, fascia, cartilage, dura, or any other musculoskeletal tissue for transplantation.
(iii) Skin means any human skin tissue for transplantation.
(iv) Eye means a human cornea or any other ocular tissue for transplantation.
(v) Reproductive tissue means any tissue from the reproductive tract intended for use in artificial insemination or any other assisted reproductive procedure. This includes, but is not limited to, semen, oocytes, embryos, spermatozoa, spermatids, ovarian tissue, testicular tissue and epididymal aspirates.
(vi) Human milk means human milk for ingestion by a child other than the mother's own.
(vii) Hematopoietic progenitor cells means human precursor or progenitor hematopoietic cells derived from bone marrow, peripheral blood or other tissue sources (see Subpart 58-5 of this Title).
(2) The following exceptions shall apply to the definition of tissue bank in this subdivision:
(i) An organ procurement organization shall not constitute a tissue bank solely by virtue of storing or arranging for the storage of heart valves.
(ii) An entity that uses tissue or fluids exclusively for diagnostic purposes, after removal or withdrawal of these materials in the course of standard medical practice, shall not constitute a tissue bank.
(iii) A hospital whose tissue banking activities are limited to requesting organs and/or tissue donations, or referring potential donors or next of kin to licensed comprehensive tissue procurement services pursuant to Public Health Law, article 43-A, shall not constitute a tissue bank.
(ab) Tissue bank compliance officer means an employee of a tissue transplantation facility who is responsible for communicating all department requirements pertinent to transplantation services to each transplantation service director in the facility and for responding to inquiries from the department regarding compliance with this Part.
(ac) Tissue bank director means a person who is appointed by the owner of a tissue bank and meets the requirements of section 52-2.5(a)(2) of this Part, who may be the medical director, and has responsibility for the operation of the tissue bank.
(ad) Tissue services means the type and extent of services provided by tissue banks acquiring, processing, storing and/or distributing tissues for transplantation, transfer, artificial insemination or implantation. Types of tissue services sites and their definitions are:
(1) Comprehensive tissue procurement service means a facility or organization that engages in donor selection, solicitation and retrieval activities related to tissues from living and/or cadaveric donors.
(2) Limited tissue procurement service means a facility or organization whose tissue acquisition activities are limited to donor selection and solicitation by its own staff or the provision of staff, training or equipment for tissue acquisition activities to assist a comprehensive tissue procurement service in retrieving tissue. Retrieval of tissues on the premises of a limited tissue procurement service shall be performed by the staff or agents of a comprehensive tissue procurement service. Hospitals whose tissue banking activities are limited to requesting organ and/or tissue donations, or referring potential donors or next of kin to licensed comprehensive tissue procurement services are not subject to the licensure requirements in Subpart 52-2 of this Part.
(3) Tissue processing facility means a facility or organization that engages in any or all activities associated with processing, storage and/or distribution of human tissues for transplantation, transfer, artificial insemination or implantation.
(4) Tissue storage facility means a facility that engages in any or all activities associated with storage and distribution of human tissues for transplantation, transfer, artificial insemination, and/or implantation, except insemination/implantation sites storing, for less than six months, semen collected and processed by a semen bank appropriately licensed by the department.
(5) Tissue transplantation facility means a facility which temporarily stores and transplants tissue, except for tissue intended for autogeneic transplantation, provided such tissue does not leave the operating room for processing and/or storage.
(6) Tissue transplantation service means a unit within a tissue transplantation facility that is independently supervised and transplants one or more types of tissue.
(7) Insemination/implantation site means a location at which artificial insemination or other assisted reproductive procedures are performed, using reproductive tissues from anonymous donors, directed donors and/or client-depositors. Semen processing, limited to washing, concentrating and storing semen from patients of physicians associated with the licensed insemination/implantation site or from the patients' regular sexual partners, and limited storage (less than six months' duration) may be undertaken without additional licensure.
(ae) Transplantation service director means a physician who directs a tissue transplantation service.
(af) Viral inactivation means a process that subjects tissue to sterilization using ethylene oxide gas, gamma irradiation, or other sterilization method generally accepted by leading authorities in transplant medicine.
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.5 Quality assurance and safety requirements
(a) Quality assurance.
(1) Records shall document that the following quality control procedures are in place at the tissue bank, except for a limited tissue procurement service:
(i) preventive maintenance, periodic inspections and testing for proper operation of equipment, including annual calibration of thermometers used to monitor the temperature of tissue in storage, against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against and found to be in agreement with an NIST-certified thermometer;
(ii) monitoring of all temperature-controlled spaces and equipment to assure proper performance;
(iii) validation of computer systems, microprocessor-controlled equipment and associated software;
(iv) validation of processing and testing methodologies; and
(v) supervisory review of test results prior to labeling of the tissue.
(2) Processing, laboratory and storage facilities shall be maintained in a clean and orderly manner, and shall be of suitable size, construction and location to assure tissue and personnel safety.
(3) All reagents and solutions shall be in-date, stored properly and labeled to indicate identity and, as appropriate, titer, strength or concentration, recommended storage requirements, preparation or expiration date, and other pertinent information. All such materials shall be removed from use on the expiration date. Materials of substandard reactivity and deteriorated materials shall be discarded regardless of expiration date.
(4) All specimens for testing accompanying the retrieved tissue shall be sufficiently stable to provide accurate and precise test results suitable for clinical interpretation. The tissue bank shall ensure that specimens are collected, preserved, and transported to the laboratory in such a manner as to meet this requirement. Specimens for analysis shall be identified fully and accessioned in a log book. The accessioning system shall be designed to trace the tissue to a specific donor and to identify the date and, if applicable, the time of retrieval.
(5) Control samples and standards shall be assayed regularly in order to validate test results on patient samples and to monitor reagents, operating characteristics of instruments, and accuracy of volumetric equipment. The frequency required for such testing shall be determined by the nature of the testing. Records of test procedures, reagents, calibrations, and results with control samples and standards shall be maintained and be available at all times for use by processing laboratory personnel and inspection by the department. As appropriate, these records shall document the precision required for every method, automated or manual, and its restandardization schedule. Control limits for standards and reference samples shall be recorded and shall indicate when test results are outside acceptable limits. Values for quantitative assays shall be reported only if the analytical run of which they are a part is an acceptable run as determined by a protocol approved by the laboratory director. If the analytical error exceeds limits established by the laboratory's quality control program, remedial action shall be taken and documented, and the patient specimen, if available, retested. Whether or not the specimen is available for retesting, the initial result shall be reported as invalid.
(6) Current standard operating procedure manuals or other procedural guides specific to the facility shall be available at all times in the immediate work area of personnel engaged in tissue retrieval, processing, testing, storage and distribution activities. There shall be a written procedure for each tissue collection, processing, storage and distribution activity performed at the facility. Manuals shall contain a protocol for writing, maintaining and periodic review of standard operating procedures by user personnel and management staff. Procedure manuals shall have the following features:
(i) a standardized format;
(ii) a system of numbering and/or entitling individual procedures;
(iii) a clearly written description of purpose for each procedure;
(iv) a reference section listing appropriate scientific literature and industry and/or corporate standards espoused by the tissue bank;
(v) clearly defined areas of personnel responsibility by title;
(vi) documented approval of procedures and procedural modifications, by the tissue bank director, and annual review by the tissue bank director or authorized supervisor;
(vii) instructions for the completion of reports and forms, including examples;
(viii) authorship and effective date, and date of review for each procedure; and
(ix) a system of archiving earlier versions of procedures and forms.
(7) The policies and procedures specified in the current standard operating procedures manual shall be followed at all times. If deviations or deficiencies are identified, appropriate corrective action shall be taken and documented.
(8) The tissue bank director shall establish and maintain a planned and periodic internal review program for monitoring and evaluating the quality and appropriateness of the banking activities conducted. Included in the program shall be a system for designing and implementing corrective action for any problems identified. Quality assurance deficiencies shall be documented, and evidence shall be available that problems are reported to supervisory personnel in a timely manner and that corrective action is implemented, documented and subsequently followed-up.
(b) Safety.
The tissue bank shall implement written safety and infection control policies and procedures to ensure protection from unnecessary physical, chemical and biological hazards.
(1) Decontamination and disposal techniques for regulated medical waste shall be utilized. All hazardous and regulated waste materials shall be handled, stored and discarded pursuant to Part 70 of this Title, or in the case of out-of-state banks, in accordance with the hazardous waste disposal requirements of the state in which the disposal occurs.
(2) If autoclave equipment is used for sterilization, the pressure, temperature, and duration of each cycle shall be recorded, and such records maintained for one year. For each run, these parameters shall be within the manufacturer's recommended operating standards. If any one or more of these parameters fall outside the manufacturer's standards, all material shall be reautoclaved. Chemical, biological and physical detection systems should be used in conjunction with these other measurements of performance.
(3) Eating, drinking, smoking, or the application of cosmetics or contact lenses shall not be permitted in work areas. Refrigerators or freezers used for storing tissue, specimens or reagents shall not be used for any other purpose.
(4) Gloves and laboratory coats, gowns or other protective clothing shall be worn as necessary while handling specimens or tissues. Such protective clothing shall not be worn outside the work area and shall be disposed of in an appropriate receptacle.
(5) A tissue bank performing tissue processing or laboratory testing shall have written policies and procedures in the following areas:
(i) infection control;
(ii) biosafety;
(iii) chemical safety and, if radioactive materials are used, radiological safety;
(iv) emergency response to worksite accidents; and
(v) waste disposal.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 84.4 Amendment of rules
These rules may not be amended except on approval by the New York State Civil Service Commission of a written request by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.6 Quality assurance program
The governing body shall establish and maintain a coordinated quality assurance program which integrates the review activities of all hospital services to enhance the quality of patient care and identify and prevent medical, dental and podiatric malpractice.
(a) The governing body shall establish a quality assurance committee, at least one member to be a member of the governing body of the hospital and who is not otherwise affiliated with the hospital in an employment or contractual capacity. The quality assurance committee shall report its activities, findings and recommendations to the governing body as often as necessary, but no less often than four times a year. The quality assurance committee shall:
(1) develop a written plan which details:
(i) the establishment and implementation of a medical, dental and podiatric malpractice prevention program;
(ii) the manner in which the committee will relate to the medical staff executive committee, if any, the hospital governing body and the chief executive officer;
(iii) the manner in which the medical, dental and podiatric malpractice program will relate to other hospital administrative mechanisms and procedures;
(iv) the role and responsibility of each service or department in the quality assurance process; and
(v) the authority of the committee regarding recommendation or implementation of corrective action;
(2) administer the hospital quality assurance program to assure:
(i) the identification of actual or potential problems concerning patient care and clinical performance;
(ii) the assessment of the cause and scope of problems identified;
(iii) the development and recommendation of proposed courses of action to address problems identified;
(iv) the use, in the revision of hospital policies and procedures, of information gathered regarding problems identified;
(v) the implementation, through established mechanisms, of actions necessary to correct the identified problems;
(vi) the monitoring and evaluation of actions taken and the implementation of remedial action to ensure effectiveness; and
(vii) the documentation of all measures taken pursuant to this section in the quality assurance program.
(b) The activities of the quality assurance committee shall involve all patient care services and shall include, as a minimum:
(1) review of the care provided by the medical and nursing staff and by other health care practitioners employed by or associated with the hospital. Such review shall include a determination that the hospital is admitting only those patients for whom it has appropriate staff, resources and equipment and transferring those patients for whom the hospital does not have the capability to provide care, except under conditions of disasters and/or emergency surge that may require admissions to provide care to those patients;
(2) review of mortalities;
(3) review of morbidity in circumstances other than those related to the natural course of disease or illness;
(4) review of infections, complications, errors in diagnosis, transfusions and results of treatments;
(5) review of medical records, medical care evaluation studies, complaints, incidents and staff suggestions regarding patient care and safety, utilization review findings, profile analysis and other pertinent data sources;
(6) the maintenance and continuous collection of information concerning the hospital's experience with negative health care outcomes and incidents injurious to patients, patient grievances, professional liability premiums, settlements, awards, costs incurred by the hospital for patient injury prevention and safety improvement activities; and
(7) the committee shall oversee and coordinate the following:
(i) the establishment of a medical, dental and podiatric staff privileges review procedure through which credentials, physical and mental capacity, and competence in delivering health care services are reviewed at least biennially as part of an evaluation of staff privileges and in accordance with section 405.4 of this Part. These procedures shall include the collection of the following information from a physician, dentist or podiatrist prior to granting or renewing professional privileges or association in any capacity with the hospital:
(a) the name of any hospital or facility with which the physician, dentist or podiatrist has had any association, employment, privileges or practice and, if such association, employment, privileges or practice have been suspended, restricted, terminated, curtailed or not renewed, the reasons for such action;
(b) the substance of any pending malpractice actions or professional misconduct proceedings in this or any other state and any report made pursuant to section 405.3(e) of this Part;
(c) any judgment or settlement of any professional malpractice action and any finding of professional misconduct in this or any other state; and
(d) any information relative to findings pertinent to violations of patients' rights as set forth in section 405.7 of this Part;
(ii) upon initial application for or renewal of hospital staff privileges, the receipt of a waiver by the physician, dentist or podiatrist of any confidentiality provisions concerning the information set forth in subparagraph (i) of this paragraph and a sworn statement by the physician, dentist or podiatrist that the information is complete, true and accurate;
(iii) prior to granting or renewing privileges or association to any physician, dentist, or podiatrist, or hiring a physician, dentist or podiatrist, the hospital shall request from:
(a) any hospital with or at which such physician, dentist or podiatrist, has or had privileges, was associated or was employed during at least the preceding five years the following information concerning the physician, dentist or podiatrist:
(1) any pending professional misconduct proceedings or any professional malpractice actions in New York or another state;
(2) any judgment or settlement of a malpractice action and any finding of professional misconduct in New York or another state; and
(3) any information required to be reported by hospitals pursuant to section 405.3(e) of this Part; and
(b) the National Practitioner Data Bank or any successor database, any information available concerning:
(1) payments for the benefit of the physician, dentist or podiatrist in settlement of, or in satisfaction of, in whole or in part, a claim or a judgment against such physician, dentist or podiatrist for medical malpractice;
(2) licensure actions by any medical or professional board relating to the physician, dentist, or podiatrist;
(3) adverse actions affecting clinical privileges of the physician, dentist or podiatrist; and
(4) other actions or information relevant to the professional competence and conduct of the physician, dentist or podiatrist;
(iv) the provision by the hospital, within 45 days, in response to requests from any other hospital or facility performing credentials review for medical staff appointment or reappointment, of information related to the physician's, dentist's, or podiatrist's professional practice within the facility for at least five years;
(v) the maintenance of a file on each physician, dentist and podiatrist granted privileges or otherwise associated with the hospital which shall contain the information collected pursuant to subparagraphs (i) through (iii) of this paragraph, to be updated at least on a biennial basis, and all other relevant information gathered in accordance with the hospital's quality assurance program and as required by this section;
(vi) a biennial review of credentials, physical and mental capacity and competence in delivering health care services of all clinical staff who are employed or associated with the hospital which for physicians, dentists and podiatrists shall include a comprehensive review of the information maintained in accordance with subparagraph (v);
(vii) a procedure for the prompt resolution of grievances by patients or their representatives related to accidents, injuries, treatment and other events that may result in claims of medical, dental or podiatric malpractice;
(viii) education programs dealing with patient safety, patients' rights, injury prevention, staff responsibility to report professional misconduct, legal aspects of patient care, improved communication with patients and causes of malpractice claims for staff personnel engaged in patient care activities; and
(ix) continuing education programs for medical, dental and podiatric staff in their areas of speciality.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-4 PROHIBITION OF FIREWORKS
10 CRR-NY 9-4.1 Fireworks use prohibited
The use of fireworks or dangerous fireworks, as defined by subdivision (1) of section 270.00 of the Penal Law, during the State disaster emergency declared by Executive Order No. 202, and any extension thereof, is prohibited, except as may otherwise be permitted pursuant to section 405.00 of the Penal Law.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.9 Toilets, privies, lavatories, showers
(a) No privy shall be located within 50 feet of any sleeping room, dining room, mess hall or kitchen.
(b) The following facilities shall be provided within 200 feet of the sleeping quarters:
(1) one toilet or privy seat for each 15 males or less, plus one urinal for each 30 males or less;
(2) one toilet or privy seat for each 15 females or less;
(3) at least one lavatory with water under pressure for each 20 occupants or less, or other handwashing facilities acceptable to the permit-issuing official.
(c) Showers with water under pressure heated to between 110° and 120°F, and one shower head for each 20 occupants or less, shall be provided.
(d) At summer day and traveling summer day camps only, the availability and ratio of toilet or privy seats, urinals and lavatories per camper shall be reasonably satisfactory to the permit- issuing official. Showers are not required.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.71 Contributed services
See donated services.
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.1 Background and intent
(a)
(1) Chapter 769 of the Laws of 2005, as amended by chapters 331 and 673 of the Laws of 2006, imposed the requirement for review of the criminal history record of certain prospective employees of residential health care facilities licensed under article 28 of the Public Health Law and certified home health agencies, licensed home care services agencies or long term home health care programs certified, licensed, or authorized under article 36 of the Public Health Law who are hired or used on or after September 1, 2006 and who will provide direct care or supervision to patients, residents or clients of such providers.
(2) Chapter 60 of the Laws of 2014, part A, sections 22 and 24, as amended by chapter 94 of the Laws of 2014, imposed the requirement for review of the criminal history record of certain employees of adult homes, enriched housing programs, and residences for adults licensed under article 7 of the Social Services Law who are hired or used on or after January 1, 2015 and who will provide direct care or supervision to residents of such providers.
(3) Chapter 471 of the Laws of 2016, as amended by chapter 206 of the Laws of 2017, imposed the requirement for review of the criminal history record of certain employees of providers certified under article 40 of the Public Health Law who are hired on or after April 1, 2018 and who will provide direct care or supervision to patients of such providers.
(b) This legislation was intended to enable such providers to secure appropriate individuals to staff their facilities and programs, by utilizing criminal history information concerning individuals seeking employment.
(c) The purpose of this Part is to establish standards and procedures for such criminal history record checks.
Chapter I STATE SANITARY CODE
Part 19 CLINICAL LABORATORY DIRECTORS
10 CRR-NY 19.3 Director of a clinical laboratory or blood bank; certificate of qualification issuance, duties and responsibilities
(a) Certificate required.
An individual serving as a director or assistant director of a clinical laboratory or blood bank must hold a certificate of qualification issued after the department has determined that the applicant meets the requirements specified in sections 19.2 and 19.3 of this Part, and has demonstrated, in accordance with subdivision (c) of this section and section 19.4(a) of this Part, that he or she possesses the character, competence, training, and ability to direct the technical and scientific operation of a clinical laboratory or blood bank, and ensure the proper supervision or performance of test procedures, adherence to the department's quality control standards, and accurate reporting of findings of tests.
(b) An applicant for a certificate of qualification must submit a complete, original, signed, and sworn application in such form and manner as may be required by the department, and must supply such additional information as may be required by the department. An individual seeking renewal of a certificate of qualification must submit an application no later than 90 days prior to expiration of the current certificate.
(c) To qualify for, and maintain, a certificate of qualification, a laboratory director and any assistant director shall demonstrate that he or she possesses knowledge of basic clinical laboratory sciences and operations, and shall have the training and/or experience and physical capability to discharge the following responsibilities:
(1) provide advice to referring health care providers regarding the significance of laboratory findings and ensure that reports of test results include pertinent information required for the interpretation of laboratory data;
(2) maintain an effective working relationship with applicable accrediting and regulatory agencies, administrative officials, and the medical community;
(3) define, implement, and monitor standards of performance for the laboratory and for other ancillary laboratory testing programs in conformance with the department’s clinical laboratory standards of practice;
(4) monitor all work performed in the laboratory to ensure that medically reliable data are generated;
(5) assure that the laboratory participates in monitoring and evaluating the quality and appropriateness of services rendered, within the context of a quality management system, regardless of where the testing is performed;
(6) ensure that sufficient qualified personnel are employed with documented training and/or experience to supervise and perform the work of the laboratory;
(7) ensure that policies and procedures are established for monitoring staff to assess competency and, whenever necessary, to provide remedial training to improve skills;
(8) specify in writing the responsibilities and duties of all laboratory personnel;
(9) provide continuing education to laboratory staff;
(10) ensure that a current and complete procedure manual is available to all personnel;
(11) set goals, develop and allocate resources within the laboratory;
(12) provide effective administrative direction of the laboratory, in conjunction with the individual(s) responsible for financial management of the laboratory, to ensure adequate resources are available to operate the laboratory in a manner consistent with all State and Federal requirements;
(13) select all reference laboratories for services not offered by the laboratory;
(14) promote a safe laboratory environment for personnel and the public; and
(15) ensure that the laboratory, when applicable, is enrolled in a proficiency testing program acceptable to the department for the testing performed and that the laboratory adheres to the proficiency testing program’s administrative and technical requirements.
(d) Required qualifications.
(1) Applicants for a certificate of qualification in bacteriology, mycobacteriology, mycology, and/or parasitology must qualify under section 19.2(a)(1)(i), (a)(2)(i), (d)(1)(i), (d)(1)(viii), (d)(1)(x) or (d)(2) of this Part.
(2) Applicants for a certificate of qualification in virology must qualify under section 19.2(d)(1)(viii), (d)(1)(x) or (d)(2) of this Part. Applicants for a certificate of qualification in virology limited to antigen detection and molecular methods must qualify under section 19.2(a)(1)(i), (a)(2)(i) or (d)(1)(i) of this Part.
(3) Applicants for a certificate of qualification in diagnostic immunology must qualify under section 19.2(a)(1)(i), (a)(2)(i), (d)(1)(i), (d)(1)(vii), (d)(1)(viii), (d)(1)(x) or (d)(2) of this Part.
(4) Applicants for certificate of qualification in hematology must qualify under section 19.2(a)(1)(i), (a)(2)(i), (d)(1)(vi) or (d)(2) of this Part. Applicants qualifying under section 19.2(d)(1)(vi) of this Part must document that the required training and/or experience includes or is supplemented by six months' training and/or experience in an acceptable laboratory.
(5) Applicants for a certificate of qualification in immunohematology must qualify under section 19.2(a)(1)(i), (a)(2)(i), or (d)(2) of this Part.
(6) Applicants for a certificate of qualification in clinical chemistry, blood pH and gases, endocrinology, or therapeutic substance monitoring - quantitative toxicology must qualify under section 19.2(a)(1)(i), (a)(2)(i), (d)(1)(i), (d)(1)(ii), (d)(1)(xi) or (d)(2) of this Part.
(7) Applicants for a certificate of qualification in histopathology and/or cytopathology must qualify under section 19.2(a)(1)(ii) or (a)(2)(ii) of this Part.
(8) Applicants for a certificate of qualification in oral pathology must qualify under section 19.2(a)(1)(ii), (a)(2)(ii), or (c) of this Part.
(9) Applicants for a certificate of qualification in dermatopathology must qualify under section 19.2(a)(1)(ii), (a)(1)(iii), (a)(2)(ii), (a)(2)(iii) or (d)(1)(iv) of this Part.
(10) Applicants for a certificate of qualification in cytogenetics, histocompatibility, cellular immunology, genetic testing, fetal defect markers, forensic identity, oncology, parentage/identity testing, trace elements, and/or transplant monitoring must qualify under section 19.2(d)(2) of this Part.
(11) Applicants for a certificate of qualification in transfusion services must be physicians and must qualify under section 19.2(b)(1), (b)(2) or (b)(3) of this Part.
(12) Applicants for a certificate of qualification in blood banking collection-comprehensive must qualify under section 19.2(d)(2) of this Part. Required experience in blood services must include at least one year's training and/or experience in collection and testing of blood for allogeneic transfusion.
(13) Applicants for a certificate of qualification in blood banking collection-limited must qualify under section 19.2(a)(1)(i), (b)(1)(i), or (d)(1)(vi) of this Part.
(14) Applicants for a certificate of qualification in clinical toxicology must qualify under section 19.2(a)(1)(i), (b)(1)(i), (d)(1)(i), (d)(1)(ii), (d)(1)(iii), (d)(1)(xi), or (d)(2) of this Part.
(15) Applicants for a certificate of qualification in forensic toxicology must qualify under section 19.2(d)(1)(iii), (d)(1)(v), or (d)(2) of this Part.
(16) Applicants for a certificate of qualification in andrology must qualify under section 19.2(d)(1)(i) or (d)(2) of this Part; or under section 19.2(a)(1)(i) or (b)(1)(i) of this Part including or supplemented by at least six months' training and/or experience in andrology.
(17) Applicants for a certificate of qualification in blood lead must qualify under section 19.2(a)(1)(i), (b)(1)(i), (d)(1)(i), (d)(1)(iii), (d)(1)(v), (d)(1)(xi), or (d)(2) of this Part.
(e) Scope and limitations.
(1) The requirements for qualification set forth in section 19.2 of this Part shall apply to all laboratory directors, regardless of prior grandfathered status, upon expiration of current certificates of qualification if the laboratory director is no longer employed in a laboratory or in the field of laboratory medicine.
(2) Additional categories of testing may not be added to a certificate of qualification issued on a grandfathered basis. Such a certificate will not be renewed if allowed to lapse.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.4 Qualifications of service coordinators
(a) All early intervention service coordinators shall meet the following qualifications:
(1) a minimum of one of the following educational or service coordination experience credentials:
(i) two years experience in service coordination activities as delineated in this Subpart (voluntary or part-time experience which can be verified will be accepted on a pro rata basis); or
(ii) one year of service coordination experience and an additional year of experience in a service setting with infants and toddlers with developmental delays or disabilities; or
(iii) one year of service coordination experience and an Associates degree in a health or human service field; or
(iv) a Bachelors degree in a health or human service field; or
(v) a license, certification, or registration in one of the professions listed in section 69-4.1(al) of this Subpart.
(2) demonstrated knowledge and understanding in the following areas:
(i) infants and toddlers who may be eligible for early intervention services;
(ii) State and Federal laws and regulations pertaining to the Early Intervention Program;
(iii) principles of family centered services;
(iv) the nature and scope of services available under the Early Intervention Program and the system of payments for services in the State; and
(v) other pertinent information.
(b) Service coordinators shall participate in the introductory service coordination training session sponsored or approved by the department of Health, in the first three months and by no later than one year of direct or contractual employment as an early intervention service coordinator, provided that training sessions are offered and accessible in locations with reasonable proximity to their place of employment at least three times annually.
(1) Employees of approved agency providers shall submit documentation of participation in the introductory service coordination training to their employers for retention in their personnel record.
(2) Individual service coordinators must submit documentation of their participation in introductory service coordination training to the department of Health for retention with their approved application to deliver service coordination services.
(3) Failure to participate in the introductory service coordination training sponsored or approved by the department of Health may result in the disqualification as a provider of service coordination services in accordance with procedures set forth in section 69-4.17(i) of this Subpart.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.15 Closures, mergers, acquisitions, consolidations, restructurings and inpatient bed de-certifications
(a) The commissioner may grant approval of a temporary adjustment to the non-capital components of rates calculated pursuant to this Subpart for eligible ambulatory care facilities licensed under article 28 of the Public Health Law (PHL).
(b) Eligible facilities shall include:
(1) facilities undergoing closure;
(2) facilities impacted by the closure of other health care facilities;
(3) facilities subject to mergers, acquisitions, consolidations or restructuring;
(4) facilities impacted by the merger, acquisition, consolidation or restructuring of other health care facilities; or
(5) outpatient facilities of general hospitals which have entered into an agreement with the department to permanently decertify a specified number of staffed hospital inpatient beds, as reported to the department.
(c) Facilities seeking rate adjustments under this section shall demonstrate through submission of a written proposal to the commissioner that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:
(1) protect or enhance access to care;
(2) protect or enhance quality of care;
(3) improve the cost effectiveness of the delivery of health care services; or
(4) otherwise protect or enhance the health care delivery system, as determined by the commissioner.
(d)
(1) Such written proposal shall be submitted to the commissioner at least 60 days prior to the requested effective date of the temporary rate adjustment and shall include a proposed budget to achieve the goals of the proposal. Any temporary rate adjustment issued pursuant to this section shall be in effect for a specified period of time as determined by the commissioner, of up to three years. At the end of the specified timeframe, the facility shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and this Subpart. The commissioner may establish, as a condition of receiving such a temporary rate adjustment, benchmarks and goals to be achieved in conformity with the facility's written proposal as approved by the commissioner and may also require that the facility submit such periodic reports concerning the achievement of such benchmarks and goals as the commissioner deems necessary. Failure to achieve satisfactory progress, as determined by the commissioner, in accomplishing such benchmarks and goals shall be a basis for ending the facility's temporary rate adjustment prior to the end of the specified timeframe.
(2) The commissioner may require that applications submitted pursuant to this section be submitted in response to and in accordance with a request for applications or a request for proposals issued by the commissioner.
(e) Federally qualified health centers with reimbursement rates issued pursuant to PHL section 2807(8) may apply for a temporary rate adjustment pursuant to this section as an alternative rate-setting methodology in accordance with the provisions of PHL section 2807(8)(f).
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.11 Reimbursement
The pertinent provisions of Part 86 of this Title shall apply to approved medical technology demonstration projects; provided, however, that reimbursement pursuant to title 11 (Medical Assistance for Needy Persons) of article 5 of the Social Services Law shall not be available unless there is Federal financial participation pursuant to title XIX of the Social Security Act (Medicaid).
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SOCIAL WORKER PUBLIC HEALTH SOCIAL WORKER
10 CRR-NY 11.170 Definition
The term public health social worker shall mean a social worker who identifies, assesses and manages social problems relating to illness and disability, the receipt of medical care and the attainment and maintenance of health.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.12 Labeling
Each bottle or container shall bear a label, to be affixed to each bottle or container before it leaves the plant. Wording shall be printed in English, in legible type which shall be in contrast by typography, layout or color, with other printed matter on the label, cap, or container.
(a) Each label shall show:
(1) The type of source water:
(i) For water coming from springs: “Spring Water.”
(ii) For artesian or pumped water taken from the ground, from drilled wells or approved dug wells: “Well Water.”
(iii) For a municipal water supply source, the name of the municipal supply, such as “New York City Public Water Supply”, “Buffalo City Public Water Supply”, etc.
(iv) For bottled waters identified on the label as being distilled, the type of source water does not need to be shown.
(2) Address and location of the bottling facility or corporate offices.
(3) Net contents and/or capacity of the container.
(4) The assigned New York State Health Department certificate number. Abbreviations are limited to “NYSHD Cert. #000.”
(5) Where sodium content information is provided, a statement of the number of milligrams of sodium in a specified serving and the net quantity (measure) of each serving shall be placed on the label.
(b) In all situations where the commissioner has exempted a bottled water from the inorganic chemical and/or radiological maximum contaminant levels, an appropriate label, approved by the commissioner, shall be conspicuously placed on all bottles or containers of such exempted water manufactured, distributed or sold at retail within the State of New York. The label shall contain the statement:
“This water contains levels of minerals* in excess of standards for drinking water established by the New York State Commissioner of Health and, therefore, should not be used as a principal or sole source of drinking water.”
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 126 MONTGOMERY COUNTY
VILLAGES VILLAGES
10 CRR-NY 126.6 Village of Fort Plain—wells
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the well which comprises a source of the public water supply of the Village of Fort Plain, Montgomery County, New York. Said well is located on land owned by the Village of Fort Plain and is situated adjacent to Lincoln Street, Fort Plain, New York.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds of potassium chloride (commonly used as fertilizer) calcium chloride (commonly used for road maintenance) or sodium chloride (commonly used for water softener regeneration or road maintenance).
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the well.
(5) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(6) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(7) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(8) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(9) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(10) Water supply shall mean the public water supply of the Village of Fort Plain, Montgomery County, New York obtained from ground water sources.
(11) Well shall mean the well now used as a source of this public water supply or to any additional well which may be constructed at this point as a source for this public water supply.
(c) Human excreta.
No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 250 feet of the well.
(d) Sewage.
No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground (except into watertight pipes connected to a sewage disposal system, a permit for which shall have been granted by the appropriate State agency having jurisdiction over such facility) within 250 feet of the well. It is provided, however, that no such watertight pipe shall be located within 15 feet of the well.
(e) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within 250 feet of the well.
(f) Refuse disposal area.
No refuse disposal area shall be located within 500 feet of the well.
(g) Cemeteries.
No interment of a human body shall be made within 250 feet of the well.
(h) Chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within 500 feet of the well.
(i) Chloride salt.
No chloride salt storage area shall be located within 500 feet of the well except in weather-proof buildings or watertight vessels.
(j) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 500 feet of the well.
(k) Junkyards.
No junkyard shall be located within 250 feet of the well.
(l) Trespassing.
No trespassing shall be allowed upon the property of the Village of Fort Plain upon which the well is located and no person or persons shall enter in or upon such property except the person or persons as may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the supply or except such other persons as may be authorized to enter said property by the Village of Fort Plain.
(m) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources) Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(n) Inspections.
The village board of trustees, or any person or persons as may be charged with the maintenance or supervision of the water supply; shall make regular and thorough inspections of the area surrounding the well to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid village board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general surroundings of the well at the time of the last inpsection.
(o) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-8 HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING
10 CRR-NY 58-8.3 Confidentiality
Each clinical laboratory, blood bank, tissue bank or organ procurement organization performing, or causing the performance or receiving the results of HIV testing shall establish and implement procedures for confidentiality, disclosure and re-disclosure consistent with applicable Federal and State law and regulations, including article 27-F of the Public Health Law and New York State Insurance Law, section 2611(c). No bill, claim for reimbursement or invoice issued by a clinical laboratory, blood or tissue bank or its agent shall disclose the nature of the service rendered to a named individual by using the acronym HIV, or the words human immunodeficiency virus or similar identifying words, unless disclosure is authorized by law and the intended recipient of the bill, claim or invoice is an entity subject to New York State or Federal confidentiality, disclosure and re-disclosure requirements.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.1 Definitions
As used in this Part, the following words and terms shall have the indicated meaning:
(a) Adequate shall mean sufficient to accomplish the purpose intended, and to such a degree that no unreasonable risk is presented to health or safety. Within the meaning of this Part, an item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with recognized generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession shall be considered adequate.
(b) Anchoring system shall mean a combination of ties, anchoring equipment and ground anchors that will, when properly designed and installed, resist overturning and lateral movements of the mobile home from wind forces.
(c) Drinking water shall mean water provided or used for human consumption, food preparation, or for lavatory, culinary, bathing or laundry purposes.
(d) Feeder assembly shall mean the overhead or under chassis electrical feeder conductors, including the grounding conductor, together with the necessary fittings and equipment, or a power supply cord listed for mobile home use, designed for the purpose of delivering the electrical supply from the source to the distribution panel within the home.
(e) Generally accepted standards shall mean those referenced in the New York State Building Construction Codes and Fire Prevention Code (9 NYCRR), or their successor(s), or any other standards filed with the Secretary of State.
(f) Home shall mean a mobile or manufactured home in a mobile home park.
(g) Manufactured home shall mean a structure, transportable in one or more sections with or without a permanent foundation, and includes the plumbing, heating, air conditioning, and electrical systems contained therein.
(h) Mobile home shall mean a structure, which is eight feet or more in width and 32 feet or more in length, transportable in one or more sections, built on a permanent chassis, and designed to be used as a dwelling with or without a permanent foundation, when connected to the required utilities, and includes the plumbing, heating, air conditioning, and electrical systems contained therein.
(i) Mobile home accessory building or structure shall mean a building or structure which is an addition to or supplements the facilities provided a mobile home. It is not a self-contained, separate, and habitable building or structure.
(j) Mobile home park (hereafter also known as park ) shall mean a property consisting of a tract of land maintained by an operator for mobile homes and/or manufactured homes, and buildings or other structures that may be pertinent to their use, any part of which may be occupied by persons for residential purposes other than recreation, traveling, or vacationing, and who are provided services or facilities necessary for their use of the property.
(k) Mobile home site (hereafter also known as site ) shall mean a designated parcel of land in a mobile home park provided by the operator and designed for accommodating, one mobile or manufactured home, its accessory buildings or structures, and accessory equipment for the exclusive use of the occupants.
(l) Mobile home stand shall mean that area of a site which has been reserved the placement of the home.
(m) Operator shall mean the owner, lessee or any other person designated as responsible for the maintenance and operation of the park and such services and facilities as are provided and/or necessary for the use of such property.
(n) Permit-issuing official shall mean the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, or such grade I or grade II public health administrator or county health director may designate the director of environmental health of the health district; and, the State regional health director or area director may designate the district sanitary engineer or district administrator as additional persons authorized to issue the permits required by this Part.
(o) Person shall mean an individual, group of individuals, partnership, firm, corporation, association, political subdivision, government agency, municipality, industry, estate or any legal entity whatever.
(p) Refuse shall mean all putrescible and nonputrescible solid waste including, but not limited to garbage, rubbish, ashes, incinerator residue, street cleanup, dead animals, offal and solid commercial wastes.
(q) Service equipment shall mean the electrical equipment containing the disconnecting means, overcurrent protection devices, and receptacles or other means for connecting a mobile home feeder assembly.
(r) Sewage shall mean excreta and the waste from a flush toilet, bath, sink, lavatory, dishwashing, or laundry machine or the water-carried waste from any other fixture or equipment or machine.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.2 Legal base
(a) Office of Mental Health.
(1) Section 7.09 of the Mental Hygiene Law (MHL) grants the Commissioner of Mental Health the power and responsibility to adopt regulations that are necessary and proper to implement matters under his or her jurisdiction.
(2) Section 7.15 of the MHL charges the Commissioner of Mental Health with the responsibility for planning, promoting, establishing, developing, coordinating, evaluating and conducting programs and services of prevention, diagnosis, examination, care, treatment, rehabilitation, training, and research for the benefit of persons with mental illness. Such law further authorizes the commissioner to take all actions that are necessary, desirable, or proper to carry out the statutory purposes and objectives of the Office of Mental Health, including undertaking activities in cooperation and agreement with other offices within the Department of Mental Hygiene, as well as with other departments or agencies of State government.
(3) Section 31.04 of the MHL authorizes the Commissioner of Mental Health to set standards of quality and adequacy of facilities, equipment, personnel, services, records and programs for the rendition of services for adults diagnosed with mental illness or children diagnosed with emotional disturbance, pursuant to an operating certificate.
(4) Sections 31.07, 31.09, 31.13, and 31.19 of the MHL authorize the Commissioner of Mental Health or his or her representatives to examine and inspect such programs to determine their suitability and proper operation. Section 31.16 authorizes such commissioner to suspend, revoke or limit any operating certificate, under certain circumstances.
(5) Section 31.11 of the MHL requires every holder of an operating certificate to assist the Office of Mental Health in carrying out its regulatory functions by cooperating with the Commissioner of Mental Health in any inspection or investigation, permitting such commissioner to inspect its facility, books and records, including recipients’ records, and making such reports, uniform and otherwise, as are required by such commissioner.
(6) Article 33 of the MHL establishing basic rights of persons diagnosed with mental illness.
(7) Sections 364 and 364-a of the Social Services Law give the Office of Mental Health responsibility for establishing and maintaining standards for medical care and services in facilities under its jurisdiction, in accordance with cooperative arrangements with the Department of Health.
(b) Department of Health.
Section 2803 of the Public Health Law (PHL) authorizes the Public Health and Health Planning Council to adopt and amend rules and regulations, subject to the approval of the commissioner, to implement the provisions of PHL article 28, and to establish minimum standards governing the operation of health care facilities.
(c) Office of Alcoholism and Substance Abuse Services.
(1) Section 19.07(c) of the MHL charges the Commissioner of the Office of Alcoholism and Substance Abuse Services with the responsibility to ensure that persons who abuse or are dependent on alcohol and/or substances and their families are provided with care and treatment that is effective and of high quality.
(2) Section 19.07(e) of the MHL authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt standards including necessary rules and regulations pertaining to substance use disorder treatment services.
(3) Section 19.09(b) of the MHL authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations necessary and proper to implement any matter under his/her jurisdiction.
(4) Section 19.21(b) of the MHL requires the Commissioner of the Office of Alcoholism and Substance Abuse Services to establish and enforce regulations concerning the licensing, certification, and inspection of substance use disorder treatment services.
(5) Section 19.21(d) of the MHL requires the Office of Alcoholism and Substance Abuse Services to establish reasonable performance standards for providers of services certified by the office.
(6) Section 19.40 of the MHL authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to issue operating certificates for the provision of substance use disorder treatment services.
(7) Section 32.01 of the MHL authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt any regulation reasonably necessary to implement and effectively exercise the powers and perform the duties conferred by article 32 of the MHL.
(8) Section 32.07(a) of the MHL authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations to effectuate the provisions and purposes of article 32 of the MHL.
(9) Section 32.05(b) of the MHL provides that a controlled substance designated by the Commissioner of Health as appropriate for such use may be used by a physician to treat a chemically dependent individual pursuant to section 32.09(b) of the MHL.
(10) Section 32.09(b) of the MHL provides that the Commissioner of the Office of Alcoholism and Substance Abuse Services may, once a controlled substance is approved by the Commissioner of Health as appropriate for such use, authorize the use of such controlled substance in treating a chemically dependent individual.
(d) Pursuant to section 365-l(7) of the Social Services Law and part L of chapter 56 of the Laws of 2012, the Commissioners of the Office of Mental Health, Office of Alcoholism and Substance Abuse Services and Department of Health are jointly authorized to establish operating, reporting and construction requirements, as well as joint survey requirements and procedures for entities operating under the auspices of one or more such agencies in order to integrate the delivery of health and behavioral health services in an efficient and effective manner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 54 REQUIREMENTS FOR SELF-DEFENSE SPRAY DEVICES
10 CRR-NY 54.3 Requirements
Every self-defense spray device which is purchased, possessed or used in New York State shall satisfy all of the following requirements:
(a) Every self-defense spray device shall contain oleoresin capsicum, and no other substance, as the active ingredient.
(b) The contents of every self-defense spray device shall not contain more than 0.7 percent by weight total capsaicinoids.
(c) The net weight of every self-defense spray device shall not exceed 0.75 ounce.
(d) Every self-defense spray device shall have a safety device.
(e) Every self-defense spray device shall be sold in a sealed, tamper-proof package.
(f) Every self-defense spray device shall not be camouflaged.
(g) Every self-defense spray device shall be accompanied by an insert or inserts which include directions for use, first aid information, safety and storage information and which shall also contain a toll-free telephone number for the purpose of allowing any purchaser to call and receive additional information regarding the availability of local courses in self-defense training and safety in the use of a self-defense spray device.
(h) Every self-defense spray device shall bear the following label: “Warning: The use of this substance or device for any purpose other than self-defense is a criminal offense under the law. The contents are dangerous - use with care. This device shall not be sold by anyone other than a licensed or authorized dealer. Possession of this device by a person under the age of 18 or by anyone who has been convicted of a felony or assault is illegal. Violators may be prosecuted under the law.” This label shall appear on the self-defense spray device if the self-defense spray device does not bear the labels required by the California Penal Code pursuant to section 12403.7(a)(5)(B) and by the United States Consumer Product Safety Commission pursuant to 16 Code of Federal Regulations section 1500. This label shall appear on self-defense spray device packaging materials or the self-defense spray device if the self-defense spray device bears the labels required by California Penal Code pursuant to section 12403.7(a)(5)(B) and by the United States Consumer Product Safety Commission pursuant to 16 Code of Federal Regulations section 1500.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-3 PROHIBITION ON THE SALE OF ELECTRONIC LIQUIDS WITH CHARACTERIZING FLAVORS
10 CRR-NY 9-3.1 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) The terms electronic cigarette , e-cigarette , electronic liquid , and e-liquid shall have the same meanings as established in Subpart 9-2 of this Part.
(b) The term flavored e-liquid means any e-liquid with a distinguishable taste or aroma, other than the taste or aroma of tobacco or menthol, imparted either prior to or during consumption of an e-cigarette or a component part thereof, including but not limited to tastes or aromas relating to any fruit, chocolate, vanilla, honey, candy, cocoa, dessert, alcoholic beverage, mint, wintergreen, herb or spice, or any concept flavor that imparts a taste or aroma that is distinguishable from tobacco flavor but may not relate to any particular known flavor. An e-liquid shall be presumed to be a flavored e-liquid if a tobacco retailer, manufacturer, or a manufacturer’s agent or employee has made a statement or claim directed to consumers or the public, whether expressed or implied, that the product or device has a distinguishable taste or aroma other than the taste or aroma of tobacco or menthol.
(c) The term possession means having physical possession or otherwise exercising dominion or control over flavored e-liquids or a product containing the same. For purposes of this definition, among other circumstances not limited to these examples, the following individuals and/or entities shall be deemed to possess flavored e-liquids, or a product containing the same:
(1) any individual or entity that has an ownership interest in a retail, distribution or manufacturing establishment that possesses, distributes, sells or offers for sale flavored e-liquids, or a product containing the same; and
(2) any clerk, cashier or other employee or staff of a retail establishment, where the establishment possesses, distributes, sells or offers for sale a flavored e-liquids or a product containing the same, and who interacts with customers or other members of the public.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.65 Clinic outpatient
A clinic outpatient is one who is registered with a formally organized hospital service unit known as a clinic. The clinic constitutes an organizational entity to provide diagnosis and/or treatment under the direction of a specialty or subspecialty department of the hospital pursuant to section 405.1032 of this Subchapter.
10 CRR-NY 441.39 Bad debt
An uncollectible receivable.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-8 WATERSHED PROTECTION PLANS
10 CRR-NY 128-8.1 Local government stormwater protection plans
(a) A local government of a town, village, or county in the watershed may submit to the department for review and approval a proposed local government stormwater protection plan (“Stormwater Plan”) to undertake all or some aspects of watershed protection as set forth in section 128-3.9 of this Part. The Stormwater Plan may be submitted individually by a local government or jointly with one or more adjoining local government(s) in accordance with the requirements of this Subpart.
(1) Within 90 days of receipt by the department of a proposed Stormwater Plan, the department shall review the proposed Stormwater Plan to determine whether it meets the requirements of this section and notify the local government, in writing, whether the proposed Stormwater Plan is approved.
(2) If the department fails to notify the local government(s) in writing of its determination within the 90 day period set forth in paragraph (1) of this subdivision, the local government(s) may notify the department of its failure by means of certified mail, return receipt requested to the local department representative who is responsible for processing the Stormwater Plan.
(3) If the department fails to notify the local government(s) within 10 business days of the receipt of such notice the Stormwater Plan shall be deemed approved subject to the terms and conditions set forth in the most recent submission by the local government(s).
(b) Pursuant to the terms and conditions of an approved Stormwater Plan, the department may issue a waiver from specific provisions of section 128-3.9 of this Part, including the prohibition of construction of an impervious surface within the limiting distance of 100 feet of a watercourse or wetland or within the limiting distance of 300 feet of a reservoir, reservoir stem or controlled lake, for all applicants of projects located within some or all of the geographical area of the local government(s). The department may issue such waivers after a local government(s) has an approved Stormwater Plan.
(c) An approvable Stormwater Plan shall include:
(1) the specific provision(s) of section 128-3.9 of this Part from which the waiver is sought;
(2) a description of the metes and bounds of the geographical area (town, village, county, or part thereof) for which the waiver is sought, including a map of the described area;
(3) mechanisms to be established by the local government that are at least as protective of the watershed reservoir drainage basin in which the waiver will be effective as the specific provisions of section 128-3.9 of this Part from which the waiver is sought;
(4) a commitment by the local government(s) to implement each element of the Stormwater Plan in accordance with the terms of the Stormwater Plan and a schedule for implementation of all elements of the Stormwater Plan;
(5) an agreement by the local government(s) to coordinate with the department any review by the local government(s) required under the State Environmental Quality Review Act for regulated activities, as defined in these rules and regulations;
(6) the rights, obligations and roles of the local government(s) and the department under the Stormwater Plan; and
(7) identification of the approximate number, technical expertise and experience of personnel and all other resources that will be dedicated to carrying out such plan.
(d) The mechanisms to be established pursuant to paragraph (c)(3) of this section may include:
(1) stormwater control structures, or best management practices, that capture and treat stormwater from existing non-point pollution sources such as areas of concentrated impervious surfaces;
(2) mechanisms or programs that address the capture and treatment of stormwater from future non-point pollution sources on a community-wide basis such as the creation of a stormwater district;
(3) land use controls, zoning, and other local laws, ordinances and rules and regulations that will protect the quality of the water supply, including but not limited to laws and rules and regulations concerning wetland protection, protection of hydrologically sensitive areas, and control of runoff from non-point pollution sources; or
(4) educational programs providing information to residents of the town, village, or county whose local government is involved in the watershed protection plan process concerning:
(i) the challenges of protecting water quality and the Federal, State and local requirements for watershed protection;
(ii) the water supply system as a natural resource and source of drinking water; and
(iii) actions that can be taken by residents and the local government to enhance water quality protection.
(e) An annual report shall be submitted by the local government to the department on each anniversary of the date of the signing of the approved Stormwater Plan. The annual report shall include, but need not be limited to the following information:
(1) a statement by the local government of its compliance with the terms and conditions of the approved Stormwater Plan; and
(2) a statement of future commitment of adequate financial, personnel and other resources to continue compliance with the terms and conditions of the approved Stormwater Plan.
(f) Once the Stormwater Plan is approved by the department, the Stormwater Plan shall be considered valid and effective.
(1) The local governments proposing the Stormwater Plan may, upon written notice to the city, modify the plan at any time after it has been agreed upon. If the Stormwater Plan is proposed to be modified, the department shall make a determination within 60 days of notice of the proposed modification, whether the Stormwater Plan as modified shall continue to be valid and effective. In making such a determination, the department shall consider whether the Stormwater Plan as modified, taken as a whole, continues to be at least as protective of the watershed as the specific provisions of section 128-3.9 of this Part from which the waiver applies. The Stormwater Plan shall continue to be valid and effective during the period of the department's review of any proposed modification. If the department determines that the proposed modification would cause the Stormwater Plan to be not as protective as the provisions of section 128-3.9 of this Part which are being waived, the department shall so notify the local government(s). The existing and approved Stormwater Plan will then remain valid and effective until and unless the local government(s) implemented the proposed changes to the Stormwater Plan.
(2) If at any time the department determines that the local government's administration of all or part of the Stormwater Plan is not as protective as the provisions of section 128-3.9 of this Part which are being waived, the department may revoke or modify the Stormwater Plan after notice has been given to the local government and an opportunity to meet and discuss the problem has been provided.
(3) Upon a final determination to revoke the Stormwater Plan the waivers issued thereunder shall be void and the watershed rules and regulations contained herein shall be applicable in the area of the watershed that was previously exempt pursuant to the waivers issued under the Stormwater Plan.
(4) Any Stormwater Plan agreed to shall be reviewed by the parties agreeing to such plan 15 years after such plan becomes effective in order to determine whether such plan has met and will continue to meet its goals.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.10 Confidentiality
Medical, financial and personal information provided to the Adult Cystic Fibrosis Assistance Program to establish and maintain eligibility shall be kept confidential in accordance with Public Health Law, section 206.1(j).
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.21 Vector and vermin control
The premises are to be free of insect and rodent infestations that may cause a nuisance or health hazard. Bats shall be excluded from living areas of occupied buildings.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.1 Preface
[ 2000 ]
(a) A Listing of Accounts is a listing of account titles, with numerical symbols, used in the compilation of financial data concerning the assets, liabilities, capital, revenues and expenses of an enterprise.
(b) An outline of the required Listing of Accounts for hospitals is presented in this Part along with an explanation of the numerical coding system. A description of the nature and content of each account required to be used and reported is included in the Description of Accounts, Part 444 of this Article. It is recognized, however, that it is impossible to develop a Listing of Accounts that will fulfill all the requirements of all hospitals. Many hospitals will not require the detailed information provided for in the Listing of Accounts; others may require even more detailed classification. The Listing of Accounts is designed (at the zero level, except where noted) to provide the basis for a minimum standard of uniform accounting and reporting which will meet the needs of management, regulators, planners and others.
(c) Hospitals are required to use for reporting purposes all balance sheet accounts which have capitalized titles and which have numerical codes with a fourth digit of zero when such balance sheet items exist. These accounts are referred to as zero level accounts.
(d) Hospitals are required to use for reporting purposes all revenue and expense accounts which have capitalized titles and which have numerical codes with a fourth digit of zero when such a function as defined in this manual exists even though the activity is not separately organized within the hospital. The only circumstance under which the hospital need not report an existing zero level account is when the patient service provided in a daily hospital services cost center is not provided in a discrete unit.
(e) Since the zero level accounts presented in this manual are required, all zero level accounts presented herein, except as noted above, must be reported by the hospital wherever the related item or function exists in that hospital. A hospital will not be granted an exception to the establishment of an account solely because of reporting difficulty.
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.14 Activities
The operator, directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, must:
(a) ensure that activities are an integral part of the program, are age appropriate, and reflect the registrants' individual interests and cultural backgrounds;
(b) ensure that activities are designed to enhance registrant participation in the program, home life and the community;
(c) involve appropriate volunteers and volunteer groups in the program, unless prohibited by law;
(d) provide sufficient equipment and supplies for the operation of the activity program;
(e) provide or arrange for transportation to and from community events and outings; and
(f) ensure that activities are included as part of each care plan.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.55 Fundraising
This functional reporting center must include all the expenses associated with fundraising efforts by the residential health care facility.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.8 Natural classification of expense
[ 2500 ]
(a) The coding system for expenses provides for the use of six digits: four digits to the left of the decimal point and two digits to the right of the decimal point. If two digits to the right of the decimal point are not sufficient for the individual hospital requirements, additional digits to the right of the decimal point may be added to obtain the desired detail.
(b) Digit designations are as follows:
(1) First digit—indicates the primary account classification of the expense account.
6 Daily Hospital and Ambulatory Service Expense
7 Ancillary Service Expense
8 Other
9 Non-Operation Expense
(2) Second through fourth digits (010-999)—indicate the primary subclassification of accounts.
(3) Decimal point—the two required digits (fifth and sixth digits as specified below) identify secondary account classifications.
(c) Natural classifications of expense (the fifth and sixth digits) are specified below:
(1)
.00 Salaries and Wages.
.01 Management and Supervision
.02 Technician and Specialist
.03 Registered Nurses
.04 Licensed Vocational (Practical) Nurses
.05 Aides, Orderlies and Attendants
.06 Physicians
.07 Dentist
.08 Intern, Resident and Fellow
.09 Non-Physician Medical Practitioners
.11 Environment, Hotel and Food Service Employees
.12 Clerical and Other Administrative Employees
.19 Other Employee Classifications
(2)
.20 Employee benefits.
.21 FICA
.22 SUI and FUI
.23 Group Health Insurance
.24 Group Life Insurance
.25 Pension and Retirement
.26 Workers' Compensation Insurance
.27 Union Health and Welfare
.28 Other Payroll Related Employee Benefits
.29 Employee Benefits (Non-Payroll Related)
(3)
.30 Professional Fees.
.31 Medical-Physicians
.32 Medical-Therapists and Other Non-Physicians
.33 Consulting and Management Fees
.34 Legal Fees
.35 Audit Fees
.39 Other Fees
(4)
.40 Medical and Surgical Supplies.
.41 Prostheses
.42 Surgical Supplies—General
.43 Anesthetic Materials
.44 Oxygen and Other Medical Gases
.45 IV Solutions
.46 Pharmaceuticals
.47 Radioactive Materials
.48 Radiology Films
.49 Other Medical Care Materials and Supplies
(5)
.50 Non-Medical and Non-Surgical Supplies.
.51 Food—Meats, Fish and Poultry
.52 Food—Other
.53 Tableware and Kitchen Utensils
.54 Linen and Bedding
.55 Cleaning Supplies
.56 Office and Administrative Supplies
.57 Employee Wearing Apparel
.58 Instruments and Minor Equipment
.59 Other Non-Medical and Non-Surgical Supplies
(6)
.60 Utilities.
.61 Electricity
.62 Fuel
.63 Water
.64 Disposal Service
.65 Telephone/Telegraph
.66 Purchased Steam
.69 Utilities—Other
(7)
.70 Purchased Services.
.71 Medical
.72 Maintenance and Repairs
.73 Medical School Contracts
.74 Laundry and Linen
.75 Data Processing
.76 Management and Contracted Services
.77 Collection Agency
.78 Transcription Services
.79 Other Purchased Services
(8)
.80 Other Direct Expenses.
.81 Insurance
.82 Interest
.83 Licenses and Taxes (other than on Income)
.84 Dues, Books and Subscriptions
.85 Outside Training Sessions (including Travel)
.86 Travel—Other
.87 Postage
.88 Printing and Duplicating
.89 Other Expenses
(9)
.90 Depreciation/Rent.
.91 Depreciation and Amortization—Buildings and Building Improvements
.92 Depreciation—Fixed Equipment
.93 Depreciation—Movable Equipment
.94 Depreciation and Amortization—Land Improvements and Other
.95 Lease/Rentals—Buildings, Improvements and Fixed Equipment
.96 Lease/Rentalsmdash;Movable Equipment
.97 Lease/Rentals—Other
(d) Examples of coding for expenses are as follows:
(1) A registered nurse provides nursing care to a Pediatric Acute patient. The salary expense applicable to the registered nurse would be recorded as follows:
| Daily Hospital Service Expense | 6 | | --- | --- | | Pediatric Acute | 170 | | Decimal Point | . | | Salaries and Wages | 0 | | Registered Nurses or 6170.03 | 3 |
(2) A dietician prepares fish for serving to patients in a daily hospital service cost center. The salary expense applicable to the dietician would be recorded as follows:
| Other Operating Expense | 8 | | --- | --- | | Dietary Services | 310 | | Decimal Point | | | Salaries and Wages | 1 | | Environmental, Hotel and Food | 1 | | Service Employee or 8310.11 | |
(8) The recording of the food (fish) prepared for the patients would be recorded as follows:
| Other Operating Expense | 8 | | --- | --- | | Dietary Services | 310 | | Decimal Point | | | Non-Medical and Non-Surgical Supplies | 5 | | Food—Meats, Fish and Poultry or 8310.51 | 1 |
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.94 Notice and opportunity for public hearing
(a) Before a variance proposed to be granted by the department under section 5-1.90 or 5-1.91 of this Subpart may take effect, the department shall provide notice and opportunity for public hearing on the proposed variance. A notice given pursuant to the preceding sentence may cover the granting of more than one variance and a hearing held pursuant to such notice shall include each of the variances covered by the notice.
(b) Before a compliance or implementation schedule prescribed by the department pursuant to the granting of a variance under section 5-1.90 of this Subpart or an exemption under section 5-1.92 of this Subpart may take effect, the department shall provide notice and opportunity for public hearing on the proposed compliance or implementation schedule, or both. A notice given pursuant to the preceding sentence may cover the proposal of more than one such schedule and a hearing held pursuant to such notice shall include each of the schedules covered by the notice.
(c) Public notice of an opportunity for hearing pursuant to subdivision (a) or (b) of this section shall be circulated in a manner designated to inform potentially interested persons of the proposed action. Requests for hearing shall be submitted to the department within 30 days after issuance of such public notice.
(d) Notice of public hearings to be held pursuant to a request submitted by an interested person or on the department's own motion shall be given not less than 15 days before the time scheduled for the hearing, in a form and manner to be prescribed by the department. Notices of public hearing shall be circulated in a manner designated to inform interested persons of the hearing.
(e) If no timely request for hearing is submitted and the department does not determine to hold a public hearing on his own motion, the proposed variance or schedule prescribed pursuant to the granting of a variance or exemption shall become effective 30 days after notice of opportunity for hearing is given pursuant to subdivision (c) of this section. If a public hearing is held, the department shall take an action with respect to such proposed variance or schedule within 30 days after the end of the public hearing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 454 FUNCTIONAL REPORTING
10 CRR-NY 454.2 Concepts for functional reporting
(a) In order to comply with the reporting requirements of the New York State Department of Health, residental health care facilities must adhere to the following basic concepts.
(1) Residential health care facilities must follow the uniform accounting policies and practices as specified in Part 452 of this Article. Items such as methods of capitalization and depreciation of assets and direct charging of maintenance repairs, and payroll-related benefits to using centers are examples of important policies which must be adhered to for the annual uniform financial report.
(2) The principles and concepts utilized in the preparation of the annual uniform financial report will be based upon a portrayal of the activities on a functional basis regardless of third-party reimbursement practices.
(3) Another concept affecting the preparation of the annual uniform financial report is the requirement that costs will be measured at a level where uniformity can be obtained and a standard statistical measurement applied. For purposes of reporting, it was determined that standard units of measure would not be applied to certain nonrevenue or general support services; however, their total cost would be identifiable. The application of standard units of measure for some support services and ancillary revenue centers and all program centers would occur at the direct cost level. Standard units of measure may also be applied to support services, ancillary revenue and program service centers after cost allocation.
(4) Uniform financial reporting for revenue and expense categories is divided into three categories, as follows:
(i) nonrevenue support services centers—includes those reporting centers which do not normally produce patient service revenue and which tend to support the activities and services provided by the patient care services or special education, research or auxiliary programs. Reporting centers representing functions not necessarily associated with services would also be included in this category, such as insurance, etc;
(ii) ancillary service centers—includes those reporting centers which provide diagnostic and treatment services for inpatient and outpatient care; and
(iii) program and auxiliary service centers—includes those patient care, education, research and auxiliary programs for which the residential health care facility is ultimately organized to provide. All effort within the facility is ultimately related to these final program centers.
(b) Conversion from responsibility to functional reporting.
(1) A fundamental aspect of the uniform financial reporting program is the portrayal of revenue and expenses on a functional basis rather than following the organizational pattern of the specific residential health care facility.
(2) The need for uniform functional reporting practices occurs from the fact that facilities will identify costs and revenue according to responsibility centers; that is, the reporting of costs according to the operating units such as departments. Because of the significant variation of the size and scope of residential health care facilities, there may be variation in the assignment of costs within each chart of accounts. Therefore, for uniform functional reporting of revenue and expenses, there may be a need for reclassifications to convert costs from the responsibility reporting format to a functional reporting format. Functional reporting may be defined as the reporting of costs according to the type of activities.
(3) Certain facilites will be required to reclassify certain revenue and expenses to meet the specifications for uniform reporting. Without this conversion from responsibility to functional reporting, residential health care facilities would not be reporting costs in a uniform manner, thus defeating the purposes of the uniform financial reporting requirements within the State.
(4) To achieve uniform functional reporting, all facilities will be required to reclassify revenue, expenses and statistics according to the definition of the functional centers discussed in Part 455 of this Article.
(i) Reclassifications, as discussed in this Part are of two types:
(a) To obtain the required level of reporting. This type of reclassification may be necessary to reach the required level of reporting because the facility has combined several departments. For instance, smaller facilities may be combining the costs of housekeeping and maintenance in one reporting center. In such cases, it is necessary to reclassify the total direct costs into the reporting centers relating to these two types of services.
(b) To correct accumulation of costs. This type of reclassification would be necessary when the expense associated with a particular function is recorded in a reporting center different from the functional description specified in this section. For instance, a reclassification would be required if the Patient Food Services Department recorded the costs associated with hand-feeding of patients, because these costs should have been recorded in the nursing reporting center relating to that patient program.
(ii) These reclassifications may be computed on any one of the following bases:
(a) analysis of direct expense, including time and cost studies;
(b) ratio of total charges to charges of a specific cost center; or
(c) ratio of total units of service to units of service reclassified in a specific reporting center.
(iii)
(a) Reclassifications must be made for significant amounts of misplaced costs. Significant is defined, for the purposes of this section, as an amount in excess of:
(1) one full-time equivalent employee within the functional center transferred to or from for salary costs; or
(2) 10 percent of the direct costs or $1,000, whichever is greater, of the functional center transferred to or from, for other than salary costs.
(b) For the purposes of this Part, an estimate may be utilized to determine the limination for salary costs. This estimate should be based on an approximation of one employee's total paid working hours during the year; e.g., 2,000 hours representing one full-time employee.
(c) Pursuant to the above criteria, the determination of the necessity for reclassification of salary costs may be made based on time studies. A time study must be made of employees who are performing activities related to more than one function. Time studies would be performed for such employees for a two-week period per quarter, for all four quarters in a year. The time study would result in a percentage of employees' hours worked, by function, to total hours worked. These percentages would, for each quarter, be applied to total hours paid for the same employees to arrive at hours paid by function. The results would be totaled for all four quarters and then compared to the estimate of one full-time equivalent of 2,000 hours to determine whether or not a reclassification is required.
(d) When reclassifying full-time equivalent employees between cost centers, non-work hours, i.e., vacation, sick pay, etc., will also be reclassified.
(e) The tests of significance indicated above do not apply to the areas described in section 453.4 of this Article. These allocations must be classified as described in that section. Also, in determining the segregation of costs between the Cafeteria and Patient Food Service Reporting Centers, where joint kitchen facilities are used, the criteria described in those functional reporting centers is to be utilized.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-2 MANAGEMENT OF REGULATED MEDICAL WASTE
10 CRR-NY 70-2.2 Containment and storage
(a) Regulated medical waste shall be separated from other waste as soon as practicable at the point of generation prior to storage, treatment or disposal. Containers holding regulated medical waste containing or mixed with hazardous waste, radioisotopes and/or toxic drug waste shall be so labeled to identify waste types contained therein and so as to provide other information, including but not limited to isotope and level of radioactivity pertinent to determining whether specific procedures for management and/or disposal are applicable. Radiological medical waste shall be stored until decayed to a background radiation level prior to transport off-site of the generating facility and/or treatment.
(b) Containment of regulated medical waste for handling, storage, and treatment shall be accomplished with a primary container for protection from the elements and limiting exposure to employees and the public. Each primary container holding regulated medical waste shall be:
(1) marked prominently with the universal warning sign or the word "biohazard";
(2) impervious to moisture, be secured and situated so as to prevent leakage or preclude loss of contents during handling, storage and/or transport; and
(3) be located away from pedestrian traffic, be vermin and insect free, and shall be maintained in a sanitary condition.
(c) Whenever regulated medical waste is transported off-site for treatment elsewhere, the primary container shall have affixed a label or imprint indicating the name and address of the generation facility and shall comply with the transport requirements of subdivision (h).
(d)
(1) In addition to the requirements of subdivisions (b) and (c) of this section, the primary container for regulated medical waste, with the exception of sharps, shall be a plastic bag; red in color; and of a strength sufficient to resist ripping, tearing, or bursting under normal conditions of use and handling.
(2) In addition to the requirements of subdivisions (b) and (c) of this section, the primary container for discarded sharps shall be rigid, leakproof, puncture-resistant and closable, and may serve as a secondary container for purposes of transport, provided it meets the definition of a secondary container.
(e)
(1) Under no circumstances shall a sharps container be filled beyond the fill line indicated on the container.
(2) Sharps containers shall be removed from the patient care areas to a room or area designated for regulated medical waste storage, whenever the container has reached the fill line indicated on the container. Sharps containers shall be removed from patient care areas within 30 days or upon the generation of odors or other evidence of putrification, whichever occurs first, without regard to fill level.
(f) Regulated medical waste, with the exception of sharps as provided in subdivision (e) of this section, may be held in patient care areas for a period not to exceed 24 hours and at a clinical laboratory for a period not to exceed 72 hours, at which time the waste shall be moved to a storage area.
(g)
(1) Each storage area shall be adequate for the volume of regulated medical waste generated between scheduled waste pick-ups by a transporter, or, for facilities treating the waste on-site, the volume of waste that can be treated on-site within a 24-hour period.
(2) Each storage area shall:
(i) display prominent signage indicating the space is used to store regulated medical waste;
(ii) be designed or equipped to prevent unauthorized access;
(iii) be designed or located to protect waste from the elements, and prevent access by vermin;
(iv) hold the waste at a temperature that prevents rapid decomposition and resultant odor generation;
(v) be appropriately ventilated; and
(vi) be of sufficient size to allow clear separation of regulated medical waste from any other waste, whenever waste other than regulated medical waste is stored in the same area.
(3) Regulated medical waste shall not be stored for a period exceeding 30 days, except that a site generating under 50 pounds of regulated medical waste per month and not accepting regulated medical waste for treatment from other facilities, may store waste for a period not exceeding 60 days.
(h) Prior to transport off-site of the generating facility for treatment elsewhere:
(1) primary containers shall have affixed a label or imprint indicating the name and address of the generating facility; and
(2) primary containers, except as provided in paragraph (c)(2) of this section, shall be placed in a secondary container with an affixed label or imprint, indicating the name and address of the generating facility, and such container marked prominently with signage indicating that the contents are infectious or regulated medical waste; and, if applicable, with an affixed label indicating that the contents contain or are mixed with hazardous waste, and/or toxic drug waste.
(i) All internal surfaces of a reusable secondary container used to hold regulated medical waste shall be completely protected by a disposable liner, which may also function as the primary container provided it meets the criteria for a primary container provided in subdivisions (b) and (c) of this section. The liner shall be removed as a secured unit with the waste and treated as regulated medical waste. A reusable secondary container shall undergo washing and decontamination upon emptying whenever the liner is compromised; visual inspection yields evidence that the container's surface has come in contact with the contained waste prior to treatment; the contained waste includes cultures and/or stocks; or the contained waste has a highly infectious bioload.
(j) Under no circumstances shall regulated medical waste be transferred from one container to another ( e.g. , for consolidation or loading of a treatment system) in a manner that compromises health and safety of the persons handling the waste. Regulated medical waste being moved from one container to another, or one location to another within a facility shall as a minimum be secured in a primary container.
(k) Reusable sharps containers shall not be opened for consolidation or other purposes unless such procedure has been approved as part of the facility's treatment system operation plan.
(l) Disposable secondary containers for storing and handling regulated medical waste shall be treated as regulated medical waste.
(m) Transport of regulated medical waste within a facility from the point of generation to the point of storage or treatment shall be by covered cart or other appropriately covered conveyance system marked prominently with signage indicating that the contents are infectious or are regulated medical waste; provided, however, waste held in containers meeting the definition of secondary container may be transported within a facility from point of generation to the point of storage or treatment using an open conveyance system ( e.g. , laboratory cart or dolly) provided each container is labeled and appropriately closed. Regulated medical waste shall not be moved within a facility by gravity alone without control of impact, i.e. , trash chutes or slides.
(n) Regulated medical waste shall not be compacted unless it has undergone treatment as provided in section 70-2.3 of this Subpart.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.7 Approval fee computation
(a) Except as otherwise provided in this section, the approval fee assessed to each environmental laboratory shall be computed as follows:
(1) the total projected budget of the environmental laboratory approval program for the upcoming State fiscal year (April 1st to March 31st) shall be computed (hereafter “the budget”);
(2) the total number of laboratories shall be multiplied by $500 and the product deducted from the budget, resulting in the balance of the program cost;
(3) one-half of the balance of the program cost shall be divided by the sum of the total adjusted volume of all laboratories, excluding governmental laboratories. The resulting number shall be the volume fee constant; and
(4) one-half of the balance of the program cost shall be divided by the sum of the analytes for all laboratories, based on the highest number of analytes for which each laboratory held approval during the previous approval year. The resulting number shall be the analyte fee constant;
(5) the approval fee for each laboratory shall be calculated by adding:
(i) $500; and
(ii) the volume fee constant multiplied by the sum of the adjusted volume for the applicant laboratory; and
(iii) the analyte fee constant multiplied by the sum of the analytes for that laboratory;
(6) governmental laboratories are exempted from paying that portion of the fee based on adjusted volume.
(b) An environmental laboratory, which is applying for a certificate of approval in a category in which it was not conducting tests on New York State samples prior to its application, shall pay for such approval a fee of:
(1) $500 regardless of the number of months remaining in the approval year; and
(2) an amount calculated by multiplying the analyte fee constant described in subdivision (a) of this section by the total number of analytes within each category for which a certificate of approval is sought, prorated for the months remaining in the approval year.
(c) An environmental laboratory, which is applying for a certificate of approval in a category in which it was conducting tests on New York State samples prior to its application, shall pay an initial approval fee computed as an annual fee but prorated for the months remaining in the approval year or $500, whichever is greater. Such laboratory's adjusted volume shall not be used in recalculating a fee constant for the first approval year in which it operates.
(d) Changes in analytes or subcategories during an approval year shall not require payment of additional fees during that approval year.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.15 Cabinets
Cabinets shall be provided for storage of clean linen ad towels. They shall have tight fitting doors that shall be kept closed to protect the linen and towels from dust and dirt.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.20 Ambulatory visits by source of payment
(a) Emergency Services (account 6710).
(1) Number of visits.
(i) Outpatient visits, plus
(ii) Visits resulting in inpatient admissions.
(iii) Total must equal Standard Unit of Measure.
(2) Number of visits, excluding visits resulting in inpatient admissions.
(i) Total visits, less
(ii) Visits resulting in inpatient admissions.
(b) Clinic Services (account 6720).
(1) Number of visits.
(i) Outpatient visits, plus
(ii) Visits resulting in inpatient admissions.
(iii) Total must equal Standard Unit of Measure.
(2) Number of visits, excluding visits resulting in inpatient admissions.
(i) Total visits, less
(ii) Visits resulting in inpatient admissions.
(c) Community Mental Health Center.
(1) Number of visits.
(i) Outpatient visits, plus
(ii) Visits resulting in inpatient admissions.
(2) Number of visits, excluding visits resulting in inpatient admissions.
(i) Total visits, less
(ii) Visits resulting in inpatient admissions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.5 Surrogacy program informed consent
(a) Surrogacy programs shall obtain written informed consent from all prospective parties to the surrogacy agreement prior to entering into such agreement and shall develop and implement an informed consent form. The informed consent form shall be written in plain language and available in English, or the language the individual giving consent is most proficient in reading, and shall include, at a minimum, the following:
(1) a statement that the surrogate has been informed that their name and address will be kept on file by the surrogacy program;
(2) a statement that the surrogate has been advised of the option to voluntarily share their information with the surrogacy registry upon completion of the surrogacy agreement;
(3) HIPAA-compliant authorization for disclosure of the surrogate’s relevant medical history information to prospective intended parent(s) and their physicians, consistent with statutory requirements for the disclosure of medical information;
(4) a statement that the surrogate has the right to terminate the surrogacy agreement prior to becoming pregnant by means of assisted reproduction pursuant to article 5 C of the Family Court Act;
(5) a statement regarding the surrogacy program’s screening of prospective surrogates, and the criteria assessed therein; and
(6) a copy of the Surrogates’ Bill of Rights, as set forth in article 5 C of the Family Court Act.
(b) Informed consent obtained pursuant to this section shall not constitute, or be a substitute for, informed consent to any medical procedure, medication or other medical treatment.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.1 Definitions
(a) Institution means a college, university or other institution for higher education authorized to confer degrees.
(b) Student means any person born on or after January 1, 1957, who is registered to attend or attends classes at an institution whether full-time or part-time. Part-time student means a student enrolled for at least six, but less than 12 semester hours, or the equivalent, per semester or at least four but less than eight semester hours per quarter in an approved degree or registered certificate program in a degree granting institution. Full-time student means a student enrolled for 12 or more semester hours, or the equivalent, per semester or eight or more semester hours per quarter.
(c) Immunization means an adequate dose or doses of an immunizing agent against measles, mumps and rubella which meets standards approved by the United States public health service for such biological products and which is approved by the State Department of Health under such conditions as may be specified by the public health council.
(d) Health practitioner means any person authorized by law to administer an immunization.
(e) Attendance means the physical presence of the student at the institution and shall begin on the first scheduled day of classes for a student each semester.
(f) School means a public, private or parochial elementary, intermediate or secondary school building.
(g) Certificate of Immunization means that document, prepared by the health practitioner who administers an immunization, which specifies the products administered and the dates of administration (see Public Health Law, section 2165[5]). It may also show physician-verified history of disease and/or laboratory evidence of immunity. Certificate of Immunization shall also mean an immunization record submitted by the institution or school which the student previously attended, which specifies the products administered and the dates of administration and whose source was a certificate of immunization from a health practitioner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.46 Outpatient clinics
This functional reporting center must contain all the expenses associated with an organized service providing diagnostic, preventive, curative, rehabilitative and educational services on a scheduled basis to ambulatory patients. Additional activities include but are not limited to the following: participating in activities designed to promote health education; assisting in administration of physical examinations and diagnosis and treatment of ambulatory patients; referring patients who require prolonged or specialized care to appropriate services; assigning patients to physicians in accordance with clinic rules; and making patients' appointments through required professional service functions.
(a) Standard unit of measure: number of visits.
Enter all visits to medical clinics. Each visit is counted as one.
(b) Data source.
The number of visits shall be the actual count maintained by the clinics.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
LICENSURE LICENSURE
10 CRR-NY 89.12 Issuance of a temporary permit
(a) A temporary permit is a document issued by the department that allows an individual who qualifies under section 3505 of the Public Health Law to practice radiologic technology pending an examination. The permit shall be in effect for 180 days from the date of issue. It shall expire 10 days after notification by an accrediting organization that the individual has failed to pass the qualifying examination. An individual with a temporary permit does not qualify for intravenous contrast administration certification.
(b) The department may issue a temporary permit to an applicant who has been discharged from active duty with the Armed Forces of the United States or has satisfactorily completed an accredited course of study located outside of the State of New York, within one year preceding the date of application, who otherwise qualifies for admission to examination and provides a copy of the examination admission letter from an approved accrediting organization.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 129 NIAGARA COUNTY
10 CRR-NY 129.1 Village of Middleport
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as heretofore set forth, shall apply to all natural and artificial reservoirs and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Village of Middleport, Niagara County, NY.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the storage and impounding reservoir which is tributary thereto or which serves as a source of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or any channel of any kind, the waters of which when running, whether continuously or occasionally, flow or may flow into the public water supply of the Village of Middleport.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(3) Every privy, privy vault, pit or other receptacle of any kind or place, used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all such excreta shall be received in suitable watertight receptacles and shall at all times be disposed of as hereinafter set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain these receptacles or the privy or the place in which they are kept in a proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape in being transferred from the privy or place of temporary storage to the place of disposal hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to the occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth not less than 18 inches below the surface, in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Village of Middleport, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry, garage or stable wastes, sewage or excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Village of Middleport, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Village of Middleport, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 75 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse tributary to the public water supply. The watering of animals or poultry in any reservoir of the public water supply of the Village of Middleport is prohibited. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any watercourses tributary to the public water supply of the Village of Middleport.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the Village of Middleport, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings therefrom may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the Village of Middleport.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Middleport, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the Village of Middleport.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the public water supply of the Village of Middleport, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the whole or any part of any reservoir of the public water supply of the Village of Middleport.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Middleport.
(j) Inspections.
The board of trustees of the Village of Middleport or such other board as may be charged with the maintenance or supervision of the public water supply of the village or its duly appointed representatives shall make regular and thorough inspections of the reservoir, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the reservoir, watercourses and drainage areas tributary to the public water supply of the Village of Middleport at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.84 Date of change in certified bed capacity—increase
The date the hospital receives approval from the Department of Health to utilize a unit or portion thereof.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS
10 CRR-NY 80.37 Records; researchers
(a) Researchers, licensed and authorized to possess and use controlled substances, shall keep a record of all such substances received and used by them.
(1) A record of all such controlled substances received shall include date of receipt, name and address of vendor, type and quantity of drug received. A duplicate invoice or separate itemized list furnished by the vendor will be sufficient to meet this record requirement providing it contains all the information required and is maintained in a separate file.
(2) A record of all controlled substances used shall include the name of the person authorized to control and use such drugs, the date, type and quantity of drug and signature of the user.
(b) In addition, such records shall contain the following information for each controlled substance:
(1) Name of substance.
(2) Each finished form (such as 10 mg. tablet, or 10 mg. concentration per fluid ounce or milliliter) and the number of units or volume of finished form in each commercial container.
(3) The number of commercial containers of such finished form received from other persons, including the date of and number of containers in each receipt, and the name, address, and registration number of the person from whom the containers were received.
(4) The amount of such finished form dispensed, including the name and address of the person to whom it was dispensed, the date of dispensing, and the written or typewritten name or initials of the individual who dispensed or administered the substance.
(5) The number of units or volume of the finished form and/or commercial containers disposed of in any other manner by the researcher, including the date and manner of disposal.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 5 HIV/AIDS HEALTH SERVICES
Part 420 COMPREHENSIVE AMBULATORY HIV PROGRAMS
10 CRR-NY 420.1 Applicability
Comprehensive Ambulatory HIV Programs (CAHP) are programs approved at facilities established under article 28 of the Public Health Law which provide the full range of ambulatory care clinical services, as described in this Part, appropriate for the continuous care of patients who have been diagnosed with HIV, whether symptomatic or asymptomatic.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.17 Electrical
(a) Installation of electrical service, wiring, and fixtures shall conform to the Uniform Code. A certificate of approval provided by a qualified electrical inspector shall be submitted for all new electrical work.
(b) The electrical service, wiring and fixtures shall be in good repair and safe condition. Where conditions indicate a need for inspection, the electrical service and wiring shall be inspected by a qualified electrical inspector, and a copy of the inspection report and certificate of approval shall be submitted to the permit-issuing official.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.274 Psychiatric night care
A program of inpatient care, similar to that described under psychiatric day care, and must include overnight stay in the facility.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.202 Separability
If any provision of this Subpart is held invalid, such invalidity shall not affect other provisions which shall be given effect without the invalid provisions.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.104 Emergency outpatient
An emergency outpatient is one who is admitted to the emergency, accident or equivalent service of the hospital for the diagnosis and/or treatment of a condition. The service is one operated pursuant to section 405.1033 of this subchapter.
Article 7 HOME HEALTH AGENCIES; TREATMENT CENTERS AND DIAGNOSTIC CENTERS
Part 432 HOSPICE OPERATION
10 CRR-NY 432.1 Applicability
Hospices shall comply with the standards for such programs set forth in the State Hospital Code, Subchapter C of this Chapter.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.58 Oakwood Park Corporation, Belle Terre
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such additional wells as may be developed in the future on the property of the Oakwood Park Corporation in the village of Belle Terre, Suffolk County, New York, such well being the sources of public water supply furnished by said corporation to the village of Belle Terre and surrounding territory in the town of Brookhaven.
(b) [Definitions.]
(1) The term well whenever used in this section means any well now used as a source of this public water supply or any additional well which may be constructed on the property of the Oakwood Park Corporation in the village of Belle Terre for the purpose of this water supply.
(2) Wherever the linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(2) Every privy or receptacle for the storage or deposit of human excreta located between 100 feet and 200 feet from any well shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of in accordance with the provisions of paragraph (3) of this subdivision.
(3) The excreta collected in the aforesaid watertight receptacles permitted under paragraph (2) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent its being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well.
(4) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged or deposited nor allowed to be discharged or deposited on or beneath the surface of the ground within 200 feet of any well except into watertight receptacles, the contents of which shall be removed as provided by paragraph (3) of subdivision (c). It is provided, however, that no such watertight receptacle shall be located nearer than 150 feet from any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited or allowed to be discharged or deposited on or beneath the surface of the ground within 150 feet of any well.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or other material or wastes that pollute water shall be deposited or allowed to be deposited on or beneath the surface of the ground within 200 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise over or through the ground into any well except in a properly purified condition.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 150 feet of any well.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 150 feet of any well.
(h) Trespassing.
No trespassing shall be allowed upon the property of the Oakwood Park Corporation upon which the wells of the public water supply of the village of Belle Terre and surrounding territory are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said corporation.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(j) General clause.
In addition to observing the foregoing requirements all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Oakwood Park Corporation.
(k) Inspections.
The Oakwood Park Corporation, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid corporation to cause copies of any such rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the corporation to promptly notify the State Commissioner of Health of such violations. The aforesaid corporation shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.6 Role of local health units
(a) Local health units shall provide public and professional education and community outreach on lead poisoning prevention.
(b) Local health units shall provide blood lead screening or arrange for blood lead screening for each child who requires screening as provided in section 67-1.4 of this Subpart and whose parent or guardian is unable to obtain a lead test for their child because the child is uninsured or the child's insurance does not cover lead screening.
(c) Local health units shall establish a sliding fee schedule for blood lead screening of children from families with incomes in excess of 200 percent of the Federal poverty level, pursuant to section 606 of the Public Health Law, and shall collect fees for blood lead testing from third-party payors, when available.
(d) Local health units shall provide environmental management as required under this Part.
(e) Local health units shall provide data to identify exposure patterns and high risk populations for strategic planning for lead poisoning prevention at the State and local level.
(f) Local health units shall institute measures to identify and track children with elevated blood lead levels to assure appropriate follow-up.
(g) Local health units who serve as a child's primary health care provider shall carry out activities in accordance with section 67-1.2(a)(1) through (9) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.8 Medical/professional staff
(a) The medical/professional staff of the PCH/CAH shall consist of at least one doctor of medicine or osteopathy and may also include licensed dentists and other qualified personnel as defined in section 407.1(g) of this Part and as determined to be appropriate by the governing body to provide approved services in accordance with their respective qualifications and patient needs.
(b) For purposes of this section, the term medical staff , as used in section 405.4 of this Title, may refer to the medical/professional staff of a PCH/CAH.
(c) For the conduct of its medical/professional staff, PCHs/CAHs shall comply with the provisions of section 405.4 of this Title. In addition to such requirements, PCHs/CAHs shall:
(1) ensure that members of the emergency medical/professional staff have successfully completed the necessary course work and training for basic cardiac life support or advanced cardiac life support, have received their credentialing from the hospital and are available on-site at all times during posted hours of operation;
(2) ensure that a system is in place to provide for the ongoing oversight and direction by a physician of all professional staff in accordance with applicable practice acts and regulations;
(3) if the hospital is a member of a rural health network, develop a system in which network medical/professional staff participate and collaborate to provide consultation, assistance with medical emergencies, and patient referrals; and
(4) ensure that at least one doctor of medicine or osteopathy is available by radio or phone, and one is on standby as a backup for consultation and patient referral assistance, on a 24-hour a day basis except that CAHs shall ensure that physicians are present for sufficient periods of time to provide the necessary and appropriate medical direction, medical care services, consultation, and supervision of hospital health care staff in accordance with patient needs.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 78 STATEMENT TO BE FURNISHED BY EVERY PERSON LICENSED PURSUANT TO ARTICLE 34 OF THE PUBLIC HEALTH LAW
10 CRR-NY 78.2 Format for statement of goods and services selected
The statement of goods and services selected shall be in the following format:
ITEMIZATION OF FUNERAL SERVICES AND MERCHANDISE SELECTED
The following are the charges for the services, merchandise and livery you have selected. You will not be charged for any item you do not choose unless it is necessary because of other selections you have made. Any such charges are explained below.
I. FUNERAL HOME CHARGES (Indicate N/A for items of service and/or merchandise that are not provided.)
A. Alternative Services
1. Direct Cremation
$ __
2. Direct Burial
$ __
B. Transfer of remains to the funeral establishment, including
personnel, equipment and vehicle.
$ __
C. Preparation of Remains
1. Embalming (including use of preparation room)
$ __
If you select a funeral for which this firm requires embalming, such as a funeral with viewing, you may have to pay for embalming. You do not have to pay for embalming you do not approve if you select arrangements such as direct cremation or direct burial. If we charge for embalming, we will explain why below.
2. Other preparation (including use of preparation room but excluding embalming)
a. Topical Disinfection
$ __
b. Custodial Care
$ __
c. Dressing/Casketing
$ __
d. Cosmetology
$ __
e. Restoration
$ __
f. Other (specify)
_________
$ __
______________
D. Arrangements
$ __
Basic arrangements: including funeral director, other staff, equipment and facilities to respond to initial request for service, the arrangement conference, securing of necessary authorizations and coordination of service plans with parties involved in the final disposition of the deceased.
E. Supervision (funeral director and staff)
1. Supervision for visitation
$ __
2. Supervision for funeral service
$ __
3. Other supervision (specify)
_________
$ __
_________________
F. Use of the Facilities
1. Use of the facilities for visitation
$ __
2. Use of facilities for funeral service
$ __
3. Other use of facilities (specify)
_________
$ __
___________________
G. Livery
1. a. Hearse or
$ __
b. Alternative vehicle
$ __
(Specify type:
_________
)
2. Flower vehicle
$ __
3. Limousine(s)
$ __
(Specify number: __@ $__/limousine)
4. Passenger car(s)
$ __
(Specify number: __@$__/car)
H. Merchandise
$ __
1. Casket or Alternative Container
$ __
a. Supplier
b. Model name or number
c. Material: Species of wood
or kind of metal
weight or
gauge
__
or alternative container (describe)
d. Interior
2. Outer Interment Receptacle
$ __
Supplier
Model name or number
Material
I. Additional Services and Merchandise Selected
(Describe and show price)
______________
$ __
______________
$ __
______________
$ __
______________
$ __
J. Limited Services
1. Forwarding remains to
__________
$ __
2. Receiving remains from
_________
$ __
TOTAL OF FUNERAL HOME CHARGES
$ __
II. CASH ADVANCES
These are estimated charges for items to be paid to others. We will charge you no more for these items than is actually paid the third parties. (Describe and show estimated charges.)
______________
$ __
______________
$ __
______________
$ __
______________
$ __
ESTIMATED TOTAL OF CASH ADVANCES
$ __
III. SUMMARY OF CHARGES
1. Funeral Home Charges
$ __
2. Cash Advances
$ __
TOTAL FUNERAL CHARGES
$ __
IV. EXPLANATION OF CHARGES
Explain charges for embalming and for any items that are not required by law but may be necessary because of cemetery requirements, crematory requirements or other selections made.
Signature of Licensed Funeral Director
Date
Printed or Typed Name of Funeral Director
ACKNOWLEDGMENT OF RECEIPT
I have received this itemization of funeral services
and merchandise selected.
Signature of Licensed Funeral Director
Date
PUBLIC NOTICE
The New York State Department of Health is responsible for licensing and regulating New York State funeral directing under the Public Health Law.
You may contact the Department at:
Bureau of Funeral Directing
New York State Department of Health
Corning Tower, Empire State Plaza
Albany, NY 12237
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
HANDWASHING HANDWASHING
10 CRR-NY 14-4.140 Mobile food service establishment handwashing facilities
(a) Mobile food service establishments are to have adequate handwashing facilities provided and maintained in the food preparation areas. Sinks not in use for food storage, preparation or processing or not in use for utensil or dishwashing may be used for handwashing.
(b) Each handwashing facility is to be provided with running hot and cold or tempered potable water.
(c) Each handwashing facility is to be provided with handcleaning soap or detergent kept in a sanitary storage receptacle. Individual single-service towels are to be provided. Common towels are prohibited.
(d) Handwashing facilities are to be kept clean and in good repair.
(e) Handwashing signs are to be posted at handwashing facilities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.7 Funeral directing
(a) A funeral director, undertaker or embalmer shall not permit any unlicensed person to engage in or take charge of the activities for which a license to engage in the business or practice of funeral directing, undertaking or embalming is required by the provisions of the Public Health Law.
(1) A licensed and registered funeral director or undertaker or a registered resident shall be present and personally supervise and arrange for the removal or transfer of each dead human body from the place where death occurs, or from the place where it is released to him/her by the family or other legal authority.
(2) A licensed and registered funeral director or undertaker or a registered resident shall be present and personally supervise the conduct of each funeral service.
(3) Nothing herein shall be construed as prohibiting religious supervision of the funeral service by a member or members of the clergy designated by the family of the deceased person.
(4) A licensed and registered funeral director or undertaker or a registered resident shall, unless prevented by the rules or documented practices of the cemetery, be present and personally supervise the interment, delivery to and acceptance by crematory personnel at the crematory, or the pickup from or the delivery to a common carrier, of a dead human body.
(5) No person other than a duly licensed and registered funeral director or undertaker shall make or be permitted to make arrangements on behalf of any funeral director, undertaker or funeral firm with a customer or customer's designee:
(i) for temporary or final entombment, or cremation, disinterment, reinterment or other lawful disposition of a dead human body;
(ii) for the care, preparation, shipment or transportation of a dead human body; or
(iii) for the purchase, sale or rental of funeral merchandise, services or paraphernalia.
The taking of preliminary information over the telephone by an unlicensed person shall not be construed as the making of funeral arrangements under this section.
(b)
(1) In no case shall a dead human body be released from any hospital, institution or other place where the death occurred or from the place where the body is held by legal authority to any person not a duly licensed and registered funeral director or undertaker or a registered resident.
(2) Every person, including, although not limited to, a person in charge of a hospital, institution, or place where a person has died, having lawful possession, charge, custody or control of a dead human body, shall request the person seeking to obtain the release of said body and acting as, for, or in behalf of a funeral director or funeral firm, to produce his/her current certificate of registration, showing that he/she is personally entitled to practice as a funeral director, undertaker or as a registered resident.
(c) Every person, including a person acting lawfully in an emergency, in charge of a cemetery, crematory, vault or other place to which a dead human body is brought for temporary or permanent disposition shall require the person in charge of such body to identify himself/herself as a duly licensed and registered funeral director or undertaker or as a registered resident and to produce his/her current certificate of registration as such.
(d) In the event such burial or other disposition is not in the charge of a duly licensed and registered funeral director or undertaker or registered resident, the person in charge of the cemetery, crematory, vault or other place where dead human bodies are brought for temporary or permanent disposition shall immediately submit to the Department of Health the name and address of the person who had charge of the body at the time of burial or other disposition and the name and address of the funeral director, undertaker, registered resident or funeral firm for which such person was acting.
(e) In the event that a person other than a duly licensed and registered funeral director or undertaker shall make any arrangements for the purchase, sale of rental or funeral merchandise, services or paraphernalia accompanied by the representative of a decedent at a casket showroom, display room or other facility, the owner or manager of such facility shall immediately notify the Department of Health of the name and address of the person and of the funeral director, undertaker or funeral firm for which such person was acting.
(f) Nothing contained in this section shall be deemed to require that a mere transporter, to whom or to which a dead human body has been duly released for the sole purpose of transportation or transfer, shall be a duly licensed and registered funeral director or undertaker or a registered resident.
(g) A funeral director, undertaker or funeral firm entering another state or a province of the Dominion of Canada, personally or by an agent or employee, pursuant to a reciprocal agreement between the State Commissioner of Health and such state or province, shall not violate any statute, code, rule or regulation of such state or province relating to the practice of funeral directing, undertaking or the equivalent thereof.
(h) A registered resident may only render the services described in this section under the supervision of the sponsor for his/her registration. A registered resident shall not have the authority to sign any form or document required by law which requires the signature of a licensed funeral director, or to make funeral arrangements or to own or manage a funeral firm.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.10 Environment
(a) The minimum physical plant requirements necessary for certification for existing facilities to provide integrated care services are described herein. Providers licensed or certified by a State licensing agency after the effective date of this Part that wish to provide integrated care services or anticipate new construction or significant renovations shall comply with the requirements under Part 710 (Approval of Medical Facility Construction), Part 711 (General Standards of Construction) and Part 715 (Standards of Construction for Freestanding Ambulatory Care Facilities) of this Title.
(b) Outpatient clinic sites proposing to integrate services pursuant to these standards must currently be in compliance with the applicable State licensing agency’s environmental standards currently governing the site.
(c) Standards for integrated care services clinics.
In addition to being in compliance with the applicable State licensing agency’s environmental standards currently governing the site as required under subdivision (b) of this section, integrated services providers shall meet the following requirements:
(1) General facility requirements.
(i) A current and accurate floor plan, specifying room locations, dimensions and functions will be provided to each applicable State licensing agency. Program space, except medical examination and treatment rooms, may be shared between certified outpatient services pursuant to an approved schedule. Individual and group rooms shall not be utilized for multiple services simultaneously.
(ii) An adequately furnished waiting area shall be available to those waiting for services and shall be supervised to control access to the facility. There shall be sufficient separation and supervision of various treatment groups ( e.g. , children) to ensure safety.
(iii) Accessibility for person with disabilities, including availability of accessible bathroom facilities.
(iv) Sufficient space for individual and group sessions consistent with the number of people served and the service offered shall be available. Space shall afford visual and acoustical privacy for both individuals served and staff.
(v) Sufficient and appropriate furnishings and program related equipment and materials for the population served.
(vi) Areas for the proper storage, preparation and use or dispensing of medications and medical supplies and equipment shall be made available. Sharps containers shall be provided and secured, syringes and other supplies should be securely stored, and provisions for holding medical waste are required.
(vii) Controlled access to and maintenance of records and confidentiality of all patient information.
(viii) Annual inspection and testing of the existing fire alarm system, including battery operated smoke detectors, fire extinguishers, emergency lighting systems, illuminated exit signs and environmental controls and heating/cooling systems shall be conducted.
(ix) Facilities shall be maintained in a clean and responsible manner which protects the health and safety of all occupants.
(2) Specific facility requirements for integrating primary care services.
(i) Notwithstanding Part 710 (Approval of Medical Facility Construction), Part 711 (General Standards of Construction) and Part 715 (Standards of Construction for Freestanding Ambulatory Care Facilities) of this Title, physical plant standards under this subclause apply to a behavioral health clinic provider authorized to integrate primary care services with no more than three proposed examination rooms for physical health services.
(a) Clean storage. A separate room or closet for storing clean and sterile supplies shall be provided. This storage shall be in addition to that of cabinets and shelves within the examination rooms or patient treatment areas.
(b) An integrated services provider shall dispose of soiled linens and trash appropriately, either through specially-designated receptacles or separate holding room depending upon the volume of soiled materials generated.
(c) If utilizing a receptacle for soiled linens and trash, such receptacle shall not exceed 32 gallons in capacity, except as set forth in clause (d) of this subparagraph, and shall meet the following:
(1) The average density of the container capacity in a room or space shall not exceed 0.5 gal/ft sq.
(2) A receptacle with a capacity of 32 gallons shall not exceed any 64 ft sq. area.
(3) Mobile soiled linen or trash collection receptacles greater than 32 gallons shall be located in a room protected as a hazardous area when not attended.
(d) If utilizing a receptacle for soiled linens and trash exceeding 32 gallons in capacity at any given time, the integrated services provider shall maintain a soiled holding room.
(1) Soiled holding is for separate collection, storage, and disposal of soiled materials.
(2) A soiled holding room shall be provided, if a dedicated space cannot be provided in the storage area.
(3) All contaminated materials shall be located and placed in a secured and sealed container and disposed of properly in accordance with all applicable laws and regulations. This shall be in the dedicated storage space that is secured and access is only by the integrated care services clinic staff.
(4) The containers used solely for recycling clean waste or for patient records awaiting destruction outside a hazardous storage area shall be a maximum capacity of 96 gallons. Containers used solely for recycling clean waste or for patient records awaiting destruction outside of a hazardous storage area may exceed 96 gallons, but only if the provider/supplier is in compliance with National Fire Protection Association (NFPA) 101 Life Safety Code, 2012 edition, sections 18/19.7.5.7.2.
(e) Toilet rooms.
(1) A toilet room containing a hand-washing station shall be accessible from all examination and treatment rooms.
(2) Public toilet. Toilet(s) for public use shall be immediately accessible to the waiting area. In smaller units (less than four employees), the toilet may be unisex.
(3) Where a facility contains no more than three examination and/or treatment rooms, the patient toilet shall be permitted to serve waiting areas.
(4) Staff toilet and lounge shall be provided in addition to and separate from public and patient facilities.
(5) Centralized staff facilities are not required in small centers. In small centers, staff may utilize shared toilet facilities. Small centers less than four employees.
(6) Floors shall have a smooth, hard, non-absorbent surface that extends upward onto the walls at least six inches (152 mm). Vinyl composition tile (VCT) shall not be used in toilet rooms.
(f) Examination and treatment rooms.
(1) No more than three examination rooms shall be provided.
(2) At least one examination room shall be available for each provider who may be on duty at any one time.
(3) Provision shall be made to preserve patient privacy from observation from outside an examination/treatment room through an open door.
(4) A counter or shelf space for completing documentation shall be provided.
(g) Space requirements.
(1) Each examination/observation room shall have a minimum clear floor area of 80 square feet.
(2) The examination room can be a minimum of 72 square feet in size. If other examination rooms meet the Americans with Disabilities Act (ADA) standards for accessible design set forth in parts 35 and 36 of title 28 of the Code of Federal Regulations (ADA accessibility standards), assistance can be provided by an individual accompanying the patient or a staff member who escorts the patient in and out of the examination room.
(3) If three examination rooms are provided, two shall meet the ADA accessibility standards.
(4) Room arrangement shall permit a minimum clear dimension of 2 feet 8 inches (81.28 centimeters) at each side and at the foot of the examination table, recliner, or chair.
(5) Each room shall be designed so that the dimensions of the room are proportional to the square footage to avoid configurations that might hinder the functionality of the program space.
(h) Hand-washing stations.
(1) A hand-washing station shall be provided in each room where hands-on patient care is provided.
(2) Hand sanitation dispensers shall be provided in addition to hand-washing stations.
(3) Hand-washing basins/countertops shall be made of porcelain, stainless steel, or solid surface materials. Basins shall be permitted to be set into plastic laminate countertops if, at a minimum, the substrate is marine-grade plywood (or equivalent) with an impervious seal.
(4) Sinks shall have well-fitted and sealed basins to prevent water leaks onto or into cabinetry and wall spaces.
(5) The water pressure at the fixture shall be regulated.
(6) Design of sinks shall not permit storage beneath the sink basin, and should accommodate ADA accessibility standards for clearance under the sink basin.
(i) Waiting area.
(1) The waiting area for patients and any individuals that accompanies patients shall be under staff control.
(2) The seating shall contain no fewer than two spaces for each consultation room and no fewer than 1.5 spaces for the combined projected capacity at one time of the group rooms.
(3) Where the psychiatric outpatient unit has a formal pediatrics service, a separate, controlled area for pediatric patients shall be provided.
(4) The waiting area shall accommodate wheelchairs.
(5) Provisions for drinking water shall be available for waiting patients. In shared facilities, provisions for drinking water may be outside the outpatient area if convenient for use.
(j) Corridor allowed to be used as a waiting area.
(1) Fixed furniture in egress corridor. The furniture must be securely attached to the floor or wall and can be on only one side of the corridor. Each grouping of furniture cannot exceed 50 square feet and must be at least 10 feet from other groupings.
(2) Furniture shall be located so as to not obstruct access to building service and fire protection equipment, such as fire extinguishers, manual fire alarm boxes, shutoff valves, and similar equipment.
(3) Corridors throughout the smoke compartment shall be protected by an electrically supervised automatic smoke detection system, or the fixed furniture spaces shall be arranged and located to allow direct supervision by the facility staff from a nurses’ station or similar space.
(4) The smoke compartment shall be protected throughout by an approved, supervised automatic sprinkler system.
(k) Combustible decorations in egress corridors and rooms.
(1) Combustible decorations shall be flame-retardant or are treated with approved fire-retardant coating that is listed and labeled for application to the material to which it is applied.
(2) The decorations shall meet the requirements of NFPA 701, Standard Methods of Fire Tests for Flame Propagation of Textiles and Films.
(3) The decorations exhibit a heat release rate not exceeding 100 KW when tested in accordance with NFPA 289, Standard Method of Fire Test for Individual Fuel Packages, using the 20 KW ignition source.
(4) The decorations, such as photographs, paintings, and other art, are attached directly to walls, ceiling, and non-fire rated doors in accordance with the following:
(i) Decorations on non-fire rated doors shall not interfere with the operation or any required latching of the door.
(ii) Decorations shall not exceed 20 percent of the wall, ceiling, or door areas inside any room or space of a smoke compartment that is not protected throughout by an approved automatic sprinkler system.
(iii) Decorations shall not exceed 30 percent of the wall, ceiling, and door areas inside any room or space of a smoke compartment that is protected throughout by an approved supervised automatic sprinkler system.
(l) Existing openings in exit enclosures to mechanical equipment spaces that are protected by fire-rated door assemblies. These mechanical equipment spaces must be used only for non-fuel-fired mechanical equipment, must contain no storage of combustible materials, and must be located in sprinklered buildings. This waiver allowance will be permitted only if the provider/supplier is in compliance with all other applicable NFPA 101 Life Safety Code, 2000 edition, exit provisions, as well as with section 7.1.3.2.1(9)(c) of the NFPA 101 Life Safety Code, 2012 edition.
(ii) Behavioral health clinic providers authorized to integrate physical health services with more than 3 proposed examination rooms shall comply with the requirements under Part 710 (Approval of Medical Facility Construction), Part 711 (General Standards of Construction) and Part 715 (Standards of Construction for Freestanding Ambulatory Care Facilities) of this Title.
(d) Building code requirements.
(1) All services and facilities are required to adhere to applicable building codes as well as all local occupancy, use, building and zoning laws.
(2) A valid certificate of occupancy is required.
(3) NFPA 101 Life Safety Code, 2000 edition, for chapter 20 New Ambulatory Health Care, chapter 21 Existing Ambulatory Health Care, chapter 38 New Business, and chapter 39 Existing Business Occupancies.
(4) New York State Sanitary Code.
(5) All occupied areas shall be ventilated by natural and/or mechanical means.
(6) Air-handling duct systems shall meet the requirements of NFPA 90A.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.2 Definitions
(a) Shared health facility or facility shall mean any arrangement or operation for the delivery of medical or health care or services which meets all of the following requirements:
(1) Any combination of four or more practitioners licensed under:
(i) article 131 of the Education Law (physician); or
(ii) article 131-A of the Education Law (physical therapist, physiotherapist, physician's associate, specialist's assistant); or
(iii) article 132 of the Education Law (chiropractor); or
(iv) article 133 of the Education Law (dentist, dental hygienist); or
(v) article 137 of the Education Law (pharmacist); or
(vi) article 139 of the Education Law (registered professional nurse, licensed practical nurse); or
(vii) article 141 of the Education Law (podiatrist); or
(viii) article 143 of the Education Law (optometrist); or
(ix) article 144 of the Education Law (ophthalmic dispensor, optician); or
(x) article 156 of the Education Law (occupational therapist); or
(xi) article 159 of the Education Law (speech pathologist, audiologist).
(2) One or more of the practitioners receives payment under the Medical Assistance Program on a fee-for-service basis;
(3) The total aggregate remuneration from the Medical Assistance Program of one or more of the practitioners exceeds $5,000 for any one month during the preceding 12 months;
(4) The practitioners practice their professions at a common physical location;
(5) The practitioners share:
(i) common waiting rooms or areas; or
(ii) examining rooms; or
(iii) treatment rooms; or
(iv) other space; or
(v) the services of supporting staff; or
(vi) equipment.
(6) A person, whether a practitioner or not:
(i) is in charge of, controls, manages or supervises substantial aspects of the arrangement or operation for the delivery of health or medical services at the practitioners' common physical location; or
(ii) makes available to the practitioners the services of administrative, nursing, clerical, secretarial, maintenance, or other supporting staff who are not employees of the practitioners.
(b) Practitioner shall mean a person who is engaged in the practice of human medicine, dentistry or related professions and duly licensed in accordance with the provisions of title VIII of the New York State Education Law.
(c) Provider shall mean any qualified physicians, dentists, nurses, optometrists and other related professional personnel receiving reimbursement from the program.
(d) Purveyor shall mean any person who, whether or not located in a building which houses a shared health facility, engages in the business of supplying to patients, directly or indirectly, any medical supplies, equipment or services for which reimbursement under the program is received, including, but not limited to, clinical laboratory services or supplies, X-ray laboratory services or supplies; inhalation therapy services or equipment; ambulance services; sick room supplies; physical therapy services or equipment; orthopedic or surgical appliances or supplies; drugs, medication or medical supplies; eyeglasses, lenses, or other optical supplies or equipment; hearing aids or devices; and any other goods, services, supplies, equipment or procedures prescribed, ordered, recommended or suggested for medical diagnosis, care or treatment.
(e) Program shall mean the New York State program of medical assistance for needy persons (Medicaid) as provided in title II of article 5 of the New York State Social Services Law.
(f) Patient shall mean anyone eligible to receive or receiving benefits under the provisions of the New York State program of medical assistance for needy persons, as provided in title XI of article 5 of the New York State Social Services Law.
(g) Commissioner shall mean the Commissioner of Health of the State of New York.
(h) Department shall mean the New York State Department of Health.
(i) Operator shall mean the owner of the premises in which a shared health facility is located, or the lessee, if the structure in which the shared health facility is located has been leased pursuant to a lease.
(j) Manager or administrator shall mean an individual designated by the shared health facility owner or operator to assume functional responsibility for the management and coordination of the activities within the facility.
(k) For purposes of this Part, a combination of four or more practitioners shall be deemed to exist for the remainder of the shared health facility registration period if at any time during such registration period four or more practitioners occupy professional office space or practice their professions at a common physical location.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.149 GAAP
Generally accepted accounting principles.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS
10 CRR-NY 80.35 Unlicensed activity
(a) No person shall conduct research, instructional activities or chemical analysis of controlled substances in this State without first having obtained a license from the department.
(b) Licensees.
Licensees shall register with the appropriate Federal agency or agencies in the comparable controlled substance schedule provided for under Federal regulations.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 134 ORLEANS COUNTY
10 CRR-NY 134.1 Village of Albion
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Otter Creek and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Albion, Orleans County, New York.
(b) [Definitions.]
(1) The term reservoir whenever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Otter Creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse whenever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running whether continously or occasionally eventually flow or may flow into the public water supply of the village of Albion.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained, or allowed to remain within 50 feet of any reservoir or watercourse tributary to the public water supply of the village of Albion.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or watercourse tributary to the public water supply of the village of Albion.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacle permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at some suitable point at least 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(6) Whenever, owing to the character of the soil or the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Albion, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 150 feet of any reservior or watercourse tributary to the public water supply of the village of Albion.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Albion is prohibited; nor shall any such watering be allowed in any watercourse tributary to the water supply within 1000 feet upstream from the impounding reservoir on Otter Creek. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Albion.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(3) No human excreta and no compost or other matter containing human exereta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Albion nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such place that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Albion.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor an offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Albion.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Albion.
(j) Inspections.
The board of trustees of the village of Albion shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source of* act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.101 Manufacturers, distributors, importers and exporters
Manufacturers, distributors, importers and exporters of controlled substances shall keep records required by article 33 of the Public Health Law, and as otherwise provided by this Part and in particular section 80.23.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.233 Other operating revenue
Other operating revenue includes revenue from nonpatient care services to patients and sales and activities to persons other than patients, and the value of donated commodities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
MORTGAGE LOAN CHARGES MORTGAGE LOAN CHARGES
10 CRR-NY 87.21 Charges for development period
Public Health Law, §§ 2868, 2881
The governmental supervising agency charges for the development period from inception of the project to, but not including, the occupancy date, for mortgage closings on or after July 1, 1970, shall be nine-tenths of one percent of the mortgage loan, payable on requisition on or after the mortgage closing to the State Department of Health by the mortgagor. Adjustments of charges for the development period shall be made by adjusting future operational period payments.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 151 ULSTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 151.3 Village of Saugerties
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on the Plattekill Creek and all watercourses tributary thereto or ultimately discharging into said reservoirs, those bodies of water being sources of the public water supply of the village of Saugerties, Ulster County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on Plattekill Creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the water supply of the village of Saugerties.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1)
(i) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply of the village of Saugerties, except the properly constructed and operated sewage disposal plant, as hereinafter set forth in subparagraph (ii) of paragraph (1) of subdivision (d), provided, however, that the property on which the privy, privy vault, pit, cesspool or any other receptacle intended for the deposit of human excreta is built or to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(ii) Every privy, privy vault, pit or other receptacle used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in subparagraph (i) of this paragraph cannot be obtained within the limits of such property shall be placed as far as possible from any reservoir or watercourse tributary to the public water supply of the village of Saugerties and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight vessels or receptacles are provided, they shall be placed in watertight concrete or masonry receptacles and shall be located as far as practicable from any reservoir or watercourse tributary to the public water supply of the village of Saugerties. All receptacles referred to in this subparagarph shall be constructed only with the approval of and under the supervision of the board of water commissioners of the village of Saugerties and so located that the tops of such receptacles shall be above the highest known water level of the reservoirs or tributary watercourses.
(iii) Whenever a privy, privy vault, pit or other receptacle of any kind used for either the temporary storage or permanent deposit of human excreta is especially constructed and made watertight and located nearer any reservoir or tributary watercourse than the distance named in subparagraph (i) of this paragraph, such receptacle shall be emptied at regular intervals and disinfected as often as may be necessary to maintain them in a proper sanitary condition and to effectually prevent any overflow and in the case of the properties occupied by the owners during the summer, the said receptacles shall be emptied at least once every fall at the end of the summer season, disinfected with lime and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with direction of the board of water commissioners of the village of Saugerties and in such a manner as to effectually prevent any pollution of the public water supply of the village of Saugerties.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(3) Every privy, privy vault, pit or other receptacle or place, used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall be at all times maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Saugerties.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1)
(i) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Saugerties, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 200 feet of any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(ii) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Saugerties, shall be operated, constructed, enlarged, altered or put in operation without permission of the State Commissioner of Health. All sewage disposal plants on the watershed of reservoirs or watercourses tributary to the public water supply of the village of Saugerties shall be operated and maintained under the supervision of the board of water commissioners of the village of Saugerties.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind except the effluent from a properly constructed and operated sewage disposal plant, as heretofore provided under subparagraph (ii) of paragraph (1) of this subdivision, shall be thrown or discharged into any reservoir or watercourse tributary to the public water supply of the village of Saugerties, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Saugerties is prohibited, nor shall any such watering be allowed in any watercourse tributary to this supply within 1000 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute by muddy leachings or excretal matters any streams tributary to the public water supply of the village of Saugerties.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(3) No human excreta, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground at any point on any watershed tributary to the public water supply of the village of Saugerties, nor shall such human excreta, compost or other matter containing the same be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 150 feet from any reservoir or any watercourse tributary to the public water supply of the village of Saugerties.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs except by written permission and in strict compliance with the regulations to be adopted by the board of water commissioners of the village of Saugerties, nor in any manner that may pollute the waters of this public water supply. All ice cutting shall be done under rigid inspection and supervision of the board of water commissioners.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Saugerties.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet from any reservoir or from any watercourse tributary to the public water supply of the Village of Saugerties.
(j) Inspections.
The board of water commissioners shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.14 Voluntary surrender
(a) The parties to a cooperative agreement or a planning process may mutually agree to voluntarily surrender their certificate of public advantage. At least 30 days prior to the surrender of the certificate of public advantage, the parties shall file a notice of such decision with the department. Such notice shall be provided by the department to the Attorney General and, as appropriate, the mental hygiene agencies.
(b) The termination of the cooperative agreement which is the subject of the certificate of public advantage by one or more parties to such cooperative agreement shall be considered to result in a voluntary surrender.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.60 South Bay Consolidated Water Company, Amityville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on a plot of land approximately one acre in area at Green Street, Amityville, and along the right-of-way of the Long Island Railroad, which forms the source of the public water supply of the South Bay Consolidated Water Company, serving the village of Amityville, Suffolk County, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as sources of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the wells.
(c) Privies adjacent to the wells.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 20 feet of any well forming the source of the public water supply of the village of Amityville.
(2) No privy, privy vault, pit, cesspool or other receptacle which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well forming the source of the public water supply of the village of Amityville.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in-such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well forming the source of the public water supply of the village of Amityville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraph [6] of subdivision [c] and this paragraph, or into suitable watertight iron pipes with leaded joints connected to a sewage disposal system, a permit for which shall have been granted by the State Commissioner of Health) within 200 feet of any well forming the source of the public water supply of the village of Amityville. It is provided, however, that no such watertight receptacles shall be within 75 feet nor any such watertight iron pipe shall be located within 25 feet of any well forming the source of the public water supply of the village of Amityville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any well forming the source of the public water supply of the village of Amityville.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well forming the source of the public water supply of the village of Amityville, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well forming the source of the public water supply of the village of Amityville.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well forming the source of the public water supply of the village of Amityville.
(f) Dead animals, offal, industrial wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within a distance of 300 feet of any well forming the source of the public water supply of the village of Amityville.
(g) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well forming the source of the public water supply of the village of Amityville.
(h) Trespassing.
No trespassing shall be allowed upon the property of the New York Water Service Corporation upon which the wells forming the source of the public water supply of the village of Amityville are located, and no person or persons shall enter in or upon such property except the representative of the New York Water Service Corporation or any person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the water supply or except such other person as may be authorized to enter said property by the New York Water Service Corporation.
(i) Inspections.
The South Bay Consolidated Water Company or any person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Amityville or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the South Bay Consolidated Water Company to promptly notify the State Commissioner of Health of such violations. The South Bay Consolidated Water Company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(j) [General clause.]
In addition to observing the foregoing requirements all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the village of Amityville.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.8 Effective date for surrogacy program licensure
Any agency, business, person or entity that is required to be licensed as a surrogacy program under this Subpart shall apply and must be approved for licensure pursuant to this section prior to commencing operations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.2 Reclassification for reporting purposes
(a) Reclassifications are necessary to adjust the financial data contained in the hospital's records to the reporting requirements in this Article where they are not recorded on a functional basis. The reclassifications must be completed prior to preparing the required reporting forms and must be maintained as part of the hospital's books and records.
(b) There are two types of reclassifications:
(1) reclassifications to obtain the required level of reporting; and
(2) reclassifications to correct accumulation of costs and revenues.
(c) The first type of reclassification may be necessary to reach the required level of reporting because the hospital has combined several cost or revenue centers. For instance, a hospital may be combining the costs of diagnostic radiology with therapeutic radiology. In such cases, it is necessary to reclassify the total direct costs by natural classification of expense incurred for the two different types of services into two specific cost centers relating to these two types of services.
(d) The second type of reclassification, to correct the accumulation of costs and revenues, would be necessary when the expense and/or revenue associated with a particular function is recorded in a cost center different from the functional description specified in this Manual. For instance, a reclassification would be required if the Surgery Services cost/revenue center included the costs and revenues associated with the sale of prostheses and appliances because these costs and revenues must be reported in the Medical Supplies Sold cost/revenue centers rather than the Surgery Services cost/revenue centers.
(e) If expenses and revenues related to the functions as defined by this Manual have not been included in the direct costs or revenues of the indicated cost center, a reclassification is required, if significant. In no instance shall an amount be considered insignificant if, in any year for any cost center, the aggregate amount of misplaced costs or revenues is equivalent to the lesser of:
(1) three percent of the direct costs of the functional center transferred to or from; or
(2) one quarter of one percent of the total annual operating expenses.
(f) However, in no case is a reclassification necessary if the aggregate amount of misplaced cost per cost center is less than $1,000.
(g) These reclassifications may be computed on any one of the following bases:
(1) analysis of direct expense, including time and cost studies;
(2) ratio of total charges to charges of a specific cost center; or
(3) ratio of total units of service to units of service being reclassified in a specific cost center.
(h) Activities common to most functional reporting centers, such as planning, appraising, analyzing, preparing staffing schedules, meeting legal requirements and sanitary standards, keeping abreast of applicable fields, clerical work incidental to the activities of the functional reporting center, documenting work performed, initiating requisitions, the provision for and receipt of in-service education, educating patients for self-care, maintaining specialized libraries, preparing budgets, evaluating assigned personnel and attending meetings, shall be assigned to the functional reporting center in which the activity is performed. The operation of equipment includes preventive maintenance such as cleaning, oiling and calibration.
(i) Other activities are unique (as herein defined) and their cost must be reported per the cost center functional descriptions. If the cost of these activities are accumulated in a different cost center, they must be reclassified. To assist in the identification of these, a sample list of functions whose costs must occasionally be reclassified is included in the following Functional Reclassification Matrix along with the centers to which they must be reclassified if they are significant.
)
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 451 DEFINITIONS
10 CRR-NY 451.2 Accommodation fee
An advance payment or transfer of a specified amount of funds or property by, or on behalf of, an aged person to a facility as full or partial payment for the promise to provide accommodations for the remainder of the person's life.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.47 Hospital indigent care pool payments
(a) Effective for periods on and after January 1, 2013, payments pursuant to subdivision 5-d of section 2807-k of the Public Health Law shall be made in accordance with the provisions of this section.
(1) Funds reserved in the Financial Assistance Compliance Pool (FACP) pursuant to section 2807-k(5-d)(b)(iv) of the Public Health Law for the calendar years 2014 through 2022 shall be distributed to hospitals which demonstrate substantial compliance, as determined by the commissioner, with the provisions of section 2807-k(9-a) of the Public Health Law (the financial assistance law or FAL).
(2) Hospitals which are determined to be in substantial FAL compliance by the end of each calendar year shall receive the following year’s FACP funds as soon as practical in such year, in accordance with subdivision (b) of this section.
(b) For the purposes of distributions in accordance with this section, each hospital’s relative uncompensated care need amount shall be determined in accordance with the following:
(1) All uninsured inpatient units of service as reported in exhibit 32 of the institutional cost report from the cost reporting year two years prior to the distribution year, but excluding hospital-based residential health care facility (“RHCF”) and hospice units of service, shall be multiplied by the average applicable Medicaid inpatient rate in effect for January 1st of the distribution year.
(2) All uninsured outpatient units of service as reported in exhibit 33 of the institutional cost report from the cost reporting year two years prior to the distribution year, but excluding referred ambulatory and home health services, shall be multiplied by the average applicable Medicaid outpatient rate in effect for January 1st of the distribution year.
(3) The inpatient amounts determined pursuant to paragraph (1) of this subdivision for each hospital shall be summed and adjusted by a statewide inpatient cost adjustment factor equivalent to the aggregate sum of the inpatient uninsured units multiplied by the step-down cost per unit for each applicable inpatient service, excluding hospital-based RHCF and hospice services, for all hospitals statewide, divided by the aggregate sum of the amounts determined pursuant to paragraph (1) of this subdivision for all hospitals statewide.
(4) The outpatient amounts determined pursuant to paragraph (2) of this subdivision for each hospital shall be summed and adjusted by a statewide outpatient cost adjustment factor equivalent to the aggregate sum of the outpatient uninsured units multiplied by the step-down cost per unit for each applicable outpatient service, excluding referred ambulatory and home health services, for all hospitals statewide, divided by the aggregate sum of the amounts determined pursuant to paragraph (2) of this subdivision for all hospitals statewide.
(5) The adjusted inpatient and outpatient amounts determined pursuant to paragraphs (1) through (4) of this subdivision for each hospital shall be summed and reduced by the sum of all of the cash payments collected from such uninsured patients as reported in the institutional cost report from the cost reporting year two years prior to the distribution year to determine each hospital’s net adjusted uncompensated care need.
(6) The uncompensated care nominal need for each hospital shall be calculated as the net adjusted uncompensated care need multiplied by the sum of:
(i) 0.40; and
(ii) the Medicaid inpatient utilization rate multiplied by 0.60.
The Medicaid inpatient utilization rate shall be calculated based on discharge data reported in exhibit 32 of the institutional cost report from the cost reporting year two years prior to the distribution year and shall include fee-for-service and managed care discharges for acute and exempt services.
(c) For the 2013 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (“DSH”) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than two and a half percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than two and a half percent less than the average distributions such hospitals received pursuant to sections 2807-k and 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(d) For the 2014 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (“DSH”) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than five percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than five percent less than the average distributions such hospitals received pursuant to section 2807-k and 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(e) For the 2015 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (“DSH”) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than seven and a half percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than seven and a half percent less than the average distributions such hospitals received pursuant to sections 2807-k and 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(f) For the 2016 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (DSH) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 10 percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 10 percent less than the average distributions such hospitals received pursuant to section 2807-k and section 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(g) For the 2017 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (DSH) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 12½ percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 12½ percent less than the average distributions such hospitals received pursuant to section 2807-k and section 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(h) For the 2018 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (DSH) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 15 percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 15 percent less than the average distributions such hospitals received pursuant to section 2807-k and section 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that such payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be further adjusted on a percentage basis, as determined by the commissioner, sufficient to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(i) For the 2019 calendar year, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (DSH) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 17½ percent less than the average distributions such hospitals received pursuant to section 2807-k of the Public Health Law for the three year period January 1, 2010, through December 31, 2012.
(2) $994,900,000 shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, further adjusted by a transition factor that shall be calculated such that no hospital shall experience a reduction in payments pursuant to this section that is greater than 17½ percent less than the average distributions such hospitals received pursuant to section 2807-k and § 2807-w of the Public Health Law, excluding academic medical center grants received pursuant to section 2807-k(5-b)(b)(v) of the Public Health Law, and after any reductions made pursuant to section 2807-k(17) of the Public Health Law, for the three year period January 1, 2010, through December 31, 2012.
(3) Payments made pursuant to paragraphs (1) and (2) of this subdivision shall be further adjusted such that payments made to hospitals that experience increases in payments, as compared to the average of such payments made pursuant to this section for the three year period January 1, 2010 through December 31, 2012, shall be sufficient, as determined by the commissioner, to ensure, in conjunction with such other funding as may be made available, the full funding of the transition adjustments described in paragraphs (1) and (2) of this subdivision.
(j) For the 2020 through 2022 calendar years, payments shall be made as follows:
(1) $139,400,000 shall be distributed as Medicaid disproportionate share hospital (DSH) payments to major public general hospitals, including the hospitals operated by public benefit corporations, on the basis of each hospital’s uncompensated care nominal need, as determined in accordance with the provisions of subdivision (b) of this section, as a share of the aggregate uncompensated care nominal need for all major public general hospitals.
(2) The $969,900,000 shall be shall be distributed as Medicaid DSH payments to eligible general hospitals, other than major public general hospitals, on the basis of each hospital’s uncompensated care need share, as determined in accordance with the provisions of subdivision (b) of this section, excluding any reductions made pursuant to section 2807-k(17) of the Public Health Law.
(3) Payments made pursuant to paragraph (2) of this subdivision shall be further adjusted such that such payments made to hospitals shall be subject to an aggregate reduction of $150,000,000, provided that eligible general hospitals, other than major public general hospitals, that qualify as enhanced safety net hospitals under section 2807-c(34) of the Public Health Law for state fiscal year 2019-2020 shall not be subject to such reduction. The methodology to allocate the reduction shall take into account the payor mix of each voluntary hospital, including the percentage of inpatient days paid by Medicaid. Such methodology will calculate the total public payor mix of each facility and calculate an average public payor mix. For the purposes of this subparagraph, public payor mix means the percentage of total reported Medicaid and Medicare inpatient days, as reported in Exhibit 32 of the Institutional Cost Report (ICR) for the reporting period two years prior to the distribution year, where Medicaid and Medicare were the primary payors, out of total reported inpatient days which includes all inpatient services but excludes alternate level of care days.
Hospitals exceeding the calculated average of public payor mix will be exempt from reductions pursuant to this subparagraph. Hospitals that fall below the calculated average of public payor mix will be subject to a proportionate reduction pursuant to this subparagraph.
(4) Payments made pursuant to paragraph (2) shall be further adjusted such that $64,600,000 shall be distributed to eligible general hospitals, other than major public general hospitals, that qualify as Enhanced Safety Net Hospitals under section 2807-c(34) of the Public Health Law as of April 1, 2020, and that experience a reduction in indigent care pool payments pursuant to this subdivision when compared to their 2019 ICP payments. Such additional payments shall be calculated to equal the proportional reduction experienced by the facility out of the total decrease experienced by all qualifying Enhanced Safety Net Hospitals multiplied by the $64,600,000.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.336 Unrestricted funds
Funds which bear no external restrictions as to use or purpose; i.e., funds which can be used for any legitimate purpose designated by the governing board, as distinguished from funds restricted externally for specific operating purposes, for plant replacement and expansion and for endowment.
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.10 Health provider network access and reporting requirements
The operator of a facility shall obtain from the department's health provider network (HPN), HPN accounts for each facility he or she operates and ensure that sufficient, knowledgeable staff will be available to and shall maintain and keep current such accounts. At a minimum, 24-hour, seven-day-a-week contacts for emergency communication and alerts must be designated by each facility in the HPN communications directory. A policy defining the facility's HPN coverage consistent with the facility's hours of operation, shall be created and reviewed by the facility no less than annually. Maintenance of each facility's HPN accounts shall consist of, at a minimum, the following:
(a) sufficient designation of the facility's HPN coordinator(s) to allow for HPN individual user application;
(b) designation by the facility operator of sufficient staff users of the HPN accounts to ensure rapid response to requests for information by the State and/or local Department of Health;
(c) adherence to the requirements of the HPN user contract; and
(d) current and complete updates of the communications directory reflecting changes that include, but are not limited to, general information and personnel role changes as soon as they occur, and at a minimum, on a monthly basis.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.76 Dispensing; prohibition
Controlled substances shall not be prescribed for, administered or dispensed to addicts or habitual users of controlled substances except as provided by the Public Health Law or this Part.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.10 Wet storage
Packaged food is not to be stored in contact with water or undrained ice. Wrapped sandwiches are not to be stored in direct contact with ice.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.63 Enhanced coagulation performance requirements
Systems must achieve the percent reduction of TOC specified in subdivision (a) of this section (Step 1) between the source water and the combined filter effluent, unless the State approves a system's request for alternate minimum TOC removal (Step 2) requirements, which are provided in subdivision (d) of this section.
(a) Required (Step 1) TOC reductions, which are provided in the following table, are based upon specified source water TOC and alkalinity levels:
(Step 1) Required Removal of TOC by Enhanced Coagulation for Surface Water Systems or Systems Using Groundwater Under the Direct Influence of Surface Water that Use Conventional Filtration Treatment
| | Source Water Alkalinity | | | | --- | --- | --- | --- | | | | | | | Source water TOC (mg/l) | 0-60 mg/l as CaCO3 (percent removal required) | >60-120 mg/l as CaCO3 (percent removal required) | >120 mg/l as CaCO3 (percent removal required) | | | | | | | >2.0-4.0 | 35.0 | 25.0 | 15.0 | | >4.0-8.0 | 45.0 | 35.0 | 25.0 | | >8.0 | 50.0 | 40.0 | 30.0 |
(b) Systems that must comply with the requirements contained in subdivision (a) of this section must calculate compliance using the method provided in either paragraph (1) of this subdivision or the applicable provisions of paragraph (2) of this subdivision.
(1) Systems must calculate compliance quarterly, beginning after the system has collected 12 months of data, by determining an annual average using the following method:
(i) determine actual monthly TOC percent removal, equal to: (1 - (treated water TOC/source water TOC) × 100;
(ii) determine the required monthly TOC percent removal from either subdivision (a) or (d) of this section;
(iii) divide the value in subparagraph (i) of this paragraph by the value in subparagraph (ii) of this paragraph;
(iv) add together the results of subparagraph (iii) of this paragraph for the last 12 months and divide by 12;
(v) if the value calculated in subparagraph (iv) of this paragraph is less than 1.00, the system is not in compliance with the TOC percent removal requirements.
(2) Systems may use the provisions in subparagraphs (i) through (iii) of this paragraph instead of the calculations in paragraph (1) of this subdivision to determine compliance with TOC percent removal requirements.
(i) In any month that the system's treated or source water TOC level is less than or equal to 2.0 mg/l, the system may assign a monthly value of 1.00 (instead of the value calculated in paragraph [1] of this subdivision) when calculating compliance under the provisions of subdivision (a) of this section.
(ii) In any month that the system's source water SUVA, prior to any treatment, is less than or equal to 2.0 l/mg-m, the system may assign a monthly value of 1.00 (instead of the value calculated in paragraph [1] of this subdivision) when calculating compliance under the provisions of subdivision (a) of this section.
(iii) In any month that the system's finished water SUVA is less than or equal to 2.0 l/mg-m, the system may assign a monthly value of 1.00 (instead of the value calculated in paragraph [1] of this subdivision) when calculating compliance under the provisions of subdivision (a) of this section.
(c) Systems that cannot achieve the (Step 1) TOC removals required by subdivision (a) of this section due to water quality parameters or operational constraints must apply to the State, within three months of failure to achieve the TOC removals required by (Step 1), for approval of alternate minimum TOC removal (Step 2) requirements, described in subdivision (d) of this section. Until the State approves the alternate minimum TOC removal (Step 2) requirements, the system must meet the (Step 1) TOC removals contained in subdivision (a) of this section.
(d) Alternate minimum TOC removal (Step 2) requirements.
Applications made to the State by enhanced coagulation systems for approval of alternate minimum TOC removal (Step 2) requirements must include, as a minimum, results of bench- or pilot-scale testing conducted using the methodology prescribed in paragraph (1) of this subdivision to determine the alternate enhanced coagulation level. Applications for alternate minimum TOC (Step 2) requirements must be approved by the State before they can replace the previous (Step 1) TOC removal requirements. The alternate TOC removal is determined by the method described in paragraphs (1) through (5) of this subdivision.
(1) The alternate minimum TOC removal is the percentage of TOC removed at the point where an incremental addition of 10 mg/l of alum, or equivalent amount of iron coagulant (ferric salt), results in a TOC removal of ≤0.3 mg/l. This TOC removal percentage is then defined as the minimum TOC removal required for the system. Once approved by the State, this minimum TOC removal requirement supersedes the minimum TOC (Step 1) removal required by the table in subdivision (a) of this section. This requirement will be effective until such time as the State approves a new value based on the results of a new bench- and pilot-scale test. Failure to achieve State-set alternative minimum TOC removal levels is a violation.
(2) Bench- or pilot-scale testing of enhanced coagulation must be conducted by using representative water samples and adding 10 mg/l increments of alum, or equivalent amounts of iron coagulant, until the pH is reduced to a level less than or equal to the enhanced coagulation (Step 2) target pH shown in the following table:
Enhanced Coagulation Step 2 Target pH
| | | | --- | --- | | Alkalinity (mg/l as CaCO3) | Target pH | | | | | 0 - 60 | 5.5 | | >60 - 120 | 6.3 | | >120 - 240 | 7.0 | | >240 | 7.5 |
(3) For waters with alkalinities of less than 60 mg/l for which addition of small amounts of alum or equivalent addition of iron coagulant drives the pH below 5.5 before significant TOC removal occurs, the system must add necessary chemicals to maintain the pH between 5.3 and 5.7 in samples until the TOC removal of 0.3 mg/l per 10 mg/l alum added, or equivalent addition of iron coagulant, is reached.
(4) The system may operate at any coagulant dose or pH necessary (consistent with the State Sanitary Code) to achieve the minimum TOC percent removal approved under paragraph (1) of this section.
(5) If the TOC removal is consistently less than 0.3 mg/l of TOC per 10 mg/l of incremental alum dose at all dosages of alum (or equivalent addition of iron coagulant), the water is deemed to contain TOC not amenable to enhanced coagulation. The system may then apply for a waiver of enhanced coagulation requirements.
Part 15 MIGRANT FARMWORKER HOUSING
STANDARDS STANDARDS
10 CRR-NY 15.8 Toilets, privies
(a) General requirements.
Toilet facilities shall be provided. These facilities shall be conveniently located constructed of cleanable materials, and maintained in a sanitary condition and in good repair. Toilet facilities for groups of people consisting of both sexes, except those in individual dwelling units, or those shared by not more than two family groups, shall be so arranged that the facilities are separate for each sex. Toilet facilities shall be accessible without having to pass through any sleeping room.
(b) Location, construction.
Toilet facilities for all new construction and/or renovation construction shall consist of flush toilets. Existing sanitary privies can be used until October 1, 1999, provided that all of the following conditions are met: location is such that it does not cause pollution of any water supply source or surface water; facilities are adequate in number and type for the camp occupancy; adequate insect and vermin-proofing (screening, self-closing doors, etc.) is provided and maintained; toilet seats and lids are provided and maintained; adequate lighting is provided; adequate ventilation is provided for both the pit and privy enclossure; and, facilities are maintained in sanitary condition and good repair. All privies shall be replaced with flush toilets on or before October 1, 1999.
(c) Minimum standard; prohibitions.
There shall be at least the following: one toilet or privy seat for each 15 occupants or fraction thereof for each sex. Urinals shall be provided at the rate of one urinal for each 30 men or fraction thereof in the camp, and may be substituted for up to a maximum of one-third of the required toilets, or additional flush toilets may be provided in place of required urinals. In determining the required number of toilets for men and women, family groups which have toilet facilities in their own dwelling unit shall not be counted. Urinals shall not be required in toilet facilities within a dwelling unit. The required toilet facilities shall be within 200 feet, of each sleeping room. No flush toilet fixture or urinal shall be in a sleeping room. No privy shall be within 50 feet of any sleeping room, dining room, mess hall or cooking area. When multiple toilets or privy seats are located in a common room or space, privacy enclosures shall be provided.
(1) All housing constructed after May 1, 1997, shall have urinals provided at the rate of one for each 25 men, or fraction thereof, in the housing facility.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.183 Inventory control
The control of merchandise, materials, goods in process, finished goods, and supplies on hand by accounting and physical methods. An accounting control is effected by means of a stock or stores ledger, mechanical storage records, or a ledger account in which the quantities or amounts (or both) of goods received during an accounting period are added to corresponding balances at the beginning of the period and amounts of goods sold or otherwise disposed of are deducted at a calculated cost based on individual identification or any of various methods of averaging. Physical controls consist of various plans of buying, storing, handling, issuing, supervising and stock-taking. Stock-ledger control is made more effective by physical control in the nature of continuous check of the goods on hand.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.24 Trend factor
The commissioner shall establish trend factors for hospitals to project the effects of price movements on historical operating costs. Rates of payment excluding capital, as calculated pursuant to the provisions of this Subpart, shall be trended to the applicable rate year by the trend factors developed in accordance with the provisions of subdivision 10 of section 2807-c of the Public Health Law.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.4 Approval period
The department may approve for a six-year period the course work or training as submitted by an organization or person.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.57 Portable, bedside or mobile X-ray equipment excluding dental, veterinary and podiatric equipment
(a) Equipment.
(1) The protective tube housing shall be of diagnostic type.
(2) Collimating devices capable of restricting the useful beam to the area of clinical interest shall be used and shall provide the same degree of protection as is required of the tube housing.
(3) The X-ray films used as the recording medium during the X-ray examination shall show substantial evidence of cut-off (beam delineation).
(4) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filtration (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(5) A device shall be provided which terminates the exposure after a preset time interval or exposure.
(6) All mobile, portable or beside equipment shall be provided with cones or metal frames so that the minimum source to skin distance is at least 12 inches.
(7) The exposure switch shall be of the dead-man type and shall be provided with a cord sufficiently long that the operator can stand at least six feet from the patient, the X-ray tube and the useful beam.
(b) Use.
If a mobile unit is used routinely in one location it shall be considered a fixed installation, and shall meet the requirements of section 16.56 of this Part.
(c) Conditions for operation of equipment.
(1) No person shall be regularly employed to hold patients or films during exposures nor shall such duty be performed by any individual occupationally exposed to radiation during the course of his/her other duties. When it is necessary to restrain the patient, mechanical supporting or restraining devices shall be used. If patient or films must be held by an individual, that individual shall be protected with appropriate shielding devices such as protective gloves and a protective apron of at least 0.25 mm lead equivalent. No part of the attendant's body shall be in the useful beam. The exposure of any individual used for holding patients shall be monitored. Pregnant women and persons under 18 years of age shall not hold patients under any conditions.
(2) Gonadal shielding of not less than 0.5 mm lead equivalent shall be used for patients who have not passed the reproductive age during radiographic procedures in which the gonads are in the useful beam, except for cases in which this would interfere with the diagnostic procedure.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.77 State notification
(a) The supplier of water shall make State notification within 24 hours of learning of the existence or potential existence of a public health hazard, or within 48 hours for any other violation or situation that may pose a risk to public health. Section 5-1.52 table 13 of this Subpart lists violations and situations that require State notification.
(b) The information provided in a State notification shall include, but not be limited to, the following:
(1) a description of the violation or situation, including the contaminant of concern, and (as applicable) the contaminant level;
(2) when the violation or situation occurred;
(3) what the system is doing to correct the violation or situation; and
(4) when the water system expects to return to compliance.
(c) Groundwater systems and groundwater sources that complete corrective action to correct significant deficiencies or address fecal contamination of a groundwater source must notify the State within 30 days of the completion of the action.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.3 Referrals prohibited
Except as provided in this Part or in Public Health Law article 2 title 11-D, a practitioner authorized to order clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services may not make a referral for such services to a health care provider authorized to provide such services where such practitioner or immediate family member of such practitioner has a financial relationship with such health care provider. A referral shall not be construed to include an arrangement whereby a treating practitioner makes arrangements with another covering practitioner for the treatment and/or care of the treating practitioner's patients for services routinely provided by the treating practitioner when the treating practitioner is unavailable to treat such patients.
(a) Effective December 8, 2002, physical therapy services shall be subject to all applicable provisions of this Subpart governing designated health services to the same extent that clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services are subject to this Subpart, including, but not limited to, provisions governing prohibited referrals, disclosure requirements, disclosure forms and financial relationships.
Subchapter D LABORATORIES
Part 54 REQUIREMENTS FOR SELF-DEFENSE SPRAY DEVICES
10 CRR-NY 54.1 Purpose
The purpose of this rule is to protect public health, safety and welfare by specifying the type of self-defense spray device that may lawfully be purchased, possessed or used in New York State.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
LOCAL HEALTH OFFICER LOCAL HEALTH OFFICER
10 CRR-NY 11.2 Qualifications
(a) A local health officer, other than a Commissioner of Health or a public health director, shall be either:
(1) a physician who is currently registered to practice medicine in New York State; or
(2) a non-physician with appropriate medical consultation who possesses:
(i) a baccalaureate degree from a regionally accredited or New York State registered college or university and two years of experience in the administration, enforcement or management of a health or public health related program, including one year of supervisory experience; or
(ii) a master's degree in public health or a related field from a regionally accredited or New York State registered college or university and one year of supervisory experience in the administration, enforcement or management of a health or public health related program; or
(iii) a current license or certificate of registration to practice a health or public health related profession and one year of supervisory experience in the administration, enforcement or management of a health or public health related program; or
(iv) a combination of education and experience deemed equivalent to the above by the State Commissioner of Health.
(b) All appointments to the position of local health officer of persons qualified under this section and the appointment of and arrangements for the medical consultant when necessary must be approved by the State Commissioner of Health. The required medical consultation for non-physician local health officers may be provided by the existing medical consultant, if any, to the county health officer in the county in which the affected municipality is located.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.103 Institutional dispensers
Persons acting as institutional dispensers of controlled substances shall keep records required by article 33 of the Public Health Law, and as otherwise provided by this Part and in particular section 80.48.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.3 Tissue procurement services
(a) A facility that engages in donor selection and solicitation, and retrieval of ocular eye tissue shall be licensed by the department as a comprehensive tissue procurement service.
(b) A facility whose tissue acquisition activities are limited to donor selection and solicitation by its own staff shall be licensed by the department as a limited tissue procurement service.
(c) Comprehensive tissue procurement services retrieving ocular tissue aseptically from cadaveric donors shall maintain written standard operating procedures that assure that the retrieval environment, including, but not limited to walls, floors and permanent equipment, is suitable for enucleation or excision and adequate to prepare a clean surgical field. A working sink shall be available.
(d) Ocular tissue retrieval shall be performed only by trained retrieval technicians under the supervision of the director of a licensed eye bank. The director of the licensed eye bank shall be responsible for developing policies, procedures and standards for the educational background, training, certification and continuing education of retrieval technicians. Documentation of compliance with this requirement and the standards developed shall be maintained.
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.12 Disposition of unused tissue
(a) Thawed cardiovascular tissue that is not used by the tissue transplantation facility within 24 hours of thawing shall be used for education or research purposes authorized by Public Health Law section 4302, or discarded pursuant to Part 70 of this Title. Packaging of cardiovascular tissue for destruction shall be designed to obscure the contents.
(b) Cardiovascular tissue returned by the tissue transplantation facility for possible reissuance shall meet all storage and transport requirements of this Part. The cardiovascular tissue bank shall not reissue tissue returned by the tissue transplantation facility, unless written criteria approved by the tissue bank medical director are met.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.3 Reimbursement for attending and consulting physician services
Reimbursement for attending and consulting physician services rendered to hospice patients shall be in accordance with the Medicaid fee schedule set forth in this title, as amended pursuant to chapter 904 of the Laws of 1984. The current fee schedule is set forth in section 7.0 of the Medicaid Management Information System Provider Manual, Physicians (Revised January 1985). Copies of this schedule may be obtained from the Bureau of Program, Policy and Operations of the Division of Medical Assistance of the New York State Department of Social Services, 40 North Pearl Street, Albany, NY 12243. The current physicians fee schedule is available for inspection and copying at the Department of Health Records Access Office, 10th Floor, Corning Tower Building, Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.1 Determination of public need pursuant to section 2802 of the Public Health Law
(a) The factors for determining public need for health services and medical facilities shall include, but not be limited to:
(1) the current and projected population characteristics of the service area, including relevant health status indicators and socio-economic conditions of the population;
(2) normative criteria for age and sex specific utilization rates to correct for unnecessary utilization for health services;
(3) standards for facility and service utilization, comparing actual utilization to capacity, taking into consideration fluctuation of daily census for certain services, the geography of the service area, size of units, and specialized service networks;
(4) the patterns of in and out migration for specific services and patient preference or origin;
(5) the need that the population served or to be served has for the services proposed to be offered or expanded, and the extent to which all residents in the area, and in particular low- income persons, racial or ethnic minorities, women, handicapped persons, and other underserved groups and the elderly, will have access to those services;
(6) in cases involving the reduction or elimination of a service including those involving the relocation of a facility or service, the extent to which need will be met adequately and the effect of the reduction, elimination, or relocation of the service or facility on the ability of the low-income persons, racial and ethnic minorities, women, handicapped person, and other underserved groups, and the elderly, to obtain needed health care;
(7) the contribution of the proposed service or facility in meeting the health needs of members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to health services (for example, low-income persons, racial and ethnic minorities, women, and handicapped persons). For the purpose of determining the extent to which the proposed service or facility will be accessible to such persons, following shall be considered:
(i) the extent to which medically underserved populations currently use the applicant's services in comparison to the percentage of the population in the applicant's service area which is medically underserved, and the extent to which medically underserved populations are expected to use the proposed services if approved;
(ii) the performance of the applicant in meeting its obligation under the applicable civil rights statutes prohibiting discrimination on the basis of race, color, national origin, handicap, sex and age;
(iii) the extent to which Medicare, Medicaid and medically indigent patients are served by the applicant; and
(iv) the extent to which the applicant offers a range of means by which a person will have access to its services.
(b) The evaluative procedure for review of public need pursuant to section 2802 of the Public Health Law shall include, but not be limited to:
(1) description of proposal as submitted by applicant for construction;
(2) identification of use rates in the service area for the service or services involved;
(3) identification of current and projected user population of the service, area;
(4) identification of resulting estimate of future quantitative need as projected for a period of five years from last complete calendar year reported;
(5) identification of existing service(s) which are the same as those proposed by the applicant available in the service area;
(6) identification of existing service(s) which are the same as those proposed by the applicant which will be available to meet future need in the service area;
(7) identification of service(s) which are the same as those proposed by the applicant and which have been approved for construction but are not in operation in the service area;
(8) identification of resulting resource(s) available in service area five years in future to meet need;
(9) identification of percent of need met for proposed service(s);
(10) description of the current utilization for all service(s) which are the same as those proposed by applicant in the service area;
(11) description of the current utilization for allied or alternate services in the service area;
(12) description of any migration patterns for health care in the service area;
(13) description of any evidence of inappropriateness of placement in the service area for the subject service(s) and related service(s); and
(14) description of the distribution of service(s) in relation to the population's distribution.
(c) The public need analysis for each proposal will include a determination of the appropriate service area. The county in which the construction is proposed shall be the service area, unless the commissioner, upon consideration of the advice of the State Hospital Review and Planning Council, determines that a service area other than the county is more appropriate. The applicant or the health systems agency may delineate a service area other than the county together with evidence in support of such delineation. After reviewing the evidence, the commissioner, upon consideration of the advice of the council, may determine that the proposed service area is not acceptable. In cases wherein a service area other than the county is being proposed, the following shall be considered:
(1) the patterns of in-and-out migration for specific services which are the same as those proposed by the applicant and patient preference or origin; and
(2) appropriateness of travel and referral patterns.
(d) Medical facilities shall be planned to achieve efficiency and economy of operation and care of high quality. In addition to the other pertinent provisions of this Part, the analysis to determine whether there is a public need for the proposed construction shall include consideration of additional factors as appropriate, including but not limited to the following:
(1) the condition of the facility's existing structures and equipment and the extent to which they are in compliance with the applicable standards of facility operation and construction under this Title;
(2) whether the architectural solutions proposed by the applicant to address the issues which are the subject of the application are:
(i) cost efficient with respect to the anticipated operational and capital cost impact of the proposal;
(ii) necessary to correct nonwaiverable requirements or standards of operation or construction under this Title;
(iii) necessary to address a problem or situation which will require corrective action within two years;
(3) [ Reserved ]
(4) whether the proposal is consistent with the applicant's long-range capital plan;
(5) whether the applicant will take advantage of opportunities for the efficient and economic reuse and recycling of existing physical plant resources, where feasible and appropriate;
(6) the life cycle incremental operational and capital cost effectiveness and efficiency of the proposal;
(7) whether the proposal could be adapted to accommodate changes in pertinent technology;
(8) whether the applicant will take advantage of opportunities to gain economies and improvements in the provision of services by entering into appropriate arrangements for sharing facilities, services or equipment with other facilities; and
(9) whether there are alternative methods or solutions available, which are more efficient, based on capital and operating costs, to address the subject problem or situation that will nevertheless ensure the provision of a level and quality of care and service that is in compliance with pertinent Federal and State statutes, rules and regulations.
(e) Any application for construction wherein a determination of public need is made pursuant to this section shall be subject to the following:
(1) The commissioner may, during the processing of an application, propose to disapprove the application solely on the basis of a determination of public need in advance of his consideration of the questions of the adequacy of financial resources, sources of future revenue and the character and competence of the applicant without, however, waiving his right to consider such criteria at a later date.
(2) In the event the commissioner upon the recommendation of the State Hospital Review and Planning Council proposes to disapprove an application solely on the basis of a lack of public need and the applicant then requests a hearing, the commissioner may direct the completion of the other required by Public Health Law, section 2802, the results of which shall be presented to the State Hospital Review and Planning Council for recommendations, which reviews may then be included as grounds for the proposed disapproval to be considered at the hearing. If the commissioner directs the completion of such reviews, a copy of the report containing the results of the reviews shall be mailed to the applicant at least 60 days prior to the date set for hearing.
(3) In the event the commissioner proposes to disapprove an application solely on the basis of no public need and the State Hospital Review and Planning Council does not concur with such proposed disapproval, the application shall be returned to the department without a formal recommendation. The commissioner shall then direct the completion of the other reviews required by Public Health Law, section 2802, and shall return the application to the State Hospital Review and Planning Council for its formal recommendation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.12 Records to be kept when blood, blood components or derivatives are issued for allogeneic or autogeneic transfusion
(a) For blood and blood components, records of the following information, as applicable, shall be kept in the blood bank and made available to the department for inspection:
(1) source;
(2) unit identification code upon receipt and, if different, upon issuance;
(3) unit ABO and Rh groups;
(4) expiration date;
(5) results of all pretransfusion testing;
(6) disposition of the unit, including remote storage location, if any, and intended recipient's name or, if the name is unknown, identification code;
(7) identification of the station code or person taking possession of the unit;
(8) documentation of visual inspection;
(9) date and time of issuance; and
(10) results of all tests associated with the investigation of all transfusion reactions, with the conclusions reached and the report signed, or approved by electronic equivalent, by the director of the blood bank or a qualified physician designated by the director of the blood bank.
(b) For coagulation factor concentrates, logbook records of the following information shall be kept and made available to the department for inspection:
(1) manufacturer;
(2) lot number;
(3) expiration date;
(4) disposition, including recipient's name if administered; and
(5) date of issue.
(c) For all derivatives, records associated with the investigation of all reactions, with the conclusions reached and the report signed, or approved by electronic equivalent, by the director of the blood bank or a qualified physician designated by the director of the blood bank, shall be kept and made available to the department for inspection.
(d) These recordkeeping requirements shall also apply to blood components issued to limited transfusion services and to blood components issued to ambulance transfusion services.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 138 RENSSELAER COUNTY
CITIES CITIES
10 CRR-NY 138.1 City of Troy
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to sources of supply which comprise the source of the public water supply of the City of Troy, Rensselaer County, NY. Said sources being those portions of the drainage areas of the streams which form or are tributary to the sources of water supply of the Tomhannock Reservoir and the Quackenkill Diverting Dam Reservoir and to all other lakes, ponds or reservoirs whose waters form or are tributary to the sources of water supply of the City of Troy, NY.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale or used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the City of Troy public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the City of Troy public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the City of Troy public water supply.
(16) Water supply shall mean the public water supply of the City of Troy, Rensselaer County, NY.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed, unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except (i) watertight receptacles, (ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the State Commissioner of Health and (iii) a properly designed, constructed and operated treatment works that has been approved by the State Commissioner of Health.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraphs (4) and (9) of this subdivision shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) of this subdivision or at a properly designed, constructed and operated sewage disposal system that has been approved by the State Commissioner of Health.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the State Commissioner of Health. The New York State Health Department “Standards for Waste Treatment Works”, Bulletin 1, Parts I, II and III, and paragraph (5) of this subdivision shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of the ground on the watershed (except into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the State Commissioner of Health) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(d) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within 50 feet of any reservoir or watercourse.
(e) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(f) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(g) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I—Ionizing Radiation—Title 10 Health of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(h) Junk yards.
No junk yard shall be located within 100 feet of any reservoir or watercourse.
(i) Bathing, swimming and wading.
Bathing, swimming and wading of any kind are prohibited in any reservoir or watercourse owned by the City of Troy.
(j) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the City of Troy.
(k) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Troy within 1000 feet of any water supply intake, reservoir spillway or reservoir dam except by duly authorized employees of the City of Troy in the performance of their duties of supervision and maintenance of the water supply. No boating utilizing inboard or outboard motors shall be allowed in or upon any reservoir or watercourse owned by the City of Troy, except by duly authorized employees of the City of Troy in the performance of their duties of supervision and maintenance of the water supply.
(l) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the City of Troy within 1,000 feet of any water supply intake, except by duly authorized employees of the City of Troy in the performance of their duties of supervision and maintenance of the water supply.
(m) Herbicides, pesticides and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse, unless a permit to do so has been obtained from the State Commissioner of Health.
(n) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(o) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in the contamination of any portion of the water supply.
(p) Inspections.
The commissioner of the Department of Public Utilities of the City of Troy, or his duly authorized representative, shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid commissioner to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid commissioner to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of the Department of Public Utilities shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(q) Penalties.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.7 Radiation dose limits for individual members of the public
(a) Dose limits for individual members of the public.
(1) Except for doses received from patients released under the provisions of section 16.123 of this Part, each licensee or registrant shall conduct operations so that:
(i) the dose in any unrestricted area from external sources does not exceed 0.02 mSv (0.002 rem) in any one hour; and
(ii) the total effective dose equivalent to individual members of the public from the licensed or registered operation, exclusive of the dose contribution from the licensee's or registrant's disposal of radioactive material into sanitary sewerage in accordance with section 16.8 of this Part, does not exceed one mSv (0.1 rem) in a year, except where structural modifications to the building or the equipment is required of existing facilities where radiation equipment were installed prior to January 1, 1994 and the use of the radiation source does not change after January 1, 1994 and which result in a total effective dose equivalent to a member of the public which does not exceed five mSv (0.5 rem) in a year.
(2) If radioactive materials are released into the air or water by any person in such a manner that the radioactive materials may be reconcentrated in the environment or may be added to any other radioactive materials released to the environment, the department may restrict the release by such person to assure that the limits set forth in this Part are not exceeded.
(b) Compliance with dose limits for individual members of the public.
(1) The licensee or registrant shall make or cause to be made, surveys of radiation levels in unrestricted areas and radioactive materials in effluents released to unrestricted areas, which shall be used to ascertain compliance with the dose limits for individual members of the public in subdivision (a) of this section.
(2) A licensee or registrant shall maintain records of measurements and calculations used to demonstrate compliance with the annual dose limit in subdivision (a) of this section.
(3) The licensee or registrant may petition the department to adjust the effluent concentration values in Appendix 16-C, Table 2, infra, for members of the public, to take into account the actual physical and chemical characteristics of the effluents, such as, aerosol size distribution, solubility, density, radioactive decay equilibrium, and chemical form.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.22 Movable equipment
(a) Necessary and reasonable expenses related to movable equipment (depreciation computed on a straight-line method or accelerated under a double declining balance or sum-of-the-years-digits method, interest on indebtedness, lease, etc.) are considered allowable costs for residential health care facilities subject to such ceilings as may be established and promulgated by the Commissioner of Health.
(b) An arms length lease purchase agreement with a nonrelated lessor involving equipment entered into on or after October 23, 1992 which meets any one of the four following conditions, establishes the lease as a virtual purchase.
(1) The lease transfers title of the equipment to the lessee during the lease term.
(2) The lease contains a bargain purchase option.
(3) The lease term is at least 75 percent of the useful life of the equipment. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the equipment.
(4) The present value of the minimum lease payments (payments to be made during the lease term including bargain purchase option, guaranteed residual value and penalties for failure to renew) equals at least 90 percent of the fair market value of the leased property. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the equipment. Present value is computed using the lessee's incremental borrowing rate, unless the interest rate implicit in the lease is known and is less than the lessee's incremental borrowing rate, in which case the interest rate implicit in the lease is used.
(c) If a lease is established as a virtual purchase under subdivision (b) of this section, the rental charge is includable in capital-related costs as the lesser of the annual rent or the annual costs of ownership which shall be limited to depreciation and interest. When the cost of ownership becomes less than the annual rent, the rental charge shall be includable in capital-related costs. The aggregate rental or lease costs included in capital-related costs may not exceed the costs of ownership that would have been included in capital-related costs over the useful life of the asset had the provider received legal title to the asset.
(d) If a facility enters into a sale and leaseback agreement involving equipment on or after October 23, 1992, the amounts to be included in capital-related costs are the lesser of the annual rent or the annual costs of ownership. When the cost of ownership becomes less than the annual rent, the rental charge shall be includable in capital-related costs. The aggregate rental or lease costs included in capital-related costs may not exceed the costs of ownership which shall be limited to depreciation and interest that would have been included in capital-related costs over the useful life of the asset had the provider retained legal title to the asset.
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.13 Filing of exceptions
(a) Within 30 days of the date a copy of the report of the hearing officer and proposed order or, hearings governed by Public Health Law, section 230, within 15 days of the date a report of the hearing committee and proposed recommendation is sent to the parties, any party may submit exceptions to the report and order or recommendation to the Supervising Administrative Law Judge.
(b) The exceptions may include:
(1) the particular findings of fact, conclusions of law, or disposition with which the party disagrees, the reasons for disagreement and a substitute finding, conclusion or disposition;
(2) general comments on the suitability of the report and order or recommendation; and
(3) an alternative proposed order or recommendation for consideration and adoption by the commissioner, his designee, or other decisionmaker.
(c) The party shall send a copy of its exceptions to all other parties or their attorneys and the hearing officer.
(d) The opportunity to submit exceptions may be waived by such party.
(e) On notice to all parties, the party may request the Supervising Administrative Law Judge to extend the exception period. The Supervising Administrative Law Judge shall only address a request for an extension that has been made prior to the expiration of the exception period and after giving all other parties an opportunity to state their position on the request. The exception period may be extended by the Supervising Administrative Law Judge at the request of either party, for the good cause shown, and on notice to both parties. Extensions of time shall not be granted to allow a party to respond to exceptions already filed by another party.
(f) All exceptions shall be submitted to the commissioner, his designee, or other decisionmaker with the record of the hearing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 451 DEFINITIONS
10 CRR-NY 451.3 Accounting
The art of recording, classifying and summarizing in a significant manner and in terms of money, transactions and events which are, in part at least, of a financial character, and interpreting the results thereof.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.5 Operator responsibilities and reporting requirements
(a) The operator of a temporary residence shall employ or designate an individual who is acceptable to the permit-issuing official to be in charge of the property to maintain the facilities, and who shall be on or available to the property at all times when the property is occupied or open for occupancy, who is capable of providing an adequate response to all matters affecting the life, safety and health of the occupants.
(b) A telephone number or other method for summoning the individual in charge shall be posted in an area readily accessible to the facility occupants.
(c) The operator shall report to the permit-issuing official within 24 hours of notification of any of the following occurrences:
(1) an injury or illness occurring at a swimming pool, bathing beach or recreational aquatic spray ground as required in Part 6 of this Title;
(2) a condition suspected of affecting the quantity or quality of the on-site potable water supply or constituting a public health hazard as specified in Subpart 5-1 of this Title;
(3) an illness suspected of being food or water-borne to have resulted from the consumption of food or water at the temporary residence, as required in Subparts 5-1 and 14-1 of this Title;
(4) an illness related to exposure to carbon monoxide within a temporary residence;
(5) all fires which result in a report or a call to a fire or police department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-4 MENTAL HEALTH AND SUBSTANCE USE DISORDERTREATMENT PARITY COMPLIANCE PROGRAM
10 CRR-NY 98-4.1 Purpose
The purpose of this Subpart is to establish mental health and substance use disorder parity compliance program requirements to ensure that managed care organizations (MCOs) are providing coverage for benefits for the treatment of mental health and substance use disorder that is comparable to other health benefits provided by the MCO, as required under both state and federal law. This Subpart requires that such compliance programs establish corporate governance for parity compliance, identify discrepancies in coverage of services for the treatment of mental health conditions and substance use disorder, and ensure appropriate identification and remediation of improper practices.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.3 Awards
(a) Award amount.
Physicians who agree to practice in an underserved area for two years and meet the other eligibility requirements under this Subpart shall be eligible for awards of up to $15,000 per year during their first and second year of practice in such area. Recipients who agree to practice in an underserved area for an additional two years and meet the other eligibility requirements under this Subpart shall be eligible for awards of up to $20,000 per year in their third and fourth years of practice in such area.
(b) Award payments.
Awards shall be paid directly to the recipient who will be required to apply the funds to pay off qualifying debt.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.8 Immunization for children excluded from school
Whenever a child has been refused admission to or continued attendance at a school for lack of acceptable evidence of immunization, immunity or exemption as specified in section 66-1.4 of this Subpart, the principal, teacher, owner, or person in charge of the school shall:
(a) notify the person in parental relation to the child of his/her responsibility to have the child immunized and of the public resources available for doing so;
(b) notify the local health authority of the name and address of the excluded child and of the immunization or immunizations which the child lacks; and
(c) provide, with the cooperation of the local health authority, for a time and place at which the required immunization or immunizations may be administered.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.43 Bed complement (beds available)
The total number of accommodations which are available (those set up and staffed for use). This figure should exclude the newborn nursery bassinets, beds in rooms intended for induction, recovery, labor, emergency, diagnostic and treatment purposes, and beds in such nonadaptable areas as corridors.
Chapter I STATE SANITARY CODE
Part 24 ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Subpart 24-2 PROHIBITED FACILITIES
10 CRR-NY 24-2.1 Definition
Establishment shall mean any place in which entry, membership, goods or services are purchased.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.22 Inpatient care statistics by unit
(a) Basic data requirements.
(1) Number of inpatients treated:
(i) In hospital on first day of reporting period.
(ii) Admissions during current reporting year.
(iii) Total patients treated.
(2) Transfers:
(i) In.
(ii) Out.
(3) Number of discharges:
(i) Deaths.
(ii) Other.
(iii) Total.
(4) Number of patients in hospital on the last day of the reporting period.
(5) Census patient days of care rendered.
(6) Certified bed capacity end of period.
(b) Types of units.
Please refer to section 446.44(b) of this Part for all program services for which these statistics are to be reported.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.20 Town of Ripley
(a) Application.
The rules and regulations herein set forth, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Belson Creek and all watercourses tributary thereto or which may ultimately discharge into said Belson Creek or which may be developed in the future to serve as sources of the water supply to the Town of Ripley.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Town of Ripley water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plants, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Town of Ripley.
(17) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flow or may flow into the Town of Ripley water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Town of Ripley water supply.
(19) Oil or gas well shall mean any well drilled in contemplation of producing oil or gas in any quantity.
(20) Deep well injection or disposal well shall mean any well intended to be used as a place of storage or receptacle for drilling fluids, brine solutions, or any other waste or toxin in any form.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction, and are among those introduced through normal agricultural practices which are acceptable to the Town of Ripley.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250-feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir, or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Town of Ripley.
(ii) Boating. No boating or watercraft of any type shall be allowed in or upon the waters of any reservoir or watercourse owned by the Town of Ripley except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Town of Ripley within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Town of Ripley in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Oil or gas or injection wells.
No oil or gas well shall be located within a 500-foot linear distance of any reservoir or watercourse. No deep well injections or disposal well shall be located within a 1,000-foot linear distance of any reservoir or watercourse.
(10) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Town of Ripley.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500-feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities, and shall not apply to agricultural field drainage tiles.
(e) Inspections.
The Superintendent of Public Works, or any other person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Superintendent of Public Works to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Superintendent of Public Works to promptly notify the State Commissioner of Health of such violations. The aforesaid Superintendent of Public Works shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.234 Outpatient
A hospital patient who receives services in one or more of the facilities of the hospital when he or she is not currently an inpatient or a home care patient.
10 CRR-NY 441.237 Owner's equity
Net worth.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.4 Need for permit
No person shall construct or abandon any water well unless a permit has first been secured from the permit issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.34 Pilot reimbursement projects
(a) The commissioner may waive the requirements of this Subpart to effect the development of additional knowledge and experience in different types of reimbursement mechanisms, contingent upon the approval of the United States Department of Health and Human Services where necessary.
(b) Individual facilities or groups of facilities shall enter into such ventures with the understanding that the reimbursement received over the life of the projects shall be as defined in the experiment contract.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
OFFENSES, VIOLATIONS AND ENFORCEMENT OFFENSES, VIOLATIONS AND ENFORCEMENT
10 CRR-NY 80.120 Powers of commissioner
The commissioner, and any representative authorized by him, shall have the power to administer oaths, compel the attendance of witnesses and the production of books, papers and records and to take proof and testimony concerning all matters within the jurisdiction of the department.
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.4 Breath analysis instruments
(a) The commissioner approves, for use in New York State, breath analysis instruments found on the Conforming Products List of Evidential Breath Alcohol Measurement Devices as established by the U.S. Department of Transportation/National Highway Traffic Safety Administration (NHTSA), published in the Federal Register on March 11, 2010 (75 Fed. Reg. 11624-11627, available for public inspection and copying at the Department of Health Records Access Office, Corning Tower, Empire State Plaza, Albany, NY 12237). A facsimile of that list is set forth in subdivision (b) of this section. At the request of a training agency, the commissioner may approve a breath analysis instrument that has been accepted by NHTSA but is not on the Conforming Products List published in the Federal Register on March 11, 2010, if the commissioner determines that approval of such instrument is appropriate.
(b) Conforming Products List of Evidential Breath Measurement Devices.
Federal Register / Vol. 75, No. 47 / Thursday, March 11, 2010 / Notices
CONFORMING PRODUCTS LIST OF EVIDENTIAL BREATH MEASUREMENT DEVICES
| Manufacturer and model | Mobile | Nonmobile | | --- | --- | --- | | Alcohol Countermeasure Systems Corp., Mississauga, Ontario, Canada: | | | | Alert J3AD* | X | X | | Alert J4X.ec | X | X | | PBA3000C | X | X | | BAC Systems, Inc., Ontario, Canada | | | | Breath Analysis Computer* | X | X | | CAMEC Ltd., North Shields, Tyne and Ware, England: | | | | IR Breath Analyzer* | X | X | | CMI, Inc., Owensboro, Kentucky: | | | | Intoxilyzer Model: | | | | 200 | X | X | | 200D | X | X | | 240 (aka: Lion Alcolmeter 400+ outside the U.S.) | X | X | | 300 | X | X | | 400 | X | X | | 400PA | X | X | | 1400 | X | X | | 4011* | X | X | | 4011A* | X | X | | 4011AS* | X | X | | 4011AS-A* | X | X | | 4011AS-AQ* | X | X | | 4011AW* | X | X | | 4011A27-10100* | X | X | | 4011A27–10100 with filter* | X | X | | 5000 | X | X | | 5000 (w/Cal. Vapor Re-Circ.) | X | X | | 5000 (w/⅜″ ID Hose option) | X | X | | 5000CD | X | X | | 5000CD/FG5 | X | X | | 5000EN | X | X | | 5000 (CAL DOJ) | X | X | | 5000VA | X | X | | 8000 | X | X | | PAC 1200* | X | X | | S–D2 | X | X | | S–D5 (aka: Lion Alcolmeter SD–5 outside the U.S.) | X | X | | Draeger Safety, Inc. (aka: National Draeger) Irving, Texas: | | | | Alcotest Model: | | | | 6510 | X | X | | 6810 | X | X | | 7010* | X | X | | 7110* | X | X | | 7110 MKIII | X | X | | 7110 MKIII–C | X | X | | 7410 | X | X | | 7410 Plus | X | X | | 7510 | X | X | | 9510 | X | X | | Breathalyzer Model: | | | | 900 | X | X | | 900A* | X | X | | 900BG* | X | X | | 7410 | X | X | | 7410–II | X | X | | EnviteC by Honeywell GmbH, Fond du Lac, Wisconsin: | | | | AlcoQuant 6020 | X | X | | Gall's Inc., Lexington, Kentucky: | | | | Alcohol Detection System-A.D.S. 500 | X | X | | Guth Laboratories, Inc., Harrisburg, Pennsylvania: | | | | Alcotector BAC-100 | X | X | | Alcotector C2H5OH | X | X | | Intoximeters, Inc., St. Louis, Missouri: | | | | Photo Electric Intoximeter* | | X | | GC Intoximeter MK II* | X | X | | GC Intoximeter MK IV* | X | X | | Auto Intoximeter* | X | X | | Intoximeter Model: | | | | 3000 | X | X | | 3000 (rev B1)* | X | X | | 3000 (rev B2)* | X | X | | 3000 (rev B2A)* | X | X | | 3000 (rev B2A) w/FM option* | X | X | | 3000 (Fuel Cell)* | X | X | | 3000 D* | X | X | | 3000 DFC* | X | X | | Alcomonitor | | X | | Alcomonitor CC | X | X | | Alco-Sensor III | X | X | | Alco-Sensor III (Enhanced with Serial Numbers above 1,200,000) | X | X | | Alco-Sensor IV | X | X | | Alco-Sensor IV XL | X | X | | Alco-Sensor V | X | X | | Alco-Sensor AZ | X | X | | Alco-Sensor FST | X | X | | Intox EC/IR | X | X | | Intox EC/IR II | X | X | | Intox EC/IR II (Enhanced with serial number 10,000 or higher) | | X | | Portable Intox EC/IR | X | X | | RBT–AZ | X | X | | RBT–III | X | X | | RBT III–A | X | X | | RBT IV | X | X | | RBT IV with CEM (cell enhancement module) | X | X | | Komyo Kitagawa, Kogyo, K.K., Japan: | | | | Alcolyzer DPA–2* | X | X | | Breath Alcohol Meter PAM 101B * | X | X | | Lifeloc Technologies, Inc., (formerly Lifeloc, Inc.), Wheat Ridge, Colorado: | | | | PBA 3000B | X | X | | PBA 3000-P * | X | X | | PBA 3000C | X | X | | Alcohol Data Sensor | X | X | | Phoenix | X | X | | Phoenix 6.0 | X | X | | EV 30 | X | X | | FC 10 | X | X | | FC 20 | X | X | | Lion Laboratories, Ltd., Cardiff, Wales, United Kingdom: | | | | Alcolmeter Model: | | | | 300 | X | X | | 400 | X | X | | 400+ (aka: Intoxilyzer 240 in the U.S.) | X | X | | SD–2 * | X | X | | SD–5 (aka: S–D5 in the U.S.) | X | X | | EBA* | X | X | | Intoxilyzer Model: | | | | 200 | X | X | | 200D | X | X | | 1400 | X | X | | 5000 CD/FG5 | X | X | | 5000 EN | X | X | | Luckey Laboratories, San Bernardino, California: | | | | Alco-Analyzer Model: | | | | 1000* | | X | | 2000* | | X | | Nanopuls AB, Uppsala, Sweden: | | | | Evidenzer | X | X | | National Patent Analytical Systems, Inc., Mansfield, Ohio: | | | | BAC DataMaster (with or without the Delta-1 accessory): | | | | BAC Verifier DataMaster (w/or without the Delta-1 accessory) | X | X | | DataMaster cdm (w/or without the Delta-1 accessory) | X | X | | DataMaster DMT | X | X | | Omicron Systems, Palo Alto, California: | | | | Intoxilyzer Model: | | | | 4011* | X | X | | 4011AW * | X | X | | PAS International, Fredericksburg, Virginia: | | | | Mark V Alcovisor | X | X | | Plus 4 Engineering, Minturn, Colorado: | | | | 5000 Plus 4* | X | X | | Seres, Paris, France: | | | | Alco Master | X | X | | Alcopro | X | X | | Siemans-Allis, Cherry Hill, New Jersey: | | | | Alcomat* | X | X | | Alcomat F* | X | X | | Smith and Wesson Electronics, Springfield, Massachusetts: | | | | Breathalyzer Model: | | | | 900* | X | X | | 900A* | X | X | | 1000* | X | X | | 2000* | X | X | | 2000 (non-Humidity Sensor)* | X | X | | Sound-Off, Inc., Hudsonville, Michigan: | | | | AlcoData | X | X | | Seres Alco Master | X | X | | Seres Alcopro | X | X | | Stephenson Corp.: | | | | Breathalyzer 900* | X | X | | Tokai-Denshi Inc., Tokyo, Japan: | | | | ALC–PRO II (US) | X | X | | U.S. Alcohol Testing, Inc./Protection Devices, Inc., Rancho Cucamonga, California: | | | | Alco-Analyzer 1000 | | X | | Alco-Analyzer 2000 | | X | | Alco-Analyzer 2100 | X | X | | Verax Systems, Inc., Fairport, New York: | | | | BAC Verifier* | X | X | | BAC Verifier Datamaster | X | X | | BAC Verifier Datamaster II* | X | X |
_______
* Instruments marked with an asterisk (*) meet the Model Specifications detailed in 49 FR 48854 (December 14, 1984) ( i.e., instruments tested at 0.000, 0.050, 0.101, and 0.151 BAC.) Instruments not marked with an asterisk meet the Model Specifications detailed in 58 FR 48705 (September 17, 1993), and were tested at BACs = 0.000, 0.020, 0.040, 0.080, and 0.160. All instruments that meet the Model Specifications currently in effect (dated September 17, 1993) also meet the Model Specifications for Screening Devices to Measure Alcohol in Bodily Fluids.
(c) No law enforcement agency shall use a breath analysis instrument unless the training agency has verified that representative samples of the specific make and model perform properly. Maintenance shall be conducted as specified by the training agency, and shall include, but shall not be limited to, calibration at a frequency as recommended by the device manufacturer or, minimally, annually.
(d) Training agencies shall be responsible for maintaining records pertaining to verification and maintenance (including calibration) of breath analysis instruments and standards; provided, however, that record keeping maintenance may be delegated, in whole or in part, to the law enforcement agency using the breath analysis instrument(s).
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 108 CLINTON COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 108.13 Morrisonville Water district
(a) Application.
The rules and regulations herein set forth, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Riley Brook and all watercourses tributary thereto or which may ultimately discharge into said Riley Brook or which may be developed in the future to serve as sources of the water supply to the Morrisonville Water District.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhard motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Morrisonville Water District water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Morrisonville Water District, Town of Schuyler Falls, Clinton County, New York.
(17) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the Morrisonville Water District's water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Morrisonville Water District's water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250 foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 1000-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 1000 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectively prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta shall be constructed, placed, maintained or allowed to remain within a 100-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1000-foot linear distance of any reservoir, or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Morrisonville Water District.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Morrisonville Water District except by duly authorized employees of the Town of Schuyler Falls in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Morrisonville Water District within a 1000-foot linear distance of the water supply intakes except by duly authorized employees of the Town of Schuyler Falls in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Manure. No manure pile shall be maintained or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 1000-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Morrisonville Water District.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility, within a 100-foot linear distance of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(e) Inspection.
The Town Board of the Town of Schuyler Falls or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Town Board or its duly appointed representative to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Town Board or its duly appointed representative to promptly notify the State Commissioner of Health of such violations. The aforesaid Town Board or its duly appointed representative shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.1 Background and intent
(a) Physical and behavioral health conditions ( i.e. , mental illness and/or substance use disorders) often occur at the same time. Persons with behavioral disorders frequently experience chronic illnesses such as hypertension, diabetes, obesity, and cardiovascular disease. These illnesses can be prevented and are treatable. However, barriers to primary care, as well as the difficulty in navigating complex health care systems, are a major obstacle to individuals with behavioral health disorders seeking treatment for their physical conditions.
(b) Primary care settings have, at the same time, become a gateway to the behavioral health system, as people seek care for mild to moderate behavioral health needs ( e.g. , anxiety, depression, or substance use) in primary health care settings. Health care providers have long recognized that many patients have both physical and behavioral health care needs, yet physical and behavioral health care services have traditionally been provided and paid for separately. Even behavioral health services have traditionally been treated in a bifurcated system ( e.g. , substance use disorder treatment is treated separately from mental health treatment).
(c) The term integrated care describes the systematic coordination of primary and behavioral health care services. The growing awareness of the prevalence and cost of comorbid physical and behavioral health conditions, and the increased recognition that integrated care can improve outcomes and achieve savings, has led to increasing acceptance of delivery models that integrate physical and behavioral health care. Moreover, most patients prefer to have their physical and behavioral health care delivered in one place, by the same team of clinicians.
(d) Accordingly, these regulations will prescribe standards for the integration of physical and behavioral health care services in certain outpatient programs licensed by the Department of Health, the Office of Mental Health, and/or the Office of Alcoholism and Substance Abuse Services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.3 Application for approval
(a)
(1) An application for a certificate of approval shall be submitted to the department by the owner(s) and technical director(s) of an environmental laboratory on a form prescribed by the department. No certificate of approval shall be granted to any laboratory failing to supply all the information requested on the application form.
(2) For each category for which approval is sought, the application for approval shall specify the analytes to be determined, the types of sample(s) to be analyzed (such as soil or water), and the approved methods to be employed for each analyte/sample type.
(3) The department may require additional information regarding the laboratory, including, but not limited to, its ownership, organization, quality system, testing program, premises, qualifications of personnel, equipment, method of reporting results of analyses, and number of analyses performed each calendar year.
(b) Upon receipt of such application, the department shall review the laboratory's performance in required proficiency testing, quality system documentation, technical director(s) credentials, previous performance in on-site assessments, if applicable, and any additional materials and/or information requested, and shall determine whether the applicant laboratory qualifies for a certificate of approval, the analytes by category for which approval is to be issued, and the approval fee to be paid. Prior to issuance or renewal of a certificate of approval, the approval fee shall be paid, unless otherwise expressly authorized by the department pursuant to Subpart 55-3 of this Part.
(c) For purposes of the application and approval process, testing facilities housed in separate buildings shall be considered separate environmental laboratories, unless such facilities obtain a waiver for this requisite from the department. The requirements of this subdivision shall not be waived unless the department determines that:
(1) effective supervision of the operation of all such facilities can be exercised by the same technical director(s);
(2) the facilities do not duplicate each other's analytical, reporting and/or recordkeeping activities; and
(3) the facilities are owned by the same legal entity.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.5 Multiphasic health screening facilities
(a) The requirements of section 703.3 of this Part with respect to submission of a medical service plan shall not apply to a multiphasic health screening facility.
(b) A multiphasic health screening facility shall have an affiliation with a backup medical facility. The affiliation agreement between a screening and a backup facility shall be in writing and the responsibilities of these facilities shall be clearly stated.
(c) Mobile health screening units shall be either an extension of an established and certified medical facility or have an affiliation with a certified facility or an organized medical facility acceptable to the commissioner.
(d) The geographic area to be served shall be designated.
(e) Services provided shall be under the supervision of a currently licensed physician.
(f) Services shall be provided only to persons referred by a practicing physician, except in a case where the screening facility is under the auspices of a general hospital or an independent out-of-hospital health facility which has been certified by the department, a public health agency, or a health insurance group or plan approved by the Superintendent of Insurance.
(g) The components of any battery of tests to be performed shall be tailored to the population to be screened and each proposed screening facility shall present justifications for the tests offered.
(h) All findings of screening tests performed shall be provided in writing to the referring physician or agency making the referral.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 111 DELAWARE COUNTY
COMPANIES COMPANIES
10 CRR-NY 111.20 Bovina Center Water Company
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Coulter Brook and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply furnished by the Bovina Center Water Company to the Village of Bovina Center, Delaware County, NY
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Coulter Brook which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basin,) stream, ditch, gutter or other channel of every kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Bovina Center.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply of the Village of Bovina Center.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Bovina Center.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches [ continued ] below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Bovina Center, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Bovina Center is prohibited. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Bovina Center.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Bovina Center, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetables refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Bovina Center.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Bovina Center.
(j) [Inspections.]
The Bovina Center Water Company shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the water company to promptly notify the State Commissioner of Health of such violations. The water company shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.27 Federal upper limit compliance
In the event the State cannot provide assurances satisfactory to the secretary of the Department of Health and Human Services related to a comparison of rates of payment for general hospital inpatient services to beneficiaries of the title XIX program determined in accordance with this Subpart in the aggregate to maximum reimbursement payments provided in Federal law and regulation which are substantially the same as such assurances in effect on October 26, 1987 for purposes of securing Federal financial participation in such payments, such rates of payments shall be adjusted proportionally as necessary to meet Federal requirements for securing Federal financial participation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.165 Holding account
See clearing account.
10 CRR-NY 441.153 General ledger
A ledger containing accounts in which all the transactions of a business enterprise or other accounting unit are classified either in detail or in summary form.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.96 Enforceability of final schedule prescribed pursuant to granting of variance or exemption
Once a schedule prescribed pursuant to the granting of a variance under section 5-1.90 of this Subpart or an exemption under section 5-1.92 of this Subpart has become final pursuant to section 5-1.94(e) of this Subpart, the conditions or requirements of any such schedule shall be enforceable, on the application of the commissioner, by any court of competent jurisdiction in the same manner as an order of the commissioner under section 1107 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.17 Medical director's office
This functional reporting center must contain all the expenses, both professional and clerical, associated with the medical director's office and providing overall medical administration at the facility. Additional activities include but are not limited to the following: providing administrative guidance to physicians at the facility; monitoring the quality of physician care; conducting medical staff meetings; providing clerical assistance to physicians. Note that the time spent by the medical director on direct patient care, as well as in this function, must be specifically assigned to the appropriate reporting center and is not subject to the reclassification criteria. Reference: section 452.4(i) and section 454.2(b) of this Article.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.3 Permit for operation, inspections, access
(a) Application for permit.
Application for a permit shall be made by the operator to the permit-issuing official at least 30 days before operation or the expiration of an existing permit or a change in name, owner or operator.
(b) An application for a permit may be denied when the applicant has exhibited a history of non-compliance with the requirements of this Subpart or Subpart 7-1 of this Part; the campground is found to be a potential source of danger to the general public health and safety or the health and safety of the occupants of the campground; or the campground does not comply with the requirements of this Subpart.
(c) A permit for a campground shall be issued for a period of not more than three years from the date of issue. A permit shall not be transferable or assignable and shall expire upon a change of the operator of the campground or upon the date specified by the permit-issuing official.
(d) Revocation, suspension.
A permit may be revoked or suspended by the permit-issuing official or the State Commissioner of Health if the campground for which the permit was issued is found to have been maintained, operated or occupied in violation of the Public Health Law, or this Chapter or the sanitary code of the health department in which the campground is located or upon abandonment of the operation. Before suspension, or revocation of a permit, the permittee shall be given the opportunity to be heard by the permit-issuing official or his designated officer to contest the revocation or suspension of the permit to operate. A permit may be surrendered by a permittee.
(e) The permit-issuing official or representative shall be allowed entry at any time for the purposes of inspection to any property operated as a campground as defined by this Subpart.
(f) A separate permit to operate a temporary residence shall not be required for structures which are available for overnight transient occupancy, and which do not meet the definition of a camping unit.
(g) A permit issued for the operation of a campground shall be posted in a conspicuous place on the premises.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.9 Accrual reporting
The recognizing and reporting of the effects of transactions and other events on the assets and liabilities of the hospital entity in the time period to which they relate, rather than only when cash is received or paid.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.14 Physical containment levels; P4 level
(a) Laboratory practices.
(1) Laboratory doors shall be kept closed while experiments are in progress.
(2) Work surfaces shall be decontaminated following the completion of the experimental activity and immediately following spills of organisms containing recombinant DNA molecules.
(3) All laboratory wastes shall be steam-sterilized (autoclaved) before disposal. Other contaminated materials such as glassware, animal cages, laboratory equipment, and radioactive wastes shall be decontaminated by a method demonstrated to be effective before washing, reuse, or disposal.
(4) Mechanical pipetting devices shall be used; pipetting by mouth is prohibited.
(5) Eating, drinking, smoking, and storage of food are not permitted in the P4 facility.
(6) Persons shall wash their hands after handling organisms containing recombinant DNA molecules and when they leave the laboratory.
(7) Care shall be exercised to minimize the creation of aerosols. For example, manipulations such as inserting a hot inoculating loop or needle into a culture, flaming an inoculation loop or needle so that it splatters, and forceful ejection of fluids from pipettes or syringes shall be avoided.
(8) Biological materials to be removed from the P4 facility in a viable or intact state shall be transferred to a non-breakable sealed container, which is then removed from the P4 facility through a pass-through disinfectant dunk tank or fumigation chamber.
(9) No materials, except for biological materials that are to remain in a viable or intact state, shall be removed from the P4 facility unless they have been steam-sterilized (autoclaved) or decontaminated by a means demonstrated to be effective as they pass out of the P4 facility. All wastes and other materials as well as equipment not damaged by high temperature or steam shall be steam-sterilized in the double-door autoclave of the P4 facility. Other materials which may be damaged by temperature or steam shall be removed from the P4 facility through a pass-through fumigation chamber.
(10) Materials within the class III cabinets shall be removed from the cabinet system only after being steam-sterilized in an attached double-door autoclave or after being contained in a non-breakable sealed container, which is then passed through a disinfectant dunk tank or a fumigation chamber.
(11) Only persons whose entry into the P4 facility is required to meet program or support needs shall be authorized to enter. Before entering, such persons shall be advised of the nature of the research being conducted and shall be instructed as to the appropriate safeguards to ensure their safety. They shall comply with instructions and all other required procedures.
(12) Persons under 18 years of age shall not enter the P4 facility.
(13) Personnel shall enter into and exit from the P4 facility only through the clothing change and shower rooms. Personnel shall shower at each egress from the P4 facility. Air locks shall not be used for personnel entry or exit except for emergencies.
(14) Street clothing shall be removed in the outer side of the clothing-change area and kept there. Complete laboratory clothing, including undergarments, head cover, shoes, and either pants and shirts or jumpsuits, shall be used by all persons who enter the P4 facility. Upon exit, personnel shall store this clothing in lockers provided for this purpose or discard it into collection hampers before entering the shower area.
(15) The universal biohazard sign is required on the P4 facility access doors and on all interior doors to individual laboratory rooms where experiments are conducted. The sign shall also be posted on freezers, refrigerators, or other units used to store organisms containing recombinant DNA molecules.
(16) An insect and rodent control program shall be instituted.
(17) Animals and plants not related to the experiment shall not be permitted in the laboratory in which the experiment is being conducted.
(18) Vacuum outlets shall be protected by filter and liquid disinfectant traps.
(19) Use of the hypodermic needle and syringe shall be avoided when alternate methods are available.
(20) The laboratory shall be kept neat and clean.
(21) If experiments involving other organisms which require lower levels of containment are to be conducted in the P4 facility concurrently with experiments requiring P4-level containment, they shall be conducted in accordance with all P4-level laboratory practices specified in this section.
(b) Containment equipment.
(1) Experimental procedures involving organisms that require P4-level physical containment shall be conducted either in:
(i) a class III cabinet system; or in
(ii) class I or class II cabinets that are located in a specially designed area in which all personnel are required to wear one-piece positive-pressure isolation suits.
(2) Laboratory animals involved in experiments requiring P4-level physical containment shall be housed either in cages contained in class III cabinets or in partial-containment caging systems (such as horsfall units, open cages placed in ventilated enclosures, or solid-wall and -bottom cages covered by filter bonnets, or solid-wall and -bottom cages placed on holding racks equipped with ultraviolet irradiation lamps and reflectors) that are located in a specially designed area in which all personnel are required to wear one-piece positive-pressure suits.
(3) Alternative selection of containment equipment. Experimental procedures involving a host-vector system that provides a one-step higher level of biological containment than that specified can be conducted in the P4 facility using containment equipment requirements specified for the P3 level of physical containment. Alternative combinations of containment safeguards are shown in Table II.
Table II
POSSIBLE COMBINATIONS OF CONTAINMENT SAFEGUARDS
| Classification of experiment | Alternate combinations of physical and biological containment | | | | | | --- | --- | --- | --- | --- | --- | | Physical Containment | | | | | | | Physical containment | Biological containment* | Laboratory design specified for: | Laboratory practices specified for: | Containment equipment specified for: | Biological containment | | P4 | HV1 | P4 | P4 | P4 | HV1 | | P4 | HV1 | P4 | P4 | P4** | HV2 |
*
See section 61-1.16 of this Subpart for description of biological containment.
**
In the case gloves shall be worn, in addition to the clothing requirements specified in paragraph (a)(14) of this section.
(c) Special laboratory design.
(1) The laboratory shall be located in a restricted-access facility which is either a separate building or a clearly demarcated and isolated zone within a building. Clothing-change areas and shower rooms shall be provided for personnel entry and egress. These rooms shall be arranged so that personnel leave through the shower area to the change room. A double-door ventilated vestibule or ultraviolet air lock shall be provided for passage of materials, supplies, and equipment which are not brought into the P4 facility through the change room area.
(2) Walls, floors, and ceilings of the P4 facility are constructed to form an internal shell which readily allows vapor-phase decontamination and is animal- and insect-proof. All penetrations through these structures and surfaces are sealed. (The integrity of the walls, floors, ceilings, and penetration seals should ensure adequate containment of a vapor-phase decontaminant under static pressure conditions. This requirement does not imply that these surfaces must be airtight.)
(3) A foot-, elbow-, or automatically operated hand-washing facility shall be provided near the door within each laboratory in which experiments involving recombinant DNA are conducted in open-face biological safety cabinets.
(4) Central vacuum systems are permitted. The system, if provided, shall not serve areas outside the P4 facility. The vacuum system shall include in-line HEPA filters near each use point or service cock. The filters shall be installed so as to permit in-place decontamination and replacement. Water supply and liquid and gaseous services provided to the P4 facility shall be protected by devices that prevent backflow.
(5) Drinking water fountains shall not be installed in laboratory or animal rooms of the P4 facility. Foot-operated water fountains are permitted in the corridors of the P4 facility. The water service provided to such fountains shall be protected from the water services to the laboratory areas of the P4 facility.
(6) Laboratory doors shall be self-closing.
(7) A double-door autoclave shall be provided for sterilization of material passing out of the P4 facility. The autoclave doors shall be interlocked so that both doors will not be open at the same time.
(8) A pass-through dunk tank or fumigation chamber shall be provided for removal from the P4 facility of material and equipment that cannot be heat-sterilized.
(9) All liquid effluents from the P4 facility shall be collected and decontaminated before disposal. Liquid effluents from biological safety cabinets and laboratory sinks shall be sterilized by heat. Liquid effluents from the shower and hand washing facilities may be inactivated by chemical treatment. HEPA filters shall be installed in all vents from effluent drains.
(10) An individual supply and exhaust-air ventilation system shall be provided. The system shall maintain pressure differentials and directional air flow as required to ensure inflow from areas outside the facility toward areas of highest potential risk within the facility. The system shall be designed to prevent the reversal of air flow. The system shall sound an alarm in the event of system malfunction.
(11) Air within individual laboratories of the P4 facility may be recirculated if HEPA-filtered.
(12) The exhaust air from the P4 facility shall be HEPA-filtered and discharged to the outdoors so that it is dispersed clear of occupied buildings and air intakes. The filter chambers shall be designed to allow in situ decontamination before removal and to facilitate certification testing after replacement.
(13) The treated exhaust-air from class I and class II biological safety cabinets may be discharged directly to the laboratory room environment or to the outdoors. The treated exhaust-air from class III cabinets shall be discharged to the outdoors. If the treated exhaust-air from these cabinets is to be discharged to the outdoors through the P4 facility exhaust air system, it shall be connected to this system so as to avoid any interference with the air balance of the cabinets or the facility exhaust air system.
(14) As noted in paragraph (b)(1) of this section, the P4 facility may contain specially designed areas in which all personnel are required to wear one-piece positive-pressure isolation suits. Such areas shall be airtight. The exhaust-air from the suit area shall be filtered by two sets of HEPA filters installed in series, and a duplicate filtration unit and exhaust fan shall be provided. The air pressure within the suit area shall be less than that in any adjacent area. An emergency lighting system, communication systems, and power source shall be provided. A double-door autoclave shall be provided for sterilization of all waste materials to be removed from the suit area. Personnel who enter this area shall wear a one-piece positive-pressure suit that is ventilated by a life-support system. The life-support system shall be provided with alarms and emergency backup air. Entry to this area is through an airlock fitted with airtight doors. A chemical shower area shall be provided to decontaminate the surfaces of the suit before removal.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.80 Machine construction
Food vending machines are to be constructed and maintained to protect food furnished from contamination under conditions at the machine location. These conditions include temperature, dust and dirt, chemicals as dust, fumes and vapors, power failure and vandalism.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.11 Water supply
The water supply serving all plumbing fixtures, including drinking fountains, lavatories and showers, shall, after treatment, meet the applicable requirements of Part 5 of this Title.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 154 WAYNE COUNTY
10 CRR-NY 154.2 Village of Macedon
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well located on land owned by the village and situated approximately a mile west of the center of the village, which forms the source of the public water supply of the village of Macedon, Wayne County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of the well of the public water supply of the village of Macedon.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of the well of the public water supply of the village of Macedon.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the village of Macedon.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of the well of the public water supply of the Village of Macedon.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of the well of the public water supply of the Village of Macedon.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the Village of Macedon and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from the well of the public water supply of the Village of Macedon.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of the well, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of the well of the public water supply of the Village of Macedon.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 250 feet of the well of the public water supply of the Village of Macedon.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village upon which the well of the public water supply of the Village of Macedon is located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Village of Macedon.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of the well of the public water supply of the Village of Macedon.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the well of the public water supply of the Village of Macedon.
(j) Inspections.
The board of water commissioners of the Village of Macedon or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Macedon or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-10 STEM HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 52-10.2 Licensure and compliance with standards
No hematopoietic progenitor cell bank shall operate in New York State unless licensed by the department under Subpart 52-2 of this Part. All of the provisions of Subparts 52-1 and 52-2 of this Part shall apply to a hematopoietic progenitor cell bank, except for the recordkeeping requirements contained in section 52-2.9 of this Part. All hematopoietic progenitor cell banks shall comply with the standards and requirements set forth in Subpart 58-5 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.278 Record
A book or document containing or evidencing some or all of the activities of a hospital or containing or supporting a transaction, entry or account. Examples: a book of account; subsidiary ledger; invoice; voucher; contract; correspondence; internal report; minute book.
10 CRR-NY 441.7 Accounting policy
The general principles and procedures under which the accounts of an organization are maintained and reported; any one such principle or procedure.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.15 Reports
(a) Reports of stolen, lost, or missing licensed or registered sources of radiation.
(1) Telephone reports.
Each licensee or registrant shall report to the department by telephone as follows:
(i) Immediately after its occurrence becomes known to the licensee or registrant, stolen, lost, or missing licensed radioactive material in an aggregate quantity equal to or greater than 1,000 times the quantity specified in Appendix 16-A, Table 9, infra, under such circumstances that it appears to the licensee or registrant that an exposure could result to individuals in unrestricted areas; or
(ii) Within 30 days after its occurrence becomes known to the licensee, lost, stolen, or missing licensed radioactive material in an aggregate quantity greater than 10 times the quantity specified in Appendix 16-A, Table 9, infra, that is still missing.
(iii) Immediately after its occurrence becomes known to the registrant, a stolen, lost, or missing radiation equipment.
(iv) Immediately after the discovery of an event that prevents immediate protective action necessary to avoid exposures to radiation or radioactive materials which could exceed the regulatory limits, or releases of radioactive material which could exceed regulatory limits; due to an event such as an explosion, or toxic gas release.
(2) Written reports.
Each licensee or registrant required to make a report pursuant to this subdivision shall, within 30 days after making the telephone report, make a written report to the department setting forth the following information:
(i) a description of the licensed or registered source of radiation involved, including, for radioactive material, the kind, quantity, and chemical and physical form; and, for radiation equipment, the manufacturer, model and serial number, type and maximum energy of radiation emitted;
(ii) a description of the circumstances under which the loss or theft occurred; and
(iii) a statement of disposition, or probable disposition, of the licensed or registered source of radiation involved; and
(iv) exposures of individuals to radiation, circumstances under which the exposures occurred, and the possible total effective dose equivalent to persons in unrestricted areas; and
(v) actions that have been taken, or will be taken, to recover the source of radiation; and
(vi) procedures or measures that have been, or will be, adopted to ensure against a recurrence of the loss or theft of licensed or registered sources of radiation.
(3) After filing the written report, the licensee or registrant shall also report any additional substantive information on the loss or theft within 30 days after the discovery of such information.
(4) The names of individuals who may have received exposure to radiation must be stated only in a separate and detachable portion of the report.
(b) Notification of incidents.
(1) Immediate notification.
Notwithstanding other requirements for notification, each licensee or registrant shall immediately report each event involving a source of radiation possessed by the licensee or registrant that may have caused or threatens to cause any of the following conditions:
(i) An individual to receive:
(a) a total effective dose equivalent of 0.25 Sv (25 rem) or more; or
(b) an eye dose equivalent of 0.75 Sv (75 rem) or more; or
(c) a shallow dose equivalent to the skin or extremities of 2.5 Gy (250 rad) or more; or
(ii) The release of radioactive material, inside or outside of a restricted area, so that, had an individual been present for 24 hours, the individual could have received an intake five times the occupational ALI. This provision does not apply to locations where personnel are not normally stationed during routine operations, such as hot-cells or process enclosures.
(2) Twenty-four hour notification.
Each licensee or registrant shall, within 24 hours of discovery of the event, report each event involving loss of control of a licensed or registered source of radiation possessed by the licensee or registrant that may have caused, or threatens to cause, any of the following conditions:
(i) An individual to receive, in a period of 24 hours:
(a) a total effective dose equivalent exceeding 0.05 Sv (5 rem); or
(b) an eye dose equivalent exceeding 0.15 Sv (15 rem); or
(c) a shallow dose equivalent to the skin or extremities exceeding 0.5 Sv (50 rem); or
(ii) The release of radioactive material, inside or outside of a restricted area, so that, had an individual been present for 24 hours, the individual could have received an intake in excess of one occupational ALI. This provision does not apply to locations where personnel are not normally stationed during routine operations, such as hot-cells or process enclosures.
(3) The licensee or registrant shall prepare each report filed with the department pursuant to this subdivision so that names of individuals who have received exposure to sources of radiation are stated in a separate and detachable portion of the report.
(4) Licensees or registrants shall make the reports required by paragraphs (1) and (2) of this subdivision by telephone, telegram, mailgram, or facsimile to the department.
(5) The provisions of this subdivision do not apply to doses that result from planned special exposures, provided such doses are within the limits for planned special exposures, and are reported pursuant to subdivision (d) of this section.
(c) Reports of exposures, radiation levels, and concentrations of radioactive material exceeding the limits.
(1) Reportable events.
In addition to the notification required by subdivision (b) of this section, each licensee or registrant shall submit a written report within 30 days after learning of any of the following occurrences:
(i) incidents for which notification is required by subdivision (b) of this section;
(ii) doses in excess of any of the following:
(a) the occupational dose limits for adults in section 16.6(a) of this Part;
(b) the occupational dose limits for a minor in section 16.6(g) of this Part;
(c) the limits for an embryo/fetus of a declared pregnant woman in section 16.6(h) of this Part;
(d) the limits for an individual member of the public in section 16.7(a) of this Part;
(e) any applicable limit in the license or registration; or
(iii) levels of radiation or concentrations of radioactive material in:
(a) a restricted area in excess of applicable limits in the license or registration;
(b) an unrestricted area in excess of 10 times the applicable limit set forth in this Part or in the license or registration, whether or not involving exposure of any individual in excess of the limits in section 16.7(a) of this Part.
(2) Contents of reports.
(i) Each report required by this subdivision shall describe the extent of exposure of individuals to radiation and radioactive material, including, as appropriate:
(a) estimates of each individual's dose; and
(b) the levels of radiation and concentrations of radioactive material involved; and
(c) the cause of the elevated exposures, dose rates, or concentrations; and
(d) corrective steps taken or planned to ensure against a recurrence, including the schedule for achieving conformance with applicable limits, generally applicable environmental standards, and associated license or registration conditions.
(ii) Each report filed pursuant to paragraph (1) of this subdivision shall include for each individual exposed: the name, social security account number, and date of birth. With respect to the limit for the embryo/fetus in section 16.6(h) of this Part, the identifiers should be those of the declared pregnant woman. The report shall be prepared so that this information is stated in a separate and detachable portion of the report.
(3) All licensees or registrants who make reports pursuant to this subdivision shall submit the report in writing to the department.
(d) Reports of planned special exposures.
The licensees or registrant shall submit a written report to the department within 30 days following any planned special exposure conducted in accordance with section 16.6(f) of this Part, informing the department that a planned special exposure was conducted and indicating the date the planned special exposure was conducted and indicating the date the planned special exposure occurred and the information required by section 16.14(e) of this Part.
(e) Notifications and reports to individuals.
(1) Requirements for notification and reports to individuals of exposure to radiation or radioactive material are specified in section 16.13 of this Part.
(2) When a licensee or registrant is required pursuant to subdivision (c) of this section to report to the department any exposure of an individual to radiation or radioactive material, the licensee or registrant shall also notify the individual. Such notice shall be transmitted at a time not later than the transmittal to the department, and shall comply with the provisions of section 16.13 of this Part.
(f) Reports of leaking or contaminated sealed sources.
If a sealed source is determined to be leaking or contaminated, a report shall be filed within five days with the department describing the equipment involved, the test results and the corrective action taken.
(g) Each professional practitioner who treats or diagnoses any suspected radiation illness shall report in writing to the department within seven days after such treatment or diagnoses, the fact thereof and the full name, address and age of the individual. Included in this reporting requirement are patients who have developed clinical symptoms as a result of contact with radioactive (gold) jewelry.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 142 SCHENECTADY COUNTY
VILLAGES VILLAGES
10 CRR-NY 142.1 Village of Delanson
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the upper and lower reservoirs and their tributaries located in the Town of Duanesburg which now serve or which may be developed in the future to serve as sources of the public water supply of the Village of Delanson, Schenectady County, New York and to all watercourses tributary thereto to ultimately discharging into said reservoirs.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Delanson public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh or channel of any kind, the waters of which flow or may flow into the Village of Delanson public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Village of Delanson public water supply.
(16) Water supply shall mean the public water supply of the Village of Delanson, Schenectady County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except:
(i) watertight receptacles;
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; or
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraphs (4) and (9) of this subdivision shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) of this subdivision or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and which may be constructed at or near the same location thereof as a source of the public water supply of said Village of Scotia.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Village of Delanson.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Delanson.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Delanson except by duly authorized employees of the Village of Delanson in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Delanson within 1,000 feet of the water supply intakes except by duly authorized employees of the Village of Delanson in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemical.
No herbicides, pesticides or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources) Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The village board of trustees, or any person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the village board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons do not immediately comply with the rules and regulations, it shall be the further duty of the village board of trustees to promptly notify the State Commissioner of Health of such violations. The village board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections made, the number of violations found, the number of notices served and the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.5 Accountability
The obligation of an employee, agent or other person to supply a satisfactory report, often periodic, of action or of failure to act following delegated authority/responsibility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.4 Village of Westfield
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs on Chautauqua Creek and its tributaries which serve as sources of the public water supply of the village of Westfield, Chautauqua County, N. Y. and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the village of Westfield.
(2) The term reservoir means any natural or artificially impounded body of water serving as a source of the water supply of the village of Westfield and to any additional reservoir which may be constructed or used for said water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into the water supply of the village of Westfield.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any reservoir or watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or water course.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the distances of 200 feet and 75 feet from any reservoir or watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 300 feet of any reservoir or watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall be located not less than 200 feet from any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 200 feet of any reservoir or watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing, boating and fishing.
(1) No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse.
(2) No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir or watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the water supply.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of any reservoir or watercourse tributary to the water supply.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(l) Inspections.
The board of water commissioners of the village of Westfield or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of the village shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.280 Rehabilitation beds
Beds assigned to a service for the primary purpose of assisting in the rehabilitation of disabled persons through a medical program integrated with psychiatric, social and vocational evaluation and services, under competent professional supervision.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.61 Prevention of COVID-19 transmission by covered entities
(a) Definitions.
(1) Covered entities for the purposes of this section, shall include:
(i) any facility or institution included in the definition of “hospital” in section 2801 of the Public Health Law, including but not limited to general hospitals, nursing homes, and diagnostic and treatment centers;
(ii) any agency established pursuant to article 36 of the Public Health Law, including but not limited to certified home health agencies, long term home health care programs, acquired immune deficiency syndrome (AIDS) home care programs, licensed home care service agencies, and limited licensed home care service agencies;
(iii) hospices as defined in section 4002 of the Public Health Law; and
(iv) adult care facility under the department’s regulatory authority, as set forth in article 7 of the Social Services Law.
(2) Personnel , for the purposes of this section, shall mean all persons employed or affiliated with a covered entity, whether paid or unpaid, including but not limited to employees, members of the medical and nursing staff, contract staff, students, and volunteers, who engage in activities such that if they were infected with COVID-19, they could potentially expose other covered personnel, patients or residents to the disease.
(3) Fully vaccinated , for the purposes of this section, shall be determined by the department in accordance with applicable Federal guidelines and recommendations. Unless otherwise specified by the department, documentation of vaccination must include the manufacturer, lot number(s), date(s) of vaccination; and vaccinator or vaccine clinic site, in one of the following formats:
(i) record prepared and signed by the licensed health practitioner who administered the vaccine, which may include a CDC COVID-19 vaccine card;
(ii) an official record from one of the following, which may be accepted as documentation of immunization without a health practitioner’s signature: a foreign nation, NYS Countermeasure Data Management System (CDMS), the NYS Immunization Information System (NYSIIS), City Immunization Registry (CIR), a department-recognized immunization registry of another state, or an electronic health record system; or
(iii) any other documentation determined acceptable by the department.
(b) Covered entities shall continuously require personnel to be fully vaccinated against COVID-19, absent receipt of an exemption as allowed below. Covered entities shall require all personnel to receive at least their first dose before engaging in activities covered under paragraph (2) of subdivision (a) of this section. Documentation of such vaccination shall be made in personnel records or other appropriate records in accordance with applicable privacy laws, except as set forth in subdivision (c) of this section.
(c) Exemptions. Personnel shall be exempt from the COVID-19 vaccination requirements set forth in subdivision (b) of this section as follows:
(1) Medical exemption. If any licensed physician, physician assistant, or certified nurse practitioner certifies that immunization with COVID-19 vaccine is detrimental to the health of member of a covered entity’s personnel, based upon a pre-existing health condition, the requirements of this section relating to COVID-19 immunization shall be inapplicable only until such immunization is found no longer to be detrimental to such personnel member’s health. The nature and duration of the medical exemption must be stated in the personnel employment medical record, or other appropriate record, and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the Advisory Committee on Immunization Practices of the U.S. Department of Health and Human Services), and any reasonable accommodation may be granted and must likewise be documented in such record. Covered entities shall document medical exemptions in personnel records or other appropriate records in accordance with applicable privacy laws by:
(i) September 27, 2021 for general hospitals and nursing homes; and
(ii) October 7, 2021 for all other covered entities. For all covered entities, documentation must occur continuously, as needed, following the initial dates for compliance specified herein, including documentation of any reasonable accommodation therefor.
(d) Upon the request of the department, covered entities must report and submit documentation, in a manner and format determined by the department, for the following:
(1) the number and percentage of personnel that have been vaccinated against COVID-19;
(2) the number and percentage of personnel for which medical exemptions have been granted; and
(3) the total number of covered personnel.
(e) Covered entities shall develop and implement a policy and procedure to ensure compliance with the provisions of this section and submit such documents to the department upon request.
(f) The department may require all personnel, whether vaccinated or unvaccinated, to wear an appropriate face covering for the setting in which such personnel are working in a covered entity. Covered entities shall supply face coverings required by this section at no cost to personnel.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
CONSTRUCTION CONSTRUCTION
10 CRR-NY 6-1.9 Construction compliance certificate
The operator shall submit, prior to public use of new facilities or equipment, a construction compliance certificate to the permit-issuing official. This certificate shall be prepared and signed by a professional engineer or architect licensed to practice in New York State. The certificate shall include a statement that the pool and the appurtenances have been constructed in accordance with approved plans and specifications.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 114 ESSEX COUNTY
VILLAGES VILLAGES
10 CRR-NY 114.2 Village of Port Henry
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all natural and artificial reservoirs and Bartlett Brook and to all watercourses tributary thereto or ultimately discharging into said brook or reservoirs, these bodies of water being sources of the public water supply of the village of Port Henry, Essex County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoirs which serve as sources of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the impounding and storage reservoirs tributary to the public water supply of the village of Port Henry.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourses.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Port Henry.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or any watercourse tributary to the public water supply of the village of Port Henry.
(3) No privy, privy vault. pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained within any mine or mine shaft, the drainage from which, either by gravity or by pumping, flows directly or indirectly into any reservoir or watercourse of the Port Henry water supply.
(4) No privy, privy vault, pit, cesspool or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said privy, privy vault, pit, cesspool or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(5) Every privy, privy vault, pit, cesspool or other receptacle, used for the temporary or permanent storage of human excreta which is constructed, located or maintained within any mine or mine shaft, from which privy or receptacle the excreta are not at once removed automatically by means of watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(6) The excreta collected in the aforesaid removable receptacles permitted under paragraphs (4) and (5) of this subdivision shall be removed and the receptacles thoroughly cleaned and disinfected as often as may be found necessary to maintain these receptacles or the privy or the place in which they are kept in a proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of disposal, hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(7) Unless otherwise specifically ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraphs (4) and (5) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface, in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet of any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(8) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the village of Port Henry, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes or sewage or other excremental matter from any water closet, privy, receptacle, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Port Henry nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground except into watertight vessels or receptacles,the contents of which are to be removed as provided by paragraph (6) of subdivision (c), within 200 feet of any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, tributary to the public water supply of the village of Port Henry, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(3) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe nor shall any animal or poultry be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir of the public water supply of the village of Port Henry. This shall not, however, be construed to prohibit animals from being watered in any portion of the watercourse tributary to the public water supply of the village of Port Henry, but no watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any streams tributary to the public water supply of the village of Port Henry.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry, and none of the above-named objects or sources of pollution shall be constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings therefrom may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance, of not less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse not to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Port Henry, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry and no manure or compost of any kind shall be thrown, placed, piled or spread upon the ground within a distance of 75 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the public water supply of the village of Port Henry, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs, Bartlett Pond or watercourses below Bartlett Pond tributary to the public water supply of the village of Port Henry.
(h) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Port Henry.
(j) Inspections.
The board of trustees of the village of Port Henry or such other board, as may be charged with the maintenance or supervision of the public water supply of the village or its duly appointed representative shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the reservoirs, watercourses and drainage areas tributary to the public water supply of the village of Port Henry at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.10 Purpose
Pursuant to Public Health Law, section 611, the New York State Department of Health (NYSDH) is authorized to pay State aid for approved vector surveillance and control programs. These rules and regulations are promulgated to define the conditions under which the NYSDH will approve vector surveillance and control activities for State aid.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-3.1 Eligibility for admission
Patients may be admitted to either in-patient or out-patient services irrespective of residence or ability to pay. All admissions should be by referral of the attending physician and shall be consistent with the research interests of the institute; i.e., investigations of the cause, mortality, treatment, prevention and cure of cancer and allied diseases. In the event that limitations on the patient care resources of the institute require restrictions on the admission of patients, preference shall be given to residents of New York State.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.5 Trend factor, increases to compensation and other adjustments
(a) Trend factor.
For years in which the department does not update the base year, subject to the approval of the Director of Budget, the department may use a compounded trend factor to bring base year costs forward to the appropriate rate period. The trend factor shall be taken from applicable years from consumer and producer price indices, including, but not limited to the Medical Care Services Index; U.S. city average, by expenditure category and commodity and service group for the period April to April of each year.
(b) Increases to compensation.
(1) Applicability. On or after January 1, 2015, rates of reimbursement for providers that operate eligible programs as defined in this section will be revised to incorporate funding for compensation increases to their direct support professional employees. Such rate increases will be effective January 1, 2015. The compensation increase funding will be included in the provider's rate issued for January 1, 2015 or in a subsequent rate with the inclusion of funding in the amount necessary to achieve the same funding impact as if the rate had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(2) Definitions. As used in this section, the following terms shall have the following meanings:
(i) Direct support professionals are those defined as direct care and support per consolidated fiscal report (CFR) appendix R and reported on the CFR under the position title code identifiers of 100 or 200. Contracted staff salary information will not be utilized.
(ii) Clinical staff are those defined as clinical per CFR appendix R and reported on the CFR under the position title code identifier of 300. Contracted staff salary information will not be utilized.
(iii) Eligible rate based programs shall mean supervised community residences (including supervised IRAs), supportive community residences (including supportive IRAs), or group day habilitation programs.
(3) Increases for eligible rate based programs.
(i) January 1, 2015 increase. Rates for eligible rate based programs will be revised to incorporate funding for compensation increases to direct support professional employees. Such rate increases will be effective January 1, 2015. The compensation increase funding will be included in the provider’s rate issued for January 1, 2015, or in a subsequent rate with the inclusion of funding in the amount necessary to achieve the same funding impact as if the rate had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(ii) April 1, 2015 increase. In addition to the compensation funding effective January 1, 2015, providers that operate supervised IRAs, including supervised community residences, supportive IRAs, including supportive community residences, and group day habilitation will receive a compensation increase targeted to direct support professional and clinical employees to be effective April 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits. The April 1, 2015 direct support professionals compensation funding will be the same, on an annualized basis, as that compounded on the amount which was calculated for the January 1, 2015 compensation increase and will be an augmentation to the January 1, 2015 increase.
(iii) Calculations. The basis for the calculation of provider and regional direct care, support and clinical salary averages and associated fringe benefit percentages will be the data in providers’ CFRs for July 1, 2010 through June 30, 2011 for providers reporting on a fiscal year basis or January 1, 2011 through December 31, 2011 for providers reporting on a calendar year basis.
(a) The January 1, 2015 and April 1, 2015 direct support professionals compensation increase funding formula will be as follows:
(1) The annual impact of a two percent increase to 2010-11 or 2011 salaried direct care dollars, salaried support dollars and associated fringe benefits will be calculated.
(2) The annual impact of the two percent increase for salaried direct care dollars, salaried support dollars and associated fringe will be added to the appropriate operating components in the rate methodology. This will result in a recalculation of provider and regional average direct care wages, provider and regional average employee-related components, provider and regional average program support components, and provider and regional average direct care hourly rates.
(3) The provider direct care hourly rate – adjusted for wage equalization factor will be recalculated to utilize the provider average direct care hourly rate and regional average direct care hourly rate, as calculated in subclause ( 2 ) of this clause.
(4) An identification will be made of the dollar difference between the provider direct care hourly rate – adjusted for wage equalization factor, which is in the rate in effect on December 31, 2014, and the provider direct care hourly rate – adjusted for wage equalization factor, as calculated in subclause ( 3 ) of this clause.
(5) The rate difference identified in subclause ( 4 ) of this clause will be multiplied by the calculated direct care hours in the rate in effect on December 31, 2014 to calculate the additional funding generated by the direct care compensation adjustment.
(6) The rate add-on for the compensation increase shall be determined by dividing the additional funding, as calculated in subclause ( 5 ) of this clause by the rate sheet units in effect on January 1, 2015.
(b) The April 1, 2015 clinical compensation increase funding formula will be as follows:
(1) The annual impact of a two percent increase to 2010-11 or 2011 salaried clinical dollars and associated fringe benefits will be calculated.
(2) The annual impact of the two percent increase for salaried clinical dollars and associated fringe will be added to the appropriate operating components in the rate methodology. This will result in a recalculation of provider and regional average employee-related components, provider and regional average clinical hourly wages.
(3) The provider clinical hourly wage – adjusted for wage equalization factor will be recalculated to utilize the provider average clinical hourly wage and regional average clinical hourly wage, as calculated in subclause ( 2 ) of this clause.
(4) An identification will be made of the dollar difference between the provider clinical hourly wage – adjusted for wage equalization factor, which is in the rate in effect on December 31, 2014, and the provider clinical hourly wage – adjusted for wage equalization factor, as calculated in subclause ( 3 ) of this clause.
(5) The rate difference identified in subclause ( 4 ) of this clause will be multiplied by the provider salaried clinical hours in the rate in effect on December 31, 2014 to calculate the additional funding generated by the clinical compensation adjustment.
(6) The rate add-on for the compensation increase shall be determined by dividing the additional funding, as calculated in subclause ( 5 ) of this clause by the rate sheet units in effect on January 1, 2015.
(c) Other adjustments.
Effective July 1, 2016, the reimbursement for supervised residential habilitation and day habilitation will exclude costs for direct clinical services. Direct clinical services are defined as face-to-face clinical interventions delivered by clinical staff directly to program participants. Direct clinical services include occupational therapy (OT), physical therapy (PT), speech language pathology (SLP), psychology and social work, where OT, PT and SLP direct services are provided by staff who are licensed clinicians, and where psychology and social work services are not related to the provision or oversight of habilitation services and are delivered or supervised by licensed clinical staff.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.80 Daily hospital services
Daily hospital services are those inpatient services generally included by the hospital in a daily service charge, sometimes referred to as the “room and board” charge. Included in such services are the room, dietary and nursing services, minor medical and surgical supplies, and the use of certain equipment and facilities for which the hospital does not customarily make a separate charge.
10 CRR-NY 441.163 Health-related care
Care, other than medical, that is performed by qualified personnel and pertains to protective, preventive, personal and social services.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
CARRIERS AND CONTROL OF CARRIERS OF DISEASE CARRIERS AND CONTROL OF CARRIERS OF DISEASE
10 CRR-NY 2.42 Control of typhoid carriers
(a) Disposition of body wastes.
The urine and feces of a typhoid carrier shall be disposed of in such a manner that they will not endanger any public or private water supply or be accessible to flies.
(b) Prohibition of food handling.
No typhoid carrier shall prepare or handle any food or drink to be consumed by persons other than members of the household with whom he resides.
(c) Restrictions of certain employments.
No typhoid carriers shall conduct or be employed in any restaurant, hotel, or boarding house.
(d) Restrictions concerning boarding homes for children.
No typhoid carrier shall reside or be employed in a boarding home for children.
(e) Restrictions of certain occupations.
No typhoid carrier shall engage in the occupation of nurse, cook, waiter, nursemaid or in any other occupation involving the handling of milk, cream, milk products, or utensils used in the production thereof.
(f) Restrictions of residence where cows are kept.
No typhoid carrier shall be permitted to reside on premises on which one or more cows are kept except under conditions to be prescribed by the health officer, which conditions shall include a written agreement signed by the carrier, or if the carrier be a minor, by his parent or duly appointed guardian and by the owner of the cows or his representative. Such agreement shall stipulate either:
(1) that no milk, cream or other dairy products from such premises will be sold, or given away to persons other than members of the household residing on such premises; or
(2) that milk and cream will be sold from such premises only after a special permit is issued by the local health officer and countersigned by the district State health officer and the local health officer of the jurisdiction in which the milk or cream is to be sold, provided, however, that a county or part-county health commissioner or city health officer (in cities of 50,000 population or over) may issue such permit directly. Such permit and agreement shall provide that:
(i) the milk or cream be sold only to the individual or firm designated in the permit, which individual or firm restricts its output to a pasteurized product;
(ii) the carrier will not engage in any activities involving milking or the handling of milk, cream or dairy utensils, or enter the milk house or barns where the milk-producing cows are kept;
(iii) no milk or cream which is to be subsequently sold nor any utensils used in the production of milk or cream shall be brought into the house occupied by the carrier;
(iv) no changes shall be made in the source of the water supply or in the system by which it is distributed on the farm, nor in the means of sewage disposal, except with the approval of the local health officer, provided, however, that a county or part-county health commissioner, or city health officer (in cities of 50,000 or over) may give such approval;
(v) all other members of the carrier's household except those who have had typhoid fever, shall have been vaccinated against typhoid fever.
(g) Notification of removal.
No typhoid carrier shall change his usual place of abode without first notifying the local health officer giving the proposed new address, and the health officer shall immediately inform the State Department of Health and the health officer into whose jurisdiction such carrier is to remove.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.5 Local representatives
(a) Information about these rules and regulations and application and other forms required by these rules and regulations may be obtained from the following offices of the department. Applications for department approval of a regulated activity must be submitted to one of the offices of the department listed in subdivision (b) of this section. Petitions appealing from a determination issued by the department or requesting a hearing on a cease and desist order issued by the department must be submitted to the offices listed in subdivision (c) of this section.
(1) New York City Department of Environmental Protection Chief, Engineering Section 465 Columbus Avenue Valhalla, New York 10595 Telephone: (914) 742-2069
(2) New York City Department of Environmental Protection Five Jay Street Katonah, New York 10536 Telephone: (914) 232-5171 City Tie-line: (212) 349-4017
(3) New York City Department of Environmental Protection Deputy Chief, Engineering P.O. Box 370 Route 28A Shokan, New York 12481 Telephone: (914) 657-6972
(4) New York City Department of Environmental Protection P.O. Box 353 Grahamsville, New York 12740 Telephone: (914) 985-2275 City Tie-line: (212) 349-1930
(5) New York City Department of Environmental Protection P.O. Box D Downsville, New York 13755 Telephone: (607) 363-7000
(b) Applications for department approval of a regulated activity must be submitted to one of the following offices of the department:
(1) New York City Department of Environmental Protection Deputy Chief, Engineering 465 Columbus Avenue Valhalla, New York 10595 Telephone: (914) 773-4418
(2) New York City Department of Environmental Protection Deputy Chief, Engineering P.O. Box 370 Route 28A Shokan, New York 12481 Telephone: (914) 657-6972
(c) Petitions for appeal of a determination issued by the department in accordance with section 128-2.8 of this Part and petitions for a hearing on a cease and desist order issued by the department in accordance with section 128-2.9 of this Part must be submitted to the address listed in paragraph (1) of this subdivision, with a copy to the address listed in paragraph (2) of this subdivision.
(1) New York City Office of Administrative Trials and Hearings 40 Rector Street New York, New York 10006-1705 Telephone: (212) 442-4900
(2) New York City Department of Environmental Protection General Counsel 59-17 Junction Boulevard 19th Floor Corona, New York 11368-5107 Telephone: (718) 595-6555
(d) For communications with the department regarding any known or suspected violations of these rules and regulations or notification of potential contamination of the water supply occurring anywhere in the watershed:
New York City Water Supply Watershed Police Telephone:
Croton/Kensico (914) 245-6694
Beerston (607) 865-4185
(e) The local representative of the New York State Department of Health is:
New York State Department of Health Office of Regulatory Reform Tower Building, Room 2415 Empire State Plaza Albany, New York 12237-0097 (518) 473-7488
(f) Addresses and phone numbers contained herein are informational and persons subject to these rules and regulations shall utilize successor addresses and phone numbers where appropriate.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.11 Waste disposal
Waste water from all plumbing fixtures shall be discharged into municipal sewers where available. Otherwise suitable facilities shall be installed for the absorption of the wastes by the soil in underground systems, so that no nuisance is created.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 458 NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 458.5 Supplies and materials classification index
This section presents guidelines forreporting supplies and services expenses by the proper functional reporting center and natural classification. Items whose use is common to more than one functional reporting center are not referenced to a single center but to the “appropriate” reporting center. Some items are too general in nature to be referenced to a specific natural classification. Therefore, the reference is to the “appropriate” natural classification.
| Item | Functional reporting center | Natural classification | | --- | --- | --- | | Abrasive floor surfacing | Plant Operation and Maintenance | Other Supplies and Materials | | Accounting and audit fees | Fiscal Services | Auditing Services | | Ace bandages | Central Service Supply | Other Medical Care Materials and Supplies | | Acetylene, dissolved | Plant Operation and Maintenance | Other Supplies and Materials | | Acids, laundry | Laundry and Linen Services | Other Supplies and Materials | | Actuarial fees | Fiscal Services | Consulting and Management Services | | Adapters, glass, metal, syringe | Central Service Supply | Other Medical Care Materials and Supplies | | Adhesive pads | Central Service Supply | Other Medical Care Materials and Supplies | | Adhesive remover | Central Service Supply | Other Medical Care Materials and Supplies | | Adhesive tape | Central Service Supply | Other Medical Care Materials and Supplies | | Administrative resident stipends | Appropriate Reporting Center | Interns, Residents and Fellows | | Admission forms | Social Services | Office and Administrative Supplies | | Advertising, community educ. | Administrative Services | Other Direct Expenses | | Advertising, employment | Administrative Services | Other Direct Expenses | | Advertising, sale of assets and waste | Appropriate Reporting Center | Other Direct Expenses | | Advertising, other | Appropriate Reporting Center | Other Direct Expenses | | Affiliation Dues, Nursing Home Association | Administrative Services | Dues to Nursing Home Associations | | Air cushions, invalid | Central Service Supply | Other Medical Care Materials and Supplies | | Airways | Central Service Supply | Other Medical Care Materials and Supplies | | Albuminometers | Laboratory Services | Minor Nonmedical Equipment | | Alcohol, grain | Pharmacy | Medicine Cabinet Drugs | | Alcohol, rubbing | Central Service Supply | Other Medical Care Materials and Supplies | | Alcohol packets | Central Service Supply | Other Medical Care Materials and Supplies | | Alcohol permit fees | Pharmacy | Licenses and Taxes (other than income taxes) | | Alcohol records | Pharmacy | Office and Administrative Supplies | | Alkalies, laundry | Laundry and Linen Services | Other Supplies and Materials | | Ambulance fees | Transportation | Other Purchased Services | | Ambulance insurance premiums | Administrative Services | Insurance | | Ambulance licenses | Administrative Services | Licenses and Taxes (other than income taxes) | | Ambulance rental | Transportation | Rentals or Lease—Movable Equipment | | Ammonia | Housekeeping Service | Cleaning Supplies | | Analgesics | Pharmacy | Medicine Cabinet Drugs | | Arbitration expenses | Administrative Services | Legal Services | | Aspirin | Pharmacy | Medicine Cabinet Drugs | | Assessments, improvement | Administrative Services | Licenses and Taxes (other than income taxes) | | Assessments, operating | Administrative Services | Licenses and Taxes (other than income taxes) | | Association, dues Nursing Home Association | Administrative Services | Dues to Nursing Home Association | | Association dues, other | Appropriate Reporting Center | Other Direct Expenses | | Atomizers | Central Service Supply | Other Medical Care Materials and Supplies | | Attorney's fees | Administrative Services | Legal Service | | Audit fees | Fiscal Services | Auditing Services | | Autoclave tape | Central Service Supply | Other Supplies and Materials | | Automatic door repairs | Plant Operation and Maintenance | Repairs and Maintenance—Purchased Services Nonassignable | | Automatic telephone rentals | Administrative Services | Rental or Lease—Movable Equipment | | Automobile insurance premium | Appropriate Reporting Center | Insurance | | Automobile license | Appropriate Reporting Center | Licenses and Taxes (other than income taxes) | | Automobile rentals | Appropriate Reporting Center | Rental or Lease—Movable Equipment | | Automobile repairs | Appropriate Reporting Center | Repairs and Maintenance—Purchased Services Directly Assignable | | Awards, employee | Appropriate Reporting Center | Other Direct Expenses | | Awards, volunteer service | Administrative Services | Other Direct Expenses | | Badges, identification, employees | Administrative Services | Office and Administrative Supplies | | Badges, identification, volunteers | Administrative Services | Office and Administrative Supplies | | Bags, laundry | Laundry and Linen Services | Other Supplies and Materials | | Bags, paper | Appropriate Reporting Center | Other Supplies and Materials | | Bandages | Central Service Supply | Other Medical Care Materials and Supplies | | Bands, identification | Social Services | Other Supplies and Materials | | Bands, rubber | Appropriate Reporting Center | Office and Administrative Supplies | | Bank charges | Fiscal Services | Other Direct Expenses | | Basin, bath, emesis, face | Appropriate Nursing Reporting Center | Minor Nonmedical Equipment | | Baskets, drug | Pharmacy | Minor Nonmedical Equipment | | Baskets, waste | Appropriate Reporting Center | Minor Nonmedical Equipment | | Baskets, specimen, collection (sputum, urine and feces) | Laboratory Services | Minor Nonmedical Equipment | | Bath caps | Laundry and Linen Services | Other Supplies and Materials | | Bath mats | Laundry and Linen Services | Other Supplies and Materials | | Bath robes | Laundry and Linen Services | Other Supplies and Materials | | Batteries, flashlight | Appropriate Reporting Center | Other Supplies and Materials | | Bedpans | Appropriate Reporting Center | Minor Nonmedical Equipment | | Benzalkonium chloride sol. and tinct. | Central Service Supply | Other Medical Care Materials and Supplies | | Blankets | Laundry and Linen Services | Linen and Bedding | | Blood bank supplies | Laboratory Services | Other Medical Care Materials and Supplies | | Blood, for patients | Laboratory Services | Other Medical Care Materials and Supplies | | Blood derivatives | Laboratory Services | Other Medical Care Materials and Supplies | | Blood type tests, purchased | Laboratory Services | Medical—Purchased Services | | Blow bottles | Appropriate Reporting Center | Other Supplies and Materials | | Board member expenses | Administrative Services | Appropriate Natural Classification | | Bond, Underwriting and issuance cost | Interest on Capital Debt | Administrative Fees—Long term Debt | | Bonding discount amortization | Interest on Capital Debt | Interest | | Bonding insurance premiums, employees | Appropriate Reporting Center | Insurance | | Bond interest expense | Interest on Capital debt | Interest | | Book and journal binding | Administrative Services | Other Direct Expenses | | Bookkeeping forms | Fiscal Services | Office and Administrative Supplies | | Books, medical | Administrative Services | Books, Periodicals, Etc. | | Borax | Laundry and Linen Services | Other Supplies and Materials | | Bottles, drug | Pharmacy | Other Supplies and Materials | | Bottles, reagent | Laboratory Services | Other Supplies and Materials | | Bottles, specimen | Laboratory Services | Other Supplies and Materials | | Bread and pastries | Appropriate Dietary Reporting Center | Dietary—Food | | Brooms | Housekeeping Service | Other Supplies and Materials | | Brushes | Housekeeping Service | Other Supplies and Materials | | Buckets, scrub | Housekeeping Service | Other Supplies and Materials | | Building repairs by outside concerns | Plant Operation and Maintenance | Repairs and Maintenance—Purchased Services—Nonassignable | | Bulbs, electric light | Plant Operation and Maintenance | Other Supplies and Materials | | Burners, bunsen | Laboratory Services | Other Supplies and Materials | | Business interruption insurance | Administrative Services | Insurance | | Business machine rentals | Appropriate Reporting Center | Rental or Lease—Movable Equipment | | Business office forms | Fiscal Services | Office and Administrative Supplies | | Buttons | Laundry and Linen Services | Other Supplies and Materials | | Canes | Central Service Supply | Other Medical Care Materials and Supplies | | Caps, ice (bags) | Central Service Supply | Other Medical Care Materials and Supplies | | Capsules | Pharmacy | Medicine Cabinet Drugs | | Carpenter tools | Plant Operation and Maintenance | Minor Nonmedical Equipment | | Carpeting and rugs, cleaning | Housekeeping Service | Other Purchased Services | | Cartage, drayage, and freight | | | | (1) supplies | Same Reporting Center as Item Purchased | Other Direct Expenses | | (2) equipment | Same Reporting Center as Item Purchased | | | Cash shortages, overages | Fiscal Services | Other Direct Expenses | | Casters | Appropriate Reporting Center | Other Supplies and Materials | | Cases, pillow | Laundry and Linen Services | Linen and Bedding | | Catheter boxes, trays | Central Service Supply | Other Medical Care Materials and Supplies | | Catheters, metal, rubber, etc. | Central Service Supply | Other Medical Care Materials and Supplies | | Chart envelopes | Medical Records | Office and Administrative Supplies | | Chart, patient | Medical Records | Office and Administrative Supplies | | Checkbooks and voucher checks | Fiscal Services | Office and Administrative Supplies | | Chemicals, pharmaceutical | Pharmacy | Prescription Drugs | | Chemicals, reagent | Laboratory Services | Other Medical Care Materials and Supplies | | Chinaware | Appropriate Dietary Reporting Center | Dietary—Other | | Chux | Laundry and Linen Services | Disposable Linens | | Cleaning compounds | Housekeeping Service | Cleaning Supplies | | Cleavers, chopping | Appropriate Dietary Reporting Center | Dietary—Other | | Clocks, household | Appropriate Reporting Center | Minor Nonmedical Equipment | | Clocks, interval timer | Appropriate Reporting Center | Minor Nonmedical Equipment | | Clothes racks | Appropriate Reporting Center | Minor Nonmedical Equipment | | Clothing, inpatients | Laundry and Linen Services | Other Supplies and Materials | | Clothing, staff | Appropriate Reporting Center | Employee Wearing Apparel | | Cloths, face | Laundry and Linen Services | Linen and Bedding | | Cloths, table | Appropriate Dietary Reporting Center | Other Supplies and Materials | | Coal and coke | Plant Operation and Maintenance | Other Utilities | | Cocaine | Pharmacy | Prescription Drugs | | Colanders | Appropriate Dietary Reporting Center | Minor Nonmedical Equipment | | Collection fees | Fiscal Services | Collection Services | | Compensations, physician | | | | (1) payroll | Appropriate Reporting Center | Salaries and Wages—Physicians | | (2) non-payroll | Appropriate Reporting Center | Physicians Fees | | Compound tincture benzoin | Central Service Supply | Other Medical Care Materials and Supplies | | Consultant fees | | | | (1) from non-related organization | Appropriate Reporting Center | Consulting and Management Services | | (2) from related organization | Appropriate Reporting Center | Management Services | | Containers, false teeth | Appropriate Reporting Center | Other Supplies and Materials | | Containers, needle | Central Service Supply | Other Medical Care Materials and Supplies | | Controlled substances | Pharmacy | Prescription Drugs | | Controls, sterilizer | Appropriate Reporting Center | Other Supplies and Materials | | Cotton, absorbent | Central Service Supply | Other Medical Care Materials and Supplies | | Cotton balls | Central Service Supply | Other Medical Care Materials and Supplies | | Cottonseed oil | Central Service Supply | Other Medical Care Materials and Supplies | | Covers, tray or table (patients) | Appropriate Dietary Reporting Center | Other Supplies and Materials | | Cross match fees (see Laboratory Procedures) | | | | Crutches | Central Service Supply | Instruments and Minor Medical Equipment | | Cuffs, blood pressure | Central Service Supply | Instruments and Minor Medical Equipment | | Cups, china | Appropriate Dietary Reporting Center | Dietary—Other | | Cups, paper, beverage | Appropriate Dietary Reporting Center | Other Supplies and Materials | | Cups, sputum, paper | Central Service Supply | Other Medical Care Materials and Supplies | | Curtains and draperies, window, cleaning | Housekeeping Service | Other Purchased Services | | Curtains and draperies, cubicle, initial | Housekeeping Service | Other Supplies and Materials | | Cushions, air, invalid | Central Service Supply | Other Medical Care Materials and Supplies | | Cutters, paper | Appropriate Reporting Center | Minor Nonmedical Equipment | | Dairy products | Appropriate Reporting Center | Dietary—Food | | Data processing fees, patient discharge information | Fiscal Services | Other Purchased Services | | Data processing fees, patient discharge information | Utilization Review | Other Purchased Services | | Data processing fees,. general accounting | Fiscal Services | Other Purchased Services | | Data processing forms | Fiscal Services | Office and Administrative Supplies | | Data processing supplies | Fiscal Services | Office and Administrative Supplies | | Dental supplies | Dental | Other Medical Care Materials and Supplies | | Depreciation, major movable equipment | Appropriate Reporting Center | Depreciation and Amortization | | Depreciation, minor equipment | Appropriate Reporting Center | Depreciation and Amortization | | Depressors, tongue | Central Service Supply | Other Medical Care Materials and Supplies | | Detective service | Security | Other Purchased Services | | Detergents (laundry) | Laundry and Linen Services | Cleaning Supplies | | Developers and hypo solutions | Appropriate Reporting Center | Other Supplies and Materials | | Dextrose | Pharmacy | Prescription Drugs | | Dinnerware | Appropriate Dietary Reporting Center | Dietary—Other | | Dishes, evaporating, Petri | Laboratory Services | Minor Nonmedical Equipment | | Dishes, table | Appropriate Dietary Reporting Center | Dietary—Other | | Dishpans | Appropriate Dietary Reporting Center | Minor Nonmedical Equipment | | Disinfectants | Housekeeping Service | Other Supplies and Materials | | Dissectors | Laboratory Services | Instruments and Minor Medical Equipment | | Doilies, tray, paper | Appropriate Dietary Reporting Center | Other Supplies and Materials | | Douche pans | Central Service Supply | Minor Nonmedical Equipment | | Draperies and curtains (see Curtains) | | | | Drayage (see Cartage) | | | | Dressing tray | Central Service Supply | Minor Nonmedical Equipment | | Dressings | Central Service Supply | Other Medical Care Materials and Supplies | | Drinking cups (see Cups) | | | | Droppers, medicine | Central Service Supply | Other Medical Care Materials and Supplies | | Dues, association, nursing home | Administrative Services | Dues to Nursing Home Associations | | Dues, professional organizations | Appropriate Reporting Center | Other Direct Expenses | | Dust control | Housekeeping Service | Other Purchased Services | | Dyes, laundry | Laundry and Linen Services | Other Supplies and Materials | | Education supplies, students' | Appropriate Reporting Center | Other Supplies and Materials | | Education supplies, inservice-Nursing | Nursing Administration | Other Supplies and Materials | | Education supplies. inservice—Other | Appropriate Reporting Center | Other Supplies and Materials | | Electric light bulbs | Plant Operation and Maintenance | Other Supplies and Materials | | Electricity | Plant Operation and Maintenance | Electricity | | Elevator inspection fees | Plant Operation and Maintenance | Other Direct Expense | | Elevator liability insurance | Plant Operation and Maintenance | Insurance | | Elevator repairs | Plant Operation and Maintenance | Repairs and Maintenance-Purchased Service Nonassignable | | Employee benefits. F.I.C.A. | Reporting Center to which Employee is Assigned | FICA | | Employee benefits, unemployment insurance | Reporting Center to which Employee is Assigned | State Unemployment Insurance and Federal Unemployment Insurance | | Employee benefits, parking | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, meals | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, health insurance | Reporting Center to which Employee is Assigned | Group Health Insurance | | Employee benefits, life insurance | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, tuition | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, recreational and cultural activities | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, licenses | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee benefits, pension, nonunion | Reporting Center to which Employee is Assigned | Pension and Retirement—Nonunion | | Employee benefits, pension, union | Reporting Center to which Employee is Assigned | Pension and Retirement—Union | | Employee benefits, housing allowance | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Employee uniforms, hospital owned | Laundry and Linen Services | Employee Wearing Apparel | | Employment agency fees | Administrative Services | Other Fees | | Enema, disposable | Central Service Supply | Other Medical Care Materials and Supplies | | Engineering tools | Plant Operation and Maintenance | Minor Nonmedical Equipment | | Envelopes, films, x-rays | Radiology | Other Supplies and Materials | | Envelopes, paper, other | Appropriate Reporting Center | Office and Administrative Supplies | | Epsom salts | Central Service Supply | Other Medical Care Materials and Supplies | | Equipment repair by outside concerns | Appropriate Reporting Center | Repairs and Maintenance—Purchase Services—Directly Assignable | | Express charges (see Cartage) | | | | Exterminator (pest control services) | Housekeeping Service | Other Purchased Services | | Extractors, fruit juice | Appropriate Dietary Reporting Center | Minor Nonmedical equipment | | Face cloths | Laundry and Linen Services | Linen and Bedding | | Face masks | Central Service Supply | Other Medical Care Materials and Supplies | | Fees, medical—Physicians | Appropriate Reporting Center | Physicians Fees | | Fees, medical—Therapists | Appropriate Reporting Center | Therapists and Others (nonphysicians) | | Fees, nonmedical (see specific category) | | | | Fidelity bond premiums | Reporting Center to which Employee is Assigned | Insurance | | Film hangers | Radiology | Minor Nonmedical Equipment | | Films | Radiology | Other Medical Care Materials and Supplies | | Filters—air conditioners | Plant Operation and Maintenance | Other Supplies and Materials | | Fingerprinting supplies | Security | Other Supplies and Materials | | Fire insurance premiums | Administrative Services | Insurance | | Flashlight and batteries | Appropriate Reporting Center | Other Supplies and Materials | | Flasks, general | Appropriate Reporting Center | Other Supplies and Materials | | Flowers, decorative | Housekeeping Services | Other Direct Expenses | | Flower pots and planters | | | | (1) inside facility | Housekeeping Services | Other Supplies and Materials | | (2) outside facility | Grounds | Other Supplies and Materials | | Food, meat, fish and poultry | Appropriate Dietary Reporting Center | Dietary—Food | | Food, other | Appropriate Dietary Reporting Center | Dietary—Food | | Forks, kitchen | Appropriate Dietary Reporting Center | Dietary—Other | | Forms, medical record, medical history, etc. | Medical Records | Office and Administrative Supplies | | Freight Charges (see Cartage) | | | | Fruits and vegetables | Appropriate Dietary Reporting Center | Dietary—Food | | Fuel, gas | Plant Operation and Maintenance | Gas | | Fund raising expenses | Fund Raising | Appropriate Natural Classification | | Funnels | Appropriate Reporting Center | Other Supplies and Materials | | Gags, mouth | Central Service Supply | Other Supplies and Materials | | Garbage cans | Housekeeping Service | Minor Nonmedical Equipment | | Gas (fuel) | Plant Operation and Maintenance | Gas | | Gasoline | Appropriate Reporting Center | Other Supplies and Materials | | Gauze | Central Service Supply | Other Medical Care Materials and Supplies | | Germicides, cleaning | Housekeeping Service | Cleaning Supplies | | Glass, window | Plant Operation and Maintenance | Other Supplies and Materials | | Glassware, kitchen, dining room | Appropriate Dietary Reporting Center | Dietary—Other | | Glassware, laboratory | Laboratory Services | Other Supplies and Materials | | Gloves, disposable | Central Service Supply | Other Supplies and Materials | | Gloves, reuseable | Central Service Supply | Other Supplies and Materials | | Glucose, I.V. | Pharmacy | Prescription Drugs | | Glue, furniture, etc. | Plant Operation and Maintenance | Other Supplies and Materials | | Glycerine | Pharmacy | Medicine Cabinet Drugs | | Gowns, employee | Laundry and Linen Services | Employee Wearing Apparel | | Gowns, patients' | Laundry and Linen Services | Other Supplies and Materials | | Graduates, glass | Laboratory Services | Other Supplies and Materials | | Grass seed | Grounds | Other Supplies and Materials | | Graters, food | Appropriate Dietary Reporting Center | Minor Nonmedical Equipment | | Greases, lubricating | Appropriate Reporting Center | Other Supplies and Materials | | Guard service fees | Security | Other Purchased Services | | Hammers, percussion reflex | Central Service Supply | Instruments and Minor Medical Equipment | | Hangers, coat | Housekeeping | Other Supplies and Materials | | Hangers, film | Radiology | Minor Nonmedical Equipment | | Hardware | Appropriate Reporting Center | Other Supplies and Materials | | Heaters | Appropriate Reporting Center | Minor Nonmedical Equipment | | Heating, ventilating and air conditioning supplies | Plant Operation and Maintenance | Other Supplies and Materials | | Holders, napkin | Appropriate Dietary Reporting Center | Dietary—Other | | Holders, needle | Central Service Supply | Instruments and Minor Medical Equipment | | Holders, sputum cup | Central Service Supply | Other Supplies and Materials | | Holders, test tube | Laboratory Services | Other Supplies and Materials | | Hot packs, apparatus | Central Service Supply | Instruments and Minor Medical Equipment | | Hot water bottles | Central Service Supply | Instruments and Minor Medical Equipment | | Hydrogen Peroxide | Central Service Supply | Other Medical Care Materials and Supplies | | Hypodermic needles | Central Service Supply | Other Medical Care Materials and Supplies | | I.V. set | Pharmacy | Other Medical Care Materials and Supplies | | I.V. additives | Pharmacy | Prescription Drugs | | I.V. solutions | Pharmacy | Prescription Drugs | | I.V. supplies | Pharmacy | Other Medical Care Materials and Supplies | | Ice (purchased) | Appropriate Reporting Center | Other Supplies and Materials | | Ice bags | Appropriate Reporting Center | Other Supplies and Materials | | Ident-a-bands | Social Services | Other Supplies and Materials | | Income tax | Note: Income Taxes are Nonoperating Expenses which are not assigned to Functional Reporting Centers | Other Direct Expenses | | Ink, printing | Administrative Services | Other Supplies and Materials | | Ink, marking | Laundry and Linen Services | Other Supplies and Materials | | Insect extermination expense | Housekeeping Service | Other Purchased Services | | Insecticides | Housekeeping Service | Other Supplies and Materials | | Inservice education supplies (see Education supplies) | | | | Inspection fees and permits | Appropriate Reporting Center | Other Direct Expenses | | Instruments, tray—reusable | Central Service Supply | Instruments and Minor Medical Equipment | | Instruments, tray—disposable | Central Service Supply | Other Medical Care Materials and Supplies | | Insurance: | | | | Boiler liability | Plant Operation and Maintenance | Insurance | | Bonding liability | Reporting Center to which Employee is Assigned | Insurance | | Elevator liability | Plant Operation and Maintenance | Insurance | | Fire | Administrative Services | Insurance | | Malpractice liability | Administrative Services | Insurance | | Unemployment | Reporting Center to which Employee is Assigned | State Unemployment Insurance and Federal Unemployment Insurance | | Workers' Compensation (ind. injury) | Reporting Center to which Employee is Assigned | Workers' Compensation Insurance | | Intercommunication system expense | Administrative Services | Appropriate Natural Classification | | Interest expense, current working capital | Administrative Services | Interest | | Interest expense, long term | Interest on Capital Debt | Interest | | Intramuscular injectables | Pharmacy | Prescription Drugs | | Irrigating solutions | Central Service Supply | Other Medical Care Materials and Supplies | | Irrigation tips | Central Service Supply | Instruments and Minor Medical Equipment | | Irrigation | Central Service Supply | Instruments and Minor Medical Equipment | | Jackets, orderlies, operating room, etc. | Laundry and Linen Services | Employee Wearing Apparel | | Jars, specimen | Laboratory Services | Other Supplies and Materials | | Journals, medical (see Magazines) | | | | Kettles, steam (patients' use) | Central Service Supply | Minor Nonmedical Equipment | | Kettles, steam (kitchen) | Appropriate Dietary Reporting Center | Minor Nonmedical Equipment | | Keys | Security | Other Supplies and Materials | | Kitchen utensils | Appropriate Dietary Reporting Center | Dietary—Other | | Knife, bread, butcher, etc. | Appropriate Dietary Reporting Center | Dietary—Other | | Labels, drug | Pharmacy | Other Supplies and Materials | | Labels, other | Appropriate Reporting Center | Other Supplies and Materials | | Labor relations and consultation fees | Administrative Services | Consulting and Management Services | | Laboratory procedures by facility based physicians | Laboratory Services | Physicians Fees | | Laboratory procedures by outside concerns | Laboratory Services | Contracted Services | | Lactometers | Laboratory Services | Other Supplies and Materials | | Ladders | Plant Operation and Maintenance | Minor Nonmedical Equipment | | Lamps, electric | Appropriate Reporting Center | Minor Nonmedical Equipment | | Lancets | Central Service Supply | Other Medical Care Materials and Supplies | | Lancets, blood | Central Service Supply | Other Medical Care Materials and Supplies | | Lanterns (battery or gas type) | Plant Operation and Maintenance | Minor Nonmedical Equipment | | Laundering—outside concerns | Laundry and Linen Services | Contracted Services | | Laxatives, simple | Pharmacy | Medicine Cabinet Drugs | | Lease costs (see Rental Charges) | | | | Legal fees, collections | Fiscal Services | Legal Services | | Legal fees | Administrative Services | Legal Services | | Lens paper | Laboratory Services | Other Supplies and Materials | | Licenses | Administrative Services | Licenses and Taxes (other than income tax) | | Lime, chlorinated | Housekeeping Service | Cleaning Supplies | | Linen, bed | Laundry and Linen Services | Linen and Bedding | | Linen, disposable | Laundry and Linen Services | Disposable Linens | | Linen, sterile | Laundry and Linen Services | Linen and Bedding | | Litmus paper | Laboratory Services | Other Supplies and Materials | | Long distance telephone charges | Administrative Services | Telephone and Telegraph | | Lubricating fluids | Central Service Supply | Other Medical Care Materials and Supplies | | Lubricating jelly | Central Service Supply | Other Medical Care Materials and Supplies | | Lumber | Plant Operation and Maintenance | Other Supplies and Materials | | Lye | Laundry and Linen Services | Cleaning Supplies | | Magazines, lobby | Administrative Services | Books, Periodicals, Etc. | | Magazines, medical journals | Appropriate Reporting Center | Books, Periodicals, Etc. | | Magazines, general interest | Administrative Services | Books, Periodicals, Etc. | | Magazines. department | Appropriate Reporting Center | Books, Periodicals, Etc. | | Maintenance contracts, major movable equipment | Appropriate Reporting Center NOTE: If the appropriate functional reporting center is Plant Operation and Maintenance, then these items should be assigned to the Natural Classification, Repairs and Maintenance Purchased Services Nonassignable | Repairs and Maintenance—Purchased Services Directly Assignable | | Maintenance contracts, fixed equipment | Appropriate Reporting Center NOTE: If the appropriate functional reporting center is Plant Operation and Maintenance, then these items should be assigned to the Natural Classification, Repairs and Maintenance—Purchased Services—Nonassignable | Repairs and Maintenance—Purchased Services—Directly Assignable | | Maintenance contracts, minor movable equipment | Appropriate Reporting Center NOTE: If the appropriate functional reporting center is Plant Operation and Maintenance, then these items should be assigned to the Natural Classification, Repairs and Maintenance—Purchased Services—Nonassignable | Repairs and Maintenance—Purchased Services—Directly Assignable | | Maalox | Pharmacy | Medicine Cabinet Drugs | | Mangle aprons | Laundry and Linen Services | Other Supplies and Materials | | Marking ink and labels | Laundry and Linen Services | Other Supplies and Materials | | Mats, bath | Laundry and Linen Services | Other Supplies and Materials | | Mattress covers and pads | Laundry and Linen Services | Linen and Bedding | | Measures, metal | Appropriate Reporting Center | Other Supplies and Materials | | Meat and poultry | Appropriate Reporting Center | Dietary—Food | | Membership dues, Nursing Home Asso. | Appropriate Reporting Center | Dues to Nursing Home Associations | | Membership dues, other | Appropriate Reporting Center | Other Direct Expenses | | Mortars | Appropriate Reporting Center | Other Supplies and Materials | | Mortgage, interest expense | Interest on Capital Debt | Interest | | Motor oil, car, truck | Appropriate Reporting Center | Other Supplies and Materials | | Motor vehicle insurance | Appropriate Reporting Center | Insurance | | Motor vehicle license | | | | (see Licenses) | | | | Mouthwash, nonprescription | Central Service Supply | Other Medical Care Materials and Supplies | | Mucous bulbs | Central Service Supply | Other Medical Care Materials and Supplies | | Narcotics | Pharmacy | Pharmaceuticals | | Narcotic permit fees | Pharmacy | Licenses and Tax (other than income taxes) | | Narcotic records | Pharmacy | Office and Administrative Supplies | | Needles, aneurysm, aspirating | Central Service Supply | Instruments and Minor Medical Equipment | | Needles, spinal, hypodermic | Central Service Supply | Instruments and Minor Medical Equipment | | Needles, sewing | Laundry and Linen Services | Other Supplies and Materials | | Nets, laundry | Laundry and Linen Services | Other Supplies and Materials | | Newspapers | Appropriate Reporting Center | Books, Periodicals, Etc. | | Nitroglycerine | Pharmacy | Prescription Drugs | | Novacaine | Pharmacy | Prescription Drugs | | Nurses' uniforms (when hospital furnished), except student's | Laundry and Linen Services | Employee Wearing Apparel | | Office supplies (printing and stationery) | Appropriate Reporting Center | Office and Administrative Supplies | | Oil, fuel #2 | Plant Operation and Maintenance | Fuel Oil #2 | | Oil, fuel #4 | Plant Operation and Maintenance | Fuel Oil #4 | | Oil, fuel #6 | Plant Operation and Maintenance | Fuel Oil #6 | | Oils and greases, general | Plant Operation and Maintenance | Other Supplies and Materials | | Orthopedic Supplies | Central Service Supply | Other Medical Care Materials and Supplies | | Oxygen | Central Service Supply | Other Medical Care Materials and Supplies | | Packets—alcohol, lemon/glycerine | Central Service Supply | Other Medical Care Materials and Supplies | | Pack (hot) apparatus, electric (see Heaters, Hot pack, Kettles) | | | | Packs, steam | Central Service Supply | Instruments and Minor Medical Equipment | | Pads, bed, table, etc. (cloth) | Appropriate Reporting Center | Linen and Bedding | | Pads, cleaning | Housekeeping Service | Cleaning Supplies | | Pads, laundry, mangle, press | Laundry and Linen Services | Other Supplies and Materials | | Pads, rubber floor mat | Appropriate Reporting Center | Other Supplies and Materials | | Pails, scrub | Housekeeping Service | Cleaning Supplies | | Paint brushes | Plant Operation and Maintenance | Other Supplies and Materials | | Painting, contracted | Plant Operation and Maintenance | Repairs and Maintenance—Purchased Services—Nonassignable | | Painters' drop cloths | Plant Operation and Maintenance | Other Supplies and Materials | | Paints, shellacs, varnishes | Plant Operation and Maintenance | Other Supplies and Materials | | Pans, baking | Appropriate Dietary Reporting Center | Minor Nonmedical Equipment | | Pans, dust | Housekeeping Service | Cleaning Supplies | | Paper, duplication machine | Administrative Services | Office and Administrative Supplies | | Paper, data processing | Fiscal Services | Office and Administrative Supplies | | Paper, print shop supplies | Administrative Services | Other Supplies and Materials | | Paper cups | Appropriate Reporting Center | Dietary—Other | | Paper, shelf, toilet | Housekeeping Service | Other Supplies and Materials | | Paper plates | Appropriate Dietary Reporting Center | Dietary—Other | | Paper, wax | Appropriate Dietary Reporting Center | Dietary—Other | | Pencils, lead, crayon, marking | Appropriate Reporting Center | Office and Administrative Supplies | | Pens | Appropriate Reporting Center | Office and Administrative Supplies | | Pension plan premiums—nonunion | Rptg. Ctr. to which Employee is Assigned | Pension and Retirement—Non-Union | | Pension plan premiums—union | Rptg. Ctr. to which Employee is Assigned | Pension and Retirement—Union | | Percussion hammers | Central Service Supply | Instruments and Minor Medical Equipment | | Periodicals | Appropriate Reporting Center | Books, Periodicals, Etc. | | Personal property tax (see Taxes) | | | | Pillows | Housekeeping Service | Linen and Bedding | | Pins, laundry | Laundry and Linen Services | Other Supplies and Materials | | Pins, safety, straight | Appropriate Reporting Center | Other Supplies and Materials | | Pipettes | Laboratory Services | Other Supplies and Materials | | Pitcher, water | Appropriate Reporting Center | Other Supplies and Materials | | Plaster, building | Plant Operation and Maintenance | Other Supplies and Materials | | Plasters, adhesive | Central Service Supply | Other Medical Care Material and Supplies | | Plate, china, dinner, salad, etc. | Appropriate Dietary Reporting Center | Dietary—Other | | Plates, x-ray (film) | Radiology | Other Medical Care Materials and Supplies | | Plumbing supplies | Plant Operation and Maintenance | Other Supplies and Materials | | Polishes | Housekeeping Service | Cleaning Supplies | | Postage, for general use | Administrative Services | Other Direct Expenses | | Postage, for specific departments | Appropriate Reporting Center | Other Direct Expenses | | Powders, film developing | Radiology | Other Supplies and Materials | | Powders, insect | Housekeeping Service | Other Supplies and Materials | | Powders, scouring | Housekeeping Service | Cleaning Supplies | | Power, purchased | Plant Operation and Maintenance | Appropriate Natural Classification | | Prescriptions (outside purchases) | Pharmacy | Other Purchased Services | | Prescription blanks | Pharmacy | Office and Administrative Supplies | | Radiology services by outside concern | Radiology | Medical Purchased Services | | Rags, cleaning | Housekeeping Service | Cleaning Supplies | | Razor blades | Appropriate Reporting Center | Other Supplies and Materials | | Razors | Appropriate Reporting Center | Other Supplies and Materials | | Receptacles, waste | Housekeeping Service | Minor Nonmedical Equipment | | Record forms, medical | Medical records | Office and Administrative Supplies | | Records for transcribing machines | Appropriate Reporting Center | Office and Administrative Supplies | | Rectal tubes | Central Service Supply | Other Medical Care Materials and Supplies | | Registers, narcotic | Pharmacy | Office and Administrative Supplies | | Rental charges, major movable equipment | Appropriate Reporting Center | Rental or Lease—Movable Equipment | | Rental charges, fixed equipment, general | Depreciation, Leases, and Rentals | Rental or Lease—Fixed Equipment | | Rental charges, minor equipment | Appropriate Reporting Center | Rental or Lease—Movable Equipment | | Rental charges, reusable supp. | Appropriate Reporting Center | Other Direct Expenses | | Rental charges, duplicating machine | Administrative Services | Rental or Lease—Movable Equipment | | Rentals, intercommunicating equipment | Administrative Services | Rental or Lease—Movable Equipment | | Rentals, safety deposit boxes | Administrative Services | Other Direct Expenses | | Repair, replacement of personal property (eye glasses, dentures, hearing aides, etc.) | Administrative Services | Other Direct Expenses | | Repairs, minor, to buildings | Plant Operation and Maintenance | Repairs and Maintenance—Purchased | | (by an outside concern) | | Services Nonassignable | | Repairs, purchased, to equipment (identifiable with specific departments): | | | | Major movable | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Fixed equipment | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Minor equipment | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Reusable supplies | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Repairs, purchased, to equipment | | | | (not identifiable with specific departments) | | | | Pillow mikes | Appropriate Nursing Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Lobby furniture | Plant Operation and Maintenance | Repairs and Maint.—Purch. Serv.— Nonassignable | | T.V., patients | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Wheelchair | Appropriate Reporting Center | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Research expense | Research | Appropriate Natural Classification | | Respirators | Central Service Supply | Instruments and Minor Medical Equipment | | Ribbons, typewriter | Appropriate Reporting Center | Office and Administrative Supplies | | Rubber bands | Appropriate Reporting Center | Office and Administrative Supplies | | Safety pins | Appropriate Reporting Center | Other Supplies and Materials | | Saucers, plant | Housekeeping Service | Other Supplies and Materials | | Scissors sharpening | Appropriate Reporting Center | Other Purchased Services | | Scoops, flour, sugar, etc. | Appropriate Dietary Reporting Center | Dietary—Other | | Seafood | Appropriate Dietary Reporting Center | Dietary—Food | | Sedatives | Pharmacy | Prescription Drugs | | Service charges on equipment repairs | Appropriate Reporting Center Note: If the appropriate functional reporting center is Plant Operation and Maintenance, then these items should be assigned to the Natural Classification, Repairs and Maintenance-Purchased Services—Nonassignable. | Repairs and Maint.—Purch. Serv.— Dir. Assignable | | Sharpeners, pencil | Appropriate Reporting Center | Other Supplies and Materials | | Sheets, linen | Laundry and Linen | Linen and Bedding | | Sheets, rubber, on patients' beds | Appropriate Nursing Reporting Center | Other Supplies and Materials | | Sheet wadding | Appropriate Reporting Center | Other Supplies and Materials | | Signals, communication (beepers) | Administrative Services | Minor Nonmedical Equipment | | Slippers, paper | Appropriate Reporting Center | Other Supplies and Materials | | Slips, laundry | Laundry and Linen Services | Office and Administrative Supplies | | Snow removal | Grounds | Other Purchased Services | | Soaps, dishwashing | Appropriate Dietary Reporting Center | Cleaning Supplies | | Soaps, floor, toilet | Housekeeping Service | Cleaning Supplies | | Soaps, laundry | Laundry and Linen Services | Cleaning Supplies | | Splints | Central Service Supply | Other Medical Care Materials and Supplies | | Steam cleaner rental | Housekeeping Service | Rental or Lease—Movable Equipment | | Steam, purchased | Plant Operation and Maintenance | Other Utilities | | Sterile water | Central Service Supply | Other Supplies and Materials | | Stethoscopes | Central Service Supply | Instruments and Minor Medical Equipment | | Strike expenses | Administrative Services | Appropriate Natural Classification | | Suction tips, disposable | Central Service Supply | Other Medical Care Materials and Supplies | | Supplies, patient chargeable | Central Service Supply | Appropriate Natural Classification | | Suppositories | Central Service Supply | Other Medical Care Materials and Supplies | | Sutures | Central Service Supply | Other Medical Care Materials and Supplies | | Syringes, hypo. | Central Service Supply | Other Medical Care Materials and Supplies | | Syringes, irrigating | Central Service Supply | Other Medical Care Materials and Supplies | | Tablets, paper | Appropriate Reporting Center | Office and Administrative Supplies | | Tape remover | Appropriate Reporting Center | Other Medical Care Materials and Supplies | | Tape, twilled | Laundry and Linen Services | Other Supplies and Materials | | Taxes, real estate | Plant Operation and Maintenance | Licenses and Taxes (other than income tax) | | Taxes, personal property | Plant Operation and Maintenance | Licenses and Taxes (other than income tax) | | Taxes, business | Administrative Services | Licenses and Taxes (other than income tax) | | Telegraph expense | Administrative Services | Telephone and Telegraph | | Telephone expense | | | | General lines service | Administrative Services | Telephone and Telegraph | | Dedicated lines service | Appropriate Reporting Center | Telephone and Telegraph | | Long Distance, patient | Administrative Services | Telephone and Telegraph | | Long Distance, administration | Administrative Services | Telephone and Telegraph | | Long Distance, medical staff | Medical staff service | Telephone and Telegraph | | Taxicab charges | Appropriate Reporting Center | Travel, Conferences and Workshops | | Test Tubes | Laboratory Services | Other Supplies and Materials | | Theft of Goods | Appropriate Reporting Center | Appropriate Natural Classification | | Thermometers, mouth, bath, rectal | Central Service Supply | Other Medical Care Materials and Supplies | | Thermostat, wall | Plant Operation and Maintenance | Other Supplies and Materials | | Thread, sewing | Laundry and Linen Services | Other Supplies and Materials | | Throat bags | Central Service Supply | Other Medical Care Materials and Supplies | | Time cards (payroll) | Fiscal Services | Office and Administrative Supplies | | Tips, irrigating, suction, uterine, etc. | Central Service Supply | Other Medical Care Materials and Supplies | | Tires, car, truck | Appropriate Reporting Center | Other Supplies and Materials | | Tissue, facial | Appropriate Reporting Center | Other Supplies and Materials | | Toilet paper | Housekeeping Service | Other Supplies and Materials | | Tongs, crucible | Laboratory Services | Minor Nonmedical Equipment | | Tongue depressors | Central Service Supply | Other Medical Care Materials and Supplies | | Towels, bath, face | Laundry and Linen Services | Linen and Bedding | | Towels, paper | Appropriate Reporting Center | Other Supplies and Materials | | Traction rope | Central Service Supply | Other Medical Care Materials and Supplies | | Transportation—patients | Transportation | Appropriate Natural Classification | | Transportation—staff | Appropriate Reporting Center | | | Travel, conventions and conferences Travel expense: | Appropriate Reporting Center | Travel, Conferences and Workshops | | Educational | Appropriate Educational Reporting Center | Travel, Conferences and Workshops | | Recruiting | Administrative Services | Travel, Conferences and Workshops | | "Community" | Administrative Services | Travel, Conferences and Workshops | | Board | Administrative Services | Travel, Conferences and Workshops | | Medical staff | Medical Staff Services | Travel, Conferences and Workshops | | Administration | Administrative Services | Travel, Conferences and Workshops | | Tray covers, paper (patients' meals) | Patient Food Service | Dietary—Other | | Trays, dressing | Central Service Supply | Minor Nonmedical Equipment | | Trays, serving, patients' | Patient Food Service | Minor Nonmedical Equipment | | Trays, desk | Appropriate Reporting Center | Other Supplies and Materials | | Trays, staining | Laboratory Services | Other Supplies and Materials | | Tubes, centrifuge test, etc. | Laboratory Services | Other Supplies and Materials | | Tubes, colon, connecting, duodenal, infusion, intravenous, etc. | Central Service Supply | Other Medical Care Materials and Supplies | | Tubes, specimen | Laboratory Services | Other Supplies and Materials | | Tubing, glass, heat resisting | Laboratory Services | Other Supplies and Materials | | Tubing, rubber | Central Service Supply | Other Supplies and Materials | | Tuition, employee education | Reporting Center to which Employee is Assigned | Other Employee Benefits | | Tumblers, glass, drinking | Appropriate Reporting Center | Dietary—Other | | Underpads (excluding disposables) | Laundry and Linen Services | Linen and Bedding | | Underpads (disposables) | Laundry and Linen Services | Disposable Linen | | Uniforms (hospital furnished) | | | | Employees | Reporting Center to which Employee is Assigned | Employee Wearing Apparel | | Volunteer | Administrative Services | Employee Wearing Apparel | | Candystriper | Administrative Services | Employee Wearing Apparel | | Urinals, patient | Appropriate Reporting Center | Minor Nonmedical Equipment | | Urinometers | Laboratory Services | Minor Nonmedical Equipment | | Utensils | Appropriate Dietary Reporting Center | Dietary—Other | | Utensils, stainless steel, kitchen | Appropriate Dietary Reporting Center | Dietary—Other | | Utensils, stainless steel, medical | Central Service Supply | Instruments and Other Minor Medical Equipment | | Utensils, stainless steel, other | Appropriate Reporting Center | Minor Nonmedical Equipment | | Vaporizers, medicinal (steam kettles) | Central Service Supply | Minor Nonmedical Equipment | | Vases, decorative | Housekeeping Service | Other Supplies and Materials | | Vegetable oil | Appropriate Dietary Reporting Center | Dietary—Food | | Venetian blind cleaning | Housekeeping Service | Other Purchased Services | | Volunteer meals | Administrative Services | Other Direct Expenses | | Volunteer uniforms | Administrative Services | Employee Wearing Apparel | | Volunteer badges | Administrative Services | Other Supplies and Materials | | Wash Cloths | Laundry and Linen Services | Linen and Bedding | | Waste receptacles | Housekeeping Service | Minor Nonmedical Equipment | | Water | Plant Operation and Maintenance | Water and Sewer | | Water treatment compounds | Plant Operation and Maintenance | Other Supplies and Materials | | Wax, floor | Housekeeping Service | Cleaning Supplies | | Window glass | Plant Operation and Maintenance | Other Supplies and Materials | | Window washing expense | Housekeeping Service | Other Purchased Services | | (outside concerns) | | | | Wrappers, cloth | Appropriate Reporting Center | Other Supplies and Materials | | Wringers, mop | Housekeeping Service | Minor Nonmedical Equipment | | X-ray film | Radiology | Other Medical Care Materials and Supplies | | X-ray procedures, facility based physicians | Radiology | Physicians Fees | | X-ray procedures, purchased outside | Radiology | Medical—Purchased Services |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.4 Medical direction
(a) Medical direction of a human milk bank shall be provided by a physician, who may also be the director of the bank, in consultation with the medical advisory committee. Such physician shall be licensed and currently registered with the New York State Education Department, and possess a minimum of four years' experience in neonatology, pediatrics, blood banking or a related field.
(b) The medical director and the medical advisory committee shall establish operating procedures and monitor the medical efficacy of milk banking services, and shall, consistent with this Part, develop:
(1) medical criteria for donor participation;
(2) quality standards for the milk, including methodologies and criteria for heat-processing; and
(3) policies for priority distribution of milk when demand exceeds the supply.
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.1 Purpose, scope and applicability
(a) The purpose of this Part is to provide rules and procedures for the New York State Department of Health to provide financial assistance to public water systems from the New York State Drinking Water State Revolving Fund created by chapter 413 of the Laws of 1996 of the State of New York. This is a cooperative program in conjunction with the New York State Environmental Facilities Corporation. That agency's regulations can be found in 21 NYCRR, Part 2604.
(b) This Part applies to all public water systems in New York State seeking or receiving financing from the fund and to the activities of the department in the discharge of its duties related to the fund.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-10 APPENDICES
10 CRR-NY 128-10.3 Tests for analytical determination of concentrations of elements
The following tests and methods are used by the department in assessing the impacts of a regulated activity on a reservoir, reservoir stem or controlled lake. An applicant may conduct sampling in waters owned by the city as set forth herein with prior authorization by the department.
(a) Collection of samples and assessment of impacts.
(1) In conducting tests or making analytical determinations to ascertain conformity or nonconformity with the standards set forth in Subpart 128-4 of this Part, samples should be collected from locations which are representative of the general quality of water in the watercourse, reservoir, reservoir stem or controlled lake.
(2) In assessing the impact of a proposed regulated activity on a watercourse, reservoir, reservoir stem, or controlled lake, or in determining compliance with the standards set forth in Subpart 128-4 of this Part, the department will examine the impacts of the proposed activity throughout the year and the impacts on the photic, metalimnion and hypolimnion zones of the reservoir, reservoir stem or controlled lake.
(3) Impacts on reservoirs will be determined on the basis of samples taken on a schedule which is sufficient to reflect temporal variability and to meet regulatory requirements.
(4) Sampling locations in reservoirs will include: dams, intakes, mid-pool stations, and main tributaries into each reservoir. At every station, an integrated sample of the photic zone shall be taken. At deeper stations, samples will be collected from the metatimnion and hypolimnion.
(5) Reservoir stem samples should be collected in the section of the reservoir stem that is free-flowing and unimpeded by the reservoir when the impoundment is at full pool elevation.
(b) Tests and analytical determinations. Tests or analytical determinations to determine compliance or noncompliance with the water quality standards in Subpart 128-4 of this Part should be made in accordance with:
(1) Standard Methods for the Examination of Water and Wastewater , 12th edition, 1965, Table 18, Qualitative Description of Odors, page 306. American Public Health Association, American Water Works Association, and Water Pollution Control Federation, 2626 Pennsylvania Avenue NW, Washington, DC 20037.
(2) Standard Methods for the Examination of Water and Wastewater , 18th edition, 1992, American Public Health Association, American Water Works Association, and Water Environment Federation, 2626 Pennsylvania Avenue NW, Washington, DC 20037.
(3) Methods for Chemical Analysis of Water and Wastes , 1979, Environmental Protection Agency (EPA), Superintendent of Documents, US Government Printing Office, Washington, DC 20402; and
(4) By other methods approved by the commissioner as giving results equal or superior to methods listed in any of the above documents.
(c) All materials referenced in this Subpart are available for inspection and copying at the New York State Department of Health, Office of Regulatory Affairs, Corning Tower, Room 2415, Empire State Plaza, Albany, NY, 12237, and the Department of Environmental Protection, 465 Columbus Avenue, Valhalla, NY 10595.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.2 Requirements for attendance at an institution
(a) No institution shall permit any student to attend such institution unless the student has furnished to the institution the documentation in subdivision (b), (c), (d), or (e) of this section.
(b) A certificate of immunization that shows the student has:
(1) either:
(i) received two doses of live measles virus vaccine, the first dose administered after the age of 12 months and the second dose administered more than 30 days after the first dose but after 15 months of age; or
(ii) been diagnosed by a physician as having had measles disease; or
(iii) demonstrated serological evidence of measles antibodies; or
(iv) if the student is unable to provide a certificate of immunization that satisfies the requirements in subparagraph (i), (ii) or (iii) of this paragraph, documentation that proves the student attended primary or secondary school in the United States after 1980 will be sufficient proof that the student received one dose of live measles virus vaccine. If such documentation is provided, then the student must also provide a certificate of immunization that documents a dose of measles vaccine was administered within one year prior to attendance at the post-secondary institution; and
(2) either:
(i) received a single dose of live rubella virus vaccine administered after the age of 12 months; or
(ii) demonstrated serological evidence of rubella antibodies; and
(3) either:
(i) received a single dose of live mumps virus vaccine administered after the age of 12 months; or
(ii) been diagnosed by a physician as having had mumps disease; or
(iii) demonstrated serological evidence of mumps antibodies:
(c) A certificate of immunization that shows the student is in the process of completing the requirements of subdivision (b) of this section and:
(1) has received at least one dose of live measles virus vaccine as required in subdivision (b); and
(2) has complied with the requirements in subdivision (b) of this section for mumps and rubella; and
(3) has an appointment to return to a health practitioner for the remainder of the immunizations specified in subdivision (b), if this appointment is scheduled no more than 90 days since administration of the first dose of measles virus vaccine.
(d) If any licensed physician, licensed midwife (caring for a pregnant student), or nurse practitioner certifies in writing that one or more of the required immunizations may be detrimental to the student's health or is otherwise medically contraindicated, the requirements of subdivisions (b) and (c) of this section shall be waived until such immunization is determined no longer to be detrimental to the student's health or otherwise medically contraindicated. This statement must specify those immunizations which may be detrimental and the length of time they may be detrimental.
(e) A written and signed statement from the student or in the event that the student is a minor, from their parent or guardian, that they hold sincere and genuine religious beliefs which prohibit immunization of the student. When a religious exemption is claimed, the institution may require supporting documents.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.3 Continuity of activity
[ 1120 ] A basic reporting concept is that of continuity of activity, or the going concern. The assumption is that the hospital will continue to function indefinitely. It then becomes necessary to divide the life of the hospital into reporting periods, to determine revenues earned and expenses incurred during each period and to measure the amounts of assets and obligations at the end of each period.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.6 Wastewater treatment plants
(a) Minimum requirements.
(1) Unless otherwise permitted by these rules and regulations, the design, construction, or operation of a wastewater treatment plant is prohibited where such design, construction, or operation causes a discharge, or storage which is reasonably likely to lead to a discharge, of sewage or sewage effluent into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
(2) The design of new wastewater treatment plants, and the plans and specifications resulting from that design, require the review and approval of the department. The construction of new wastewater treatment plants shall be in conformance with the plans and specifications approved by the department.
(3) The design for an expansion or an alteration or modification of new or existing wastewater treatment plants, and the plans and specifications resulting from that design, require the review and approval of the department. The construction of the expansion or alteration or modification shall be in accordance with the plans and specifications approved by the department.
(4) The owner or operator of a new or existing wastewater treatment plant shall operate and maintain the wastewater treatment plant in accordance with the operations and maintenance manual for the plant. Such manual shall be prepared by the owner and approved by the department.
(5) No new wastewater treatment plants with a surface discharge, or expansion or alteration or modification of new or existing wastewater treatment plants, shall cause a contravention of the water quality standards set forth in Subpart 128-4 of this Part or the phosphorus water quality values set forth in the New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.1.1, Ambient Water Quality Standards and Guidance Values (October 22, 1993).
(6) No part of any seepage unit or absorption field for a subsurface discharge from a wastewater treatment plant shall be located within the limiting distance of 100 feet of a watercourse or wetland or within the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake.
(7) Wastewater treatment plants with surface discharges into the watershed shall be capable of achieving 99.9 percent removal and/or inactivation of Giardia lamblia cysts and 99.99 percent removal and/or inactivation of enteric viruses.
(8) Wastewater treatment plants with either surface or subsurface discharges within the watershed shall provide phosphorus removal using the best treatment technology so that the wastewater treatment plant is designed to be operated and maintained to meet the following requirements:
| SPDES Permitted | Total | | --- | --- | | Total Flow | Phosphorus Limit | | (gallons/day) | (mg/l) | | ≤50,000 | 1.0 | | >50,000 and <500,000 | 0.5 | | ≥500,000 | 0.2 |
(9) Wastewater treatment plants with surface discharges to intermittent streams in the watershed shall be operated and maintained to meet the intermittent stream effluent limits set forth in the New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.3.1, Total Maximum Daily Loads and Water Quality-Based Effluent Limits (July 8, 1996) and New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.3.1B, Total Maximum Daily Loads and Water Quality-Based Effluent Limits, Amendments-Low and Intermittent Stream Standards (July 8, 1996), provided however, that the effluent limit for a discharge of a pollutant to an intermittent stream shall in no case be less stringent than the effluent limit which would apply to the same discharge of the pollutant to the first downstream perennial stream.
(10) Within one year of the effective date of these rules and regulations, the owners of all existing wastewater treatment plants shall submit to the department for review and approval an operations and maintenance plan and a schedule setting forth a plan for bringing the wastewater treatment plant into compliance with all of the requirements of this section. Any such plan that is disapproved by the department shall be revised and resubmitted to the department for review and approval within 90 days after the initial disapproval. Owners of existing wastewater treatment plants must secure final department approval of such operation and maintenance plans and such a schedule setting forth a plan for bringing the plant into compliance by no later than 18 months from the effective date of these rules and regulations, and must complete all work in order for such plants to be brought into compliance with the requirements of this section by no later than five years from the effective date of these rules and regulations or any extended period of time approved by the department upon good cause shown.
(11) Existing wastewater treatment plants with surface discharges are prohibited from expanding if they are located in an area where new wastewater treatment plants with surface discharges are prohibited by these rules and regulations. This paragraph shall not apply to existing wastewater treatment plants which discharge subsurface or the expansion of existing wastewater treatment plants where the expanded portion discharges subsurface.
(12) Existing wastewater treatment plants with surface discharges may expand if they are located in an area where new wastewater treatment plants with surface discharges are allowed by these rules and regulations. The plans submitted to expand the wastewater treatment plant shall meet all of the requirements of this section.
(13) Existing wastewater treatment plants with subsurface discharges may expand. The expanded portion of such wastewater treatment plants shall meet all of the design standards and other requirements of this section.
(14) Any approval of a new or expanded wastewater treatment plant issued by the department shall expire and thereafter be null and void unless construction is completed within five years of the date of issuance of such approval or any extended period of time approved by the department upon good cause shown. Following expiration of the approval, the plans for the wastewater treatment plants may be resubmitted to the department for consideration for a new approval.
(b) Requirements for wastewater treatment plants located within phosphorus restricted basins. No new wastewater treatment plants with surface discharges, or expansions of existing wastewater treatment plants with surface discharges, shall be allowed in a phosphorus restricted basin. A variance from this provision may be sought in accordance with the requirements set forth in section 128-6.1(d) of this Part.
(c) Requirements for wastewater treatment plants local coliform restricted basins. No new wastewater treatment plants with surface discharges, or expansions of existing wastewater treatment plants with surface discharges, shall be allowed in a coliform restricted basin. A variance from this provision may be sought in accordance with the requirements set forth in section 128-6.1(d)(1) of this Part.
(d) Treatment requirements for wastewater treatment plants located within the 60-day travel time to intake.
(1) The map indicating the demarcation line for the watershed areas that are located within the 60-day travel time to intake appears in section 128-10.1 of this Part. Large detailed maps of such areas are available to be reviewed by the public during business hours at the regional offices listed in section 128-1.5 of this Part.
(2) Within the 60-day travel time to the intake the following requirements are applicable:
(i) new wastewater treatment plants with surface discharges, or expansions of existing wastewater treatment plants with surface discharges, are prohibited;
(ii) existing wastewater treatment plants with SPDES permitted surface discharges may continue to operate provided the treated effluent is also subject to sand filtration, disinfection, phosphorus removal, and microfiltration or a department-approved equivalent technology to microfiltration, as required by these rules and regulations;
(iii) new and existing wastewater treatment plants with subsurface discharges may commence or continue to operate provided that the treated effluent is also subject to sand filtration and phosphorus removal, and for SPDES permitted discharges greater than 30,000 gallons per day (gpd), disinfection, as required by these rules and regulations.
(e) Treatment requirements for wastewater treatment plants located in the watershed and beyond the 60-day travel time to intake.
(1) The map indicating the demarcation line for the watershed areas that are located beyond the 60-day travel time to intake appears in section 128-10.1 of this Part. Large detailed maps of such areas are available to be reviewed by the public during business hours at the regional offices listed in section 128-1.5 of this Part.
(2) Beyond the 60-day travel time to the intake the following requirements are applicable:
(i) new wastewater treatment plants with surface discharges into a reservoir, reservoir stem, controlled lake, or wetland are prohibited;
(ii) all new surface discharges into a watercourse, and any existing wastewater treatment plants with SPDES permitted surface discharges may commence or continue to operate, provided that the treated effluent is also subject to sand filtration, disinfection, phosphorus removal, and microfiltration or a department-approved equivalent technology to microfiltration, as required by these rules and regulations;
(iii) new and existing wastewater treatment plants with subsurface discharges may commence or continue to operate, provided that the treated effluent is also subject to sand filtration, phosphorus removal, and for SPDES permitted discharges greater than 30,000 gallons per day (gpd), disinfection, as required by these rules and regulations.
(f) Design, operation and maintenance requirements.
(1) This subdivision shall apply to new and existing wastewater treatment plants.
(2) The criteria used by the department to approve the design for any new wastewater treatment plant or the portion of any new or existing wastewater treatment plant which is being expanded or altered or modified shall be all applicable requirements of law, including the standards set forth in the following documents:
(i) “Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities,” New York State Department of Environmental Conservation (1988); and
(ii) “Recommended Standards for Wastewater Facilities,” Great Lakes—Upper Mississippi River Board of State Public Health and Environmental Managers (1990).
(3) The department shall not approve a wastewater treatment plant, or any proposed expansion of a wastewater treatment plant, which discharges within the watershed, if there is inflow or infiltration into a sewerage system connected to such wastewater treatment plant which causes either:
(i) the State authorized flow limit of the wastewater treatment plant to be exceeded; or
(ii) the strength of the sewage influent to the wastewater treatment plant to be diluted to a level that adversely affects the efficacy of the State permitted and department approved treatment process.
(4) The department shall not approve a wastewater treatment plant, or any proposed expansion of a wastewater treatment plant, if there is an indication of exfiltration from a sewerage system connected to such wastewater treatment plant.
(5) All wastewater treatment plants shall meet the following requirements to insure uninterrupted reliable operation:
(i) all wastewater treatment plants shall provide standby power units sufficient to run the entire plant in order to ensure uninterrupted reliable operation in the event of utility power failure and these units shall be equipped with an alarm and automatic start-up capability;
(ii) all vital plant structures, mechanical and electrical equipment of new or existing wastewater treatment plants located or designed within the 100-year flood plain shall be protected from damage from a 100-year flood that may affect or disrupt its function or general performance. Such structures and equipment shall remain fully operational in a 25-year flood.
(iii) the disinfection system shall be provided with backup units, an alarm and equipment that will insure processing of the plant flow without interruption and the backup electrical and/or mechanical equipment shall be equipped with automatic start-up capability.
(iv) in wastewater treatment plants with a SPDES permitted surface discharge of 50,000 gpd or less, there shall be a minimum of two sand filters, each rated to handle the full plant flow. In wastewater treatment plants with a SPDES permitted surface discharge greater than 50,000 gpd, there shall be a minimum of three sand filters, each rated to handle one-half of the full plant flow;
(v) all wastewater treatment plants must be equipped with a flow meter that includes a recording device; and
(vi) all alarm systems shall require telemetering to a central location with around the clock operator presence or, in the alternative, to an operator's residence so that a response shall be initiated immediately.
(6) The following requirements shall apply to all wastewater treatment plants with subsurface discharges or absorption fields located in the watershed:
(i) the loading rate to the absorption trench may be 25 percent greater than that required under the design standards listed in paragraph (2) of this subdivision;
(ii) an additional area of at least 50 percent of the absorption field area shall be set aside as a reserve field area;
(iii) at a minimum, one percolation and one deep hole test shall be performed in both the primary absorption field area and in the reserve absorption field area. An applicant shall notify the department in writing at least seven business days prior to performance of such tests, and specify the location and the time of the tests. At the option of the department, a department representative may witness these tests; and
(iv) the use of pumping, mechanical dosing or other mechanical devices requires a pump chamber equipped with an alarm to indicate malfunction, a backup pump, and any other safety features required by the department to prevent overflow.
(7)
(i) All owners or operators of department approved wastewater treatment plants in the watershed shall, prior to commencement of construction of such wastewater treatment plants, deposit with the department a performance bond for the completion of the construction of the wastewater treatment plant and an additional bond or other guaranty for the payment of labor and material furnished in the course of such construction. Upon completion of construction and payment of labor and materials, such bonds or other guaranties shall be released. Additionally, prior to commencement of operation of the approved wastewater treatment plant, the owners or operators of the approved wastewater treatment plant shall provide a surety bond, or a reasonable guaranty, that they shall continue to maintain and operate the system for a period of five years. The surety bond or guaranty shall be in an amount sufficient to insure the full and faithful performance by the owners or operators of the wastewater treatment plants, and their successors and assigns, with regard to their obligation to properly maintain and operate the wastewater treatment plants in accordance with all requirements of law and according to the conditions set by the department in its approval; provided, however, that such surety bond or guaranty shall not be required by the department where the owners or operators of the wastewater treatment plant have provided a surety bond or guaranty for the maintenance and operation of the wastewater treatment plant to the local governing body, in an amount necessary to insure the full and faithful performance of the operation and maintenance of the wastewater treatment plant; provided further, that such surety bond or guaranty shall not be required where the owner or operator of the wastewater treatment plant is a village, town, county or city. The commissioner may, at his or her discretion, increase the amount of such surety bond or guaranty, but not to exceed an amount necessary to insure the full and faithful performance of the operation of the wastewater treatment plant. All such bonds shall be prepared on the forms of bonds authorized by the City of New York and shall have as a surety such company or companies that shall be approved by the City of New York and are authorized to do business in the State of New York.
(ii) The commissioner may authorize the provision of other security, including cash, if the commissioner finds that compliance with the bond requirement is not reasonably possible and the public interest would be served by such authorization. The alternative security shall be deposited with the Comptroller of the City of New York.
(iii) Whenever an owner or operator of a wastewater treatment plant deposits securities or other obligations with the City of New York, in lieu of a performance bond, it shall be with the understanding that the Comptroller of the City of New York, or his or her successors, may sell and use the proceeds thereof for any purpose for which the principal or surety on such bond would be liable under the terms of the approval. If money is deposited with the comptroller, the owner or operator of the wastewater treatment plant shall not be entitled to receive interest on such money from the City of New York.
(8) The transfer of any approval or permit issued by the department for the construction and/or operation of any wastewater treatment plant shall require department approval. The department shall approve such transfer provided that the transferee demonstrates sufficient financial, technical, and professional capability to construct, operate and/or maintain the subject wastewater treatment plant in compliance with applicable laws, as cited in paragraph (a)(1) of this section, the provisions of these rules and regulations, and the terms and conditions of any approval or permit granted by the department.
(g) Application requirements.
(1) An application for review and approval of a new wastewater treatment plant shall include the following information:
(i) a department application form and an environmental assessment form (EAF long form);
(ii) a facility plan which shall include: a description of the project, flow and waste load estimations, site characteristics, evaluation of existing system, if applicable, and existing local or related facilities, including any related water quality problems, examination of the project service area, estimation of growth, examination of alternative solutions and explanation of why the proposed option was chosen, analysis of potential impacts, analysis of hydraulic and organic capacities (including waste assimilation capacity analysis), description of unit processes and explanation of sizing, operation under emergency conditions, and sludge processing, storage and disposal methods, estimation of costs, proposed financing methods and anticipated user fees, outline of operation and maintenance requirements (including cost projections), and regulatory review and permitting requirements;
(iii) an engineering plan which shall include: location plan, site plan, schematic of plant hydraulic profile, piping schematic, location, dimension and elevations of plant process units and appurtenances, mechanical system layout, electrical system layout, and erosion and sediment control and stormwater management plan.
(iv) construction specifications, including material and equipment specifications;
(v) construction schedule;
(vi) in cases where a draft environmental impact statement (“DEIS”) is to be prepared for an activity and the DEIS complies with the requirements of article 8 of the Environmental Conservation Law and the regulations promulgated thereunder, and includes the information required in this Part, the DEIS may constitute all or part of the application for review and approval under this Part. In such case the applicant will provide the department with notice and a copy of the DEIS; however, no approval shall be issued by the department prior to review of the FEIS and issuance of a finding to approve; and
(vii) a copy of the draft SPDES permit, if any, and, when issued, a copy of the final SPDES permit. Copies of any revisions to the draft SPDES permit shall also be provided to the department as they become available to the applicant.
(2) An application for review and approval of an expansion or of an alteration or modification of a new or existing wastewater treatment plant shall include all of the information required in paragraph (1) of this subdivision where applicable, and shall either:
(i) certify that the wastewater treatment plant is in compliance with all of the requirements of this section, and all requirements of its SPDES permit; or
(ii) certify that a schedule for the wastewater treatment plant to come into compliance with the requirements of this section and with the requirements of its SPDES permit has been submitted to the department for approval. A copy of such compliance schedule shall be attached to the application.
(3) An application for review and approval of a plan for bringing an existing wastewater treatment plant into compliance with the requirements of this section shall include the operation and maintenance manual for the wastewater treatment plant.
(4) All approvals for new or expansion of existing wastewater treatment plants are conditioned on the applicant's submission of record drawings and an operation and maintenance manual once construction is complete.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-1.183 Animals
Live animals, including birds and turtles, are to be excluded from food service operations. This exclusion does not apply to edible fish, crustacea, shellfish, or to fish in aquariums. Patrol dogs accompanying security police officers or guide dogs accompanying blind persons are permitted in the dining area.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-5 PURCHASING AND CONTRACTING
10 CRR-NY 88-5.2 Requirements
(a) For contracts for the purpose of services and commodities that exceed the discretionary buying thresholds and require a formal competitive process under the State Finance Law, and, under Public Health Law, section 409-c(4)(b), do not require approval by the State Comptroller.
(1) The facility shall follow a formal competitive process, maintain a procurement record, publish notices in the State's procurement opportunities newsletter and meet the requirements for the letting of contracts, in accordance with the State Finance Law, Economic Development Law and the State Procurement Council Procurement Guidelines.
(2) Every bid solicitation, including invitations for bid and requests for proposals, shall:
(i) prescribe the minimum specifications or requirements that must be met in order to be considered responsive, including the legal requirements in appendix A of the State Procurement Council Procurement Guidelines;
(ii) describe other specifications or requirements that constitute the technical criteria for the procurement, including, as applicable, the general specifications in appendix B of the State Procurement Council Procurement Guidelines;
(iii) describe and disclose the general manner in which the evaluation and selection shall be conducted;
(iv) provide that the facility may require clarification from offerers for purposes of assuring a full understanding of responsiveness to the solicitation requirements;
(v) provide that revisions may be permitted from all offerers determined to be susceptible of being selected for contract award, prior to award; and
(vi) provide that separable portions of offers may be rejected.
(3) For the purchase of services, every bid solicitation shall identify the relative importance and/or weight of cost and the overall technical criterion to be considered by the facility in its determination of best value.
(4) Further requirements regarding these procurements are as defined in the department's administrative policy and procedures manual.
(b) For single or sole source procurements for services or commodities or procurements made to meet emergencies arising from unforeseen causes, which, under Public Health Law, section 409-c(4)(b), do not require approval by the State Comptroller:
(1) The facility shall meet all applicable requirements for the letting of contracts and shall document in the procurement record the bases for a determination to purchase from a single source or sole source, or the nature of the emergency giving rise to the procurement.
(2) For single source procurements, the facility shall document in the procurement record the circumstances leading to the selection of the vendor, including the alternatives considered, the rationale for selecting the specific vendor and the basis upon which it determined the cost was reasonable.
(3) Further requirements regarding these procurements are as defined in the department's administrative policy and procedures manual.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS DISPENSING TO ADDICTS AND HABITUAL USERS, AND TREATMENT PROGRAMS
10 CRR-NY 80.84 Practitioners and pharmacies; prescribing, administering and dispensing for the treatment of narcotic addiction
Pursuant to the provisions of the Federal Drug Addiction Treatment Act of 2000 (DATA 2000) (106 P.L. 310, div. B, title XXXV, section 3502[a]), an authorized practitioner may prescribe, administer or dispense an approved controlled substance, and a licensed registered pharmacist may dispense an approved controlled substance, to a patient participating in an authorized controlled substance maintenance program approved pursuant to article 32 of the Mental Hygiene Law for the treatment of narcotic addiction.
(a) An approved controlled substance shall mean the following controlled substance which has been approved by the Food and Drug Administration (FDA), or its successor agency, and the New York State Department of Health for the treatment of narcotic addiction:
(1) buprenorphine.
(b) An authorized practitioner is a practitioner specifically registered with the Drug Enforcement Administration to prescribe, administer or dispense an approved controlled substance for the treatment of narcotic addiction, and approved for such purpose pursuant to the provisions of article 32 of the Mental Hygiene Law.
(1) The total number of such patients of an authorized practitioner at any one time shall not exceed the limit established by DATA 2000 and the Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), or its successor agency.
(2) An authorized practitioner prescribing an approved controlled substance for the treatment of narcotic addiction, in addition to preparing and signing an official New York State prescription or an electronic prescription in accordance with section 3332 of the Public Health Law and section 80.69 of this Part, shall also include his/her unique DEA identification number on the prescription.
(3) An authorized practitioner may dispense an approved controlled substance for the treatment of narcotic addiction in accordance with section 3331 of the Public Health Law and section 80.71 of this Part.
(c) A pharmacist may dispense an approved controlled substance for the treatment of narcotic addiction pursuant to a prescription issued by an authorized practitioner. Such dispensing shall be in accordance with section 3333 of the Public Health Law and section 80.74 of this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.4 Contents of reports; procedures
(a) Reports of physical abuse, mistreatment or neglect made pursuant to this Part shall be made immediately by telephone and followed within 48 hours in writing to the New York State Department of Health, Office of Health Systems Management.
(b) The New York State Department of Health, Office of Health Systems Management shall maintain at all times a toll-free telephone line for the receipt of such reports.
(c) Written reports shall be made on forms supplied by the commissioner and shall include the following information: the identity of the person making the report and where he or she can be located; the name and address of the residential health care facility; the names of the operator and administrator of the facility, if known; the name of the subject of the alleged physical abuse, mistreatment or neglect, if known; the name of the person accused of committing the alleged physical abuse, mistreatment or neglect, if known; the nature and extent of the physical abuse, mistreatment or neglect; the date, time, and specific location of the occurrence; the names of next of kin or sponsors of the subject of the alleged physical abuse, mistreatment or neglect, if known; and any other information which the person making the report believes would be helpful to further the investigation. Written reports made other than on forms supplied by the commissioner which contain the information required herein shall be treated as if made on such forms. Such written reports shall be admissible in evidence, consistent with the provisions of this Part, in any actions or proceedings relating to physical abuse, mistreatment or neglect of persons receiving care or services in residential health care facilities.
(d) In any case where more than one person (as enumerated in section 2803-d of the Public Health Law) is required to report by law, a single telephone report followed by a single written report (as specified in subdivision [c] of this section) containing the names and signatures of those persons required to report will serve as proof that those persons required to report have complied.
(e) Each facility shall make available in a conspicuous public place such forms (as specified in subdivision [c] of this section) to patients, staff and visitors.
(f) Each facility shall be required to post conspicuously a poster, provided by the New York State Department of Health, Office of Health Systems Management, containing information regarding the filing of reports of physical abuse, mistreatment or neglect.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.5 Responsibilities of home care services entities
(a) A home care services entity will have the following responsibilities with respect to home care services workers employed on or after September 25, 2009:
(1) For any home care services worker who began their training on or after September 25, 2009, a home care services entity shall access the worker’s registry information prior to the worker beginning to provide home care services for that entity.
(2) A person who successfully completed a state approved education or training program for home health aides or personal care aides that began on or after September 25, 2009, may not provide home care services unless the person’s information has been posted to the registry by the education or training program.
(3) Within 10 business days after the worker has been employed by the home care services entity, enter the information required by section 3613(3)(f) of the Public Health Law into the registry in the form and manner required by the department.
(4) A person who successfully completed a State approved education or training program for advanced home health aides may not provide advanced home health aide services unless the person's information has been posted to the registry by the department.
(5) For all home care services workers who successfully completed training before September 25, 2009, prior to the worker beginning to provide home care services, a home care services entity must access the worker’s registry information. If the worker is not yet listed in the registry, the entity shall, prior to the individual beginning to provide home care services:
(i) obtain the information required by section 3613(3)(a)-(f) of the Public Health Law from the home care services worker;
(ii) obtain a copy of the certificate issued to the prospective employee by the State-approved training program; and
(iii) enter the information required by Public Health Law section 3613(3)(a)-(f) into the registry.
(6) Within 10 business days after the home care services worker begins to provide home care services, update the registry information to show the worker’s employment with the entity, including the start date.
(7) Within 10 business days after receiving information from a home care services worker that is not in the registry, update the registry to include the new or updated information. If the updated information is a change of name, obtain and retain documentation of the change as provided in section 403.6(a)(4) of this Part.
(8) Within 10 business days after a home care services worker’s employment with the entity is terminated, update the registry with the date on which the worker’s employment with the entity was terminated.
(9) Upon request of any home care services worker currently employed by the entity, provide access to complete registry information relating to the employee, including a printed report if requested.
(10) Within 10 business days after a request by a home care services worker, correct information in the registry that was entered incorrectly by the entity. An entity must request verification from the worker supporting the correction. If the correction involves a change of name, obtain and retain documentation of the change as provided in section 403.6(a)(4) of this Part.
(b) For every home care services worker who was employed by a home care services entity as of September 25, 2009, the home care services entity shall, on a schedule provided by the department, enter all of the information required by section 3613(3)(a)-(f) of the Public Health Law on the registry with respect to such workers.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 700 GENERAL
10 CRR-NY 700.2 Definitions.*
(a) The following definitions of medical facilities, based on standards approved by the commissioner, shall apply to this Chapter unless the context otherwise requires:
(1) Accredited hospital or other accredited medical facility , as defined in article 28 of the Public Health Law, shall mean a hospital or facility which has been accredited by an accreditation agency to which the Centers for Medicare and Medicaid Services has granted deeming status and which the commissioner has determined has accrediting standards sufficient to assure the commissioner that hospitals or facilities so accredited are in compliance with operational standards under this Chapter.
(2) Emergency room or department shall mean a designated area of a hospital that includes one or more reception and treatment rooms appropriately staffed and equipped to provide prompt and efficient care of emergency patients in accordance with the provisions of Subchapter C of this Chapter.
(3)
(i) Existing hospital or other existing medical facility shall mean a facility which, on the day prior to the effective date of this subparagraph, had a valid operating certificate under article 28 of the Public Health Law.
(ii) New hospital or other new medical facility shall mean that physical area included in a project for which, both on and after the effective date of this subparagraph, an application is submitted under provisions of Part 710 of Subchapter B of this Title, and which encompasses any or all of the following:
(a) change in scope of services of an existing facility;
(b) acquisition of a physical plant, which was not previously operated as a health care facility for the same level of care, as is proposed;
(c) acquisition of property and construction of a new physical plant;
(d) construction of a new physical plant on property already owned by an established facility;
(e) renovations and/or alterations to an existing facility, which involve:
(1) major physical and/or structural changes;
(2) major fixed equipment changes, other than replacements;
(3) the classification as a new medical facility shall be limited only to those sections and/or wings of an existing facility, for which such renovation, alterations and/or equipment changes are approved;
(f) one or more additions to an existing facility. The classification as a new medical facility shall be limited to the additions.
(iii) The provisions of clause (ii)( e ) of this paragraph shall not apply to an existing hospital or medical facility, as defined by subparagraph (i) of this paragraph which does not meet the minimum requirements of sections 711.4, 711.5, 711.6, 711.7 and 711.8 of this Title, because of life safety, structural, physical, mechanical and/or electrical deficiencies, and which is approved to perform such alterations, renovations and/or fixed equipment changes as are necessary to achieve compliance with the aforementioned sections.
(4) Health-related facility shall mean a facility, institution, intermediate care facility, or a separate or distinct part thereof, providing therein lodging, board and social and physical care, including but not limited to the recording of health information, dietary supervision and supervised hygienic services incident to such care to six or more residents not related to the operator by marriage or by blood within the third degree of consanguinity.
(5) Hospital shall mean an institution with beds for one or more inpatients not related to the operator which is primarily engaged in providing services and facilities to inpatients by or under the supervision of a physician, and which meets the following requirements:
(i) provides diagnostic and therapeutic services for medical diagnosis, treatment and care of injured and sick persons and has, as a minimum, laboratory and radiology services and organized departments of medicine and surgery;
(ii) has an organized medical staff which may include, in addition to doctors of medicine, doctors of osteopathy and dentistry;
(iii) has bylaws, rules and regulations pertaining to standards of medical care and service rendered by its medical staff;
(iv) maintains medical records for all patients;
(v) has a requirement that every patient be under the care of a member of the medical staff;
(vi) provides 24-hour patient services;
(vii) has in effect a written, currently applicable utilization review plan, acceptable to the department, which provides for utilization review studies designed to evaluate the appropriateness of admissions to the hospital, lengths of stay, discharge practices, use of medical and hospital services and all related factors which may contribute to the efficient provision of hospital and physician services;
(viii) has in effect agreements with a home health agency for referral and transfer of patients to home health agency care when such service is appropriate to meet the patient's requirements.
(6) Home care services agency shall mean an organization primarily engaged in arranging and/or providing, directly or through contract arrangement, one or more of the following: nursing services, home health aide services, advanced home health aide services, medical supplies, equipment and appliances, and other therapeutic and related services which may include, but shall not be limited to, physical and occupational therapy, speech pathology, nutritional services, medical social services, personal care services, homemaker services and housekeeper services which may be of a preventive, therapeutic, rehabilitative, health guidance and/or supportive nature to persons at home.
(7) Certified home health agency shall mean a home care services agency which possesses a valid certificate of approval issued pursuant to the provisions of article 36 of the Public Health Law, or a residential health care facility or hospital possessing a valid operating certificate issued under article 28 of the Public Health Law which is authorized under article 36 to provide a long term home health care program. Such an agency or program must participate as a home health agency under the provisions of titles XVIII and XIX of the Federal Social Security Act.
(8) Long term home health care program shall mean a coordinated plan of care and services provided at home to invalid, infirm or disabled persons who are medically eligible for placement in a hospital or residential health care facility, and who would require such placement for an extended period of time if such program were unavailable.
(i) Such program shall be provided in the person's home or in the home of a responsible relative or other responsible adult.
(ii) Such program shall be provided in adult care facilities, other than shelters for adults, certified pursuant to section 460-b of the Social Services Law, provided that the person meets the admission and continued-stay criteria for such facility. Services provided by the program shall not duplicate or replace those which the facility is required by law or regulation to provide.
(iii) Approved long term home health care program providers may include, as part of their long term home health care program, upon approval by the commissioner, a discrete AIDS home care program as defined in this section.
(iv) A long term home health care program that does not obtain authorization to provide an AIDS home care program shall not be precluded from providing services within its existing authority to patients who are diagnosed as having AIDS, or are deemed by a physician, within his judgment, to be infected with the etiologic agent of acquired immune deficiency syndrome, and who have an illness, infirmity or disability which can be reasonably ascertained to be associated with such infection.
(9) The terms treatment center and diagnostic center shall mean a medical facility with one or more organized health services not part of an inpatient hospital facility or vocational rehabilitation center primarily engaged in providing services and facilities to out-of-hospital or ambulatory patients by or under the supervision of a physician or, in the case of a dental service or dispensary, of a dentist, for the prevention, diagnosis and, in the case of a treatment center, treatment of human disease, pain, injury, deformity or physical condition, not including the individual or group private practice of medicine.
(10) Narcotic addiction rehabilitation center shall mean an institution with beds for one or more inpatients, not related to the operator, which is primarily engaged in providing facilities and services by or under the supervision of a physician to patients addicted to narcotic drugs, and which meets the following requirements:
(i) provides rehabilitation services for individuals addicted to narcotic drugs, pursuant to the provisions of article 9 of the Mental Hygiene Law;
(ii) has an organized rehabilitation staff which shall include, but not be limited to, physicians, dentists and narcotic rehabilitation officers;
(iii) has rules and regulations pertaining to standards of rehabilitation services rendered by its rehabilitation staff approved by the department;
(iv) maintains medical and rehabilitation records for all clinical patients;
(v) provides 24-hour patient services; and
(vi) has in effect a utilization review plan approved by the department and an affiliation agreement with an accredited hospital for the provisions of those hospital services not provided by the center.
(11) Nursing home shall mean a facility, institution, or portion thereof, providing therein, by or under the supervision of a physician, nursing care and other health, health-related and social services as specified in this Chapter for 24 or more consecutive hours to three or more nursing home patients who are not related to the operator by marriage or by blood within the third degree of consanguinity, including, but not limited to, an infirmary section which is identifiable as a nursing home unit in a special area, wing or separate building of a public or voluntary home or of a general or special hospital.
(12) [ Reserved ]
(13) Outpatient department shall mean a hospital division or department primarily engaged in providing services for ambulatory patients, by or under the supervision of a physician, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition.
(14) Patient care unit or nursing unit shall mean a designated area, including a group of patient rooms with adequate supporting rooms, areas, facilities, services and personnel providing nursing care and management of patients, which is planned, organized, operated and maintained to function as a unit so as to encourage the efficient delivery of patient services and effective observation of and communication with patients.
(15) Multiphasic health screening facility shall mean a treatment center or diagnostic center wherein a battery of tests is performed for the purpose of discovering the presence or absence of clinical findings which may be indicators of early disease and which may provide physicians with a base line of clinical data useful in the medical care and follow-up of patients.
(16)-(18) [ Reserved ]
(19) Cardiac surgical center shall mean an inpatient care unit of a hospital which shall be approved as such by the department and shall be appropriately staffed and equipped to provide both diagnostic and surgical services.
(20) A cardiac diagnostic center shall mean an inpatient care unit of a hospital, approved by the department, which may exist independent of a complete cardiac surgical service. The diagnostic center shall be appropriately staffed and equipped to provide a full range of diagnostic services, including coronary arteriography and/or other cardiac invasive diagnostic procedures.
(21) Rural hospital shall mean any hospital as defined in this subdivision, which does no meet any of the absolute criteria of subparagraph (ii) of this paragraph and which, when assessed against the weighted criteria of subparagraph (i), achieves a total score greater than or equal to six points. Facilities which meet the definition are expected to develop appropriate linkages with hospitals providing a greater range of services and/or medical equipment. Identification as a rural hospital shall not be construed as diminishing the need for such planning efforts.
(i) Weighted criteria.
(a) Size. Facility size shall be measured by capacity as listed on the operating certificate. A certified capacity of 75 beds or less shall be worth 3 points; a certified capacity of greater than 75 and less than or equal to 100 beds shall be worth 2 points; a certified capacity of greater than 100 beds shall be worth 0 points.
(b) Population density. Population density shall be measured by use of the most recently used New York State Economic Development Board statistics. Location of the facility in a county which has a population density of 100 persons per square mile or less shall be worth 3 points; location in a county with a population density of greater than 100 and less than or equal to 150 persons per square mile shall be worth 2 points; location in a county with a population density of greater than 150 persons per square mile shall be worth 0 points.
(c) Facility budget. The size of the facility budget shall be measured by base year financial and statistical data submitted to the department pursuant to Subpart 86-1 of this Title. A budget of $6,500,000 or less shall be worth 2 points; a budget of greater than $6,500,000 but less than or equal to $7,500,000 shall be worth 1 point; a budget of greater than $7,500,000 shall be worth 0 points.
(d) Admissions. The number of admissions shall be measured by base year financial and statistical data submitted to the department pursuant to Subpart 86-1 of this Title. Total base year admissions of less than or equal to 4,000 shall be worth 2 points; total base year admissions of greater than 4,000 but less than or equal to 4,500 shall be worth 1 point; total base year admissions of greater than 4,500 shall be worth 0 points.
(ii) Absolute criteria. A facility which meets any of these criteria shall not be a rural hospital if:
(a) the facility is located in New York City, or in the counties of Monroe, Erie, Nassau, Suffolk, Albany, Westchester, Orange, Schenectady, Rensselaer, Onondaga and Oneida;
(b) the facility is the subject of an action by the commissioner seeking revocation, suspension, limitation or annulment of its operating certificate for structural or operational deficiencies;
(c) the commissioner has found, after considering public need, that suspension, limitation modification or revocation of the facility's operating certificate is consistent with the public interest in conservation of health resources;
(d) the facility is a specialty hospital; or
(e) the facility is located within five miles of an existing acute care unit.
(22) Part-time clinic site shall mean an ambulatory care program site operated less than 60 hours per month (as determined by the aggregate hours of program site operation) by a general hospital or a diagnostic or treatment center which is approved to operate part-time clinics. A part-time clinic site is a site other than the primary delivery site(s) listed on the primary facility's operating certificate; provided, however, that any health care services provided in elementary or secondary schools to students during regular school hours shall not qualify as part-time clinic sites under this Title.
(23) Hospice shall mean a coordinated program of home and inpatient care which treats the terminally ill patient and family as a unit, employing an interdisciplinary team acting under the direction of an autonomous hospice administration. The program provides palliative and supportive care to meet the special needs arising out of physical, psychological, spiritual, social and economic stresses which are experienced during the final stages of illness, and during dying and bereavement.
(24) Outpatient surgery is a service organized to provide those surgical procedures of less intensity than ambulatory surgery which are performed in an outpatient treatment room for patients at low risk, require minimal pre- and post-procedure observation and treatment, are not likely to be time-consuming or followed by complications, are not associated with a condition which would require hospitalization and includes those procedures listed in section 85.6 of this Title.
(25) Licensed home care services agency means a home care services agency issued a license pursuant to article 36 of the Public Health Law.
(26)
(i) AIDS home care program means a coordinated plan of care and services provided at home to persons who are medically eligible for placement in a hospital or residential health care facility and who:
(a) are diagnosed by a physician as having acquired immune deficiency syndrome (AIDS); or
(b) are deemed by a physician, within his judgment, to be infected with the etiologic agent of acquired immune deficiency syndrome, and who have an illness, infirmity or disability which can be reasonably ascertained to be associated with such infection.
Such program shall be provided by a long term home health care program specifically authorized pursuant to article 36 of the Public Health Law to provide an AIDS home care program; or an AIDS center, as defined in Part 405 of this Title, specifically authorized pursuant to article 36 of the Public Health Law to provide an AIDS home care program. Such program shall be provided in the person's home or in the home of a responsible relative, other responsible adult, adult care facilities specifically approved to admit or retain residents for such program, or in other residential settings as approved by the commissioner in conjunction with the Commissioner of Social Services. Such program shall provide services, including but not limited to the full complement of health, social and environmental services provided by long term home health care programs in accordance with regulations promulgated by the commissioner. Such programs shall also provide such other services as required by the commissioner to assure appropriate care at home for persons eligible under such program.
(ii) A long term home health care program that does not obtain authorization to provide an AIDS home care program shall not be precluded from providing services within its existing authority to patients who are diagnosed as having AIDS, or are deemed by a physician, within his judgment, to be infected with the etiologic agent of acquired immune deficiency syndrome, and who have an illness, infirmity or disability which can be reasonably ascertained to be associated with such infection.
(27) Hospice residence shall mean a hospice operated home which is residential in character and physical structure, and operated for the purpose of providing more than two hospice patients, but not more than 16 hospice patients, with hospice care.
(28) Dually certified hospice residence bed shall mean a bed located in a hospice residence that has been approved by the department to be used alternately for residential hospice care and inpatient hospice care.
(b) The following definitions of medical staff and paramedical personnel, based on standards approved by the commissioner, shall apply to this Chapter unless the context otherwise requires:
(1) Associate narcotic rehabilitation counsellor shall mean a person who:
(i) has a master's degree from a college or university approved by the Education Department; or
(ii) has had three years' experience, one year of which must have been in a supervisory capacity, in social casework, guidance counseling, vocational rehabilitation, or an appropriate subject-matter program in a social science field.
(2) Audiologist shall mean a person who is licensed as required by article 159 of the New York State Education Law.
(3) Auxiliary nursing personnel shall mean unlicensed, nonprofessional workers employed to assist registered professional nurses in hospitals.
(4) Dietician shall mean a person who has received a baccalaureate degree with major studies in food and nutrition from a college or university approved by the Education Department and is registered or is eligible for registration by The American Dietetic Association, or has the equivalent of such training and experience and who participates annually in continuing dietetic education.
(5) [ Reserved ]
(6) Full-time health officer shall mean the county, part-county or city health commissioner in cities of 50,000 population or over, or the district health officer, having jurisdiction in the geographic area in which the medical facility is located.
(7) Medical staff shall mean all physicians and dentists appointed by the governing authority and responsible to such authority for the adequacy and quality of the medical care rendered to patients in a medical facility.
(8) Narcotic rehabilitation chief officer shall mean a person who has a bachelor's degree from a college or university approved by the Education Department or holds a license as a registered professional nurse and has had two years' supervisory experience in custodial care of inmates or patients or who has four years' experience in professional nursing or custodial care of inmates or patients, two years of which must have been in a supervisory capacity.
(9) Home health aide shall mean a person who carries out health care tasks under the supervision of a registered nurse or licensed therapist and who may also provide assistance with personal hygiene, housekeeping and other related supportive tasks to a patient with health care needs in his/her home. Home health aides shall have successfully completed a basic training program in home health aide services or an equivalent exam approved by the department and possess written evidence of such completion.
(10) Nurse aide shall mean any nonlicensed or noncertified person who provides direct personal patient/resident services, including safety, comfort, personal hygiene or patient/resident protection services under the supervision of a registered professional nurse or licensed practical nurse in a residential health care facility.
(11) Occupational therapist shall mean a person who is registered with the American Occupational Therapy Association, or either a graduate of a program in occupational therapy approved by the Council on Medical Education of the American Medical Association in collaboration with the American Occupational Therapy Association or a graduate of a curriculum in occupational therapy which is recognized by The World Federation of Occupational Therapists and is eligible for registration with the American Occupational Therapy Association.
(12) Occupational therapy assistant shall mean a person who is certified by and currently registered with the New York State Education Department. When working in an occupational therapy program, approved by the department, the assistant must work under the supervision of an occupational therapist who is licensed by and currently registered with the New York State Education Department.
(13) Personal attendant shall mean a person who assists residents of a health-related facility with carrying out daily activities related to personal hygiene and social fellowship under satisfactory supervision.
(14) Personal care aide shall mean a person who, under professional supervision, provides patients assistance with nutritional and environmental support and personal hygiene, feeding and dressing and/or, as an extension of self-directed patients, selects health-related tasks. A personal care aide shall have successfully completed:
(i) a training program in home health aide services or equivalent exam as specified in paragraph (9) of this subdivision; or
(ii) one full year of experience in providing personal care services through a home care services agency within three years preceding the effective date of an initial license issued pursuant to article 36 of the Public Health Law: or
(iii) a training program in personal care services as specified in 18 NYCRR 505.14(a) and (e). A copy of 18 NYCRR 505.14(a) and (e) is available for inspection and copying at the offices of the records access officer, Department of Health, Corning Tower, Empire State Plaza, Albany; and
(iv) in those instances where the personal care aide is to be providing assistance with health-related tasks, such aide shall be trained as in subparagraph (iii) of this paragraph and training in health-related tasks shall be completed in full prior to the personal care aide's assignment to any patient, as evidenced by written documentation of such completion.
(15) Homemaker shall mean a person who meets standards established by the Department of Social Services and assists and instructs persons at home because of illness, incapacity or absence of a caretaker relative in managing and maintaining a household, dressing, feeding and incidental household tasks.
(16) Housekeeper shall mean a person who meets the standards established by the Department of Social Services and, in situations in which services of a trained homemaker are not required, does light work or household tasks for persons at home because of iilness, incapacity or the absence of a caretaker relative.
(17) Qualified hospital administrator shall mean a person who:
(i) holds a degree of doctor of medicine or a master's degree or its equivalent in hospital administration, public health, science, administrative medicine, or business administration when granted for a program in hospital administration, from a college or university approved by the Education Department or whose program is approved by the Association of University Programs of Hospital Administration, and has served a minimum of two years as the administrator, associate or assistant administrator of an accredited hospital or in health service administration acceptable to the commissioner; or
(ii) is a registered professional nurse who has served a minimum of three years as an administrator, associate or assistant administrator of an accredited hospital; or
(iii) holds a bachelor's degree from a college or university approved by the Education Department and has served a minimum of five years as an administrator, associate or assistant administrator in an accredited hospital; or
(iv) is, or has been prior to January 1, 1968, the administrator of a hospital, or has served a minimum of seven years as an associate or assistant administrator of a hospital with a valid hospital operating certificate; or, prior to February 1, 1966, the administrator of a hospital, or has served a minimum of seven years as an associate or assistant administrator of a hospital which would meet the standards for hospital certification.
(18) A community health nurse shall mean a nurse whose primary functions, under qualified nursing supervision, are to plan, provide, direct and evaluate nursing care in a variety of settings and offer instruction and guidance in health practice for individuals and families. Such nurse shall be licensed and currently registered and shall have the following additional qualifications:
(i) baccalaureate degree in nursing from an approved program; or
(ii) a baccalaureate degree in nursing from a nonapproved program supplemented by content which can be equated to the approved program; or
(iii) be a registered professional nurse with:
(a) a baccalaureate degree in a health or human services field; or
(b) two years' experience in home care.
(19) A supervising community health nurse shall mean a liensed and currently registered professional nurse whose primary functions are to supervise, instruct and guide nursing and auxiliary personnel in providing high quality nursing services. Such nurse shall have the following qualifications:
(i) a baccalaureate degree in nursing or a health or human services field and two years' experience in home care; or
(ii) the following combination of education, experience and/or training:
(a) four years' experience in home care; and
(b) six credit hours, or the equivalent, of education/training in public health and principles of management.
(20) Director of patient services shall mean a licensed and currently registered nurse who is responsible for clinical direction and supervision of patient care services. Such individual shall meet the following qualifications:
(i) two years as a supervising community health nurse; or
(ii) two years of home care nursing experience plus a masters degree in nursing, public health, business administration or another health-related field.
(21) Certified home health agency administrator shall mean a person who is responsible to the governing authority for the administrative operation of a certified home health agency and who meets the following minimum qualifications:
(i) is a licensed physician;
(ii) is a registered professional nurse; or
(iii) is a person who has training and experience in health services administration and at least one year of supervisory or administrative experience in home health care or related health programs.
(22) A certified registered nurse anesthetist or registered nurse anesthetist or nurse anesthetist shall mean a registered professional nurse licensed and currently registered with the New York State Education Department who:
(i) has satisfactorily completed a prescribed course of study in a school of nurse anesthesia accredited by the Council on Accreditation of Nurse Anesthesia Education Programs/Schools or other accrediting body which the commissioner finds to be substantially equivalent;
(ii) has passed the national certifying examination given by the Council on Certification of Nurse Anesthetists or other certifying examination which the commissioner finds to be substantially equivalent; and
(iii) is currently certified by the Council on Certification of Nurse Anesthetists or by the Council on Recertification of Nurse Anesthetists or other accrediting body which the commissioner finds to be substantially equivalent.
A registered professional nurse licensed and currently registered with the New York State Education Department who does not meet the requirements as set forth in subparagraphs (i), (ii) and (iii) of this paragraph, shall be permitted to continue the practice of nurse anesthesia only under the supervision of a qualified anesthesiologist until one year after the effective date of these regulations.
(23) Qualified radiation physicist shall mean a graduate physicist who has been certified, by the American Board of Radiology, by the American Board of Industrial Hygiene or by the American Board of Health Physics, as a qualified radiation physicist.
(24) Qualified social worker shall mean a person who holds a master's degree in social work after successfully completing a prescribed course of study at a graduate school of social work accredited by the Council on Social Work Education and the Education Department, and who is certified or licensed by the Education Department to practice social work in the State of New York. When employed by a certified home health agency, long-term home health care program or hospice, such social worker must have had one year of social work experience in a health care setting.
(25) Qualified specialist shall mean a physician who holds a current license to practice medicine in the State of New York, and who:
(i) is a diplomate of the appropriate American board or who has been certified as a specialist by the American osteopathic specialty board for the respective specialty; or
(ii) has been notified of admissibility to examination by such board, or presents evidence of completion of an approved qualifying residency in such specialty; or
(iii) holds the rank of attending or associate attending specialist in an accredited voluntary or governmental hospital which is approved for training in the specialty in which the physician has privileges; or
(iv) holds an appropriate specialist rating granted by the Workers' Compensation Board after May 1960, provided the award is based on training approved by the respective specialty board.
(26) Recreation assistant shall mean an individual who has an associate degree in recreation supervision from an approved two-year college curriculum or from a New York State community college, which training shall include or be supplemented by one or more credit courses relative to the aging process and related disabilities.
(27) Therapeutic recreation specialist shall mean a person who, prior to the effective date of this paragraph, was approved by the department as a qualified therapeutic recreationist, or, on or after its effective date:
(i) holds a master's degree with a major in therapeutic recreation and has one year of full-time, paid work experience in an activities program for the aged, ill and handicapped in a health care setting; or
(ii) holds a master's degree with a major in general recreation and has two years of full- time, paid work experience in an activities program for the aged, ill and handicapped in a health care setting; or
(iii) holds a master's degree in a field allied to therapeutic recreation and has three years of full-time, paid work experience in an activities program for the ill, aged and handicapped in a health care setting; or
(iv) holds a baccalaureate degree with a major in therapeutic recreation and has three years of full-time, paid work experience in an activities program for the aged, ill and handicapped in a health care setting; or
(v) holds a baccalaureate degree in general recreation and has four years of full-time, paid work experience in an activities program for the aged, ill and handicapped in a health care setting; or
(vi) holds a baccalaureate degree in a field allied to therapeutic recreation and has five years of full-time, paid work experience in an activities program for the aged, ill and handicapped in a health care setting; and
(vii) has submitted credentials to the department which shall include an application for verification of qualifications, official college transcripts, and resume of work experience, including name and address of facility or agency, dates of employment, job description and job title.
(28) Social work assistant or case aide shall mean a person who holds a baccalaureate degree in social work from a college or university having a course of study accredited by the Council on Social Work Education, or an associate degree in the human services, or who has had four years of full-time, paid experience in social work in a social agency adhering to acceptable standards, or who has an equivalent combination of the foregoing education and experience satisfactory to the department.
(29) Speech pathologist shall mean a person who is licensed as required by article 159 of the New York State Education Law.
(30) Activities director shall mean a person who, prior to the effective date of this paragraph, was approved by the department as a qualified trained activities leader, or, on or after its effective date:
(i) is a qualified occupational therapist; or
(ii) is a qualified therapeutic recreation specialist; or
(iii) is a qualified occupational therapy assistant; or
(iv) is a qualified recreation assistant; or
(v) has a minimum of two years' full-time, paid experience, acceptable to the department, in an activities program in a health care setting.
(31) Activities program consultant shall mean a person who is qualified either as an occupational therapist or as a therapeutic recreation specialist as defined in this Subchapter.
(32) Physical therapist assistant shall mean an individual who is licensed by and currently registered with the New York State Education Department, or who has been issued a valid limited permit by that department. The assistant must work under the supervision of a physical therapist who is licensed by and currently registered with the New York State Education Department.
(33) Physical therapy aide shall mean a nonprofessional person who assists with the implementation of a physical therapy program under the supervision of a physical therapist who is licensed by and currently registered with the New York State Education Department.
(34) Registered physician's assistant shall mean an individual who has completed a program for the education and training of physician's assistants, or its equivalent, approved by the New York State Education Department, and who is currently registered as a physician's assistant by the New York State Education Department.
(35) Registered specialist's assistant shall mean an individual who has completed a program for the education and training of specialist's assistants, or its equivalent, approved by the New York State Education Department, and who is currently registered as a specialist's assistant by the New York State Education Department.
(36) Licensed midwife shall mean an individual licensed by the State Education Department under article 140 of the Education Law to practice midwifery.
(37) Respiratory therapist shall mean a person who is licensed and currently registered as a respiratory therapist pursuant to article 164 of the New York State Education Law.
(38) Dietetic service supervisor shall mean a person who:
(i) is a dietician; or
(ii) has a baccalaureate degree with major studies in food and nutrition, dietetics or food service management, has one year of supervisory experience in the dietetic service of a health care institution; or
(iii) is a graduate of a dietetic technician training program, corresponding or classroom, approved by the American Dietetic Association; or
(iv) is a graduate of a State-approved course that provided 90 or more hours of classroom instruction in food service supervision and has experience as a supervisor in a health care institution with consultation from a dietician; and
(v) has submitted credentials to the department for verification of qualifications.
(39) Supervising nurse in a skilled nursing facility shall mean a person who is currently registered as a licensed professional nurse in New York State, and who:
(i) is responsible for the supervision of more than one nursing unit and is not assigned simultaneously head nurse and/or charge nurse functions;
(ii) critically observes the courses of actions of nursing personnel and is free to move from place to place in the facility in order to do so; and
(iii) is responsible for teaching, counseling and developing the skills of nursing personnel in relation to diagnosing the nursing care problems of patients, to treating patients in emergency situations and to providing that care which requires the knowledge and skill of a registered professional nurse as so defined.
(40) Head nurse shall mean a person who:
(i) is currently registered as a licensed professional nurse in New York State; and
(ii) is responsible for diagnosing nursing needs of patients and for planning, coordinating and evaluating patient care on one nursing unit for a 24-hour period.
(41) Charge nurse shall mean a person who is:
(i) currently registered in New York State either as a:
(a) licensed professional nurse; or
(b) licensed practical nurse who has licensure by successful completion of the New York State licensure examination or, if licensed previously in another state, has licensure in New York State on the basis of successfully completing the examinations in the other state; and
(ii) responsible for nursing activities on one tour of duty on one nursing unit.
(42) Registered professional nurse shall mean a person who is licensed and currently registered as a registered professional nurse pursuant to article 139 of the New York State Education Law.
(43) Licensed practical nurse shall mean a person who is licensed and currently registered as a licensed practical nurse pursuant to article 139 of the New York State Education Law.
(44) Physical therapist shall mean a person who is licensed by and currently registered with the New York State Education Department or who has been issued a valid limited permit by that department.
(45) Acting leisure-time activities director shall mean a person who is in the process of completing any of the requirements for that of a qualified leisure-time activities director.
(46) Medical record practitioner shall mean a person who:
(i) is eligible for certification as a registered record administrator (RRA) or an accredited record technician (ART), by the American Medical Record Association under its requirements in effect; or
(ii) is a graduate of a school of medical record science that is accredited jointly by the Council on Medical Education of the American Medical Association and the American Medical Record Association.
(47) Hospice administrator shall mean a person who possesses a baccalaureate or higher degree from a regionally accredited college or university or one approved by the New York State Education Department, and has a minimum of two years of professional experience in the delivery of health care services, which shall include at least one year in a responsible administrative position.
(48) Hospice medical director shall mean a physician who is licensed and currently registered to practice medicine in the State of New York.
(49) Hospice nurse coordinator shall mean a registered professional nurse who is currently licensed and registered in the State of New York and:
(i) possesses a baccalaureate degree in nursing and has a minimum of four years of professional experience in the delivery of nursing services which shall include at least two years in a supervisory or administrative position; or
(ii) has a minimum of six years of professional experience in the delivery of nursing services which shall include at least two years in a supervisory or administrative position.
(50) Pastoral care coordinator shall mean a person who has had a minimum of one year of training and experience in pastoral/spiritual counseling, and has a baccalaureate degree from a regionally accredited college or university or one recognized by the New York State Education Department.
(51) Coordinator of hospice volunteer services shall mean a person who has demonstrated, to the satisfaction of the hospice administrator, the ability to organize and coordinate volunteer services.
(52) Hospice volunteer shall mean a lay or professional person who contributes time and talent to a hospice program without economic remuneration and is considered one of the hospice's personnel.
(53) Respiratory therapy technician shall mean a person who is licensed and currently registered as a respiratory therapy technician pursuant to article 164 of the New York State Education Law.
(54) Advanced home health aide shall mean a certified home health aide who has satisfied all requirements to perform advanced tasks set forth in subdivision (2) of section 6908 of the Education Law and regulations issued by the State Education Department thereunder and who is currently listed in the home care worker registry maintained by the department pursuant to subdivision (9) of section 3613 of the Public Health Law as having satisfied all applicable requirements for performing advanced tasks as an advanced home health aide. An advanced home health aide shall have successfully completed a training program for advanced home health aides that is approved by the department or the State Education Department.
(c) The following general definitions, based on standards approved by the commissioner, shall apply to this Chapter, unless the context otherwise requires:
(1) Ambulant patient shall mean a person who has the ability to walk on level surfaces and to negotiate stairs and ramps independent of human assistance or supervision, using the following mechanical devices or aids when necessary: prosthesis, brace, cane or handrail.
(2) Applicant shall mean a government agency, corporation or individual or partnership of individuals established or incorporated as required by the Public Health Law proposing to construct or operate a medical facility who has submitted an application for such construction or an operating certificate to the department.
(3) Board shall mean the provision of food and drink appropriate for the physical needs and medical conditions of hospital patients and residents, including the provision of therapeutic diets appropriate for individual patients and residents.
(4) Commissioner shall mean the State Commissioner of Health.
(5) Council shall mean the State Hospital Review and Planning Council.
(6) Department shall mean the New York State Department of Health.
(7) [ Reserved ]
(8) Governing authority or operator shall mean the policy-making body of a government agency, the board of directors or trustees of a corporation or the proprietor or proprietors of a proprietary facility, agency or program to which the department has issued an operating certificate, certificate of approval or license.
(9) A health-related facility resident shall mean a person who, because of social, physical, developmental or mental condition, requires institutional care and services above the level of room and board in order to secure basic services necessary to function, but who does not require the inpatient care and services provided by a hospital or skilled nursing facility and, in addition, may have one or more of, but is not limited to, the following characteristics:
(i) possesses a degree of functional capacity permitting varied degrees of independence that reflect chronic disease conditions which may be stabilized, or mental and emotional impairment requiring medications and a range of care and services which stress health and social maintenance and prevention of further deterioration;
(ii) whose stay in the health-related facility is usually long-term and whose admission, which is not for social reasons alone, reflects the absence of alternate community, family or personal resources to meet the individual's needs;
(iii) needs a planned program of care and supervision on a continuous 24-hour-a-day basis emphasizing personal care and services under the direction of a physician;
(iv) needs assistance in securing planned, basic recreational and diversional activities and services of other disciplines such as nutritional and social work counseling, through coordinated resident care plans which also include sustaining contacts with the community and which support the need and desire to function as independently as possible and prevent withdrawal and other symptoms of early deterioration;
(v) needs health services which are under the direct supervision of a registered nurse or other health professionals who have responsibility for developing and coordinating nursing care and resident care plans and who periodically review and revise such plans;
(vi) needs periodic or intermittent skilled nursing care and services but not continuous skilled services which in the aggregate require the direct supervision by licensed nursing personnel; and
(vii) requires services which can usually be delivered by nonlicensed personnel and are primarily support kinds of services such as assistance with activities of daily living.
(10) Lodging shall mean the provision of a clean, safe, healthy, sheltered environment suitably equipped and staffed for the residential and protective care of patients and residents.
(11) Nonambulant patient shall mean a person who is bedfast, chairfast or roombound, or who can sit in, but not propel, a wheelchair.
(12) Nursing home patient shall mean a person:
(i) diagnosed by a physician as having one or more clinically determined illnesses or conditions that cause the person to be so incapacitated, sick, invalid, infirm, disabled or convalescent as to require at least medical and nursing care; and
(ii) whose assessed health care needs, in the professional judgment of his physician or a medical team:
(a) do not require care or active treatment of the patient in a general or special hospital in or near his community;
(b) cannot be met satisfactorily in the person's own home or home substitute through providing such home health services, including medical and other health and health-related services as are available in or near his community; and
(c) cannot be met satisfactorily in a physician's office, hospital clinic or other ambulatory care setting because of the unavailability of medical and other health and health-related services for the person in such setting in or near his community.
(13) [ Reserved ]
(14) Home care services shall mean one or more of the following services provided to persons at home:
(i) those services provided by a home care services agency;
(ii) home health aide services;
(iii) personal care services;
(iv) advanced home health aide services;
(v) homemaker services; or
(vi) housekeeper services.
(15) Home health aide services shall mean health care tasks, personal hygiene services, housekeeping tasks and other related supportive services essential to the patient's health.
(16) Personal care services shall mean assistance to the patient with personal hygiene, dressing, feeding and household tasks essential to his/her health.
(17) Advanced home health aide services shall mean assistance to the patient with advanced tasks defined in subdivision (2) of section 6908 of the Education Law and regulations issued by the State Education Department thereunder and assigned by the supervising registered professional nurse.
(18) Homemaker services shall mean assistance and instruction in managing and maintaining a household, dressing, feeding and incidental household tasks for persons at home because of illness, incapacity or the absence of a caretaker relative. Such services shall be provided by persons who meet the standards established by the Department of Social Services.
(19) Housekeeper services shall mean the provision of light work or household tasks which do not require the services of a trained homemaker. Such services may be provided, for persons at home because of illness, incapacity or the absence of a caretaker relative, by persons who meet the standards established by the Department of Social Services.
(20) Government funds shall mean funds provided under the provisions of title 11 of article 5 of the Social Services Law.
(21) [ Reserved ]
(22) Personal service shall mean the service provided to each resident of a health-related facility which contributes to a clean, safe, healthy and attractive environment, and which provides supervision or assistance in daily activities in order to maintain an optimal state of health and physical and emotional well-being and safe-guard the individual rights and privileges of the resident.
(23) [ Reserved ]
(24) Semiambulant patient shall mean a person who is not an ambulant or a nonambulant patient and who:
(i) can walk assisted by crutches only, or who has the ability to walk on level surfaces independently, but needs human assistance or supervision when negotiating stairs;
(ii) can move from place to place by using a walker or by propelling a wheelchair; or
(iii) needs human assistance or supervision for walking on a level surface.
(25) Sponsor shall mean the agency and/or the person or persons, other than the patient or resident, responsible in whole or in part for the financial support of the patient or resident including the costs of care in the medical facility.
(26) Activities program shall mean a planned schedule of recreational, social and other purposeful activity for nursing home patients designed to make their life more meaningful; to stimulate and support the desire to use their physical and mental capabilities to the fullest extent; to enable them to maintain a sense of usefulness and self-respect, but not specifically designed to correct or remedy any disability.
(27) Hospital ambulance service means the service of a hospital, as defined in article 28 of the Public Health Law, in transporting sick, disabled or injured persons by motor vehicle or other forms of transport to and from facilities or institutions providing hospital service when such service is provided by a hospital operating such service, or contracting therefor.
(28) Ambulance means a motor vehicle, or other form of transport, equipped to transport sick, disabled or injured individuals.
(29) [ Reserved ]
(30) Rehabilitation therapy services shall include but not be limited to audiology, occupational therapy, physical therapy, speech pathology and audiology.
(31) Verification of qualifications shall mean a department review and approval of the education, related experience and, where required, licensure, registration or certification of each occupational and physical therapist, speech pathologist, audiologist, occupational therapy assistant, physical therapist's assistant, recreation assistant, activities director and therapeutic recreation specialist providing service to health facilities certified by the department.
(32)-(33) [ Reserved ]
(34) Nutritional services shall mean the:
(i) assessment of nutritional needs and food patterns;
(ii) planning for and/or the provision of foods and drink appropriate for the individual's physical and medical needs and environmental conditions; and
(iii) providing nutrition education and counseling to meet normal and therapeutic needs.
(35)-(41) [ Reserved ]
(42) Restraint shall mean a physical device or chemical used to limit, restrict or keep under control patient movements.
(43) Family planning shall mean the planning for children, including the spacing and limiting of childbirth by medical means and the overcoming of involuntary infertility.
(44)-(46) [ Reserved ]
(47) Leisure-time activities department shall mean a department whose personnel are responsible for working with the healthy aspects of residential health-care facility patients/ residents by making available a planned, scheduled program of diverse and meaningful activities to meet residents' needs and interests. These activities can be pursued on a voluntary basis individually, independently, in a group, and at group functions. These activities are designed to ensure continuity of the resident's prior lifestyle, but are not specifically designed to correct or remedy any physical or mental disability or dysfunction.
(48) Verification of qualifications shall mean a department review and approval of the education and related experience of each leisure-time activities director, acting leisure-time activities director, leisure-time activities consultant, and physical therapist's assistant providing services to health facilities certified by the department.
(49) Rehabilitation therapy (skilled therapy) is administered by a qualified professional to restore physical function insofar as possible and/or help patients adjust or compensate for loss of function. These objectives should be accomplished within a reasonable length of time.
(50) A maintenance program is established and monitored by the qualified occupational therapist or physical therapist. This program helps the patient/resident retain an existing level of function and may be continued for an undetermined period of time. In general, maintenance is not skilled therapy. With few exceptions, it is carried out by supportive personnel.
(51) Medical social services shall mean the identification, assessment and management of social problems related to illness, the receipt of medical care and the attainment and maintenance of health as performed by qualified social workers.
(52) Medical supplies, equipment and appliances shall mean those items primarily and customarily used to serve a medical purpose and which are generally not useful to a person in the absence of an injury or illness.
(53) State health planning and development agency shall mean the State health planning and development agency designated pursuant to the National Health Planning and Resources Development Act of 1974, and any amendments thereto.
(54) Autonomous hospice administration shall mean a identifiable administrative group that has a distinct organizational structure, accountable to the hospice's governing authority either directly or through the governing authority's chief executive officer, for all aspects of the hospice.
(55) Hospice patient shall mean a person in the terminal stage of illness, with a life expectancy of approximately 12 months or less, who, alone or in conjunction with designated family member(s), has voluntarily requested admission and has been accepted into a hospice for which the department has issued a certificate of approval; provided, however, that nothing herein shall be construed to require provision of services to a patient that are not covered by the patient’s payment source.
(56) Hospice patient's family shall mean the hospice patient's immediate relations, including a spouse, brother, sister, child or parent. In addition, other relations and individuals with significant personal ties to the hospice patient may be designated as members of the hospice patient's family by mutual agreement among the hospice patient, the relation or individual and the hospice.
(57) Bereavement services shall mean those supportive services provided to the family to assist them in coping with the death of the patient.
(58) Palliative and supportive care shall mean services provided to a hospice patient for the reduction and abatement of pain and other symptoms and stresses associated with terminal illness and dying.
(59) Pastoral care shall mean services provided for the spiritual, religious and emotional support of the patient and family.
(60) Palliative care shall mean active, interdisciplinary care provided to a patient and/or a hospice patient with advanced, life-limiting illness, focusing on relief of distressing physical and psychosocial symptoms and meeting spiritual needs with the goal of achievement of the best quality of life for patients and families.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.20 Interest for all LTHHCPs
(a) Necessary interest on both current and capital indebtedness is an allowable cost for all LTHHCPs.
(b) To be considered as an allowable cost, interest shall be incurred to satisfy a financial need, and at a rate not in excess of what a prudent borrower would have had to pay in the money market at the time the loan was made. Also, the interest shall be paid to a lender not related through control, ownership, affiliation or personal relationship to the borrower except in instances where the prior approval of the Commissioner of Health has been obtained. Financial need for capital indebtedness relating to a specific project shall exist when all available restricted funds designated for capital acquisition of that type have been considered for equity purposes.
(c) Interest expense shall be reduced by investment income, with the exception of income from funded depreciation, qualified pension funds, trusteed malpractice insurance funds or in instances where income from gifts or grants is restricted by donors. Interest on funds borrowed from a donor-restricted fund or funded depreciation is an allowable expense. Investment income shall be defined as the aggregate net amount realized from dividends, interest, rental income, interest earned on temporary investment of withholding taxes, as well as all gains and losses. If the aggregate net amount realized is a loss, the loss is not allowable. Rate year investment income shall reduce rate year interest expense allowed for reimbursement as follows:
(1) for all LTHHCPs, investment income shall first be used to reduce operating interest expense for that year; and
(2) any remaining amount of investment income, after application of (1), shall be used to reduce capital interest expense reimbursed that year for LTHHCP's; and
(3) any remaining amount of investment income after application of (2) shall not be considered in the determination of allowable costs.
(d) Interest on current indebtedness shall be treated and reported as an operating administrative expense.
(e) Where a public finance authority has established a mortgage rate of interest such that sufficient cash flows exist to retire the mortgage prior to the stated maturity, the amount of the mortgage to be forgiven, at the time of such forgiveness, shall be capitalized as deferred asset and amortized over the remaining mortgage life, as a reduction of the facility's capital expense.
(f) Voluntary facilities shall report mortgage obligations financed by public finance authorities for their benefit and which they are responsible to repay, as liabilities in the general fund when such mortgage obligations are incurred.
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.11 Severability
If any clause, sentence, paragraph or section of this Part shall be adjudged by any court of competent jurisdiction to be invalid, the judgment shall not affect, impair or invalidate the remainder thereof, but shall be confined in its operation to the clause, sentence, paragraph or section thereof directly involved in the controversy in which the judgment shall have been rendered.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.13 Sampling and analytical requirements
The supplier of water shall collect raw water samples at a frequency prescribed by the State and analyze such samples for contaminants using an approved method, with method exceptions as listed in the tables in section 5-1.52 of this Subpart, and by an approved laboratory as described in section 5-1.74 of this Subpart.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.22 Supervision
(a) Personnel.
(1) At least one supervisory staff person shall provide periodic supervision of the spray ground as specified in the safety plan.
(b) Safety equipment.
(1) Required first aid equipment must be provided at the spray ground unless otherwise specified in the safety plan. A first aid kit, which may be any commercially prepared 24-unit kit or a supply of band aids, bandages, compresses and self adhering gauze bandages.
(c) Safety plan.
Operators of spray grounds must develop, update and implement a written safety plan, consisting of procedures for daily patron supervision, injury prevention, reacting to emergencies, injuries and other incidents, providing first aid and summoning help. The safety plan shall be approved by the permit-issuing official and kept on file at the spray ground. Approval will be granted when all the components of this section are addressed so as to protect the health and safety of the patrons and the plan sets forth procedures to insure compliance with this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 124 MADIS0N COUNTY
CITIES CITIES
10 CRR-NY 124.1 City of Oneida
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Florence Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the City of Oneida, Madison County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoir on Florence Creek, which is tributary to or which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Oneida.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 500 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the City of Oneida.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 500 feet of any reservoir or within 150 feet of any watercourse tributary to the public water supply of the City of Oneida.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the City of Oneida.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the City of Oneida, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 500 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the City of Oneida.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the City of Oneida, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the City of Oneida.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the City of Oneida.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the City of Oneida. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the City of Oneida.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the City of Oneida, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the City of Oneida.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the City of Oneida, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the City of Oneida; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 300 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the City of Oneida.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the City of Oneida.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the City of Oneida, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 500 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the City of Oneida.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the City of Oneida, except by duly authorized employees of the City of Oneida in the performance of their duties of supervision and maintenance of the public water supply of the City of Oneida.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the City of Oneida.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the City of Oneida.
(j) Inspections.
The board of water commissioners of the City of Oneida or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the City of Oneida or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the result of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.1 Preface
(a) The health, welfare and economic well-being of nearly nine million residents in the five counties of New York City (“the city”), and of an increasing number of upstate New York communities is inextricably tied to the quality of the source waters in the watersheds of the New York City Water Supply located in Westchester, Putnam, Dutchess, Delaware, Ulster, Greene, Sullivan and Schoharie Counties, and Fairfield County in Connecticut. The high quality of these waters faces a continuing threat from the cumulative and episodic impacts of pollution sources generated by certain land uses and activities in the watersheds. It is the duty of the Commissioner of the New York City Department of Environmental Protection (the “department”) and the New York State Department of Health to protect the high quality of waters from which the city's water supply is drawn and preserve it from degradation for the purpose of protecting the health and general welfare of its consumers.
(b) These rules and regulations repeal in their entirety and supersede the rules and regulations for the Department of Water Supply, Gas and Electricity of the City of New York enacted the 11th day of June, 1953.
(c) These rules and regulations are hereby enacted pursuant to the authority vested in the New York State Department of Health and the Commissioner of the Department of Environmental Protection, as set forth in section 128-1.3 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 413 CONSUMER INFORMATION SYSTEM
10 CRR-NY 413.2 Disclosure
(a) The facility shall post consumer information in a prominent location where it is readily accessible and can be seen easily by all residents, residents' designated representatives, residents' families and visitors.
(b) The RHCF survey profile and any statement of deficiencies issued since the last certification survey shall be posted at the time the facility sends a plan of correction to the appropriate area office or in any event, no later than 14 days from the receipt of the statement of deficiencies or survey profile summary. Any enforcement poster shall be posted immediately on receipt and shall remain in place until the enforcement action is resolved.
(c) The consumer information shall remain posted during the time any appeal by the facility is in process.
(d) Facility staff shall be made available at the request of a resident or prospective resident, their designated representative, or family to discuss consumer information.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.58 Fluoroscopic installations excluding veterinary installations
(a) Equipment.
(1) The protective tube housing shall be of the diagnostic type.
(2) Equipment shall be constructed so that the entire cross section of the useful beam is always intercepted by the primary protective barrier respective of the position.
(i) Collimators and adjustable diaphragms or shutters used to restrict the size of the useful beam shall provide the same degree of protection as is required of the tube housing.
(ii) The exposure shall automatically terminate when the barrier is removed from the useful beam.
(3) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
(i) for equipment manufactured prior to August 1, 1974:
| Operating kVp | Minimum total filtration (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(ii) for equipment manufactured after August 1, 1974:
| Designed operating range (kVp) | Measured operating potential (kVp) | Minimum HVL mm of Al | | --- | --- | --- | | Below 51 | 30 | 0.3 | | | 40 | 0.4 | | | 50 | 0.5 | | 51 to 70 | 51 | 1.2 | | | 60 | 1.3 | | | 70 | 1.5 | | Above 70 | 71 | 2.1 | | | 80 | 2.3 | | | 90 | 2.5 | | | 100 | 2.7 | | | 110 | 3.0 | | | 120 | 3.2 | | | 130 | 3.5 | | | 140 | 3.8 | | | 150 | 4.1 |
(4) Fluoroscopic exposure switch shall be of the dead-man type.
(5) The source tabletop distance shall not be less than 12 inches (30 cm) and should not be less than 15 inches (38 cm).
(6) Fluoroscopy equipment shall not be operated for human use unless a cumulative timing device, activated by the fluoroscope exposure switch, is functioning. It shall indicate the passage of a period of irradiation, not exceeding five minutes, either by a signal audible to the operator or by temporary interruption of the irradiation.
(7)
(i) The fluoroscopic exposure rate when measured under the following conditions shall not exceed five Roentgens per minute:
(a) the controls are set to the dose rate mode used for the fluoroscopic procedure most commonly performed on that fluoroscopic unit;
(b) the image intensifier is set to the largest field of view;
(c) the image intensifier is at 12 inches (30 cm) above the tabletop or the overtable fluro tube is at a source to image distance normally used for an average patient;
(d) a patient phantom composed of 1½ inches (3.8 cm) thickness of type 1100 aluminum and 0.02 inch (0.5 mm) thickness of copper or an equivalent device is completely intercepting the useful beam; and
(e) the measurement is made at the measurement location specified in 21 CFR section 1020.32(d)(3) (see section 16.200 of this Part).
(ii) If the exposure rate cannot be measured, the exposure integrated for one minute under the same conditions as subparagraph (i) of this paragraph shall not exceed five Roentgens.
(8) Using the measurement locations specified in 21 CFR section 1020.32(d)(3) (see section 16.200 of this Part), the maximum exposure rate measured in air shall not exceed 10 Roentgens per minute except as follows:
(i) Equipment manufactured before May 19, 1995 and certified in accordance with 21 CFR part 1020 (see section 16.200 of this Part) and having an optional high level control is limited to a maximum output of five Roentgens per minute unless the high level control is activated and an audible signal to that effect is provided. When the high level control is activated, the maximum exposure rate measured in air at a point where the center of the useful beam enters the patient shall not exceed 20 Roentgens per minute.
(ii) Certified equipment manufactured after May 19, 1995 with automatic exposure rate and having an optional high level control is limited to a maximum output of 10 Roentgens per minute unless the high level control is activated and an audible signal to that effect is provided. When the high level control is activated, the maximum exposure rate measured in air at a point where the center of the useful beam enters the patient shall not exceed 20 Roentgens per minute.
(iii) Certified equipment manufactured after May 19, 1995 without automatic exposure rate is limited to five Roentgens per minute unless the high level control is activated and an audible signal to that effect is provided. When the high level control is activated, the maximum exposure rate measured in air at a point where the center of the useful beam enters the patient shall not exceed 20 Roentgens per minute.
(9) With the system configured for the most frequently performed procedure, the fluoroscopic and fluorographic, if the system is equipped for image acquisition, exposure rates shall be measured with each of the following attenuators in the beam:
0.75 inch (19 mm) of aluminum (pediatric patient – 25 kg.);
1.50 inches (38 mm) of aluminum (small adult patient – 50 kg.;
1.50 inches (38 mm) of aluminum and 0.02 inch (0.5 mm) of copper (average adult patient –75 kg.);
1.50 inches (38 mm) of aluminum and 0.08 inch (2.0 mm) of copper (large adult patient – 100 kg);
1.50 inches (38 mm) of aluminum and 0.08 inch (2.0 mm) of copper and 0.12 inch (3.0 mm) of lead (for maximum fluoroscopic exposure rate only).
The fluoroscopic exposure rates for the most frequently performed procedure shall be posted so that they are conspicuous to the operator.
(10) Primary protective barriers shall provide the following protection:
(i) for uncertified equipment, with the image intensifier 14 inches (36 cm) from the tabletop, the exposure rate two inches (5 cm) beyond the image intensifier shall not exceed 30 mR/hr for each Roentgen per minute at the tabletop with the intensifier in the useful beam without a patient and with the fluoroscope operating at the highest potential available for use.
(ii) for certified equipment, the exposure rate due to transmission through the barrier with the attenuation block in the useful beam combined with radiation from the image intensifier, if provided, shall not exceed two milliroentgens per hour at four inches (10 cm) from any accessible surface of the fluoroscopic imaging assembly beyond the plane of the image receptor for each Roentgen per minute of entrance exposure rate.
(11) In the absence of a tabletop, a cone or spacer frame shall limit the source-to-skin distance to not less than 12 inches (30 cm) for all mobile fluoroscopic equipment. Units intended for specific surgical application may be used at shorter source skin distances but in no case less than eight inches (20 cm).
(12) The spatial resolution of the fluoroscopic system shall be measured using a test tool composed of a line pair (lp) plate with discreet line pair groups and a maximum lead foil thickness of 0.1 mm or an equivalent device. The test tool shall be placed on a 0.75 inch (19 mm) thickness of type 1100 aluminum, large enough to completely intercept the useful beam, with the test tool 12 inches (30 cm) from the entrance surface of the image receptor assembly. If the system has variable source-to-image distance (SID), the measurement SID shall not exceed 40 inches (100 cm). The image receptor of the fluoroscopic system shall be operated in the largest available field of view (FOV) that does not exceed six inches (15 cm). If all the fluoroscopic system's FOVs exceed six inches (15 cm), the system shall be operated in the smallest FOV. The minimum spatial resolution at center of the beam for all FOVs shall be determined by the following equation: 2 lp/mm × (6 inches [15cm]/size of FOV used) = minimum number of lp/mm.
(13) The low contrast performance of the fluoroscopic system shall be capable of resolving a minimum hole size of 3 mm using a test tool composed of a 1.0 mm aluminum sheet with two sets of four holes of dimension 1.0, 3.0, 5.0 and 7.0 mm and a phantom composed of a 1½ inch (3.8 cm) thickness of type 1100 aluminum large enough to completely intercept the useful beam or an equivalent device. The test tool shall be 12 inches (30 cm) from the entrance surface of the image receptor assembly. The image receptor of the fluoroscopic system shall be operated in the largest available field of view (FOV) that does not exceed six inches (15 cm). If all the fluoroscopic system's FOVs exceed six inches (15 cm), the system shall be operated in the smallest FOV.
(14) Radiation therapy simulation systems shall be exempt from the requirements of paragraphs (2), (6), (7) and (8) of this subdivision provided that:
(i) the systems are designed and used in a manner such that no individual other than the patient is in the X-ray room during periods of time when the system is producing X-rays; and
(ii) systems which do not meet the requirements of paragraph (6) of this subdivision are provided with a means of indicating the cumulative time that an individual patient has been exposed to X-rays. Procedures shall require in such cases that the timer be reset between examinations.
(b) Conditions for operation of equipment.
(1) The operator of the installation shall make and record the exposure and exposure rate measurements made pursuant to paragraphs (a)(7) and (8) of this section, where the center of the useful beam enters the patient during routine fluoroscopy and cinefluoroscopy, at annual intervals or more frequently if outputs are found to exceed the limits defined in this section.
(2) Unless measurements indicate that they are not needed protective garments of at least 0.25 mm lead equivalent each shall be worn by all persons within the fluoroscopic room except for the patient.
(3) Only persons needed in the fluoroscopic room shall be present during irradiation.
(4) The cumulative fluoroscopic timer must be reset for each new patient.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.6 Bottling plant facilities
Bottling plants must be constructed to facilitate cleanliness and be maintained to maximize sanitation and public health protection.
(a) Buildings and rooms shall be of sufficient size to allow for the proper installation of equipment and to allow for movement of personnel during operation.
(b) The bottle filling operations shall be separated from other plant operations or storage areas by tight walls, ceilings and self-closing doors or other appropriate barriers to isolate these areas and provide protection against incidental contamination. Conveyor openings shall not exceed the size required to permit passage of containers.
(c) Plant buildings shall be verminproof.
(d) Walls and ceilings shall be smooth, light color, washable and kept in good repair. Overhead structures, fixtures, ducts and pipes shall not be suspended over working areas so that drip or condensate may contaminate products or product contact surfaces.
(e) Floors shall be smooth, nonabsorbent, and verminproof. Floors are to be graded to adequate drains equipped with traps and grills.
(f) Doors and windows to outside areas shall be adequately screened and/or otherwise protected against entry of vermin, airborne contamination, and particulates.
(g) All rooms are to be provided with sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, odors and fumes.
(h) Lighting, either natural or artificial, shall be provided in all rooms where bottled or packaged waters are produced. An intensity of not less than 50 foot-candles shall be provided in inspection areas; 30 foot-candles in work spaces and five foot-candles in storage areas. Light bulbs, fixtures, skylights or other glass suspended over exposed production areas shall be of the safety type or otherwise protected from breakage to prevent finished product contamination.
(i) Washrooms shall be convenient, separate and apart from any room or rooms where bottled or packaged water is processed and from areas where bottles and packages are sanitized. Toilets, urinals and wash basins shall be provided, as appropriate, for the number of employees. Washrooms shall be equipped with self-closing doors and fitted with windows or separate ventilation to the outside. Signs shall be posted directing employees to wash their hands after using the toilet.
(j) Clean, dry storage facilities shall be provided for finished product containers and packaging materials.
(k) Dressing rooms shall be provided for changing and hanging street apparel and shall be apart and separate from work areas.
(l) Wastewater disposal shall be provided and have discharge to a municipal wastewater system or a State approved individual wastewater disposal system.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.15 Water quality monitoring
(a) No bathing beach shall be maintained or operated on any body of water when the water quality is determined by the permit-issuing official to constitute a potential hazard to health if used for bathing. To determine if the water quality constitutes a potential hazard to health requiring closure of the beach, the permit-issuing official shall consider one or a combination of any of the following items: results of a sanitary survey; historical water quality model for rainfall and other factors; verified spill or discharge of contaminants affecting the bathing area; and water quality indicator levels specified in this section.
(b) Sample collection and analysis when required for surveillance or design purposes shall be in accordance with the frequency, locations and procedures specified by the permit-issuing official. All samples collected from bathing beaches shall be examined in laboratories possessing State Department of Health certification for water supplies.
(c) Bacteriological quality.
The following bacteriological indicator levels shall be used when determining acceptability of water quality for bathing beaches.
(1) Based on a single sample, the upper value for the density of bacteria shall be:
(i) 1,000 fecal coliform bacteria per 100 ml; or
(ii) 61 enterococci per 100 ml for freshwater; or
(iii) 104 enterococci per 100 ml for marine water; or
(iv) 235 E. coli per 100 ml for freshwater ( E. coli is not to be used as an indicator in marine water).
(2) Based on the mean of the logarithms of the results of the total number of samples collected in a 30 day period, the upper value for the density of bacteria shall be:
(i) 2,400 total coliform bacteria per 100 ml; or
(ii) 200 fecal coliform bacteria per 100 ml; or
(iii) 33 enterococci per 100 ml for freshwater; or
(iv) 35 enterococci per 100 ml for marine water; or
(v) 126 E. coli per 100 ml for freshwater ( E. coli is not to be used as an indicator in marine water).
(3) When the above described levels are exceeded, the permit-issuing official shall cause an investigation to be made to determine the source or sources of pollution and, along with other factors described in subdivision (a) of this section determine if the beach shall be closed.
(d) Chemical quality.
The water shall be free of chemical substances capable of creating toxic reactions, skin or membrane irritations to the general public.
(e) Physical quality.
Physical inspection shall verify that the water is free of deposits, growths, oils, greases or other substances in the water capable of creating a health or safety hazard.
(f) Biological quality.
Algae and aquatic vegetation shall be controlled so that no hazard to bathers result. Any chemical used to control vegetation and algae shall not be capable of creating toxic reactions, skin or membrane irritations when the beach is in operation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 457 INTERPRETATIONS
10 CRR-NY 457.1 Interpretations
This Part contains the procedures for requesting interpretations and special waivers relating to this Article.
(a) Residential health care facilities may have significant questions relative to meaning and interpretation of various aspects of this Article. Correspondence requesting interpretations should include suggestions on how the issue in question should be handled and considered by any advisory group to the Department of Health. Correspondence requesting interpretations and/or waivers with supporting documentation should be sent to:
New York State Office of Health Systems Management
Division of Health Care Financing
Empire State Plaza
Albany, N.Y. 12237
(b) Major instances or items for which approval or interpretation may be sought include:
(1) interpretation of statements, as applied to a specific residential health care facility;
(2) approval to change allocation statistics;
(3) approval to establish new functional centers; and
(4) approval in waive specific procedures based on unique situations of the facility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.5 Certification of enforcement programs
(a) The local government of a town, city, village or county may apply to the department, care of the engineering section (see section 128-1.5 of this Part) for certification of a program to enforce specific provisions of these rules and regulations.
(b) A local government's proposed program for enforcement of specific provisions of these rules and regulations may include the following:
(1) inspection of premises for potential violations of these rules and regulations and the preparation of written reports detailing the results of each such inspection; and
(2) issuance of notices of violation of specific provisions of these rules and regulations.
(c) An application for certification of a local government's enforcement program shall include the following information:
(1) identification of the specific provisions of the rules and regulations that the local government intends to enforce;
(2) number, technical expertise and experience of personnel and identification of other resources that will be dedicated to the enforcement program;
(3) identification of funding or revenue sources for implementation of the program, including a commitment of such funding for the next fiscal year;
(4) identification of the specific department, unit or officials who will be designated to enforce the rules and regulations;
(5) identification of information management capability to insure efficient administration and adequate recordkeeping; and
(6) any other information requested by the department.
(d) The department shall review an application for certification in accordance with the procedures set forth in section 128-7.1(d) of this Subpart. A determination to certify shall be based upon a finding by the department that the resources, funding and enforcement program proposed by the applicant will provide a level of efficiency and effective protection of the water supply equal to that which would otherwise be provided by the department under these rules and regulations. Any memorandum of understanding for an enforcement program shall provide that the designated enforcement personnel of the local government shall be agents of the department for purposes of enforcement of specific provisions of these rules and regulations, and provided further, that such memorandum of understanding shall state that the department shall retain the authority to enforce these rules and regulations in addition to any enforcement by the local government.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 454 FUNCTIONAL REPORTING
10 CRR-NY 454.3 Standard units of measure
(a) The purpose of the standard unit of measure is to provide a uniform statistic for measuring costs. The unit of measure for revenue-producing centers has been developed to reflect man effort, where possible, and the volume of services rendered to patients.
(b) With regard to the standard unit of measure, the following terms are defined as follows:
(1) A clinic outpatient is one who is admitted to the clinical service of the residential health care facility for diagnosis or treatment on an ambulatory basis in a formally organized unit of a medical specialty or subspecialty clinic or service.
(2) A day-care outpatient is one who is participating in a psychiatric or medical day or night care program and is not included in the daily inpatient census.
(3) A home health outpatient is one who receives medical services at his residence from representatives of an organized home health program of the residential health care facility.
(4) Meals on wheels is a program whereby a patient receives dietary services at his residence from representatives of the residential health care facility.
(5) A homemaker outpatient is one who receives domestic services at his residence from representatives of the residential health care facility. Examples of services are housekeeping, maintenance, laundry, etc.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.11 Reports and records
(a) When requested, a laboratory shall submit reports containing such information and data concerning its technical operation as may be specified by the department. Such reports shall be signed both by the owner and director of the laboratory.
(b) Each clinical laboratory or blood bank shall have records indicating the daily accession of specimens and containing the following information:
(1) The laboratory shall have an accession system which may be a computerized accession system. It shall include:
(i) the accession number or other identification of the specimen;
(ii) the name or other identification of the person from whom the specimen was taken;
(iii) the date the specimen was received in the laboratory;
(iv) the test or tests requested for that specimen;
(v) if the request for the test was oral and, contrary to the requirements of subdivision (b) of section 58-1.7 of this Subpart, the request was not followed by a written request, a statement to that effect, provided that, in the case of a computerized accession system, such a statement may be recorded in a separate accession log;
(vi) in the event a specimen is forwarded to another clinical laboratory for tests, the name of such other laboratory, the date upon which the specimen was forwarded, the date it was tested or the result or results were reported, and the date the report of findings was received from such laboratory, provided that, in the case of a computerized accession system, such information may be recorded in a separate accession log;
(vii) a brief description of the condition of unsatisfactory specimens when received, for example, broken, leaked, hemolyzed, turbid, etc. 'ovided that, in the case of a computerized accession system such information may be recorded in the laboratory report required by paragraph (2) of this subdivision;
(viii) if the specimen is not received from another laboratory either:
(a) the date the specimen was tested; or
(b) the date the result was reported, provided that the testing date or dates are available upon the request of the originating physician for the same period of time specified in subdivision (c) of this section for the retention of the report, unless the information required by clause ( a ) or ( b ) is recorded in the laboratory report required by paragraph (2) of this subdivision;
(ix) the hour, if required, when the specimen was received in the laboratory, unless such information is recorded in the laboratory report required by paragraph (2) of this subdivision;
(x) the name of the licensed physician or other authorized person or clinical laboratory or blood bank submitting the specimen, unless such information is recorded in the laboratory report required by paragraph (2) of this subdivision;
(xi) where a computerized accession system is in use, hard copy (computer generated) accession records shall be available to the laboratory staff or other authorized person in the laboratory for three months from the receipt of the specimen and shall contain all information required by paragraph (1) of this subdivision to be recorded in a computerized accession system.
(2) Each clinical laboratory or blood bank shall produce a laboratory report and shall supply the original of said report to the physician or other authorized person submitting each specimen for analysis. Each laboratory shall retain a duplicate copy of the report. Pathology reports shall utilize an accepted system of disease nomenclature. Each report shall contain the following information:
(i) patient name or other identification and the name of the person or institution referring the specimen;
(ii) the result of the laboratory test or tests;
(iii) the date, and hour if required, when the specimen was originally collected by the physician or other authorized person;
(iv) the name under which the laboratory has been issued a permit and its address;
(v) any information required to be recorded by paragraph (1) of this subdivision;
(vi) reports including numerical results shall include normal values, reference intervals, or similar method for identifying abnormal values. Alternative procedures other than reporting these values on the report may be approved by the department; and
(vii) if the specimen is received from another laboratory, either the date the specimen was tested or the date the result was reported, provided that the testing date or dates are available upon request of the originating physician or forwarding laboratory for the same period of time specified in subdivision (c) of this section.
(c) All records and reports of tests performed including the original or duplicates of original reports received from another laboratory shall be kept on the premises of both laboratories and shall be exhibited to representatives of the department on request. Records listed below shall be retained by the laboratory for at least the period specified. If other New York State or Federal regulations or statutes require retention for different periods of time, the laboratory shall retain the appropriate record for the longest period applicable. Records shall be retained in their original form for a period of three months and may thereafter be stored on microfilm, microfiche, or other photographic record, or as magnetic tapes or other media in an electronic data processing system. Such records shall be adequately protected against destruction, either by archival storage of duplicated photographic or electronic medium or by other suitable means providing equivalent protection. Records which are required to be retained for more than two years may, after two years, be stored off the immediate laboratory premises, provided they can be available to the laboratory staff or other authorized person in the laboratory within 24 hours of a request for records.
(1) Requests for tests shall be retained for the same period of time as required for the test results or seven years, whichever is less, except that referral information for cytogenetic cases shall be retained for six years.
(2) Accession records shall be retained for seven years.
(3) Records of quality control results shall be retained for two years.
(4) Preventative maintenance, service and repair records shall be retained for as long as the instrument remains in use, except that records of monitoring of temperature-controlled spaces shall be kept for one year.
(5) The following types of laboratory reports shall be retained for at least the period specified:
(i) tissue pathology including exfoliative cytology—20 years;
(ii) syphilis serology—negative report—two years;
(iii) cytogenetics—25 years; and
(iv) all others—7 years.
(6) Worksheets containing instrument readings and/or personal observations upon which the outcome is based shall be retained for one year.
(d) The following requirements shall apply to the retention and disposition of specimens:
(1) Specimens shall be retained so as to be accessible to the laboratory within 24 hours for at least the period set forth below:
(i) blood film—other than routine—1 year;
(ii) blood film—routine—6 months;
(iii) bacteriology slide on which a diagnosis depends—1 year;
(iv) cytology slide showing any abnormality—7 years;
(v) cytology slide showing no abnormality—3 years;
(vi) tissue block—20 years;
(vii) histopathology block—20 years;
(viii) histopathology slide—20 years;
(ix) bone marrow biopsy—20 years;
(x) cytogenetic slide—6 years;
(xi) photographic slide of cytogenetic karyotype—25 years; and
(xii) recipient blood specimens—1 week stoppered at 6°C.
(2) All specimens shall be disposed of in a manner designed to minimize the likelihood of causing infection to any member of the public or laboratory staff. The laboratory shall have a written protocol which shall be available to the department for inspection, describing its procedures for the disposal of specimens.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.3 Village of Holcomb
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells and springs which comprise the source of the public water supply of the Village of Holcomb. Said wells and springs are located on land owned by the village and are situated on both sides of Oak Mount Avenue, about 1,500 feet southerly of Main Street in the village.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well or spring.
(7) Manure shall mean animal feces or urine.
(8) Nonagricultural animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural and nonagricultural associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial or industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision (2) of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Village of Holcomb.
(20) Wells or springs shall mean any well or spring now used as a source of water supply for the Village of Holcomb or any additional well or spring which may be developed at this point in the future as a source for such water supply.
(21) Regulated zone shall mean that area beyond the distances hereinafter specified but within the area bounded and described as follows:
(i) On the north by an east-west line perpendicular to Oak Mount Avenue and 500 feet north of the water pump house; on the east by a north-south line parallel to and 1,000 feet east of the centerline of Oak Mount Avenue; on the south by an east-west line parallel to and 1,800 feet south of the centerline of Gauss Road; and on the west by a north-south line parallel to and about 1,500 feet west of the centerline of Oak Mount Avenue.
(ii) A map showing the limits of the regulated zone is available for review at the village public works department offices and the New York State Department of Health, Bureau of Public Water Supply, Albany.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural waste.
No manure or offal shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the wells or springs. Within the regulated zone, manure or offal may be spread if approved by the village.
(2) Cemeteries.
No interment of a human body shall be permitted within a 300-foot linear distance of the wells or springs.
(3) Chloride salt.
No storage of chloride salt shall be permitted within a 1,000-foot linear distance of the wells or springs. Within the regulated zone, chloride salt must be stored in such a manner to prevent storm water or snowmelt from dissolving the salt and carrying the solution into the underlying soil formations. Such chloride salt shall be covered in a manner reasonably acceptable to the village.
(4) Farm or domestic animals.
No quartering of farm animals or commercial penning of domesticated animals shall be permitted within a 500-foot linear distance of the wells or springs.
(5) Herbicides and pesticides.
No herbicides or pesticides, except short-term biodegradable type for residential use, shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells or springs unless a permit has been obtained from the appropriate municipality or State agency having jurisdiction. No bulk storage of herbicides or pesticides for commercial use is permissible within the regulated zone.
(6) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle for temporary storage or permanent disposal of human excreta and sewage shall be constructed, located, placed, maintained or allowed to remain within a 1,000-foot linear distance of the wells or springs.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the wells or springs.
(iii) Collection and transport of sewage or polluted liquid shall only be allowed in watertight pipes or containers which shall be approved by the appropriate State agency having jurisdiction. Ultimate disposal shall be to a treatment works or disposal site approved by the State Department of Environmental Conservation. Within the regulated zone, subsurface disposal systems shall only be allowed if reviewed and approved by the village and a permit has been granted by the appropriate State agency having jurisdiction over such facility.
(7) Junkyard.
No junkyard shall be located within a 500-foot linear distance of the wells or springs. Within the regulated zone, no refuse disposal or disposal of oil, gasoline, battery acid, etc. from junkyards shall be permitted upon or beneath the surface of the ground.
(8) Major earthworks or commercial excavations. No activity involving major earthworks or commercial excavations shall be permitted within 1,000-foot linear distances of the wells or springs. Within the regulated zone, no such work which will penetrate the underlying water table or change the course of groundwater shall be permitted.
(9) Petroleum products.
No storage containers shall be permitted below ground and no storage containers shall be permitted above ground in excess of 30 gallons, within a 350-foot linear distance of the wells or springs. No storage containers shall be permitted below ground in excess of 500 gallons and no storage containers shall be permitted above ground in excess of 30 gallons unless set on a concrete slab with low curb to contain spills or leakage, within a 700-foot linear distance of the wells or springs but beyond 350 feet. Within the regulated zone below-ground storage in excess of 1,000 gallons is permissible if constructed and monitored as follows:
(i) Owners of all new tanks will be required to obtain a permit from the village. The permit will indicate the methods for installing and testing new tanks. The conditions of such permit shall be subject to review and approval by the State Department of Health.
(ii) Only tanks approved by the American Petroleum Institute will be acceptable for new construction.
(iii) Owners of tanks for storage of gasoline, diesel fuel, etc., which is pumped to cars, trucks or other movable equipment, shall keep daily records of usage and delivery of fuel. These records shall be kept on file, for inspection by the village, and a copy sent to the village public works department every three months.
(10) Radioactive material.
No radioactive material shall be disposed of by burial in the soil within a 1,000-foot linear distance of the wells or springs or within the regulated zone.
(11) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells or springs.
(12) Toxic substances.
No storage of toxic substances, except as permitted by the provisions of paragraph (9) of this subdivision shall be permitted within a 1,000-foot linear distance of the wells or springs.
(13) Trespassing.
No trespassing shall be allowed upon the property of the village upon which the wells and springs are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the village.
(14) Other wastes.
No pollutant of any kind shall otherwise be discharged or deposited upon the property of the Village of Holcomb upon which the wells or springs are located.
(e) Inspections.
The village board or its duly authorized village representative shall make regular and thorough inspections of the area surrounding the wells and springs to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. The aforesaid village board shall report to the State Commissioner of Health in writing annually, prior to the 30th of January, the results of the regular inspections made during the preceding year. The report shall state the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the wells and springs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.4 Reporting period
[1130]
(a) For cost reporting purposes, the program will require submission of annual reports covering a 12-month period of operations based upon the provider's accounting year.
(b) The provider may select any annual period for cost reporting purposes as long as the reporting period selected is the same as that used for Medicare reimbursement. Once a provider has made a selection and reported accordingly, it is required thereafter to report annually for periods ending as of the same date, unless the intermediary approves a change in the provider's reporting period.
(c) A cost reporting period under the program consisting of one of the following will be considered in compliance with the reporting periods cited above:
(1) 12 successive calendar months;
(2) 13 four-week periods with an additional day (two in a leap year) added to the last week or period to make it coincide with the end of the calendar year or month; or
(3) a reporting period which will vary from 52 to 53 weeks because it must always end on the same day of the week (Monday, Tuesday, etc.) and always end on:
(i) whatever date this same day of the week last occurs in a calendar month; or
(ii) whatever date this same day of the week falls on which is nearest to the last day of the calendar month, even though this same day falls in the first week of the following month.
(d) The method selected must be consistently followed.
(e) A provider may prepare a short-period cost report for part of a year under the circumstances described in sections 2414.1 through 2414.3 of the Medicare Provider Reimbursement Manual (HIM-15), part I.
(f) Providers in a chain organization, or other group of providers, are required to file individual cost reports.
(g) Upon entering the health insurance program, a new provider may select an initial cost reporting period of at least 1 month but not to exceed 13 months. For example, a new provider which starts with the Medicare program on September 15, 1974, and wishes to adopt a reporting period ending September 30, 1974, must file a report for the period September 15, 1974 to September 30, 1975. Such a provider cannot file a report for the 15-day period ending September 30, 1974.
(h) A hospital beginning operations must select an initial reporting period beginning on the first day of operation, through the last month preceding the hospital's selected fiscal year. For example, a hospital beginning operations August 15, 1980, selecting a fiscal year beginning January 1st, would have an initial fiscal period running from August 15, 1980 through December 31, 1980. It would then move to the standard January 1st to December 31st fiscal year.
(i) Whatever fiscal year is used for reporting purposes must coincide with that used for Medicare (Medicaid for Medicaid-only hospitals) cost reporting purposes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.6 Collection and handling of hematopoietic progenitor cells
(a) All hematopoietic progenitor cell specimens obtained by bone marrow aspiration shall be collected by the medical director of the procurement service or other qualified physician, physician's assistant, or a nurse practitioner under the supervision of the medical director. Hematopoietic progenitor cells obtained by peripheral blood apheresis shall be collected by an individual trained in pheresis in accordance with the requirements of section 58-2.15 of this Part. Cord blood collection shall be performed by staff with documented training, experience and proficiency in the techniques utilized.
(b) Hematopoietic progenitor cell collection apparatus and containers shall be clean, pyrogen-free and sterile.
(c) Phlebotomy and bone marrow aspiration puncture sites shall be prepared by a procedure which conforms to current medical standards generally accepted by leading authorities in transplantation medicine.
(d) Hematopoietic progenitor cell collection systems shall meet the following minimum requirements:
(1) hematopoietic progenitor cells shall be collected under aseptic conditions using an approved system adequately protected against contamination;
(2) additives shall be used as required to ensure the continued suitability of hematopoietic progenitor cells for transplantation and retention of viability. All changes in additives shall be validated on-site, and such validation shall be documented;
(3) each container shall be legibly labeled or tagged at the time of collection with;
(i) the donor's identification code and date of collection;
(ii) if known, the recipient/patient's name, the name of the hospital where the patient is to be transplanted, and the patient's hospital registration number, social security number, birth date or similar identifying information;
(4) each final container shall be legibly labeled or tagged at the time of issuance with:
(i) if performed, the results of laboratory tests for syphilis, HBsAg and antibodies to HBV, HCV, HIV-1, HIV-2, HTLV-I and CMV, unless the results were forwarded to the hematopoietic progenitor cell transplantation service in advance or included in records accompanying the hematopoietic progenitor cells; and
(ii) a biohazard label, if the donor has tested reactive or positive for any of the tests required in section 58-5.4(c) or (d)(1) of this Subpart; and
(5) if microbial culturing is performed, suspected contamination shall be reported to the transplantation service.
(e) Prior to collection of cord blood, an access agreement/acknowledgment shall be consummated between the administration of the hospital or other collection site and the licensed cord blood bank.
Chapter I STATE SANITARY CODE
Part 13 TRANSPORTATION OF DEAD BODIES
10 CRR-NY 13.3 Disinterments
(a) No dead human bodies shall be disinterred for transportation and/or removal to another cemetery or crematory without a permit from the registrar of vital statistics having jurisdiction at the place of disinterment. No permit is necessary for removal within the same cemetery.
(b) The funeral director or undertaker shall make a request to disinter the body on a form provided by the commissioner. Upon receipt of such request, the local registrar shall issue a permit as required by section 13.1(a) of this Part.
(c) If the original burial container has not retained its integrity, transfer to another container shall be required if transportation of the body is necessary. If the remains are to be transported by common carrier, the provisions of section 13.1(b) of this Part shall apply.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.5 Human excreta
(a) Unless otherwise permitted by these rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge, of human excreta into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
(b) Emptying, discharging or transferring the contents of a sewage vault or other sewage receptacle into any watercourse, wetland, reservoir, reservoir stem, or controlled lake is prohibited.
(c) Transportable sewage receptacles shall have tightly fitting covers which shall be securely fastened during transport.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.255 Physical life
Total potential operating life, as of a machine, as contrasted with useful or economic life, which may be much less because of the presence of obsolescence or inadequacy, or both.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.5 Commissioner's order
The commissioner has authority to issue orders to address dangers to the health of the people as set forth in Public Health Law section 16. The commissioner can exercise such authority to address a violation of this Part if, in his or her opinion, such a danger exists. It is hereby recognized that, dependent upon the opinion and discretion of the commissioner as applied to each circumstance, he or she may issue such an order in the event of a continuing or repeat violation of this Part at or by a retail establishment when the entity and/or its owner(s) or employee(s) knew or should have known of the violation. As determined by the commissioner, such an order could require the closure of the retail establishment, among other relief. Although not required, this section serves as notice that such an order could be issued. The circumstances and relief described in this notice are only examples and in no way bind the commissioner or limit his or her authority to issue such an order, or the relief set forth in such an order, under any circumstance whatsoever.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.61 Certified bed days available
Bed days are computed by multiplying the number of certified beds (excluding newborn) available throughout the period by the number of days in the period. If there is an increase or decrease in the number of certified beds available during the period, the number of certified beds available for each part of the cost reporting period should be multiplied by the number of days for which that number was available.
10 CRR-NY 441.171 Imprest fund
A fixed cash fund or petty cash fund in the form of currency, a bank checking account, or both, maintained for expenditures that must be made in cash, and, from time to time, restored to its original amount by a transfer from general cash of a sum equal to the aggregate of disbursements; a form of working fund.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-2 MANAGEMENT OF REGULATED MEDICAL WASTE
10 CRR-NY 70-2.4 Transfer of regulated medical waste for off-site treatment
(a) Generators of regulated medical waste shall transfer such waste for off-site treatment only to a regulated medical waste transporter permitted by the Department of Environmental Conservation; provided, however, that a generator of under 50 pounds of regulated medical waste per month registered with the Department of Environmental Conservation pursuant to 6 NYCRR Part 364 may transport its own waste for off-site treatment.
(b) A facility that generates waste and arranges transport for off-site treatment or disposal, or otherwise participates in the transport of regulated medical waste shall ensure that a regulated medical waste tracking form prescribed by the Department of Environmental Conservation accompanies each load.
(c) All solid waste transported in a load containing regulated medical waste shall be treated as regulated medical waste, unless the regulated medical waste is separately contained in a secondary container meeting the requirements of section 70-2.2(h) of this Subpart or is otherwise kept separate from the solid waste by leak-proof barriers.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
ENHANCED TREATMENT FOR CRYPTOSPORIDIUM ENHANCED TREATMENT FOR CRYPTOSPORIDIUM
10 CRR-NY 5-1.81 Source water monitoring requirements at systems using surface water and ground water under the direct influence of surface water (GWUDI) sources
(a) Source water monitoring.
(1) Initial round of source water monitoring. Systems shall conduct the following monitoring, based on the monitoring schedule prescribed in paragraph (3) of this subdivision, unless they meet the monitoring exemption criteria in paragraph (4) of this subdivision:
(i) Filtered systems serving at least 10,000 people shall sample their source water for Cryptosporidium, E. coli, and turbidity at least monthly for 24 months.
(ii) Unfiltered systems serving at least 10,000 people shall sample their source water for Cryptosporidium at least monthly for 24 months.
(iii) Filtered systems serving fewer than 10,000 people:
(a) shall sample their source water for E. coli and use an approved method to enumerate the presence of E. coli at least once every two weeks for 12 months;
(b) may avoid E. coli monitoring if the system notifies the State that it will monitor for Cryptosporidium as described in subparagraph (iv) of this paragraph. The system shall notify the State no later than three months prior to the date the system is otherwise required to start E. coli monitoring under paragraph (3) of this subdivision; and
(c) shall sample their source water for Cryptosporidium at least twice per month for 12 months, or at least monthly for 24 months, if, based on monitoring conducted under this subparagraph, they meet one of the following criteria:
(1) the annual mean E. coli concentration is greater than 10 E. coli/ 100 mL; or
(2) the system does not conduct E. coli monitoring at least once every two weeks for 12 months;
(3) the State may approve an alternative to the E. coli concentration specified in subclause (1) of this clause to trigger Cryptosporidium monitoring. This approval by the State will be provided to the system in writing and will include the basis for the State’s determination that the alternative trigger concentration will provide a more accurate identification of whether a system will exceed the Bin 1 Cryptosporidium level specified in section 5-1.83(a)(2) of this Subpart.
(iv) Unfiltered systems serving fewer than 10,000 people shall sample their source water for Cryptosporidium at least twice per month for 12 months or at least monthly for 24 months.
(v) Systems may sample more frequently than required under this section if the sampling frequency is evenly spaced throughout the monitoring period.
(2) Second round of source water monitoring. Systems shall conduct a second round of source water monitoring that meets the requirements for monitoring parameters, frequency, and duration described in paragraph (1) of this subdivision, unless they meet the monitoring exemption criteria in paragraph (4) of this subdivision. Systems shall conduct this monitoring on the schedule in paragraph (3) of this subdivision.
(3) Monitoring schedule. Systems shall comply with the monitoring schedule prescribed in 40 CFR 141.701(c).
(4) Monitoring avoidance.
(i) Filtered systems are not required to conduct source water monitoring under this section if the system will provide a total of at least 5.5-log of treatment for Cryptosporidium, equivalent to meeting the treatment requirements of Bin 4 in section 5-1.83(b) of this Subpart.
(ii) Unfiltered systems are not required to conduct source water monitoring under this section if the system will provide a total of at least 3-log Cryptosporidium inactivation, equivalent to meeting the treatment requirements for unfiltered systems with a mean Cryptosporidium concentration of greater than 0.01 oocysts/L in section 5-1.83(c) of this Subpart.
(iii) If a system chooses to provide the level of treatment in subparagraph (i) or (ii) of this paragraph, as applicable, rather than start source water monitoring, the system shall notify the State in writing no later than the date the system is otherwise required to submit a sampling schedule for monitoring under subdivision (b) of this section. Alternatively, a system may choose to stop sampling at any point after it has initiated monitoring if it notifies the State in writing that it will provide this level of treatment. Systems shall install and operate technologies to provide this level of treatment by the applicable treatment compliance date in section 5-1.83(d) of this Subpart.
(5) Plants operating only part of the year. Systems with surface water sources or ground water sources directly influenced by surface water and with plants that operate for only part of the year shall conduct source water monitoring in accordance with this section and section 5-1.80 of this Subpart, but with the following modifications:
(i) systems shall sample their source water only during the months that the plant operates unless the State specifies another monitoring period based on plant operating practices;
(ii) systems with plants that operate less than six months per year and that monitor for Cryptosporidium shall collect at least six Cryptosporidium samples per year during each of two years of monitoring. Samples shall be evenly spaced throughout the period the plant operates.
(6) New sources.
(i) A system that begins using a new source of surface water or ground water directly influenced by surface water after the system is required to begin monitoring under paragraph (3) of this subdivision shall monitor the new source on a schedule approved by the State. Source water monitoring shall meet the requirements of this section. The system also shall meet the bin classification of section 5-1.83(a) of this Subpart and Cryptosporidium treatment requirements of section 5-1.83(b) or (c) of this Subpart, as applicable, for the new source on a schedule approved by the State.
(ii) The requirements of this paragraph also apply to new systems that use surface water or ground water directly influenced by surface water, that begin operation after the monitoring start date applicable to the system’s size under paragraph (3) of this subdivision.
(iii) The system shall begin a second round of source water monitoring no later than six years following initial bin classification or determination of the mean Cryptosporidium level, as applicable.
(b) Sampling schedules.
(1) Systems required to conduct source water monitoring under this section shall submit a sampling schedule that specifies the calendar dates when the system will collect each required sample. Systems shall submit sampling schedules to the State no later than three months prior to any applicable date referenced in paragraph (a)(3) of this section. If the State does not respond to a system regarding its sampling schedule, the system shall sample at the reported schedule.
(2) Systems shall collect samples within two days before or two days after the dates indicated in their sampling schedule, unless one of the following conditions applies:
(i) If an extreme condition or situation exists that may pose danger to the sample collector, or that cannot be avoided and causes the system to be unable to sample in the scheduled five-day period, the system shall sample as close to the scheduled date as is feasible, unless the State approves an alternate sampling date. The system shall submit an explanation for the delayed sampling date to the State concurrent with the shipment of the sample to the laboratory.
(ii) If a system is unable to report a valid analytical result for a scheduled sampling date due to equipment failure, loss of or damage to the sample, failure to comply with the analytical method requirements, including the quality control requirements in subdivision (d) of this section, or the failure of an approved laboratory to analyze the sample, then the system shall collect a replacement sample. The replacement sample shall be collected no later than 21 days after receiving information that an analytical result cannot be reported for the scheduled date, unless the system demonstrates that collecting a replacement sample within this time frame is not feasible, or the State approves an alternative resampling date. The system shall submit an explanation for the delayed sampling date to the State concurrent with the shipment of the replacement sample to the laboratory.
(3) Systems that fail to meet the criteria of paragraph (2) of this subdivision for any source water sample required under subdivision (a) of this section shall revise their sampling schedules to add dates for collecting all missed samples. Systems shall submit the revised schedule to the State for approval prior to when the system begins collecting the missed samples.
(c) Sampling locations.
(1) Systems required to conduct source water monitoring under subdivision (a) of this section shall collect samples for each plant that treats a surface water or GWUDI source. Where multiple plants draw water from the same influent, such as the same pipe or intake, the State may approve one set of monitoring results to be used to satisfy the requirements for all plants.
(2) Systems shall collect source water samples prior to chemical treatment, such as coagulants, oxidants, and disinfectants, unless the State determines that collecting a sample prior to chemical treatment is not feasible for the system and that the chemical treatment is unlikely to have a significant adverse effect on the analysis of the sample.
(3) Systems that recycle filter backwash water shall collect source water samples prior to the point of filter backwash water addition.
(4) Bank filtration.
(i) Systems that receive Cryptosporidium treatment credit for bank filtration, as applicable, shall collect source water samples in the surface water prior to bank filtration.
(ii) Systems that use bank filtration as pretreatment to a filtration plant shall collect source water samples from the well ( i.e. , after bank filtration). Use of bank filtration during monitoring shall be consistent with routine operational practice. Systems collecting samples after a bank filtration process may not receive treatment credit for the bank filtration.
(5) Multiple sources. Systems with plants that use multiple water sources, including multiple surface water sources and blended surface water and ground water sources, shall collect samples as specified in subparagraph (i) or (ii) of this paragraph. The use of multiple sources during monitoring shall be consistent with routine operational practice.
(i) If a sampling tap is available where the sources are combined prior to treatment, systems shall collect samples from that tap.
(ii) If a sampling tap where the sources are combined prior to treatment is not available, systems shall collect samples at each source near the intake on the same day and select one of the following options for sample analysis:
(a) systems may composite samples from each source into one sample prior to analysis. The volume of sample from each source shall be weighted according to the proportion of the source in the total plant flow at the time the sample is collected; or
(b) systems may analyze samples from each source separately and calculate a weighted average of the analysis results for each sampling date. The weighted average shall be calculated by multiplying the analysis result for each source by the fraction the source contributed to total plant flow at the time the sample was collected and then summing these values.
(6) Additional requirements. Systems shall submit a description of their sampling location(s) to the State at the same time as the sampling schedule. This description shall address the position of the sampling location in relation to the system’s water source(s) and treatment processes, including pretreatment, points of chemical treatment, and filter backwash recycle. If the State does not respond to a system regarding sampling location(s), the system shall sample at the reported location(s).
(d) Reporting source water monitoring results.
(1) Systems shall report results from the source water monitoring no later than 10 days after the end of the first month following the month when the sample is collected.
(2) Systems shall report the following information, as applicable, for the source water monitoring samples required under subdivision (a) of this section:
(i) Systems shall report the following data elements for each Cryptosporidium analysis: PWS ID; facility ID sample collection date sample type (field or matrix spike); sample volume filtered (in liters, to the nearest 0.25 liter); confirmation that 100 percent of filtered volume was examined; and the number of oocysts counted.
(a) For matrix spike samples, systems shall also report the sample volume spiked and estimated number of oocysts spiked. These data are not required for field samples.
(b) For samples in which less than 10 liters are filtered or less than 100 percent of the sample volume is examined, systems shall also report the number of filters used and the packed pellet volume.
(c) For samples in which less than 100 percent of sample volume is examined, systems shall also report the volume of resuspended concentrate and volume of this resuspension processed through immunomagnetic separation.
(ii) Systems shall report the following data elements for each E. coli analysis: PWS ID; facility ID; sample collection date; analytical method number; method type; source type; E. coli/100 mL; and turbidity. Systems serving fewer than 10,000 people that are not required to monitor for turbidity are not required to report turbidity with their E. coli results.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.5 Investigation and determination
(a) Upon receipt of a report made pursuant to this section, the New York State Department of Health, Office of Health Systems Management, shall initiate within 48 hours an onsite investigation of the allegations contained in the report.
(b) Notification of the receipt of a report shall be made immediately by the New York State Department of Health, Office of Health Systems Management, to the appropriate district attorney, if a prior standing request in writing has been made to the department by the district attorney.
(c) Prior to the completion of the investigation by the New York State Department of Health, Office of Health Systems Management, every reasonable effort shall be made to notify, personally or by certified mail, any person under investigation for having committed an act of physical abuse, mistreatment or neglect.
(d) The commissioner shall make a written determination, based on the findings of the investigation, of whether or not sufficient credible evidence exists to sustain the allegations contained in the report or supports a conclusion that a person not named in such report has committed an act of physical abuse, neglect or mistreatment.
(1) A copy of such written determination, together with a notice of the right to a hearing as provided in this subdivision, shall be sent by registered or certified mail to each person who the commissioner has determined has committed an act of physical abuse, neglect or mistreatment.
(2) A letter shall be sent to any other person alleged in such report to have committed such an act stating that a determination has been made that there is not sufficient evidence to sustain the allegations relating to such person.
(3) A copy of each such determination and letter shall be sent to the facility in which the alleged incident occurred.
(e) The commissioner may make a written determination, based on the findings of the investigation, that sufficient credible evidence exists to support a conclusion that a person required by this section to report physical abuse, mistreatment or neglect had reasonable cause to believe that such an incident occurred and failed to report such incident. A copy of such written determination, together with a notice of the right to a hearing as provided in this Part, shall be sent by registered or certified mail to each person who the commissioner has determined has failed to report as required by this Part.
(f) All information relating to any allegation which the comimssioner has determined is not sustained shall be expunged as provided in section 81.1 of this Part. Whenever information is expunged, the commissioner shall notify any official notified pursuant to this section that the information has been expunged.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.62 Chain organization
A health care, or other organization consisting of a group of two or more facilities which are owned, leased or, through any other device, controlled by one business entity.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.1 Supplementary reports of spontaneous abortions and fetal deaths for epidemiological surveillance; filing
Every physician and hospital shall file a supplementary report with the State Commissioner of Health of each spontaneous abortion or other fetal death occurring naturally. Such report shall be filed within 10 days of the occurrence of such event on such forms as may be prescribed by the commissioner to facilitate epidemiological investigation and surveillance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.30 Psychiatric
This functional reporting center must contain all the expenses associated with providing specialized diagnostic and therapeutic procedures by a licensed psychiatrist or psychologist. Additional activities include but are not limited to the following: consultation with patients, patient relatives and attending physician; establishing goal-directed relationship with patient; participating in group and milieu therapy.
(a) Standard unit of measure: number of visits.
A visit is defined as psychiatric care provided by the psychiatrist and/or psychiatric staff, regardless of whether the patient visits the psychiatric office or is visited by the psychiatrist and/or psychiatric staff.
(b) Data source.
The number of visits shall be an actual count maintained by the psychiatric office.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.2 Acute care facilities
(a) The methodology will be utilized in the evaluation of certificate of need applications involving the construction or establishment of new or replacement beds in an acute care hospital and the need for acute care facilities and services. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in Part 708 of this Title and section 709.1 of this Part, become a statement of basic principles and planning/decisionmaking tools for guiding and directing the development of hospital services throughout the State. Additionally, it is intended that the methodology will provide potential applicants with a framework to develop specific hospital feasability studies submitted as a part of certificate of need applications while allowing health systems agencies sufficient flexibility to consider the unique and special characteristics of their respective areas in determining bed need. The methodology is conceptually based on the application of uniform planning objectives at the county and/or State level. Its purpose is to provide guidance, to insure flexibility, and to assist the health systems agencies, the Commissioner of Health and potential applicants in determining the future need for acute care beds as consistent with the certificate of need program. The goals and objectives of the methodology expressed in this section are expected to insure that an adequate institutional bed supply is available for normal and emergency needs. The methodology helps identify counties where the projection of future acute care bed need implies a potential for excess capacity and where significant issues of hospital access and viability may occur. The goals and objectives of this methodology also are expected to result in minimizing the need for costly inpatient care by encouraging the development and expansion of more desirable lower cost alternatives, as well as insuring that high quality care and an adequate institutional bed supply are available.
(b) For purposes of this methodology, the base year shall be 1991 and the planning target year shall be 1996. The planning area shall be the county.
(c) The methodology uses the following steps to estimate the need for medical/surgical and pediatric beds in the planning target year:
(1) The normative discharge utilization rates by county of patient residence for males and females ages 0-9, 10-14, 15-19, 20-44, 45-64, 65-74, 75-84 and 85 and over are derived for medical/surgical and pediatric services for the base year and the year five years previous to the base year as set forth in paragraphs (d)(1) through (3) of this section.
(2) The population, males and females ages 0-9, 10-14, 15-19, 20-44, 45-64, 65-74, 75-84 and 85 and over, is estimated by county for the base year, the year five years previous to the base year and for the planning target year as set forth in paragraph (d)(4) of this section.
(3) Normative discharge utilization rates per 1,000 population by county of patient residence and by peer groups of counties for males and females ages 0-9, 10-14, 15-19, 20-44, 45-64, 65-74, 75-84 and 85 and over are estimated for the planning target year as set forth in paragraphs (d)(5) through (8) of this section.
(4) The number of expected discharges is derived by multiplying the utilization rates by county for males and females ages 0-9, 10-14, 15-19, 20-44, 45-64, 65-74, 75-84 and 85 and over for the planning target year by the estimated county population for the planning target year divided by 1,000.
(5) Total expected discharges by county of residence is the sum of the expected discharges as set forth in paragraph (4) of this subdivision.
(6) To derive the estimated number of discharges in the planning target year by county of hospitalization, the estimated number of expected discharges for the planning target year by county of residence is adjusted to reflect the migration of patients between counties in the State and for patients migrating from other states to New York as set forth in paragraphs (d)(9) and (10) of this section.
(7) Discharges in the planning target year, by county of expected hospitalization, are distributed by diagnostic related groups (DRG) and payor categories as set forth in paragraph (d)(11) of this section.
(8) Actual average base year length of stay for discharges in the county of hospitalization for each DRG and payor group is compared to national experience in length of stay for each DRG and payor group as set forth in paragraph (d)(12) of this section. The lowest length of stay, either the national experience or the county actual average base year length of stay for each DRG and payor group, is multiplied by the expected number of discharges for that DRG and payor group to derive expected days of hospitalization in the planning target year. Expected days of hospitalization in the planning target year by DRG and payor groups are summed to derive total expected days.
(9) Days of care provided to adults and pediatric patients are separated from total expected days of hospitalization in the planning target year as set forth in paragraph (d)(13) of this section. Medical/surgical bed need is derived from adult days and pediatric bed need is derived from pediatric days.
(10) Expected adult and pediatric days of hospitalization in the planning target year are divided by 365 to derive average daily census for each county.
(11) Estimated medical/surgical and pediatric beds needed in the planning target year for each county are calculated by dividing average daily census by the expected occupancy rate as set forth in paragraph (d)(14) of this section.
(12) The estimates of public need for medical/surgical and pediatric beds for the planning target year for each county are adjusted, as set forth in paragraphs (d)(15), (16) and (17) of this section, to reflect the use of these beds for alternate level of care patients and other extraordinary disease occurrences which were not adequately reflected in the historic use rate experience.
(d) The methodology for determining public need for acute care beds and the estimates of projected bed need by county for the planning target year shall be as follows:
(1) The initial data base for the base year and the year five years previous to the base year is extracted from the Statewide Planning and Research Cooperative System (SPARCS) for medical/surgical and pediatric discharges. Excluded are neonatal discharges, newborns, and discharges with nonmedical/surgical DRGs of maternity, psychiatry, drug abuse, alcohol abuse, burns and medical rehabilitation. In the event other methodologies are developed by the Department of Health to project acute care bed need for extraordinary disease occurrences, these discharges also shall be removed from the base year and the year five years previous to the base year. For the purposes of this methodology, discharges with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are excluded.
(2) Counties with similar demographic and socio-economic characteristics are grouped into peer groups for purposes of this methodology:
Group
1:
Bronx, Kings, New York, Queens;
2:
Dutchess, Nassau, Orange, Rockland, Suffolk, Richmond, Westchester;
3:
Albany, Broome, Erie, Monroe, Niagara, Oneida, Onondaga;
4:
Genesee, Madison, Montgomery, Ontario, Oswego, Rensselaer, Saratoga, Schenectady, Wayne,
5:
Cattaraugus, Chautauqua, Chemung, Clinton, Cortland, Jefferson, Otsego, Steuben, Tompkins, Ulster, Warren;
6:
Columbia, Greene, Hamilton, Herkimer, Livingston, Orleans, Putnam, Schoharie, Schuyler, Seneca, Washington, Wyoming, Yates;
7:
Allegany, Cayuga, Chenango, Delaware, Essex, Franklin, Fulton, Lewis, St. Lawrence, Sullivan;
8:
Tioga.
(3) To isolate health system changes that are occurring with the growth of hospital and free-standing ambulatory-surgery programs, discharges in the initial data base for the base year and the year five years previous to the base year are further classified based on their principal procedure code in SPARCS. Discharges whose principal procedure is included in the Department of Health's Ambulatory Surgery data base are classified as appropriate for ambulatory surgery. Exceptions to this classification include obstetric and newborn cases, deaths, transfers to acute care and long term care facilities and procedures done less than five percent of the time on an ambulatory basis.
(4) The population age 0-9, 10-14, 15-19, 20-44, 45-64, 65-74, 75-84 and 85 and older shall be estimated by county by sex for the base year, the year five years previous to the base year and the planning target year using linear interpolation of the population projections developed by the New York State Department of Economic Development and by population categories based on U.S. Census Bureau data. If the population projections for the planning target year are based on census data collected 10 years or more before the planning target year, population projections for the planning target year shall be adjusted to account for the percent difference in the most recent year's actual census and the Department of Economic Development's population projection for that same year.
(5) A normative discharge utilization rate per 1,000 population by county of patient residence, for each sex, age group, and ambulatory-surgery category is calculated by dividing the number of discharges by the population for each sex and age group and multiplying this ratio by 1,000.
(6) For each peer grouping of counties, the number of discharges in each sex, age group, and ambulatory-surgery category are summed for a group total in the base year and the year five years previous to the base year. The population projection for the base year and the year five years previous to the base year for each sex and age group are summed for all counties in a peer group for a peer group population total.
(7) A normative discharge utilization rate per 1,000 population by county peer group for each sex, age group, and ambulatory-surgery category is derived by dividing the sum of county discharges by the sum of county population estimates as set forth in paragraph (6) of this subdivision and multiplying by 1,000. An average annual rate of change is calculated for each sex, age group, and ambulatory-surgery category between the year five years previous to the base year and the base year.
(8) The projected utilization rate for the planning target year is calculated by applying the county peer group's average annual rate of change for each age group, sex and ambulatory-surgery category to each county's base year utilization rate and then each year thereafter up to the planning target year. This procedure shall be performed in all county peer groups, except groups 1 and 8, to derive a county estimated utilization rate for the planning target year. For group 8, the base year actual utilization rates shall be used for the planning target year. For group 1, the lowest actual average annual rate of change between the year five years previous to the base year and the base year for each age, sex end ambulatory-surgery category shall be applied to each county's base year rate and each year thereafter up to the planning target year.
(9) To account for the migration of patients from the county of residence to the county of hospitalization, the projected number of discharges by county of residence in the planning target year will be subdivided among the counties of hospitalization according to the same proportions as experienced by discharges in the base year. For example, if 50 percent of the base year discharges residing in county A were hospitalized in county B, then 50 percent of the projected planning target year discharges residing in county A shall be assumed hospitalized in county B. Discharges in the counties of hospitalization are summed to derive a total number of discharges by county of hospitalization.
(10) To account for the estimated number of non-New York State residents hospitalized in New York State counties in the planning target year, the actual number of non-New York State residents in the base year is added to the projected number of discharges in the planning target year as calculated in paragraph (9) of this subdivision. In the event that reliable information becomes available from the health systems agencies or other sources on migration pattern changes expected either within New York State counties or from non-New York State residents, then the migration patterns from the base year may be adjusted accordingly before being applied to the planning target year.
(11) For the purposes of this methodology, the 1991 Federal grouping system of DRGs, as set forth in Appendix D-1, infra, shall be used. The following four payor categories are used:
(i) Medicare;
(ii) Medicaid;
(iii) Blue Cross plus other commercial carriers; and
(iv) all other payors including self-pay.
The percent distribution of discharges by DRG and payor group in the base year is applied to the number of discharges projected for the planning target year to derive the projected number of discharges by DRG and payor group by county of hospitalization.
(12) For the purposes of this methodology, the 75th percentile of national length of stay data, as set forth in Appendix D-2, infra, shall be used. This national data is collected from inpatient discharge records submitted by hospitals participating in the Professional Activity Study. If a DRG is excluded from the national survey because it is no longer valid, ungroupable or inappropriate for length of stay determinations, then the actual New York State average length of stay by payor group in the base year shall be used for the expected length of stay in the target year.
(13) Pediatric days are defined as days for patients ages 0-14. The actual proportion of pediatric days as a percent of total medical/surgical and pediatric days combined for the base year is calculated for each county of hospitalization based on the age of the patients discharged. This actual base year percent distribution is multiplied by the projected number of total medical/surgical and pediatric days combined for the planning target year to derive projected pediatric days.
(14) The following occupancy levels are applied to project acute care bed need by county and bed type:
| Bed Type | Urban | Rural | | --- | --- | --- | | Medical/surgical | .85 | .80 | | Pediatric | .70 | .65 | | Obstetric | .75 | .70 |
For purposes of this methodology, the following counties are considered urban - Albany, Broome, Dutchess, Erie, Monroe, Nassau, Niagara, Oneida, Onondaga, Orange, Rockland, Suffolk, Westchester, Bronx, Kings, New York, Queens and Richmond. The rural occupancy proportions shall be applied in all other counties in New York State.
(15) Patients who no longer require acute care but stay in the hospital Pending discharge are termed alternate level of care (ALC) patients. Their bed use shall be added to the acute care bed need projected for the planning target year. The number of ALC days in the base year and the year five years previous to the base year is extracted from the SPARCS case-mix file by county of hospitalization for the following age groups - 0-44, 45-64, 65-74, 75-84 and 85 and older. The statewide average annual rate of change in the number of ALC days by age group is calculated between the year five years previous to the base year and the base year. This average annual rate of change is applied to the statewide actual number of ALC days by age group in the base year and each year thereafter to the planning target year. The total number of ALC days statewide for the planning target year by age group are then distributed to each county of hospitalization according to the percent distribution of ALC days by county in the base year.
(16) Projected ALC days by county of hospitalization are summed across the age groups to derive a total number of expected ALC days by county. ALC days by county are divided by 365 to calculate an average daily census which is then added to the projected number of acute care beds needed in each county.
(17) The estimates of need for acute care beds as derived in the foregoing provisions of this section do not include estimates of need for acute care beds for patients with HIV/AIDS. Need for acute care beds to serve such patients shall be in addition to the estimates of need otherwise derived in this subdivision. If there are other patients with extraordinary disease occurrences whose acute care use is not adequately represented in the base year rate or in the rate for the year five years previous to the base year, an estimate of expected additional acute care bed need for the planning target year also shall be added to account for the needs of these patients.
(e) The methodology to derive an estimate for the need for obstetrical or maternity service beds in the planning target year shall be as follows:
(1) The number of expected live births for the planning target year is calculated by applying the projected age-specific birth rate for the planning target year as estimated by the New York State Department of Economic Development to the projected female population of child-bearing age (15-44 years) for the planning target year. If the projections of births for the planning target year are based on census data collected 10 years or more before the planning target year, projections of births for the planning target year shall be adjusted to account for the percent difference in the most recent year's actual births and the Department of Economic Development's projection of births for that same year.
(2) An estimated rate of spontaneous fetal deaths and induced abortions is applied to the projected female population of child-bearing age (15-44 years) for the planning target year and then added to the expected number of live births to derive total expected obstetric discharges.
(3) To derive the estimated number of discharges in the planning target year by county of hospitalization, the estimated number of expected discharges for the planning target year by county of residence shall be adjusted to reflect the migration of patients between counties in the State and for patients migrating from other states to New York for the female population ages 15-44, as set forth in paragraphs (d)(9) and (10) of this section.
(4) The number of estimated obstetric discharges for the planning target year is adjusted to account for the number of antenatal admissions, defined as admissions to obstetric beds which, while maternity related, do not result in a delivery. Examples of antenatal services are ectopic pregnancies, threatened abortions, miscarriages, false labor and maternity-related diagnostic procedures. The same proportion of antenatal discharges by county of hospitalization, in the base year is added to the estimated number of obstetric discharges in the planning target year.
(5) Expected discharges for the planning target year by obstetric-related diagnostic related group and payor are distributed as set forth in paragraph (d)(11) of this section.
(6) The expected number of obstetric days for the planning target year is calculated by multiplying the number of projected discharges for each obstetric-related DRG and payor group by either the actual average county length of stay or the 75th percentile of national length of stay by DRG and payor group, as set forth in Appendix D-2, infra, whichever is lower. Total obstetric days for the planning target year shall be further adjusted to reflect an expected length of stay for cesarean deliveries estimated by the Department of Health based on an analysis of the expected frequency and length of stay of cesarean section deliveries in New York State hospitals.
(7) The expected number of obstetric days of hospitalization in the planning target year is divided by 365 to derive an average daily census for each county.
(8) The estimated number of obstetric beds needed in each county in the planning target year is calculated by dividing the average daily census by the expected occupancy rate as set forth in paragraph (d)(14) of this section.
(f) Periodically, but at least every five years from the base year, the Department of Health, in conjunction with the health systems agencies' and the State Hospital Review and Planning Council, shall review and update the methodology and projections established pursuant to this section to project acute care bed need to a new planning target year not to exceed five years from a new base year.
(g) The county acute care bed need totals for medical/surgical, pediatric and obstetric beds determined in accordance with subdivisions (c), (d) and (e) of this section shall constitute the estimated public need for medical/surgical, pediatric and obstetric beds in each county for the planning target year. Each health systems agency may review the estimated bed need of its region and, in conjunction with the Department of Health and the State Hospital Review and Planning Council, may:
(1) make recommendations for amending the need estimates developed in accordance with subdivisions (c), (d) and (e) of this section to reflect local characteristics. Factors that may be considered in this analysis include, but are not limited to, the following: an analysis of current utilization patterns as it relates to projected trends developed pursuant to the methodology for determining public need for acute care beds in subdivisions (c), (d), and (e) of this section, health status indices of the population, high and low variation discharge composition, ambulatory care sensitive discharge experience and trends in alternate level of care;
(2) identify counties at high risk of undergoing acute care system changes due to an estimated excess of medical/surgical, pediatric and/or obstetric bed capacity for the planning target year. Acute care system changes shall refer to any or all of the following occurrences: discontinuation of acute care services, conversion of all or a portion of the acute care beds, decertification of all or a portion of the acute care beds or hospital closure. A county at high risk of acute care system changes is one that meets at least one of the following criteria:
(i) the estimated acute care bed need in the county for the planning target year is less than 85 percent of existing capacity and there is at least one hospital in the county with fewer beds than the estimated excess in medical/surgical, pediatric, and/or obstetric beds for the county; or
(ii) the county is identified as being at high risk by the local health systems agency, subject to the approval of the commissioner, when other factors are determined to result in acute care systems changes.
(h) The Department of Health in conjunction with the health systems agencies may develop institution-specific recommendations, with the concurrence of the State Hospital Review and Planning Council, for expected service needs and capital expenditure requirements. Commencing in 1994, and no more frequently than once a year, acute care facilities, in counties identified as being at high risk pursuant to subdivision (g) of this section, may be required to submit to the commissioner, on forms prescribed by the commissioner, a summary assessment of the facility's service needs and capital expenditure requirements for at least the following five calendar years. Based on these five-year plans and the estimated need for acute care beds in the county, the department, in consultation with the local health systems agencies, shall identify the need for appropriate changes in facility utilization and services provided to achieve the projected acute care bed need.
(i) Results of the acute care bed need methodology, as set forth in subdivisions (c), (d) and (e) of this section, together with any adjustments approved by the commissioner in consultation with the State Hospital Review and Planning Council and developed in accordance with subdivision (g) of this section, shall be used when an application proposes one of the following:
(1) an increase in the facility's medical/surgical, pediatric or obstetric bed composition;
(2) a change in the operator of a hospital that requires a need review;
(3) a capital investment which meets at least one of the following criteria:
(i) the project is a Capital Architectural and Program Alternatives (CAPA) project with total basic costs of construction as defined in section 710.1 of this Title, exceeding $25,000,000; or
(ii) the total basic costs of construction is an amount which is greater than 50 percent of the net depreciated value of the facility's total fixed assets used for hospital purposes.
(j) When submitting feasibility studies in support of applications which are subject to this section, applicants shall use the same discharge utilization rate calculations and trends as used in the acute care bed need methodology set forth in subdivisions (c), (d) and (e) of this section. Feasibility studies may not incorporate changes in hospital discharges based on market share changes except in the following instances:
(1) acquisition of another hospital and consolidation of inpatient activity;
(2) introduction of new services unavailable to the hospital service area population; or
(3) continued increases in the market share between the year five years previous to the base year and the base year.
(k) The review of, and recommendations and decisions concerning, applications subject to this section shall be based upon the following:
(1) the estimated county acute care bed need as set forth in subdivisions (c), (d), (e) and (g) of this section; and
(2) the county's expected service needs and capital expenditure requirements, and the recommendations developed and need for changes identified in accordance with subdivision (h) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
FACILITY OPERATIONS FACILITY OPERATIONS
10 CRR-NY 72-1.10 Protective eyewear
(a) The operator shall ensure that each patron using an ultraviolet radiation device possesses adequate protective eyewear; such protective eyewear shall be in accordance with all applicable federal regulations.
(b) Adequate protective eyewear shall be provided at no additional charge to patrons not possessing their own protective eyewear.
(c) The operator shall have available for patron use an adequate number of sets of protective eyewear.
(d) The protective eyewear provided by the operator other than single-use disposable eyewear shall be cleaned and then disinfected after each use according to provisions detailed in section 72-1.9(d)(5) of this Subpart.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.17 Security standards; agents of nonpractitioners
When controlled substances are distributed by nonpractitioners through agents ( i.e., detailmen), the licensee is responsible for providing and requiring adequate security to guard against theft or diversion while the substances are being stored or handled by the agent.
Subchapter N PROFESSIONAL MEDICAL AND DENTAL SERVICES
Part 91 EXCESS LIABILITY INSURANCE POOL: PHYSICIANS AND DENTISTS
10 CRR-NY 91.3 Determination of cost and reimbursement of excess medical malpractice coverage
(a) Based on the certification by general hospitals pursuant to section 91.2 of this Part of physicians and dentists eligible for excess coverage or equivalent excess coverage, the Superintendent of Insurance shall determine and certify to each general hospital and to the Commissioner of Health, and may amend such determination and certification as necessary, the cost of excess malpractice insurance or equivalent excess insurance, including an allocable share of pool administration costs, for medical and dental malpractice occurrences between July 1, 1986 and June 30, 1987, July 1, 1987 through December 31, 1987, and semi-annual periods beginning July 1st and January 1st, thereafter.
(b)
(1) The Commissioner of Health or his designee shall adjust the established inpatient rates of each general hospital (for rate periods during the periods July 1, 1986 through June 30, 1987, and annual periods beginning July 1st, thereafter, excluding rates of payment for State governmental agencies for rate periods during the period July 1, 1991 through June 30, 1992 and annual periods beginning July 1st, thereafter) proportionally, based upon the allocation of the general hospital's inpatient malpractice costs among rate payors and general hospital charge payors used in determining inpatient rates of payment and charges for 1986; and each annual period thereafter, for such general hospital pursuant to Subpart 86-1 of this Title, to reflect the cost of excess insurance coverage or equivalent excess coverage allocated to such general hospital pursuant to subdivision (a) of this section for such rate periods, and shall adjust the determination of the general hospital's maximum inpatient charges. The Commissioner of Health shall further adjust such rates of payment (excluding rates applicable to State governmental agencies as of July 1, 1991) to reflect significant changes in volume of service. The adjustment shall be made for the periods July 1, 1986 to June 30, 1987, and semi-annual periods beginning July 1st and January 1st, thereafter, and shall not be carried forward.
(2) In the event that rates of payment for persons eligible for payment pursuant to title XVIII of the Federal Social Security Act (Medicare) do not include the portion of such cost allocable to such patients, such portion of the cost shall for purposes of further adjustment be reallocated among payors whose rates of payment or charges are determined in accordance with Subpart 86-1 of this Title and rates of payment for such payors (excluding rates applicable to State governmental agencies as of July 1, 1991) shall be adjusted proportionally based upon the allocation of general hospital malpractice costs among such payors used in determining inpatient rates of payment and charges for 1986, and each respective annual rate period thereafter, for such general hospital pursuant to Subpart 86-1 of this Title and the determination of the general hospital's maximum inpatient charges shall be adjusted so that the costs of such excess insurance coverage or equivalent excess coverage excluding costs allocated or reallocated to rates applicable to State governmental agencies for periods on and after July 1, 1991, are fully reflected in hospital inpatient rates of reimbursement and maximum charges; provided, however, that if a general hospital's inpatient malpractice cost is allocated entirely to title XVIII of the Federal Social Security Act (Medicare) in determining rates and charges for 1986, and each respective annual rate period thereafter, in accordance with Subpart 86-1 of this Title, (excluding rates applicable to State governmental agencies on and after July 1, 1991) for purposes of further adjustment the cost of excess insurance coverage or equivalent excess coverage shall be reallocated among payors whose rates of payment or charges are determined in accordance with Subpart 86-1 of this Title based upon the statewide average general hospital malpractice cost allocation among such payors in each rate period. Such adjustments shall be made for the periods July 1, 1986 through June 30, 1987, and semi-annual periods beginning July 1st and January 1st, thereafter, and shall not be carried forward.
(c) In rate periods commencing January 1, 1990 and thereafter, the Commissioner of Health or his designee shall adjust proportionally the established inpatient rates of each general hospital excluding rates of payment applicable to State governmental agencies on and after July 1, 1991 based upon the allocation of the general hospital's inpatient malpractice costs among rate payors and general hospital charge payors used in determining inpatient rates of payment and charges for such general hospitals for such rate period pursuant to Subpart 86-1 of this Title, to reflect payments due to the hospital excess liability pool or refunds received from the hospital excess liability pool by the hospital pursuant to section 91.4(e) of this Part, and maximum inpatient charges of such general hospital computed in accordance with Subpart 86-1 of this Title shall be adjusted accordingly. Such adjustments in a rate period shall not be carried forward except that such adjustments shall be included in volume adjustments authorized for such hospital for such rate period.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.2 Practice requirements/eligibility
(a) A new pediatric practitioner may be eligible to contract with the program if the practitioner:
(1) agrees to provide pediatric services full-time in a designated pediatric area;
(2) agrees that the ratio of the practice's target patient population to the total patient population will be equal to or greater than the ratio of the target population in the designated area to the total population in that designated area;
(3) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Pediatricians);
(4) has the education, training and access to health care facilities to provide pediatric services to the eligible population (or, for a pediatric nurse practitioner, a practice arrangement with a pediatric practitioner who meets such requirements) including:
(i) hospital admitting privileges;
(ii) arrangements for 24-hour backup coverage; and
(iii) has purchased medical malpractice insurance from a medical liability insurer; and
(5) is responsible for paying his/her own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her malpractice insurance premiums.
(b) An additional service obstetric practitioner may be eligible to contract with the program if the practitioner:
(1) agrees to increase the number of the target population provided comprehensive obstetrical services over the number served preceding the application;
(2) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Obstetricians and Gynecologists, the American Academy of Family Practitioners, or the American College of Nurse-Midwives);
(3) has the education, training and access to health care facilities to provide obstetric services to the eligible population (or, for obstetric nurse practitioners, a practice arrangement with an obstetric practitioner who meets such requirements) including:
(i) hospital admitting and delivery privileges in a hospital with maternity services or practice privileges in a birth center; and
(ii) arrangements for 24-hour backup coverage; and
(iii) has purchased medical malpractice insurance from a medical liability insurer; and
(4) is responsible for paying his/her/their own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her malpractice insurance premiums.
(c) A disproportionate share obstetric practitioner may be eligible to contract with the program if the practitioner:
(1) agrees to maintain his/her/their current high number of the target population provided comprehensive obstetrical services: the number of deliveries required to be performed to be considered a group providing a disproportionate share of services is the sum of those required for each individual to be a disproportionate share provider;
(2) agrees to provide medical care in accordance with accepted medical standards (for example, standards accepted by the American College of Obstetricians and Gynecologists, the American Academy of Family Practitioners, or the American College of Nurse-Midwives);
(3) has the education, training and access to health care facilities to provide obstetric services to the eligible population (or for obstetric nurse practitioners, a practice arrangement with an obstetric practitioner who meets such requirements) including:
(i) hospital admitting and delivery privileges in a hospital with maternity services or practice privileges in a birth center;
(ii) arrangements for 24-hour backup coverage; and
(iii) has purchased medical malpractice insurance from a medical liability insurer; and
(4) is responsible for paying his/her/their own malpractice insurance premiums or is a member of a partnership or professional corporation which is responsible for paying his/her/their malpractice insurance premiums.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.176 Dressing rooms and areas
In establishments where employees routinely change clothes, rooms or areas are to be designated and used for this purpose. These designated rooms or areas are not to be used for food preparation, storage or service, or for utensil washing or storage.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.212 Net square feet
Gross square feet of a building less common areas. To determine net square feet, the number of square feet in each cost center of the hospital may be determined either by a physical measurement of the hospital or by a measurement from blueprints. Floor area measurements should be taken from the center of walls to the center of adjoining corridors if a hallway services more than one cost center. Exclude stairwells, elevators, and other shafts, commonly used (lobbies, etc.) and idle areas. Idle areas are those areas that are closed off or unused for a period of time. Hallways, waiting rooms, storage areas, etc., serving only one cost center should be included in that cost center. The effect of using only usable space in the allocable floor area is to allocate the nonproductive space (commonly used and idle area) among the cost centers in the ratio of space used.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
VILLAGES VILLAGES
10 CRR-NY 127.1 Village of Freeport
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such additional wells as may be developed in the future on the property of the Village of Freeport, Nassau County, New York, such wells being the sources of public water supply of the Village of Freeport.
(b) Definitions.
(1) The term well whenever used in this section means any well now used as a source of this public water supply or any additional well which may be constructed on the property of the Village of Freeport for the purpose of this water supply.
(2) Wherever the linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies, cesspools, septic tanks.
(1) No privy, cesspool, septic tank, subsurface leaching tile or receptacle of any kind for the storage, deposit or disposal of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(2) No human excreta or sewage shall be so stored, disposed of or discharged onto the surface of the ground so that the material will drain or be washed by rain or melting snow to points within 200 feet of any well, and no person shall commit a nuisance by the discharge of body wastes on the surface of the ground within 200 feet of any well.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(4) No cesspool, pit or receptacle of any kind for the storage, deposit or disposal of bath water, sink or laundry wastes, garbage, refuse, manure or putrescible matter shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(d) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any well.
(e) Trespassing.
No trespassing shall be allowed upon the property of the Village of Freeport upon which the wells of the public water supply are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said village.
(f) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(g) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Village of Freeport.
(h) Inspections.
The Village of Freeport, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid village to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Village of Freeport to promptly notify the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.94 Existing equipment
A food vending machine or piece of equipment used in existing food vending operations is acceptable for that operation provided that it is in good repair, maintained in a sanitary condition, the food-contact surfaces are nontoxic, and it performs its intended function in a satisfactory manner without contaminating food by normal use.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 2 PUBLIC HEALTH NURSE 2
10 CRR-NY 11.44 Supervisory level definition
The term supervising public health nurse shall mean a nurse who supervises public health nurses 1 and 2 and other staff. A supervising public health nurse plans, provides, and evaluates nursing care in a variety of settings with the goal of improving health outcomes and is actively involved in the planning, development, provision and evaluation of public health programs designed to prevent disease and improve the health of individuals, families, specific populations, high-risk groups and/or communities. A supervising public health nurse may be involved in program administration and/or program budget development and monitoring and/or quality improvement initiatives, and/or acting as advocate and liaison for constituents and/or policy development.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.29 Maintenance of medical records
(a) Private practicing psychiatrists shall maintain medical records containing information sufficient to justify the diagnosis and warrant the treatment of each medical assistance patient served.
(b) As part of this documentation, each medical record shall include:
(1) identifying information about the person treated;
(2) current diagnosis as contained in an approved nomenclature manual such as the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, 1980 (copies are available from the publisher, American Psychiatric Association, 1700 18th Street, N.W., Washington, DC 20009) or the International Classification of Diseases, 9th revision, Clinical Modification, 1978 (copies are available from the publisher, Commission on Professional and Hospital Activities, 1968 Green Road, Ann Arbor, MI 48105). Both publications are available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY;
(3) a description of the patient's problems, strengths, conditions, disabilities and needs;
(4) a statement of the goals and objectives of treatment to address the patient's problems, disabilities and needs, including an estimate of the duration of the patient's need for treatment, a description of the proposed treatment and prognosis;
(5) progress notes providing a chronological description of the patient's progress in relation to the goals and objectives of the established plan of treatment; and
(6) a summary of the patient's condition and disposition when treatment is completed or terminated.
(c) Patient medical records shall be retained in accordance with requirements contained in Social Services regulations (18 NYCRR 540.7).
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.9 Computers
(a) The provision, at less than fair market value, of computers, including hardware, hard drives, or monitors; or of computer equipment or supplies such as stands, tables, printers, printer stands, interfacing telephone lines, or modems; or of software, by a clinical laboratory to a health services purveyor, is prohibited, except as stated in this section.
(b) Nothing in Public Health Law, section 587 or in this Subpart shall be construed to prohibit a clinical laboratory from providing a computer, computer equipment, computer supplies and/or software, and/or developing and providing software, to a health services purveyor, under the following circumstances:
(1) the computer, computer equipment, computer supplies and/or software are solely and exclusively used for, and are solely and exclusively dedicated to, enabling the health services purveyor to:
(i) make referrals of specimens for the performance of clinical laboratory services to the clinical laboratory;
(ii) receive, access, print and/or store test results from the clinical laboratory, including cumulative test results concerning a particular patient, and including test related information stored by the clinical laboratory;
(iii) transmit data to the clinical laboratory necessary for preparation of laboratory requisition forms and/or billing invoices; and
(iv) transfer laboratory related data from the clinical laboratory to any computer system maintained by the health services purveyor;
(2) the clinical laboratory takes reasonable steps to ensure that the computer, computer equipment, computer supplies and/or software are solely and exclusively used as set forth in this Subpart;
(3) the clinical laboratory reasonably monitors the use of the computer, computer equipment, computer supplies and/or software;
(4) ownership of the computer, computer equipment, computer supplies and/or software remains in the clinical laboratory;
(5) the clinical laboratory is responsible for all repair and maintenance of the computer, computer equipment and/or software; and
(6) the clinical laboratory maintains reasonable documentation that the computer, computer equipment, computer supplies and/or software is being used solely and exclusively as set forth in this Subpart.
(c) Nothing in Public Health Law, section 587 or in this Subpart shall be construed to prohibit a general hospital licensed pursuant to article 28 of the Public Health Law from providing a computer, computer equipment, computer supplies and/or software to a health services purveyor to facilitate the delivery of clinical laboratory services and health services to inpatients and outpatients of the general hospital, including, but not limited to, records access, patient admission, outpatient or inpatient service scheduling, and clinical laboratory service authorization, provided that the health services purveyor is a staff member or has professional privileges at the general hospital.
(d) Any computer, computer equipment, computer supplies and/or software provided to a health services purveyor in a manner prohibited by this Subpart, and which is in the possession of the health services purveyor at the time this Subpart becomes effective, shall be:
(1) returned to the clinical laboratory by the health services purveyor or reclaimed by the clinical laboratory within 60 days of the effective date of this Subpart; or
(2) brought into compliance with this Subpart within 60 days of the effective date of this Subpart.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.28 Applicability and general requirements
(a) Sections 85.28 and 85.29 of this Part shall only apply to outpatient psychiatric care provided by a private practicing psychiatrist.
(b) A private practicing psychiatrist is a physician who renders treatment to a patient on a fee- for-service basis and who is compensated for those services directly through the medical assistance for the needy program, except that payment for services may be made directly to a professional corporation or partnership in which the private practicing psychiatrist is a member or with which the private practicing psychiatrist is associated, or in the case of a shared health facility as provided in subdivision 8 of section 4708 of the Public Health Law.
(c) To be a covered benefit under medical assistance for the needy as provided in section 365-a of the Social Services Law, outpatient psychiatric care rendered by a private practicing psychiatrist must be provided by a qualified psychiatrist in accordance with the requirements of this section and section 85.29 of this Part.
(d) A qualified psychiatrist shall meet the requirements contained in the Social Services regulations (18 NYCRR 505.2).
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.8 Scope of audit and report of CPA
A MCO shall have financial statements furnished pursuant to section 98-3.4 of this Subpart audited by the CPA. The audit of the MCO’s financial statements shall be conducted in accordance with generally accepted auditing standards. The MCO shall attach to its financial statements a description, for each person assigned to the engagement pursuant to section 98-3.11 of this Subpart, of the following: the accountant’s background and experience in general, the accountant’s experience with insurance matters, and whether each is a CPA.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.15 Religious services and counseling
If provided, religious services and counseling must be included in the registrant's care plan.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.2 Corporate organization
(a) Members of the board of directors of a nursing home company shall be responsible for company assets, liabilities, administration and operations as required by article 28-A of the Public Health Law and the Not-For-Profit Corporation Law.
(b) The certificate of incorporation of a nursing home company shall be in a form designated by the State Commissioner of Health as meeting the requirements of the Not-For-Profit Corporation Law, and the Public Health Law and the Public Health Council.
(c) By-laws of a nursing home company shall contain a requirement that a nursing home company be constructed and operated in accordance with all applicable provisions of the State Hospital Code. The by-laws shall require that meetings of the board of directors be held no less frequently than annually and shall set forth provisions relating to the election of members and officers of the board, the notice requirements for board meetings, the duties and powers of the board, the provisions for amendment or repeal of the by-laws, and a requirement that the board shall make every effort to avoid contracts which may involve a conflict of interest, disclosure being required in writing to the board by any board member having an interest in any contract or proposed contract relating to the development, construction or operation of a company. A nursing home company shall file a copy of the by-laws and any amendments thereto with the State Department of Health.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.2 Birth records; confidential information
(a) A certified copy or a certified transcript of a birth certificate shall be issued only:
(1) upon order of a court of competent jurisdiction;
(2) upon specific request by the person, if 18 years of age or more, or by a parent or other lawful representative of the person to whom the record of birth relates; or
(3) upon specific request therefor to the Commissioner of Health of the State of New York by municipal, State or Federal agencies when needed for official purposes.
(b) A certification of birth shall be issued when required for a proper purpose. A proper purpose shall not exist when the record is requested for commercial or profitmaking purposes or to satisfy idle curiosity.
(c) The confidential information for medical and health use only furnished with a certificate of live birth shall not be copied and shall be detached except as herein provided. Data thereon, as determined by the State Commissioner of Health, shall be recorded on appropriate storage media for scientific research only. Following such recording the portion containing such confidential information shall be detached from the original certificate by the State Commissioner of Health or other person authorized by him who shall then destroy such portion. No copy of a certificate issued pursuant to sections 4173 and 4174 of the Public Health Law shall contain such information.
(d) The request for a certified copy of a birth certificate, a certified transcript of a birth certificate or a certification of birth shall include such documentation required by the State Health Commissioner to establish the stated need.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
VILLAGES VILLAGES
10 CRR-NY 148.1 Village of Jeffersonville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Leikel Brook and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Village of Jeffersonville, Sullivan County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoir on Leikel Brook, which is tributary to or which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Jeffersonville.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the Village of Jeffersonville.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper and sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 400 feet from any reservoir or watercourse tributary to the public water supply of the village of Jeffersonville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface [waters] or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any watercloset, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Jeffersonville, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 200 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Jeffersonville, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of any reservoir of*75 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Jeffersonville.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Jeffersonville. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Jeffersonville.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Jeffersonville, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Jeffersonville.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Jeffersonville, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 400 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the village of Jeffersonville; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Jeffersonville.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the village of Jeffersonville, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the village of Jeffersonville.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Jeffersonville, except by duly authorized employees of the village of Jeffersonville in the performance of their duties of supervision and maintenance of the public water supply of the village of Jeffersonville.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or within 300 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the village of Jeffersonville.
(j) Inspections.
The board of trustees of the village of Jeffersonville or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Jeffersonville or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 410 SCHEDULED SHORT-TERM CARE IN A NURSING HOME
10 CRR-NY 410.3 Service approval and physical space
(a) A request for approval of a proposal for a scheduled short-term care service shall be subject to a limited review pursuant to the provisions of section 710.1(c)(5)(iv)( c ) of this Title. Letters of request shall include any information relating to costs for construction or hiring of new staff associated with this proposal.
(b) The addition of up to two beds to be used exclusively for scheduled short-term care, shall not be counted within the State certified bed capacity of the facility and shall be exempt from the provisions of section 709.1 (Determination of Public Need Pursuant to section 2802 of the Public Health Law) and section 709.3 (Residential Health Care Facility Beds) of this Title.
(c) The spaces and equipment shall meet the applicable standards of construction set forth in Part 711 or 713 of Subchapter C of this Title.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 114 ESSEX COUNTY
INSTITUTIONS INSTITUTIONS
10 CRR-NY 114.35 State Hospital at Raybrook
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs, watercourses and drainage areas tributary thereto, used as sources of the water supply of the State Hospital for the Treatment of Incipient Pulmonary Tuberculosis at Raybrook, New York.
(b) Definitions.
(1) For the purposes of this section institution means the State Hospital for the Treatment of Incipient Pulmonary Tuberculosis at Raybrook, New York.
(2) Water supply means the water supply of the State Hospital for the Treatment of Incipient Pulmonary Tuberculosis at Raybrook, New York.
(3) Reservoir means Alford Pond and the intake reservoir on the outlet stream of said pond and any additional reservoir which may be constructed or used for water supply for the institution.
(4) Watercourse means any spring, stream, marsh or channel of any kind, the waters of which flow or may flow into the water supply of the State Hospital for the Treatment of Incipient Pulmonary Tuberculosis at Raybrook, New York.
(5) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse tributary to the water supply of the institution.
(2) No privy, privy vault, pit, cesspool or other receptacle, placed or used for the permanent deposit of human excreta and which is not watertight, shall be constructed, located, placed, maintained or allowed to remain within 250 feet of any reservoir or watercourse tributary to the water supply of the institution.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraphs (1) and (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers be thoroughly covered while being transported and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or watercourse tributary to the water supply of the institution.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the water supply of the institution, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 250 feet of any reservoir or watercourse tributary to the water supply of the institution.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the water supply of the institution, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any reservoir or watercourse tributary to the water supply of the institution.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the water supply of the institution.
(e) Bathing, boating, fishing and ice cutting.
No person shall bathe, boat, fish or cut ice and no domestic animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in the intake reservoir of the water supply of the institution.
(f) Animals, manure, compost and barnyards.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the water supply of the institution.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the water supply of the institution, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or watercourse tributary to the water supply of the institution; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or watercourse tributary to the water supply of the institution.
(3) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain within 100 feet from any reservoir or watercourse tributary to the water supply of the institution.
(g) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the water supply of the institution, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the water supply of the institution.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or any watercourse tributary to the water supply of the institution.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or any watercourse tributary to the water supply of the institution.
(j) Inspections.
The superintendent of the institution or such other person or persons as may be charged with the maintenance or supervision of the water supply of the institution shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said superintendent to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the superintendent to promptly notify the State Commissioner of Health of such violations. The superintendent shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the institution.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.141 Fund asset
An asset belonging to a particular fund or a group of funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.2 Board of examiners; general powers
(a) The board by majority vote of the whole number shall adopt and amend rules and regulations, to be certified by the commissioner prior to filing with the Secretary of State, to effectuate the provisions and purposes of article 28-D of the Public Health Law.
(b) The board shall take such actions as may be necessary to enable the State to meet the requirements set forth in section 1908 of the Social Security Act, the Federal rules and regulations promulgated thereunder and other pertinent Federal authority.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.14 Patient revenue account descriptions
[3221]
(a) The specific patient revenue accounts and related expense accounts are listed in Part 443 of this Article. Detailed descriptions of the functions or types of activities to be included in each revenue center are included in the cost center descriptions which follow. The revenue relative to these functions and activities must be reported in the revenue account matching the cost center in which the costs are reported. For example, charges for Pediatric Acute services are reported in Pediatric Acute (account 3170) and the cost of the services are reported in Pediatric Acute (account 6170). Emergency Services are reported in Emergency Services (account 3710) and the cost of the services are reported in Emergency Services (account 6710). Thus a matching of revenues and expenses is achieved within each cost center.
(b) For the new reporting requirements contained in the following subdivisions of this section, the initial reporting year is indicated in parentheses. For example, account 3620—Skilled Nursing Care—Medicaid Certified in subdivision (f) of this section has 1980 in parentheses. This means this revenue center must be reported for the reporting period beginning in 1980 and thereafter. All other revenue centers are required to be reported for reporting periods beginning in 1979 and thereafter.
(c) DAILY HOSPITAL SERVICES—ACUTE CARE REVENUE.
3010
MEDICAL/SURGICAL ACUTE
3170
PEDIATRIC ACUTE
3210
PSYCHIATRIC ACUTE
3250
OBSTETRICS ACUTE
3280
DEFINITIVE OBSERVATION
3290
OTHER ACUTE CARE
(d) DAILY HOSPITAL SERVICES—INTENSIVE CARE REVENUE.
3310
MEDICAL/SURGICAL INTENSIVE CARE
3330
CORONARY CARE
3331
Myocardial Infarction
3332
Pulmonary Care
3333
Heart Transplant
3339
Other Coronary Care
3350
PEDIATRIC INTENSIVE CARE
3370
NEO-NATAL INTENSIVE CARE
3380
BURN CARE
3390
PSYCHIATRIC INTENSIVE CARE
3410
OTHER INTENSIVE CARE I
3420
OTHER INTENSIVE CARE II (1980 Optional)
3430
OTHER INTENSIVE CARE III (1980 Optional)
(e) DAILY HOSPITAL SERVICES—NURSERY REVENUE
3510
NEWBORN NURSERY
3520
PREMATURE NURSERY
(f) DAILY HOSPITAL SERVICES—SUB-ACUTE CARE REVENUE.
3610
SKILLED NURSING CARE—MEDICARE OR MEDICARE/MEDICAID CERTIFIED (1980)
3620
SKILLED NURSING CARE—MEDICAID CERTIFIED (1980)
3630
PSYCHIATRIC LONG-TERM CARE
3640
TUBERCULOSIS LONG-TERM CARE (1980)
3650
INTERMEDIATE CARE—MENTALLY RETARDED (1982)
3660
INTERMEDIATE CARE—OTHER (1980)
3670
RESIDENTIAL CARE
3680
OTHER SUB-ACUTE CARE SERVICES
3680
OTHER SUB-ACUTE CARE HOSPITAL SERVICES (1982)
3690
OTHER SUB-ACUTE CARE NON-HOSPITAL SERVICES (1982)
(g) AMBULATORY SERVICES REVENUE
3710
EMERGENCY SERVICES
3711
Emergency Room
3712
Observation
3719
Other Emergency Services
3720
CLINIC SERVICES
3721
Allergy Clinic
3722
Cancer Clinic
3723
Cardiology Clinic
3724
Dental Clinic
3725
Dermatology Clinic
3726
Diabetic Clinic
3727
Drug Abuse Clinic
3728
Ear, Nose and Throat Clinic
3729
Eye Clinic
3731
General Medicine Clinic
3732
Obstetrics/Gynecology Clinic
3733
Orthopedic Clinic
3734
Pediatric Clinic
3735
Physical Medicine Clinic
3736
Psychiatric Clinic
3737
Surgery Clinic
3738
Urology Clinic
3739
Venereal Disease Clinic
3799
Other Clinic Services
3810
HOME PROGRAM DIALYSIS EQUIPMENT—100% (1980)
3820
HOME PROGRAM DIALYSIS OTHER (1980)
3830
AMBULATORY SURGERY SERVICES
3840
PSYCHIATRIC DAY AND NIGHT CARE SERVICES
3850
AMBULANCE SERVICES
3860
OTHER AMBULATORY SERVICES
3870
FREE STANDING CLINIC I
3880
FREE STANDING CLINIC II (1980 Optional)
3890
FREE STANDING CLINIC III (1980 Optional)
3910
HOME HEALTH SERVICES—SKILLED NURSING CARE (1980)
3920
HOME HEALTH SERVICES—MEDICAL SOCIAL SERVICES (1980)
3930
HOME HEALTH SERVICES—HOME HEALTH AIDES (1980)
3990
HOME HEALTH SERVICES—OTHER HOME HEALTH (1980)
(h) ANCILLARY SERVICES REVENUE
4010
LABOR AND DELIVERY SERVICES
4040
SURGERY SERVICES (1980)
4041
General Surgery
4042
Open Heart Surgery
4043
Neurosurgery
4044
Orthopedic Surgery
4045
Kidney Transplant
4046
Other Organ Transplants
4049
Other Surgical Services
4060
RECOVERY SERVICES (1980)
4080
ANESTHESIOLOGY
4110
MEDICAL SUPPLIES SOLD
4130
DURABLE MEDICAL EQUIPMENT—SOLD (1982)
4140
DURABLE MEDICAL EQUIPMENT—LEASED/RENTED (1982)
4150
DRUGS SOLD
4210
LABORATORY SERVICES—CLINICAL
4211
Chemistry
4212
Hematology
4213
Immunology (Serology)
4214
Microbiology (Bacteriology)
4215
Procurement and Dispatch
4216
Urine and Feces
4219
Other Clinical Laboratories
4230
LABORATORY SERVICES—PATHOLOGICAL
4231
Cytology
4232
Histology
4233
Autopsy
4239
Other Pathological Laboratories
4250
WHOLE BLOOD AND PACKED RED CELLS (1980)
4260
BLOOD STORING AND PROCESSING
4290
ELECTROCARDIOGRAPHY
4310
CARDIAC CATHETERIZATION LABORATORY
4320
RADIOLOGY—DIAGNOSTIC
4321
Angiocardiography
4322
Ultrasonography
4339
Radiology—Diagnostic—Other
4340
CT SCANNER
4360
RADIOLOGY—THERAPEUTIC
4380
NUCLEAR MEDICINE
4381
Nuclear Medicine—Diagnostic
4382
Nuclear Medicine—Therapeutic
4420
RESPIRATORY THERAPY
4440
PULMONARY FUNCTION TESTING
4460
NEUROLOGY—DIAGNOSTIC
4461
Electroencephalography
4462
Electromyography
4510
PHYSICAL THERAPY
4530
OCCUPATIONAL THERAPY
4550
SPEECH-LANGUAGE PATHOLOGY
4570
RECREATIONAL THERAPY
4580
AUDIOLOGY
4590
OTHER PHYSICAL MEDICINE
4670
PSYCHIATRIC/PSYCHOLOGICAL SERVICES
4671
Individual Therapy
4672
Group Therapy
4673
Family Therapy
4674
Biofeedback
4675
Psychological Testing
4676
Electric Shock Therapy
4689
Other Psychiatric/Psychological Services
4710
RENAL DIALYSIS
4711
Hemodialysis
4713
Peritoneal Dialysis
4715
Patient Dialysis Training
4719
Other Dialysis
4730
KIDNEY ACQUISITION
4750
OTHER ORGAN ACQUISITION
4910
OTHER ANCILLARY SERVICES
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.40 Food protection; potentially hazardous food; temperature and refrigeration requirements
(a) Food is to be protected from contamination during storage, transportation, display, while being held for service, or dispensing by a vending machine or in connection with vending operations. The temperature of potentially hazardous food is to be 45°F (7.2°C) or below, or 140°F (60°C) or above, at all times, except during necessary times of preparation, the actual time required to load or otherwise service the machine and for a maximum machine ambient temperature recovery period of 30 minutes following completion of loading or servicing operations. The total time that potentially hazardous food may be at a temperature between 45°F (7.2°C) and 140°F (60°C) is not to exceed two hours. Intact shell egg temperatures shall be considered acceptable if ambient storage temperature is 45°F (7.2°C) or less.
(b) Vending machines dispensing potentially hazardous food are to have heating or refrigeration units with thermostatic controls that are able to maintain the food at 140°F (60°C) or above, or 45°F (7.2°C) or below when fully loaded. These vending machines are also to have automatic controls which prevent the machine from vending potentially hazardous food until serviced by the operator in the event the temperature in the food storage compartment is not within allowed operating limits for any reason except for the permitted 30-minute period following servicing or loading.
(c) Potentially hazardous food which has been held at temperatures between 45°F (7.2°C) and 140°F (60°C), for times exceeding those allowed in this Part, is not to be vended, sold, donated or given away for use in whole or in part for human consumption.
(d) Potentially hazardous foods are to be labeled showing the name and address of the establishment where prepared and packaged.
(e) Food-vending machines vending potentially hazardous food requiring heated or refrigerated storage are to have thermometers, accurate to plus or minus 2°F (1.1°C), located in the machine that are readily observable by the person servicing the machine, showing the coldest part of the heated storage compartment and the warmest part of the refrigerated compartment.
(f) Shell eggs or foods containing shell eggs are to be heated to 145°F (62.8°C) or greater unless an individual consumer requests preparation of a shell egg or food containing shell eggs in a style such as raw, poached or fried which must be prepared at a temperature less than 145°F in order to comply with the request.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.2 Definitions
(a) Adequate shall mean sufficient to accomplish the purposes for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(b) Foot shower shall mean a shower head or similar water fixture for use in rinsing debris from patrons' feet.
(c) Patrons shall mean those individuals utilizing the spray grounds.
(d) Permit-issuing official (PIO) shall mean the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law. The permit-issuing official may designate additional persons to act in his/her behalf to issue permits required by this Subpart.
(e) Qualified swimming pool water treatment operator shall mean an individual who has successfully completed an adequate course of instruction regarding the safe and effective operation and maintenance of pool water treatment equipment.
(f) Recreational aquatic spray grounds , also known as spray grounds , are the buildings and appurtenances used in conjunction with a spray pad in which sprayed water is continually drained and collected in a treatment and recirculation system.
(g) Spray features shall mean the devices and plumbing used to convey the treated water to the spray pad to spray the patrons.
(h) Spray pad shall mean the specific area consisting of the play surface, spray features, and drains, upon which the patrons stand and are sprayed with water.
(i) Spray pad treatment system shall mean the equipment and processes used to filter, disinfect and circulate the water used for the spray pad and spray features.
(j) Spray pad treatment tank shall mean the vessel used to collect the water that has been sprayed on the spray pad and returned through the spray pad drains.
(k) Supervisory staff shall mean individuals responsible for supervising the patrons to ensure compliance with regulations for use, and trained in the operation and maintenance of the spray pad treatment system.
(l) Uniform Code shall mean the 19 NYCRR Chapter XXXIII, Subchapter A - State Uniform Fire Prevention and Building Code.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.4 General price list
A funeral firm shall present a printed or typewritten price list for retention to the individuals who inquire in person about funeral arrangements or the prices and availability of funeral services and merchandise offered. When individuals inquire in person about funeral arrangements or the prices of funeral services or merchandise, the funeral firm must offer them the list upon beginning discussion either of funeral arrangements or of the selection of any funeral services or merchandise. This list must contain at least the following information:
(a) The true funeral firm name, address and telephone number as registered with the department;
(b) A caption describing the list as a "General Price List";
(c) The effective date of the price list; and
(d) Immediately above the price disclosures required by this section, the list shall contain the statements:
(1) "The goods and services shown below are those we can provide to our customers. You may choose only the items you desire. If legal or other requirements mean you must buy any items you did not specifically ask for, we will explain the reason in writing on the statement we provide describing the funeral services and merchandise you selected."
(2) "This list may not include prices for certain items that you select, such as cemetery charges or crematory services, flowers and newspaper notices. The estimated or final prices for those items will be shown on the itemized statement describing the funeral services and merchandise you selected."
(3) If the services of the funeral director and staff cannot be declined by the purchaser, the following sentence must be inserted between the second and third sentences of the required statement in paragraph (1) of this subdivision: "However, any funeral arrangements you select will include a charge for our services."
(4) For some items that the funeral firm buys for the customer such as flowers and newspaper notices, if the firm charges more than the cost or receives and retains a rebate, commission or trade or volume discount, a sentence must be added at the end of the statement required by paragraph (2) of this subdivision, "We charge you for our services in buying certain items."
(e) The list shall include funeral home charges in the following order with the retail prices (expressed either as a flat fee or as the price per hour, mile or other unit of computation) and the other information below for each service regularly offered for sale. If any of the services or merchandise are not regularly offered by the funeral firm, they do not have to appear on the general price list.
(1) Alternative services.
(i) Direct cremations. The price range for direct cremations offered by the funeral firm must be listed. In addition, at least two package prices must be listed: for direct cremation where the purchaser provides the container and for direct cremation using an alternative container or an unfinished wooden box. The services and the container (where applicable) included in each package price must be described. Each package price must include at least the transfer of remains, services of the funeral director and staff, necessary authorizations, the transportation of the remains by livery to the crematorium and the return of the cremains to the funeral firm. In immediate conjunction with the prices for direct cremations, there must be the statement, "If you want to arrange a direct cremation, you may use an unfinished wooden box or an alternative container. Alternative containers can be made of heavy cardboard, pressed wood or composition materials (with or without an outside covering), or may be pouches of canvas or other materials." A second statement must also be included that, "The direct cremation prices do not include the crematory charge."
(ii) Direct burials. The price range for direct burials offered by the funeral firm must be listed. In addition, at least two package prices must be listed: for direct burial where the purchaser provides the casket and for direct burial using an alternative container or unfinished wooden box. Other package prices for direct burials using caskets may also be listed. The services and the container (where applicable) included in each package price must be described. Each package price must include the transfer of remains, services of the funeral director and staff, necessary authorizations, and the transportation of the remains to the cemetery by livery. The statement "The direct burial prices do not include cemetery charges" must be included.
(2) Transfer of remains to the funeral establishment. The price for transfer of remains must include personnel, equipment and vehicle.
(3) Preparation of remains.
(i) Embalming. The price must include use of the preparation room. In immediate conjunction with the price for embalming there must be the statement, "In New York State, embalming is not required by law. If you do not want embalming, you have the right to choose an arrangement which does not require you to pay for embalming such as direct cremation or direct burial. If you select certain funeral arrangements, such as viewing or an open casket funeral, embalming may be required by the funeral firm."
(ii) Other preparation of remains (excluding embalming). The price for topical disinfection (when there is no embalming), custodial care, dressing/casketing, cosmetology and restoration must be listed. The charges for other services regularly offered as "other" shall be specifically listed. If the firm intends to charge for custodial care, a specific time interval must be listed after which a charge is incurred and the statement must be included next to that item on the price list. "Custodial care will not be charged on the days when embalming or other preparation of the remains occurs, visitation is held or a funeral service is conducted." In immediate conjunction with the heading "Other Preparation of Remains" the statement "Preparation of the remains, unless selected, is not required for direct cremation or for direct burial" must appear.
(4) Arrangements. The charge for basic arrangements shall include the services of the funeral director, other staff, equipment and facilities to respond to the initial request for service, the arrangement conference, securing of necessity authorizations and coordination of service plans with parties involved in the final disposition of the deceased. The charge for these services may not be included in the casket prices and are already included in the quoted prices for direct cremation, direct burial, forwarding of remains or receiving of remains. For other types of funeral arrangements, the funeral firm may require that a charge for arrangements be added to the cost of the services provided. If the funeral firm has this requirement, it must place in immediate conjunction with the price for arrangements the statement, "The charge for our services will be added to the total cost of the funeral arrangements you select. However, this charge will not be added to the cost for direct cremation, direct burial, forwarding of remains or receiving of remains because the prices for those services include this charge."
(5) Supervision. The charges for supervision by the funeral director and support staff for visitation and for the funeral service must be listed. Other supervision charges, if any, must be specifically listed. These charges may not be added to the cost for direct cremation, direct burial, forwarding of remains or receiving of remains.
(6) Use of the facilities. Separate prices must be listed for use of facilities for visitation, use of facilities for funeral service, and other use of facilities, if any. Each of the prices must include the equipment used. Any price for "other use of the facilities" must clearly identify what the price is for and what facilities are included. No charges may be made under this paragraph for the use of facilities included under the paragraphs of this subdivision. For example, no charge can be made for the use of the preparation room because its use is included in paragraph (3) of this subdivision. A separate charge may not be listed for parking facilities, lounges, storage rooms or other common facilities.
(7) Livery. Separate prices must be listed along with description of the equipment for each of the livery services offered by the funeral firm: a hearse, alternative vehicle with identification of the alternative vehicle, limousine, passenger car, flower vehicle and/or other livery service.
(8) Merchandise.
(i) Casket or alternative container. The price range for caskets and alternative containers offered by the funeral firm must be stated together with the statement "A complete price list will be provided at the funeral home." As an alternative, the funeral firm may include in the general price list all of the casket price information required by section 79.2 of this Part.
(ii) Outer interment receptacle. The price range for outer interment receptacles offered by the funeral firm must be stated together with the statement "A complete price list will be provided at the funeral home." As an alternative, the funeral firm may include in the general price list all of the outer interment receptacle price information required by section 79.3 of this Part.
(9) Additional services and merchandise.
(i) The price of acknowledgment cards, catering services, food, nonalcoholic beverages, or any additional services and merchandise routinely offered by the funeral firm must be stated with an explanation of what is included.
(ii) If the funeral firm offers to purchase additional merchandise or services and charges more than the actual cost or receives and retains a rebate, commission, trade or volume discount or other benefit, the firm must include a statement under this heading that it will purchase additional merchandise and services for the customer. In immediate conjunction with this statement must be the sentence, “The prices in this section include a charge for our services in buying these items.”
(10) Limited services.
(i) Forwarding of remains. Prices must be listed for the services of the funeral firm for forwarding remains to another funeral firm together with a list of services provided for any quoted price. A package price must be listed that includes transfer of remains to funeral establishment, securing necessary authorizations, the services of the funeral director and staff and local transportation of the remains to point of shipment. In addition, a statement must be included indicating how other means of transportation will be charged beyond the local point of shipment. Public transportation (by common carrier) may only be charged as "cash advance."
(ii) Receiving of remains. Prices must be listed for the services of the funeral firm for receiving remains from another funeral firm together with a list of services provided for any quoted price. A package price must be listed that includes transfer of remains to funeral establishment and/or place of local disposition, securing necessary authorizations, the services of the funeral director and staff. In addition a statement must be included indicating how other means of transportation will be charged. Public transportation (by common carrier) may only be charged as a "cash advance."
(f) The list shall include items of service and merchandise which are routinely available as cash advances.
(1) Cash advances. A listing must be placed on the general price list indicating what items of service and merchandise are routinely available as cash advances. If the funeral firm is willing to purchase other cash advance items, it may include a statement to that effect. A statement must be included in immediate conjunction with the cash advance information that "Services and merchandise provided as cash advance items will be billed at the same amount paid by the funeral firm." The funeral firm may not charge the customer any more than the actual cost for cash advance items and must deduct from the charge to the customer any rebate, commission, trade or volume discount or other benefit received. Cash advance items shall include, but are not limited to the following services or merchandise: cemetery or crematory charges; clergy honoraria; certified copies of the death certificate or transcripts; escorts; chevra kadisha (Tahara); public transportation (common carrier); gratuities; bridge and road tolls; and telephone and telegraph charges.
(g) Each price for transfer of remains or for other transportation by livery included in the general price list must be stated as a flat fee for a specified number of miles from the funeral firm or for a geographical zone. The number of miles or the boundaries of the geographical zone included in the flat fee must be stated next to the price. If the firm charges for additional mileage beyond the specified distance or geographical zone, the additional mileage charge must be stated in immediate conjunction with the flat fee.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 110 CORTLAND COUNTY
10 CRR-NY 110.1 City of Cortland
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 695 of the Laws of 1911, and as heretofore set forth shall apply to Otter Creek and to all watercourses entering or ultimately discharging into said stream above the springs in the city of Cortland, said springs being the source of water supply of the city of Cortland.
(b) [Definition of terms.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding reservoirs and distributing reservoirs on Otter Creek and to any additional reservoirs which may be constructed on Otter Creek or any of its tributaries.
(2) The term watercourses wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the water supply of the said city of Cortland.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any reservoir or watercourse of the water supply of the city of Cortland nor within the area bounded and described as follows: beginning at a point in the center of Townley Avenue in the city of Cortland in line with the southerly boundary of the properties of J. M. Samson and Susan N. Milne, situated west of Townley Avenue, thence running southwest a distance of 380 feet along the center line of Townley Avenue to a point in said avenue east of the north east corner of the lower reservoir of the city waterworks, thence south 84 d. 44′ east a distance of 304 feet; thence south 3 d. 29′ west a distance of 877.2 feet; thence north 86 d. 31′ west a distance of 489.8 feet to a point in center line of Townley Avenue; thence southwesterly along center line of Townley Avenue, a distance of 660 feet to a point on the center line of said Townley Avenue; thence north 85 d. 50′ west a distance of 401 feet; thence south 87 d. 00′ west a distance of 1031.4 feet; thence south 5 d. 24′ west a distance of 514.9 feet; thence south 82 d. 23′ west a distance of 2,065.1 feet; thence north 5 d. 31′ east a distance of 439.9 feet; thence north 73 d. 38′ west across highway a distance of 1238.5 feet; thence south 1 d. 02′ west a distance of 633.1 feet; thence north 83 d. 30′ west across Otter Creek a distance of 410.65 feet; thence north 5 d. 23′ east a distance of 838.8 feet; thence north 78 d. 01′ east a distance of 1105.7 feet to a point on center line of highway; thence south 84 d. 10′ east a distance of 1142.9 feet; thence north 4 d. 59′ east a distance of 421.7 feet; thence south 84 d. 44′ east a distance of 596.4 feet; thence north 41 d. 31′ east a distance of 1,854 feet; thence south 84 d. 44′ east a distance of 1220 feet to the place of beginning.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 150 feet of any reservoir or watercourse of the water supply of the city of Cortland nor within the area bounded and described in paragraph (1) of this subdivision.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distance of 75 feet and 150 feet as provided by paragraphs (1) and (2) of this subdivision from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall be at all times maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of said water supply, nor shall any such excreta be disposed of within the area bounded and described in paragraph (1) of this subdivision.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or excremental matter from any water closet, privy or cesspool shall be thrown, placed, led, conducted, discharged or allowed to escape or flow from any pipe, drain or ditch either directly or indirectly into any reservoir or watercourse of the water supply of the city of Cortland, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground below the surface within 300 feet of any such reservoir or watercourse nor within the area bounded and described in paragraph (1) of subdivision (c).
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall* thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the city of Cortland; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the city of Cortland within 100 feet of any such reservoir or within 75 feet of any such watercourse nor within the area bounded and described in paragraph (1) of subdivision (c).
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the city of Cortland.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the city of Cortland, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the water supply of the City of Cortland nor within the area bounded and described in paragraph (c)(1) of this section; and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excreta or compost containing human excrement shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from any reservoir or 200 feet from any watercourse of the water supply of the City of Cortland; nor within the area bounded and described in paragraph (c)(1) of this section; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse nor within the area bounded and described in paragraph (c)(1) of this section.
(4) No decayed or fermented fruit or vegetable, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor onto the area bounded and described in paragraph (c)(1) of this section, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the City of Cortland without first having been passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the City of Cortland nor onto the area bounded and described in paragraph (c)(1) of this section; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir and of not less than 100 feet before entering any such watercourse.
(g) Fishing, boating and ice cutting.
(1) No fish shall be taken from any reservoir or watercourse nor shall any person fish in any reservoir or watercourse or through the ice upon the same nor trespass upon the waters of any reservoir or watercourse or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the City of Cortland in the exercise of their duties in the management and operation of the reservoirs; nor shall any person or persons cut or remove any ice from any of the reservoirs which form or are tributary to the sources of public water supply furnished by the City of Cortland.
(2) No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the City of Cortland nor within the area bounded and described in paragraph (c)(1) of this section.
(h) Inspection.
The City of Cortland, through its superintendent of waterworks, shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said superintendent of waterworks to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the superintendent of waterworks to promptly notify the State Commissioner of Health of such violations. The superintendent of waterworks shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.4 Applicability
(a) These rules and regulations apply to all persons undertaking, or proposing to undertake, the activities in the categories listed below, where such activities are specifically regulated in these rules and regulations and occur in the New York City watershed:
(1) discharge or storage of pathogenic materials;
(2) discharge or storage of hazardous substances and hazardous wastes;
(3) discharge or storage of radioactive materials;
(4) discharge or storage of petroleum products;
(5) discharge or transport of human excreta;
(6) design, construction and operation of wastewater treatment plants;
(7) design, construction and operation of sewerage systems and service connections;
(8) design, construction and operation of intermediate sized and individual sewage treatment systems;
(9) discharge of stormwater and sediment, and preparation and implementation of Stormwater Pollution Prevention Plans;
(10) construction of impervious surfaces;
(11) discharge from miscellaneous point sources;
(12) discharge of solid waste, including the siting of junkyards and solid waste management facilities;
(13) discharge from agricultural activities;
(14) discharge or storage of pesticides;
(15) application and storage of fertilizers; or
(16) snow disposal and application and storage of winter highway maintenance materials.
(b) These rules and regulations apply to substantial alterations or modifications of the activities described in subdivision (a) of this section.
(c) These rules and regulations apply to a substantial alteration or modification of any noncomplying regulated activity, as set forth in these rules and regulations.
(d) These rules and regulations apply to noncomplying regulated activities that are required to come into compliance with these rules and regulations as set forth in these rules and regulations.
(e) The boundaries of the New York City watershed have been delineated on United States Geological Survey maps, which are available for inspection at the offices of the local representatives of the department and the New York State Department of Health listed in section 128-1.5 of this Subpart. A map of the watershed is provided in section 128-10.1 of this Part for reference purposes only.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.4 Fees for applications and monitoring
(a) An application filing fee of $5,000 must be paid to the department at the time an application for a certificate of public advantage or for renewal of a certificate of public advantage is submitted pursuant to this Subpart.
(b) The applicant shall also cover the cost of consultants needed by the department to assist in the review of the application for a certificate of public advantage and any subsequent applications for renewal and in periodic monitoring, as determined by the department.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.10 Required records and confidentiality
(a) Complete and accurate records of blood, blood components and derivatives released for allogeneic or autogeneic transfusion shall be kept for seven years or six months after the expiration date of the individual product, whichever is later, by the blood bank preparing the product and by the institution using the product. Such records shall be open to inspection by the department and shall include the information specified in sections 58-2.11 and 58-2.12 of this Subpart. For all collected or distributed blood, blood components and derivatives, the donor's name, address, telephone number, social security number and any other information which would directly or indirectly identify the blood donor of any specific unit shall not be disclosed by the blood bank to any person or entity except upon the written consent of the donor or except to the department and other agencies which issue clinical laboratory and/or blood bank permits to the facility whose records are requested.
(b) Blood banks and transfusion services shall file a Blood Services Activity Report annually with the department.
(c) Records shall be maintained of all tests, controls, reagents and current procedures, in a manner acceptable to the department in conformance with generally accepted laboratory principles.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
SUPPORTING DOCUMENTS SUPPORTING DOCUMENTS
10 CRR-NY 36.10 Official certification that record of birth is not on file required
Each application for the delayed registration on an unrecorded birth shall be accompanied by a statement issued either by the local registrar of the community where the birth is believed to have occurred or by the State Department of Health to the effect that a search of the records has been made and that no record bearing the name of the person whose birth is to be recorded was found.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.254 Physical inventory
An inventory determined by observation and evidenced by a listing of the actual count, weight or measure.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
WATER SUPPLY WATER SUPPLY
10 CRR-NY 14-4.120 Water supply
(a) Water supplied a mobile food service establishment or pushcart is to be obtained from a supply complying with the requirements of Part 5 of this Title. The water storage tank, fill piping and distribution piping are to be installed and maintained to protect the water from contamination. The entire system is to be constructed to be drained by gravity.
(b) A water system with a storage tank of at least 40 gallons is to be provided in a mobile food service establishment unless all food served is prepackaged and wrapped at a commissary or food processing establishment, or a lesser or greater amount is acceptable to the permit-issuing official. The permit-issuing official may allow mobile food service establishments that perform minimal food handling away from the commissary to carry less than 40 gallons of water, providing that a sufficient quantity of water be stored for food preparation, utensil cleaning and handwashing.
(c) Bottled and packaged potable water is to be obtained from a source approved by the State Commissioner of Health and handled and stored in a way that protects it from contamination. Bottled and packaged potable water is to be dispensed in the original container.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.5 Statements or bills for health services
Statements or bills for patient health services rendered in a hospital or by a home health agency as defined in article 28 of the Public Health Law shall:
(a) indicate the nature of the service for which a charge is being made;
(b) indicate that professional or other services not provided by the hospital, or by the home health agency for which a charge is not included, may be billed independently; and
(c) be rendered to a patient or the patient's legal representative without charge.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.8 Processing and storage of tissue
(a) Until processing, eyes shall be stored at a temperature of between two and six degrees Celsius.
(b) The corneal-scleral segment shall be examined grossly for clarity, epithelial defects, foreign objects, contamination and scleral color for evidence of jaundice.
(c) Slit-lamp examination of whole eyes or the corneal-scleral rim of excised tissue shall be performed to detect epithelial and stromal pathology, including edema, cell density, opacities, scars and guttata. A system, as determined by the tissue bank medical director, shall be in place to categorize tissue adequacy for transplantation.
(d) Eyes and ocular tissue shall be preserved using aseptic technique, in:
(1) a moist chamber kept at a temperature of between two and six degrees Celsius;
(2) a short-term preservation medium stored and used in accordance with the manufacturer's instructions and/or with written procedures approved by the tissue bank director;
(3) a long-term culture medium used in accordance with written procedures approved by the tissue bank director;
(4) a frozen or dehydrated state, if corneal tissue is used for epikeratoplasty;
(5) the frozen state, as scleral grafts immersed in antibiotic solution; or
(6) any other method in accordance with written procedures approved by the tissue bank medical director and currently accepted by leading authorities in eye transplant medicine.
(e) Thawed tissue that has been refrozen shall not be issued for transplantation.
(f) The duration of storage subsequent to application of each preservation method above shall be clearly specified in written procedures approved by the tissue bank medical director.
(g) Tissue shall be maintained aseptically at a temperature appropriate to the method of preservation utilized. The tissue bank director shall determine the appropriate temperature based upon the method of preservation utilized, manufacturers' instructions, standards set forth in this Part and standards in current scientific literature. The refrigeration device used for storage shall be reserved for ocular and other tissue and related supplies, with clearly defined and labeled areas for all tissues stored. Quarantined tissue awaiting test results shall be segregated from tissue ready for distribution. Unless an alternative mechanism is in place for immediate notification and action to be taken in the event of a power failure, the refrigeration device shall be equipped with an audible alarm to detect temperature deviations above and below the established limits of storage, and a thermometer calibrated at least annually against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer.
(h) Thermometers shall be visually monitored daily or temperatures shall be continuously monitored mechanically for fluctuations potentially affecting the quality of the tissue. Temperature records shall be available for inspection by the department for the entire period of storage and for one year afterwards.
(i) If whole eye is stored in a moist chamber, corneal excision shall occur within 12 hours, and tissue shall be transplanted within a time period established in written policy by the tissue bank medical director and the medical advisory committee.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.35 Personnel; health monitoring programs
The institution and the PI shall be responsible for determining, in connection with each recombinant DNA activity, medical surveillance of all personnel with duties in recombinant DNA activity facilities before, during, and after their involvement in the activity, including, as appropriate, a serum collection program, periodic examinations, immunizations, reporting and investigating accidents and illnesses and medical evaluation.
Note:
See NIH Laboratory Safety Monograph for further details.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.13 Bathhouse and toilet facilities
(a) General.
Adequate toilet and handwashing facilities must be provided for all bathing beaches. In determining the location of toilet and handwashing facilities for ocean beaches, factors which shall be considered include, but are not limited to, susceptibility of the area to flooding, groundwater depth in the area, and potential for shifting of sand dunes and erosion.
(b) Walls and floors of the bathhouse shall be free from cracks or open joints. The floors should be well drained.
(c) All toilet facilities and dressing rooms shall be adequately lighted, ventilated and maintained.
(d) When showers are provided, they shall be supplied with water at a temperature of at least 90°F and no more than 110°F at a rate of at least 1.5 gallons per minute per shower head. Thermostatic, tempering or mixing valves shall be kept in good operation to prevent scalding of the bathers.
(e) All toilet facilities shall be provided with soap, paper towels or electrical hand-drying units, and covered waste receptacles. Suitable sanitary napkin receptacles shall be provided in toilet facilities used by females.
(f) Care of suits and towels.
All bathing suits and towels furnished or rented shall be washed with a detergent in hot water, rinsed and thoroughly dried after each use.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.200 Emergency occurrences, reporting of foodborne disease
(a) In the event of an occurrence such as fire, flood, power outage, or similar event which might result in the contamination of food or which might prevent potentially hazardous food from being held at required temperatures, the person in charge of the establishment is to immediately notify the permit-issuing official.
(b) Any food service operator except those regulated by Chapter V of this Title having actual or constructive knowledge of the occurrence of illness allegedly due to the consumption of food served at the establishment, shall report the same within 24 hours by telephone, telegram or in person to the permit-issuing official.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 411 OMBUDSMEN ACCESS TO RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 411.1 Duty of the operator
The operator shall:
(a) ensure that ombudsmen who are duly certified and designated by the State Office for the Aging shall have access to a residential health care facility without restriction, and shall prohibit interference with ombudsmen when they are performing their official duties and retalization or reprisal against any resident, employee or other person, who has filed a complaint with, or provided information to, such ombudsmen;
(b) ensure privacy and confidentiality in such visits with the patients by duly authorized ombudsmen; and
(c) ensure that records access ombudsmen specially designated under section 544 of the State Executive Law shall have access to medical and personal records, subject to the following provisions and exceptions:
(1) the patient/resident, or, where appropriate, the patient's/resident's appointed committee, shall provide express written consent;
(2) periods of access shall include normal business hours, and may include other times mutually acceptable to the ombudsmen and the facility by appointment;
(3) one or more members of the facility's staff shall be available to arrange for inspection, interpretation, and, for a reasonable fee, to photocopy such records; and
(4) a physician's personal notes, which shall mean the physician's speculations, reminders, impressions other than diagnostic impressions, and other information unrelated to treatment decisions, may be excluded from disclosure;
(d) ensure that residents, employees or other person(s) may file complaints with or provide information to any long-term care patient ombudsman as specified in section 411.1(a) of this Part.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.14 Water quality for proposed sources of water supply
Before the approval of a source of water supply for public water system purposes, a report shall be submitted to the State. Such report shall include, but may not be limited to, all of the following:
(a) a summary of available raw water quality data for at least 10 years before the date of the report or as otherwise required by the State;
(b) a sanitary survey of the watershed or aquifer, with particular emphasis on water quality as affected by existing or potential spills, point and nonpoint discharges, and natural seasonal occurrences; and
(c) a description of the proposed water treatment processes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.8 Continuance of a certificate of authority
(a) Continuance of a certificate of authority shall be contingent upon satisfactory performance by the MCO of delivery, continuity, accessibility and quality of the services to which an enrolled member is entitled, compliance of the MCO with the provisions of article 44 of the Public Health Law and this Subpart, the continuing fiscal solvency of the MCO, except for PCPCPs, and compliance with all conditions set forth on the certificate of authority. The commissioner may impose conditions and limitations on a certificate of authority. Failure to comply with such conditions and limitations shall be deemed unsatisfactory performance.
(b) All new contracts or forms of contracts and material amendments to existing contracts, including all attachments thereto, between the MCO and health services providers, whenever proposed, shall include the provisions in section 98-1.5(b)(6)(i)-(v) of this Subpart and shall require prior approval and be submitted to the commissioner in advance of their proposed implementation in accordance with guidelines issued by the commissioner as per section 98-1.5(b)(6)(v) of this Subpart.
(c) Any amendments to any risk-sharing arrangements contained in any contracts between the MCO and providers, with the exception of routine trending of fees or other reimbursement amounts, shall not be entered into without prior approval of the commissioner and, as appropriate, the superintendent.
(d) Any contemplated amendment to or revision of an approved contract with, or on behalf of, the enrollees of an MCO shall be submitted to the superintendent and approved by the superintendent prior to the execution of an amended or revised contract with, or, as applicable, on behalf of the enrollees of an MCO, except in the case of contracts entered into between an MCO and a social services district or the State on behalf of the enrollees of an MCO for services provided pursuant to title XIX, which shall require prior approval by the commissioner and, as required by Federal law, the Federal agency with oversight responsibility for such programs.
(e) Any revisions in rates of payment for enrollees of programs authorized by title XIX must receive the prior approval of the commissioner.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-4 FEE AND REVENUE PLAN FOR DEPARTMENTAL SERVICES
10 CRR-NY 40-4.2 Applicability
(a) It shall be the responsibility of each facility rendering to the public services covered by the fee schedule provided in section 40-4.1 of this Subpart to remit the annual fee in the form and by the date required by the department, except that no fee shall be charged in the case of a facility operated by a person, firm or corporation or association for charitable, philanthropic or religious purposes or by a municipality.
(b) Failure to pay the prescribed fee shall result in nonissuance of a permit to operate or summary suspension of any existing permit until such fee is paid.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.6 Tissue processing facilities
A facility which processes skin shall be licensed by the department as a tissue processing facility. Such facilities shall make available to the department a statement of the procedures used in the preparation, testing and storage of the tissue or tissues distributed, or offered for use. The premises, equipment, procedures, records, circulars of instruction and tissues shall be available for inspection and/or testing by the department as required. Copies of all brochures and other informational materials and instructions, including descriptions of methods of tissue handling, shall be available to the department. Each container of tissue shall be clearly labeled with the donor identification code or a unique tissue identification number, unit size and expiration date, if applicable.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-2 DRUG SUBSTITUTION
10 CRR-NY 60-2.3 Identification of manufacturer
The label affixed to the immediate container in which the drug is sold or dispensed shall indicate the name and strength of the drug product and its manufacturer, unless the prescriber specifically states otherwise.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.65 Westbury Water District
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on land, owned by the Westbury Water District, and bounded by Drexel Avenue, Schenck Avenue, Hicks Lane and Hicks Nursery in the unincorporated village of Westbury, town of North Hempstead, which wells form the source of the public water supply of the Westbury Water District, the incorporated village of Old Westbury, the Carle Place Water District, and the New Cassel Water District, Nassau County, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the wells.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the Westbury Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Westbury Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the Westbury Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which shall have been granted by the State Commissioner of Health) within 200 feet of any well of the public water supply of the Westbury Water District. It is provided, however, that no such watertight receptacle shall be within 75 feet nor any such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the Westbury Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any well of the public water supply of the Westbury Water District.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the Westbury Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well of the public water supply of the Westbury Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the Westbury Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well of the public water supply of the Westbury Water District.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Westbury Water District upon which the wells of the public water supply of the Westbury Water District are located, and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Westbury Water District.
(h) Inspections.
The board of water commissioners of the Westbury Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Westbury Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health, in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.8 Accrual
(a) The recognition of events and conditions as they occur, rather than in the period of their receipt, or payment.
(b) The partial recognition of an item of revenue or expense and its related assets or liability resulting from the lack of coincidence of the reporting period and the contractual or benefit period.
(c) An amount accrued.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter F DISEASE REGISTRY
Part 62 ALZHEIMER'S DISEASE AND RELATED DISORDERS REGISTRY
10 CRR-NY 62.4 Access to confidential file
A confidential file of the reported Alzheimer's and related disorders patients will be entered into a computer system. Persons seeking access to the file for scientific research shall complete a form stating the requester's name, affiliated organization and a narrative delineating research purpose. The requester shall inform the Department of Health if he/she plans to make patient contact as part of the research. The requester shall guarantee in writing the confidentiality of all material reviewed from the Alzheimer's disease registry, and any patient or family contacts. The Department of Health will consult the requester's references and his/her supervisor. After the aforesaid review, the commissioner shall determine whether to give the requester access to the registry.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.94 Equipment construction; in-place cleaning
Equipment intended for inplace cleaning is to be constructed so that:
(a) cleaning and sanitizing solutions can be circulated throughout a fixed system using an effective cleaning and sanitizing regimen;
(b) cleaning and sanitizing solutions contact all interior food-contact surfaces; and
(c) the system is self-draining or can be completely evacuated.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.79 Multiple distribution systems
A water supply system or facility with multiple distribution systems on separate sources of water supply shall be considered a single public water system if all the following conditions are met:
(a) the separate sources are the same source type, with:
(1) the groundwater sources located in the same aquifer area; or
(2) the surface water intakes located in the same water body and the intakes at the same approximate depth and location;
(b) the water supply system or facility is owned and operated by the same person(s);
(c) the water supply system or facility is operated for the same purposes and for the same time period; and
(d) the water supply system or facility serves 25 or more people or 15 or more service connections.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.9 Proof of financial resources
The applicant shall submit proof of financial resources sufficient to execute the plans as submitted.
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.7 Sewage disposal
(a) Sewage shall mean excreta and the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(b) Facilities shall be provided and maintained for the treatment and/or disposal of sewage in a manner acceptable to the permit-issuing official. A plan or sketch of the proposed or modified facility shall be submitted to the permit-issuing official at least 30 days prior to construction; no work is to start until the plan or sketch is approved.
(c) Sewage on the surface of the ground or accessible to children is prohibited.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.5 Amendments
(a) Subsequent to an approval or contingent approval of an application under this Part, any change, as set forth in paragraphs (b)(1) through (3) of this section, shall constitute an amendment to the application, and the applicant shall submit appropriate documentation as may be required by the commissioner pursuant to this Part in support of such amendment. The amended application shall be referred to the health systems agency having jurisdiction and the Public Health and Health Planning Council for their reevaluation and recommendations. The approval of the commissioner shall be obtained for any such amended application.
(b) Any of the following shall constitute an amendment:
(1) a change in the number and/or types of beds and/or services, other than a reduction of service which would be subject to administrative review;
(2) a change in the location of the site of the construction if outside the facility's planning area as identified in Part 709 of this Title. If the change in site, within the facility's planning area, impacts geographic accessibility in such planning area, the commissioner may before making any finding that such change is in the best interest of the planning area seek the recommendation of the Public Health and Health Planning Council and the health systems agency having geographical jurisdiction. In addition, for applications to establish diagnostic and treatment centers which were not reviewed competitively within a batch, a change of site within a planning area shall not constitute an amendment pursuant to the provisions of this section and shall require only the prior approval of the commissioner; or
(3) any change in the applicant.
(c)
(1) If the commissioner determines that increases in total project costs or total basic costs of construction are due to factors of an emergency nature such as labor strikes, fires, floods or other natural disasters, or factors beyond the control of the applicant, or modifications to the architectural aspects of the application which are made on the recommendation of the department, the commissioner may permit review of the application to proceed without the need for the application to be referred back to the health systems agency and the council pursuant to this Part. However, failure of the applicant to obtain financing or appropriate environmental and zoning permits or approvals shall not be deemed to be beyond the control of the applicant.
(2) If the applicant can document by evidence acceptable to the commissioner that increases in total project costs or total basic costs of construction were caused by delays in obtaining zoning or planning approvals which were beyond its control, the commissioner may permit review of the application to proceed without the need for the application to be referred back to the health systems agency and the council pursuant to this Part. The evidence should clearly demonstrate that the applicant had timely pursued the zoning or planning permits and in addition that the applicant has now obtained all such required permits and approvals and is prepared to proceed with the project.
(3) If the applicant can document, by evidence acceptable to the commissioner, that increases in the total basic cost of construction were caused by inflation in excess of that estimated and approved in the application and that such inflation has affected the total basic cost of construction as a result of delays which were beyond the applicant's control, the commissioner may permit review of the application to proceed without the need for the application to be referred back to the health systems agency and the Public Health and Health Planning Council pursuant to this Part. The evidence shall demonstrate clearly that the increase in inflation exceeds that estimated an approved in the application, and that any delays resulting in such inflationary cost increases were beyond the applicant's control.
(d) The applicant must obtain the prior approval of the commissioner for any change relating to the program scope or functional space concept of the project, total project costs or increase in total basic costs of construction, a change in the ownership interest in the land, building or equipment relating to the proposal, a change in the location of the site of the construction, or interest rates relating to the financing of any aspect of the project, regardless of whether such change constitutes an amendment under this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.9 Responsibilities of persons designated by the Commissioner of Health
Persons designated by the Commissioner of Health as specified under sections 85.1 through 85.8 and section 85.13 of this Part shall complete and forward reports of their activities as specified by the Commissioner of Health. The designated persons shall maintain copies of all notices of determinations of coverability and noncoverability and notifications of decisions on appeal and records which document the basis for all determinations of coverability and noncoverability and decisions on appeal and shall make such copies and records available to persons designated by the Commissioner of Health for review and evaluation as required.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.7 Emergency and disaster preparedness
Medical facilities shall have an acceptable written plan, rehearsed and updated at least twice a year, with procedures to be followed for the proper care of patients and employees, including the reception and treatment of mass casualty victims, in the event of an internal or external emergency or disaster arising from the interruption of normal services resulting from earthquake, tornado, flood, bomb threat, strike, interruption of utility services and similar occurrences. All employees are to be trained in all aspects of preparedness for any interruption of services and for any disaster.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.2 Statewide immunization registry
(a) Definitions.
(1) Statewide immunization information system shall mean the statewide (except New York City) computerized database of immunizations developed and maintained by the New York State Department of Health, known as the New York State Immunization Information System ("NYSIIS" or "system").
(2) Citywide immunization registry (CIR) shall mean the immunization information system maintained by the New York City Department of Health and Mental Hygiene, capable of collecting, storing and disclosing the electronic and paper records of vaccinations administered to persons less than 19 years of age and those persons 19 and older with consent in accordance with the New York City Health Code. For the purposes of this definition, the term New York City Department of Health and Mental Hygiene shall mean such agency or any successor agency responsible for the CIR.
(3) Health care provider for the purposes of this section shall mean any person authorized by law to order an immunization or any health care facility licensed under article 28 of the Public Health Law or any certified home health agency established under section 3606 of the Public Health Law.
(4) Designees shall mean individuals, acting under the authority of a health care provider or another category of authorized user, who have been specifically delegated responsibility to access NYSIIS or the CIR and perform the functions permitted the primary authorized user.
(5) Emancipated minors shall mean those children less than 18 years of age who by virtue of a court decision declaring them emancipated, or who because they are otherwise emancipated under the law, are able to make their own decisions regarding health care services.
(6) Registrants shall mean all individuals for whom an immunization or exemption to immunization or blood lead analysis is recorded in the system, at any time following January 1, 2008 for NYSIIS and January 1, 1994 for the CIR. Registrants also include individuals born in New York State (outside of New York City) on or after January 1, 2004 for NYSIIS or born in New York City on or after January 1, 1996 for the CIR.
(7) School , for the purposes of this section, shall mean any agency or entity required by law or regulation to verify immunization status for participants prior to or at selected times during enrollment, including licensed day care facilities. Such verification is an authorized delegation of public health authority for the purposes of fulfilling this public health mandate related to verification of immunization status.
(8) Authorized users of NYSIIS and the CIR shall mean the following categories of users, who are permitted access only to records of registrants falling within their administrative or clinical responsibilities. An authorized user in a category below may designate the ability to access the system to others where indicated:
(i) health care providers who order an immunization, and their designees, including Regional Health Information Organizations or other Health Information Technology entities as defined in 18 NYCRR section 504.9(h)(2);
(ii) local health districts;
(iii) commissioners of local social services districts and their designees;
(iv) the commissioner of the Office of Children and Family Services and his/her designees;
(v) schools;
(vi) third party payers;
(vii) WIC programs;
(viii) colleges;
(ix) professional and technical schools;
(x) children’s overnight camps and summer day camps;
(xi) registered professional nurses; and
(xii) pharmacists authorized to administer immunizations pursuant to subdivision (2) of section 6801 of the Education Law.
(b) Mandated reporting.
(1) Mandated reporters to NYSIIS and the CIR include any health care provider, as defined in this section, who administers an immunization or conducts a blood lead analysis of a sample.
(2) Mandated reporters must report any immunization to a child less than 19 years of age to either NYSIIS or the CIR, depending on the location of administration of the vaccine.
(3) Article 28 facilities or certified home health agencies established under section 3606 of the Public Health Law in which providers are responsible for administration of vaccines may, when agreed to by the facility and the provider ordering the vaccination, assume reporting responsibility for the authorized individuals administering vaccines within their facilities.
(4) A person who administers but does not order immunizations is not responsible for reporting the immunizations to the system, unless acting as a designee of the health care provider who ordered the immunization and under whose supervision the vaccine was administered. The ordering health care provider remains responsible for supervising his/her designee and ensuring that appropriate and timely reporting occurs.
(5) When vaccines are administered based on non-patient specific orders, the health care provider ordering the immunizations shall ensure that required data elements for each vaccination are submitted to NYSIIS or the CIR, depending on the location of administration of the vaccine.
(c) Information required to be reported, methods of reporting, exceptions and timeliness of reporting.
(1) Information required to be reported to NYSIIS or the CIR, to the extent available to the provider shall include: the patient’s name (first, middle and last); date of birth; gender; race; ethnicity; address, including zip code; telephone numbers; birth order (if multiple birth); birth state/country; mother’s maiden name; mother’s or other responsible party’s name (first, middle and last); vaccines for children program eligibility; Medicaid number; and vaccine administration date, type, lot number and manufacturer, except as noted in paragraph (3) of this subdivision. A provider should report elements for any additional data fields in NYSIIS or the CIR when available.
(2) Methods of reporting. All data elements reported to NYSIIS or the CIR must be submitted electronically except as provided in paragraph (3) of this subdivision.
(i) Direct online entry of immunization information into NYSIIS. Authorized users with read/write access and their designees may submit information directly to the statewide system using their individual access accounts.
(ii) Health care providers with existing electronic information systems compatible with NYSIIS. Such providers may request, on an individual or group basis, permission to download information from current systems into a department-prescribed file format for transfer directly to NYSIIS. The provider is responsible for the costs/programming needed to effect these data transfers, ensuring that transfers are completed on a timely basis and updating provider-specific data systems when changes are made to these systems.
(iii) Historical immunization information previously submitted to a regional registry. Health care providers who have submitted immunization records to one of the regional immunization registries (Healthy Shot or Immunization Registry and Information Source [“IRIS”]) may authorize submission of this regionally-archived immunization history information to the statewide system.
(iv) Submission of immunization information to NYSIIS or the CIR. Providers must submit immunization information to NYSIIS or the CIR, dependent upon the IIS operating in the area in which they practice, not the IIS appropriate to the patient’s area of residence. Exchange of information between IIS’s will be the responsibility of NYSIIS and the CIR.
(3) Exceptions to reporting requirements to NYSIIS.
(i) Hospitals participating in the statewide perinatal data system are exempted from entering immunization information directly into NYSIIS for newborns during their initial hospital stay. Information submitted through the statewide perinatal data system will populate NYSIIS’s required information fields. Hospitals located in New York State, outside of New York City, are required to report to NYSIIS all other immunizations administered to children less than 19 years of age while under their care.
(ii) A provider may submit incomplete immunization electronic files or may manually enter incomplete immunization information into the statewide system in fulfillment of requirements for submission of historical immunization information. Required information for immunizations administered after January 1, 2008, which is missing shall be entered when it becomes available to the provider.
(4) Timeliness of reporting. Providers ordering immunizations must submit immunization information to NYSIIS or the CIR within 14 days of administration of the immunization. Providers must also submit information regarding immunizations not previously reported for each registrant.
For NYSIIS only:
(i) Providers must submit any missing information requested by NYSIIS within 14 days of the issuance of the request.
(ii) For individuals exempt from administration of vaccines, providers must submit patient information, including the reason that such immunization may be detrimental to the child’s health, as defined in section 66-1.1(l) of this Subpart, to the statewide immunization information system within 14 days following the in-person clinical interaction that occurs at or after what would normally have been the due date for administration of an age-appropriate immunization to that child, according to current national immunization recommendations.
(d) Allowable access levels and permitted uses of NYSIIS and/or CIR data by authorized users specific to the organization they are representing.
(1) Allowable access levels.
(i) Read/write access. Only health care providers providing services to the registrant and State and local Department of Health staff may compile reports, read immunization information, enter immunization information and change immunization information, with limitations as specified below. Health care providers who have been granted a time-limited deferral on electronic data submission to NYSIIS may access the information by phone or via written request.
(ii) Read-only access. Authorized users not listed in subparagraph (i) of this paragraph (such as schools) are permitted read-only access to NYSIIS and/or the CIR. Read-only access allows the user to view records of only those children under their administrative responsibility and to compile reports based on data aggregated from those records.
(2) Permitted uses of NYSIIS or CIR data. All requests for use of NYSIIS information by an authorized user which are not included in the allowable uses for that person as noted in subparagraphs (i)-(x) of this paragraph are prohibited without the approval of the commissioner of the State Department of Health; or, for requests for CIR information, without the approval of the commissioner of the New York City Department of Health and Mental Hygiene or his or her designee. Approval is contingent on ongoing adherence to the terms and conditions of the user agreements. Allowable uses of the data for particular categories of users include:
(i) Health care providers or their designees may access NYSIIS or CIR data for the provision of care and treatment, either temporary or longer term, to a particular registrant. The information can be used either on a patient-specific basis or to generate reports specific to their practice to determine immunizations received by a specific group of registrants, review of practice coverage, generation of reminder and recall notices, quality improvement, vaccine inventory and accountability inclusive of Vaccines for Children (VFC) Program inventory and accountability, vaccine ordering, VFC re-enrollment, and printing a copy of the immunization record for the registrant or the registrant’s parent or guardian, as appropriate.
(a) If other child health status or test results information becomes available through NYSIIS or the CIR that may be useful in determining the course of treatment for the child, such information will be made available on an as-needed and authorized basis to health care providers.
(ii) Schools may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that school or school system or may run school-specific reports that aggregate available data. Access will be limited to data for registrants enrolling or already enrolled in a particular school or school system.
(iii) Commissioners of local social services districts and their designees may access NYSIIS or CIR data with regard to children in their legal custody. Such information may be used for quality assurance and accountability by local social services districts.
(iv) The commissioner of the Office of Children and Family Services and his/her designees may access NYSIIS or CIR data with regard to children in his/her legal custody. Such information may be used for ensuring appropriate care and treatment of children for whom the Office of Children and Family Services maintains custody and responsibility.
(v) Local health departments may access immunization data in NYSIIS and the CIR for purposes of outreach, quality improvement and vaccine accountability, epidemiological studies and disease control within their own county. Local health department staff may be granted access to immunization information in NYSIIS and the CIR for registrants whose immunizations were administered within their own county and for registrants residing in the county whose immunizations were administered outside of the county.
(vi) Third party payers may access NYSIIS or CIR data for the purpose of performing quality assurance, accountability and outreach relating to enrollees covered by their plan. Third party payers must request information from the appropriate registries.
(vii) The Commissioner of Health and the commissioner of the New York City Department of Health and Mental Hygiene and their designated staffs will have full read/write access to their respective systems/registries in order to fulfill file maintenance and improvement functions and may use the data in both NYSIIS and the CIR for purposes of outreach, quality improvement and vaccine accountability, research, epidemiological studies and disease control.
(a) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene or his or her designee may provide, on request, registrant-specific information to other State or city immunization systems and systems maintained by the Indian Health Service and tribal nations recognized by the State or the United States on a routine basis pursuant to a written agreement with each system requiring such system to conform to national standards for maintaining the integrity of the data, protecting the confidentiality of personal information and using the data only for purposes permitted in this section.
(b) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene may provide registrant-specific information to Federal health officials, State or city immunization systems and systems maintained by the Indian Health Service and tribal nations recognized by the State or the United States and others identified by the commissioner of each respective immunization information system, for activities necessary to protect public health, in accordance with any written agreement required by such commissioner.
(c) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene may provide institutes of higher education, medical research centers or other institutions engaged in epidemiological research or other public health research access to de-identified registrant information in NYSIIS or the CIR for research purposes if approved by the Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene, as appropriate.
(viii) WIC programs for the purposes of verifying immunization and lead testing status for those seeking or receiving services, as well as referral for immunizations or lead tests as needed.
(ix) Colleges may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that college or college system or may run college-specific reports that aggregate available data. Access shall be limited to data for registrants enrolling or already enrolled in a particular college or college system.
(x) Professional and technical schools may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that professional or technical school or may run college-specific reports that aggregate available data. Access shall be limited to data for registrants enrolling or already enrolled in a particular professional or technical school.
(xi) Children’s overnight camps and summer day camps may access NYSIIS or CIR data for verifying immunization history for children attending that overnight camp or summer day camp or may run camp-specific reports that aggregate available data. Access shall be limited to data for registrants attending a particular overnight or summer day camp.
(xii) Any parent or guardian of a registrant less than 18 years of age or the registrant himself/herself if 18 years or older or an emancipated minor, may receive a copy of an immunization record at no cost from their local health department, the CIR or NYSIIS.
(e) Methods of accessing immunization data.
Each person seeking access to NYSIIS and/or the CIR must submit a completed application for access.
(f) Maintenance of security and confidentiality.
(1) Each person accessing the statewide system must have a distinct password and system ID that conform to industry standards, and with level and type of access tied to the type of user, as defined in subdivision (d) of this section.
(2) Each person must understand and agree to adhere to the confidentiality protocol developed by the department or the NYCDOHMH prior to either submitting or obtaining data from NYSIIS or the CIR.
(g) Provision of NYSIIS information to registrant’s family/guardian.
(1) Mandated reporters to NYSIIS must provide the parent or legal guardian of each registrant with a copy of an informational brochure or letter from the department at the time of each registrant’s initial entry into the statewide system by that provider.
(2) If the parent/guardian speaks a primary language other than English, mandated reporters to NYSIIS must make every attempt to provide statewide system-related information comparable to the department’s brochure in the primary language of the parent or guardian.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.65 Purpose of issue
A prescription, in order to be effective in legalizing the possession of controlled substances, shall be issued for legitimate medical purposes only. The responsibility for the proper prescribing and dispensing of controlled substances shall be on the physician, dentist, podiatrist, veterinarian or other authorized practitioner, but a corresponding liability shall rest with the pharmacist who fills the prescription. An order purporting to be a prescription, issued to an addict or habitual user of controlled substances, not in the course of professional treatment but for the purpose of providing the user with narcotics or other controlled substances sufficient to keep him comfortable by maintaining his customary use, is not a prescription within the meaning of subdivision 30 of section 3302 of the Public Health Law and the person knowingly filling such an order, as well as the person issuing it, shall be subject to the penalties provided for violation of the provisions of law relating to controlled substances.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.6 Prior approval request process
(a) Expenses that require prior approval.
Assistive technology, vehicle modifications, environmental modifications, myo-electric limbs, certain types of transportation for medical care and services (including travel involving overnight accommodations), private duty nursing, treatment with a specialty drug, experimental treatment for which the enrollee's provider has submitted documentation that complies with the same standards set out in section 4910(2)(b)(i)-(iii) of the Public Health Law, custom-made durable medical equipment, hearing aids, and more than 1,080 hours of respite care in a calendar year.
(b) Prior approval requests, other than emergency requests as set forth in section 69-10.15 of this Subpart, will be determined within 30 days from the date all necessary documentation in support of the request has been received.
(c) General documentation requirements.
In the absence of more specific requirements for particular types of expenses, every request for prior approval except for private duty nursing, which is subject to the requirements of section 69-10.10 of this Subpart, must be accompanied by a written statement from the enrollee's treating physician stating why the service, equipment, or treatment in issue is necessary.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 452 BASIC CONCEPTS, REPORTING PRINCIPLES AND SPECIALIZED REPORTING AREAS
10 CRR-NY 452.4 Specialized reporting areas
(a) Interdepartmental services.
The following represent areas for which costs must be directly assigned to the functional reporting center operating such costs. The term interdepartmental services, for the purposes of this Article, is defined as the direct cost of utility provided by one residential health care facility department to another. The objective of accounting for interdepartmental services is to establish a proper distribution of direct costs prior to any cost allocation process.
(1) For the purposes of this Article, the following are costs which should be so treated:
(i) Plant maintenance.
(a) All direct costs incurred in the routine maintenance, repair and service of buildings and equipment are included in the Plant Operation and Maintenance reporting center.
(b) However, the cost of noncapitalizable nonroutine maintenance and repairs directly assignable to a single reporting center (such as a major repair of an X-ray machine) must be transferred to the reporting center receiving the service. These costs include all direct expenses incurred by the Plant Operation and Maintenance cost center in performing such services.
(c) When such nonroutine maintenance and repairs are performed by nonfacility personnel, the cost related to these purchased services must be either transferred from Plant Operation and Maintenance or charged directly to the reporting center receiving the service. In the event that such costs are charged directly to the recipient reporting center, such costs must be segregated under the new natural classification provided, i.e., Repairs and Maintenance—Purchased Services Directly Assignable.
(d) It is recommended that identification of direct costs be accomplished by developing a work order system. Written work orders identifying the requesting reporting center should be prepared upon receipt of the request for services. Upon completion of the service, the direct cost of labor and materials would be entered on the work order. Completed work orders should be sent to general accounting on a regular basis so that interdepartmental costs can be recorded.
(ii) Employee benefits. Employee benefits must be reported in the functional reporting centers which include the applicable employee's compensation. This can be accomplished by accumulating all fringe benefit costs in one account and assigning the expenses to the appropriate reporting center at year-end as a preliminary adjustment prior to cost finding. This assignment can be performed on an actual basis or upon the following basis:
(a) FICA and tuition refunds—actual expense by department.
(b) Pension and health insurance.
(1) Union—gross salaries of participating individuals by department.
(2) Nonunion—gross salaries of participating individuals by department.
(c) All other benefits—the remaining benefits may be allocated to the various departments based upon gross salaries of the departments.
(iii) Major movable depreciation. Major movable depreciation must be reported in the reporting center established entitled, “Depreciation—Major Movable Equipment”. Such depreciation must be assigned to the department (as a cost allocation basis later explained) where the equipment is located and utilized. However, those providers who are not able to allocate historical costs and depreciation for major movable equipment acquired prior to January 1, 1978 may use square feet, net, to allocate depreciation by department. All additions to major movable equipment as of January 1, 1978 and thereafter will be functionalized.
(b) Residential health care facility research and education costs.
All direct costs incurred in conducting residential health care facility research and formal educational activities (as opposed to inservice education) must be reported in the appropriate unrestricted or restricted fund reporting center.
(c) Grant accountability.
When separate accounting is required by law, grant, contract, or donation restricted for research and educational activities, such grants should be reported separately. Transfers from restricted funds to match the expenditures for these activities must also be segregated. Thus, accountability is maintained for all restricted research and educational activities. Grants that represent deficit financing should be reported as a reduction of the appropriate contractual allowances when used rather than, in the case of other grants, as other operating revenue.
(d) Grant overhead allocation.
(1) No allocation of overhead should be made prior to cost finding unless such allocation is required by grant agreement. When a grant contract calls for the payment of direct costs plus an overhead factor, the overhead factor should be used in billing only.
(2) If indirect overhead must, by grant contract, be recorded in the unrestricted fund cost centers used for the recording of the direct costs of the grant activity, the natural expense classification (other direct expenses) must be used. Such overhead allocations should be accumulated separately in the unrestricted fund. For reporting to the New York State Department of Health, this amount must be offset against grant activity costs, so such remaining costs are direct costs only.
(e) Overhead allocation between facilities.
An allocation of overhead should be made prior to cost finding for facilities which share services or receive services from a service corporation. Statistical bases utilized for such allocation must be approved by the New York State Department of Health.
(f) Affiliated school contracts.
Education costs incurred relative to affiliated school contracts, including salaries, wages and stipends paid to students on approved programs and fees paid to physicians involved primarily in approved education programs, must be reflected in the appropriate education reporting center in the Unrestricted Fund.
(g) Inservice education—nursing.
(1) Nursing inservice education activities are defined as educational activities conducted within the residential health care facility for residential health care facility nursing personnel. The cost of time spent by nursing personnel as students in such classes and activities must remain in the reporting center in which their normal salary and wage costs are charged ( i.e., the reporting center in which they work). However, the cost (defined as salary, wages and payroll-related fringe benefits) of time spent in such classes and activities by those instructing and administering the programs must be included in the Nursing Administration reporting center.
(2) If instructors do not work full-time in the inservice education program, the cost (as defined above) of the portion of time they spend working in the inservice education program must be included in the “Nursing Administration” reporting center. This may be accomplished by direct distribution of these costs (by natural classification of expense category) each payroll period, or by reclassification (based upon time spent) at year end.
(3) The costs of nursing inservice education supplies (such as cassettes, books, medical supplies, etc.) and outside lecturers must also be reflected in the Nursing Administration reporting center.
(h) Inservice education—other.
All costs relative to nonnursing inservice education activities should be included in the reporting center to which they apply ( e.g., Physical Therapy, Radiology, etc.), as such inservice education activities will rarely apply to more than one functional activity.
(i) Physician remuneration.
Due to the numerous types of financial and work arrangements between residential health care facilities and physicians, comparability of costs between residential health care facilities may be significantly impaired. This section deals with the methods to be used in reporting costs and revenues related to the services of physicians.
(1) Financial arrangements.
Although the variations in financial arrangements between residential health care facilities and physicians are endless, there are five general types of such arrangements:
(i) Attending physician. Under this arrangement, the physician bills both Medicare, part B, and patients in his name for professional services provided. The residential health care facility reflects no operating revenue or expense relative to the professional component.
(ii) House physician. The residential health care facility bills Medicare, part B, in its name and receives payment, or bills in the physician's name and receives payment from the physician. The physician is paid a salary by the residential health care facility which is included in the facility's expense. Amounts received by the residential health care facility from Medicare may be operating revenue to the facility or may be a liability to Medicaid or the patient, depending upon the extent of the reimbursement ceiling in effect.
(iii) Normal arrangement. The residential health care facility bills patients for the physician's contractual professional services, including this amount as facility revenue. All department expenses are paid by the residential health care facility. The residential health care facility remits a fee to the physician which is included in facility expense.
(iv) Rental department. The physician bills the patients for certain of the part A and part B component (as defined by Medicare) and incurs all substantial direct expenses. The physician remits a fee to recover certain residential heath care facility expenses. This fee is recorded an nonoperating revenue in the appropriate department.
(v) Independent/separate department. The department functions are provided by an independent physician or group of physicians. Neither revenues nor expenses are incurred by the residential health care facility. The residential heath care facility refers patients and/or specimens to the physician or group, which is usually located on separate premises. No costs are incurred and no revenue is received under this arrangement.
(2) Work arrangement.
(i) The services provided by residential health care facility-based physicians may be categorized into five general types:
(a) professional component—providing direct patient care;
(b) education—teaching and supervising student activity in educational programs;
(c) research—working in research projects;
(d) administration—administering overall activities; and
(e) department supervision—supervising activities of the department.
(ii) When physicians are involved in more than one of the above functional activities, their remuneration, if any, should be recorded in the reporting center for which services they are paid. Prior to cost finding, their remunerations are to be reclassified to the appropriate reporting center on the residential health care facility's records.
(j) Periodic Interim Payments (PIP).
Periodic interim payments are made biweekly to a residential health care facility on the PIP program and are based on the facility's estimate of applicable Medicare reimbursement for the current cost report period. When such payments are received, a cash account in the Unrestricted Fund is debited and a PIP clearing account is credited for the amount of the payment. When applicable, Medicare charges are billed to the intermediary, the PIP clearing account is debited and patient accounts receivable is credited. At year end, adjustments must be made to eliminate any remaining balance in the PIP clearing account and to reflect the amount receivable from, or due to, the Medicare intermediary.
(k) Patient trust funds.
Patient trust funds consist of amounts deposited on behalf of the patient which are to be used for the personal care and expenditure of that patient. In most cases, these funds consist of social security funds which are received by the patient or by the residential health care facility on behalf of the patient. In most instances, the facility must give the patient an allowance each month out of these funds. Since patient trust funds are administered by a facility, these funds should be accounted for as agency funds by governmental and voluntary facilities. For proprietary facilities, these funds should be accounted for as noncurrent assets and noncurrent liabilities.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.20 Aquatic supervisory skill requirements
The New York State Department of Health is responsible for review of training courses and/or certification programs to determine acceptability.
(a) Supervision Level I—surf lifeguard.
(1) The supervision level requirements for this level shall take effect May 15, 1994.
(2) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 16 years; and
(ii) possesses a current A.R.C. basic life support for the professional rescuer CPR or equivalent certification; the certification period must not exceed one year; and
(iii) has a minimum of 20 hours (24 hours if first aid skills are included) of training acceptable to the commissioner covering those items set forth in this subdivision (stated time periods do not include final examination time or conditioning swims). Such training and ocean testing must be satisfactorily completed prior to assignment at ocean front and the certification period of training and testing must not exceed three years.
The training course and recertification program will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and substantially meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguarding to effectively communicate the subject matter required by this section.
(a) lifeguard orientation:
(1) program goals and objectives;
(2) chain of command;
(3) introduction to job of a lifeguard;
(4) introduction to lifesaving equipment and facilities;
(b) preventive lifeguarding:
(1) rules and regulations;
(2) victim recognition;
(i) distressed situation;
(ii) drowning situation (active vs. passive);
(3) bather supervision:
(i) areas of responsibility;
(ii) visual surveillance;
(iii) lifeguard stations;
(iv) lifeguard rotation and relief;
(4) causes of incidents/injuries;
(5) recognition of hazards;
(c) environmental hazards;
(d) communications:
(1) basic systems:
(i) between guards;
(ii) whistle system;
(iii) radio/phone, if applicable;
(iv) flag system for informing of water conditions, if applicable;
(2) emergency procedures:
(i) emergency action plans;
(ii) emergency medical service (EMS) response;
(3) public communication:
(i) warnings;
(ii) dangerous conditions;
(iii) lost person;
(e) rescue techniques and procedures:
(1) victim detection/recognition;
(2) front and back escapes (front head hold, rear head hold escapes, blocks);
(3) rescues with equipment (buoys, tubes, rescue boards);
(4) rescues without equipment;
(5) multiple rescues;
(6) lost bather drill/plan/practice (surface dive in nine feet of water and retrieve object from bottom);
(7) removal from water:
(i) carries;
(ii) care of back and neck injuries;
(f) first aid and emergency care (possession of a valid American Red Cross standard first aid or equivalent certification may be substituted for this segment.)
(1) bleeding and shock;
(2) choking;
(3) temperature extremes;
(4) spinal injuries (management in aquatic environment);
(5) diabetic emergencies;
(6) seizures;
(7) heart attacks and strokes;
(8) fractures, dislocation, sprains and strains;
(9) burns;
(10) eye and nose injuries;
(11) alcohol and drug overdoses;
(g) records and reports.
(iv) Such person must:
(a) correctly answer at least 80 percent of the questions in a written and/or oral test on theory and knowledge; and
(b) successfully perform/demonstrate all skills; this evaluation may be based upon observance of such person throughout the training program, and complete a 50 yard crawl in 35 seconds or less (unless the individual possesses Level II certification); and
(c) such person must complete a skills test to be conducted in the ocean, consisting of:
(1) a 300 yard crawl endurance swim; and
(2) a 50 yard swim to victim, carrying needed equipment, followed by a carry to shore and removal of victim from water.
(b) Supervision Level IIb—pool and beach lifeguard.
(1) The requirements of this subdivision shall take effect on May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 16 years (15 years is acceptable if a supervisory lifeguard is present); and
(ii) has a current A.R.C. basic life support for the professional rescuer, CPR or equivalent certification; the certification period shall not exceed one year; and
(iii) demonstrates a current ability to swim 300 yards nonstop using various strokes in good form; and surface dive to minimum nine foot depth and bring a 10 pound object to surface; and tread water for one minute; and
(iv) possesses a current certification from a recognized certifying agency acceptable to the State Health Commissioner or has within not more than a consecutive three-year period of time, completed a minimum of 20 hours (24 hours if first aid skills are included) of training acceptable to the commissioner covering those items outlined below (time periods do not include final examination time or conditioning swims):
The training course and recertification program will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and substantially meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguarding to effectively communicate the subject matter required by this section.
(a) program goals and objectives;
(b) preventive lifeguarding;
(c) victim recognition;
(d) equipment:
(1) rescue (buoys, tubes, reach pole, surf board, backboard, boat, mask, fins, snorkel);
(2) safety/lifeguarding (lifelines, lifeguards stands);
(3) personal (uniform/clothing, whistle, sunglasses, binoculars, sunscreen);
(e) orientation;
(f) in-service training;
(g) types of emergencies:
(1) life-threatening;
(2) nonlife-threatening;
(h) spinal injury management;
(i) special situations:
(1) hypothermia;
(2) heat emergencies;
(3) seizures;
(j) communication systems;
(k) emergency action plans;
(l) waterfront areas;
(m) search and recovery equipment and operations;
(n) physical fitness concepts;
(o) weather and environmental conditions;
(p) records and reports;
(q) first aid and emergency care (possession of a valid American Red Cross standard first aid or equivalent certification may be substituted for this segment):
(1) bleeding and shock;
(2) choking;
(3) temperature extremes;
(4) spinal injuries;
(5) diabetic emergencies;
(6) seizures;
(7) heart attacks and strokes;
(8) fractures, dislocations, sprains and strains;
(9) burns;
(10) eye and nose injuries;
(11) alcohol and drug overdoses;
(r) skills practice:
(1) water entry;
(2) moving victim to safety;
(3) equipment use (buoys, tubes, poles, rescue board, backboard, boat, mask, fins, snorkel);
(4) surface dive and underwater swimming;
(5) underwater search;
(6) search and recovery;
(7) lifts and assists;
(8) throwing assists;
(9) reaching assists;
(10) equipment extension;
(11) rescue breathing with flotation;
(12) rescue breathing without flotation;
(13) defense;
(14) escapes;
(15) multiple victim rescues;
(16) spinal injury, shallow water;
(17) spinal injury, deep water;
(v) such person must:
(a) correctly answer at least 80 percent of the questions on a written and/or oral test on theory and knowledge; and
(b) successfully perform/demonstrate all skills; and
(c) successfully:
(1) complete a 25-yard freestyle swim in 20 seconds; and
(2) perform a shallow dive, sprint 25 yards, recover 10-pound object from pool edge or gutter, then return 25 yards supporting 10-pound object; and
(3) demonstrate knowledge of:
(i) approaches;
(ii) escapes;
(iii) carries/tows;
(iv) spinal (shallow water) entry, approach, turn and support victim;
(v) spinal (deep water) entry, approach, turn and move victim to poolside or shallow end;
(vi) rescue tube swim/use;
(vii) surface dive and underwater swim;
(viii) tread water for one minute holding a diving brick with both hands.
(c) Supervision Level III.
(1) The requirements of this subdivision shall take effect on May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 18 years; and
(ii) possesses a current A.R.C. community CPR or equivalent certification; the certification period must not exceed one year; and
(iii) is competent to:
(a) understand and apply the rules and regulations of this Part and implement the safety plan; and
(b) evaluate environmental hazards; and
(c) use lifesaving equipment and facility; and
(d) undertake bather/crowd control.
(d) Supervision Level IV.
(1) The requirements of this subdivision shall take effect on May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) is at least 18 years of age; and
(ii) possesses a current A.R.C. community CPR or equivalent certification.
(e) Lifeguard supervision and management.
(1) No person shall be qualified under this subdivision unless such person:
(i) Possesses current certification issued by a certifying agency determined by the State Department of Health to provide an adequate level of training in lifeguard supervision and management covering those items set forth below. Certification shall be valid for the time period specified by the certifying agency, but may not exceed a consecutive three-year period from course completion. The training course will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguard supervision and management to effectively communicate the subject matter required by this section:
(a) Program Goals and Objectives.
(b) Lifeguard and Lifeguard Supervisor Duties and Responsibilities.
(c) Injury Prevention and Preventative Lifeguarding:
(1) Communication Systems.
(2) Patron Surveillance:
(i) Victim Recognition.
(ii) Effective Scanning.
(iii) Lifeguard Positioning and Rotation.
(iv) Lifeguard Breaks.
(3) Surveillance for Groups:
(i) Instruction Programs.
(ii) Large Groups and Children's Camps:
(A) Coordinating Large Groups and Pre-arrangements.
(B) Buddy and Board Systems.
(C) Swimming Ability Assessment.
(D) Swimming Area Selection.
(iii) Competitive Events.
(4) Facility Operation and Management:
(i) Safety Equipment.
(ii) Hazards.
(iii) Weather Conditions.
(d) Types of Emergencies and Emergency Action Plans (EAP).
(e) Lifeguard Preparedness:
(1) Staff Orientation and Training.
(2) In-service Training.
(f) Risk Management.
(ii) Such person must correctly answer at least 80 percent of the questions on a written and/or oral test on theory and knowledge.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.9 Professional practitioners and related provisions
(a) Nothing in sections 16.6 through 16.16 of this Part shall limit any human use of radiation in diagnostic or therapeutic procedures pursuant to section 16.19 of this Part provided that with respect to use on humans of radioactive material, such use is in accordance with a specific or general license issued under this Part, or an exemption therefrom.
(b) Each professional practitioner who administers, inserts, or implants an amount of radioactive material into a patient in such quantities as to require such patient to be confined for radiation protection purposes pursuant to section 16.123 of this Part shall require that such patient wear a wrist band. The wrist band shall bear the radiation symbol, the quantity and type of radioactive material administered, inserted or implanted and the date on which such quantity was measured.
(c) Radioactive cadavers.
(1) If any patient containing radioactive material, which was administered for therapeutic purposes, dies it shall be the responsibility of the doctor who pronounces such patient as dead to notify immediately the physician in charge of the case or his/her designated representative.
(2) No person shall commence any autopsy on any cadaver that contains radioactive material in a quantity that exceeds five millicuries, which was administered for therapeutic purposes, without first having consulted with and being advised by the radiation safety officer of the hospital or, if he/she is not available, the physician responsible for the administration of the radioactive material. If neither is available, their designated representative may serve.
(3) A radioactivity report on every cadaver containing more than five millicuries of radioactive material which was administered for therapeutic purposes, shall be completed by the radiation safety officer or the physician responsible for the administration of the radioactive material or their designated representatives. The report must include the name and address of the hospital; the name of the deceased; the name, address and telephone number of the next of kin; the name, address and telephone number of the funeral home to which the deceased will be sent; the radionuclide involved, the approximate activity on the day of the report and the physical form; the location of the radioactive materials in the body and the external rate at the body surface closest to the source; the precautions to be observed during autopsy or handling of the body by the funeral director; and the name of the person who prepared the form. This report shall accompany the body (whether autopsied or not) when it is surrendered to the funeral director. The department shall be notified in person, or by telephone, mailgram or facsimile within 24 hours of the death and a copy of the radioactivity report shall be sent to the department within 15 days of the death.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.1 Definition
As used in this Subpart, the term medical facility or facility shall mean all facilities covered by the terms general hospital or certified home health agency as defined in articles 28 and 36 of the Public Health Law, provided that such facility possesses a valid operating certificate or certificate of approval issued by the State Commissioner of Health and has been established, licensed or certified as required by law.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.13 General requirements for performance of anatomic pathology and cytopathology procedures
(a) Facilities.
(1) Laboratory space.
(i) Work areas must be clean, well-lighted and well-ventilated.
(ii) Utilities (water, gas, suction, electricity) must be available, as needed.
(iii) Microscopic work area(s), including space and furniture, must be conducive to high-quality performance.
(iv) Cytopreparation area(s) must be separate from screening and clinical/secretarial area(s) so that personnel are protected from hazardous fumes and screening areas are free from distractions.
(v) There must be sufficient space for quality control, administrative, and clerical functions.
(vi) Storage of records and specimens must be in compliance with section 581.1-1(c) and (d) of this Subpart.
(2) Safety precautions.
(i) Health and safety precautions comparable to those required in hospital laboratories must be maintained.
(ii) Universal precautions must be enforced when liquid specimens are handled.
(3) Equipment and reference resources.
(i) There must be an adequate number of high- quality, well-maintained binocular microscopes.
(ii) Preventive maintenance of microscopes and other equipment and must be performed, as recommended by the manufacturer, and documented in a log book.
(iii) A core reference library should be conveniently available on the laboratory premises.
(4) Support personnel. There should be adequate clerical and laboratory assistance personnel, whose number and type are dependent on the volume of work.
(5) Salaries. The method of compensation should not adversely affect the quality of performance. Cytotechnologists should be free from quota or other pressures that limit appropriate slide review time.
(b) Laboratory operation.
(1) Specimens must be identified properly and must be accompanied by a complete test requisition containing minimal clinical information.
(2) A laboratory procedure manual describing the handling and storage of specimens from origination to final report, including collection, preservation, transportation, rescreening protocol and standards for specimens or slides, must be available in the work area.
(3) Solutions and stains.
(i) Solutions and stains must be labelled to indicate concentration, expiration date, and storage requirements.
(ii) Stains must be monitored daily and written records thereon maintained.
(iii) Cross-contamination of specimens must be avoided. Nongynecologic specimens must be stained separately from gynecologic specimens. Solutions must be filtered or replaced daily; particular care must be taken to filter solutions after processing body fluid specimens.
(iv) Solutions and stains must be kept covered when not in use and stored at appropriate temperatures.
(4) Microscopy.
(i) All microscopy must be performed on the laboratory premises.
(ii) Cytotechnologist functions should include evaluation of the adequacy of specimens, marking of areas appropriate for further review, and rendering of a provisional interpretation.
(c) Special requirements for histopathology, oral pathology and dermatopathology.
(1) All special stains shall be controlled for intended reactivity by the use of positive tissue sections, processed at the same time as the unknown tissue sections. Acid-fast staining procedures must include both a positive and a negative control slide.
(2) All unprocessed remnants of tissue specimens shall be retained in a fixative solution until the portions submitted for microscopy have been examined and diagnosed by a pathologist.
(3) Stained slides and paraffin blocks shall be retained for a minimum of 20 years from the date of examination.
(4) It is recommended that copies of reports be kept in numeric and alphabetic cross files. A numerical accession record satisfies the numeric file recommendation.
(5) Records must indicate the total number of blocks taken and the name of the pathologist who diagnosed the case.
(6) A duplicate copy of all reports, or the capability to reproduce the same, must be retained by the laboratory for 20 years.
(7) All slides referred for consultation must have the patient's name and other identifiers written on the label.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.26 Termination of services
(a) The Division of Health Care Financing in the Department of Health shall be notified immediately of the deletion of any previously offered service or of the withholding of services from patients paid for by government agencies. Such notification shall include a statement indicating the date of the deletion or withholding of such service and the cost impact on the LTHHCP of such action. Any overpayments by reason of such deletion of previously offered service shall be subject to such penalties as the Commissioner of Health may impose in the amount of up to 25 percent of the overpayment for negligent incorrect completion or negligent failure to file such notification, and up to 100 percent of the overpayment for willful incorrect completion or negligent failure to file such notification. The penalties assessed under this section are separate from, and shall not be construed to be in mitigation of damages which may be recovered pursuant to section 145-b of the Social Services Law.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.6 Recordkeeping
A covered facility shall maintain the environmental assessment required by section 4-2.3 and the sampling and management plan required by section 4-2.4 of this Subpart, and any associated sampling results, on the facility premises for at least three years. Such records shall be made available to the department immediately upon request.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.10 Minimum utilization standards
(a) For the purpose of determining the number of threshold visits to be used in the computation of basic rates, the commissioner shall establish minimum utilization standards as provided in this section. Such standards shall be based upon an assessment of visits per full-time equivalent for health care personnel. A full-time equivalent (FTE) shall be based upon a 35-40 hour week.
(b) For the comprehensive primary care facilities, threshold visits shall be imputed at:
(1) 3,500 visits per year per FTE for the services of physicians and physician specialists;
(2) 3,000 visits per year per FTE for the services of dentists;
(3) 2,100 visits per year per FTE for the services of other health care providers, such as physician's assistants, licensed midwives, nurse practitioners and dental hygienists;
(4) 2,100 visits per year per FTE for the services of therapists, such as speech, occupational and physical therapists;
(5) 1,500 visits per year per FTE for the services of mental health counselors.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.4 Award rescissions and deferrals
(a) An award may be rescinded by the commissioner if:
(1) prior to the full payment of an award, the recipient withdraws from or fails to continue in his/her primary care residency program;
(2) the recipient is convicted of a felony or a lesser offense related to professional activity;
(3) the recipient is found to have provided fraudulent or willfully misrepresented information in the application or supporting documents; or
(4) the recipient fails to apply award monies received toward repayment of all or part of a recipient's qualifying debt.
(b) An award may be postponed or deferred temporarily by the commissioner because of one or more of the conditions described in subdivision (a) of this section if the commissioner determines that the condition will be corrected within a reasonable time or that the circumstances warrant a deferral rather than a rescission.
(c) The commissioner will notify the president of any award rescissions or deferrals.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.37 Computation of basic rates of payment for services provided to Medicaid patients by preferred primary care providers
(a) For payments made pursuant to this section and pursuant to section 86-1.11(h) of this Part, for ambulatory care services to Medicaid patients, reimbursement shall be based upon a uniform payment schedule with a discrete price set forth in subdivision (c) of this section.
(b) To be eligible to receive reimbursement pursuant to this section, facilities must be licensed pursuant to article 28 of the Public Health Law, and certified to provide general medical services, and enter into a written agreement with the commissioner to provide the discrete services described in subdivision (c) of this section. These clinic services are defined on the basis of patient characteristics and provider services. Patient characteristics include age, sex and diagnoses. Provider services include diagnostic examinations, treatments, and ancillary services including significant diagnostic technologies. Diagnostic technologies are defined as: diagnostic nuclear medicine, diagnostic radiology, diagnostic ultrasound, cardiography, cardiac fluoroscopy, echocardiography, and neurological and neuromuscular procedures.
(c) The 71 clinic services for which reimbursement shall be available at prices established pursuant to this section are:
(1) Diagnostic investigation exams NEC.
This visit shall be for any patient for the purpose of diagnostic investigation of problems attendant to physical medicine nowhere else categorized. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures and shall include necessary laboratory tests and the use of diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section. This visit shall only occur after a complete physical and history and shall include all other laboratory and diagnostic technology ancillaries that are required to complete the diagnostic investigation. This visit is not for the sole purpose of receiving an x-ray.
(2) Diagnostic investigation with nuclear imaging.
This visit shall be for patients requiring diagnostic nuclear imaging including contrast imaging in order to complete a diagnostic investigation. This visit shall only occur after a complete physical and history and shall include all other laboratory and diagnostic technology ancillaries that are required to complete the diagnostic investigation, and any other services specified in the agreement referenced in subdivision (b) of this section. This visit is not for the sole purpose of receiving diagnostic nuclear medicine.
(3) Diagnostic investigation with computerized axial tomography imaging.
This visit shall be for patients requiring a CAT scan in order to complete a diagnostic investigation. This visit shall only occur after a complete physical and history and shall include all other laboratory and diagnostic technology ancillaries that are required to complete the diagnostic investigation, and any other services specified in the agreement referenced in subdivision (b) of this section. This visit is not for the sole purpose of receiving a CAT scan.
(4) Diagnostic investigation with magnetic resonance imaging.
This visit shall be for patients requiring a MRI in order to complete a diagnostic investigation. This visit shall only occur after a complete physical and history and shall include all other laboratory and diagnostic technology ancillaries that are required to complete the diagnostic investigation, and any other services specified in the agreement referenced in subdivision (b) of this section. This visit is not for the sole purpose of receiving an MRI.
(5) Management exam NEC.
This visit shall be for any patient for the treatment of problems attendant to physical medicine nowhere else categorized. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(6) Medication administration.
This visit shall be for the sole purpose of administering drugs, injectables or renewal of a prescription with a concomitant brief provider assessment, and any other services specified in the agreement referenced in subdivision (b) of this section.
(7) Pediatric annual well care exam.
This visit shall be for healthy children ages three years through 17 years. This visit shall include a physical examination, developmental appraisal, nutritional assessment, hearing and vision screening, immunizations as indicated, selected laboratory tests such as hematocrit, blood counts, lead screening, TB Tine, urinalysis, VD for teenagers, on an appropriate schedule, and other services specified in the agreement referenced in subdivision (b) of this section.
(8) Adult annual well care exam.
This visit shall be for generally healthy patients over 17 years of age. This visit shall include an annual physical examination, health education, nutritional assessment, blood pressure, hearing and vision screening, selected ancillaries when appropriate, including standard laboratory tests, chest x-rays, mammograms, and any other services specified in the agreement referenced in subdivision (b) of this section.
(9) First prenatal—routine.
This visit shall be for females with a confirmed diagnosis of a normal pregnancy for the purpose of initiating a prenatal care treatment regimen. This visit shall include a complete physical examination and history, nutritional counseling, health education, appropriate treatment measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(10) First prenatal—complicated.
This visit shall be for females with a confirmed diagnosis of a complicated pregnancy for the purpose of initiating a prenatal care treatment regimen. This visit shall include a complete physical examination and history, nutritional counseling, health education, appropriate treatment measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(11) Prenatal management revisit—complicated.
This visit shall be for females with a confirmed pregnancy and complications primarily related to pregnancy. This visit shall be for the purpose of providing ongoing prenatal care including a limited physical examination, nutritional counseling, health education, appropriate treatment and diagnostic measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(12) Post partum management—complicated.
This visit shall be for females with a confirmed pregnancy and complications primarily related to pregnancy. This visit shall be for the purpose of providing post partum care including a limited physical examination, nutritional counseling, health education, appropriate treatment and diagnostic measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(13) Prenatal revisit well care—normal.
This visit shall be for female patients with a confirmed normal pregnancy. This visit shall be for the purpose of providing ongoing routine or uncomplicated prenatal care including a limited physical examination, nutritional counseling, health education, appropriate treatment and diagnostic measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(14) Post partum management—normal.
This visit shall be for females of all ages for the purpose of providing post partum care following a normal pregnancy and delivery. This visit shall be for the purpose of post partum care including a limited physical examination, nutritional counseling, health education, appropriate treatment and diagnostic measures including laboratory ancillaries and the use of key technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(15) Neonatal and congenital diagnostic investigation.
This visit shall be for the purpose of investigation of problems of congenital disorders and newborns with medical conditions. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries and the use of diagnostic technologies, and other services specified in the agreement referenced in subdivision (b) of this section.
(16) Management of neonatal and congenital problems.
This visit shall be for the treatment of problems associated with congenital disorders and newborns with problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries, and other services specified in the agreement referenced in subdivision (b) of this section.
(17) Pediatric well care exam.
This visit shall be for healthy newborns and children under three years of age. This visit shall include a physical examination, developmental checks, health education for the parents as warranted, immunizations as indicated, selected laboratory tests and screening procedures such as PKU, sickle cell, lead, TB Tine, urinalysis, hematocrit, on an appropriate schedule, and other services specified in the agreement referenced in subdivision (b) of this section.
(18) Female reproductive diagnostic investigation.
This visit shall be for the purpose of investigating female reproductive problems. This visit shall include a physical examination and history with appropriate diagnostic and treatment measures including laboratory ancillaries and the use of diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(19) Management of female reproductive problems.
This visit shall be for the treatment of female reproductive problems. This visit shall include a physical examination and history with appropriate diagnostic and treatment measures including appropriate laboratory ancillaries, and any other services specified in the agreement referenced in subdivision (b) of this section.
(20) Annual gynecological examination.
This visit shall be for an annual gynecological examination. This visit shall include a physical examination and history, health education, a full pelvic examination, pap smear, appropriate laboratory ancillaries and any other services specified in the agreement referenced in subdivision (b) of this section.
(21) Contraceptive well care exam.
This visit shall be for the purpose of providing contraceptives and family planning. This exam shall include a physical examination and history, health and family planning education, appropriate laboratory ancillaries and any other services specified in the agreement referenced in subdivision (b) of this section.
(22) Ear, nose and throat diagnostic investigation—adult.
This visit shall be for patients over 17 years of age for the purpose of investigation of ear and nasopharynx problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(23) Ear, nose and throat diagnostic investigation—pediatric.
This visit shall be for children up to and including 17 years of age for the purpose of investigation of ear and nasopharynx problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(24) Management of ear, nose and throat problems—adult.
This visit shall be for patients over 17 years of age for the treatment of problems of the ear and nasopharynx. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(25) Management of ear, nose and throat problems—pediatric.
This visit shall be for children up to and including 17 years of age for the treatment of problems of the ear and nasopharynx. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(26) Ophthalmological services.
This visit shall be for any patient for eye examinations and treatment of eye disorders. This visit shall include appropriate ophthalmological procedures as well as any laboratory ancillaries or diagnostic technologies required, and any other services specified in the agreement referenced in subdivision (b) of this section.
(27) Respiratory diagnostic investigation—adult.
This visit shall be for patients over 17 years of age for the purpose of investigation of respiratory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(28) Respiratory diagnostic investigation—pediatric.
This visit shall be for children up to and including 17 years of age for the purpose of investigation of respiratory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(29) Management of respiratory problems—adult.
This visit shall be for patients over 17 years of age for the treatment of respiratory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(30) Management of respiratory problems—pediatric.
This visit shall be for children up to an including 17 years of age for the treatment of respiratory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(31) Systemic infection diagnostic investigation.
This visit shall be for the purpose of investigation of systemic infections. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(32) Management of systemic infections.
This visit shall be for the treatment of systemic infections. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(33) Gastrointestinal diagnostic investigation.
This visit shall be for the purpose of investigation of gastrointestinal problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(34) Management of gastrointestinal problems—adult.
This visit shall be for patients over 17 years of age for the treatment of gastrointestinal problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(35) Management of gastrointestinal problems—pediatric.
This visit shall be for children up to and including 17 years of age for the treatment of gastrointestinal problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(36) Hepatobiliary diagnostic investigation.
This visit shall be for the purpose of investigation of hepatobiliary problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(37) Management of hepatobiliary problems.
This visit shall be for the treatment of hepatobiliary problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(38) Genito-urological diagonstic investigation.
This visit shall be for male patients for the purpose of investigation of genito-urological and reproductive problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(39) Management of genito-urological problems.
This visit shall be for male patients for the treatment of genito-urological problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(40) Cardiac diagnostic investigation.
This visit shall be for the purpose of investigation of cardiac and circulatory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(41) Management of cardiac problems.
This visit shall be for the treatment of cardiac and circulatory problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(42) Endocrinal diagnostic investigation.
This visit shall be for the purpose of investigation of diabetes and other metabolic problems and diseases of the endocrine system and pancreas. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(43) Management of other endocrinal problems.
This visit shall be for the treatment of other metabolic problems and diseases of the endocrine system and pancreas, excluding diabetes. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(44) Management of diabetes—pediatric.
This visit shall be for children up to and including 17 years of age for the treatment of problems associated with diabetes. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(45) Management of diabetes—adult.
This visit shall be for patients over 17 years of age for the treatment of problems associated with diabetes. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(46) Skin and soft tissue diagnostic investigation.
This visit shall be for the purpose of investigation of skin and soft tissue injuries and problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(47) Inflammatory muscular/skeletal diagnostic investigation.
This visit shall be for the purpose of investigation of muscular/skeletal problems including arthritis, rheumatism and other inflammatory/degenerative diseases of the joints and bones. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(48) Other muscular/skeletal diagnostic investigation.
This visit shall be for the purpose of investigation of other muscular/skeletal problems, excluding arthritis, rheumatism and other inflammatory/degenerative diseases of the joints and bones. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures, and shall include necessary laboratory tests and the use of key diagnostic technologies, and any other services specified in the agreement referenced in subdivision (b) of this section.
(49) Rehabilitation therapy.
This visit shall be for therapy and treatment planning for any patient with diagnosed physical disabilities requiring physical, rehabilitation or occupational services. This visit shall include the necessary laboratory ancillaries to manage the course of treatment, and any other services specified in the agreement referenced in subdivision (b) of this section.
(50) Management of skin and soft tissue problems.
This visit shall be for the treatment of skin and soft tissue injuries and problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(51) Management of poisoning.
This visit shall be for the treatment of problems associated with poisoning. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(52) Management of inflammatory muscular/skeletal problems.
This visit shall be for the treatment of muscular/skeletal problems including arthritis, rheumatism and other inflammatory/degenerative diseases of the joints and bones. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(53) Management of other muscular/skeletal problems.
This visit shall be for the treatment of other muscular/skeletal problems, excluding arthritis, rheumatism and other inflammatory/degenerative diseases of the joints and bones. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(54) Oncological diagnostic investigation.
This visit shall be for the purpose of investigation of malignancies, excluding benign tumors and malignancies of the skin. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries and the use of diagnostic technologies, and other services specified in the agreement referenced in subdivision (b) of this section.
(55) AIDS diagnostic investigation.
This visit shall be for the purpose of investigation of the AIDS virus. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries and the use of diagnostic technologies, and other services specified in the agreement referenced in subdivision (b) of this section.
(56) Other hematological diagnostic investigation.
This visit shall be for the purpose of investigation of other myeloproliferative diseases of the blood and blood forming organs, and anemias. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries and the use of diagnostic technologies, and other services specified in the agreement referenced in subdivision (b) of this section.
(57) Therapeutic IV push and chemotherapy injection.
This visit shall be for therapy and treatment planning for any patient diagnosed with an oncological/hematological problem requiring a therapeutic regime, either IV push and/or chemotherapy injection to ameliorate symptoms, or reverse or cure malignancies, excluding benign tumors and malignancies of the skin, and myeloproliferative diseases of the blood and blood forming organs. Therapies will include IV push and chemotherapy injection. This visit shall include necessary laboratory ancillaries to manage the course of treatment, and any other services specified in the agreement references in subdivision (b) of this section.
(58) Therapeutic infusions.
This visit shall be for therapy and treatment planning for any patient diagnosed with an oncological/hematological problem requiring a therapeutic regime of infusions, including blood product transfusions to ameliorate symptoms, or reverse or cure malignancies, excluding benign tumors and malignancies of the skin, and myeloproliferative diseases of the blood and blood forming organs. Therapies will include infusions including transfusions of blood products. This visit shall include necessary laboratory ancillaries to manage the course of treatment, and any other services specified in the agreement references in subdivision (b) of this section.
(59) Therapeutic radio therapy.
This visit shall be for therapy and treatment planning for any patient diagnosed with an oncological/hematological problem requiring a therapeutic regime of radio therapy to ameliorate symptoms, or reverse or cure malignancies, excluding benign tumors and malignancies of the skin, and myeloproliferative diseases of the blood and blood forming organs. Therapies will include radiation therapy or hyperthermia as an adjunct to radiation therapy. This visit shall include necessary laboratory ancillaries to manage the course of treatment, and any other services specified in the agreement references in subdivision (b) of this section.
(60) Oncological management.
This visit shall be for the management of patients currently undergoing a therapeutic regime to ameliorate symptoms, or reverse or cure malignancies, excluding benign tumors and malignancies of the skin, and myeloproliferative diseases of the blood and blood forming organs. Therapies will include IV push and chemotherapy injection, infusions including blood product transfusions, and radiation therapy or hyperthermia as an adjunct to radiation therapy, and other services specified in the agreement referenced in subdivision (b) of this section. Patients need not receive therapy every visit. When the patient does not receive therapy, the visit shall include observation of the therapy's effects and the use of laboratory ancillaries necessary for managing and assessing the course of therapy.
(61) Management of anemias—pediatric.
This visit shall be for children up to and including 17 years of age for the treatment of anemias. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries, and other services specified in the agreement referenced in subdivision (b) of this section.
(62) Management of anemias—adult.
This visit shall be for patients over 17 years of age for the treatment of anemias. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(63) Management of AIDS—pediatric.
This visit shall be for children up to and including 17 years of age for the treatment of AIDS. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(64) Management of AIDS—adult.
This visit shall be for patients over 17 years of age for the treatment of AIDS. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(65) Management of other hematological problems.
This visit shall be for the treatment of other myeloproliferative diseases of the blood and blood form organs. This visit shall include a physical examination and history with appropriate treatment and diagnostic laboratory tests, and any other services specified in the agreement referenced in subdivision (b) of this section.
(66) Neurological and psycho/social diagnostic investigation.
This visit shall be for the purpose of investigation of problems related to the central nervous system, medical conditions attendant to mental illness, substance abuse, and social problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries and the use of diagnostic technologies, and other services specified in the agreement referenced in subdivision (b) of this section.
(67) Speech and hearing services—adult.
This visit shall be for patients over 17 years of age for the purpose of an audiology examination, and speech therapy and treatment planning, and any other services specified in the agreement referenced in subdivision (b) of this section.
(68) Speech and hearing services—pediatrics.
This visit shall be for children up to and including 17 years of age for the purpose of an audiology examination, and speech therapy and treatment planning, and any other services specified in the agreement referenced in subdivision (b) of this section.
(69) Neurological and psycho/social management.
This visit shall be for the treatment of problems associated with the central nervous system, medical problems attendant to mental illness, substance abuse, and social problems. This visit shall include a physical examination and history with appropriate treatment and diagnostic measures including laboratory ancillaries, and other services specified in the agreement referenced in subdivision (b) of this section.
(70) Counseling.
This visit shall be for the primary purpose of providing supportive counseling, extended individual and family counseling, somatotherapy and health education to patients with diagnosed mental illness or substance abuse problems and any other service specified in the agreement referenced in subdivision (b) of this section. This visit shall not be for a medical work up although ancillaries necessary to monitor and provide treatment of the patient are included.
(71) Diagnostic investigation of vascular systems.
This visit shall be for patients requiring radiologic exams of cardiac vessels and other arterial and various radiologic procedures. This visit shall only occur after a complete physical and history and shall include all other laboratory and diagnostic technology ancillaries that are required to complete the diagnostic investigation, and any other services specified in the agreement referred in subdivision (b) of this section. This visit is not for the sole purpose of receiving diagnostic radiologic procedures.
(d) The prices established pursuant to this section shall provide full reimbursement for the following:
(1) physician services, nursing services, therapist services, technician services, nutrition services, health education services, psychosocial services, care coordination services and other related professional expenses directly incurred by the licensed facility;
(2) space occupancy and plant overhead costs;
(3) all ancillary services including laboratory tests, diagnostic tests including professional interpretations, and as detailed in the agreement described in subdivision (b) of this section;
(4) all medical supplies, immunizations, and drugs directly related to the provision of the services as detailed in the agreement pursuant to subdivision (b) of this section; and
(5) administrative personnel, business office, data processing, recordkeeping, housekeeping, and other related facility overhead expenses.
(e) The price for each service shall be adjusted for regional differences in wage levels to reflect differences in labor costs for personnel providing direct patient care and clinic support staff.
(f) During the initial rate period of provider participation, reimbursement to preferred primary care providers shall be no less than that which would be received pursuant to sections 86-4.1 through 86-4.31 of this Subpart.
(g) The commissioner shall establish trend factors to project increases in the base year prices during the effective period of the reimbursement rates. The trend factors shall be developed using available price indices including elements of the United States Department of Labor consumer and producer price indices and special price indices developed by the commissioner for this purpose. The projected trend factors shall be updated on an annual basis, based upon current and available data.
(h) Any clinic services not covered in subdivision (c) of this section shall be reimbursed based on the provider's established cost-based all inclusive visit rate pursuant to this Subpart.
(i) In addition to complying with the requirements for recording and reporting financial and statistical data in sections 86-4.3, 86-4.4 and 86-4.5 of this Subpart, facilities designated as preferred primary care providers shall complete surveys of patient characteristics, treatment patterns, health care organization factors, costs associated with patient care, and other factors as undertaken from time to time by the commissioner.
(j)
(1) An adjustment may be made to payments described in this section for diagnostic and treatment centers designated as preferred primary care providers to support the facility's efforts to meet the health care needs of the community. Activities for which such adjustment may be available include, but are not limited to, patient access after routine hours of operation; effective operation of patient management record systems and appointment systems; assurance of continuity of patient care with the same practitioner or team of practitioners; other essential support for the scope of practice undertaken by preferred primary care diagnostic and treatment centers; effective quality assurance, utilization management and patient care management systems; outreach, case management and community intervention consistent with the designation; and participation in comprehensive programs to provide substance and alcohol treatment services.
(2)
(i) An adjustment may also be made to increase coverage of disproportionate share of bad debt and charity care losses of preferred primary care providers which acquired capital assets through financing from public authorities.
(ii) Such adjustment shall be based on the unrecovered capital costs associated with the disproportionate share of bad debt and charity care, which shall be calculated by applying the capital component of the facility's Medicaid rate of payment for the rate period for which the allowance is being determined, to identified eligible visits as defined in section 86-4.12 of this Subpart.
(k) An adjustment shall be made to payments described in this section to cover the costs of primary medical malpractice insurance sufficient to meet the requirements of section 91.1(a) of this Title for physicians employed by preferred primary care diagnostic and treatment centers.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.14 Sewage treatment
Facilities shall be provided and maintained for the satisfactory treatment or scavenging and disposal of sewage. In addition, such facilities shall meet the following requirements:
(a) Submission of plans.
A plan for proposed new or modified sewage treatment facilities or scavenging systems shall be submitted to the permit-issuing official at least 30 days prior to beginning construction.
(b) Plan approval and construction.
A permit or written approval for the sewage system plan(s) shall be obtained from the permit-issuing official and/or the New York State Department of Environmental Conservation. No construction of new or modified sewage treatment facilities shall be commenced until such permit or written approval has been received by the permittee. Construction shall be in accordance with the approved plans.
(c) The presence of inadequately treated sewage on the surface of the ground is prohibited.
(d) Privies shall be so located, constructed and maintained that they will not pollute a water supply, surface water, adjacent ground surface, or permit access of flies or rodents to the privy vault. Privy vault contents shall be emptied and/or adequately treated.
(e) At least one sanitary dumping station for each 100 campsites or less must be provided. Sites provided with individual sewer connections shall not be counted when determining the required number of sanitary dumping stations. Sanitary dumping stations shall not be required at campgrounds for tent or camping cabin use only.
(f) Seasonal campsites.
Seasonal campsites constructed after the effective date of this Subpart, intended for use by self-contained recreational vehicles shall be provided with either:
(1) a sewer inlet connection; or
(2) an acceptable operator run scavenger service for routine collection of sewage from each recreational vehicle. Information regarding the scavenger equipment and collection schedule shall be submitted to the permit-issuing official for review and approval.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.268 Procedure
A unit of activity in an ancillary cost center. For example, a procedure in a radiology cost center may be a series of pictures which constitute an exam.
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.16 Pooled investments
[ 1360 ]
(a) Investments of various funds may be pooled unless prohibited by law or the terms of a donation or grant. Gains/losses and investment income on pooled investments must be distributed to participating funds on a basis utilizing market value.
(b) To illustrate the market value method of distributing gains/losses and income on pooled investments, assume the following facts:
(1) A hospital decides to create a pool of investments from funds provided from the following sources:
| Market value at inception of pool* | | | | --- | --- | --- | | | Amount | % of total pool | | Unrestricted fund | $1,000,000 | 20% | | Endowment Fund (single endowment) | $3,000,000 | 60% | | Plant Replacement and Expansion (PR&E) Fund | $1,000,000 | 20% | | | $5,000,000 | 100% |
*
This serves as the initial distribution basis.
(2) Gains/losses on the Endowment Fund must be added to or deducted from the principal; however, the investment income is available for unrestricted purposes under the terms of the gift.
(3) Gains/losses and investment income for the Plant Replacement and Expansion Fund must be added to or deducted from fund balance pursuant to the wishes of the donor.
(4) There were no gains/losses on the sale of investments for the first year the pool was in existence. The income generated by the pool for that year was $400,000.
(5) Any gains on investment sales and investment income are not reinvested in the investment pool. The cash is remitted to funds that are entitled to the gains and/or income.
(c) The distribution of the income for the first year would be based on each participating fund's percentage of the pool based on its contribution at market value at the initiation of the pool.
(1) Therefore, the distribution would be as follows:
| | Distributed to | Income distributed | | --- | --- | --- | | Unrestricted Fund | (total income of $400,000 × 20%) | $ 80,000 | | Endowment Fund | (total income of $400,000 × 60%) | 240,000 | | PR&E Fund | (total income of $400,000 × 20%) | 80,000 | | | | $400,000 |
(2) The accounting entries necessary to account for the distribution of income from the pooled investments would be as follows:
| | Account | Dr. | Cr. | | --- | --- | --- | --- | | (i) Unrestricted Fund | | | | | Cash | 1010 | $320,000 | | | Unrestricted income from Endowment Fund (nonoperating revenue) | 9050 | | $240,000 | | Income, gains and losses from unrestricted investments | 9040 | | $ 80,000 | | To record the income from pooled investments for the year. | | | | | (ii) PR&E Fund | | | | | Cash | 1510 | $ 80,000 | | | Fund balance | 2690 | | $ 80,000 | | To record the income from pooled investments for the year. | | | |
(d) In the second year the following facts are assumed:
(1) On the first day of the year the hospital decided to add $1,000,000 of unrestricted funds to the pooled investments. On that date, but prior to making the aforementioned addition, the pooled investments had the same cost, $5,000,000, as at inception, but a market value of $6,000,000. There were no other additions to the pool during this year.
(2) There were net gains on the sale of investments of $100,000 for the year and the investment income was $500,000 for the same period.
(e) Based on the above facts, the distribution percentage (%) for the income and gains on pooled investments for each of the participating funds would be based on the market value of the investment pool as of the date of the last addition and would be calculated as follows:
| Revised distribution basis | | | | --- | --- | --- | | | Units | % of total units | | (1) Unrestricted Fund. | | | | Market Value $6,000,000 × 20% (distribution % prior to addition) | $1,200,000 | | | Addition to pool at fair value as of that date | 1,000,000 | | | | $2,200,000 | 31.4% | | (2) Endowment Fund. | | | | Market value $6,000,000 × 60% (distribution % prior to addition - no new additions) | $3,600,000 | 51.4% | | (3) PR&E Fund. | | | | Market Value $6,000,000 × 20% (distribution % prior to addition - no new additions) | 1,200,000 | 17.2% | | | $7,000,000 | 100.0% |
(f) The income and gains from pooled investments for the second year would be based on the newly computed distribution and would be as follows:
| | Current distribution % | Gains to be distributed | Income to be distributed | | --- | --- | --- | --- | | Unrestricted Fund | 31.4% | $ 31,400 | $157,000 | | Endowment Fund | 51.4% | 51,400 | 257,000 | | PR&E Fund | 17.2% | 17,200 | 86,000 | | | 100.0% | $100,000 | $500,000 |
(g) The accounting entries necessary to reflect the above distribution would be as follows:
| (1) Unrestricted Fund. | | | | | --- | --- | --- | --- | | | Account | Dr. | Cr. | | Cash | 1010 | $445,400 | | | Unrestricted income from Endowment Fund (nonoperating revenue) | 9050 | | $257,000 | | Income, gains and losses from unrestricted investments | 9040 | | 188,400 | | To record the income and gains on pooled investments attributable to these funds for the year. | | | | | (2) Endowment Fund. | | | | | Cash | 1810 | $ 51,400 | | | Fund balance (gains on sales of investments) | 2890 | | $ 51,400 | | To record the gains on pooled investments attributable to this fund for the year. | | | | | (3) PR&E Fund. | | | | | Cash | 1510 | $103,200 | | | Fund balance | 2690 | | $103,200 | | To record the gains and income on pooled investments attributable to this fund for the year. | | | |
(h) As the above example illustrates, each time an addition is made to the investment pool a new distribution basis must be calculated. This is also true for any reductions to the pool. All gains/losses and investment income from the beginning of the accounting period up to the date of the addition must be determined and distributed on the basis of account balances prior to the addition. Any gains/losses and investment income subsequent to an addition would be distributed on the new basis until another addition or reduction is made.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.4 General rule
A final notice of determination will not be issued until there has been full compliance with the provisions of 6 NYCRR Part 617 and this Part, including the payment to the department of all necessary fees and costs. For the purposes of this Part, in certain instances, based on the applicant's preliminary environmental documentation supplied to the department, a tentative approval of a proposed action involving an applicant may be granted.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ATTENDANCE ATTENDANCE
10 CRR-NY 84.10 Basic workweek
The basic workweek for annual salaried employees of State departments, agencies and institutions, other than those employed on a part-time basis only and other than employees excluded from the application of overtime compensation under the rules of the Director of the Budget adopted pursuant to section 134 of the Civil Service Law, shall be 40 hours; provided, however, that where a shorter workweek would not interfere with the proper performance of government functions an appointing authority may establish a basic workweek of not less than 37<< hours and five days for any employees under its appointive jurisdiction as may be designated by it with the approval of the Division of the Budget; provided, however, that this section shall not be construed to increase the workweek of any employee for whom a workweek of less than 40 hours was prescribed by law, rule or administrative regulation as of January 2, 1957.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.14 Non-APG payments
(a) Psychotherapy services by clinical social workers.
To the extent authorized pursuant to section 2807(2-a) of the Public Health Law, payments for individual psychotherapy services provided by clinical social workers, as defined by section 86-4.9 of this Subpart, shall be established at $40.64 for encounters lasting between 20 and 30 minutes and at $62.33 for encounters lasting between 45 and 50 minutes and at $69.93 for family therapy encounters lasting between 45 and 50 minutes.
(b) Wheelchair evaluation services.
Payments for comprehensive wheelchair evaluations, which shall include assessments, fittings and training consisting of at least two hours of direct patient care services, shall be established at $302.
(c) Eyeglasses dispensing.
Payments for dispensing eyeglasses shall be established at $89.77, plus capital, when such service includes the cost of providing the eyeglasses and at $38.05, plus capital, when such service does not include the cost of providing the eyeglasses. the capital add-on per visit for each provider shall be the provider's capital add-on per visit as otherwise calculated pursuant to applicable provisions of section 2807(2) of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.18 Patient days by source of payment
(a) Adults and Pediatrics.
(1) Exclude Routine Newborn.
(2) Exclude Sub-Acute Care Services (account numbers 6610-6690).
(b) Routine Newborn.
(1) Born in hospital.
(2) Discharged with the mother.
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.10 Agents, nominees and fiduciaries
Agents, nominees and fiduciaries whether testamentary or inter vivos shall not be considered proper applicants for establishment, transfer of interest or transfer of stock of a facility except that the following persons may apply for establishment approval in accordance with and subject to the requirements and conditions set forth in article 28 of the Public Health Law:
(a) a natural person appointed as trustee of an express testamentary trust created by a deceased sole proprietor, partner or shareholder in the operation of a hospital for the benefit of a person less than 25 years of age; or
(b) a natural person appointed conservator pursuant to article 77 of the Mental Hygiene Law or a natural person appointed committee of the property of an incompetent pursuant to article 78 of the Mental Hygiene Law or a sole proprietor, partner or shareholder of a hospital, with respect to a hospital owned by a conservatee or incompetent.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.1 Definitions
(a) Approval means the procedures used by the department to approve providers of service as set forth in section 69-4.5 of this Subpart, which may include the requirement that approved evaluators, service coordinators, and providers of early intervention services enter into and periodically renew agreements with the department in order to conduct evaluations or render service coordination services or early intervention services in the Early Intervention Program and sets forth the terms and conditions of provider participation in the program, including establishing the obligations, expectations, and relationship between the department, municipalities within the State, and the provider.
(b) Approved provider shall mean a provider of service that is approved by the department in accordance with section 69-4.5(a)(4) of this Subpart and that has entered into an agreement with the department, where the department has required such an agreement for program participation.
(c) Assessment means initial and ongoing procedures used to identify:
(1) the child’s unique needs and strengths and the services appropriate to meet those needs; and
(2) the resources, priorities and concerns of the family and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of their infant or toddler with a disability.
(d) Child find system means all policies and procedures established by the State early intervention service agencies to:
(1) ensure that at-risk and eligible children are identified, located, and referred to the early intervention official or public health officer as designated by the municipality;
(2) determine the extent to which children are receiving needed services; and
(3) ensure coordination among the State agencies’ major efforts to identify at-risk and eligible children.
(e) Completed mediation means:
(1) the parties have participated in mediation and reached an agreement;
(2) the parties have participated in mediation but have been unable to reach an agreement during mediation or the parent requests an impartial hearing;
(3) a parent’s request for mediation has not been accommodated according to the time frame set forth in section 69-4.17(g)(13) of this Subpart; or
(4) the early intervention official declines to participate in mediation.
(f) Days means calendar days.
(g) Department means the New York State Department of Health.
(h) Designated county official means the official designated by the municipality as responsible for receipt of referrals of children suspected of having or at-risk, for developmental delays or disabilities.
(i) Developmental delay means that a child has not attained developmental milestones expected for the child’s chronological age adjusted for prematurity in one or more of the following areas of development: cognitive, physical (including vision, hearing, oral motor feeding and swallowing disorders), communication, social/emotional, or adaptive development and meets the level of delay set forth in section 69-4.23 of this Subpart.
(j) Disability means a developmental delay or a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.
(k) Dominant or native language , when used with respect to an individual who is limited English proficient, means the language or mode of communication normally used by that individual, or in the case of the child, the language normally used by the parent of an eligible or potentially eligible child, except that:
(1) For evaluations and assessments conducted pursuant to section 69-4.8 of this Subpart, dominant or native language means the language normally used by the child, if determined developmentally appropriate for the child by qualified personnel conducting the evaluation and assessment.
(2) When used with respect to an individual who is deaf or hard of hearing, blind or visually impaired, or for an individual with no written language, dominant or native language means the mode of communication that is normally used by the individual.
(l) Early intervention official means an appropriate municipal official designated by the chief executive officer of a municipality and an appropriate designee of such official.
(m) Early intervention services means:
(1) services that are:
(i) designed to meet the developmental needs of children eligible under this program and the needs of the family related to enhancing the child’s development in accordance with the functional outcomes specified in the individualized family service plan, in one or more of the following areas of development, including:
(a) physical;
(b) cognitive;
(c) communication;
(d) social or emotional; or
(e) adaptive;
(ii) selected in collaboration with the parent;
(iii) in compliance with State standards;
(iv) provided:
(a) under public supervision;
(b) by qualified personnel;
(c) in conformity with an individualized family service plan and to the maximum extent appropriate, provided in natural environments;
(d) at no cost to the family; and
(v) are cost effective.
(2) Early intervention services include:
(i) Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities. This does not include a medical device that is surgically implanted, including a cochlear implant, or the optimization ( e.g. , mapping), maintenance, or replacement of that device.
(ii) Assistive technology service means a service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. Assistive technology services include:
(a) the evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child’s customary environment;
(b) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;
(c) selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;
(d) coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
(e) training or technical assistance for a child with disabilities or, if appropriate, that child’s family; and
(f) training or technical assistance for professionals (including individuals providing early intervention services) or other individuals who provide services to, or are otherwise substantially involved in, the major life functions of individuals with disabilities.
(iii) Applied behavior analysis (ABA) means the design, implementation, and evaluation of systematic environmental changes to produce socially significant change in human behavior through skill acquisition and the reduction of problematic behavior. ABA includes direct observation and measurement of behavior and the identification of functional relations between behavior and the environment. These include contextual factors such as establishing operations, antecedent stimuli, positive reinforcers, and other consequences that are used to produce the desired behavior change.
(iv) Audiology, including:
(a) identification of children with auditory impairment using at risk criteria and appropriate audiologic screening techniques;
(b) determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;
(c) referral for medical and other services necessary for the habilitation or rehabilitation of children with auditory impairment;
(d) provision of auditory training, aural rehabilitation, speech reading and listening device orientation and training, and other services;
(e) provision of services for prevention of hearing loss; and
(f) determination of the child’s need for individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.
(v) Family training, counseling, home visits and parent support groups, including services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of a child eligible under this Part in understanding the special needs of the child and enhancing the child's development.
(vi) Medical services only for diagnostic or evaluation purposes means services provided by a licensed physician to determine a child’s developmental status and need for early intervention services subject to reasonable prior approval requirements for exceptionally expensive services as prescribed by the commissioner.
(vii) Nursing services, including:
(a) the assessment of health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;
(b) provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and
(c) administration of medications, treatments, and regimens prescribed by a licensed physician.
(viii) Nutrition services, including:
(a) conducting individual assessments in nutritional history and dietary intake; anthropometric, biochemical, and clinical variables; feeding skills and feeding problems; and, food habits and food preferences;
(b) developing and monitoring appropriate plans to address the nutritional needs of eligible children; and
(c) making referrals to appropriate community resources to carry out nutrition goals.
(ix) Occupational therapy includes services to address the functional needs of a child related to adaptive development, adaptive behavior and play, and sensory, motor, and postural development. These services are designed to improve the child’s functional ability to perform tasks in home, school, and community settings, and include:
(a) identification, assessment, and intervention;
(b) adaptation of the environment, and selection, design and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and
(c) prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.
(x) Physical therapy includes services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status and effective environmental adaptation. These services include:
(a) screening, evaluation, and assessment of infants and toddlers to identify movement dysfunction;
(b) obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and
(c) providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems.
(xi) Psychological services, including:
(a) administering psychological and developmental tests, and other assessment procedures;
(b) interpreting assessment results;
(c) obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and
(d) planning and managing a program of psychological services, including psychological counseling for children and parents, family counseling, consultation on child development, parent training, and education programs.
(xii) Service coordination, including assistance and services provided by a service coordinator to enable an eligible child and the child’s family to receive the rights, procedural safeguards and services that are authorized to be provided under the Early Intervention Program.
(xiii) Sign language and cued language services include teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation.
(xiv) Social work services, including:
(a) making home visits to evaluate a child’s living conditions and patterns of parent-child interaction;
(b) preparing a social/emotional developmental assessment of the child within the family context;
(c) providing individual and family-group counseling with parents and other family members, and appropriate social skill building activities with the child and parents;
(d) working with those problems in a child’s and family’s living situation (home, community, and any center where early intervention services are provided) that affect the child’s maximum utilization of early intervention services; and
(e) identifying, mobilizing, and coordinating community resources and services to enable the child and family to receive maximum benefit from early intervention services.
(xv) Special instruction, including:
(a) the design of learning environments and activities that promote the child’s acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;
(b) curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the child’s individualized family service plan;
(c) providing families and any primary caregivers ( e.g., child care providers) with information, skills, and support related to enhancing the skill development of the child; and
(d) working with the child to enhance the child’s development.
(xvi) Speech-language pathology, including:
(a) identification of children with communicative or oropharyngeal disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;
(b) referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communicative or oropharyngeal disorders and delays in development of communication skills; and
(c) provision of services for the habilitation, rehabilitation, or prevention of communicative or oropharyngeal disorders and delays in development of communication skills.
(xvii) Vision services, including:
(a) evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities;
(b) referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and
(c) communication skills training, orientation and mobility training for all environments, visual training, independent living skills training, and additional training necessary to activate visual motor abilities.
(xviii) Health services means services necessary to enable a child to benefit from the other early intervention services during the time that the child is receiving other early intervention services. The term includes:
(a) such services as clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services; and
(b) consultation by physicians with other service providers concerning the special health care needs of eligible children that will need to be addressed in the course of providing other early intervention services.
(c) The term health services does not include the following:
(1) services that are surgical in nature (such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus); or
(2) services that are purely medical in nature (such as hospitalization for management of congenital heart ailments, or the prescribing of medicine or drugs for any purpose).
(3) devices necessary to control or treat a medical condition.
(4) medical-health services (such as immunizations and regular “well-baby” care) that are routinely recommended for all children; or
(5) services that are related to the implementation, optimization ( e.g. , mapping), maintenance, or replacement of a medical device that is surgically implanted, including a cochlear implant.
(i) Nothing in this Subpart shall limit the right of an infant or toddler with a disability with a surgically implanted device ( e.g. , cochlear implant) to receive the early intervention services that are identified in the child’s IFSP as being needed to meet the child’s developmental outcomes.
(ii) Nothing in this Subpart shall prevent the provider from routinely checking that either the hearing aid or the external components of a surgically implanted device ( e.g. , cochlear implant) of an infant or toddler with a disability are functioning properly.
(xix) Transportation and related costs includes the cost of travel ( e.g., mileage or travel by taxi, common carrier, or other means) and other costs ( e.g., tolls and parking expenses) that are necessary to enable an eligible child and the child’s family to receive early intervention services.
(n) Eligible child means any infant or toddler from birth through two years who has a disability, provided in paragraph (1) of this subdivision.
(1) Any eligible child who has been determined to be eligible for program services under section 4410 of the Education Law and who:
(i) turns three years of age on or before August 31st, shall, if requested by the parent, be eligible to continue receiving early intervention service until September 1st of that calendar year; or
(ii) turns three years of age on or after September 1st, shall, if requested by the parent and if already receiving early intervention services, be eligible to continue receiving early intervention services until January 2nd of the next calendar year; except
(iii) if the infant or toddler is receiving preschool special education services under section 4410 of the Education Law, he or she shall not be an eligible child.
(2) Eligibility for early intervention services shall end on the day before the child's third birthday for any child who is found ineligible for services under section 4410 of the Education Law, or for whom an eligibility determination for such services has not been made prior to the child's third birthday.
(3) The term eligible child shall also include any infant or toddler with a disability who is:
(i) an Indian child that resides on a reservation geographically located in the State;
(ii) a homeless child as defined in section 725 of 42 U.S.C. 11434a, the McKinney-Vento Homeless Assistance Act ; or
(iii) who is a ward of the State.
(o) Evaluation means the multidisciplinary procedures used by appropriate qualified personnel to determine a child’s initial and continuing eligibility for the Early Intervention Program, including identifying the level of functioning of the child in each of the following areas of development: cognitive, physical, communication, social or emotional, and adaptive development that is consistent with the level of developmental delay as defined in subdivision (h) of this section. An initial evaluation is the evaluation to determine a child’s initial eligibility for the program.
(p) Evaluator means a team of two or more professionals approved pursuant to section 69-4.5 of this Subpart to conduct screenings and evaluations.
(q) Family assessment means a voluntary family-directed assessment conducted by qualified personnel to identify family priorities, resources and concerns, which the family decides are relevant to their ability to enhance their child’s development, and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of the family’s infant or toddler with a disability.
(r) Family concerns means those areas that parent identifies as needs, issues, or problems which they wish to have addressed within the individualized family service plan.
(s) Family priorities means those areas which the parent selects as essential targets for early intervention services to be delivered to their child and family unit.
(t) Family resources means the strengths, abilities, and formal and informal supports that can be mobilized to address family concerns, needs or desired outcomes.
(u) Hearing officer means the person duly designated for the purpose of conducting or participating in a hearing pursuant to the Public Health Law, including an administrative officer or an administrative law judge assigned by the department to the hearing.
(v) Hearing record means:
(1) all notices, pleadings, and motions;
(2) evidence presented during the hearing;
(3) questions and offers of proof, objections thereto, and rulings thereon;
(4) any statements of matters officially noticed by the hearing officer; and
(5) any findings of fact, conclusions of law, decision, determination, opinion, order or report made by the impartial hearing officer.
(w) Include means that the items named are not all of the possible items that are covered whether like or unlike the ones named.
(x) Individualized family service plan (IFSP) means a written plan for providing early intervention services to a child eligible for the Early Intervention Program and the child's family. The plan must:
(1) be developed jointly by the family, appropriate qualified personnel involved in the provision of early intervention services and the early intervention official;
(2) be based on the evaluation and assessment described in section 69-4.8 of this Subpart;
(3) include matters as specified in section 69-4.11 of this Subpart; and
(4) be implemented as soon as possible once written parental consent for the early intervention services in the IFSP is obtained.
(y) Informed clinical opinion means the best use of quantitative and qualitative information by qualified personnel regarding a child, and family if applicable. Such information includes, if applicable, the child's functional status, rate of change in development, and prognosis.
(z) Informed consent means:
(1) The parent has been fully informed of all information relevant to the activity for which consent is sought, in the parent's dominant language or other mode of communication.
(2) the parent understands and agrees in writing to the carrying out of the activity for which consent is sought, and the consent describes that activity and lists the records if any that will be released and to whom; and
(3) the parent understands that the granting of consent is voluntary on the part of the parent and may be revoked at any time.
(aa) Initial service coordinator means the service coordinator designated by the early intervention official upon receipt of a referral of a child thought to be eligible for early intervention services who functions as the service coordinator who participates in the formulation of the individualized family service plan.
(ab) Interim individualized family service plan means a temporary plan developed with parental consent for a child with a known developmental delay or disability who has apparent immediate needs to enable early intervention service delivery between initial identification of the child's needs and the completion of the multidisciplinary evaluation.
(ac) Mediation means a voluntary, non-adversarial process by which the parent of a child and the early intervention official or designee are assisted in the resolution of a dispute.
(ad) Medical/biological risk means early developmental and health events suggestive of medical needs or biological insults to the developing central nervous system which, either singly or collectively, increase the probability of later disability.
(ae) Multidisciplinary means the involvement of two or more professionals from different disciplines or professions.
(af) Municipality means a county outside of the City of New York or the City of New York in the case of a county contained within the City of New York.
(ag) Natural environment means settings that are natural or normal for the child's age peers who have no disability, including the home, a relative's home when care is delivered by the relative, child care setting, or other community setting in which children without disabilities participate.
(ah) Ongoing service coordinator means the service coordinator designated in the individualized family service plan.
(ai) Parent means a parent by birth or adoption, or person in parental relation to the child. With respect to a child who is a ward of the State, or a child who is not a ward of the State but whose parents by birth or adoption are unknown or unavailable and the child has no person in parental relation, the term parent means a person who has been appointed as a surrogate parent for the child in accordance with section 69-4.16 of this Subpart. This term does not include the State if the child is a ward of the State.
(aj) Person in parental relation means:
(1) the child's legal guardian;
(2) the child's standby guardian after their authority becomes effective pursuant to section 1726 of the Surrogate's Court Procedure Act;
(3) the child's custodian; a person shall be regarded as the custodian of a child if he or she has assumed the charge and care of the child because the parents or legally appointed guardian of the minor have died, are imprisoned, are mentally ill, or have been committed to an institution, or because they have abandoned or deserted such child or are living outside the state or their whereabouts are unknown; or
(4) persons acting in the place of a parent, such as a grandparent or stepparent with whom the child lives, as well as persons who are legally responsible for the child's welfare;
(5) except, this term does not apply to a child who is a ward of the State, and does not include a foster parent.
(ak) Provider means an agency or individual approved in accordance with section 69-4.5 of this Subpart to deliver service coordination, evaluations, and/or early intervention services.
(1) Agency means an entity which employs qualified personnel, and may contract with individual providers or other agencies which are approved by the department, for the provision of Early Intervention Program evaluations, service coordination, and/or early intervention services.
(2) Individual provider shall mean a person who holds a State-approved or recognized certificate, license, and/or registration, as applicable, in one of the disciplines set forth in subdivision (al) of this section and is approved by the department as an individual provider. An individual may contract with one or more approved agency providers.
(3) Payee provider shall mean an approved provider that shall directly bill third party and governmental payers for early intervention services in the first instance through the department’s fiscal agent.
(al) Qualified personnel are those individuals who are approved as required by section 69-4.5 of this Subpart and under contract with or employed by approved agency providers who deliver services to the extent authorized by their licensure, certification or registration, to eligible children and have appropriate licensure, certification, and/or registration, as applicable, in the area in which they are providing services, including:
(1) audiologists;
(2) occupational therapy assistants;
(3) licensed practical nurses, registered nurses and nurse practitioners;
(4) licensed behavior analysts;
(5) certified behavior analyst assistants;
(6) low vision specialists;
(7) orientation and mobility specialists;
(8) vision rehabilitation therapists;
(9) occupational therapists;
(10) optometrists;
(11) physical therapists;
(12) physical therapy assistants;
(13) pediatricians and other physicians;
(14) physician assistants;
(15) psychologists;
(16) registered dietitians and certified dietitions/nutritionists;
(17) school psychologists;
(18) clinical and master social workers;
(19) special education teachers and teachers of students with disabilities, birth to grade two;
(20) speech and language pathologists;
(21) teachers of the blind and partially sighted, teachers of the blind and visually handicapped, and teachers of the blind and visually impaired;
(22) teachers of the deaf and hearing impaired and teachers of the deaf and hard of hearing;
(23) teachers of the speech and hearing handicapped and teachers of speech and language disabilities; and
(24) other categories of personnel as designated by the commissioner.
(am) Record means any information recorded in anyway, maintained by an early intervention official, designee, or approved evaluator, service provider or service coordinator. A record shall include any file, evaluation, report, study, letter, telegram, minutes of meetings, memorandum, summary, interoffice or intraoffice communication, memorandum reflecting an oral conversation, a handwritten or other note, chart, graph, data sheet, film, videotape, slide, sound recording, disc, tape and information stored in microfilm or microfiche or in computer readable form.
(an) Screening means a process involving those instruments, procedures, family information and observations, and clinical observations used by an approved evaluator to assess a child's developmental status to indicate what type of evaluation, if any, is warranted.
(ao) Ward of the State means a child whose custody and guardianship have been transferred to the local social services official pursuant to a voluntary surrender by the child's parent or by a family court or surrogate's court in conjunction with the termination of the parental rights of the child's parent.
(ap) Personally identifiable information shall mean the same as personally identifiable information as defined in 34 CFR 99.3 of the Family Educational Rights and Privacy Act (FERPA), except that the term student and school as used in FERPA shall mean child and early intervention service provider , respectively, as used in this Subpart, and includes:
(1) the name of the child, the parent or other family member;
(2) the address of the child, the parent or other family member;
(3) a personal identifier such as the social security number of the child, parent or other family member;
(4) a list of personal characteristics or other information that would make it possible to identify the child, the parent or other family member with reasonable certainty.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.194 Enforcement
(a) Operation of a mobile food service establishment or pushcart without a permit is a violation of this Subpart. The permit-issuing official or his designated representative may order any mobile food service establishment or pushcart in his jurisdiction, operating without a valid permit, to close and cease all food operation immediately and to remain closed until the establishment or operation has obtained and displays a valid permit.
(b) For serious, repeated or persistent violations of any of the requirements of this Subpart, or for interference with the permit-issuing official or his designated representative in the performance of his duties, the permit may be revoked after notice and an opportunity for a hearing has been provided by the permit-issuing official.
(c) The permit-issuing official may suspend a permit and order immediate cessation of operations and service of food at a mobile food service establishment or pushcart within his jurisdiction when, in his opinion, continued operation is an imminent hazard to public health. Any person so ordered is to comply immediately, and within 15 days is to be provided with an opportunity to be heard and to present proof that continued operation does not constitute a danger to the public health.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.12 Water supply
(a) An agricultural fairground served by an off-site public water system (as defined in Subpart 5-1 of this Title) must comply with the requirements of subdivisions (d)(1), (3)-(5), (d)(6)(i), (iii), and (iv), (d)(7), (e)-(g) (excluding source water and nitrate/nitrite monitoring), (h), (i), (j)(2), (k)-(m) of this section.
(b) An agricultural fairground served by a nonpublic agricultural fairground water system must comply with those requirements of Subpart 5-1 of this Title that apply to noncommunity water systems and subdivisions (c), (d)(1)-(4), (d)(6)-(7), (e)-(m) of this section. The agricultural fairground owner shall ensure that the agricultural fairground's water supply complies with all applicable requirements.
(c) Source water.
(1) The only permissible water sources shall be those taken from a ground water aquifer (ground water source) and developed in accordance with paragraph (d)(3) of this section; provided, however, an admixture of ground water and surface water or water exposed to the ground surface is not permitted. Shallow well points and dug wells are prohibited.
(d) Planning, siting, treatment and approval.
(1) Siting: Before an agricultural fairground owner initiates construction of a new agricultural fairground water system, the owner shall notify the permit-issuing official and, to the extent practicable, given the topography of the fairground and generally accepted engineering practice, avoid locating part or all of the agricultural fairground water system at a site which:
(i) is subject to a significant risk from earthquake, fire or any other potentially catastrophic event; or
(ii) is within the floodplain of a 100-year flood or is lower than any recorded high tide in the vicinity of the agricultural fairground.
(2) A nonpublic agricultural fairground water system shall be designed, constructed, located and protected from existing or potential sources of contamination in a manner approved by the permit-issuing official. All nonpublic agricultural fairground water sources shall be located upgradient of potential sources of contamination and the minimum separation distances between any potential source of contamination and a potable water source shall be as follows:
| Potential Contamination Source | Minimum Distance from Potable Water Source (in feet) | | --- | --- | | | | | Waste Water Treatment System | | | Absorption Field Seepage Pit | 1001 1501 | | Barnyard, Silo, Barn, Gutter, Animal Pen; including any animal waste storage and handling area | 100 |
____ 1When sewage treatment systems are located in coarse gravel, the closest part of the treatment system shall be at least 200 feet away from the well.
(3) Approval of plans and completed works.
(i) No agricultural fairground owner shall make, install or construct, or allow to be made, installed or constructed, an agricultural fairground water system or any addition or deletion to or modification of an agricultural fairground water system until the plans and specifications for such system, or any addition or deletion or modification of such system, have been submitted to and approved by the permit-issuing official.
(ii) Recommended Standards for Water Works, 1997 edition, published by Health Research Inc., P.O. Box 7126, Albany, NY 12224 available for public inspection at the offices of the records access officer of the New York State Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237, shall, in their entirety, be the basis on which all plans and specifications for agricultural fairground water systems will be reviewed and approved. The department may allow deviations from these standards in accordance with procedures and criteria established by the commissioner.
(iii) The permit-issuing official may approve such plans or require such modification as is necessary to protect public health or safety. Application for plan approval shall be made on a form prescribed by the permit-issuing official.
(iv) An agricultural fairground owner shall receive written approval from the permit- issuing official before placing into service any agricultural fairground water system made, installed, constructed, expanded, reduced or modified pursuant to this section.
(4) Reporting emergencies - interruptions, changes in sources or treatment. The agricultural fairground owner shall report, or ensure that a person acting on his or her behalf reports, any incident or condition which affects, or may affect, the quantity or quality of the agricultural fairground water supply to the permit-issuing official as soon as possible but in any event no later than 24 hours from the occurrence. There shall be no change made to the source, or method of treatment, of the potable water supply, either temporary or permanent, without first receiving written approval from the permit-issuing official. An adequate supply of potable water must be provided and maintained during all times of agricultural fairground operation.
(5) Adequacy of distribution system. The agricultural fairground owner shall ensure that the agricultural fairground water system is maintained and operated to assure a minimum working pressure of 20 pounds per square inch at ground level at all points in the distribution system. Measurements of pressure shall be obtained from representative points of use.
(6) Providing treatment for agricultural fairground water systems. The agricultural fairground owner shall provide such treatment as necessary to deliver to the consumer a water conforming to the requirements of this section.
(i) Every agricultural fairground water distribution system shall have the capability to provide disinfection for the purpose of annual start-up and/or booster chlorination.
(ii) Minimum treatment for a ground water source shall be disinfection by chlorination in a manner which is adequate to destroy harmful microorganisms and approved in writing by the permit-issuing official. Other disinfection methods the State Commissioner of Health has determined in writing to be of comparable effectiveness shall be permitted.
(iii) The free chlorine residual disinfection concentration in the water entering the distribution system cannot be less than 0.2 milligram per liter (mg/l) for more than four hours.
(iv) Any on-site disinfection system must have redundant components to ensure continuous disinfection. Auxiliary power with automatic start and alarm is required at all disinfection facilities where a power outage would result in a loss or reduction in the ability of the system to maintain a disinfection concentration as required by this Subpart.
(7) Campgrounds water supply.
(i) Potable water shall be readily available, easily accessible and in a quantity capable of providing at least 55 gallons per day per campsite, which includes water use for toilets, handwashing, showers and individual campsite food preparation and clean-up.
(ii) Potable water shall be provided within 250 feet of all campsites. One water spigot with a soakage pit or other disposal facilities shall be provided for each 10 campsites not provided with individual spigots on the campsites.
(e) Annual start-up.
The agricultural fairground owner must ensure and confirm in writing to the permit-issuing official that the following actions have been taken with respect to the agricultural fairgound water system, 15 days prior to the opening of the first event for which the water supply is utilized each year:
(1) All water mains that are not subject to continuous water use shall be adequately flushed and coliform samples shall be collected in accordance with paragraph (g)(1) of this section.
(2) All water mains that are not subject to continuous water use shall be disinfected by:
(i) completely filling the main to remove all air pockets, flushing the main to remove particulates, and filling the main with potable water. The potable water shall then be chlorinated by feeding liquid hypochlorite at a constant rate such that the water will not have less than a 25 mg/l free chlorine residual throughout the agricultural fairground water system. After a 24-hour holding period there must be a free chlorine residual of not less than 10 mg/l throughout the agricultural fairground water system; or
(ii) using a disinfection method the State Commissioner of Health has determined in writing to be of comparable effectiveness.
(3) Free chlorine residual disinfection concentrations shall be measured for the two days immediately following the completion of the main disinfection, as prescribed in paragraph (2) of this subdivision, at representative points in the distribution system, to ensure chlorine residuals of not less than 0.2 mg/l.
(4) All existing distribution systems shall be surveyed to ensure there are no physical connections between the potable water supply and any nonpotable water supply, and any nonpotable water supply shall be conspicuously labeled as a nonpotable supply.
(5) Any connection to the potable water supply without an air gap shall have at a minimum an anti-siphon valve or vacuum breaker or additional protection sufficient to address the degree of hazard.
(f) Prior to individual event start-up.
The agricultural fairground owner must ensure, and confirm in writing, in a monthly operation report to the permit-issuing official, that the following actions have been taken with respect to the agricultural fairground water system:
(1) All portions of an agricultural fairground water system that are not subject to year- round water use shall maintain a minimum of a.2 mg/l free chlorine residual at representative points throughout the distribution system for at least the two days prior to the opening of each event at the agricultural fairground.
(2) Additional flushing may be required at the discretion of the permit-issuing official when he or she has reason to believe that the chlorine residual has diminished, and the potential exists for a total coliform and/or E. coli violation as set forth in paragraph (g)(1) of this section or a contaminant may present a risk to public health.
(g) Maximum contaminant levels (MCLs) and monitoring frequency.
(1) The agricultural fairground owner must monitor the agricultural fairground water system and ensure its compliance with the MCLs as set forth below:
Nitrate, Nitrite, Total Nitrate and Nitrite, and Microbiological Maximum Contaminant Levels and Monitoring Requirements
| Contaminant | MCL | Monitoring Requirements Ground Water | | --- | --- | --- | | | | | | Nitrate | 10 mg/l (as Nitrogen) | One sample per entry point per year (nonpublic agricultural fairground water system only) | | Nitrite | 1 mg/l (as Nitrogen) | One sample per entry point (nonpublic agricultural fairground water system only) | | Total Nitrate and Nitrite | 10 mg/l (as Nitrogen) | Separate samples not required. Total of above samples (nonpublic agricultural fairground water system only) | | Total Coliform | Any positive sample | Nonpublic Agricultural Fairground Water System | | | | Prior to first event of the season: | | | | • At all sources and at representative points in the distribution system.1 | | | | During each fairground's operating year, monthly: | | | | • At representative points in the distribution system. | | | | During the County Fair held at the fairground, daily (except for the last 2 days of the event): | | | | • At representative points in the distribution system. | | | | Off-site Public Water System | | | | Prior to first event of the season: | | | | • At representative points in the distribution system.1 | | Escherichia coli (E. coli) | Any positive sample | Any routine total coliform sample or repeat total coliform sample that is coliform positive must be analyzed for Escherichia coli (E. coli) | | Total Trihalomethanes (TTHM) | 0.1 mg/l | Permit-issuing official's discretion2 |
____
1 Samples must be collected no more than 28 days prior to the first event of the season and the analytical results from those samples must be submitted in writing to the permit-issuing official no less than 14 days prior to the first event.
2 Permit-issuing official's discretion means that the permit-issuing official may require monitoring when he or she has reason to believe that the MCL has been violated, the potential exists for an MCL violation or the contaminant may present a risk to public health.
(2) Free chlorine residual disinfection concentrations shall be measured:
(i) prior to each individual event at representative points in the distribution system; and
(ii) daily during each individual event at representative points in the distribution system.
(3) Additional monitoring may be required at the discretion of the permit-issuing official, if the official has reason to believe that an MCL has been violated, the potential exists for an MCL violation or a contaminant may present a risk to public health.
(4) The agricultural fairground owner must submit in writing to the permit-issuing official a monitoring plan for the agricultural fairground water system at least 30 days prior to the opening of the first event of the year. This plan must include a detailed map of all sample locations with a description of each sample point.
(h) Approved laboratories.
(1) For determining compliance with this Subpart, only results of analyses performed by an environmental laboratory approved in accordance with Subpart 55-2 of this Title may be considered.
(2) The agricultural fairground owner shall require the approved environmental laboratory performing such analyses to send laboratory results directly to the permit-issuing official and in a manner prescribed by the permit-issuing official.
(i) Cross-connection control.
(1) There shall be no physical connection between the agricultural fairground potable water supply and any nonpotable water supply. Any nonpotable source of water must be adequately separated from a potable supply and conspicuously posted as nonpotable water. Any connection to the agricultural fairground water system without an air gap shall have at a minimum an anti-siphon valve or vacuum breaker. The permit-issuing official may require additional protection from back-siphonage and/or back-pressure sufficient to address the degree of hazard.
(j) Protection and supervision of agricultural fairground water systems.
(1) An agricultural fairground owner shall exercise due care and diligence in the maintenance and supervision of all sources of the agricultural fairground water system to prevent its contamination or depletion.
(2) An agricultural fairground owner operating an agricultural fairground water system shall exercise due care and diligence in the operation and maintenance of water system facilities and their appurtenances to ensure continued compliance with the provisions of this Subpart. Facilities approved by the permit-issuing official shall be operated in accordance with their design.
(k) Operation of an agricultural fairground water system.
(1) The agricultural fairground owner shall employ the appropriate grade of operator to operate the agricultural fairground water system in accordance with the designation of an agricultural fairground water system type listed below:
| Agricultural fairground water system type | Required minimum operator grade1 | | --- | --- | | | | | Agricultural fairground water system with on-site groundwater treatment ( i.e., filtration and disinfection) | IIB | | Agricultural fairground water system with on-site disinfection | C | | Purchases water from a public water system as defined in Subpart 5-1.1 of this Title | D |
____
1 Requirements as set forth in Subpart 5-4 of this Title.
(i) The person or persons in charge of the operation of such agricultural fairground water system shall be certified in accordance with the requirements for the certification of community and nontransient noncommunity water system operators as prescribed in Subpart 5-4 of this Title.
(ii) An agricultural fairground owner shall keep complete daily records of an agricultural fairground water system when in operation, on forms provided or approved by the department. Copies of such records shall be sent to the permit-issuing official by the 10th calendar day subsequent to each month of operation. These records shall include the results of all tests, measurements or analyses required to be made by this Subpart or requested or ordered by the permit-issuing official.
(l) Bulk and bottled water supplies.
(1) Bulk water shall not be used at an agricultural fairground for consumptive or culinary purposes unless such use is expressly permitted by the permit-issuing official. Bulk water supplies, if permitted, shall contain a minimum free chlorine residual of 0.5 mg/l, and shall be secured, transported and transferred by a certified bulk water hauler in accordance with Subpart 5-6 of this Title.
(2) Neither the owner of an agricultural fairground, nor any operator of a food service establishment at an agricultural fairground, shall sell, offer for sale or deliver bottled water for human consumption, food preparation or culinary purposes unless the bottled water is certified by the Commissioner of Health in accordance with Subpart 5-6 of this Title.
(m) Drinking fountains at an agricultural fairground shall be of adequate sanitary design and construction.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 141 SARATOGA COUNTY
10 CRR-NY 141.2 Village of Mechanicville
L. 1893, § 70; L. 1899, ch. 251
(a) [Application.]
The following rules and regulations shall apply to Plum Brook and to the impounding and distributing reservoir of the Mechanicville water supply, supplying the public water supply of the village of Mechanicville, Saratoga County, New York, and to all watercourses entering or ultimately discharging into said streams or bodies of water.
(b) [Definitions.]
(1) The term reservoir whenever used in this section is intended to mean and comprise every natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter the public water supply of the village of Mechanicville.
(2) The term watercourse wherever used in this section is intended to mean and comprise every spring, stream, ditch, gutter or other watercourse of any kind, the waters of which when running, whether constantly or occasionally, eventually flow or may flow into the public water supply of the village of Mechanicville.
(c) Privies adjacent to reservoirs or watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for the temporary storage or deposit of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet, horizontal measurement, of the high-water mark of any reservoir or of the edge, margin or precipitous bank of any watercourse of the Mechanicville supply.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 200 feet, horizontal measurement, of the water line of any reservoir of the Mechanicville water supply or within 150 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply.
(3) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 200 feet, horizontal measurement, of the high-water mark of any reservoir or within the aforesaid 150 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them from being washed over the surface of the ground by rain or melting snow and at distances of not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner therof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Department of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage or excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the Mechanicville water supply, nor shall any such matter be placed, led, discharged or allowed to escape onto the surface of the ground or into the ground below the surface within 300 feet, horizontal measurement, from the high-water mark of any reservoir or within 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply.
(2) No garbage, putrescible matter, house slops, bath waters, kitchen or sink waste, refuse or waste water from creameries, cheese factories, laundries nor water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the Mechanicville water supply. Nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of any ground or into the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the Mechanicville water supply within 100 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the Mechanicville water supply.
(e) Bathing, animals, manure, compost, etc.
(1)
(i) No person shall be allowed to bathe in any reservoir or watercourse of the Mechanicville water supply, nor shall any animals or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor be washed therein.
(ii) The watering of live stock or animals in the distributing reservoir of the Mechanicville water supply or in the streams tributary thereto within a distance of 500 feet from said reservoir is hereby prohibited. Nor shall cattle or live stock be pastured or allowed to graze within 25 feet of the high-water margin of said reservoir or within 25 feet of the banks of said tributary streams at any point within 500 feet from said reservoir.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile nor compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 150 feet, horizontal measurement, from high-water mark of any reservoir or less than 75 feet, horizontal measurement, from the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply, and none of the above-named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainage, leachings or washings from the same may enter any reservoir or watercourse of the Mechanicville water supply without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir nor less than 75 feet before entering any watercourse of the Mechanicville water supply.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from the high-water line of any reservoir nor within a distance of 200 feet from the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply, and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of the high-water line of any reservoir nor within 75 feet of the edge, margin or precipitous bank of any watercourse of the Mechanicville water supply.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the Mechani ville water supply without first having passed over or through such an extent of soil as to have become properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or a distance not less than 50 feet before entering any watercourse of the Mechanicville water supply.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal nor any refuse from any slaughterhouse nor any decomposable or putrescible refuse or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the Mechanicville water supply without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir and not less than 100 feet before entering any watercourse of the Mechanicville water supply.
(g) Boating and fishing.
(1) Skating, boating, fishing from boats, from rafts, from the shore and through the ice are hereby prohibited in any and all of the reservoirs of the Mechanicville water supply.
(2) The board of health of the Village of Mechanicville, when necessary to regulate or diminish the number of fish in any of the reservoirs or when in their opinion such privileges may be extended without endangering the purity of the water supply, are hereby authorized to permit boating or fishing or both under explicit regulations and restrictions. Such permit, regulations and restrictions must first be approved in writing by the State Commissioner of Health.
(3) A violation or noncompliance with any of the resrictions or regulations under which such permit for boating or fishing is issued shall be construed as a violation or noncompliance with this subdivision of the rules and regulations.
(h) [Prohibition.]
No water from the Hudson River shall at any time be pumped into the distributing system or into any reservoir of the Mechanicville water supply.
(i) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, chapter 484 of the Laws of 1904 and chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of the above rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.4 Staffing
(a) A health systems agency shall have appropriate staff to fulfill health planning and development activities and functions as defined in section 82-1.6 of this Subpart.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.3 Minimum training standards
Rape crisis counselors must have at least 40 hours of training, at least 30 hours of which must have been completed prior to certification and the remainder of which must be completed within one year from the date of certification. This training shall include, but need not be limited to, instruction in the following:
(a) the dynamics of sexual offenses, sexual abuse and incest;
(b) crisis intervention techniques;
(c) client-counselor confidentiality requirements;
(d) communication skills and intervention techniques;
(e) an overview of the State criminal justice system;
(f) an update and review of State laws on sexual offenses, sexual abuse and incest;
(g) the availability of State and community resources for clients;
(h) working with a diverse population;
(i) an overview of child abuse and maltreatment identification and reporting responsibilities; and
(j) information on the availability of medical and legal assistance for such clients.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.35 Computation of basic rates for clinic services provided to Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) sero-positive patients by freestanding ambulatory care facilities and hospital clinic outpatient services
(a) For payments made pursuant to this section and pursuant to section 86-1.11(h) of this Part, for ambulatory services to AIDS patients, HIV positive patients, and patients seeking verification of HIV infection, reimbursement shall be based upon a single payment schedule with a discrete price for each of the five clinic services set forth in subdivision (c) of this section.
(b) To be eligible to receive reimbursement pursuant to this section, facilities must be licensed pursuant to article 28 of the Public Health Law and certified to provide general medical services and complete a written signed agreement with the commissioner to provide these discrete services. Facilities interested in establishing such agreements must submit in writing the required documentation in a manner acceptable to the commissioner. Such agreement shall describe the Medicaid patients who will be eligible for reimbursement under this section and shall establish the documentation and services required for patient assignment to each of the five clinic services.
(c) The five clinic services for which reimbursement shall be available according to the prices as established by this section are as follows:
(1) HIV counseling and testing visits. This visit shall mean the provision of pre-test HIV counseling in a medical setting as performed in compliance with article 27-f of the State Public Health Law. This visit shall also include laboratory testing necessary to determine whether a person has HIV disease. This visit shall also mean the provision of post-test HIV counseling in a medical setting as performed in compliance with the confidentiality provisions of article 27-f of the State Public Health Law for those individuals whose test results are positive. This visit is available for the purpose of informing these individuals of their test results and providing supportive counseling for those HIV zero positive persons experiencing adverse psychological responses to their serostatus.
(2) Post-test counseling visit. This visit shall mean the provision of post-test HIV counseling in a medical setting as performed in compliance with the confidentiality provisions of article 27-f of the State Public Health Law for those persons whose test results are negative. This visit is available for the purpose of informing these individuals of their results and counseling them on preventive measures.
(3) Initial comprehensive HIV medical evaluation visit. This visit shall mean a comprehensive medical history and physical examination, and laboratory testing necessary for the evaluation of HIV disease and related conditions. The evaluation shall be complete enough to: establish the state of HIV illness, diagnose active opportunistic infections and tumors, identify appropriate prophylactic therapies to prevent future opportunistic infections, initiate indicated anti-HIV therapy, and identify significant psycho-social problems to be addressed in the care plan.
(4) Drug and immunotherapy visits for HIV infected patients. This visit shall mean to those HIV-related treatments that require active health care supervision during the treatment visit and/or extensive amount of provider monitoring following the treatment.
(5) Monitoring visit for asymptomatic HIV disease. This visit shall mean the clinical and laboratory evaluation necessary to monitor the status of HIV disease to indicate the appropriate stage to initiate active drug treatment for HIV or prophylactic treatment for opportunistic infections.
(d) The prices established pursuant to this section shall provide full reimbursement for the following:
(1) physician services, nursing services, technician services, and other related professional expenses directly incurred by the licensed facility;
(2) space occupancy and plant overhead costs;
(3) administrative personnel, business office, data processing, recordkeeping, housekeeping, and other related facility overhead expenses;
(4) all ancillary services including laboratory tests and diagnostic X-ray services where specified in the treatment regimes and as detailed in the agreement pursuant to subdivision (b) of this section; and
(5) all medical supplies, immunizations, and drugs directly related to the provision of the services except for those drugs used to treat AIDS patients for which fee for service reimbursement is available under section 7.0 of the Medicaid Ordered Ambulatory Services Fee Schedule as contained in the Medicaid Management Information Systems (MMIS) Clinic Services Provider Manual (revised October, 1988). Copies of the schedule may be obtained from the New York State Department of Social Services and are available for inspection and copying at the Department of Health, Records Access Office, 22nd Floor, Corning Tower Building, Governor Nelson A. Rockefeller Empire State Plaza, Albany, New York 12237-0042.
(e) The price for each service shall be adjusted for regional differences in wage levels, space occupancy and facility overhead costs.
(f) The commissioner shall establish trend factors to project increases in the base year prices during the effective period of the reimbursement rates. The trend factors shall be developed using available price indices including elements of the United States Department of Labor consumer and producer price indices and special price indices developed by the commissioner for this purpose. The projected trend factors shall be updated on an annual basis, based upon current and available data.
(g) At the discretion of the commissioner, health services may be added or deleted from the visits contained in subdivision (c) of this section. The commissioner shall notify participating providers of such changes at least 60 days before such changes shall be effective and the agreements as outlined in subdivision (b) of this section shall be modified to encompass any such changes.
(h) Payment for any other clinic services which are not covered pursuant to subdivision (c) of this section shall be reimbursed as follows:
(1) for facilities with a cost-based all inclusive clinic visit rate established pursuant to this Subpart or to Subpart 86-1, services shall be reimbursed at the all inclusive clinic visit rate.
(2) for facilities without a cost-based all-inclusive rate, fee for service reimbursement is available under the Ordered Ambulatory Services Fee Schedule as referenced in paragraph (d)(5) of of this section for medical services ordered by the patient's attending physician.
(i) For financial reporting purposes and statistical reporting purposes, facilities which provide services pursuant to subdivision (c) of this section must comply as appropriate with the standards established for said reporting in section 86-1.3 or 86-4.3 of this Part.
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY
10 CRR-NY 85.2 Standards for surgical intervention
(a) To be covered benefit under medical assistance for the needy as provided in section 365-a(a)(5)(b) of the Social Services Law, specified surgical procedures shall meet the standards for intervention established in this section. The specified procedures are:
(1) cataract surgery to restore vision.
(2) eye muscle surgery to correct strabismus and to prevent functional loss when binocular vision still exists.
(3) myringotomy, with or without tube insertion to preserve hearing.
(4) tubal ligation or vasectomy to interdict conception.
(5) termination of pregnancy.
(b) The patient's surgeon shall ensure that the aplicable standards for any of the specific procedures specified in subdivision (a) of this section are met and documented within the hospital medical record of the patient. Such medical record shall be accessible to the commissioner, or his designee, for review.
(c) The first three days of inpatient care, services and supplies for persons admitted to inpatient hospital care under this section shall be deemed a covered benefit under medical assistance for the needy. To be a covered benefit after the third day of inpatient care, there shall be a determination of benefit coverability prior to the end of the third day by a person designated by the Commissioner of Health. Such initial determination shall be for a specified period of time not to exceed the 50th percentile of length of stay norms for comparable patients which have been authorized by the Commissioner of Health or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in section 85.5(a) of this Part, such specified period of time shall not exceed the 40th day of stay. Determination of coverability shall be based upon the performance of one or more of the procedures which meet the standards for surgical intervention listed in subdivision (a) of this section and the need for treatment on an inpatient hospital basis as documented in the patient's medical record. Subsequent to this initial determination of coverability, extensions of benefit coverability shall be subject to length of stay limitations of sections 85.5 and 85.7 of this Part.
(d) A determination of benefit coverability under this section shall be made by a designated physician or non-physician under a designated physician's supervision. A determination of non-coverability shall be made only by a designated physician. If such non-coverability determination is made, any care, supplies or services provided beyond three days shall not be a covered benefit under medical assistance for the needy.
(e) Notice of determination shall be given to the patient's surgeon, the hospital administrator and, if there is a determination of non-coverability, to the patient. The hospital shall keep any such notification on file, accessible for review by representatives of the State or the local social services district. The patient's surgeon or hospital administrator may within three days of the date of such notification, appeal a determination of non-coverability in writing to the physician or physicians designated by the commissioner for such purpose. Notification of decision on appeal shall be given to the patient's surgeon, the hospital administrator and the patient. If the determination of non-coverability is affirmed on appeal, any inpatient care, supplies or services provided beyond three days shall not be a covered benefit.
(f) If the person designated by the Commissioner of Health decides in the course of making determinations of coverability under this section or it is determined from other sources that a physician, physicians or the hospital are admitting patients under this section for the performance of procedures which do not meet the standards established in this section, the designated person shall give written notification to the physician(s) and the hospital that if such admissions continue, the initial three day period of stay will no longer be deemed a covered benefit. If patients are thereafter admitted for medical conditions which do not meet the standards established in this section to be a covered benefit, the designated person shall notify the physician(s) and the hospital that the first three days of inpatient stay will be subject to a determination of coverability. Such determination of coverability shall be made prior to the end of the third day of inpatient hospital stay in accordance with the procedures in subdivisions (a) through (e) of this section. If there is a determination of non-coverability, any inpatient hospital care, supplies or services provided shall not be a covered benefit under medical assistance for the needy.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-7 ASSISTED LIVING PROGRAM
10 CRR-NY 86-7.3 Adjustments to rate of payment
(a) For the calendar year 1992, for each region, the direct component as identified in section 86-7.2(b)(2) of this Subpart and the mean indirect price per day divided by the regional indirect input price adjustment factor for the patient classification group as identified in section 86-7.2(b)(3) of this Subpart shall be trended to 1992 by a roll factor to project allowable cost increases for the rate period. The trend factors used in the calculation of the roll factor shall be determined in a manner consistent with the methodology set forth in section 86-2.12 of this Part. A weighted average roll factor shall be calculated for each region. Relative weights shall be assigned to each trend factor group within the region and shall be based upon the aggregate operating portion of RHCF rates as defined in section 86-2.10(a)(7) of this Part using the initial July 1, 1992 RHCF rate certified by the commissioner pursuant to section 2807(3) of the Public Health Law times the 1990 RHCF's patient days. The weighted average roll factor for each region shall be calculated by multiplying the weights for each trend factor group within each region times the respective July 1, 1992 roll factors determined pursuant to section 86-2.12 of this Part excluding prospective adjustments made pursuant to section 86-2.12(f).
(b) For calendar years beginning January 1, 1993 and on January 1st of each subsequent year, the 1992 rate of payment as identified in section 86-7.2(c) of this Subpart shall be increased by a roll factor to project allowable cost increases for the rate period. The trend factor(s) used in the calculation of the roll factor shall be determined in a manner consistent with the methodology set forth in section 86-2.12 of this Part. A weighted average roll factor shall be calculated for each region. The weighted average roll factor for the rate period shall be computed utilizing the weights developed from the computation in subdivision (a) of this section adjusted to reflect any changes in trend factor groups made pursuant to section 86-2.12 of this Part. The regional weighted average roll factor for the rate period shall also include the prospective annual adjustments to the RHCF trend factors made pursuant to section 86-2.12(f).
(c) The rate of payment shall not exceed customary charges to the general public.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.18 Waiver
The permit-issuing official may waive any requirements under sections 14-2.13 and 14-2.14 of this Subpart when, in his opinion, it does not endanger the public health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.12 Cytopathology standards and quality assurance
(a) Definitions.
(1) Examination means the initial review or screening of cytopathology samples by a cytotechnologist to determine if the sample is negative, abnormal or questionable and shall include the marking of potentially abnormal cells and completion of laboratory records.
(2) Reexamination means the review of slides which have been examined or screened as normal. The selection of these slides must be made based on a protocol, available in the laboratory, which includes patient history, qualifications of the examining cytotechnologist and source of referral.
(3) Facilitating means the preparation and review of nongynecological slides by a cytotechnologist for diagnosis by a pathologist and shall include the marking of abnormal cells and selection of representative slides.
(4) Quality control and quality assurance means those procedures and protocols, including reexamination, in place in the laboratory to assure consistency, reliability, documentation and accuracy of results reported and shall include corrective actions taken in the event of laboratory error.
(5) Cytotechnologist means a clinical laboratory professional specializing in the analysis of cytopathology samples, including Pap smears, for cervical cancer and other related diseases, who meets the qualifications specified by the department in section 58-1.5 of this Subpart. For purposes of the work standard in subdivision (b) of this section, this shall mean any person who is engaged in the examination of Pap smears.
(6) Cytotechnologist work standard means a limitation on the number of Pap smears (also known as gynecologic slides) and nongynecologic slides which a cytotechnologist may examine or facilitate during a particular time period, or other limitation on the quantity, speed or manner of examination of slides by a cytotechnologist.
(7) Employ means to employ or contract with a cytotechnologist to examine cytological materials, including gynecologic and nongynecologic slides.
(8) Part-time means working less than a seven and one-half or an eight-hour day for a particular employer.
(9) Clinical laboratory means a clinical laboratory licensed by the Department of Health of the City of New York or by the New York State Department of Health.
(10) Work day means a 24-hour period during which a cytotechnologist examines cytological materials for a clinical laboratory.
(11) Work month means a calendar month during which a cytotechnologist examines cytological materials, including gynecologic slides, for a clinical laboratory.
(12) Nongynecological slide means a slide containing material obtained from other than the cervical-vaginal area. For each nongynecologic case for which up to three slides are submitted, each of the slides shall count as one toward the work standard. For each nongynecologic case where more than three slides are submitted, only the first three shall be counted toward the work standard.
(13) Total hours worked means the time spent during each work day at all employers examining slides and performing ancillary duties as defined in paragraph (b)(3) of this section. For part-time cytotechnologists, the denominator shall be based on a seven and one-half or an eight hour day adjusted as described in paragraphs (b)(3)-(4) of this section such as assisting in fine needle aspirations, staining and preparation of slides, accessioning test requests, and reporting test results, but shall not include quality control or quality assurance activities including reexamination of slides determined to be negative by those qualified as cytology laboratory supervisors or training. For part-time employees, the denominator shall be based on an eight-hour day adjusted as above.
(b) Cytotechnologist work standard.
(1) No cytotechnologist shall exceed the applicable cytotechnologist work standard. No clinical laboratory shall require, authorize, encourage or permit any cytotechnologist to exceed the applicable cytotechnologist work standard. In determining whether a cytotechnologist exceeds the applicable cytotechnologist work standard, all work performed by the cytotechnologist during a given work day shall be considered, without regard to the clinical laboratory or other person for which it was performed.
(2) Unless otherwise provided, a cytotechnologist may examine no more than 80 one-slide gynecologic cases or 50 two-slide gynecologic cases per work day. If a cytotechnologist also examines nongynecologic slides in a given work day, the cytotechnologist's workload for gynecologic slides shall be correspondingly reduced, in accordance with written guidelines prepared by the clinical laboratory and filed with the department, so that a cytotechnologist examines no more than a combined total of 100 gynecologic and nongynecologic slides per work day.
(3) If a cytotechnologist spends more than one hour per day at any laboratory performing duties not directly related to examination of slides, such as assisting in fine needle aspirations, staining and preparation of slides. quality control and quality assurance activities, reporting test results, training, continuing education and routine clerical work, the laboratory director must decrease that cytotechnologist's workload and hours spent in screening.
(4) When a cytotechnologist works part-time or performs duties other than examination, the slide limit must be prorated using one or more of the following formulas:
(i) Screening one-slide gynecologic cases:
Hours worked on slides × 80 (cases)
Total hours worked in a work day
(ii) Screening two-slide gynecologic cases:
Hours worked on slides × 50 (cases)
Total hours worked in a work day
(iii) Facilitating nongynecologic cases (up to three slides):
Hours worked on slides × 30 (cases)
Total hours worked in a work day
(5) In no case shall the hourly rate of examination exceed more than 12.5 slides per hour per cytotechnologist, unless the laboratory has the department's approval to exceed this limit.
(6) The laboratory must provide rest periods and breaks as needed by the cytotechnologist.
(7) Exceptions.
(i) Each laboratory shall evaluate the performance of each cytotechnologist in its employ, and establish an appropriate examination volume limitation based on the cytotechnologist's experience, documented accuracy and performance in proficiency testing, or on other reasons, including false-negative or false-positive interpretations. Under no circumstances shall this volume be exceeded, even if it is lower than the maximum work standard.
(ii) A cytotechnologist may exceed the work standard by 20 percent, with the written approval of the department. The laboratory director may request such approval based on each cytotechnologist's experience, documented accuracy, including false-negative or false-positive interpretations, and a performance score in proficiency testing of not more than two errors. Documentation of department approval shall be available in the laboratory, and may be revoked by the department with prior notice to the laboratory, based on a cytotechnologist's performance in proficiency testing or other evidence that the cytotechnologist's accuracy is other than acceptable. The laboratory director shall monitor the performance of each cytotechnologist and advise the department whenever the approval is to be revoked based on on-the-job performance.
(iii) Cytotechnologists who qualify as supervisors under section 58-1.4 of this Subpart may re-examine up to 20 slides per day in addition to the workload standard, provided the combined total number of slides does not exceed 100, as part of the quality assurance program of the laboratory, with the prior approval of the department, based on documented accuracy, including false-negative and false-positive interpretations, and performance in proficiency testing. Such approval may be revoked, with prior notice to the laboratory, based on proficiency testing performance or other evidence that the cytotechnologist's accuracy is other than acceptable. Records shall be maintained to document the examination volume and hours worked by each cytotechnologist.
(iv) The department may increase the cytotechnologist work standard beyond the level already authorized elsewhere in this section for cytotechnologists using a Federal Food and Drug Administration (FDA)-approved device in the preparation or examination of cytology slides:
(a) in determining whether to increase the cytotechnologist work standard with respect to a particular device, the department shall consider the following: the FDA's approved use of the device; studies of the accuracy, reliability and appropriate use of the device; input from clinical laboratories using the device; recommendations of experts in the field of cytology and/or cytotechnology; and other relevant information as appropriate;
(b)
(1) the department may require a clinical laboratory wishing to exceed the cytotechnologist work standard set forth elsewhere in this section to request in writing the department's approval. The department may also require the applicant laboratory to provide, in a form acceptable to the department, some or all of the following information regarding the device in use at the laboratory: the device manufacturer's recommendations, if any, regarding the quantity ( i.e., slide volume), speed or manner of slide examination, and the basis for such recommendations; documentation of training for each cytotechnologist using the device; each cytotechnologist's experience using the device, including false-negative and false-positive interpretations, workload, and number of hours spent examining slides; each cytotechnologist's performance on proficiency testing; as well as any other information as determined appropriate by the department to assess device capacity and user capability; and
(2) the department shall provide written notice of the authorized work standard established pursuant to this subparagraph. The department may set a work standard in writing that applies to one or more cytotechnologists;
(c) laboratories shall maintain documentation of approval pursuant to this subparagraph for a minimum of two years after use of the device is discontinued;
(d) if the department determines that a cytotechnologist work standard authorized pursuant to this subparagraph increases the rate of errors or compromises the reliability of results, the department shall adjust the standard as it deems appropriate and shall notify the affected clinical laboratories in writing of such change. Clinical laboratories that find the adjustment unacceptable may request only in writing that the department reconsider its determination; and
(e) notwithstanding the foregoing, any cytotechnologist work standard authorized by the department pursuant to this subparagraph shall be at least as stringent as the Federal standards promulgated under the Federal clinical laboratory improvement amendments of 1988 and/or other applicable law(s).
(c) Regularly scheduled education programs, averaging two hours per month, must be provided to the cytotechnologists and records thereof maintained.
(d) Recordkeeping.
(1) Each clinical laboratory shall maintain records on work standards for three years, in a form approved by the department, which set forth, for each cytotechnologist employed by the clinical laboratory:
(i) the name and registration number of the cytotechnologist;
(ii) the number of hours worked by the cytotechnologist in each work day;
(iii) the number of one-slide and two-slide gynecologic cases and nongynecologic cases and slides examined by the cytotechnologist, as well as the total number of slides examined during each work day; and
(iv) the actual hours worked, if required by the department, for any cytotechnologist working at more than one employer.
(2) Every cytopathology laboratory shall maintain, and make available to the department upon request, a calendar year workload report containing the following information for every cytotechnologist employed for any period of time during that calendar year:
(i) the name of cytotechnologist;
(ii) registration number of cytotechnologist;
(iii) number of days worked and, for part-time cytotechnologist, full-day equivalent number calculated;
(iv) number of one-slide gynecologic cases read by the cytotechnologist;
(v) number of two-slide gynecologic cases read by the cytotechnologist; and
(vi) number of nongynecologic cases read by the cytotechnologist.
(3) Every cytotechnologist shall maintain, and make available to the department upon request, a calendar year workload report containing the following information for every cytopathology laboratory in which the cytotechnologist performed screening and/or facilitating during that calendar year:
(i) name of laboratory;
(ii) identification number of laboratory;
(iii) number of days worked and, for part-time cytotechnologists, full-day equivalent number calculated;
(iv) number of one-slide gynecologic cases read by the cytotechnologist;
(v) number of two-slide gynecologic cases read by the cytotechnologist; and
(vi) number of nongynecologic cases read by the cytotechnologist.
(4) Each cytotechnologist shall maintain records on work standards for three years, in a form approved by the department, which set forth:
(i) the number of hours worked by the cytotechnologist in each work day;
(ii) the number of one-slide and two-slide gynecologic cases and nongynecologic cases and slides examined, as well as the total number of slides examined during each work day;
(iii) the name and address of the clinical laboratory(ies) or other person(s) for whom the slides were examined;
(iv) the cytotechnologist registration number assigned by the department; and
(v) the actual hours worked at each employer, if required by the department.
(5) Records required to be maintained by clinical laboratories and cytotechnologists shall be made available for inspection and copying by the department upon request.
(6) Multiple employers. Whenever a cytotechnologist is employed by more than one clinical laboratory or other person during a work day, the cytotechnologist shall advise each clinical laboratory or person of any previous employment during the work day and the amount of work performed, to ensure that the applicable cytotechnologist work standard is not exceeded.
(e) Standards for gynecologic slides.
(1) Each laboratory must establish a written protocol defining the standards to be used for determining if a slide is inadequate to test. These standards must be available in the laboratory and must be provided to each ordering physician or other practitioner.
(2) A gynecologic slide or a Pap smear shall not result in a diagnostic report if:
(i) the apparent condition of the specimen indicates that it is unsatisfactory for testing or that it is inappropriate for the test requested;
(ii) it has been collected, labeled, preserved or otherwise handled in such a manner that it has become unsatisfactory or unreliable as a test specimen;
(iii) the slide is broken to such extent that it cannot be repaired adequately so that cells are not obscured or lost; and
(iv) it contains insufficient cells or the cells are obscured by inflammation, blood, or lubricating ointment, so that an accurate diagnosis cannot be made.
(3) The laboratory shall note in the laboratory record and in the report to the physician the reason for the unsatisfactory evaluation. Such records must be available for inspection by the department. The total number of unsatisfactory smears should be reported to the department at least annually.
(4) If a slide is unsatisfactory under this subdivision, the clinical laboratory shall have an affirmative duty to advise the collecting physician or other practitioner that the slide or specimen is unsatisfactory and request the submission of a new slide. If the inadequacy is due to collection and preservation technique, the laboratory shall offer assistance to the practitioner in collection of adequate samples, free of contamination and foreign material.
(5) As minimum clinical information, the laboratory order form must request the patient's date of onset of last menstrual period, age, previous abnormal cytology, and previous significant history.
(6) If the minimum required clinical information is not included on the order form or is otherwise unavailable, the laboratory must request this information. If the clinical information is not received, the laboratory record must be so noted and the report to the physician must state that the required information was not provided.
(7) Slides from negative cases must be retained for at least five years and slides from cases with abnormalities must be retained for at least 10 years.
(8) Laboratory records must identify the cytotechnologist and/or cytopathologist who diagnosed the case.
(f) Reexamination of slides.
(1) Each laboratory must establish a system for targeted reexamination of at least 10 percent of gynecologic slides determined to be not abnormal or questionable. Documentation of this system must be available in the laboratory for inspection by the department and to ordering physicians or other practitioners.
(2) Reexamination shall be based on prior cancer and other history of the patient, results of previous examinations, patient risk status as determined by the clinical physician, source of referral ( i.e., practices and/or clinics with high-risk patients or high incidence or from geographical areas with high risk of disease). Reexamination shall also be performed on slides examined by new or inexperienced cytotechnologists and those determined to be in need of remediation based on proficiency testing performance. Records of this rescreening must be maintained for three years.
(3) In addition, the laboratories employing more than one cytotechnologist must establish a system, which may be part of reexamination, to ensure the laboratory's consistency, in examination of slides by two or more individuals or by the same individual on different occasions. Copies of the results must be maintained for three years and be available for inspection and copying by the department.
(4) All gynecologic cases which have been interpreted by a cytotechnologist as dysplasia, cervical intraepithelial neoplasia (CIN), carcinoma in situ (CIS) or malignancy and all nongynecologic cases must be reviewed by a pathologist.
(5) Cases with abnormal findings as described in paragraph (4) of this subdivision must be tracked by the laboratory and follow-up information, including results of subsequent biopsies, must be documented and available in the laboratory for three years.
(6) Records of recognized false-positive and false-negative cases must be maintained, including copies of subsequent biopsy reports, for 20 years, and be available to the department.
(g) Registration of cytotechnologists.
(1) All cytotechnologists, as defined in this Subpart, who are employed by a clinical laboratory must register with the department on the form provided by the department.
(2) The registration application must include the name and home address of the cytotechnologist; the name and address of all locations at which the cytotechnologist is employed as a cytotechnologist, regardless of whether the site or facility is under New York State or New York City permit; the cytotechnologist's working days and hours at each facility or site; the cytotechnologist's education and experience; the cytotechnologist's social security number as required under section 5 of the New York State Tax Law; and other information the department may require for enforcement of this Subpart.
(3) Within 30 days of a change in home address, employer or employer address, the cytotechnologist must notify the department on the form provided by the department.
(4) The department will advise each cytotechnologist of the assigned registration number and provide an identification card to each cytotechnologist. The registration number must be used on all records, as required by the department. The registration card must be kept by the cytotechnologist and a copy must be maintained by each employing laboratory.
(5) No clinical laboratory shall employ a cytotechnologist unless the cytotechnologist is registered under this section. If the cytotechnologist is not registered at the time of hiring, an application for registration must be made within one week of commencing employment. When a cytotechnologist is hired, resigns or otherwise is separated from the laboratory, the laboratory director must so advise the department.
(6) A cytotechnologist's registration may be revoked, denied, suspended, or annulled upon falsification of information on the registration application, falsification of laboratory workload records, termination from a laboratory for cause, or other violation of the law, rules and regulations.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.6 Allowable costs
(a) To be considered as allowable in determining reimbursement rates, costs must be properly chargeable to necessary patient care. Except as otherwise provided in this Part, or in accordance with specific determination by the commissioner, allowable costs shall be determined by the application of the principles of reimbursement developed for determining payments under the title XVIII (Medicare) program.
(b) Allowable costs may not include costs for services that have not been approved by the commissioner.
(c) Allowable cost shall include a monetary value assigned to services provided by religious orders and for services rendered by an owner and operator of a facility.
(d) Allowable costs may not include amounts in excess of reasonable or maximum title XVIII (Medicare) costs or in excess of customary charges to the general public. This provision shall not apply to services furnished by public providers free of charge or at a nominal fee.
(e) Allowable costs shall not include expenses or portions of expenses reported by individual facilities which are determined by the commissioner not to be reasonably related to the efficient production of service because of either the nature or amount of the particular item.
(f) Any general ceilings applied by the commissioner, as to allowable costs in the computation of reimbursement rates, shall be published in a hospital memorandum or other appropriate manner.
(g) [ Reserved ]
(h) Allowable costs shall not include costs which principally afford diversion, entertainment or amusement to their owners, operators or employees.
(i) Allowable costs shall not include any interest charged or penalty imposed by governmental agencies or courts, and the costs of policies obtained solely to insure against the imposition of such a penalty.
(j) Allowable costs shall not include the direct or indirect costs of advertising, public relations and promotion except in those instances where the advertising is specifically related to the operation of the facility and not for the purpose of attracting patients.
(k) Allowable costs shall not include costs of contributions or other payments to political parties, candidates or organizations.
(l) Allowable costs shall include only that portion of the dues paid to any professional association which has been demonstrated, to the satisfaction of the commissioner, to be allocable to expenditures other than for public relations, advertising and political contributions. Any such costs shall also be subject to any cost ceilings that may be promulgated by the commissioner pursuant to subdivision (f) of this section.
(m) [ Reserved ]
(n) Allowable costs shall not include any element of cost, as determined by the commissioner, to have been created by the sale of a medical facility.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.96 Discount earned
A reduction in the purchase price of a good or service because of early payment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.12 Cost guidelines for reimbursement purposes
(a) For the purpose of promulgating cost-based rates or rates based on budget, the department shall establish regional guidelines to be applied to the rate for each service to be provided. The cost guidelines shall be computed on a regional basis and based on the most recent annual cost data available to the department. For this purpose, LTHHCPs shall be grouped on the following basis:
(1) Downstate: Putnam, Rockland, Westchester, Nassau, Suffolk, Kings, New York, Richmond, Queens and Bronx Counties.
(2) Upstate: All other New York State counties.
(b) The cost guidelines shall be established by:
(1) calculating a group average cost;
(2) centering the cost of any provider whose costs are not between 75 percent and 125 percent of the group average by raising or lowering the provider's cost, as appropriate, to the 75-percent and 125-percent limits;
(3) recalculating the group average; and
(4) multiplying the recalculated group average by 110 percent.
(c)
(1) For the purpose of review of initial rates based on budget, the cost guidelines shall be 115 percent of the recalculated group average cost.
(2) If the rate based on cost or budget is at or below the cost guideline, such a rate shall be promulgated.
(3) If the initial rate based on budget is in excess of the cost guideline, the department shall contact the LTHHCP prior to promulgation of the initial rate and determine if the rate is justified based on a written submission by the LTHHCP. If the department determines that the initial rate based on budget in excess of the guideline is justified, the department shall promulgate such a rate for the applicable rate period. If the department determines that the initial rate based on budget in excess of the cost guideline is not justified, a rate set at the guideline amount shall be promulgated for the applicable rate period.
(d)
(1) If the rate based on cost is in excess of the cost guideline, a rate set at the actual cost shall be promulgated. For each rate year, within 90 days of notification of the rate, the LTHHCP may submit written documentation justifying a rate in excess of the cost guideline. If a program whose cost-based rates exceed the cost guideline fails to submit written documentation justifying the rate within 90 days of notification of the rate, that program's rates which exceed the guideline shall revert to the guideline level on a retrospective basis.
(i) The written documentation submitted by a LTHHCP may indicate what conditions have resulted in a rate in excess of the cost guideline or describe what steps the LTHHCP shall take in pursuing a less expensive alternative way of delivering the service, or both.
(2) If the department determines that the written documentation justifies a rate based on cost in excess of the guideline, such a rate shall remain at the actual cost amount for the applicable rate year only.
(3) If the department determines that the written documentation does not justify a rate based on cost in excess of the guideline amount, the promulgated rate shall revert to the guideline amount on a retrospective basis.
(4)
(i) If the written documentation outlines steps to be taken by the LTHHCP in pursuing a less expensive alternative way of delivering a service, the LTHHCP shall be required to submit an application for prospective revision of a rate. The promulgated rate shall remain as it is promulgated pursuant to this subdivision until the rate is revised pursuant to the department's written approval of the LTHHCP's application for revision of the rate.
(ii) A justification which outlines a plan of action to be taken by the LTHHCP must contain a time frame within which that plan of action shall be implemented. The LTHHCP can use such a justification only once and cannot use such a justification to justify rates in excess of the cost guideline in rate years which do not fall within the specified time frame for implementation of the plan of action.
(5) In making determinations pursuant to this subdivision, the commissioner shall consider generally applicable factors, including but not limited to:
(i) allowable costs;
(ii) geographical differences in elements of cost;
(iii) geographical differences in availability and cost of personal services;
(iv) economic factors in the area in which the LTHHCP is located;
(v) factors associated with program capacity, patient census, and service to special populations; and
(vi) the need for incentives to improve services and institute economies.
(e) The department shall establish a cap on reimbursable base year administrative and general costs equal to 30% of total reimbursable base year operational costs of a provider of services, excluding a provider of services reimbursed on an initial budget basis, and a new provider, excluding changes in ownership or changes in name, who begins operation in the year prior to the year which is used as a base year in determining rates of payment. The cap on administrative and general costs shall be applied after the application of the cost guidelines described in this section.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.4 Enforcement
(a) Permits and placarding.
(1) The permit-issuing official may order any facility operating without a permit as required in section 7-1.3 of this Subpart to close, and remain closed until a valid permit for operation of the facility is obtained.
(2) The enforcement procedures delineated in the Public Health Law or otherwise provided by law shall be used as appropriate. Where a public health hazard is found, the portion of the temporary residence impacted by the hazard shall be placarded to prohibit use until the hazard is corrected in order to protect the public health and safety of the occupants. When a placard is used, it shall be conspicuously posted at each entrance or walkway leading to the portion of the property where the hazard exists. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration, or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Title and the Public Health Law.
(3) As soon as possible and in any event within 15 days after placarding a facility, the operator shall be provided with an opportunity to be heard and present evidence that continued operation of the facility does not constitute a danger to the public. The hearing shall be conducted by the permit-issuing official or the designated hearing officer.
(4) The permit-issuing official or designated representative shall inspect the premises within two working days of notification that the hazard has been eliminated. The placards will be removed after the permit-issuing official or his designated representative verifies that the hazard has been eliminated.
(b) Public health hazards.
Any of the following violations are public health hazards which require immediate corrective or remedial action and which require the permit-issuing official or designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(1) the condition of the electric service, wiring or electrical system components is such that an imminent fire or shock hazard exists;
(2) the potable water system contains contaminants in excess of the maximum contaminant levels prescribed in applicable sections of Part 5 of this Title;
(3) use of an unapproved water supply source for potable use;
(4) insufficient quantity of water to meet drinking or sanitary demands;
(5) the treatment of the potable water system, when required for disinfection or removal of contaminants, is not continuous;
(6) disinfection of the potable water system is inadequate to destroy harmful microorganisms or to maintain a specified chlorine residual;
(7) the presence of cross connections or other faults in the water distribution or plumbing systems which result, or may result, in the contamination of the potable water system;
(8) inadequately treated sewage discharging on the ground surface in an area accessible to the facility occupants and/or public, or which may result in pollution of a ground or surface water supply or bathing beach;
(9) inadequately operated and/or maintained fire alarm and fire suppression systems;
(10) failure to provide or maintain required exits;
(11) failure to maintain required exits or smoke barrier doors, emergency lights, or exit signs;
(12) improper storage of flammable, volatile liquids or hazardous materials;
(13) any other condition the permit-issuing official determines to be a public health hazard.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.17 Long-term ventilator beds
(a) This methodology will be utilized to evaluate certificate of need applications for the certification of long-term ventilator beds, which are operated in residential health care facilities for individuals experiencing respiratory failure who can be treated through mechanical ventilation. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decision making tools for directing the distribution of long-term ventilator beds. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate number of long-term ventilator beds are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors for determining the public need for long-term ventilator beds shall include, but not be limited to, the following:
(1) The planning areas for determining the public need for long-term ventilator beds shall be the designated health systems regions.
(2) The number of long-term ventilator beds in each health systems region required to meet the public need shall be determined by dividing the projected annual patient days for the service by 365, and dividing the result by 0.95 to allow for a 95 percent occupancy rate. The projected long-term ventilator patient days used in this calculation shall be determined as follows:
(i) The annual number of potential candidates for long-term ventilator beds shall be determined by calculating the total number of annual general hospital discharges in the planning area for DRG 475 (respiratory system diagnosis with ventilator support), plus an additional 10 percent, and multiplying the resulting figure by 0.32.
(ii) The number of potential candidates for long-term ventilator beds shall be multiplied by a 125-day length-of-stay to project the annual number of patient days for long-term ventilator patients.
(3) The review of certificate of need applications will consider the documented referral patterns in the planning area, the expected length-of-stay based on the case-mix of long-term and short-term patients, the ability of the applicant to successfully wean ventilator patients, and the ability and commitment of the applicant to accept the difficult-to-place ventilator patients ( e.g., ventilator patients with hemodialysis needs or patients with bacterial infections).
(4) The long-term ventilator bed need methodology will be reviewed within three years from the effective date of this section.
(c)
(1) The bed need estimates developed pursuant to subdivision (b) of this section shall constitute the public need for ventilator beds in the planning area subject to further adjustments in accordance with subdivision (d) of this section.
(2) Notwithstanding that there is an indication of need in a planning area for additional long-term ventilator beds as determined in accordance with subdivision (b) of this section, there shall be a rebuttable presumption that there is no need for any additional long-term ventilator beds in such planning area if the overall occupancy rate for existing long-term ventilator beds in such planning area is less than 95 percent based on the most recently available data. It shall be the responsibility of an applicant in such instances to demonstrate that there is a need for additional long-term ventilator beds despite the less than 95 percent occupancy rate in the planning area utilizing the factors set forth in subdivision (d) of this section.
(3) The department shall evaluate the appropriateness of the 95 percent occupancy threshold criterion in this section, based on the most recent data available, within three years of the effective date of this section.
(d) Notwithstanding any other provision of this section, when the estimates of need for long-term ventilator beds developed in accordance with subdivision (b) of this section indicate the need for additional beds, such estimates of additional need may be modified, based on information and data gathered from relevant sources relating to significant local factors pertaining to the planning area, or on statewide factors, where relevant, which factors may include, but not necessarily be limited to, those set forth in paragraphs (1) through (3) of this subdivision. When making recommendations to the State Hospital Review and Planning Council and the Public Health Council concerning the impact of the factors set forth in this subdivision, the department shall, to the extent practicable, indicate the relative priority of such factors:
(1) the impact of requirements pertaining to placing persons with disabilities into the most integrated setting appropriate so as to enable persons with disabilities to interact with non-disabled persons to the fullest extent possible;
(2) recommendations made by the local health systems agency, if applicable;
(3) documented evidence of the unduplicated number of patients on waiting lists who are appropriate for admission to long-term ventilator care who experience a long stay in acute care facilities awaiting discharge to a residential health care facility for long-term ventilator care.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.151 General fund
See operating fund.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.6 Village of Dansville (well supply)
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to wells which comprise the source of the public water supply of the Village of Dansville. Said wells are located on land owned by the Village of Dansville and are situated approximately 264 feet north of the hamlet of Perkinsville, New York on Steuben County Road 91, in the Town of Wayland, New York, bounded by Perkinsville Rod and Gun Club to the east, County Road 91 to the west, Wayland to the north and south.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, goon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Village of Dansville.
(16) Wells shall mean wells now used as a source of this water supply or any additional wells which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells, except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells, and not within a 500-foot to 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the wells.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the wells.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(8) Trespassing.
No trespassing shall be allowed upon the village well site property located in the Town of Wayland and no person or persons shall enter in or upon such property, except the person or persons duly authorized to enter said property by the Village of Dansville.
(e) Inspections.
The Village of Dansville Board of Trustees or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the area surrounding the wells to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of said violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.3 Miscellaneous: duties of an operator
(a) The operator shall not knowingly employ or allow anyone to work at a mass gathering who would pose a significant risk of disease to the public.
(b) Children under 16 years of age not accompanied by an adult at a mass gathering shall be provided with adequate and competent adult supervision exercised by a supervisor or supervisors present on the property.
(c) Satisfactory arrangements shall be made to assure adequate medical and nursing supervision and care at, or readily available to, the mass gathering.
(d) A person to whom a permit to promote or hold a mass gathering has been issued shall employ or designate an individual, who is acceptable to the permit-issuing official to be in charge of the property to maintain the facilities, and who shall be on or available to the property at all times when the property is occupied or open for occupancy, who is capable of providing an adequate response to all matters affecting the life, safety and health of the occupants.
(e) A person to whom any permit is issued shall comply with the provisions of this Subpart and with all conditions stated in the permit and shall allow the permit-issuing official or his representative to enter the premises at any reasonable time to ascertain compliance with the conditions of the permit and with this Subpart.
(f) The site shall be provided with a network of interior roads to be kept clear at all times for service and emergency vehicles, and shall be serviced by access roads which will permit an adequate flow of traffic and ensure the free passage of emergency vehicles.
(g) Each person attending the mass gathering shall be provided with a site map showing the location of all facilities, and adequate signs shall be provided locating all facilities.
(h) A separate overnight camping area or areas shall be provided.
(i) Adequate light for toilet areas, service areas and walkways shall be provided.
(j) A maintenance and internal security staff acceptable to the permit-issuing official shall be provided to assure proper operation of all facilities.
(k) Traffic control measures that will preclude hazards to vehicular and pedestrian traffic shall be implemented.
(l) The operator of a mass gathering shall make arrangements such that no flammable or volatile liquids or materials are stored in or adjacent to the area of the gathering, and that adequate fire fighting equipment is available to protect the life and health of the people attending the gathering.
(m) The operator shall provide the services and facilities outlined in the engineering report and approved by the permit-issuing official.
(n) The operator shall provide such emergency health-care services and facilities as may be required under applicable provisions of sections 18.3 and 18.4 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.21 Self-insurance
[ 1420 ] Self-insurance by a hospital for potential losses due to unemployment, workers' compensation and malpractice claims, asserted or otherwise, places all or part of the risk of such losses on the hospital rather than insuring against all or part of such losses with an independent insurer. For uniform reporting purposes for self-insurance, hospitals must follow the guidelines of Statement 5 of the Financial Accounting Standards Board.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.5 Admission to the examination
(a) An applicant shall be determined qualified and eligible to take the examination for licensing as a nursing home administrator when the applicant has successfully documented to the board that he or she has met or exceeded the age, moral character and suitability, education including courses of study, and experience qualifications for licensure as established by the board.
(b) An applicant for examination who does not qualify shall be given written notification by the board of his or her lack of qualification and the reasons therefor. Within 30 days of the mailing of such notification, the applicant may petition the board in writing for a review of his or her application.
(c) A candidate for licensure who does not receive a passing grade on his or her licensing examination within five years of notification by the board of his/her eligibility to sit for the examination shall be required to reapply and requalify under the then current laws and rules and regulations. The candidate shall be permitted to take the licensing examination no more than three times during the five-year period of eligibility.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.5 Effective period of reimbursement rates
Certification of reimbursement rates of payment shall be for a 12-month calendar year period or for such other period as may be prescribed by the Commissioner of Health.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.28 White-water slides
(a) White-water slides shall be operated to meet the specific requirements listed below, in addition to other applicable sections of this Subpart.
(b) Supervision shall be provided at the top and bottom of each white-water slide, as required in section 6-1.23 of this Subpart.
(c) Use of white-water slides shall prohibit the following practices:
(1) Chain-riding or stopping in flumes.
(2) Standing or kneeling in flumes.
(3) Sliding shall be performed only in a feet forward position.
(d) Warning signs shall be posted stating the above prohibitions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.1 Statement of purpose
The purpose of this Subpart is to set forth the methods and procedures governing the availability, location and nature of those records of the New York State Department of Health subject to the provisions of article 6 of the Public Officers Law, known as the Freedom of Information Law, and the rules of the Committee on Open Government.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.42 Bassinets
Those beds assigned for regular use by infants newly born in the hospital and which ae maintained in areas allotted for newborn infant lodging.
10 CRR-NY 441.227 Operating fund
The funds within the unrestricted fund which have not been designated by the governing board of the hospital for special uses.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 101 ALLEGANY COUNTY
10 CRR-NY 101.3 Village of Wellsville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to that portion of the Genesee River and its tributary watercourses located within the State of New York and above the intake of the public water supply of the village of Wellsville, Allegany County, N. Y., these streams being sources of the public water supply of the village of Wellsville.
(b) [Definitions.]
(1) The term watercourse wherever used in this section is intended to mean and include every spring, pond, reservoir, stream, ditch, gutter or other channel of any kind the water of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the village of Wellsville.
(2) Wherever a linear distance of a structure or object from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(2) No privy, privy vault, pit, cesspool or any other receptacle, used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(3) No cesspool, pit or other receptacle of any kind, used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance of not less than 300 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any watercourse within the State of New York tributary to the public water supply of the village of Wellsville, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 150 feet of any such watercourse tributary to the public water supply of the village of Wellsville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which clothing, bedding or carpets have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any watercourse within a distance of 100 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(3) No clothing, bedding, carpets, nor anything that pollutes water, shall be washed, rinsed or placed in any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any watercourse nor be washed therein within 1000 feet above the intake of the Wellsville water supply. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams within the State of New York tributary to the public water supply of the village of Wellsville.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 25 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet before reaching any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed within the State of New York tributary to the public water supply of the village of Wellsville, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any watercourse with the State of New York tributary to the public water supply of the village of Wellsville, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 25 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any watercourse tributary to the public water supply of the village of Wellsville.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 150 feet before entering any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(g) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(h) Cemetaries.
No interment of a human body shall be made within a distance of 300 feet from any watercourse within the State of New York tributary to the public water supply of the village of Wellsville.
(i) Inspections.
The commissioners of the water and light department of the village of Wellsville shall make regular and thorough inspections of the streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notice of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the commissioners of the water and light department to promptly notify the State Commissioner of Health of such violations. The commissioners shall report in writing annually, on the first of January, the results of the regular inspection made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.4 Certification of reports
(a) All financial and statistical reports shall be certified by an independent licensed public accountant or an independent certified public accountant on forms prescribed and provided by the department. A copy of the audited financial statements shall accompany the financial and statistical reports. Where the required financial and statistical report data are incorporated into the audited financial statements of a larger entity, the independent licensed public accountant or the independent certified public accountant shall provide the information necessary to reconcile the cost report presentation to the financial statements in detail. An accountant shall not be independent if:
(1) any family relationship, including a relationship by marriage, exists between any accountant, member or employee of the accounting firm and the owner, operator or administrator of the facility;
(2) any business relationship other than one related to accounting services exists between any accountant, member or employee of the accounting firm and the owner, operator or administrator of the facility;
(3) any accountant, member or employee of the accounting firm is responsible for the books and records of the facility; or
(4) any accountant, member or employee of the accounting firm is a member of the board of directors, officer or employee of the facility.
(b) The requirements of subdivision (a) of this section shall not apply to facilities operated by units of government of the State of New York whose total operating costs are less than $100,000.
(c) All financial and statistical reports shall be certified by the operator of a proprietary facility, an officer of a voluntary facility or the public official responsible for the operation of a public facility, on forms prescribed and provided by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.18 Accounting for property, plant and equipment
[ 1380 ]
(a) Classification of fixed asset expenditures.
[ 1381 ] Property, Plant and Equipment and related liabilities must be recorded in the Unrestricted Fund, since segregation in a separate fund would imply the existence of restrictions on the use of the asset. Cost of construction in progress and related liabilities must be recorded in the Unrestricted Fund as incurred except for assets and liabilities related to certain debt agreements.
(b) Basis of valuation.
[ 1382 ]
(1) Property, Plant and Equipment must be reported on the basis of cost. Cost shall be defined as historical cost or fair market value at the date of gift of donated property.
(2) Property, Plant and Equipment must be reported on the basis of the historical cost incurred by the present owner in acquiring the asset under a bona fide sale. The historical cost shall not exceed the lower of current reproduction cost adjusted for straight-line depreciation or fair market value at the time of purchase. See section 104.10 of HIM-15. Cost is defined as historical cost or fair market value of donated property on the date of acquisition.
(c) Accounting control.
[ 1383 ]
(1) To maintain accounting control over capital assets of the hospital, a plant asset ledger should be maintained as part of the general accounting records. Some items of equipment should be treated as individual units within the plant ledger when their individuality and unit cost justify such treatment. Other items of equipment, if they are similar and are used in a single cost center, may be grouped together and treated as a single unit within the ledger.
(2) All equipment purchased on or after the first day of a hospital's first accounting period beginning after the effective date of this manual, and all equipment purchased prior to such date where the necessary records have been maintained, must be segregated in the plant ledger record by cost center so that the cost of equipment and the related depreciation for each cost center is available.
(d) Capitalization policy.
[ 1384 ]
(1) If a depreciable asset has at the time of its acquisition an estimated useful life of three or more years and an historical cost of at least $300, its cost must be capitalized, and written off ratably over the estimated useful life of the asset.
(2) If a depreciable asset has an historical cost of less than $300, or if the asset has a useful life of less than three years, its costs are recorded in the year it is acquired, subject to the provisions of writing off the cost of minor movable equipment. The hospital may, if it desires, establish a capitalization policy with lower minimum criteria but under no circumstances may the above criteria be exceeded. Alterations and improvements in excess of $300 which extend the life a minimum of three years or increase the productivity or efficiency of an asset, as opposed to repairs and maintenance which either restore the asset to or maintain it at its normal or expected service life, must be capitalized and depreciated over their expected useful lives, not to exceed the lives of the asset to which they are fixed. Normal repair and maintenance costs are to be reported as expense in the current accounting period.
(3) For cost reporting periods beginning January 1, 1981 and thereafter, the historical cost limits will be adjusted to “an historical cost of at least $500 or, if it is acquired in quantity, the cost of the quantity is at least $1,000”. The new $500 limit will also apply to alterations and improvements. All other principles cited above will continue in force.
(e) Minor equipment.
[ 1385 ]
(1) Minor equipment includes such items as wastebaskets, bedpans, silverware, mops, buckets, etc. The general characteristics of this equipment are:
(i) in general, no fixed location, and subject to use by various cost centers within a hospital;
(ii) comparatively small in size and unit cost;
(iii) subject to inventory control;
(iv) fairly large quantity in use; and
(v) generally, a useful life of less than three years.
(2) There are two ways in which the cost of minor equipment may be reported:
(i) The original cost of this equipment may be capitalized and not depreciated. Any replacements to this base stock would be reported as operating expenses. The amount of the base stock would be adjusted only if there were a significant change in the size of the base stock.
(ii) All purchases of minor equipment may be capitalized and depreciated over their estimated useful lives.
(3) Once a hospital has applied one of the methods, that method must be used consistently thereafter.
(f) Interest expense during period of construction.
[ 1386 ] Frequently hospitals borrow funds to construct new facilities or modernize and expand existing facilities. Interest costs incurred during the period of construction must be capitalized as a part of the cost of the construction. The period of construction is considered to extend to the date the constructed asset is ready for use. When proceeds from a construction loan are invested and income is derived from such investments during the construction period, the amount of interest expense to be capitalized must be reduced by the amount of such income.
(g) Depreciation policies.
[ 1387 ]
(1) Depreciation on plant assets used in the hospital's operations must be reported as an operating expense in the Unrestricted Fund. The straight line method of depreciation must be used for all assets acquired after July 1970. The estimated useful life of a depreciable asset is its normal operating or service life in terms of utility to the hospital. Some factors to be considered in determining useful life include normal wear and tear, obsolescence due to normal economic and technological advances, climatic or local conditions and the hospital's policy for repair and replacement.
(2) In selecting a proper useful life for computing depreciation, hospitals must utilize the most recent useful life guidelines published by the Secretary of the Department of Health and Human Services or, if none exist, the most recent guidelines published by the Internal Revenue Service or the 1973 guidelines published by the American Hospital Association. However, with the rapidly changing technology in hospitals, these recommendations may not be all-inclusive; in which case, the expertise of the manufacturer, or other reliable sources, may be considered. Any changes in estimated useful lives must be properly documented by the hospital and approved by the hospital's Medicare intermediary.
(3) For reporting purposes each hospital must establish, and follow consistently from year to year, a policy relative to the amount of depreciation to be taken in the year of acquisition and disposal of depreciable assets. Examples of acceptable policies are:
(i) Computing first year depreciation based upon the portion of time the asset was in use during the year. That is, if a depreciable asset was received and in use in the hospital for eight months in the year of acquisition, two thirds of a full year's depreciation expense would be recognized in that first year.
(ii) Recording one half of the yearly depreciation expense in the years of acquisition and disposal, regardless of the date of acquisition or disposal.
(4) Depreciation expense reported on buildings, purchased or constructed, in the year of acquisition or disposal must be based on the actual time during which the building was in use for hospital operations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-2 UMBILICAL CORD BLOOD TESTING
10 CRR-NY 69-2.2 Cord blood test for syphilis
Every responsible physician or birth attendant shall acquire from all infants born, whether alive or dead after 22 weeks gestation, a sample of blood from the umbilical cord and submit it to an approved laboratory for standard serological tests for syphilis. If body blood from the mother is tested for syphilis at the time of birth, the cord blood test requirement shall be waived if the infant's body blood is tested after any positive test result of the mother's blood.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.201 Waiver
The permit-issuing official may waive, in writing, any of the requirements of this Subpart, and the waiver included as a condition of the permit to operate, when it reasonably appears that the public health will not be endangered by such waiver. All such waivers are to be only for the same period as the term of the permit.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.13 Sampling, methods and recordkeeping
(a) Bottled water shall be sampled at the frequency and analyzed for the water quality parameters outlined in section 5-6.11 of this Subpart.
(b) Samples for any water quality parameter not specified in section 5-6.11 of this Subpart shall be collected and analyzed as may be required by the State.
(c) Sampling methods and analyses shall, at a minimum, meet the following requirements:
(1) Source water samples shall be taken from each approved source.
(2) Finished product water samples shall be taken from a batch or segment of a continuous production run for each type of bottled water produced during a day's production. The representative sample shall consist of a primary container of the finished product.
(3) All required finished product water quality analyses must be performed by an approved laboratory.
(4) All required source water quality analyses must be performed by an approved laboratory.
(5) Analyses shall be conducted by the analytical requirements set forth in Standard Methods for the Examination of Water and Wastewater, current edition, or alternate methods approved by the department's Environmental Laboratory Approval Program.
(d) Container sampling for each container size shall, at a minimum, meet the following requirements:
(1) Containers and closures shall be inspected to vefify that they are free from contamination.
(2) At least once every three months, a total coliform swab and/or rinse count should be made from at least four containers and closures selected just before filling and sealing. No more than one of the four samples may exceed more than one bacteria per milliliter of capacity or one colony per square centimeter of surface area. All samples shall be free of coliform organisms. The procedure and apparatus for these total coliform tests shall be in conformance with those recognized by the State. Tests shall be performed by qualified plant personnel or an approved laboratory.
(e) Record retention and reporting shall, at a minimum, meet the following requirements:
(1) Records shall be kept of all inspections, cleaning and sanitizing operations and bottling production. Records of all microbiological and chemical testing must also be maintained by owners and operators of bottled and bulk water facilities and shall be available to the State for the most recent five-year period for microbiological analyses and 10 years for chemical analyses.
(2) Monthly operating reports for bottlers operating in New York State shall be submitted to the State. Reports shall include the total monthly production including specific production figures for finished product intended for distribution and sale in New York State and all physical, chemical, radiological and microbiological analytical results for that month; the treatment processes and chemicals used; sources of water and other pertinent data. Form GEN 221, Report on Bottled Water Operation or a form containing equivalent information shall be used for this purpose. Failure to submit these reports shall be cause for suspension and/or revocation of the certificate of approval.
(3) Out-of-state bottlers shall submit their monthly operating reports no later than the 10th of the month following the month of the reporting period. The annual inspection report performed by the government agency having jurisdiction shall be submitted each year. The monthly operating reports and annual inspection report are to be sent directly to:
New York State Department of Health
Bureau of Public Water Supply Protection
Two University Place
Western Avenue, Room 406
Albany, NY 12203-3313
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.5 License issuance and denial
(a) A tissue bank, other than a tissue transplantation facility, tissue storage facility or a limited procurement service, shall be issued a license for one or more tissue categories, provided that:
(1) the owner(s) and/or an authorized representative have submitted a license application pursuant to this Subpart;
(2) a tissue bank director has been appointed who:
(i) is a physician licensed and currently registered to practice medicine in New York State or in the state in which he or she practices, and has at least two years' training or experience in the category or categories of tissue, or in a related field, as determined by the department; or
(ii) is a person with a doctoral degree in an appropriate biological science, and has a minimum of two years' tissue banking experience in the category or categories of tissue, or in a closely related field, as determined by the department; or
(iii) is a person with a master's degree in an appropriate biological science, and has a minimum of four years' tissue banking experience in the category or categories of tissue, or in a closely related field, as determined by the department; or
(iv) is a person with a bachelor's degree in an appropriate biological science, and has a minimum of six years' tissue banking experience in the category or categories of tissue, or in a closely related field, as determined by the department; and
(v) holds a current certificate of qualification from the department, in the category or categories of testing, if laboratory testing is performed by the tissue bank;
(3) the medical director is a physician licensed and currently registered to practice medicine in New York State or in the state in which he or she practices. The tissue bank director may serve as the medical director if he or she is a physician licensed and currently registered to practice medicine in New York State or in the state in which he or she practices;
(4) for tissue banks other than insemination/implantation sites, the medical advisory committee is found acceptable by the department;
(5) the department has found that the tissue bank owners any parties with a controlling interest, medical director and tissue bank director have the character and competence to ensure that the tissue bank is competently staffed, properly equipped, and operated in accordance with the law, and that such tissue bank will be so operated. In making such a determination, the department shall consider the factors listed in subdivision (e) of this section with respect to the tissue bank, the director, medical director, and owner(s) of the tissue bank, and any affiliated person, including parties with a controlling interest; and
(6) the tissue bank has corrected deficiencies found on any inspection conducted by the department and any deficiencies noted by the department in the standard operating procedures manual submitted with the application.
(b) A tissue transplantation facility shall be issued a license for one or more tissue categories, provided that:
(1) the owner(s) and/or authorized representative have submitted a license application pursuant to this Subpart;
(2) a tissue bank compliance officer has been appointed;
(3) a director who is a physician licensed and currently registered to practice medicine in New York State is appointed for each tissue transplantation service within the tissue transplantation facility;
(4) the tissue transplantation facility is established pursuant to Public Health Law, article 28, or is the private office of a physician licensed and currently registered to practice medicine in New York State;
(5) the department has found no evidence that the tissue bank compliance officer and director of each tissue transplantation service within the tissue transplantation facility lack the character and competence to ensure that the tissue transplantation facility is competently staffed, properly equipped and operated in accordance with the law, and that such tissue transplantation facility will be so operated. In making such a determination, the department shall consider the factors listed in subdivision (e) of this section with respect to the tissue transplantation facility, the tissue bank compliance officer and the director of each tissue transplantation service within the tissue transplantation facility; and
(6) the tissue transplantation facility has corrected any deficiencies noted by the department in the written standard operating procedure manual or records of tissue issuance and, if inspected, the tissue transplantation facility has corrected any deficiencies found.
(c) A tissue storage facility shall be issued a license provided:
(1) the owner(s) and/or authorized representative(s) have submitted a license application pursuant to this Subpart;
(2) a director has been appointed who has at least two years' experience in the storage of tissue or in a related field, as determined by the department;
(3) the medical director is a physician licensed and currently registered to practice medicine in New York State or in the state in which he or she practices. The tissue storage facility director may serve as the medical director only if he or she is a physician licensed and currently registered to practice medicine in New York State or in the state in which he or she practices;
(4) if inspected, the facility has corrected any deficiencies found; and
(5) the department has found that the tissue bank owners and any parties with a controlling interest, medical director and tissue bank director have the character and competence to ensure that the facility is competently staffed, properly equipped and operated in accordance with the law, and that such tissue bank will be so operated. In making such a determination, the department shall consider the factors listed in subdivision (e) of this section with respect to the facility, the director(s) and owner(s) of the facility, and any affiliated person, including parties with a controlling interest.
(d) A nontransplant anatomic bank or limited tissue procurement service shall be issued a license provided:
(1) the owner(s) and/or authorized representative(s) have submitted a license application pursuant to this Subpart;
(2) if inspected, the bank has corrected any deficiencies found; and
(3) the bank is competently staffed, properly equipped and operated in accordance with the law. In making such a determination, the department may consider the factors listed in subdivision (e) of this section with respect to the bank, the director(s) and owner(s) of the bank, and any affiliated person, including parties with a controlling interest.
(e) In determining whether to deny a license, the department may consider the following factors with respect to the tissue bank or nontransplant anatomic bank director(s) and owner(s), and any affiliated person, including parties with a controlling interest:
(1) false representation or omission of a material fact in filing the license application or during inspection;
(2) failure to supply further information necessary to process the license application, within three months of the department's written request, without satisfactory explanation;
(3) conviction of any crime or sustained charges of administrative violations of State or Federal laws, rules and regulations, related to the operation of a site performing health care services or a funeral directing firm, including, but not limited to, the Public Health Law or related statutes;
(4) the employment of unqualified technical personnel or an insufficient number of such personnel or support personnel;
(5) a pattern of deficiencies on on-site inspection, especially in areas of quality assurance, management, and handling of regulated medical waste and radioactive materials, including:
(i) refusal or inability to produce records or reports as requested by department employees;
(ii) failure to correct deficiencies from inspection to inspection;
(iii) deviation from regulations and/or accepted standards so as to jeopardize the quality of tissue services provided or pose a hazard to employees, donors, recipients or the public; and
(iv) refusal to provide department employees with access to the premises;
(6) knowing acceptance of tissue requisitions from or provision of tissue services or tissue to a person or persons not authorized by law to provide such services, or possess or use such tissue;
(7) failure of the director to be on the premises for an adequate amount of time and adequately supervise technical personnel to ensure the proper performance of all tissue services provided;
(8) failure to establish and follow procedures for disposal or handling of tissue or infectious or radioactive medical waste, as determined by the governing State and Federal agencies, or disposal in a manner which endangers the public, the employees, or the environment; and
(9) whether the bank is in compliance with the technical requirements specified in this Subpart, Subpart 52-3 of this Part and/or the Subpart specific to each category of tissue.
(f) License denial.
(1) If the department proposes to deny a license to a tissue bank or nontransplant anatomic bank, the bank shall be given written notice of the proposed denial, stating the reason or reasons for the denial. Such notice shall be sent by certified mail and shall be a final determination to be effective 30 days from the date of the notice unless reconsideration is requested pursuant to paragraphs (3), (4) and (5) of this subdivision.
(2) Denial of a license shall preclude the applicant from operating a tissue bank or nontransplant anatomic bank in New York State, either directly or indirectly through any other person.
(3) If the department gives notice of proposed denial of a license, the applicant may request reconsideration of the proposed denial by submitting a written request for reconsideration to the department within 30 days of the date of the notice. Submission of a request for reconsideration within 30 days shall stay any action to deny a license, pending the department's decision regarding such reconsideration.
(4) The written request for reconsideration shall include all information the applicant wishes to be considered, including any written documentation which would controvert the reason for the denial or disclose that the denial was based upon a mistake of fact.
(5) Within 90 days of receipt of the request for reconsideration, the department shall review its initial determination to deny a license and shall issue a written determination after reconsideration. The determination after reconsideration may affirm, revoke, or modify the proposed denial, allow issuance of a license conditional on maintenance of corrective action, or require that the applicant take corrective action. Such determination shall be the final decision of the department.
(6) No license application shall be considered for any applicant who is substantially the same as an applicant who has been denied a license within six months of the final determination of the department denying such application. In the event an applicant has received two successive license denials, no license application shall be considered for that applicant within two years of the last final determination of the department denying a previous application.
(7) In addition to any penalties provided under the Public Health Law and Penal Law, falsification or failure to make full disclosure on a license application shall be deemed to constitute, in itself, a bar to obtaining a tissue bank or nontransplant anatomic bank license in New York State.
(g) A tissue bank license shall list the categories of tissue and types of tissue services offered, as defined in section 52-1.1(aa) and (ad) of this Subpart, respectively. Such license shall be conspicuously posted on the premises of the bank.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.23 Supervision
(a) Personnel.
The requirements of this subdivision do not apply to pools described in section 6-1.2(o) of this Subpart.
(1)
(i) When a swimming pool, spa pool, or wading pool is part of a temporary residence or a campground, as defined in Part 7 of this Title, the operator must provide either Supervision Level IIa, IIb, III, or IV aquatic supervision. When Supervision Level III or IV is selected, on-premise CPR certified staff is not required. The temporary residence or campground operator must notify the permit-issuing official in writing of the supervision level selected and at least 15 days before making any subsequent changes to the supervision level selected for each swimming pool.
(ii) The operator of a temporary residence or campground bathing facility described in subdivision (i) of this paragraph shall not allow the use of the temporary residence or campground bathing facility by persons other than registered overnight patrons of the temporary residence or campground and their guests when Supervision Level III or IV is selected.
(2) The supervision level required at each swimming pool, other than those described in paragraph (1) of this subdivision, will be determined based on the following:
(i) Supervision Level IIa or IIb is required for all white water slides, wave pools or aquatic amusements and when any of the following are present: water depth is five feet or greater; diving boards; flotation devices (other than those bearing a U.S. Coast Guard Type I-III label); pool deck slides; surface area of the pool exceeds 2,000 square feet.
(ii) Supervision Level III is required at spa and wading pools.
(iii) Supervision Level IV is required when the water depth is less than five feet and the surface area of the pool is less than or equal to 2,000 square feet.
(3) Aquatic supervisory staff must meet the requirements of section 6-1.31 of this Subpart or section 6-2.20(a) of this Part. When a facility voluntarily provides aquatic supervisory staff or a supervision level exceeding those required by this section, all the requirements of this Subpart relative to supervision are applicable.
(4)
(i) At least one aquatic supervisory staff of at least the required supervision level shall be provided for each 3,400 square feet of pool surface area or fraction thereof at pools required to use Supervision Levels II-III personnel. When pools exceed 3,400 square feet of pool surface area at least one additional aquatic supervisory staff shall be provided when the number of bathers exceeds or is likely to exceed 50 percent of the pool bather capacity, based on 25 square feet of pool surface area per bather. Pool operators may limit the portions of the pool open to bathers and provide the required aquatic supervisory staff consistent with the pool area open.
(ii) Adequate aquatic staff (Level II-III) must be provided for visual surveillance of the entire pool area(s) that are open to bathing.
(5) Additional aquatic supervisory staff may be required by the permit-issuing official whenever it is necessary for the protection of the pool patrons (bathers). Factors, including but not limited to, pool shape, diving board use, patron decorum, patron alcohol consumption; and, bathing facilities used primarily for the developmentally disabled may be the basis for increased coverage.
(6) The aquatic supervisory staff shall be at pool side, providing direct supervision of the pool patrons, except at pools requiring Supervision Level IV and spa pool facilities. At spa pools the Supervision Level III aquatic staff shall be on premises and shall provide periodic supervision as specified in the safety plan. Aquatic supervisory staff on duty shall be engaged only in activities that involve the direct supervision of bathers. When instructional activities occur, including but not limited to learn to swim programs, physical education classes and swim team activities, and the supervisory staff required by paragraphs (4) and (5) of this subdivision provide the instruction, at least one additional staff meeting at least Supervision Level III must be provided for each aquatic supervisory staff engaging in instructional activities. When a Supervision Level III staff is utilized to assist a Supervision Level II staff with direct supervision of bathers during instruction, the Supervision Level III staff must possess certification in aquatic injury prevention and emergency response as specified in section 6-1.31(c)(2) of this Subpart. The written safety plan must describe the duties, positioning at pool side and interaction between the Supervision Level II and III staff which ensures adequate bather supervision and emergency response.
(7) At wave pool facilities, a minimum of three aquatic staff of Supervision Level II, two of whom are in lifeguard chairs equipped with equipment that will immediately stop the wave-making machine, shall be present whenever the wave-making machine is in operation.
(8) Swimming pools required to have Supervision Level II aquatic staff shall provide a supervising lifeguard when the facility is required to provide three or more aquatic staff.
(9) The facility operator shall be responsible for verification of aquatic supervisory staff qualifications. Copies of the certificates or other documents showing possession of such qualifications shall be kept on file at the site and made available to the permit-issuing official upon request.
(10) A swimming pool permitted to use Supervision Level IV, shall comply with the following pool use rules:
(i) Two or more adults, 18 years of age or older, must be present at the pool when the bathing facility is in use, with at least one adult on the pool deck.
(ii) Supervision Level IV facility personnel shall be on premises at all times the pool is in use and will conduct at least one visual check daily, prior to operation/use. The visual check shall confirm the pool is in compliance with the requirements of this Subpart, including safety equipment and water quality. Upon completion of these inspections, the personnel signs the log, and records the time of inspection and number of persons using the pool. A log is to be provided and maintained by the facility operator to record time of the periodic inspection(s) and other required information.
(iii) Children less than 16 years of age must at all times be accompanied by a parent or guardian or similar adult responsible for their safety and behavior while at the bathing facility.
(iv) A free telephone conveniently located must be provided at the facility with posted numbers for the nearest emergency service (police, fire department, ambulance, hospital).
(v) Required safety equipment must be provided at poolside unless otherwise specified in the safety plan.
(vi) Warning signs of a minimum 36″ × 24″ size with safety conditions and methods for summoning CPR certified individual, when CPR trained staff is required, must be posted. The warning sign must state:
Two or more adults, 18 years of age or older, must be present at the pool when the bathing facility is in use, with at least one adult on the pool deck.
Children less than 16 years of age must at all times be accompanied by an adult responsible for their safety and behavior while at the bathing facility.
Shallow Water - No Diving (for pools with water depths less than eight feet).
Method of summoning on-premise CPR staff (only where CPR trained staff is required).
Location of free telephone and numbers to contact.
(vii) The bathing facility operator shall provide to all patrons a written statement or brochure. Only patrons who have received this statement may use the bathing facility. The brochure or statement must state at least the following:
NEVER SWIM ALONE. A minimum of two adults, 18 years of age or older, must be present whenever this swimming facility is in use, with at least one adult remaining on the pool deck.
THERE IS NO SUBSTITUTE FOR ADEQUATE SUPERVISION. Children under 16 years of age must be accompanied to the bathing facility by a parent or guardian, (an adult who is responsible for the children and their behavior.)
IN AN EMERGENCY, NOTIFY THE FACILITY OPERATOR AND CONTACT HELP AS SOON AS POSSIBLE. A free telephone is provided at this facility (describe location). Telephone numbers for the nearest emergency medical service are posted.
Only use this facility during posted hours of operation.
Don’t drink alcohol and swim.
(b) Lifesaving equipment.
(1) Required lifesaving equipment shall be readily accessible near the swimming pool deck at all swimming pools, and kept in good repair. Minimum equipment shall include:
(i) a first aid kit, which may be any commercially prepared 24-unit kit or a supply of bandaids, bandage compresses and self-adhering gauze bandages; and a pocket face mask or face shield with a one way valve to assist with CPR;
(ii) at Supervision Level IIa or IIb swimming pools: one rescue tube with an attached line for each lifeguard required by this section; one reaching pole at least 15 feet long; and a full-size commercially available spine board or a spine board six feet long and a minimum 16 inches wide provided with straps to aid in immobilization of a victim and hand holds; and
(iii) at Supervision Level IV swimming pools, temporary residence swimming pools using Supervision Level III in accordance with subparagraph (a)(1)(ii) of this section, or homeowner swimming pools as defined in section 6-1.2(o) of this Subpart: two U.S. Coast Guard approved ring buoys at least 18 inches in diameter fitted with a quarter-inch diameter line a length of 1.5 times the maximum width of the pool or 50 feet whichever is less, and a reaching pole at least 15 feet long.
(2) Elevated lifeguard chairs shall be provided at all pools greater than 2,000 square feet that utilize Supervision Level IIa or IIb aquatic supervisory staff. One elevated lifeguard chair is required for each 3,400 square feet of pool surface area or fraction thereof. The chairs shall be located so as to provide a clear, unobstructed view of the pool bottom in the pool area under surveillance and be in compliance with section 6-1.29, item 6.2, of this Subpart.
(c) Safety plan.
Operators of swimming pools must develop, update and implement a written pool safety plan, consisting of procedures for daily bather supervision, injury prevention; reacting to emergencies, injuries, and other incidents, providing first aid and summoning help. The safety plan shall be approved by the permit-issuing official and kept on file at the pool. Approval will be granted when all the components of this section are addressed so as to protect the health and safety of the bathers, and the plan sets forth procedures to insure compliance with this Subpart.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.5 Ice
Ice that is consumed or that touches food is to be made from potable water from approved sources in a manner that protects it from contamination. Such ice is to be obtained only in chipped, crushed, or cubed form and in single-use safe plastic or wet-strength paper bags filled and sealed at the point of manufacture. The ice is to be held in these bags until it is dispensed in a way that protects it from contamination.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.5 Review process
The department shall review applications pursuant to this Subpart, in consultation with the Attorney General and, as appropriate, the mental hygiene agencies. The factors to be considered in evaluating applications shall include, but shall not be limited to:
(a) the financial condition of the parties to the cooperative agreement, including whether any health care provider party is experiencing financial distress and may be forced to cease operations or eliminate a service in the absence of the cooperative agreement;
(b) the dynamics of the relevant primary service area, including the availability of suitable and accessible health care services and the level of competition in the primary service area, the likelihood that other health care providers will enter or exit the primary service area, the health care workforce and the existence of unique challenges such as difficulties in recruiting and retaining health care professionals;
(c) the potential benefits of a cooperative agreement or planning process, including but not limited to the likelihood that one or more of the following may result from such cooperative agreement or planning process:
(1) preservation of needed health care services in the relevant primary service area that would be at risk of elimination in the absence of a cooperative agreement;
(2) improvement in the nature or distribution of health care services in the primary service area, including expansion of needed health care services or elimination of unnecessary health care services;
(3) enhancement of the quality of health care provided by the parties to the cooperative agreement;
(4) expansion of access to care by medically-underserved populations;
(5) lower costs and improved efficiency of delivering health care services, including reductions in administrative and capital costs and improvements in the utilization of health care provider resources and equipment; or
(6) implementation of payment methodologies that control excess utilization and costs, while improving outcomes;
(d) the potential disadvantages of a cooperative agreement or planning process, including but not limited to the likelihood that one or more of the following may result from such cooperative agreement or planning process:
(1) increased costs or prices of health care in the primary service area resulting from the cooperative agreement, after taking into consideration improvements in quality and outcomes;
(2) diminished quality, availability, and efficiency of health care services;
(3) inability of health care payers or health care providers to negotiate reasonable payment and service arrangements; or
(4) reduced competition among physicians, allied health professionals, other health care providers, or other persons furnishing goods or services to, or in competition with, health care providers and the potential for adverse health system quality, accessibility and cost consequences;
(e) the availability of arrangements that are less restrictive to competition and achieve the same benefits or a more favorable balance of benefits over disadvantages attributable to any reduction in competition;
(f) other benefits or disadvantages identified in the course of review; and
(g) the extent to which active supervision is likely to mitigate the disadvantages.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 708 APPROPRIATENESS REVIEW
10 CRR-NY 708.2 Definitions
(a) For the purposes of this Part, the following terms shall have the following meanings:
(1) A finding of appropriateness means a finding that a hospital service or home care service substantially meets the criteria set forth in this Part.
(2) Areawide review means the review of a specific hospital service or home care service as delivered by all providers of such service in a health service area of the State which:
(i) shall culminate in findings regarding the appropriateness of what service over the entire health service area or the State; and
(ii) may result in institution-specific findings.
(3) Areawide finding means a finding regarding the appropriateness of a specific hospital service or home care service as delivered by all providers of such service in a health service area or the State which is based on the areawide review of the service in accordance with the criteria set forth in this Part.
(4) Institution-specific finding means a finding regarding the appropriateness of a specific hospital service or home care service as delivered by a specific provider which is based on the areawide review of the service in accordance with the criteria set forth in this Part.
(5) Hospital service means a health service which:
(i) is provided by a hospital or other provider as defined in article 28 of the Public Health Law, including hospital services and health-related services as define therein; and
(ii) is offered at the time of review for appropriateness, or was offered in the 12 months prior to the review and also will be offered in the 12 months following the review, or which will be offered during the 12 months following the review.
(6) Home care service means a home care service as defined in article 36 of the Public Health Law which:
(i) is provided by a certified home health agency as defined in article 36 of the Public Health Law; and
(ii) is offered at the time of the review for appropriateness, or was offered in the 12 months prior to the review and also will be offered in the 12 months following the review, or which will be offered during the 12 months following the review.
(7) Affected persons include: the persons or entities whose service is being reviewed; the State Health Planning and Development Agency having jurisdiction; the health systems agency for the health service area in which the service is offered; health systems agencies serving contiguous health service areas; other hospitals and certified home health agencies within the health service area; any agency which establishes rates for hospitals or certified home health agencies; and members of the public who regularly use the service being reviewed.
(8) State Health Plan means the plan required to be developed by the State Health Planning and Development Agency and the Statewide Health Coordinating Council pursuant to the provisions of the National Health Planning and Resources Development Act of 1974, Public Law 93-641, as amended.
(b) The services subject to review are defined as follows:
(1)
(i) Burn care services is that care provided to burn patients in a facility having the capability, equipment and personnel to provide those highly skilled treatment measures required by such victims. Three degrees of severity of burn injury are identified to define the level of treatment:
(a) Major burn injury is at least a second degree burn requiring hospitalization of the patient whose chances of survival are less than 95 percent or whose injury frequently results in disability. A 95 percent chance of survival can generally be described as a second degree burn of greater than 25 percent total body surface area (TBSA) in persons between the ages of 15 and 35 years, and greater than 20 percent TBSA in children younger than 15 years and adults between 35 and 60 years of age, and all burns involving poor-risk patients, that is anyone older than 60 years and anyone with a positive history of chronic and severe illness. Also included in this category are all third degree burns of 10 percent TBSA or greater, all burns significantly involving the hands, face, eyes, ears, feet or perineum, all circumferential burns, all serious inhalation injuries, and all electrical burns and complicated burn injuries involving fractures or other major trauma.
(b) Moderate uncomplicated burn injury is a burn injury requiring hospitalization and generally described as a second degree burn of less than 25 percent TBSA but more than 15 percent in persons between the ages of 15 and 35 years, and between 10 percent and 20 percent in children younger than 15 years and in adults between 35 and 60 years of age, and a third degree burn of less than 10 TBSA but more than 2 percent. Excluded from this category are all poor-risk patients, that is, anyone older than 60 years and anyone with a positive history of chronic and severe illness, all burns significantly involving the eyes, ears, face, hands, feet or perineum, all circumferential burns, all serious inhalation injuries, and all electrical burns and complicated burn injuries involving fractures or other major trauma.
(c) Minor burn injury is a second degree burn of less than 15 percent TBSA in persons between the ages of 15 and 35, and less than 10 percent TBSA in children younger than 15 years and in adults between 35 and 60 years of age, and a third degree burn of less than two percent. Excluded from this category are all poor-risk patients, that is, anyone older than 60 years and anyone with a positive history of chronic and severe illness, all burns significantly involving the eyes, ears, face, hands, feet or perineum, all circumferential burns, all serious inhalation injuries, and all electrical burns and complicated burn injuries involving fractures or other major trauma.
(ii) Burn care takes place in the following treatment settings:
(a) Burn unit/center —a facility with a discrete intensive care unit, dedicated beds, highly skilled staff and equipment and which treats major burn victims.
(b) Burn program —a facility with the trained personnel and equipment to provide complete care of moderate uncomplicated burn injuries including rehabilitation.
(c) Hospital emergency room —a facility treating minor burn injuries and providing emergency care for moderate and major burn injuries until appropriate referral transfer can take place.
(2) [ Reserved ]
(3)
(i) End stage renal disease (ESRD) is a stage of renal impairment that appears irreversible or permanent and requires a regular course of dialysis or transplantation to maintain life.
(ii) Dialysis is a process by which dissolved substances are removed from a patient's body by diffusion from one fluid compartment to another. The two types of dialysis in common use are:
(a) hemodialysis, which is a process utilizing an artificial kidney to remove fluids and metabolic end products from the bloodstream; and
(b) peritoneal dialysis, which is a process utilizing a natural semi-permeable membrane surrounding the peritoneal cavity to remove toxic metabolic waste products from the patient's bloodstream. This process takes place within the patient's body.
(iii) Transplantation is a process by which ( a ) a kidney is excised from a live or cadaveric donor, ( b ) that kidney is implanted in an ESRD patient, and ( c ) supportive care is furnished to the living donor and to the recipient following implantation.
(iv) Acute short-term dialysis is dialysis required by some persons on a short-term emergency basis as a result of a disease or accident.
(v) End stage renal disease can be treated in such settings as specified in section 757.1 of this Subchapter.
(vi) Self-dialysis is dialysis performed with little or no professional assistance by an ESRD patient who has completed an appropriate course of training.
(vii) Home dialysis training is a program that trains ESRD patients to perform self- dialysis or home dialysis with little or no professional assistance, and trains other individuals to assist patients in performing self-dialysis or home dialysis.
(viii) Need and utilization of the service will be determined using the following factors:
(a) certified capacity, which is the number of stations approved to accommodate chronic renal dialysis patients per patient shift;
(b) station, which is the combination of the chair, the water and electrical supply and the machine for treatment of the chronic renal patient; and
(c) a patient shift, which is the length of time required to dialyze one patient, usually 4-5 hours.
(4)
(i) Computed tomography is a technique where a sharply collimated X-ray beam is passed from the gantry through the body from a source which rotates around the body in a specific arc. As the beam passes through the body from its perimeter, its intensity is reduced. The transmitted intensity of the beam varies in accordance with the density of the tissue it passes through and is measured by sensitive detectors and, from this information, cross- sectional pictures or other images may be generated. A computer is used to generate the image from the measurements of X-ray beam intensity. Tissue images can be done with or without contrast agents. Computed tomography services are rendered by computed tomography (C.T.) scanners.
(ii) Computed tomography scanner is an imaging machine which combines the information generated by a scanning X-ray source and detector system with a computer to reconstruct an image of the full body, including the head.
(iii) Scan or a patient procedure includes the initial image plus any additional images relating to the same area of diagnostic interest occurring during a single visit.
(iv) A host facility for the purposes of this Part is a hospital which is certified to provide computed tomography services and houses a computer tomography scanner. A host facility provides services to members of a computed tomography scanner consortium and/or other institutions not certified for computed tomography services.
(v) Computed tomography scanner consortium for purposes of this Part is a formal referral network of hospitals, all of which are certified to provide computed tomography scanning services which are provided by a host facility.
(5) [ Reserved ]
(6)
(i) Comprehensive physical medicine and rehabilitation. Rehabilitation is the process of providing, in a coordinated manner, those comprehensive services deemed appropriate to the needs of a person with a disability, in a program designated to achieve objectives of improved health, welfare, and realization of one's maximum physical, social, psychological, and vocational potential for useful and productive activity.
(ii) A comprehensive inpatient physical medicine and rehabilitation program is a distinct organizational unit within a general hospital, a rehabilitation hospital, residential health care facility which provides coordinated and integrated services that include evaluation and treatment, and emphasizes education and training of those served. The program is applicable to those individuals who require an intensity of services which includes, as a minimum, physician coverage 24 hours per day, seven days per week, with daily (at least five days per week) medical supervision, complete medical support services including consultation, 24-hour-per-day nursing, and daily (at least five days per week) multidisciplinary rehabilitation programming for a minimum of three hours per day.
(a) A spinal cord injury program provides coordinated and integrated services for spinal cord injured persons, whether from trauma or disease, within a designated area (beds) within a facility providing a comprehensive physical medicine and rehabilitation program, enabling those served to achieve optimal functions. A spinal cord injury program is consistent with the standards for a comprehensive inpatient physical medicine and rehabilitation program.
(b) A brain injury program is an intensive rehabilitation program designed to prevent and/or minimize chronic disabilities while restoring the individual to the optimal level of physical, cognitive, and behavioral functioning. Persons served are generally not in a chronic vegetative state and the population of the unit consists primarily of those with traumatically acquired, nondegenerative, structural brain damage resulting in residual deficits and disability. Inclusion of other cerebral disorders should be based upon age, disability profiles, and service needs. The program is not intended to function as a stroke rehabilitation program, although some persons with a cerebral vascular accident may be served. A brain injury program is consistent with the standards for a comprehensive inpatient physical medicine and rehabilitation program.
(iii) Outpatient physical medicine and rehabilitation is a program of coordinated and integrated evaluation and/or treatment services with emphasis on education and training of those served. It is applicable to those individuals with disabling impairments requiring an intensity of services including, as a minimum: medical supervision, medical support services and consultation, patient education, and appropriate allied therapies.
(7)
(i) Emergency departments and emergency services. Emergency departments and emergency services consist of staff, facilities and resources to evaluate, initially manage, treat or transfer patients to another facility that can provide definitive treatment.
(ii) An emergency visit is any unscheduled visit to the emergency facility.
Emergency care begins in the prehospital setting, continues in the emergency facility, and concludes when the responsibility for the patient is transferred to another physician or the patient is discharged. The care of the patient during the continuum of emergency care is under the direction of the emergency physician who is responsible for the timely evaluation, treatment and transfer of the patient.
Chapter III PUBLIC WATER SUPPLIES
Subchapter C WATER SUPPLY SOURCES
Part 170 SOURCES OF WATER SUPPLY
10 CRR-NY 170.3 Definitions
As used in this Part, the following words and phrases shall have the following meanings:
(a) Potable water means water suitable for drinking, culinary or food processing purposes.
(b) Protected from contamination includes, in addition to responsibility for the prevention of contamination, responsibility for the reservation, surveillance, storage, diversion, collection, treatment, processing, distribution and use of water for domestic and municipal purposes.
(c) Source of water supply means any ground water, aquifer, surface water body or water course from which by any means water is regularly taken either periodically or continuously for drinking, culinary or food processing purposes or which has been classified for present or future public beneficial use as a source for domestic or municipal purposes.
(d) Contamination means any substance or characteristic which will make the water unsuitable or unsafe including a constituent or characteristic in an amount exceeding the allowable limits therefor hereinafter set forth.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.21 Capital cost reimbursement for propietary LTHHCPs
(a) Reimbursement for capital costs shall be allowable in determining rates for proprietary LTHHCPs. These costs shall be included as such costs are allocated from a related organization to the extent that:
(1) those costs are reasonably related to the efficient production of long-term home health care services; and
(2) the bases of allocation of such costs are consistent with regulations applicable to the cost reporting of the related organization.
(b) Any capital expenditures associated with non-arms length leases shall be approved and certified to, if required, pursuant to article 36 of the Public Health Law. In the computation of rates for non-arms length leases, the capital cost shall be included in allowable costs only to the extent that it does not exceed the amount which the LTHHCP would have included in allowable costs if it had legal title to the asset (the cost of ownership), such as straight-line depreciation, insurance, and interest. Accelerated depreciation on these assets may not be included in allowable costs under any circumstances.
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.31 Mergers, acquisitions and consolidations
(a) Rates of payment.
As used in this section, the terms merger, acquisition and consolidation shall mean the combining of two or more general hospitals licensed under article 28 of the Public Health Law, where such combination is consistent with the public need, would create a new, more economical entity, reduce the costs of operation, result in the reduction of beds and/or improve service delivery. In order to be eligible for reimbursement pursuant to this section, the applicant facility must have previously received a certificate of need (CON) approval by the commissioner and/or Public Health Council approval for the merger, acquisition, or consolidation pursuant to the Public Health Law. Payments for hospitals subject to a merger, acquisition or consolidation for inpatient acute care services that are not otherwise exempt from DRG case-based rates of payment will be effective on the date the transaction is effected and shall be computed in accordance with this Subpart except as follows:
(1) The WEF used to adjust the statewide base price shall be calculated by combining all components used in the calculation pursuant to section 86-1.19 of this Subpart for all hospitals subject to the merger, acquisition or consolidation.
(2) The direct GME payment per discharge added to the case payment rates of teaching hospitals shall be calculated by dividing the total reported Medicaid direct GME costs for all teaching hospitals subject to the merger, acquisition, or consolidation by the total reported Medicaid discharges reported by such hospitals in the applicable base period.
(3) The indirect GME payment per discharge added to the case payment rates of teaching hospitals shall be calculated in accordance with section 86-1.20 of this Subpart, except the ratio of residents to beds used in the calculation shall be based on the total residents and beds of all such hospitals subject to the merger, acquisition, or consolidation.
(4) The non-comparable payment per discharge added to the case payment rates shall be calculated by dividing the total reported Medicaid costs for qualifying non-comparable cost categories for all hospitals subject to the merger, acquisition, or consolidation by the total reported Medicaid discharges reported by such hospitals in the applicable base period.
(b) Closures, mergers, acquisitions, consolidations and restructurings.
(1) The commissioner may grant approval of a temporary adjustment to the non-capital components of rates calculated pursuant to this Subpart for eligible general hospitals.
(2) Eligible facilities shall include:
(i) facilities undergoing closure;
(ii) facilities impacted by the closure of other health care providers;
(iii) facilities subject to mergers, acquisitions, consolidations or restructuring; or
(iv) facilities impacted by the merger, acquisition, consolidation or restructuring of other health care providers.
(3) Facilities seeking rate adjustments under this section shall demonstrate through submission of a written proposal to the commissioner that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:
(i) protect or enhance access to care;
(ii) protect or enhance quality of care;
(iii) improve the cost effectiveness of the delivery of health care services; or
(iv) otherwise protector enhance the health care delivery system, as determined by the commissioner.
(4)
(i) Such written proposal shall be submitted to the commissioner at least 60 days prior to the requested effective date of the temporary rate adjustment and shall include a proposed budget to achieve the goals of the proposal. Any temporary rate adjustment issued pursuant to this section shall be in effect for a specified period of time as determined by the commissioner, of up to three years. At the end of the specified timeframe, the facility shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and this Subpart. The commissioner may establish, as a tion of receiving such a temporary rate adjustment, benchmarks and goals to be achieved inconformity with the facility's written proposal as approved by the commissioner and may also require that the facility submit such periodic reports concerning the achievement of such benchmarks and goals as the commissioner deems necessary. Failure to achieve satisfactory progress, as determined by the commissioner, in accomplishing such benchmarks and goals shall be a basis for ending the facility's temporary rate adjustment prior to the end of the specified timeframe.
(ii) The commissioner may require that applications submitted pursuant to this section be submitted in response to and in accordance with a request for applications or a request for proposals issued by the commissioner.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASE CONTROL
10 CRR-NY 40-2.21 Tuberculosis; performance standards
The local health department shall maintain a program designed to minimize the incidence of tuberculosis. The program shall include, at a minimum, activities to ensure:
(a) timely tuberculosis surveillance and reporting;
(b) detection and follow-up with individuals identified as infected with tuberculosis, including contact investigations performed in close collaboration with healthcare facilities, schools, workplaces, and other settings;
(c) provision of clinical services for tuberculosis disease or infection, either directly, through referral, or by contract;
(d) provision, or activities to ensure provision, of directly observed therapy for persons with tuberculosis, regardless of whether the local health department is the primary medical provider; and
(e) distribution of at least one communication per year to healthcare providers, clinics and laboratories regarding local and regional morbidity rates, CDC guidelines, diagnostic and treatment modalities, and department reporting requirements for tuberculosis.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.2 Qualifications of donors
(a) The medical director shall be responsible for the determination that blood may be collected safely from a donor and that the donor's blood is acceptable for collection. This determination shall be made by the medical director or trained staff members under the medical director's supervision on the day of collection of the blood. In addition, autogeneic collections prior to anticipated surgery or other medical procedure shall require the written authorization of the donor's health care provider and written consent of the donor. If autogeneic blood is to be subsequently used for allogeneic transfusion, all requirements in subdivision (f) of this section must be met.
(b) Only those persons may be accepted as donors of blood for allogeneic use who are in good health as indicated by:
(1) freedom from infectious skin lesions at the phlebotomy site and from any infectious skin disease generalized to an extent that creates a risk of contamination of the blood;
(2) freedom from any disease transmissible by blood transfusion, insofar as can be determined by history and examinations required in this Subpart;
(3) freedom from active tuberculosis. A person with a history of tuberculosis may be accepted as a blood donor following completion of drug therapy;
(4) freedom from syphilis. However, blood for plasma fractionation into heat-treated or pathogen-inactivated derivatives may be accepted;
(5) freedom from a history of viral hepatitis for a duration specified by the United States Public Health Service;
(6) freedom from a history of malaria or travel to or residence in malarially endemic areas for periods of time considered to increase risks for malaria exposure, as determined by the United States Public Health Service. However, plasma for transfusion or fractionation may be accepted from donors with a history of malaria or travel to a malarially endemic area;
(7) freedom from signs and symptoms of human immunodeficiency virus (HIV) infection; and
(8) freedom from other medical contraindications.
(c) For allogeneic collection, a person may not be accepted as a blood donor:
(1) whose health may be affected adversely by the bleeding;
(2) who has received a transfusion of blood or blood components within the past year, with the exception of autogeneic transfusion;
(3) who is under 17 years of age, except that donors who are 16 years of age may be accepted, if they have presented written permission specific to the occasion from a parent or guardian;
(4) who is 76 years of age, or older, except that donors who are 76 or older may be accepted at the after satisfactory case-by-case review of the donor by the medical director or his/her designee;
(5) who is known to use or presents indications of having used illegal injectable drugs;
(6) whose oral temperature exceeds 37.5 degrees Celsius (99.5 degrees Fahrenheit);
(7) whose pulse after resting is faster than 110 or slower than 45 beats per minute, except if the donor is an athlete with high exercise tolerance; or whose pulse exhibits pathologic irregularities;
(8) whose systolic blood pressure exceeds 180 millimeters of mercury, or whose diastolic pressure exceeds 100 millimeters;
(9) whose weight is less than 50 kilograms (110 pounds), except that a donor whose weight is between 40 kilograms (88 pounds) and 50 kilograms (110 pounds) may donate a volume proportionate to the donor's weight, provided that the anticoagulant is proportionately reduced and the container is appropriately labeled;
(10) whose hemoglobin content is less than 12.5 grams per deciliter or whose hematocrit is less than 38 percent, as determined by techniques found by the department to meet medical standards generally accepted in New York State;
(11) who is known ever to have received pituitary-derived human growth hormone; or
(12) who falls into a category of individuals determined by the United States Public Health Service to be unsuitable for blood donation.
(d) For allogeneic collection:
(1) All donors shall be given educational materials on risk activities for HIV infection and shall be advised that persons at risk for HIV infection should refrain from donating blood.
(2) Each donor shall be provided the opportunity to indicate confidentially, at the time of donation or after donation, that blood collected may be unsuitable for transfusion.
(e) For autogeneic collection only:
(1) There are no age limits.
(2) The hemoglobin concentration of the donor-patient should be no less than 11 grams per deciliter, or the hematocrit, if substituted, should be no less than 33 percent, unless otherwise approved in writing by the medical director of the blood bank or other physician designated by such medical director.
(3) The frequency of phlebotomy for autogeneic transfusion shall be determined by the medical director of the blood bank and the donor-patient's physician. Phlebotomy of the donor-patient within 72 hours of the time of the anticipated surgery or transfusion must be authorized in writing by the medical director or other physician designated by the medical director.
(4) Donation for autogeneic transfusion should not be undertaken if medically contraindicated.
(f) Blood withdrawn for autogeneic transfusion may not be used for allogeneic transfusion unless the donor meets all the criteria set forth in subdivision (b), and paragraphs (c)(2), (5) and (6) of this section, and the unit meets the requirements set forth in section 58-2.3(a) of this Subpart. The minimum hemoglobin concentration for such a unit shall be 12.5 grams per 100 milliliters or a hematocrit of 38 percent, and the minimum volume for such a unit shall be 405 milliliters.
(g) Blood withdrawn in order to promote the health of a donor otherwise qualified under the provisions of this section shall not be used for transfusion unless the container label indicates the donor's disease that necessitated withdrawal of blood, except that, in the case of a donor with hemochromatosis, blood without such labeling may be used for transfusion, provided that the blood bank has demonstrated that therapeutic phlebotomy is available free of charge to hemochromatosis patients and that all other requirements of this Subpart have been met.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.12 Disposition of unused tissue
(a) All musculoskeletal tissue determined to be unsuitable for transplantation, or education or research purposes authorized by Public Health Law section 4302 shall be discarded pursuant to Part 70 of this Title. Packaging of musculoskeletal tissue for destruction shall be designed to obscure the contents.
(b) Musculoskeletal tissue returned by the tissue transplantation facility for possible reissuance shall meet all storage and transport requirements of this Part. The musculoskeletal tissue bank shall not reissue tissue returned by the tissue transplantation facility, unless written criteria approved by the tissue bank medical director are met.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.1 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) Administrative law judge means a person designated by the Commissioner of Health to conduct hearings under sections 60-1.6, 60-1.11 and 60-1.12 of this Subpart. The commissioner may delegate to the Administrative Law Judge the power to render final decisions in these matters.
(b) Adverse action shall mean the imposition of monetary penalties, suspension or disqualification from, or the denial of participation in the WIC program. It shall not mean nonrenewal of a contract, the term of which has expired, nor notification to a vendor to cease and desist from depositing WIC checks in the vendor's bank account.
(c) Applicant means a person who submits an application to a local agency for its determination of his/her eligibility to receive supplemental foods under the WIC program.
(d) Categorically ineligible means not meeting the definition of pregnant women, breastfeeding women, postpartum women, or infant or child as set forth in subdivision (m) of this section.
(e) Commissioner means the Commissioner of Health of the State of New York.
(f) Conference means a meeting prior to a request for a fair hearing, between a representative of a local agency and an applicant or participant who is aggrieved by the determination or action of such agency, to discuss such determination or action.
(g) Department shall mean the New York State Department of Health.
(h) Fair hearing means the procedure under section 60-1.6 and 60-1.12 of this Subpart by which applicants, participants, food vendors and local agencies may appeal certain determinations or actions of a local agency or of the State agency.
(i) FNS means the Food and Nutrition Service of the United States Department of Agriculture.
(j) Food instrument means a WIC check, drawn on the account of the State Department of Health exchangeable for WIC-approved products.
(k) Food vendor means any establishment which accepts WIC food instruments whether contracted to do so or not.
(l) Local agency means an agency which has contracted with New York State to provide WIC benefits to participants.
(m) Participant means a person who is a pregnant woman, a breastfeeding woman for up to one year postpartum, a postpartum women up to six months following delivery, an infant under one year of age, or a child between one and five years of age, or their representative, who is receiving supplemental foods or food instruments under the WIC program.
(n) Persons with a special nutritional risk condition means pregnant women at nutritional risk as demonstrated by hematological or anthropometric measurements, or other documented nutritionally related medical conditions which demonstrate the need for supplemental foods, infants under six months of age, and members of migrant farm worker households who plan to leave the jurisdiction of the local agency.
(o) Petitioner means an applicant, participant or his/her parent or guardian, food vendor or local agency who requests a hearing from the department.
(p) Respondent means a food vendor or local agency from whom the department seeks a monetary penalty under the provisions of section 60-1.11 of this Subpart.
(q) WIC food vendor means a food vendor which has a contract in effect with a local agency to supply supplemental foods to persons receiving benefits under the WIC program.
(r) WIC program means the Special Supplemental Food Program for Women, Infants, and Children authorized by the Federal Child Nutrition Act of 1966, as amended.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-1.13 Payment of maintenance charges
The director shall render bills at suitable intervals and a final bill as soon as practicable on discharge of the patient, to the person or agency in each instance who guaranteed payment, or, if payment is to be made from public funds, to the proper fiscal officer of the agency or the county or municipality indicated.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.277 Reclassification
The process of recasting a hospital's revenue and expense accounts into a new structure, e.g., moving from a responsibility to a functional arrangement. For purposes of this manual, the process of converting the hospital's accounts so as to comply with the prescribed reporting principles, definitions, listing of accounts and formats found in this manual. An audit trial of the conversion process must be maintained.
10 CRR-NY 441.4 Account
A formal record of a particular type of transaction expressed in money and kept in a ledger.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.91 Variance from required use of any specified treatment technique
(a) The supplier of water may request, and the department may grant, one or more variances from any treatment technique requirement, except filtration and disinfection, in accordance with section 5-1.30(b), (c) and (g) of this Subpart on a finding that such treatment technique is not necessary to protect the health of persons served by the public water system because of the raw water source or sources of such system.
(b) As a condition to the granting of a variance under subdivision (a) of this section, the supplier of water shall perform monitoring and other requirements as prescribed by the department.
(c) Notwithstanding subdivisions (a) and (b) of this section, section 5-1.30 of this Subpart shall govern the conditions under, and the manner which, a waiver of mandatory disinfection treatment for a ground source of water supply may be granted.
(d) The technologies listed in this section are the best technology, treatment techniques, or other means available for achieving compliance with the maximum contaminant levels for organic chemicals listed in section 5-1.52 table 3 of this Subpart:
)
)
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(e) The following are the best technologies, treatment techniques, or other means available for achieving compliance with the maximum contaminant levels for the inorganic chemicals and radionuclides in section 5-1.52, tables 1 and 7 of this Subpart:
)
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(f) The following are the affordable technologies, treatment techniques, or other means available to systems serving 10,000 persons or fewer for achieving compliance with the MCL for arsenic as listed in section 5-1.52 table 1 of this Subpart:
)
(g) The community water systems and nontransient noncommunity water systems must install and/or use any treatment method identified in subdivisions (d) and (e) of this section as a condition for granting a variance except as provided in subdivision (h) of this section. If after the system's installation of the treatment method, the system cannot meet the MCL, that system shall be eligible for a variance.
(h) If a system can demonstrate through comprehensive engineering assessments, which may include pilot plant studies, that the treatment methods identified in subdivisions (d) and (e) of this section would only achieve a de minimis reduction in contaminants, the State may issue a schedule of compliance that requires the system being granted the variance to examine other treatment methods as a condition of obtaining the variance.
(i) If the State determines that a treatment method identified in subdivision (g) of this section is technically feasible, the State may require the system to install and/or use that treatment method in connection with a compliance schedule. The State's determination shall be based upon studies by the system and other relevant information.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.110 Employee
As distinguished from an independent contractor, a person subject to the will and control of an employer with respect to what the employee does and how he does it, and who is on the payroll of the institution.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.1 Scope
All owners of cooling towers shall comply with this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.3 Times and places for inspecting records
(a) Records shall be available for inspection and copying by members of the public and members of the news media on every day that the offices of the department are open for the transaction of business between the hours of 8:30 a.m. and 4:45 p.m.
(b) Records may be inspected at locations designated by the appropriate records access officer, whose titles and business addresses are as set forth in section 50-14 Of this Subpart.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
AUTHORIZATION AUTHORIZATION
10 CRR-NY 43-1.7 Authorization of reimbursement for tuberculosis health care and services
(a) Tuberculosis health care services shall be paid by the local health official with jurisdiction or the State only as authorized. Authorization for local charges shall be made by the local health official where the patient resides. Authorization for State charges shall be made by the designee of the State Health Commissioner.
(b) Providers shall be deemed authorized to collect reimbursement for tuberculosis health care services when they are so notified by the local health official or designee of the State Health Commissioner, if they comply with the requirements of this Subpart.
(c) Reimbursement for inpatient hospital services for a patient hospitalized for a period in excess of six weeks during a calendar year are not authorized unless approved in writing before expiration of the six weeks. Authorization for local charges may only be made by the local health official where the patient resides. If the patient is a potential State charge, the provider shall request authorization for care beyond six weeks by writing to the local health official where the patient resides. Such health official shall recommend whether such care is justified or not to the designee of the State Health Commissioner. Authorization for State charges may only be made by the designee of the State Health Commissioner.
(d) In determining which tuberculosis health care services to authorize for a tuberculosis patient, the local health official or designee of the State Health Commissioner shall consider available alternative tuberculosis health care services and determine the most appropriate source to meet the patient's needs.
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.1 Definitions
As used in this Part, unless the context otherwise requires:
(a) Subdivision shall have the meaning ascribed to it in section 1115 of the Public Health Law.
(b) Developer means a person, partnership, corporation or other legal entity undertaking or participating in the establishment of a subdivision.
(c) Individual water supply system means a single system of piping, tanks or other facilities together with a source of water intended to supply only a single lot.
(d) Individual sewerage system means a single system of piping, tanks or other facilities serving only a single lot and disposing of sewage or other liquid wastes into the soil of the lot.
(e) Community water system means a source of water and necessary appurtenances together with a distribution system serving more than one lot, whether owned by a municipal corporation or private utility.
(f) Community sewerage system means a system utilized for the collection and disposal of sewage, or other wastes of a liquid nature, including the various devices for the treatment of such wastes serving more than one lot, whether owned by a municipal corporation or private utility.
(g) Comprehensive study shall have the meaning ascribed to it in sections 1263-a and 1361 of the Public Health Law, for public sewerage and refuse respectively, or in section 442 of the Conservation Law, for public water, as applicable.
(h) Department means the New York State Department of Health.
(i) Commissioner means the New York State Commissioner of Health.
(j) Dry sewer means a pipe intended to carry domestic waste at such future time as sewerage and treatment facilities are constructed.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.314 Standby pay (on-call)
Compensation paid to an employee for being available to work.
Article 7 HOME HEALTH AGENCIES; TREATMENT CENTERS AND DIAGNOSTIC CENTERS
Part 431 TREATMENT CENTERS AND DIAGNOSTIC CENTERS
10 CRR-NY 431.1 Applicability
Treatment centers and diagnostic centers shall comply with the standards for such centers set forth in the State Hospital Code, Subchapter C of this Chapter.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.89 Use of liquid nitrogen and dry ice
For the purposes of this section, liquid nitrogen shall mean nitrogen in its cryogenic liquid form, which comes in direct contact with food or is used as a food additive. Dry ice shall mean carbon dioxide in its solid form, which comes in direct contact with food or is used as a food additive.
(a) Only food-grade liquid nitrogen or dry ice may be added to food.
(b) Liquid nitrogen, used in the preparation of food, shall be evaporated completely or the operator shall ensure that all residual liquid nitrogen is drained prior to service.
(c) Dry ice, used in the preparation of food, shall be sublimated completely prior to service or the operator shall ensure no residual dry ice is served to the patrons.
(d) Liquid nitrogen or dry ice shall not be added to any food before service, such that a fog or smoke effect remains at time of service or is created during eating.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.12 Assisted reproduction service provider conflicts of interest
(a) The assisted reproduction service providers shall develop and maintain policies to avoid conflicts of interest while facilitating, arranging, and engaging in the services contemplated in a surrogacy agreement.
(b) The assisted reproduction service provider’s conflict of interest policy shall apply to all personnel of the assisted reproduction service provider, including but not limited to owners, employees, and contractors.
(c) Such conflict of interest policies shall prohibit, at a minimum, the following conduct:
(1) any sort of kickback or making or receiving a referral for a fee under Education Law section 6530(18) or any other State or Federal law;
(2) fee-splitting under Education Law section 6530(19);
(3) financially benefitting from a referral under Education Law section 6530(17);
(4) ordering or arranging for excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient under Education Law section 6530(35);
(5) making self-referrals under Public Health Law article 2, title 2-D; and
(6) entering into an arrangement with a clinical laboratory under which the clinical laboratory does not directly bill the patient as required by Public Health Law section 586.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.72 Operation of a public water system
(a) The supplier of water and the person or persons in charge of the operation of a public water system shall operate and maintain the public water system in such a manner to meet the requirements of this Subpart.
(b) The person or persons in charge of operation of a public water system shall be certified pursuant to Subpart 5-4 of this Part.
(c) Complete daily records shall be kept of the operation of a public water system.
(1) A copy of daily operation records in a format provided or approved by the State shall be sent to the State by the 10th calendar day of the next reporting period. These records shall include the results of all tests, measurements or analysis required to be made by this Subpart or as requested by the State. All operational records shall be available to the State either upon request or in conjunction with periodic sanitary surveys conducted by the State.
(2) Systems using conventional filtration treatment or direct filtration must conduct continuous turbidity monitoring for each individual filter, as described in section 5-1.52 table 10A of this Subpart. Systems must record the results of individual filler monitoring every 15 minutes. Systems must maintain individual filter monitoring results for at least three years. Systems must report to the State that they have conducted individual filter turbidity monitoring within 10 days after the end of each month the system serves water to the public. Systems must report to the State individual filter turbidity measurement results within 10 days after the end of each month the system serves water to the public only if measurements demonstrate one or more of the following conditions, except that systems serving fewer than 10,000 persons are not required to comply with subparagraph (ii) of this paragraph:
(i) For any individual filter that has a measured turbidity level of greater than 1.0 nephelometric turbidity units (NTU) in two consecutive measurements taken 15 minutes apart, the system must report the filter identification number, the turbidity measurement, and the date(s) on which the exceedance occurred. In addition, the system must either produce a filter profile for the filter within seven days of the exceedance (if the system is not able to identify an obvious reason for the abnormal filter performance) and submit the profile to the State, or report the obvious reason for the exceedance.
(ii) For any individual filter that has a measured turbidity level of greater than 0.5 NTU in two consecutive measurements taken 15 minutes apart at the end of the first four hours of continuous filter operation after the filter has been backwashed or otherwise taken offline, the system must report the filter number, the turbidity, and the date(s) on which the exceedance occurred. In addition, the system must either produce a filter profile for the filter within seven days of the exceedance (if the system is not able to identify an obvious reason for the abnormal filter performance) and submit the profile to the State, or report the obvious reason for the exceedance.
(iii) For any individual filter that has a measured turbidity level of greater than 1.0 NTU in two consecutive measurements taken 15 minutes apart at any time in each of three consecutive months, the system must report to the State the filter number, the turbidity measurement, and the dates on which the exceedance occurred. In addition, the system must conduct a self-assessment of the filter within 14 days of the exceedance and submit the self-assessment to the State. The self-assessment must consist of at least the following components: assessment of filter performance; development of a filter profile; identification and prioritization of factors limiting filter performance; assessment of the applicability of corrections; and preparation of a filter self-assessment report.
(iv) For any individual filter that has a measured turbidity level of greater than 2.0 NTU in two consecutive measurements taken 15 minutes apart at any time in each of two consecutive months, the system must report to the State the filter number, the turbidity measurement, and the dates on which the exceedance occurred. In addition, the system must arrange for the conduct of a comprehensive performance evaluation (CPE) by the State or a third party approved by the State no later than 30 days following the exceedance, and have the evaluation completed and submitted to the State no later than 90 days following the exceedance.
(3) Systems using conventional filtration treatment or direct filtration treatment must notify the State in writing by December 8, 2003, if the system recycles spent filter backwash water, thickener supernatant, or liquids from dewatering processes. This notification must include, at a minimum, the following information:
(i) A plant schematic showing the origin of all flows which are recycled (including, but not limited to, spent filter backwash water, thickener supernatant, and liquids from dewatering processes), the hydraulic conveyance used to transport them, and the location where they are reintroduced back into the treatment plant.
(ii) Typical recycle flow in gallons per minute (gpm), the highest observed plant flow experienced in the previous year (gpm), design flow for the treatment plant (gpm), and the State-approved operating capacity for the plant where the State has made such determinations.
(4) Groundwater systems and groundwater sources that are required to conduct process compliance monitoring to assure the achievement of four-log virus treatment, must record the lowest treatment performance each day and record the date and duration of any failure to achieve four-log virus treatment for a period of more than four hours. In the event of failure to achieve required virus treatment, the system shall continue to monitor treatment performance every four hours until the system returns to compliance with minimum performance requirements. The State must be notified of any failure to meet process compliance monitoring requirements as well as any failure to achieve four-log virus treatment, as soon as possible, but no later than the end of the next business day.
(5) Surface water systems and ground water systems under the direct influence of surface water that are required to provide enhanced filtration and disinfection for Cryptosporidium, shall report to the State in accordance with the treatment and/or management options used to comply with the treatment requirements under section 5-1.83(b) or (c) of this Subpart, as applicable. Alternatively, the State may approve a system to certify operation within required parameters for treatment credit, rather than reporting monthly operational data. The applicable treatment compliance dates are found in section 5-1.83(d) of this Subpart.
(i) For systems using the watershed control program option, notice of intention to develop a new or continue an existing watershed control program shall be submitted no later than two years before the treatment compliance date. The watershed control plan shall be submitted no later than one year before the treatment compliance date. The annual watershed control program status report shall be submitted every 12 months. For community water systems, the watershed sanitary survey report shall be submitted every three years. For noncommunity water systems, the watershed sanitary survey report shall be submitted every five years.
(ii) For systems using the alternative source/intake management option, verification that the system has relocated the intake or adopted the intake withdrawal procedure, reflected in monitoring results, shall be submitted.
(iii) For systems using the presedimentation option, monthly verification of the following shall be submitted within 10 days after the month in which the monitoring was conducted: continuous basin operation; treatment of 100 percent of the flow; continuous addition of coagulant; and at least 0.5-log mean reduction of influent turbidity or compliance with alternative State-approved compliance criteria.
(iv) For systems using the two-stage lime softening option, monthly verification of the following shall be submitted within 10 days after the month in which the monitoring was conducted: chemical addition and hardness precipitation occurred in two separate and sequential softening stages prior to filtration; and both stages treated 100 percent of the plant flow.
(v) For systems using the bank filtration option, initial demonstration of the following shall be submitted no later than treatment compliance date: aquifer shall be unconsolidated sand containing at least 10 percent fines; and setback distance of at least 25 feet (0.5-log credit) or 50 feet (1.0-log credit). If the monthly average of daily maximum turbidity is greater than 1 NTU, then the system shall report the result and submit an assessment of the cause within 30 days after the month in which the monitoring was conducted, beginning on the applicable treatment compliance date.
(vi) For systems using the combined filter performance option, monthly verification of the following shall be submitted within 10 days following the month in which the monitoring was conducted: combined filter effluent (CFE) turbidity levels less than or equal to 0.15 NTU in at least 95 percent of the four-hour CFE measurements taken each month.
(vii) For systems using the individual filter performance option, monthly verification of the following shall be submitted within 10 days following the month in which the monitoring was conducted: individual filter effluent (IFE) turbidity levels less than or equal to 0.15 NTU in at least 95 percent of sample each month in each filter; and no individual filter greater than 0.3 NTU in two consecutive readings 15 minutes apart.
(viii) For systems using the demonstration of performance option, the results from testing following a State-approved protocol shall be submitted no later than the treatment compliance date. Monthly verification of operation within the conditions of State approval for demonstration of performance credit, may be required to be submitted within 10 days after the month in which the monitoring was conducted, beginning on the applicable treatment compliance date.
(ix) For systems using the bag filter and cartridge filter option, demonstration that the following criteria are met shall be submitted no later than the treatment compliance date: the process meets the definition of bag or cartridge filtration; and the removal efficiency established through challenge testing that meets criteria approved by the State. Monthly verification that 100 percent of the plant flow was filtered shall be submitted within 10 days after the month in which monitoring was conducted, beginning on the applicable treatment compliance date.
(x) For systems using the membrane filtration option, results of verification testing demonstrating the following shall be submitted no later than the treatment compliance date: removal efficiency established through challenge testing that meets criteria approved by the State; and integrity test method and parameters, including resolution, sensitivity, test frequency, control limits, and associated baseline. A monthly report summarizing the following shall be submitted within 10 days after the month in which monitoring was conducted: all direct integrity tests above the control limit; and, if applicable, any turbidity or alternative State-approved indirect integrity monitoring results triggering direct integrity testing and the corrective action that was taken.
(xi) For systems using the second stage filtration option, monthly verification that 100 percent of flow was filtered through both stages, and that the first stage was preceded by a coagulation step, shall be submitted within 10 days after the month in which monitoring was conducted.
(xii) For systems using the slow sand filtration (as secondary filter) option, monthly verification that both a slow sand filter and a preceding separate stage of filtration treated 100 percent of surface water flow shall be submitted within 10 days after the month in which monitoring was conducted.
(xiii) For systems using the chlorine dioxide option, a summary of CT values for each day shall be submitted within 10 days after the month in which monitoring was conducted.
(xiv) For systems using the ozone option, a summary of CT values for each day shall be submitted within 10 days after the month in which monitoring was conducted.
(xv) For systems using the UV option, validation test results demonstrating operating conditions that achieve the required UV dose shall be submitted no later than the treatment compliance date. A monthly report, summarizing the percentage of water entering the distribution system that was not treated by UV reactors operating within validated conditions for the required dose shall be submitted within 10 days after the month in which monitoring was conducted.
(6) Within 10 days of the end of any quarter in which monitoring of disinfection byproducts (DBP) and/or disinfection byproduct precursors (DBPP) is required under section 5-1.52 table 9A and/or sections 5-1.60 and 5-1.61 of this Subpart, the following must be reported to the State:
(i) number of DBP and DBPP samples taken during the quarter;
(ii) date and results of each DBP and DBPP sample taken during the last quarter;
(iii) the arithmetic average of DBP quarterly results for the last four quarters for each monitoring location (LRAA). If the LRAA calculated based on fewer than four quarters of data would cause the MCL to be exceeded regardless of the monitoring results of subsequent quarters, the system must report this information to the State as part of the first report due following the end of the quarter or anytime thereafter that this determination is made. If the system is required to conduct monitoring at a frequency that is less than quarterly, the system must make compliance calculations beginning with the first compliance sample unless the system is required to conduct increased monitoring under section 5-1.52 table 9A or 5-1.51 of this Subpart;
(iv) whether the MCL for Total Trihalomethanes (TTHM) and/or Halo Acetic Acids (5) (HAA5) was violated at any monitoring location;
(v) any operational evaluation levels that were exceeded during the quarter and, if so, the location and date, and the calculated TTHM and HAA5 levels;
(vi) if the system is a surface water system or a system using a source of ground water under the direct influence of surface water, and seeking to qualify for or remain on reduced TTHM/HAA5 monitoring, source water Total Organic Carbon (TOC) information must be reported for each treatment plant that treats surface water or ground water under the direct influence of surface water, as follows:
(a) the number of source water TOC samples taken each month during last quarter;
(b) the date and result of each TOC sample taken during last quarter;
(c) the quarterly average of monthly TOC samples taken during the last quarter;
(d) the running annual average (RAA) of quarterly TOC averages from the past four quarters;
(e) whether the TOC RAA exceeded 4.0 mg/L.
(d) Any supplier of water of a public water system, subject to the provisions of this Subpart, shall retain at a convenient location the following records:
(1) Records of microbiological analyses made pursuant to this Subpart shall be retained for at least five years, and records of chemical and turbidity analyses made pursuant to this Subpart shall be retained for at least 10 years. Actual laboratory reports may be kept, or data may be transferred to tabular summaries, if the following information is included:
(i) the date, place and time of sampling, and the name of the person who collected the sample;
(ii) identification of the sample whether it was a routine distribution point sample, check sample, raw or process water sample or other special purpose sample;
(iii) date of analyses;
(iv) laboratory and person responsible for performing the analysis;
(v) the analytical technique or method used; and
(vi) the results of the analyses.
(2) All Level 1 and Level 2 assessment forms, documentation of corrective actions completed as a result of such assessments, and any other summary documentation of sanitary defects and corrective actions, shall be retained for at least five years.
(3) All records of repeat samples that are taken for the purpose of obtaining an extension of the 24-hour period for collecting such repeat samples shall be retained for at least five years.
(4) Records of action taken by the supplier of water to correct significant deficiencies and/or violations of the requirements of this Subpart shall be retained for at least 10 years.
(5) Copies of any written reports, including summaries or communications relating to sanitary surveys of the public water system shall be retained for at least 10 years.
(6) Records concerning a variance or exemption granted to the public water system shall be retained for at least five years following the expiration of such variance or exemption.
(7) Copies of the records or data summaries shall be provided to any consumer of the public water system within 15 days on written request by a consumer. The supplier of water may require prepayment of a fee to cover the cost of handling and reproduction of the records and data summaries requested.
(8) The supplier of water must provide the State with copies of all repeat or special total coliform sample results and all Escherichia coli (E. coli) sample results, within five days of receipt.
(9) Beginning June 8, 2004, systems using conventional filtration treatment or direct filtration that recycle spent backwash water, thickener supernatant or liquids from the dewatering processes must collect the following recycle flow information:
(i) copy of the recycle notification and information submitted to the State in accordance with paragraph (c)(3) of this section;
(ii) list of all recycle flows and the frequency with which they are returned;
(iii) average and maximum backwash flow rate through the filters and the average and maximum duration of the filter backwash process in minutes;
(iv) typical filter run length and a written summary of how filter run length is determined;
(v) the type of treatment provided for the recycle flow; and
(vi) data on the physical dimensions of the equalization and/or treatment units, typical and maximum hydraulic loading rates, type of treatment chemicals used and average dose and frequency of use, and frequency at which solids are removed, if applicable.
(10) For surface water systems and ground water systems under the direct influence of surface water, the following records shall be maintained:
(i) Systems shall keep results from the initial round of source water monitoring under section 5-1.81(a)(1) of this Subpart and the second round of source water monitoring under section 5-1.81(a)(2) of this Subpart until three years after bin classification under section 5-1.83(a) of this Subpart for filtered systems, or determination of the mean Cryptosporidium level under section 5-1.83(c) of this Subpart for unfiltered systems for the particular round of monitoring.
(ii) Systems shall keep any notification to the State that they will not conduct source water monitoring due to meeting the criteria of section 5-1.81(a)(4) of this Subpart for three years.
(iii) Systems shall keep the results of treatment monitoring associated with Cryptosporidium and with uncovered finished water storage facilities under section 5-1.32 of this Subpart for three years.
(e) Each community water system which serves 15 or more service connections used by year- round residents or regularly serves at least 25 year-round residents shall prepare and provide an annual water supply statement (report) to the customers it serves. The report must contain information on the quality of the water delivered by the system and characterize the risks (if any) from exposure to contaminants detected in the drinking water in an accurate and understandable manner. For the purpose of this Subpart, customers are defined as billing units or service connections to which water is delivered by a community water system.
(f) The report shall contain such information as is required in this subdivision and any additional information required by the State, except that paragraph (7) and subparagraphs (13)(vii) through (xi) of this subdivision shall not apply to systems serving fewer than 1,000 service connections. The information required to be included in the report is described in this subdivision.
(1) Information on the source of the water delivered. The report must identify the source(s) of the water delivered by the community water system by providing information on:
(i) the type of the water source ( e.g., surface water, groundwater); and
(ii) the commonly used name (if any) and location of the body (or bodies) of water or aquifer(s).
If the State has completed a source water assessment, the report must notify consumers of the availability of this information and the means to obtain it. The report must include a brief summary of the system's susceptibility to potential sources of contamination, using language provided by the State.
(2) Definitions for maximum contaminant level, maximum contaminant level goal, maximum residential disinfectant level and maximum residual disinfectant level goal. Each report must include the definitions set forth using the following language:
(i) Maximum contaminant level goal (MCLG). The level of a contaminant in drinking water below which there is no known or expected risk to health. MCLGs allow for a margin of safety.
(ii) Maximum contaminant level (MCL). The highest level of a contaminant that is allowed in drinking water. MCLs are set as close to the MCLGs as feasible.
(iii) Maximum residual disinfectant level (MRDL). The highest level of a disinfectant that is allowed in drinking water.
(iv) Maximum residual disinfectant level goal (MRDLG). The level of a drinking water disinfectant below which there is no known or expected risk to health, MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants.
(3) Definitions for variances and exemptions. A report for a community water system operating under a variance or an exemption issued under sections 5-1.90-5-1.96 of this Subpart must include the following language: Variances and Exemptions: State permission not to meet an MCL or a treatment technique under certain conditions.
(4) Definitions for action level and treatment technique. A report that includes information on a contaminant that is regulated as a treatment technique ( i.e., turbidity) or action level ( i.e., lead, copper) must include one or both of the following statements:
(i) Treatment technique (TT). A required process intended to reduce the level of a contaminant in drinking water.
(ii) Action level (AL). The concentration of a contaminant which, if exceeded, triggers treatment or other requirements which a water system must follow.
(5) Information on detected contaminants from sampling used to determine compliance. For the purpose of this subdivision (except Cryptosporidium, Giardia and radon monitoring), detected means: at or above the contaminant's method detection limit (MDL), as defined in section 5-1.1(bl) of this Subpart, or as prescribed by the State. Any contaminants specified in sections 5-l.41 (lead and copper) and 5-1.51 of this Subpart and section 5-1.52 tables 8A, 8B, 8C, 8D, 9A, 9B, 9C, 9D, 10, 10A, 11, 11A, 11B, 12, 16 and 17 of this Subpart that are detected during compliance monitoring shall be displayed in one table or in several adjacent tables. Additionally, the report shall include detected monitoring results for samples collected and analyzed by the State and/or detected monitoring results of additional samples required by the State. If a system is allowed to monitor for specific contaminants less often than once a year, the table shall include the date and results of the most recent sampling and the report shall include a brief statement indicating that the data presented in the report are from the most recent testing done in accordance with the regulations. No data older than five years need be included. For the contaminants listed in section 5-1.52 tables 8A, 8B, 8C, 8D, 9A, 9B, 9C, 9D, 10, 10A, 11, 11B, 12, 16 and 17 of this Subpart the table(s) shall contain:
(i) the State MCL for that contaminant expressed as a number equal to or greater than 1.0;
(ii) the MCLG (as prescribed by the State) for that contaminant expressed in the same units as the MCL;
(iii) if there is no MCL for a detected contaminant, the table must indicate that there is a treatment technique, or specify the action level, applicable to that contaminant, and the report must include the definitions for treatment technique and/or action level, as appropriate, specified in paragraph (4) of this subdivision;
(iv) for contaminants subject to a MCL, except turbidity and total coliforms, the highest contaminant level used to determine compliance with this Subpart1 and the range of detected levels, as follows:
(a) when compliance with the MCL is determined annually or less frequently: the highest detected level at any sampling point and the range of detected levels expressed in the same units as the MCL;
(b) when compliance with the MCL is determined more frequently than annually: the highest average of any of the sampling points used to determine compliance and the range of all sampling points expressed in the same units as the MCL;
(c) when compliance with the MCL is determined by calculating a running annual average of all samples taken at a monitoring location: the highest average of any of the monitoring locations used to determine compliance and the range of all sampling points expressed in the same units as the MCL. For the MCLs for TTHM and HAA5, systems shall include the highest locational running annual average for TTHM and HAA5 and the range of individual sample results for all monitoring locations expressed in the same units as the MCL. If more than one location exceeds the TTHM or HAA5 MCL, the system shall include the locational running annual averages for all locations that exceed the MCL; and
(d) when compliance with the MCL is determined on a system-wide basis by calculating a running annual average of all samples at all sampling points the report must include: the average used to determine compliance and the range of detection expressed in the same units as the MCL;
(v) surface water and groundwater under the direct influence systems are required to include information from turbidity monitoring in the report:
(a) turbidity reported pursuant to the requirements of sections 5-1.30 and 5-1.52 table 10 of this Subpart (for systems that must install filtration but have not) include the highest monthly average. The report should include health effects language prescribed by the State;
(b) turbidity reported pursuant to the requirements of sections 5-1.30(c) and 5-1.52 table 10A of this Subpart (for systems that have met the criteria of avoiding filtration) include the highest single measurement found in any one month. The report should include an explanation of the reasons for measuring turbidity; and
(c) turbidity reported pursuant to sections 5-1.30 and 5-1.52 table 10A of this Subpart (for systems that filter and use turbidity as an indicator of filtration performance) include the highest single measurement and the lowest monthly percentage of samples meeting the turbidity limits specified in section 5-1.52 table 4A of this Subpart for the filtration technology being used. The report should include an explanation of the reasons for measuring turbidity;
(vi) for lead and copper: the 90th percentile value of the most recent round of sampling, the range of detections, and the number of sampling sites exceeding the AL;
(vii) for total coliform:
(a) the highest monthly number of positive samples for systems collecting fewer than 40 samples per month; or
(b) the highest monthly percentage of positive samples for systems collecting at least 40 samples per month;
(viii) for E. coli detected in the distribution system: the total number of positive samples; and
(ix) the likely source(s) of detected contaminants (as prescribed by the State) shall be reported.
If a community water system distributes water to its customers from multiple hydraulically independent distribution systems that are fed by different raw water sources, the report shall include data from each separate distribution system. Alternatively, systems could produce separate reports tailored to include data for each service area. The table(s) must clearly identify any violations of MCLs or TTs and the report must contain a clear and readily understandable explanation of the violation including: the duration of the violation, the potential adverse health effects, and actions taken by the system to address the violation. To describe the potential health effects, the system must use language prescribed by the State.
(6) Information on nondetected contaminants from sampling used to determine compliance. Analytical test results for the contaminants listed in section 5-1.52 tables 8A, 8B, 8C, 8D, 9A, 9B, 9C, 9D, 10, 10A, 11, 12, 16 and 17 of this Subpart or additional monitoring required by the State which are not detected shall be:
(i) described in the report in a brief narrative; or
(ii) presented in the report as a separate table or list.
(7) Analytical results for source water samples not used to determine compliance. If the analytical results for samples of source(s) of water supply, other than those for Cryptosporidium or Giardia; used to determine compliance; or listed in section 5-1.52 tables 16 and 17 of this Subpart, are not included in the report, they shall be placed in a supplement to the report.
(8) Information on Cryptosporidium, Giardia and radon. If the system has performed any monitoring for Cryptosporidium, Giardia or radon, which indicates that Cryptosporidum or Giardia may be present in the source water or the finished water or that radon may be present in finished water, the report must include:
(i) a summary of the following: sampling sites; number of tests per year; testing results; and actions taken in response to those results; and
(ii) an explanation of the significance of the results.
(9) Compliance with the State Sanitary Code. The report must note any violation that occurred during the year covered by the report of a requirement listed in subparagraphs (i)-(v) of this paragraph, and include a clear and readily understandable explanation of the violation, any potential adverse health effects related to the violation, and the steps the system has taken to correct the violation:
(i) monitoring and reporting and recordkeeping of compliance data;
(ii) filtration and disinfection prescribed by sections 5-1.30 and 5-1.32 of this Subpart. For systems which have failed to install adequate filtration or disinfection equipment or processes, or have had a failure of such equipment or processes which constitutes a violation, the report must include language prescribed by the State;
(iii) lead and copper control requirements. The report shall include health effects language specified in 40 CFR 141.54(d) for lead, copper, or both for systems which fail to take one or more actions prescribed by sections 5-1.40 through 5-1.48 of this Subpart;
(iv) the report must include health effects language prescribed by the State for systems which violate the TTs specified in section 5-1.51 of this Subpart for Acrylamide and Epichlorohydrin; and
(v) violation of the terms of a variance, an exemption, or an administrative or judicial order.
(10) Variances and exemptions. If a system is operating under the terms of a variance or an exemption issued under sections 5-1.90—5-1.96 of this Subpart the report must contain:
(i) an explanation of the reasons for the variance or exemption;
(ii) the date on which the variance or exemption was issued;
(iii) a brief status report on the steps the system is taking to install treatment, final alternative sources of water, or otherwise comply with the terms and schedules of the variance or exemption; and
(iv) a notice of any opportunity for public input in the review, or renewal, of the variance or exemption.
(11) Educational information. The report must contain the language of subparagraph (i) of this paragraph or alternative language approved by the State. The report also must include the language of subparagraphs (ii) through (iv) of this paragraph.
(i) The sources of drinking water (both tap water and bottled water) include rivers, lakes, streams, ponds, reservoirs, springs, and wells. As water travels over the surface of the land or through the ground, it dissolves naturally-occurring minerals and can pick up substances resulting from the presence of animals or from human activities. Contaminants that may be present in source water include: microbial contaminants; inorganic contaminants; pesticides and herbicides; organic chemical contaminants; and radioactive contaminants.
(ii) In order to ensure that tap water is safe to drink, the State and the EPA prescribe regulations which limit the amount of certain contaminants in water provided by public water systems. The State Health Department's and the FDA's regulations establish limits for contaminants in bottled water which must provide the same protection for public health.
(iii) Drinking water, including bottled water, may reasonably be expected to contain at least small amounts of some contaminants. The presence of contaminants does not necessarily indicate that water poses a health risk. More information about contaminants and potential health effects can be obtained by calling the Environmental Protection Agency's safe drinking water hotline (800-426-4791).
(iv) Some people may be more vulnerable to disease causing microorganisms or pathogens in drinking water than the general population. Immuno-compromised persons such as persons with cancer undergoing chemotherapy, persons who have undergone organ transplants, people with HIV/AIDS or other immune system disorders, some elderly, and infants can be particularly at risk from infections. These people should seek advice from their health care provider about their drinking water, EPA/CDC guidelines on appropriate means to lessen the risk of infection by Cryptosporidium, Giardia and other microbial pathogens are available from the safe drinking water hotline (800-426-4791).
(12) Additional health effects statements for arsenic, nitrate, lead, total trihalomethanes and fluoride:
(i) A system which detects arsenic at levels above 5 ug/l, but less than or equal to the MCL must include in its report a short informational statement about arsenic, using language prescribed by the State.
(ii) A system which detects nitrate at levels above 5 mg/l, but below the MCL must include a short informational statement about the impacts of nitrate on children using language prescribed by the State.
(iii) A system which detects lead above the action level in more than 5 percent and up to and including 10 percent of the sites sampled (or for systems sampling less than 20 sites and even one sample is above the action level) must include a short informational statement about the special impact of lead on children using language prescribed by the State.
(iv) A system using only groundwater or using surface water as its source and serving less than 10,000 persons, which detects TTHMs above 80 ug/l, but below 100 ug/l, as an annual average, monitored and calculated as described in section 5-1.52 table 3 of this Subpart, must until January 1, 2004, include health effects language prescribed by the State.
(v) A system which detects fluoride at levels above 2 mg/l, but below the MCL must include in its report an informational statement about fluoride, using language prescribed by the State.
(13) Additional information. Each report must also include the items listed in subparagraphs (i)-(xii) of this paragraph:
(i) the name and address of the community water system and the public water system identification number;
(ii) the name and telephone number of the owner, operator, or designee of the community water system as a source of additional information concerning the report;
(iii) the telephone number of the county or district health department office which has jurisdiction over the water system;
(iv) information ( e.g., time and place of regularly scheduled board meetings) about opportunities for public participation in decisions that may affect the quality of the water;
(v) a brief statement explaining the number of people served by the community water system;
(vi) a brief description of the types of treatment that the water received before entering the distribution system;
(vii) for systems that calculate water use of all customers with meters, an accounting of the total annual amount of water withdrawn, delivered, and lost from the system;
(viii) a brief description of any water source restricted, removed from service, or otherwise limited in its use and any actions taken to secure new supplies or replace lost capacity;
(ix) water conservation measures customers can take such as, but not limited to, retrofitting plumbing fixtures, altering irrigation timing, using irrigation sensors, leak detection, proper use of water conserving appliances, daily conscientious use of water, and the estimated savings in water and energy or money from the use of such measures;
(x) a description of any major modification completed by the water system during the reporting period to include a brief description of each and its effect on the water system, and a discussion of capital improvements needed or planned;
(xi) for systems that bill their customers, the report shall include the annual average charge for water, either in annual charge per average resident user or annual charge per 1,000 gallons of water delivered; and
(xii) systems may also include such additional information as they deem necessary for public education consistent with, and not detracting from, the purpose of the report.
(14) Information for non-English speaking residents. In communities with a large proportion of non-English speaking residents, as determined by the State, the report must contain information prescribed by the State in the appropriate language(s) expressing the importance of the report.
(15) Information on unregulated contaminants. If the system was required to monitor for contaminants listed in section 5-1.52 table 16 of this Subpart, the report must identify a person and provide the telephone number to contact for information on the monitoring results.
(16) Water systems are required to include information regarding significant deficiencies as follows:
(i) any significant deficiency that remains uncorrected at the end of the year (December 31st) or any other significant deficiency as directed by the State. A description of the significant deficiency must include: the date the significant deficiency was identified by the State; status of corrective action; the completion date if corrective action has been completed; and if corrective action has not been completed, the reason why it has not been completed. Uncorrected significant deficiencies must be reported each year until the annual report documents that corrective action is completed; and
(ii) any failure to take corrective action to correct a significant deficiency in system facilities or operation, including a description of the significant deficiency, the date the significant deficiency was identified by the State, and the reason why corrective action has not been taken.
(17) Groundwater systems and systems with groundwater sources are also required to include information regarding source sampling and process compliance monitoring as follows:
(i) report of fecal indicator positive ground water source sample, including: the date the fecal contamination of the source was identified; the likely source of the contamination, if known; the date(s) and status of any corrective action; and potential health effects language prescribed by the State;
(ii) if required to perform four-log virus treatment, failure to provide the treatment must be described including date(s) of failure and whether four-log virus treatment has resumed; and
(iii) if required to perform four-log virus treatment, failure to meet process compliance monitoring requirements must be described including date(s) of failure and whether the required process compliance monitoring has resumed.
(g) Report delivery and recordkeeping.
(1) Report distribution to consumers.
(i) Each community water system must mail or otherwise directly deliver one copy of the report to each bill-paying customer by the date specified in subdivision (h) of this section.
(ii) The system must make a good faith effort to reach consumers who do not get water bills, using methods prescribed by the State.
(iii) Each community water system serving 100,000 or more people must post the current year's report to a publicly-accessible site on the Internet.
(iv) Each community water system must make its reports available to the public upon request.
(v) If a supplement is prepared in accordance with paragraph (f)(7) of this section, the report must contain a statement that describes that the analytical results for source water samples not used to determine compliance are contained in a supplement and that the supplement is available to the customer on request. The supplement shall also be:
(a) published in a notice at least one-half page in size, in one newspaper of general circulation within the water district;
(b) made available on the Internet, along with supplements from the two prior years, if such prior supplements exist, and notice of the availability of such information on the Internet shall be clearly provided on the report and on each billing statement; or
(c) made available at all New York State documents information access centers, documents reference centers, documents depository libraries and documents research depository libraries within the water district and if no such libraries exist within the water district at a public library within the water district, and notice of the availability of the supplement at such library or libraries shall be clearly provided on the report and on each billing statement.
Such supplement need not be included in the copy of the report mailed or directly delivered to each bill-paying customer.
(2) Report distribution to State agencies.
(i) No later than the date the system is required to distribute the report to its customers, each community water system must mail one copy of the report and one copy of the supplement, if prepared, to the commissioner of the State Health Department and the county or district health department office which has jurisdiction over the water system. The system must also deliver (by September 1st) to these two agencies a certification that the report has been distributed to customers, and that the information is correct and consistent with the compliance monitoring data previously submitted to the State.
(ii) No later than the date the system is required to distribute the report to its customers, each community water system serving 1,000 or more service connections must deliver a copy of the report and a copy of the supplement, if prepared to the Commissioner of Environmental Conservation.
(iii) Investor-owned community water systems regulated by the Public Service Commission (PSC) shall also deliver a copy of the report and a copy of any supplement prepared, to that agency.
(3) Recordkeeping requirements. Any system subject to this Subpart must retain copies of the report for no less than three years.
(h) Applicable dates.
(1) All community water systems must deliver a copy of the report, to its bill-paying customers and take good faith efforts to each consumers who do not get water bills on or before May 31st of each year.
(2) Each community water system serving 100,000 or more people must post their current year's report on a publicly accessible site on the Internet by May 31st of each year.
(3) All community water systems must deliver a copy of the report and a copy of the supplement, if prepared, to the required regulatory agencies on or before May 31st of each year.
(4) A new community water system, must deliver its first report to its customers and a copy of the report and the supplement, if prepared to the required regulatory agencies by May 31st of the year after its first full calendar year in operation and annually thereafter.
(5) A community water system that sells water to another community water system, must deliver the applicable information required in paragraphs (f)(1), (5)-(10) and (13) of this section to the buyer system:
(i) by April 1st of each year; or
(ii) on a date mutually agreed upon by the seller and the purchaser, and specifically included in a contract between the parties.
(6) By September 1st, each community water system must mail a copy of the certification form to the State Health Department and the county or district health department office which has jurisdiction over the water system.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 408 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS (CSFRHN)
10 CRR-NY 408.4 Supervision by the commissioner
The implementation of a NOP and operation of a CSFRHN shall be subject to the active supervision of the commissioner pursuant to the provisions of this Part and Parts 407, 680 and Subpart 752-1 of this Title, and in accordance with the following provisions.
(a) Approval and implementation of network operational plans. A central services facility rural health network shall implement a network operational plan only after receiving the approval of the commissioner to do so.
(1) Networks seeking approval to implement an operational plan shall submit the plan simultaneously to the department and to the HSA(s) having geographical jurisdiction in the region in which the network intends to operate.
(2) The commissioner shall consider the recommendations of the HSA(s) having jurisdiction in the region in which the network intends to operate in determining whether to approve or disapprove a NOP.
(3) The commissioner shall notify the applicant, the appropriate HSA(s), and the Public Health Council in writing of a determination to approve a NOP and of his findings concerning access and proposed efficiencies supporting such determination.
(4) Where the commissioner proposes to disapprove a network operational plan, he shall provide the applicant with a detailed written statement of the basis or bases for such disapproval.
(5) In the event that a CSFRHN fails to implement an approved network operational plan in accordance with its terms, is the subject of a resolution by the Public Health Council revoking its establishment approval or fails to provide information required or requested in the course of the commissioner's active supervision of the network, the commissioner, after a hearing, may revoke, limit or annul approval to implement a NOP. The commissioner shall notify the network, the Public Health Council and the HSA(s) having geographical jurisdiction in the region in which the network operates regarding any proposed revocation, limitation or annulment of approval to implement a NOP.
(b) Supervision of network operation.
The commissioner shall actively supervise and monitor the operation of central services facility rural health networks and their participating providers to assure compliance with the intent and goals of the NOP, the requirements of article 29-A of the Public Health Law, Parts 407, 680 and Subpart 752-1 of this Title and this Part. To insure the active supervision of the commissioner, CSFRHNs and affiliated providers shall:
(1) be subjected to scheduled and unscheduled surveillance visits;
(2) agree in writing to submit any documentation, reports or other information requested by the commissioner, including information necessary to complete an annual evaluation.
(3) cooperate in any review and assessment of written complaints or other documentation indicating that it is not in compliance with the intent and goals of the network development program pursuant to sections 2950 and 2957 of the Public Health Law;
(4) certify in the annual network report that a process is in place to assure that all health care providers located in the network's service area interested in participating in the network and willing to meet the network's terms and conditions have been provided the opportunity to affiliate with the network, and that consumer input is available on a regular and on-going basis with respect to the development and operation of the CSFRHN; and
(5) submit, initially with a proposed NOP, or thereafter prior to implementing or amending, all agreements between a CSFRHN and affiliated providers, or between affiliated providers resulting from or in furtherance of the objectives of the network with which they are affiliated and which provide for arrangements involving prices, methods of payment, areas of operation or restrictions thereon or any other matter which is or may be construed to be inconsistent with the requirements of State or Federal laws prohibiting monopolies, unreasonable restraints of trade and related activities. All such agreements shall contain express provisions acknowledging that:
(i) such agreements or any proposed amendments thereto, shall not be effective until approved by the commissioner;
(ii) that the commissioner may provide copies to and seek the advice of the Attorney General in making any determination to approve or disapprove such agreements; and
(iii) the parties agree to cease, suspend or amend any such agreement at any time upon receipt of written notification from the commissioner or the Attorney General to do so.
(6) The commissioner shall annually review and evaluate each agreement approved pursuant to paragraph (5) of this subdivision as to its continuing effect on access to health services, efficiencies achieved in the provision of services and whether the advantages derived from any anticompetitive activity continue to outweigh any disadvantages, and shall issue a written report of his findings.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.26 Organization and administration
A nursing home shall be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.
(a) Administration.
(1) No nursing home shall operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator's license and registration, or temporary license, issued pursuant to article 28-D of the Public Health Law. The administrator shall set an example for all staff members, consultants and others affiliated with the facility which recognizes that the institution exists to serve the interests of and the needs of the residents, which emphasizes the importance of a resident's right to independence regarding all aspects of institutional life and encourages residents to participate together with staff in resolving conflicts and problems which frequently arise in a group residential setting. The administrator shall:
(i) be readily accessible to residents and staff for consultations;
(ii) involve the Resident Council in addressing the need to seek compromises between conflicting resident and staff interests and needs;
(iii) encourage professional and respectful behavior on the part of the staff toward residents; and
(iv) seek to involve staff at all levels in developing and implementing an interdisciplinary approach to resident services, in order to better serve the individual and group interests of residents.
(2) Administrator coverage.
(i) Nursing homes with 41 or more beds shall employ a full-time administrator.
(ii) Nursing homes with 40 beds or less shall designate in writing a licensed and registered administrator for an amount of time in accordance with the following:
(a) In no event shall an administrator be employed for fewer than twelve hours per week; such hours to be served during normal business hours of 7:00 a.m. to 5:30 p.m. Monday thru Friday.
(b) The department may require employment greater than 12 hours per week based on:
(1) the size of the facility;
(2) the history and nature of any operating deficiencies; and
(3) any investigations or other problems brought to the attention of the commissioner.
(iii) The governing body shall designate in writing a staff member to serve as alternate administrator for all hours that the administrator of record is absent from duty to ensure that all shifts, 24 hours a day, 7 days a week are covered by administrative supervision.
(iv) No person whose license to practice nursing home administration has been forfeited, revoked, annulled, or placed on inactive status or suspended shall be involved in the administration and direction of a nursing home either on a full-time, part-time or acting basis.
(3) When, by reason of death, resignation, incapacity, illness or other reason, the nursing home does not have a licensed and currently registered nursing home administrator capable of carrying out such functions, the governing body shall immediately notify the commissioner, assign such duties to a named individual acceptable to the commissioner in accordance with that individual's training, experience and prior record of work performance at the nursing home, and provide for supervision of the nursing home by a licensed and currently registered nursing home administrator in accordance with the following:
(i) A plan for the supervision of the unlicensed acting nursing home administrator shall be submitted to the Department which provides that:
(a) the nursing home is making a bonafide effort to recruit a licensed and registered nursing home administrator;
(b) there is no other licensed and registered person in the facility available, capable and willing to accept the position;
(c) the supervising administrator will provide a minimum of four hours of onsite supervision weekly during normal business hours unless the department determines that more hours are necessary based on:
(1) the quality of care in the facility;
(2) the qualifications of the unlicensed acting administrator; and
(3) the on-site presence of qualified administrative staff.
(ii) The unlicensed acting administrator shall serve for a maximum of three months except that the nursing home may request and receive from the department one additional three month extension upon a finding that the unlicensed acting administrator has performed his or her duties effectively and that the quality of resident care and services has not deteriorated.
(4) In addition to the other responsibilities delineated herein, the administrator shall:
(i) report to the governing body at regular intervals;
(ii) implement the policies of the nursing home by making operating decisions, including but not limited to general supervision, employing and discharging of staff, programming and, where appropriate, integrating the services of the nursing home with the community's health resources;
(iii) assure that the residents' council:
(a) meets as often as the membership deems necessary;
(b) is directed by the residents and is chaired by a resident or another person elected by the membership; and
(c) may meet with any member of the supervisory staff provided that reasonable notice of the council's request is given to such staff;
(iv) agree to assign a staff person in consultation with the resident council, acceptable to such council, to act as advisor or coordinator, to facilitate the council in holding regular meetings and to assist members in carrying out council activities, including obtaining necessary information to become informed of facility policies, exploring the solutions to problems and conveying to the administrator issues and suggestions which require administrative action;
(v) assure that any complaints, problems or issues reported by the council to the designated staff person or administration are addressed; and that a written report addressing the problem, issues or suggestions is sent to the council when requested; and
(vi) assure that except in extraordinary circumstances such as health emergencies, the facility has visiting hours encompassing at least 10 hours within a 24-hour period, including at least two meal periods, and that a statement as to the visiting hours is posted in a public place such as the main lobby or the residents' dining room.
(5) The facility shall provide such secretarial, accounting, receptionist and other supportive personnel, and such office equipment and supplies, as are needed for satisfactory administration of the nursing home.
(b) Governing body.
The nursing home shall have a governing body, or designated persons functioning as a governing body, that is legally responsible for establishing and implementing policies regarding the management and operation of the facility. The governing body shall:
(1) appoint an administrator who is eligible for such appointment and who functions in accordance with subdivision (a) of this section;
(2) determine and establish written policies consistent with the stated purposes of the facility, the program of services provided, its physical structure and equipment, the number and qualifications of staff members, and their job classifications and descriptions;
(3) be responsible for the operation of the facility;
(4) be responsible for providing or arranging services for residents as required in this Subchapter;
(5) employ or otherwise arrange for the services of such personnel as are required in this Subchapter;
(6) assure that a method is implemented to promptly deal with complaints and recommendations made by residents or designated representatives which:
(i) enables complaints and recommendations to be made orally or put in writing;
(ii) brings complaints and recommendations promptly to the attention of the administration for review and resolution;
(iii) responds to all residents or designated representatives as to action taken or the reason why no action was taken, as soon as possible and except under extraordinary circumstances such as health or administrative emergencies, within 21 days after the complaint or recommendation was made; and
(iv) provides for review and evaluation of the effectiveness of the complaint process;
(7) assure that the complaint and recommendation method is made known to:
(i) all residents upon admission and their designated representatives; and
(ii) all nursing, social service and other appropriate personnel, in order to assist residents who want to make a complaint or recommendation;
(8) assure that the facility establishes a residents' council;
(9) be responsible for compliance with all provisions of this Subchapter;
(10)
(i) post in a public place a notice supplied by the New York State Department of Health containing:
(a) the time and date the facility shall assess residents to determine case mix intensity, pursuant to section 86-2.30 of this Title; and
(b) department auditors will be in the facility to review the data submitted by the facility in the patient review instrument for the current assessment period; and
(c) a statement that each resident and/or the resident's designated representative has the right to know the specific assignment to a patient classification category; and
(d) the person within the facility to contact for this information;
(ii) notify the resident and/or the resident's designated representative according to the following procedures, that a process exists for reimbursement purposes to assign residents to a patient classification category as contained in Appendix 13-A of this Title entitled “Patient Categories and Case Mix Indices Under Resource Utilization Group (RUG-II) Classification System”:
(a) upon admission to the facility, at the initial resident assessment required pursuant to section 415.11 of this Part a designated professional staff member shall inform the resident and/or resident's designated representative of this process and that further information on the classification system is available upon request; and
(b) the process by which residents are classified for reimbursement purposes into the RUG-II classification system shall be, at least annually, an item for discussion on the agenda at a resident council as required by paragraph (8) of this subdivision;
(11) furnish for the staff telephone services consisting of at least one operational, unlocked, noncoin telephone installation on each floor of the facility, for the use of professional staff in the performance of their duties;
(12) permit activities related only to the operation of the facility except that the operator, subject to prior written approval of the commissioner, may, where such arrangement will not result in any diminishment of resident care or services, or adversely affect the cost of delivering nursing home services;
(i) enter into a written contract for the purpose of leasing unneeded space and equipment on the premises of the facility to a health care practitioner licensed by the State Education Department, or to a provider licensed under the Public Health Law, Mental Hygiene Law, or Social Services Law to provide health care services to residents or nonresidents, where such arrangements will also promote needed health care services for residents; or
(ii) prepare food for consumption off-site as part of a nutrition program or make available service of meals, nutrition education, and nutrition counseling for nonresidents on-site;
(13) notify the department immediately of anticipated or actual termination of any service vital to the continued safe operation of the facility or to the health and safety of its residents and personnel, including but not limited to the anticipated or actual termination of telephone, electric, gas, fuel, water, heat, air conditioning, rodent or pest control, contract food, or contract laundry services, and the services of key full- or part-time personnel such as the administrator, director of nurses, consultant physician, consultant dietitian or others; and apply remedial measures promptly and notify the department immediately regarding the nature of results of such measures;
(14) transfer residents to another appropriate facility only after consultation, as appropriate, with the resident, his or her physician, and designated representative except in an emergency situation, in which case the operator shall notify the physician and designated representative immediately and record the reason for the transfer; and
(15) ensure that members of the governing body make themselves available to hold meetings with representatives of the resident council at least 3 times a year to discuss matters contained in a jointly developed agenda.
(c) Staff qualifications and personnel management.
The nursing home shall employ on a full-time, part-time or consultant basis a sufficient number of professional staff members who are educated, oriented and qualified to carry out the provisions of this Part and to assure the health, safety, proper care and treatment of the residents.
(1) With regard to personnel management, the facility shall:
(i) provide personnel in accordance with paragraph (2) of this subdivision, with a planned orientation to nursing home operation and resident care and such on-the-job training as is necessary for each properly to perform his or her individual job assignments;
(ii) have on file and furnish each employee with a copy of written policies governing conditions of employment, including the job description for his or her position;
(iii) assure that each part-time, full-time or private duty employee, consultant, volunteer, or other person serving in any other capacity in the nursing home shall:
(a) receive an orientation which shall include but not be limited to the following:
(1) a review and explanation of relevant personnel policies and procedures, including his or her job description;
(2) an orientation to the facility's organization, its long-term care philosophy, the roles of all personnel in the organization;
(3) an orientation to the physical plant, infection control, quality assessment and assurance and the environmental aspects of the facility;
(4) the facility safety program, including fire safety, accident prevention, resident emergency procedures, and facility operation during disruption of services;
(5) resident's rights; and
(6) resident abuse and neglect reporting requirements as set forth in section 2803-d of the Public Health Law;
(b) be on duty, alert and appropriately dressed during the entire tour of duty, part-time assignment, consultation visit, volunteer work, private duty or other employment in the nursing home;
(c) maintain personal cleanliness and hygiene; and
(d) conduct himself or herself in a professionally acceptable manner with all residents, employees and guests, including refraining from abusive, immoral or other unacceptable conduct, behavior or language and demonstrating respect for each resident's dignity in full recognition of his or her individuality;
(iv) assign each employee duties consistent with his or her job description and with his or her level of competence, education, preparation and experience; and
(v) develop and implement policies and procedures which require:
(a) the provision for a physical examination and recorded medical history for personnel including all employees and members of the medical and dental staff. The examination shall be of sufficient scope to ensure that, consistent with Federal and State statutes prohibiting discrimination on the basis of disability or handicap, no person shall assume his/her duties unless he/she is free from a health impairment that would present a risk to the resident which cannot be reasonably accommodated, or which might interfere with the performance of his/her duties, including the habituation or addiction to depressants, stimulants, narcotics, alcohol or other drugs or substances which may alter the individual's behavior. The nursing home is required to provide such examination without cost for all employees. The nursing home shall also conduct a health status assessment of all volunteers whose activities are such that a health impairment would pose a risk to residents or personnel, in order to determine that the health and well being of residents and personnel are not jeopardized by the condition of such volunteers. The nursing home shall require the following of all personnel as a condition of employment or affiliation:
(1) for all personnel prior to employment or affiliation, except for personnel with no clinical or patient contact responsibilities who are located in a building or site with no patient care services, an initial individual tuberculosis (TB) risk assessment, symptom evaluation, and TB test (either tuberculin skin test or Food and Drug Administration [FDA] approved blood assay for the detection of latent tuberculosis infection), and annual assessments thereafter. Positive findings shall require appropriate clinical follow-up. The medical staff shall develop and implement policies regarding positive findings, including procedures for facilitating and documenting treatment for latent TB infection where indicated. Annual TB assessment shall include education, individual risk assessment, and follow-up tests as indicated; and
(2) a certificate of immunization against rubella which means:
(i) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of rubella antibodies;
(ii) a document indicating one dose of live virus rubella vaccine was administered on or after the age of 12 months, showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization; or
(iii) a copy of a document described in item ( i ) or ( ii ) of this subclause, which comes from a previous employer or the school which the employee attended as a student; and
(3) a certificate of immunization against measles, for all personnel born on or after January 1, 1957, which means:
(i) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of measles antibodies;
(ii) a document indicating two doses of live virus measles vaccine were administered with the first dose administered on or after the age of 12 months and the second dose administered more than 30 days after the first dose but after 15 months of age showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization;
(iii) a document, indicating a diagnosis of the employee as having had measles disease, prepared by the physician, physician's assistant/specialist's assistant, licensed midwife or nurse practitioner who diagnosed the employee's measles; or
(iv) a copy of a document described in item ( i ), ( ii ) or ( iii ) of this subclause which comes from a previous employer or the school which the employee attended as a student;
(4) if any licensed physician, physician's assistant/specialist's assistant, licensed midwife or nurse practitioner certifies that immunization with measles and/or rubella vaccine may be detrimental to the employee's health, the requirements of subclause ( 2 ) and/or ( 3 ) of this clause relating to measles and/or rubella immunization shall be inapplicable until such immunization is found no longer to be detrimental to such employee's health. The nature and duration of the medical exemption must be stated in the employee's employment medical record and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the American Academy of Pediatrics and the Immunization Practices Advisory Committee of the U.S. Department of Health and Human Services);
(b) the reassessment of the health status of all personnel as frequently as necessary, but no less than annually, to ensure that personnel are free from health impairments which pose a risk to residents or personnel which cannot be reasonably accommodated or which may interfere with the performance of duties;
(c) that all personnel report immediately to their supervisor or the administrator any signs or symptoms of personal illness. All personnel making such report shall be referred to an appropriate health care professional for assessment of the risk to residents and personnel. Based on this assessment, the nursing home shall authorize appropriate measures to be taken, including but not limited to removal, reassignment or return to duty.
(2) For all personnel, the facility shall provide planned orientation and staff development programs, including but not limited to:
(i) an orientation for each new employee prior to or within one week of employment;
(ii) on-the-job skill training as is necessary for each to properly perform his or her job;
(iii) continuous staff development programs to increase knowledge, skills and understanding of problems and ways of dealing with problems associated with residents needing nursing home care including knowledge of the quality assurance and assessment program in the facility; and
(iv) maintenance of records of these activities, including the methods used and an evaluation on their effectiveness.
(3) For all personnel who provide services in the nursing home, for whom licensure, registration or certification is required, the facility shall obtain and retain verification of license number or certification with expiration date of same.
(4) For all services and departments, the facility shall maintain:
(i) an organization chart;
(ii) a master plan for staffing; and
(iii) policies and procedure manuals.
(d) Nurse aide certification and training.
(1) Definitions. The following terms used in this section shall be defined as follows:
(i) Nurse aide training program coordinator shall mean a person who is assigned the administrative responsibility and accountability for the RHCF nurse aide training program. The program coordinator (PC) shall be a registered professional nurse with at least two years experience in a nursing home and demonstrated competency to teach adult learners as evidenced and documented by at least one of the following:
(a) completion of a professionally recognized course in teaching adult learners or New York State Education Department teacher certification;
(b) two years of experience teaching nursing or nursing related programs to adults in an academic setting approved by the State Education Department or other recognized accrediting body; or
(c) two years of experience teaching nurse aides in a residential health care facility.
(ii) Instructor shall mean the person who is assigned the educational responsibility for the nursing home nurse aide training program. This person shall have the day-to-day responsibility for implementing the facility's training program in accordance with the facility's policies and procedures and State and Federal requirements. The instructor shall be a registered professional nurse with at least one year of experience in a nursing home who has demonstrated ability to teach adult learners as evidenced and documented by at least one of the following:
(a) completion of a professionally recognized course in teaching adult learners or New York State Education Department teacher certification;
(b) two years of experience teaching nursing or nursing related programs to adults in an academic setting approved by the State Education Department or other recognized accrediting body; or
(c) two years of experience teaching nurse aides in a residential health care facility.
(iii) Clinical skills evaluator or nurse aide evaluator shall mean a person who administers part or all of the State authorized residential health care facility nurse aide competency examinations. This person shall be a registered professional nurse who has one year of nursing home experience and has successfully completed the State approved clinical evaluator or nurse aide evaluator program. Effective July 1, 1992 only individuals possessing nurse aide evaluator designation may administer the State RHCF nurse aide competency examinations.
(2) Nurse aide certification. In order to obtain nurse aide certification and be listed in the New York State RHCF Nurse Aide Registry as described in section 415.31 of this Part, an individual must successfully complete a State approved residential health care facility nurse aide training program as described in paragraph (2) of this subdivision and pass the State authorized clinical skills competency examination and written or oral competency examination as described in paragraph (3) of this subdivision.
(i) The residential health care facility nurse aide training program shall be reviewed and approved by the department prior to implementation as to the requirements contained in this section.
(ii) The facility shall be notified by the department within 90 days of the submission of the program whether the program has been approved, disapproved or additional information is required.
(iii) Program approval will be granted for a term not to exceed two years and is subject to on-site review for the purpose of determining compliance with applicable State and Federal requirements during the course of all facility surveys.
(iv) Approved programs must notify the department, in the form and manner described by the department, and may be subject to review, whenever substantive changes are made to the program.
(v) Approval to provide training by or in the facility will be withdrawn by the department for up to two years each time the facility:
(a) fails to permit unannounced visits;
(b) fails to meet all of the applicable Federal and State requirements for nurse aide training and competency evaluation;
(c) is subjected to an extended or partial extended survey;
(d) is assessed a civil monetary penalty of $5,000 or more;
(e) has a temporary manager, receiver or caretaker appointed; or
(f) is subjected to a ban on admissions or a denial of payment under either the title XVIII or title XIX programs.
(3) Nurse aide training program.
The training program shall be supervised by a program coordinator who meets the definition specified in subparagraph (1)(i) of this subdivision and conducted by the instructor who meets the definition specified in subparagraph (1)(ii) of this subdivision. The program coordinator may be the director of nursing services provided that the director of nursing services does not perform the actual training. Additional health care personnel may supplement the instructor to provide specialized training provided that such supplemental trainers have at least one year of experience in their field of expertise.
(i) The nurse aide training program shall include classroom and clinical training which enhances both skills and knowledge and, when combined, shall be of at least 100 hours' duration. The clinical training shall as a minimum include at least 30 hours of supervised practical experience in a nursing home. The nurse aide training program shall include stated goals, objectives, and measurable performance criteria specific to the curriculum subject material, the resident population and the purpose of the facility, and shall be consistent with the curriculum outlined below. This curriculum shall be taught at a fourth to sixth grade English literacy level. Facilities with special populations shall supplement the curriculum to address the needs of such populations accordingly. The curriculum shall otherwise include, but not be limited to the following:
(a) normal aging:
(1) anatomical changes;
(2) physiological changes;
(3) psychosocial aspects:
(i) role changes;
(ii) cultural changes;
(iii) spiritual needs; and
(iv) psychological and cognitive changes; and
(4) concept of wellness and rehabilitation.
(b) psychological needs of the resident:
(1) adjustment to institutional living;
(2) working with resident and family during admission/transfer/discharge;
(3) residents' rights:
(i) respect and dignity;
(ii) confidentiality;
(iii) privacy; and
(iv) self-determination; and
(4) sexual adjustments in relation to illness, physical handicaps and institutional living;
(c) communication in health care facilities:
(1) relating to residents, families, visitors, and staff;
(2) methods of communication in overcoming the barriers of language and cultural-differences; and
(3) communicating with residents who have sensory loss, memory, cognitive or perceptual impairment;
(d) personal care needs:
(1) care of the skin, mouth, hair, ears and nails; and
(2) dressing and grooming;
(e) resident unit and equipment:
(1) bed-making; and
(2) care of personal belongings such as clothing, dentures, eyeglasses, hearing aids and prostheses;
(f) nutritional needs:
(1) basic nutritional requirements for foods and fluids;
(2) special diets;
(3) meal services;
(4) assistance with eating:
(i) use of adaptive equipment; and
(ii) feeding the resident who needs assistance; and
(5) measuring and recording fluid and food intake;
(g) elimination needs:
(1) physiology of bowel and bladder continence:
(i) maintaining bowel regularity; and
(ii) physical, psychosocial and environmental causes of incontinence;
(2) nursing care for the resident with urinary and/or bowel incontinence:
(i) toileting programs;
(ii) care of urinary drainage equipment;
(iii) use of protective clothing; and
(iv) enemas;
(3) measuring urinary output;
(4) bowel and bladder training programs; and
(5) care of ostomies including but not limited to colostomy and ileostomy;
(h) mobility needs:
(1) effects of immobility; and
(2) ambulation and transfer techniques:
(i) use of assistive devices;
(ii) use of wheelchairs; and
(iii) use of mechanical lifters;
(i) sleep and rest needs:
(1) activity, exercise and rest; and
(2) sleep patterns and disturbances;
(j) nursing care programs for the prevention of contractures and decubitus ulcers (pressure sores);
(1) body alignment, turning and positioning;
(2) individualized exercise programs;
(3) special skin care procedures;
(4) use of special aids; and
(5) maintenance of individualized range of motion;
(k) observing and reporting signs and symptoms of disability and illness:
(1) physical signs and symptoms:
(i) determination of temperature, pulse, respiration;
(ii) testing urine;
(iii) measuring height and weight;
(2) behavioral changes; and
(3) recognizing and reporting abnormal signs and symptoms of common diseases and conditions, including but not limited to:
(i) shortness of breath;
(ii) rapid respirations;
(iii) coughs;
(iv) chills;
(v) pain and pains in chest or abdomen;
(vi) blue color to lips;
(vii) nausea;
(viii) vomiting;
(ix) drowsiness;
(x) excessive thirst;
(xi) sweating;
(xii) pus;
(xiii) blood or sediment in urine;
(xiv) difficult or painful urination;
(xv) foul-smelling or concentrated urine; and
(xvi) urinary frequency;
(l) infection control:
(1) medical asepsis;
(2) handwashing; and
(3) care of residents in isolation;
(m) resident safety:
(1) environmental hazards;
(2) smoking;
(3) oxygen safety; and
(4) use of restraints;
(n) nursing care needs of resident with special needs due to medical conditions such as but not limited to:
(1) stroke;
(2) respiratory problems;
(3) seizure disorders;
(4) cardiovascular disorders;
(5) sensory loss and deficits;
(6) pain management;
(7) mentally impairing conditions:
(i) associated behavior disorders; and
(ii) characteristics of residents such as wandering, agitation, physical and verbal abuse, sleep disorders, and appetite changes;
(o) mental health and social service needs:
(1) self care according to the resident's capabilities;
(2) modifying behavior in response to the behavior of others;
(3) developmental tasks associated with the aging process; and
(4) utilizing the resident's family as a source of emotional support;
(p) resident rights; and
(q) care of the dying resident including care of the body and personal effects after death.
(r) care of cognitively impaired residents:
(1) techniques for addressing the unique needs and behaviors of individuals with dementia;
(2) communicating with cognitively impaired residents;
(3) understanding the behaviors of cognitively impaired residents;
(4) appropriate responses to the behaviors of cognitively impaired residents; and
(5) methods of reducing the effects of cognitive impairments.
(ii) The training program shall maintain a performance record of the major duties and skills taught each nurse aide trainee. At the end of the training program, a copy of the performance record shall be given to the trainee and the trainee's employer, if different from the training facility. As a minimum, the performance record shall include the following;
(a) a listing of the measurable performance criteria for each duty and skill expected to be learned in the program;
(b) an entry showing satisfactory or unsatisfactory performance;
(c) the date of the performance; and
(d) the name of the instructor supervising the performance.
(4) Nurse aide competency evaluation.
Subsequent to the completion of the nurse aide training program including the satisfactory performance of all duties and skills listed in the performance record, the facility shall arrange for the nurse aide trainee to take and pass the State authorized residential health care facility nurse aide clinical skills competency examination and the written or oral competency examination as follows:
(i) the clinical skills competency examination shall be given by a licensed registered nurse, who meets the definition of the clinical skills evaluator until June 30, 1992 and effective July 1, 1992 the nurse aide evaluator specified in subparagraph (1)(iii) of this subdivision and who is not otherwise associated with the facility employing and/or training the nurse aide trainee. The trainee shall have three opportunities to pass the clinical skills examination; and
(ii) after passing the clinical skills examination, the trainee shall have three opportunities to pass the written or oral competency examination. The nurse aide trainee will obtain certification and be listed in the Registry upon passing the written or oral examination.
(5) The operator shall not charge a fee to any individual for the costs of training, including textbooks and materials, or for the costs of the competency examinations.
(i) If within 12 months of completing a State approved RHCF nurse aide training program, an individual is employed or is given an offer of employment by a facility, the facility must arrange, in a form and manner indicated by the department, for the individual to receive reimbursement from the State for the amount of the costs, up to the CAP established by the State, incurred by the individual for the training. Such reimbursement shall be on a pro rata basis based on the length of subsequent employment as an RHCF nurse aide in the RHCF.
(ii) If within 12 months of completing the State approved RHCF nurse aide competency evaluation program, an individual is employed or is given an offer of employment by a facility, the facility must arrange, in a form and manner indicated by the department, for the individual to receive reimbursement from the State for the acceptable amount of the costs, up to the CAP established by the State, incurred by the individual for the examinations. Such reimbursement shall be on a pro rata basis based on the length of subsequent employment as an RHCF nurse aide in the RHCF.
(6) Nurse aide recertification.
The certified nurse aide shall be recertified every two years no later than the last day of the month in which certification was received. To obtain recertification the certified nurse aide shall demonstrate in the form indicated by the department that he/she has worked at least seven hours for compensation as a health care nurse aide during the previous 24-month period. The operator shall implement nurse aide recertification in accordance with the following:
(i) the required documentation shall be provided in the form indicated by the department to each nurse aide who either currently works for or last worked for compensation as a nurse aide in the facility;
(ii) a fee shall not be charged by the operator to any nurse aide for any cost associated with recertification;
(iii) the recertification fee for each nurse aide who either currently works for or last worked for compensation as a nurse aide in the facility shall be paid by the operator except that the nurse aide staffing agency or employment organization which currently employs the nurse aide may pay this fee; and
(iv) after any period of 24 consecutive months during which the certified nurse aide did not provide nurse aide care for compensation in a residential health care facility, such nurse aide shall be required to requalify as specified in the following clause ( a ) or ( b ) of this subparagraph to be listed in the New York State RHCF Nurse Aide Registry:
(a) nurse aides who, on or after July 1, 1989, successfully completed a State-approved nurse aide training program in accordance with applicable Federal and State requirements, must pass the State-authorized residential health care facility nurse aide clinical skills competency examination and the written or oral competency examination; and
(b) all other nurse aides must successfully complete a State-approved nurse aide training program and pass the State-authorized residential health care facility nurse aide clinical skills competency examination and the written or oral competency examination.
(7) The operator shall complete a performance review of each nurse aide at least once every 12 months.
(i) Written records shall be maintained which indicate the content of and attendance at each inservice training program.
(ii) Each nurse aide trainee and certified nurse aide shall attend and be compensated for at least six hours of inservice education in every six-month period.
(8) The operator shall ensure that the certified nurse aide regularly attends inservice education programs provided for all personnel and that the programs shall include the following:
(i) a portion of each individual's annual inservice education as required by subparagraph (iv) of this paragraph shall be based upon the outcome of the individual's annual performance review as specified in paragraph (7) of this subdivision, and address the areas of weakness in the individual's performance;
(ii) inservice education must also address the special needs of the residents in the facility, including the care of the cognitively impaired;
(iii) written records shall be maintained which indicate the content of and attendance at each inservice training program and the outcomes of the performance review; and
(iv) each certified nurse aide shall attend and be compensated for inservice education sufficient to ensure the continuing competence of the nurse aide of not less than six hours of inservice education in every six-month period.
(e) Use of outside resources.
If the nursing home does not employ a qualified professional person to furnish a specific service to be provided by the facility, the nursing home shall have that service furnished to residents by a qualified person or agency outside the facility in accordance with the following:
(1) The operator shall enter into written agreement with the outside resource which shall comply with the provisions of this section and section 400.4 of this Title and shall:
(i) specify that the operator retains professional and administrative responsibility for obtaining services that meet professional standards and principles that apply to professionals providing services in such a facility;
(ii) require that such services are provided on a timely basis;
(iii) set forth the responsibilities, function, objectives and terms of the agreement, including financial arrangements and charges of each such outside resource; and
(iv) be signed by an authorized representative of the facility and the person or the agency providing the service.
(2) The outside resource, when acting as a consultant, shall apprise the administrator of recommendations, plans for implementation and continuing assessment in his or her areas of responsibility through dated, signed reports which shall be retained by the administrator for follow-up action and evaluation of performance.
(f) Disaster and emergency preparedness.
(1) The nursing home shall have a written plan, updated at least twice a year, with procedures to be followed for the proper care of residents and personnel, and for the reception and treatment of mass casualty victims, in the event of an internal or external emergency resulting from natural or man-made causes including but not limited to earthquake, severe weather, flood, bomb threat, chemical spills, strike, interruption of utility services, nuclear accidents, fire or similar occurrences.
(2) The nursing home shall develop and implement written policies concerning missing residents.
(3) The nursing home shall:
(i) train all employees in emergency procedures when they begin to work for the facility;
(ii) periodically, but at least annually review the written plan with existing staff; and
(iii) carry out staff drills in accordance with the written plan at least twice a year.
(g) Transfer agreements.
Nursing homes shall have in effect a written transfer agreement with one or more general hospitals as required to meet the medical care needs of residents. Such transfer agreements shall:
(1) comply with the provisions of section 400.9 of this Title;
(2) ensure that residents are admitted to the general hospital on a timely basis when such transfer is medically appropriate as determined by the attending physician or other approved practitioner; and
(3) provide for the transfer of medical and other information needed for care and treatment of residents, when the transferring facility deems it appropriate.
(h) Financial policies.
(1) The facility shall:
(i) specify its refund policies in writing to each resident, next of kin and/or sponsor prior to admission; and
(ii) refund promptly any amount or proportion of prepayment in excess of the amount or proportion thereof obligated for services already furnished in the event the resident leaves the nursing home prior to the end of the prepayment period for reasons beyond the control of the resident, next of kin and/or sponsor. In the event that the resident leaves for reasons within his or her control, or that of the next of kin and/or sponsor, the facility shall not retain from the prepayment or charge in the absence of a prepayment, an amount in excess of one day's basic rate in addition to any amount obligated for services already furnished.
(2) The facility shall not enter into any contract or agreement with the resident, next of kin and/or sponsor for life care of the resident.
(3) No facility or agent, consultant, employee or representative thereof shall:
(i) pay any commission, bonus, rebate or gratuity to any organization, agency, physician, employee or other person for referral of any resident to the nursing home;
(ii) request and/or accept any remuneration, tip or gratuity in any form from a resident, next of kin and/or sponsor for any services provided or arranged or for denial of services by the nursing home other than specified fees ordinarily paid for care, excluding donations, gifts and legacies given in behalf of the facility; or
(iii) accept any remuneration, rebate, gift, benefit or advantage of any form from any vendor or other supplier because of the purchase, rental or loan of equipment, supplies or services for the facility or resident, excluding normal business practices.
(4) In the event that the operator of the facility and the consulting physician or any other professional provider of services are one and the same person, he or she shall not reimburse himself or herself as consultant for such services provided to the facility or directly to any resident other than for services provided in an emergency.
(5) If a resident authorizes the facility in writing to manage his or her personal finances in accordance with section 415.3(g)(1) of this Part, the facility shall hold, safeguard, manage and account for personal funds of the resident deposited with the facility in accordance with the following:
(i) Deposit of funds.
(a) Funds in excess of $50. The facility shall deposit any resident's personal funds in excess of $50 in an interest bearing account (or accounts) that is separate from any of the facility's operating accounts, and that credits all interest earned on the resident's funds to his or her account. In pooled accounts, there shall be a separate accounting for each resident's share.
(b) Funds less than $50. The facility shall maintain a resident's personal funds that do not exceed $50 in a non-interest bearing account or petty cash fund.
(ii) Accounting and records. The facility shall establish and maintain a system that assures a full and complete and separate accounting, according to generally accepted accounting principles, of each resident's personal funds entrusted to the facility on the resident's behalf. The system shall contain, as a minimum, the resident's name, Medicaid case number where applicable, date of admission, date and amount of each withdrawal or deposit, and balance at each transaction.
(a) The system shall preclude any commingling of resident funds with facility funds or with the funds of any person other than another resident.
(b) The individual financial record shall be available within one business day of a request, to the resident or his or her designated representative.
(c) The individual financial record shall document each deposit or withdrawal of funds including the signature of the resident or the resident's designated representative for each transaction.
(iii) Notice of certain balances. The facility shall notify the resident when the amount in the account of a resident who receives Medicaid benefits reaches $200 less than the SSI resource limit for one person, specified in section 1611(a)(3)(B) of the Social Security Act, and that, if the amount in the account, in addition to the value of the resident's other nonexempt resources, should reach the SSI resource limit for one person, the resident may lose eligibility for Medicaid or SSI.
(iv) Conveyance upon death. Upon the death of a resident with a personal fund deposited with the facility, the facility shall convey within 30 days the resident's funds, and a final accounting of those funds, to the individual or probate jurisdiction administering the resident's estate.
(v) Assurance of financial security. The facility shall purchase a surety bond, or provide self-insurance, to assure the security of all personal funds of residents deposited with the facility.
(vi) Limitation on charges to personal funds. The facility shall not impose a charge against the personal funds of a resident for any item or service for which payment is made under Medicaid or Medicare (except for applicable deductible and coinsurance amounts). The facility may charge the resident for requested services that are more expensive than or in excess of covered services.
(a) Services included in Medicare or Medicaid payment. During the course of a covered Medicare or Medicaid stay, the facilities shall not charge a resident for the following items and services:
(1) nursing services and specialized rehabilitative services;
(2) dietary services;
(3) an activities program;
(4) room/bed maintenance services; and
(5) routine personal hygiene items and services.
(b) Optional covered items and services. A facility may choose to provide residents with supplies, equipment and transportation essential to the activities program required by section 415.5(g) of this Title. If it chooses to provide these items and services, they shall be included as covered Medicare or Medicaid services and reimbursed under those program benefits. No charges shall be made to residents for those services.
(c) Items and services that may be charged to residents' funds. Listed below are general categories and examples of items and services that the facility may charge to residents' funds if they are requested by a resident and payment is not made by Medicare or Medicaid:
(1) telephone;
(2) television/radio for personal use;
(3) personal comfort items, including smoking materials, notions and novelties, and confections;
(4) cosmetic and grooming items and services, in excess of those for which payment is made under Medicaid or Medicare;
(5) personal clothing;
(6) personal reading matter;
(7) gifts purchased on behalf of a resident;
(8) flowers and plants;
(9) social events and entertainment offered off the premises and outside the scope of the activities program, provided under section 415.5(g) of this Part;
(10) noncovered special care services such as private duty nurses consistent with Medicare and Medicaid rules and regulations for residents who are beneficiaries of these programs; and
(11) specially prepared or alternative food requested instead of the food generally prepared by the facility, if it is documented that the requested food costs more than food provided to other residents, except that food provided under section 415.3(f)(6) of this Part shall not be charged to residents' funds.
(d) Requests for items and services.
(1) The facility shall not charge a resident or his or her designated representative for any item or service not requested by the resident or the designated representative.
(2) The facility shall not require a resident or his or her designated representative to request any item or service as a condition of admission or continued stay.
(3) The facility shall inform the resident or his or her designated representative requesting an item or service for which a charge will be made that there will be a charge for the item or service and what the charge will be.
(6) The facility shall:
(i) upon receiving prepayment or advance money for the purpose of being applied to payments in satisfaction of or as security for the performance of facility responsibilities, deposit such money, which shall continue to be the money of the person making the prepayment, in an interest-bearing account in a bank or with a financial agent;
(ii) not be required to deposit prepayment in an interest-bearing account where such money is to be applied to payments when due, until 61 days after such prepayment or advanced money is made;
(iii) notify in writing each of the persons making such prepayment of the name and address of the bank or financial agent with which the deposit is made and the amount of such deposit;
(iv) be entitled to receive an administrative expense equivalent to one percent per annum upon the prepayment money deposited, which shall be in lieu of all other administrative expenses;
(v) inform any person making prepayment as security for the performance of facility responsibilities that waivers of the provisions of this paragraph are void.
(7) Equity withdrawal.
No facility or governing body may withdraw or reduce a facility's equity so as to create or increase a negative net worth by means of a withdrawal without the prior approval of the commissioner.
(i) The term withdrawal shall mean:
(a) any payment of cash or transfer of other assets by a facility directly or indirectly to or for the benefit of its operator or owner; and
(b) any liability or contingent liability incurred within any period of 12 consecutive months by a facility or its operator by reason of a mortgage, lease, borrowing or other transaction relating to such facility that exceeds, in the aggregate, $25,000.
(ii) Negative net worth shall be calculated without regard to any surplus created by reevaluation of assets.
(iii) An application for approval shall be submitted in writing at least 60 days prior to the proposed withdrawal and shall specify the purpose of the withdrawal and the details concerning such withdrawal including, where applicable, such items as the principal amount, interest rate, repayment terms, conditions of default, remedies upon default and obligee of any transaction to be consummated in a proposed withdrawal. The application shall contain a verified current balance sheet and a description of the facility's cash position, including as cash such cash equivalents as certificates of deposit and treasury bills.
(iv) In reviewing an application for withdrawal, the commissioner shall consider:
(a) the necessity for the withdrawal;
(b) whether such withdrawal would impair the facility's ability to render quality care;
(c) any expense which such withdrawal would generate; and
(d) the financial condition of the facility in general.
(8) No facility shall enter into a real property mortgage or lease transaction without 30 days' prior notice in writing to the commissioner.
(i) Admission policies and practices.
(1) The nursing home shall:
(i) admit a resident only on physician's orders and in accordance with the resident assessment criteria and standards as promulgated and published by the department, and specified in sections 86-2.30(i) and 400.12 of this Title, which shall include, as a minimum:
(a) an assessment, performed prior to admission by or on behalf of the agency or person seeking admission for the resident of the resident's level of care needs according to the resident assessment criteria and standards promulgated and published by the department (and specified in sections 86-2.30[i] and 400.12 of this Title);
(b) for those residents failing to meet the criteria and standards for admission to the nursing home (as indicated in New York State criteria for level of care, specified in section 400.12 of this Title), a certification signed by a physician member of the transferring facility's utilization review agent or signed by the responsible social services district's local Medicaid medical director or designee, indicating the reason(s) the resident requires nursing home level of care; and
(c) for residents in general hospitals and residing in the community, the SCREEN, as specified in section 400.12 of this Title, performed prior to admission to the nursing home shall not be completed by personnel of a residential health care facility, except where a certified home health agency or other appropriate community-based assessor has been contacted by the resident or the resident's designated representative, for the purpose of completing the SCREEN, and has not completed the SCREEN within 48 hours;
(ii) accept and retain only those nursing home residents for whom it can provide adequate care;
(iii) admit each resident only after a pre-admission personal interview with the resident's physician, the resident, his or her next of kin and/or sponsor, as appropriate, except that a telephone interview may be substituted when a personal interview is not feasible, and a summary of all interviews shall be recorded on the resident's chart or other appropriate record;
(iv) maintain a written record of all financial arrangements with the resident, his or her next of kin and/or sponsor, with copies executed by and furnished to each party;
(v) make no arrangement for prepayment for basic services exceeding three months;
(vi) assess no additional charges, expenses or other financial liabilities in excess of the daily, weekly or monthly basic rate except:
(a) upon express written approval and authority of the resident, next of kin or sponsor;
(b) upon express written orders of the resident's personal, alternate or staff physician stipulating specific services and supplies not included as basic services;
(c) upon 30 days' prior written notice to the resident or designated representative, of additional charges, expenses or other financial liabilities due to the increased cost of maintenance and/or operation of the nursing home; and, upon request of the resident, designated representative or of the department, financial and statistical supportive evidence sufficient to reflect such change in economic status shall be provided; or
(d) in the event of a health emergency involving the resident and requiring immediate special services or supplies to be furnished during the period of the emergency;
(vii) provide to each resident or designated representative at the time of admission, a written copy of the following information and services which shall be considered as basic information and services to be made available to all residents:
(a) the daily, weekly or monthly rate;
(b) board, including therapeutic or modified diets, as prescribed by a physician;
(c) lodging; a clean, healthful, sheltered environment, properly outfitted;
(d) 24 hours-per-day nursing care;
(e) the use of all equipment, medical supplies and modalities, notwithstanding the quantity usually used in the everyday care of nursing home residents, including but not limited to catheters, hypodermic syringes and needles, irrigation outfits, dressings and pads, and so forth;
(f) fresh bed linen, as required, changed at least twice weekly, including sufficient quantities of necessary bed linen or appropriate substitutes changed as often as required for incontinent residents;
(g) hospital gowns or pajamas as required by the clinical condition of the resident, unless the resident, next of kin or sponsor elects to furnish them, and laundry services for these and other launderable personal clothing items;
(h) general household medicine cabinet supplies, including but not limited to non-prescription medications, materials for routine skin care, oral hygiene, care of hair, and so forth, except when specific items are medically indicated and prescribed for exceptional use for a specific resident;
(i) assistance and/or supervision, when required, with activities of daily living, including but not limited to toilet, bathing, feeding and ambulation assistance;
(j) services, in the daily performance of their assigned duties, by members of the nursing home staff concerned with resident care;
(k) use of customarily stocked equipment, including but not limited to crutches, walkers, wheelchairs or other supportive equipment, including training in their use when necessary, unless such item is prescribed by a physician for regular and sole use-by a specific resident;
(l) activities program, including but not limited to a planned schedule of recreational, motivational, social and other activities, together with the necessary materials and supplies to make the resident's life more meaningful;
(m) social services as needed;
(n) physical therapy, on either a staff or fee-for-service basis, as prescribed by a physician, administered by or under the direct supervision of a licensed and currently registered physical therapist;
(o) occupational therapy, on either a staff or fee-for-service basis, as prescribed by a physician, administered by or under the supervision of a qualified occupational therapist;
(p) speech pathology services, on either a staff or fee-for-service basis, as prescribed by a physician, administered by a qualified speech pathologist;
(q) audiology services, on either a staff or fee-for-service basis, as prescribed by a physician, administered by a qualified audiologist; and
(r) dental services, on either a staff or fee-for-service basis, as administered by or under either the personal or general supervision of a licensed and currently registered dentist;
(viii) apply the following restrictions to the admission and retention of residents:
(a) residents under 16 years of age shall be admitted only to a nursing home area approved for such occupancy by the department and separate and apart from adult residents;
(b) prenatal, intrapartum or postpartum, and maternity patients shall not be admitted;
(c) residents identified and assessed to need nursing home care shall not be barred from admission or retention solely on the basis that they are also maintained on alcohol or substance abuse treatment programs; and
(d) a resident suffering from a communicable disease shall not be admitted or retained unless a physician certifies in writing that transmissibility is negligible, and poses no danger to other residents, or the facility is staffed and equipped to manage such cases without endangering the health of other residents;
(ix) not discriminate because of race, color, blindness, sexual preference or sponsorship in admission, retention and care of residents;
(x) establish and implement written policies and procedures governing the admission process which ensure compliance with State and Federal anti-discrimination laws which apply to the governing body. Such laws include, but need not be limited to, the applicable provisions of this Part; Public Health Law, section 280a(9); the New York State Civil Rights Law, sections 40 and 40-c; article 15 (Human Rights Law) of the State Executive Law, sections 291, 292 and 296 and title 42 of the United States Code, sections 1981, 2000a, 2000a-2, 2000d, 3602, 3604 and 3607. Copies of the cited State and federal statues are available from West Publishing Company, P.O. Box No. 64526, St. Paul, MN 55164-0526, the publisher of McKinney's Consolidated Laws of New York annotated and the United States Code annotated. Copies of such statues are also available for public inspection and copying at the Records Access Office, Department of Health, Tower Building, Empire State Plaza, Albany, NY 12237. The policies and procedures shall include but not be limited to the following:
(a) the prominent inclusion in admission application forms and policy statements of a legend summarizing the applicable federal and State anti-discrimination laws;
(b) the prominent display in the admissions office of the New York State Division of Human Rights nondiscrimination regulatory poster. This poster is available from the State Division of Human Rights, 55 West 125 Street, New York, NY 10027. A copy of this poster is also available for public inspection and copying at the Department of Health's Records Access Office at the address set forth above;
(c) explicit advice to potential patients of their right to nondiscriminatory treatment in admissions;
(d) the training of admission personnel in the requirements of federal and State anti-discrimination laws listed above; and
(e) written admission policies which specifically state the criteria used in making admission decisions. If a waiting list is used in making admission decisions, the list shall be maintained in written form including the date of each application. The operation and utilization of the waiting list shall be described in the written admission policies;
(xi) furnish to all hospitals within the long-term care planning area and to any hospital, referral agency, or individual upon request a copy of the facility's admission policies; and
(xii) maintain a centralized log on the receipt and disposition by the facility of persons referred for admission. For the purposes of this subdivision, receipt by the facility of a completed hospital/community patient review instrument for a person needing nursing home care shall constitute a patient referral. The log shall contain for each referral a patient identifier, and indicate the race, sex, color, national origin of the referral, the date of referral, referring hospital or agency, and date and type of disposition of referral by the facility. Records of such log shall be retained for 18 months from date of entry. In lieu of a log, a facility may meet the requirements of this subdivision by retaining the completed hospital/community patient review instrument forms received by the facility for 18 months from receipt in a central place organized by date of receipt and marked by date and type of disposition.
(2) The nursing home shall advise each potential resident or designated representative prior to or at the time of admission, that all medical and dental services which are provided by the facility will be provided by practitioners who have an affiliation with the facility. Potential residents whose personal attending physician or dentist is not approved to provide services to the resident after admission shall be duly notified prior to or at the time of admission. The facility shall promptly receive and evaluate requests by such personal attending physician or dentist, to be approved to attend to such prospective resident consistent with resident care policies and procedures of the facility.
(3) The nursing home shall advise each potential resident or designated representative that he or she may seek a second opinion if he or she disagrees with the diagnosis or treatment being provided, and may call in a specialist selected by the resident or designated representative for medical consultation. The facility shall not be required to bear the expense of such visit.
(j) Misappropriation of resident property.
The nursing home shall establish and implement policies and procedures for the receipt, review and investigation of allegations of misappropriation of resident property by individuals in the employ of and/or whose services are utilized by the facility. Such policies and procedures shall be coordinated with the process governing the handling of complaints as set forth in section 415.3 of this Part.
(1) For purposes of this subdivision, misappropriation of resident property shall mean the theft, unauthorized use or removal, embezzlement or intentional destruction of the resident's personal property including but not limited to money, clothing, furniture, appliances, jewelry, works of art, and such other possessions and articles belonging to the resident regardless of monetary value.
(2) In accordance with policies and procedures governing misappropriation of resident property, the nursing home shall:
(i) ensure that upon receipt of an allegation of misappropriation as submitted by the resident, designated representative, other individual or source, an investigation of the matter shall be undertaken not later than 48 hours after receipt;
(ii) maintain a log containing information regarding the receipt, review, investigation, and disposition of every allegation of misappropriation of resident's property including the name of the complainant and the resident, a description of the personal property involved, and staff designated to conduct the review and investigation;
(iii) notify the resident and complainant in writing as to the findings upon disposition of the allegation;
(iv) notify the appropriate police agency when the results of the investigation indicate there is reasonable cause to believe that a resident's personal property valued at more than $250 has been misappropriated or may elect to make such notification when the resident's personal property is valued at less than that amount;
(v) monitor the status of all referrals to a police agency on a regular basis but not less often than quarterly; and
(vi) notify the department within 72 hours of receipt of the notice that such referral resulted in conviction of an individual who was involved in misappropriation of resident property.
(3) Upon receipt of such notice of criminal conviction involving misappropriation of property by a nurse aide and after the department has provided to the individual an opportunity to be heard to dispute the allegations and conviction resulting from misappropriation of resident property, the department shall, pursuant to Public Health Law, section 2803-d, as amended by chapter 717 of the Laws of 1989, report such finding to the New York State RHCF Nurse Aide Registry established in accordance with Public Health Law, section 2803-j, as amended by such chapter. Any brief statement not exceeding 150 words by the nurse aide disputing the findings shall also be included in the report, provided that any such statement containing the names of any resident or complainant shall be returned to the submitting individual and shall not be reported to the registry.
(k) Feeding assistant training course.
(1) The feeding assistant training program shall consist of a minimum of 15 hours of education and training and must include all of the topics and lessons specified in the State-approved feeding assistant training program curriculum.
(2) The State-approved feeding assistant training program shall include, but not be limited to, training in the following content areas:
(i) resident rights;
(ii) infection control;
(iii) safety and emergency procedures, including Heimlich Maneuver;
(iv) communications and interpersonal skills;
(v) changes in resident's condition;
(vi) appropriate response to resident behavior;
(vii) assistance with eating and hydration; and
(viii) feeding techniques.
(3) The facility shall issue a certificate of completion to each individual who successfully completes the State-approved feeding assistant training program. The certificate shall include the full name of the feeding assistant and the facility-issued trainee or employee ID number, signature of feeding assistant, name and address of the facility, date the individual successfully completed the feeding assistant training program, name, title and signature of the training program instructor, and name and signature of the nursing home administrator.
(4) The facility shall retain records of each individual who completes their State-approved feeding assistant program. Such records shall include, but not be limited to:
(i) the full name of the feeding assistant, facility-issued trainee or employee ID number, name and address of the facility, dates on which each content area of the feeding assistant training program was delivered and successfully completed, the date on which the individual successfully completed the feeding assistant training program, and the name, title and signature of the training program instructor.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
LIQUID WASTES AND SEWAGE LIQUID WASTES AND SEWAGE
10 CRR-NY 14-4.130 Liquid waste and sewage holding and disposal
Sewage and liquid wastes are to be stored in a permanently installed holding tank that has at least 15 percent greater capacity than the water supply tank in a manner which protects the premises, personnel and contents within the establishment and surroundings from contamination. All plumbing is to be constructed and maintained to prevent contamination of the potable water supply, food equipment, utensils, the premises, contents, employees and patrons. All sewage and liquid waste is to be disposed of in a public sanitary sewer or a sewage disposal system constructed and operated in a manner acceptable to the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.11 Determinations of Commissioner of Health
(a) The Commissioner of Health may make a determination, as appropriate, that part or all of past, present or future inpatient care, services and supplies in a hospital are not a covered benefit under medical assistance for the needy if the hospital:
(1) has failed adequately to review, act upon, and report to the department regarding discharge information provided to the hospital which has been compiled and analyzed by the department from information submitted to it by the hospital under paragraph (4) of subdivision (e) of section 405.3, Medical Facilities - Minimum Standards;
(2) has failed to correct the deficiencies identified by the review of such discharge information;
(3) has failed to submit discharge information on the forms required under paragraph (4) of subdivision (e) of section 405.9, Medical Facilities -Minimum Standards or subdivision (c) of section 85.8 of this Part or has provided information on such forms which is not complete or not accurate;
(4) has claimed reimbursement for patients who did not meet benefit coverability definitions under this Part during a portion of or all of their inpatient hospital stay.
(5) has provided care, services and supplies in a manner which results in excessive patient stay;
(6) has failed fully to record information justifying benefit coverability of care or services provided;
(7) has failed to comply with section 405.26, Medical Facilities -Minimum Standards pertaining to utilization review;
(8) has failed to fulfill its responsibilities under this Part.
(b) Such determinations of noncoverability may be made with respect to inpatient hospital care which the commissioner's designee has previously determined to be a covered benefit under medical assistance for the needy. No determination of noncoverability shall be made pursuant to paragraphs (4), (5) and (6) of subdivision (a) of this section if the commissioner's designee has previously determined such inpatient hospital care to be a covered benefit under medical assistance for the needy and the designee was an employee of the State Department of Health.
(c) The commissioner may make a determination that certain conditions and types of inpatient hospital care, services and supplies are not a covered benefit as inpatient hospital care under medical assistance for the needy when evaluation and study of such conditions and types of care, services and supplies results in a finding that such care, services and supplies are not required to be performed on an inpatient hospital basis.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.157 Governing board
The policy-making board of the hospital. Some of the responsibilities usually attributed to the governing board may be assumed by appropriate committees.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.7 Collection, storage and disposition of reproductive tissue
(a) Semen collection containers shall be clean and nontoxic to sperm.
(b) Each semen collection container shall be labeled legibly prior to collection with the donor's or client-depositor's name or identification code, unless another system is used to ensure absolute identification, and shall also be labeled at the time of collection with the date and time of collection.
(c) Semen storage containers and support vehicles shall be labeled so as to maintain identification throughout all phases of processing, storage and distribution, in a manner not subject to deterioration at low temperatures. Such containers and/or vehicles shall be labeled with the reproductive tissue bank identification and semen specimen collection date, donor's identification code or, in the case of a client-depositor, his name and semen specimen collection date. Semen shall be frozen with a suitable cryopreservative and stored continuously until placed in either a freezer section reserved for semen, equipped with a thermometer, or a liquid nitrogen storage tank. The thermometer shall be calibrated at least annually against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, an NIST-certified thermometer. Thermometers shall be either visually monitored daily or continuously monitored mechanically, and, if applicable, liquid nitrogen levels shall be checked at least twice a week for fluctuations in temperature potentially affecting the quality of the semen. Storage shall be at a temperature of minus 130 degrees Celsius or lower. Semen from client-depositors shall be stored in a freezer section or tank separate from that for donor semen, and shall not be exposed to ambient air unless absolutely necessary. Temperature records or liquid nitrogen level records shall be available for inspection by the department for the entire period of storage and for one year afterward.
(d) Frozen semen in transit from a reproductive tissue bank to an insemination/implantation site shall be maintained in liquid nitrogen or vapor until immediately prior to the artificial insemination or assisted reproductive procedure. Frozen semen shall be transported by the bank or its agents, the staff of the insemination/implantation site, or the recipient with the written authorization of her physician.
(e) The insemination/implantation site shall inspect semen samples for proper labeling and appearance immediately after thawing. If the physical appearance is abnormal or there is indication or suspicion of overt microbial contamination, the semen shall not be utilized for artificial insemination or other assisted reproducted procedures.
(f) Reproductive tissue stored for a client-depositor shall not be destroyed or released for other purposes as a result of nonpayment of storage fees or for any other reasons, without documentation that the client-depositor was given at least 30-days' written notice by certified mail, return receipt requested.
(g) Oocytes shall be collected, processed and stored as oocytes or embryos according to written procedures approved by the reproductive tissue bank director in consultation with the medical director and the medical advisory committee. Storage containers and support vehicles shall be labeled or segregated so as to maintain tissue identification throughout all phases of processing, storage and distribution, in a manner not subject to deterioration at low temperatures. Final embryo containers shall be labeled with the identification code or name of the source of both the component oocyte and spermatozoan.
(h) Embryos shall not be created for donation by fertilizing donor oocytes with donor semen, except at the request of a specific patient who intends to use such embryos for her own treatment.
(i) Embryos shall not be created using semen or oocytes of client-depositors or directed donors who are blood relatives of the other gamete provider to a degree that their sexual contact would constitute incest under New York State law.
Chapter III PUBLIC WATER SUPPLIES
Subchapter C WATER SUPPLY SOURCES
Part 170 SOURCES OF WATER SUPPLY
10 CRR-NY 170.2 Applicability and scope
This Part shall apply throughout the entire State of New York, except the City of New York, and shall apply to all sources of water supply in the State and classified, under the authority of article 12 of the Public Health Law in Parts 701 through 703 of Title 6 of the Official Compilation of Codes, Rules and Regulations of the State of New York, as Classes AA, A, A-special (International boundary waters), AA-special (Lake Champlain drainage basin), AA-special (upper Hudson River drainage basin) and GA.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.7 Gross annual receipts
(a) A laboratory which has no gross annual receipts to report because it did not operate in New York State the previous permit year shall pay a first year accreditation fee of $1,000 regardless of the number of months remaining in the permit year. When applying for renewal of that permit, the laboratory shall report its gross receipts for the calendar months in which it operated and these receipts shall be projected to a 12-month basis for the purpose of computing gross annual receipts.
(b) A laboratory which has no permit, but accepted business which required it to have a New York State permit, had gross annual receipts in the previous permit year, and applies for a permit after commencement of the permit year shall pay a fee computed as an annual fee but prorated for the months remaining in the permit year, or $1,000, whichever is greater.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.4 Owner responsibilities and reporting requirements
(a) Each owner of an agricultural fairground must submit a report assessing all water sources at their respective fairgrounds. This report shall be prepared by a New York State licensed professional engineer, and must be submitted to the permit-issuing official at least 60 days before any event. This report is not required if the owner of the agricultural fairground can demonstrate that other documentation has been submitted to the permit-issuing official that adequately addresses the required components of the report, as specified in this section. This report shall address all drinking water sources for agricultural fairgrounds served by a nonpublic fairground water system and address all on-site water sources for those served by an off-site public water system. It shall include a sanitary survey and historical data and information on source development and quality; distribution system operations, including an assessment of actual and possible cross-connections; wastewater disposal; and solid and animal waste storage, handling and disposal practices, and certifying that any nonpotable water supply is adequately separated from the potable water supply and conspicuously labeled as a nonpotable water supply. Such report shall identify the location of all on-site structures and buildings, sources of on-site water (potable or nonpotable), water distribution systems, wastewater treatment facilities, and solid and animal waste storage and handling facilities, and shall adequately characterize the hydrogeology of the fairground. Such report shall also evaluate the fairground infrastructure's compliance with this Subpart and identify each aspect on noncompliance and preferred options for compliance.
(b) The owner of an agricultural fairground shall designate an individual to be in charge of the fairground property and to maintain the fairground facilities. Such individual shall be on or available to promptly be on the fairground property at all times when the agricultural fairground is occupied or open for occupancy. The telephone number or other method for summoning this individual shall be posted conspicuously in an area readily accessible by the agricultural fairground occupants.
(1) The agricultural fairground owner or the owner's designee shall successfully complete an adequate course of instruction with a curriculum including, but not limited to, the operation and/or oversight of agricultural fairground water supplies, sewage disposal, animal waste handling, and food service establishments.
(c) The agricultural fairground owner shall be responsible for operation and maintenance of the fairground infrastructure, including the water supply, sewage disposal, animal waste, toilet and handwashing facilities, in accordance with the requirements of this Subpart.
(d) The agricultural fairground owner must provide a written schedule and description of events for each calendar year to the permit-issuing official at least 30 days prior to the first scheduled event for the year. The schedule may be revised as necessary and the permit-issuing official shall be notified prior to any additional or rescheduled events.
(e) The agricultural fairground owner must require that all food service, campground or temporary residence facilities not operated by the agricultural fairground owner possess a valid permit as required by this Title.
(f) The agricultural fairground owner shall report the following to the permit-issuing official as soon as possible, and no later than 24 hours from the date of the occurrence or date the operator should reasonably have known of the occurrence:
(1) any public health hazard specified in section 7-5.5(b) of this Subpart or any illness suspected to be associated with such hazard; or
(2) any illness suspected to have resulted from consumption of food from a food service establishment at the agricultural fairground.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.8 Reporting requirements
Whenever requested, a nontransplant anatomic bank shall submit reports to the department containing such information and data concerning its activities as may be required by this Part. Such reports shall be signed by the director of the nontransplant anatomic bank.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.42 Ambulance service
(a) The costs of this service, regardless of how it is provided, must be reported as follows:
(1) As an ambulatory program service.
(2) Under account 6850—Ambulance Services.
(b) Data to be reported if the service exists.
(1) Does this service apply to Medicaid recipients in the same manner as all other recipients of this service?
(2) If not, explain:
(i) Reason for this policy.
(ii) Extent that Medicaid Service has been excluded from the amount reported.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.21 Outlier and transfer cases rates of payment
(a)
(1) High cost out lierrates of payment shall be calculated by reducing total billed patient charges, as approved by IPRO, to cost, as determined based on the hospital's ratio of cost to charges. Such calculation shall use the most recent data available as subsequently updated to reflect the data from the year in which the discharge occurred, and shall equal 100 percent of the excess costs above the high cost outlier threshold. High cost outlier thresholds shall be developed for each individual DRG and adjusted by hospital-specific wage equalization factors (WEF) and increased by the Consumer Price Index from the base period used to determine the statewide base price and the rate period.
(2) A non-public, not-for-profit general hospital which has not established an ancillary and routine charges schedule shall be eligible to receive high-cost outlier payments equal to the average of high-cost outlier payments received by comparable hospitals, as determined using the following criteria:
(i) downstate hospitals;
(ii) hospitals with a Medicaid fee for service case mix greater than 1.75;
(iii) hospitals with Medicaid fee for service revenue greater than $30 million of total revenue; and
(iv) hospitals with a proportion of Medicaid fee for service outlier to inlier cases greater than 3.0 percent.
(b) Rates of payment to non-exempt hospitals for inpatients who are transferred to another non-exempt hospital shall be calculated on the basis of a per diem rate for each day of the patient's stay in the transferring hospital, subject to the exceptions set forth in paragraphs (1), (2) and (3) of this subdivision. The total payment to the transferring facility shall not exceed the amount that would have been paid if the patient had been discharged. The per diem rate shall be determined by dividing the DRG case-based payment per discharge as defined in section 86-1.15(b)of this Subpart by the arithmetic inlier length of stay (LOS) for that DRG, as defined in section 86-1.15(o) of this Subpart, and multiplying by the transfer case's actual length of stay and by the transfer adjustment factor of 120 percent. In transfer cases where the arithmetic inlier LOS for the DRG is equal to one, the transfer adjustment factor shall not be applied.
(1) Transfers among more than two hospitals that are not part of a merged facility shall be reimbursed as follows:
(i) the facility which discharges the patient shall receive the full DRG payment; and
(ii) all other facilities in which the patient has received care shall receive a per diem rate unless the patient is in a transfer DRG.
(2) A transferring facility shall be paid the full DRG rate for those patients in DRGs specifically identified as transfer DRGs.
(3) Transfers among non-exempt hospitals or divisions that are part of a merged or consolidated facilityshall be reimbursed as if the hospital that first admitted the patient had also discharged the patient.
(4) Services provided to neonates discharged from a hospital providing neonatal specialty services to a hospital reimbursed under the case payment system for purposes of weight gain shall be reimbursed and assigned to the applicable APR-DRG upon admission or readmission.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.175 Indirect liability
(a) An obligation not yet incurred but for which responsibility may have to be assumed in the future; as, the possible liability from the premature settlement of a long-term contract.
(b) A debt of another, as the result of which an obligation to pay may develop; a contingent liability.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.83 Lubrication
Bearings and gears requiring lubricants are to be designed and constructed so that the lubricant cannot leak, drip or be forced into the food or onto food-contact surfaces. Food-grade lubricants are to be used on or within food-contact surfaces.
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.3 Action to be taken by local board
Within five days of the filing with the local board of health of the report provided for in section 8.2, supra , such local board shall:
(a) convene, and examine into the complaint and if it appears that a nuisance dangerous to health exists;
(b) furnish the owner, agent or occupant of the premises on which the condition alleged to constitute a nuisance exists, with a written statement of the condition found; and have duly served upon such owner, agent or occupant, a notice to appear before the board of health at a stated time and place, to show cause why such condition should not be declared a nuisance dangerous to health and an order for its abatement issued, and the prescribed penalty imposed if the condition constitutes a violation of a local health regulation in force in the municipality;
(c) if, after such hearing, it decides that the condition found to exist constitutes a nuisance dangerous to health, issue and enter upon its minutes an order directing the abatement of such nuisance, a copy of which order shall be order upon the owner, agent or occupant of the premises, or posted conspicuously thereon;
(d) impose in addition, if the condition constitutes a violation of a local health regulation in force in the municipality, the prescribed penalty for such violation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.6 Certification of rape crisis counselors
(a) Rape crisis programs shall certify that rape crisis counselors have met the training requirements set forth in section 69-5.3 of this Subpart and shall keep records regarding certified rape crisis counselors consisting of the following:
(1) documentation of training received on the provision of services to victims of sexual offenses, sexual abuse or incest;
(2) for rape crisis counselors with less than 40 hours of training, a plan for completing the training requirements within one year from the date of certification;
(3) documentation of ongoing education and training;
(4) an agreement signed by each counselor to adhere to the program's client confidentiality policy;
(5) annual performance evaluation reports;
(6) an attestation signed by the training coordinator that the rape crisis counselor meets the minimum training requirements for certification; and
(7) an attestation signed by the training coordinator that the rape crisis counselor has completed the 40 hours of required training.
(b) The governing authority of each rape crisis program approved under this Subpart must provide the department with a list of its certified rape crisis counselors semi-annually, beginning 30 days from the date of department approval of the program.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.12 Contents of environmental impact statements
(a) Environmental impact statements are to be clearly written in a brief and concise manner capable of being read and understood by the public. Within the framework presented in subdivision (d) of this section, such statements should address in detail only the specific significant environmental impacts which can be reasonably anticipated. They should not contain more detail than is appropriate considering the nature and magnitude of the proposed action, the significance of its potential impacts and the existing resources and capability of the agency responsible for the statement. Highly technical material shall be summarized, and if it must be included in its entirety, it shall be referenced in the statement and included in an appendix.
(b) Draft and final environmental impact statement shall be preceded by a cover sheet stating:
(1) whether it is a draft or final;
(2) the name or other descriptive title of the action;
(3) the location (county and town, village or city) of the action;
(4) the name and address of the agency which required its preparation and the name and telephone number of a person at the agency to be contacted for further information;
(5) identification of individuals or organizations which prepared any portion of the statement; and
(6) the date of its completion.
(c) If a draft or final environmental impact statement exceeds 10 pages in length, it shall have a table of contents following the cover sheet and a precise summary which adequately summarizes the statement, focusing on issues of controversy, matters to be decided and major conclusions.
(d) The body of all draft and final environmental impact statements shall contain at least the following:
(1) a description of the proposed action, its purpose and need;
(2) a description of the environmental setting;
(3) a statement of the environmental impact of the proposed action, including its short- and long-term effects, and typical associated environmental effects;
(4) an identification of any adverse environmental effects which cannot be avoided if the proposed action is implemented;
(5) a description and evaluation of reasonable alternatives to the action which would achieve the same or similar objectives (the description and evaluation should be at a level of detail sufficient to permit a comparative assessment of the alternatives discussed; the no-action alternative must be also discussed and evaluated);
(6) an identification of any irreversible and irretrievable commitments of resources which would be involved in the proposed action should it be implemented;
(7) a description of mitigation measures proposed to minimize the adverse environmental impacts;
(8) a description of any growth-inducing aspects of the proposed action;
(9) a discussion of the effects of the proposed action on the use and conservation of energy;
(10) a list of any underlying studies, reports and other information obtained and considered by the agency in preparing the statement;
(11) (for final EIS only) copies or a summary of the substantive comments received in response to the draft environmental impact statement and the agency's response to such comment;
(12) all changes made to the draft EIS incorporated in the final EIS shall be specifically indicated and identified as such; and
(13) for State agency actions in the coastal area, an identification of the coastal policies of Executive Law, article 42, as contained in 19 NYCRR 600.5 which are applicable to such actions and a discussion of the effects of the proposed action on such applicable policies; except when that State agency action in the coastal area is within the boundaries of an approved local waterfront revitalization program area, and the action is one identified by the Secretary of State pursuant to section 916(1)(a) of the Executive Law, the identification and discussion shall instead be of the effects of the proposed action on the applicable policies and purposes of such an approved local waterfront revitalization program.
(e) An environmental impact statement may incorporate by reference all or portions of other documents which contain information relevant to the statement. The referenced document shall be made available to the public in the same places where the agency makes available copies of the statement. When a statement uses incorporation by reference, the referenced document shall be briefly described as a part of the annotated bibliography of the EIS and its date of preparation provided.
(f) A final EIS may consist of: the draft EIS, including any necessary revisions to it, copies or a summary of the substantive comments received and their source (whether or not the comments were received in the context of a hearing), and the substantive responses of the department, if it is lead agency, to the comments. All revisions made to the draft EIS shall be specifically indicated and identified as such in the final EIS.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.4 Petroleum products
(a) Unless otherwise permitted by these rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge, of petroleum products into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
(b) New aboveground and underground petroleum storage facilities, which require registration under Part 612 of Title 6 NYCRR, or new tanks which expand the capacity of existing facilities which require registration under Part 612 of Title 6 NYCRR, are prohibited within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake. Notwithstanding this prohibition, the expansion of an existing aboveground or underground petroleum storage facility shall be allowed within the aforesaid limiting distances provided that the owner or operator of such facility demonstrates to the department that the application of the limiting distances would preclude the continuation of an existing business.
(c) New home heating oil tanks not requiring registration under Part 612 of Title 6 NYCRR, within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake are prohibited from being installed underground and shall be located either aboveground or contained in a basement with a concrete or other impervious floor.
(d) New aboveground and underground petroleum storage tanks of 185 gallons or more which are neither home heating oil tanks regulated under subdivision (c) of this section nor located at facilities requiring registration under Part 612 of Title 6 NYCRR, are prohibited within the limiting distance of 25 feet of a watercourse or wetland, or within the limiting distance of 300 feet of a reservoir, reservoir stem, or controlled lake, except that such new tanks may be allowed within the aforesaid limiting distances provided that the applicant demonstrates to the department that application of the limiting distances would preclude the continuation of an existing business or the continued identical use of the existing facility.
(e) Subdivisions (b), (c), and (d) shall not apply to:
(1) the storage of any petroleum products that is a noncomplying regulated activity;
(2) the storage of petroleum products for agricultural purposes;
(3) the replacement in kind of existing petroleum storage facilities or tanks;
(4) the storage of petroleum products where such storage is necessary to operate a wastewater treatment plant approved by the department; and
(5) the storage of petroleum products where such storage is made necessary by construction of a new facility or the alteration or modification of an existing facility used in connection with the operation of a public water supply system.
Part 112 DUTCHESS COUNTY
CITIES CITIES
10 CRR-NY 112.1 City of Beacon
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 395 of the Laws of 1928, shall apply to any natural or artificial reservoir, watercourse or drainage area tributary thereto or ultimately discharging into said reservoirs, serving as sources of the public water supply of the city of Beacon, Dutchess County, New York.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the city of Beacon, Dutchess County, New York.
(2) The term reservoir means any natural or artificially impounded body of water serving as the source of the aforesaid water supply and to any additional reservoir which may be constructed or used for this water supply.
(3) The term watercourse means every spring, pond (other than reservoir), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 300 feet from any reservoir or watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or any watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the limiting distances prescribed in paragraph (4) of this subdivision and the distance of 300 feet from any reservoir or any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall, after due notice to the owner thereof, be removed to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage, bath water, sink or laundry wastes shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 300 feet of any reservoir or any watercourse, except into watertight receptacles the contents of which shall be removed as provided by paragraph (3) of subdivision (c) or into a sewage treatment plant, plans for which shall be submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom shall pollute any reservoir or watercourse.
(h) Manure piles.
No manure pile or compost heap shall be maintained or allowed to remain within 100 feet of any reservoir or any watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Fishing, boating and ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply, except by duly authorized employees of the city of Beacon in the performance of their duties of supervision and maintenance of the water supply.
(j) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or within 100 feet of any watercourse tributary to the water supply.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(l) Inspections.
The department of public works of the city of Beacon or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the city of Beacon or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said board to promptly notify the State Commissioner of Health of such violations. The department of public works shall report to the State Commissioner of Health in writing annually, on the first day of January; the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.9 Penalties
A penalty for violation or failure to comply with any provision of this Subpart may be assessed (see Public Health Law, section 206).
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.12 Water quality for existing sources of water supply
(a) Whenever the supplier of water determines or is advised by the State that one or more of the MCLs set forth in this Subpart are or may be exceeded; or that effectiveness of treatment processes diminishes to the extent that a violation of the treatment techniques or MCLs set forth in this Subpart may occur; or that any deleterious changes in raw water quality have occurred; or that a change in the character of the watershed or aquifer has been observed which may affect water quality; or that any combination of the preceding exists, the supplier of water shall notify the State and do the following:
(1) undertake a study to determine the cause or causes of such conditions, independent of known or anticipated treatment technology;
(2) modify existing or install treatment to comply, to the extent practicable, with sections 5-1.30, 5-1.50, 5-1.51 and 5-1.60 of this Subpart;
(3) initiate water sampling as needed to delineate the extent and nature of the cause of concern;
(4) investigate all or part of the watershed or aquifer to verify any existing or potential changes in the character of the sources of water supply; and
(5) submit a written report to the State within 30 days of the onset of the foregoing conditions summarizing the findings outlined in paragraphs (1) through (4) of this subdivision.
(b) The State may require the supplier of water to conduct sanitary surveys and to conduct water sampling related to watersheds and groundwater aquifers which are sources of water supply to identify and evaluate the significance of existing and potential sources of pollution and to report the results to the State. Also, sanitary surveys shall be used to evaluate the adequacy of the public water system, the source or sources of water supply and the water treatment plant to produce a potable water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.30 Swing bed reimbursement
(a) Definitions.
(1) For purposes of this section, eligible hospitals shall mean those hospitals fined as rural hospitals and meeting the swing bed program requirements in Part 406 of this Title.
(2) Rate shall mean the aggregate governmental payment made to eligible facilities per patient day as defined in section 86-2.8 of this Title for the care of patients receiving care pursuant to title XIX of the Federal Social Security Act (Medicaid).
(b) Rates of payment.
Payments to eligible hospitals for patient days resulting from the usage of swing beds in caring for patients for whom it has been determined that inpatient hospital care is not medically necessary, but that skilled nursing or health-related care is required, shall be determined as follows:
(1) The operating component of the rate shall consist of the following:
(i) a direct component which shall be equivalent to the 1988 statewide average direct case mix neutral cost per day for hospital-based residential health care facilities, after application of the Regional Direct Input Price Adjustment Factor (RDIPAF) as determined pursuant to Subpart 86-2 of this Part, trended to the appropriate rate year;
(ii) an indirect component which shall be equivalent to the 1988 statewide average indirect cost per day for hospital-based residential health care facilities, after application of the RDIPAF pursuant to Subpart 86-2 of this Part, trended to the appropriate rate year;
(iii) a noncomparable component which shall be equivalent to the 1988 statewide average noncomparable cost per day for hospital-based residential health care facilities, trended to the appropriate rate year.
(2) For general hospitals with more than 49 beds, the maximum number of days for which the operating component of the rate as defined in paragraph (1) of this subdivision shall be paid shall be equivalent to 15 percent of a hospital's total annual patient days for acute, exempt unit, and alternate level of care services, excluding swing bed days.
(3) The operating component of the rate as defined in paragraph (1) of this subdivision shall be paid for the first 60 days per year during which a patient is receiving care as a participant in the swing bed program. Any patient stay in excess of 60 days per year shall be reimbursed at the prevailing average rate paid for the care of Alternate Level of Care (ALC) patients pursuant to the provisions of section 86-1.56 of this Subpart. The 60-day period shall begin the first day on which the patient receives care as a participant in the swing bed program.
(4) A capital cost per diem shall be paid on the basis of budgeted capital costs allocated in the swing bed program, pursuant to the provisions of section 86-1.59 of this Subpart, divided by patient days associated with the swing bed program, reconciled to actual total capital expense.
(c) Payments from all other payors.
Payments to eligible hospitals for care provided to patients under the swing bed program by any nongovernmental payor shall be at a per diem rate as established by such eligible hospital.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.17 Laboratory tests to be performed prior to allogeneic or autogeneic transfusion
(a) Tests shall be performed to determine the ABO and Rho (D) groups of each recipient in accordance with procedures approved by the department pursuant to this Subpart. ABO grouping tests shall include both forward and reverse grouping, except that reverse grouping is not required for infants under four months of age. Prior to transfusion, the ABO group of all units of whole blood and red blood cell components, as well as the Rh group of all such units labeled as Rh-negative, shall be confirmed using a sample obtained from an attached segment. Any discrepancies shall be reported in writing to the collecting facility and resolved prior to issuance of the blood for transfusion purposes.
(b) Serum or plasma from each recipient or, in the case of an infant under four months of age, the infant’s mother, shall be tested for unexpected alloantibodies using reagent red blood cells that meet F.D.A. standards, are intended for this purpose and are not pooled. Methods of testing for unexpected alloantibodies shall demonstrate sensitizing and hemolytic antibodies.
(c) Except in cases necessitating emergency release of group-compatible blood, or in the case of transfusion of a volume of blood or blood components exceeding the recipient's expected normal blood volume in a 24-hour period, compatibility between recipient and donor blood shall be determined. If a clinically significant antibody has been detected, or if there is a history of presence of such an antibody, compatibility testing shall include an antiglobulin phase crossmatch. If no clinically significant antibody has been detected, and there is no known history of presence of such an antibody, the crossmatching procedure to be used may be determined by the director of transfusion services, but shall, at minimum, consist of an immediate spin test or use of a validated computer system, except that crossmatching is not required for infants under four months of age.
(d) In the case of patients requiring repeated blood transfusions, or those pregnant or transfused with allogeneic red blood cell-containing components within the previous three months, fresh blood specimens shall be drawn for compatibility testing and antibody screening at intervals of not more than three days prior to the day of transfusion, except for neonates, to whom no time limits apply.
(e) A pre-transfusion sample of recipient blood, including serum or plasma, shall be retained for seven days after each transfusion for further testing in the event of an adverse reaction.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.2 Casket price list
A funeral firm shall present for information and review a printed or typewritten price list to individuals who inquire in person about caskets or alternative containers. The funeral firm may neither discuss nor show caskets or alternative containers until a casket price list is offered to the customer. The list must contain at least the retail price of each casket and alternative container offered which does not require special ordering; supplier name; model name or number; species of wood, kind and gauge of metal or other construction material; description of the interior; and the effective date of the price list. The list must contain the true funeral firm name and address as registered with the department and a caption describing the list as a "Casket Price List." In lieu of a written list, other formats, such as notebooks, brochures or charts may be used if they contain the same information as required in a printed or typewritten list and are displayed in a clear and conspicuous manner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.3 Numerical coding system
[ 2100 ]
(a) General.
(1) The numerical coding system in the Listing of Accounts is based on the use of a six-digit numbering system. Account numbers include four digits to the left of a decimal point which identify primary account classifications, and two digits to the right which identify secondary account classifications.
(2) The numerical coding system also provides, for daily hospital and ancillary service revenue accounts only, that positions seven and eight can be used for designating the program in which the patient is being served as defined by the second and third digits of the daily hospital and ambulatory services numbers.
(3) The first digit of an account designates the financial statement classification of the account:
(1) —Assets
(2) —Liabilities, Equity, and Capital or Fund Balances
(3) —Daily Hospital and Ambulatory Services Revenue
(4) —Ancillary Services Revenue
(5) —Other Operating Revenue and Deductions from Revenue
(6) —Daily Hospital and Ambulatory Services Expenses
(7) —Ancillary Services Expenses
(8) —Research Expenses: Education Expenses; General Services Expenses; Fiscal Service Expenses; Administrative Services Expenses; Medical Care Administration Expenses; Other Operating Expenses
(9) —Non-Operating Revenue and Expenses
(4) The second, third and fourth digits of the daily hospital services, ambulatory services and ancillary services centers are the same for revenue and expense.
)
)
)
(c) BALANCE SHEET ACCOUNTS
[ 2110 ] The balance sheet coding uses only the first four digits appearing to the left of the decimal point. The two digits to the right of the decimal point are available for the optional use of the hospital.
(d) DAILY HOSPITAL AND AMBULATORY SERVICES
[ 2120 ] The daily hospital and ambulatory services revenue allows the use of six digits—four to the left of the decimal and two to the right of the decimal. The digits to the left of the decimal represent the functional area serving the patient; the first digit to the right of the decimal represents the classification of service category of the patient service which the patient received and the second digit represents the primary payor for services rendered (Medicare—Part A, Blue Cross, Self Pay, etc.).
(e) ANCILLARY SERVICES REVENUE
[ 2130 ] The ancillary services revenue allows the use of eight digits—four to the left of the decimal point and four to the right. The digits to the left of the decimal represent the ancillary service area rendering service; the first digit to the right of the decimal represents the classification of service category of the patient service which the patient received, and the second digit represents the primary payor for services rendered (Medicare—Part A, Blue Cross, Self Pay, etc.). The third and fourth digits to the right of the decimal point may be used to designate the program in which the patient is being served as defined by the second and third digits of the daily hospital and ambulatory services cost centers.
(f) OPERATING EXPENSE
[ 2140 ] The expense coding uses six digits—four to the left of the decimal and two to the right. The digits to the left of the decimal represent the cost center incurring the expense. The digits to the right of the decimal represent the natural classification of expense. See Chapter III, sections 3300-3390 for explanation of digits representing the natural classification of expense.
(g) NON-OPERATING REVENUE AND EXPENSE
[ 2150 ] Non-Operating revenue and expense consist of amounts not directly related to patient care, related patient services or the revenue and expense of related goods. The non-operating revenue and expenses, coding uses the four digits appearing to the left of the decimal point. The digits to the right of the decimal are available for the optional use of the hospital.
10 CRR-NY 443.5 Listing of accounts—income statement
[2300]
(a) For the new reporting requirements contained in the following subdivisions of this section, the initial reporting year is indicated in parentheses. For example, Accounts 3620/6620 - Skilled Nursing Care Medicaid Certified in subdivision (b) paragraph (4) of this section has 1980 in parentheses. This means this cost center must be reported for the reporting period beginning in 1980 and thereafter. All other cost centers are required to be reported for reporting periods ending in 1979 and thereafter.
(b) DAILY HOSPITAL SERVICES [2310]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | (1) ACUTE CARE. | | | | 3010 | 6010 | MEDICAL/SURGICAL ACUTE | | 3170 | 6170 | PEDIATRIC ACUTE | | 3210 | 6210 | PSYCHIATRIC ACUTE | | 3250 | 6250 | OBSTETRICS ACUTE | | 3280 | 6280 | DEFINITIVE OBSERVATION (1980) | | 3290 | 6290 | OTHER ACUTE CARE | | (2) INTENSIVE CARE. | | | | 3310 | 6310 | MEDICAL/SURGICAL INTENSIVE CARE | | 3330 | 6330 | CORONARY CARE | | 3331 | 6331 | Myocardial Infarction | | 3332 | 6332 | Pulmonary Care | | 3333 | 6333 | Heart Transplant | | 3339 | 6339 | Other Coronary Care | | 3350 | 6350 | PEDIATRIC INTENSIVE CARE | | 3370 | 6370 | NEONATAL INTENSIVE CARE | | 3380 | 6380 | BURN CARE | | 3390 | 6390 | PSYCHIATRIC INTENSIVE CARE | | 3410 | 6410 | OTHER INTENSIVE CARE I | | 3420 | 6420 | OTHER INTENSIVE CARE II (1980 Optional) | | 3430 | 6430 | OTHER INTENSIVE CARE III (1980 Optional) | | (3) NURSERY. | | | | 3510 | 6510 | NEWBORN NURSERY | | 3520 | 6520 | PREMATURE NURSERY | | (4) SUB-ACUTE CARE | | | | 3610 | 6610 | SKILLED NURSING CARE-MEDICARE OR MEDICARE/MEDICAID CERTIFIED (1980) | | 3620 | 6620 | SKILLED NURSING CARE-MEDICAID CERTIFIED (1980) | | 3630 | 6630 | PSYCHIATRIC LONG-TERM CARE | | 3640 | 6640 | TUBERCULOSIS LONG-TERM CARE (1980) | | 3650 | 6650 | INTERMEDIATE CARE-MENTALLY RETARDED (1982) | | 3660 | 6660 | INTERMEDIATE CARE-OTHER (1980) | | 3670 | 6670 | RESIDENTIAL CARE | | 3680 | 6680 | OTHER SUB-ACUTE CARE SERVICES | | 3680 | 6680 | OTHER SUB-ACUTE CARE HOSPITAL SERVICES (1982) | | 3690 | 6690 | OTHER SUB-ACUTE CARE NON-HOSPITAL SERVICES (1982) |
(c) AMBULATORY SERVICES [2320]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | 3710 | 6710 | EMERGENCY SERVICES | | 3711 | 6711 | Emergency Room | | 3712 | 6712 | Observation | | 3719 | 6719 | Other Emergency Services | | 3720 | 6720 | CLINIC SERVICES | | 3721 | 6721 | Allergy Clinic | | 3722 | 6722 | Cancer Clinic | | 3723 | 6723 | Cardiology Clinic | | 3724 | 6724 | Dental Clinic | | 3725 | 6725 | Dermatology Clinic | | 3726 | 6726 | Diabetic Clinic | | 3727 | 6727 | Drug Abuse Clinic | | 3728 | 6728 | Ear, Nose and Throat Clinic | | 3729 | 6729 | Eye Clinic | | 3731 | 6731 | General Medicine Clinic | | 3732 | 6732 | Obstetrics/Gynecology Clinic | | 3733 | 6733 | Orthopedic Clinic | | 3734 | 6734 | Pediatric Clinic | | 3735 | 6735 | Physical Medicine Clinic | | 3736 | 6736 | Psychiatric Clinic | | 3737 | 6737 | Surgery Clinic | | 3738 | 6738 | Urology Clinic | | 3739 | 6739 | Venereal Disease Clinic | | 3799 | 6799 | Other Clinic Services | | 3810 | 6810 | Home Program Dialysis Equipment-100% (1980) | | 3820 | 6820 | Home Program Dialysis-Other (1980) | | 3830 | 6830 | AMBULATORY SURGERY SERVICES | | 3840 | 6840 | PSYCHIATRIC DAY AND NIGHT CARE SERVICES | | 3850 | 6850 | AMBULANCE SERVICES | | 3860 | 6860 | OTHER AMBULATORY SERVICES | | 3870 | 6870 | FREE STANDING CLINIC | | 3880 | 6880 | FREE STANDING CLINIC II (1980 Optional) | | 3890 | 6890 | FREE STANDING CLINIC III (1980 Optional) | | 3910 | 6910 | HOME HEALTH SERVICES-SKILLED NURSING CARE (1980) | | 3920 | 6920 | HOME HEALTH SERVICES-MEDICAL SOCIAL SERVICES (1980) | | 3930 | 6930 | HOME HEALTH SERVICES-HOME HEALTH AIDES (1980) | | 3990 | 6990 | HOME HEALTH SERVICES-OTHER HOME HEALTH (1980) |
(d) ANCILLARY SERVICES [2330]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | (1) LABOR AND DELIVERY SERVICES. | | | | 4010 | 7010 | LABOR AND DELIVERY SERVICES | | (2) SURGICAL SERVICES GROUP. | | | | 4040 | 7040 | SURGERY SERVICES | | 4041 | 7041 | General Surgery | | 4042 | 7042 | Open Heart Surgery | | 4043 | 7043 | Neurosurgery | | 4044 | 7044 | Orthopedic Surgery | | 4045 | 7045 | Kidney Transplant | | 4046 | 7046 | Other Organ Transplants | | 4049 | 7049 | Other Operating Room Services | | 4060 | 7060 | RECOVERY SERVICES (1980) | | 4080 | 7080 | ANESTHESIOLOGY | | (3) MEDICAL SUPPLIES AND EQUIPMENT GROUP. | | | | 4110 | 7110 | MEDICAL SUPPLIES SOLD | | 4130 | 7130 | DURABLE MEDICAL EQUIPMENT-SOLD (1982) | | 4140 | 7140 | DURABLE MEDICAL EQUIPMENT-LEASED / RENTED (1982) | | (4) DRUGS SOLD. | | | | 4150 | 7150 | DRUGS SOLD | | (5) LABORATORY SERVICES GROUP. | | | | 4210 | 7210 | LABORATORY SERVICES-CLINICAL | | 4211 | 7211 | Chemistry | | 4212 | 7212 | Hematology | | 4213 | 7213 | Immunology (Serology) | | 4214 | 7214 | Microbiology (Bacteriology) | | 4215 | 7215 | Procurement and Dispatch | | 4216 | 7216 | Urine and Feces | | 4219 | 7219 | Other Clinical Laboratories | | 4230 | 7230 | LABORATORY SERVICES-PATHOLOGICAL | | 4231 | 7231 | Cytology | | 4232 | 7232 | Histology | | 4233 | 7233 | Autopsy | | 4239 | 7239 | Other Pathological Laboratories | | 4250 | 7250 | WHOLE BLOOD AND PACKED RED CELLS (1980) | | 4260 | 7260 | BLOOD STORING AND PROCESSING | | (6) ELECTROCARDIOGRAPHY. | | | | 4290 | 7290 | ELECTROCARDIOGRAPHY | | (7) CARDIAC CATHETERIZATION. | | | | 4310 | 7310 | CARDIAC CATHETERIZATION LABORATORY | | (8) RADIOLOGY SERVICES GROUP. | | | | 4320 | 7320 | RADIOLOGY-DIAGNOSTIC | | 4321 | 7321 | Angiocardiography | | 4322 | 7322 | Ultrasonography | | 4329 | 7329 | Radiology-Diagnostic-Other | | 4340 | 7340 | CT SCANNER | | 4360 | 7360 | RADIOLOGY-THERAPEUTIC | | 4380 | 7380 | NUCLEAR MEDICINE | | 4381 | 7381 | Nuclear Medicine-Diagnostic | | 4382 | 7382 | Nuclear Medicine-Therapeutic | | (9) RESPIRATORY THERAPY. | | | | 4420 | 7420 | RESPIRATORY THERAPY | | (10) PULMONARY FUNCTION. | | | | 4440 | 7440 | PULMONARY FUNCTION TESTING | | (11) NEUROLOGY-DIAGNOSTIC. | | | | 4460 | 7460 | NEUROLOGY-DIAGNOSTIC | | 4461 | 7461 | Electroencephalography | | 4462 | 7462 | Electromyography | | (12) THERAPY SERVICES GROUP | | | | 4510 | 7510 | PHYSICAL THERAPY | | 4530 | 7530 | OCCUPATIONAL THERAPY | | 4550 | 7550 | SPEECH-LANGUAGE PATHOLOGY | | 4570 | 7570 | RECREATIONAL THERAPY | | 4580 | 7580 | AUDIOLOGY | | 4590 | 7590 | OTHER PHYSICAL MEDICINE | | 4670 | 7670 | PSYCHIATRIC/PSYCHOLOGICAL SERVICES | | 4671 | 7671 | Individual Therapy | | 4672 | 7672 | Group Therapy | | 4673 | 7673 | Family Therapy | | 4674 | 7674 | Biofeedback Training | | 4675 | 7675 | Psychological Testing | | 4676 | 7676 | Shock Therapy | | 4689 | 7689 | Other Psychiatric/Psychological Services | | (13) RENAL DIALYSIS. | | | | 4710 | 7710 | RENAL DIALYSIS | | 4711 | 7711 | Hemodialysis | | 4713 | 7713 | Peritoneal Dialysis | | 4715 | 7715 | Patient Dialysis Training | | 4719 | 7719 | Other Dialysis | | (14) ORGAN ACQUISITION AND OTHER. | | | | 4730 | 7730 | KIDNEY ACQUISITION | | 4750 | 7750 | OTHER ORGAN ACQUISITION | | 4910 | 7910 | OTHER ANCILLARY SERVICES |
(e) OTHER OPERATING REVENUE [2340]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | 5020 | | TRANSFERS FROM RESTRICTED FUNDS FOR RESEARCH EXPENSES | | 5220 | | NURSING EDUCATION | | 5221 | | Registered Nurses | | 5222 | | Licensed Vocational (Practical) Nurses | | 5240 | | POSTGRADUATE MEDICAL EDUCATION — APPROVED TEACHING PROGRAMS | | 5250 | | POSTGRADUATE MEDICAL EDUCATION — NON-APPROVED TEACHING PROGRAMS | | 5260 | | OTHER HEALTH PROFESSION EDUCATION | | 5261 | | School of Medical Technology | | 5262 | | School of X-ray Technology | | 5263 | | School of Respiratory Therapy | | 5264 | | Administrative Intern Program | | 5265 | | Medical Records Librarian Program | | 5280 | | TRANSFERS FROM RESTRICTED FUNDS FOR EDUCATION EXPENSES | | 5320 | | NON-PATIENT FOOD SALES (1980) | | 5330 | | LAUNDRY AND LINEN SERVICES REVENUE | | 5350 | | SOCIAL SERVICES REVENUE | | 5360 | | HOUSING REVENUE | | 5361 | | Employee Housing | | 5363 | | Student Housing | | 5440 | | PARKING REVENUE | | 5450 | | HOUSEKEEPING SERVICES REVENUE | | 5610 | | TELEPHONE AND TELEGRAPH REVENUE | | 5620 | | DATA PROCESSING SERVICES REVENUE | | 5690 | | PURCHASING SERVICES REVENUE | | 5710 | | SALE OF ABSTRACTS/MEDICAL RECORDS | | 5760 | | DONATED COMMODITIES | | 5770 | | DONATED BLOOD | | 5780 | | CASH DISCOUNTS ON PURCHASES | | 5790 | | SALE OF SCRAP AND WASTE | | 5810 | | REBATES AND REFUNDS | | 5820 | | VENDING MACHINE COMMISSIONS | | 5830 | | OTHER COMMISSIONS | | 5840 | | TELEVISION/RADIO RENTALS | | 5850 | | NON-PATIENT ROOM RENTALS | | 5860 | | MANAGEMENT SERVICES REVENUE | | 5870 | | OTHER OPERATING REVENUE | | 5880 | | TRANSFERS FROM RESTRICTED FUNDS FOR OTHER OPERATING EXPENSES |
(f) DEDUCTIONS FROM REVENUE [2350]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | 5900 | | PROVISION FOR BAD DEBTS | | 5910 | | CONTRACTUAL ADJUSTMENTS — MEDICARE | | 5911 | | Contractual Adjustments-Medicare-Part A | | 5912 | | Contractual Adjustments-Medicare-Part B | | 5920 | | CONTRACTUAL ADJUSTMENTS — MEDICAID | | 5930 | | CONTRACTUAL ADJUSTMENTS — BLUE CROSS | | 5940 | | CONTRACTUAL ADJUSTMENTS—OTHER | | 5950 | | CHARITY / UNCOMPENSATED CARE— HILL BURTON (1980) | | 5960 | | CHARITY / UNCOMPENSATED CARE —OTHER (1980) | | 5970 | | RESTRICTED DONATIONS AND GRANTS FOR INDIGENT CARE (Credit Balance Sheet) | | 5980 | | ADMINISTRATIVE, COURTESY, AND POLICY DISCOUNTS AND ADJUSTMENTS | | 5990 | | OTHER DEDUCTIONS FROM REVENUE |
(g) OTHER OPERATING EXPENSES [2360]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | (1) RESEARCH EXPENSES. | | | | | 8010 | RESEARCH | | (2) EDUCATION EXPENSES. | | | | | 8220 | NURSING EDUCATION | | | 8221 | Registered Nurses | | | 8222 | Licensed Vocational (Practical) Nurses | | | | POSTGRADUATE MEDICAL EDUCATION— PRIMARY CARE TEACHING PROGRAMS-APPROVED: | | | 8240 | INTERNAL MEDICINE (1981) | | | 8250 | FAMILY PRACTICE (1981) | | | 8260 | PEDIATRICS (1981) | | | 8270 | POSTGRADUATE MEDICAL EDUCATION — OTHER APPROVED TEACHING PROGRAM (1980) | | | 8280 | POSTGRADUATE MEDICAL EDUCATION— NON-APPROVED TEACHING PROGRAMS (1980) | | | 8290 | OTHER HEALTH PROFESSION EDUCATION (1980) | | | 8291 | School of Medical Technology | | | 8292 | School of X-ray Technology | | | 8293 | School of Respiratory Therapy | | | 8294 | Administrative Intern Program | | | 8295 | Medical Records Librarian Program | | (3) GENERAL SERVICES. | | | | | 8310 | DIETARY SERVICES | | | 8320 | NON-PATIENT FOOD SERVICE (1980) | | | 8330 | LAUNDRY AND LINEN | | | 8350 | SOCIAL WORK SERVICES (1980) | | | 8360 | HOUSING | | | 8361 | Employee Housing | | | 8362 | Nonpaid Workers Housing | | | 8365 | Student Housing | | | 8400 | PLANT MAINTENANCE (1982) | | | 8410 | PLANT OPERATIONS AND MAINTENANCE | | | 8410 | PLANT OPERATION (1982) | | | 8411 | Plant Operations | | | 8412 | Plant Maintenance | | | 8413 | Grounds | | | 8430 | SECURITY | | | 8440 | PARKING | | | 8450 | HOUSEKEEPING | | | 8460 | CENTRAL SERVICES AND SUPPLY (1980) | | | 8470 | PHARMACY | | (4) FISCAL SERVICES. | | | | | 8510 | GENERAL ACCOUNTING | | | 8520 | PATIENT ACCOUNTS, ADMITTING AND REGISTRATION | | | 8521 | Patient Accounting | | | 8522 | Credit and Collection | | | 8523 | Cashiering | | | 8524 | Inpatient Admitting | | | 8525 | Emergency Room Registration | | | 8526 | Clinic Registration | | | 8527 | Referred Ambulatory Registration | | | 8528 | Other Outpatient Registration | | | 8530 | ADMITTING (1982) | | | 8540 | REGISTRATION (1982) | | | 8541 | Emergency Room Registration | | | 8542 | Clinic Registration | | | 8543 | Referred Ambulatory Registration | | | 8549 | Other Outpatient Registration | | (5) ADMINISTRATIVE SERVICES. | | | | | 8610 | HOSPITAL ADMINISTRATION | | | 8611 | Office of Hospital Administrator | | | 8612 | Governing Board | | | 8613 | Public Relations | | | 8614 | Spiritual Care | | | 8615 | Communications | | | 8616 | Personnel | | | 8617 | Management Engineering | | | 8618 | Health Sciences Library | | | 8619 | Auxiliary Groups | | | 8621 | Data Processing | | | 8690 | PURCHASING AND STORES | | | 8710 | MEDICAL RECORDS | | | 8720 | MEDICAL STAFF ADMINISTRATION | | | 8730 | MEDICAL STAFF SERVICES | | | 8740 | MEDICAL CARE REVIEW | | | 8741 | PSRO | | | 8749 | Other Medical Care Review | | | 8750 | NURSING ADMINISTRATION | | | 8751 | In-service Education—Nursing | | | 8759 | Nursing Administration—Other | | | 8760 | MEDICAL PHOTOGRAPHY AND ILLUSTRATION | | | 8780 | FUND RAISING | | (6) UNASSIGNED EXPENSE | | | | | 8810 | DEPRECIATION AND AMORTIZATION | | | 8811 | Land Improvements | | | 8812 | Buildings and Improvements | | | 8813 | Leasehold Improvements | | | 8814 | Fixed Equipment | | | | Intangibles | | | 8815 | LEASES AND RENTALS (MANDATORY REPORTING)(1980) | | | 8816 | Land | | | 8817 | Buildings and Improvements | | | 8818 | Fixed Equipment | | | 8820 | DEPRECIATION AND AMORTIZATION—MOVABLE EQUIPMENT (1980) | | | 8825 | LEASES AND RENTALS—MOVABLE EQUIPMENT MANDATORY REPORTING) (1980) | | | 8830 | EMPLOYEE BENEFITS—NON-PAYROLL RELATED (1980) | | | 8840 | INSURANCE—HOSPITAL AND PROFESSIONAL MALPRACTICE | | | 8850 | INSURANCE—OTHER | | | 8860 | LICENSES AND TAXES (OTHER THAN INCOME TAXES) | | | 8870 | INTEREST—SHORT—TERM | | | 8880 | INTEREST—LONG—TERM | | (7) HOLDING ACCOUNTS. | | | | | 8991 | CENTRAL PATIENT TRANSPORTATION | | | 8992 | NURSING FLOAT PERSONNEL | | | 8993 | EMPLOYEE BENEFITS—PAYROLL RELATED |
(h) NON-OPERATING REVENUE AND EXPENSE [2370]
| Account Number | | | | --- | --- | --- | | Revenue | Expense | Account Title / (Reporting Year Effective) | | 9010 | | GAINS OR LOSSES ON SALE OF HOSPITAL PROPERTY | | 9020 | | UNRESTRICTED CONTRIBUTIONS | | 9030 | | DONATED SERVICES | | 9040 | | INCOME, GAINS, AND LOSSES FROM UNRESTRICTED INVESTMENTS | | 9041 | | Unrealized Gains and Losses on Marketable Securities | | 9050 | | UNRESTRICTED INCOME FROM ENDOWMENT FUNDS | | 9051 | | Unrealized Gains and Losses on Marketable Securities | | 9060 | | UNRESTRICTED INCOME FROM OTHER RESTRICTED FUNDS | | 9061 | | Unrealized Gains and Losses on Marketable Securities | | 9070 | | TERM ENDOWMENT FUNDS BECOMING UNRESTRICTED | | 9080 | | TRANSFERS FROM RESTRICTED FUNDS FOR NONOPERATING EXPENSE | | 9110 | | DOCTORS' PRIVATE OFFICE RENTAL REVENUE | | 9120 | | OFFICE AND OTHER RENTAL REVENUE | | 9130 | | RETAIL OPERATIONS REVENUE | | 9150 | | OTHER NONOPERATING REVENUE | | | 9210 | DOCTORS' OFFICE OFFICE RENTAL EXPENSE | | | 9220 | OFFICE AND OTHER RENTAL EXPENSE | | | 9230 | RETAIL OPERATIONS EXPENSE | | | 9240 | MAINTENANCE OF NON-PAID WORKERS (1981) | | | 9250 | OTHER NONOPERATING EXPENSE | | | 9410 | PROVISION FOR INCOME TAXES | | | 9411 | Federal—Current | | | 9412 | Federal—Deferred | | | 9413 | State—Current | | | 9414 | State—Deferred | | | 9415 | Local—Current | | | 9416 | Local—Deferred | | | 9500 | EXTRAORDINARY ITEMS |
Part 441 DEFINITIONS
10 CRR-NY 441.90 Depreciable cost
That part of the cost of a fixed asset that is to be spread over useful life; i.e., cost less the estimated recovery from resale or salvage.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.13 Adjustments to provisional rates based on errors
(a) Errors resulting from submission of fiscal and statistical information by a LTHHCP may be corrected if brought to the attention of the State Commissioner of Health within 120 days of receipt of the commissioner's initial rate computation sheets. Errors on the part of the State Department of Health resulting from the rate computation process may be corrected if brought to the attention of the commissioner within 120 days of receipt of the commissioner's initial rate computation sheet. Subsequent errors on the part of the State Department of Health resulting from the revision of a rate may be corrected if brought to the attention of the commissioner within 30 days of receipt of the commissioner's revised rate computation sheet. In no event, however, shall a facility have less than 120 days from receipt of the initial rate computation sheets to bring errors to the attention of the commissioner.
(b) Rate appeals pursuant to this section, if not commenced within 120 days of receipt of the commissioner's initial rate computation sheet, may be initiated at time of audit. Such rate appeals shall be recognized only to the extent that they are based upon errors in the cost and/or statistical data submitted by the LTHHCP or, in the case of a governmental facility, by the sponsor government, or errors made by the Department of Health.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.6 Disclosure form
NOTICE TO PATIENTS
Because of concerns that there may be a conflict of interest when a physician refers a patient to a health care facility in which the physician has a financial interest, New York State passed a law. The law prohibits me, with certain exceptions, from referring you for clinical laboratory services, pharmacy services, radiation therapy, or X-ray or imaging services to a facility in which I or any of my immediate family members have a financial interest. If certain of the exceptions in the law apply, or if I am referring you for other than clinical laboratory, pharmacy, radiation therapy services, or x-ray or imaging services, I can make the referral under one condition. The condition is that I disclose this financial interest and tell you about alternative providers where you may go to obtain these services. This disclosure is intended to help you make a fully informed decision about your health care.
I or my immediate family members have a financial relationship with the following providers:
For more information about alternative providers, please ask me or my staff. We will provide you with names and addresses of providers best suited to your individual needs that are nearest to your home or place of work.
Name of Physician
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.1 Definition
For purposes of this section, a swing bed program operated by a rural hospital that has an approval from the Health Care Financing Administration (HCFA) to provide posthospital skilled nursing faciity (SNF) care shall mean beds used interchangeably as either general hospital or nursing home beds with reimbursement based on the specific type of care provided so that use of beds in this manner provides small hospitals with greater flexibility in meeting fluctuating demands for inpatient general hospital and nursing home care.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 141 SARATOGA COUNTY
10 CRR-NY 141.3 City of Saratoga Springs
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Loughberry Lake and its tributaries, including Bog Meadow Brook, east of the city dam at Old Louden Road which now serve or which may be developed in the future to serve as sources of the public water supply of the City of Saratoga Springs, Saratoga County, New York and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the City of Saratoga Springs public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the water of which flow or may flow into the City of Saratoga Springs public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the City of Saratoga Springs public water supply.
(16) Water supply shall mean the public water supply of the City of Saratoga Springs, Saratoga County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter 1 (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the City of Saratoga Springs.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the City of Saratoga Springs.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Saratoga Springs except by duly authorized employees of the City of Saratoga Springs in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the City of Saratoga Springs except by duly authorized employees of the City of Saratoga Springs in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III, (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The commissioner of public works, or any person or persons may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether this Part is being complied with. It shall be the duty of the aforesaid commissioner of public works or any person or persons as may be charged with the maintenance or supervision of the water supply, to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notice of such violations. If such persons served do not immediately comply with this Part, it shall be the further duty of the aforesaid commissioner of public works or any person or persons as may be charged with the maintenance or supervision of the water supply, to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of public works or any person or persons as may be charged with the maintenance or supervision of the water supply, shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with the provisions of section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.59 Cooling towers; performance standards
The local health department shall maintain a program that ensures cooling towers are operated pursuant to the New York State Public Health Law and Subpart 4-1 of the State Sanitary Code (Subpart 4-1 of this Title).
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.59 Use of computed tomography equipment
(a) Definitions.
(1) Computed tomography (CT) scan and computerized axial tomography (CAT) scan refer to an imaging procedure that uses x-rays to create cross-sectional images of the human body.
(2) Computed tomography dose index (CTDI) means the integral of the dose profile along a line perpendicular to the tomographic plane divided by the product of the nominal tomographic section thickness and the number of tomograms produced in a single scan where the dose profile is centered around z = 0 and for a multiple tomogram system, the scan increment between adjacent scans is nT;
)
z = position along a line perpendicular to the tomographic plane;
D (z) = Dose at position z;
T = Nominal tomographic section thickness;
n = Number of tomograms produced in a single scan
(3) CT x-ray system is technology that is used to perform CT scans and includes but is not limited to, a control panel, image display device, gantry, x-ray tube, collimating device with filters, high voltage transformer and a data acquisition system.
(4) CT scanner refers to technology used to perform and interpret CT scans and includes, but is not limited to, a control panel, gantry, high voltage generator, x-ray tube, table and display devices that are used for image interpretation.
(5) CTDI100 is the dose measurement made with a 16cm diameter (head/pediatric body) or a 32cm diameter (body) acrylic phantom. The measurements are made utilizing a 100mm long pencil ionization chamber. Readings are made with the ion chamber in both the center (axial or central dose) position and near surface slots of the phantom (the peripheral dose).
(6) CTDIW , the weighted or blended dose, is calculated by adding together two-thirds of the CTDI100 peripheral dose with one-third of the CTDI100 axial or center dose. (CTDIW = 2/3 CTDI100 peripheral + 1/3 CTDI100axial or center). CTDIW represents an average dose in the x and y planes.
(7) CTDIVOL represents the integrated dose over the total volume that is irradiated, CTDIVOL = (1/PITCH) x (CTDIW), where “Pitch” is defined as the table travel per rotation divided by the collimation of the x-ray beam. CTDIVOL represents the average dose in the x, y and z planes.
(8) CT conditions of operation means all selectable parameters governing the operation of a CT x-ray system including nominal tomographic section thickness, filtration, and the technique factors.
(9) CT dosimetry phantom means the phantom used for determination of the dose delivered by a CT x-ray system. The phantom shall be a right circular cylinder of polymethyl-methacrylate of density 1.19±0.01 grams per cubic centimeter. The phantom shall be at least 14 centimeters in length and shall have diameters of 32.0 centimeters for testing any CT system designed to image any section of the body (whole body scanners) and 16.0 centimeters for any system designed to image the head (head scanners) or for any whole body scanner operated in the head scanning mode. The phantom shall provide means for the placement of a dosimeter(s) along its axis of rotation and along a line parallel to the axis of rotation 1.0 centimeter from the outer surface and within the phantom.
(10) Dose length product (DLP) is defined as the CTDIvol times the irradiated length of the body for the whole series of images that are taken during a CT scan.
(11) Picture Archiving and Communication System (PACS) is a medical imaging technology that provides access to and storage for medical images from multiple modalities. It is comprised of an image acquisition system, display, network and data storage or archiving system.
(12) Reference plane means a plane which is displaced from and parallel to the tomographic plane.
(13) Scan means the complete process of collecting x-ray transmission data for the production of a tomogram or a series of tomograms.
(14) Scan increment means the amount of relative displacement of the patient with respect to the CT x-ray system between successive scans measured along the direction of such displacement.
(15) Technique means the settings selected on the control panel of the equipment and may include the position of the x-ray tube, image intensifier and patient.
(16) Technique chart means a chart that lists the standard settings and positions for a given technique.
(17) Tomogram is an image of a tissue plane or section of tissue.
(18) Tomographic plane means that geometric plane which the manufacturer identified as corresponding to the output tomogram.
(19) Tomographic section means the volume of an object whose x-ray attenuation properties are imaged in a tomogram.
(b) CT x-ray system equipment requirements.
(1) Each control panel and gantry of a CT x-ray system shall include visual signals that indicate to the operator of the CT x-ray system whenever x-rays are being produced and when x-ray production is terminated, and, if applicable, whether the shutter is open or closed.
(2) Each CT x-ray system shall be equipped with a control that allows the operator of the CT x-ray system to terminate the x-ray exposure at any time during a scan, or series of scans, when the exposure time is greater than one-half second duration.
(3) Each CT x-ray system shall be designed such that the CT conditions of operation to be used during a scan or a scan sequence are indicated prior to the initiation of a scan or a scan sequence.
(4) Each CT x-ray system shall include a clearly and conspicuously labeled emergency shutoff button or switch.
(5) Premature termination of the x-ray exposure by the operator shall necessitate resetting of the CT conditions of operation by the operator prior to the initiation of another scan.
(c) Patient communication and viewing requirements.
(1) Each CT x-ray system shall be equipped to allow two-way aural communication between the patient and the operator at the control panel.
(2) Each CT x-ray system shall be equipped with windows, mirrors, closed-circuit television, or an equivalent to permit continuous visual observation of the patient during CT scanning by the CT operator from the control panel.
(3) When the primary viewing system is by electronic means, an alternate viewing system (which may be electronic) shall be available for use in the event of failure of the primary viewing system.
(d) Calibration.
(1) Each registrant shall ensure that the calibration of the radiation output of each CT x-ray system that it operates is performed by, or under the direction of, a licensed medical physicist.
(2) Each registrant shall maintain and make available for review by the department, on the premises of its radiation installation where a CT x-ray system is located written procedures for the appropriate calibration of the CT x-ray system.
(3) After initial installation, the CT x-ray system shall be calibrated prior to its use on human beings and recalibrated at least within every 14 months thereafter. Any change or replacement of components of a CT x-ray system which could cause a change in the radiation output will require a recalibration within 30 days of component installation by a licensed medical physicist operating within their scope of practice.
(4) The calibration of the radiation output of a CT x-ray system shall be performed with a calibrated dosimetry system. This system shall have been calibrated either by the National Institute of Standards and Technology (NIST) or by an American Association of Physicists in Medicine (AAPM) Accredited Dosimetry Calibration Laboratory (ADCL) and traceable to NIST. The calibration shall have been performed within the previous 24 months and after any servicing that might have affected system calibration.
(5) CT dosimetry phantom(s) shall be used in determining the radiation output of each CT x-ray system. Such phantom(s) shall meet the following specifications and conditions of use:
(i) any effects on the doses measured because of the removal of phantom material to accommodate dosimeters shall be accounted for through appropriate corrections to the reported data or included in the statement of maximum deviation for the values obtained using the phantom; and
(ii) all dose measurements shall be performed with the CT dosimetry phantom placed on the patient couch or support device without additional attenuation materials present;
(iii) the requirements of subparagraphs (i) and (ii) of this paragraph can also be met by using an alternative method of radiation measurement and calculation published in the peer-reviewed scientific literature and acceptable to the department.
(6) Records of calibrations performed shall be maintained for a period of three years at the radiation installation where the CT is located.
(e) Quality assurance testing.
(1) Each registrant shall maintain a Quality Assurance (QA) manual that shall contain written procedures for all testing and shall meet the requirements specified in this section and section 16.23(a)(1) of this Part. The CT Quality Assurance procedures shall have been developed under the direction of a licensed medical physicist or radiologist.
(2) The QA procedures shall incorporate the use of one or more image quality dosimetry phantoms or the phantom supplied by the original equipment manufacturer which have the capability of providing an indication of contrast scale, noise, nominal tomographic section thickness, the resolution capability of the system for low and high contrast objects, and measuring the mean CT Number for water or other reference material. All of these image quality parameters shall be evaluated at least annually by a licensed medical physicist.
(3) Written records of the QA checks performed by the registrant shall be maintained for review by the department for a period of at least three years.
(4) QA checks shall include the following:
(i) Images obtained with the CT dosimetry phantom(s) using the same processing mode and CT conditions of operation as are used to perform calibrations. The images shall be retained as photographic copies or as electronic copies stored within the CT x-ray system or stored on the PACS.
(ii) Dose assessment for the most common CT examinations that are performed on the system for which reference levels have been published by the American College of Radiology (ACR), the American Association of Physicists in Medicine (AAPM) or the National Council on Radiation Protection and Measurements (NCRP) for pediatric heads, pediatric abdomens, adult heads and adult abdomens.
(iii) An evaluation of image quality.
(f) Operating procedures and policies.
(1) The CT x-ray system shall not be operated on a human being except by a physician or by a radiologic technologist licensed pursuant to article 35 of the Public Health Law who has been specifically trained in its operation.
(2) The registrant shall ensure that each CT x-ray system has a radiation protection survey or other measurement and assessment of exposure to persons in controlled and non-controlled areas made at the time of installation. Additional radiation protection surveys shall be done after any change in the radiation installation or equipment which might cause a significant increase in radiation hazard.
(3) Each CT x-ray system shall have available at the control panel written information regarding the operation and calibration of the CT x-ray system. Such information shall include:
(i) dates of the latest calibration and QC checks and the location within the facility where the results of those tests may be obtained;
(ii) instructions on the use of the CT dosimetry phantom(s) including a schedule of QC tests that are appropriate for the system as determined by the manufacturer, allowable variations for the indicated parameters, and the results of at least the most recent spot checks conducted on the system;
(iii) a current set of default protocols are available at the control panel (either electronically or as a document) which specifies for each routine examination the CT conditions of operation and the slice thickness, spacing between slices and/or pitch;
(iv) a list of techniques optimized for the body part being imaged to obtain a quality image and to ensure that the lowest amount of radiation is used as consistent with good medical practice.
(4) If the QC testing on the CT x-ray system identifies that a system operating parameter has exceeded a tolerance as specified in the Quality Assurance manual, use of the CT x-ray system on patients shall be limited to those exceptions permitted by established written instructions of the licensed medical physicist or radiologist. Upon completion of corrective action, the QC testing shall be repeated to verify that the system is back within tolerance.
(5) Commencing one year after the effective date of these regulations, each registrant performing CT scans on human beings shall ensure that for each scan, the radiation dose delivered by the scanner to a reference phantom or the dose received by the patient is saved and recorded. The dose delivered shall be recorded as Computed Tomography Dose Index volume (CTDIvol), dose length product (DLP) or other dosimetry metric published in the peer reviewed scientific literature and acceptable to the department. The dose received by a patient shall be recorded as organ dose or other dosimetry metric published in the peer reviewed scientific literature and acceptable to the department.
(6) The displayed dose shall be verified on an annual basis by or under the supervision of a licensed medical physicist to ensure that the equipment manufacturer’s displayed dose is within 20 percent of the measured dose.
(7) Eighteen months after the effective date of these regulations, each current registrant that performs diagnostic CT scans on human beings shall be accredited by a nationally recognized accreditation program that is acceptable to the department. A facility performing CT that loses their existing accreditation or a registrant or licensee that fails to obtain accreditation must report this fact within 30 days to the department. After the effective date of these regulations new licensees or registrants will have 18 months to become accredited, but must demonstrate that they have initiated the accreditation process within 90 days of the start of operations.
(8) Each registrant that performs CT scans on human beings shall establish and implement a policy and a procedure to ensure that:
(i) a request for a CT scan originates from a physician or other authorized health care practitioner familiar with the patient’s clinical condition; and
(ii) the request includes sufficient information to demonstrate the medical indication for the CT examination and allow for the proper performance and interpretation of the CT scan.
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.2 Definitions
(a) Covered facilities.
The term covered facilities means all general hospitals and residential health care facilities as defined in article 28 of the Public Health Law.
(b) Legionella culture sampling and analysis.
The term Legionella culture sampling and analysis means the collection of a water sample for the measurement of the live culture of Legionella involving the use of specialized media and laboratory methods for growth to determine the species and serogroup.
(c) Potable water system.
The term potable water system means a building water distribution system that provides water intended for human contact or consumption.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 139 ROCKLAND COUNTY
COMPANIES COMPANIES
10 CRR-NY 139.16 New York Water Service Corporation at Garnerville and Thiells
(a) Application.
The following rules and regulations, enacted in accordance with the provisions of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 879 of the Laws of 1953, and numbered article 2 thereof, shall apply to all existing wells and such wells as may be developed in the future on the properties of the New York Water Service Corporation at Garnerville and Thiells, in the town of Haverstraw, Rockland County, New York, such wells being a source of public water supply of said corporation.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the New York Water Service Corporation in the town of Haverstraw, Rockland County, New York.
(2) The term wells means the wells now used as sources of this public water supply or any wells developed in the future as additional sources of this public water supply, which are located on land now owned by the corporation at Garnerville and Thiells in the town of Haverstraw, Rockland County, New York.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No human excreta shall be buried in the soil at a distance of less than 500 feet from any well.
(2) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(3) Every privy or receptacle for the storage or deposit of human excreta, located between the prescribed 100 feet and 200 feet from any well, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of so that no nuisance will be created.
(4) Whenever, in the opinion of the State Commissioner of Health excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged nor deposited on or beneath the surface of the ground within 200 feet of any well except into watertight receptacles, the contents of which shall be removed before overflowing in such a manner as to prevent the pollution of the ground about the receptacle, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be located within 50 feet of any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited on or beneath the surface of the ground within 200 feet of any well.
(e) Wastes, refuse and garbage.
No garbage, refuse putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited on or beneath the surface of the ground within 200 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the wells.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any well.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 200 feet of any well.
(h) Trespassing.
No trespassing shall be allowed upon the property of the New York Water Service Corporation upon which the wells of the public water supply of said corporation are located and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the New York Water Service Corporation.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 200 feet of any well.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(k) Inspections.
The New York Water Service Corporation, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid corporation to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the New York Water Service Corporation to promptly notify the State Commissioner of Health of such violations. The aforesaid corporation shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.2 Construction
Terms not defined in this Subpart are defined in Subpart 52-1 of this Part. Skin banks shall apply for licensure and otherwise comply with Subpart 52-2 of this Part, and shall meet all general technical standards for tissue banks specified in Subpart 52-3 of this Part.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.5 Granting of approval
(a) Within 45 days of receipt of a complete application, the department shall issue to each rape crisis program that meets the requirements of this Subpart, approval to certify its rape crisis counselors for the confidentiality privilege.
(b) Approval obtained pursuant to subdivision (a) of this section shall continue for three years from the date of notification by the commissioner of approval of the application submitted by the rape crisis program until receipt by the organization of written notice, from the commissioner, terminating approval of the program, whichever occurs first. The commissioner may extend approval of the program for additional three-year periods if the organization has complied with all requirements of this section during the prior period of approval.
(c) If a program submits an application that does not meet the requirements of this Subpart, the department will provide the applicant with written comments regarding the required modifications needed to obtain approval.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.11 Schedule for construction applications
The commissioner, after consultation with the health systems agencies, shall establish a schedule for the review of project scope and concept construction applications by the health systems agencies, the department and the council. Such schedule shall require that:
(a) review periods will be established by the commissioner with the agreement of the health systems agencies for the consideration of applications proposing similar types of construction and services; each review period for similar types of construction and services will occur not less than once each year;
(b)
(1) beginning on January 1, 1994, applications received between January 1st and June 30th of each year shall be reviewed by the health systems agencies and the department and presented to the council for its consideration prior to June 30th of the following year and applications received between July 1st and December 31st of each year shall be reviewed by the health systems agencies and the department and presented to the council for consideration prior to December 31st of the following year; and
(2) applications which the commissioner has determined address high priority health care needs for which there is a demonstrated acute shortage of particular equipment and/or services or as may be indicated by the application of existing need regulations in Part 709 of this Title for specific services and equipment, may be processed more quickly than the six-month batch provided for in paragraph (1) of this subdivision, as an expedited batch; provided, however, that the department shall advise the health care industry, and all specific parties known to be interested or who have requested such notification in writing, at least three months in advance of the date on which it intends to commence a particular expedited batch;
(c) to qualify for review during the appropriate review period, an application shall meet criteria established by the commissioner to assure the application is complete in order to permit substantive review;
(d) applications requesting emergency construction resulting from unforeseen circumstances necessary to protect patient care and safety or primary care applications proposed to be funded by State grant money or primary care applications for freestanding facilities proposed to be funded under Federal Public Law 95-210, 93-222 or 89-4, as amended, or proposed by an organization authorized to operate pursuant to article 44 of the Public Health Law, as amended, shall be reviewed promptly;
(e) the commissioner after consultation with the health systems agencies shall establish procedures to be followed by health systems agencies when making recommendations to the department; such procedures shall include a relative priority of applications;
(f) a health systems agency recommendation that is inconsistent with the provisions of article one of the State Hospital Code on the determination of public need for medical facility construction shall be explained and documented by the agency; when the department makes a decision contrary to the recommendation of the health systems agency, the department shall document the reason for such decision.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.266 Present value
The price a buyer is willing to pay for one or a series of future benefits, the term generally being associated with a formal computation of the estimated worth in the future of such benefits from which a discount or compensation for waiting is deducted.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 151 ULSTER COUNTY
TOWNS TOWNS
10 CRR-NY 151.4 Highland Water District, Town of Lloyd, Ulster County
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to four Illinois Mountain Reservoirs numbers 1-4 and all watercourses tributary thereto or which may ultimately discharge into any of the said four Illinois Mountain Reservoirs or which may be developed in the future to serve as sources of the water supply to the Highland Water District in the Town of Lloyd.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or second-hand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, and industrial, municipal, agricultural and nonagricultural associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for depositing of refuse from a single family, a member of which is the owner, occupant, or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Highland Water District, Town of Lloyd.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage.
(18) Toxic substance shall mean any toxic substance as so defined by subdivision two of section 4801 of the Public Health Law.
(19) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(20) Water district means the Highland Water District, Town of Lloyd.
(21) Water supply shall mean the public water supply of the water district.
(22) Watercourse shall mean every spring, stream, marsh, or channel or water of any kind which flows into the water supply of the water district.
(23) Watershed shall mean the entire drainage area contributing water to the water supply of the water district.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings and watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except ( a ) watertight receptacles; ( b ) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and ( c ) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tight-fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 2,500-foot linear distance of any reservoir or watercourse and not within a 3,500-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned and used as water supply source by the water district.
(ii) Boating and fishing. No boating and fishing shall be allowed in or upon the waters of any reservoir or watercourse owned and used as water supply source by the water district.
(iii) Trespassing. No trespassing shall be allowed in or upon any reservoir or watercourse owned by the water district, within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the water district in the performance of their duties of supervision and maintenance of the water supply, and agents of organizations having leases, licenses or easements from the Town of Lloyd.
(8) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(9) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(10) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the water district.
(11) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 2,500-foot linear distance of any reservoir or watercourse.
(12) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The Town Board of the Town of Lloyd as commissioners of the water district or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law. The aforesaid town board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.2 Definitions
As used in this Part, the following terms shall have the meanings indicated:
(a) Family practice residency training program means a family practice residency program accredited by the Liaison Committee on Graduate Medical Education (LCGME) for three years of postgraduate medical education (PGY-1, PGY-2, PGY-3) in the specialty of family practice, or accredited by the American Osteopathic Association for two years of postgraduate training in family practice (PGY-2, PGY-3).
(b) Resident means a physician employed in a training position in a family practice residency training program.
(c) Commissioner means the State Commissioner of Health.
(d) Approved plan means a funding application submitted by the director of a family practice residency training program, providing the information specified in section 49.3 of this Part and approved by the Commissioner.
(e) Program means family practice residency training program.
Part 41 GRANTS FOR SCHOOL HEALTH PROJECTS
10 CRR-NY 41.1 Applicability
This Part shall apply to State grants paid for school health projects funded under chapter 50 of the Laws of 1981 or any subsequent State law providing funding through the State Department of Health for similar school health projects.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.12 Records to be kept by a tissue transplantation facility
(a) The director of each tissue transplantation service shall be responsible for records kept by the tissue transplantation facility. In addition to the records specified in Subpart 52-2 of this Part, the following records shall be kept, separate from recipient records, by the tissue transplantation facility:
(1) results of bacterial culture;
(2) records of appropriate storage and temperature monitoring of ocular tissue; and
(3) a dedicated record allowing accurate tracking of tissue to each recipient.
(b) A copy of the order for issuance of the tissue, including the name and signature of the ordering physician or person authorized by law to order such issuance, shall be kept by the tissue transplantation facility. A record in the patient's chart shall be satisfactory documentation of such order for issuance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 453 MANDATORY REPORTING LEVELS
10 CRR-NY 453.3 Listing and definitions
(a) Current assets.
(1) Cash.
(2) Savings accounts.
(3) Certificates of Deposit.
These assets, paragraphs (1)-(3), represent the amount of cash on deposit in banks that is immediately available for use in financing various fund activities, amounts of cash that are on hand for minor disbursements, and amounts of cash that are held in savings accounts and certificates of deposits.
(4) Investments.
Current securities, including U.S. government securities, other current investments, share of pooled investments, cash and investments held in escrow, evidenced by certificates of ownership or indebtedness, should be included in these reporting levels.
(5) Accounts and Notes Receivable.
These assets should reflect the amounts due from residential health care facility patients and their third-party sponsors.
(6) Allowance for Uncollectible Receivables and Third-Party Contractuals. These are valuation type (or contra-asset) reporting levels. Credit balances represent the estimated amount of uncollectible receivables from patients and third-party payors.
(7) Receivables from Third-Party Payors.
These assets reflect the estimated amount due from third-party reimbursement programs based on cost reports which will be submitted or have already been submitted and/or audited. Other levels should be maintained for each year's settlement if more than one year's settlement is included in an estimated amount, and by program if separately reimbursed.
(8) Pledges and Other Receivables (Pledges).
(9) Due from Parent/Subsidiary/Affiliate.
These assets, paragraphs (8) and (9), reflect pledges, grants and legacies due the facility as well as miscellaneous receivables due from staff, employees, affiliates, and interest receivable. An allowance for the estimated amount of uncollectible pledges should also be reported.
(10) Due from Other Funds.
These assets reflect the amounts due between funds. These balances should not be construed as receivables because they do not represent external claims. Instead, these balances should be viewed as representing assets of the general funds that are currently accounted for as restricted funds.
(11) Inventory.
These assets reflect the cost of unused supplies. Perpetual inventory records should be maintained and adjusted periodically to show actual amounts of supplies on hand. These adjustments should be applied to the inventory and distributed to the requisitioning cost centers. The extent of inventory control and detailed recordkeeping will depend on the size and organizational complexity of the residential health care facility.
(12) Prepaid Expenses.
These prepaid asset and other asset levels represent costs incurred that are properly chargeable to a future accounting period. Other current assets not included elsewhere can be included here.
(b) Assets whose use is limited.
(1) Depreciation Funds.
(2) Operating Escrow Funds.
(3) Mortgage Repayment Escrow.
These assets, paragraphs (1)-(3) of this subdivision are provided to account for Board-designated assets, or assets whose use is restricted as to withdrawal or use.
(c) Property, Plant and Equipment—Historical Cost.
(1) Land.
The balance of this asset reflects the cost of land used in residential health care facility operations. Included here are the costs of offsite sewer and water lines, public utility charges for servicing the land, government assessments for street paving and sewers, curbs and sidewalks whose replacement is not the responsibility of the facility, and other land expenditures of a nondepreciable nature. Unlike buildings and equipment, land does not deteriorate with use or with the passage of time; therefore, no depreciation is accumulated.
(2) Land Improvements.
All depreciable land expenditures for residential health care facility operations are charged to this asset. This includes the costs of onsite sewer and water lines; paving of roadways, parking lots, curbs and sidewalks (if replacement is the responsibility of the facility); and the cost of shrubbery, fences, and walls.
(3) Buildings.
The original costs of all buildings and any subsequent additions used in residential health care facility operations are included here. Included are architectural, consulting and legal fees related to the acquisition or construction of buildings, and interest paid on construction loans during the period of construction.
(4) Leasehold Improvements.
All expenditures for the depreciable improvement of leased land and buildings used in residential health care facility operations are to be included here.
(5) Fixed Equipment.
Expenditures for fixed equipment are included in this amount. The equipment should fulfill the following requirements:
(i) It should be affixed to the building and not be subject to transfer or removal.
(ii) It should be a depreciable asset with a life less than or equal to that of the building to which it is affixed.
(iii) It should be used in residential health care facility operations. Fixed equipment includes such items as boiler, generators, incinerators, elevators, engines, pumps, air conditioning systems and refrigeration machinery.
(6) Major Movable Equipment.
Depreciable equipment included in this amount fulfills the following requirements:
(i) It should be movable, as distinquished from fixed equipment.
(ii) It should have sufficient individuality and size to make control by means of identification tags feasible.
(iii) It should usually have a minimum life of three years or more.
(iv) It should be used in residential health care facility operations. Major movable equipment includes such items as automobiles and trucks, desks, beds, chairs, accounting machines, oxygen tents and X-ray apparatus.
(7) Minor Equipment.
Equipment included here generally fulfills the following requirements:
(i) Its location is usually not fixed and it is subject to requisition or use by various departments of the residential health care facility.
(ii) It should be of relatively small size.
(iii) It should be subject to storeroom control.
(iv) There should be a fairly large number of pieces in use.
(v) It should usually have a useful life of three years or less.
(vi) It should be used in residential health care facility operations. Minor equipment includes such items as wastebaskets, bedpans, syringes, catheters, basins, glassware, silverware, pots and pans, mattresses and surgical instruments. Each facility should develop capitalization parameters, in accordance with Medicare regulations and in consultation with its independent public accountants.
(8) Construction in Progress.
This must include the construction costs of uncompleted facilities that will be used for residential health care facility operations. Upon completion of the construction program, these amounts would be transferred and the appropriate asset debited. In the case of projects that are financed through debt agreements that require formal segregation of project assets and/or separate accountability, the construction in progress should be accounted for in the Plant Replacement and Expansion Fund. Upon completion of the construction program, these amounts should be transferred to appropriate operating fund assets.
(d) Accumulated Depreciation—Historical Cost.
(1) Land Improvements.
(2) Buildings.
(3) Leasehold Improvements.
(4) Fixed Equipment.
(5) Major Movable Equipment.
(6) Minor Equipment.
These amounts reflect the depreciation accumulated on the listed assets used in residential health care facility operations.
(e) Deferred Charges and Other Assets.
(1) Cash.
(2) Time Deposits and Equivalents.
(3) Patient Fund Held in Trust (proprietary facilities only).
(4) Other Assets.
(5) Investments.
(6) Investment in Nonoperating Property, Plant and Equipment.
(7) Accumulated Depreciation—Investments in Nonoperating Plant and Equipment. Included in these levels, paragraphs (1)-(7), are the costs (or fair market value at date of donation) of property, plant, and equipment not used in residential health care facility operations, and the accumulated depreciation on these assets. Other assets not included elsewhere are also included here.
(8) Other Intangible Assets.
This level is required to record intangible assets such as goodwill and organization costs.
(9) Due from Plant Replacement and Expansion Funds (noncurrent).
This level reflects the receivables of the operating fund from the plant replacement and expansion funds relative to special restricted funds required by debt agreement. These amounts would increase as the operating fund transfers assets to these restricted funds. These transfers are considered to give rise to receivables/payables between the funds, rather than reductions or increases to their fund balances, since the source of the assets are provided either from operations or from a portion of the proceeds from the debt financing. These operating fund receivables and the corresponding Plant Replacement and Expansion Fund liabilities will be reduced as the assets are used in these restricted funds to reduce debt, replace assets or pay specified operating expenses.
(f) Current Liabilities.
(1) Notes and Loans Payable.
(2) Current Portion of Long-Term Debt.
These required levels, paragraphs (1) and (2) reflect liabilities of the residential health care facility to vendors, banks, and other creditors, evidenced by promissory notes due and payable within one year.
(3) Accounts Payable.
This required level reflects the amounts due to trade and other creditors for supplies and services purchased.
(4) Accrued Compensation and Related Liabilities.
This required level reflects the actual or estimated liabilities of the residential health care facility for salaries and wages payable and liability amounts related to payroll.
(5) Other Accrued Expenses.
This required level represents current liabilities that have accumulated at the end of the month or accounting period for those expenses.
(6) Advances from Third-Party Payors.
Included here are liabilities to third-party payors for current financing and other types of advances due and payable within one year. Liabilities to third-party payors arising from reimbursement settlements are not to be included. Such liabilities must be included in Payable to Third-Party and Private Payors, paragraph (7) of this subdivision.
(7) Payable to Third-Party and Private Payors.
These amounts reflect reimburse ment settlements due to third-party and private payors.
(8) Due to Other Funds.
Liabilities to other funds are to be recorded here. These liabilities should not be construed as payables because no external obligation exists.
(9) Income Taxes Payable.
The amount of income taxes currently payable should be included here.
(10) Other Current Liabilities.
(11) Deferred Revenue—Patient Deposits.
(12) Deferred Revenue—Other.
(13) Due to Parent/Subsidiary/Affiliate.
(i) Deferred revenue is defined as revenue received or accrued that is applicable to services to be rendered within the next fiscal or calendar accounting period. Deferred revenue applicable to accounting periods extending beyond the next accounting period should be included under Deferred Credits and Other Liabilities, subdivision (g) of this section. Any deferred revenue items, previously classified as noncurrent liabilities, that have become current should be included here.
(ii) Also included are unrestricted fund current liabilities which have not been provided for elsewhere.
(iii) In addition, certain construction project liabilities would be included here, in the Plant Replacement and Expansion Fund, for those projects that are financed through debt agreements that require final accountability of project activities. These liabilities should be reduced as paid or transferred to the operating fund when the project is completed and the assets are transferred to the appropriate operating fund assets.
(g) Deferred Credits and Other Liabilities.
(1) Deferred Income Taxes.
(2) Deferred Third-Party Revenue.
These required levels, paragraphs (1) and (2), reflect the effects of any timing differences between book and tax or third-party reimbursement accounting.
(3) Due to Operating Fund—Long-Term.
This level reflects the liabilities of the plant replacement and expansion funds to the operating fund relative to special restricted funds required by debt agreements. These amounts would increase as the operating fund transfers assets into these funds. The source of such funds could either be provided from operations or a portion of the proceeds from the debt financing. The liabilities in the Plant Replacement and Expansion Fund and the corresponding receivables in the operating fund would be reduced as the assets are used to reduce debt, replace assets or pay specified operating expenses.
(4) Other Liabilities.1
(5) Patient Funds Held in Trust1 (proprietary facilities only).
(h) Long-Term Debt.
(1) Long-Term Debt.
Included here are amounts which reflect those liabilities that have maturity dates extending more than one year beyond the current year-end.
(2) Long-term debt liabilities would also be included in the plant replacement and expansion funds for those projects that are financed through debt agreements that require separate accountability of project activities.
(3) These liabilities should be transferred to the operating fund when the project is completed and the assets are transferred to the appropriate operating fund assets.
(i) Fund Balances (Not-for-Profit Residential Health Care Facilities).
(1)
(i) Fund Balances—Each Major Fund Group.
(ii) Restricted Project Fund Balance.
(iii) Depreciation Fund Balance.
(iv) Retirement of Indebtedness Fund Balance.
(v) Operating Escrow Fund Balance.
(vi) Donor-Restricted Fund Balance.
(vii) Transfers from Restricted Funds for Capital Outlays.
(viii) Value of Donated Property, Plant and Equipment.
(ix) Transfers to Operating Fund for Operating Purposes.
(x) Transfers of Amounts Equivalent to Depreciation.
(2)
(i) General fund balances represent the difference between total general fund assets and total general fund liabilities; that is, the net assets of the general fund.
(ii) The Transfers from Restricted Funds for Capital Outlays reporting level should be credited for the cost of capital items purchased with money from the restricted funds. The fair market value at the date of donation of donated property, plant and equipment should be credited to value of donated property, plant and equipment. At the end of the year these amounts should be closed out to the fund balance.
(iii) The credit balances of the restricted fund balances represent the net amount of each restricted fund's assets that is available for its designated purpose. These fund balances must be credited for all income earned on restricted fund assets and for gains from the disposal of such assets, and must be debited for all losses from disposal of such assets.
(iv) If, however, such items are treated as operating fund income (considering legal requirements and donor intent), the restricted fund balance should be charged for such income and due to operating funds should be credited.
(j) Equity.
(1) Investor-Owned Corporation.
The level of detail required to report equity amounts reflects the difference between the total assets and the total liabilities of the investor-owned corporation.
(i) Stockholders' Equity.
(ii) Preferred Stock.
(iii) Common Stock.
(iv) Retained Earnings.
(v) Treasury Stock.
(vi) Additional Paid-In Capital.
(2) Investor-Owned Partnership.
These amounts represent the net assets of the partnership.
(i) Capital.
(ii) Partner's Draw.
(3) Sole Proprietorship or Governmentally Operated Facilities.
(i) Capital.
(ii) Retained Earnings.
(iii) Contributions from Other Funds. This reporting level is to be used to record the value of assets contributed to an enterprise fund for its unrestricted use and without any liability attached to them. It corresponds, in a general sense, to capital invested by stockholders of a private corporation. The most common source is from the general revenues of a governmental unit, usually through the general fund, to provide initial resources for acquisition of the enterprise.
(k) Revenue.
The following represent mandated reporting levels of revenue. To reiterate, where a reporting level coincides with a functional reporting center, such level is listed only, designated with an asterisk(*) and not defined. All functional reporting centers are described in detail in Part 455 of this Article.
(1) Nursing and Professional Services.
(i) Residential Health Care Facility.*
(ii) Domiciliary Care Facility.*
(iii) Adult Day Health Care.*
(iv) Home Health Care.*
(v) Homemaker.*
(vi) Outpatient Clinics.*
(vii) Meals on Wheels.*
(viii) Intermediate Care Facility—Mental Retardation.*
(ix) Independent Living.*
(x) Specialty Pediatric.*
(xi) Head Injury.*
(xii) Acquired Immune Deficiency Syndrome.*
(xiii) Respite Care.
(xiv) Long-Term Ventilator Dependent.*
(xv) Central Medical Supplies and Equipment.*
(xvi) Laboratory Services.*
(xvii) Electrocardiology.*
(xviii) Electroencephalogy.*
(xix) Radiology.*
(xx) Inhalation Therapy.*
(xxi) Pharmacy.*
(xxii) Podiatry.*
(xxiii) Dental.*
(xxiv) Psychiatric.*
(xxv) Physical Therapy.*
(xxvi) Occupational Therapy.*
(xxvii) Speech and Hearing Therapy.*
(xxviii) Medical Staff Service.*
(2) Other Operating Revenues.
(i) Transfers from Restricted Funds for Research. This required level of detail reflects the amount of money transferred from restricted funds to the unrestricted fund to match expenses incurred by the unrestricted fund in the current period for restricted fund research activities only. Amounts should be segregated for each specific restricted fund activity or group of activities for which separate accounting is required by law, grant or donation agreement.
(ii) Transfers from Restricted Funds for Education. Included here is the amount of money transferred from restricted funds to the unrestricted fund to match expenses incurred by the unrestricted fund in the current period for restricted fund education activities only. Amounts should be segregated for each specific restricted fund activity or group of activities for which separate accounting is required by law grant or donation agreement.
(iii) Transfers from Restricted Funds for Specific Operating Purposes. This level reflects the amount of money transferred from restricted funds to the unrestricted fund to match expenses incurred by the unrestricted fund in the current period for restricted fund activities other than research and education.
(iv) Supplies Sold to Other than Patients. This level reflects the income earned by the institution in the sale of medical supplies sold to other than patients.
(v) Private Duty Nurses' Fees. This level is used to report revenues earned on services of private duty nurses.
(vi) Barber and Beauty Shops.*
(vii) Cafeteria.*
(viii) Gift Shop.*
(ix) Public Restaurant.*
(x) Laundry and/or Linen Services. This level should include revenues earned by providing laundry services to employees and students. See also subparagraph (k)(2)(xxiii) of this section.
(xi) Telephone and Telegraph Services. Money received from patients, employees and others in payment for residential health care facility telephone and telegraph services should be reported here.
(xii) Parking. Money received from visitors, employees and others in payment for parking privileges should be reported here.
(xiii) Television and Radio Rentals. This level should be used to report the revenue from television and radio rentals.
(xiv) Medical Record and Abstract Fees. This level should be used to report medical record transcript and abstract fees.
(xv) Sale of Scrap and Waste. This level should be used to report the revenue from sale of miscellaneous scrap and waste.
(xvi) Vending Machine Commissions (net). Commissions earned by the residential health care facility from coin-operated vending machines and telephones should be reported here.
(xvii) Housing.*
(xviii) Physicians' Offices and Other Rentals.*
(xix) Cash Discounts on Purchases. The amounts of cash discounts taken by the residential health care facility on purchases should be reported here. Trade discounts, however, should be treated as reductions in the costs of items purchased.
(xx) Rebates and Refunds from Vendors. This level should be used to report the revenue from rebates and refunds of expenses.
(xxi) Donated Commodities. This level should be used to report the fair market value of donated commodities.
(xxii) Interest, Finance and Penalty Charges on Accounts Receivable. This level should be used to report interest, finance and penalty charges billed (net of an estimate for uncollectibles).
(xxiii) Services to Other Organizations. This level should include revenues earned from the provision of services to other organizations or individuals.
(3) Nonoperating Revenue.
(i) General Contributions.
(ii) Donated Services.
(iii) Gain (Loss) on Sale of Property.
(iv) Income and Gains from Unrestricted Fund Investments.
(v) Unrestricted Income from Endowment Funds.
(vi) Unrestricted Income from Other Restricted Funds.
(vii) Term Endowment Funds Becoming Unrestricted.
(viii) Transfers from Restricted Funds for Nonoperating Purposes.
(ix) Contributions from Other Funds (governmentally operated facilities only). This reporting level reflects periodic transfers, from the general fund or special revenue fund to an enterprise fund, that serve as a subsidy for the operation of the enterprise. This level is not to be confused with the reporting level Deficit Financing Grants, paragraph (l)(5) of this section, which relates to contractual arrangements.
(x) Extraordinary Gain (Loss).
(l) Deductions from Revenue.
(1) Bad Debts.
(i) This level should contain periodic estimates of the amounts of accounts and notes receivable that are likely to be credit losses. The estimated amounts of bad debts can be based on an experience percentage applied to the balances of accounts receivable or the amount of charges made to patients' accounts during the period, or it can be based on a detailed aging and analysis of patients' accounts.
(ii) Because residential health care facilities experience bad debt patterns that vary with classes or types of patients, the computation of the estimate or provision should take these differences into consideration.
(2) Contractual Adjustments.
(i) These levels of detail must be used to report the differential (if any) between the amount (based on the residential health care facility's full established rates) of contractual charges to patients for services rendered during the period covered by the contract, and the amounts received and due from third-party agencies in payment of such charges, including adjustments estimated at year end.
(ii) Should the facility receive more than its established rates from a contractor, the differential will reduce these amounts.
(iii) In any instance in which the difference between the amount of a patient's bill and the payment received by the residential health care facility from a third-party agency is recoverable from the patient, the differential is retained in Accounts and Notes Receivable until it is paid or deemed to be a bad debt and is written off.
(iv) Specific required sublevels of reporting detail were outlined in section 453.2 of this Part.
(3) Charity Services.
(i) This level of detail should be used to report the difference between the amount (based on the residential health care facility's full established rates) of bills for services to charity patients and the amount (if any) to be received from patients in payment for such services. This difference should be credited directly to Accounts and Notes Receivable, rather than to an allowance, because charity discounts are readily determinable.
(ii) In order to properly distinguish between patients whose uncollectible bills should be considered charity write-offs and patients whose uncollectible bills should be considered bad debts, all patients should be classified at the time of admission or as soon after as possible as charity (full or partial) or paying patients. There may be some instances in which charges to a patient are considerably greater than was anticipated because of complications unforeseen at the time of admission, and the patient then is unable to pay the full amount. In such cases the patient should be reclassified as a charity patient, and the charges attributable to the unforeseen complications should be considered charity service. Uncollectible charges to patients classified as paying patients should be treated as credit losses—that is, bad debts—except for contractual adjustments, policy discounts and administrative adjustments.
(4) Other Deductions.
Adjustments in charges for services rendered, in the form of courtesy allowances and employee discounts from the residential health care facility's full established rates, should be reported here and credited to Accounts and Notes Receivable.
(5) Deficit Financing Grants.
This level is used to report voluntary and governmental grants received for the purpose of funding deficits at the residential health care facilities in accordance with contracted arrangements. Reference: subparagraph (k)(3)(ix) of this section.
(m) Expenses.
The following represents mandatory reporting levels of expense. To reiterate, in addition to the following, the sublevel of natural classification of expense is also mandated.
(1) All Functional Reporting Centers, described in Part 455 of this Article, subject to the significance of criteria outlined therein.
(2) Nonoperating Expenses.
(i) Federal, State and Local Income Tax—Current.
(ii) Federal, State and Local Income Tax—Deferred.
(n) The following represent mandatory reporting levels for statistical information:
(1) Standard Units of Measure, as detailed and defined under each Functional Reporting Center in Part 455 of this Article.
(2) Cost Allocation Basis, as detailed and defined for each Functional Reporting Center in section 456.3 of this Article.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.17 Procedural safeguards
(a) The early intervention official shall make reasonable efforts to ensure that the parent is fully informed, in their dominant language, and understand the rights and entitlement afforded them under the Early Intervention Program, including the right to:
(1) elect or decline to have the child screened and/or evaluated to determine eligibility for early intervention services and to participate in the voluntary family assessment process;
(2) elect or decline to participate in the Early Intervention Program without jeopardizing their right to future participation in the Early Intervention Program;
(3) accept or decline any early intervention service without jeopardizing other early intervention services;
(4) confidentiality of personally identifiable information;
(5) review and correct records;
(6) be notified by the early intervention official within a reasonable time prior to a proposal or refusal to initiate or change the identification, evaluation, or delivery of appropriate early intervention services to the child and family unit;
(7) participate in and invite the participation of others in all decisionmaking meetings regarding a proposal, or refusal, to initiate or change the identification, evaluation, or delivery of services to the child and family unit;
(8) use due process procedures to resolve complaints;
(9) use an attorney or advocate in any and all dealings with the State Early Intervention Program;
(10) receive an explanation of the use of and impact on insurance, including protection against co-payments and safeguards for lifetime and annual caps as provided in State law; and
(11) when the initial service coordinator or the early intervention official has not made contact with the parent prior to the evaluation, the approved evaluator shall review with the parent their rights under the program and document the review in the evaluation summary.
(b) Notice.
(1) Written notice must be given by the early intervention official to the parent of an eligible child 10 working days before the early intervention official proposes or refuses to initiate or change the identification, evaluation, service setting, or the provision of appropriate early intervention services to the child and the child's family.
(i) The notice must be sufficient in detail to inform the parent about:
(a) the action that is being proposed or refused;
(b) the reasons for taking such action; and
(c) all procedural safeguards available under the Early Intervention Program, including a description of mediation, impartial hearing, and the department’s complaint process; the procedures for accessing these safeguards; and any timelines under these procedures.
(ii) The notice must be:
(a) written in language understandable to the general public; and
(b) provided in the dominant language of the parents, unless it is clearly not feasible to do so.
(iii) If the dominant language or other mode of communication of the parent is not a written language, the early intervention official shall take steps to ensure that:
(a) the notice is translated orally or by other means to the parent in the parent's dominant language or other mode of communication;
(b) the parent understands the notice; and
(c) there is written evidence that the requirements of this paragraph have been met.
(iv) If a parent is deaf or blind, or has no written language, the mode of communication must be that normally used by the parent (such as sign language, braille, or oral communication).
(2) The early intervention official shall make reasonable efforts to ensure the parent receives written notification about the right to due process and the method by which mediation and an impartial hearing can be requested at the following times:
(i) upon denial of eligibility;
(ii) upon disagreement among the IFSP team members, including the early intervention official and the parent, on an initial or subsequent IFSP or proposed amendment to an existing IFSP; and
(iii) upon request from the parent for such information.
(c) Confidentiality.
(1) The early intervention official shall ensure that a written notice is provided to parents when a child is referred to the Early Intervention Program, and annually thereafter, that is adequate to fully inform parents about the Early Intervention Program requirements for protecting the confidentiality of personally identifiable information specified in subdivisions (c) through (e) of this section, and about parents’ rights related to these protections, including:
(i) a description of the children for whom personally identifiable information is maintained, the types of information collected, the methods used in gathering the information (including the sources from whom information is gathered), and the uses to be made of the information;
(ii) a summary of the policies and procedures that shall be followed regarding storage, disclosure to third parties, retention, and destruction of personally identifiable information;
(iii) a description of all the rights of parents and children regarding this information, including their right to inspect, review, and request amendment of their child’s early intervention records, their right to consent in writing to disclosure of personally identifiable information, and the procedures to exercise these rights; and
(iv) a description of the complaint procedures available to parents.
(2) Early intervention officials and providers of evaluations and early intervention services shall protect the confidentiality of personally identifiable information at the collection, maintenance, use, storage, disclosure, and destruction stages.
(3) Personally identifiable data, information, or records pertaining to an eligible child shall not be disclosed by any officer or employee of the department, any officer or employee of the municipality, or any provider or the provider’s employees or contracted providers to any person other than the parent of such child, except in accordance with part 99 of title 34 of the Code of Federal Regulations (Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402 available from the Early Intervention Program, Room 208, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0618), available at http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title34/34tab_02.tpl, to preserve the confidentiality of records pertaining to children participating in the Early Intervention Program.
(i) Except as authorized under part 99 of title 34 of the Code of Federal Regulations , written parental consent shall be obtained before personally identifiable information is disclosed to anyone other than authorized representatives, officials, employees, or contractors of the department, municipalities, and providers collecting, maintaining, or using the information for purposes of the Early Intervention Program.
(4) Each municipality, evaluator, service provider and service coordinator shall adopt procedures comparable to those set forth in part 99 of title 34 of the Code of Federal Regulations (Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402 available from the Early Intervention Program, Room 208, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0618), available at http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title34/34tab_02.tpl, to preserve the confidentiality of records pertaining to eligible children participating in the Early Intervention Program.
(5) Early intervention officials, all providers and all personnel involved in mediation and impartial hearing procedures shall:
(i) implement and maintain policies and procedures to assure the protection of confidential personally identifiable information, which may include existing policies and procedures where appropriate and applicable;
(ii) submit assurances that all employees and contracted providers, consultants, and volunteers with access to personally identifiable information are informed of and are required to adhere to all confidentiality requirements of personally identifiable information;
(iii) adhere to all legal requirements that protect records containing sensitive information ( e.g. , such as sexual or physical abuse, treatment for mental illness or mental health problems, HIV status, communicable disease status, the child’s parentage, etc.); and
(iv) identify the person or persons with designated responsibility for guaranteeing the confidentiality of personally identifiable information.
(6) The early intervention official and providers shall ensure the confidentiality of all information maintained in an electronic format, except as required or permitted by State or Federal law.
(7) The early intervention official shall provide for the confidential exchange of information among parent, evaluators, service providers and service coordinators, including policies and procedures which enable the parent to voluntarily give written consent for general release of information.
(i) The parent shall be informed of the right to refuse to sign a general release and offered the opportunity to sign a more selective release which specifies by name or category those individuals to whom information may be disclosed or from whom it may be sought.
(ii) The parent’s authorization for general release shall be revocable at any time and the parent shall be informed of the right to revoke such authorization. Such information shall be included on any such release form.
(8) The early intervention official shall make reasonable efforts to ensure notification of the parent when maintenance of personally identifiable information is no longer necessary for the purposes of the Early Intervention Program.
(i) At the request of the parent, the early intervention official shall ensure all personally identifiable information is removed from the record and destroyed. However, a permanent record of the child’s name, date of birth, parent name and contact information (including address and phone number), names of service coordinator(s) and provider(s), and exit data (including year and age upon exit and any programs entered into upon exiting) may be maintained without time limitation.
(d) Access to records.
(1) The early intervention official and approved evaluators, service providers, and service coordinators shall ensure the parent is afforded the opportunity to review and inspect all the records pertaining to the child and the child's family that are collected, maintained, or used for the purposes of the Early Intervention Program, unless the parent is otherwise prohibited such access under State or Federal law. The opportunity to review and inspect the record includes the right to:
(i) understandable explanations about and/or interpretations of the record upon the parent's request;
(ii) obtain a copy of the record within 10 calendar days of the receipt of the request by the early intervention official or approved evaluator, service provider, or service coordinator;
(iii) obtain a copy of the record within five working days if the request is made as part of a mediation or impartial hearing; and
(iv) have a representative of the parent view the record.
(2) For children in the care and custody or custody and guardianship of the local social services district, the local commissioner of social services or designee shall be accorded access to the records collected, maintained or used for the purposes of the Early Intervention Program.
(3) A provider may presume that the parent has authority to inspect and review records relating to his or her child unless the provider has been advised that the parent does not have the authority under applicable State law governing such matters as custody, foster care, guardianship, separation, and divorce.
(4) The early intervention official or evaluator, service provider or service coordinator may charge a reasonable fee not to exceed 10 cents per page for the first copy and 25 cents per page for any additional copies of the record, provided that the fee does not prevent the parent from exercising the right to inspect and review records and providing that no fees shall be charged to parents to obtain copies of any evaluation or assessment documents to which parents are specifically entitled under other sections of this Subpart, except an evaluator or service provider may charge for copies as permitted under Public Health Law, section 18.
(5) Parents shall not be charged fees for the search and retrieval of the record.
(6) Where any part of the record contains information on more than one child, the parent shall only have the opportunity to review and inspect the portion of the record which pertains to their child.
(7) Each early intervention official, evaluator, service provider and service coordinator shall keep a record of parties obtaining access to records gathered, maintained, or used for purposes of the Early Intervention Program (except access by parents and authorized employees of the municipality or approved evaluator, service provider, or service coordinator) including the name of the party, the date access was given, and the purpose for which the party is authorized to use the records.
(e) Amending the record.
(1) The early intervention official, evaluator, service provider and service coordinator shall ensure the parent the right to present objections and request amendments to the contents of the record because the parent believes the information is inaccurate, misleading, or violates the privacy or other rights of the child or parent.
(2) The parent may at any time present objections pertaining to the contents of the record to the early intervention official, evaluator, service provider or service coordinator, and request that amendments be made.
(3) The early intervention official, evaluator, service provider or service coordinator shall respond to the parent objection and request for amendments of the record within 10 working days.
(i) If the early intervention official, evaluator, service provider or service coordinator concurs with the parent's request, the service coordinator shall ensure the contents of the record are amended as requested and notify the parent of the amendment in writing or via a verbal explanation in their dominant language unless clearly not feasible to do so.
(ii) If the early intervention official, evaluator, service provider or service coordinator does not concur with the parent's request to amend the record, the early intervention official shall notify the parent in writing of the decision and inform the parent of the right to an administrative hearing in accordance with procedures set forth in paragraph (4) of this subdivision.
(4) An administrative hearing to amend the record must meet, at a minimum, the following requirements:
(i) the municipality shall hold the hearing within a reasonable time after it has received the request for the bearing from the parent;
(ii) the municipality shall give the parent notice of the date, time, and place, reasonably in advance of the hearing;
(iii) the hearing may be conducted by any individual designated by the municipality, who does not have direct interest in the outcome of the hearing;
(iv) the municipality shall give the parent a full and fair opportunity to present evidence relevant to the issues. The parent may, at their own expense, be assisted or represented by one or more individuals of his or her own choice, including an attorney;
(v) the municipality shall make a decision in writing within a reasonable period of time after the hearing;
(vi) the decision must be based solely on the evidence presented at the hearing, and must include a summary of the evidence and reasons for the decision;
(vii) if, as a result of the hearing, the municipality determines that the record contains information that is inaccurate, misleading, or violates the privacy or other rights of the child or parent, the municipality shall order the amendment of the record as requested by the parent;
(viii) if the record is ordered to be amended, the early intervention official shall ensure the record is amended and notify the parent in writing of the amendment; and
(ix) if, as a result of the hearing, the municipality determines that the contents of the record are not inaccurate or misleading or do not violate the privacy or other rights of the child and parent, the municipality shall order that the parent be notified in writing of such decision and informed of the right to place a statement in the record reflective of their views. The municipality shall ensure that such parental statement is incorporated, maintained, and disseminated as part of the record.
(f) Availability of due process.
(1) The parent of an eligible or potentially eligible child shall have the right to access mediation and/or an impartial hearing at no cost for the resolution of individual child complaints regarding eligibility determinations or the provision of early intervention services.
(2) The department of Health shall establish, implement, and maintain impartial hearing and mediation processes for the resolution of individual complaints regarding the identification, evaluation, assessment, eligibility determinations, and development, review and implementation of the individualized family service plan (IFSP).
(i) The department of Health shall ensure the availability of hearing officers who are trained and knowledgeable of the Federal and State law and regulations pertaining to the Early Intervention Program and the conduct of administrative hearing procedures.
(3) The failure of the parent to participate in mediation proceedings for the resolution of a complaint or dispute shall not constitute a failure to exhaust administrative remedies and shall not prevent the parent from accessing an impartial hearing.
(g) Mediation procedures.
(1) The department shall ensure that a statewide mediation system shall be available to ensure parent and early intervention officials may voluntarily access a non-adversarial process for the resolution of complaints regarding the provision of early intervention services.
(2) Mediation services for the resolution of disputes regarding eligibility determination or early intervention service delivery shall be available from community dispute resolution centers upon the written request of the parent and/or early intervention official and the mutual agreement of the parent and the early intervention official to participate in mediation.
(3) The early intervention official shall ensure the parent, upon the request for mediation services by the parent or the early intervention official, is informed regarding:
(i) the voluntary nature of mediation;
(ii) the parent’s right to withdraw at any time from mediation;
(iii) that the mediation process cannot be used to deny or delay a parent’s right to an impartial hearing, or to deny any other due process rights afforded under this section;
(iv) the right to be accompanied by supportive persons and/or an attorney; and
(v) that a written, signed mediation agreement resulting from a successful full or partial resolution under this subdivision is a legally binding document which is enforceable in any state court of competent jurisdiction or in a district court of the United States.
(4) The parent's request to the early intervention official for mediation services may be made in a written format selected by the parent.
(5) The early intervention official's request that the parent agree to participate in mediation services shall be made in writing in the dominant language of the parent, if feasible, and in a manner understandable to the parent.
(6) If the early intervention official requests mediation, the early intervention official shall obtain the express written consent of the parent to transmit personally identifiable information to the community dispute resolution center.
(7) Within two working days of receipt of a request by the early intervention official for mediation by the parent, the early intervention official shall notify the appropriate community dispute resolution center in writing of the request for mediation. The parent and service coordinator shall simultaneously be sent a copy of such notification, which shall include:
(i) the names, addresses, and telephone numbers of the parties to participate in the mediation;
(ii) the need for interpretive services, if any; and
(iii) the nature of the dispute(s) which has resulted in the request for mediation.
(8) Immediately upon receipt of a request for mediation, the community dispute resolution center shall contact the parent and early intervention official to discuss at a minimum the following:
(i) the mediation process;
(ii) a convenient site and time for the mediation; and
(iii) the need for interpretative services or alternative communication services, if any.
(9) The community dispute resolution center shall, upon a determination of the mutual agreement of the parent and early intervention official to participate in mediation, make appropriate arrangements for and convene the mediation proceedings within two weeks of the receipt of the request by the early intervention official, unless an extension is requested or consented to in writing by the parent.
(i) The mediation proceedings shall be convened at a date, time, and location convenient to the parent.
(10) The mediator and community dispute resolution center shall maintain the confidentiality of all personally identifiable information as required by State or Federal law or regulations.
(11) The parent and the early intervention official may represent themselves during the mediation proceedings.
(i) The parent and the early intervention official shall have the right to invite others to accompany them at the mediation proceeding.
(12) The parent and/or the early intervention official may be accompanied by an attorney at the mediation proceeding, provided that advanced notice is given to the other party of the intention to be accompanied by an attorney.
(13) The mediation process shall be completed within 30 calendar days of the receipt of the request for mediation by the community dispute resolution center.
(i) When mediation has resulted in successful negotiation of a partial or full agreement on areas in dispute between the parent and the early intervention official, the mediator shall document the terms of the negotiated agreement, including a list of unresolved issues, in writing and obtain the signatures of the parent and the early intervention official on the written agreement.
(a) The written agreement shall state that all discussions that occurred during the mediation process will remain confidential and shall not be used as evidence in any subsequent due process hearing or civil proceeding.
(ii) The mediator shall, whenever feasible, provide the written agreement in the dominant language of the parent or other alternative mode of communication.
(iii) The mediator shall forward a copy of such agreement to the community dispute resolution center, which shall ensure that the parent, early intervention official, and service coordinator receive a copy of the written agreement.
(iv) The service coordinator shall ensure that the terms of services agreed to in the written agreement are incorporated into the individualized family service plan within five working days of the receipt of the written agreement.
(v) When the mediation has not resulted in the negotiation of a resolution, the early intervention official shall ensure the parent is informed of the right to and procedures for requesting and obtaining an impartial hearing.
(vi) In any due process proceedings subsequent to the mediation process, only requests for mediation and mediation agreements may be available for presentation as evidence.
(14) Mediation records shall be maintained by the community dispute resolution center for a period of at least six years.
(h) Impartial hearing procedures for individual child complaints.
(1) The parent shall have the right to an impartial hearing which ensures the fair and prompt resolution of individual child disputes or complaints.
(i) A request for an impartial hearing must be made in writing and signed by a parent and submitted to the Commissioner of Health or designee.
(2) Upon the receipt of a request for an impartial hearing, the Commissioner of Health or designee shall inquire of the early intervention official whether or not mediation has been requested or completed, and provide the parent and respondents with a notice of hearing. If any party is represented by counsel, notice also shall be served upon the attorney representing the party.
(i) The notice of hearing shall, at a minimum:
(a) specify the date, time, and place of the hearing, which shall be convenient to the parent;
(b) briefly state the issues which are to be the subject of the impartial hearing, if known;
(c) explain the manner in which the impartial hearing will be conducted;
(d) describe the circumstances under which attorney's fees shall be reimbursed;
(e) advise the parent of the right to be represented by counsel and to be accompanied by any person of their choice;
(f) advise the parent of the right to interpreter for the deaf services;
(g) advise the parent of the right to testify, present evidence, and produce and cross-examine witnesses;
(h) advise the parent of the right to appeal the decision of the hearing officer;
(i) inform the parent that early intervention services that are not in dispute shall be continued pending the decision of the hearing officer and any appeal of such decision; and
(j) inform the parent of the availability and procedures for requesting mediation.
(ii) If the municipality intends to be represented by counsel, the early intervention official shall notify the parent within five working days of receipt of the notice of an impartial hearing request, and the hearing shall be held no sooner than five working days from the receipt of the notice.
(a) The service coordinator shall ensure the parent is informed about legal services and advocacy organizations available to assist them in the impartial hearing process.
(3) All notices and papers connected with a hearing, other than the notice of hearing and statement of charges, if any, may be served by ordinary mail and may be deemed complete three days after mailing.
(4) Upon receipt of a request for an impartial hearing, a hearing officer shall be assigned.
(i) The hearing officer shall complete the impartial hearing and render a decision within 30 days of the filing of a written request by the parent.
(ii) No hearing officer shall preside who has any bias with respect to the matter involved in the proceeding. Any party may file with the department a request, together with a supporting affidavit, that a hearing officer be removed on the basis of personal bias or for other good cause.
(iii) A hearing officer shall be disqualified for bias. For purposes of this Subpart, bias shall exist only when there is an expectation of pecuniary or other personal benefit from a particular outcome of the case; when the individual is an employee of any agency or other entity involved in the provision of early intervention services or care of the child; or, when there is a substantial likelihood that the outcome of the case will be affected by a person's prior knowledge of the case, prior acquaintance with the parties, witnesses, representatives, or other participants in the hearing, or other predisposition with regard to the case. The appearance of impropriety shall not constitute bias and shall not be a grounds for disqualification. Hearing officers are presumed to be free from bias.
(iv) A hearing officer may disqualify himself/herself for bias on his/her own motion. A party seeking disqualification for bias has the burden of demonstrating bias. The party seeking disqualification shall submit to the hearing officer an affidavit pursuant to State Administrative Procedures Act, section 303 setting forth the facts establishing bias. Mere allegations of bias shall be insufficient to establish bias.
(v) The hearing officer shall rule on the request for disqualification.
(vi) Upon the refusal of the impartial hearing officer to voluntarily withdraw from the case, the party filing the request shall have the right to appeal this decision to a court of competent jurisdiction. Any such appeal shall not interrupt the hearing proceedings unless the parties consent to an adjournment pending the outcome of such appeal or otherwise ordered by a court.
(5) The hearing officer shall conduct the impartial hearing in a fair and impartial manner and shall have the power to:
(i) rule upon requests by parties to the hearing, including all requests for adjournments;
(ii) administer oaths and affirmations and issue subpoenas requiring the attendance and testimony of witnesses and the production of books, records and other evidence pertinent to the impartial hearing;
(iii) admit or exclude evidence;
(iv) limit the number of times any witness may testify, repetitious examination or cross-examination, and the amount of corroborative or duplicative testimony;
(v) hear arguments on facts or law;
(vi) order that opening statements be made by the parties to the impartial hearing;
(vii) order the parties to appear for a pre-hearing conference to consider matters which may simplify the issue or expedite the hearing, and which may ensure that the parties understand the procedures governing the hearing;
(viii) ensure that a written or electronic verbatim record of the proceedings is maintained and made available to the parties; and
(ix) perform such other acts as may be necessary for the maintenance of order and efficient conduct of the impartial hearing, unless otherwise prohibited by law or regulation.
(6) A parent involved in an impartial hearing has the right to obtain a written or electronic verbatim transcription of the proceeding.
(7) The procedures used to conduct the impartial hearing proceeding shall provide the parties with a fair and prompt resolution of any dispute.
(i) The parties to the impartial hearing may be represented by legal counsel or individuals with special knowledge or training with respect to children eligible for early intervention services and may be accompanied by other persons of their choice.
(ii) The parent shall have the right to determine whether or not the child who is the subject of the impartial hearing shall attend the hearing.
(iii) The impartial hearing shall be closed to the public unless the parent requests an open hearing. Upon such request, the hearing officer shall make a determination regarding whether the hearing will be opened to the public.
(iv) The parties to the impartial hearing, and their respective counsel or representative, if any, shall have an opportunity to present evidence and to question all witnesses at the hearing.
(v) All evidence including documents and a listing of witnesses shall be disclosed to the opposing party at least five working days before the hearing.
(a) The parent has the right to prohibit the introduction of any evidence at the proceeding that has not been disclosed to the parent at least five days before the proceeding.
(vi) The local social services commissioner or designee shall be afforded notice and a right to be heard at any mediation process and/or impartial hearing for any child in his or her care and custody or custody and guardianship.
(vii) Each witness shall be sworn or given an affirmation by the impartial hearing officer.
(viii) The hearing officer shall consider all relevant evidence and shall include as part of the record all records, documents and memoranda submitted into evidence. The formal rules of evidence do not apply; provided, however that any request for mediation and mediation agreement entered into by the parties may be included as evidence.
(ix) The parties may enter into a stipulation to resolve the matters in dispute at any time prior to the issuance of a decision by the impartial hearing officer.
(a) The parties shall inform the hearing officer of such stipulation.
(b) Upon such notice, the hearing officer shall terminate the proceedings and provide notice to the department of Health of the termination.
(x) The hearing officer may issue a consent order upon such stipulation by the parties. Such consent order shall have the same force and effect and shall be implemented in the same manner as an order issued by the hearing officer.
(xi) Upon conclusion of the proceedings, the hearing officer shall render a written decision within 30 days of the request for the hearing, which shall include:
(a) the findings of fact and conclusions of law;
(b) a determination regarding the matters in dispute;
(c) an order of implementation of the determination; and
(d) the right to appeal the decision to a court of competent jurisdiction.
(xii) The decision of the hearing officer shall be final, provided that any party may seek judicial review by a court of competent jurisdiction.
(xiii) The hearing officer may grant specific extensions of time beyond the period set out in subparagraph (xi) of this paragraph at the request of either party.
(xiv) Where a decision is not rendered within 30 days, the hearing officer may issue interim orders which shall ensure that the child and family receive appropriate early intervention services to the extent feasible and consistent with the services requested by the parent.
(xv) Where the hearing officer determines that delay in rendering a written decision may result in harm to the child's health or welfare, the hearing officer may provide for an expedited hearing, including an interim verbal decision where necessary, to be followed by a written decision.
(xvi) A copy of the written decision shall be mailed to the parties of the hearing, the service coordinator for the child and family, the Commissioner of Health or designee, and the local social services commissioner or designee for children in his or her care and custody or custody and guardianship.
(xvii) The early intervention official or service coordinator shall modify the individualized family service plan no later than five working days after receipt of the written or oral decision, whichever is issued sooner.
(xviii) The records and decisions by hearings officers shall be maintained for at least six years.
(i) Availability of complaint procedures.
(1) All complaints alleging violations of laws, rules and regulations by a State early intervention service agency, early intervention official, or provider approved to deliver early intervention services shall be submitted by a parent, representative of the parent or any other individual or entity to the department of Health for investigation and resolution. For the purpose of this section, provider refers to evaluators, service providers and service coordinators.
(i) Complaints shall be submitted in writing to the department.
(ii) The complaint shall allege a violation of laws, rules or regulations that occurred not more than one year prior to the date that the complaint is received.
(iii) The party filing the complaint must forward a copy of the complaint to the early intervention official, any provider who is the subject of the complaint, and to the service coordinator of the child named in the complaint, at the same time the party files the complaint with the department.
(iv) The complaint shall include:
(a) a statement that the department, municipality, or provider has violated a requirement of part C, title 34 of the Code of Federal Regulations, title II-A of article 25 of the Public Health Law; or Subpart 69-4: Early Intervention Program regulations;
(b) the facts on which the complaint is based; and
(c) the signature and contact information for the complainant.
(v) If alleging violations with respect to a specific child, the complaint shall also include:
(a) the name, date of birth, and address of the residence of the child;
(b) the name of the provider(s), service coordinator, and municipality serving the child;
(c) a description of the nature of the problem associated with the child, including facts relating to the problem; and
(d) a proposed resolution of the problem to the extent known and available to the party at the time the complaint is filed.
(2) All investigations shall be completed within 60 calendar days of the receipt the complaint by the Department of Health.
(3) Upon receipt of a complaint the complainant shall be informed of the following:
(i) the procedures governing the investigation;
(ii) the opportunity to submit additional information, either orally or in writing, about the allegations in the complaint;
(iii) the opportunity for a parent who has filed a complaint to voluntarily engage in mediation, in accordance with subdivision (g) of this section;
(iv) the right of the complainant to receive a written decision that addresses each allegation in the complaint, contains findings of fact and conclusions, and describes the reasons for the final decision; and
(v) that the subject of the complaint shall have the opportunity to respond to the complaint.
(4) The department may permit an extension of the time limit of the issuance of a written decision under paragraph (2) of this subdivision only if:
(i) exceptional circumstances exist with respect to a particular complaint; or
(ii) the parent (or individual or organization) and the department, municipality, or provider involved agree to extend the time to engage in mediation pursuant to subparagraph (3)(iii) of this subdivision.
(5) The investigation of any complaint shall include:
(i) the opportunity for the subject of the complaint to respond to the complaint;
(ii) an on-site investigation, if the department determines it is necessary;
(iii) provision for an interview of the complainant; any person named in the allegation; and, any person who is likely to have relevant information pertaining to the allegation; and
(iv) provision for the receipt of any documentation which may confirm or deny the substance of the allegation.
(6) Upon completion of an investigation a determination shall be made by the department as to whether the allegation is substantiated and the complainant and subject of the investigation shall be notified in writing of such determination.
(i) Upon completion of an investigation resulting in substantiation of one or more allegations, the department may require corrective action be taken by the subject of the investigation and, where the subject is an approved individual or agency, may take such other actions, including but not limited to actions in accordance with section 69-4.24 of this Subpart.
(ii) Written notification shall include:
(a) the findings and determination of the merit of each allegation; and
(b) where applicable, corrective actions to be taken which may include participation in technical assistance or other actions prescribed by the department.
(iii) Corrective action plans developed by the subject of an investigation shall be submitted for approval to the department.
(a) At a minimum, the corrective action plan shall specify the date by which the plan shall be implemented and procedures for implementation.
(7) If a written complaint is received and it is the subject of an impartial hearing, or it contains multiple issues of which one or more are part of such a hearing, the department shall set aside any part of the complaint that is being addressed in the impartial hearing until the conclusion of the hearing. However, any issue in the complaint that is not a part of the impartial hearing shall be resolved using the time limit and procedures described in this section.
(8) If an issue raised in a complaint filed under this section has previously been decided in an impartial hearing involving the same parties, the impartial hearing decision shall be binding on that issue.
(9) A complaint alleging the department, a municipality, service coordinator, or provider's failure to implement an impartial hearing decision shall be resolved by the department.
(10) Nothing herein regarding the filing of complaints shall prohibit the department or any party, including a parent, representative of the parent, or any other individual or entity, from communicating with the department orally or in writing, from responding to requests for assistance in resolving any concerns or problems related to the delivery of early intervention services; provided, however, that such parties shall be informed by the department of the availability of complaint procedures.
(j) Pendency.
(1) During the pendency of any mediation, impartial hearing, or appeal, the early intervention official shall ensure the following services for the child and family are implemented:
(i) the services provided pursuant to the individualized family service plan previously in effect; or
(ii) if the early intervention official and the parent do not agree on the IFSP, the sections of the proposed IFSP that are not in dispute.
(2) The early intervention official of a municipality to which a child and family has moved shall ensure that the services identified in the previous individualized family service plan of the former municipality shall continue to be provided to the extent feasible until a new individualized family service plan has been developed or that the parent and early intervention official otherwise agree to a modification of such former plan.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.6 Conflict of interest
(a) No entity shall be qualified for certification as an external appeal agent if it owns or controls, is owned or controlled by, or exercises common control with any of the following:
(1) any national, State or local illness, health benefit or public advocacy group;
(2) any national, State or local society or association of hospitals, physicians, or other providers of health care services; or
(3) any national, State or local association of health care plans.
(b) An applicant for certification as an external appeal agent shall submit a sworn statement setting forth that none of the control affiliations proscribed in subdivision (a) of this section apply to the applicant, and that the applicant, its medical director and each of its owners, officers, directors and management employees, either:
(1) has no material familial, financial or professional affiliation, as those terms are defined in section 98-2.2(d)-(f) of this Subpart, with any person or entity listed in subparagraphs (2)(i)-(v) of this subdivision; or
(2) provides a list of those material familial, financial and professional affiliations, each of which may, upon certification, result in a prohibited conflict of interest in connection with an external appeal because of such affiliation with:
(i) any health care plan;
(ii) any owner, officer, director, or management employee of any health care plan;
(iii) any health care provider, physician's medical group, independent practice association, or provider of pharmaceutical products or services or durable medical equipment;
(iv) any facility at which a health service would be provided; or
(v) any developer or manufacturer of a health service.
(c) Following certification:
(1) if an external appeal agent acquires ownership or control of, or becomes owned or controlled by, or acquires and begins to exercise common control with any entity described in paragraphs (a)(1)-(3) of this section, the external appeal agent shall notify the Departments of Health and Insurance in writing within five business days of such acquisition or exercise of control. Such notice shall be sufficient basis for the revocation of certification without a hearing; and
(2) the sworn statement required by subdivision (b) of this section shall be amended and resubmitted to the Departments of Health and Insurance within five business days of the addition or deletion of any material affiliation as described in subparagraphs (b)(2)(i)-(v) of this section.
(d) The applicant shall submit a detailed written description of its policies, processes and procedures for ensuring, in accordance with the criteria set forth in subdivisions (b) and (c) and paragraphs (e)(2)-(4) of this section and section 98-2.5(h)(2) of this Subpart, that appeals will be conducted by impartial clinical peer reviewers, for the reporting and review of clinical peer reviewer conflicts of interest and for assigning or reassigning an appeal where a conflict or potential conflict is identified and further, that the applicant, its medical director and each of its owners, officers, directors, management employees and clinical peer reviewers have no material familial, financial or professional affiliation with the enrollee whose health care service is the subject of an appeal assigned to it subsequent to certification as an external appeal agent or with the enrollee's designee.
(e) Unavoidable conflicts; minimization.
Notwithstanding any other provision of law and in accordance with section 4913(2) of the Public Health Law and section 4913(b) of the Insurance Law:
(1) If the superintendent determines in the course of assigning an external appeal that a conflict is unavoidable because all external appeal agents certified pursuant to this Subpart or their medical director, owners, officers, directors and/or management employees have a disqualifying material affiliation with one or more of the persons or entities listed in subparagraphs (b)(2)(i)-(v) of this section in relation to the appeal to be assigned, the superintendent shall make a random assignment of the appeal in accordance with section 98-2.8 of this Subpart, provided, however, that the certified external appeal agent assigned shall, within two business days of the assignment or for an expedited appeal, within 24 hours of the assignment, certify to the superintendent by sworn statement that the clinical peer reviewer(s) who will review the external appeal have been assigned in accordance with paragraph (2) of this subdivision and subdivision (f) of this section. When an appeal must be assigned pursuant to this paragraph, the superintendent shall notify the enrollee that all certified agents have a proscribed material affiliation(s), of the need to randomly assign the appeal to one of the external appeal agents certified by the State in order that a determination of the appeal be obtained and of the nature of the affiliation(s) involving the certified external appeal agent assigned to the appeal, and shall inform the enrollee that, in no event shall the agent's clinical peer reviewer(s) who reviews the appeal have any affiliation proscribed by this section.
(2) An agent assigned pursuant to this Subpart shall not assign an appeal to a clinical peer reviewer(s) which has a material affiliation with any of those persons listed in subparagraphs (b)(2)(i)-(v) of this section or to a clinical peer reviewer(s) which has a material familial, financial or professional affiliation with the enrollee whose health care service is the subject of the appeal, or with the enrollee's designee.
(3) Where a clinical peer reviewer has a material affiliation with a health maintenance organization or line of business thereof, such affiliation alone shall not constitute a disqualifying conflict with respect to an appeal involving an affiliated health maintenance organization or line of business with respect to which the clinical peer reviewer has no material affiliation.
(4) Where a clinical peer reviewer has a material affiliation with a hospital or other licensed provider which is an affiliate of a larger hospital or other provider system or network, such affiliation alone shall not constitute a disqualifying conflict with respect to an appeal involving another hospital or other provider affiliated with such hospital or provider system with respect to which the clinical peer reviewer has no material affiliation.
(f) No appeal shall be assigned to an external appeal agent or clinical peer reviewer that participated in or issued an internal utilization review decision or the final adverse utilization review determination which is the basis for an external appeal.
(g) Any appeal assigned to an external appeal agent or clinical peer reviewer which is subsequently determined to involve a disqualifying material affiliation, or prior involvement of the external appeal agent or clinical peer reviewer in the underlying internal utilization review decision or final adverse utilization review determination, shall be immediately returned for reassignment to the superintendent, or the external appeal agent, respectively. If the appeal is being returned to the superintendent, the certified external appeal agent shall also immediately notify the superintendent, by telephone or fax, that the appeal is being returned.
(h) Notwithstanding any other provision of this Subpart, a certified external appeal agent may assign an appeal to a clinical peer reviewer with unique expertise and experience with respect to a health care service which is relevant to an appeal for reasons which may include, but shall not necessarily be limited to:
(1) the development or participation in the development of a service, procedure or related equipment; and/or
(2) prior training and participation in the diagnosis or treatment of a condition rarely encountered or rarely encountered in the geographic area in which the enrollee resides, provided, however, that such clinical peer reviewer did not participate in the internal utilization review decision or the final adverse determination which is the basis for the external appeal.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.16 Absences during school year
Except as provided by these rules and except as provided by the department's annual calendar for the school year, employees shall not be entitled to any leave of absence with pay during the school year; provided, however, that the department may grant time off with pay for religious observance, teacher conferences and other appropriate professional meetings, and for extraordinary or emergency absences. Employees may be required to make up such time off by appropriate adjustments in their daily or weekly work schedules.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.33 Out-of-state providers
(a) For discharges occurring on and after December 1, 2009, rates of payment for inpatient hospital services provided by out-of-state providers in accordance with the prior approval requirements set forth in section 365-a(4)(d) of the Social Services Law shall be as follows:
(1)
(i) the weighted average of inpatient rates, including a teaching adjustment where applicable, in effect for similar services for hospitals located in the downstate region of New York State shall apply with regard to services provided by out-of-state providers located in the New Jersey Counties of Sussex, Passaic, Bergin, Hudson, Essex, Union, Middlesex and Monmouth, in the Pennsylvania County of Pike, and in the Connecticut counties of Fairfield and Litchfield;
(ii) for rates effective beginning January 1, 2014, the weighted average of inpatient rates, including a teaching adjustment where applicable, in effect for similar services for hospitals located in the downstate region of New York State shall also apply with regard to services provided by out-of-state providers located in cities where the city’s population census is 500,000 or greater based on the U.S. Department of Commerce United States Census Bureau; and
(2) the weighted average of inpatient rates, including a teaching adjustment where applicable, in effect for similar services for hospitals located in the upstate region of New York State shall apply with regard to all other out-of-state providers;
(3) high cost outlier rates of payment shall be calculated in accordance with section 86-1.21 of this Subpart with the exception of the wage equalization factor (WEF) being based upon the weighted average of the upstate or downstate region;
(4) the weighted average of the capital component of the inpatient rates in effect for similar services for hospitals located in New York State shall apply with regard to services provided by out-of-state providers.
(b) Notwithstanding any inconsistent provision of this section, in the event the department determines that an out-of-state provider is providing services that are not available within New York State, the department may negotiate payment rates and conditions with such provider; provided however, such payments shall not exceed the provider's usual and customary charges for such services.
(c) For purposes of this section, the downstate region of New York State shall consist of the New York Counties of Bronx, New York, Kings, Queens, Richmond, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam and Dutchess, and the upstate region of New York State shall consist of all other New York counties.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.20 HIV infection control
(a) All facilities regulated under this article shall:
(1) implement and enforce a program for the prevention of circumstances which could result in an employee or patient/client becoming exposed to significant risk body substances which could put them at significant risk of HIV infection during the provision of services, as defined in sections 63.1 and 63.9 of this Title. Such a program shall include:
(i) use of scientifically accepted protective barries during job-related activities which involve, or may involve, exposure to significant risk body substances. Such preventive action shall be taken by the employee with each patient/client as an essential element for the prevention of bidirectional spread of HIV;
(ii) use of scientifically accepted preventive practices during job-related activities which involve the use of contaminated instruments or equipment which may cause puncture injuries;
(iii) training at the time of employment and yearly staff development programs on the use of protective equipment, preventive practices, and circumstances which represent a significant risk for all employees whose job-related tasks involve, or may involve, exposure to significant risk body substances;
(iv) provision of personal protective equipment for employees which is appropriate to the tasks being performed; and
(v) a system for monitoring preventive programs to assure compliance and safety;
(2) implement and enforce a policy/procedure for the management of individuals who are exposed to significant risk body substances under circumstances which constitute significant risk of transmitting or contracting HIV infection. The policy/procedure shall include:
(i) a system for reporting to a designated individual in the facility exposure thought to be a circumstance which constitutes significant risk of transmitting or contracting HIV infection;
(ii) evaluation of the circumstances of a reporting exposure and services for providing follow-up of the exposed individual which includes:
(a) medical and epidemiological assessment of the individual who is the source of the exposure, where that individual is known and available;
(b) if indicated epidemiologically, HIV counseling and voluntary testing of the source individual. Disclosure of the HIV status of the source individual can be made with the express written consent of the protected individual, or a person authorized pursuant to law to consent to health care for the protected individual if such person lacks capacity to consent, or pursuant to court order, if the HIV status is not known to the exposed individual;
(c) appropriate medical follow-up of the exposed individual;
(iii) assurances for protection of confidentiality for those involved in reported exposures.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY LIMITATIONS ON HOSPITALIZATION, INCLUDING SURGERY
10 CRR-NY 85.1 Emergency or urgent surgery
(a) To be a covered benefit under medical assistance for the needy as provided in section 365-1(5)(a) of the Social Services Law, any emergency or urgent surgery shall be for alleviation of severe pain or for the immediate diagnosis and/or treatment of conditions which threaten disability or death if not promptly diagnosed or treated. No such emergency or urgent surgery requires prior determination of coverability. In each case, a person designated by the Commissioner of Health shall determine coverability of this benefit based upon the documented existence of one or more conditions such as the following:
(1) obstetrical crises and/or labor;
(2) acute trauma;
(3) reparative or reconstructive surgical procedures performed within 60 days of acute trauma;
(4) malignancy, confirmed or suspected;
(5) hemorrhage or threat of hemorrhage;
(6) serious infection;
(7) severe pain;
(8) shock or impending shock;
(9) decompensated vital functions or threat to vital functions such as sensorium, respiration, circulation, excretion and sensory organs;
(10) congenital defects or abnormalities in a newborn infant best managed by prompt intervention;
(11) any condition the management of which requires prompt diagnostic procedures necessarily performed on an inpatient basis such as biopsy and endoscopy; or
(12) any other condition which causes severe pain or threatens disability or death if not promptly diagnosed or treated.
(b) The first three days of inpatient care, services and supplies for persons admitted to inpatient hospital care under this section shall be deemed a covered benefit under medical assistance for the needy. To be a covered benefit after the third day of inpatient care, there shall be a determination of benefit coverability prior to the end of the third day by a person designated by the Commissioner of Health. Such initial determination shall be for a specified period of time not to exceed the 50th percentile of length of stay norms for comparable patients which have been authorized by the Commissioner Health or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in section 85.5(a) of this Part, such specified period of time shall not exceed the 40th day of stay. Determination of coverability shall be based upon the existence of one or more conditions such as those listed in subdivision (a) of this section which can be treated only on an inpatient hospital basis, as documented in the patient's medical record. Subsequent to this initial determination of coverability, extensions of benefit coverability shall be subject to length of stay limitations of sections 85.5 and 85.7 of this Part.
(c) Determination of benefit coverability under this section shall be made by a designated physician or nonphysician under a designated physician's supervision. A determination of noncoverability shall be made only by a designated physician. If such determination of noncoverability is made, any care, supplies or services provided beyond three days shall not be a covered benefit under medical assistance for the needy.
(d) Notice of determination shall be given to the patient's surgeon, the hospital administrator and, if there is a determination of noncoverability, to the patient. The hospital shall keep any such notification on file, accessible for review by representatives of the State or of the local social services district. The patient's surgeon or hospital administrator may, within three days of the date of such notification, appeal a determination of noncoverability in writing to the physician or physicians designated by the commissioner for such purpose. Notification of the decision on appeal shall be given to the patient's surgeon, the hospital administrator and the patient. If the determination of noncoverability is affirmed on appeal, any inpatient hospital care, supplies or services provided beyond three days shall not be a covered benefit.
(e) If the person designated by the Commissioner of Health decides in the course of making determinations of coverability under this section or it is determined from other sources that a physician, physicians or the hospital are admitting patients under this section for medical conditions which are not for alleviation of severe pain or for the immediate diagnosis and/or treatment of conditions which threaten disability or death if not promptly diagnosed or treated, the designated person shall give written notification to the physician(s) and the hospital that if such admissions continue, the initial three-day period of stay will no longer be deemed a covered benefit. If patients are thereafter admitted for medical conditions which are not for the aforesaid purposes, the designated person shall notify the physician(s) and the hospital that to be a covered benefit, the first three days of inpatient stay will be subject to a determination of coverability. Such determination of coverability shall be made prior to the end of the third day of inpatient hospital stay in accordance with the procedures in subdivisions (a), (b), (c) and (d) of this section. If there is a determination of non-coverability, any inpatient hospital care, supplies or services provided shall not be a covered benefit under medical assistance for the needy.
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-5 PURCHASING AND CONTRACTING
10 CRR-NY 88-5.1 Purpose
Section 409-c(4)(b) of the Public Health Law permits the health care facilities within the Department of Health greater flexibility in purchasing and contracting.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 114 ESSEX COUNTY
VILLAGES VILLAGES
10 CRR-NY 114.1 Village of Keeseville
See section 108.1, supra.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.10 Waste disposal
The disposal or payment for disposal by a clinical laboratory for a health services purveyor of hazardous waste, radioactive waste and/or regulated medical waste shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PERSONNEL PERSONNEL
10 CRR-NY 14-1.70 Employee health
No person is to work in a food service establishment:
(a) in a capacity which can result in contamination of food or food-contact surfaces with disease-causing organisms;
(b) while infected with a disease in a communicable form capable of transmission by food;
(c) who is otherwise a carrier of organisms that cause such disease; or
(d) while afflicted with a boil or infected wound.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.40 Rent and equity
(a) Does any rent expense you reported remain in the New York State Cost Allocation process?
(1) Leases and Rentals—Fixed Assets (account 8815); or
(2) Leases and Rentals—Movable Equipment (account 8825).
(b) If yes, report the following:
(1) For each lessor organization, report the amount of rent expense:
(i) fixed assets, separately from
(ii) movable equipment.
(2) Provide the name of the lessor organization and indicate if:
(i) you have an arm's length arrangement, or
(ii) a non-arm's length arrangement.
(c) If a non-arm's length arrangement exists, the owner/lessor must provide:
(1) Actual expense relative to the asset leased/rented:
(i) Depreciation.
(ii) Mortgage interest.
(iii) Insurance.
(iv) Property taxes.
(v) Other (specify).
(2) Condensed balance sheet relative to the asset leased/rented:
(i) Total assets.
(ii) Total liabilities.
(iii) Total capital (equity).
(d) Definition of non-arm's length arrangement.
(1) Operator of proprietary facility has more than a 10 percent interest in the equity of a company providing real property, goods or services to the facility.
(2) An interest in the equity means an operator has ownership or control, direct or indirect, in such a company.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH ENGINEER PUBLIC HEALTH ENGINEER
10 CRR-NY 11.101 Entry level qualifications
A public health engineer must possess a baccalaureate degree in engineering from a regionally accredited or New York State registered college or university or a license to practice as a professional engineer in New York State.
Part 1 GENERAL PROVISIONS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 1.31 Disclosure of confidential cancer information
(a) The identity of any person contained in a report of cancer made pursuant to the provisions of section 2401 of the Public Health Law, or cancer data collected for other specific research studies, shall not be disclosed except:
(1) for the purpose of scientific studies and research when the State Commissioner of Health determines that substantial knowledge may be gained by such disclosure leading toward the reduction of morbidity and mortality; or
(2) for surveillance or evaluation activities that are government sponsored at the federal, state or Canadian province level, when the State Commissioner of Health determines that the proposed activity is of significant public health importance and that release of identifiable information is necessary for the proposed activity.
The recipient shall limit the use of such information to the specific purpose for which such disclosure is made, shall not further disclose such information (except when the recipient is another cancer registry pursuant to laws applicable to such registry), and shall satisfy the State Commissioner of Health that the confidentiality of patient identity will be maintained.
(b) Criminal penalties.
Criminal penalties for violations of this section are those provided for in section 229 of the Public Health Law.
(c) Civil penalties.
Civil penalties for violations of this section are those provided for in section 12 of the Public Health law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.11 Testing of ignition interlock devices
(a) The department may require a testing laboratory, as defined in section 59.1 of this Part, to submit its credentials for department review prior to accepting any report submitted by the testing laboratory in support of an ignition interlock device manufacturer's application for certification.
(b) The testing laboratory shall provide, directly to the department, a detailed report of test data and findings of the ignition interlock device's performance on each standard, generated by the testing laboratory, documenting that at least two representative instruments of an ignition interlock device model have successfully met the requirements of section 59.10(c) of this Part.
(c) The testing laboratory's report shall minimally include: a description of tests performed; data and findings for each test conducted, with numerical readouts as appropriate; a description of the effectiveness of the ignition interlock device's security provisions, if any, for detection and recording of attempted tampering and preventing circumvention; the reliability of the device's data recording features; and a description of the effectiveness of the device over a range of environmental conditions. The report shall include a dated and signed attestation by the person supervising such testing that identifies the ignition interlock device model and manufacturer, and states that all tests on the named device model were conducted in accordance with NHTSA specifications.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.64 Clearing account
A primary account containing costs that are to be transferred to other accounts; an intermediate account to which is transferred a group of costs or revenues or a group of accounts containing costs or revenues and from which a distribution of the total is made to other accounts.
10 CRR-NY 441.217 Nonoperating revenue
The revenue of a hospital which is not directly related to patient care, related patient services, or the sale of related goods. For example, nonoperating revenue includes unrestricted gifts, unrestricted income from endowment funds, gain on sale of hospital properties, and retail operation revenue.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.42 Monitoring requirements for lead and copper in tap water
(a) Sample requirements.
(1) Sample site location.
(i) Each water system shall complete a materials evaluation of its distribution system in order to identify a pool of targeted sampling sites that meets the requirements of this section, and which is sufficiently large to ensure that the water system can collect the number of lead and copper tap samples required in paragraph (3) of this subdivision. All sites from which first draw samples are collected shall be selected from this pool of targeted sampling sites. Sampling sites may not include faucets that have point-of-use or point-of-entry treatment devices designed to remove inorganic contaminants.
(ii) The public water system shall review sources of information listed below in order to identify a sufficient number of sampling sites. In addition, the system shall seek to collect such information, where possible, in the course of its normal operations ( e.g. , checking service line material when reading water meters or performing maintenance activities):
(a) all plumbing codes, permits, and records in the files of the building department(s) which indicate the plumbing materials that are installed within publicly and privately owned structures connected to the distribution system;
(b) all inspections and records of the distribution system that indicate the material composition of the service connections that connect a structure to the distribution system; and
(c) all existing water quality information which includes the results of all prior analyses of the system or individual structures connected to the system indicating locations that may be particularly susceptible to high lead or copper concentrations.
(iii) The pool of targeted sampling sites for community water systems shall consist of:
(a) structures containing lead pipes, copper pipes with lead solder installed after 1982; and/or served by a lead service line. Sampling sites shall be selected from the following building types, in this order, until each building type is exhausted before moving to the next building type:
(1) residential single family (Tier 1 sample sites);
(2) multiple-family residence where at least 20 percent of the structures served by the water system are multiple-family residences (Tier 1 sample sites);
(3) any community water system with insufficient Tier 1 sampling sites shall complete its sampling pool with Tier 2 sampling sites, consisting of buildings, including multiple-family residences that contain copper pipes with lead solder installed after 1982 or lead pipes; and/or served by a lead service line: (Tier 2 sample sites);
(b) where insufficient sites are available meeting the criteria of clause ( a ) of this subparagraph, the sampling pool shall be completed using single family residences that contain copper pipes with lead solder installed before 1983 (Tier 3 samples sites);
(c) where insufficient sampling sites are available meeting the criteria of clauses ( a ) and ( b ) of this subparagraph, the sampling pool shall be completed using representative sites that contain plumbing materials commonly found throughout the water system’s distribution system;
(d) any water system whose distribution system contains lead service lines shall draw 50 percent of the samples it collects during each monitoring period from sites that contain lead pipes, or copper pipes with lead solder, and 50 percent of the samples from sites served by a lead service line. A water system that cannot identify a sufficient number of sampling sites served by a lead service line shall collect first-draw samples from all of the sites identified as being served by such lines.
(iv) The pool of targeted sampling sites for a nontransient noncommunity water system shall consist of structures that:
(a) contain copper pipes and leaded solder joints installed after 1982 or contain lead pipes; and/or
(b) are served by a lead service line.
(v) A nontransient noncommunity water system with insufficient Tier 1 sampling sites shall complete its sampling pool with sampling sites having copper pipes with lead solder joints installed before 1983. If additional sites are needed to complete the sampling pool, the nontransient noncommunity water system shall use representative sites throughout the distribution system.
(2) Sample collection methods. Samples shall be collected in a manner that will reasonably reflect potential lead levels delivered to user taps in accordance with 40 CFR 141.86(b)(2).
(i) All samples for lead and copper shall be collected from user taps and shall be first draw samples with the following exceptions: lead service line samples collected under section 5-1.45(b)(2) of this Subpart; or, if a system meets the criteria in section 5-1.47(g) of this Subpart ( e.g. , prisons and hospitals).
(ii) Each first-draw tap sample for lead and copper shall be one liter in volume and have stood motionless in the plumbing system of each sampling site for at least six hours. First-draw samples from residential housing shall be collected from the cold water kitchen tap or bathroom sink tap. First-draw samples from a nonresidential building shall be one liter in volume and shall be collected at an interior tap from which water is typically drawn for consumption. Non-first-draw samples collected in lieu of first-draw samples pursuant to subparagraph (a)(2)(iii) of this paragraph shall be one liter in volume and shall be collected at an interior tap from which water is typically drawn for consumption. First-draw samples may be collected by the system or the system may allow residents to collect first-draw samples after instructing the residents of the sampling procedures specified in this paragraph. To avoid problems of residents handling nitric acid, acidification of first-draw samples may be done up to 14 days after the sample is collected. After acidification to resolubilize the metals, the sample must stand in the original container for the time specified in the approved EPA method before the sample can be analyzed. If a system allows residents to perform sampling, the system may not challenge, based on alleged errors in sample collection, the accuracy of sampling results.
(iii) Each service line sample shall be one liter in volume and have stood motionless in the lead service line for at least six hours. Lead service line samples shall be collected in one of the following three ways:
(a) at the tap after flushing the volume of water between the tap and the lead service line. The volume of water shall be calculated based on the interior diameter and length of the pipe between the tap and the lead service line;
(b) tapping directly into the lead service line; or
(c) if the sampling site is a building constructed as a single-family residence, allowing the water to run until there is a significant change in temperature which would be indicative of water that has been standing in the lead service line.
(iv) A water system shall collect each first draw tap sample from the same sampling site from which it collected a previous sample. If, for any reason, the water system cannot gain entry to a sampling site to collect a follow-up tap sample, the system may collect the follow-up tap sample from another sampling site in its sampling pool as long as the new site meets the same targeting criteria, and is within reasonable proximity of the original site.
(v) A nontransient noncommunity water system, or a community water system that meets the criteria of 40 CFR 141.85(b)(7), that does not have enough taps that can supply first draw samples, as defined in 40 CFR 141.2, may apply to the State in writing to substitute non-first-draw samples. Such systems must collect as many first-draw samples from appropriate taps as possible and identify sampling times and locations that would likely result in the longest standing time for the remaining sites. The State has the discretion to waive the requirement for prior State approval of non-first-draw sample sites selected by the system, either through State regulation or written notification to the system.
(3) Number of samples. A water system conducting standard monitoring shall collect at least one lead and copper tap sample during each monitoring period specified in subdivision (b) of this section from the number of sampling sites listed in the table below under Standard Monitoring. A water system conducting reduced monitoring shall collect at least one lead and copper tap sample during each monitoring period specified in subdivision (c) of this section from the number of sampling sites listed in the table below under Reduced Monitoring. Such reduced monitoring sites shall be representative of the sites required for standard monitoring.
If a public water system has fewer than five drinking water taps that can be used for human consumption and that meet the sample site criteria of subparagraph (1)(iii) of this subdivision to reach the required number of sample sites listed in the following table, the system may collect at least one sample from each tap and then collect additional samples from those taps on different days during the monitoring period to meet the required number of sites; or, with written State approval, collect fewer samples provided that all taps that can be used for human consumption are sampled. The State must approve this reduction of the minimum number of samples in writing based on a request from the system or onsite verification by the State. The State must specify sampling locations when a system is conducting reduced monitoring. A public water system may also apply to the State in writing to substitute non-first-draw samples. Such systems must collect as many first-draw samples from appropriate taps as possible and identify sampling times and locations that would likely result in the longest standing time for the remaining sites.
| Population Served | Standard Monitoring | Reduced Monitoring | | --- | --- | --- | | | Number of Sites | Number of Sites | | >100,000 | 100 | 50 | | 10,001 to 100,000 | 60 | 30 | | 3,301 to 10,000 | 40 | 20 | | 501 to 3,300 | 20 | 10 | | 101 to 500 | 10 | 5 | | ≤100 | 5 | 5 |
(b) Standard monitoring.
Required samples shall be collected during six-month monitoring periods, beginning January 1st or July 1st of each calendar year.
(1) All systems shall monitor during each six-month monitoring period until:
(i) the system exceeds the lead or copper action level and is therefore required to implement the corrosion control treatment requirements under section 5-1.41 of this Subpart, in which case the system shall continue standard monitoring; or
(ii) the system is deemed to have optimized corrosion control in accordance with section 5-1.41(b) of this Subpart in which case the system may reduce monitoring in accordance with subdivision (c) of this section.
(2) Monitoring after installation of corrosion control and/or source water treatment. Any system which installs corrosion control treatment or source water treatment shall monitor during each six-month monitoring period following the installation of treatment with the first monitoring period to begin either January 1st or July 1st, whichever comes first.
(i) Any system which installs source water treatment pursuant to section 5-1.45(a)(2)(i) of this Subpart shall monitor during two consecutive six-month monitoring periods by the date specified in section 5-1.45(a)(2)(ii) of this Subpart.
(3) Monitoring after State designates water quality parameter values for optimal corrosion control. After the State designates the values for water quality parameters under section 5-1.41(f) of this Subpart, the system shall monitor during each six-month monitoring period following designation of water quality parameter values with the first monitoring period to begin either January 1st or July 1st, whichever comes first.
(c) Reduced monitoring.
(1) A system serving 50,000 or fewer persons that meets the lead and copper action levels during each of two consecutive six-month monitoring periods may reduce the number of samples in accordance with paragraph (a)(3) of this section, and reduce the frequency of sampling to once per year. A system serving 50,000 or fewer persons that meets the lead and copper action levels during three consecutive years under reduced monitoring may reduce the frequency of monitoring for lead and copper from annually to once every three years. Samples collected during the initial two six-month monitoring periods may be accepted as monitoring for the first year of a three-year reduced monitoring frequency. A system serving 50,000 or fewer persons collecting fewer than five samples as specified in paragraph (a)(3) of this section that meets the lead and copper action levels during each of two consecutive six-month monitoring periods may reduce the frequency of sampling to once per year. The system may not reduce the number of samples required to below the minimum of one sample per available tap. This sampling shall begin during the calendar year immediately following the end of the second consecutive six-month monitoring period.
(2) Any water system that has optimal corrosion control treatment installed that meets the lead action level and maintains the range of values for optimal corrosion control treatment during each of two consecutive six-month monitoring periods may reduce the frequency of monitoring to once per year and reduce the number of lead and copper samples in accordance with paragraph (a)(3) of this section if it receives written approval from the State. This sampling shall begin during the calendar year immediately following the end of the second consecutive six-month monitoring period. Samples collected during the initial two six-month monitoring periods can be applied to the first year of a three-year reduced monitoring frequency.
Upon written approval from the State, any water system that has optimal corrosion control treatment installed that meets the lead action level and maintains the range of values for the water quality control parameters reflecting optimal corrosion control treatment during three consecutive years of monitoring may reduce the frequency of monitoring for lead and copper from annually to once every three years. Samples collected once every three years shall be collected no later than every third calendar year.
(3) A water system on a reduced monitoring schedule shall collect these samples from representative sites included in the pool of targeted sampling sites identified in subdivision (a) of this section. Systems sampling annually or less frequently shall conduct the lead and copper tap sampling during the months of June, July, August, or September unless the State has approved a different sampling period in accordance with subparagraph (i) of this paragraph.
(i) The State, upon request by a water system, may approve a different period for conducting the lead and copper tap sampling for systems on a reduced monitoring schedule. Such a period shall be no longer than four consecutive months and shall represent a time of normal operation where the highest levels of lead are most likely to occur. This sampling shall begin during the calendar year immediately following the end of the second consecutive six-month monitoring period for systems initiating annual monitoring and during the three-year period following the end of the third consecutive calendar year of annual monitoring for systems initiating triennial monitoring.
(ii) Systems monitoring annually, that have been collecting samples during the months of June through September and that receive State approval to alter their sample monitoring period under subparagraph (i) of this paragraph, shall collect their next round of samples during a time period that ends no later than 21 months after the previous round of sampling. Systems monitoring triennially that have been collecting samples during the months of June through September, and receive State approval to alter the sampling collection period as per subparagraph (i) of this paragraph, shall collect their next round of samples during a time period that ends no later than 45 months after the previous round of sampling. Subsequent rounds of sampling shall be collected annually or triennially, as required by this section. Water systems with waivers that serve 50,000 or fewer persons that have been collecting samples during the months of June through September and choose to alter their sample collection period under subparagraph (i) of this paragraph shall collect their next round of samples before the end of the 9-year period.
(4) Any water system that demonstrates for two consecutive 6-month monitoring periods that the tap water lead level is less than or equal to 0.005 mg/L and the tap water copper level is less than or equal to 0.65 mg/L, at the 90th percentile calculated in accordance with section 5-1.41(c) of this Subpart, may reduce the number of samples in accordance with paragraph (a)(3) of this section and reduce the frequency of sampling to once every three calendar years.
(5) Conditions requiring a return to standard monitoring.
(i) A system serving 50,000 or fewer persons subject to reduced monitoring that does not have corrosion control treatment installed and that exceeds the lead or copper action level shall resume standard monitoring at the standard number of sampling sites every six months in accordance with subdivision (b) of this section. Such a system shall also conduct water quality parameter monitoring in accordance with section 5-1.43(b) of this Subpart. This monitoring shall begin during the six-month monitoring period immediately following the lead or copper action level exceedance with the first monitoring period to begin either January 1st or July 1st, whichever comes first. Any such system may resume reduced monitoring if it meets the reduced monitoring criteria as specified in paragraph (1) of this subdivision.
(ii) Any water system that has optimal corrosion control treatment installed that fails to meet the lead action level during any four-month monitoring period, or that fails to operate at or above the minimum value or within the range of values for the water quality parameters specified by the State under section 5-1.41(f) of this Subpart for more than nine days in any six-month monitoring period specified in section 5-1.43(b)(3) of this Subpart shall resume standard monitoring at the standard number of sampling sites every six months in accordance with subdivision (b) of this section, and resume standard monitoring for water quality parameters in accordance with section 5-1.43(b) of this Subpart. This standard monitoring shall begin during the six-month monitoring period immediately following the water quality parameter excursion or lead action level exceedance with the first monitoring period to begin either January 1st or July 1st, whichever comes first. Any such system may resume reduced monitoring if it meets the reduced monitoring criteria as specified in paragraph (1) of this subdivision.
(6) Any water system subject to reduced monitoring that either adds a new source of water or changes any water treatment shall notify the State in writing within 60 days of any proposed changes. The State may require any system that makes treatment or source changes to resume standard monitoring in accordance with subdivision (b) of this section or take other appropriate steps such as increased water quality parameter monitoring or re-evaluation of its corrosion control treatment given the potentially different water quality considerations. Any proposed changes to add a new source or long-term change in treatment must be consistent with section 5-1.22(a) of this Subpart and approved by the State prior to implementation.
(d) Additional monitoring by systems.
The results of any monitoring conducted in addition to the minimum requirements of this section shall be considered by the system and the State in making any determinations ( i.e. , calculating the 90th percentile lead or copper level) under sections 5-1.40 through 5-1.48 of this Subpart.
(e) Invalidation of lead or copper tap water samples.
The State may invalidate a lead or copper tap water sample if one of the following conditions is met:
(1) the laboratory establishes that improper sample analysis caused erroneous results;
(2) the State determines that the sample was taken from a site that did not meet the site selection criteria of this section;
(3) the sample container was damaged in transit;
(4) there is substantial reason to believe that the sample was subject to tampering.
If a sample is invalidated, it does not count toward determining lead or copper 90th percentile levels or toward meeting the minimum monitoring requirements for that system. To invalidate a sample, the decision and the rationale for the decision must be documented in writing. The system shall submit to the State, for invalidation determination, the results it believes should be invalidated along with supporting documentation and the rationale for supporting invalidation of the samples. If after invalidation of sample results, the system has too few samples to meet minimum sampling requirements, replacement samples shall be taken as soon as possible, but no later than 20 days after invalidation or by the end of the applicable monitoring period, whichever is later. Replacement samples apply only to the monitoring period associated with the original sample, and shall be taken from the same location. If resampling from the same location is not possible or the sample site was invalidated, the resample may be taken from other sites in the sampling pool not already used for sampling during that monitoring period.
(f) Monitoring waivers for systems serving 3,300 or fewer persons.
Any water system that serves 3,300 or fewer persons and meets the criteria in this subdivision may be eligible for a waiver to reduce monitoring of lead and copper to once every nine years (full waiver), or only for lead, or only for copper (partial waiver). The system must demonstrate that its distribution system and service lines and all drinking water supply plumbing, including plumbing conveying drinking water within all residences and buildings connected to the system, are free of lead-containing materials and/or copper-containing materials as those terms are defined as follows:
(1) Lead. To qualify for a full waiver or a waiver of the tap water monitoring requirements of lead ( i.e. , a lead waiver), the water system must provide certification and supporting documentation to the State that the system is free of all lead-containing materials, as follows:
(i) it contains no plastic pipes which contain lead plasticizers, or plastic service lines which contain lead plasticizers; and
(ii) it is free of lead service lines, lead pipes, lead soldered pipe joints, and leaded brass or bronze alloy fittings and fixtures, unless such fittings and fixtures meet the specifications of any standard established pursuant to section 5-1.22 of this Subpart (Approval of plans and completed works).
(2) Copper. To qualify for a full waiver or a waiver of the tap water monitoring requirements of copper ( i.e. , a copper waiver), the water system must provide certification and supporting documentation to the State that the system contains no copper pipes or copper service lines.
(3) Approval of waiver application. The system will be notified of the State’s determination in writing, setting forth the basis for its decision and any condition of the waiver. The system may be required to perform specific activities ( e.g. , limited monitoring, periodic outreach to customers to remind them to avoid installation of materials that might void reduced monitoring) to avoid the risk of lead or copper concentration of concern in tap water. A system serving fewer than 3,300 persons must continue monitoring for lead and copper at the tap as required in paragraphs (1)-(4) of this subdivision, as appropriate, until it receives written notification that the reduced monitoring has been approved.
(4) Monitoring frequency for systems with waivers.
(i) A system with a full waiver must conduct tap water monitoring for lead and copper in accordance with paragraph (c)(4) of this section at the reduced number of sampling sites identified in paragraph (a)(3) of this section at least once every nine years and provide the materials certification specified in this subdivision for both lead and copper to the State along with the monitoring results. Samples collected every nine years must be collected no later than every ninth calendar year.
(ii) A system with a partial waiver monitoring for a single contaminant must conduct tap water monitoring for that contaminant in accordance with paragraph (c)(4) of this section at the reduced number of sampling sites specified in paragraph (a)(3) of this section at least once every nine years and provide the materials certification specified in this subdivision pertaining to the contaminant along with the monitoring results. Such systems must also continue to monitor for the contaminant not on reduced monitoring in accordance with requirements of paragraphs (b)(1) through (3) and subdivision (c) of this section, as appropriate.
(iii) Any water system with a full or partial wavier must notify the State in writing in accordance with section 5-1.48(a)(3) of this Subpart of any upcoming long-term change in treatment or addition of a new source. The State must review and approve the addition of a new source or change in water treatment before it is implemented by the water system. The State has the authority to require the system to add or modify waiver conditions ( e.g. , require recertification that the system is free of lead-containing and/or copper-containing materials require additional round(s) of monitoring), if it deems such modifications are necessary to address treatment or source water changes at the system.
(iv) If a system with a full or partial waiver becomes aware that it is no longer free of lead-containing or copper-containing materials, as appropriate, ( e.g. , as a result of new construction or repairs), the system must notify the State in writing no later than 60 days after becoming aware of such a change.
(5) Continued eligibility. Systems may continue to be eligible for a waiver, and such waiver will renew automatically, unless any of the conditions listed in subparagraphs (i)-(iii) of this paragraph occurs. If a waiver is not renewed, the system shall meet the requirements for action level exceedances or for the three-year reduced monitoring cycle, as appropriate. A system whose waiver has been revoked may re-apply for a waiver at such time as it again meets the appropriate materials and monitoring criteria of paragraphs (1) and (2) of this subdivision.
(i) A system with a full waiver or a lead waiver no longer satisfies the materials criteria of subparagraph (1)(i) of this subdivision or has a 90th percentile lead level greater than 0.005 mg/L.
(ii) A system with a full waiver or a copper waiver no longer satisfies the materials criteria of paragraph (2) of this subdivision or has a 90th percentile copper level greater than 0.65 mg/L.
(iii) The State notifies the system, in writing, that the waiver has been revoked, setting forth the basis of its decision.
(6) Requirements following waiver revocation. A system whose full or partial waiver has been revoked by the State is subject to the corrosion control treatment and lead and copper tap water monitoring requirements, as follows:
(i) if the system exceeds the lead and/or copper action level, the system must implement corrosion control treatment as specified in section 5-1.41(c)(2) of this Subpart, and any other applicable requirements;
(ii) if the system meets both the lead and the copper action level, the system must monitor for lead and copper at the tap no less frequently than once every three years using the reduced number of sample sites specified in section 5-1.43(a)(2) of this Subpart.
(7) Any water system with a full or partial waiver shall notify the State in writing of any upcoming long-term change in treatment or addition of a new source, consistent with section 5-1.22(a) of this Subpart and approved by the State prior to implementation. The State must review and approve the addition of a new source or long-term change in water treatment before it is implemented by the water system. The State may require the system to add or modify waiver conditions ( e.g. , require recertification that the system is free of lead-containing and/or copper-containing materials, require additional round[s] of monitoring), if it deems such modifications are necessary to address treatment or source water changes at the system.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.1 Definition of temporary food service establishment and frozen desserts
(a) A temporary food service establishment means a place where food is prepared or handled and served to the public, with or without charge, and which operates at a fixed location in conjunction with a single event or celebration of not more than 14 consecutive days duration.
(b) Frozen desserts are ice cream, frozen custard, French ice cream, French custard ice cream, artificially sweetened ice cream, ice milk, artificially sweetened ice milk, fruit sherbet, non-fruit sherbet, water ices, non-fruit water ices, confection frozen without stirring, dairy confection frozen without stirring, manufactured dessert mix, frozen confection, melloream frozen dessert, parevine, frozen yogurt, freezer made shakes, freezer made milk shakes, dietary frozen dessert, whipped cream confection and bisque tortoni, as all such products are commonly known, together with any mix used in making such frozen desserts, and any products which are similar in appearance, odor or taste to such products, or are prepared or frozen as frozen desserts are customarily prepared and frozen, whether made with dairy products or non-dairy products. Any operation producing chips or flakes of ice made from water with or without additives, served to the consumer with or without flavorings added by the operator or consumer, is included as a retail frozen dessert within this definition. This operation is commonly known as a slush operation.
(c) Retail frozen desserts are to be manufactured from ingredients and are to be identified in conformance with the applicable requirements of Part 39 of the rules and regulations of the State Department of Agriculture and Markets (1 NYCRR Part 39).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.293 Reserve
A segregation of retained earnings evidenced by the creation of a subordinate account. The segregation may be temporary or permanent, the purpose being to indicate to stockholders and creditors that a portion of retained earnings is recognized as unavailable for dividends. Examples: reserve for contingencies; reserve for improvements; sinking fund reserve.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.11 Assisted reproduction service provider registration
(a) An assisted reproduction service provider is prohibited from performing any medical procedures for a gestational surrogacy agreement unless such assisted reproduction service provider is registered with the department. In order to register with the department as an assisted reproduction service provider, an assisted reproduction service provider shall provide to the department in a form acceptable to the department:
(1) information demonstrating that the assisted reproduction service provider is licensed to operate as a tissue bank under section 52-2.1 of this Title;
(2) information regarding any other health care practitioner or health care facility licenses held by the assisted reproduction service provider or the health care practitioners who work for the assisted reproduction service provider;
(3) information regarding the assisted reproduction service provider’s health commerce system account; and
(4) the types of procedures, and an estimate of the number of each type of procedure that will be performed annually, to effectuate gestational surrogacy agreements.
(b) An assisted reproduction service provider shall maintain and regularly monitor an account on the health commerce system.
(c) Assisted reproduction service providers shall establish policies and procedures relating to the selection and evaluation of prospective surrogates and the evaluation of prospective intended parents. Policies and procedures for screening of gestational surrogates must be consistent with the department’s guidelines and best practices, which shall be published on the department’s website. Policies and procedures for screening and evaluation of intended parents must be consistent with clinical best practices.
(d) Assisted reproductive service providers already providing ART service as of the effective date of this Subpart shall have until June 16, 2021 to comply with this Part.
(e) Upon a change of ownership of an assisted reproductive service provider, within 30 days, such new owner shall update the information that the assisted reproductive service provider is required to submit to the department by this Part.
Subpart 69-2 UMBILICAL CORD BLOOD TESTING
10 CRR-NY 69-2.5 Duties of the responsible physician and birth attendant
The responsible physician or birth attendant shall:
(a) collect, label, submit specimens and assure that test results are recorded as specified in sections 69-2.2, 69-2.3(b) and 69-2.3(c) of this Subpart unless the birth occurs in an institution in which the chief executive officer is responsible for these procedures under section 69-2.3 of this Subpart;
(b) report all positive test results from cord, newborn or mother's blood, in accordance with sections 2.10 and 2.12 of this Title, to the local health unit within 24 hours of receiving the report from the approved laboratory;
(c) ascertain that both mother and infant are treated in accordance with appropriate therapy and that follow-up treatment is arranged, if syphilis is confirmed; and
(d) work in cooperation with designated public health investigators to assure that diagnosis, therapy, and any necessary follow-up testing meet current standards of care.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 130 ONEIDA COUNTY
CITIES CITIES
10 CRR-NY 130.1 City of Rome
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law and of the whole thereof, as last amended by chapter 879 of the Laws of 1953, shall apply to Fish Creek and all its tributaries and reservoirs which now serve or which may be developed in the future to serve as sources of the public water supply of the City of Rome and to all watercourses and drainage areas tributary to or ultimately discharging into said Fish Creek or reservoirs. Particular rules shall be applicable to the zones specified.
(b) Definitions.
(1) The term water supply whenever used in this section refers to the public water supply of the City of Rome, Oneida County, New York.
(2) The term watershed refers to all land situated so that drainage therefrom is towards Fish Creek or its tributaries upstream from the water supply intake structure.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The term linear distances refers to the shortest horizontal distance from the nearest point of the structure or object to the tributaries or the high-water mark of the reservoir.
(5) The term intake reservoir refers to the approximate 10-million-gallon reservoir formed by the diverting dam on the east branch of Fish Creek in the town of Annsville, at the southern end of which is located the intake to the 36-inch main supply line.
(6) The term Boyd Reservoir (Lake Tagasoke) refers to the approximately 1.34-billion-gallon impounding reservoir formed by the construction of Boyd Dam in the Town of Lewis, Lewis County, construction of which was completed in 1959.
(7) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(8) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(9) The term sewage disposal works refers to an installation in which sewage is discharged to the ground waters.
(10) The term sewage treatment plant refers to an installation from which treated sewage is discharged to surface waters.
(c) Zones.
The complete watershed shall be delineated by zones as follows:
(1) Zone A —From diverting dam at intake reservoir upstream 1,700 feet to include all areas presently owned by the City of Rome and including all drainage areas tributary to Fish Creek between these two points.
(2) Zone B —Fish Creek from the northern limit of zone A to the dam at Boyd Reservoir, including all drainage area tributary to Fish Creek between these points.
(3) Zone C —From dam at Boyd Reservoir to northern limit of watershed, including all tributaries exclusive of zone D.
(4) Zone D —Boyd Reservoir (Lake Tagasoke) and all adjacent property owned by the City of Rome.
(d) General rules and regulations.
(1) [Human excreta.]
(i) No human excreta shall be deposited, thrown or allowed to escape into the reservoirs or any tributary.
(ii) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(iii) No human excreta shall be buried in the soil on the watershed of the water supply, unless deposited in trenches or pits at a distance of not less than 300 feet from the reservoir or within 150 feet of any tributary and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(iv) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the limiting distance specified for the particular zone cannot be obtained, shall be placed as far as possible from the reservoir or tributary and especially constructed of concrete, masonry or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from the reservoir or any tributary. All privies or receptacles referred to in this subparagraph shall be constructed or installed only with the approval of the City of Rome.
(v) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after 20 days notice to the owner thereof and an opportunity to be heard, to such place as shall be considered safe and proper by the State Commissioner of Health. Summary action may be taken without notice if, in the opinion of the commissioner, the offending object or structure constitutes an imminent and acute hazard to public health.
(2) Garbage, refuse, etc. No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other organic or chemical matter that pollutes water shall be deposited in the reservoirs or tributaries nor on or beneath the surface of the ground within 200 feet of any reservoir nor 50 feet of any watercourse nor in such a manner that it can be washed by rain, melting snow or other means over the surface or through the ground into any reservoir or watercourse.
(3) Bathing. No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir formed by existing or future water supply dams on Fish Creek nor in any watercourse tributary to Fish Creek, which flows through lands owned by the City of Rome.
(4) Animals. No stable for cattle, horses, barnyard, hog yard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals or water place for animals or poultry shall be maintained in such a way to pollute any watercourse with excremental matter.
(5) Cemeteries. No interment of a human body shall be made within a distance of 200 feet of any reservoir or within a distance of 100 feet of any tributary.
(6) Sewage.
(i) No sewage from an individual residence shall be discharged or allowed to flow into the water supply of the City of Rome or beneath the surface of the ground within 100 feet of the reservoir or Fish Creek or within 50 feet of any tributary. These restrictions and limiting distances shall not apply to sewage disposal works installed under and in accordance with plans which first have been prepared by and installed under the supervision of a professional engineer after approval by the city engineer of the city of Rome. Approval shall be on the basis of standard practice of the New York State Department of Health.
(ii) No sewage, bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into the water supply of the city of Rome or beneath the surface of the ground within 100 feet of the reservoirs or Fish Creek or within 50 feet of any tributary, except from an individual residence as provided for under subparagraph (i) of this paragraph or the effluent from the properly constructed and operated sewage treatment plant installed under and in accordance with plans prepared by a professional engineer which first have been submitted to and approved by the State Commissioner of Health. Approval shall be on the basis of standard practice of the New York State Department of Health.
(7) [General clause.]
In addition to observing the preceding general rules and specific rules for each zone, all persons living on or visiting the watershed shall refrain from an act, though not actually specified, which may result in contamination of any portion of the water supply.
(e) Specific rules (applicable to zones specified).
In addition to the above general rules, the following rules are applicable to the indicated zones, the boundaries of which have been previously delineated:
(1) Zone A.
(i) No boating or fishing of any kind or trespassing shall be allowed in or upon the water or ice of the reservoir or that portion of Fish Creek which flows through lands owned by the city of Rome, except by duly authorized employees of the city of Rome in the performance of their duties of supervision and maintenance of the water supply.
(ii) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed or maintained or allowed to remain within 200 feet of the reservoir or within 200 feet of Fish Creek.
(iii) No sewage shall be deposited on or beneath the surface of the ground within 200 feet of the intake reservoir or of the high-water mark of Fish Creek.
(iv) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into the reservoir or any tributary nor be deposited beneath the surface or on the surface of the ground within 200 feet of the reservoir or within 200 feet of Fish Creek.
(2) Zone B.
(i) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed or maintained or allowed to remain within 100 feet of Fish Creek or within 50 feet of any tributary except a watertight receptacle as set forth in subparagraph (iv) of paragraph (1) of subdivision (d) of the general rules, provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(ii) No sewage shall be discharged or allowed to flow into Fish Creek or any tributary nor deposited beneath the surface or on the surface of the ground within 100 feet of Fish Creek or within 50 feet of any tributary except into watertight receptacles, the contents of which shall be disposed of as provided for by subparagraph (iii) of paragraph (1) of subdivision (d).
(iii) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into Fish Creek or any tributary nor be deposited beneath the surface or on the surface of the ground within 100 feet of Fish Creek or within 50 feet of any tributary.
(3) Zone C.
(i) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed or maintained or allowed to remain within 100 feet of Fish Creek or within 25 feet of any tributary except a watertight receptacle as set forth in paragraph (iv) of paragraph (1) of subdivision (d) of the general rules, provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(ii) No sewage shall be discharged or allowed to flow into Fish Creek or any tributary nor deposited beneath the surface or on the surface of the ground within 50 feet of Fish Creek or within 25 feet of any tributary except into watertight receptacles, the contents of which shall be disposed of as provided for by subparagraph (iii) of paragraph (1) of subdivision (d).
(iii) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into Fish Creek or any tributary nor be deposited beneath the surface or on the surface of the ground within 50 feet of Fish Creek or within 25 feet of any tributary.
(4) Zone D.
In addition to all the general rules, specific rules promulgated by the city of Rome shall apply to this zone which is entirely within city-owned property.
(f) Inspections.
The department of public works of the city of Rome or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of the department of public works, shall make regular and thorough inspections of the reservoir, watercourses and drainage areas tirbutary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said department of public works to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said department of public works to promptly notify the State Commissioner of Health of such violations. The department of public works shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(g) Penalty: in accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.11 Records to be kept by a tissue transplantation facility
(a) The director of each tissue transplantation service shall be responsible for records kept by the tissue transplantation facility. In addition to the records specified in Subpart 52-2 of this Part, the following records shall be kept, separate from recipient records, by the tissue transplantation facility:
(1) a disposition log allowing accurate tracking of tissue to each recipient; and
(2) records of appropriate storage and temperature monitoring of skin.
(b) A copy of the order for issuance of the skin, including the name and signature of the ordering physician or person authorized by law to order such issuance, shall be kept by the tissue transplantation facility. A record in the patient's chart shall be satisfactory documentation of such order for issuance.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.20 Theft or loss
The licensee shall promptly notify the department of any theft or loss or any controlled substance. Such theft or loss shall be reported on forms furnished by the department. Thefts shall be reported whether or not the controlled substances are subsequently recovered, the responsible parties identified or action taken against them.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.14 Collection of source plasma
(a) Notwithstanding any requirements in this Subpart to the contrary for blood collection by means other than plasmapheresis, blood banks collecting, processing, and/or distributing source plasma, as defined in title 21 of the Code of Federal Regulations (CFR) part 640, shall comply with applicable requirements in title 21 CFR parts 630 and 640 and any additional requirements in this section.
(b) Direction.
The director of a blood bank collecting, processing, and/or distributing source plasma shall be a licensed physician who holds a Certificate of Qualification in Blood Banking Collection – Comprehensive pursuant to Part 19 of this Title. The director may serve as the responsible physician for the purposes of title 21 CFR part 630; however, if the director is not the responsible physician, the responsible physician shall be a physician licensed in New York State. Except for testing procedures for clinical testing, the director may delegate approval of new or revised standard operating procedure manuals or other procedural guides required by section 58-2.8 of this Subpart.
(c) Informed consent.
The consent of a prospective donor shall be obtained in writing. If the donor will be immunized with human blood components, the donor shall be informed of the risk of transfusion-transmitted infections and the increased risk of receiving incompatible blood in future transfusions. A prospective donor who is to be deliberately exposed to an antigen shall also be given a general description of the immunization program, including the nature of the material to be injected. All of this information shall also be given to each prospective donor in written form, and the donor's consent shall be signed and witnessed. The blood bank director or responsible physician shall approve information provided to the donor regarding risks or hazards of the procedure and such approval may not be delegated.
(d) Care of source plasma donors.
A responsible physician, physician substitute, or other person who is specifically trained in recognizing and addressing reactions that may occur in association with the procedures being performed, shall be immediately available on the premises during a plasmapheresis procedure. A blood bank collecting source plasma must establish, maintain and follow standard operating policies and procedures for management of donor adverse reactions that include using 9-1-1 or obtaining other rapid emergency medical services for donors when medically necessary.
(e) Personnel training.
All persons performing plasmapheresis procedures shall have completed a training program in plasmapheresis procedure technique. The training program must include training in donor screening, venipuncture techniques, instrument operation, prevention of and initially addressing donor reactions, and proper documentation of all completed procedures. At the end of the training program, each plasmapheresis operator must be able to:
(1) safely and effectively operate the cell separator systems in use at the facility;
(2) harvest plasma which meets quality standards;
(3) manage fluid volumes safely; and
(4) prevent, and when necessary, initially address adverse reactions.
(f) Manual plasmapheresis procedures.
Before the blood container is separated from the donor for processing, it shall bear two separate and independent means of identification to enable both the donor and the phlebotomist to determine without doubt that the contents originate from the donor. The identity of the donor and the container shall be confirmed by at least two staff members, trained in accordance with subdivision (e) of this section, prior to reinfusion of the red blood cells. Red blood cells shall be returned to the donor within two hours of the phlebotomy.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.12 Swimming pools and bathing beaches
A swimming pool or bathing beach operated as a part of a campground for the use of occupants, guests, invitees or employees shall be constructed, maintained and operated so as to comply with the provisions of Subpart 6-1 or 6-2 of this Title as appropriate.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.11 Patient food service
(a) This functional reporting center must contain all the expenses associated with the procurement, storage, processing and delivery of food and nourishments to the floors and dining facilities in compliance with public health regulations and physicians' orders. This would include the material costs relative to tube feeding of a high protein diet. Additional activities include but are not limited to the following: teaching patients and their families about nutrition and modified diet requirements; determining patient food preferences in terms of type of food and method of preparation; preparing selective menus for various specific diet requirements; preparing or recommending a diet manual, approved by the medical staff, for use by physicians and nurses; and delivering and collecting food trays to the floors and dining facilities for meals and nourishments.
(b) Where this center and the Cafeteria functional reporting center share kitchen facilities with corresponding common salaries of cooks, food costs, minor equipment costs, administrative costs, etc., such common costs must be entirely distributed (preferably on a monthly basis) to the Patient Food Service and Cafeteria functional reporting centers, based on the ratio of number of meals served in each area. Note that such distribution must be performed and is not subject to the reclassification criteria detailed in section 454.2(b) of this Article. The patient meal count should be made by counting one meal for each tray sent to a patient at mealtime. Nourishments should be excluded. For a meal count, tube feedings will be counted as three meals for each day so fed. An equivalent meal count should be made in the cafeteria by use of the following procedures: count a free meal served as a full meal. A full meal consists of meat, potato, vegetable, salad, beverage and dessert. When there is a selection of entrees, desserts, etc., at different prices, use an average in calculating the selling price of a full meal. An equivalent meal in a pay cafeteria is determined by dividing total sales by the average selling price of a full meal served at noon.
(c) Standard unit of measure: dietary meals served.
Number of meals served shall include only regularly scheduled meals and exclude snacks and fruit juices served between regularly scheduled meals. For a meal count, tube feedings will be counted as three meals for each day as fed.
(d) Data source.
The number of meals served shall be determined from an actual count maintained by the dietary and nursing departments.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.10 Exclusion in event of disease outbreak
(a) For those diseases listed in PHL section 2164 only, in the event of an outbreak, as defined in section 2.2(d) of this Title, of a vaccine-preventable disease in a school, the commissioner, or his or her designee, or in the City of New York, the Commissioner of Health of the New York City Department of Health and Mental Hygiene, may order the appropriate school officials to exclude from attendance all students who either have been exempted from immunization under section 66-1.3(c) of this Subpart, or are in the process of receiving required immunizations pursuant to section 66-1.3(b) of this Subpart.
(b) The exclusion shall continue until the commissioner or his or her designee, or in the City of New York, the Commissioner of Health of the New York City Department of Health and Mental Hygiene, determines that the danger of transmission has passed.
(c) Schools must maintain a list of susceptible students who should be excluded from attendance in the event of an outbreak of vaccine preventable disease. This list must include all students who have been excused from immunization under section 66-1.3(c) of this Subpart and students who are in the process of completing immunization series or awaiting the results of serologic testing for any vaccine preventable disease specified under section 66-1.3(b) of this Subpart. The list shall be updated each time a new student enrolls in the school or a student’s immunization status changes.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.12 Waiver of co-payments, co-insurance, deductibles and fees
(a) Routine waiver by a clinical laboratory of co-payments, co-insurance, or deductibles for clinical laboratory services performed for recipients of such services who are patients of a referring health services purveyor shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(b) Waiver of fees for clinical laboratory services for the patients of a referring health services purveyor who are enrolled in an HMO by a clinical laboratory which is not a participating laboratory of the HMO, where such waiver results in consideration being received by the referring health services purveyor, shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(c) Nothing in Public Health Law, section 587 or in this Subpart shall be construed to prohibit a clinical laboratory from:
(1) waiving a co-payment, co-insurance, deductible, or fee for a particular patient based on the patient's inability to pay, in which case the clinical laboratory shall maintain a record documenting the patient's inability to pay; or
(2) waiving a co-payment, co-insurance, deductible or fee, if the cost of collection is greater than the amount to be collected.
(d) Nothing in Public Health Law, section 587 or in this Subpart shall be construed to prohibit a clinical laboratory from offering a discount to a referring health services purveyor provided that:
(1) the health services purveyor appropriately reflects the discount on any costs or charges reported and/or claimed by the health services purveyor under any third party reimbursement program; and
(2) the discounted price is consistent with fair market value; or
(3) the discounted price reflects a volume discount, whereby the amount of the discount is reasonably related to costs saved by the clinical laboratory.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.161 Health facility
Any licensed facility, place or building which is organized, maintained and operated for the diagnosis, care and treatment of human illness, physical or mental, including convalescence and rehabilitation and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons, to which such persons are admitted for a 24-hour stay or longer.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.40 Food protection; potentially hazardous food, temperature and refrigeration requirements
(a) Food is to be protected from contamination during storage, preparation, display, service and transportation. The temperature of potentially hazardous food is to be 45 degrees Fahrenheit (7.2 degrees Celsius) or below, or 140 degrees Fahrenheit (60 degrees Celsius) or above at all times, except during necessary times of preparation or during a limited period of time, while being held for service, which may not exceed two hours. Intact shell egg temperatures shall be considered acceptable if the ambient storage temperature is 45 degrees Fahrenheit (7.2 degrees Celsius) or less.
(b) Potentially hazardous food requiring refrigeration is to be cooled by an adequate method so that every part of the product is reduced from 120 degrees Fahrenheit (48.9 degrees Celsius) to 70 degrees Fahrenheit (21.1 degrees Celsius) within two hours and to 45 degrees Fahrenheit (7.2 degrees Celsius) or below within four additional hours.
(c) Intact shell eggs shall be stored at an ambient temperature of 45 degrees Fahrenheit (7.2 degrees Celsius) or below.
Part 12 MATERNAL AND CHILD HEALTH
CONTROL OF DISEASE CONTROL OF DISEASE
10 CRR-NY 12.2 Precautions to be observed for the prevention of purulent conjunctivitis of the newborn
It shall be the duty of the attending physician, licensed midwife, licensed nurse or other authorized provider in attendance at a delivery to place into the eyes of the infant, on delivery, an agent effective for preventing purulent conjunctivitis of the newborn, such as tetracycline or erythromycin eye preparation or a one percent solution of nitrate of silver.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.3 Hematopoietic progenitor cell procurement
(a) Facilities where allogeneic or autogeneic hematopoietic progenitor cells are collected shall be adequately lighted, ventilated and equipped, and be operated in a manner which conforms to current medical standards generally accepted by leading authorities in transplantation medicine.
(b) Each hematopoietic progenitor cell procurement service, except for such facilities collecting cord blood only, shall document association with a hematopoietic progenitor cell transplantation facility and compliance with the procedures, protocols and recordkeeping requirements for collection as established by the transplantation facility, as well as all requirements of this Subpart.
(c) All required clinical laboratory testing shall meet the standards of article 5, title V of the Public Health Law.
(d) For bone marrow harvesting procedures, adequate facilities shall be available for the administration of anesthesia and for emergency resuscitation. A qualified anesthesiologist shall be on the premises at all times during harvesting procedures.
(e) Emergency services shall be immediately available to any donor who manifests an adverse reaction.
(f) A physician shall explain the hazards of the donation procedure to the donor in such a manner that the donor is offered an opportunity to refuse consent. The donor shall be advised of the risks of hematopoietic progenitor cell donation and of the anesthesia method to be used, the potential need for transfusional support and possible side effects of each procedure, and options for disposition of hematopoietic progenitor cells no longer needed by the intended recipient. All this information shall be provided to each prospective donor in written form. The written informed consent of the prospective donor shall then be obtained. Autogeneic donors shall also be informed of the risks associated with hematopoietic progenitor cell collection.
(g) Informed consent for collection of cord blood shall be obtained from the donor's mother before stem cells are placed in inventory. In all cases of in utero cord blood collection, consent shall be obtained prior to collection.
(h) Hematopoietic progenitor cells from autogeneic donors shall not be destroyed or released for purposes other than infusion into the intended patient without written authorization from the director of the facility storing the hematopoietic progenitor cells and:
(1) if the donor/patient is deceased, written documentation of death; or
(2) if the donor/patient is living, written authorization from the physician currently responsible for treating the patient for the underlying disorder for which the hematopoietic progenitor cells were collected; and documented informed consent from the donor/patient or donor/ patient's guardian, unless it is documented that no response was received within 60 days to at least two written requests for such consent sent at least 30 days apart. Documentation of such written requests shall be maintained.
(i) Hematopoietic progenitor cells from allogeneic donors shall not be destroyed or released for purposes other than transplantation into the originally intended recipient without the written authorization of the intended recipient's physician and documentation that the intended recipient, if living, has been notified that the cells will not be available.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 610 SPECIAL REQUIREMENTS FOR NONPROFIT CORPORATIONS
10 CRR-NY 610.2 Application to solicit contributions
A nonprofit corporation seeking Public Health Council approval for authority to solicit contributions for any corporate purpose or two or more purposes which require the approval of the council shall:
(a) File with its application the documents and information required by section 600.1 of this Title and section 610.1 of this Part.
(b) Demonstrate to the satisfaction of the council that it would be successful in raising funds necessary to establish the proposed facility or program within the period planned, which shall not be more than five years from the date of the council's approval. An application of this kind shall otherwise be denied or granted on the basis of the same criteria as required by section 600.2 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.1 Definitions
(a) Techniques and methods means the collection, processing and determination of the alcoholic content of body fluids such as human blood, saliva or urine, and of breath or alveolar air by protocols and/or instruments determined by the commissioner to be acceptable.
(b) Per centum by weight of alcohol as used in the Vehicle and Traffic Law and the Environmental Conservation Law means percent weight per volume, that is, grams of alcohol per 100 milliliters of whole blood.
(c) Chemical tests/analyses include breath tests conducted on breath analysis instruments approved by the commissioner in accordance with section 59.4 of this Part.
(d) Training agency or agencies means the Office of Public Safety of the Division of Criminal Justice Services, the Division of State Police, the Nassau County Police Department, the Suffolk County Police Department and/or the New York City Police Department.
(e) Commissioner means the New York State Commissioner of Health.
(f) Department means the New York State Department of Health.
(g) Ignition interlock device means any blood alcohol concentration equivalence measuring device which connects to a motor vehicle ignition system and prevents a motor vehicle from being started without first determining through a deep lung breath sample that the operator's equivalent breath alcohol level does not exceed the calibrated setting on the device as required by standards in this Part.
(h) Blood alcohol concentration (BAC) means the weight amount of alcohol contained in a unit volume of blood, measured as grams ethanol/100 ml blood and expressed as %, grams %, % weight/volume (w/v), and % BAC. Blood alcohol concentration in this Part shall be designated as % BAC.
(i) Testing laboratory means a nationally recognized, independent materials testing laboratory that is not affiliated with, and operates autonomously from, any ignition interlock device manufacturer, is properly equipped and staffed to carry out test procedures required by this Part, and is independently accredited in accordance with requirements for the competence of testing and calibration laboratories promulgated as a standard by the International Organization for Standardization (ISO), or other commensurate standard acceptable to the department.
(j) Breath analysis instrument means a device that complies with section 59.4 of this Part.
(k) Saliva means oral fluid.
(l) Calibration means the activity of verifying that a value generated by the instrument is in acceptable agreement with the assigned value for a traceable and/or certified reference standard, including any adjustment to the instrument to bring it into acceptable agreement.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH EPIDEMIOLOGIST PUBLIC HEALTH EPIDEMIOLOGIST
10 CRR-NY 11.196 Definition
The term local public health epidemiologist shall mean a person who investigates the occurrence of disease, injury or other health-related conditions or events in populations to describe the distribution of disease or risk factors for disease occurrence for the purpose of population-based prevention and control.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.18 Relationship between an MCO and an IPA
(a) An MCO shall be responsible for its agreements with an IPA, for the agreements between the IPA and other IPAs, physicians and other health care providers and suppliers and for the care provided through such arrangements to the same extent as it is responsible for arrangements with all other types of health care providers.
(b) The requirements of article 44 of the Public Health Law and this Subpart shall apply to an IPA and all physicians, other IPAs, health care providers and suppliers contracting with an IPA to the same extent they apply to all other health care providers participating with an MCO in a comprehensive health services plan.
(c) Nothing in this Part shall prohibit an IPA from employing providers or other persons to provide review of medical care utilization patterns, quality of care issues, or other program review functions on behalf of its panel of contracted participating providers, even though such providers may also have contracted with the IPA as an independent member or participating provider.
(d) An MCO contracting with an IPA shall require that the financial records of the IPA shall account in detail for all funds received from the MCO, including, where applicable, fees for services performed by the IPA, and for the disbursement of all such funds.
(e) An MCO proposing a risk sharing arrangement with an IPA may not enter into any such arrangement without first obtaining approval from the commissioner or superintendent, as appropriate, in accordance with guidelines issued by the commissioner in accordance with section 98-1.5(b)(6)(v) of this Subpart or the superintendent in accordance with Regulation 164. To obtain the commissioner's approval, the MCO shall provide to the satisfaction of the commissioner the following:
(1) a current list of the owners, officers, directors, and limited liability company managers and members of the IPA;
(2) the complete text of the proposed contract(s), and all attachments thereto, which shall include provisions whereby:
(i) the parties expressly agree to amend or terminate the agreement at the direction of the commissioner;
(ii) the IPA will submit both quarterly and annual financial statements to the MCO and the MCO will notify the commissioner of any substantial change in the financial condition of the IPA; and
(iii) the parties agree that all provider contracts shall contain a clause providing that the provider shall not, in the event of default by the IPA, demand payment from the MCO for any covered services rendered to the MCO's enrollees for which payment was made by the MCO to the IPA pursuant to the financial risk sharing agreement;
(3) in the event that the MCO contracts with the IPA to delegate management functions, a contract which complies with all the requirements of this Subpart;
(4) such information concerning the financial condition of the IPA and any providers participating in a risk sharing arrangement as the commissioner may require to make a determination, including information demonstrating that the IPA and any providers sharing risk with the IPA are financially responsible and capable of assuming such risk and have satisfactory insurance, reserves or other arrangements to support an expectation that they will meet their obligations to MCOs, providers and enrollees; and
(5) a demonstration by the MCO and the IPA, to the commissioner's satisfaction, that the elements of a proposed arrangement will not constitute improper incentives to providers, in accordance with physician incentive plan guidelines, and will not result in a deterioration in access to or the quality of care provided to an MCO's enrollees.
(f) The commissioner may assess fines against an MCO in accordance with section 12 of the Public Health Law after a hearing and finding of a violation, by an MCO and/or IPA and/or the physicians and any other health care providers and suppliers contracting with an IPA, of this Subpart and articles 28 and 44 and title I of article 49 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.158 Gross
Undiminished by related deductions, except corrections; applied to sales, revenues, income, expense, and the like.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.24 Research
(a) All research costs shall be excluded from allowable costs in computing reimbursement rates.
(b) Research includes those studies and projects which have as their purpose the enlargement of general knowledge and understanding, are experimental in nature and hold no prospect of immediate benefit to the program or its patients.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.201 Medical services
The services pertaining to medical care that are performed at the direction of a physician on behalf of patients by physicians, dentists, nurses, and other professional and technical personnel.
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.1 Introduction
(a) General hospitals, hereinafter referred to as hospitals, shall comply with all of the requirements of this Part:
(1) hospitals shall comply with construction standards contained in Article 2 of Subchapter C of this Chapter (Medical Facility Construction); and
(2) the commissioner may accept as evidence of compliance with the minimum operational standards of this Part, accreditation by an accreditation agency to which the Centers for Medicare and Medicaid Services has granted deeming status and which the commissioner has determined has accrediting standards sufficient to assure the commissioner that hospitals so accredited are in compliance with such operational standards. The commissioner can choose to enter into collaborative agreements with such accreditation agencies so that the accreditation agency’s accreditation survey can be used in lieu of a departmental survey. A list of accreditation agencies with which the department has a collaborative agreement will be posted on the department's website. Hospitals shall notify the commissioner in writing within seven days after receipt of notice of failure to be accredited, re-accredited or the loss of accreditation by the accreditation agency.
(b) The provisions of Parts 700, except for paragraphs (a)(1), (21)-(22), (b)(25) and (c)(7), (35)-(41) of section 700.2; 702; 703, except for section 703.6; 706; and 707 of Article 1 of this Chapter shall not apply to general hospitals.
(c) Any person, partnership, stockholder, corporation or other entity with the authority to operate a hospital must be approved for establishment by the Public Health Council unless otherwise permitted to operate by the Public Health Law or as provided for by section 405.3 of this Part. For the purposes of this Part, a person, partnership, stockholder, corporation or other entity is an operator of a hospital if it has the decision-making authority over any of the following:
(1) appointment or dismissal of hospital management-level employees and medical staff, except the election or removal of corporate officers by the members of a not-for-profit corporation;
(2) approval of hospital operating and capital budgets;
(3) adoption or approval of hospital operating policies and procedures;
(4) approval of certificate of need applications filed by or on behalf of the hospital;
(5) approval of hospital debt necessary to finance the cost of compliance with operational or physical plant standards required by law;
(6) approval of hospital contracts for management or for clinical services; and
(7) approval of settlements of administrative proceedings or litigation to which the hospital is party, except approval by the members of a not-for-profit corporation of settlements of litigation that exceed insurance coverage or any applicable self-insurance fund.
(d) Nothing in subdivision (c) of this section shall require the establishment of any member of a not-for-profit corporation, which operates a hospital, based upon such member's reservation and exercise of the power to require that the hospital operate in conformance with the mission and philosophy of the hospital corporation.
(e) The requirements of this Part relating to patient care and services shall apply to patients of all ages, including newborns, pediatric and geriatric patients.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MOBILE FOOD SERVICE ESTABLISHMENTS MOBILE FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-4.31 Definition of food processing establishment and commissary
(a) A food processing establishment is a commercial establishment operated under license or permit of an appropriate regulatory authority where food is manufactured or packaged for human consumption at another establishment or place.
(b) A mobile food service establishment commissary is an establishment operated under license or permit of an appropriate regulatory authority where food is manufactured, stored, prepared, portioned or packaged, or any combination of these, where such food is intended for consumption at another establishment or place. It is also the place which is used as the base of operations for one or more mobile food service establishments or pushcarts, where such unit or units are serviced, cleaned, supplied, maintained, and where the equipment, utensils and facilities are serviced, cleaned and sanitized.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.330 Trial balance
A list or abstract of the balances or of total debits and total credits of the accounts in a ledger, the purpose being to determine the quality of posted debits and credits and to establish a basic summary for financial statements. The term is also applied to a list of account balances (and their total) abstracted from a customer's ledger or other subsidiary ledger for the purpose of testing their totals with the related control account.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.10 Other requirements
Structures at a mass gathering which are available for workers for overnight occupancy shall meet the requirements of Subpart 7-1 of this Part.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.93 Equipment construction; cleanability
Equipment is to be constructed to be cleanable:
(a) without being disassembled;
(b) by disassembling without the use of tools; or
(c) by easy disassembling with the use of only simple tools, such as a mallet, a screwdriver or an open-end wrench kept available near the equipment, unless designed for in-place cleaning.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.25 Misadministrations
(a) A medical misadministration shall be the administration of:
(1) a radiopharmaceutical or radiation from a source other than the one ordered;
(2) a radiopharmaceutical or radiation to the wrong person;
(3) a radiopharmaceutical or radiation by a route of administration or to a part of the body other than that intended by the ordering physician;
(4) an activity of a radiopharmaceutical for diagnostic purposes that differs from the activity ordered by more than 50 percent;
(5) an activity of a radiopharmaceutical for therapeutic purposes that differs from the activity ordered by more than 10 percent;
(6) a therapeutic radiation dose from any source other than a radiopharmaceutical or brachytherapy source such that errors in computation, calibration, time of exposure, treatment geometry or equipment malfunction result in a calculated total treatment dose differing from the final total treatment dose ordered by more than 10 percent;
(7) a therapeutic radiation dose from a brachytherapy source such that errors in computation, calibration, treatment time, source activity, source placement or equipment malfunction result in a calculated total treatment dose differing from the final total treatment dose ordered by more than 10 percent;
(8) a therapeutic radiation dose in any fraction of a fractionated treatment such that the administered dose in the individual treatment or fraction differs from the dose ordered for that individual treatment or fraction by more than 50 percent except when the administered dose is lower than the dose ordered by more than 50 percent due to machine interruption, or due to patient inability or decision to not finish the treatment;
(9) a CT scan in which any of the following occur:
(i) a CT scan is performed on the wrong person;
(ii) a CT scan is performed on the wrong body part;
(10) a CT scan that results in damage to an organ, organ system or results in hair loss or erythema as determined by a physician.
(b) Records and reports of misadministrations.
(1) Diagnostic misadministrations.
(i) Records of misadministration as defined in subdivision (a) of this section which involve diagnostic procedures, and the corrective actions taken pursuant to section 16.23(a)(1)(ix) of this Part shall be retained for three years; and
(ii) if such a misadministration results in a dose to the patient exceeding five rem to the whole body or 50 rem to any individual organ, or the administration of iodine-131 or iodine-125 in the form of iodide, and in a quantity greater than 30 microcuries, the licensee or registrant shall notify the department in writing within 15 days and make and retain a record pursuant to paragraph (3) of this subdivision.
(2) Therapy misadministrations.
(i) When a misadministration described in paragraph (a)(5), (6) or (7) of this section, in which the percentage of error is equal to or less than 20 percent is discovered the licensee or registrant shall immediately investigate the cause and take corrective action; and
(a) The licensee shall make and retain a record of all therapy misadministrations described in this subparagraph. The record shall contain all the information called for in paragraph (3) of this subdivision and shall be retained for six years.
(ii) When a therapy misadministration described in paragraph (a)(1), (2), (3) or (8) of this section is discovered; or when a misadministration described in paragraph (a)(5), (6) or (7) of this section in which the percentage of error is greater than 20 percent is discovered; the licensee or registrant shall notify the department by telephone. The licensee or registrant shall also notify the referring physician of the affected patient and the patient, of any therapy misadministration described in this subparagraph, with the exception of misadministrations described in paragraph (a)(1) and (8) of this section. When it is not medically advisable to give such information to the patient the information shall be made available to the patient's responsible relative or guardian on the patient's behalf. These notifications must be made within 24 hours after the misadministration is discovered. If the referring physician, patient, or the patient's responsible relative or guardian cannot be reached within 24 hours, the licensee or registrant shall notify them as soon as practicable. It is not required that the patient be notified without first consulting the referring physician; however, medical care for the patient shall not be delayed because of this.
(iii) Within seven days after an initial therapy misadministration report, the licensee or registrant shall send a written report to the department. The written report must contain the name of the licensee or registrant; the information called for in paragraph (3) of this subdivision; and whether the licensee or registrant notified the patient or the patient's responsible relative or guardian. A separate report is not required when an incident report containing all the aforesaid information is submitted to the department pursuant to Part 405 of this Title.
(3) Each licensee or registrant shall maintain a record of each reportable misadministration for six years. The record must contain the names of all individuals involved in the event (including the treating physician, allied health personnel, the patient, and the patient's referring physician), the patient's social security number or identification number if one has been assigned, a brief description of the event, the effect on the patient, and actions taken to prevent recurrence.
(4) Within seven days after an initial therapy misadministration report made pursuant to subparagraph (2)(ii) of this subdivision, the licensee or registrant shall provide the patient a written report with a copy to the patient's referring physician. The report shall contain a brief description of the event, the effect on the patient including any change in the patient's health status which resulted or could result from the misadministration, and recommendations for the appropriate course of treatment or follow-up. If it is not medically advisable to give such information to the patient, the report shall be made available to the patient's responsible relative or guardian on the patient's behalf and documented in the patient's treatment record.
(5) A misadministration described in paragraph (a)(9) or (10) of this section shall be reported to the department in writing within 15 days of occurrence.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.2 Persons required to report
(a) All persons listed in subdivision (1) of section 2803-d of the Public Health Law are required to report, and all other persons may report, physical abuse, mistreatment or neglect in accordance with this Part.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.3 Definitions
As used in this Subpart, the following words and terms shall have the indicated meaning, except as otherwise specifically provided:
(a) Nonpublic water system means any water supply serving less than 25 individuals on a daily basis and having less than five service connections.
(b) Point-of-use treatment means any type of chemical added to the water or any type of treatment device or system of devices installed on a water line within the property line of a consumer or on a nonpublic water source to improve water quality.
(c) Service connection means the pertinent pipes, valves and fittings that connect a distribution system to a consumer's facility.
(d) State means the State Commissioner of Health, or his designated representative.
(e) Water quality treatment district means a district established under applicable provisions of the County Law and the Town Law which allow county or town ownership and operation of point-of-use treatment systems.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.25 Hospital research and education costs
[ 1630 ] All direct costs incurred in conducting hospital research and formal educational activities (as opposed to in-service education) must be recorded in Unrestricted Fund cost center accounts 8010-8199 (Research Expenses) or 8220-8299 (Education Expenses).
(b) Grant accountability.
[ 1631 ] When separate accounting is required by law, grant contract, or donations restricted for research and educational activities, separate cost centers must be maintained. Transfers from restricted funds to match the expenditures for these activities must also be segregated into separate accounts in the series 5020-5199 (Research) or 5280-5300 (Education). Thus, accountability is maintained for all restricted research and educational activities.
(c) Overhead allocation.
[ 1632 ]
(1) No allocation of indirect overhead is to be made on the books prior to cost reporting unless such allocation is required by grant contract. When a grant contract calls for the payment of direct costs plus an overhead factor, the overhead factor should be included in billing, but no allocation should be made in the hospital's accounting records.
(2) The following example illustrates the accounting treatment of restricted grant activity:
(i) Assume that a hospital received a specific research grant on December 1, which called for payment of direct costs incurred, plus an overhead allocation of 10 percent of such costs. At December 31 (the hospital's year-end), $150 of direct costs had been incurred. The following entries would be made in the hospital's accounting records at December 31:
(ii) Unrestricted Fund.
(ii) Unrestricted Fund.
| | Account | Dr. | Cr. | | --- | --- | --- | --- | | Research | 8010 | $150 | | | Cash | 1010 | | $150 | | Due from Specific Purpose Fund | 1074 | $165 | | | Transfer from restricted funds for research expenses | 5020 | | $165 | | To record specific research direct costs and to set up receivable and other operating revenue from restricted fund for direct costs, plus overhead allocation. | | | | | (iii) Specific Purpose Fund. | | | | | Fund balance-Transfers to Operating Fund for Operating Purposes | 2797 | $165 | | | Due to Operating Fund | 2781 | | $165 | | To record liability to Unrestricted Fund for direct research costs and overhead allocation. | | | |
(3) If direct overhead must, by grant contract, be recorded in the Unrestricted Fund cost centers used for the recording of the direct costs of the grant activity, the natural expense classification.89 (other expenses) must be used. A separate cost center entitled “Overhead Applied” should be established in the Unrestricted Fund and credited with the amount of such overhead allocation. For reporting purposes the balance in the “Overhead Applied” cost center must be offset against the grant activity cost center, so costs remaining in the grant activity cost center are direct costs only.
(d) Affiliated school contracts.
[ 1633 ] Education costs incurred relative to affiliated school contracts must be reflected in the Education series of accounts (8220-8299) in the Unrestricted Fund. Salaries, wages and stipends paid to students on approved programs (including interns and residents) must be reflected in this series of accounts. Salaries, wages and stipends paid to interns and residents must be reflected in the appropriate natural classification of the Postgraduate Medical Education cost centers (Approved - account 8240 and Non-Approved - account 8250). Fees paid to physicians involved primarily in approved education programs must also be recorded in the Education series of accounts, in the appropriate cost center.
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.14 Fund accounting
[ 1340 ]
(a) General.
(1) Many hospitals receive, from donors and other third parties, income, gifts, bequests and grants that are restricted as to use. When funds with donor-imposed restrictions are received, they must be reported separately. This would not preclude the pooling of assets for investment purposes.
(2) For balance sheet reporting, donor-restricted funds must be recorded separately in the appropriate restricted fund classifications. For income statement purposes, expenses relating to donor-restricted activities must be recorded in the Unrestricted Fund, and the earned share relative to such current year donor-restricted activities must be recorded as “Other Operating Revenue” unless otherwise restricted by covenant agreement. Hospitals receiving no restricted income, gifts, bequests or grants need not use separate fund accounting.
(3) Restricted funds generally fall into three categories: Plant Replacement and Expansion Fund, Specific Purpose Fund, and Endowment Fund. The accounts within each restricted fund are self-balancing, as each fund constitutes a separate subodinate accounting entity. The following sections outline the conditions and events which require separate accountability and the required accounting treatment for transactions within the established funds.
(b) Unrestricted Fund.
[ 1341 ]
(1) The Unrestricted Fund is used to account for funds derived from the day-to-day activities of the hospital and unrestricted contributions. Funds which originate from unrestricted gifts or previously accumulated income may be designated by the governing board for special uses. If the governing board designates assets in this manner, it should be recognized that the board also has the authority to rescind its action. For this reason, such funds must be accounted for in the Unrestricted Fund as “board-designated assets”. All other funds within the Unrestricted Fund must be accounted for as operating funds. A separate structure of accounts in the Unrestricted Fund has been provided for operating funds and board-designated assets.
(2) The term restricted should not be used in connection with board or other internal hospital appropriations or designations of assets.
(c) Plant Replacement and Expansion Fund.
[ 1342 ]
(1) Resources restricted by donors and other third parties for the acquisition or construction of plant assets or the reduction of related debt must be accounted for in the Plant Replacement and Expansion Fund.
(2) When expenditures for plant assets are made by the Unrestricted Fund for the Plant Replacement and Expansion Fund, a transfer must be made from the Plant Replacement and Expansion Fund to match such expenditures if such funds are available. The entries to record such expenditures and the required transfer in both funds are as follows:
(i) Unrestricted Fund
| June 30 | Account | Dr. | Cr. | | --- | --- | --- | --- | | Construction in progress | 1260 | $1,000 | | | Other accounts payable | 2029 | | $1,000 | | Due from Plant Replacement and Expansion Fund | 1073 | $1,000 | | | Transfer from restricted funds for capital outlay | 2294 | | $1,000 | | (ii) Plant Replacement and Expansion Fund | | | | | Transfer to Unrestricted Fund for capital outlay | 2695 | $1,000 | | | Due to Operating Fund | 2581 | | $1,000 | | To record construction expenses incurred and related interfund transfer entries. | | | |
(3) Due to/due from accounts are to be used as an interim measure and should be reduced within a reasonable period of time by a transfer of assets (generally cash or investments) between the respective funds.
| (i) Plant Replacement and Expansion Fund | | | | | --- | --- | --- | --- | | July 3 | Account | Dr. | Cr. | | Due to Operating Fund | 2851 | $1,000 | | | Cash | 1510 | | $1,000 | | (ii) Unrestricted Fund | | | | | Cash | 1010 | $1,000 | | | Due from Plant Replacement and Expansion Fund | 1073 | | $1,000 | | To record transfer of cash from Plant Replacement and Expansion Fund to the Operating Fund. | | | | | (iii) Unrestricted Fund | | | | | July 5 | | | | | Other accounts payable | 2029 | $1,000 | | | Cash | 1010 | | $1,000 | | To record payment of the liability. | | | |
(4) If cash is disbursed for plant assets directly from the Plant Replacement and Expansion Fund, the plant assets must nonetheless be recorded in the Unrestricted Fund, with the accompanying credit made to Fund Balance. In the Plant Replacement and Expansion Fund, fund balance would be debited, and a cash account credited. No entries would be made to the interfund payable or receivable accounts, nor would any cash be transferred between funds.
(5) The preferred method of accounting for the expenditure of restricted Plant Replacement and Expansion funds is specified above. However, because of restrictions placed on construction funds by certain funding authorities, such expenditures and related liabilities are required to be recorded in the Plant Replacement and Expansion Fund. If expenditures for plant assets are recorded in the Plant Replacement and Expansion Fund, the plant assets must be transferred to the appropriate asset account in the Unrestricted Fund, with the accompanying credit made to the Unrestricted Fund balance. In the Plant Replacement and Expansion Fund, fund balance would be debited, and the temporary accounts(s) credited. No entry would be made to the interfund payable or receivable accounts. (Accounts have not been provided in this manual for recording such expenditures and related liabilities. Hospitals may establish such accounts as necessary.)
(6) Income earned and any net realized gains on investments must be reflected as an addition to the fund balance if so specified by the donor. If available for general operating purposes, they must be included in nonoperating revenue in the Unrestricted Fund.
(d) Specified Purpose Fund.
[ 1343 ]
(1) Funds received which are restricted for a specific operating purpose must be accounted for in the Specific Purpose Fund. These resources must be recorded as other operating revenue in the period in which expenditures are made for the purpose specified by the donor.
(2) Income earned and any net realized gains on investments must be recorded as an addition to fund balance if required to conform to the donor's instructions or as nonoperating revenue of the Unrestricted Fund if such revenue is available for general purposes.
(e) Endowment Fund.
[ 1344 ]
(1) Funds classified as endowment include:
(i) pure endowment (principal is to remain intact in perpetuity);
(ii) term endowments (principal is available for use upon the passage of time or the occurrence of an event).
(2) When term endowments become available to the governing board for unrestricted purposes, they must be recorded as nonoperating revenue; if these funds are restricted, they must be transferred to the appropriate restricted fund.
(3) Income earned on endowment fund investments must be accounted for in accordance with donors' instructions if restricted, or as nonoperating revenue in the Unrestricted Fund if not restricted.
(f) Interfund Transactions.
[ 1345 ]
(1) As is shown in the Chart of Accounts, the only liability accounts included in the restricted funds ( i.e., all funds other than the Unrestricted Fund) are liabilities to other funds (with the exception of the Endowment Fund, which allows for the inclusion of certain liabilities on Endowment Fund assets, and the Plant Replacement and Expansion Fund for certain covenant agreements as explained under number 1342).
(2) Thus, virtually all liabilities incurred by the hospital are to be recorded in the Unrestricted Fund. When these liabilities apply to restricted fund activities, a receivable from the applicable restricted fund must be recorded within the Unrestricted Fund. A payable to the Unrestricted Fund (or transfer of funds if paid immediately), as well as a reduction of the restricted fund balance, is recorded within the applicable restricted fund.
(3) Except for expenses incurred in conformity with covenant agreements, all expenses relating to restricted fund activities must be recorded in the Unrestricted Fund in the cost center category to which they apply. This is true whether the actual expenditures of cash are made from the Unrestricted Fund or a restricted fund. Separate cost centers must be established within each of these categories to record restricted activities for which separate accounting is required by the terms of the grant or gift. Sufficient account numbers have been allowed so that specific restricted fund activities may be segregated. Transfers from the restricted funds to match these expenses must be made in one of the following accounts:
(i) transfers from restricted funds for Research Expenses (account 5020);
(ii) transfers from restricted funds for Education Expenses (account 5280); or
(iii) transfers from restricted funds for Other Operating Expenses (account 5880).
(4) Example.
In the following example, assume that $200 of consulting costs were incurred (this consulting was performed by a nonrelated organization) for restricted research activities, recorded as an expense and a liability in the Unrestricted Fund, and subsequently paid.
(i) Unrestricted Fund
| June 1 | Account | Dr. | Cr. | | --- | --- | --- | --- | | Research | 8010 | $200 | | | Accounts payable | 2020 | | $200 | | Due from Specific Purpose Fund | 1074 | $200 | | | Transfers from restricted funds for Research Expenses | 5020 | | $200 | | (ii) Specific Purpose Fund | | | | | June 1 | | | | | Transfers to Operating Fund for Operating Purposes | 2797 | $200 | | | Due to Operating Fund | 2781 | | $200 | | To record the expense and related liability for costs incurred in restricted research activities in the Operating Fund and record an interfund liability and reduction in fund balance in the Specific Purpose Fund. | | | | | (iii) Unrestricted Fund | | | | | June 10 | | | | | Cash | 1010 | $200 | | | Due from Specific Purpose Fund | 1074 | | $200 | | (iv) Specific Purpose Fund | | | | | June 10 | | | | | Due to Operating Fund | 2781 | $200 | | | Cash | 1710 | | $200 | | To record the transfer of cash to the Operating Fund. | | | | | (v) Unrestricted Fund | | | | | June 15 | | | | | Accounts payable | 2020 | $200 | | | Cash | 1010 | | $200 | | To record the payment of the liability. | | | |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.3 Prohibited business practices by health services purveyors—general
(a) No health services purveyor shall solicit, receive, accept, or agree to receive or accept any payment or other consideration from a clinical laboratory, or its agent, employee or fiduciary for the referral of specimens for the performance of clinical laboratory services.
(b) No health services purveyor shall participate in the division, transference, assignment, rebate, or splitting of fees with any clinical laboratory, or its agent, employee or fiduciary, or with any other health services purveyor, in relation to clinical laboratory services.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.4 Maintaining eligibility for an award
(a) Continuous enrollment.
Award recipients must be continuously enrolled either part-time or full-time in consecutive academic years and be in good standing in accordance with the standards and regulations established by the New York State Higher Education Services Corporation and the institution where the award recipient is receiving training.
(b) Transfers.
An award recipient who transfers to another primary care practitioner program may continue to be eligible for an award if:
(1) the recipient notifies the commissioner prior to the transfer;
(2) the recipient continues training in a primary care practitioner program in the profession for which the award was granted; and
(3) the transfer does not increase the total period of training beyond that which is allowed by this Subpart.
(c) Reporting requirements.
Award recipients must report to the Department of Health and the Higher Education Services Corporation at least annually and as may be necessary to implement the program on such forms and at such times as required by the commissioner and the president.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.4 Donor qualifications
(a) In addition to all the requirements of this Subpart, limited tissue procurement services and comprehensive tissue procurement services shall comply with the donor qualification requirements in Subpart 52-3 of this Part.
(b) Unless specifically authorized by the tissue bank medical director, musculoskeletal tissue shall not be released for allogeneic transplant from donors with any of the following conditions:
(1) evidence of rheumatoid arthritis;
(2) a disease of unknown etiology; or
(3) malaria within the last three years or travel to a malarially endemic area within the last six months.
(c) Social history as recorded in the medical chart of the donor, or as provided by a friend or family member shall be considered in the donor selection process.
(d) The medical director of the comprehensive tissue procurement service shall be responsible for determining that the donor and the donated musculoskeletal tissue are acceptable based on medical history information and established donor selection criteria as specified in this Part, and a physical examination.
(e) Written policy shall specify the range of acceptable donor age limits for allogeneic musculoskeletal tissue donation. This policy shall be determined by the tissue bank medical director in consultation with the medical advisory committee of the comprehensive tissue procurement service.
(f) Written criteria for acceptance of donors of autogeneic tissue shall be specified by the transplantation service director of the tissue transplantation facility, unless such criteria have been specified already by the medical director of a comprehensive tissue procurement service.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.29 Periodic interim payments
[ 1690 ]
(a) Periodic interim payments are made biweekly to a hospital on the PIP program and are based on the hospital's estimate of applicable Medicare reimbursement for the current cost report period. When such payments are received, a cash account in the Unrestricted Fund is debited and a-PIP Clearing Account (account 1051) is credited for the amount of the payment. When applicable Medicare charges are billed to the intermediary, the PIP Clearing Account is debited and patient accounts receivable is credited. At year-end, adjustments must be made to eliminate any remaining balance in the PIP Clearing Account and to reflect the amount receivable from, or due to, the Medicare intermediary.
(b) To illustrate these entries, assume the following facts:
(1) PIP payments during the year totaled $100,000, and applicable Medicare charges billed during the year were as follows:
| Total charges | $98,000 | | --- | --- | | Noncovered charges | 4,000 | | Deductibles and coinsurance | 8,000 | | and | |
(2) Applicable unbilled Medicare charges and in-house patient balances were as follows at year-end:
| Total charges | $10,000 | | --- | --- | | Noncovered charges | 500 | | Deductibles and coinsurance | 1,200 | | and | |
(3) Applicable reimbursable costs per the Medicare cost report prepared for the year were $92,000.
(c) In summary form, the accounting entries necessary to properly reflect the above transactions would be:
| | Account | Dr. | Cr. | | --- | --- | --- | --- | | (1) Cash | 1010 | $100,000 | | | PIP Clearing Account | 1051 | | $100,000 | | To record the receipt of PIP payments during the year. | | | | | (2) Inpatient Receivables— Discharged & Unbilled | 1032 | 108,000 | | | Various Revenue Accounts | | | 108,000 | | To record applicable Medicare revenue for the year. | | | | | (3) PIP Clearing Account | 1051 | 86,000 | | | Inpatient Receivables—Other | 1035 | 12,000 | | | Inpatient Receivables— Discharged & Unbilled | 1032 | | 98,000 | | To record the billing of Medicare charges to the intermediary ($86,000) and to Medicare patients for noncovered charges and deductibles and coinsurance ($12,000). | | | | | (4) PIP Clearing Account | 1051 | 8,300 | | | Inpatient Receivables— Discharged & Unbilled | 1032 | | 8,300 | | To transfer the amount of applicable unbilled Medicare receivables at year-end to the PIP Clearing Account ($10,000 − $500 − $1,200). | | | | | (5) PIP Clearing Account—Medicare | 1051 | 5,700 | | | Contractual Adjustments— Medicare | 5910 | | 5,700 | | To transfer the balance in the PIP Clearing Account at year-end to the Contractual Adjustments account (the PIP Clearing Account must be zero at year-end). | | | | | (6) Contractual Adjustments Medicare | 5910 | 17,200 | | | Reimbursement Settlement | 2071 | | | | Due—Medicare | | | $17,200 | | To record the amount of cost report reimbursement settlement due, based upon cost report filed (total PIP payments of $100,000 and deductibles/coinsurance in the amount of $9,200, less $92,000 reimbursable inpatient costs per the cost report). | | | |
(d) Although the preceding illustration reflects year-end adjustments, similar entries should be made at the end of each month in order to properly reflect the amount of contractual adjustment during the year. In order to do this, cost reimbursement settlement must be estimated. When done at month-end, entries 4 - 6 would be reversed at the beginning of the next month.
(e) The above example adheres to the principle that, at year-end, the entire amount receivable from or payable to the intermediary by a provider under the PIP program must be reflected in account 1052.00 or 2061.00. There are no receivables “in-transit” under the PIP program. Although more complex systems of accounting for periodic interim payments and related billings are permissible—such as establishing separate subaccounts for: (1) PIP cash received; (2) Medicare PIP billings, including amounts unbilled at year-end; and (3) PIP contractual allowances—this basic principle must be followed.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.11 Solid waste
(a) Siting or horizontal expansion of a junkyard or a municipal solid waste landfill, within the limiting distance of 250 feet of a watercourse or wetland, or the siting or horizontal expansion of a junkyard or a solid waste management facility within the limiting distance of 1,000 feet of a reservoir, reservoir stem or controlled lake is prohibited except for:
(1) recyclable handling and recovery facilities that handle non-putrescible solid waste, such as newspapers, magazines, corrugated boxes, glass, cans and plastic, but not non-putrescible solid waste such as batteries, car batteries, and waste oil;
(2) composting facilities for individual households for personal use; or
(3) expansion of the existing permitted municipal solid waste landfill located within Delaware County.
(b) Discharge of solid waste directly into any watercourse, wetland, reservoir, reservoir stem or controlled lake is prohibited. For purposes of this subdivision, solid waste includes materials that are otherwise exempt from compliance with Part 360 of Title 6 NYCRR, as described in section 360-1.2(a)(4) of Title 6 NYCRR. This subdivision shall not apply to discharge of treated leachate in accordance with the requirements of these rules and regulations and a valid SPDES permit.
(c) Only construction and demolition debris that is recognizable uncontaminated concrete, asphalt pavement, brick, soil, stone, trees or stumps, wood chips, or yard waste may be used as fill in the watershed.
(d) All new solid waste management facilities, or altered or modified existing solid waste management facilities within the limiting distance of 300 feet of a watercourse or wetland, or within the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake, are required to submit Stormwater Pollution Prevention Plans to the department for review and approval, in accordance with section 128-3.9(b)(3)(v) of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.5 Immunization records from previous schools
An immunization record forwarded from the child's previous school, which contains all of the information specified in subdivision (a) of section 66-1.3 of this Subpart, may be accepted by the principal or person in charge of the school in lieu of a certificate of immunization.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.5 Village of Cornwall
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Black Rock Brook and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Cornwall, Orange County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Black Rock Brook which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the village of Cornwall.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(3) No cesspool, pit or other receptacles of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be throroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at some suitable point off the watershed tributary to the public water supply of the village of Cornwall.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta, or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Cornwall, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Cornwall is prohibited; nor shall any such watering be allowed in any watercourse tributary to this water supply. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Cornwall.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Cornwall nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or watercourse tributary to the the public water supply of the village of Cornwall.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatsoever shall be allowed in or upon the waters or ice of the reservoirs or watercourses tributary to the public water supply of the village of Cornwall.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Cornwall.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Cornwall.
(j) Inspections.
The board of trustees of the village of Cornwall shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.5 Minimum standards for individual onsite wastewater treatment systems
(a) Individual onsite wastewater treatment systems shall be designed and constructed in accordance with the standards of the State Commissioner of Health as set forth in Appendix 75-A of this Title.
(b) Plans for the design of individual onsite wastewater treatment systems shall be prepared directly by or under the supervision of a design professional.
(c) Prior to construction of an individual onsite wastewater treatment system utilizing an alternative system pursuant to Appendix 75-A of this Title, plans for the design of the system shall be reviewed and approved by the State or county health department official having jurisdiction. A design professional shall supervise the construction of the alternative system and ensure that such construction conforms to the approved plans. After construction is completed, a design professional shall provide the State or county health department official having jurisdiction with a certification that the construction of the alternative system was supervised by a design professional and that such construction conforms to the approved plans.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 40-2.0 Scope of Subpart 40-2
In accordance with applicable provisions of article 6 of the Public Health Law, this Subpart establishes standards of performance and minimum requirements for core public health services relating to family health, communicable disease control, chronic disease prevention, community health assessment, environmental health, and emergency preparedness and response.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.18 Additional requirements; surrender of radioactive material; sealing of radiation equipment
Notwithstanding any exemption set forth in this Part:
(a) The department may, by rule, regulation or order, impose upon any person possessing a radiation source such requirements, in addition to those set forth in this Part, as it deems appropriate or necessary to protect the public health and safety and to minimize danger to life and property from radiation hazards.8
(b) The department may by order require the removal through an authorized transferee or the surrender to the department of any radioactive material by any person who is not able or equipped, or who fails, to observe with regard to such radioactive material such radiation protection standards as are established by the department, or who uses such radioactive material in violation of law or this Part or order of the department or in a manner other than as set forth in a license issued therefor by the department. Such person shall decontaminate any premises which may have been contaminated with radioactive material as a result of his activities to such radiation levels as the department may specify. The expenses incidental to such transfer, surrender, and/or decontamination shall be borne by such person responsible for the source.
(c) The department may by order require radiation equipment sealed, with an official New York State Department of Health seal or other suitable method, when such equipment is used by any person who is not able or equipped, or fails to observe with regard to such radiation equipment such radiation protection standards as are established by the department, or who uses such radiation equipment in violation of law or this Part or order of the department. Radiation equipment sealed by the department pursuant to this subdivision shall not be unsealed without prior authorization by the department.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.30 Providing treatment for public water systems
The supplier of water shall provide such treatment as necessary to deliver to the consumer a water conforming to the requirements of this section and determined using an approved method, with method modifications as listed in the tables in section 5-1.52 of this Subpart, and by an approved laboratory as described in section 5-1.74 of this Subpart.
(a) Minimum treatment for a ground water source shall be disinfection by chlorination or other microbial contaminant treatment acceptable to the State in accordance with the provisions of section 5-1.22 of this Subpart. If chemical disinfection is used, the disinfectant residual concentration must be maintained at all times and under no circumstances shall be less than the required concentration for more than four hours. Unless other corrective action is approved by the State, any ground water source where fecal contamination has been observed, or where a significant deficiency may be causing or has the potential to cause the introduction of contamination into the water delivered to customers, must be treated to remove or inactivate 99.99 percent (four-log) of viruses. Continuous monitoring of active microbial treatment processes is required, except as provided in section 5-1.52 table 15 of this Subpart.
(b) Minimum treatment for surface water sources or ground water sources directly influenced by surface water shall be filtration and disinfection techniques, approved by the State in accordance with section 5-1.22 of this Subpart, capable of at least 99 percent removal of Cryptosporidium oocysts, 99.9 percent removal and/or inactivation of Giardia lamblia cysts, and 99.99 percent removal and/or inactivation of viruses, between a point where the raw water is no longer subject to recontamination by surface water runoff and a point downstream before or at the first consumer. Compliance with this treatment technique is required for surface water sources or within 18 months after ground water sources are determined to be directly influenced by surface water, unless the department determines that the supplier of water can meet specific avoidance criteria as defined in subdivision (c) of this section. Required performance monitoring shall be conducted in accordance with section 5-1.52 table 10A of this Subpart. Compliance with these treatment technique requirements shall also include:
(1) filtration facilities designed and operated to meet performance standards in accordance with section 5-1.52 table 4A of this Subpart;
(2) for systems using chlorine, the free chlorine residual disinfection concentration in the water entering the distribution system must be at least 0.2 milligrams per liter and may not be less than the required minimum concentration for compliance for more than four hours. Systems using other chemical disinfectants shall maintain residual disinfection levels entering the distribution system comparable to requirements for systems using chlorination. Continuous monitoring is required, except as provided in section 5-1.52 table 15 of this Subpart; and
(3) by June 8, 2004, any system that recycles spent filter backwash water, thickener supernatant, or liquids from dewatering process must return these flows through the processes of a system's existing conventional or direct filtration system.
(c) A public water system that uses a surface water source or a ground water source directly influenced by surface water which fails to comply with any of the following avoidance criteria shall develop and submit to the State, within three months of such failure to comply, a written plan for installing filtration and disinfection. Also, filtration and disinfection shall be installed, in accordance with subdivision (b) of this section, within 18 months of such failure to comply.
(1) Raw water fecal coliform concentrations must be equal to or less than 20 colonies per 100 milliliters or total coliform concentration must be equal to or less than 100 colonies per 100 milliliters in at least 90 percent of measurements made over the previous six months that the system was in operation. Monitoring shall be conducted in accordance with section 5-1.52 table 11A of this Subpart. If both fecal and total coliform analyses are performed, the fecal coliform results will take precedence.
(2) Raw water turbidity levels must not exceed five nephelometric turbidity units unless the department determines that the turbidity was caused by an unusual and unpredictable event. No more than two such events in the previous 12 months or no more than five events in the previous 120 months that the system was in operation are allowed. An event means a series of consecutive days during which at least one turbidity measurement each day exceeds five nephelometric turbidity units. Monitoring is to be conducted in accordance with section 5-1.52 table 10A of this Subpart.
(3) Disinfection must be sufficient to ensure at least 99.9 percent inactivation of Giardia lamblia cysts, and 99.99 percent inactivation of viruses, and 99 or 99.9 percent inactivation of Cryptosporidium (per section 5-1.83[c][2] of this Subpart), between a point where the raw water is no longer subject to recontamination by surface water runoff and a point downstream before or at the first consumer. Actual CT values must be equal to or greater than the required values found in section 5-1.52 tables 14A through 14I of this Subpart, except for one day in each month that the system served water to the public, or except where the State determines that an additional failure in one month in the previous 12 months was caused by circumstances that were unusual and unpredictable. The supplier of water must calculate the CT values of the system for each day the system is in operation to document satisfactory disinfection. The necessary parameters and related monitoring frequencies to conduct this evaluation include:
(i) temperature of the disinfected water measured at least once per day at each residual disinfectant concentration sampling point;
(ii) pH of the disinfected water, measured at least once per day at each chlorine residual disinfectant concentration sampling point by systems using chlorine;
(iii) the disinfectant contact time (T), determined daily during peak hourly flow; and
(iv) the residual disinfectant concentration (C), before or at the first customer, measured daily during peak hourly flow.
(4) The disinfection system must have redundant components to ensure continuous disinfection. Auxiliary power with automatic start and alarm is required at all disinfection facilities where a power outage would result in a loss or reduction in the ability of the system to maintain a disinfection concentration as required by this Subpart.
(5) For systems using chlorine, the free chlorine residual disinfection concentration in the water entering the distribution system must be at least 0.2 milligram per liter and may not be less than the required minimum concentration for compliance for more than four hours, unless the State determines that any such failure was caused by circumstances that were unusual and unpredictable. Systems using other chemical disinfectants shall maintain residual disinfection levels entering the distribution system comparable to requirements for systems using chlorination. Continuous monitoring is required, except as provided in section 5-1.52 table 15 of this Subpart.
(6) The disinfection residuals or the heterotrophic plate count results in the water in the distribution system must meet the requirements outlined in subdivision (g) of this section and section 5-1.52 table 11 of this Subpart unless the State determines that the failure to meet the requirements was not caused by a deficiency in the treatment of the source water.
(7) The watershed control program must provide natural or man made barriers to the occurrence, transport and/or survival of Cryptosporidium oocysts, Giardia lamblia cysts and viruses. The watershed control program must include, but is not limited to the following:
(i) ownership or protective controls of the watershed, except where the supplier of water submits written justification to show that the travel time of the water to the intake is greater than 60 days under all but emergency conditions. Protective controls can include written agreements with landowners within the watershed but must include as a minimum the absence of any bathing beach as defined in Subpart 6-2 of this Title, except for a bathing beach owned and/or maintained by an individual for use by the individual's family or friends;
(ii) no new sewage discharges to any watercourse shall be allowed where the time of travel from the point of discharge to the intake is 60 days or less. Existing sewage discharges with a current State Pollutant Discharge Elimination System (SPDES) permit issued by the New York State Department of Environmental Conservation, where the time of travel from the point of discharge to the intake is 60 days or less, shall, as a minimum, have secondary treatment followed by sand filtration and disinfection at facilities designed to achieve 99.9 percent removal and/or inactivation of Giardia lamblia cysts and 99.99 percent removal and/or inactivation of viruses by June 29, 1993. Existing or new sewage discharges with a SPDES permit issued by the New York State Department of Environmental Conservation, where the time of travel from the point of discharge to the intake is greater than 60 days, shall, as a minimum, have secondary treatment followed by sand filtration and disinfection at facilities designed to achieve 99.9 percent removal and/or inactivation of Giardia lamblia cysts and 99.99 percent removal and/or inactivation of viruses by June 29, 1993 or a later date set forth in a plan submitted to the commissioner and approved using the criteria for the long term plan as described in subparagraph (vii) of this paragraph. The sewage treatment facilities required herein shall be operated in conformance with their design specifications and the conditions of their SPDES permit;
(iii) watershed rules and regulations promulgated and enforced in accordance with title I of article 11 of the Public Health Law; including as a minimum prohibition or controls on waste discharges which contain or potentially may contain Cryptosporidium oocysts, Giardia lamblia cysts and/or viruses;
(iv) identification and evaluation of pertinent geological, hydrological and physical characteristics or features and potential conditions or activities which may influence water quality;
(v) a monitoring and surveillance program to assess water quality and water quantity trends;
(vi) an annual report submitted by the supplier of water to the department describing watershed activities, especially activities that affect water quality, identifying new and existing water quality concerns and remediation efforts taken and any other reports required pursuant to adopted watershed rules and regulations. The annual report must be submitted to the department no later than the 10th of October of each year; and
(vii) a long-term plan for the implementation of the watershed control program, including a description of the commitment of human and financial resources for such program shall be submitted to the commissioner for approval from systems that serve more than 100,000 persons, obtain water from a watershed or watersheds that involve multiple political subdivisions and own less than 25 percent of the land in the watershed. The approval shall be based on the exercise of a reasonable discretion by the commissioner in reviewing and accepting the proposed levels of human and fiscal resources to be committed for successful implementation of the plan, measured by projected cost of the administration, inspection, enforcement, land acquisition, sewage treatment plant upgrading and other activities and/or services related to such watershed control program, including the resolution of inherent water quality and quantity questions and the reliability of the method of funding. Failure to obtain the approval of the long term plan or failure to secure the required human or financial resources will result in a requirement to provide filtration, in accordance with the provisions of this Subpart. The approval of the long-term plan shall be for a period of 10 years, subject to further review and approval for successive 10-year periods. Notwithstanding any approval granted pursuant hereto, if Federal or State law or regulation shall henceforth unconditionally mandate filtration of surface water sources, then any such approvals shall forthwith cease and terminate with filtration thereafter to be provided, in accordance with the provisions of this Subpart, when reasonably feasible.
(8) The public water system must not have been identified as a source of a water-borne disease outbreak since 1980.
(9) The public water system shall comply with the trihalomethane, haloacetic acid, bromate and chlorite maximum contaminant levels and the maximum residual disinfectant levels in accordance with section 5-1.52 of this Subpart.
(10) The public water system must not exceed a total coliform treatment technique trigger in accordance with section 5-1.52 of this Subpart in 11 months of the 12 previous months that the system served water to the public on an ongoing basis, unless the State determines that failure to meet this requirement was not caused by a deficiency in treatment of the source water.
(d) Notwithstanding anything to the contrary in section 5-1.12, 5-1.23, 5-1.51 or 5-1.77 of this Subpart, if the public water system fails to comply with the treatment technique and/or the monitoring requirements of subdivision (a), (b), (c) or (g) of this section, fails to install the filtration and/or disinfection treatment required by this section or fails to comply with the avoidance criteria requirements contained in subdivision (c) of this section, the system violates this Subpart and shall make State and public notification, including any required mandatory health effects language. Pursuant to subdivision (c) of this section, if at any time the raw water turbidity exceeds five nephelometric turbidity units, the system shall consult with the State within 24 hours of learning of the exceedance. Based on this consultation, the State may determine that the exceedance constitutes a public health hazard, as found in section 5-1.1(bz)(4) of this Subpart, which requires a Tier 1 notification. When consultation does not take place within the 24-hour period, the water system must distribute a Tier 1 notification no later than 48 hours after the system learns of the violation. Ground water systems that are required to provide 4-log virus treatment, surface water systems and ground water under the direct influence of surface water (GWUDI) systems that use chemical disinfection must notify the State whenever residual disinfectant levels in the water entering the distribution system are less than the specified concentration pursuant to subdivisions (b) and (c) of this section. Any water system that uses chemical disinfection must make State notification whenever disinfectant residual levels entering the distribution system are not restored within four hours.
(e) The State may grant a waiver, on the submission of a written application, renewable for a period up to three years, to the disinfection rule established by this section for a ground water source if:
(1) the record of the microbiological and physical characteristics for the ground water source or sources not directly influenced by surface water demonstrates that they conformed to the MCL's of this Subpart, for the 12 months immediately preceding the date of application for waiver; such record shall be established under procedures provided by the department;
(2) an environmental laboratory approved pursuant to Subpart 55-2 of this Title, is used by the supplier of water to provide monitoring of drinking water quality and delivery of drinking water in conformity with this Subpart;
(3) an active cross-connection control program to prevent the backflow or entry of undesirable and toxic substances into the water distribution system is adopted and maintained by the supplier of water, and such cross-connection control program shall include the maintenance of adequate distribution system pressures, in accordance with section 5-1.27 of this Subpart;
(4) watershed rules and regulations to protect such ground water source are adopted pursuant to the provisions of article 11 of the Public Health Law, updated as necessary, and administered by the supplier of water, or other watershed controls satisfactory to the State are adopted, updated and administered;
(5) all water storage facilities are adequately protected pursuant to section 5-1.32 of this Subpart; and
(6) all sources of the water supply are properly located, constructed and effectively protected and maintained.
(f) The State may waive the requirements of paragraphs (e)(3) through (6), of this section for a ground water source at a noncommunity water system or a community water system serving fewer than 50 dwelling units, based on periodic evaluation of a sanitary survey and the geology of the area; the chemical characteristics of the water; the location, construction and protection of the ground water source; and the method of water storage and distribution.
(g) When a chlorine-based chemical disinfectant is used, the residual disinfectant concentration in the distribution system, measured as free or combined chlorine shall be maintained at detectable concentrations at representative points in the distribution system, in accordance with the monitoring requirements in section 5-1.52 table 11 of this Subpart. No more than five percent of the free chlorine residual samples shall be undetectable in any two consecutive months that the system serves water to the public. Chlorine residual or heterotrophic bacteria analyses shall be performed in accordance with section 5-1.52 table 11 of this Subpart. Monitoring for heterotrophic bacteria may be substituted for free chlorine residuals. A heterotrophic plate count result equal to or less than 500 colonies per milliliter is considered to be equivalent to a measurable free chlorine residual.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.61 Method of payment
Expenditures by local health departments shall be reimbursed as follows, provided all requirements of this Part are met:
(a) Base grant.
(1) For local health departments providing all of the core services set forth in Subpart 40-2 of this Part, the State aid base grant shall be 100 percent of net eligible expenditures for performance of these services to a maximum of $650,000 or the amount representing 65 cents per capita, whichever is greater.
(2) For local health departments that the commissioner has approved to provide fewer than all of the core services set forth in Subpart 40-2 of this Part, the State aid base grant shall be 100 percent of net eligible expenditures for performance of approved core services to a maximum amount determined by the commissioner that reflects the reduced scope of services.
(3) For the purposes of this section, population shall be determined by the local population data published as of January 1st of each calendar year by the New York State Department of Health.
(b) A local health department’s net eligible expenses for performance of core public health services, in excess of the base grant, shall be reimbursed at a rate consistent with section 616 of the Public Health Law, after review and approval of all State aid applications.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.111 Employee benefit
A pension provision, retirement allowance, insurance coverage, paid vacation, sick leave, and holiday time off or other cost representing a present or future return to an employee, which is neither deducted on a payroll nor paid for by the employee.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.5 Village of Mayville
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the wells which comprise the source of the public water supply of the Village of Mayville, Chautauqua County, New York. Said wells are located on land owned by Village of Mayville and are situated approximately near Patterson Street and Morris Street in said village.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds of potassium chloride (commonly used as fertilizer) calcium chloride (commonly used for road maintenance) or sodium chloride (commonly used for water softener regeneration or road maintenance).
(2) Human excreta shall mean human feces and urine.
(3) Junk yard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(5) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(6) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(7) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(8) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(9) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(10) Water supply shall mean the public water supply of the Village of Mayville, Chautauqua County, New York.
(11) Well shall mean the wells now used as a source of this public water supply or to any additional well which may be constructed at this point as a source for this public water supply.
(c) Human excreta.
(1) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 250 feet of the well.
(2) No human excreta shall be deposited or spread upon or beneath the surface of the ground within 250 feet of the well.
(d) Sewage.
No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground (except into watertight pipes connected to a sewage disposal system, a permit for which shall have been granted by the appropriate State agency having jurisdiction over such facility) within 250 feet of the well. It is provided, however, that no such watertight pipe shall be located within 15 feet of the well.
(e) Refuse.
No refuse shall be deposited on or beneath the surface of ground within 250 feet of the well.
(f) Refuse disposal area.
No refuse disposal area shall be located within 500 feet of the well.
(g) Cemeteries.
No interment of a human body shall be made within 250 feet of the well.
(h) Chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within 140 feet of the well located at Morris Street and within 240 feet of the well located at Patterson Street.
(i) Chloride salt.
No chloride salt storage area shall be located within 500 feet of the well except in weather-proof buildings or watertight vessels.
(j) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter 1 — Ionizing Radiation — Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 500 feet of the well.
(k) Junk yards.
No junk yard shall be located within 250 feet of the well.
(l) Trespassing.
No trespassing shall be allowed upon the property of the Village of Mayville, upon which the well is located and no person or persons shall enter in or upon such property except the person or persons as may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the supply or except such other persons as may be authorized to enter said property by the Village of Mayville.
(m) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources) Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(n) Inspections.
The board of water commissioners, or any person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the area surrounding the well as to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid board of water commissioners, to cause copies of any rules and regulations violated to be served upon persons violating the same together with notices of such violations. If such persons served do not immediately comply with these rules and regulations, it shall be the further duty of the aforesaid board of water commissioners, to promptly notify the State Commissioner of Health of such violations. The aforesaid board of water commissioners shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general surroundings of the well at the time of the last inspection.
(o) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.2 Housekeeping
(a) The entire facility, including but not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment, and furnishings, shall be maintained in good repair, clean and free of insects, rodents and trash.
(b) Responsibility for direct supervision of housekeeping service shall be assigned to one person, properly qualified by training and experience.
(c) Dusting, mopping and vacuum cleaning shall be done in a manner which will not spread dust or other particulate matter.
(d) Adequate supplies and equipment for housekeeping functions shall be provided with cleaning compounds and hazardous substances properly labeled and stored.
(e) Solid wastes, including garbage, rubbish and other refuse, biological wastes and infectious materials, shall be collected, stored and disposed of in a manner that will prevent the transmission of disease and not create a nuisance or fire hazard, nor provide a breeding place for insects or rodents; dressings, surgical, biological and obstertical wastes, infectious materials and disposable syringes and needles shall be destroyed on the premises by incineration, or as approved by the department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.9 Required records
(a) Reproductive tissue bank records shall be open to inspection by the department and shall be kept for at least seven years after release of reproductive tissue for artificial inseminations or assisted reproductive procedures not resulting in a live birth, and 25 years for inseminations or assisted reproductive procedures known to have resulted in a live birth. For all donated reproductive tissue, the donor's name, address, and any other information which would directly or indirectly identify the donor shall not be disclosed or released by the reproductive tissue bank to any person or entity, except upon the written informed consent of the donor, or except to authorized employees of the department or as permitted by law. The recipient's name, address, and any other information which would directly or indirectly identify the recipient shall not be disclosed or released by the insemination/implantation site to any person or entity, except upon the written informed consent of the recipient, or except to authorized employees of the department, or as permitted by law.
(b) In addition to the recordkeeping requirements of section 52-2.9(c) of this Part, each reproductive tissue bank shall maintain applicable donor/client-depositor records which include:
(1) for donors, pertinent family history of any genetic disorders;
(2) documentation of donor and client-depositor written informed consent;
(3) for semen donors, outcome of any prior artificial insemination or other assisted reproductive procedures, if known, including number of successful pregnancies, if any, and any reports from insemination/implantation sites which would affect the donor's acceptability; and
(4) documented approval of the reproductive tissue bank director, or his/her designee, of the acceptability of the donor.
(c) In addition to the recordkeeping requirements of section 52-2.9(e) and (f) of this Part, each reproductive tissue bank shall maintain applicable records which include:
(1) donor's identification code or client-depositor's name;
(2) for semen donations, documentation of laboratory cryosensitivity testing, and, if performed, results of viability checks after thawing and during storage, if any;
(3) the name of the insemination/implantation site, the physician or other person authorized by law to perform artificial insemination or assisted reproductive procedures, and/or receive reproductive tissue, and the name of the person communicating the order for distribution of the tissue;
(4) the recipient's name, if the name has been provided to the reproductive tissue bank with her informed consent, or the recipient's identification code, if used;
(5) documentation of training, certification, licensure, if required by law, and continuing education for each staff member; and
(6) any adverse outcomes, including infectious diseases in recipients or their offspring and genetic defects in offspring, which shall be reported to the donors if there is any possibility that the donor's reproductive tissue contributed to the adverse outcome.
(d) The following records shall be kept, separate from the recipient' s records, by an insemination/implantation site for each insemination or assisted reproductive procedure performed:
(1) donor's identification code or name, if the reproductive tissue originates from a client-depositor;
(2) evidence that reproductive tissue from donors and/or client-depositors has been obtained from a reproductive tissue bank licensed pursuant to Subpart 52-2 of this Part;
(3) disposition of the reproductive tissue, including, but not limited to, the name or identification code of the recipient, destruction logs, and autoclaving or incineration records;
(4) the name and signature of the ordering physician or other person authorized by law to order issuance of the reproductive tissue;
(5) results of sperm viability checks, if performed; and
(6) signature of the person receiving the sample and condition of the sample upon receipt.
(e) The insemination/implantation site shall document the outcome of the artificial insemination or assisted reproductive procedure, including, but not limited to, any known adverse outcome in the infant or infectious disease in the recipient, as well as any known successful pregnancies. This information shall also be reported to the reproductive tissue bank releasing the tissue, even if the reproductive tissue bank is the same entity as the insemination/implantation site.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.5 Administrative requirements
(a) PCH and CAH administration. PCHs and CAHs shall comply with the requirements of section 405.3 of this Title regarding administration.
(b) Admission/discharge/transfer.
(1) General.
(i) The administrative and medical/professional staff shall develop for approval by the governing body written admission and discharge policies designed to protect the health and safety of patients, and shall not assign or delegate the functions of admission and discharge to any referral agency.
(ii) The priority use of inpatient beds in the hospital shall be for short stay acute cases that can be discharged or transferred within a limited period of time. A PCH or CAH certified to provide swing-bed services shall ensure the timely availability of acute care beds at all times.
(iii) Long term cases shall be assigned to the swing-bed capacity of the hospital.
(2) Admissions.
(i) Each patient shall be advised of his or her rights pursuant to section 407.7 of this Part and, as appropriate, the criteria for Medicaid eligibility.
(ii) No person shall be denied admission to the hospital because of race, creed, national origin, sex, disability (subject to the capacity of the hospital to provide necessary treatment), sexual orientation or source of payment.
(iii) Except in emergencies, patients shall be admitted only upon referral and under the care of a licensed and currently registered practitioner who has been granted admitting privileges by the governing body. The patient's condition and provisional diagnosis shall be established on admission by the patient's admitting practitioner and shall be noted in the patient's medical record.
(iv) Except in emergencies and under exceptional circumstances ( i.e. , weather, availability of transport, equipment or staff), a hospital shall admit as patients only those who require the type of medical services authorized by the hospital's operating certificate and specified in the hospital's written admission and discharge policies.
(a) Authorized admissions to CAHs shall involve only patients that, by the judgment of the admitting practitioner, are determined to have medical needs that can be managed and resolved within the 96-hour time period allowed for inpatient services pursuant to 42 CFR section 485.620 as expressly set forth in section 407.2(c) of this Part. Patients presenting with conditions that have the reasonable potential for requiring a greater amount of time to resolve shall be transferred to a more appropriate full service hospital.
(b) Authorized admissions criteria for PCHs shall be developed locally based on the service and resource capabilities of the PCH, its supporting full service hospital(s) and, if appropriate, any network in which it operates. Expected length of stay necessary to meet a patient's medical needs shall not be used as a criterion for admission to PCHs.
(v) PCHs and CAHs shall comply with the provisions of section 405.9(b)(6)-(14) of this Title.
(3) Sexual offense evidence.
PCHs and CAHs shall comply with the provision of section 405.9(c) of this title regarding the maintenance of sexual offense evidence.
(4) Child abuse and maltreatment.
PCHs and CAHs shall comply with the provisions of section 405.9(d) of this Title with respect to identification, assessment, reporting and management of cases of suspected child abuse and maltreatment.
(5) Domestic violence.
PCHs and CAHs shall comply with the provisions of section 405.9(e) of this Title with regard to the identification, assessment, treatment and appropriate referral of cases of suspected or confirmed domestic violence.
(6) Discharge/transfer.
Hospitals shall comply with the provisions of section 405.9(i)(1) of this Title concerning discharge/transfer. In addition, PCHs and CAHs shall comply with the following:
(i) in carrying out discharge planning functions, PCHs and CAHs that are members of a rural health network may include as the discharge planning coordinator a member of the network utilization review committee who has appropriate training and experience to perform such duties;
(ii) ensure that discharge planning staff have available current information regarding home care programs, institutional health care providers, and other support services, including their scope of services, admission and discharge policies and payment criteria;
(iii) each removal, transfer or discharge shall be carried out in accordance with written PCH/CAH policy, and, if the facility is a member of a rural health network, network policy. Such policies shall specify referral arrangements and transfer protocols outlining the duties and responsibilities involved in determining the necessity of a transfer and for personnel involved in the transfer and shall be set forth in written agreements between the PCH/CAH and appropriate receiving hospital(s); and
(iv) each patient being removed or discharged shall be provided with information and/or assistance as required for linking the patient with a community based primary care provider.
(c) Incident reporting.
PCHs/CAHs shall comply with the provisions of section 405.8 of this Title regarding incident reporting.
(d) Medical records.
PCHs/CAHs shall comply with the provisions of section 405.10 of this Title regarding medical records.
(e) Request for consent to an anatomical gift.
PCHs/CAHs shall comply with the provisions of section 405.25 of this Title regarding requests for consent to an anatomical gift.
(f) Utilization review.
PCHs/CAHs shall comply with the provisions of section 405.26 of this Title regarding utilization review.
(g) Information policy and other reporting requirements.
PCHs/CAHs shall comply with the provision of sections 86-1.2, 86-1.3 and 400.18 of this Title regarding information policy and other reporting requirements.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.97 Discrete unit
A separately organized, staffed and equipped unit of the institution.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.6 Availability of department records
(a) All records of the department are available for public inspection and copying, except that access may be denied to records or portions thereof that:
(1) are specifically exempted from disclosure by State or Federal statute;
(2) if disclosed would constitute an unwarranted invasion of personal privacy;
(i) an unwarranted invasion of personal privacy includes, but is not limited to;
(a) disclosure of employment, medical or credit histories or personal references of applicants for employment;
(b) disclosure of items involving the medical or personal records of a client or patient in a medical facility;
(c) sale or release of lists of names and addresses if such lists would be used for commercial or fund-raising purposes;
(d) disclosure of information of a personal nature when disclosure would result in economic or personal hardship to the subject party and such information is not relevant to the work of the department or the agency requesting it; or
(e) disclosure of information of a personal nature reported in confidence to the department and not relevant to the ordinary work of the department;
(ii) disclosure is not construed to constitute an unwarranted invasion of personal privacy when:
(a) identifying details are deleted;
(b) the person to whom a record pertains consents in writing to disclosure;
(c) upon presenting reasonable proof of identity, a person seeks access to records pertaining to him/her;
(3) if disclosed would impair present or imminent contract awards or collective bargaining negotiations;
(4) are trade secrets or are maintained for the regulation of commercial enterprise which, if disclosed, would cause substantial injury to the competitive position of the subject enterprise;
(5) are compiled for law enforcement purposes and which, if disclosed, would:
(i) interfere with law enforcement investigations or judicial proceedings;
(ii) deprive a person of a right to a fair trial or impartial adjudication;
(iii) identify a confidential source or disclose confidential information relating to a criminal investigation; or
(iv) reveal criminal investigative techniques or procedures, except routine techniques or procedures;
(6) if disclosed would endanger life or safety of any person;
(7) are inter-agency or intra-agency material which are not:
(i) statistical or factual tabulations or data;
(ii) instructions to staff that affect the public; or
(iii) final agency policy or determination; or
(8) are examination questions or answers which are requested prior to the final administration of such questions.
(b) Nothing in this Subpart shall permit disclosure which constitutes an unwarranted invasion of personal privacy, if such disclosure is prohibited under article 6-A (Personal Privacy Protection Law) of the Public Officers Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.147 Funded reserve
A pension reserve, a reserve for bonuses or for the retirement of preferred stock, or other prospective future liability against which certain assets have been accumulated and set aside or earmarked.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 10.1 Application
These sections shall apply to all establishments where barbering or cosmetology is practiced.
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.25 Shaving brushes, mugs and finger bowls
The use of shaving brushes and shaving mugs is prohibited. The use of finger bowls is prohibited unless a separate sanitary inner paper liner or cup is used for each customer and discarded immediately after use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.10 Required records of tissue acquisition, testing, processing and storage
Each cardiovascular tissue bank shall maintain donation records as required by Subpart 52-2 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.15 Accumulated depreciation
The fixed-asset valuation account resulting from depreciation provisions; also known as reserve for depreciation, accrued depreciation, and allowance(s) for depreciation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.5 Retrieval of tissue
(a) Skin shall be retrieved using aseptic technique in an operating room or other aseptic premises approved by the tissue bank medical director. In all cases, a vigorous surgical scrub and disinfectant solution nontoxic to epithelial cells shall be used in preparing the donation site for skin retrieval in accordance with standard operating room practice.
(b) Retrieval of skin from cadaveric donors shall occur within a time limit after cessation of cardiac function specified in written policies approved by the medical director of the comprehensive tissue procurement service.
(c) If an ante mortem blood sample is not available from a cadaveric donor, a post mortem sample of sufficient quantity to perform required testing shall be drawn via a cardiac insertion or from a large vein or artery.
(d) Skin specimen containers and packaging materials shall be sterile and nontoxic.
(e) Each skin and blood specimen container shall be labeled legibly at the time of retrieval with the tissue bank identification, and donor identification code or unique tissue identification number. The date, time and anatomic site of retrieval shall be recorded on accompanying documents.
(f) Fresh-cut skin shall be maintained in a sterile, isotonic solution or other nutrient medium during the skin removal procedure, and transported to the tissue processing facility at the completion of the procedure.
(g) Skin samples for testing for microbial contamination shall be recovered from each anatomical site and placed in a separate, appropriately labeled container.
(h) Skin and blood specimen containers shall be labeled so as to maintain identification throughout all phases of processing, storage and distribution, in a manner not subject to significant deterioration under conditions of transport and storage.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.1 Pathogenic materials
Unless otherwise permitted by these rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge, of pathogenic materials into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this section that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.4 Claims for cost of care and maintenance
(a) Each resident shall be expected to pay each month from his or her assets, resources or income such amounts on account of the care and maintenance provided by the facility as the State Department of Health shall find to be reasonable. Payments may be paid directly by the resident, or by an agent of the resident, to the home or, if the resident chooses and so authorizes, his entire assets and income may be placed in a joint account with the treasurer of the home for withdrawal by him of the established maintenance charge from the account each month.
(b) Each applicant shall agree, when his or her available resources are insufficient to pay the entire cost of care or maintenance on a current basis, to apply for medical assistance under the New York State Medicaid Program through the New York State Veterans' Home.
(c) Each applicant shall make arrangements satisfactory to the State Department of Health for funeral expenses.
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-3 REQUIREMENTS FOR AUTOCLAVES USED TO TREAT REGULATED MEDICAL WASTE
10 CRR-NY 70-3.3 Generally accepted and alternative operating parameters
(a) Unless other operating parameters have been approved pursuant to subdivision (c) of this section, operating parameters for treating of regulated medical waste in a gravity-feed autoclave shall be:
(1) at least 60 minutes residence time at a temperature at least 121°C and a pressure of 15 pounds per square inch (15 psig); or
(2) at least 45 minutes residence time at a temperature at least 135°C and a pressure of 31 pounds per square inch (31 psig).
(b) Unless other operating parameters have been approved pursuant to subdivision (c) of this section, operating parameters for treating regulated medical waste in a vacuum-displacement autoclave shall be:
(1) at least 45 minutes residence time at a temperature at least 121°C and a pressure of 15 pounds per square inch (15 psig); or
(2) at least 30 minutes residence time at a temperature at least 135°C and a pressure of 31 pounds per square inch (31 psig).
(c) No facility shall treat regulated medical waste using an autoclave at operating parameters other than those prescribed in subdivision (a) or (b) of this section, unless the treatment method has been approved by the department as an alternative treatment technology pursuant to Subpart 70-5 of this Part.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.54 Veterinary radiographic and fluoroscopic installations
(a) Fixed radiographic installations.
(1) Equipment.
(i) The protective tube housing shall be of diagnostic type.
(ii) Collimating devices capable of restricting the useful beam to the area of clinical interest shall be used and shall provide the same degree of protection as is required of the tube housing.
(iii) The X-ray films used as the recording medium during the X-ray examination shall show substantial evidence of cut-off (beam delineation).
(iv) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(v) A device shall be provided which terminates the exposure after a preset time interval or exposure. The exposure switch shall be of the dead-man type and shall be so arranged that it cannot be operated outside a shielded area.
(2) Structural shielding.
(i) Control apparatus for the radiographic equipment shall be located in in an adjacent room or in a fixed booth within the same room provided such booth is composed of radiation shielding to a minimum height of seven feet. The control booth either shall be so arranged that the radiation has to be scattered at least twice before entering the booth, or shall be provided with a protective door that is interlocked in such a way that the X-ray tube(s) cannot be energized unless the door is in the closed position.
(ii) The operator shall be able to see the animal patient by means of a mirror or through a window of lead equivalent sufficient for the required protection and so placed that the operator is always in a shielded position.
(3) Conditions for operation of equipment.
(i) Only persons required for the X-ray procedure shall be in the X-ray room during the exposures.
(ii) When an animal patient must be held in position during exposures, mechanical supporting or restraining devices shall be used. Animal patients or films shall be held only under extreme conditions when clinically necessary. Individuals holding animal patients or films shall wear protective gloves having at least 0.5 mm lead equivalent, a protective apron of at least 0.25 mm lead equivalent, and shall keep all parts of his/her body out of the useful beam. The exposure of any individual used for holding animals shall be monitored. Pregnant women and persons under 18 years of age shall not hold animal patients or films under any conditions.
(b) Portable or mobile radiographic installations.
(1) Equipment.
(i) The protective tube housing shall be of diagnostic type.
(ii) Collimating devices capable of restricting the useful beam to the area of clinical interest shall be used and shall provide the same degree of protection as is required of the tube housing.
(iii) The X-ray film used as the recording medium during the X-ray examination shall show evidence of cut-off (beam delineation).
(iv) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(v) A device shall be provided which terminates the exposure after a preset time interval or exposure.
(vi) A dead-man type of exposure switch shall be provided with a cord sufficiently long so that the operator can stand at least six feet from the animal patient, the X-ray tube, and the useful beam.
(2) Conditions for operation of equipment.
(i) No person shall be regularly employed to support or hold animals or film during X-ray exposures.
(ii) When an animal must be held in position during exposures, mechanical supporting or restraining devices shall be used. Individuals should hold animals only when clinically necessary under extreme conditions. Such individuals shall wear protective gloves having at least 0.5 mm lead equivalent, a protective apron of at least 0.25 mm lead equivalent, and shall keep all parts of his body out of the useful beam. The exposure of any individual used for holding animals shall be monitored. Fertile women and individuals under 18 years of age shall not hold animals under any conditions.
(c) Fluoroscopic installations.
(1) Equipment.
(i) The protective tube housing shall be of diagnostic type.
(ii) Equipment shall be so constructed that the entire cross section of the useful beam is always intercepted by a primary protective barrier (usually a lead glass screen or image intensifier assembly) irrespective of the panel screen distance. For conventional fluoroscopes, this requirement may be assumed to have been met if, when the collimating system is opened to its fullest extent, an unilluminated margin is left on all edges of the fluorescent screen regardless of the position of the screen during use.
(a) Collimaters, and adjustable diaphragms, or shutters used to restrict the size of the useful beam shall provide the same degree of protection as is required of the tube housing.
(b) The exposure shall automatically terminate when the barrier is removed from the useful beam.
(c) With the fluorescent screen 14 inches from the panel of the tabletop, the exposure rate two inches beyond the viewing surface of the screen shall not exceed 30 mR/hr for each roentgen per minute at the tabletop with the screen in the useful beam without a patient and with the fluoroscope operating at the highest potential employed.
(iii) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(iv) The fluoroscopic exposure switch shall be of the dead-man type.
(v) Mobile fluoroscopic equipment is subject to the following additional requirements:
(a) in the absence of a tabletop, a cone or spacer frame shall limit the source-to-skin distance to not less than 12 inches;
(b) image intensification shall always be provided;
(c) it shall be impossible to operate a machine unless the useful beam is intercepted by the image intensifier.
(2) Conditions for operation of equipment.
(i) Protective gloves and aprons of at least 0.25 mm lead equivalent each shall be made available and shall be worn by the fluoroscopist during every examination.
(ii) Unless measurements indicate that they are not needed protective gloves and protective aprons of at least 0.25 mm lead equivalent each shall be worn by the physician, nurse, technician and all other persons within the fluoroscopic room.
(iii) Only persons needed in the fluoroscopic room shall be present during the exposure.
(iv) The fluoroscopic room shall be free of extraneous light that interferes with the examination.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 135 OSWEGO COUNTY
10 CRR-NY 135.1 Village of Central Square
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well located on land owned by the village of Central Square and situated approximately 1,500 feet northeast of the center of the village on the Mallory Road and which forms the source of the public water supply of the village of Central Square, Oswego County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) [Privies.]
(1) No privy, privy vault, pit, cesspool or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain upon, and no garbage, putrescible matter, kitchen or sink wastes, manure or any polluted water or liquid of any kind shall be thrown or discharged upon the property owned by the village of Central Square surrounding the well which is the source of water supply.
(2) No privy, privy vault, pit, cesspool or other receptacle which is not watertight, placed or used for the permanent or temporary deposit of human excreta, shall be located closer than 200 feet from the well which is the source of the public water supply of the village of Central Square.
(d) [Sewage.]
No sewer used to conduct sewage, kitchen wastes or polluted water of any kind shall be located or maintained within 150 feet of the well, which is the source of water supply of the village of Central Square, and all sewers located or maintained at less than 200 feet of the well, which is the source of water supply of the village of Central Square, shall be constructed of cast iron pipe laid with watertight joints.
(e) [Trespassing.]
No trespassing shall be allowed upon the property of the village of Central Square upon which the well of the public water supply of the village is located, and no person or persons shall enter in or upon such property except duly authorized officials of the village of Central Square or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Central Square.
(f) [Inspections.]
The board of trustees of the village of Central Square or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Central Square or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(g) [Penalty.]
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.6 Variances
(a) The commissioner may on written application grant a variance from a specific provision of this Part in a particular case, subject to appropriate conditions, where such variance is in harmony with the general purpose and intent of this Part.
(b) The commissioner may impose more stringent requirements in a specific case when necessary to assure an adequate and satisfactory water supply and sewerage facility for the subdivision.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.6 Deferral and waiver
(a) Deferrals.
The commissioner may delay or defer the service obligation start date, the service obligation and/or the repayment obligation of a recipient due to extreme hardship, or to permit the recipient to continue training in primary care specifically approved by the commissioner. Extreme hardship includes, but is not limited to, serious illness or injury of the recipient or a member of the recipient's immediate family or other circumstances beyond the control of the recipient that would make it extremely difficult or impossible for the recipient to fulfill the service obligation or repayment requirements.
(b) Waiver.
The commissioner may waive all or part of the service obligation and/or any repayment obligation incurred by a recipient due to extreme hardship.
(c) Evidence of hardship.
A request for a deferral or waiver of a service or repayment obligation must be submitted in writing on forms prescribed by the commissioner. The commissioner may request sworn statements and appropriate documentation to support the recipient's request.
(d) Notice.
The commissioner will notify the president of any service or repayment obligation deferrals or waivers.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.4 Definitions
For the purposes of this Part:
(a) Behavioral health care means care and treatment of mental illness and/or substance use disorders.
(b) Diagnostic and treatment center means a medical facility as defined in section 751.1 of this Title or an extension clinic as defined in section 401.1(g) of this Title.
(c) Governing authority means the entity that substantially controls the operator or provider of services to which a State licensing agency has issued an operating certificate. The governing authority is the body possessing the right to appoint and remove directors or officers, to approve bylaws or other organizational documents, to approve strategic or financial plans for a provider of services, or to approve operating or capital budgets for a provider of services.
(d) General hospital outpatient program means a distinct part or unit within a general hospital as defined by section 2801(10) of the Public Health Law through which outpatient services, other than hospital-based ambulatory surgery services, are provided.
(e) Host site means a single outpatient site at which a provider who is licensed or certified by the Department of Health, the Office of Mental Health or the Office of Alcoholism and Substance Abuse Services is approved to provide integrated care services pursuant to this Part.
(f) Integrated care services means the systematic coordination of evidence-based physical and behavioral health care in clinics licensed by one or more State licensing agencies in order to promote health and better outcomes, particularly for populations at risk.
(g) Integrated services provider means a provider holding multiple operating certificates or licenses to provide outpatient services, who has also been authorized by a commissioner of a State licensing agency to deliver identified integrated care services at a specific site in accordance with the provisions of this Part.
(h) Medical director is a physician who is responsible for the medical services provided by the integrated services provider, for the overall direction of the medical procedures provided and the direct supervision of medical staff in the performance of medical services.
(i) Outpatient services means clinic services provided by a diagnostic and treatment center or general hospital outpatient program pursuant to PHL article 28, a mental health clinic licensed pursuant to MHL article 31, or a substance use disorder clinic certified pursuant to MHL article 32.
(j) Primary care services means services provided by a physician, nurse practitioner, or midwife acting within his or her lawful scope of practice under title VIII of the Education Law and who is practicing primary care.
(k) State licensing agency means the State agency with statutory authority to license or certify a provider of outpatient services and designated in accordance with the provisions of this Part with responsibility to monitor compliance by an integrated services provider with the provisions of this Part. State licensing agency is limited to the Department of Health, the Office of Mental Health, or the Office of Alcoholism and Substance Abuse Services, as applicable.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.6 Definitions and sources of statistics for Medicaid cost allocation
| | Statistic | Definition or Method of Computation | Source | | --- | --- | --- | --- | | (a) OTHER OPERATING EXPENSES | | | | | (1) | Assigned Time— Nursing Education | Number of hours worked by enrolled nursing students (RN or LPN) by assigned program service area. | Education curriculum and work records | | (2) | Assigned Time— Post Grad. Med. Ed. (Approved Program) | Number of hours worked on premises by interns and residents in the approved postgraduate medical education programs by assigned cost center. Outside time is excluded. | Education curriculum and work records | | (3) | Assigned Time— Post Grad. Med Ed. (Non-Approved Prog.) | Number of hours worked on premises by interns and residents in the non-approved postgraduate medical education programs by assigned cost center. Outside time is excluded. | Education curriculum and work records | | (4) | Time spent— Social Work Services | Number of hours utilized by social workers handling specific patient's needs, by program service area to which the patients are assigned. Time spent not related to a specific patient is not to be counted. | Departmental records or Time Study | | (5) | Number of rooms Occupied by Dept. Assigned— Housing | The average number of rooms rented to hospital employees, non-paid workers and students participating in education programs carried on by the hospital by department to which the personnel are assigned. Exclude common areas (i.e., recreation room) in the room count. A monthly census as of the last day of every month must be taken and averaged for the year. | Personnel and General Accounting records | | (6) | Net Square Feet Maintained— Plant Maintenance | For each cost center for which maintenance is provided, allocate based upon the total net square feet of the cost center maintained. Net square feet is defined as: The interior square feet in each functional cost center of the hospital determined by either a physical measurement of the hospital or a measurement from blueprints. Floor area measurements must be taken from the center of interior walls to the center of adjoining corridors, if such corridors service more than one cost center. Exclude stairwells, elevators, and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only one cost center must be included in that cost center. When changes in area have been made during the year as a result of new construction, cost center relocation, expansion or contraction, statistical data must be maintained to allow for the development of "weighted" areas for the fractional part of the year. For example, the addition or deletion of 1200 square feet for a six-month period would be an adjustment of 600 square feet; where the same area serves more than one functional cost center, this area must be apportioned between or among the appropriate functions. | Blueprints of the Hospital plant or actual measurement if blueprints are not available | | (7) | Net Square Feet—Plant Operation, Energy, Security, and Parking, Plant Operation & Maintenance | Net square feet by department is defined as follows: The interior square feet in each functional cost center of the hospital determined by either a physical measurement of the hospital or a measurement from blueprints. Floor area measurements must be taken from the center of interior walls to the center of adjoining corridors, if such corridors service more than one cost center. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc.. serving only one cost center must be included in that cost center. When changes in area have been made during the year as a result of new construction, cost center relocation, expansion or contraction, statistical data must be maintained to allow for the development of "weighted" areas for the fractional part of the year. For example, the addition or deletion of 1200 square feet for a six-month period would be an adjustment of 600 square feet; where the same area serves more than one functional cost center, this area must be apportioned between or among the appropriate functions. | Blueprints of the Hospital plant or actual measurement if blueprints are not available | | (8) | Assigned Time— Housekeeping | Scheduled housekeeping hours of service to be spent in maintaining cleanliness and sanitation of each functional cost center. Hours to be spent cleaning general and unused areas must be excluded. | Housekeeping Cost Center records | | (9) | Assigned Time— Other Health Professional Ed. | Number of hours worked on premises by health profession student, excluding RN, LV(P)N, intern and resident students, by assigned cost centers. | Education curriculum and work records | | (10) | Patient Meals Served— Dietary Services | Number of patient meals served shall include only regular scheduled meals and exclude snacks and fruit juices served between regular scheduled meals. | Actual count maintained by Dietary Services cost center | | (11) | Adjusted F.T.E. Employees— Non-Patient Food Service | Divide the total annual paid hours (including vacation, sick leave and overtime) for all those employees for whom the cafeteria is available for use by cost center by 40 hours; divide the result by 52. If employees are paid for unused sick leave, exclude the hours so paid from the calculation. Please round to nearest tenth of an F.T.E. only. | Payroll or Personnel Records | | (12) | Dry and Clean Pounds Distributed— Laundry and Linen | The weight of linen processed plus the equivalent weight of disposable linen substitutes used. Include uniforms and linen from Personnel quarters and employee housing. If linen is not weighed, a conversion from pieces to pounds is allowed. If soiled linen is weighed, divide by 1.1. | Actual count maintained by the Laundry and Linen Dept. | | (13) | Costed requisitions and Cost of Sales— Central Services and Supply | Central Services Costed requisitions means: Total dollar amount (based on invoice cost) of nonchargeable supplies transferred from the central services and supplies cost center to each using cost center. Central Services Cost of Sales means: The invoice cost of all supplies sold to patients and others regardless of the issuing cost center. | Copies of cost center requisitions or other documentation | | (14) | Costed Requisitions ad Cost of Sales— Pharmacy | Pharmacy costed requisitions means: Total dollar amount (based on invoice cost) of nonchargeable pharmaceutical items transferred from the Pharmacy Cost Center to each using cost center Pharmacy Cost of Sales means: The invoice cost of all pharmaceutical items sold to patients and others regardless of issuing cost center. | Copies of cost center requisitions or other documentation | | (15) | Accumulated Cost—General Accounting; Patient Accounting; Admitting and Registration; Hospital Administration; Insurance— Malpractice; Insurance— Other; Licenses and Taxes; Interest— Short-Term | To be generated through computer software. Nothing is to be reported. | Not Applicable | | (16) | Direct Cost of Supplies Expensed— Purchasing and Stores | Total direct cost of medical and surgical supplies (natural classification.40) and nonmedical and nonsurgical supplies (natural classification.50) by cost center, as reclassified, excluding pharmacy (accounts 8470 and 7150), patient dietary service (account 8310), and non-patient food services (account 8320). | General Accounting records | | (17) | Hours of Service— Medical Records | Accumulated hours of service to program service centers. If this is unavailable, a questionnaire time survey may be used. | Departmental records or Time Study | | (18) | Percent of Effort— Medical Staff Administration | Percent of time spent by the Chief of Medical Staff in the ancillary or program service areas for which he has responsibility. | Time Study | | (19) | Professional Component by Cost Center Assigned— Medical Staff Services | Using the calculations made to generate the reclassification necessary to create this cost center, distribute costs back to the appropriate ancillary or program service area from which the physician cost arose (i.e., Radiology, Laboratory, Emergency Room, etc.). | General Accounting records | | (20) | Number of Discharges— Medical Care Review | The number of patients discharges from the Hospital accumulated by program service centers, excluding routine newborn. | Medical Records or statistical reports | | (21) | Hours of Total Direct Nursing Service— Nursing Administration | Actual hours worked of nurses for which administration is provided by assigned area. | Personnel, Payroll or Departmental records | | (22) | Dollars of Depreciation/ Amortization by Cost Center— Depreciation &Amortization (Fixed Assets). Refer to subdivision (c) of this section for an example. | The depreciation expense related to each building (or wing) distributed through square feet to departments in that building (or wing) (resulting statistic reported as a weighted statistic, dollars of depreciation). The square feet used to distribute the expense is Net Square Feet by building (or wing) defined as follows: The interior square feet in each functional cost center of the hospital determined by either a physical measurement of the hospital or a measurement from blueprints. Floor area measurements must be taken from the center of interior walls to the center of adjoining corridors, if such corridors service more than one cost center. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc. serving only one cost center must be included in that cost center. When changes in area have been made during the year as a result of new construction, cost center relocation, expansion or contraction, statistical data must be maintained to allow for the development of "weighted" areas for the fractional part of the year. For example, the addition or deletion of 1200 square feet for a six-month period would be an adjustment of 600 square feet; where the same area serves more than one functional cost center, this area must be apportioned between or among the appropriate functions. | General Accounting records and blueprints of the Hospital plant or actual measurement of blueprints are not available | | (23) | Dollars of Lease/Rent by Cost Center— Leases and Rentals (Fixed Assets). Refer to subdivision (c) of this section for an example. | The lease and rental expense related to each building (or wing) distributed through square feet to departments in that building (or wing) (resulting statistic reported is a weighted statistic, dollars of rentals and leases). The square feet used to allocate the expense is Net Square Feet by building (or wing) defined as follows: The interior square feet in each functional cost center of the hospital determined by either a physical measurement of the hospital or a measurement from blueprints. Floor area measurements must be taken from the center of interior walls to the center of adjoining corridors, if such corridors service more than one cost center. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only one cost center must be included in that cost center. When changes in area have been made during the year as a result of new construction, cost center relocation, expansion or contraction, statistical data must be maintained to allow for the development of "weighted" areas for the fractional part of the year. For example, the addition or deletion of 1200 square feet for a six-month period would be an adjustment of 600 square feet; where the same area serves more than one functional cost center, this area must be apportioned between or among the appropriate functions. | General Accounting records and blueprints of the Hospital plant or actual measurement if blueprints are not available | | (24) | Dollars of Depreciation by Cost Center— Depreciation & Amortization— Movable Equipment. Refer to subdivision (c) of this section for an example. | The cost of depreciation on movable equipment must be allocated to the functional cost center utilizing that equipment. Where the cost center of depreciation on movable equipment is utilized by two or more functional cost centers, the depreciation must be allocated between the cost centers based upon cost center usage. | Plant Ledger records | | (25) | Dollars of Lease/Rent by Cost Center— Leases and Rentals— Movable Equipment. Refer to subdivision (c) of this section for an example. | The cost of leases/rentals on movable equipment must be allocated to the functional cost center utilizing the equipment. Where the cost of leases/rentals on movable equipment is utilized by two or more functional cost centers, the lease/rent must be allocated between the cost centers based upon cost center usage. | General Accounting records and Lease/ Rent Agreements | | (26) | F.T.E. Employees— Employee Benefits— Non-Payroll-Related | Divide the total annual paid hours (including vacation, sick leave and overtime) for all employees by cost center by 40 hours; divide the result by 52. If employees are paid for unused sick leave, exclude the hours so paid from the calculation. Please round to nearest tenth of an F.T.E. only. | Payroll or Personnel records | | (27) | Dollars of Interest by Cost Center— Interest— Long-term. Refer to subdivision (c) of this section for an example. | The interest expense related to capital debt will be allocated through square feet to departments in the building (or wing) for which the debt was incurred (weighted statistic, dollars of interest). The square feet used to allocate the expense is Net Square Feet by building (or wing) defined as follows: The interior square feet in each functional cost center of the hospital determined by either a physical measurement of the hospital or a measurement from blueprints. Floor area measurements must be taken from the center of interior walls to the center of adjoining corridors, if such corridors service more than one cost center. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. Hallways, waiting rooms, storage areas, etc. serving only one cost center must be included in that cost center. When changes in area have been made during the year as a result of new construction, cost center relocation, expansion or contraction, statistical data must be maintained to allow for the development of "weighted" areas for the fractional part of the year. For example, the addition or deletion of 1200 square feet for a six-month period would be an adjustment of 600 square feet; where the same area serves more than one functional cost center, this area must be apportioned between or among the appropriate functions. | General Accounting records and blueprints of the Hospital plant or actual measurement if blueprints are not available | | (28) | Time Spent— Medical Photography and Illustration | The number of hours utilized by another functional cost center of personnel in the Medical Photography and Illustration cost center. | Departmental records or Time Study | | (b) ANCILLARY SERVICES | | | | | (1) | Number of Procedures— Labor and Delivery Services | Refer to the definition of the Standard Unit of Measure in section 444.20(a) of this Article. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (2) | Surgery Minutes— Surgery Services | Refer to the definition of the Standard Unit of Measure in section 444.20(b)(1) of this Article. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (3) | Recovery Minutes— Recovery Services | Refer to the definition of the Standard Unit of Measure in section 444.20(b)(2) of this Article. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (4) | Anesthesia Minutes— Anesthesiology | Refer to the definition of the Standard Unit of Measure in section 444.20(b)(3) of this Article. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (5) | Departmental Gross Charges— Medical Supplies Sold; Durable Medical Equipment—Sold; Durable Medical Equipment— Leased/Rented; Drugs Sold; Cardiac Catheterization Laboratory; Respiratory Therapy; Speech/Language Pathology Audiology; Psychiatric/Psychological Services | Report gross charges for the specific department by the required program service areas. All-inclusive rate hospitals have the option of using the Standard Units of measure for the applicable functional cost center reported by the required program service areas in lieu of Departmental Gross Charges, if charges are not available. | General accounting records | | (6) | C.A.P. Workload—Laboratory Services— Clinical; Laboratory Services— Pathological; Whole Blood and Packed Red Cells; Electrocardiology; Pulmonary Function Testing | Most recent College of American Pathologists Workload Measurement Unit Manual. Refer to subdivisions (e), (f) and (j) of section 444.20 of this Article for a further definition of the Standard Unit of Measure. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (7) | California R.V.U.—Radiology —Diagnostic; Radiology— Therapeutic; Nuclear Medicine; Neurology—Diagnostic | California Medical Association, 1974 California Relative Value Studies. Refer to the definitions of the Standard Units of Measure in section 444.20(h)(1), (h)(3), (h)(4) and (k) of this Article. Report this statistic by the required program service areas. | Department records or Statistical reports | | (8) | Number of Procedures —C.T. Scanner | Refer to the definition of the Standard Unit of Measure in section 444.20(h)(2) of this Article. Report this statistic by the required program service areas. | Departmental records or Statistical reports | | (9) | American Physical Therapy Association R.V.U. —Physical Therapy | Refer to the definition of the Standard Unit of Measure in section 444.20(l)(1) of this Article for Physical Therapy (account 7530). Report this Statistic by the required program service areas. | Departmental records or Statistical reports | | (10) | American Occupational Therapy Association R.V.U.—Occupational Therapy | Refer to the definition of the Standard Unit of Measure in section 444.20(l)(2) of this Article for Occupational Therapy (account 7530). Report this statistc by the required program service areas. | Departmental records or Statistical reports | | (11) | Assigned Time —Recreational Therapy | Number of hours worked by Recreational Therapists with patients, by program service to which patients are assigned. | Departmental records | | (12) | Number of Treatments— Other Physical Medicine | Refer to the definition of the Standard Unit of Measure in section 444.20(l)(6) of this Article. Report this Statistic by the required program service area. | Departmental records or Statistical reports | | (13) | Number of Treatments— Renal Dialysis | Refer to the definition of the Standard Unit of Measure in section 444.20(m) of this Article. Report this statistic by the required program service area. | Departmental records or Statistical reports | | (14) | Provider Specify—Other Ancillary Services | If a provider has a specific ancillary service that they feel is not provided for above, a complete description of that service along with a proposed Cost Allocation Statistic should be submitted to OHSM for prior approval (prior means six months before a fiscal year ends). | Departmental records or Statistical reports |
(c) EXAMPLE
(1) Wherever dollars are required as the Cost Allocation Base, the intent is to accomplish the allocation of the applicable mandatory zero-level account's cost through the direct expensing of that cost. For example, if the direct expense of Interest—Long-Term (account 8880) contains interest related to two long-term financing agreements, one related to the purchase of a C.T. Scanner and one related to a new addition, the method to be used in structuring the statistics—Dollars of Interest—is illustrated in the following paragraphs.
(2) Procedure outline.
(i) Allocate interest on the new addition on the basis of Net Square Feet, within the new addition.
(ii) Allocate interest on the C.T. Scanner directly to the C.T. Scanner cost center (account 7340).
(iii) Combine the results of the above producing the statistic Dollars of Interest, as illustrated below.
(3) Calculations.
| (i) | Cost Center | (1) Interest on addition | (2) Interest on C.T. Scanner | (1 + 2) Statistic Reported | | --- | --- | --- | --- | --- | | | Laboratory— | | | | | | Clinical | 15,000 | — | 15,000 | | | Pathological | 20,000 | — | 20,000 | | | Dietary | 10,000 | — | 10,000 | | | Nuclear Medicine | 50,000 | — | 50,000 | | | C.T. Scanner | 5,000 | 20,000 | 25,000 | | | TOTAL | 100,000 | 20,000 | 120,000 |
(ii) The interest on the addition is distributed on Net Square Feet in the addition, as follows:
| Cost Center | Square Feet | Percent | Expense Distribution | | --- | --- | --- | --- | | Laboratory— | | | | | Clinical | 1,500 | 15 | 15,000 | | Pathological | 2,000 | 20 | 20,000 | | Dietary | 1,000 | 10 | 10,000 | | Nuclear Medicine | 5,000 | 50 | 50,000 | | C.T. Scanner | 500 | 5 | 5,000 | | TOTAL | 10,000 | 100 | 100,000 |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.5 Alternative pricing methods
Alternative pricing methods are not permitted except for package prices which are agreed upon between the funeral firm and a governmental agency, or between the funeral firm and a not-for-profit corporation for members of the corporation or other persons whose interests are represented by the corporation. The itemization requirements of Part 78 of this Title must be complied with and if an alternative pricing method is selected by the person making arrangements, the charges must be listed and provided to the person on an itemization statement which complies with Part 78. Package prices must be broken down and listed by their component parts on the itemization statement except for the "Alternative Services" and the "Limited Services" in section 79.4(e)(1) and (10) of this Part.
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.4 Funeral service schools
(a) Approval procedure.
(1) Any school offering a curriculum in funeral service education may make application for approval on a form provided by the department and shall remit the fee prescribed by law.
(2) Any school applying for approval shall supply all data necessary for a complete evaluation of its administration, curriculum, physical facilities, faculty, and such other information as the department may require.
(3) A certificate of approval shall be issued to a school maintaining standards satisfactory to the department.
(4) The department may grant full approval, provisional approval, limited approval or conditional approval.
(5) Approval shall be on a fiscal-year basis, starting April 1st of each year and terminating the following March 31st. The certificate of approval issued to any school by the department during a fiscal year shall expire at the end of that fiscal year. Application for renewal of approval in any year shall be made not later than 60 days prior to the beginning of the new fiscal year. Each school shall remit with the renewal application such fee as is prescribed by law.
(6) The department may, in lieu of the approval procedures contained in paragraphs (1)-(3) and (5) of this subdivision, accept the certification of accreditation issued by an accrediting organization recognized by the department, or the department may conduct its own examination and evaluation to determine the degree of compliance by the school of the rules, regulations and standards of the accrediting agency.
(7) Approval of a school for funeral service education may be withdrawn by the department for any violation of this Part or of the provisions of the Public Health Law or other statutes pertaining to funeral directing, or the rules, regulations and standards of the accrediting agency. When charges of violation are brought to the attention of the department, the affected school shall be notified in writing of the alleged violations, and shall be given an opportunity to be heard on the charges. If, after hearing, the school shall be found guilty of the violations, the certificate of approval may be withdrawn by order of the commissioner served personally or by mail on the school.
(8)
(i) A school whose approval has been withdrawn shall not be eligible for a new approval until such time as the school has corrected all conditions specified in the withdrawal order.
(ii) Reports. Each approved school shall report in writing to the department the name and address of each student enrolled in the funeral service course who has expressed an intention to apply for a funeral director license in the State of New York. Upon graduation, a certification of graduation, together with a transcript of grades and attendance records, shall be forwarded by the school to the department within 20 days after graduation.
(iii) Students. A student, enrolled in the funeral service course of an approved school, who enters active service in the Armed Forces of the United States of America, may continue his academic studies, provided such student registers within one year after the date of the honorable termination of his initial term of such active service, but credit for studies prior to his entry therein shall be at the discretion of the school administrator.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.18 Daily hospital services expenses description
[ 3250 ]
(a) Acute care.
[ 3251 ]
(1) 6010
MEDICAL/SURGICAL ACUTE
(i) Function. Medical/Surgical Acute Care Units provide care to patients on the basis of physicians' orders and approved nursing care plans. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Medical/Surgical acute patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(2) 6170 PEDIATRIC ACUTE
(i) Function. Pediatric Acute Care Units provide care to Pediatric patients (children less than 14 years) in Pediatric nursing units on the basis of physicians' orders and approved nursing care plans. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing the patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Pediatric patients. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients less than 14 years admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(3) 6210 PSYCHIATRIC ACUTE
(i) Function. Psychiatric Acute Care Units provide care to patients admitted for diagnosis as well as treatment on the basis of physicians' orders and approved nursing care plans. The units are staffed with nursing personnel specially trained to care for the mentally ill, mentally disordered, or other mentally incompetent persons. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Psychiatric patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(4) 6250 OBSTETRICS ACUTE
(i) Function. The provision of care to the mother following delivery on the basis of physicians' orders and approved nursing care plans is provided in the Obstetrics Acute Care Unit. Additional activities include, but are not limited to, the following:
Instructing of mothers in postnatal care and care of the newborn; serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids including, I.V. s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Obstetrics patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(5) DEFINITIVE OBSERVATION.
(i) Function. Definitive Observation is the delivery of care to patients requiring care more intensive than that provided in the acute care areas, yet not sufficiently intensive to require admission to an intensive care area. Patients admitted to this cost center are generally transferred there from an intensive care unit after their condition has improved. The unit is staffed with specially trained nursing personnel and contains monitoring and observation equipment for intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing dressings and cleansing wounds and incisions; observing and recording emotional stability or patients; assisting in bathing patients and helping into and out of bed; observing patients for reactions to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Definitive Observation patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(6) 6290 OTHER ACUTE CARE
(i) Function. Other Acute Care Units provide acute care to patients on the basis of physicians' orders and approved nursing care plans. Included are those units not required to be included in other specific Acute Care cost centers such as detoxification care (chemical dependency). Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Other Acute Care patients not required to be included in other specific Acute Care cost centers. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(b) Intensive care. [ 3252 ]
(1) 6310 MEDICAL/SURGICAL INTENSIVE CARE
(i) Function. A Medical/Surgical Intensive Care Unit provides patient care of a more intensive nature than that provided to the Medical and Surgical Acute patients. The unit is staffed with specially trained nursing personnel and contains monitoring and specialized support equipment for patients who, because of shock, trauma or threatening conditions, require intensified comprehensive observation and care. Additional activities include, but are not limited, to the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V s and blood; answering of patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing intensive daily bedside care to Medical/Surgical Intensive Care patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(2) 6330
CORONARY CARE
6331
Myocardial Infarction
6332
Pulmonary Care
6333
Heart Transplant
6339
Other Coronary Care
(i) Function. The delivery of care of a more specialized nature than that provided to the usual Medical, Surgical and Pediatric patient is provided in the Coronary Care Unit. The unit is staffed with specially trained nursing personnel and contains monitoring and specialized support or treatment equipment for patients who, because of heart seizure, open heart surgery or threatening conditions, require intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. These cost centers contain the direct expenses incurred in providing intensive daily bedside care to Coronary Care patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to each of these units. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(3) 6350 PEDIATRIC INTENSIVE CARE
(i) Function. A Pediatric Intensive Care Unit provides care to children less than 14 years of age of a more intensive nature than the usual Pediatric Acute level. The units are staffed with specially trained personnel and contain monitoring and specialized support equipment for patients who, because of shock, trauma, or threatening conditions, require intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing of equipment and assisting of physicians during patient examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Pediatric Intensive Care patients. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(4) 6370 NEO-NATAL INTENSIVE CARE
(i) Function. A Neo-Natal Intensive Care Unit provides care to newborn infants that is of a more intensive nature than care provided in Newborn Acute Units. Care is provided on the basis of physicians' orders and approved nursing care plans. The units are staffed with specially trained nursing personnel and contain specialized support equipment for treatment of those newborn infants who require intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Feeding infants; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment needed for this function; preparing equipment and assisting physicians during infant examination and treatment; changing dressings or assisting physicians in changing dressings and cleansing wounds and incisions; bathing infants; observing patients for reactions to drugs; and administering specified medication; infusing fluids, including I.V.'s and blood.
(ii) Description. This cost center contains the direct expenses incurred in providing intensive daily bedside care to Neo-Natal Intensive Care patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(5) 6380 BURN CARE
(i) Function. A Burn Care Unit provides care to severely burned patients that is of a more intensive nature than the usual acute nursing care provided in medical and surgical units. Burn units are staffed with specially trained nursing personnel and contain specialized support equipment for burn patients who require intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment needed for this function; preparing equipment and assisting physicians during patient examination and treatment; changing dressings and cleansing wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping them into and out of bed; observing patients for reactions to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering patients' call signals; and keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing intensive daily bedside care to Burn Care patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(6) 6390 PSYCHIATRIC INTENSIVE CARE
(i) Function. Psychiatric Intensive Care Units provide care to psychiatric patients which is of a more intensive nature than the usual nursing care provided in Psychiatric Acute Units. The units are staffed with specially trained nursing personnel and contain monitoring and specialized support equipment for patients who, because of shock, trauma, or threatening conditions, require intensified, comprehensive observation and care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Psychiatric Intensive Care patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(7) 6410
OTHER INTENSIVE CARE I
6420
OTHER INTENSIVE CARE II
6430
OTHER INTENSIVE CARE III
(i) General. Three zero level accounts have been established for this function to provide for the reporting of each discrete Other Intensive Care Unit separately. The designations I, II, and III do not represent levels of care. The function, description, standard unit of measure, and data source that follow apply equally to each zero level account.
(ii) Function. Other Intensive Care Units provide patient care of a more intensive nature than that provided to the Medical and Surgical Acute patients. The unit is staffed with specially trained nursing personnel and contains monitoring and specialized support equipment for patients who require intensified comprehensive observation and care. Included are those units not required to be included in other specific intensive care cost centers. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment related to this function; preparing equipment and assisting physicians during patient examination and treatment; changing dressings and cleansing wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; infusing fluids including I.V.'s and blood; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(iii) Description. This cost center contains the direct expenses incurred in providing intensive daily bedside care to Other Intensive Care patients in those units not required to be included in other specific Intensive Care cost centers. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iv) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(v) Data source. The number of patient days shall be taken from daily census counts.
(vi) Effective dates. The reporting of Other Intensive Care II (account 6420) and Other Intensive Care III (account 6430) is optional for reporting periods beginning in 1980. For reporting periods beginning in 1981 and thereafter, the reporting of these accounts is required.
(c) Nursery
[ 3253 ]
(1) 6510 NEWBORN NURSERY
(i) Function. Daily care for newborn infants (including “Boarder” babies) is provided in Newborn Nursery units on the basis of physicians' orders and approved nursing care plans. Additional activities include, but are not limited to, the following:
Feeding infants; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment related to this function; preparing equipment and assisting physicians during infant examination and treatment; changing or assisting physicians in changing dressings and cleansing wounds and incisions; bathing infants; observing patients for reaction to drugs; administering specified medication; infusing fluids, including I.V.'s and blood.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Newborn Nursery patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of newborn patient days. Report patient days of care for all infant patients (including “boarder” babies) admitted to this unit. Include the day of admission but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one newborn patient day.
(iv) Data source. The number of newborn nursery patient days shall be taken from daily census counts.
(2) 6520 PREMATURE NURSERY
(i) Function. Daily care for premature infants (infants born at any time through the 37th week of gestation [259 days]) is provided in these nursery units on the basis of physicians' orders and approved nursing care plans. Additional activities include, but are not limited to, the following:
Feeding infants; collecting sputum, urine and feces samples; monitoring vital life signs; operating specialized equipment needed for this function; preparing equipment and assisting physicians during infant examination and treatment; changing dressings or assisting physicians in changing dressings and cleansing wounds and incisions; bathing infants; observing patients for reactions to drugs; administering specified medication; infusing fluids, including I.V.'s and blood.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to Premature Nursery Patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of premature patient days. Report patient days of care for all infant patients admitted to this unit. Include the day of admission but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one newborn patient day.
(iv) Data source. The number of premature patient days shall be taken from daily census counts.
(d) Sub-acute care.
[ 3254 ]
(1) 6610
SKILLED NURSING CARE—MEDICARE OR MEDICARE/MEDICAID CERTIFIED
(i) Function. This unit is certified to participate in the Medicare program or is certified to participate in both the Medicare and Medicaid programs as a skilled nursing facility that is a distinct part of a hospital or a separate cost entity in a hospital in accordance with the regulatory definitions for participation in and provision of services under these programs. Skilled Nursing Care is provided to patients on the basis of physicians' orders and approved nursing care plans and consists of care in which the patients require convalescent and/or restorative services at a level less intensive than the Medical, Surgical and Pediatric acute care requirements. This center is sometimes referred to as Extended Care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patients' examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to patients requiring extended skilled nursing care usually lasting 30 days or more. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(v) Effective dates. Reporting periods beginning in 1980 and thereafter.
(2) 6620
SKILLED NURSING CARE—MEDICAID-CERTIFIED
(i) Function. This unit is certified to participate in the Medicaid program as a distinct part of a hospital or a separate cost entity in a hospital in accordance with the regulatory definitions for participation in Medicaid. It is not certified for participation in Medicare. Skilled Nursing Care is provided to patients on the basis of physicians' orders and approved nursing care plans, and consists of care in which the patients require convalescent and/or restorative services at a level less intensive than the Medical, Surgical and Pediatric acute care requirements. This center is sometimes referred to as Extended Care. Additional activities include, but are not limited to, the following:
Serving and feeding of patients; collecting of sputum, urine and feces samples; monitoring of vital life signs; operating of specialized equipment related to this function; preparing equipment and assisting physicians during patients' examination and treatment; changing of dressings and cleansing of wounds and incisions; observing and recording emotional stability of patients; assisting in bathing patients and helping into and out of bed; observing patients for reaction to drugs; administering specified medication; answering patients' call signals; keeping patients' rooms (personal effects) in order.
(ii) Description. This cost center contains the direct expenses incurred in providing daily bedside care to patients requiring extended skilled nursing care usually lasting 30 days or more. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(v) Effective date. Reporting periods beginning in 1980, and thereafter.
(3) 6630 PSYCHIATRIC LONG-TERM CARE
(i) Function. Medical care, nursing services, and intensive supervision of chronically mentally ill, mentally disordered, or other mentally incompetent persons is rendered in the Psychiatric Long-Term Care Unit.
(ii) Description. This cost center contains the direct expenses incurred in providing daily care to Psychiatric Long-Term patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(4) 6640
TUBERCULOSIS LONG-TERM CARE
(i) Function. Tuberculosis Long-Term Care is provided to tuberculosis patients on the basis of physicians' orders and approved nursing care plans. The care is provided at a level less intensive than acute care requirements.
(ii) Description. This cost center contains the direct expenses incurred in providing daily services to patients requiring tuberculosis long-term care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(v) Effective date. Reporting periods beginning in 1980 and thereafter.
(5) 6650
INTERMEDIATE CARE—MENTALLY RETARDED
(i) Function. Intermediate Care—Mentally Retarded is the provision of supportive, rehabilitative, restorative and preventive health services in conjunction with a socially oriented program for patients with psychiatric or developmental impairment, and the maintenance and operation of 24-hour services including room, personal care, and continuous nursing service under the direction of a professional nurse.
(ii) Description. This cost center contains the direct expenses incurred in providing daily services to patients requiring intermediate nursing care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(v) Effective date. Reporting periods beginning in 1982 and thereafter.
(6) 6660
INTERMEDIATE CARE—OTHER
(i) Function. Intermediate Care is the provision of supportive, restorative and preventive health services in conjunction with a socially oriented program for patients, and the maintenance and operation of 24-hour services including room, personal care, and continuous nursing service under the direction of a professional nurse.
(ii) Description. This cost center contains the direct expenses incurred in providing daily services to patients requiring intermediate nursing care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(v) Effective date. Reporting periods beginning in 1980 and thereafter.
(7) 6670 RESIDENTIAL CARE
(i) Function. Residential Care is the provision of safe, hygienic, sheltered living for residents not capable of fully independent living. Regular and frequent, but not continuous, medical and nursing services are provided. Also included is self-care. Self-care units provide supportive, restorative and preventive health care for ambulatory patients who are capable of caring for themselves under the supervision of a professional nurse. The unit is used by recovering patients who are making the transition to discharge or by patients who are undergoing tests and medical evaluation who require a minimal amount of nursing supervision. These patients generally eat in a central dining facility and do not require bedside nursing care.
(ii) Description. This cost center contains the direct expenses incurred in providing residential care to patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iv) Data source. The number of patient days shall be taken from daily census counts.
(8) 6680 OTHER SUB-ACUTE CARE SERVICES
(i) Description. This cost center contains the direct expenses incurred in maintaining sub-acute care daily hospital services units not specifically required to be included in other sub-acute care cost centers. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(ii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iii) Data source. The number of patient days shall be taken from daily census counts.
(iv) Expiration date. The final year for reporting this cost center is cost reporting periods beginning in 1981.
(9) 6680
OTHER SUB—ACUTE CARE HOSPITAL SERVICES
(i) Description. Other sub-acute care units provide hospital level of care that is less intensive than regular acute care but is more intensive than skilled nursing facility level of care. This unit may provide long-term hospital care to patients other than psychiatric or tuberculosis patients. Also, this unit may be certified to participate in Medicare as a “subprovider” other than a subprovider furnishing care to psychiatric or tuberculosis patients. Care in this unit is furnished on the basis of physicians' orders and approved nursing care plans.
(ii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iii) Data source. The number of patient days shall be taken from daily census counts.
(iv) Effective date. Reporting periods beginning in 1982 and thereafter.
(10) 6690
OTHER SUB—ACUTE CARE NON-HOSPITAL SERVICES
(i) Description. This cost center contains the direct expenses incurred in maintaining sub-acute care daily hospital non-hospital services units not specifically required to be included in other sub-acute care cost centers. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(ii) Standard Unit of Measure: number of patient days. Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(iii) Data source. The number of patient days shall be taken from daily census counts.
(iv) Effective date. Reporting periods beginning in 1982 and thereafter.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.199 Hearings
The hearings provided for in this Subpart are to be conducted by the permit-issuing official or his designated hearing officer.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.2 Applicability and scope
This Subpart sets the requirements for State approval relating to the formation and operation of water quality treatment districts within New York State.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.13 Pesticides
Unless otherwise permitted by these rules and regulations, the discharge or use, or storage of pesticides which is reasonably likely to lead to a discharge, of pesticides into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.341 Zero level accounts
Accounts which have an account number with a fourth digit of zero.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.9 Conduct of the hearing
At the hearing the complainant and the respondent may appear personally or otherwise and shall have the right of counsel, to cross-examine witnesses and to produce evidence and witnesses in his or its behalf. Thew technical rules of evidence shall be dispensed with in the conduct of the hearing.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.24 Variance; waiver
(a) Variance.
In order to allow time to comply with certain provisions of this Subpart, an operator may submit a written request to the permit-issuing official for a variance from a specific provision(s) when the health and safety of the children attending the camp and the public will not be prejudiced by the variance, and where there are practical difficulties or unnecessary hardships in immediate compliance with the provision. An operator must meet all terms of an approved variance(s) including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the permit-issuing official specifies. For any variance request relating to the requirements of section 7-2.25(b) of this Subpart, the permit-issuing official shall consult with and obtain approval from the State Department of Health, prior to granting or denying the variance.
(b) Waiver.
In order to accept alternative arrangements that do not meet certain provisions of this Subpart but do protect the safety and health of the campers and the public, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Subpart. Such request shall indicate justification that circumstances exist that are beyond the control of the operator, compliance with the provision would present unnecessary hardship and that the public and camper health and safety will not be endangered by granting such a waiver. The permit-issuing official shall consult with a representative of the State Department of Health prior to granting or denying a waiver request. An operator must meet all terms of an approved waiver(s), including the condition that it will remain in effect indefinitely unless revoked by the permit-issuing official or the facility changes operators. For any waiver request relating to the requirements of section 7-2.25(b) of this Subpart, the permit-issuing official shall consult with and obtain approval from the State Department of Health, prior to granting or denying the waiver.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.20 Laboratory and blood bank
(a) Approved laboratory or blood bank.
The facility shall provide for blood and laboratory services to meet the needs of its residents, pursuant to orders by authorized licensed practitioners, and shall be responsible for the quality and timeliness of such services:
(1) by promptly performing such services as the facility is licensed to provide directly under Subparts 58-1 and 58-2 of this Title, as appropriate, and, is certified to perform by the Medicare program; and
(2) by promptly arranging for an approved blood bank or laboratory services to perform such services as the facility may require, but not provide. Such services shall be obtained from entities approved under Subparts 58-1 and 58-2 of this Title, as appropriate, which are certified by the Medicare program to provide such services.
(b) Transportation.
The facility shall assist the resident in making transportation arrangements to and from the source of laboratory or blood bank service, if the resident needs assistance.
(c) Records.
The facility shall ensure that authenticated and dated reports of clinical laboratory and blood bank services are placed in the resident's clinical record.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.15 Audit and review
(a) Providers shall be subject to audit by the commissioner, his agents or designees. With respect to such audits and reviews, the provider may be required:
(1) to reimburse the department for overpayments discovered by audits; and
(2) to pay restitution for any direct or indirect monetary damage to the program resulting from their improperly or inappropriately furnishing covered drugs, services, supplies or equipment.
(b) The commissioner, his agents or designees, may conduct audits and reviews, and investigate potential fraud or abuse in a provider's conduct.
(c) The commissioner, his agents or designees, may pay or deny claims, or delay claims for audit review.
(d) When audit findings indicate that a provider has provided covered drugs, services, supplies or equipment in a manner which may be inconsistent with regulations governing the program, or with established standards for quality, or in an otherwise unauthorized manner, the commissioner may summarily suspend a provider's participation in the program and/or payment of all claims submitted and of all future claims may be delayed or suspended. When claims are delayed or suspended, a notice of withholding payment or recoupment shall be sent to the provider by the department. This notice shall inform the provider that within 30 days he/she may request in writing an administrative review of the audit determination before a designee of the commissioner. The review must occur and a decision rendered within a reasonable time after a request for review. If the designee of the commissioner decides withholding or recoupment is warranted, or if no request for review is made by the provider within the 30 days provided, the department shall continue to recoup or withhold funds pursuant to the audit determination.
(e) Where investigation indicates evidence of abuse by a provider, the provider may be fined, suspended, restricted or terminated from the program.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.116 Drying
All equipment and utensils are to be air-dried after sanitizing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.26 AICPA
American Institute of Certified Public Accountants.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.62 Television receivers and other household appliances
(a) No home television receiver or other household equipment, whether used in the home or elsewhere, which emits radiation on application of high voltage, shall be offered, transferred, or consigned for sale or use in the State of New York unless it be constructed to prevent radiation therefrom at a level greater than 0.5 milliroentgen per hour, measured two inches or five centimeters from its surface, and averaged over an area of 1.55 square inches or 10 square centimeters.
(b) No replacement part which on being installed would cause the assembled unit for which it is intended to exceed the radiation limit allowed under this section shall be offered, transferred, or consigned for sale or use in the State of New York.
(c) No person shall alter or adjust any home television receiver or other household equipment, whether used in the home or elsewhere, which can emit radiation, in such manner as to increase the radiation emission level thereof, unless the level thereby achieved be within the emission limit allowed under this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.3 Recording and reporting of financial and statistical data
(a) Effective for all fiscal years beginning on or after January 1, 1975 treatment centers and/or diagnostic centers shall use the accrual basis of accounting except where an alternate basis is mandated by law. For fiscal years beginning on or after January 1, 1986 treatment centers and/or diagnostic centers shall submit to the New York State Department of Health a certified Ambulatory Health Care Facility-1 form (AHCF-1) no later than April 30th of each year or a later due date if specified in the annual report form transmittal.
(1) Investments, other than donations, shall be reported on the balance sheet of the AHCF-1 at cost. However, the notes to the financial statements shall describe the assets and indicate the quoted market value and cost for each category of investment.
(2) Fixed assets, other than donations, shall be reported on the balance sheet of the AHCF-1 at cost.
(b) Each facility shall complete and file with the department and/or its agent annual financial and statistical report forms supplied by the department and/or his agent. Each facility shall also file a copy of the audited financial statements for the facility, covering the same period as the annual report. Information contained in such filings shall be used by the department to establish rates of payment.
(c) Facilities shall submit to the commissioner separate financial and statistical data for each service and procedure for which rates are established.
(d) Effective on and after January 1, 1995 all diagnostic and/or treatment centers including satellite clinics covered under the same licensure and excluding diagnostic and/or treatment centers operated by New York City or by the New York City Health and Hospitals Corporation shall maintain all books and records utilized for cost reporting and reimbursement purposes on a calendar-year basis.
(e) Financial and statistical report forms shall be completed in accordance with generally accepted accounting principles as applied to medical facilities, unless the report instructions authorize specific variation from such principles.
(f) The financial and statistical reports required by this Subpart shall be submitted to the department and/or its agent no later than 120 days after the close of the fiscal year or a later due date if specified in the annual report form transmittal. A single 30 day extension of time for filing reports may be granted by the commissioner only if a request for extension is received prior to the due date of the report and only if the facility justifies that the reports cannot be filed by the due date for reasons beyond the control of the facility.
(g) [ Reserved ]
(h) In the event a facility fails to file the required financial and statistical reports on or before the due date or extended due date, or fails to comply with the provisions of section 86-4.4 of this Subpart, the commissioner shall reduce the facility's current rate paid by State governmental agencies by two percent beginning the first day of the calendar month following the original due date of the required reports and continuing until the last day of the month in which the required reports are filed.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.78 Pharmacists; dispensing out-of-state prescriptions; schedule II, III, IV and V controlled substances
(a) A licensed, registered pharmacist, or a pharmacy intern acting in conformity with the provisions of section 6808 of the Education Law, and regulations thereunder, in a registered pharmacy may, in good faith and in the course of his/her professional practice, dispense to an ultimate user, controlled substances in schedule II, III, IV and V upon delivery to such pharmacist of an out-of-state prescription within 30 days of the date such prescription was signed by an authorized practitioner.
(b) Such prescription shall have been written with ink, indelible pencil, typewriter, or by other electronic means approved by the department, and shall be signed by the practitioner. Electronic prescriptions may be created, signed and transmitted electronically, provided the practitioner complies with all other requirements for issuing controlled substance prescriptions in this Part and with Federal requirements for electronic prescribing of controlled substances. A prescription generated on an electronic system that is printed out or transmitted via facsimile is not considered an electronic prescription and shall be manually signed. The prescription shall contain the following:
(1) name, sex, address and age of the ultimate user for whom the substance is intended, or, if the ultimate user is an animal, the species of such animal and the name and address of the owner or person in custody of such animal;
(2) the printed name, address, Drug Enforcement Administration registration number, telephone number and the handwritten signature or, in the case of an electronic prescription, the electronic signature of the prescribing practitioner;
(3) specific directions for use, including, but not limited to, the dosage and frequency of dosage;
(4) the date upon which such prescription was prepared and actually signed by the prescribing practitioner. The prescription shall have been dated as of, and signed on, the date it is issued; and
(5) the quantity of dosage units prescribed;
(6) an electronic prescription shall contain the requirements as provided in paragraphs (1)-(5) of this subdivision except such prescription shall contain an electronic signature and shall be transmitted and received by electronic means. Such electronic signature shall meet the signature requirements set forth in paragraph (2) of this subdivision.
(c) Out-of-state prescriptions shall be dispensed in conformity with provisions set forth in this Part for official prescriptions and electronic prescriptions. Prescription information from all out-of-state prescriptions for a controlled substance shall be filed with the department in accordance with section 80.73(f) of this Part.
(d) Pharmacies shall file out-of-state prescriptions for a controlled substance in the same manner as otherwise required by this Part.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.4 Award rescissions and deferrals
(a) An award may be rescinded by the commissioner if:
(1) prior to payment of an award, the recipient withdraws from the program or fails to begin his/her service obligation in an underserved area;
(2) the recipient is convicted of a felony or a lesser offense related to professional activity;
(3) the recipient is found to have provided fraudulent or willfully misrepresented information in the application or supporting documents; or
(4) the recipient fails to apply award monies received toward repayment of all or part of his/her qualifying debt.
(b) An award may be postponed or deferred temporarily by the commissioner because of one or more of the conditions described in subdivision (a) of this section if the commissioner determines that the condition will be corrected within a reasonable time or that the circumstances warrant a deferral rather that a rescission.
(c) The commissioner will notify the president of any award rescissions or deferrals.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 120 HERKIMER COUNTY
VILLAGES VILLAGES
10 CRR-NY 120.5 Village of Ilion
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Ilion Reservoirs numbers one, two and three and all watercourses tributary thereto or which may ultimately discharge into said Ilion reservoirs or which may be developed in the future to serve as sources of the water supply to the Ilion water commission of the Village of Ilion.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high water line of a watercourse.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal wastes and agricultural and nonagricultural associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Village of Ilion.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(18) Toxic substance shall mean any toxic substance as so defined by statute (see subdivision 2 of section 4801 of the Public Health Law).
(19) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing, or disposing of sewage.
(20) Water commission shall mean Ilion water commission of the Village of Ilion.
(21) Water supply shall mean the public water supply of the Village of Ilion.
(22) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flow or may flow into the Village of Ilion's water supply.
(23) Watershed shall mean the entire drainage area contributing water to the Village of Ilion's water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250-foot from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacle shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility.
(5) Junkyard.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse of the Village of Ilion water supply.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse of the Village of Ilion water supply except by duly authorized employees of the Water Commission in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse of the Village of Ilion water supply within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the water commission in the performance of their duties of supervision and maintenance of the water supply.
(8) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(9) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(10) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse of the Village of Ilion water supply.
(11) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(12) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500-foot of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The Ilion Water Commission of the Village of Ilion or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representatives make regular and thorough inspections of the reservoirs, watercourses, and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Water Commission to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Water Commission to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of law (see section 1102 of the Public Health Law). The aforesaid Water Commission shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by law (see section 1103 of the Public Health Law).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.90 State aid reimbursement amounts
Under emergency situations, the department shall reimburse counties or municipalities for 50 percent of the cost for emergency vector control measures as approved by the department. Emergency funds will only be available after the county or municipality has expended all other forms of State aid for vector surveillance and vector control programs.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.180 Interfund transfer
The transfer of money or other asset or of a liability from one fund to another.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.5 General requirements for institutions caring for infants that provide a referral for infants to obtain hearing screening
(a) This section shall apply to those exempt from direct administration of the infant hearing screening program. The administrative officer of a facility as described in section 69-8.2(c) of this Subpart shall designate a program manager responsible for infant hearing screening who shall ensure infants are referred for an outpatient screening for hearing loss.
(b) The program manager for infant hearing screening shall ensure that infants are referred, prior to discharge from the facility, to a provider licensed under State Education Law and authorized under such law to perform infant hearing screening or an article 28 facility.
(1) The parent shall be informed that the screening should be completed within four weeks of the infant's discharge from the facility if possible and not later than 12 weeks following birth.
(2) The parent shall be provided with education materials on the importance of early detection of hearing loss, supplied by or consistent with department materials; and, a list of licensed providers and/or article 28 facilities where infant hearing screening may be obtained.
(3) The parent shall receive a prescription for an outpatient screening by an article 28 provider or a provider licensed under the State Education Law and authorized by such law to perform infant hearing screening. The prescription shall require that results be returned to the facility issuing the prescription.
(4) The referral, including issuance of a prescription, shall be documented in the infant's record and discharge summary to facilitate follow-up by the infant's primary health care provider.
(c) The program manager shall be responsible for ensuring that results of infant hearing screening reported to the facility are documented in the infant's record and reported to the department as prescribed by the commissioner.
(d) The department may seek corrective action as necessary to ensure infants are screened for hearing loss under the referral process provided for in this section.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.107 Confidentiality
No person who has knowledge by virtue of his office of the identity of a particular patient or research subject, a manufacturing process, a trade secret or a formula shall disclose such knowledge, or any report or record thereof, except:
(a) to another person who by virtue of his office as an employee of the department is entitled to obtain such information;
(b) pursuant to judicial subpoena or court order in a criminal investigation or proceedings;
(c) to an agency, department of government, or official board authorized to regulate, license or otherwise supervise a person who is authorized by article 33 of the Public Health Law to deal in controlled substances, or in the course of any investigation or proceeding by or before such agency, department or board;
(d) to the prescription monitoring program registry and to authorized users of such registry as set forth in Public Health Law section 3371(2);
(e) to a practitioner to inform him or her that a person under his or her treatment with a controlled substance also may be under treatment with a controlled substance by another practitioner for the purposes of Public Health Law section 3371(2), and to facilitate the department’s review of individual challenges to the accuracy of controlled substance histories pursuant to Public Health Law section 3343-a(6);
(f) to a pharmacist to provide information regarding prescriptions for controlled substances presented to the pharmacist for the purposes of Public Health Law section 3371(2) and to facilitate the department’s review of individual challenges to the accuracy of controlled substance histories pursuant to Public Health Law section 3343-a(6);
(g) to the deputy attorney general for Medicaid fraud control, or his or her designee, in furtherance of an investigation of fraud, waste or abuse of the Medicaid program, pursuant to an agreement with the department;
(h) to a local health department for the purpose of conducting public health research or education:
(1) pursuant to an agreement with the commissioner;
(2) when the release of such information is deemed appropriate by the commissioner;
(3) for use in accordance with measures required by the commissioner to ensure that the security and confidentiality of the data is protected; and
(4) provided that disclosure is restricted to individuals within the local health department who are engaged in the research or education;
(i) to a medical examiner or coroner who is an officer of or employed by a State or local government, pursuant to his or her official duties;
(j) to an individual for the purpose of providing such individual with his or her own controlled substance history or, in appropriate circumstances, in the case of a patient who lacks capacity to make health care decisions, a person who has legal authority to make such decisions for the patient and who would have legal access to the patient’s health care records, if requested from the department pursuant to Public Health Law section 3343-a(6) or from a treating practitioner pursuant to Public Health Law section 3371(2)(a)(iv); and
(k) to appropriate law enforcement agencies, as reasonably appears to be necessary, for the purposes of providing relevant information about suspected criminal activity, including controlled substances prescribed or dispensed, where the department has reason to believe that a crime related to the diversion of controlled substances has been committed.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.7 Required laboratory tests on donors and donated tissue
All required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state cardiovascular tissue procurements, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulatory authority, the United States Health Care Financing Administration, or by the department.
(a) Blood samples from all allogeneic cardiovascular tissue donors shall be tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), human T-lymphotropic virus type I (HTLV-I), and hepatitis C virus (HCV), as well as for hepatitis B surface antigen (HBsAg) and for syphilis, for purposes of donor selection.
(b) Testing of each cardiovascular tissue unit for aerobic and anaerobic contamination from each retrieval site shall be performed prior to final packaging, using standard laboratory procedures. Whenever fresh tissue is transplanted, the results of cultures shall be made available to the transplantation surgeon on a daily basis until the final reading has been completed.
(c) All cardiovascular tissue from living donors intended for allogeneic use shall be quarantined for six months. After such time and prior to distribution of the tissue for transplantation, the donor shall be retested for HBsAg and antibodies to HCV, HIV-1 and HIV-2 and tested for antibodies to hepatitis B core antigen (anti-HBc).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.29 Ambulatory care
Health services rendered to persons who are not confined overnight in a health care institution. Ambulatory care services are often referred to as outpatient services.
10 CRR-NY 441.193 License
A permission granted by competent authority to engage in a business or corporation or any activity otherwise unlawful.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SOCIAL WORKER PUBLIC HEALTH SOCIAL WORKER
10 CRR-NY 11.171 Entry level qualifications
A public health social worker must be licensed as a master social worker by the New York State Education Department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.3 Inspection, reproduction and reports
(a) The commissioner or his authorized representative may inspect, reproduce, require reproduction of or require reports on:
(1) any medical facility record, report or other written document or report to or from an inspecting, accrediting or certifying body which he may require for the purpose of conducting cost analyses and studies of standards and procedures relating to operating certificates, or certificates of approval under the provisions of the Public Health Law; and
(2) any patient medical record, clinical log or other patient record which he may require for the purpose of conducting medical audits under the provisions of paragraph (j) of subdivision 1 of section 206 and article 28 of the Public Health Law; and
(3) the disclosure of any interest in the operation of a medical facility or any interest in the ownership of the property interests in a medical facility which he may require for the purpose of conducting an analysis of the operation of medical facilities and standards and procedures relating to operating certificates under the provisions of the Public Health Law; and
(4) such other medical facility records as may be required.
(b) The medical facility shall not charge the commissioner or his authorized representative for the cost of reproducing any records, reports or documents required by this section, but such reproduction costs shall be an allowable expense of the medical facility for the purposes of third- party reimbursement.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.36 Long-term inpatient rehabilitation program for head-injured residents
(a) Definition.
A head injury program shall mean a planned combination of services provided in a nursing home unit approved by the commissioner pursuant to Part 710 of this Title as a provider of specialized services for head-injured residents on a designated resident care unit of at least 20 beds. The head-injury program shall be designed specifically to serve medically stable, traumatically brain-injured individuals with an expected length of stay from 3 to 12 months. The program shall provide goal-oriented, comprehensive, interdisciplinary and coordinated services directed at restoring the individual to the optimal level of physical, cognitive and behavioral functioning. The population served shall consist primarily of individuals with traumatically acquired, nondegenerative, structural brain damage resulting in residual deficits and disability. The program shall not admit or retain individuals who are determined to be a danger to self or others.
(b) General requirements.
The nursing home shall ensure:
(1) the development and implementation of a planned and systematic program for monitoring and assessing the quality and appropriateness of resident care to assure care is provided in accordance with current standards of professional practice. The quality assurance process shall define methods for the identification and selection of clinical and administrative problems to be reviewed with written documentation of such reviews. The process shall include but not be limited to reviews of clinical records, resident and family complaints and suggestions, incident reports and the resident's response to discharge plans. There shall be documentation that recommendations are followed up, action is taken to resolve identified problems and results of such action are assessed periodically;
(2) sufficient space, equipment and facilities are available to support the clinical, educational and administrative functions of the program in accordance with standards set forth in Parts 711 and 713 of this Title;
(3) transfer agreements are in effect with other facilities, in accordance with section 400.9 of this Title for the acceptance of referrals or the transfer of head-injured residents in need of services not available at the facility;
(4) the development and consistent application of written admission and continued stay criteria for this service which include but are not limited to the use of a generally recognized classification system for measuring each individual's physical, affective, behavioral and cognitive level of functioning and the family's capabilities and functioning, and are consistent with the following requirements:
(i) a resident admitted for long-term rehabilitation shall be a person who has suffered a traumatic brain injury with structural nondegenerative brain damage, is medically stable, is not in a persistent vegetative state, demonstrates potential for physical, behavioral and cognitive rehabilitation and may evidence moderate to severe behavior abnormalities. The resident must be capable of exhibiting at least localized responses by reacting specifically but inconsistently to stimuli;
(ii) a resident admitted for coma management shall be a person who has suffered a traumatic brain injury with structural nondegenerative brain damage and is in a coma. The resident may be completely unresponsive to any stimuli or may exhibit a generalized response by reacting inconsistently and nonpurposefully to stimuli in a nonspecific manner; and
(iii) a resident who has diffuse brain damage caused by anoxia, toxic poisoning, cerebral vascular accident, or encephalitis may be admitted to this program if considered appropriate for coma management and long-term rehabilitation;
(5) records are maintained for at least two years identifying persons who were determined by the facility to be ineligible for admission under the head injury program. The records should indicate the reason for ineligibility and any referral action taken;
(6) inservice and continuing education programs which address the medical, physical, cognitive, psychosocial and behavioral needs of head injured residents are conducted on a regular basis for all personnel caring for such residents;
(7) educational programs are conducted for personnel not providing direct care but who come in contact on a regular basis with head-injured residents. The programs should familiarize personnel with the specific needs of these residents; and
(8) education and counseling services are available and offered to the residents and families as needed.
(c) Program management and staffing.
There shall be distinct staffing for the direct care services in the head injury program unit.
(1) The program shall be administered by a program director who has at least two years of clinical or administrative experience in head injury rehabilitation programs. The program director has specific responsibilities which include but are not limited to:
(i) administrative direction and oversight of the program;
(ii) ongoing review of the program and implementation of program changes as identified; and
(iii) development and implementation of educational programs on an ongoing basis for staff working with head injured residents.
(2) A physician who has advanced training and experience in the care of the head injured shall be responsible for the medical direction and medical oversight of the head injury program.
(3) A qualified specialist in physical medicine and rehabilitation or a physician who has training and experience in the care and rehabilitation of head injured patients or residents shall be responsible for the medical management of each resident.
(4) Head injury programs admitting and retaining residents who also require treatment for psychiatric disorders shall have on staff qualified specialists in psychiatry sufficient in number to meet the needs of these residents. A qualified specialist in psychiatry shall be designated to assist in the development and implementation of policies and procedures governing the provision of services for residents with psychiatric disorders, including criteria for transfer of such residents to an appropriate program which is licensed under the Mental Hygiene Law.
(5) A primary interdisciplinary team of health care professional with special interest, training, experience and expertise in head injury rehabilitation shall be responsible for the assessment, coordinated program and care planning, and direct services for each head injured resident. The interdisciplinary team members shall be specifically assigned to serve head injured resident and the team shall include as a minimum the following types of health care professionals:
(i) physician;
(ii) registered professional nurse;
(iii) physical therapist;
(iv) occupational therapist;
(v) speech-language pathologist;
(vi) social worker;
(vii) dietitian;
(viii) therapeutic recreation specialist; and
(ix) clinical psychologist with at least one year of training in neuropsychology.
(6) Nursing services for the head injury unit shall be under the direction of a registered professional nurse with experience in the provision of rehabilitation nursing for head injured patients or residents.
(7) There shall be at least one registered professional nurse with experience in rehabilitation nursing assigned to each shift on the head injury unit.
(8) Consultative services of qualified specialists shall be available as needed to the head injury program in accordance with resident needs.
(9) Depending upon types of residents being served and individual resident's needs, the program shall provide or make formal arrangements for vocational rehabilitation services and special education services.
(d) Interdisciplinary care planning.
(1) A member of the interdisciplinary team managing the resident shall be designated to:
(i) coordinate the overall plan of care and services and identify unmet needs for each resident including discharge and follow-up plans;
(ii) serve as a liaison among resident, family and staff to ensure that resident and family concerns are addressed; and
(iii) serve as a liaison with educational, social and vocational resources in the community which are serving the resident.
(2) A written, comprehensive care plan shall be developed and implemented which establishes rehabilitation goals for each resident. The plan shall be developed on admission by the interdisciplinary team and the attending physician in consultation with the resident, the resident's family and outside agencies, as necessary. The care plan shall be reviewed at least every 14 days and modified according to the resident's needs by the interdisciplinary team. The comprehensive care plan is based upon total and ongoing integrated, interdisciplinary assessments which shall address as a minimum, medical and neurological status, emotional and psychiatric status, nutritional status, the developmental needs of children and adolescents, sensorimotor capacity, cognitive, perceptual and communicative capacity, affect and mood, activities of daily living skills, educational or vocational capacities, sexuality issues and concerns, family counseling and community reintegration needs and recreation and leisure time interests.
(3) A written discharge plan shall be developed within 30 days of admission for each resident as part of the overall care plan and shall include input from all professionals caring for the resident, the resident's family, and as appropriate, any outside agency or resource that will be involved with the resident following discharge.
(4) The family and resident shall receive preparation for discharge through the facility's educational and counseling services.
(5) Provision shall be made by the facility for the follow-up of each resident after discharge to assess the resident's response to the discharge plan.
(e) Utilization review monitoring.
The facility shall participate with the commissioner or his designee in a program of resident care and services monitoring which shall include but not be limited to review of admissions, care and services provided, continued stays, and discharge planning. The facility shall furnish such records and reports at such frequency as the commissioner or his designee may require and shall make available members of the interdisciplinary resident care team for case conferences as the commissioner or his designee deems necessary.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.8 Fire safety standards
(a) Fire alarm systems.
Automatic fire alarm systems, when provided, and the related detection equipment shall be operated and maintained as to provide adequate warning to all the occupants in the event of a fire. Documentation shall be available on-site indicating the system is maintained in accordance with applicable sections of the uniform code. A copy of such documentation shall be available for review by the permit-issuing official or designated representative at the time of inspection.
(b) Automatic fire suppression systems.
Automatic fire suppression systems, when provided, shall be operated and maintained as to provide detection and suppression functions of fire related events as necessary. Documentation shall be available on-site indicating the system is maintained in accordance with applicable sections of the uniform code. A copy of such documentation shall be available for review by the permit-issuing official or designated representative at the time of inspection.
(c) Portable fire extinguishers.
Portable fire extinguishers shall be conspicuously located and readily accessible for use in the event of a fire. Documentation shall be available on-site indicating the extinguishers are located and maintained in accordance with applicable sections of the uniform code. A copy of such documentation shall be available for review by the permit-issuing official or designated representative at the time of inspection.
(d) Exit signs and emergency lighting.
Illuminated exit signs and emergency lighting (when required) shall be readily visible and maintained operational at all times, and shall clearly identify a safe continuous path of travel to the exterior of the building.
(e) Exit maintenance and discharge.
All exits and exit pathways shall be maintained free and clear of obstructions at all times and discharge directly to the exterior of the building, in a manner which facilitates safe and prompt egress. Doors located in exit pathways shall be non-lockable against egress, operable with a single motion, and devoid of hooks, bolts, bars or similar restrictive devices.
(f) Vertical and horizontal confinement.
Existing building construction features, such as doors designed to prevent the spread of fire and smoke throughout the building, shall be maintained as designed at all times.
(g) Fire safety and evacuation plans.
A copy of the fire safety and evacuation plan submitted to the local code enforcement official shall be available on-site for review by the permit-issuing official or designated representative at the time of inspection. The fire safety and evacuation plans shall be updated as required in accordance with applicable sections of the uniform code. The permit-issuing official may require submission of the fire safety and emergency plan.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.31 Food; definitions of contamination and potentially hazardous food; food sources; hermetically sealed foods
(a) Food is to be free from adulteration, spoilage, filth or other contamination, and suitable for human consumption.
(b) Contamination means exposing food to filth, toxic substances, manual contact during service or preparation if such food will not be subsequently cooked prior to service, rodent or insect contact or infestation, or any condition which permits introduction of pathogenic microorganisms or foreign matter. Potentially hazardous foods held at temperatures between 45 degrees Fahrenheit (7.2 degrees Celsius) and 140 degrees Fahrenheit (60 degrees Celsius) either for a period of time exceeding that reasonably required for preparation or for more than two hours, the allowed service time, are considered to be contaminated. Contaminated food is considered adulterated.
(c) Potentially hazardous food is any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea, cooked potato, cooked rice or other ingredients, including synthetic ingredients, in a form capable of supporting:
(1) rapid and progressive growth of infectious, or toxigenic microorganisms; or
(2) the slower growth of C. botulinum.
The term does not include foods with a water activity (Aw) value of 0.85 or less, or a hydrogen ion concentration (pH) level of 4.6 or below.
(d) Food is to be obtained from approved sources that comply with all laws relating to food and food labeling. The use of food prepared in any place that is not operated under jurisdiction of an appropriate regulatory agency and having a current permit or license to operate, if required, from that agency is prohibited.
(e) Hermetically sealed foods are to have been processed in commercial food processing establishments meeting requirements of section 14-1.21 of this Subpart. The use of home-canned foods in food service establishments is prohibited.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.27 Movable-bottom pools
Movable-bottom floor pools shall be operated and maintained in accordance with special requirements specified in section 6-1.29, item 15.4, of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 85.14 Definitions
The following definitions shall apply to sections 85.14 through 85.17 of this Part:
(a) Adverse finding shall mean a determination by the utilization review agent of a residential health care facility that a patient or resident who is receiving benefits under the medical assistance for the needy program requires a lower level of care than he is presently receiving.
(b) Multi-level facility shall mean a residential health care facility which provides both skilled nursing care and health-related care at its premises.
(c) The patient review forms and criteria for level of care shall mean the patient assessment criteria and standards promulgated and published by the Office of Health Systems Management (Patient Review Instrument [PRI] Patient Screening Instrument [SCREEN] and Criteria for Level of Care) as contained in subdivision (i) of section 86-2.30 and section 400.12 of this Title, except that such forms and criteria shall not apply for patients/residents who are younger than 16 years of age.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
TOWNS TOWNS
10 CRR-NY 133.20 Town of Newburgh
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Chadwick Lake and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Consolidated Water District of the Town of Newburgh, Orange County, New York, hereinafter referred to as consolidated water district and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir, or to the edge, margin or precipitous bank forming the ordinary high-water line of a watercourse.
(5) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial or industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the deposition of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the consolidated water district public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system used for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh or channel of any kind, the waters of which flow or may flow into the consolidated water district public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the consolidated water district public water supply.
(16) Water supply shall mean the public water supply of the consolidated water district, Orange County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except (i) watertight receptacles, (ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the State Commissioner of Health and (iii) a properly designed, constructed and operated treatment works that has been approved by the State Commissioner of Health.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 200 feet of any reservoir or within 100 feet of any watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above or paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the State Commissioner of Health.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been approved by the State Commissioner of Health. The New York State Health Department “Standards for Waste Treatment Works”, Bulletin 1, Parts I, II and III, and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (except into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the State Commissioner of Health) within 200 feet of any reservoir or within 100 feet of any watercourse. These restrictions and limiting distances shall not apply to any sewage treatment works installed in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I—Ionizing Radiation—Title 10 Health of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junk yards.
No junk yard shall be located within 250 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Town of Newburgh.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Town of Newburgh.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Town of Newburgh within 500 feet of any water supply intake except by duly authorized employees of the Town of Newburgh in the performance of their duties of supervision and maintenance of the water supply. No boating utilizing internal combustion inboard or outboard motors shall be allowed in or upon any reservoir or watercourse owned by the Town of Newburgh except by duly authorized employees of the Town of Newburgh in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Town of Newburgh within 500 feet of any water supply intake except by duly authorized employees of the Town of Newburgh in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the State Commissioner of Health.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 200 feet of any reservoir or within 100 feet of any watercourse.
(n) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in the contamination of any portion of the water supply.
(o) Inspections.
The Town Board of the Town of Newburgh, or any person or persons as may be charged with the maintenance or supervision of the water supply of the aforesaid consolidated water district shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. The aforesaid town board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.124 Fair market value
(a) Value determined by bona fide bargaining between well-informed buyers and sellers, usually over a period of time.
(b) An estimate of market value, in the absence of sales or quotations.
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.9 Onsite inspection
Upon completion of the project or each phase of a mega-project as set forth in the commissioner's letter of approval, an onsite inspection of the construction and equipment will be made to assure that such are in accordance with the prior approval of the commissioner. The applicant shall notify the area administrator requesting such inspection two months prior to the anticipated completion date. Based upon the final onsite inspection report of the Bureau of Architectural and Engineering Review indicating that the construction is acceptable as completed, a preopening survey shall be conducted by the area office. After the completion of the preopening survey, the area administrator shall, by writing, advise the applicant, if the results of the survey are acceptable, that the premises so inspected may be occupied. In addition, if applicable, the department shall issue an operating certificate consistent with the findings of the preopening survey.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.6 Service obligation
(a) Service obligation.
A recipient is required to practice in an underserved area in the profession for which he/she received an award for a period of 18 months for each annual award received for full-time study. A recipient is required to practice in an underserved area in the profession for which he/she received an award for a period of nine months for each annual award received for part-time study. However, in no case shall the total number of months of service be less than 18. If a recipient receives more than one award, the service obligations for such awards shall run consecutively.
(b) Practice requirements.
A recipient must agree to the following practice requirements:
(1) provide primary care services in an underserved area;
(2) work in a practice site that accepts payment on behalf of beneficiaries of title XVIII of the Federal Social Security Act (Medicare) and individuals eligible for medical assistance pursuant to title 11 of article five of the Social Services Law; and
(3) provide 35 hours per week of direct patient care in the underserved area.
(c) Reporting date.
A recipient is required to begin his/her service obligation within 60 days of either completing the education for which he/she has received a Primary Care Service Corps scholarship award, or receiving a license or becoming registered or certified, as appropriate, in that profession, whichever occurs later, except that the reporting date shall not exceed:
The number of months from the effective date as determined by the following formula:
M = (Y × 12) + 6
where “M” is the maximum number of months from the effective date of the award by which a recipient must begin the service obligation; “Y” is the number of years in which funding is received.
(1) In the case of a recipient whose award has been deferred, the period of time of the approved deferral shall not be included in the calculation of the reporting date described in this section.
(d) Alternative service.
In the event a recipient fails to qualify for licensure, registration or certification, as appropriate, or is unable to fulfill the service obligation in the profession for which the Primary Care Service Corps scholarship award is given, the commissioner may permit the individual to provide alternative service which would meet the intent of the public service obligation.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.88 Display and service of food
(a) Food placed on display is to be protected against contamination. Easily cleanable counter-protector devices, cabinets, display cases, containers or other similar protective equipment are to be used. Self-service openings in counter guards are required to protect food from unnecessary manual contact by consumers. The quantity of food displayed is to be appropriate to meet immediate needs.
(b) The requirements for counter-protector devices required in subdivision (a) of this section are waived when the food displayed is at a catered party or occasion where the consumers are limited to a single group, not the general public, and where the food will be on display for no more than two hours. All leftover food not protected while displayed must be discarded.
(c) All artificial lighting fixtures located over, by or within food storage, preparation, service or display facilities, and facilities where utensils and equipment are cleaned and stored, are to be protected to prevent broken glass from falling into food or onto food-contact surfaces. This requirement does not include decorative lighting fixtures in areas used exclusively for dining.
(d) Infrared or other heat lamps are to be protected against breakage by shielding surrounding and extending beyond the bulb, leaving only the face of the bulb exposed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.4 Applicability
This Part applies to proceedings instituted by the service of finding of violation as described in section 76.5 of this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 112 DUTCHESS COUNTY
VILLAGES VILLAGES
10 CRR-NY 112.5 Village of Millbrook
(a) Application.
The rules and regulations set forth in this section duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the source of the public water supply of the village of Millbrook. Said water supply is located approximately one mile east of the village along NYS Route 44 on land identified as Dutchess County Office of Real Property Tax number 6865-265185. The location of boundaries designated for the protection zones, which comprise the Millbrook public water supply watershed, are described on the watershed protection zone map, dated April 1992 and filed with the New York State Commissioner of Health, Albany, NY, and with the village clerk of the village of Millbrook, Dutchess County, NY, and included as subdivision (j) of this section.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Aquifer shall mean a consolidated or unconsolidated geologic formation, group of formations or part of a formation capable of yielding a significant amount of groundwater to wells, springs or infiltration galleries.
(3) Chloride salt shall mean any bulk quantities of chloride compounds and other deicing compounds intended for application to roads, including mixtures of sand and chloride compounds in any proportion where the chloride compounds constitute over eight percent of the mixture. A bulk quantity of chloride compounds means a quantity of 1,000 pounds or more, but does not include any chloride-compounds in a solid form, including granules, which are packaged in waterproof bags or containers which do not exceed 100 pounds each.
(4) Commissioner of Health unless otherwise noted, shall be the Commissioner of Health of the State of New York.
(5) Disposal shall mean the discharge, deposit, injection, dumping, spilling, leaking, or placing of any solid waste, radioactive material, hazardous waste, or wastewater into or on any land or water so that such solid waste, radioactive material, hazardous waste, or wastewater will remain on the land or water and will not be removed.
(6) Environmental assessment form shall be a form used by an agency to assist it in determining the environmental significance or nonsignificance of actions as defined in 6 NYCRR, Part 617.
(7) Fertilizers shall be any commercially produced mixture generally containing phosphorous, nitrogen, and potassium which is applied to the ground to increase nutrients to plants.
(8) Flood plain shall be the land contiguous to streams, ponds, estuaries, and lakes which would be inundated by the flood having a one percent chance of being equalled or exceeded in any given year.
(9) Groundwater shall be any water beneath the land surface in the saturated zone.
(10) Hazardous material shall mean any substance listed in or exhibiting characteristics identified in either 6 NYCRR Part 371 or 597.
(11) Herbicides shall mean any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any weed, and being those substances defined as herbicides pursuant to Environmental Conservation Law, section 33-0101.
(12) Human excreta shall mean human feces and urine.
(13) Manure shall mean animal feces and urine.
(14) Nonagricultural associated animal waste shall mean manure obtained from nonagricultural industries.
(15) Nonpoint discharge shall mean discharges of pollutants not subject to SPDES (State Pollutant Discharge Elimination System) permit requirements.
(16) Open storage shall mean the holding of a material in a way that the material is exposed to the elements of nature.
(17) Pest shall mean:
(i) any insect, rodent, fungus, weed; or
(ii) any other form of terrestrial or aquatic plant or animal life or virus, bacteria or other micro-organism (except viruses, bacteria or micro-organisms on or in living man or other living animals) which the Commissioner of Environmental Conservation declares to be a pest, as provided by Environmental Conservation Law, section 33-0101.
(18) Pesticide shall mean any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any pest, and any substance or mixture of substances intended for use as a plant regulator, defoliant or desiccant, and being those substances defined as pesticides pursuant to Environmental Conservation Law, section 33-0101 et seq.
(19) Point source discharge shall mean pollutants discharged from a point source as defined in Environmental Conservation Law, section 17-0105.
(20) Protection zone shall mean any of the watershed management zones, as delineated on the watershed protection zone map, dated April 1992, and included as subdivision (j) of this section and described herein. These zones shall be designated Zone I, Zone II and Zone III.
(21) Radioactive material shall mean any material in any form that emits radiation spontaneously, excluding those radioactive materials or devices containing radioactive materials whose receipt, possession, use and transfer are exempt from licensing and regulatory control pursuant to regulations of the New York State Department of Labor or United States Nuclear Regulatory Commission.
(22) Radiation shall mean ionizing radiation; that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(23) Recyclables handling and recovery facility shall mean a solid waste management facility, other than pickup and transfer vehicles, at which recyclables are separated from the solid waste stream, or at which previously separated recyclables are collected, for collection, storage, and off-site shipment.
(24) Septage shall be the contents of a septic tank, cesspool, or other individual wastewater treatment work which receives domestic sewage wastes.
(25) Sludge shall be the solid, semi-solid or liquid waste generated from a waste processing facility, but does not include the liquid stream of effluent.
(26) Solid waste shall mean all putrescible and nonputrescible materials or substances discarded or rejected as being spent, useless, worthless or in excess to the owners at the time of such discard or rejection, including but not limited to garbage, refuse, industrial and commercial waste, sludges from air or water control facilities, rubbish, ashes, contained gaseous material, incinerator residue, demolition and construction debris, discarded automobiles and offal but not including sewage and other highly diluted water carried materials or substances and those in gaseous form, and being those wastes defined as solid waste pursuant to Environmental Conservation Law, section 27-0701.
(27) Solid waste management facility means any facility employed beyond the initial waste collection process including, but not limited to, transfer stations, bailing facilities, rail haul or barge haul facilities, processing systems, including resource recovery facilities or other facilities for reducing solid waste volume, sanitary landfills, facilities for the disposal of construction and demolition debris, plants and facilities for compacting, composting or pyrolization of solid wastes, incinerators and other solid waste disposal, reduction or conversion facilities, as defined in Environmental Conservation Law, section 27-0701 et seq.
(28) Spill shall mean any escape of a substance from the containers employed in storage, transfer, processing, or use.
(29) State Pollutant Discharge Elimination System or SPDES shall mean the system established pursuant to article 17 title 8 of the Environmental Conservation Law for issuance of permits authorizing discharges to the waters of the State of New York.
(30) Stormwater runoff recharge basins shall mean a man-made device capable of retaining surface water runoff to induce groundwater infiltration.
(31) Supplier of water shall mean the village of Millbrook, Dutchess County, NY, incorporated under the laws of New York State. The village of Millbrook is the owner and operator of the public water supply facilities located within the watershed protection zones as described on the watershed protection zone map, dated April 1992, filed with the New York State Commissioner of Health, Albany, NY, and with the village clerk of the Village of Millbrook, Dutchess County, NY, and included as the subdivision (j) of this section.
(32) Wastewater treatment work shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, collection and distribution pipes, on-site disposal systems and seepage units, constructed drainage ditch or surface water intercepting ditch, or other works not specifically mentioned in this paragraph, installed for the purpose of transport, treatment, neutralization, stabilization, storage, or disposal of wastewater.
(33) Wastewater shall mean aqueous carried waste including, but not limited to, dredge spoil, solid waste, hazardous waste, incinerator ash and residue, septage, garbage, refuse, sludge, chemical waste, infectious waste, biological material, radioactive materials, heat, and industrial, municipal and agricultural waste.
(34) Water supply protection zone shall mean the land area, known as Zone II, delineated on the map, dated April 1992 and filed with the New York State Commissioner of Health and with the village clerk of the village of Millbrook, and included as subdivision (j) of this section. The water supply protection zone includes a portion of the Millbrook stream bed, a portion of the intermittent surface stream network, the southeastern gravel deposit areas of the watershed and other areas of the watershed having gravelly and sandy soils.
(35) Watershed protection zone shall mean the land area, known as Zone III, which is tributary to Zone II and is the tributary surface area from which the aquifer is replenished by runoff. The watershed protection zone is delineated on the map, dated April 1992 and filed with the New York State Commissioner of Health and with the village clerk of the village of Millbrook, and included as subdivision (j) of this section.
(36) Water supply shall mean the public water supply of the village of Millbrook.
(37) Watercourse shall mean every spring, stream, wetland, and marsh, from which water may flow into the village of Millbrook public water supply.
(38) Watershed shall mean that land area which contributes water to a specific stream, aquifer or aquifer recharge area or portion(s) thereof and shall include the three designated protection zones known as Zone I, Zone II, and Zone III.
(39) Well shall mean any present or future artificial excavation used as a source of public water supply which derives water from the interstices of the rocks or soils which it penetrates including bored wells, drilled wells, driven wells, infiltration galleries, and trenches with perforated piping, but excluding ditches or tunnels, used to convey groundwater to the surface.
(40) Well head protection zone shall mean the ±119.0 acre parcel owned by the supplier of water (identified as tax parcel #6865-265185) located at the confluence of the Shaw Brook and the Mill Brook which contains the public water supply facilities and the well cone of depression. This zone shall also be known as Zone I as delineated on the map, dated April 1992 and filed with the New York State Commissioner of Health and with the village clerk of the village of Millbrook, and included as subdivision (j) of this section.
(c) General provisions.
(1) The manufacture, use, storage, disposal or discharge of any products, materials or by-products, such as wastewater, solid waste, hazardous waste or any pollutant within the identified protection zones must conform to the requirements of this section.
(2) Any person or entity preparing an environmental assessment form or an environmental impact statement for a project in Zones I, II, or III as defined in this section shall file a copy with the Commissioner of Health and the supplier of water.
(3) An inventory and census shall be initiated and updated every five years by the supplier of water of all systems, facilities and activities in the protection zones that may contribute to water supply source contamination including, as a minimum, those activities included in the original inventory and census, a summary of which is included as subdivision (k) of this section.
(4) Spills.
Within any of the herein defined protection zones, any person who is the owner of, or in actual or constructive possession or control of a hazardous material, petroleum, or radioactive material, or any agent or employee thereof, or any person in a contractual relationship therewith, who is responsible for, or has knowledge of any spill, as defined in subdivision (b) of this section, of any hazardous material, petroleum, or radioactive material to the ground surface or any water body, shall notify the supplier of water, the New York State Department of Environmental Conservation and the Dutchess County Department of Health. All spills shall be reported to the supplier of water, the New York State Department of Environmental Conservation and the Dutchess County Department of Health within two hours of such spill, or when knowledge of such spill is obtained.
(d) Specific regulations: Zone I.
(1) All land shall be protected and controlled through direct ownership of the land or through the acquisition of protective easements or other appropriate measures by the supplier of water in order to prevent contamination.
(2) All systems, facilities, and activities are prohibited except for physical pumping and treatment facilities and controls. The area shall not be used for any purpose other than public water supply except when a permit has been issued by the village board for non-intrusive recreation uses such as hunting, fishing, picnicking, nature study, or hiking.
(3) The development of the water supply sources shall be designed, constructed and maintained subject to the approval and enforcement authority of the Dutchess County Health Department, New York State Department of Environmental Conservation and New York State Department of Health so as to eliminate the opportunity for pollution to enter the water sources.
(4) The physical pumping facilities and controls shall be protected against damage from tampering by fencing or other enclosures or by their manner of construction and installation.
(5) The area shall be posted prohibiting trespass for any purpose except as permitted in paragraph (2) of this subdivision.
(e) Specific regulations: Zone II.
(1) Wastewater treatment works:
(i) all wastewater treatment works discharging to groundwater and receiving wastewater without the admixture of industrial or other wastes, as those terms are defined in Environmental Conservation Law, section 17-0701, in quantities of less than 1,000 gallons per day shall be designed, installed and maintained in accordance with the standards established in 10 NYCRR Part 75 (Appendix 75-A) and any wastewater disposal standards promulgated by the Dutchess County Health Department where such standards are more stringent. Where required, permits for the installation or continued use of wastewater treatment works shall be obtained and may be denied when rapid percolation is found; and
(ii) all other wastewater treatment works, including design, installation and maintenance, are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation.
(2) Point source discharge.
Point source discharges, other than stormwater runoff conduits and discharges pursuant to subparagraph (1)(i) of this subdivision, are prohibited except pursuant to an authorization issued by the New York State Department of Environmental Conservation.
(3) Septage and sludge:
(i) storage of septage, sludge or human excreta, other than storage associated with the operation of an individual wastewater treatment work, is prohibited; and
(ii) the land application of septage, sludge or human excreta is prohibited.
(4) Solid waste management facilities.
The establishment or continued operation of solid waste management facilities are prohibited, except for a disposal area located within the property boundaries of a single family residence or farm for solid waste generated from that residence or farm or a recyclables handling and recovery facility with an on-site capacity not exceeding 450 tons per month, operated pursuant to a valid permit, regulatory exemption or other authorization by the New York State Department of Environmental Conservation.
(5) Animal waste storage.
Areas utilized for the storage or stockpiling of manure and agricultural associated animal waste shall be constructed and maintained such that seepage, leachate or runoff from storage or stockpiling of animal waste cannot adversely impact the quality of the groundwater or surface water.
(6) Hazardous material:
(i) storage and use of hazardous material is subject to the approval and enforcement authority of the State Department of Environmental Conservation or other agency having jurisdiction; and
(ii) disposal of hazardous material is prohibited.
(7) Radioactive material.
Storage, use and disposal of radioactive material are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation, the State Department of Health, and any other State or Federal agency having jurisdiction.
(8) Fertilizer and manure use:
(i) open storage of fertilizers for nonfarm and nonresidential use is prohibited;
(ii) agricultural use of fertilizers and land application of manure shall be in conformance to the degree practicable with Controlling Agricultural Nonpoint Source Water Pollution in New York State - A Guide to the Selection of Best Management Practices to Improve and Protect Water Quality, dated 1991, prepared by Patricia Longabucco, published by the Bureau of Technical Services and Research, Division of Water, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12223, and available for public inspection and copying from the New York State Department of Health, Bureau of Management Services, Empire State Plaza, Corning Tower, Room 2230, Albany, NY 12237; and
(iii) fertilizer use for nonfarm and nonresidential usage shall not be applied in a manner or at rates which would contaminate the village water supply.
(9) Pesticide and herbicide use:
(i) pesticide and herbicide storage and use are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation;
(ii) disposal of pesticides, including herbicides other than for those uses set forth in subparagraph (i) of this paragraph, is prohibited;
(iii) disposal of water used for make-up water or for washing of equipment is prohibited except pursuant to an authorization issued by the New York State Department of Environmental Conservation; and
(iv) use of streams as a source of water or for make-up water or washing of equipment used in conjunction with pesticides and herbicides is prohibited.
(10) Petroleum storage:
(i) aboveground or underground petroleum storage tanks, including design, installation and maintenance, are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation as per Environmental Conservation Law, sections 17-0303 and 17-1001 et seq.; and
(ii) abandoned petroleum tanks are subject to the closure requirements of 6 NYCRR, section 613.9.
(11) Stockpiles:
(i) storage of chloride salts is prohibited except in structures designed to minimize contact with precipitation and constructed on low permeability pads designed to control seepage and runoff; and
(ii) storage of coal is prohibited except in structures designed to minimize contact with precipitation and constructed on low permeability pads designed to control seepage and runoff.
(12) Chloride salt application.
Deicing chloride salt use is restricted to the minimum amount needed for public safety.
(13) Construction and closure of wells:
(i) oil and gas well construction, maintenance and abandonment are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation; and
(ii) water supply well construction, maintenance and abandonment are subject to the approval and enforcement authority of the Dutchess County Health Department and the New York State Department of Health as set forth in standards and procedures contained in section 5-1.22 of the State Sanitary Code and the New York State Department of Environmental Conservation under 6 NYCRR Part 601.
(14) Cemeteries.
All cemeteries shall be operated to prevent contamination of the public water supply.
(15) Sediment generation:
(i) farm tillage practices shall be in conformance to the degree practible with Controlling Agricultural Nonpoint Source Water Pollution in New York State - A Guide to the Selection of Best Management Practices to Improve and Protect Water Quality, prepared by Patricia Longabucco, published by the Bureau of Technical Services and Research, Division of Water, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12223, and available for public inspection and copying from the New York State Department of Health, Bureau of Management Services, Empire State Plaza, Corning Tower, Room 2230, Albany, NY 12237; and
(ii) land disturbing activities which may result in deterioration of the quality or quantity of the public water supply source, including general construction, highway construction, access road construction and maintenance are prohibited except where measures have been put in place to prevent erosion and sediment production.
(f) Specific regulations: Zone III.
(1) Wastewater treatment works:
(i) all wastewater treatment works discharging to groundwater and receiving wastewater without the admixture of industrial or other wastes, as those terms are defined in Environmental Conservation Law, section 17-0701, in quantities of less than 1,000 gallons per day shall be designed, installed and maintained in accordance with the standards established in 10 NYCRR Part 75 (Appendix 75-A) and any wastewater disposal standards promulgated by the Dutchess County Health Department where such standards are more stringent. Where required, permits for the installation or continued use of wastewater treatment works shall be obtained; and
(ii) all other wastewater treatment works, including design, installation and maintenance, are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation, or its agent.
(2) Point source discharge.
Point source discharges, other than stormwater runoff conduits and discharges pursuant to subparagraph (1)(i) of this subdivision, are prohibited except pursuant to an authorization issued by the New York State Department of Environmental Conservation.
(3) Septage and sludge:
(i) land application of septage, sludge or human excreta within 200 linear feet of any stream, watercourse or Zone I or Zone II boundary is prohibited; and
(ii) land application of septage, sludge or human excreta which is permitted under this subdivision shall be pursuant to a permit issued by the New York State Department of Environmental Conservation or New York State Department of Health as appropriate.
(4) Solid waste management facilities.
Solid waste management facilities may be established or operated pursuant to a valid permit, regulatory exemption, or other authorization issued by the New York State Department of Environmental Conservation.
(5) Animal waste storage.
Areas utilized for the storage or stockpiling of manure and agricultural associated animal waste shall be constructed and maintained such that seepage, leachate or runoff from storage or stockpiling of animal waste cannot adversely impact the quality of the groundwater or surface water.
(6) Hazardous material.
Storage, use and disposal of hazardous material are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation or other agency having jurisdiction.
(7) Radioactive material.
Storage, use, or disposal of radioactive material are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation, New York State Department of Health and other State or Federal agencies having jurisdiction.
(8) Fertilizer and manure use:
(i) open storage of fertilizers for nonfarm and nonresidential use is prohibited;
(ii) agricultural use of fertilizers and land application of manure shall be in conformance to the degree practicable with Controlling Agricultural Nonpoint Source Water Pollution in New York State - A Guide to the Selection of Best Management Practices to Improve and Protect Water Quality, dated 1991, prepared by Patricia Longabucco, published by the Bureau of Technical Services and Research, Division of Water, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12223, and available for public inspection and copying from the New York State Department of Health, Bureau of Management Services, Empire State Plaza, Corning Tower, Room 2230, Albany, NY 12237; and
(iii) fertilizers for nonfarm and nonresidential usage shall not be applied in a manner or at rates which would contaminate the village water supply.
(9) Pesticide, including herbicide, use:
(i) all pesticide, including herbicide, storage, application and use shall be subject to approval and enforcement authority of the New York State Department of Environmental Conservation;
(ii) disposal of pesticides, including herbicides, other than those uses set forth in subparagraph (i) of this paragraph, is prohibited unless approved by the New York State Department of Environmental Conservation;
(iii) disposal of water used for make-up water or for washing of equipment is prohibited except pursuant to an authorization issued by the New York State Department of Environmental Conservation; and
(iv) use of streams for make-up water or washing of equipment used in conjunction with pesticides and herbicides is prohibited.
(10) Petroleum storage:
(i) aboveground or underground petroleum storage tanks shall be installed, operated and maintained as required by Environmental Conservation Law, sections 17-0303 and 17-1001 et seq.; and
(ii) abandoned petroleum tanks are subject to the closure requirements of 6 NYCRR section 613.9.
(11) Stockpiles:
(i) storage of chloride salts is prohibited except in structures designed to minimize contact with precipitation and constructed on low permeability pads designed to control seepage and runoff; and
(ii) storage of coal is prohibited except in structures designed to minimize contact with precipitation and constructed on low permeability pads designed to control seepage and runoff.
(12) Chloride salt application.
Deicing chloride salt use is restricted to the minimum amount needed for public safety.
(13) Construction and closure of wells:
(i) oil and gas well construction, maintenance and abandonment are subject to the approval and enforcement authority of the New York State Department of Environmental Conservation; and
(ii) water supply well construction, maintenance and abandonment are subject to the approval and enforcement authority of the Dutchess County Department of Health and the New York State Department of Health as set forth in the standards and procedures contained in section 5-1.22 of the State Sanitary Code and the New York State Department of Environmental Conservation under 6 NYCRR, Part 601.
(14) Cemeteries.
All cemeteries shall be operated to prevent contamination of the public water supply.
(15) Sediment generation:
(i) farm tillage practices shall be in conformance to the degree practicable with Controlling Agricultural Nonpoint Source Water Pollution in New York State - A Guide to the Selection of Best Management Practices to Improve and Protect Water Quality, dated 1991, prepared by Patricia Longabucco, published by the Bureau of Technical Services and Research, Division of Water, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12223, and available for public inspection and copying from the New York State Department of Health, Bureau of Management Services, Empire State Plaza, Corning Tower, Room 2230, Albany, NY 12237; and
(ii) land disturbing activities which may result in the deterioration of the quality or quantity of the public water supply source including general construction, highway construction, access road construction and maintenance are prohibited except where measures have been put in place to minimize erosion and sediment production.
(g) Inspections.
The officials of the village of Millbrook, or any persons charged with the maintenance or supervision of the public water supply system by its officers or their duly appointed representative, shall make regular and thorough inspections of the identified protection zones to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid officials to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid officials to promptly notify the Commissioner of Health or his designee of such violations. The aforesaid shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations abated and the general conditions of the protection zones at the time of the last inspection.
(h) Variances.
(1) The Commissioner of Health, or his authorized representative, may, upon written application from the owner, operator, or person in charge of a site, grant a variance from the requirements of these regulations, provided that a variance may only be granted if the regulated activity, alone or cumulatively with any other proposed activity, will not cause the contamination or degradation of the water supply. The issuance of a variance shall not authorize any use or extension of use in Zones I, II, or, III for which a permit is required by any local, State or Federal authority, but shall authorize the filing of a permit application.
(2) An application for a variance must:
(i) include the applicant's name, address, and his interest in the subject property; and the owner's name and address if different from the applicant;
(ii) include the owner's signed consent to the application if made by any person or entity other than the owner of the site;
(iii) include the street address and legal description of the subject site;
(iv) include a sketch plan illustrating all proposed site alterations, all structures existing on site, the existing uses and zoning of adjacent parcels, site contours and drainage patterns;
(v) demonstrate that the regulated activity will not cause an increased risk of contamination or degradation of the water supply;
(vi) identify the specific provision of these rules and regulations from which the variance is sought;
(vii) demonstrate that due to conditions unique and peculiar to the applicant's situation, compliance with these rules and regulations would be unduly burdensome or result in substantial hardship that cannot be otherwise mitigated;
(viii) demonstrate that any undue burden or substantial hardship was not created by the applicant, and cannot be avoided except by a variance;
(ix) demonstrate that alternatives to the regulated activity have been considered and that there is no available alternative which would not require a variance;
(x) demonstrate the regulated activity as proposed includes adequate mitigation measures to justify such variance; and
(xi) be submitted to the supplier of water and the commissioner.
(3) Review by the supplier of water.
Within 90 days of the receipt of an application for variance, the supplier of water shall make a written recommendation to the commissioner as to whether the applicant has met the standards for a variance. In order to make its recommendation, the supplier of water may request additional information from the applicant. The supplier of water may also hold a public hearing on the application, upon 30 days notice. The supplier of water's written recommendation shall be forwarded by the supplier of water to the commissioner and served on the applicant.
(4) Decision of the commissioner:
(i) the commissioner or his authorized representatives may solicit the views of the supplier of water on a variance application. After reviewing the application and any recommendations provided by the supplier of water, the commissioner will render a decision to grant, grant with conditions or deny a variance application. The requirements of paragraph (2) of this subdivision shall be used as the basis for each decision. The commissioner may hold a public hearing on the application, if deemed necessary, to seek further information prior to rendering a final decision;
(ii) the commissioner shall impose such conditions as he or she may deem necessary or prudent to preserve the quality of the water supply. All conditions shall be expressly set forth and the reasons for such conditions specified. Violations of the conditions of a variance shall be a violation of these rules and regulations;
(iii) the issuance of a variance from a requirement imposed by this section shall not act as a variance from any regulation or requirement of any other Federal, State or local agency, or any other regulation or requirement of the Department of Health; and
(iv) in granting a variance or a conditioned variance, the commissioner may require financial security, impose time limitations or limit transfer of the approval.
(i) Remedies for violation.
Remedies for violation of these rules and regulations shall be those specified by sections 1102 and 1103 of the Public Health Law.
(j) Village of Millbrook - Water Supply Protection Zone Map, April 1992.
)
)
(k) Millbrook Watershed Inventory and Census, Revised 1992.
Village of Millbrook
Summary Report
Millbrook Watershed Inventory and Census
(Revised 1992)
In order to assess the impact to regulated parties of the proposed watershed rules and regulations, an inventory of the existing land uses within the Millbrook public water supply watershed was conducted by the village. The land use inventory was then compared with the prohibited activities as described in the proposed watershed rules and regulations. The land use inventory was compiled using:
1. A land use survey of the Millbrook watershed conducted in 1988. The individual landowners in the watershed were contacted either in person or by telephone and asked about: current land use; location and number of on-site structures; location, number and content of on-site bulk storage tanks; location, size and type of on-site wastewater treatment facilities; and location, depth and yield of on-site drinking water wells. A copy of the survey form used is attached to this report.1
2. The April 1989 list of Inactive Hazardous Waste Disposal Sites for Dutchess County, prepared by the New York State Department of Environmental Conservation.
B. The January 1990 Quarterly Status Report of Inactive Hazardous Waste Disposal Sites, prepared by the New York State Department of Environmental Conservation.
4. The Freedom of Information Law to request information concerning generators of hazardous waste and owners and operators of petroleum and chemical bulk storage facilities.
5. A visual survey.
6. Recent subdivision and site plan maps on file with the Town of Washington Planning Board.
Land Use Inventory:
As identified through the land use inventory, land uses within the Millbrook public water supply watershed are:
Mabbettsville Hamlet
A veterinarian; bowling alley; proposed retail nursery/landscape operation; ice cream stand; automobile dealership with repair facility; automobile repair shop; professional offices; retail delicatessen; antique shop; apartment building; municipal park with swimming (pond); power equipment dealership building (vacant); and single family dwellings. Outside of the Mabbettsville Hamlet
Large areas of vacant land either currently used or once used as pasture or cultivation of crops for food or livestock; large lot (greater than 5 acres) single family residences; horse and cattle farms with single family and accessory apartments, barns and outbuildings; tool manufacturer; apartment building; private school; municipal landfill; and private hunting preserve.
ANALYSIS:
The comparison of land uses within the Millbrook public water supply watershed with the proposed watershed rules and regulations indicates that adoption and implementation of the proposed rules and regulations will not have a detrimental economic impact on landowners within the watershed and will not result in the significant loss of the economic value of any existing residential, commercial or municipal land uses This conclusion is based on the following:
• In Zone I, any use of the well head protection area other than as a public water supply and for non-intrusive recreation activities such as hunting, fishing, picnicking, nature study and hiking is prohibited.
The village of Millbrook owns in fee simple absolute the 119 acre site on which the public water supply infiltration galleries and wells are located. This entire 119 acre parcel is designated Zone I and is under the exclusive control of the village of Millbrook. No economic impact to the use and ownership of the Zone I area is anticipated.
• In Zone II and Zone III, wastewater treatment works must be properly designed installed and maintained.
On-site wastewater treatment, storage and disposal for the individual residential, commercial and municipal land uses within the watershed are provided through individual septic systems. No economic impact to residential, commercial or municipal land uses in Zone II and Zone III as a result of the design, installation and maintenance requirement for wastewater treatment works is anticipated.
• In Zone II, storage of septage, sludge or human excreta are prohibited. The exception is for storage and disposal of septage, sludge or human excreta associated with a properly functioning wastewater treatment work.
No commercial or private sites for storage of septage, sludge or human excreta, other than storage and disposal of wastewater associates with the proper operation of individual wastewater treatment works, were identified by the land use inventory. On-site storage of septage, sludge and human excreta via individual wastewater treatment works for residential, commercial or municipal land uses are permitted within Zone II. No economic impact to residential, commercial or municipal land uses as a result of the prohibition on storage or disposal of septage, sludge or human excreta is anticipated.
• In Zone II, solid waste management facilities are prohibited. The exception is for disposal areas located within the property boundaries of a single family residence or farm used for disposal of solid waste generated by that single family or farm, and a recycling facility having an on-site capacity not exceeding 450 tons per month.
The proposed definition of “solid waste management facility” is taken directly from the rules and regulations promulgated by the New York State Department of Environmental Conservation regarding solid waste disposal facilities and landfills. (See 6 NYCRR 360 et seq. ). Included in the Part 360 regulations are specific exemptions to the regulations (6 NYCRR 360-1.7(b)) for certain waste disposal and resource separation activities. The proposed Zone II exception to the watershed rules and regulations for disposal areas located within the property boundary of a single family residence or farm, and for recycling facilities having a limited on-site storage capacity, are consistent with the Part 360 regulations and exemptions to the regulations.
Only one solid waste management facility within the Zone II boundary, the town of Washington landfill, was identified. The town landfill would be directly affected by adoption and implementation of the proposed watershed rules and regulations. Implementation of the rules and regulations would require closure of the landfill resulting in loss of the use of municipal property and potential hardship on town residents to find alternative waste disposal sites. However, the town of Washington is currently under a consent order to study the closure of the landfill and is actively moving toward preparation of a closure plan. Because the town was undertaken to close the existing landfill and provide for post closure monitoring, the prohibition on solid waste management facilities within Zone II will have no additional adverse economic effect on, town residents or the town of Washington.
• In Zones II, disposal of hazardous material is prohibited.
The proposed rules will not prohibit the storage and use of hazardous material as part of a business process but will prohibit disposal of such material anywhere in the Zone II boundary. No operational sites for commercial or private disposal of hazardous material within Zone II were identified by the land use inventory. Although the inventory identified an automobile dealership located in Mabbettsville as a listed generator of hazardous material, the dealership is required, pursuant to Environmental Conservation Law, to provide for disposal of hazardous material in a permitted hazardous waste disposal facility. There are no permitted hazardous waste disposal facilities located anywhere in the Millbrook public water supply watershed. Thus, the prohibition on disposal of hazardous material in Zone II will have no additional adverse economic effect on existing residential, commercial or municipal land uses.
• In Zone II, open storage of fertilizer for non-farm and non-residential use is prohibited.
No operational open air sites for storage or chemical fertilizer for commercial use were identified by the land use inventory. It should be noted, however, that this prohibition does not prohibit the use of chemical fertilizer but instead regulates the manner in which it is stored. The prohibition, therefore, could impose some minor cost on a landowner to comply with the regulation, but would otherwise limit the lawful use of property.
• In Zone II, disposal of pesticides, including herbicides, is prohibited.
No operational sites for disposal of containers of unused pesticides and herbicides were identified by the land use inventory. Similar to the restriction on open air storage of chemical fertilizers, this prohibition does not limit or prevent the use of pesticides or herbicides but regulates the manner of their disposal. Environmental Conservation Law requires unused or waste pesticides or herbicides be disposed of in a permitted solid waste management facility or a permitted hazardous waste disposal facility as appropriate.
• In Zone II and Zone III, disposal of water used for make-up water or for washing of equipment used in conjunction with pesticides and herbicides is prohibited.
This regulation would prohibit the prospective disposal of water used for make-up water or water used to wash equipment used in conjunction with pesticides and herbicides except pursuant to a NYSDEC authorization.
TOWN OF WASHINGTON
WATER RESOURCES SURVEY
JUNE 1988
The following survey is designed to help the Town of Washington plan measures to protect the surface and ground water resources of the Mill Brook, the Shaw Brook, and associated tributaries.
Name
__________
Address _________
____________
____________
Tax Map #_________
1. Describe the current use of the property.
Single family
_______
Multi-Family (number)_____
Commercial (type)
______
Retail (type)_______
Offices (type)
_______
Vacant or Forested (type) ___
Agriculture (type)
______
Other (type)________
2. Describe number, type, and approximate location of on-site structures.
3. Describe approximate location, age, and size of all on-site septic systems.
4. Describe approximate location, age, capacity, and contents of all above ground and below ground storage tanks.
5. Describe approximate location, age, depth, yield, and name of driller of all on-site wells.
6. Space for additional comments is provided below.
7. Please use the back of this sheet to complete a sketch of the property and approximate location of fixtures (well and septic) and buildings. Where appropriate include names of streams and roadways.
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.6 Village of Sherman
(a) Application.
The rules and regulations hereinafter duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the wells which comprise the source of public water supply of the Village of Sherman, Chautauqua County, New York. Said wells are located on land owned by the Village of Sherman and are situated in the southwest corner of the village. well No. 1 is located approximately 250 feet north of French Creek and well No. 2-B is located approximately 540 feet southwest of well No. 1.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds of potassium chloride (commonly used as fertilizer) calcium chloride (commonly used for road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the wells.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(8) Refuse shall mean all putrescible and non-putrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(9) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(12) Water supply shall mean the public water supply of the Village of Sherman, Chautauqua County, New York.
(13) Well shall mean the wells now used as a source of this public water supply or to any additional wells which may be constructed at these locations as a source for this public water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York (10 NYCRR Part 170).
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a linear distance of 250 feet.
(2) Chloride salt.
No chloride salt storage area shall be located within a linear distance of 500 feet except in weather-proof buildings or water-tight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500 foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within a linear distance of 250 feet.
(ii) No human excreta shall be deposited or spread upon or beneath the surface of the ground within a linear distance of 250 feet.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250 foot linear distance of the wells except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15 food linear distance of the wells.
(5) Radioactive material.
No radioactive material in excess of the quantity listed of said material in Table 4, Appendix 1, Part 16, Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York (10 NYCRR Part 16) shall be disposed of by burial in soil within a linear distance of 500 feet.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a linear distance of 250 feet.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a linear distance of 250 feet.
(iii) Refuse disposal area. No refuse disposal area shall be located within a linear distance of 500 feet.
(7) Toxic chemical.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a linear distance of 500 feet.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Village of Sherman upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons as may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the supply or except such other persons as may be authorized to enter said property by the Village of Sherman.
(e) Inspections.
The trustees of the Village of Sherman or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells as to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general surroundings of the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.11 Food service
(a) A plan for new or modified food service facilities shall be submitted to the permit-issuing official at least 60 days prior to beginning construction. All kitchens, dining areas and food service equipment associated with the service of food to the public, including occupants of the temporary residence, shall be approved by the permit-issuing official and constructed, maintained and operated so as to comply with applicable provisions of Part 14 of this Title.
(b) When food or food utensils are provided within an occupancy unit, the dishes and utensils shall be single service or adequately washed, rinsed and sanitized and shall be handled and stored in a sanitary manner.
(c) Clean and adequately sanitized drinking glasses or single service cups shall be supplied for use in each individual guest room.
(d) Food service(s) operated by a vendor other than the temporary residence operator shall require a separate permit to operate in accordance with Part 14 of this Title.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.2 Village of Cherry Valley
[L. 1893, ch. 661, art. 5]
(a) Privies adjacent to reservoirs, springs or watercourses.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind, the water of which, when running, flows eventually into a reservoir of the Cherry Valley public water supply.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception of storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or within 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit of human excreta which is constructed, located or maintained between the aforesaid limits of 50 to 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or 50 to 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid and from which the said excrement is not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of disposal beyond the maximum aforesaid limit shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition, and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limits.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or the floor of said privy.
(5) The excreta so collected shall be so removed as to cause the least nuisance possible and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid.
(3) No garbage or other putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be placed upon or below the surface of the ground where they may be washed into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark or precipitous bank thereof.
(c) Manures, compost and similar matter.
(1) No stable, pigsty, henhouse, barnyard, hog or duck yard, hitching or standing place for horses or cattle or other place where animal manure accumulates and compost or manure heap shall be located or maintained within 100 feet of nor shall they or any watering place for horses, cattle or other animals be so arranged that the polluted drainings therefrom shall flow into or through open or covered drains within 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir or within 130 feet of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so as to be washed a less distance than 50 feet over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(d) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or any part thereof, nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory, shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof, or of the polluted drainage therefrom, shall be washed on the surface for less than 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Cemeteries.
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(f) Management of the reservoirs.
(1) The reservoirs of the Cherry Valley public water supply shall not be unnecessarily drawn down during the warm months, but shall be kept as deep and as nearly at a uniform level as possible to prevent the pollution of the water with dead organic matter.
(2) No filter or screen shall be used when in a filthy condition and liable to pollute the water in the mains; and no filter or screen shall be used at the head of the main which can not be constantly examined and cleaned.
(g) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, a penalty of $50 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above mandatory rules and regulations, to be recovered under the said act.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.150 Gain or loss
The net result of a concluded transaction or of an operating period following the application of generally accepted accounting principles.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.12 Water supply
The water supply serving all plumbing fixtures, including drinking fountains, lavatories and showers, shall, after treatment, meet the applicable requirements of Part 5 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.19 Depreciation for voluntary and public residential health care facilities
(a) Reported depreciation based on approved historical cost of buildings, fixed equipment and capital improvements thereto is recognized as a proper element of cost for voluntary and public residential health care facilities. Useful lives shall be the higher of the reported useful life or those useful lives from the most recent edition of Estimated Useful Lives of Depreciable Hospital Assets, American Hospital Association.
(b) In the computation of rates effective for voluntary residential health care facilities, depreciation shall be included on a straight line method on plant and nonmovable equipment. Depreciation shall be funded unless the Commissioner of Health shall have determined, upon application by the residential health care facility, and after inviting written comments from interested parties, that the requested waiver of the requirements for funding is a matter of public interest and necessity. In instances where funding is required, such fund may be used only for capital expenditures with approval as required or for the amortization of capital indebtedness. Funding for plant and fixed equipment shall mean that the transfer of monies to the funded accounts shall occur by the end of the fiscal period in which the depreciation is recorded. Board-designated funds and the accrual of liabilities to the funded depreciation accounts (due to/from accounts) shall not be recognized as funding of depreciation. Deposits to the funded depreciation accounts must remain in such accounts to be considered as valid funding transactions unless expended for the purpose for which it was funded.
(c) In the computation of rates for public residential health care facilities, depreciation is to be included on a straight line method on plant and nonmovable equipment.
(d) Residential health care facilities financed by mortgage loans pursuant to the Nursing Home Companies Law or the Hospital Mortgage Loan Construction Law (defined as facilities for purposes of this subdivision only) shall conform to the requirements of this Subpart.
(1) In lieu of depreciation and interest, on the loan-financed portion of the facilities the State Commissioner of Health shall allow debt service on the mortgage loan as set forth in the mortgage repayment schedule computed by the Medical Care Facilities Finance Agency, together with such required fixed charges, sinking funds and reserves as may be determined by the commissioner as necessary to assure repayment of the mortgage indebtedness. Such mortgage repayment schedule may allow for the accelerated repayment of the soft costs, including, but not limited to, mortgage and bond insurance costs, start-up operating costs, underwriter discounts, government agency fees and investment contract fees, included in the approved total project cost.
(2) Effective January 1, 1995 for facilities in an initial period of operation, facilities which have approved discrete units serving specialty populations as defined in paragraphs (5), (6), (7) and (8) of section 86-2.15(b) of this Subpart, which serve AIDS residents, long term ventilator dependent residents, residents requiring behavioral interventions in specialized programs or traumatic brain injured residents who receive long term inpatient rehabilitation, respectively, shall be reimbursed for certain capital expenditures requiring a cash outlay as follows:
(i) Debt service amortization and interest, property insurance and SONYMA annual fees shall be divided by an estimate of patient days in the calculation of the capital component of the specialty population unit rate that is promulgated for the initial period of operation.
(a) An estimate of patient days shall be determined by the department based on a reasonable projection of utilization during the initial period of operation. The reasonable projection of utilization shall be based on factors that shall include, but not be limited to, prior initial utilization of similarly situated facilities.
(b) Initial period of operation is defined as the period commencing on the initial effective date on which the facility is certified by the department to begin operation of the discrete unit(s) identified in paragraph (2) of this subdivision, and ending on the last day of the 12th month of continuous operation or the beginning date of the initial cost report filed in accordance with section 86-2.2(e) of this Subpart, whichever is shorter.
(ii) The capital component of the facility's rate for the initial period of operation shall be subject to audit for utilization based on actual patient days in the initial period of operation. Such capital component of the rate shall be retrospectively or prospectively adjusted based on such audit.
(e) In the computation of rates for voluntary residential health care facilities which are rented from proprietary interests, the provisions of section 86-2.21 of this Subpart shall apply, except where the realty was previously owned by the voluntary residential health care facility or where the proprietary interest has representation on the board of directors of the voluntary residential health care facility.
(f)
(1) In the event that a residential health care facility is sold or leased or is the subject of any other realty transaction, the capital cost component of such rate shall be considered to be continuing with the same force and effect as though such sale, lease or other realty transaction has not occurred.
(2) A lease with a related organization described in subdivision (a) or (d) of section 86-2.26 if this Subpart shall be deemed to be a non-arms length lease.
(3) Any capital expenditures associated with non-arms length leases shall be approved and certified to, if required, pursuant to article 28 of the Public Health Law. In the computation of reimbursement for non-arms length leases, the capital cost shall be included in allowable costs only to the extent that it does not exceed the amount which the facility would have included in allowable costs if it had legal title to the asset (the cost of ownership), such as straight-line depreciation, insurance, and interest. Accelerated depreciation on these assets may not be included in allowable costs under any circumstances.
(g)
(1) The provisions of subdivision (a) of this section may be waived for certain qualifying facilities. In order to be considered a qualifying facility, all of the following conditions must be met:
(i) A sale or transfer between nonrelated parties must take place.
(ii) The purchaser must assume the seller's remaining mortgage repayment schedule at the associated fixed rate of interest.
(iii) The difference between the unpaid principal balance of the seller's mortgage (first mortgage) and the Medicaid-allowable transfer price must be generated either from second mortgage proceeds or contributed equity capital or both.
(iv) The annual amount of allowable interest expense incurred as described in section 86-2.20 of this Subpart under terms of the first and second mortgage, plus the annual principal debt amortization, exclusive of that portion attributable to the acquisition of land must be less than that which would otherwise be reimbursed pursuant to subdivision (a) of this section and section 86-2.20 of this Subpart if no assumption of the existing first mortgage were made. (This comparison is hereinafter referred to as the comparative analysis test.)
(v) For purposes of this subdivision, the loan-financed portion of the Medicaid-allowable transfer price shall be held constant and the comparative analysis test shall be applied to each year of the effective term of the first and second mortgages. Equity capital will be considered as first applying to the acquisition of the land, then to the acquisition of the building. In instances where more than one facility is involved in the transaction, the facilities may be combined for purposes of the comparative analysis test.
(2) Qualifying facilities shall be reimbursed prinicpal debt amortization, interest and return of equity in the following manner:
(i) Principal debt amortization. In each year, during the effective term of the mortgage, the capital cost component of the rate shall include a payment factor sufficient to reimburse the principal debt amortization component of the allowable portion of the mortgage, with the exception of that portion of the indebtedness which is attributable to the acquisition of the land.
(ii) Interest. The capital cost component shall include a payment factor sufficient to reimburse interest associated with the allowable portion of the mortgage at a rate which the commissioner finds to be reasonable and is in accordance with the provisions of section 86-2.20 of this Subpart.
(iii) Return of equity. The equity portion of the Medicaid-allowable transfer price, except for that portion which is attributable to the acquisition of the land, shall be reimbursed in equal annual amounts beginning in the first year following the expiration of the term of the mortgages over the remaining useful facility life.
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-1.11 Expenses prior to admission
Except when specifically authorized by the State Commissioner of Health or his authorized representative, expenses incurred prior to admission for the purpose of complying with requirements for admission, other than authorized expenses incurred by State employees in the line of duty, shall not be a charge upon the State.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.10 Exclusions from payment
Payments for the following shall be excluded from rates set pursuant to this Subpart:
(a) Drugs and other pharmaceutical products and implantable family planning devices for which separate and distinct outpatient billing and payment were authorized by the department as of December 31, 2007, and as set forth by the department in written billing instructions issued to providers subject to this Subpart, and as may be subsequently modified by the department, HIV counseling and testing visits, post-test HIV counseling visits (positive results), HIV counseling visit (no testing), day health care service (HIV), TB/directly observed therapy — downstate levels 1 and 2, TB/directly observed therapy — upstate levels 1 and 2, AIDS clinic therapeutic visits in general hospital outpatient clinics, child rehabilitation services provided under rate code 2887 in general hospital outpatient clinics, Medicaid obstetrical and maternity services (MOMS) provided under rate code 1604.
(b) Visits solely for the purpose of receiving ordered ambulatory services.
(c) Visits solely for the purpose of receiving pharmacy services.
(d) Visits solely for the purpose of receiving education or training services, except with regard to services authorized pursuant to clause (A) of subparagraph (ii) of paragraph (f) of subdivision 2-a of section 2807 of the Public Health Law.
(e) Visits solely for the purpose of receiving services from licensed social workers, except with regard to psychotherapy services provided by Federally Qualified Health Centers or Rural Health Centers subject to reimbursement pursuant to this Subpart, or as authorized pursuant to clauses (C) and (D) of subparagraph (ii) of paragraph (f) of subdivision 2-a of section 2807 of the Public Health Law.
(f) Visits solely for the purpose of receiving group services, except with regard to clinical group psychotherapy services provided by Federally Qualified Health Centers or Rural Health Centers subject to reimbursement pursuant to this Subpart and provided, however, that reimbursement for such group services shall be determined in accordance section 86-4.9(h) of this Part.
(g) Offsite services, defined as medical services provided by a facility’s outpatient staff at locations other than those operated by and under the facility’s licensure under article 28 of the Public Health Law, or visits related to the provision of such offsite services, except with regard to offsite services provided by Federally Qualified Health Centers or Rural Health Centers and provided, however, that reimbursement for such offsite services shall be determined in accordance with section 86-4.9(i) of this Part.
(h) The following APGs shall not be eligible for reimbursement pursuant to this Subpart:
065 RESPIRATORY THERAPY
066 PULMONARY REHABILITATION
117 HOME INFUSION
190 ARTIFICIAL FERTILIZATION
311 FULL DAY PARTIAL HOSPITALIZATION FOR SUBSTANCE ABUSE
313 HALF DAY PARTIAL HOSPITALIZATION FOR SUBSTANCE ABUSE
314 HALF DAY PARTIAL HOSPITALIZATION FOR MENTAL ILLNESS
319 ACTIVITY THERAPY
371 ORTHODONTICS
430 CLASS I CHEMOTHERAPY DRUGS
431 CLASS II CHEMOTHERAPY DRUGS
432 CLASS III CHEMOTHERAPY DRUGS
433 CLASS IV CHEMOTHERAPY DRUGS
434 CLASS V CHEMOTHERAPY DRUGS
441 CLASS VI CHEMOTHERAPY DRUGS
443 CLASS VII CHEMOTHERAPY DRUGS
452 DIABETES SUPPLIES
453 MOTORIZED WHEELCHAIR
454 TPN FORMULAE
456 MOTORIZED WHEELCHAIR ACCESSORIES
465 CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
999 UNASSIGNED
(i) The following APGs shall not be eligible for reimbursement pursuant to this Subpart when they are presented as the only APGs applicable to a patient visit or when the only other APGs presented with them are one or more of the APGs listed in subdivision (h) of this section:
281 MAGNETIC RESONANCE ANGIOGRAPHY – HEAD AND/OR NECK
282 MAGNETIC RESONANCE ANGIOGRAPHY – CHEST
283 MAGNETIC RESONANCE ANGIOGRAPHY – OTHER SITES
284 MYELOGRAPHY
285 MISCELLANEOUS RADIOLOGICAL PROCEDURES WITH CONTRAST
286 MAMMOGRAPHY
287 DIGESTIVE RADIOLOGY
288 DIAGNOSTIC ULTRASOUND EXCEPT OBSTETRICAL AND VASCULAR OF LOWER EXTREMITIES
289 VASCULAR DIAGNOSTIC ULTRASOUND OF LOWER EXTREMITIES
290 PET SCANS
291 BONE DENSITOMETRY
292 MRI – ABDOMEN
293 MRI – JOINTS
294 MRI – BACK
295 MRI – CHEST
296 MRI – OTHER
297 MRI – BRAIN
298 CAT SCAN BACK
299 CAT SCAN- BRAIN
300 CAT SCAN- ABDOMEN
301 CAT SCAN- OTHER
302 ANGIOGRAPHY, OTHER
303 ANGIOGRAPHY, CEREBRAL
330 LEVEL I DIAGNOSTIC NUCLEAR MEDICINE
331 LEVEL II DIAGNOSTIC NUCLEAR MEDICINE
332 LEVEL III DIAGNOSTIC NUCLEAR MEDICINE
373 LEVEL I DENTAL FILM
374 LEVEL II DENTAL FILM
375 DENTAL ANESTHESIA
380 ANESTHESIA
390 LEVEL I PATHOLOGY
391 LEVEL II PATHOLOGY
392 PAP SMEARS
393 BLOOD AND TISSUE TYPING
394 LEVEL I IMMUNOLOGY TESTS
395 LEVEL II IMMUNOLOGY TESTS
396 LEVEL I MICROBIOLOGY TESTS
397 LEVEL II MICROBIOLOGY TESTS
398 LEVEL I ENDOCRINOLOGY TESTS
399 LEVEL II ENDOCRINOLOGY TESTS
400 LEVEL I CHEMISTRY TESTS
401 LEVEL II CHEMISTRY TESTS
402 BASIC CHEMISTRY TESTS
403 ORGAN OR DISEASE ORIENTED PANELS
404 TOXICOLOGY TESTS
405 THERAPEUTIC DRUG MONITORING
406 LEVEL I CLOTTING TESTS
407 LEVEL II CLOTTING TESTS
408 LEVEL I HEMATOLOGY TESTS
409 LEVEL II HEMATOLOGY TESTS
410 URINALYSIS
411 BLOOD AND URINE DIPSTICK TESTS
413 CARDIOGRAM
435 CLASS I PHARMACOTHERAPY
436 CLASS II PHARMACOTHERAPY
437 CLASS III PHARMACOTHERAPY
438 CLASS IV PHARMACOTHERAPY
439 CLASS V PHARMACOTHERAPY
440 CLASS VI PHARMACOTHERAPY
444 CLASS VII PHARMACOTHERAPY
448 AFTER HOURS SERVICES
455 IMPLANTED TISSUE OF ANY TYPE
457 VENIPUNCTURE
460 CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
461 CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
462 CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
463 CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
464 CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
470 OBSTETRICAL ULTRASOUND
471 PLAIN FILM
472 ULTRASOUND GUIDANCE
473 CT GUIDANCE
490 INCIDENTAL TO MEDICAL, SIGNIFICANT PROCEDURE OR THERAPY VISIT
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.9 Specialized template populations
Notwithstanding any other provisions of this Subpart, rates for individuals identified by OPWDD as qualifying for specialized template populations funding shall be as follows:
(a) For individuals initially identified as qualifying for specialized template populations funding between November 1, 2011 and March 31, 2014.
| Residential – Specialized Level of Care | | | --- | --- | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $166,400 | | Upstate | $150,500 | | | | | Residential – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $189,500 | | Upstate | $171,500 | | | | | Residential – Auspice Change | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $136,500 | | Upstate | $123,500 | | | | | Day Services – Specialized Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $41,730 | | Upstate | $37,562 | | | | | Day Services – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $46,433 | | Upstate | $43,063 |
(b) For individuals initially identified as qualifying for specialized template populations funding after March 31, 2014.
| Residential – Highly Complex Level of Care | | | --- | --- | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $189,500 | | Upstate | $171,500 | | | | | Residential – Auspice Change | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $136,500 | | Upstate | $123,500 | | | | | Day Services – Highly Complex Level of Care | | | Region | Gross Annual Funding Allocation Per Individual – Operating Only | | Downstate | $46,433 | | Upstate | $43,063 |
(c) January 1, 2015 increase.
The fees for specialized template populations funding will be revised to incorporate funding for compensation increases to direct support professional employees. Such fee increases will be effective January 1, 2015. The compensation increase funding will be included in the provider’s fee issued for January 1, 2015 or in a subsequent fee with the inclusion of funding in the amount necessary to achieve the same funding impact as if the fee had been issued on January 1, 2015. The compensation increase funding will be inclusive of associated fringe benefits.
(d) April 1, 2015 increase.
In addition to compensation funding effective January 1, 2015, the fees for specialized template population funding will revised to incorporate funding for a compensation increase to direct support professional and clinical employees to be effective April 1, 2015. The April 1, 2015 direct support compensation funding will be compounded on the amount which was calculated for the January 1, 2015 compensation increase and will be an augmentation to the January 1, 2015 increase.
(e) Calculations.
(1) The portion of the fee that is identified as direct care and support will be increased by two percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional direct support compensation increases for January 1, 2015 and April 1, 2015.
(2) The portion of the fee that is identified as clinical will be increased by two percent and multiplied by the fee sheet fringe benefit percentage to calculate the additional clinical compensation increase for April 1, 2015.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
ENHANCED TREATMENT FOR CRYPTOSPORIDIUM ENHANCED TREATMENT FOR CRYPTOSPORIDIUM
10 CRR-NY 5-1.80 Applicability
The provisions of this section, and sections 5-1.81 through 5-1.83 of this Subpart apply to all public water systems supplied by a surface water source(s) or ground water source(s) directly influenced by surface water, provided the system serves 15 or more service connections or serves 25 or more persons. The requirements in this section for filtered systems apply to any system with a surface water or GWUDI source that is required to provide filtration, regardless of whether the system is currently operating a filtration system. All treatment must comply with the requirements of the Microbial Toolbox Components as described in 40 CFR 141.715 through 40 CFR 141.720. Any unfiltered systems that are in compliance with the filtration avoidance criteria in section 5-1.30(c) of this Subpart, are subject to the requirements in sections 5-1.80 through 5-1.83 of this Subpart pertaining to unfiltered systems. Wholesale system compliance with sections 5-1.81 through 5-1.83 of this Subpart is based on the population of the largest system in the combined distribution system. The above systems shall comply with the following requirements:
(a) Systems shall conduct an initial and a second round of source water monitoring for each plant that treats water from a surface water source or ground water source directly influenced by surface water. This monitoring may include Cryptosporidium, E. coli, and turbidity, as described in section 5-1.81(a) through (d) of this Subpart, to determine what level, if any, of additional Cryptosporidium treatment shall be provided. Cryptosporidium monitoring shall be done using an approved method. The following method modifications must also be followed:
(1) samples must be at least 10 liters (L) or a packed pellet volume of at least 2 milliliters (mL) must be used. If a 10 L sample cannot be processed, as much sample volume as can be filtered by two filters, as described in 40 CFR 141.704(a)(1), must be processed, up to a packed pellet volume of at least 2 mL;
(2) the method-required matrix spike (MS) samples must be spiked and filtered by a laboratory certified for the method;
(3) if the volume of the MS is greater than 10 L, the volume greater than 10 L may be filtered in the field, and the filtered sample may be shipped with the 10 L sample to the laboratory where the 10 L sample is spiked and filtered through the filter that was used to collect the balance of the sample in the field;
(4) flow cytometer-counted spiking suspensions must be used for MS samples and ongoing precision and recovery samples.
(b) Systems that plan to make a significant change to their disinfection practice shall develop disinfection profiles and calculate disinfection benchmarks, as described in section 5-1.82 of this Subpart.
(c) Filtered systems shall determine their Cryptosporidium treatment bin classification, as described in section 5-1.83(a) of this Subpart, and provide additional treatment for Cryptosporidium, if required, as described in section 5-1.83(b) of this Subpart. All unfiltered systems shall determine their mean Cryptosporidium level and provide treatment for Cryptosporidium as described in section 5-1.83(c) of this Subpart. Systems shall implement Cryptosporidium treatment according to the schedule in section 5-1.83(d) of this Subpart.
Part 12 MATERNAL AND CHILD HEALTH
CONTROL OF DISEASE CONTROL OF DISEASE
10 CRR-NY 12.3 Precautions to be observed for the prevention of hemorrhagic diseases and coagulation disorders of the newborn and infants related to vitamin K deficiency
It shall be the duty of the attending physician, licensed midwife, registered professional nurse or other licensed medical professional attending the newborn to assure administration of a single intramuscular dose of 0.5-1.0 mg. of vitamin K1 oxide (phytonadione) within six hours of birth in accordance with current standards of medical care.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.5 Disclosure pursuant to a release
(a) No confidential HIV-related information, including such information as related to domestic violence screening, shall be disclosed pursuant to a general release except to insurance companies as noted in section 63.6(a)(9) of this Part. Disclosure is permitted pursuant to a release of confidential HIV-related information. The release must be signed by the protected individual, or if the protected individual lacks capacity to consent, by a person specified in section 63.6(a)(1) of this Part.
(b) All written disclosures of confidential HIV information must be accompanied by a statement prohibiting redisclosure. The statement shall include the following language or substantially similar language: “This information has been disclosed to you from confidential records which are protected by State law. State law prohibits you from making any further disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law. Any unauthorized further disclosure in violation of State law may result in a fine or jail sentence or both. A general authorization for the release of medical or other information is not, except in limited circumstances set forth in this Part, sufficient authorization for further disclosure. Disclosure of confidential HIV information that occurs as the result of a general authorization for the release of medical or other information will be in violation of the State law and may result in a fine or a jail sentence or both.”
(c) If oral disclosures are necessary, they must be accompanied or followed as soon as possible, but no later than 10 days, by the statement required by subdivision (b) of this section.
(d) The statement required by subdivisions (b) and (c) of this section is not required for disclosures made in accordance with section 63.6(a)(1), (4) or (9) of this Part, for releases made by a physician or their agent or public health officer to a contact; or for releases made by a physician or their agent to a person authorized pursuant to law to consent to the health care of the protected person when the person has been counseled and has refused to disclose and the disclosure is medically necessary. For disclosures of confidential HIV-related information from the patient's medical record to persons who are permitted to access this information pursuant to section 63.6(a)(3), (5), (6), (7) and (10) and (e) and (f) of this Part, it shall be sufficient for the statement required by subdivisions (b) and (c) of this section to appear as part of the medical record when a medical record is disclosed.
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.7 Annual assessment of the immunization level of students attending the institution
The institution shall provide annually to the commissioner, on a form provided by the commissioner, a summary report of the immunization status of students attending the institution to whom this regulation applies. This report must be submitted by December 15th of each year.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.52 Returns to supplier
Any person holding a Federal registration number who is in possession of a controlled substance listed in any schedule may, without being licensed as a distributor, return that substance to either the distributor from whom he obtained it or to the manufacturer of the substance provided that:
(a) In the case of a schedule II controlled substance, an order form is used as provided under Federal regulations.
(b) In the case of a schedule III, IV or V controlled substance, a written record is maintained which indicated the:
(1) date of transaction;
(2) name, form and quantity of the substance;
(3) name, address and registry number of the person making the return; and
(4) name, address and registry number of the supplier or manufacturer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.87 Deferral (or deferment)
The accounting treatment accorded the receipt or accrual of revenue before it is earned, or the incurrence of an expenditure before the benefits therefrom are received. Such items are balance-sheet liabilities or assets and are carried forward to the income account of succeeding periods as the revenue is earned or as the benefits are received from the expenditure.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.110 All equipment at vending locations to be kept clean
(a) Food-contact surfaces are to be cleaned and sanitized each time the machine is serviced at an unattended vending operation, and daily or as needed to protect food from contamination at an attended vending operation.
(b) Nonfood-contact surfaces of equipment are to be cleaned as often as necessary to keep the equipment free of accumulations of dust, dirt, food particles and other debris.
(c) Clean and sanitized equipment and utensils, including single-service articles, are to be handled, transported, stored and offered for consumer use so that they are protected from contamination.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 112 DUTCHESS COUNTY
COMPANIES COMPANIES
10 CRR-NY 112.21 Staatsburg Water Company
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to the Indekill and to all watercourses entering or ultimately discharging into said stream above the intake of the impounding reservoir, said stream being a source of water supply of the Staatsburg Water Company in Dutchess County, N Y.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply furnished by the Staatsburg Water Company.
(2) The term reservoir means any natural or artifically impounded body of water serving as a source of the aforesaid water supply and to any additional reservoir which may be constructed or used for the water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any reservoir or watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the distances of 200 feet and 100 feet from any reservoir or watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 200 feet of any reservoir or watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall be located not less than 100 feet from any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes shall be allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 75 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse, nor in such a manner as to pollute said reservoir or watercourse.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(k) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Staatsburg Water Company.
(l) Inspections.
The Staatsburg Water Company or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of that company shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said water company to promptly notify the State Commissioner of Health of such violations. The Staatsburg Water Company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.7 Disinfection
(a) Any person who disinfects a cooling tower shall be a commercial pesticide applicator or pesticide technician who is qualified to apply biocide in a cooling tower and certified in accordance with the requirements of article 33 of the Environmental Conservation Law and 6 NYCRR Part 325, or a pesticide apprentice under the supervision of a certified applicator.
(b) The name and certification number of the applicator or the business name and registration number of the company providing the disinfection shall be maintained on-site in accordance with section 4-1.9 of this Subpart.
(c) Only biocide products registered by the New York State Department of Environmental Conservation for use in cooling towers or pesticidal devices produced in a USEPA registered establishment may be used in disinfection.
(d) The terms disinfect and disinfection in this Part means the control of microorganisms or microbial growth. The term disinfection shall not include the cleaning of a cooling tower through application of detergents, penetrants, brushes or other tools, high-powered water, or any other method that does not involve the use of a pesticide, as defined in 6 NYCRR Part 325.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 42.1 Application for State aid
(a) All counties and cities performing or contracting for laboratory tests related to the municipal health department's performance of eligible services described in this Part, must submit to the New York State Department of Health an application for State aid for laboratory services, on an annual basis, no later than on the date specified by the State Commissioner of Health.
(b) The application shall contain a detailed budget of proposed expenditures, estimated revenues, a copy of the latest schedule of laboratory fees, and other information that may be required by the Commissioner of Health.
(c) When a city or county contracts with a laboratory for public health laboratory services, in addition to the State aid application, a list of tests and the rate to be paid by the municipality for each test must be filed with the State Department of Health no later than on the date specified by the State Commissioner of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 458 NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 458.4 Index for salaries by job title
This index presents guidelines for classifying specific job titles by the proper natural classification.
| Job Title | Natural classification of expense | | --- | --- | | Accountant | Technicians, Specialists and Non-Physician Medical Practitioners | | Accounting Clerk | Clerical and Other Administrative Employees | | Activity Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Activity Aide | Aides, Orderlies and Assistants | | Administrative Assistant | Management and Supervision | | Administrative Secretary | Clerical and Other Administrative Employees | | Administrator | Management and Supervision | | Admitting Officer | Management and Supervision | | Admitting Clerk | Clerical and Other Administrative Employees | | Assistant Administrator, Director | Management and Supervision | | Associate Administrator, Director | Management and Supervision | | Attendant | Aides, Orderlies and Assistants | | Attorney | Technicians, Specialists and Non-Physician Medical Practitioners | | Audiologist | Technicians, Specialists and Non-Physician Medical Practitioners | | Audiometrist | Technicians, Specialists and Non-Physician Medical Practitioners | | Auditor, Internal | Technicians, Specialists and Non-Physician Medical Practitioners | | Baker | Technicians, Specialists and Non-Physician Medical Practitioners | | Boiler Repairman | Environment, Hotel and Food Service Employees | | Bookkeeper | Clerical and Other Administrative Employees | | Business Office Manager | Management and Supervision | | Carpenter | Environment, Hotel and Food Service Employees | | Cashier | Clerical and Other Administrative Employees | | Chaplain | Technicians, Specialists and Non-Physician Medical Practitioners | | Chief | Management and Supervision | | Clerk | Clerical and Other Administrative Employees | | Clerk-Typist | Clerical and Other Administrative Employees | | Communications Coordinator | Management and Supervision | | Computer Operator | Technicians, Specialists and Non-Physician Medical Practitioners | | Controller | Management and Supervision | | Cook | Technicians, Specialists and Non-Physician Medical Practitioners | | Coordinator, Physical Medicine | Management and Supervision | | Corrective Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Dark Room Attendant | Aides, Orderlies and Assistants | | Dental Assistant | Aides, Orderlies and Assistants | | Dental Hygienist | Technicians, Specialists and Non-Physician Medical Practitioners | | Dental Lab Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Dentist | Physicians Salaries | | Dietary Aide | Environment, Hotel and Food Service Employees | | Dietetic Clerk | Clerical and Other Administrative Employees | | Dietitian | Technicians, Specialists and Non-Physician Medical Practitioners | | Director | Management and Supervision | | Dispatcher | Clerical and Other Administrative Employees | | Dispensary Clerk | Clerical and Other Administrative Employees | | Driver | Environment, Hotel and Food Service Employees | | Duplicating Machine Operator | Clerical and Other Administrative Employees | | Educational Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | EEG Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | EKG Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Electrical Repairman | Environment, Hotel and Food Service Employees | | Electro-Medical Repairman | Environment. Hotel and Food Service Employees | | Elevator Operator | Environment, Hotel and Food Service Employees | | Employment Manager | Management and Supervision | | Extractor Man | Environment, Hotel and Food Service Employees | | File Clerk | Clerical and Other Administrative Employees | | Fireman, Boiler | Environment, Hotel and Food Service Employees | | Flatwork Finisher | Environment, Hotel and Food Service Employees | | Foreman | Management and Supervision | | Grounds Keeper | Environment, Hotel and Food Service Employees | | Guard | Environment, Hotel and Food Service Employees | | Guide | Clerical and Other Administrative Employees | | Health Physicist | Technicians, Specialists and Non-Physician Medical Practitioners | | Housekeeping Aide | Environment, Hotel and Food Service Employees | | Housekeeping Attendant | Environment, Hotel and Food Service Employees | | Housekeeping Crew Leader | Management and Supervision | | Incinerator Man | Environment, Hotel and Food Service Employees | | Industrial Engineer | Technicians, Specialists and Non-Physician Medical Practitioners | | Inhalation Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Inhalation Therapy Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Intern, M.D. | Interns, Residents and Fellows | | Instructor | Technicians, Specialists and Non-Physician Medical Practitioners | | Insurance Clerk | Clerical and Other Administrative Employees | | Interviewer | Clerical and Other Administrative Employees | | Job Analyst | Technicians, Specialists and Non-Physician Medical Practitioners | | Keypunch Operator | Clerical and Other Administrative Employees | | Laboratory Aide | Aides, Orderlies and Assistants | | Laboratory Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Library Assistant | Clerical and Other Administrative Employees | | Licensed Practical Nurse (LPN) | Licensed Practical Nurses | | Maintenance Man Helper | Environment, Hotel and Food Service Employees | | Maintenance Mechanic | Environment, Hotel and Food Service Employees | | Manager | Management and Supervision | | Manual-Arts Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Medical Laboratory Assistant | Management and Supervision | | Medical Librarian | Technicians, Specialists and Non-Physician Medical Practitioners | | Medical Record Librarian | Management and Supervision | | Medical Record Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Medical Secretary | Clerical and Other Administrative Employees | | Medical Stenographer | Clerical and Other Administrative Employees | | Medical Technologist | Technicians, Specialists and Non-Physician Medical Practitioners | | Medical Transcriptionist | Technicians, Specialists and Non-Physician Medical Practitioners | | Messenger | Clerical and Other Administrative Employees | | Music Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Nurse, Head | Registered Nurse | | Nurse, Licensed Practical | Licensed Practical Nurses | | Nurse, Practitioner | Technicians, Specialists and Non-Physician Medical Practitioners | | Nurse, Staff (RN) | Registered Nurses | | Nursing Aide | Aides, Orderlies and Assistants | | Occupational Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Occupational Therapy Aide | Aides, Orderlies and Assistants | | Optometrist | Technicians, Specialists and Non-Physician Medical Practitioners | | Orderly | Aides, Orderlies and Assistants | | Owner/Operator | Management and Supervision | | Painter, Maintenance | Environment, Hotel and Food Service Employees | | Parking Lot Attendant | Clerical and Other Administrative Employees | | Pathologist | Physicians Salaries | | Patient Food Service Worker | Environment, Hotel and Food Service Employees | | Personnel Assistant | Clerical and Other Administrative Employees | | Pharmacist | Technicians, Specialists and Non-Physician Medical Practitioners | | Pharmacy Helper | Aides, Orderlies and Assistants | | Physiatrist | Physicians Salaries | | Physical Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Physical Therapy Aide | Aides, Orderlies and Assistants | | Physician | Physicians Salaries | | Physician's Assistant | Technicians, Specialists and Non-Physician Medical Practitioners | | Plasterer, Maintenance | Environment, Hotel and Food Service Employees | | Plumber, Maintenance | Environment, Hotel and Food Service Employees | | Podiatrist | Physicians Salaries | | Presser, Hand | Environment, Hotel and Food Service Employees | | Press Operator | Environment, Hotel and Food Service Employees | | Printer | Technicians, Specialists and Non-Physician Medical Practitioners | | Programmer | Technicians, Specialists and Non-Physician Medical Practitioners | | Prosthetist-Orthotist | Technicians, Specialists and Non-Physician Medical Practitioners | | Public Information Specialist | Technicians, Specialists and Non-Physician Medical Practitioners | | Purchasing Agent | Technicians, Specialists and Non-Physician Medical Practitioners | | Radiologic Technologist | Technicians, Specialists and Non-Physician Medical Practitioners | | Radiologist | Physicians Salaries | | Receptionist | Clerical and Other Administrative Employees | | Recreational Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Recreation Director | Technicians, Specialists and Non-Physician Medical Practitioners | | Refrigeration Mechanic | Technicians, Specialists and Non-Physician Medical Practitioners | | Residence Director | Management and Supervision | | Resident | Interns, Residents and Fellows | | Seamstress | Environment, Hotel and Food Service Employees | | Secretary | Clerical and Other Administrative Employees | | Social Work Assistant | Aides, Orderlies and Assistants | | Social Worker | Technicians, Specialists and Non-Physician Medical Practitioners | | Speech and Hearing Therapist | Technicians, Specialists and Non-Physician Medical Practitioners | | Speech Clinician | Technicians, Specialists and Non-Physician Medical Practitioners | | Speech Pathologist | Technicians, Specialists and Non-Physician Medical Practitioners | | Stationary Engineer | Environment, Hotel and Food Service Employees | | Stock Clerk | Clerical and Other Administrative Employees | | Supervisor | Management and Supervision | | Supervisor, Registered Nurse | Management and Supervision (supervising two or more units/areas) | | Systems Analyst, Data Processing | Technicians, Specialists and Non-Physician Medical Practitioners | | Telephone Operator | Clerical and Other Administrative Employees | | Therapy Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Thermograph Technician | Technicians, Specialists and Non-Physician Medical Practitioners | | Training Officer | Management and Supervision | | Transcribing Machine Operator | Clerical and Other Administrative Employees | | Truck Driver | Environment, Hotel and Food Service Employees | | Tumbler Operator | Environment, Hotel and Food Service Employees | | Typist | Clerical and Other Administrative Employees | | Wall Washer | Environment, Hotel and Food Service Employees | | Ward Clerk | Clerical and Other Administrative Employees | | Washperson | Environment, Hotel and Food Service Employees | | Window Washer | Environment, Hotel and Food Service Employees |
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 137 PUTNAM COUNTY
10 CRR-NY 137.1 Village of Brewster
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Village of Brewster. Said wells are located in the Town of Southeast on land owned by the Village of Brewster and are more particularly situated easterly of IR 84, approximately 900 feet northerly of the intersection of US Route 6 and NYS Route 22.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, garbage, sewage sludge, chemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal and agricultural- and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Village of Brewster.
(20) Wells shall mean any well now used as a source of water supply for the Village of Brewster or any additional wells which may be constructed or developed in the future as a source of such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for the raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facilities. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the wells.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the wells.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Village of Brewster upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Brewster.
(11) Other wastes.
No pollutant of any kind shall be discharged or deposited upon the property of the Village of Brewster upon which the wells are located except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(e) Inspections.
The Village of Brewster, by its trustees or its duly appointed representatives, or any person or persons charged with the maintenance or supervision of the public water supply system, shall make regular and thorough inspections of the area surrounding the wells to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid trustees of the village to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the village to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees of the village shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations abated and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-3 HEALTH MAINTENANCE ORGANIZATIONS
10 CRR-NY 86-3.5 Health maintenance organization differential
(a) Pursuant to section 2807-c(2-a) of the Public Health Law, health maintenance organizations certified under article 44 of the Public Health Law or article 43 of the Insurance Law shall pay a nine percent differential on their rates of payment for general hospital inpatient services (hereinafter referred to as the HMO factor) into a statewide health maintenance organization pool, unless the HMO factor is eliminated or reduced in accordance with Public Health Law, section 2807-c(2-a). Payment of the HMO factor shall not be required for subscribers who are eligible for medical assistance pursuant to the Social Services Law, and/or participants in regional pilot projects established pursuant to chapter 703 of the Laws of 1988.
(b)
(1) Commencing on August 15, 1992 and on a monthly basis thereafter, each health maintenance organization shall pay the HMO factor, established or adjusted in accordance with section 2807-c(2-a) of the Public Health Law, into a statewide health maintenance organization pool for each patient discharged on or after July 1, 1992. Funds accumulated in the statewide health maintenance organization pool, including income from invested funds, shall be transferred and credited to the general fund.
(2) Payments to the statewide health maintenance organization pool and reports required pursuant to paragraph (5) of this subdivision shall be due on or before the 15th day following the end of each month. Health maintenance organizations shall submit estimated amounts due for patients discharged in a calendar month in accordance with this section unless payment of actual amounts due for such calendar month has been made within such 15-day time period. If a health maintenance organization fails to submit actual or estimated payment in accordance with this subdivision, the health maintenance organization shall be subject to interest and penalties in accordance with section 2807-c(2-a)(c)(ii) of the Public Health Law.
(3) Estimated amounts due for patients discharged in each calendar month shall be determined by multiplying the applicable HMO factor established by section 2807-c(2-a) of the Public Health Law by the sum of actual claims paid, and claims reported to the HMO but not paid, and estimated incurred but not reported claims. The monthly payment shall also include a prior period adjustment that reconciles actual inpatient claims experience compared to prior estimates of amounts due, consistent with methodologies used in preparation of the HMO's certified financial statements.
(4) Each HMO required to make payments shall make a final reconciliation and adjustment for each differential payment period. For the year 1992, the differential payment period shall be for the period July 1st through December 31st. For years subsequent to 1992, the differential payment period shall be a calendar year period, except that the differential payment period shall be the six-month period ending June 30th if the HMO has qualified for a complete elimination of the differential effective July 1st of that year. The final reconciliation for any differential payment period shall be based on the audited inpatient claims experience of the HMO and certified by a certified public accountant. The final reconciliation shall be completed no earlier than three months following the end of the period, and shall be due four months after the end of the period.
(5) HMOs shall file reports in such form and manner as designated by the Department of Health. Such reports shall indicate the amounts paid based on the discharges in each calendar month and shall separately indicate actual claims paid, claims reported but not paid and claims incurred but not reported, as well as indicate the adjustments made due to reconciliation of prior period estimated claims experience. If an HMO fails to submit the differential payment, the Department of Health for purposes of determining interest and penalties in accordance with section 2807-c(2-a)(c)(ii) of the Public Health Law shall estimate the amounts due pursuant to this section based on the average inpatient monthly claims expense contained in the most recent HMO financial reports submitted to the New York State Insurance Department or the Department of Health.
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.1 Definitions
For the purposes of this section, the following words shall have the following meanings:
(a) The term abuse shall mean inappropriate physical contact with a patient or resident of a residential health care facility, while such patient or resident is under the supervision of the facility, which harms or is likely to harm the patient or resident. Inappropriate physical contact includes, but is not limited to, striking, pinching, kicking, shoving, bumping and sexual molestation.
(b) The term mistreatment shall mean inappropriate use of medications, inappropriate isolation or inappropriate use of physical or chemical restraints on or of a patient or resident of a residential health care facility, while such patient or resident is under the supervision of the facility.
(c) The term neglect shall mean failure to provide timely, consistent, safe, adequate and appropriate services, treatment, and/or care to a patient or resident of a residential health care facility while such patient or resident is under the supervision of the facility, including but not limited to: nutrition, medication, therapies, sanitary clothing and surroundings, and activities of daily living.
(d) The term reasonable cause shall mean that upon a review of the circumstances, there is sufficient evidence for a prudent person to believe that physical abuse, mistreatment, or neglect has occurred. Circumstances to be reviewed shall include, but not be limited to any of the following: a statement that physical abuse, mistreatment or neglect has occurred, the presence of a physical condition at variance with the history or course of treatment of the patient or resident, and the visual or aural observation of an act or condition of physical abuse, mistreatment or neglect.
(e) The term expunge shall mean:
(1) in the case of a reported incident or circumstance which is not supported by sufficient credible evidence, the obliteration of any information, contained in any document, which identifies any individual or facility; or
(2) in the case where there is not sufficient credible evidence to support an accusation against an individual, the obliteration of any information, contained in any document, which identifies such individual.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.9 Construction compliance certificate
The operator shall submit, prior to opening new facilities or equipment, a construction compliance certificate to the permit-issuing official. This certificate shall be prepared and signed by a professional engineer or architect licensed to practice in New York State. The certificate shall include a statement that the bathing beach, the buildings and all appurtenances have been constructed in accordance with approved plans and specifications.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.4 Permits and fees
(a) The PIO shall issue a permit to a person who meets the requirements of these rules and submits an application on a form prescribed by the State Commissioner of Health along with payment of a $120 registration fee per biennial registration period and an inspection fee as specified in section 72-1.5(b) of this Subpart.
(b) A permit issued pursuant to these rules shall be issued to a specific applicant for a specified location and shall be effective for no more than two years from the date of issuance.
(c) Permits may be issued for a period of less than two years, with appropriate proration of the registration fee at the rate of $5.00 per month or each portion of a month thereof.
(d) The PIO may stagger biennial registration periods among tanning facilities as needed to effectively administer permits within their jurisdiction. The PIO may choose to stagger periods by date of application, by size of regulated facility, by geographic location, or by some other classification or grouping determined by the PIO.
(e) When registration periods are staggered, the first registration period shall be January 1st through June 30th and the second period shall be July 1st through December 31st, or some other scheme may be used as determined by the PIO to effectively administer permits within their jurisdiction.
(f) Operators of tanning facilities shall obtain a permit before beginning operation.
(g) Each permit shall include but not be limited to the following: one facility name, one facility location, name of owner/operator, registration period and name of PIO.
(h) A permit is not transferable from one person to another or from one establishment location to another.
(i) The permit shall be conspicuously posted within the tanning facility.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.15 Actions involving a Federal agency
(a) When a draft and final EIS for an action have been prepared under the National Environmental Policy Act 1969, the department shall have no obligation to prepare an additional EIS under this Part. However, except in the case of excluded or exempt actions, the department may not undertake or approve the action until the Federal final EIS has been completed and the agency has made the findings prescribed in section 97.10 of this Part and 6 NYCRR 617.9.
(b) Where a negative declaration or other written threshold determination that the action will not require a Federal impact statement has been prepared under the National Environmental Policy Act of 1969, the determination shall not constitute compliance with SEQR. In such cases, the department retains its responsibilities for compliance with SEQR.
(c) In the case of an action involving a Federal agency for which either a Federal negative declaration or a Federal draft and final EIS has been prepared, except where otherwise required by law, a final decision by a Federal agency shall not be controlling on any State or local agency decision on the action.
(d) No SEQR findings are required for actions which are excluded or exempt from SEQR.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 153 WASHINGTON COUNTY
COMPANIES COMPANIES
10 CRR-NY 153.10 Spring Brook Water Company, Hudson Falls
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) of the State of New York, as finally amended by chapter 391 of the Laws of 1933, shall apply to the public water supply provided for the Village of Hudson Falls, New York, and its vicinity by Spring Brook Water Company or its successors.
(b) Definitions.
Definitions of terms whenever used in this section:
(1) The term public water supply means all natural and artificial reservoirs, wells and watercourses tributary to the public water supply system of Spring Brook Water Company or its successors serving the Village of Hudson Falls, New York.
(2) The term watershed means all those drainage areas and such additional areas which are now or may be tributary to sources of said public water supply.
(3) The term source of supply means the surface and ground waters—natural springs, wells, natural or artificial ponds and reservoirs—which are tributary to said public water supply.
(4) The term watercourse means every spring, stream, brook, natural ditch or channel (other than reservoirs) having a definite thread of flow through which water flows to said public water supply.
(5) The term reservoir means any place either natural or artificial wherein water is or may be impounded or stored and utilized as a source of said public water supply.
(6) The term well means any well now in use or which may be developed and used as a source of such public water supply.
(7) The term human excreta means feces, urine and other human wastes of whatever name or nature commonly disposed of by so-called dry system or privy.
(8) The term sewage means liquids containing, either mixed or singly, human excreta, bath water or other decomposing organic matter of human origin flowing in or from a drainage system or sewer. This term does not apply to ordinary kitchen sink and laundry wastes which do not contain sewage and which do not flow through the same drainage system used for bath waters or liquids containing human excretions.
(9) The term septic tank means any watertight receptacle intended for the reception, sedimentation, modification by bacterial action and discharge of sewage prior to its ultimate disposal in a leaching system.
(10) The term leaching system means any cesspool, tile drain, leaching beds or other system by which the effluent from any septic tank may escape and percolate into the surrounding soil.
(11) The term structure means any privy, septic tank, cesspool, leaching system or appurtenances or any building housing animals or poultry.
(c) Relation of structures to watercourses, reservoirs, wells, etc.
The controlling distance between a specified structure or object and any watercourse, reservoir, well, etc. shall be the distance measured in a horizontal plane from the nearest point of such structure to the nearest edge, margin or precipitous bank at the recognized high-water mark of a reservoir or well or to the ordinary water line of any watercourse.
(d) [Human excreta.]
(1) No human excreta shall be deposited, thrown or placed in or be allowed to escape into any watercourse, reservoir or well of such public water supply.
(2) No human excreta shall be spread or deposited upon the surface of the ground on any part of the watershed.
(3) No human excreta shall be deposited underneath the surface of the ground or any part of the watershed within a distance of 300 feet from a reservoir or well or 150 feet from any watercourse, except in watertight containers as prescribed by paragraphs (6) through (9) of this subdivision.
(4) No human excreta shall be buried in the ground on any part of the watershed outside the distance prescribed in paragraph (3) of this subdivision unless it be deposited in a trench or pit and covered with a minimum of 18 inches of earth, compacted in such a manner as to effectually prevent its being washed onto the surface of the ground by rain or melting snow.
(5) Where a privy or other place in regular use or intended for regular use for the deposit of human excreta is not provided with a watertight receptacle or watertight pit or vault, but has a porous receiving pit or vault, such structure or place shall not be allowed to remain within a distance of 300 feet of any reservoir or well or within 150 feet of any watercourse, and no such structure shall be erected within the aforesaid distances. The contents of such pits or vaults shall be disposed of in the manner prescribed by paragraph (4) of this subdivision.
(6) Where a privy or other place used for the deposit of human excreta is provided with a watertight receptacle or watertight pit or vault, such privy or other place shall not be located or be allowed to remain within a distance of 200 feet of any reservoir or well or within a distance of 100 feet of any watercourse, except as hereinafter provided in paragraph (7) of this subdivision. (For septic tanks or watertight cesspools, see paragraph [9] of this subdivision.)
(7) Wherever the limiting distances stipulated in paragraph (6) of this subdivision cannot be obtained, then such privy shall be placed as far as possible from any reservoir, well or watercourse and shall be constructed of masonry, concrete or metal in such manner as to form a watertight receptacle from which no outward percolation can take place, and any such installation shall be made only with the approval and under the supervision of Spring Brook Water Company or its successors. The contents of such watertight receptacle, if deposited on the watershed, shall be disposed of in the manner prescribed by paragraph (4) of this subdivision.
(8) Every privy, privy vault, pit or other receptacle used for the deposit or storage of human excreta located between the limiting distances stipulated in paragraphs (5) and (6) of this subdivision shall be provided with an approved watertight receptacle or watertight removable container which shall be emptied when filled within six inches of the top and the contents disposed of in the manner prescribed by paragraph (4) of this subdivision.
(9) Any septic tank installed for the deposit of sewage shall be watertight and all inlet and outlet pipes shall be watertight for a distance of not less than 300 feet from any reservoir or well and 150 feet from any watercourse, and no leaching bed or cesspool for the disposal of the effluent from such septic tank shall be installed within these distances. (See subdivision [f].)
(10) No cesspool for the deposit of sewage shall be installed within 300 feet of any reservoir or well nor within 150 feet of any watercourse. When any cesspool is cleaned, the deposits or matter shall be disposed of in the manner prescribed by paragraph (4) of this subdivision.
(11) Whenever, in the opinion of the State Commissioner of Health, human wastes or excremental matter from any privy, receptacle, trench, pit or place of disposal may be washed over the surface of the ground or percolate through the soil in an imperfectly purified and unsafe condition so as to reach any watercourse or reservoir or well, then said privy, receptacle, trench, pit or place of disposal shall be removed, after due notice thereof, to such a place as shall in his opinion be safe and proper and in conformity with this section.
(e) [Sink wastes.]
No sink or laundry wastes or polluted liquids of any kind not specified or included herein shall be discharged or allowed to flow into any reservoir, well or watercourse nor shall they be deposited under the surface of the ground within 100 feet of any reservoir, well or watercourse.
(f) [Exception for approved plans.]
The restrictions herein contained and the limiting distances do not apply to sewer and sewer appurtenances or to sewage treatment plants, such as septic tanks with tile drains or leaching bed, cesspools, etc., constructed in accordance with plans submitted to and approved by the State Commissioner of Health and installed under the supervision of Spring Brook Water Company or its successors.
(g) [Garbage.]
No garbage, refuse, putrescible matter, decayed fruits and vegetables or any other matter that may pollute or contaminate water shall be deposited in any reservoir, well or watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir, well or watercourse nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface of the ground into any reservoir, well or watercourse.
(h) [Bathing.]
No person shall wade, bathe or swim or be permitted to wade, bathe or swim in any reservoir or watercourse.
(i) [Boating, fishing.]
No boating or fishing of any kind, ice cutting or trespassing shall be permitted in any reservoir except by duly authorized employees of Spring Brook Water Company or its successors in the regular performance of their duties in the supervision, operation and maintenance of the water supply.
(j) [Animals.]
(1) No animal or animals, including poultry and swine, shall be watered, washed or allowed to wade, wallow, swim or stand in any reservoir. No animal or animals, including poultry and swine, shall be washed or be permitted to wade, wallow, swim or stand in any watercourse nor shall any swine be watered in any watercourse and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter of animal origin.
(2) No building for the housing of animals or poultry and no barnyard, hogyard, pigpen or permanent poultry yard shall hereafter be constructed or placed so as to be located within a distance of 200 feet from any reservoir or well or 100 feet from any watercourse. A temporary poultry yard may, however, be located at a distance of not less than 35 feet from a watercourse, provided it be relocated at least annually.
(3) No hitching or standing place for animals shall be located in such a manner that the drainage, leachings or washings therefrom can pollute any reservoir, well or watercourse.
(4) No manure shall be piled or allowed to remain piled within 200 feet of any reservoir or well nor within 100 feet of any watercourse. The limiting distances herein specified shall not apply to manure when spread as fertilizer and immediately plowed under.
(k) [Camps.]
No camp (including tourist cabins), tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use (except as a private camp or dwelling maintained by a person for his own personal use and for the use of his family and friends) shall be located, placed or maintained within a distance of 300 feet of any reservoir, well or watercourse, except when such camps, tent, building or other structure is connected with a permanent sewer system and sewage treatment plant approved by the State Commissioner of Health.
(l) [Cemeteries.]
No interment of the body of a human being or animal shall be made within a distance of 300 feet from any reservoir, well or watercourse and any interment on the watershed shall be made in a manner which will prevent any pollution of the water supply.
(m) [General clause.]
Every person living on or visiting the watershed or passing over the public highways thereon shall refrain from any act not herein specified which may pollute such public water supply.
(n) [Inspection.]
Spring Brook Water Company or such other person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoirs, watercourses and watersheds tributary thereto for the purposes of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the owners of the said water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violation. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said owners to promptly notify the State Commissioner of Health of such violation. The owners of the said water supply shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(o) [Penalty.]
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
PERSONNEL PERSONNEL
10 CRR-NY 14-4.81 Personnel training
The permit-issuing official may establish and conduct or designate training programs and require that owners and/or operators of mobile food service establishments or pushcarts attend them.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.12 Accrued expense
See accrued liability.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.2 Construction
Terms not defined in this Subpart are defined in Subpart 5-21 of this Part. Human milk banks shall apply for licensure and otherwise comply with Subpart 52-2 of this Part, and shall meet all general technical standards for tissue banks specified in Subpart 52-3 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 458 NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 458.3 Other than salaries and wages
(a) Employee benefits.
The costs of employee benefits are charged directly to the appropriate functional reporting center. If such benefits are charged initially to an employee benefits account, they must be assigned to appropriate functional reporting centers at year-end prior to cost finding. Reference: section 452.4(a)(1)(ii). Specific classifications for employee benefits follow:
(1) Employee Uniform Allowance;
(2) FICA;
(3) State Unemployment and Federal Unemployment Insurance;
(4) Group Health Insurance;
(5) Pension and Retirement—Union;
(6) Workers' Compensation Insurance;
(7) Pension and Retirement—Nonunion;
(8) Disability;
(9) Other Employee Benefits;
(10) Union Health and Welfare; and
(11) Employee Meal Allowance.
(b) Fees.
The fees and other amounts paid for professional services of people who are not on the facility's payroll are included in the following classifications:
(1) Administrative Fees—Long-Term Debt;
(2) Physicians' Fees.
Included in this classification are all fees paid to nonsalaried physicians for patient care and supervisory activities, and other professional fees for service;
(3) Therapists and Other (Nonphysicians);
(4) Consulting and Management Services;
(5) Legal Services;
(6) Auditing Services;
(7) Registered Nurses;
(8) Licensed Practical Nurses;
(9) Private Duty Nurses' Fees; and
(10) Other Fees.
(c) Supplies and materials.
The following classifications are used to report the costs of the various supplies used by a residential health care facility. The fair market value of donated supplies is included in these classifications if the commodity would otherwise be purchased by the facility. An offsetting amount would be included in the reporting level Other Operating Revenue, Donated Commodities, section 453.3(i)(2)(xxi) of this Article.
(1) Disposable Linen;
(2) Prescription Drugs.
Include in this classification the cost of all drugs for which a prescription would be required if purchased at an outside pharmacy;
(3) Medicine Cabinet Drugs.
Include in this classification the cost of all drugs that could be purchased without a prescription;
(4) Other Medical Care Materials and Supplies.
Include in this classification the cost of all medical materials and supplies used in direct patient care;
(5) Dietary—Food.
Include in this classification all food purchased by the facility;
(6) Dietary—Other.
Include in this classification all dietary supplies other than food;
(7) Linen and Bedding;
(8) Cleaning Supplies;
(9) Office and Administrative Supplies;
(10) Employee Wearing Apparel;
(11) Instruments and Minor Medical Equipment;
(12) Minor Nonmedical Equipment; and
(13) Other Supplies and Materials.
Include in this classification the cost of nonmedical supplies not included elsewhere. Include the cost of miscellaneous supplies used for the personal care of patients.
(d) Purchased and contracted services.
These classifications are provided to report the costs of purchased or contracted services. For instance, if the laboratory function is contracted outside the residential health care facility, the expense would be classified Contracted Services, in the laboratory functional reporting center. If, however, a minor service such as exterior painting were purchased outside the residential health care facility, the expense would be classified Repairs and Maintenance—Purchased Services—Nonassignable. The difference between the purchased and contracted classification lies in the magnitude of the service provided by outsiders. Note that because the service rendered (exterior painting) benefited the entire facility and, therefore, is not directly assignable to a specific functional reporting center (other than the Plant Operation and Maintenance functional reporting center), the cost of the service is classified Repairs and Maintenance—Purchased Services—Nonassignable. In those instances where outside repairs and maintenance can be directly assigned to a specific functional reporting center, e.g., the repair of a piece of laundry equipment, the cost must be classified Repairs and Maintenance—Purchased Services—Directly Assignable.
(1) Repairs and Maintenance—Purchased Services—Nonassignable. Include in this classification purchased repair and maintenance services not directly assignable to a specific functional reporting center other than the Plant Operation and Maintenance functional reporting center;
(2) Repairs and Maintenance—Purchased Services—Directly Assignable. Include in this classification purchased repair and maintenance services that are directly assignable to a functional reporting center other than the Plant Operation and Maintenance functional reporting center;
(3) Medical—Purchased Services;
(4) Management Services;
(5) Collection Services;
(6) Other Purchased Services; and
(7) Contracted Services.
(e) Depreciation, leases and rentals.
(1) Depreciation and Amortization;
(2) Rental or Lease—Land;
(3) Rental or Lease—Buildings;
(4) Rental or Lease—Fixed equipment; and
(5) Rental or Lease—Movable equipment.
(f) Other direct expenses.
(1) Electricity;
(2) Gas;
(3) Water and Sewer;
(4) Fuel Oil #2;
(5) Fuel Oil #4;
(6) Fuel Oil #6;
(7) Other Utilities.
Include in this classification steam, coal and all other utilities;
(8) Insurance;
(9) Interest.
Include in this classification all interest expense of the facility;
(10) Licenses and Taxes (other than Income Taxes);
(11) Telephone and Telegraph;
(12) Dues to Nursing Home Associations;
(13) Printing, Duplicating, Microfilming;
(14) Travel, Conferences, Workshops;
(15) Books, Periodicals, Etc.; and
(16) Other Direct Expenses.
(g) Assessments from municipalities, religious or educational foundations, or other associations.
These accounts are used to report costs assessed by parent/subsidiary organizations, such as municipalities, religious or educational organizations.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.15 Refuse and animal waste, storage and disposal
(a) The agricultural fairground owner shall ensure that facilities are provided and maintained for the temporary storage and handling of refuse and animal waste to prevent insect and rodent infestations and contamination of potable water, streams, lakes or other water courses.
(b) The agricultural fairground owner shall develop and update annually a written plan describing the procedures for temporary storage and handling of refuse and animal waste. The plan must be submitted to the permit-issuing official for approval. The permit-issuing official shall approve the plan after a determination that the plan is consistent with the requirements and objectives of this Subpart.
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.10 Sewage collection and treatment
(a) Facilities shall be provided and maintained for the satisfactory treatment and disposal of sewage. In addition, such facilities shall meet the following requirements:
(1) Submission of plans. A plan for new or modified sewage treatment facilities shall be submitted to the permit-issuing official at least 60 days prior to beginning construction.
(2) Plan approval and construction. Plans for sewage treatment system construction or improvements shall be approved prior to construction by the permit-issuing official and/or New York State Department of Environmental Conservation. No construction of new or modified sewage treatment facilities shall commence until all required approvals have been obtained. Construction shall be in accordance with the approved plans.
(b) The presence of inadequately treated sewage on the surface of the ground is prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.287 Registration
The process of formally entering a patient's name on the institution's records for service in a routine outpatient care service area.
10 CRR-NY 441.305 Salvage value
The price at which an asset of any kind can be sold less whatever cost is yet to be incurred.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter N PROFESSIONAL MEDICAL AND DENTAL SERVICES
Part 91 EXCESS LIABILITY INSURANCE POOL: PHYSICIANS AND DENTISTS
10 CRR-NY 91.2 Reporting requirements
(a) Physicians and dentists who have professional privileges in a general hospital providing emergency medical care and who, from time to time, provide emergency medical care in such hospital, and who wish to avail themselves of the excess malpractice insurance coverage or equivalent excess coverage, shall submit a request in writing to the hospital with which the physician or dentist is primarily affiliated, as determined pursuant to this section, by October 24, 1986 for the period July 1, 1986 through June 30, 1987 and in accordance with notices issued by the pool administrator for annual periods beginning July 1st, thereafter, for certification of eligibility for purchase of excess malpractice insurance coverage or equivalent excess coverage as defined in section 91.1 of this Part. This request shall contain appropriate documentation and assurances that the required primary insurance is in force and will be maintained. This request shall set forth the number of admissions for each hospital where the physician or dentist has admitting privileges and the number of consultative visits for each hospital where he/she provides such services. If the physician or dentist has professional privileges in more than one general hospital, then the physician or dentist shall designate and submit the request for certification to the general hospital with which he/she is primarily affiliated. Primary affiliation shall be determined based on such factors as the number of hospital admissions or consultative services in the designated hospital in the immediate preceding fiscal year compared with hospital admissions and/or services for such period in other general hospitals in which the physician or dentist, from time to time, provides emergency medical or dental care to persons who require such care.
(b)
(1) A physician or dentist should designate as his/her primary affiliation that facility where the practitioner has the majority of admissions and/or consultative services.
(2) A physician or dentist may, however, provide an alternative designation. If another facility is so designated, the physician or dentist shall provide a justification in the written request for certification of eligibility as to the reason for the alternative designation.
(c)
(1) A hospital shall accept the designation or alternative designation of primary affiliation by a physician or dentist requesting such designation in accordance with paragraphs (b)(1) and (2) of this section, unless it has knowledge and information requiring it to reject the designation or alternative designation.
(2) If the hospital rejects a designation or an alternative designation, then it must provide written justification and specific reasons for denying the request to the physician or dentist based upon the criteria set forth in subdivision (a) of this section, and considering any justification for an alternative designation provided by the physician or dentist in accordance with paragraph (b)(2) of this section within five business days of receipt of the written request. If the hospital does not reject within five business days, the request for designation shall be deemed acceptable.
(d) All general hospitals providing emergency medical care shall certify in writing by November 7, 1986, for the periods July 1, 1986 through June 30, 1987 and in accordance with notices issued by the pool administrator for annual periods beginning July 1st, thereafter, on forms acceptable to the Superintendent of Insurance and the Commissioner of Health, those physicians and dentists who are eligible for excess medical malpractice coverage and the number of admissions and/or consultative visits for each hospital where such services are provided.
(e)
(1) If a dispute arises, the hospital and physician or dentist shall have until the general hospital certification deadline established in subdivision (d) of this section in which they may resolve any differences regarding primary affiliation and provide the certification of eligibility to the Superintendent of Insurance and the Commissioner of Health.
(2) If a physician or dentist is not certified eligible based upon such differences, the physician or dentist may designate in accordance with subdivision (b) of this section and request certification of eligibility by another general hospital as his/her primary affiliation within seven days of the deadline established in subdivision (d) of this section. Such designation must be actually received by the alternate designated hospital within such seven-day period. Within seven days of the receipt of the designation and request for certification of eligibility, such general hospital shall submit a certification of eligibility to the Superintendent of Insurance and Commissioner of Health or reject such designation.
(f) Physicians and dentists eligible or applying for certification of eligibility for purchase of excess malpractice insurance coverage shall complete and submit such applications and forms approved by the Superintendent of Insurance as required by the excess liability insurance carrier(s) for purchase of the excess liability insurance.
(g) All hospitals shall be required, on a form acceptable to the Superintendent of Insurance and the Commissioner of Health, to notify in writing every physician or dentist receiving new admitting privileges, who has not been certified eligible for excess malpractice insurance coverage pursuant to this Part at another general hospital, of the availability of excess malpractice insurance coverage under the criteria set forth in subdivision (a) of this section. Such physician or dentist may designate such general hospital and request certification of eligibility for purchase of excess malpractice insurance coverage in accordance with this section. Such physician or dentist certified eligible in accordance with this section may receive the excess malpractice insurance coverage prospectively from the date the requirements of the excess liability insurance carrier(s) are satisfied.
(h) Any physician or dentist who has not requested or received certification of eligibility for purchase with excess malpractice insurance coverage or who did not satisfy the requirements of the excess liability insurance carrier in accordance with subdivision (f) of this section may apply for designation, certification and purchase of such excess malpractice insurance coverage in accordance with this Part and may receive excess malpractice insurance coverage prospectively from the date the requirements of the excess liability insurance carrier are satisfied.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.105 Equipment location
Equipment is to be located and installed in a way that prevents food contamination and facilitates cleaning the establishment. Unobstructed working spaces are to be provided sufficient to permit employees to perform their duties readily without contamination of food or food-contact surfaces by clothing or personal contact.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.4 Licenses and registrations
(a) An applicant for a license as a nursing home administrator who has met the qualifications prescribed by article 28-D of the Public Health Law and this Part and who has passed the examination required by such article shall be issued a license by the board certifying that such applicant has met the requirements of the law and rules and regulations entitling him or her to serve, act, practice and otherwise hold himself or herself as a duly licensed nursing home administrator.
(b) Commencing January 1, 1972 and biennially thereafter, every licensee shall register with the board. Every licensee issued a license during a biennial registration period shall register with the board within 30 days following the issuing date of the license. The application for registration shall contain such information as may be specified by the board or commissioner, including name, address, age, practice status, employer, and continuing education training taken. The commissioner shall issue a certificate of registration to those persons possessing a valid license and who meet the requirements of article 28-D of the Public Health Law.
(c) The department shall issue a biennial registration card to each duly licensed nursing administrator upon the submission of a complete and accurate application for registration in a form and manner determined by the board.
(d) Every person entitled to engage in the practice of nursing home administration in the State shall permanently display in his principal place of employment his or her license to practice nursing home administration and shall have his or her current biennial registration card readily available while engaged in the practice of nursing home administration.
(e) The current biennial registration card must be exhibited when requested by any of the following:
(1) an officer or employee of the department, county or city health department, or other governmental agency engaged in the administration or enforcement of the Public Health Law, the Sanitary Code, the New York City Health Code or other laws, and rules and regulations pertaining to nursing homes; or
(2) an employer in whose employ the licensee practices or intends to practice nursing home administration.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.7 Limitations of a certificate of authority
(a) A certificate of authority pursuant to this Subpart shall be limited to the proposed article 44 service area described in the application upon which the certificate is issued.
(b) A certified operating MCO which seeks to extend its approved article 44 service area, and has defined a new potential enrolled population therein, shall submit an application, and shall not extend the service area until an amended certificate of authority is issued. An application for extension of the service area shall include:
(1) identification of the new service area for which approval is sought, and the projected enrollment on a monthly basis for three years;
(2) copies of all proposed contracts with providers of services for the proposed new service area; these contracts shall include the provisions in section 98-1.5(b)(6)(i)-(v) of this Subpart;
(3) a list of providers and facilities with whom contracts have been or will be executed, including the location and specialty area of each provider; and
(4) except for PCPCPs, such other information, including financial projections, as the commissioner, in consultation with the superintendent, as appropriate, shall deem necessary to determine the ability of the applicant to make services available and accessible to the identified potential enrollment population, and to otherwise approve the service area expansion application.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 100.15 Latham Water District, town of Colonie (wells)
(a)
[Application.]
The rules and regulations hereinafter give, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on plots of land owned by the Latham Water District, situated on the south side of Shaker Road, west of Wolf Road, approximately one and a quarter miles west of the Latham-Loudonville Road; on the east side of the Old Niskayuna Road, approximately three quarters of a mile north of the Troy-Shaker Road; and on the east side of Wade Avenue, approximately one half mile south of the Troy-Schenectady Road in the town of Colonie, Albany County, which form the source of the public water supply of the Latham Water District, town of Colonie, Albany County, N. Y.
(b) [Definitions.]
(1) The term wells wherever used in this section, is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at these points for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well.
(c) Privies adjacent to any well.
No privy, privy vault, pit, cesspool or other receptacle of any kind for the storage or deposit of human excreta shall be constructed, maintained or allowed to remain within 200 feet of the wells of the public water supply of the Latham Water District.
(d) [Bath water, wastes.]
No bath water, laundry wastes, sewage or excremental matter from any source whatsoever shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 200 feet of the wells of the public water supply of the Latham Water District.
(e) [Human excreta, compost.]
No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 200 feet of the wells and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of the wells of the public water supply of the Latham Water District.
(f) [Garbage, refuse.]
No garbage, putrescible matter, kitchen or sink wastes or refuse of any kind nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface within 200 feet of the wells of the public water supply of the Latham Water District.
(g) [Animals.]
No stable for cattle or horses, no barnyard, hogyard or pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the wells of the public water supply of the Latham Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that drainage, leachings or washings from the same may enter the wells without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from the wells of the public water supply of the Latham Water District.
(h) [Trespassing.]
No trespassing shall be allowed upon the property of the Latham Water District upon which the wells of the public water supply of the Latham Water District are located, and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Latham Water District.
(i) [Inspections.]
The board of water commissioners of the Latham Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Latham Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(j) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Latham Water District.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.7 Reporting requirements
(a) The tissue bank shall have a written procedure for documenting errors or accidents in retrieval, testing, processing, storage or distribution of tissue that may affect the safety of any product. If the error or accident is not detected prior to issuance of the tissue, specimens, or test results to a hospital or other tissue bank, transplantation facility or insemination/implantation site, the error or accident shall be reported immediately to the receiving facility. All such errors and accidents shall also be reported to the department's Wadsworth Center within seven calendar days of discovery.
(b) All New York State-licensed tissue banks that directly perform or arrange for the performance of transmissible disease testing of donors shall:
(1) make the results of such testing available, upon request, to other tissue banks receiving tissue from the same donor; and
(2) report, within 24 hours, all positive test results that affect donor suitability to the comprehensive tissue procurement service, if a different facility, except that positive culture results need not be reported if contamination can be traced to a specific step in tissue processing not affecting other tissues processed from the same donor.
(c) The comprehensive tissue procurement service shall report significant positive test results, as determined by the medical director, to facilities receiving tissues from the same donor so that decisions on quarantining and/or physician notification may be made in a timely and appropriate manner.
(d) When requested, a tissue bank shall submit reports to the department containing such information and data concerning its activities as may be required by this Part. Such reports shall be signed by the director of the tissue bank.
(e) Comprehensive tissue procurement services that terminate operations shall submit, for approval by the department, a plan for the continued storage of donor records for the minimum time periods specified in this Part.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.11 Applicability
The provisions of sections 5-1.10 through 5-1.15 of this Subpart shall apply, throughout the State of New York, to all existing and proposed sources of water supply.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.236 Overhead
(a) Any cost of doing business other than a direct cost of an output of product or service.
(b) A general name for costs of materials and services not directly adding to or readily identifiable with the product or service constituting the main object of an operation.
Chapter I STATE SANITARY CODE
Part 19 CLINICAL LABORATORY DIRECTORS
10 CRR-NY 19.4 Denial of an application for a certificate of qualification
(a) In determining whether to deny an application for a certificate of qualification in whole or in part, the department shall consider: the applicant's education, experience, and licensure as required in sections 19.2 and 19.3 of this Part; the applicant's demonstrated ability to discharge the responsibilities set forth in section 19.3(c) of this Part; the character and competence of the applicant and the laboratory or laboratories directed; and any other factors the department considers relevant, including, but not limited to:
(1) prior sustained charges of administrative violations of state or federal laws, rules and regulations related to the provision of health care services or reimbursement for such services, against the applicant individually or any laboratory directed by the applicant;
(2) conviction of any crime, including, but not limited to, any offense relating to the furnishing of, or billing for, laboratory services and medical care, services, or supplies, or which is considered an offense involving theft or fraud;
(3) false representation or omission of any material fact in making an application in any state or city of the United States for any license, permit, certificate, or registration related to a profession or business, or in making an application for a certificate of qualification or laboratory permit to New York State;
(4) submission of a laboratory permit application which conceals an ownership or controlling interest by any person who otherwise would be ineligible for a permit;
(5) failure to supply additional documentation of training and/or experience, pursuant to a written request for such documentation, in the course of applying for a certificate of qualification;
(6) on the part of any laboratory, category, or subcategory directed by the applicant, a pattern of repetitive failures of required proficiency testing performance in one or more proficiency testing categories, excluding failure for administrative reasons such as late result submission;
(7) on the part of any laboratory, category, or subcategory directed by the applicant, a pattern of deficiencies on onsite inspection, especially in areas of quality control, quality assurance, laboratory management, and handling of regulated medical waste and radioactive materials, including refusal or inability to produce records as requested by department employees, which deficiencies are not corrected from inspection to inspection or which recur at each inspection despite written notice of violations by a state or Federal licensing or auditing agency and which jeopardize the quality of test results and resulting patient care, even if interim corrections have occurred;
(8) on the part of any laboratory, category, or subcategory directed by the applicant, performance of any laboratory procedures not authorized by the laboratory permit issued pursuant to article 5, title V of the Public Health Law; or operation or direction of a laboratory without a permit; or continuing operation or failure to notify the department after a change in director, ownership, or location has voided the permit;
(9) on the part of any laboratory, category, or subcategory directed by the applicant, referral of specimens collected in New York State to laboratories which do not possess a New York State permit;
(10) on the part of any laboratory, category, or subcategory directed by the applicant, knowing acceptance of specimens or requisitions for laboratory examination from, or issuance of reports to, a person or persons not authorized by law to submit such specimens or requisitions, or receive such reports;
(11) on the part of any laboratory, category, or subcategory directed by the applicant, issuance of reports on laboratory work, including both patient samples and proficiency testing, actually performed in another laboratory, without designating the fact that the examinations or procedures were performed in another laboratory; and/or testing and reporting results on unsatisfactory specimens as defined by the department, including unlabelled specimens or specimens of insufficient quantity to conduct the analyses requested;
(12) on the part of any laboratory, category, or subcategory directed by the applicant, failure to establish and ensure that employees follow procedures for disposal or handling of specimens or infectious or radioactive medical waste, in violation of applicable state and Federal laws, rules and regulations, or in a manner which endangers the public, the laboratory's employees, or the environment;
(13) employment of unqualified or unlicensed technical personnel or an insufficient number of such personnel;
(14) failure of the applicant to be responsible for adequately supervising laboratory personnel to ensure the proper performance of all tests conducted in the laboratory; and
(15) any other factor having a direct bearing on the applicant's ability to provide or supervise the provision of high quality laboratory services, or to ensure compliance with statutory and regulatory requirements.
(b) If an application for a certificate of qualification is denied, the applicant shall be given written notice of the proposed denial, stating the reason or reasons for the denial. Such notice shall be sent by certified mail and shall be a final determination to be effective 30 days from the date of the notice, unless a hearing is requested pursuant to subdivision (c) of this section.
(c) If the department gives notice of the proposed denial of an application for a certificate of qualification, the applicant may request a hearing on the proposed denial by submitting a written request for a hearing to the department within 10 days of the date of the notice. Submission of a request for a hearing within 10 days shall stay any action to deny the application for a certificate of qualification, pending the department's decision following the hearing on such proposed denial.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-4.41 Food; food sources; food limited
(a) Food is to be free from adulteration, spoilage, filth or other contamination, and suitable for human consumption.
(b) Food is to be obtained from sources that comply with all laws relating to food and food labeling. The use of food prepared in any place that is not operated under jurisdiction of an appropriate regulatory agency and having a current permit or license, if required, to operate from that agency is prohibited. Only clean, whole eggs, with shell intact and free from cracks or checks, or pasteurized liquid, frozen or dry eggs or pasteurized dry egg products are to be used. All containers in which shell eggs are received must identify the source.
(c) Pushcarts may serve only food which requires limited preparation, such as frankfurters requiring only seasoning and cooking. The preparation or service of other potentially hazardous foods, including pastries filled with cream or synthetic cream, custards and similar products, and salads or sandwiches containing meat, poultry, eggs or fish, is prohibited. Mobile food establishments may serve foods prepared under conditions that protect it from contamination or adulteration, transported and stored at a temperature of 45°F (7.2°C) or below, or at a temperature of 140°F (60°C) or above, in facilities that maintain these temperatures, and served without contamination to the consumer. The permit-issuing official or his designated representative may require that food be served directly in the unopened container in which it was packaged, unless the equipment and operations of the mobile food service establishment are designed, constructed and operated to protect food from contamination. The foods served are limited to those listed in the permit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.1 Definitions
(a) Primary Care Practitioner Scholarship Program shall be known as the Primary Care Service Corps.
(b) Primary care practitioner shall mean a midwife, nurse practitioner, or physician assistant who is licensed, registered or certified by the appropriate governing agency to practice in New York State and who provides or arranges for coordinated primary care services.
(c) Underserved area shall mean an area, site or facility designated pursuant to section 47-3.1 of this Subpart.
(d) Primary care practitioner program shall mean a full- or part-time graduate, undergraduate or certificate course of study, approved or registered by the regents or a program registered by the Education Department or determined by the Education Department to be equivalent, and which an individual is required to complete in order to become licensed, registered, or certified as a primary care practitioner.
(e) Academic year shall mean the period between July 1st and June 30th of the following year.
(f) Full-time enrollment shall mean matriculation as a student taking at least 12 credits or their equivalent, except that in the final semester of study the student must take sufficient credits or their equivalent in order to complete training, but not fewer than six credits.
(g) Part-time enrollment shall mean matriculation as a student taking at least six credits but fewer than 12 or their equivalent per semester, except if the student is enrolled full-time and in the final semester.
(h) Recipient shall mean an individual who has signed a service agreement to receive a scholarship award under the Primary Care Service Corps program in return for a service obligation.
(i) Service agreement shall mean the written agreement prepared by the Department of Health to be signed by a recipient, prior to issuance of an award, specifying the terms of the award and the service obligation required.
(j) Scholarship award shall mean the sum of the Primary Care Service Corps funds paid to, or on behalf of, a recipient under this Subpart during one academic year. An award shall not exceed the cost of attendance which shall mean tuition, required fees, books, transportation, and room and board; nor shall it exceed $15,000 for full-time study or $7,500 for part-time study; nor shall any combination exceed $15,000 annually.
(k) Effective date shall mean the beginning date of the first semester for which the recipient has received a Primary Care Service Corps scholarship.
(l) Service obligation shall mean the period of time a recipient is required to provide primary care in an underserved area designated pursuant to section 47-3.1 of this Subpart.
(m) Alternative service shall mean work in a health facility in an underserved area as a paraprofessional or in a profession other than the one for which the award was given in fulfillment of the service obligation.
(n) Reporting date shall mean the date upon which a recipient is required to begin employment in fulfillment of the service obligation.
(o) Rescission shall mean the withdrawal, cancellation or revocation of an award in accordance with the provisions of section 47-6.5 of this Subpart, after the signing of the service agreement.
(p) Waiver shall mean full or partial release granted by the Commissioner of Health of the service obligation and/or any financial obligation for repayment of scholarship award monies incurred or owed by a recipient.
(q) Deferral shall mean a delay or temporary suspension granted by the commissioner of an award payment and/or a service obligation and/or any financial obligation for repayment of award monies incurred by a recipient, with no resulting reduction in service obligation or financial obligation.
(r) Default shall occur if a recipient has not received a waiver or deferral from the commissioner and the recipient fails to complete the program of study, the recipient is not available to fulfill his/her service obligation on the reporting date, the recipient fails to complete his/her service obligation within the time prescribed by the Commissioner of Health, or a scholarship award is rescinded pursuant to section 47-6.5(a) of this Subpart, after dispersal of scholarship monies to, or on behalf of, the recipient.
(s) President shall mean the president of the New York State Higher Education Services Corporation.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.3 Tissue procurement services
(a) A facility that engages in donor selection and solicitation, and retrieval of musculoskeletal tissue shall be licensed by the department as a comprehensive tissue procurement service.
(b) A facility whose tissue acquisition activities are limited to donor selection and solicitation by its own staff shall be licensed by the department as a limited tissue procurement service.
(c) Comprehensive tissue procurement services retrieving musculoskeletal tissue aseptically from cadaveric donors shall maintain written standard operating procedures that assure that the retrieval environment, including, but not limited to, walls, floors and permanent equipment, is suitable for retrieval and adequate to prepare an aseptic field. A working sink shall be available.
(d) Musculoskeletal tissue retrieval shall be performed only by trained retrieval technicians under the supervision of the director of a licensed comprehensive tissue procurement service. The director of the licensed comprehensive tissue procurement service shall be responsible for developing policies, procedures and standards for the educational background, training, certification and continuing education of retrieval technicians. Documentation of compliance with this requirement and the standards developed shall be maintained.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.2 Diseases screened
(a) Unless a specific exemption is granted by the State Commissioner of Health, screening pursuant to this Subpart shall be performed by the testing laboratory and according to recognized clinical laboratory procedures.
(b) In accordance with section 2500-a of the Public Health Law, the State Commissioner of Health shall designate which diseases shall be screened for and shall list such diseases on the department’s website.
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.12 Applicants holding an out-of-state nursing home administrators license
(a) An individual holding a valid and current nursing home administrator license from another state seeking a New York State nursing home administrator license must submit a complete licensure application and pay all applicable fees.
(b) The applicant must disclose all nursing home administrator and other professional licenses or comparable authorization granted or issued by any and all states, territories, possessions or foreign governments regardless of the status of such license(s).
(c) To obtain a New York State nursing home administrator license the applicant must demonstrate to the board that the applicant:
(1) is 21 years old or older;
(2) is of good moral character and suitability;
(3) is in receipt of a Baccalaureate or higher level degree from an accredited educational institution. The accrediting body must be recognized by the NYS Department of Education and acceptable to the board. Official sealed school transcripts must be received by the board directly from the educational institution;
(4) has performed successfully on the national nursing home administrator examination by passing this examination within three attempts in any five-year period.
(5) has submitted satisfactory documentation that any and all other nursing home administrator licenses or comparable authorization granted to the applicant by other states, territories, possessions or foreign governments have not been suspended, revoked or otherwise restricted for any reason. Such documentation must be received by the board directly from the licensing or authorizing agency. The board retains the right and authority to review and assess the magnitude of any such discipline and solely determine the eligibility of the applicant for licensure; and
(6) has submitted satisfactory verification from the applicant's employer(s) that the applicant has full-time (at least 35 hours per week) experience of at least two years in the preceding five-years prior to submission of application, as the AOR in an out-of-state nursing home operated in full compliance with applicable State and Federal titles 18 and 19 laws, rules and regulations.
(d) The board retains the right and authority to review and assess the submitted application and documentation including the magnitude of any such discipline and solely determine the applicant's eligibility for licensure.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.23 Movable equipment
Necessary and reasonable expenses related to movable equipment (depreciation computed on a straight-line method or accelerated under a double declining balance on sum-of-the-years-digits method, interest on indebtedness, lease, etc. pursuant to sections 86-5.17, 86-5.19, 86-5.20 and 86-5.22 of this Subpart) are considered to be allowable costs for LTHHCPs.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.17 Dental services
The facility shall provide oral hygiene care and routine and 24-hour emergency dental care in accordance with the comprehensive resident care plan and which meets generally accepted standards of dental and dental hygiene care and services.
(a) Organization.
The facility shall appoint a licensed and currently registered dentist to assist the facility in the development and implementation, in cooperation with nursing and medical services, of written dental service and oral hygiene policies and procedures which:
(1) establish oral hygiene and dental care as components of interdisciplinary resident care planning and treatment;
(2) develop an oral hygiene program to be jointly administered by nursing, dental and dental hygiene staff;
(3) set forth in detail how emergency care to alleviate pain, infection, or swelling and routine dental services are to be provided and the specific arrangements with dentist(s) who are to provide these services including the prompt referral of residents with lost or damaged dentures to a dentist if such residents will benefit from such referral; and
(4) establish a system of determining dental treatment goals for each resident based on the resident's need relative to his or her physical and mental level of functioning, the overall plan of care for the resident and the resident's preferences. These treatment goals shall range on a continuum, progressing from all essential dental services to only routine oral hygiene services and emergency services. The decision to defer treatment of identified dental conditions shall be documented based on physical or mental contraindications for care and the resident's informed choice.
(b) Admission.
An initial screening of each resident's oral health status shall be conducted within 48 hours of admission to determine the need for emergency care to alleviate pain, infection, or swelling. The presence and functioning of any oral prostheses shall be observed, and, with the resident's consent, the prostheses shall be indelibly marked for identification.
(c) Oral examination and treatment.
A complete oral examination of each resident shall be conducted by a licensed and currently registered dentist or dental hygienist within seven days following completion of the initial comprehensive assessment in accordance with section 415.11 of this Part and by a dentist at least annually thereafter. Based on treatment priorities determined at each time of examination, an individual plan of continuing oral hygiene and dental care meeting generally accepted standards of dental and dental hygiene care and services shall be established, or updated, and carried out for each resident. If treatment by a dentist is needed, such treatment shall begin within 30 days of the examination. This shall include arrangements for transportation when the services of a provider outside the facility are required.
(d) Records.
The admission dental record and records of all subsequent dental care shall be maintained as part of the resident clinical record.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.9 Human heart transplantation services
(a) This methodology will be utilized to evaluate certificate of need applications involving the initiation of human heart transplantation services. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of human heart transplantation services. The goals and objectives of the methodology expressed herein are expected to insure that an adequate number of human heart transplantation services are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors and methodology for determining the public need for human heart transplantation services shall include, but not be limited to the following:
(1) The need for human heart transplantation services will be planned initially on a statewide basis, based upon the need for two human heart transplantation centers.
(2) Each applicant for a human heart transplantation service must present evidence that a minimum of 14 transplants per year shall be achieved within two years of initial operation.
(3) There shall be no additional human heart transplantation services approved until each existing transplantation service is performing at least 30 transplantations per year at which time additional applications will be accepted and reviewed by the department.
(4) Priority consideration will be given to applicants that propose to provide this service within the facility's current capacity.
(5) Where public need is established herein, priority consideration will be given to applicants that agree to serve the medically indigent and patients regardless of the source of payment.
(6) In addition, each applicant applying to initiate a heart transplantation service must meet the following standards:
(i) Each applicant must demonstrate the availability of a heart transplantation surgeon with the ability to perform heart transplantation as evidenced by clinical experience in an existing heart transplantation program.
(ii) Each applicant must demonstrate the availability of a heart transplantation team that includes qualified specialists in cardiology, cardiovascular surgery, infectious disease, pulmonary medicine, pediatrics, neurosurgery, anesthesiology, psychiatry, immunologist, and pathologist.
(iii) Each applicant must demonstrate its participation in a donor organ procurement system, or a donor organ harvesting program, or a written affiliation agreement with an existing approved or registered donor organ procurement or harvesting agency.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.46 Empire Clinical Research Investigator Program (ECRIP)
(a) Definitions.
For purposes of this section, the following definitions shall apply:
(1) Clinical research means patient-oriented research, epidemiologic and behavioral studies, or outcomes research and health services research that are approved by an institutional review board by the time the research fellow position is filled.
(2) Clinical research plan means a plan submitted by a consortium or teaching general hospital for a research fellow position which demonstrates, in a form to be provided by the commissioner, the following:
(i) experience the sponsor-mentor and director have in clinical research and the medical field of the study;
(ii) methods, data collection and anticipated measurable outcomes of the clinical research to be performed;
(iii) training goals, objectives and experience the research fellow will be provided to assess a future career in clinical research;
(iv) scientific relevance, merit and health implications of the research to be performed;
(v) clear and comprehensive details on the research fellow position;
(vi) non-duplication with other clinical research positions from the same teaching general hospital or consortium;
(vii) methods to track the career of the research fellow once the term of the position is complete;
(viii) after awards are made, a budget including matching funds; and
(ix) any other information required by the commissioner to implement paragraph (b) of subdivision five-a of section 2807-m of the Public Health Law. The clinical research plan submitted in accordance with this paragraph may be reviewed by the commissioner in consultation with experts outside the Department of Health.
(3) Clinical research fellow position means a post-graduate residency position which:
(i) shall not be required in order for the research fellow to complete a graduate medical education program;
(ii) may be reimbursed by other sources but only for costs in excess of the funding distributed in accordance with paragraph (b) of subdivision five-a of section 2807-m of the Public Health Law;
(iii) shall exceed the minimum standards that are required by the residency review committee in the specialty the research fellow has trained or is currently training;
(iv) may supplement an existing research project;
(v) shall be equivalent to a full-time position comprising of no less than 35 hours per week;
(vi) shall provide, or be filled by a research fellow who has formalized instruction in clinical research, including biostatistics, clinical trial design, grant writing and research ethics;
(vii) shall be supervised by a sponsor-mentor who is a member of a research team directed by a researcher who must have been a principal investigator or co-principal investigator of a Federal research grant or a Patient-Centered Outcomes Research Institute grant, excluding a grant for a conference or for commercial product development, in the two years preceding the date the clinical research plan is submitted to the commissioner; and
(viii) shall be filled by a research fellow who is:
(a) enrolled or has completed a graduate medical education program, as defined in paragraph (11) of this subdivision;
(b) a United States or Canadian citizen, national, or permanent resident of the United States or Canada; and
(c) a graduate of a medical, dental or podiatric school located in New York State, a graduate or resident in a graduate medical education program, as defined in paragraph (11) of this subdivision, where the sponsoring institution, as defined in paragraph (16) of this subdivision, is located in New York State, or resides in New York State at the time the clinical research plan is submitted to the commissioner.
(4) Co-investigator shall mean a person who collaborates with the principal investigator or co-principal investigators in a grant proposal approved and awarded by a Federal agency. Such person is responsible for certain aspects of the grant work but has no budget control.
(5) Consortium means an organization or association, approved by the commissioner in consultation with the council, of general hospitals which provide graduate medical education, together with any affiliated site; provided that such organization or association may also include other providers of health care services, medical schools, payors or consumers, and which meet other criteria pursuant to subdivision six of section 2807-m of the Public Health Law.
(6) Co-principal investigator shall mean one of two people, if applicable, who conceived of and submitted a grant proposal approved and awarded by a Federal agency. Such person is typically responsible for different aspects of the grant work with a separate budget from the second co-principal investigator.
(7) Council means the New York State council on graduate medical education.
(8) Direct medical education means the direct costs of residents, interns and supervising physicians.
(9) Distribution period means each calendar year set forth in subdivision two of section 2807-m of the Public Health Law.
(10) Faculty means persons who are employed by or under contract for employment with a teaching general hospital or are paid through a teaching general hospital's affiliated faculty practice plan and maintain a faculty appointment at a medical school. Such persons shall not be limited to persons with a degree in medicine.
(11) Graduate medical education program means a post-graduate medical education residency in the United States or Canada which has received accreditation from a nationally recognized accreditation body or has been approved by a nationally recognized organization for medical, osteopathic, podiatric or dental residency programs including, but not limited to, specialty boards.
(12) Indirect medical education means the estimate of costs, other than direct costs, of educational activities in teaching hospitals as determined in accordance with the methodology applicable for purposes of determining an estimate of indirect medical education costs for reimbursement for inpatient hospital service pursuant to title XVIII of the Federal Social Security Act (Medicare).
(13) Principal investigator shall mean the person who conceived of and submitted a grant proposal approved and awarded by a Federal agency. Such person directs the work and controls the budget of such a grant.
(14) Research theme means a clinical research topic that represents a strategically important growth area for the consortium or teaching general hospital. Such theme shall be in a field of study suitable to train a resident or residents and cannot be one that has funding in the form of one or more Federal center-type grants, such as a National Institutes of Health program project grant, specialized center grant, or research program grant or cooperative agreement at the consortium or teaching general hospital.
(15) Resident means a person in a graduate medical education program that has received accreditation from a nationally recognized accreditation body or in a program approved by any other nationally recognized organization for medical, osteopathic or dental residency programs including, but not limited to, specialty boards.
(16) Sponsoring institution means the entity that has the overall responsibility for a program of graduate medical education. Such institutions shall include teaching general hospitals, medical schools, consortia and diagnostic and treatment centers.
(b) Within funding amounts set forth in paragraph (b) of subdivision (5-a) of section 2807-m of the Public Health Law and appropriated to ECRIP, and with the objective of securing Federal funding for biomedical research, training research fellows, recruiting national leaders as faculty to act as mentors, and training residents and fellows in biomedical research skills, the following distribution methodology shall apply:
(1) Distributions shall be divided equally amongst all consortia and teaching general hospitals eligible for such distributions; provided that the consortia and teaching general hospitals are required to fund and train one research fellow position per each $100,000 received and shall provide a $100,000 match in each distribution period regardless of the dollar amount distributed pursuant to this subparagraph. If a consortium or teaching general hospital receives a distribution of $400,000 or more, excluding matching funds, in any distribution period then it may implement a secondary research theme in addition to the primary research theme provided both projects demonstrate all requirements. Distributions shall be made in increments determined by the commissioner.
(2) In order to be eligible for distributions pursuant to this subdivision, each consortium and teaching general hospital shall provide to the commissioner by a date specified by the commissioner, the following data and information on a hospital-specific basis. Such data and information shall be certified as to accuracy and completeness by the chief executive officer, chief financial officer or chair of the consortium governing body of each consortium or teaching general hospital and shall be maintained by each consortium and teaching general hospital for five years from the date of submission. Such data and information shall only be submitted by teaching general hospitals currently receiving Medicaid reimbursement for direct or indirect graduate medical education and such submission is limited to a single distribution per operating certificate issued by the commissioner pursuant to subparagraph (1)(i) of this subdivision, provided however, that a teaching general hospital with two or more campuses where one campus is the major teaching affiliate with one medical school and the other campus is the major teaching affiliate with another medical school each of which provides clinical services and research facilities at their respective campuses associated with the medical school, shall be eligible for a separate ECRIP distribution at each campus.
(i) For each research fellow position, information on the type, scope, training objectives, institutional support, clinical research experience of the sponsor-mentor, the name of a principal contact person responsible for tracking the career development of researchers placed in clinical research positions, as defined in paragraph (a)(3) of this section, and who is authorized to certify to the commissioner that all the requirements of the clinical research training objectives set forth in this subparagraph shall be met.
(ii) General information on all institutions collaborating on the clinical research plan, including each institution's role in the research and specific budget information.
(iii) Information for each sponsor/mentor, including experience in mentoring and current and pending Federal research funding distribution.
(iv) Tracking information for all current and past research fellows, including but not limited to:
(a) background information;
(b) employment history;
(c) research status;
(d) current research activities;
(e) research grants and support;
(f) publications and presentations; and
(g) any other information necessary to track and obtain outcome data for all research fellows.
(v) A description of the primary research theme and secondary research theme, if applicable, and how such themes build upon the existing research activities within the consortium or teaching general hospital.
(vi) A description of relevant Federal research funding opportunities (if any) and how the research team plans to target such funding.
(vii) Identification of the research team director who must have been a principal investigator or co-principal investigator of a Federal research or a Patient-Centered Outcomes Research Institute grant within the two years prior to the submission of data pursuant to this subparagraph.
(viii) Identification of all sponsor/mentors who shall participate in the project.
(ix) A letter from the chief executive officer, chief financial officer or chair of the consortium governing body of each consortium or teaching general hospital attesting to the $100,000 match required pursuant to subparagraph (1)(ii) of this subdivision.
(x) Information on collaborations with entities located within New York State, including but not limited to, teaching general hospitals, universities, local health departments, government laboratories, and federally qualified health centers if applicable.
(xi) For each research fellow position, information on the name, citizenship status, medical education and training, and medical license number of the research fellow, if applicable, shall be provided by December 31st of the calendar year in which the distribution is made provided that if a change is requested in relation to the individual holding such position after that date, such information shall be submitted to the commissioner for approval, together with the reasons for such change.
(xii) Information on the status of the clinical research plan, accomplishments, changes in research activities, progress, and performance of the research fellow shall be provided upon completion of one-half of the award term.
(xiii) A final report detailing training experiences, accomplishments, activities and performance of the research fellow, and data, methods, results and analyses of the clinical research plan shall be provided three months after the research fellow position ends.
(xiv) Any other data or information required by the commissioner to implement this section.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.3 Definitions
As used in this Subpart, the following words or terms shall have the indicated meaning, except as otherwise specifically provided:
(a) Approved laboratory shall mean a laboratory approved and certified by the New York State Department of Health's Environmental Laboratory Approval Program.
(b) Approved source shall mean the source of water from a spring, artesian well, drilled well, municipal water supply or any other source which has been evaluated and found to be of satisfactory sanitary quality as determined by the State.
(c) Artesian well water shall mean water that comes from a deep well where water is forced up by underground pressure.
(d) Bottled water shall mean any product, including natural spring or well water taken from municipal or private utility systems or other water, distilled water, deionized water, or any of the foregoing to which chemicals may be added, which are put into sealed bottles, packages, or other containers, to be sold for domestic consumption or culinary use, involving a likelihood of such water being ingested by human beings.
(e) Bottled and Bulk Water Standards shall mean this Subpart.
(f) Bulk water shall mean water intended for potable uses which is transported by tank trucks.
(g) Commissioner shall mean the Commissioner of Health of the State of New York.
(h) Department shall mean the New York State Department of Health.
(i) Food and Drugs 21 CFR shall mean the Code of Federal Regulations, Title 21, Food and Drugs, as published in the Federal Register, Volume 42, page 14355, March 15, 1977, as amended by Volume 44, page 12175, March 6, 1979 and found in 21 CFR, Part 129 - Processing and Bottling of Bottled Drinking Water, pages 137 through 141, revised as of April 1, 1988. A copy is available for public inspection at the offices of the Records Access Officer of the Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237.
(j) Maximum contaminant level (MCL) shall mean permissible level of a physical, chemical, radiological or microbiological substance in water.
(k) Multi-use containers shall mean those containers which are intended by the bottler for more than one use.
(l) Nontoxic materials shall mean materials used in transporting, storing and packaging of bottled or bulk water, which are free of substances which may render the water harmful to health or which may adversely affect the flavor, color, odor, or microbiological or chemical quality of the finished product.
(m) Person shall mean an individual, corporation, company, association, partnership, State agency, municipality, county or Federal agency.
(n) Person in charge shall mean the designated employee or employees who are appointed and in responsible charge of the bottling facility and who are present at all times during the bottling operation.
(o) Principal organic contaminant (POC) shall mean any organic chemical compound belonging to the following classes, except for trichloromethane (chloroform), dibromochloromethane, bromodichloromethane, tribromomethane (bromoform) and any other organic chemical contaminant with a specific MCL listed in section 5-6.11 of this Subpart:
(1) Halogenated Alkane.
(2) Halogenated Ether.
(3) Halobenzenes and Substituted Halobenzenes.
(4) Benzene and Alkyl- or Nitrogen-Substituted Benzenes.
(5) Substituted, Unsaturated Hydrocarbons.
(6) Halogenated Nonaromatic Cyclic Hydrocarbons.
(p) Production line shall mean an assemblage of water bottling equipment which shares product water contact surfaces and may be used to fill one or more container types/sizes or product types.
(q) Recommended Standards for Water Works shall mean the New York State Health Department publication, 1987 edition, published by Health Research, Inc., P.O. Box 7126, Albany, NY 12224. A copy is available for public inspection at the offices of the records access officer of the Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237.
(r) Rural Water Supply shall mean the New York State Department of Health publication as copyrighted in 1966 and reprinted in 1988. A copy is available for public inspection at the offices of the records access officer of the Department of Health, Empire State Plaza, Coming Tower, Albany, NY 12237.
(s) Spring water shall mean water derived from an underground formation from which water flows naturally to the surface of the earth.
(t) State shall mean the State Commissioner of Health or his designated representative.
(u) Total trihalomethane (TTHM) shall mean the sum of the concentration of trichloromethane (chloroform), dibromochloromethane, bromodichloromethane and tribromomethane (bromoform).
(v) Unspecified organic contaminant (UOC) shall mean any organic chemical compound not otherwise specified in this Subpart.
(w) Violation shall mean the failure to comply with or conform to the provisions of this Subpart.
(x) Well water shall mean water that is taken from below the ground through piping or similar installed device using external force or vacuum.
Part 2 COMMUNICABLE DISEASES
CARRIERS AND CONTROL OF CARRIERS OF DISEASE CARRIERS AND CONTROL OF CARRIERS OF DISEASE
10 CRR-NY 2.40 Carriers of disease germs defined; subject to restrictions.*
(a) For the purpose of the Public Health Law and this Chapter a carrier of disease germs is a person in whose secretions or excretions the germs of a communicable disease are present but who does not present clinical evidence of such disease.
(b) A person shall be deemed a carrier of disease germs if:
(1) the germs of communicable disease are found in his secretions or excretions by an approved laboratory; or
(2) epidemiological evidence points to such person as the source of one or more cases of communicable disease and such person refuses to submit specimens of his bodily secretions or excretions for laboratory examination; or
(3) such person is reported as a carrier of disease germs to the State Department of Health by the health authorities of New York City or of any state or nation.
(c) In typhoid fever a person shall be considered a carrier who has not suffered from the disease within 10 days, provided that any person, in whose feces or urine or other discharge from the body typhoid bacilli are present, who has not suffered from typhoid fever within one year may be declared by the State Commissioner of Health to be a chronic typhoid carrier.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.5 Donor qualifications
(a) The human milk bank shall initially screen and periodically assess the donor for conditions and behavior that may affect the quality or nutritional value of milk, or impair the donor's health, including, but not limited to, the donor qualification requirements in Subpart 52-3 of this Part, and for:
(1) the use of medications, tobacco, alcohol and/or other substances in quantities likely to be harmful if transmitted through human milk to a recipient;
(2) systemic chronic diseases or nutritional deficiencies;
(3) acute and chronic infectious diseases;
(4) emotional conditions and/or behavioral disturbances;
(5) history of jaundice in the donor's own infant after one week of age;
(6) sources of exposures which may be associated with environmental contaminants;
(7) duration of breast feeding; and
(8) general ability to understand and follow directions regarding sanitary collection and storage of the milk, and contraindications to donation.
(b) Donors with a history or behavior which places them at high risk for human immunodeficiency virus (HIV) infection or other infectious diseases (see Subpart 52-3 of this Part) shall be permanently excluded from donation.
(c) The human milk bank shall have evidence available that the donor has been tested within one month prior to the first donation and found negative for hepatitis B virus, including hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc); hepatitis C virus; human immunodeficiency virus type 1 (HIV-1); human immunodeficiency virus type 2 (HIV-2); and to human T- lymphotropic virus type I (HTLV-I); and for syphilis and tuberculosis, and that the donor is immune to rubella. Testing for cytomegalovirus shall also be performed, unless donated milk is subjected to the Holder pasteurization method. All laboratory tests shall be performed by a laboratory operating under a permit issued by the department. For out-of-state milk donations, all required laboratory testing shall be performed by a laboratory which is approved by that state's regulating authority, the United States Health Care financing Administration, or by the department. Except for rubella and tuberculosis, testing shall be repeated every six months while the donor is participating in the milk banking program, and the donor shall be found negative prior to any subsequent donations. Milk from a donor testing positive for anti-HBc shall not be made available for clinical use.
(d) The milk bank shall obtain the informed signed consent of the donor for participation in the milk banking program.
(e) The milk bank shall implement a donor education program, including, but not limited to:
(1) the purpose of milk banking and responsibilities of the donor;
(2) operating policies and procedures of the milk bank;
(3) guidelines for sanitary collection and storage of milk;
(4) medical conditions, diseases and medications or other substances contraindicating use of the milk;
(5) diet and nutrition;
(6) smoking and alcohol consumption; and
(7) breast care and common problems associated with breast feeding and milk donation.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.3 Requirements for school admission
A principal or person in charge of a school shall not admit a child to school unless a person in parental relation to the child has furnished the school with one of the following:
(a) A certificate of immunization, as described in section 66-1.6 of this Subpart, from a health care practitioner or from NYSIIS or the CIR, documenting that the child has been fully immunized according to the requirements of section 66-1.1(f) of this Subpart.
(b) Documentation that the child is in process of receiving immunizations as defined in section 66-1.1(j) of this Subpart. A principal or person in charge of a school shall not refuse to admit a child to school, based on immunization requirements, if that child is in process.
(c) A signed, completed medical exemption form approved by the NYSDOH or NYC Department of Education from a physician licensed to practice medicine in New York State certifying that immunization may be detrimental to the child’s health, containing sufficient information to identify a medical contraindication to a specific immunization and specifying the length of time the immunization is medically contraindicated. The medical exemption must be reissued annually. The principal or person in charge of the school may require additional information supporting the exemption.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.6 Determination by the commissioner
(a) After receipt of all the documentation and recommendations required in sections 710.4 and 710.5 of this Part, and the satisfaction of all applicable outstanding contingencies imposed on the approval relating to the project, the commissioner shall make a determination. If the commissioner proposes to disapprove an application or an amendment or issue a determination contrary to the recommendation of the local health systems agency, the opportunity to request a hearing shall be afforded to the applicant or the health systems agency, as appropriate, prior to a final decision. If the application is approved, the applicant may proceed to apply for approval to start construction of the project or specific project phases, if any, pursuant to section 710.7 of this Part.
(b) Any project cost incurred which exceeds a cost already approved under this Part shall not be considered an allowable cost for reimbursement pursuant to any of the provisions of Part 86 of this Title unless, prior to incurring such cost or entering into a contract to incur such cost, the applicant has requested, in a format prescribed by the department, and obtained, the written approval of the commissioner for such increased cost.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.57 Withdrawal of blood samples by individuals other than health care practitioners licensed under title 8 of the Education Law
(a) During the course or as part of any approved public health program (including but not limited to venereal disease control and lead poisoning programs), individuals other than health care practitioners licensed under title 8 of the Education Law may withdraw a blood sample by means of skin prick or intravenous technique when so authorized by the State Commissioner of Health or local health officer.
(b) Before an individual may withdraw blood samples as provided in subdivision (a) of this section, he must have received training satisfactory to the State Commissioner of Health or local health officer to include procedures, precautions and contraindications in the use of techniques of blood withdrawal.
(c) The State Commissioner of Health or local health officer shall maintain a current list of all individuals whose training is satisfactory to him for the withdrawal of blood samples under his direction.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
SERVICES PROVIDED AND GOODS USE SERVICES PROVIDED AND GOODS USE
10 CRR-NY 446.28 Selected special service statistics
(a) Statistical requirements.
(1) Laboratory Services—Clinical (account 7210)— number of procedures.
(2) Laboratory Services—Pathological (account 7230)—number of procedures.
(3) Electrocardiology (account 7290)—number of examinations.
(4) Neurology Diagnostic (account 7460)—number of electroencephalography examinations.
(5) Radiology—Diagnostic (account 7320):
(i) Number of films.
(ii) Number of procedures.
(iii) Diagnostic isotope procedures.
(6) Radiology—Therapeutic (account 7360)—number of treatments:
(i) Superficial treatments.
(ii) Orthovoltage treatments.
(iii) Megavoltage (including Gamma) treatments.
(7) Physical Therapy (account 7510)—number of treatments.
(8) Surgery Services (account 7040):
(i) Total number of persons undergoing surgery.
(ii) Number undergoing surgery in the operating room (exclude open heart).
(iii) Number undergoing surgery elsewhere (exclude open heart).
(iv) Number receiving open heart surgery (with pump-without pump).
(v) Number of cystoscopy room procedures.
(9) Whole Blood and Packed Red Cells (account 7250)—number of transfusions.
(10) Labor and Delivery Services (account 7010):
(i) Number of deliveries.
(ii) Number of live births.
(11) Cardiac Catheterization Laboratory (account 7310)—number of procedures.
(12) Respiratory Therapy (account 7420)—number of oxygen minutes.
(13) Radiology—Diagnostic (account 7320):
(i) Number of angiocardiography procedures.
(ii) Number of Arteriography procedures.
(iii) Number of Cinefluorography procedures.
(14) Laboratory Services—Pathological (account 7230)—Tissue typing—number of tissues typed.
(15) Organs harvested (various accounts):
(i) Number of eyes harvested.
(ii) Number of kidneys harvested.
(iii) Number of other organs harvested.
(b) Distribution of statistical requirements.
(1) Please refer to section 446.44(b) of this Part for all inpatient program services for which these statistics are to be reported.
(2) Please refer to section 446.44(c) of this Part for all outpatient program services for which these statistics are to be reported.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-4.40 Definition of food; contamination; potentially hazardous food
(a) Food is any edible substance, ice, beverage or ingredient used or intended for use or for sale in whole or in part for human consumption.
(b) Contamination means exposing food to filth, toxic substances, manual contact during service or preparation if such food will not be subsequently cooked prior to service, rodent or insect contact or infestation, or any condition which permits introduction of pathogenic microorganisms or foreign matter. Potentially hazardous foods held at temperatures between 45°F (7.2°C) and 140°F (60°C) for a period of time exceeding that reasonably required for preparation are considered to be contaminated. Intact shell egg temperatures shall be considered acceptable if ambient storage temperature is 45°F (7.2°C) or less. Contaminated food is considered adulterated.
(c) Potentially hazardous food is any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea, cooked potato, cooked rice or other ingredients, including synthetic ingredients, in a form capable of supporting:
(1) rapid and progressive growth of infectious or toxigenic microorganisms; or
(2) the slower growth of C. botulinum.
The term does not include foods with a water activity (Aw) value of 0.85 or less, or a hydrogen ion concentration (pH) level of 4.6 or below.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.142 Fund balance
The excess of assets over liabilities (net equity). An excess of liabilities over assets is known as a deficit in fund balance.
Part 445 ACCOUNT DISTRIBUTION INDEX
10 CRR-NY 445.3 Supplies and Services by Natural Expense Classification Index. [4300]
| Item | Cost Center | Code | Natural Classification | | | --- | --- | --- | --- | --- | | Abdominal Packs (disposables) | Using Cost Center | | .42 | Surgical Supplies-General | | Abduction Apparatus (orthopedic) | Using Cost Center | | .58 | Instruments and Minor Equipment | | Abrasive Floor Surfacing | Plant Operations and Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Accounting and Audit Fees | Hospital Administration | 8610 | .35 | Audit Fees | | Ace Bandages | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Acetone | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Acetylene, dissolved | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Acids, laundry | Laundry and Linen | 8300 | .59 | Other Non-Medical and Non-Surgical Supplies | | Actuarial Fees | General Accounting | 8510 | .33 | Consulting and Management Fees | | Adapters, glass, metal, syringe | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Adenotomes | Using Cost Center | | .58 | Instruments and Minor Equipment | | Adhesive Pads | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Adhesive Remover | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Adhesive Tape | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Administrative Resident Stipends | Other Health Profession Education | 8260 | .19 | Other Employee Classifications | | Admission Forms | Patient Accounts, Admitting and Registration | 8520 | .56 | Office and Administrative Supplies | | Advertising, community education | Hospital Administration | 8610 | .89 | Other Expenses | | Advertising, employment | Hospital Administration | 8610 | .89 | Other Expenses | | Advertising, other | Using Cost Center | | .89 | Other Expenses | | Affiliation Dues | Hospital Administration | 8610 | .84 | Dues, Books and Subscriptions | | Air Cushions, invalid | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Airways | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Albuminometers | Using Cost Center | | .58 | Instruments and Minor Equipment | | Alcohol, grain | Using Cost Center | | .46 | Pharmaceuticals | | Alcohol, rubbing | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Alcohol Packets | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Alcohol Permit Fees | Pharmacy | 8470 | .83 | Licenses and Taxes (Other than on Income) | | Alcohol Records | Pharmacy | 8470 | .56 | Office and Administrative Supplies | | Alkalies, laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Allowances to Students | Appropriate Educational Cost Center | | | Appropriate Natural Classification | | Ambulance Fees | Ambulance Services | 6950 | .79 | Other Purchased Services | | Ambulance Insurance Premiums | Insurance-Other | 8840 | .81 | Insurance | | Ambulance Licenses | Ambulance Services | 6950 | .83 | Licenses and Taxes (Other than on Income) | | Ambulance Rental | Leases & Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Ambulance Repairs (by outside concern | Plant Maintenance | 8400 | .72 | Maintenance Repairs | | Ammonia | Housekeeping | 8450 | .55 | Cleaning Supplies | | Analgesics | Using Cost Center | | .46 | Pharmaceuticals | | Animals, research | Research | 8010 | .49 | Other Medical Care Materials and Supplies | | Animals, other | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Arbitration Expenses | Hospital Administration | 8610 | .34 | Legal Fees | | Art, mechanical and topographical work | Medical Photography and Illustration | 8760 | .89 | Other Expenses | | Arterial Graft | Using Cost Center | | .41 | Prostheses | | Assessments, improvement | Licenses and Taxes (Other than Income Taxes) | 8850 | .83 | Licenses and Taxes (Other than on Income) | | Assessments, operating | Licenses and Taxes (Other than Income Taxes | 8850 | .83 | Licenses and Taxes (Other than on Income) | | Association Dues, hospital | Hospital Administration | 8610 | .84 | Dues, Books, and Subscriptions | | Association Dues, other | Using Cost Center | | .84 | Dues, Books, and Subscriptions | | Atomizers | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Attorney's Fees | Hospital Administration | 8610 | .34 | Legal Fees | | Audit Fees | Hospital Administration | 8610 | .35 | Audit Fees | | Autoclave Tape | Central Services and Supplies | 8460 | .59 | Other Non-Medical and Non-Surgical Supplies | | Automatic Door Repairs (by outside concern) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Automatic Telephone Rentals | Leases & Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Automobile Insurance Premium | Insurance-Other | 8850 | .81 | Insurance | | Automobile License | Licenses and Taxes (Other than Income Taxes) | 8850 | .83 | Licenses and Taxes (Other than on Income) | | Automobile Rentals | Leases & Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Automobile Repairs (by outside concern) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | | Using Cost Center | | .89 | Other Expenses | | Awards, student | Appropriate Educational Cost Center | | .89 | Other Expenses | | Awards, community leaders | Hospital Administration | 8610 | .89 | Other Expenses | | Awards, Volunteer Service | Hospital Administration | 8610 | .89 | Other Expenses | | Baby Picture Costs | Retail Operations Expense | 9230 | .89 | Other Expenses | | Badges, identification, volunteers, employees | Hospital Administration | 8610 | .56 | Office and Administrative Supplies | | Bags, laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bags, paper | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Bandages | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Bands, identification | Patient Accounts, Admitting and Registration | 8520 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bands, rubber | Using Cost Center | | .56 | Office and Administrative Supplies | | Bank Charges | General Accounting | 8510 | .89 | Other Expenses | | Barium Sulphate | Using Cost Center | | .47 | Radioactive Materials | | Barometers, aneroid | Using Cost Center | | .58 | Instruments and Minor Equipment | | Basins, bath, emesis, face | Using Cost Center | | .58 | Instruments and Minor Equipment | | Baskets, drug | Pharmacy | 8470 | .58 | Instruments and Minor Equipment | | Baskets, waste | Using Cost Center | | .58 | Instruments and Minor Equipment | | Baskets, specimen, collection (sputum, urine and feces) | Using Cost Center | | .58 | Instruments and Minor Equipment | | Bath Caps | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bath Hats | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bath Robes | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Batteries, flashlight | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Beads, infants' | Newborn Nursery | 6510 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bedpans | Using Cost Center | | .58 | Instruments and Minor Equipment | | Belts, sanitary | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Benzalkonium Chloride Solution and Tinct. | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Blades, surgical | Using Cost Center | | .42 | Surgical Supplies-General | | Blankets | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Blood Bank Supplies | Blood Storing and Processing | 7260 | .49 | Other Medical Care Materials and Supplies | | Blood Donor Refreshments | Blood Storing and Processing | 7260 | .59 | Other Non-Medical and Non-Surgical Supplies | | Blood for patients | Whole Blood and Packed Red Cells | 7250 | .49 | Other Medical Care Materials and Supplies | | Blood for employees | Whole Blood and Packed Red Cells | 7250 | .49 | Other Medical Care Materials and Supplies | | Blood Derivatives | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Blood Type Tests, purchased | Laboratory Services-Clinical | 7210 | .71 | Purchased Services-Medical | | Blow Bottles | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Board Member Expenses | Hospital Administration | 8610 | | Appropriate Natural Classification | | Bond Discount Amortization | Interest-Long Term | 8880 | .89 | Other Expenses | | Bonding Insurance Premiums, employees | Insurance-Other | 8850 | .81 | Insurance | | Bond Interest Expenses | Interest-Long Term | 8880 | .82 | Interest | | Book and Journal Binding | Hospital Administration | 8610 | .89 | Other Expenses | | Bookkeeping Forms | General Accounting | 8510 | .56 | Office Administrative Supplies | | Books, medical | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Books, text | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Borax | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Bottles, drug | Pharmacy | 8470 | .59 | Other Non-Medical and Non-Surgical Supplies | | Bottles, formula | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Bottles, reagent | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Bottles, specimen | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Bread and Pastries | Appropriate Food Services Cost Center | | .52 | Food-Other | | Breast Pumps, hand | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Brooms | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Brushes | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Buckets, scrub | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Building Repairs (by outside concerns) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Bulbs, electric light | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Burners, Bunsen | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Burrs, surgical | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Business Interruption Insurance | Insurance-Other | 8850 | .81 | Insurance | | Business Machine Rentals | Leases & Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Business Office Forms | Patient Accounts, Admitting and Registration | 8520 | .59 | Other Non-Medical and Non-Surgical Supplies | | Buttons | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Cadavers | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Candy Striper Expenses | Hospital Administration | 8610 | | Appropriate Natural Classification | | Canes | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cannulas | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Caps, ice (bags) | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Caps, operating room | Laundry and Linen | 8330 | .57 | Employee Wearing Apparel | | Capsules | Pharmacy | 8470 | .59 | Other Non-Medical and Non-Surgical Supplies | | Care, employee special occasion (discount) | Administrative, Courtesy, and Policy Discounts and Adjustments | 5980 | | Not Applicable | | Carpenter Tools | Plant Maintenance | 8400 | .58 | Instruments and Minor Equipment | | Carpeting and Rugs, cleaning | Housekeeping | 8410 | .79 | Other Purchased Services | | Cartrage, drayage, and freight | | | | | | (1) (supplies) | Using Cost Center | | .89 | (1) Other Expenses | | (2) (equipment) | Equipment | 1250 | | (2) Not Applicable | | Cash Shortages, Overages | Patient Accounts, Admitting and Registration | 8520 | .89 | Other Expenses | | Casters | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Cases, pillow | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Catalogues, nursing school | Nursing Education | 8220 | .56 | Office and Administrative Supplies | | Catheter Boxes, trays | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Catheters, metal, rubber, etc. | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Chart Envelopes | Medical Records | 8710 | .56 | Office and Administrative Supplies | | Chart Covers, patient | Using Cost Center | | .56 | Office and Administrative Supplies | | Checkbooks and Voucher Checks | General Accounting | 8510 | .56 | Office and Administrative Supplies | | Chemicals, pharmaceutical | Cost of Drugs Sold | 7150 | .46 | Pharmaceuticals | | Chemicals, reagent | Appropriate Laboratory Cost Center | | .49 | Surgical Supplies—General | | Chinaware | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Chisels, bone | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Chloroform | Anesthesiology | 7080 | .43 | Anesthetic Materials | | Clamps, Supplies | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Clamps, burette, rubber tubing | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Class Pins | Appropriate Educational Cost Center | | .56 | Office and Administrative Supplies | | Cleaning Compounds | Housekeeping | 8450 | .55 | Cleaning Supplies | | Cleavers, chopping | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | | Using Cost Center | | .58 | Instruments and Minor Equipment | | Clocks, household Clocks, interval timer | Using Cost Center | | .58 | Instruments and Minor Equipment | | Clothes Racks | Using Cost Center | | .58 | Instruments and Minor Equipment | | Clothing, inpatients | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Clothing, staff | Using Cost Center | | .57 | Employee Wearing Apparel | | Cloths, face | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Cloths, table | Appropriate Food Services Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Coal and Coke | Energy | 8420 | .62 | Fuel | | Cocaine | Using Cost Center | | .46 | Pharmaceuticals | | Colanders | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Collection Fees | Patient Accounts, Admitting and Registration | 8520 | .77 | Collection Agency | | Collectors, pediatric (sputum, urine and feces) | Using Cost Center | | .58 | Instruments and Minor Equipment | | Commencement Invitations | Appropriate Educational Cost Center | | .56 | Office and Administrative Supplies | | Compensation, physician | | | | | | (1) Payroll | Assigned Cost Center | | .06 | Salaries and Wages-Physicians | | (2) Non-Payroll | Assigned Cost Center | | .31 | Medical-Physicians | | Compensation, student (non-inservice) | Appropriate Educational Cost Center | | | Appropriate Natural Classification | | Compound Tincture Benzoin | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Connectors, glass, etc. | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Consultant Fees | | | | | | (1) From Non-Related Organization | Using Cost Center | | .33 | Consulting and Management Fees | | (2) From Related Organization | Using Cost Center | | .76 | Management and Contracted Services | | Containers, false teeth | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Containers, needle | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Controlled Substances | Using Cost Center | | .46 | Pharmaceuticals | | Controls, sterilizer | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Cotton, absorbent | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cotton Balls | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cottonseed Oil | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Covers, tray or table (patients') | Dietary Services | 8310 | .59 | Other Non-Medical and Non-Surgical Supplies | | Cross Match Fees (see Laboratory Procedures) | | | | | | Crutches | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cuffs, blood pressure | Using Cost Center | | .58 | Instruments and Minor Equipment | | Culture Media | Appropriate Laboratory Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cups, china | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Cups, paper, beverage | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Cups, sputum, paper | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Curtains and Draperies, window, cleaning | Laundry and Linen | 8330 | .74 | Laundry and Linen | | Curtains and Draperies, cubicle, initial | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Cushions, air, invalid | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Cutters, paper | Using Cost Center | | .58 | Instruments and Minor Equipment | | Cyclopropane | Anesthesiology | 7080 | .43 | Anesthetic Materials | | Cytology Supplies | Appropriate Laboratory Cost Center | | .49 | Other Medical Care Materials and Supplies | | Dairy Products | Appropriate Food Services Cost Center | | .52 | Food-Other | | Data Processing Fees | Using Cost Center | | .75 | Data Processing | | Data Processing Forms | Hospital Administration | 8610 | .56 | Office and Administrative Supplies | | Data Processing Supplies | Hospital Administration | 8610 | .56 | Office and Administrative Supplies | | Dental Supplies | Appropriate Cost Center | | .49 | Other Medical Care Materials and Supplies | | Depreciation-Buildings and Building Improvements | Depreciation and Amortization Cost Center | 8810 | .91 | Depreciation and Amortization-Buildings and Building Improvement | | Depreciation-Fixed Equipment | Depreciation and Amortization Cost Center | 8810 | .92 | Depreciation-Fixed Equipment | | Depreciation-Major Movable Equipment | Depreciation and Amortization Cost Center | 8820 | .93 | Depreciation-Movable Equipment | | Depreciation-Minor Equipment | Depreciation and Amortization Cost Center | 8820 | .93 | Depreciation-Movable Equipment | | Detective Service | Security | 8430 | .79 | Other Purchased Services | | Detergents (laundry) | Laundry and Linen | 8330 | .55 | Cleaning Supplies | | Developers and Hypo Solutions | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Dextrose | Using Cost Center | | .45 | I.V. Solutions | | Diapers | Appropriate Nursing Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Dinnerware | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Diplomas, Nursing School | Nursing Education | 8220 | .56 | Office and Administrative Supplies | | Dishes, evaporating, petri | Appropriate Laboratory Cost Center | | .58 | Instruments and Minor Equipment | | Dishes, table | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Dishpans | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Disinfectants | Housekeeping | 8450 | .55 | Cleaning Supplies | | Disinfectants, surgical | Appropriate Surgery Cost Center | | .42 | Surgical Supplies-General | | Dissectors | Appropriate Laboratory Cost Center | | .58 | Instruments and Minor Equipment | | Doilies, trays, paper | Appropriate Food Services Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Douche-Pans | Using Cost Center | | .58 | Instruments and Minor Equipment | | Draperies and Curtains (see Curtains) | | | | | | Drayage (see Cartage) | | | | | | Dressing Tray | Using Cost Center | | .58 | Instruments and Minor Equipment | | Dressings | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Drills, bone Drinking Cups (see Cups) | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Droppers, medicine | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Dues, Hospital Association | Hospital Administration | 8610 | .84 | Dues, Books, and Subscriptions | | Dues, association | Appropriate Cost Center | | .84 | Dues, Books, and Subscriptions | | Dues, professional organizations | Appropriate Cost Center | | .84 | Dues, Books, and Subscriptions | | Dust Control | Housekeeping | 8450 | .79 | Other Purchased Services | | Dyes, Laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | | Insurance—Other | 8850 | .81 | Insurance | | Education Supplies, students' | Appropriate Education Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Education Supplies, inservice —Nursing | Nursing Administration | 8750 | .59 | Other Non-Medical and Non-Surgical Supplies | | Education Supplies, inservice—Other | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Electric Light Bulbs | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Electrical Supplies | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Electricity | Energy | 8420 | .61 | Electricity | | Electron Microscope Supplies | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Elevator Inspection Fees | Plant Maintenance | 8400 | .83 | Licenses and Taxes (Other than on Income) | | Elevator Liability Insurance | Insurance—Other | 8850 | .81 | Insurance | | Elevator Repairs (by outside concern) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Elevators, bone, dura, rib, etc. | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Employee Benefits, F.I.C.A. | Cost Center to which employee is assigned (see Section 1613) | | .21 | FICA | | Employee Benefits, unemployment insurance | Cost Center to which employee is assigned (see Section 1613) | | .22 | State Unemployment Insurance and Federal Unemployment | | Employee Benefits, health insurance | Cost Center to which employee is assigned (see Section 1613) | | .23 | Group Health Insurance | | Employee Benefits, life insurance | Cost Center to which employee is assigned (see Section 1613) | | .24 | Group Life Insurance | | Employee Benefits, tuition | Employee Benefits—Non-Payroll-Related | 8830 | .29 | Employee Benefits (Non-Payroll-Related) | | Employee Benefits, recreation and cultural activities | Employee Benefits—Non-Payroll-Related | 8830 | .29 | Employee Benefits (Non-Payroll Related) | | Employee Benefits, licenses | Employee Benefits—Non-Payroll-Related | 8830 | .29 | Employee Benefits (Non-Payroll Related) | | Employee Benefits, hospital health care services (free/discounted) | Administrative, Courtesy, and Policy Discounts and Adjustments | 5980 | | Not Applicable | | Employee Benefits, pension | Cost Center to Which Employee is Assigned (see Section 1613) | | .25 | Pension and Retirement | | Employee Benefits, housing allowance | Employee Benefits—Non-Payroll-Related | 8830 | .29 | Employee Benefits (Non-Payroll Related) | | Employee Uniforms, hospital-owned | Laundry and Linen | 8330 | .57 | Employee Wearing Apparel | | Employment Agency Fees | Hospital Administration | 8610 | .39 | Other Fees | | Enema, disposable | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Engineering Tools | Plant Maintenance | 8400 | .58 | Instruments and Minor Equipment | | Envelopes, films, X-ray | Appropriate Radiology Cost Center | | .48 | Radiology Films | | Envelopes, paper, other | Using Cost Center | | .56 | Office Administrative Supplies | | Epsom Salts | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Equipment Repair (by outside concern) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Ether | Anesthesiology | 7080 | .43 | Anesthetic Materials | | Ether Masks | Anesthesiology | 7080 | .49 | Other Medical Care Materials and Supplies | | Expenses Charges (see Cartage) | | | | | | Exterminator (Pest control service) | Housekeeping | 8450 | .79 | Other Purchased Services | | Extractors, fruit juice | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Face Cloths | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Face Masks | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Fees, medical—Physicians | Assigned Cost Center | | .31 | Medical-Physicians | | Fees, medical—Therapists | Assigned Cost Center | | .32 | Medical—Therapists and Other Non-Physicians | | Fees, nonmedical (see specific category) | | | | | | Fidelity Bond Premium | Insurance-Other | 8850 | .81 | Insurance | | Film Hangers | Appropriate Radiology Cost Center | | .58 | Instruments and Minor Equipment | | Films, radiology | Appropriate Radiology Cost Center | | .48 | Radiology Films | | Filters-air conditioners | Plant Operations | 8410 | .59 | Other Non-Medical and Non-Surgical Supplies | | Fingerprinting Supplies | Security | 8430 | .59 | Other Non-Medical and Non-Surgical Supplies | | Fire Insurance Premiums | Insurance-Other | 8850 | .81 | Insurance | | Flashlight and Batteries | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Flasks, general | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Flowers, decorative | Housekeeping | 8450 | .89 | Other Expenses | | Flowers purchased for resale | Retail Operations Expense | 9230 | .89 | Other Expenses | | Flower Pots and Planters | | | | | | (1) Inside Hospital | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | (2) Outside Hospital | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Food, Meat, Fish and Poultry | Appropriate Food Services Cost Center | | .51 | Food-Meat, Fish, and Poultry | | Food, Other | Appropriate Food Services Cost Center | | .52 | Food-Other | | Forceps, surgical | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Forks, kitchen | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Formulas, infant | Using Cost Center | | .52 | Food-Other | | Forms, medical record, medical history, etc. | Medical Records | 8710 | .56 | Office and Administrative | | Freight Charges (see Cartage) | | | | | | Freon, Gas-Surgical | Appropriate Surgery Cost Center | | .44 | Oxygen and Other Medical Gases | | Fruits and Vegetables | Appropriate Food Services Cost Center | | .52 | Food-Other | | Fuel, gas | Energy | 8420 | .62 | Fuel | | Fund Raising Expenses | Fund Raising | 8780 | | Appropriate Natural Classification | | Funnels | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Garbage Cans | Housekeeping | 8450 | .58 | Instruments and Minor Equipment | | Gas (fuel) | Energy | 8420 | .62 | Fuel | | Gasoline | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Gauze | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Germicides, cleaning | Housekeeping | 8450 | .55 | Cleaning Supplies | | Gift Shop Expense | Retail Operations Expense | 9230 | | Appropriate Natural Classification | | Gifts for Services | Hospital Administration | 8610 | .89 | Other Expenses | | Glass, window | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Glassware, kitchen, dining room | Appropriate Food Services Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Glassware, laboratory | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Gloves, disposable | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Gloves, reusable | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Glucose, I.V. | Using Cost Center | | .45 | I.V. Solutions | | Glue, Furniture. etc. | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Glycerine | Using Cost Center | | .46 | Pharmaceuticals | | Goggles | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Gouges, bone mastoid | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Gowns, employee | Laundry and linen | 8330 | .57 | Employee Wearing Apparel | | Gowns, patients' | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Grass Seed | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Graters, food | Appropriate Food Service Cost Center | | .58 | Instruments and Minor Equipment | | Greases, lubricating | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Guard Service Fees | Security | 8430 | .79 | Other Purchased Services | | H.A.S. Fees | Hospital Administration | 8610 | .79 | Other Purchased Services | | Hammers, percussion reflex | Using Cost Center | | .58 | Instruments and Minor Equipment | | Handles, surgical knife | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Hangers, coat | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Hangers, film | Appropriate Radiology Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Head Mirrors and Bands | Using Cost Center | | .58 | Instruments and Minor Equipment | | Heaters | Using Cost Center | | .58 | Instruments and Minor Equipment | | Heatng, ventilating and air conditioning supplies | Plant Operations | 8410 | .59 | Other Non-Medical and Non-Surgical Supplies | | Hemostats | Using Cost Center | | .58 | Instruments and Minor Equipment | | Histology Supplies | Laboratory Services-Pathological | 7230 | .49 | Other Medical Care Materials and Supplies | | Holders, napkin | Appropriate Food Service Cost Center | | .53 | Tableware and Kitchen Utensils | | Holders, needle | Using Cost Center | | .58 | Instruments and Minor Equipment | | Holders, sputum cup | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Holders, test tube | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Hot Packs, apparatus | Using Cost Center | | .58 | Instruments and Minor Equipment | | Hot Water Bottles | Using Cost Center | | .58 | Instruments and Minor Equipment | | Hydrogen Peroxide | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Hypodermic Needles | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | I.V. Set | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | I.V. Additives | Using Cost Center | | .45 | I.V. Solutions | | I.V. Solutions | Using Cost Center | | .45 | I.V. Solutions | | I.V. Supplies | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Ice (purchased) | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Ice Bags | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Ident-a-bands | Patient Accounts, Admitting and Registration | 8520 | .59 | Other Non-Medical and Non-Surgical Supplies | | Income Tax | Provision for Income Taxes | 9410 | .89 | Other Expenses | | Industrial Engineering Fees (non-related organization) | Hospital Administration | 8610 | .33 | Consulting and Management Fees | | Infant Apparel | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Ink, printing | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Ink, marking | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Insect Extermination Expense | Housekeeping | 8450 | .79 | Other Purchased Services | | Insecticides | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Inservice Education Supplies (see Education Supplies) | | | | | | Inspection Fees and Permits | Licenses and Taxes (Other than Income Taxes) | 8860 | .83 | Licenses and Taxes (Other than on Income) | | Instrument Sharpening and Repair Fees | Using Cost Center | | .79 | Other Purchased Services | | Instruments, tray-reusable | Using Cost Center | | .58 | Instruments and Minor Equipment | | Instruments, tray-disposable | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Insurance: | | | | | | Boiler Liability | Insurance-Other | 8850 | .81 | Insurance | | Bonding Liability | Insurance-Other | 8850 | .81 | Insurance | | Elevator Liability | Insurance-Other | 8850 | .81 | Insurance | | Fire | Insurance-Other | 8850 | .81 | Insurance | | Hospital Malpractice | Ins.-Hosp. & Professional Malpr. | 8840 | .81 | Insurance | | Motor Vehicle (ambulance, car, truck) | Insurance-Other | 8850 | .81 | Insurance | | Professional Malpractice | Insurance-Hospital and Prof. Malpractice | 8840 | .81 | Insurance | | Theft | Insurance-Other | | .81 | Insurance | | Unemployment | Cost Center in which Employee's Compensation is Registration | | .22 | State Unemployment Insurance and Federal Unemployment Insurance | | Workers' Compensation | Cost Center in which Employee's Compensation is Reported | | .26 | Workers' Compensation Insurance | | Intercommunication System | Hospital Administration | 8610 | | Appropriate Natural Classification | | Interest Expense, current working capital | Interest-Short Term | 8870 | .82 | Interest | | Interest Expense, long term | Interest-Long Term | 8880 | .82 | Interest | | Intramuscular Injectables | Using Cost Center | | .46 | Pharmaceuticals | | Irrigating Solutions | Central Services and Supplies | 8460 | .49 | Other Medical Care Materials and Supplies | | Irrigation Tips | Central Services and Supplies | 8460 | .58 | Instruments and Minor Equipment | | Irrigators | Central Services and Supplies | 8460 | .58 | Instruments and Minor Equipment | | Isotopes | Using Cost Center | | .47 | Radioactive Materials | | Jackets, orderlies, operating room, etc. | Laundry and Linen | 8330 | .57 | Employee Wearing Apparel | | Jars, specimen | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Journals, medical (see Magazines) Kettles, steam (patients' use) | Central Services and Supplies | 8460 | .58 | Instruments and Minor Equipment | | Kettles, steam (kitchen) | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Keys | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Kitchen Utensils | Appropriate Food Services Cost Center | | .53 | Tableware and Kitchen Utensils | | Knife Blades, surgical | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Knife Holders, surgical | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Knife, abscess, amputating, brain | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Knife, autopsy | Laboratory Services-Pathological | 7230 | .58 | Instruments and Minor Equipment | | Knife, bread, butcher, etc. | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Labels, drug | Pharmacy | 8470 | .59 | Other Non-Medical and Non-Surgical Supplies | | Labels, other | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Labor Relations and Consultation Fees | Hospital Administration | 8610 | .33 | Consulting and Management Fees | | Laboratory Procedures (by outside concerns) | Appropriate Laboratory Cost Center | | .71 | Medical | | Lactometers | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Ladders | Plant Maintenance | 8400 | .58 | Instruments and Minor Equipment | | Lamps, alcohol | Using Cost Center | | .58 | Instruments and Minor Equipment | | Lamps, electrical (light bulb) | Plant Maintenance | 8400 | .58 | Instruments and Minor Equipment | | Lamps, opthalmoscope | Using Cost Center | | .58 | Instruments and Minor Equipment | | Lancets | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Lancets, blood | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Lanterns (battery or gas type) | Plant Operations | 8410 | .58 | Instruments and Minor Equipment | | Laundering (by outside concern) | Laundry and Linen | 8330 | .74 | Laundry and Linen | | Laxatives, simple | Using Cost Center | | .46 | Pharmaceuticals | | Lease Costs (see Rental Charges) | | | | | | Legal Fees, collections | Patient Accounts, Admitting and Registration | 8520 | .34 | Legal Fees | | | Hospital Administration | 8610 | .34 | Legal Fees | | Lens Paper | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Licenses, car, ambulance and truck | Using Cost Center | | .83 | Licenses and Taxes (Other than on Income) | | Lime, chlorinated | Housekeeping | 8450 | .55 | Cleaning Supplies | | Linen, bed | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Linen, disposable | Laundry and Linen | 8830 | .54 | Linen and Bedding | | Linen, sterile | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Liners, bassinet | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Litmus Paper | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Local and Spinal Anesthetics | Using Cost Center | | .43 | Anesthetic Materials | | Long Distance Telephone Charges, general | Hospital Administration | 8610 | .65 | Telephone and Telegraph | | Lost Item Replacement, patient | Other Non-Operating Expense | 9250 | .89 | Other Expenses | | Lubricating Fluids | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Lubricating Jelly | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Lumber | Appropriate Plant Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Lye | Laundry and Linen | 8330 | .55 | Cleaning Supplies | | Magazines, lobby | Hospital Administration | 8610 | .84 | Dues, Books and Subscriptions | | Magazines, medical journals | Hospital Administration | 8610 | .84 | Dues, Books and Subscriptions | | Magazines, general interest | Hospital Administration | 8610 | .84 | Dues, Books and Subscriptions | | Magazines, cost center | Using Cost Center | | .84 | Dues, Books and Subscriptions | | Magazines, students | Appropriate Education Cost Center | | .84 | Dues, Books and Subscriptions | | Maintenance Contracts, major movable equipment | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Maintenance Contracts, fixed equipment | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Maintenance Contracts, minor equipment | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Maalox | Using Cost Center | 7150 | .46 | Pharmaceuticals | | Mangle Aprons | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Manometers, disposable | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Marking Ink and Labels | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Masks, face | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Mats, bath | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Mattress Covers and Pads | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Measures, metal | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Meat and Poultry | Appropriate Food Services Cost Center | | .51 | Food-Meats, Fish and Poultry | | Membership Dues (see dues) | | | .84 | Dues, Books, and Subscriptions | | Microbiology Supplies | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Microfilming (by outside concern) | Using Cost Center | | .79 | Purchased Services | | Mirrors, head, laryngeal, etc. | Using Cost Center | | .58 | Instruments and Minor Equipment | | Mortars | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Mortgage, interest expense | Interest-Long Term | 8880 | .82 | Interest | | Motor Oil, ambulance | Ambulance Services | 6850 | .59 | Other Non-Medical and Non-Surgical Supplies | | Motor Oil, car, truck | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Motor Vehicle Insurance | Insurance-Other | 8850 | .81 | Insurance | | Motor Vehicle Licenses (ambulances, car, truck, etc.) | Using Cost Center | | .83 | Licenses and Taxes (Other than on Income) | | Mouthwash, nonprescription | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Mucous Bulbs | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Nails, hip fracture | Appropriate Surgery Cost Center | | .41 | Prostheses | | Narcotics | Using Cost Center | | .46 | Pharmaceuticals | | Narcotic Permit Fees | Pharmacy | 8470 | .83 | Licenses and Taxes (Other than on Income) | | Narcotic Records | Pharmacy | 8470 | .56 | Office and Administrative Supplies | | Needles, aneurysm, aspirating | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Needles, spinal, hypodermic | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Needles, sewing | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Nets, laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Newspapers | Using Cost Center | | .84 | Dues, Books, and Subscriptions | | Nipples | Appropriate Cost Center | | .49 | Other Medical Care Materials and Supplies | | Nipple Shields | Appropriate Cost Center | | .49 | Other Medical Care Materials and Supplies | | Nitroglycerin | Using Cost Center | | .46 | Pharmaceuticals | | Nitrous Oxide | Appropriate Cost Center | | .43 | Anesthetic Materials | | Novocaine | Appropriate Cost Center | | .43 | Anesthetic Materials | | Nurses' Uniforms (when hospital furnished), except students' | Laundry and Linen | 8330 | .57 | Employee Wearing Apparel | | Nurses' uniforms, students' | Nursing Education | 8220 | .57 | Employee Wearing Apparel | | Nursing School Catalogues, laboratory and school room supplies | Nursing Education | 8220 | .59 | Other Non-Medical and Non-Surgical Supplies | | Office Supplies (printing and stationery) | Using Cost Center | | .56 | Office and Administrative Supplies | | Oil, fuel | Energy | 8420 | .62 | Fuel | | Oils and Greases, general | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Oral Scopolamine (O.B.) | Using Cost Center | | .46 | Pharmaceuticals | | Orangewood Sticks | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Orthopedic Supplies | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Oxygen, in therapy | Using Cost Center | | .44 | Oxygen and Other Medical Gases | | Oxygen, in anesthesia | Anesthesiology | 7080 | .44 | Oxygen and Other Medical Gases | | Pacemakers | Using Cost Center | | .42 | Surgical Supplies-General | | Packets-alcohol, lemon glycerine | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Pack (hot) Apparatus, electric (see Heaters, Hot packs, Kettles) | | | | | | Packs, abdominal (laparotomy) | Appropriate Surgery Cost Center | | .42 | Surgical Supplies-General | | Packs, hot or cold (solution filled) | Using Cost Center | | .58 | Instruments and Minor Equipment | | Packs, steam | Using Cost Center | | .58 | Instruments and Minor Equipment | | Pads, bed, table, etc. (cloth) | Using Cost Center | | .54 | Linen and Bedding | | Pads, cleaning | Housekeeping | 8450 | .55 | Cleaning Supplies | | Pads, Laundry, Mangle, press | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Pads, rubber floor mat | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Pails, scrub | Housekeeping | 8450 | .55 | Cleaning Supplies | | Paint Brushes | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Painting, contracted | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Painters' Drop Cloths | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Paints, shellacs, varnishes | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Pans, baking | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Pans, dust | Housekeeping | 8450 | .55 | Cleaning Supplies | | Paper, duplication machine | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Paper, data processing | Hospital Administration | 8610 | .56 | Office and Administrative Supplies | | Paper, print shop supplies | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Paper Cups | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Paper, shelf, toilet | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Paper Plates | Appropriate Food Services Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Paper, wax | Appropriate Food Services Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Patient Chargeable Supplies Ruined or Damaged | Central Services and Supplies | 8460 | | Appropriate Natural Classification | | Patient Reusable Supplies (changeable items) | Central Services and Supplies | 8460 | | Appropriate Natural Classification | | Pelvimeters | Using Cost Center | | .58 | Instruments and Minor Equipment | | Pencils, lead, crayon, marking | Using Cost Center | | .56 | Office and Administrative Supplies | | Pens | Using Cost Center | | .56 | Office and Administrative, Supplies | | Pension Plan Premiums | Cost Center to which Employee is Assigned (see section 1613) | | .25 | Pension and Retirement | | Percussion Hammers | Using Cost Center | | .58 | Instruments and Minor Equipment | | Perforators, medical | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Periodicals, general | Using Cost Center | | .84 | Dues, Books, and Subscriptions | | Periodicals, medical | Hospital Administration | 8610 | .84 | Dues, Books, and Subscriptions | | Periodicals, student nurses' | Nursing Education | 8220 | .84 | Dues, Books, and Subscriptions | | Personal Property Tax (see Taxes) | | | | | | Pestles | Using Cost Center | | .58 | Instruments and Minor Equipment | | Photographic Supplies | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Pillows | Housekeeping | 8450 | .54 | Linen and Bedding | | Pins, bone extension | Appropriate Surgery Cost Center | | .41 | Prostheses | | Pins, laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Pins, safety, straight | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Pipettes | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Pitchers, water | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Plasmanate | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Plaster, building | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Plaster of Paris | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Plasters, adhesive | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Plates, bone | Appropriate Cost Center | | .41 | Prostheses | | Plates, china, dinner, salad, etc. | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Plates, petri | Appropriate Laboratory Cost Center | | .58 | Instruments and Minor Equipment | | Plates, X-ray (film) | Appropriate Radiology Cost Center | | .48 | Radiology Films | | Platinum Wire | Appropriate Cost Center | | .41 | Prostheses | | Plumbing Supplies | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Pneumatic Tubes | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Polishes | Housekeeping | 8450 | .55 | Cleaning Supplies | | Postage, for general use | Hospital Administration | 8610 | .87 | Postage | | Postage, for specific cost centers | Using Cost Center | | .87 | Postage | | Powders, film developing | Appropriate Radiology Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Powders, insect | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Powders, scouring | Housekeeping | 8450 | .55 | Cleaning Supplies | | Power, purchased | Energy | 8420 | .61 | Electricity | | Prescriptions (outside purchases) | Using Cost Center | | .79 | Other Purchased Services | | Prescription Blanks | Pharmacy | 8470 | .56 | Office and Administrative Supplies | | Prostheses and Appliances | Using Cost Center | | .41 | Prostheses | | Radiology Services (by outside concern) | Appropriate Radiology Cost Center | | .79 | Other Purchased Services | | Rags, cleaning | Housekeeping | 8450 | .55 | Cleaning Supplies | | Razor Blades | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Razors | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Receptacles, waste | Using Cost Center | | .58 | Instruments and Minor Equipment | | Record Forms, medical | Medical Records | 8710 | .56 | Office and Administrative Supplies | | Records for Transcribing Machines | Using Cost Center | | .56 | Office and Administrative Supplies | | Rectal Tubes | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Registers, narcotic | Pharmacy | 8470 | .56 | Office and Administrative Supplies | | Rental Charges, major movable equipment | Leases and Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Rental Charges, fixed equipment, general | Leases and Rentals—Assets | 8815 | .95 | Lease/Rentals-Buildings, Improvements and Fixed Equipment | | Rental Charges, minor movable equipment | Leases and Rentals—Movable Equipment | 8825 | .96 | Lease/Rentals-Movable Equipment | | Rentals, safety deposit boxes | Hospital Administration | 8610 | .89 | Other Expenses | | Repair/Replacement of personal property (eyeglasses, dentures, hearing aids, etc.) | Hospital Administration | 8610 | .89 | Other Expenses | | Repairs, minor, to buildings (by outside concern) | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Repairs to Equipment (by outside concern) | | | | | | Major Movable | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Fixed Equipment | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Minor Equipment | Plant Maintenance | 8400 | .72 | Maintenance and Repairs | | Respirators | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Retractors | Using Cost Center | | .58 | Instruments and Minor Equipment | | Ribbons, typewriter | Using Cost Center | | .56 | Office and Administrative Supplies | | Rubber Bands | Using Cost Center | | .56 | Office and Administrative Supplies | | Saccharimeters | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Safety Pins | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Sanitary Pads | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Saucers, plant | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Scalpels | Using Cost Center | | .58 | Instruments and Minor Equipment | | Scissor Sharpening | Using Cost Center | | .79 | Other Purchased Services | | Scoops, common duct, Mayo, etc. | Using Cost Center | | .58 | Instruments and Minor Equipment | | Scoops, flour, sugar, etc. | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Screwdrivers, surgical | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Screws, bone | Appropriate Surgery Cost Center | | .41 | Prostheses | | Seafood | Appropriate Food Services Cost Center | | .51 | Food-Meats, Fish, and Poultry | | Sedatives | Using Cost Center | | .46 | Pharmaceuticals | | Serology Supplies | Appropriate Laboratory Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Sharpeners, pencil | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Sheepskins | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Sheets, linen | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Sheets, rubber, on patients' beds | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Sheets, wadding | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Signals, communication (beepers) | Hospital Administration | 8610 | .58 | Instruments and Minor Equipment | | Slippers, paper | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Snares, tonsil, etc. | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Snow Removal (by outside concern) | Plant Maintenance | 8400 | .72 | Purchased Services and Maintenance Repairs | | Soaps, dishwashing | Appropriate Food Services Cost Center | | .55 | Cleaning Supplies | | Soaps, floor, toilet | Housekeeping | 8450 | .55 | Cleaning Supplies | | Soaps, laundry | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Soaps, surgical | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Splints | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Steam Cleaner Rental | Movable Equipment—Leases and Rentals | 8825 | .96 | Lease/Rentals-Movable Equipment | | Steam, purchased | Energy | 8420 | .62 | Fuel | | Sterile Water | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Stethoscopes | Using Cost Center | | .58 | Instruments and Minor Equipment | | Stockinette | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Struts-Surgical | Appropriate Surgery Cost Center | | .42 | Surgical Supplies | | Suction Tips, disposable | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Supplies, patient chargeable | Cost of Medical Supplies Sold | 7110 | | Appropriate Natural Classification | | Suppositories | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Surgical Drills and Saws | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Surgical Packs and Drapes | Appropriate Surgery Cost Center | | .42 | Surgical Supplies-General | | Sutures | Using Cost Center | | .42 | Surgical Supplies-General | | Swabs | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Syringes, bulb | Using Cost Center | | .42 | Surgical Supplies-General | | Syringes, hypo. | Using Cost Center | | .42 | Surgical Supplies-General | | Syringes, irrigating | Using Cost Center | | .42 | Surgical Supplies-General | | Tablets, paper | Using Cost Center | | .56 | Office and Administrative Supplies | | Taxes, real estate | Licenses and Taxes (Other than Income Taxes | 8860 | .83 | Licenses and Taxes (Other than on Income) | | Taxes, personal property | Licenses and Taxes (Other than Income Taxes | 8860 | .83 | Licenses and Taxes (Other than on Income) | | Taxes, business | Licenses and Taxes (Other than Income Taxes) | 8860 | .83 | Licenses and Taxes (Other than on Income) | | Telegraph Expense | Hospital Administration | 8610 | .65 | Telephone/Telegraph | | Telephone Expense: | | | | | | General Lines Service | Hospital Administration | 8610 | .65 | Telephone/Telegraph | | Dedicated Lines Service | Using Cost Center | | .65 | Telephone/Telegraph | | | Medical Staff Administration | 8720 | .65 | Telephone/Telegraph | | Taxicab Charges | Using Cost Center | | .86 | Travel-Other | | Tenaculums | Using Cost Center | | .58 | Instruments and Minor Equipment | | Test Tubes | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Text Books, student nurses' | Nursing Education | 8220 | .59 | Other Non-Medical and Non-Surgical Supplies | | Thermometers, mouth, bath, rectal | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Thermostat, wall | Plant Operations | 8410 | .59 | Other Non-Medical and Non-Surgical Supplies | | Thread, sewing | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Thread, suture | Using Cost Center | | .42 | Surgical Supplies-General | | Throat Bags | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Time Cards (payroll) | General Accounting | 8510 | .56 | Office Administrative Supplies | | Tips, irrigating, suction, uterine, etc. | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Tires, ambulance | Ambulance Services | 6850 | .59 | Other Non-Medical and Non-Surgical Supplies | | Tires, car, truck | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Tissue, facial | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Toilet Paper | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Tongs, crucible | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Tongue Depressors | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Tourniquets | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Towels, bath face | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Towels, paper | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Traction Rope | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Travel, conventions and conferences | Using Cost Center | | .85 | Outside Training Sessions (Including Travel) | | Travel Expense: Educational, students | Appropriate Education Cost Center | | .85 | Outside Training Sessions (Including Travel) | | Recruiting Personnel | Hospital Administration | 8610 | .86 | Travel-Other | | "Community": Service | Hospital Administration | 8610 | .86 | Travel-Other | | Seminars, Employee | Cost Center to which Employee is Assigned | | .85 | Outside Training Sessions (Including Travel) | | Meetings, Employee | Cost Center to which Employee is Assigned | | .86 | Travel-Other | | Board | Hospital Administration | 8610 | .85 | Outside Training Sessions (Including Travel) | | | | | .86 | Travel-Other | | Medical Staff, Chief of | Medical Staff Administration | 8720 | .86 | Travel-Other | | Administration | Hospital Administration | 8610 | .86 | Travel-Other | | Tray Covers, paper (patients' meals) | Dietary Services | 8310 | .59 | Other Non-Medical and Non-Surgical Supplies | | Trays, dressing | Using Cost Center | | .58 | Instruments and Minor Equipment | | Trays, serving, patients' | Dietary Services | 8310 | .58 | Instruments and Minor Equipment | | Trays, desk | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Trays, staining | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Trephines | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Tubes, centrifuge, test, etc. | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Tubes, colon, connecting, duodenal infusion, intravenous, etc. | Using Cost Center | | .49 | Other Medical Care Materials and Supplies | | Tubes, specimen | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Tubing, glass, heat resisting | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Tubing, rubber | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Tuition, employee education | Employee Benefits—Non-Payroll-Related | 8830 | .29 | Employee Benefits (Non-Payroll Related) | | Tumblers, glass, drinking | Appropriate Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Underpads | Laundry and Linen | 8330 | .54 | Linen and Bedding | | Uniforms, doormen's | Security | 8430 | .57 | Employee Wearing Apparel | | Uniforms, elevator operators' | Plant Operations | 8410 | .57 | Employee Wearing Apparel | | Uniforms (hospital furnished:) | | | | | | Employees (not owned by hospital) | Cost Center to which Employee is Assigned | | .57 | Employee Wearing Apparel | | Students | Appropriate Education Cost Center | | .57 | Employee Wearing Apparel | | Volunteer | Hospital Administration | 8610 | .57 | Employee Wearing Apparel | | Candy Striper | Hospital Administration | 8610 | .57 | Employee Wearing Apparel | | Urinals, patient | Using Cost Center | | .58 | Instruments and Minor Equipment | | Urinometers | Appropriate Cost Center | | .58 | Instruments and Minor Equipment | | Utensils, kitchen | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Utensils, stainless steel, kitchen | Appropriate Food Services Cost Center | | .58 | Instruments and Minor Equipment | | Utensils, stainless steel, medical | Using Cost Center | | .58 | Instruments and Minor Equipment | | Utensils, stainless steel, other | Using Cost Center | | .58 | Instruments and Minor Equipment | | Valves, medical | Appropriate Surgery Cost Center | | .42 | Surgical Supplies-General | | Vaporizers, medicinal (steam kettles) | Using Cost Center | | .58 | Instruments and Minor Equipment | | Vases, decorative | Housekeeping | 8450 | .59 | Other Non-Medical and Non-Surgical Supplies | | Vegetable Oil | Appropriate Food Services Cost Center | | .52 | Food-Other | | Venetian Blind Cleaning | Housekeeping | 8450 | .79 | Other Purchased Services | | Vests, infants' | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Volunteer Uniforms | Hospital Administration | 8610 | .57 | Employee Wearing Apparel | | Volunteer Badges | Hospital Administration | 8610 | .59 | Other Non-Medical and Non-Surgical Supplies | | Wash Cloths | Laundry and Linen | 8330 | .59 | Other Non-Medical and Non-Surgical Supplies | | Waste Receptacles | Housekeeping | 8450 | .58 | Instruments and Minor Equipment | | Water | Energy | 8420 | .63 | Water | | Water Treatment Compounds | Plant Operations | 8410 | .59 | Other Non-Medical and Non-Surgical Supplies | | Wax, floor | Housekeeping | 8450 | .55 | Cleaning Supplies | | Window Glass | Plant Maintenance | 8400 | .59 | Other Non-Medical and Non-Surgical Supplies | | Window Washing Expense (by outside concern) | Housekeeping | 8450 | .79 | Other Purchased Services | | Wrappers, cloth | Using Cost Center | | .59 | Other Non-Medical and Non-Surgical Supplies | | Wrenches, bone traction, etc. | Appropriate Surgery Cost Center | | .58 | Instruments and Minor Equipment | | Wringers, mop | Housekeeping | 8450 | .58 | Instruments and Minor Equipment | | X-ray film | Appropriate Radiology Cost Center | | .48 | Radiology Films | | X-ray procedures, purchased outside | Appropriate Radiology Cost Center | | .71 | Medical |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.1 Licensure
(a) Any person who plans to operate a tissue bank or nontransplant anatomic bank or distribute tissue or nontransplant anatomic parts in New York State shall submit a completed, signed application to the department and obtain a license from the department prior to the operation of such a tissue bank or nontransplant anatomic bank, or conduct of such activity, unless otherwise specified in this Part.
(b) The department shall provide, upon request, an application for licensure as a tissue bank which may require information including, but not limited to, the following:
(1) the name, address and telephone number of the bank;
(2) the days and hours of bank operation;
(3) the type of organization sponsoring the bank, i.e., proprietary, municipal or nonprofit;
(4) the type of ownership, i.e., individual, partnership, corporation or government;
(5) if ownership is individual, corporation or partnership: the name and principal office address of the entity, and the name, title, home address and Social Security number and Federal employer identification number, if any, of the owner, officers of the corporation or the partners;
(6) if government-operated: the name, principal office address of the government entity, and the name(s), title(s) and addresses of the administrator responsible for the operation of the bank in conjunction with the director;
(7) except for facilities established pursuant to Public Health Law article 28, for any person or entity with a direct or indirect ownership interest in the tissue bank of five percent or more, or any owner who is a licensed health professional and is authorized by law to prescribe tissue services and/or perform tissue transplantation services, or principal stockholder or any person or entity with a controlling interest:
(i) name, home address, and Social Security number and employer identification number, if any, of such persons, or for a corporation, the corporate name, principal place of business, corporate executive office address and employer identification number;
(ii) the manner in which the person or entity has an ownership interest or a controlling interest, and the percentage of such ownership interest;
(iii) any existing or prior direct or indirect ownership interest or status as a person or entity with a controlling interest in any other tissue bank, laboratory, funeral firm or health care facility holding a New York State or New York City license, permit or certificate of operation, and the name and address of such tissue bank, laboratory, firm or facility, and whether such bank, laboratory, firm or facility has had its permit or license denied, revoked, suspended, limited or annulled, or currently has an enforcement proceeding pending against it; and
(iv) whether the person or entity has been convicted of, or pled guilty to, a criminal offense related to the operation of a bank, laboratory or health care facility, or of any programs established pursuant to title XVIII, XIX or XX of the Federal Social Security Act; and
(8) the category or categories of tissue, and the type or types of tissue services to be provided;
(9) a description of the tissue bank premises and equipment;
(10) any other employment of the tissue bank director and/or medical director, including the position and number of hours worked;
(11) the name, position, qualifications, duties and work schedule of all technical personnel;
(12) a copy of all existing tissue acquisition and/or processing agreements;
(13) a description of the tissue bank's proposed or existing service area for acquisition and/ or distribution of tissue;
(14) a description of educational programs, including those programs designed to encourage tissue donation;
(15) donor and recipient selection and testing criteria;
(16) a copy of each protocol or procedure required in this Subpart and in the Subpart for each category of tissue;
(17) any information required in the Subpart for each category of tissue;
(18) for a corporation: a copy of the existing certificate of incorporation, by-laws and any certificates of doing business under an assumed name, or for a partnership: a copy of the partnership agreement and any certificates of doing business under an assumed name;
(19) for the tissue bank director and medical director, if applicable, the following information:
(i) name;
(ii) work and home addresses and work telephone number;
(iii) educational background; and
(iv) work experience, including all places of employment and positions held for the 10 years immediately preceding the date of the application; and
(20) the name, title, work address and telephone number of the tissue bank compliance officer and tissue transplantation service director(s), if such personnel are required pursuant to this Part.
(c) An application for licensure as a limited tissue procurement service shall require the information specified in paragraphs (b)(1)-(8) of this section; and
(1) a list of all tissue banks performing tissue acquisition activities on the premises of a limited tissue procurement service; and
(2) the name, title and business telephone number of the person with primary responsibility for compliance with Public Health Law article 43-B.
(d) An application for licensure as a nontransplant anatomic bank shall require the information specified in paragraphs (b)(1)-(8) of this section, and:
(1) a list of all the types of nontransplant anatomic parts banked;
(2) a list of all facilities that provide nontransplant anatomic parts to the nontransplant anatomic bank;
(3) a list of all facilities in New York State to which nontransplant anatomic parts are distributed;
(4) the name, title and business telephone number of the person with primary responsibility for compliance with Public Health Law, article 43-B; and
(5) an affirmation that the tissue will be distributed only to a legal donee as designated in Public Health Law, section 4302 and will only be used by the bank for the purposes authorized by Public Health Law, section 4302.
(e) Any dentist or physician whose use of tissue is limited to virally inactivated tissue shall not be required to be separately licensed pursuant to this Part, provided he or she is licensed by, and currently registered with, the State Education Department.
(f) Shipping of any tissue from an out-of-state facility shall constitute distribution and shall require a license, unless the tissue is:
(1) avascular eye tissue or hematopoietic progenitor cells shipped to a licensed comprehensive tissue procurement service, provided the licensed comprehensive tissue procurement service shall be responsible for:
(i) the safety and appropriateness of the imported tissue as specified in Subparts 52-3 and 52-7 of this Part, and Subpart 58-5 of this Title;
(ii) obtaining documentation that valuable consideration has not been paid to the out-of-state facility transferring the tissue. Documentation that the transferring out-of-state facility is a nonprofit organization shall create a presumption that valuable consideration has not been paid;
(2) subjected to viral inactivation by a process accepted by leading authorities in the field of transplantation medicine and a written exception to the requirements of this subdivision has been granted by the department on the basis of documentation submitted by the applicant, including a detailed description of the viral inactivation methodology and procedure, and data showing the amount of virus introduced and the effectiveness of the method in destroying the virus; or
(3) from fully screened and tested donors; has been extensively processed and altered by such means as culturing over many generations, and combined with nontissue components, so that the original human tissue constitutes a small percentage of the final product; and a written exception to the requirements of this section has been granted by the department on the basis of documentation submitted by the applicant. Such documentation shall include a detailed description of the processing and donor screening performed to ensure that the tissue is free of pathogens listed in sections 52-3.4(c)(4), 52-4.7(a), 52-5.7(a), 52-6.7(a) and 52-7.7(a) of this Part, as applicable to the type of tissue procured.
(g) All changes in the tissue bank director, medical director, owner or persons with a controlling interest shall be reported as specified in section 52-2.3(a) and (b) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.4 Contracts
(a) Contracts to perform any services for a medical facility issued an operating certificate or certificate of approval shall:
(1) be in writing, signed by an authorized representative of the facility and the person or agency providing the service and dated;
(2) include each party's responsibilities, functions, objectives, financial arrangements and charges;
(3) require compliance with all pertinent provisions of this Chapter;
(4) include the following language: “Notwithstanding any other provision in this contract, the facility remains responsible for ensuring that any service provided pursuant to this contract complies with all pertinent provisions of Federal, State and local statutes, rules and regulations.”
(b) Medical facilities are hereby authorized, subject to the provisions of this Chapter, to enter into contracts and make arrangements among themselves and among other municipal, State, Federal or privately owned hospitals, or any medical schools, or other health-related facilities having or utilizing hospital services or facilities, whether or not located in this State or elsewhere, for the:
(1) mutual use, or exchange of medical resources including, but not limited to, real or personal property or employment of personnel;
(2) joint purchases of goods, supplies and services; or
(3) development of medical information, techniques and facilities useful in the progress of the medical art; reduction of medical costs and promotion of a more efficient and effective approach to the delivery of health care services.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.8 Handwashing facilities
Handwashing facilities are to be provided at each establishment. This facility is to be at least potable warm water, soap and individual paper towels.
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.112 Definition of sanitization; general requirements
Sanitization is effective bactericidal treatment by heat or chemical means, acceptable to the permit-issuing official, which destroys pathogens on surfaces treated.
(a) The following are acceptable methods of sanitizing:
(1) immersion for at least one-half minute in clean hot water at a temperature of not less than 170 degrees Fahrenheit (76.7 degrees Celsius);
(2) immersion for at least one minute in a clean solution containing at least 50 parts per million of available chlorine at a temperature of at least 75 degrees Fahrenheit (23.9 degrees Celsius);
(3) immersion for at least one minute in a clean solution containing at least 12.5 parts per million of available iodine and having pH not higher than 5.0 and at a temperature of at least 75 degrees Fahrenheit (23.9 degrees Celsius);
(4) immersion in a clean solution containing any other chemical sanitizing agent acceptable to the permit-issuing official that will provide the equivalent bactericidal effect of a solution containing at least 50 parts per million of available chlorine as hypochlorite at a temperature of at least 75 degrees Fahrenheit (23.9 degrees Celsius) for one minute;
(5) treatment with culinary-quality steam in the case of equipment too large to sanitize by immersion, but in which steam can be confined; or
(6) swabbing fixed equipment with a solution of at least twice the strength required for that sanitizing solution when used for immersion.
(b) When hot water is used for sanitizing, the following is to be provided and used:
(1) a heating device or fixture installed in, on or under the sanitizing compartment of the sink capable of maintaining the water at a temperature of at least 170 degrees Fahrenheit (76.7 degrees Celsius);
(2) a numerically scaled, indicating thermometer accurate to plus or minus two degrees Fahrenheit (1.1 degrees Celsius) convenient to the sink for frequent checks of water temperature;
(3) dish baskets of such size and design to permit complete immersion of the tableware, kitchenware and equipment in the hot water.
(c) Chemicals used for sanitizing are not to have concentrations which will leave toxic residues on surfaces treated. A test kit or other device is to be provided and used that accurately measures the parts per million concentration of the solution used, and the pH when it affects the performance of the chemical sanitizer.
(d) Chemicals, heat or other process used for sanitizing is to produce an average plate count per utensil surface examined of not more than 100 colonies, and free from coliform organisms.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.1 Applicability
On and after November 1, 2014, rates of reimbursement for intermediate care facilities for persons with developmental disabilities (ICF/DD) services, other than those provided by the Office for People With Developmental Disabilities, shall be determined in accordance with this Subpart.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.3 Annual report
(a) On or before March 1st of each year, each approved laboratory shall report the total number of individual analyte tests for the previous calendar year (January 1st—December 31st) in each category for which approval is given on forms to be provided by the department. If requested by the laboratory, this report shall be deemed confidential and exempt from disclosure under the Freedom of Information Law (article 6 of the Public Officers Law) pursuant to the authority in section 89(5) of the Public Officers Law. Failure to report or reporting falsely shall result in nonrenewal of the certificate of approval. Governmental laboratories are exempted from reporting their total adjusted volume.
(b) Thirty days after approval of the State budget, the department shall bill each laboratory for its approval fee and any adjustment due from the previous year and shall advise each laboratory of the total number of analyte tests reported by all laboratories and the total number of analytes approved for all laboratories.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 131 ONONDAGA COUNTY
VILLAGES VILLAGES
10 CRR-NY 131.2 Village of East Syracuse
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to Wright Brook, to all natural and artificial reservoirs and to all watercourses and drainage areas tributary thereto and to the Pompey and Leiter springs which serve as sources of the public water supply of the Village of East Syracuse, Onondaga County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refers to all impounding and storage reservoirs used for the collection or storage of the flow from the above named brook or springs which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), brook, stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of East Syracuse.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the Village of East Syracuse, NY.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the Village of East Syracuse, NY.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight, receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the Village of East Syracuse.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (c), within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the Village of East Syracuse.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or tributary thereof, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. No animal or poultry shall be watered in any reservoir of the public water supply of the Village of East Syracuse. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excremental matters any streams tributary to the public water supply of the Village of East Syracuse.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the Village of East Syracuse, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Village of East Syracuse.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of East Syracuse, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of East Syracuse, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the Village of East Syracuse.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the Village of East Syracuse.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tribuatry to the public water supply of the Village of East Syracuse, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Village of East Syracuse.
(g) Fishing, boating and ice cutting.
No bathing of any kind or fishing and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Village of East Syracuse except by the duly authorized employees of the Village of East Syracuse in the performance of their duties of supervision and maintenance of the public water supply.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Village of East Syracuse.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Village of East Syracuse.
(j) Inspections.
The board of water commissioners of the Village of East Syracuse or such other board as may be charged with the maintenance or supervision of the public water supply of the Village of East Syracuse or its duly appointed representative shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.10 Housekeeping service
This functional reporting center must contain all the expenses associated with care and cleaning of the interior physical plant, including care of floors (washing, waxing and stripping), walls, ceilings, partitions, windows (inside and outside), furniture stripping, disinfecting beds, fixtures (excluding equipment), and furnishings, and emptying of room trash containers. Routine housekeeping services performed by dietary personnel in dietary (kitchen) should be reported in the Patient Food Service functional center. This includes the costs of purchasing similar services from outside organizations. Additional activities include but are not limited to the following: providing pest and rodent control; gathering bacteriological surface samplings and carrying out pertinent infection control procedures; providing technical assistance in selection of furniture and furnishings; moving and relocating furniture; and arranging for refinishing, repairing and upholstering or replacement of furniture.
(a) Standard unit of measure: square feet serviced.
The number of square feet in the residential health care facility should be determined either by a physical measurement of the facility or by a measurement from blueprints. Floor area measurements should be taken from the center of walls to the center of adjoining corridors if a hallway services more than one department. Exclude stairwells, elevators and other shafts. General and unused areas are also to be excluded. When changes in assigned areas have been made during the year as a result of new construction, departmental relocation, expansion, or curtailment of service, statistical data should be maintained to allow for the development of weighted areas for the fractional part of the year.
(b) Data source.
Square feet shall be determined from the blueprints of the residential health care facility, or actual measurement if blueprints are not available. Square feet serviced should then be determined by reference to housekeeping assignments as maintained by the director of housekeeping.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.15 Snow disposal and storage and use of winter highway maintenance materials
(a) Whenever feasible removed snow shall not be disposed of directly into a watercourse, wetland, reservoir, reservoir stem or controlled lake. However, this subdivision shall not be construed to require an owner or operator to transport the removed snow in a vehicle for offsite disposal.
(b) No snow disposal activity shall be considered to be a noncomplying regulated activity.
(c) Commercial, industrial, governmental, or institutional entities shall be restricted to the use of the substances defined in these rules and regulations as winter highway maintenance materials and to the use of the minimum amount needed of such substances in order to protect the public safety. In determining the minimum amount needed for public safety, such entities should consider best management practices developed by the New York State Department of Transportation.
(d)
(1) Commercial, industrial, governmental, or institutional entities that store winter highway maintenance materials in quantities of 1,000 pounds or more that contain greater than eight percent chloride compounds shall store such materials in structures constructed on low permeability storage pads.
(2) Any outdoor areas used for loading, handling or mixing of winter highway maintenance materials shall be constructed and maintained to prevent seepage and runoff from entering any watercourse, wetland, reservoir, reservoir stem or controlled lake.
(e) All commercial, industrial, governmental, or institutional entities that store winter highway maintenance materials in quantities and composition not otherwise subject to paragraph (d)(1) of this section, shall store such materials in a manner that minimizes runoff into any watercourse, wetland, reservoir, reservoir stem, or controlled lake. Runoff may be controlled by use of control measures such as berms and covers.
(f) A winter highway maintenance material storage facility may be enlarged provided that the enlarged facility is in compliance with the storage requirements set forth in this section, and any other applicable requirements of these rules and regulations.
(g) Winter highway maintenance material storage facilities that are noncomplying regulated activities shall come into compliance with this section no later than two years from the effective date of these rules and regulations.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.90 Food preparation and service
Food is to be prepared and served with no bare hand contact unless the food will be subsequently heated to 140°F (60°C) or greater for foods that were not previously heated or to 165°F (73.9°C) or greater for foods that are being heated for a second or subsequent time. Convenient and suitable utensils and/or sanitary gloves are to be provided and used to prepare or serve food to eliminate bare hand contact and prevent contamination. Waxed paper, napkins or equivalent barrier to prevent hand contact may be used to serve food.
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.13 Floors
Floors in food preparation areas are to be constructed of concrete, asphalt, tight wood or other similar cleanable material kept in good repair. Dirt or gravel, when graded to drain, may be used as subflooring, when covered with clean removable platforms or duckboards, or covered with wood chips, shavings, or other suitable materials effectively treated to control dust.
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.192 Term of permits; nontransferable
(a) Permits will be issued for a period of time not to exceed one year. The permit-issuing official will determine the term of the permit based on the record of compliance of the establishment and the potential for risks to public health presented by operation of the establishment. After due notice and an opportunity for a hearing, the permit-issuing official may at any time change the term of any permit, or the items of food which may be served.
(b) Permits are nontransferable from one owner or operator to another, or from one mobile food service establishment or pushcart to another.
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.92 Thawing of potentially hazardous foods
Potentially hazardous foods are to be thawed:
(a) in refrigerated facilities at a temperature not to exceed 45°F (7.2°C);
(b) in a microwave oven when the food will be immediately transferred to conventional cooking facilities as part of a continuous cooking process, or when the entire uninterrupted cooking process takes place in a microwave oven; or
(c) as part of the conventional cooking process. Whole frozen poultry or poultry breasts, other than a single portion, must be completely thawed prior to conventional cooking, except for a single portion intended for service to an individual consumer.
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.80 Food preparation and service
(a) Food is to be prepared and served with no bare hand contact unless the food will be subsequenty heated to at least the minimum temperature required under section 14-1.82 of this Subpart or to 165 degrees Fahrenheit (73.9 degrees Celsius) or greater for foods that are being heated for a second or subsequent time.
(b) Convenient and suitable utensils and/or sanitary gloves are to be provided and used to prepare or serve food to eliminate bare hand contact and prevent contamination. Waxed paper, napkins or equivalent barrier to prevent hand contact can also be used to serve food.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 124 MADIS0N COUNTY
VILLAGES VILLAGES
10 CRR-NY 124.3 Village of DeRuyter
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the fire storage reservoir and to all springs, watercourses and drainage areas tributary thereto or ultimately discharging into said reservoir, such bodies of water being sources of the public water supply of the Village of DeRuyter, in the Town of DeRuyter, Madison County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the fire storage reservoir of the water-main system of the public water supply and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of DeRuyter.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or cesspool to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the Village of DeRuyter.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c] ) within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of DeRuyter.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid or any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the Village of DeRuyter. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Village of DeRuyter.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 250 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 250 feet from any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of DeRuyter, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 250 feet of any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter.
(f) Dead animals, offal, industrial wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the Village of DeRuyter, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the Village of DeRuyter.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Village of DeRuyter, except by duly authorized employees of the Village of DeRuyter in the performance of their duties of supervision and maintenance of the public water supply of the Village of DeRuyter.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of DeRuyter.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of DeRuyter.
(j) Inspections.
The board of water commissioners of the Village of DeRuyter or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of DeRuyter or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.4 Adjournment
A request for an adjournment of the hearing should be in writing and submitted to the hearing officer and other parties prior to the hearing. Adjournments shall be granted only by the hearing officer, and only after the hearing officer has consulted with both parties. When granted, adjournments should be to a specified time, day and place.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT
10 CRR-NY 43-1.17 Commissioner's orders
If a local health official fails to provide or secure tuberculosis health care services or to pay providers for such services rendered under the terms of this Subpart, the State Health Commissioner upon notice and opportunity to be heard may order the local health official to provide or secure the services or to make such payment.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.15 Ova donation registry
(a) Any assisted reproduction service provider that performs ova donor evaluation and selection shall enroll in the department’s ova donation registry, the central tracking registry of ova donors in New York State who have voluntarily agreed to participate in such registry.
(b) Upon enrollment in the ova donation registry, the assisted reproduction service provider shall be provided with a unique identifier code, which shall identify only the assisted reproduction service provider’s facility identification number as issued by the department, business name, and business address.
(c) Following retrieval of oocytes from the donor who is not also the intended parent, the assisted reproduction service provider shall ask the donor whether they would like to participate in the ova donation registry. The donor shall be provided with written informational material regarding the ova donation registry which shall indicate, at a minimum, the following:
(1) participation in the ova donation registry is voluntary and consent can be withdrawn at any time;
(2) information will be de-identified; and
(3) the assisted reproduction service provider shall adhere to all State and Federal laws regarding confidentiality of private health information, and the donor may pursue remedies against the assisted reproduction service provider under such laws for any unwarranted disclosure of their confidential health information.
(d) For any donor who indicates, by signed acceptance maintained on file with the assisted reproduction service provider, that they wish to voluntarily participate in the ova donation registry, the assisted reproduction service provider shall request a unique donor identifier code from the ova donation registry. Upon being provided such donor identifier code, the assisted reproduction service provider shall:
(1) attach such code to the donor’s confidential record maintained by the tissue bank, or otherwise associate such code with the donor’s confidential record, for tracking purposes; and
(2) generate a separate record, identified only with the donor identifier code, indicating the number of ova and the number of times ova have been donated by this particular donor, and the medical and health history of such donor, which shall include, at a minimum, all health screening criteria required under Part 52 of this Title. Such unique record shall be known as the ova donation registry record .
(e) The assisted reproduction service provider shall maintain the confidentiality of the ova donation registry record in accordance with all applicable State and Federal laws, including Public Health Law section 4365(4)(c).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
INSECT AND RODENT CONTROL INSECT AND RODENT CONTROL
10 CRR-NY 14-5.160 Insect and rodent control
The food vending operation is to be free of insects, rodents, harborage, and insect or rodent breeding conditions. Pesticides are not to be used in place of or as a substitute for proper sanitation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-3 REPORTING OF BLOOD LEAD LEVELS
10 CRR-NY 67-3.2 Reporting of elevated blood lead results by health care providers
(a) All health care providers shall assure that all of the information specified in section 67-3.1 of this Subpart is completed for all blood lead analyses ordered by the health care provider and that this information accompanies the sample to the testing laboratory.
(b) All health care providers shall notify the health officer having jurisdiction of the occurrence of any blood lead level above 45 mcg/dL (micrograms per deciliter) in a child less than 18 years of age within 24 hours of having been notified of this result by the testing laboratory.
(c) For the purposes of this Subpart, health care provider shall mean any health care practitioner who is authorized to order a blood lead test and any facility licensed pursuant to article 28 of the Public Health Law.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.53 Realty subdivisions; performance standards
The local health department shall maintain a program for approving realty subdivisions and assuring construction is in accordance with approved plans; provided that this provision shall not apply to New York City. The program shall include, at a minimum:
(a) procedures for approval of all realty subdivisions in accordance with the Public Health Law, Environmental Conservation Law, Education Law, and applicable State regulations prior to the start of construction activities; and
(b) provisions for site evaluation and construction inspections as necessary to assure that approved plans are followed.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
SERVICES PROVIDED AND GOODS USE SERVICES PROVIDED AND GOODS USE
10 CRR-NY 446.27 Organized Alcoholic Treatment Programs
(a) Types of patients served:
(1) Outpatients.
(2) Inpatients.
(3) Both.
(b) Please indicate the following data for inpatient programs:
(1) Number of certified beds at the end of the reporting period.
(2) Number of admissions during the reporting period.
(3) Number of patient days rendered during the reporting period.
(c) Please indicate the following data for outpatient programs:
(1) Register of patients on last day of reporting period.
(2) Total number of different patients treated during the reporting period.
(3) Total number of visits during the reporting period.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.13 Sewage system
(a) All waste water including filter backwash water from a spray ground shall be discharged in such a manner that waste water cannot be siphoned, flooded or otherwise discharged into the spray pad treatment tank.
(b) Waste water from the spray ground shall discharge to a public sewer system or other approved sewage disposal system.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.51 General requirements for and prohibited uses of radiation equipment
(a) General requirements.
All radiation equipment shall meet any applicable specific provision of the sections of this Part set forth under the heading “Radiation Equipment” (§§ 16.50-16.63), and all possession or use thereof shall comply with the requirements of sections of this Part set forth under the heading “General Provisions” (§§ 16.1-16.20), and any other requirement imposed by the department. Radiation equipment which is not intended to be used, must be made inoperable to the satisfaction of the department by dismantling or sealing with an official New York State Department of Health seal or other suitable method; and shall not be unsealed or restored to operable condition without prior authorization by the department.
(b) Prohibited uses and activities include:
(1) nonimage intensified fluoroscopic equipment which has not been certified in accordance with 21 CFR part 1020 (see section 16.200 of this Part);
(2) shoe-fitting fluoroscopic devices;
(3) intra-oral fluoroscopy used in dental examinations;
(4) photofluorographic equipment;
(5) the sale of gold jewelry which is known by the owner to be contaminated with radioactive materials, except for sale to the department.
(c) Precedence of Federal performance standard.
Wherever any requirement of this Part relating to radiation equipment conflicts with the Federal performance standard for diagnostic X- ray systems and their major components (21 CFR 1020.30), the Federal performance standard, when effective, shall take precedence over and supersede any conflicting requirement of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.10 Communication of internal control related matters noted in an audit
(a) In addition to the annual audited financial report, every MCO shall obtain from its CPA a written communication stating whether or not the CPA has noted any unremediated material weaknesses in the MCO’s internal control over financial reporting during the audit. The communication prepared by the CPA shall also contain a description of any unremediated material weakness as of December 31st of the immediately preceding year.
(b) The MCO shall provide a description of remedial actions taken or proposed to correct unremediated material weaknesses, if the actions are not described in the CPA’s communication.
(c) The MCO shall submit the written communication to the commissioner as part of the filing of each annual audited financial report filed with the commissioner, as required by section 98-1.16(c) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.288 Relative value unit
Index number assigned to various procedures based upon the relative amount of labor, supplies and capital needed to perform the procedure. The unit value represents the cost of performing a service relative to some other service which is used as a base, i.e., has a unit value of one.
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.5 Objective evidence
[ 1140 ]
(a) Information produced by the accounting process should be based, to the extent possible, upon objectively determined facts. Transactions should be supported by properly executed documents such as charge slips, purchase orders, suppliers' invoices, cancelled checks, etc. Such documents serve as objective evidence of transactions and should be retained as a source of verification of the data in the accounting records.
(b) Certain determinations that enter into the accounting records are based on estimates. The estimates should be based on past experience modified by expected future considerations. Examples would include recognition of estimated provisions for depreciation and bad debts.
(c) Books, papers, records or other data relevant to matters of hospital ownership, organization and operation must be maintained. The data must be maintained in an ongoing recordkeeping system which allows for the data to be readily verified by qualified auditors.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-4 MENTAL HEALTH AND SUBSTANCE USE DISORDERTREATMENT PARITY COMPLIANCE PROGRAM
10 CRR-NY 98-4.2 Applicability
This Subpart shall apply to all MCOs offering coverage that are subject to the mental health and substance use disorder requirements under Insurance Law section 4303 and Public Health Law section 4406.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
PRACTICE OF RADIOLOGIC TECHNOLOGY PRACTICE OF RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.0 Purpose and scope
This Part establishes educational, licensing and certification requirements for persons engaged in the practice of radiologic technology. This Part also describes standards for educational programs in radiologic technology.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.8 Out-of-state laboratory seeking permit
(a) Prior to any onsite inspection, an out-of-state laboratory possessing or seeking a New York State permit shall pay to the department, by certified check, bank check, teller's check or money order, a fee calculated by the department and consisting of the following components:
(1) a transportation expense, which shall be either the actual travel expense if travel is by common carrier, or a mileage expense at the rate negotiated between the State and the union representing the employees scheduled to conduct the inspection; and
(2) a per diem expense as specified by the New York State Comptroller for the inspecting employees, multiplied by the number of additional days estimated by the department to be necessary for travel and the actual inspection.
(b) In calculating this fee, the department shall estimate the total cost of the components specified in paragraph (a)(1) of this section and divide it equally among the laboratories inspected on any trip.
(c) In the event the department underestimates any of the above expenses, the laboratory shall pay any difference between the estimate and the actual expense.
(d) Fees collected shall be credited to the Clinical Laboratory Reference Fee Account. In the event the department overestimates any of the above expenses, the laboratory shall be notified of the difference between the estimate and the actual expense, and its account shall be credited that amount unless a refund is requested.
(e) Failure to pay the fee for out-of-state inspection will result in suspension or nonrenewal of the laboratory permit.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.179 Intensive care
Services provided in a routine patient care unit to patients which require extraordinary observation and care on a concentrated exhaustive and continuous basis.
10 CRR-NY 441.259 Plant
Physical properties used for institutional purposes: i.e., land, building, improvements, equipment, and so forth. The term does not include real estate or properties of restricted or unrestricted funds not used for health facility operations.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.7 Liver transplantation services
(a) This methodology will be utilized to evaluate certificate of need applications involving the initiation of liver transplantation services. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of liver transplantation services. The goals and objectives of the methodology expressed herein are expected to insure that an adequate number of liver transplantation services are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors and methodology for determining the public need for liver transplantation services shall include, but not be limited to, the following:
(1) The need for liver transplantation services will be planned for on a statewide basis based on an incidence rate of candidates for liver transplantation of 10 persons per one million population per year.
(2) There shall be one liver transplantation service center per five million population.
(3) Each applicant for a liver transplantation service must present evidence that a minimum of 20 transplants per year shall be achieved within two years of initial operation.
(4) There shall be no additional liver transplantation services approved until each existing transplantation service is performing 50 transplantations per year.
(5) Priority consideration will be given to applicants that propose to provide this service within the facility's current capacity.
(6) Where public need is established herein, priority consideration will be given to applicants that agree to serve the medically indigent and patients regardless of the source of payment.
(7) In addition, each applicant applying to initiate a liver transplantation service must meet the following standards:
(i) Each applicant must demonstrate the availability of a liver transplantation surgeon with board certification in general surgery or have equivalent experience and demonstrate the ability to perform liver transplantation as evidenced by clinical experience in an existing liver transplantation program.
(ii) Each applicant must demonstrate the availability of a liver transplantation team that includes qualified specialists in gastroenterology, hepatology, infectious disease, pulmonary medicine, immunology, hematology, pediatrics, neurology, neurosurgery and nephrology.
(iii) Each applicant must demonstrate its participation in a donor organ procurement system, or a donor organ harvesting program, or a written affiliation agreement with an existing approved or registered donor organ procurement or harvesting agency.
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.3 Selection of innovations for evaluation
(a) The commissioner shall determine those innovations in medical technology which shall require evaluation through a demonstration project before they may be considered for review and approval pursuant to section 2802 of the Public Health Law and Part 710 of this Subchapter without limitation as to time or scope, after affording the health systems agencies and the State Hospital Review and Planning Council an opportunity to submit their recommendations, based on pertinent factors including, but not limited to, the following:
(1) the relative costs associated with acquiring, operating or providing the innovation when compared to the costs associated with other methods of providing comparable services;
(2) the potential for patient or personnel harm or injury associated with the use and operation of the innovation;
(3) the need to demonstrate the medical usefulness of efficacy of the innovation; and
(4) the need to identify and collect data in order to develop appropriate need and utilization standards for the innovation.
(b) After the commissioner has determined that an innovation in medical technology will be eligible for evaluation through a demonstration project pursuant to this Part, he will so notify all medical facilities that provide a level and type of care and service for which the innovation in medical technology would be appropriate, as determined by the commissioner, based upon generally accepted standards of medical practice.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.195 Access
The permit-issuing official or his designated representative is to be permitted access for purposes of inspection at all times while the food service establishment is in operation, whether open to the public for service of food or not. Refusal of admittance, after proper identification, is cause for action to obtain permit revocation and an order to close.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.6 Procedures governing inspection and copying of records
Inspection and copying of records shall be made in the following manner:
(a) Records access requests must be reasonably described and in writing.
(b) The records access officer shall, within five business days after receipt of a request:
(1) make requested records available;
(2) deny the request in writing. Such denial should:
(i) explain the reason for the denial;
(ii) set forth the right of appeal to the records access appeals officer; and
(iii) provide the name, title, business address and telephone number of the records access appeals officer;
(3) furnish written acknowledgment of the request and the approximate date when the request will be granted or denied, which date shall not exceed 30 days from the date of acknowledgment.
(c) If access is approved, the records access officer shall cause a search for the records requested.
(d) If the record cannot be found after diligent search, the records access officer shall so notify the requestor.
(e) Upon request, the records access officer will certify that the record is a true copy.
(f) The original or file copies of records will not be released from departmental files.
(g) Persons requesting records in the possession of the department but which records originated in any other State of Federal agency shall be referred to the originating agency when there is a question concerning confidentiality requirements.
(h) Persons inspecting a record shall be allowed to copy it by any means which will not damage the record.
(i) The locations where records are available for inspection or copying pursuant to this Subpart shall be posted in conspicuous places.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-2 STATE FUNDING FOR HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-2.3 Termination
(a) A grant may be terminated by the Commissioner of Health before the expiration of the established funding period if (1) the health service area of the agency is revised during the funding period or (2) the Commissioner of Health determines that the health systems agency cannot effectively carry out the functions as defined in section 82-1.6 of this Part.
(b) Before the Commissioner of Health may terminate the funding of a health systems agency, the commissioner shall provide written notice of the reasons for termination and shall provide the health systems agency with an opportunity to meet with the Department of Health, present information and resolve the deficiencies.
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.6 Grading of examination
(a) Every candidate for a nursing home administrator license shall be required to pass an examination, as determined by the board, for such license with a minimum grade determined by the board.
(b) The board shall determine the method of grading and shall apply the method uniformly to all candidates taking that examination.
(c) The board shall not disclose the percentage ratings of candidates by individual identity to any of its officers or employees responsible for determining the final grading of an examination until such determination has been made.
Chapter I STATE SANITARY CODE
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.3 Permit required to hold or promote a public function
(a) No person shall hold or promote, by advertising or otherwise, a public function unless a permit has been issued for said function by the permit-issuing official.
(b) Application for a permit to promote or hold a public function shall be made to the permit-issuing official, on a form and in a manner prescribed by the State Commissioner of Health, by the owner/lessor of the land or facility, and the person who will promote or hold the public function. Application for a permit to promote or hold a public function shall be made at least five days before the first day of advertising and at least 30 days before the first day of the event. The application shall be accompanied by an emergency medical services operational plan complying with the requirements of this Part and any supplemental plans, reports and specifications as the permit-issuing official shall require because of concerns raised by specific circumstances pertaining to the event. In addition, the applicant shall attach to its application a copy of the crowd control plan filed or required to be filed by it with the New York State Emergency Management Office pursuant to chapter 288 of the Laws of 1988.
(c) A permit shall be valid for the time period specified thereon.
(d) A permit may be revoked by the permit-issuing official or the State Commissioner of Health for failure to comply with the terms of the permit.
(e) A permit issued for the operation of a public function shall be posted in the emergency health care unit or function office and be made available on request.
(f) Notwithstanding anything to the contrary contained in the foregoing subdivisions of this section, a permit shall not be required under this Part for an event which also constitutes a mass gathering subject to the permit requirements of Part 7 of this Chapter; provided, however, that all of the other requirements of this Part shall be applicable thereto.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
GENERAL GENERAL
10 CRR-NY 61-1.3 Certification
(a) A certificate to engage in recombinant DNA activity will be issued by the commissioner only to an institution. Except as hereinafter provided, an institution will not be issued a certificate unless it:
(1) establishes an institutional biosafety committee (IBC) composed of members approved by the commissioner as satisfying the requirements of section 61-1.31 of this Subpart; and
(2) submits a written assurance that it:
(i) will submit each recombinant DNA project to NIH, or other Federal agency designated by NIH, for approval where such approval is required by this Subpart or the NIH guidelines;
(ii) will file reports with the commissioner when requested by him showing the progress of recombinant DNA activity engaged in at the institution;
(iii) will not engage in recombinant DNA activity in any facility which does not comply with the NIH guidelines;
(iv) will conduct training programs satisfactory to the commissioner for all workers and service personnel with duties in recombinant DNA laboratories;
(v) will carry out health monitoring programs appropriate to each recombinant DNA activity engaged in;
(vi) has an emergency plan for accidents involving potentially hazardous materials involved in recombinant DNA activity; and
(vii) will comply with the requirements of article 32-A of the Public Health Law and this Subpart.
(b) An institution engaged in recombinant DNA activity subject to, and in compliance with, policies and regulations or guidelines promulgated by any agency of the Federal government for the regulation of recombinant DNA activity may submit to the commissioner copies of the documentation approved by the Federal agency, including information relating to the institutional biosafety committee of the institution. Such documentation may be accepted by the commissioner as authority for issuance of a certificate to engage in recombinant DNA activity upon the same conditions and limitations, if any, as imposed by the Federal agency.
(c) Unless the activity is prohibited by section 61-1.2 of this Subpart, an institution may be issued a certificate by the commissioner to engage in recombinant DNA activity limited to the following recombinant DNA molecules, and for such certificate shall not be required to comply with those provisions of sections 61-1.30 and 61-1.31 of this Subpart pertaining to the establishment and functioning of an institutional biosafety committee (IBC):
(1) those that are not in organisms or viruses;
(2) those that consist entirely of DNA segments from a single nonchromosomal or viral DNA source, though one or more of the segments may be a synthetic equivalent;
(3) those that consist entirely of DNA from a prokaryotic host, including its indigenous plasmids or viruses, when propagated only in that host (or a closely related strain of the same species) or when transferred to another host by well-established physiological means; also those that consist entirely of DNA from a eukaryotic host, including its chloroplasts, mitochondria or plasmids (but excluding viruses), when propagated only in that host (or a closely related strain of the same species);
(4) certain recombinant DNA molecules that consist entirely of DNA segments from different species that exchange DNA by known physiological processes, though one or more of the segments may be a synthetic equivalent, as specified in a list of such exchangers prepared and periodically revised by the director, NIH; and
(5) other classes of recombinant DNA molecules if the director, NIH, finds that they do not present a significant risk to health or the environment, and the commissioner is furnished satisfactory evidence of such finding.
(d) An institution not otherwise covered by the NIH guidelines, and not having a valid certificate pursuant to subdivision (c) of this section, is prohibited from engaging in recombinant DNA activity covered by this Subpart unless it follows the approval procedures set forth in Part VI, Voluntary Compliance, of the NIH guidelines. Upon being provided with satisfactory evidence thereof, the commissioner will issue a certificate to the institution to engage in recombinant DNA activity.
(e) Subject to the right to a hearing pursuant to section 12-a or section 16 of the Public Health Law, the commissioner may revoke or suspend the certificate of an institution upon proof that it is conducting or has conducted recombinant DNA activity requiring approval by NIH or other Federal agency designated by NIH, or approval pursuant to subdivision (d) of this section where required, without such approval.
(f) A host-vector system which is not expressly authorized by this Subpart cannot be used unless the institution registers the recombinant DNA activity with NIH and requests evaluation by NIH of the host-vector system. Cloning activity prior to certification of such host-vector system by NIH shall be limited to those genes which are characterized and are usable for evaluation of the host-vector system in its early stages of development.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.22 Third-party payments
(a) Providers shall, in the first instance and where applicable, seek payment from all third party payors, including governmental agencies, prior to claiming payment from a given municipality for evaluations conducted under the program and for services rendered to eligible children residing in the municipality and their families, provided, however, that the provider shall not obtain payment from a third party payor who is not prohibited from applying such payment, and may apply such payment, to an annual or lifetime limit specified in the insured's policy.
(1) A municipality, or its designee, and a provider shall be subrogated, to the extent of the expenditures by such municipality or for early intervention services furnished to an eligible child or parent, to any rights the child or parent may have or be entitled to for third party reimbursement.
(2) The provider shall submit notice to the insurer or plan administrator of his or her exercise of the right of subrogation upon the provider’s assignment as the early intervention service provider for the child.
(i) The right of subrogation does not attach to benefits paid or provided under any health insurance policy or health benefits prior to written notice of the exercise of subrogation rights by the insurer.
(3) Providers shall utilize the department’s fiscal agent and data system for claiming payment for evaluations and services rendered under the Early Intervention Program.
(i) Providers shall enroll, on request of the department or the department’s fiscal agent, with one or more health care clearinghouses, as necessary, for processing of claims to third party payors and for receipt of remittance advices in standard electronic format and in compliance with any applicable Federal or State regulations with respect to electronic claims transactions.
(4) Providers shall submit all claims for payment of evaluations and services within 90 days of the date of service, unless the submission is delayed due to extraordinary circumstances documented by the provider and the department’s fiscal agent has been notified of the extraordinary circumstances and has provided written acknowledgement.
(i) All claims submitted after 90 days shall be submitted within 30 days from the time the provider was relieved from the extraordinary circumstances that previously delayed a timely submission.
(ii) Claims that are not submitted within timeframes set forth shall not be reimbursed by the department’s fiscal agent from the escrow account funded by municipal governmental payors.
(b) The municipality shall pay all co-payments and deductibles to meet any requirement of an insurance policy or health benefit plan in accessing funds applied to payment for early intervention services. These payments will be subject to the same level of State reimbursement as all other payments by the municipality for early intervention services.
(1) The municipality shall establish a procedure to ensure that the parent does not make a first instance payment for co-pays and deductibles. Such procedures may include an arrangement between the municipality and the provider for payment of co-payments and deductibles to the provider directly.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.9 Recognition of other State programs
(a) An environmental laboratory located in another state may request that the department recognize, for purposes of a New York State certificate of approval, that the requirements of this Subpart for on-site assessment, technical direction, quality systems and/or proficiency testing have been met by the laboratory's participation in another state's environmental laboratory approval program. The department may recognize one or more of such requirements as met by participation in another state's program, provided:
(1) the legal, technical and recordkeeping requirements of the state regulatory program in which the laboratory is participating are determined by the department to meet or exceed New York State's requirements;
(2) the laboratory demonstrates good standing in the other state's program, including successful completion of an on-site assessment and satisfactory performance in required proficiency testing, and documents such good standing to the department;
(3) the laboratory submits to the department a completed application for approval;
(4) the laboratory pays all applicable fees required by Subpart 55-3 of this Part;
(5) the laboratory pays any costs incurred by department representatives traveling outside New York State to perform an on-site assessment pursuant to this Subpart; and
(6) the technical director(s) meet(s) the requirements of section 55-2.10 of this Subpart.
(b) The department may enter into agreements with other state agencies or programs to assist the department in assessing an environmental laboratory's performance or in determining whether another state's program meets or exceeds the department's requirements.
(c) Notwithstanding another state program's equivalency to the department's program, the department may require an environmental laboratory to participate in the department's proficiency testing program, on-site assessment, and/or similar evaluations to ensure the laboratory's full compliance with New York State statutes, regulations and standards for laboratories approved pursuant to this Subpart.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 350 ALL PAYER DATABASE (APD)
10 CRR-NY 350.3 APD data release
(a) The department shall implement quality control and validation processes to provide reasonable assurance that APD data released to the public is complete, accurate, and valid. The department shall adhere to applicable State and Federal Laws, regulations, and policies on release of Medicare and Medicaid data.
(b) Upon reasonable assurance that subdivision (a) of this section has been satisfied, the department may release data in the following manner:
(1) De-identified and/or aggregated APD data of a public use nature may be posted to a consumer-facing website.
(2) APD data, including data with identifying data elements, may be released to a New York State agency or the Federal government in a manner that appropriately safeguards the privacy, confidentiality, and security of the data.
(3) APD data, including data with identifying data elements, may be released to other data users that have met the department’s requirements for maintaining security, privacy, and confidentiality and have approved data use agreements with the department.
(c) Data users shall adhere to security, confidentiality, and privacy guidelines established by the department to prevent breaches or unauthorized disclosures of personal information resulting from any data analysis or re-disclosure. Data users bear full responsibility for breaches or unauthorized disclosures of personal information resulting from use of APD data.
(d)
(1) Where the department grants data users access to APD data that does not include identifying data elements, such access shall be subject to terms and conditions established by the department.
(2) Data users who wish to request APD data that includes identifying data elements shall submit an application for a proposed project in a form established by the department, which shall include an explicit plan for preventing breaches or unauthorized disclosures of identifying data elements of any individual who is a subject of the information. The department’s review of the proposed project shall include, but not be limited to:
(i) use of the specific identifying data elements;
(ii) adherence to the department’s guidance on the appropriate and controlled release of data; and
(iii) assurance on whether the release of identifying data elements reflects overall goals of confidentiality, privacy, security, and benefits to public and population health.
(e) Any data user that violates this section or any data use agreement executed under this section shall be liable pursuant to the provisions of the Public Health Law, including, but not limited to, sections 12 and 12-d of the Public Health Law.
(f) The department may charge reasonable fees for access to APD data, which shall be based upon estimated costs incurred and recurring for data processing, operation of the platform/data center, and software. The department shall establish a policy describing any APD data that shall be available at no charge, the fees for access to APD data subject to charge, the process for fee payment, and under what circumstances fees may be reduced or waived.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.7 Surrogacy registry
(a) At such time as the surrogacy program obtains a license, the surrogacy program shall, as a condition of licensure, enroll in the department’s surrogacy registry, the central tracking registry of surrogates in New York State who have voluntarily agreed to participate in such registry.
(b) Upon enrollment in the surrogacy registry, the surrogacy program shall be provided with a unique surrogacy program identifier code, which shall identify only the surrogacy program’s business name and business address.
(c) Upon completion of a surrogacy agreement, the surrogacy program shall ask the surrogate whether they would like to participate in the surrogacy registry. The surrogacy program shall make such inquiry upon the completion of each new surrogacy agreement, regardless of the surrogate’s prior participation in, or refusal to participate in, the surrogacy registry. The surrogate shall be provided with written informational material, written in plain language, regarding the surrogacy registry which shall indicate, at a minimum, the following:
(1) participation in the surrogacy registry is voluntary and consent can be revoked;
(2) information will be de-identified; and
(3) the surrogacy program shall adhere to all State and Federal laws regarding confidentiality of private health information, and the surrogate may pursue remedies against the surrogacy program under such laws for any illegal disclosure of their confidential health information.
(d) For any surrogate who indicates, by signed acceptance maintained on file with the surrogacy program, that they wish to voluntarily participate in the surrogacy registry, the surrogacy program shall request a unique, randomly generated surrogate identifier code from the surrogacy registry. Upon being provided such surrogate identifier code by the department, the surrogacy program shall:
(1) attach such code to the surrogate’s confidential record maintained by the surrogacy program, or otherwise associate such code with the surrogate’s confidential record, for tracking purposes; and
(2) generate a separate record, identified only with the surrogate identifier code, indicating the number of times the person associated with such code has acted as a surrogate and the health information of such surrogate, which shall at a minimum include the health screening criteria prescribed by the department. Such unique record shall be known as the surrogacy registry record .
(3) submit the surrogacy registry record to the department, in a form and manner to be determined by the department.
(e) The surrogacy program shall maintain the confidentiality of the surrogacy registry record in accordance with all applicable State and Federal laws, including Public Health Law section 2599-cc(2).
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.7 Service obligation: deferrals and waivers
(a) Service deferral.
The Commissioner of Health may delay or defer the reporting date, the service obligation or the repayment obligation incurred by a State Health Service Corps recipient due to extreme hardship. Extreme hardship includes, but is not limited to: serious illness or injury of the recipient or an immediate family member and other circumstances beyond the control of the recipient that would make it difficult or impossible for the recipient to fulfill the service obligation or repay the State of New York.
(b) Waiver.
The Commissioner of Health may waive all or part of the service obligation and/or any repayment obligation incurred by an award recipient for reasons described in subdivision (a) of this section.
(c) Evidence of hardship.
The recipient must submit, in writing, ample evidence of hardship when requesting a deferral or waiver. Applications for deferral or waiver shall be submitted on forms prescribed by the Department of Health and may include sworn statements and appropriate documentation of the recipient's claim.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-4.180 Premises
(a) Mobile food service establishments and all parts of the property used in connection with operations of the establishment are to be kept clean and free from litter.
(b) Only articles necessary to the operation and maintenance of the mobile food service establishment are to be in the establishment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.5 Retrieval of tissue
(a) Musculoskeletal tissue, including tissue for which assurance of sterility cannot be maintained, such as mandible, shall be retrieved using aseptic technique in an operating room or other aseptic premises approved by the tissue bank medical director.
(b) Retrieval of musculoskeletal tissue from cadaveric donors shall occur within a time limit after cessation of cardiac function specified in written policies approved by the medical director of the comprehensive tissue procurement service.
(c) Musculoskeletal tissue retrieved from cadaveric donors shall be transported to the tissue processing facility at a temperature of 10 degrees Celsius or lower.
(d) If an ante mortem blood sample is not available from a cadaveric donor, a post mortem sample of sufficient quantity to perform required laboratory testing shall be drawn via a cardiac insertion or from a large vein or artery.
(e) Tissue specimen containers and packaging materials shall be sterile and nontoxic.
(f) Each tissue and blood specimen container shall be labeled legibly at the time of retrieval with the tissue bank identification, and donor identification code or unique tissue identification number. The date, time and anatomic site of retrieval shall be recorded on accompanying documents.
(g) A segment or sample of musculoskeletal tissue that is not intended for viral inactivation shall be placed in a separate, appropriately labeled sterile container intended for culturing for aerobic and anaerobic contamination.
(h) Tissue and blood specimen containers shall be labeled so as to maintain musculoskeletal tissue identification throughout all phases of processing, storage and distribution, in a manner not subject to significant deterioration under conditions of transport and storage.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.14 Revisions in certified rates
(a) The State Commissioner of Health may consider only those applications for revisions of certified rates which are based on:
(1) six-month cost reports filed pursuant to subdivision (e) of section 86-5.2 of this Subpart. Such rate shall become effective on the first day of the six-month period referred to in section 86-5.2(f) of this Subpart;
(2) errors made by the department in the rate calculation process and errors in data submitted by a medical facility which have been brought to the attention of the commissioner within the time limits prescribed in section 86-5.13 of this Subpart;
(3) significant increases in the overall operating costs of the LTHHCP resulting from the implementation of additional programs, staff or services specifically mandated for the program by the commissioner;
(4) requests for waivers of any provisions of this Subpart for which waivers may be granted by the commissioner as prescribed in specific sections; and
(5) changes in the method of providing services which result in a lower overall cost for the services provided.
(b) An application by a LTHHCP for review of a certified rate is to be submitted on forms provided by the department and shall set forth the basis for the appeal and the issues of fact. Documentation shall accompany the application, where appropriate, and the department may request such additional documentation as determined necessary. An application based on error shall be submitted within the time limit set forth in section 86-5.13 of this Subpart. The commissioner shall act upon properly documented applications for rate appeals within one year of the end of the 120-day period referred to in section 86-5.13(a) of this Subpart or the receipt of the applications, whichever date is later. In the event the department requests additional documentation, the one-year time limit shall be extended for a mutually agreed upon time period for receipt of the documentation established by the commissioner in conjunction with the LTHHCP. The deadline will be set according to the nature and quantity of documentation necessary.
(1) The affirmation or revision of the rate upon such staff review shall be final, unless within 30 days of its receipt a hearing is requested, by registered or certified mail, before a rate review officer on forms supplied by the department. The request shall contain a statement of the factual issues to be resolved. The facility may submit memoranda on legal issues which it deems relevant to the appeal.
(2) Where the rate review officer determines that there is not factual issue, the request for a hearing shall be denied and the facility notified of such determination. No administrative appeals shall be available from this determination. The rate review officer, where he/she determines that there is factual issue, shall issue a notice of hearing establishing the date, time and place of the hearing and setting forth the factual issues as determined by the officer. The hearing shall be held in conformity with the provisions of Public Health Law, section 12-a, and the State Administrative Procedure Act.
(3) The recommendation of the rate review officer shall be submitted to the Commissioner of Health for final approval or disapproval and recertification of the rate where appropriate.
(c) Any modified rate certified under paragraphs (3) and (5) of subdivision (a) of this section shall be effective on the first day of the month in which the respective change is operational.
(d) In reviewing appeals for revisions to certified rates, the commissioner may refuse to accept or consider an appeal from a LTHHCP:
(1) providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council;
(2) operated by the same management when it is determined by the department that this management is providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council in one of its facilities;
(3) where it has been determined by the commissioner that the operation is being conducted by a person or persons not properly established in accordance with the Public Health Law; or
(4) where a fine or penalty has been imposed on the facility and such fine or penalty has not been paid.
In such instances, the provisions of subdivision (c) of this section shall not be effective until the date the appeal is accepted by the commissioner.
(e) Any LTHHCP determined after review by the State Hospital Review and Planning Council to be providing an unacceptable level of care shall have its current reimbursement rates reduced by 10 percent as of the first day of the month following 30 days after the date of the determination. This rate reduction shall remain in effect for a one-month period or until the first day of the month following 30 days after a determination that the level of care has been approved to an acceptable level, whichever is longer. Such reductions shall be in addition to any revision of rates based on audit exceptions.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.5 Enforcement
(a) Permits and placarding.
(1) A permit-issuing official may order any agricultural fairground operating without a permit to close and remain closed until a valid permit for operation of the agricultural fairground is obtained.
(2) The enforcement procedures delineated in sections 12, 12-a, 12-b, 16, 206, 225, 229, 308, 309, 1303-1305, and/or 1308 of the Public Health Law shall be used. When a public health hazard is found, that portion of the agricultural fairground where the hazard is located may be placarded to prohibit its use until the hazard is eliminated. When a placard is used, it shall be conspicuously posted at each entrance or walkway leading to the portion of the property where the hazard exists. Concealment, mutilation, alteration or removal of this placard without permission of the permit-issuing official is prohibited. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without the permission of the permit-issuing official shall constitute a violation of this Subpart and the Public Health Law.
(3) As soon as possible, and in any event within 15 days after placarding an agricultural fairground or portion thereof, the permit-issuing official shall provide the owner an opportunity to be heard and present evidence that the continued operation of the agricultural fairground or placarded portion thereof does not constitute a danger to the health or safety of the public. The hearing shall be conducted by the permit-issuing official or his or her designated hearing officer.
(b) Public health hazards.
(1) A public health hazard is any condition which can be reasonably expected to be responsible for or cause illness, physical injury or death. Any of the following conditions are public health hazards which require the permit-issuing official or his or her designated representative to order immediate correction or to immediately commence an enforcement action as provided by the Public Health Law and/or this Subpart:
(i) the potable water serving the agricultural fairground contains one or more contaminants in excess of one or more maximum levels prescribed in applicable sections of Part 5 of this Title and/or section 7-5.12(g) of this Subpart;
(ii) use of an unapproved or contaminated water supply source;
(iii) insufficient quantity of water to meet drinking or sanitary demands;
(iv) hazardous or toxic chemical contamination of the potable water supply;
(v) disinfection of the potable water supply which is inadequate to destroy harmful microorganisms or to maintain a specified chlorine residual;
(vi) the presence of cross-connections or other faults in the agricultural fairground's water distribution or plumbing system which results, or may result, in the contamination of the potable water supply;
(vii) the presence or storage at the agricultural fairground of animal waste which results, or may result, in contamination of a water supply;
(viii) inadequately treated sewage discharging on the ground surface in a location accessible to agricultural fairground occupants which results, or may result in contamination of a water supply;
(ix) if food service is provided by the agricultural fairground owner, the presence of any public health hazard identified in section 14-1.10(b) or (c) of this Title;
(x) the condition of the electric service, wiring or electrical system components in the camping area is such that an imminent fire or shock hazard exists; and
(xi) any other condition determined by the permit-issuing official to be a public health hazard.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
APPROVAL OF LABORATORIES APPROVAL OF LABORATORIES
10 CRR-NY 55-1.1 Purposes for which approval may be granted
(a) Approval may be granted laboratories and institutions for the use of living animals in properly performed or conducted scientific tests, experiments or investigations, including educational demonstrations. Living animals include living mammals and birds.
(b) Approval will not be granted to laboratories for the use of living animals unless evidence is presented that the general research or teaching program of the institution or laboratory will contribute to the understanding of the problems of human or animal health.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.17 Sick leave
(a) Sick leave is absence with pay necessitated by the illness or disability of the employee including illness or disability caused by pregnancy or childbirth.
(b) Employees shall earn sick leave credits at the rate of one-half day per biweekly pay period during periods they are paid their regular salary and may accumulate such credits up to a total of 150 days; provided, however, that an employee shall not earn sick leave credit for any biweekly pay period unless he is in full pay status for at least seven workdays during such biweekly pay period. A part-time employee who is required to work a fixed number of hours, five days per week, shall also earn sick leave credit as provided herein, but his total pay when absent on such leave shall be the amount which would have been due him had he been working regularly at his usual hours for such period.
(c) An employee absent on sick leave shall notify his supervisor of such absence and the reason therefor on the first day of such absence and within two hours after the beginning of the employee's workday; provided, however, that where the work is such that a substitute may be required, the department may require earlier notification, but not more than two hours prior to the beginning of the employee's workday. An employee who fails to so notify his supervisor may be deemed to be on leave without pay for that day. Sick leave credits shall not be used in units of less than one-half hour.
(d) Before absence for personal illness may be charged against accumulated sick leave credits, the department may require such proof of illness as may be satisfactory to it, or may require the employee to be examined, at the expense of the department, by a physician designated by the department. In the event of failure to submit proof of illness upon request, or in the event that, upon such proof as is submitted or upon the report of medical examination, the department finds that there is not satisfactory evidence of illness sufficient to justify the employee's absence from the performance of his duties, such absence may be considered as unauthorized leave and shall not be charged against accumulated sick leave credits. Abuse of sick leave privileges shall be cause for disciplinary action.
(e) The department may require an employee who has been absent because of personal illness, prior to and as a condition of his return to duty, to be examined, at the expense of the department, by a physician designated by the department, to establish that he is not disabled from the performance of his normal duties and that his return to duty will not jeopardize the health of other employees.
(f) In addition to personal illness of the employee, the following types of absence, when approved by the department, may be charged against accumulated sick leave credits: illness or death in the employee's family, provided, however, that charge for such absence shall not exceed a maximum of 15 days in any one school year; and personal visits to doctor or dentist. Proof of the need for such absences, satisfactory to the department, may be required.
(g) When an employee is transferred to another position in the same or a different department or agency and such position is subject to attendance rules approved by the New York State Civil Service Commission, his accumulated sick leave credits shall be transferred with him. When an employee is separated from service for other than disciplinary reasons and is subsequently reinstated or re-employed within one year after such separation, or is reinstated by action of the State Civil Service Commission, or is reinstated or reemployed while eligible for reinstatement from a preferred list, his sick leave credits accumulated and unused at the time of his separation shall be restored; provided, however, that such sick leave credits shall not be restored except when leave records satisfactory to the appointing authority are available.
(h) Every employee shall, on the date on which he becomes subject to these rules, be credited with the number of days of sick leave which he had accumulated under the Attendance Rules for Employees in New York State Departments and Institutions (see 4 NYCRR Chapter II) and had remaining to his credit as of such date.
(i) This section shall not be construed to require extension of any employment beyond the time at which it would otherwise terminate by operation of law, rule or regulation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.16 Dental services
The operator, directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, must, as appropriate:
(a) provide or refer registrants for dental services; and
(b) ensure that dental services provided to registrants or for which they are referred, are in conformance with the needs identified during the comprehensive assessment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
10 CRR-NY 43-1.1 Definitions
(a) A tuberculosis case shall mean a person diagnosed as having disease caused by M. tuberculosis determined by bacteriological evidence of tuberculous disease or a significant reaction to a mantoux tuberculin test and clinical or roentgenographic evidence of current disease.
(b) A person with tuberculosis infection shall mean a person diagnosed as having a significant reaction to the mantoux tuberculin test in the absence of clinical, roentgenographic or bacteriological evidence of tuberculous disease.
(c) A suspect shall mean a person suspected of having either tuberculosis infection or disease, (including a person who has been in close contact with a tuberculosis case) for whom diagnostic procedures have not been completed and who may or may not be receiving treatment. A person shall not be classified as a tuberculosis suspect for longer than 60 days.
(d) A tuberculosis contact shall mean a person who has been in close association with a suspect or tuberculosis case for a length of time sufficient to become infected with M. tuberculosis by breathing contaminated droplets.
(e) A provider shall mean any facility, agency or organization authorized to furnish tuberculosis health care services under article 3, 28, 36 or 44 of the Public Health Law or a licensed and registered physician.
(f) A tuberculosis patient shall mean a person who is a tuberculosis case; a tuberculosis suspect; or has a tuberculosis infection; and who has been accepted or admitted into care by a provider.
(g) Tuberculosis health care services shall mean diagnostic procedures, care, and treatment for tuberculosis patients furnished by a provider.
(h) Local health official shall mean the Commissioner of Health or public health administrator of a county or part county health district, the Commissioner of Health of the City of New York, the county health director or other appropriate health officer designated by the legislative body of each county or the corresponding authority of the City of New York to be responsible for providing or securing tuberculosis care and treatment, pursuant to section 2202(1) of the Public Health Law.
(i) A State or local charge shall mean those persons defined as such in section 2200(4) and (5) of the Public Health Law.
(j) Third-party payer shall mean Medicare, workers' compensation, medical assistance in accordance with the Social Services Law, the Veterans Administration, health and other insurers and indemnitors or other third parties by whom diagnosis, care and treatment hereunder is payable.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.6 Mail back envelopes and packages
(a) Pharmacies that provide a mail back option as part of a drug take back program and all non-resident pharmacies that distribute covered drugs to residents by mail shall:
(1) provide a prepaid package or envelope; or
(2) provide a voucher for a prepaid package or envelope, which includes patient education regarding the drug take back program and safe drug disposal methods, upon dispensing a covered drug. Patients shall be directed to mail their unused drugs using the packages or envelopes.
(b) Mail back packages and envelopes shall be preaddressed with the address of a collector registered with the DEA, or its successor agency, and the cost of shipping must be prepaid. The exterior of the package must be nondescript; water- and spill-proof; tamper-evident; tear-resistant; sealable; and have a unique identification number that enables each package to be tracked.
(c) A pharmacy shall not accept any mail back packages or envelopes that contain covered drugs unless it is registered as a collector with the DEA, or its successor agency, and uses an on-site method of destruction that complies with all applicable Federal laws and regulations.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.18 Ventilation
All indoor swimming pools shall be adequately ventilated, either by natural or mechanical means.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.10 Technical director: qualifications and responsibilities
(a)
(1) Each environmental laboratory shall appoint one or more technical directors, who shall be full-time members of the laboratory's staff, and who shall exercise actual day-to-day supervision of laboratory operations, including the reporting of results. The designation of a lead technical director shall be documented.
(2) Each technical director shall have the requisite credentials and experience for an area of analysis, such as microbiology, organic chemistry, inorganic chemistry and radiochemical analysis, and shall supervise only the areas of environmental analysis for which he or she meets the qualifications required by this section.
(b) A technical director's responsibilities shall include, but not be limited to, development and implementation of a quality system as defined in section 55-2.1 of this Subpart, including: monitoring standards of performance in quality control and quality assurance; monitoring the validity analyses performed and data generated to ensure reliable data; ensuring that sufficient numbers of qualified personnel are employed to supervise and perform the work of the laboratory; and providing educational direction to laboratory staff.
(c) An individual meeting the requirements of this section may not be the technical director of more than one approved laboratory without authorization from the department. Circumstances to be considered in the department's decision to grant such authorization may include, but not be limited to, the extent to which the operating hours of the laboratories to be directed overlap, adequacy of supervision in each laboratory, and availability of environmental laboratory services in the area served.
(d) A technical director who is absent for a period of time exceeding 15 consecutive calendar days shall designate another full-time staff member meeting the qualifications of this Subpart to assume the responsibilities of technical director temporarily. Whenever the term of such temporary direction exceeds 65 consecutive calendar days, the department shall be notified in writing.
(e) A technical director of an approved laboratory engaged in chemical analysis shall be:
(1) a person with an earned doctoral degree in the chemical, environmental, physical or biological sciences, or engineering, with at least 24 college semester credit hours in chemistry, and at least one year of experience in environmental analysis of representative inorganic and organic analytes for which the laboratory is approved or seeking approval;
(2) a person with a master's degree in the chemical, environmental, physical or biological sciences, or engineering, with at least 24 college semester credit hours in chemistry and at least one year of experience in environmental analysis of representative inorganic and organic analytes for which the laboratory is approved or seeking approval; or
(3) a person with a bachelor's degree in the chemical, environmental, physical or biological sciences, or engineering, with at least 24 college semester credit hours in chemistry and at least two years experience in environmental analysis of representative inorganic and organic analytes for which the laboratory is approved or seeking approval.
(f) A technical director of a laboratory holding or seeking approval for the contract laboratory protocol tier, in addition to meeting the requirements of subdivision (e) of this section, shall have at least three years of experience, at least one year of which shall be in a supervisory capacity.
(g) A technical director of an approved laboratory engaged in, but limited to, inorganic chemical analysis, other than contract laboratory protocol or metals analysis, shall be a person with at least an associate's degree in the chemical, physical or environmental sciences, or two years of equivalent and successful college education, with at least 16 college semester credit hours in chemistry. In addition, such a person shall have at least two years of experience performing such analysis.
(h) A technical director of an approved laboratory engaged in microbiological and/or biological testing shall be:
(1) a person with an earned doctoral degree or master's degree in the chemical, environmental, physical or biological sciences, or engineering, with at least 16 college semester credit hours in the biological sciences, including, for microbiological testing, at least one course having microbiology as a major component, and at least one year of experience in environmental analysis of representative analytes for which the laboratory is approved or seeking approval;
(2) a person with a bachelor's degree in the chemical, environmental, physical or biological sciences, or engineering, with at least 16 college semester credit hours in the biological sciences, including, for microbiological testing, at least one course having microbiology as a major component, and at least two years of experience in environmental analysis of representative analytes for which the laboratory is approved or seeking approval; or
(3) notwithstanding the requirements of paragraphs (1) and (2) of this subdivision, a person with an earned doctoral, master's, bachelor's, or associate's degree in an appropriate field of the sciences or applied sciences, with at least four college semester hours in general microbiology or a biological science course with a major microbiological component, and one year of experience in environmental analysis of representative analytes, may be a technical director of an approved laboratory, provided the laboratory is engaged in microbiological analysis limited to fecal coliform, total coliform and standard plate counts. Two year of equivalent and successful college education, including the microbiology requirement, may be substituted for an associate's degree.
(i) A technical direct of an approved laboratory engaged in radiochemical analysis shall be:
(1) a person with an earned doctoral degree in chemistry, physics or engineering, with at least 24 college semester hours in chemistry, and at least one year of experience in radiochemical analysis of environmental samples;
(2) a person with a master's degree in chemistry, physics or engineering, with at least 24 college semester hours in chemistry, and at least one year of experience in radiochemical analysis of environmental samples; or
(3) a person with a bachelor's degree in chemistry, physics or engineering, with at least 24 college semester credit hours in chemistry, and at least two years of experience in radiochemical analysis of environmental samples.
(j) Notwithstanding any other provision of this section, a full-time employee of a drinking water or sewage treatment facility who holds a valid treatment plant operator's certificate appropriate to the nature and size of such facility shall be deemed to meet the educational and experience requirements for serving as the technical director of the approved laboratory devoted exclusively to analysis of environmental samples taken within such a facility. Such approval for a water treatment facility shall be limited to determination of total dissolved solids, pH, temperature, alkalinity, acidity, total coliform organisms and standard plate counts. Such approval for a sewage treatment facility shall be limited to determination of biochemical oxygen demand, total solids, suspended solids, pH, temperature, alkalinity, acidity and fecal coliform organisms. However, such approval for a sewage treatment facility shall be extended to include determination of ammonia, total Kjeldahl nitrogen, nitrate or total phosphorus, provided such full-time employee has successfully completed a specialized course of study in the analysis of these substances, generally recognized by leading authorities in the field.
(k) Notwithstanding any other provision of this section, a full-time employee of an industrial waste treatment facility with at least one year of experience in environmental analysis, under supervision, shall be deemed to meet the requirements for serving as the technical director of an approved laboratory devoted exclusively to analysis of environmental samples taken within such a facility for determination of biochemical oxygen demand, total solids, suspended solids, pH, temperature, alkalinity, acidity and fecal coliform organisms.
(l) A technical director of an approved laboratory engaged in microscopic examination of asbestos and/or airborne fibers shall meet the following requirements:
(1) For procedures requiring use of a transmission electron microscope, a bachelor's degree, successful completion of specialized courses in use of the instrument, and one year of experience, under supervision, in use of the instrument. Such experience shall include identification of minerals.
(2) For procedures requiring use of a polarized light microscope, an associate's degree or two years of equivalent and successful college study, successful completion of formal coursework in polarized light microscopy, and one year of experience, under supervision, in use of the instrument. Such experience shall include identification of minerals.
(3) For procedures requiring use of a phase contrast microscope, as in determination of airborne fibers, an associate's degree or two years of equivalent and successful college study, documentation of successful completion of formal coursework in phase contrast microscopy, and one year of experience, under supervision, in use of the instrument.
(m) A technical director of an approved laboratory engaged in determination of radon in air shall meet the following requirements:
(1) An associate's degree in the physical sciences, or two years of equivalent and successful college education, and one year of experience in radiochemical measurements, including at least six months of experience in measurement of radon and/or radon progeny.
(2) For radon determinations using a direct continuous monitoring device, as in on-site measurement of residential radon levels, at least a high school diploma or high school equivalency diploma, and certification of successful completion of a training course in operation of the instrument, as well as six months of experience, under supervision, in use of the instrument.
(n) A person who meets the experience requirements but not the educational and/or credential requirements of this Subpart, and is functioning in a technical director's capacity on the date the laboratory becomes subject to these regulations, shall qualify as technical director of that laboratory, or any other laboratory approved by the department and performing similar analyses, provided such person can demonstrate the ability to comply with the proficiency testing and quality system requirements of this Subpart.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.48 Reporting and recordkeeping requirements
(a) Reporting requirements for tap water monitoring for lead and copper and for water quality parameter monitoring.
(1) Unless the State has specified a more frequent reporting requirement, a water system shall report the following information for all tap water samples specified in section 5-1.42 of this Subpart and for all water quality parameter samples specified in section 5-1.43 of this Subpart to the State within the first 10 days following the end of each applicable monitoring period; for monitoring periods with a duration of less than six months, the end of the monitoring period is the last date samples can be collected during that period as specified in sections 5-1.42 and 5-1.43 of this Subpart:
(i) results of all first draw lead and copper tap samples collected in accordance with section 5-1.42 of this Subpart, including site locations and the criteria used in selecting the site in accordance with section 5-1.42(a)(1) of this Subpart;
(ii) documentation for each tap water lead or copper sample for which the water system requests invalidation in accordance with section 5-1.42(e) of this Subpart;
(iii) the 90th percentile lead and copper concentrations measured from among all lead and copper tap water samples collected during each monitoring period and calculated in accordance with section 5-1.41(c) of this Subpart, unless the State calculates the system’s 90th percentile under subdivision (h) of this section;
(iv) with the exception of initial tap sampling conducted pursuant to section 5-1.42(b)(1)-(3) of this Subpart, the system shall identify any site which was not sampled during previous monitoring periods, and include an explanation of changes in sampling sites if any;
(v) the results of all tap samples for applicable water quality parameters collected in accordance with section 5-1.43(b)-(d) of this Subpart; and
(vi) the results of all samples collected at the entry point(s) to the distribution system for applicable water quality parameters under section 5-1.43(b)-(d) of this Subpart.
(2) For a nontransient noncommunity water system, or a community water system meeting the criteria of section 5-1.47(b)(2)(g) of this Subpart that does not have enough taps that can provide first-draw samples, the system shall provide written documentation to the State identifying standing times and locations for enough first-draw samples to make up its sampling pool by the start of the first applicable monitoring period in accordance with section 5-1.42(a)(3) of this Subpart or, identify in writing, each site that did not meet the six-hour minimum standing time and the length of time for that particular substitute sample collected, and include this information with the lead and copper tap sample results that are required to be submitted pursuant to subparagraph (a)(1)(i) of this subdivision.
(3) At a time specified by the State, or if no specific time is designated by the State, then as early as possible prior to the addition of a new source or any long-term change in water treatment, a water system deemed to have optimized corrosion control, a water system subject to reduced monitoring pursuant, or a water system subject to a monitoring waiver pursuant, shall submit written documentation to the State describing the change or addition as required under section 5-1.22(a) of this Subpart. A water system shall obtain approval from the State before implementing the addition of a new source or long-term change in water treatment. Examples of long-term treatment changes include the addition of a new treatment process or modification of an existing treatment process. Examples of modifications include switching secondary disinfectants, switching coagulants ( e.g. , alum to ferric chloride), and switching corrosion inhibitor products ( e.g. , orthophosphate to blended phosphate). Long-term changes can include dose changes to existing chemicals if the system is planning long-term changes to its finished water pH or residual inhibitor concentration. Long-term treatment changes would not include chemical dose fluctuations associated with daily raw water quality changes.
(4) Any system serving 3,300 or fewer persons applying for a monitoring waiver pursuant to section 5-1.42(f) of this Subpart, shall provide the following information to the State in writing by the specified deadline:
(i) by the start of the first applicable monitoring period, any system serving 3,300 or fewer persons applying for a monitoring waiver shall provide the documentation required to demonstrate that it meets the requirements of section 5-1.42(f) of this Subpart;
(ii) no later than nine years after the monitoring previously conducted pursuant to section 5-1.42(b) or (c) of this Subpart, each system serving 3,300 or fewer persons desiring to maintain its monitoring waiver shall provide the information required by section 5-1.42(f)(1)-(3) of this Subpart;
(iii) no later than 60 days after it becomes aware that it is no longer free of lead-containing and/or copper containing material, as appropriate, each system serving 3,300 or fewer persons with a monitoring waiver shall provide written notification to the State, stating the circumstances resulting in the lead-containing and/or copper-containing materials being introduced into the system and what corrective action, if any, the system plans to remove these materials.
(5) Each ground water system that limits water quality parameter monitoring to a subset of entry points under section 5-1.43(b)(2)(iii) of this Subpart shall provide by the commencement of such monitoring, written correspondence to the State that identifies the selected entry points and includes information sufficient to demonstrate that the sites are representative of water quality and treatment conditions throughout the system.
(b) Source water monitoring reporting requirements.
(1) A water system shall report the sampling results for all source water samples collected in accordance with section 5-1.44 of this Subpart within the first 10 days following the end of each source water monitoring period.
(2) With the exception of the first round of source water sampling conducted, the system shall specify any site which was not sampled during previous monitoring periods, and include an explanation of why the sampling point has changed.
(c) Corrosion control treatment reporting requirements.
By the applicable dates under section 5-1.41(c) of this Subpart or a date specified by the State, systems shall report the following:
(1) for systems demonstrating that they have already optimized corrosion control, information required in section 5-1.41(b) of this Subpart;
(2) for systems required to optimize corrosion control, their recommendation regarding optimal corrosion control treatment in accordance with section 5-1.41(c)(3) of this Subpart;
(3) for systems required to evaluate the effectiveness of corrosion control treatments, the information required for corrosion control studies in accordance with section 5-1.41(c)(3) of this Subpart;
(4) for systems required to install optimal corrosion control designated by the State, a letter certifying that the system has completed installing that treatment in accordance with section 5-1.41(e) of this Subpart.
(d) Source water treatment reporting requirements.
In accordance with section 5-1.45 of this Subpart, systems shall report the following:
(1) for systems required to make a source water treatment recommendation in accordance with section 5-1.45(a)(1) of this Subpart, the information required by that section;
(2) for systems required to install source water treatment in accordance with section 5-1.45(a)(2) of this Subpart, a letter certifying that the system has completed installing the treatment designated by the State within 24 months after the State designated the treatment.
(e) Lead service line replacement reporting requirements.
Water systems subject to the requirements of section 5-1.46 of this Subpart shall report the following to demonstrate compliance with that section:
(1) No later than 12 months after the end of a monitoring period in which a system exceeds the lead action level in sampling referred to in section 5-1.46(a) of this Subpart, the system shall submit written documentation to the State of the material evaluation conducted as required in section 5-1.42(a) of this Subpart, identify the initial number of lead service lines in its distribution system at the time the system exceeds the lead action level, and provide the system’s schedule for annually replacing at least seven percent of the initial number of lead service lines in its distribution system.
(2) No later than 12 months after the end of a monitoring period in which a system exceeds the lead action level in sampling referred to in section 5-1.46(a) of this Subpart, and every 12 months thereafter, the system shall demonstrate to the State in writing that the system has either:
(i) replaced in the previous 12 months at least 7 percent of the initial lead service lines in its distribution system; or
(ii) conducted sampling which demonstrates that the lead concentration in all service line samples from an individual line(s), meeting the requirements of section 5-1.46(b)(2) of this Subpart, is less than or equal to 0.015 mg/L. In such cases, the total number of lines replaced and/or which meet the criteria in section 5-1.46(b)(2) of this Subpart shall equal at least seven percent of the initial number of lead lines identified under paragraph (1) of this subdivision or the percentage specified by the State under section 5-1.46(d) of this Subpart.
(3) The annual letter submitted to the State under paragraph (2) of this subdivision shall contain the following information:
(i) the number of lead service lines replaced during the previous year of the system’s replacement schedule;
(ii) the number and location of each lead service line replaced during the previous year of the system’s replacement schedule; and
(iii) if measured, the lead concentration in the water and the location of each lead service line sampled, the sampling method, and the date of sampling.
(4) Any system which collects lead service line samples following partial lead service line replacement in accordance with section 5-1.46(c)(1) of this Subpart shall report the results to the State within the first ten days of the month following the month in which the system receives the laboratory results, or as specified by the State. Systems shall also report any additional information as specified by the State, and in a time and manner prescribed by the State, to verify that all partial lead service line replacement activities have taken place.
(f) Public education reporting requirements.
Water systems shall report the following to demonstrate compliance with requirements of section 5-1.47 of this Subpart:
(1) Each system shall mail a sample copy of the consumer notification of tap results to the State along with a certification that the notification has been provided no later than three months following the end of the monitoring period.
(2) Any water system that is subject to the public education requirements under section 5-1.47 of this Subpart shall, within 10 days after the end of each period in which the system is required to perform public education, send written documentation to the State that contains:
(i) a demonstration that the system has delivered the public education materials that meet the content requirements in section 5-1.47(b)(1) of this Subpart and the delivery requirements in section 5-1.47(b)(2) of this Subpart; and
(ii) a list of all newspapers, radio stations, television stations, and facilities and organizations to which the system delivered public education materials during the period in which the system was required to perform public education tasks.
(3) Unless required by the State, a system that previously has submitted the information required by subparagraph (2)(ii) of this subdivision need not resubmit the information required, as long as there have been no changes in the distribution list and the system certifies that the public education materials were distributed to the same list submitted previously.
(g) Reporting of additional monitoring data.
Any system which collects sampling data in addition to that required by this sections 5-1.40 through 5-1.48 of this Subpart, including data collected in accordance with sections 5-1.41(b)(6), 5-1.42(d), and 5-1.43(d) of this Subpart, shall report the results to the State within the first 10 days following the end of the applicable monitoring period during which the samples were collected.
(h) Reporting the 90th percentile lead and copper concentration where the State calculates a system’s 90th percentile concentrations. A water system is not required to report the 90th percentile lead and copper concentration measured from among all lead and copper tap water samples collected during each monitoring period, as required by subparagraph (a)(1)(iii) of this section if:
(1) the State has previously notified the water system that it will calculate the water system’s 90th percentile lead and copper concentrations, based on the lead and copper tap results submitted pursuant to subparagraph (2)(i) of this subdivision, and has specified a date before the end of the applicable monitoring period by which the system shall provide the results of lead and copper tap water samples; and
(2) the system has provided the following information to the State by the date specified in paragraph (1) of this subdivision:
(i) the results of all tap samples for lead and copper including the location of each site and the criteria under section 5-1.42(a)(1)(iii)-(iv) of this Subpart under which the site was selected for the system's sampling pool, pursuant to subparagraph (a)(1)(i) of this section; and
(ii) an identification of sampling sites utilized during the current monitoring period that were not sampled during previous monitoring periods, and an explanation why sampling sites have changed; and
(3) the State has provided the results of the 90th percentile lead and copper calculations, in writing, to the water system before the end of the monitoring period.
(i) Prior to the addition of a new source or any long-term change in water treatment, a water system deemed to have optimized corrosion control under section 5-1.41(b) of this Subpart, a water system subject to reduced monitoring under section 5-1.42(c) of this Subpart, or a water system subject to a monitoring waiver under section 5-1.42(f) of this Subpart shall submit written documentation to the State describing the proposed change or addition within a timeframe specified by the State, or if no specific time is designated by the State, then as early as possible.
(j) Recordkeeping requirements.
Any system subject to the requirements of sections 5-1.40 through 5-1.48 of this Subpart shall retain on its premises original records of all sampling data and analyses, reports, surveys, letters, evaluations, schedules, State approvals and determinations, and any other information required by sections 5-1.41 through 5-1.48 of this Subpart. Each water system shall retain the records required by this section for no fewer than 12 years.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.11 Foreign diplomatic personnel
No medical services shall be approved for State-aid reimbursement under this program for any staff member of a foreign legation, consulate, embassy or mission, or for any child of such staff member who resides with such staff member. Provision of medical services shall be the responsibility of the foreign country through its appropriate representative in the United States.
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.7 Remedies
(a) If the department or the corporation determines that the project or the recipient is not in compliance with the terms of the project financing and loan agreement, and, following written notice to the recipient, the project is not brought into compliance, the corporation may, on its own or at the department's direction, refuse to approve fund disbursement requests until the project is brought into compliance.
(b) Nothing in this section shall be construed to limit the rights of the department or the corporation to take actions including, but not limited to, administrative enforcement actions and actions for breach of contract against a recipient which fails to carry out its obligations under this Part or the project financing and loan agreement.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.81 Washing of fruits and vegetables
Raw fruits and raw vegetables are to be thoroughly washed with potable water before serving.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.92 Exemption from a maximum contaminant level or any treatment technique requirement
(a) The supplier of water may request, and the department may grant, one or more exemptions from any treatment technique requirement, except for disinfection of a surface water source, and/or any MCL, except for Escherichia coli (E. coli ). Exemptions may be granted to any public water system based on a finding that:
(1) because of compelling factors which may include economic factors, the public water system is unable to comply with such MCL or treatment technique requirement;
(2) the public water system was in operation on the effective date of such MCL or treatment technique requirement; and
(3) the granting of an exemption will not result in an unreasonable risk to health.
(b) Exemptions, if granted, will be issued with a mandatory compliance strategy to include, but not be limited to the following:
(1) a specific time which to achieve compliance, including increments of progress to meet the MCL or treatment technique covered by the exemption;
(2) control measures as the department may require to ensure the public health; and
(3) appropriate modifications and/or improvements to the existing system or facility as may be necessary for the system or facility to fully conform to the requirements of this Subpart.
(c) Such schedule prescribed by the department pursuant to subdivision (b) of this section shall require compliance with each MCL or treatment technique requirement no later than 12 months after the issuance of the exemption.
(d) The final date for compliance provided in any schedule in the case of any exemption may be extended by the State for a period not to exceed three years after the date of the issuance of the exemption if the public water system establishes that:
(1) the system cannot meet the standard without capital improvements which cannot be completed within the period of such exemption;
(2) in the case of a system which needs financial assistance for the necessary improvements, the system has entered into an agreement to obtain such financial assistance; or
(3) the system has entered into an enforceable agreement to become a part of a regional public water system; and the system is taking all practicable steps to meet the standard.
(e) In the case of a system which serves a population of no more than 3,300 and which needs financial assistance for the necessary improvements, an exemption granted under paragraph (a)(1) or (2) of this section may be renewed for one or more additional two-year periods not to exceed six years, if the system establishes that it is taking all practicable steps to meet the requirements of subdivision (a) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.18 Records to be kept when blood or blood component transfusions are performed
The following information shall be included on the recipient's chart or in records maintained in the blood bank:
(a) date of the transfusion;
(b) name(s) of the person(s) who performed the transfusion and who attended the recipient during the transfusion;
(c) for each unit:
(1) blood component transfused;
(2) unit identification code;
(3) unit ABO and Rh groups;
(4) start time and completion time; and
(5) description of any adverse reaction and the results of related investigation;
(d) in the case of emergency issuance of uncrossmatched blood, the signature of the physician authorizing such emergency release.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.14 Application and approval
(a) Application and approval process.
(1) Providers that possess at least two licenses/certificates from at least two separate State licensing agencies and are seeking approval to integrate services for which they are licensed or certified may submit an application to the State licensing agency of the host site.
(2) Applications shall be submitted in a format prescribed for all applicants and reviewed by the State licensing agency that regulates the services to be added, in conjunction with the State licensing agency with authority for the host clinic, as appropriate.
(3) Applications shall include information needed to demonstrate that the provider is:
(i) licensed or certified by the relevant State licensing agencies to provide services for which the provider is seeking to integrate;
(ii) in compliance with all applicable requirements of the relevant State licensing agencies;
(iii) in good standing at the time of application approval. A provider is in good standing if each clinic site for which the provider is licensed or certified to offer services:
(a) is licensed by the Office of Mental Health and has a one year or greater time frame on operating certificate (Tier 3 providers are not eligible to participate); and/or
(b) is certified by the Office of Alcoholism and Substance Abuse Services and all of its programs have an operating certificate with partial or substantial compliance (two or three years); and/or
(c) has an operating certificate from the Department of Health and not currently under any enforcement actions;
(iv) in compliance with the physical plant requirements under this Part; and
(v) a member of a health home designated by the commissioner pursuant to section 365-l of the Social Services Law.
(4) Applications may include but not be limited to requests for information regarding services to be added and the plan for implementation, staffing, operating expenses and revenues, and utilization of services as they relate to integrated care services as described in this Part.
(5) The applicant shall supply any additional documentation or information requested by the State licensing agency of the host site, in conjunction with the other State licensing agencies as appropriate, within a stated timeframe of such request, unless an extension is obtained. The granting of a request for an extension shall be at the discretion of such State licensing agency of the host site. Failure to provide the additional documentation or information within the time prescribed shall constitute an abandonment or withdrawal of the application without any further action from the State licensing agency.
(6) The affected State licensing agency shall approve or disapprove an application in writing.
(7) Applicants may appeal the denial of an application in accordance with the rules and regulations of the affected State licensed agency.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.8 Variances and waivers
(a) Variances.
In order to allow time for compliance with this Subpart, a facility may submit a written application to the department for a variance from any provision of this Subpart, for a period not exceeding 90 days, accompanied by an explanation of why such variance will not present a danger to public health. The department may approve such application for a variance in writing, subject to any conditions that it may deem appropriate to protect public health. The department may revoke such variance upon a determination that the variance may present a danger to public health.
(b) Waivers
The department may issue a written general or specific waiver with respect to any provision of this Subpart, subject to any conditions the department may deem appropriate, where the department is satisfied that such waiver will not present a danger to public health. The department may revoke such waiver upon a determination that the waiver may present a danger to public health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNITY HEALTH ASSESSMENT COMMUNITY HEALTH ASSESSMENT
10 CRR-NY 40-2.40 Community health assessment; performance standards
Local health departments shall work with community partners to conduct a community health assessment (“assessment”) and a community health improvement plan (“plan”). Together, the assessment and plan shall include, at a minimum:
(a) an analysis of secondary data and, where available, primary data on health status and demographics;
(b) a description of the demographics of the population of the jurisdiction served by the local health department;
(c) a description of the health issues of the population, the distribution of health issues, and the contributing causes of the health challenges based on the data analyzed;
(d) the identification of priority areas for health improvement based on valid criteria;
(e) a description of public health services in the community and other resources that can be mobilized to improve population health, particularly in the priority areas;
(f) improvement strategies and measurable objectives through which the municipality and its community partners will address areas for health improvement and performance targets that will be used to track progress toward improvement of public health outcomes;
(g) methods by which access to the reports is to be provided to interested stakeholders including hospitals, nursing homes, medical societies, libraries, schools, government facilities, or other agencies and other organizations; and
(h) a description of the community partners that participated in the development of the community health assessment and improvement plan and their roles in the plan.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.1 Definitions
As used in this Subpart, unless the context otherwise requires:
(a) School means and includes a public, private or parochial child-caring center, day-care agency providing day care of children as defined in this section, nursery school as defined in this section, kindergarten, and any elementary, intermediate or secondary class or school building.
(b) Child means and includes any person between the ages of two months and 18 years.
(c) Day care of children means:
(1) outside the City of New York, care provided children away from the child’s residence, for less than 24 hours per day in a licensed child day care center or a group family day care, for compensation or otherwise, for at least three hours a day;
(2) in the City of New York, any service which, during all or part of the day, regularly gives care to six or more children, not of common parentage, who are under six years of age, whether or not the care is given for compensation and whether or not it has a stated educational purpose. The total number of children receiving care shall be counted, including children or foster children of the owner or person in charge, in determining the applicability of this definition. The term shall not, however, include a service which gives care to children for five or less hours a week or a service which operates for one month a year or less.
(d) Nursery school means a place, other than one providing day care of children as defined in this section, in which organized instruction is provided for children prior to entering any public or non-public school.
(e) Health practitioner means any person authorized by law to administer an immunization. This includes a physician, nurse practitioner, nurse-midwife caring for a pregnant student, registered nurse, licensed practical nurse under the direction of a registered nurse, or physician’s assistant.
(f) Fully immunized means that an adequate dosage and number of doses of an immunizing agent licensed by the United States Food and Drug Administration has been received commensurate with the child’s age, or the child has been demonstrated to have immunity as defined in this section.
(1) For those immunizations required by section 2164 of the Public Health Law only, the number of doses that a child shall have at any given age, and the minimum intervals between these doses, shall be in accordance with the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, issued by the Advisory Committee on Immunization Practices (ACIP) as referenced in chapter 35 of the Laws of 2019 and posted on the Centers for Disease Control and Prevention website. Any child who completed an immunization series following minimum intervals prescribed in an ACIP Recommended Immunization Schedule pre-dating February 2019 shall continue to be deemed in compliance as long as the number of vaccine doses the child received conforms to the current ACIP Recommended Immunization Schedule.
(i) For all vaccinations, except as provided in subparagraphs (ii) through (vii) of this paragraph, children shall be assessed upon school entry or attendance, and annually thereafter, and be fully immunized commensurate with their age.
(ii) Any child who has satisfied the immunization requirements in effect in regulation on June 30, 2014, entering twelfth grade (or comparable age level grade equivalents) in the 2019-2020 school year only, shall be deemed in compliance with the immunization requirements set forth in this section, including those set forth in subparagraphs (iii) through (vi) of this paragraph, until such child graduates from school; provided, however, that such child shall comply with the meningococcal vaccination requirement set forth in subparagraph (vii) of this paragraph.
(iii) Any child entering or attending kindergarten through twelfth grade must have received the following vaccine doses, with the minimum intervals between these doses as established by the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger:
(a) two adequate doses of measles containing vaccine, two adequate doses of mumps containing vaccine, and at least one adequate dose of rubella containing vaccine; and
(b) five adequate doses of diphtheria and tetanus toxoids and acellular pertussis vaccine. If, however, the fourth dose of diphtheria and tetanus toxoids and acellular pertussis vaccine was given at 48 months of age or older, only four adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than 48 months of age. Doses given after age seven should start with one dose of Tdap.
(iv) Four adequate doses of poliomyelitis vaccine. If, however, the third adequate dose of poliomyelitis vaccine was given at 48 months of age or older, only three adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than 48 months of age. Beginning on or after September 1, 2016, children shall be assessed upon entry or attendance to child-caring centers, day-care agencies, nursery schools and pre-kindergarten programs and must be fully immunized against poliomyelitis commensurate with their age.
(v) Two adequate doses of varicella vaccine.
(vi) By entry to sixth grade or a comparable age level grade equivalent, any child 11 years of age or older must have received one dose of a booster immunization containing tetanus and diphtheria toxoids and acellular pertussis vaccine.
(vii) For meningococcal vaccination, beginning on and after September 1, 2016, children shall be assessed upon entry or attendance to seventh grade, or a comparable age level grade equivalent, and must have received one adequate dose of vaccine upon such entry or attendance. Children shall be assessed upon entry or attendance to twelfth grade, or a comparable age level grade, and must have received two adequate doses of meningococcal vaccine upon such entry or attendance. If, however, the first dose of meningococcal vaccine was given at 16 years of age or older, then only one adequate dose of meningococcal vaccine is required for twelfth grade.
(2) If a child is not fully immunized, catch-up immunization must then take place according to the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger.
(g) Immunity means that:
(1) for measles, mumps and rubella, a child has had a positive serologic test, as defined in subdivision (h) of this section, for those diseases, or laboratory confirmation of disease, as defined in subdivision (k) of this section;
(2) for varicella, a child has either had a positive serologic test, as defined in subdivision (h) of this section; laboratory confirmation of disease, as defined in subdivision (k) of this section; or had the disease as verified by a physician, nurse practitioner, or physician’s assistant statement;
(3) for hepatitis B, a child has had a positive serologic test, as defined in subdivision (h) of this section; or
(4) for poliomyelitis, positive serologic tests, as defined in subdivision (h) of this section, for all three serotypes of poliomyelitis, performed prior to September 1, 2019. Serologic tests against poliomyelitis performed on or after September 1, 2019 will not be accepted in place of poliomyelitis vaccination.
(h) Serologic test means a blood test for Immunoglobulin G (IgG), or for hepatitis B, a blood test for hepatitis B surface antibody, as determined by the testing lab’s criteria. Serology results reported as equivocal are not acceptable proof of immunity. A positive serologic test can be accepted in place of vaccination only for the following diseases: measles, mumps, rubella, varicella, and hepatitis B.
(i) Age appropriate means that vaccine doses administered within four calendar days of the recommended minimum age or interval will be considered valid.
(j) In process means that:
(1) a child has received at least the first dose in each immunization series required by section 2164 of the Public Health Law (except in the case of live vaccines in which a child should wait 28 days after one live vaccine administration before receiving another live vaccine, if the vaccines were not given on the same day) and has age appropriate appointments to complete the immunization series according to the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger; or
(2) a child has had blood drawn for a serologic test and is awaiting test results within 14 days after the blood draw; or
(3) a child’s serologic test(s) are negative, and therefore the child in question has appointments to be immunized within 30 days of notification of the parent/guardian to complete, or begin completion, of the immunization series based on the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger.
(4) Children who are not fully immunized can only continue to attend school if they are in the process of completing the immunization series based on the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger. If a child does not receive subsequent doses of vaccine in an immunization series according to the age appropriate ACIP catch-up schedule, including at appropriate intervals, the child is no longer in process and must be excluded from school within 14 days after the minimum interval identified by the ACIP catch-up schedule, if not otherwise exempt in accordance with section 66-1.3 of this Subpart.
(k) Laboratory confirmation of disease means, for measles, mumps, rubella or varicella, a positive laboratory test, either culture or polymerase chain reaction, detecting either the virus or viral-specific nucleic acid in a clinical specimen from the child or, for measles or rubella, a positive blood test for Immunoglobulin M (IgM) where such positive laboratory test is not otherwise explained by recent vaccination.
(l) May be detrimental to the child’s health means that a physician has determined that a child has a medical contraindication or precaution to a specific immunization consistent with ACIP guidance or other nationally recognized evidence-based standard of care.
(m) Attend or admit means enrolled in, or admitted to, a school for the purpose of participating in or receiving services at such school, including but not limited to special education or related services, participating in intra-scholastic or interscholastic sports, or other school-sponsored events or activities; or being transported on a school bus or vehicle with other school children; except where such services, transportation, events, or activities are open to the general public.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PERSONNEL PERSONNEL
10 CRR-NY 14-5.71 Employee cleanliness
(a) Employees are to maintain a high degree of personal cleanliness and are to conform with good hygienic practices when working in food vending machine operations. Employees are to wash their hands and exposed area of arms thoroughly with soap and warm water before starting work, and as often as may be necessary to remove soil and contamination. Thereafter, employees are to wash hands thoroughly after using the toilet, smoking, sneezing, coughing, eating, drinking, or otherwise soiling their hands before returning to work. Employees are to keep their fingernails clean and neatly trimmed.
(b) Tobacco in any form is not to be used by employees while engaged in food vending machine servicing, or while washing equipment or utensils, or where its use will result in contamination of food, equipment or utensils.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.14 Respiratory care services
Respiratory care services shall be provided in a manner which assures the safe and effective operation and management of staff and services necessary to provide respiratory care to hospital patients at all times. The service shall have effective and current written policies and procedures regarding staff assignments, the administration of medication, diluents and oxygen, the maintenance of safety controls and the integration of such services with other related services of the hospital.
(a) Organization and direction.
The services shall be directed by a physician who shall be responsible for the clinical aspects of organization and delivery of all respiratory care services. The physician, or another individual qualified by training and experience shall direct administrative aspects of the service.
(1) Respiratory care services shall be provided by staff who possess the necessary qualifications specified by the medical staff, consistent with provisions of the New York State Education Law.
(i) Each individual who provides respiratory care services shall be competent to provide such services as evidenced by education, training and experience and where applicable demonstrated adherence to hospital policies and procedures.
(ii) A sufficient number of qualified competent professional and support personnel shall be available to meet the respiratory care needs of the patient.
(2) Written policies and procedures shall describe mechanisms for effective management of the service, including the nature and the amount of supervision required for personnel to carry out specific procedures, as well as mechanisms governing interdepartmental relationships and communications.
(3) Staff orientation and inservice training shall be required, provided and documented in accordance with written hospital policies and procedures.
(b) Operation and service delivery.
Respiratory care services shall be provided in a manner which assures the achievement and maintenance of generally accepted standards of professional medical practice and patient care.
(1) Respiratory care services shall only be provided in accordance with specific hospital protocols/policies or upon the orders of members of the medical staff. The orders for respiratory care services shall specify the type, frequency and duration of treatment, and, as appropriate, the type and dose of medication, the type of diluent, and the oxygen concentration, consistent with generally accepted standards of care.
(2) All respiratory care services provided shall be documented in the patient's medical record, including the type of therapy, date and time of administration, effects of therapy, and any adverse reactions.
(3) If blood gases or other clinical laboratory tests are performed in the respiratory care unit, the unit shall meet the requirements for clinical laboratories with respect to management, adequacy of facilities, proficiency testing and quality control as set forth in section 405.16 of this Part.
(4) The service shall implement a planned and systematic process for the monitoring and evaluation of the quality and appropriateness of patient care and for the resolution of identified problems. The process shall involve the reporting of findings, conclusions and recommendations to the quality assurance committee in accordance with hospital policies and procedures.
(5) All equipment and services provided shall be age and size appropriate.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.32 Occupational therapy
This functional reporting center must contain all the expenses associated with teaching manual skills and independence in personal care to stimulate mental and emotional activity on the part of patients. This would include the utilization of modalities and tests of occupational therapy and rehabilitative nursing in a coordinated and integrated program of services under the direction of a physician. This would consist of instructing patients in prescribed academic subjects to prevent mental deconditioning, improving patients' mental and physical conditions and aiding in the attainment of knowledge and skills that will further patients' progress toward vocational objectives. Additional activities include but are not limited to the following: evaluation by conducting diagnostic tests; consultations; prescriptions and carrying out prescriptions; assisting patients with personal needs; counseling patients' relatives and employees on both individual case and group bases; administering accreditation and other academic tests; instructing patients in technical aspects of work participation and in discharge coordination as required by the code.
(a) Standard unit of measure: number of treatments.
Count each procedure as one treatment. In group sessions, the number of treatments would be equal to the number of patients in the group.
(b) Data source.
The number of treatments shall be an actual count maintained by the occupational therapy department.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.200 Medical record
A record kept on patients which properly contains sufficient information to identify the patient clearly, to justify his/her diagnosis and treatment, and to document the results accurately. The purposes of the record are to serve as the basis for planning and continuity of patient care; provide a means of communication among physicians and any professional contributing to the patient's care; furnish documentary evidence of the patient's course of illness and treatment; serve as a basis for review, study and evaluation; serve in protecting the legal interests of the patient, hospital and responsible practitioner; and provide data for use in research and education. Medical records and their contents are not usually available to the patient himself. The content of the record is usually confidential. Each different provider in a community caring for a given patient usually keeps an independent record of that care.
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.6 End stage renal dialysis service
(a) This methodology will be utilized in the evaluation of certificate of need applications involving the construction or establishment of new or replacement dialysis stations used in the treatment of end stage renal disease. It is the intent of the Public Health Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 670.1 of this Part, become a statement of basic principles and planning/decisionmaking tools for guiding and directing the development of dialysis stations for end stage renal disease services throughout the State. Additionally, it is intended that the methodology will provide the health systems agencies and potential applicants with sufficient flexibility to consider the unique characteristics of their respective areas in determining need. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate supply of dialysis stations are available to provide access to care to all those in need of in-facility dialysis.
(b) The factors to be considered in determining the public need for dialysis stations shall include, but not be limited to, the following:
(1) evidence that the proposed dialysis services capacity proposed will be utilized sufficiently to be financially feasible as demonstrated by a five-year analysis of projected costs and revenues associated with the program;
(2) evidence that the proposed service or additional capacity will enhance access to services by patients including members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to health services (for example, low-income persons, racial and ethnic minorities, women and handicapped persons), and/or appropriate rural populations;
(3) evidence that the facilities hours of operation and admission policies will promote the availability of services which are acceptable to those in need of such services, in particular, operational hours that permit individuals in dialysis to continue employment;
(4) the facility's willingness and ability safely to serve dialysis patients; and
(5) evidence, derived from analysis of factors including, but not necessarily limited to, patient referral and use patterns of existing dialysis facilities and services and projected referral and use patterns of both the proposed facility, and of existing facilities or services within the applicant's planning area which would result from approval of the proposed facility, indicating that approval of the proposed facility will not jeopardize the quality of services provided at or the financial viability of such existing facilities or services. However, a finding that the proposed facility will jeopardize the financial viability of one or more existing facilities will not of itself require a recommendation of disapproval of the proposed application.
(c) Public need for a proposed facility or station shall be deemed to exist, when review and consideration of evidence concerning each of the five factors set forth in subdivision (b) of this section results in an affirmative finding.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.19 Addition
An addition is something which does not merely replace a thing previously owned. This includes enlargements and extensions of existing facilities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.8 Informed consent
(a) Reproductive tissue banks shall obtain written informed consent from the donor for participation in the donation program, after the director or a designee has provided information to the donor on the procedures for collection, storage and use of semen, oocytes or embryos, and the risks of any drugs, surgical procedures and/or anesthesia administered. The informed consent shall include:
(1) a statement that the donor has been informed that his or her name and address will be kept on file by the reproductive tissue bank, and advised of the restrictions on release of donor-identifying information specified in section 52-8.9 of this Subpart;
(2) authorization for performance of genetic and infectious disease marker testing, consistent with statutory requirements for genetic testing;
(3) notification of all currently known ways in which the donor's reproductive tissue and resulting embryos may be used. If the reproductive tissue bank accepts reproductive tissue with restrictions on the manner in which embryos created may be used, the consent also shall include a statement that the reproductive tissue bank has informed the donor that it will make a good faith effort to ensure that the donor's restrictions are respected, but that it cannot guarantee that the recipients of the reproductive tissue will abide by the donor's restrictions;
(4) authorization for disclosure of the donor's medical history information to potential recipients and their physicians, consistent with statutory requirements for the disclosure of genetic and other medical information;
(5) an explanation of the oocyte donor's extent of responsibility for any costs of any medical complications associated with oocyte donation; and
(6) a statement that the reproductive tissue donor has the right to withdraw his/her consent to donation up until such time that a specific recipient has begun an assisted reproduction cycle in reliance on the availability of tissue from that donor.
(b) Reproductive tissue banks shall obtain written informed consent from the client-depositor for participation in the semen, oocyte or embryo storage program, after the director or a designee has provided information to the client-depositor on the procedures for collection/storage and retrieval of semen, oocytes or embryos, and the risks of any drugs, surgical procedures and/or anesthesia administered, as well as procedures for payment for semen, oocyte or embryo storage. The informed consent shall include the male client-depositor's specific instructions for disposition of frozen semen upon his death. The reproductive tissue bank shall maintain and adhere to written procedures for ensuring that the client-depositor's instructions are followed.
(c) The insemination/implantation site shall obtain written informed consent from the recipient for receipt of donated reproductive tissue, after a physician has explained the risks and benefits of the procedure, made available details of the medical history of the donor or donors, and, if applicable, notified the recipient that reproductive tissue bank records are required to be kept for the periods of time specified in section 52-8.9(a) of this Subpart and that the outcome of the procedure is required to be reported to the reproductive tissue bank.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.134 Authorization for the purchase, possession and dispensing of ketamine hydrochloride only to anesthetize animals for euthanasia, and of sodium pentobarbital to euthanize animals
(a) Except where different meanings are specified expressly, the terms in this section shall have the following meanings:
(1) An incorporated society for the prevention of cruelty to animals (society) shall include any incorporated humane society or society for the prevention of cruelty to animals having facilities for the care and eventual disposition of animals, within the State.
(2) Municipal animal control facility (facility) shall include any pound or shelter maintained by or under contract or agreement with any county, city, town or village within the State.
(3) Solution shall mean:
(i) a premixed solution of sodium pentobarbital, manufactured only and specifically for the euthanasia of animals, which contains such other ingredients as to place such solution within schedule III of the Controlled Substances Act (article 33, Public Health Law);
(ii) schedule II sodium pentobarbital; and
(iii) ketamine hydrochloride only for the purpose of anesthetizing animals for euthanasia.
(4) An agent is a person or persons other than a licensed veterinarian appointed by the incorporated society or municipal animal control facility, and duly registered with the department, authorized to purchase, possess and dispense:
(i) ketamine hydrochloride only to anesthetize animals for euthanasia; and
(ii) sodium pentobarbital to euthanize animals.
(5) A registered individual is a person certified and registered pursuant to subdivision (f) of this section.
(b) No society, facility or its agent shall purchase, possess, dispense or cause to be administered, a controlled substance within this State without first registering with the department.
(c) A society or facility and its agents shall also register with the Federal Drug Enforcement Administration (DEA) in the controlled substance schedule provided for under this Part.
(d) Any society or facility may register an agent to purchase, possess and dispense a controlled substance, by application to the department.
(1) The department shall issue such registration unless the commissioner finds that the application should be denied by reason of false statements in the application, conviction of a felony relating to controlled substances, suspension, revocation or denial of the applicant's Federal DEA registration, failure to provide adequate safeguards against diversion of the solution, or other good and sufficient reason such as conviction for a violent felony or a felony related to theft, an administrative determination that article 33 of the Public Health Law or provisions of this Part were violated, conviction for a misdemeanor relating to controlled substances, or any conviction under the Agriculture and Markets Law relating to the treatment of animals.
(2) Such registration shall be valid for a period of three years from the date of issuance and may be suspended or revoked upon a finding by the commissioner that the society, facility, agent or certified personnel have violated the provisions of this section, or any other requirement of this Part or article 33 or any other State law or regulation relating to the proper care of animals by societies or facilities.
(3) Any society or facility registering an agent shall immediately notify the department of any change in the employment or contractual relationship with the designated agent.
(4) Such registration shall be valid only at the registered location.
(e)
(1) Registered agents of societies or facilities may dispense solution for the euthanasia of animals only to registered individuals certified by the department to administer such a solution; or to a licensed and properly registered veterinarian and only for on-premises use.
(2) Solution may be dispensed for use off the premises only where the animal to be euthanized is injured or transport of such animal to the society or facility is not practical.
(f) Registration and certification of individuals to administer solution for euthanasia of animals.
(1) No person other than a licensed veterinarian shall receive a controlled substance from a duly authorized agent of a society or facility to euthanize animals unless the person is certified and registered with the department.
(2) To obtain a certification and registration from the department in order to administer a solution to euthanize animals, the applicant must:
(i) be 21 years of age or older;
(ii) hold a bachelor or associate degree in animal health sciences or related field; and
(iii) obtain a written certification from two licensed veterinarians or one licensed veterinarian and one licensed animal health technician in which the veterinarians or technicians state that they have observed the proficient use, by the applicant, of injections for the euthanasia of animals.
(3) Any person who meets the minimum qualifications stated in subparagraphs (2)(i) and (iii) of this subdivision, but who lacks the required bachelor or associate degrees, may obtain certification and registration from the department if such person has two years' experience in animal care including euthanasia of dogs and cats.
(4) The department shall issue such registration and certification unless the commissioner finds that the application should be denied by reason of false statements in the application, the applicant's conviction of a felony relating to controlled substances or for other good and sufficient reason.
(5) Such registration and certification shall be valid for a period of three years from the date of issuance and may be suspended or revoked upon a finding by the commissioner that the registered individual has violated the provisions of this Part, article 33 or any other State law or regulation relating to the proper care of animals, or is not competent to administer solution in the euthanasia of animals by injection.
(g) Renewal of registrations.
Registrations issued under this section shall be renewed by the department upon receipt of a completed renewal application which includes proof of attendance at a department-sponsored or -approved course in the safe and effective use of a solution in the euthanasia of animals.
(h) Safeguarding of solution.
Agents shall safeguard the solution in compliance with the standards for safeguarding controlled substances set out in section 80.6(a) and (b) of this Part.
(i) Minimum security standards for a society, facility and its agents.
(1) The solution must be stocked in a securely locked cabinet of substantial construction. The cabinet shall be stationary and made of steel or other approved metal and of sufficient size to store the stock of solution.
(2) The cabinet shall be limited to the storage of the solution, needles and syringes and solution records.
(j) Recordkeeping requirements.
(1) Agents shall keep records of all solution purchased, dispensed and administered.
(2) All purchase records, including a copy of the invoice, shall be kept in a separate file and filed by date received.
(3) A separate record of solution activities and transactions in the form of a running inventory shall be maintained and include the following:
(i) the name of the drug (by brand name);
(ii) the name of the manufacturer, lot number, NDC number;
(iii) the strength of the drug in milligrams (mg) per milliliter (ml);
(iv) the total amount of drug received in milliliters;
(v) the name, address and DEA registration number of the supplier of the drug;
(vi) the date the solution was received;
(vii) the signature of the person receiving the solution;
(viii) the date of any transaction or activity, the amount of the solution dispensed at each dispensing;
(ix) the signature of the agent who dispensed the solution;
(x) the signature of the registered individual administering the solution; and
(xi) the remaining amount of drug on hand.
(4) Any unused solution must be returned to the agent. The agent must record the date, the amount returned, the signatures of the agent and the registered individual returning the drug, and the amount on hand after such transaction.
(5) A separate record shall be maintained of all losses with a brief statement describing the incident and signed by the agent and a witness.
(6)
(i) Agents shall cause the registered individual and any contracting practitioner to receive a work card or medical record sheet when dispensing the solution and such record shall be returned to the agent upon completion of each workday.
(ii) The work card or medical report sheet shall contain information to properly identify each animal to whom the solution is administered. For each female with litter, utilize only one record or card.
(iii) The registered individual euthanizing such animal shall document on such record the date of the administration of the drug, the amount of the drug used and the registered individual's signature.
(7) All records pertaining to the solution shall be kept on the premises of the society or facility for a period of five years and shall be available readily and produced promptly for inspection by authorized representatives of the commissioner.
(k) Quarterly reports.
Within 10 days of the end of each quarter of each year, the society or facility shall submit a report to the department signed by an officer or official and the agent and include the following:
(1) the name, address and phone number of the society or facility;
(2) the agent's name, bureau registration number, DEA registration number;
(3) the total amount of solution received from suppliers;
(4) the total amount of solution dispensed to personnel;
(5) the total amount of solution returned from personnel;
(6) the total amount of solution lost for any reason;
(7) the total amount of solution on hand at the end of the quarter;
(8) an actual physical inventory count of solution on hand; and
(9) the total number of animals euthanized by species.
(l) All agents and registered individuals are under continuing duty to report immediately to the department any loss, theft or diversion of solution from the society or facility.
(m) Certification or registration by the department under this section does not authorize the use of medicated darts in a handgun.
(n) Registered individuals may administer solution for euthanasia of animals only when in the employ of a registered society or facility and only when solution is obtained from the registered agent of such society or facility.
(o) An agent of a society or facility may also obtain registration and certification to administer the solution as defined in paragraph (f)(2) of this section. However, the same individual may not act as both the agent dispensing and the registered individual administering in the same facility at the same time.
(p) Agents of an incorporated society or a facility are responsible for the proper safeguarding and handling of hypodermic syringes and needles and must comply with section 80.133(h)-(j) of this Part. All needles and syringes shall be stored in compliance with subdivision (i) of this section.
(q) The agent of a society or facility is not relieved of his responsibilities to detect or correct any diversion or mishandling of any solution by a delegation of responsibility.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.3 Provider competency
Persons or organizations seeking approval, other than DOH regulated health care facilities, including home health care agencies, shall document their expertise and competence to communicate the course materials and document that course work or training shall be supported by adequate facilities, equipment and other physical resources. Such facilities and agencies are deemed competent to provide training and education on infection control, unless they are subject to a denial or termination as provided for in section 92-1.5 of this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 152 WARREN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 152.9 Warrensburg Water District, town of Warrensburg
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Big Brook, Bennett Brook and Harrington Brook or which are fed by water from these brooks and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Warrensburg Water District in the town of Warrensburg, Warren County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoirs on Big Brook, Bennett Brook and Harrington Brook, which are tributary to or which serve as sources of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Warrensburg Water District.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the Warrensburg Water District, provided, however, that the property on which the privy, privy vault, pit or any other receptacle intended for either the temporary storage or permanent deposit of human excreta is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained within the limits of such property shall be placed as far as possible from any reservoir or watercourse and specially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of water commissioners of the Warrensburg Water District and so located that the tops of such receptacles shall be above the highest known water level of the reservoirs or watercourses.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind or any vessel, can or other container used for either the temporary storage or the permanent disposal of human excreta is specially constructed and made watertight and located nearer any reservoir or watercourse than the distance named in paragraph (1) of this subdivision, such receptacles shall be emptied at regular intervals and disinfected as often as may be necessary to maintain them in a proper sanitary condition and effectually to prevent any overflow. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the directions of the board of water commissioners of the Warrensburg Water District and in such manner as to effectually prevent any pollution of the water supply of the Warrensburg Water District.
(4) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 250 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Warrensburg Water District.
(5) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (4) of this subdivision, shall be arranged in such manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (6) and (7) of this subdivision.
(6) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents shall be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(7) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (5) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 250 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Warrensburg Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 75 feet of any reservoir or 35 feet of any watercourse tributary to the public water supply of the Warrensburg Water District.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the Warrensburg Water District. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Warrensburg Water District.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or 35 feet of any watercourse tributary to the public water supply of the Warrensburg Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 35 feet from any watercourse tributary to the public water supply of the Warrensburg Water District.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Warrensburg Water District, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 200 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Warrensburg Water District and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the Warrensburg Water District.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leaching or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have been percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the Warrensburg Water District.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Warrensburg Water District.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatsoever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Warrensburg Water District, except by duly authorized employees of the Warrensburg Water District in the performance of their duties of supervision and maintenance of the public water supply of the Warrensburg Water District.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or watercourse tributary to the public water supply of the Warrensburg Water District.
(j) Inspections.
The board of water commissioners of the Warrensburg Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Warrensburg Water District or the duly appointed representative of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being compiled with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.2 Eligibility for rape crisis program approval
To be eligible for approval:
(a) The program must provide services to alleviate the immediate and long term negative physical and emotional effects of sexual assault and abuse. Services shall be accessible, confidential, provided without coercion, and available to individuals regardless of age, gender, race, ethnicity, sexual orientation, disability status, or ability to pay. Nothing herein, however, shall prevent the operation of a program formed to meet the special needs of persons from a particular community or group, provided that the program gives the department a written assurance that it will not refuse to provide services to any person who seeks assistance from the program who is not a member of the target community or group that the program serves. These services must include but need not be limited to:
(1) twenty-four hour access to crisis intervention services including telephone hotline and phone counseling capabilities;
(2) in-person individual or group counseling;
(3) community prevention education programs;
(4) training of professionals concerning sexual assault issues;
(5) accompaniment of victims to medical facilities;
(6) advocacy on behalf of victims within the criminal justice system; and
(7) information and referral services, based on established relationships with human service providers, medical personnel, and law enforcement officials.
(b) The program must provide information to victims of sexual offenses, sexual abuse or incest that is designed to enable them to make informed decisions regarding medical and legal options and support services. Information must be provided regarding:
(1) sexually transmitted diseases;
(2) HIV/AIDS counseling and testing options;
(3) post-coital contraception;
(4) options regarding any pregnancy that may occur as a result of sexual assault or rape;
(5) evidence collection policies and procedures;
(6) civil and criminal court proceedings and availability of accompaniment and support throughout the legal process;
(7) availability of crime victims' compensation benefits; and
(8) availability of crisis intervention, telephone and in-person counseling services.
(c) Programs must have a written policy regarding client confidentiality and a protocol for obtaining an agreement signed by each counselor to adhere to that policy.
(d) Programs must be responsive to the cultural and language needs of the population served.
(e) The governing authority of the rape crisis program shall designate a training coordinator, whose training and/or experience is relevant to the services provided at the program and who shall have the authority and responsibility to oversee the training and certification of the program's rape crisis counselors.
(f) Programs must have a system in place to ensure that the minimum training standards set forth in this section are consistently met.
(g) The rape crisis program shall permit on-site program review by representatives of the department of Health and, upon request, shall make available to such representatives any records and reports related to department approval of the rape crisis program.
(h) Nothing contained in this section shall prohibit a program, with approval of the department of Health, from subcontracting for, or otherwise ensuring that the required services are available.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.295 Responsibility
The obligation prudently to exercise assigned or imputed authority attaching to the assigned or imputed role of an individual or group participating in organizational activities or decisions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.2 Hospice rates of reimbursement
(a) Pursuant to 42 USC 1396a (a) (13)(D), rates of reimbursement for hospice shall be in amounts no lower than the amounts used under part A of title XVIII of the Social Security Act. Hospices may be eligible for supplemental rates of payment under the supplemental financial assistance program in accordance with the provisions set forth in section 86-6.6 of this Subpart.
(1) The hospice payment rates are established to reimburse each of the following four specific categories of hospice care:
(i) routine home care;
(ii) continuous home care;
(iii) inpatient respite care; and
(iv) general inpatient care.
(2) Payment rates under the supplement financial assistance program are established to reimburse each of the following special need categories of hospice care:
(i) routine home care for AIDS patients;
(ii) routine home care with escort services;
(iii) routine home care for AIDS patients with escort services;
(iv) continuous home care for AIDS patients;
(v) general inpatient care for AIDS patients;
(vi) room and board services for persons receiving care in a hospice residence.
(b) Except as otherwise stated, each hospice payment rate established pursuant to this Subpart is a prospectively determined per diem amount which has been adjusted consistent with the requirements of 42 USC 1396a (a)(13)(D) to reflect regional variations in wage levels.
(c) Per diem payments shall be for only one of the categories of hospice care listed in either paragraph (1) or paragraph (2) of subdivision (a) of this section for any particular day, provided that payments for continuous home care days will vary depending upon the number of hours of continuous home care provided.
(d) For continuous home care, the rates established pursuant to subdivisions (f) and (g) of this section shall be divided by 24 to yield an hourly rate. The number of hours of continuous home care provided in a given day is then multiplied by the resulting hourly rate to yield a continuous home care payment amount for that day. A minimum of 8 hours of predominantly nursing care must be furnished on a particular day to qualify for the continuous home care reimbursement rate pursuant to this section.
(e) Beginning October 1, 1990 annual adjustments to the hospice payment rates for each category of hospice care established in this section shall be made using trend factors developed by the Commissioner of Health pursuant to section 86-6.5 of this Subpart.
(f) The hospice reimbursement rates for the four standard categories of care for hospices located within the various New York State Standard Metropolitan Statistical Areas (SMSA) and rural areas are as follows:
| SMSA Area (Counties Within Area) | Routine Home Care Rate* | Continuous Home Care Rate* | Respite Care Rate* | Inpatient Care Rate* | | --- | --- | --- | --- | --- | | (1) Albany-Schenectady-Troy (Albany, Greene, Montgomery, Rensselaer, Saratoga, and Schenectady) | $70.20 | $409.31 | $ 77.64 | $313.61 | | (2) Binghamton (Broome, Tioga) | 73.43 | 428.14 | 80.40 | 326.97 | | (3) Buffalo (Erie) | 74.79 | 436.07 | 81.57 | 332.60 | | (4) Elmira (Chemung) | 77.24 | 450.36 | 83.67 | 342.74 | | (5) Glens Falls (Warren, Washington) | 69.71 | 406.46 | 77.22 | 311.58 | | (6) Nassau-Suffolk (Nassau, Suffolk) | 86.81 | 506.19 | 91.87 | 382.38 | | (7) New York (Bronx, Kings, New York, Putnam, Queens, Richmond, Rockland, Westchester) | 94.97 | 553.75 | 98.85 | 416.14 | | (8) Niagara Falls (Niagara) | 69.33 | 404.27 | 76.90 | 310.02 | | (9) Orange County (Orange) | 76.22 | 444.40 | 82.79 | 338.52 | | (10) Poughkeepsie (Dutchess) | 80.69 | 470.45 | 86.62 | 357.04 | | (11) Rochester (Livingston, Monroe, Ontario, Orleans, Wayne) | 77.88 | 454.07 | 84.21 | 345.38 | | (12) Syracuse (Madison, Onondaga, Oswego) | 99.66 | 581.12 | 102.87 | 435.57 | | (13) Utica-Rome (Herkimer, Oneida) | 72.52 | 422.82 | 79.62 | 323.19 | | (14) NON-SMSA Area (Rural) includes Counties Not Covered Above | 69.20 | 403.51 | 76.79 | 309.48 |
*
Rates that appear on this schedule shall be effective January 1, 1990 through September 30, 1990. Beginning October 1, 1990 annual adjustments will be made to these rates pursuant to section 86-6.5 of this Subpart.
(g) The reimbursement rates under the Supplemental Financial Assistance Program for the special need categories of care for hospices located within the various New York State Standard Metropolitan Statistical Areas (SMSA) and rural areas are as follows:
| SMSA Area | Routine Home Care for AIDS Patients* | Routine Home Care Escort Services* | Routine Home Care for AIDS Patients and Escort* | Continuous Home Care for AIDS Patients* | General Inpatient for AIDS Patients* | | --- | --- | --- | --- | --- | --- | | (Counties Within Area) | | | | | | | (1) Albany-Schenectady-Troy (Albany, Greene, Montgomery, Rensselaer, Saratoga, and Schenectady) | $120.53 | $ 86.02 | $136.35 | $439.64 | $348.55 | | (2) Binghamton (Broome, Tioga) | 126.27 | 89.25 | 142.09 | 467.55 | 363.39 | | (3) Buffalo (Erie) | 128.69 | 90.61 | 144.51 | 479.32 | 369.65 | | (4) Elmira (Chemung) | 133.04 | 93.06 | 148.86 | 500.52 | 380.92 | | (5) Glens Falls (Warren, Washington) | 119.66 | 85.53 | 135.48 | 435.40 | 346.29 | | (6) Nassau-Suffolk (Nassau, Suffolk) | 150.06 | 102.63 | 165.88 | 583.32 | 424.98 | | (7) New York (Bronx, Kings, New York, Putnam, Queens, Richmond, Rockland, Westchester) | 164.56 | 110.79 | 180.38 | 653.85 | 462.50 | | (8) Niagara Falls (Niagara) | 118.99 | 85.15 | 134.81 | 432.15 | 344.56 | | (9) Orange County (Orange) | 131.23 | 92.04 | 147.05 | 491.68 | 376.23 | | (10) Poughkeepsie (Dutchess) | 139.18 | 96.51 | 155.00 | 530.37 | 396.81 | | (11) Rochester (Livingston, Monroe, Ontario, Orleans, Wayne) | 134.17 | 93.70 | 149.99 | 506.02 | 383.86 | | (12) Syracuse (Madison, Onondaga, Oswego) | 172.90 | 115.48 | 188.72 | 694.44 | 484.09 | | (13) Utica-Rome (Herkimer, Oneida) | 124.64 | 88.34 | 140.46 | 459.66 | 359.19 | | (14) NON-SMSA Area (Rural) includes Counties not Covered Above | 118.76 | 85.02 | 134.58 | 431.03 | 343.96 |
*
Rates that appear on this schedule shall be effective January 1, 1990 through September 30, 1990. Beginning October 1, 1990 annual adjustments will be made to these rates pursuant to section 86-6.5 of this Subpart.
(h) Daily payment will be made to a hospice residence for Medicaid-eligible patients who have elected hospice care and reside in a hospice residence. Payment shall be made for a hospice residence patient to take into account the room and board furnished by the hospice residence and will be in an amount equal to 94 percent of the weighted average Medicaid rate of the nursing facilities located in the region that the hospice residence is located in, as specified in Appendix 13-A, infra, of this Title. The department will calculate a 10 percent increase in the hospice residence reimbursement rate for each Wage Equalization Factor (WEF) region, as specified in Appendix 13-A of this Title, relative the rate in effect on March 31, 2018. For fiscal periods beginning April 1, 2018 and ending December 31, 2018, and for every calendar year thereafter, hospice residence reimbursement rates will be equal to 94 percent of the weighted average Medicaid rate of the nursing facilities located in the WEF region, plus the per diem value based upon the 10 percent increase calculated pursuant to this subdivision.
(i) The hospice rates of reimbursement set forth in this section are subject to the approval of the State Director of the Budget.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.112 Inventory; procedure for filing
(a) All manufacturers, distributors, importers, and exporters licensed to deal in controlled substances; all institutional dispensers and persons conducting research, instructional activities, maintenance treatment programs and analytical laboratories certified for controlled substance privileges; and all physicians, dentists, podiatrists, veterinarians and other practitioners, and all pharmacies possessing, having under their control, selling, prescribing, administering, dispensing or compounding any controlled substances in New York State shall as of May 1, 1975 and every two years thereafter, prepare and maintain an inventory of all controlled substances specified by the State Commissioner of Health by regulation as substances requiring inventory. A separate entry shall be made with respect to each kind of substance or preparation, and each kind or size of package. Each entry shall show the name, quantity and content of controlled substance and the size of the individual package, the number of packages and the total content of all packages covered by the entry on hand as of the date of the inventory. Maintaining for inspection a biennial inventory of controlled substances prepared and maintained in compliance with Federal statute and regulations shall be deemed compliance with this section.
(b) A copy of the inventory shall be retained on file with other controlled substances records, and shall be kept available for inspection for at least five years.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.22 Transportation
This functional reporting center must contain all the expenses associated with the transporting of patients and supplies to and from the facility on behalf of patient-related activities. Additional activities include but are not limited to the following: transporting patients to and from scheduled outside activities: transporting patients to and from department and other stores; transporting supplies to be used in patient-related activities.
(a) Standard unit of measure: number of trips.
The total number of trips made for the purpose of transporting patients and supplies to and from the facility.
(b) Data source.
The number of trips shall be determined from departmental logs.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRIOR APPROVAL FOR CARE AND SERVICES PRIOR APPROVAL FOR CARE AND SERVICES
10 CRR-NY 85.37 Time limits within which determinations shall be made
(a) All decisions on requests for prior approval must be made and all required notices shall be sent by the New York State Department of Health to the requesting provider and, where required, to the medical assistance patient-recipient, within 21 calendar days of receipt of such requests by the New York State Department of Health; except that in cases where prior approval requests for dental care are received in area offices outside the five boroughs of New York City and a clinic examination is necessary, the required notices above shall be transmitted within 30 calendar days of receipt of such requests by the respective upstate area office.
(b) In the event prior approval requests must be returned to the requesting provider for submission of additional information, the calendar day limit in subdivision (a) of this section will be tolled from the day the request is returned to the provider until the day the request plus additional information is returned to the New York State Department of Health.
(c) In the event the prior approval request and the requested additional information from the provider is received on a Thursday or Friday which occurs after the 19th calendar day referenced in subdivision (b) of this section, two additional working days may be added to the 21-calendar day limit specified in subdivision (a) of this section.
(d) If a determination is not made and transmitted in accordance with provisions in subdivisions (a)-(c) of this section, the New York State Department of Health shall, within two working days from the expiration of the time limits set forth in subdivisions (a)-(c) of this section, notify the requesting provider and patient-recipient of such fact and of the patient's-recipient's right to request a fair hearing to determine whether the prior approval request should be approved.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.9 Sanitizing bottles
The bottles shall be properly sanitized before use by using approved methods and approved sanitizing agents.
(a) Before filling, all multi-use containers shall be thoroughly washed in an effective cleansing agent and water solution, having a temperature not less than 120°F, followed by application of a bactericidal solution and the inside rinsed with finished product water to remove traces of sanitizing agents.
(b) The bactericidal procedure for the inside of bottles, as a minimum, shall be one of the following:
(1) Sanitize with 100 ppm chlorine water solution at 75°F for not less than 30 seconds.
(2) Sanitize with a 2 ½ percent caustic solution at a minimum temperature of 120°F followed by a rinse containing not less than 10 ppm free chlorine. Note: When caustic is discharged by high-velocity jets, this procedure shall be considered to satisfy both cleaning and bactericidal requirements.
(3) Sanitize with water at an inside bottle temperature of not less than 170°F for not less than 15 seconds.
(4) Sanitize by exposing all surfaces to a three percent caustic solution at a minimum temperature of 120°F for five minutes—by means of automatic bottle washers using high-velocity, hydro-type jets or by soaker washers—followed by a rinse containing not less than 10 ppm free chlorine.
(5) Other methods equally protective of public health as the above, when approved by the State, may be used.
(c) Single-use bottles or containers, which are free of all bacteria, dust, or other contamination, need not comply with the above sanitizing requirement before filling.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-9 LIMITED HOME CARE SERVICES AGENCIES
10 CRR-NY 86-9.1 Services
(a) Reimbursement is available under this Subpart only for the following services provided directly by limited home care services agencies, licensed by the department pursuant to section 3605 of the Public Health Law, to eligible individuals who are residents of adult homes or enriched housing programs certified in accordance with article seven of the Social Services Law:
(1) Level II personal care services, as defined in 18 NYCRR section 505.14(a)(6)(ii), including related nursing supervision, authorized and provided in accordance with rules and regulations of the department, but not including Level I personal care services as defined in 18 NYCRR section 505.14(a)(6)(i); and
(2) the administration of subcutaneous and/or intramuscular injections and application of sterile dressings by a registered professional nurse, including associated nursing tasks. Reimbursement is available under this Subpart only for services provided by limited home care services agencies which are not services that must be provided to residents of adult homes or enriched housing programs pursuant to article seven of the Social Services Law and rules and regulations of the department.
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.70 Monitoring
(a) Localities receiving State aid for vector surveillance and/or control will be subject to unannounced, onsite monitoring by New York State Department of Health personnel. Localities applying pesticide will be monitored more actively than those areas only engaging in surveillance.
(b) Localities conducting vector control activities shall provide to the department information used to monitor and evaluate the effectiveness of each control activity. Such information shall be submitted to the department as part of the locality's monthly report in the format described in the response protocols.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-5.50 Food protection
During transportation, food is to meet the requirements of this Subpart relating to food protection temperatures, handling and storage. Food, utensils, equipment and tableware are to be protected from contamination.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.213 Net worth
The aggregate presentation on the accounting records of the equities representing proprietary interests; the excess of the going concern's value of assets over liabilities to outsiders; of a corporation, the total of paid-in capital, retained earnings, and appropriated surplus; of a sole proprietorship, the proprietor's account; of a partnership, the sum of the partners' accounts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.22 Residence of qualified plaintiffs and enrollees
(a) Eligibility for or continued enrollment in the fund is not dependent on the current or past residency of a qualified plaintiff or enrollee.
(b) The fund administrator shall advise enrollees to notify the fund administrator of any changes in address within 10 business days from the date of the move in order to prevent delays.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 350 ALL PAYER DATABASE (APD)
10 CRR-NY 350.5 APD guidance
The department shall make guidance available on its website that includes:
(a) APD submissions specifications, including the data standards used and the method for reporting to the department. Submission specifications shall be developed with a goal of minimizing burden on health care providers and third-party health care payers, including utilization of nationally standardized file formats where available and feasible.
(b) APD data access and release policy, including security and usage requirements to become a data user; requirements for maintaining privacy, confidentiality, and security; and data release fee information. Data access and release requirements shall include restrictions on the release of any information that could be used, alone or in combination with other reasonably available information, to identify an individual who is a subject of the information, as well as procedures for request of identifying data elements, including the project application process established pursuant to section 350.3(d) of this Part.
(c) Program operations policy, including program purpose, scope and objectives, and general governance.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.26 Content and retention of child records
(a) Municipalities shall maintain an early intervention record for each child referred to the program which documents the performance of all activities required to be completed by early intervention officials or their designees on behalf of eligible children under article 25 of title II-A of the Public Health Law. The early intervention record shall be maintained in a confidential manner in accordance with section 69-4.17(c) of this Subpart. The early intervention record shall include the following:
(1) the original or a copy of intake and referral documents, which must include the date the child's referral was received by the municipality;
(2) Medicaid and third party payor information required for claiming, including the date such information was obtained and updated;
(3) documentation signed by the parent acknowledging receipt of information regarding the rights afforded parents under the Early Intervention Program;
(4) copies of all required written notices to the parent, which shall set forth the date the notice was sent to the parent;
(5) original or copy of signed and dated consent from the parent for the child's and family's participation in the Early Intervention Program;
(6) documentation identifying the child's and family's initial service coordinator and the date on which the such service coordinator was assigned to the child and family;
(7) where applicable, documentation of the designation of a surrogate parent for a child, including the date assigned, the surrogate parent's name and contact information, and circumstances leading to the designation of a surrogate parent;
(8) any evaluation and diagnostic reports, including family assessments and any medical records and correspondence to/from primary care physician(s) that are part of the evaluation record and demonstrate ongoing physician involvement;
(9) the child's and family's individualized family service plan and related documentation, including required six-month reviews, annual evaluations, amendments to the plan and any progress notes and other reports and documentation used at individualized family service plan meetings;
(10) originals or copies of all correspondence to/from the municipality regarding the child and family. Municipalities shall also maintain in the child's record notations of any relevant discussions with parents, providers or others regarding the child and the child's family and their participation in the Early Intervention Program, except as otherwise prohibited by law;
(11) for children in the care and custody or custody and guardianship of the local social services commissioner, originals or copies of any correspondence with the commissioner or designee of the local social services districts. Municipalities shall also maintain in the child's record notations of any relevant discussions with the commissioner or designee of the local social services district regarding the child's participation in the EIP;
(12) all records pertaining to any due process proceedings, except as otherwise prohibited by law, related to the child's and family's participation in the Early Intervention Program;
(13) original or copies of all correspondence with the local school district regarding the child's transition from the Early Intervention Program to services under section 4410 of the Education Law. Municipalities must also maintain in the child's record notations of all actions taken to ensure a smooth transition for the child from the Early Intervention Program to services under section 4410 of the Education Law;
(14) reasons for a municipalities closure of a child's case in the Early Intervention Program and date of the closure;
(15) any other documentation and records pertaining to municipal actions and responsibilities pertaining to the child's and family's participation in the Early Intervention Program.
(b) Agency and individual providers shall maintain Early Intervention Program records for each eligible child for whom the provider is authorized to deliver service coordination services, evaluations, and early intervention services. The early intervention record shall be maintained in a confidential manner in accordance with section 69-4.17(c) of this Subpart and shall document the performance of activities required to be completed by the provider on behalf of the child and family, including:
(1) written correspondence with or regarding the child/family and documentation of any relevant discussion with parents, other providers, or municipalities regarding the child and family;
(2) signed and dated parental consents relevant to delivery of services to the child and/or family;
(3) signed and dated consents related to the disclosure and/or exchange of information with other parties regarding services provided and/or the child's and family's participation in the Early Intervention Program;
(4) copies of any written notice(s) sent to the parent by the provider, which shall contain the date of such notice;
(5) the child's and family's individualized family service plan and related documentation, including required six-month reviews, annual evaluations, amendments to the plan and periodic progress notes and other reports and documentation used at individualized family service plan meetings;
(6) documentation of all authorizations by the municipality to provide early intervention services to the child and/or the child's family;
(7) documentation of accidents and incidents that have been reported to the early intervention official;
(8) written orders or recommendations from specific medical professionals when required for the services being provided to the child;
(9) reports pertaining to the child and/or family, including evaluation reports, ongoing assessments related to the services provided, and relevant professional and medical reports produced by or transmitted to the provider with parental consent;
(10) periodic progress notes shall be made by the provider and included in the child's record summarizing the effectiveness of the service and the progress being made toward outcomes included in the child's and family's individualized family service plan;
(11) where applicable, originals or copies of all written correspondence to/from the provider regarding discontinuation of services to the child and reasons why early intervention services were discontinued;
(12) documentation necessary for submission and substantiation of early intervention claims for payment by the municipality, third party payer, including the medical assistance program, and state aid reimbursement, including recipient identification (name, sex, and age of child); information on any insurance policy, plan, or contract under which the child has coverage; unit and specific type of service provided; date(s) of service; signature of parent or caregiver verifying the service was delivered; ICD diagnostic code for the condition or reasons for which care is provided; where applicable, the appropriate procedure code(s) for the service(s) provided; and, the name, address, and license, registration, certification, or where applicable, national provider identification number, of the professional delivering the service; and
(13) any other documentation relevant to activities performed and services rendered related to the child's and family's participation in the Early Intervention Program.
(c)
(1) Individual providers who directly render services to a child and family or an approved provider agency shall maintain original signed and dated session notes, following each child and family contact, which shall include the recipient's name, date of service, type of service provided, time the provider began delivering therapy to child and end time, brief description of the recipient's progress made during the session as related to the outcome contained in the individualized family service plan, name, title, and signature of the person rendering the service, and date the session note was created; and a service log signed by the parent or caregiver which documents that the service was received by the child on the date and during the period of time as recorded by the provider.
(2) Qualified personnel who are licensed, registered, or certified under State Education Law and who deliver early intervention services shall, in addition to the provisions of this Subpart, retain records in accordance with the laws and regulations that apply to their professions.
(3) A provider agency in contract with individual providers may request or require submission of copies of such providers' session notes for provider agency records.
(4) Original early intervention records generated by qualified personnel who are employees of a municipality or provider agency shall be retained by the respective municipality or provider agency.
(5) Qualified personnel shall supply original session notes upon the request of a municipality, the department, or provider agency for programmatic monitoring and fiscal audit purposes.
(d) Agency and individual providers of initial and/or ongoing service coordination services shall document all activities related to the performance of their duties as set forth in sections 69-4.6 and 69-4.7 of this Subpart, including recipient's name; date of service; a description of the specific service coordination activity performed; name, date of contact, and purpose of contact for providers or others contacted on behalf of the child and family as necessary to implement the IFSP; start and end time for each contact; and, name, title and signature of the service coordinator, as applicable.
(e) Early intervention records pertaining to a child and family shall be retained by all municipalities and agency and individual providers for a minimum of six years from the date that care, services, or supplies were provided to the child and family.
(1) Individual early intervention providers who are licensed, registered, or certified under State Education Law must retain child and family records for the period of time set forth in the laws and regulation that apply to their profession.
(2) All municipalities, except New York City, shall retain Early Intervention Program records, including but not limited to case record and screening, assessment, and referral records as follows:
(i) individual case records shall be retained until the child reaches the age of 21; and
(ii) screening, assessment, and referral records not found in individual case records must be retained for seven years.
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.9 Prior approval requests for vehicle modifications
(a) A vehicle modification request may only be made for a vehicle owned by the enrollee or a member of the enrollee's household who has consistent and ongoing contact with the enrollee and provides unpaid primary, long-term support to the enrollee. Proof of ownership of the vehicle by the enrollee or the enrollee's legal representative must be provided to the fund administrator. A modification will be approved only if the vehicle is the primary source of transportation for the participant and is used to access services and supports in the community and to improve the enrollee's independence and inclusion in the community.
(b) The vehicle modification request must be accompanied by a vehicle modifications and equipment evaluation, based on the enrollee's needs, that has been obtained from a driver rehabilitation specialist who has been certified by the Association of Driver Rehabilitation Specialists. The evaluation must specify the most cost effective and least complicated vehicle modification that will ensure safe transportation, and exit from and entrance into the vehicle for the participant, and include a detailed scope of work and specifications.
(c) Modifications can only be made to vehicles that are registered, insured and meet State inspection standards before and after the modifications are completed.
(d) Modifications maybe made either to a vehicle that is being purchased by the enrollee or a member of the enrollee's household, or to a vehicle that is structurally sound, not in need of mechanical repair as determined by the vehicle modifier, and is less than five years old or registers less than 50,000 miles.
(e) Modifications to a vehicle that the enrollee will not be driving are limited to modifications that are necessary to ensure safe transportation and safe access into and out of the vehicle.
(f) Only contractors that meet Acces-VR's qualifications or if the enrollee lives in the District of Columbia or a state other than New York, the qualifications required by the district or other state for performing vehicle modifications may submit bids for modifications.
(g) Once the initial request has been reviewed by the fund administrator, the fund administrator shall notify the enrollee or person authorized to act on the enrollee’s behalf in writing which services or items have been approved and/or denied and inform the enrollee or person authorized to act on the enrollee’s behalf of the bidding process that is required prior to the fund administrator approving payment for the vehicle modification. The enrollee or person authorized to act on the enrollee’s behalf is then required to obtain a minimum of three acceptable bids from qualified contractors.
(h) Once the fund administrator receives from the enrollee or person authorized to act on the enrollee’s behalf a minimum of three acceptable bids from qualified contractors, the fund administrator shall evaluate the qualifications of each bidder and the content of each bid to determine whether each bid is acceptable. If less than three are submitted, a written explanation of why three accepted bids were not obtained must be provided, as well as a written explanation of how the determination was made that the one or two bids being considered are reasonably priced. In order to be acceptable, a bid must:
(1) be signed by the contractor or a person duly authorized to sign on behalf of the contractor;
(2) specify the scope of work and specifications of the work; and
(3) state that all work will be done in a workmanlike manner, using materials suitable for purposes of the modification.
(i) If the two lowest bids are within 10 percent of each other, the enrollee or his or her legally authorized representative may choose one of the two lowest bids. If there is more than a 10 percent difference between the two lowest bids, the fund administrator shall choose the bid that represents the best overall value for the fund and the enrollee based on factors including not only the price offered by each bidder but also the quality, durability, extent of any warranties provided, and the safety of the product itself. The successful bidder will be notified after the fund administrator or a designee of the fund administrator:
(1) discusses the bids received with the enrollee or the person authorized to act on the enrollee’s behalf and the reasons why a particular bid is chosen by the fund administrator; and
(2) obtains the written consent of the enrollee or the person authorized to act on the enrollee’s behalf to have the installation done by that bidder.
If the enrollee or person authorized to act on the enrollee’s behalf disagrees with the fund administrator’s decision, the enrollee or person authorized to act on the enrollee’s behalf can request a review of the decision. The fund administrator will authorize payment to the successful bidder of no more than one-third of the accepted bid amount unless there are extenuating circumstances about which the fund administrator receives advance notice such as a project that can be completed in one day or involves the purchase of a product prior to installation.
(j) Any change from the specifications in terms of alternative or substitute equipment or the scope of work involved in the modification that will result in a cost increase from the bid price will require approval from the fund administrator.
(k) No additional payment will be authorized until the fund administrator has received a post-modification evaluation stating that the vehicle meets or exceeds Acces-VR Vehicle Modification Standards and that the modifications meet the enrollee's functional needs.
(l) Payment for vehicle modifications shall include, in addition to the cost of the vehicle modification itself, the cost of the vehicle modifications and equipment evaluation, the evaluation of required bids if the fund administrator finds it necessary to engage an outside expert, the post-modification evaluation, and reimbursement for travel in those instances in which the enrollee and his or her informal supports must travel outside of the geographic area in which the enrollee's community commonly obtains its medical care and services for fittings and vehicle tests.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.7 Village of Schenevus
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the well which comprises the source of the public water supply of the Village of Schenevus. Said well is located on land owned by the Village of Schenevus and is situated approximately in the south central part of the village, 100 feet north of Depot Street.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the well.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter, from a domestic, commercial, private or industrial establishment, which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Village of Schenevus.
(16) Well shall mean the well now used as a source of this water supply or to any additional well(s) which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well, except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 200-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 200-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 200-foot linear distance of the well, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the well.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well, and not within a 500-foot to a 1,000-foot linear distance of the well unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the well.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the well.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the well.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Village of Schenevus upon which the well is located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Schenevus.
(e) Inspections.
The commissioner of the water district, or any person or persons charged with the maintenance or supervision of the public water supply system, shall by its officers or their duly appointed representative make regular and thorough inspections of the area surrounding the well to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid commissioner of the water district to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid commissioner of the water district to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of the water district shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.1 Definitions
For purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Environmental laboratory means any facility that examines, or is available for the examination of, samples or specimens including, but not limited to: air, stack emissions, water, wastewater, surface water, ground water, recreational waters, swimming pools, leachate, land runoff, solid waste, hazardous waste, soil, sediments and vegetation, as well as any substance that could contribute to the pollution of or that could be contaminated by material contained in such samples or specimens. Such examinations shall be limited to qualitative or quantitative determinations of the biological, chemical, radiochemical or physical characteristics of such samples or specimens for the purposes of public or personal health protection, or the protection of the environment or natural resources. Environmental laboratories shall not include facilities or entities that perform non-laboratory chemical testing associated with residential water softeners and residential swimming pools. Environmental laboratories shall include mobile laboratories, as defined in subdivision (c) of this section.
(b) Approved laboratory means an environmental laboratory that has demonstrated to the New York State Commissioner of Health that it has met the on-site assessment, technical direction and proficiency testing requirements of this Subpart, and therefore has been issued a certificate of approval. For purposes of this Subpart, accredited shall have the same meaning as approved.
(c) Mobile laboratory means a separate, self-contained mobile facility for the examination of environmental samples or specimens as described in subdivision (a) of this section. A mobile laboratory shall have a fixed address, provided to the department with each application for approval, to which proficiency test samples and other correspondence may be sent, and shall be managed by a responsible person authorized to receive service of process.
(d) Technical director means the individual responsible for the technical and scientific operation of an environmental laboratory, and who meets the minimum qualifications in section 55-2.10 of this Subpart. If an environmental laboratory employs more than one technical director, the laboratory owner(s) shall designate one such individual as the lead technical director.
(e) Approved method means an analytical method, including sample preparation, of proven reliability, which has been approved, or given similar recognition by the United States Environmental Protection Agency (EPA) or a New York State regulatory program in environmental or public health protection, for the specific purpose for which the method is to be used. Methods approved by the department pursuant to section 55-2.5 of this Subpart shall be deemed approved methods. The department shall make available a list of approved methods to approved laboratories.
(f) Quality system means a structured laboratory management system that meets the standards for a quality system as set forth in the department's Environmental Laboratory Approval Program Quality System Standards 2002, July 1, 2002 revision, which is hereby incorporated by reference, with the same force and effect as if fully set forth herein. These standards are available for public inspection and copying at the New York State Department of Health, Records Access Office, Corning Tower, Empire State Plaza, Albany, NY 12237.
(g) Analyte means a chemical and/or physical property, element, compound, group of compounds, organism, or group of organisms, to be determined in samples examined. Sample and specimen are synonymous terms, and are used interchangeably in this Subpart.
(h) Statistical mean means the arithmetic average of a data set after outlier rejection, or, if transformation is used, the central point of data set distribution after outlier rejection.
(i) Method detection limit means the minimum concentration of an analyte that can be measured and reported with 99-percent confidence that the analyte concentration is greater than zero, as defined or stated in the least sensitive approved method.
(j) Assigned value means the nominal concentration of an analyte, based on sample preparation.
(k) Relative standard deviation means the standard deviation of a data set divided by the statistical mean, expressed as a percentage. Predictive standard deviation means the standard deviation derived from a linear regression equation based on historical data.
(l) Synthetic blank means an artificial sample with contents of known purity and without added analytes.
(m) Natural blank means a sample derived from the environment, for which the concentration of a given analyte or analytes, after repeated analyses, has been determined to be below the method detection limit.
(n) Spiked sample means a sample to which a known amount of an analyte has been added.
(o) Natural sample means a sample collected from the environment, to which no analytes have been added.
(p) Contract laboratory protocol (CLP) means a protocol, issued by the New York State Department of Environmental Conservation, for performance of environmental analyses in accordance with specifications describing: the types of samples to be analyzed (such as soil or water); internal sample-handling procedures (such as chain-of-custody or holding times); instrumentation and method of analysis to be used for each analyte; calibration procedures to be implemented (such as numbers of standards, their concentrations and acceptance criteria); quality control samples to be analyzed and the frequency of such analysis; the organization and content of reports to be issued on analytical results obtained.
(q) CLP data package means a collection of documentation whose organization and content are specified by CLPs. A CLP data package shall consist of analytical reports, including, but not limited to, a narrative description of how the analysis was performed, any problems encountered, analytical results for all samples, results for all quality control samples analyzed, copies of instrument printouts, and all logbook pages and laboratory bench sheets.
(r) Department means the New York State Department of Health.
(s) Denial means the department's refusal to approve, in total or in part, an environmental laboratory's application for approval, including resubmission of an initial or renewal application.
(t) Suspension means the department's temporary removal, in total or in part, of an environmental laboratory's approval for a defined period of time not exceeding six months, to allow such laboratory time to correct deficiencies or areas of noncompliance.
(u) Revocation means the department's withdrawal, in total or in part, of an environmental laboratory's approval.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.16 Therapeutic radiology or radiation oncology
(a) This methodology will be utilized to evaluate certificate of need applications involving the acquisition of megavoltage (MEV) devices used in therapeutic radiology. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decision making tools for directing the distribution of MEV devices. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate number of therapeutic radiology units are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors for determining the public need for MEV devices used in therapeutic radiology shall include, but not be limited to, the following:
(1) No equipment other than four or more MEV or cobalt teletherapy units with a source axis distance of 80 or more centimeters and rotational capabilities will be considered appropriate as the primary unit in a multi-unit radiotherapy service or as the sole unit in a smaller radiotherapeutic unit.
(2) Ninety-five percent of the total population of each health region is within a one-hour mean travel time, adjusted for weather conditions, of a facility providing therapeutic radiology services.
(3) The expected volume of utilization sufficient to support the need for an MEV machine shall be calculated as follows:
(i) Each applicant and MEV machine shall provide a minimum of 5,000 treatments per year and have the capacity to provide 6,500 treatments per year. These volumes may be adjusted for the expected case-mix of a specific facility.
(ii) Sixty percent of the annual incidence of cancer cases in a service area will be candidates for radiation therapy.
(iii) Fifty percent of radiation therapy patients will be treated for cure with an average course of treatment of 35 treatments and 50 percent of patients will be treated for palliation with an average course of treatment of 15 treatments. These estimates may be adjusted based on the case-mix of a specific facility.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter F DISEASE REGISTRY
Part 62 ALZHEIMER'S DISEASE AND RELATED DISORDERS REGISTRY
10 CRR-NY 62.1 Filing of reports
All cases or suspected cases of Alzheimer's disease and related disorders shall be reported to the Commissioner of Health by physicians, hospital administrators, laboratories, or persons in charge of the State institutions, pathologists, coroners and medical examiners. Reports shall be made in a manner and on forms prescribed by the commissioner. Penalties for not reporting are provided in section 12 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.61 Therapy equipment operating at potentials of 60 kVp and below
(a) Equipment.
All provisions of subdivision (a) of section 16.60 of this Part shall apply except that the leakage five centimeters from the surface of the tube housing shall not exceed 0.1 roentgen per hour.
(b) Conditions for operation of equipment.
(1) The output of the X-ray generator shall be calibrated prior to the use of the apparatus for treating humans. Calibration shall be performed by a person qualified pursuant to section 16.122(f) of this Part and experienced in the calibration of such units. The method of calibration used shall ensure accurate delivery of the prescribed dose under all conditions of use. Calibrations shall be made at least annually. Recalibration, however, shall be made after each tube replacement and after any changes or replacements in the generating apparatus which could change the X-ray output.
(2) If the tube must be hand-held during irradiation, the operator shall wear protective gloves and a protective apron of no less than 0.5 mm lead equivalent.
(3) The operator shall be able to observe and communicate with the patient during irradiation.
(4) Equipment having an output of more than 1,000 roentgens per minute at any accessible place shall not be left unattended without the power being shut off at the main disconnect switch in addition to the control panel switch.
(5) When operating equipment constructed with beryllium or other low filtration windows the operator shall insure that the useful beam is blocked at all times except when actually being used.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.23 Laboratory services
This functional reporting center must contain all the expenses associated with performance of diagnostic and routine laboratory tests on tissues and cultures necessary for the diagnosis and treatment of residential health care facility patients. This functional reporting center should also include maintenance of a blood bank within the residential health care facility. Additional activities include but are not limited to the following: transportation of specimens from nursing floors; care of laboratory equipment; preparation of samples for testing; drawing or otherwise procuring, processing, storing and issuing whole blood and blood derivatives.
(a) Standard unit of measure: CAP workload measurement units.
A Workload Recording Method for Clinical Laboratories, published by the College of American Pathologists (use the latest edition). In recording workload measurement units, workload units related to quality control studies, calibration standards and specimen collection, and repeats for which a patient is not charged, are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.
(b) Data source.
The number of workload measurement units shall be an actual count maintained by the laboratory. Copies of the Workload Recording Method can be obtained by writing to:
College of American Pathologists
7400 North Skokie Boulevard
Skokie, IL 60076
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.2 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) Allowable capital costs.
Capital costs that are allowable under 14 NYCRR Subpart 635-6.
(b) Allowable operating costs.
In the case of residential habilitation services, operating costs that are allowable under 14 NYCRR sections 635-10.4(b)(1) and 686.13(b); in the case of day habilitation services, operating costs that are allowable under 14 NYCRR section 635-10.4(b)(2).
(c) Acuity factor.
Factor developed through a regression analysis utilizing components of Developmental Disabilities Profile-2 (DDP-2) scores, average residential bed size, Willowbrook class indicators and historical utilization data to predict direct care hours needed to serve individuals. Factors are available on the department’s website: http://www.health.ny.gov/health_care/medicaid/rates/mental_hygiene/
(d) Allowable agency administration.
For non-State government and voluntary providers, from the CFR for the base year, divide the agency administration allocation (from CFR1 line 65) by the total operating costs (from CFR1 line 64) to determine the agency administration percentage.
(e) Authorized rate period units, or authorized units.
Units approved by OPWDD Budget Office to deliver Day Habilitation Services. OPWDD Budget Office adjusts the units based on addition or subtraction of individuals as well as addition or subtraction of sites. These units are tracked on an ongoing basis and reported to DOH on a semi-annual basis (January and July). Based on the unit update the operating portion of the final target rate will not change. The capital portion will be adjusted by the change in units, which will change the overall Day Habilitation rate.
(f) Base period CFR, or base year CFR.
The consolidated fiscal report (CFR) used to update methodologies.
(g) Budget neutrality adjustment.
Factor applied to the end of the methodology, by service, to ensure the total annual target reimbursement is equivalent to the total annual base reimbursement. The factors can be found on the department’s website at http://www.health.ny.gov/health_care/medicaid/rates/mental_hygiene/
(h) Capital costs.
Allowable costs that are related to the acquisition, lease and/or long-term use of land, buildings and construction equipment, leasehold improvements and vehicles.
(i) Community residence.
A facility operated as a community residence under 14 NYCRR Part 686, including an individualized residential alternative.
(j) Consolidated fiscal report (CFR).
The reporting tool utilized by all government and non-government providers to communicate annual costs incurred as a result of operating OPWDD programs and services, along with related patient utilization and staffing statistics. The CFR is the report and associated instructions as of April 1, 2013, identified by the New York State Education Department, and found at: http://www.oms.nysed.gov/rsu/Manuals_Forms/
(k) Day habilitation services.
Day habilitation services provided under the home and community-based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10.
(l) Department of Health (DOH) regions.
Regions as defined by the department, assigned to providers based upon the geographic location of the provider's headquarters as reported on the consolidated fiscal report. Such regions are as follows:
(1) Downstate: five boroughs of New York City, Nassau, Suffolk, Westchester;
(2) Hudson Valley: Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster;
(3) Upstate Metro: Albany, Erie, Fulton, Genesee, Madison, Monroe, Montgomery, Niagara, Onondaga, Orleans, Rensselaer, Saratoga, Schenectady, Warren, Washington, Wyoming;
(4) Upstate Non-Metro: Any counties not listed in paragraph (1), (2) or (3) of this subdivision.
(m) Depreciation.
The allowable cost based on historical costs and useful life of buildings, equipment, capital improvements and/or acquisition of real property. The useful life shall be based on The Estimated Useful Life of Depreciable Hospital Assets (2008 edition) except that the useful life for day habilitation buildings will be 25 years. The depreciation method used shall be straight-line method.
(n) Developmental disabilities profile (DDP-2).
The document titled Developmental Disabilities Profile (DDP-2) dated 10/16 and issued by OPWDD. This document, the developmental disabilities profile (DDP-2) user’s guide and another document titled Scoring the DDP are available during business hours and by appointment at the following locations:
(1) the Department of State, Division of Administrative Rules, One Commerce Plaza, 99 Washington Avenue, Albany NY 12231-0001;
(2) OPWDD, Attention Public Access Officer, 44 Holland Avenue, Albany, NY 12229.
(o) E-score factor.
Factor derived from analysis of evacuation scores to adjust staffing needs necessary to address health and safety needs.
(p) Evacuation score (E-score).
The score for a supervised community residence that is certified under chapter 32 or 33 of the residential board and care occupancies of the NFPA 101 Life Safety Code (2000 edition) that is provided to the department by OPWDD once a year. The E-score is described in the NFPA 101A Guide on Alternative Approaches to Life Safety, 2001 edition . The Life Safety Code and Guide on Alternative Approaches to Life Safety are available from the National Fire Protection Association, One Batterymarch Park, Quincy, MA 02169-7471; or is available during business hours and by appointment at the following locations:
(1) the Department of State, Division of Administrative Rules, One Commerce Plaza, 99 Washington Avenue, Albany, NY 12231-0001;
(2) OPWDD, Attention Public Access Officer, 44 Holland Avenue, Albany, NY 12229.
(q) Facility.
The site or physical building where actual services are provided.
(r) Final average rate.
The final average rate is determined using the final rate year reimbursable cost divided by the final rate year total units of service regardless of payer.
(s) Financing expenditures.
Interest expense and fees charged for financing of costs related to the purchase/acquisition, alteration, construction, rehabilitation and/or renovation of real property, vehicles, and equipment.
(t) Individual.
Person receiving a residential or day habilitation service.
(u) Initial period.
The first 12 months of the rate cycle.
(v) Lease/rental and ancillary payments.
A facility’s annual rental payments for real property and ancillary outlays associated with the property such as utilities and maintenance.
(w) Occupancy adjustment.
An adjustment to the calculated daily rate of a voluntary agency which provides supervised residential habilitation to account for days when Medicaid billing cannot occur because an individual has passed away or has moved to another site.
(1) For the rate periods beginning July 1, 2019, voluntary providers receive an occupancy adjustment to the operating component of their rate for vacancy days. The occupancy adjustment percentage is calculated by dividing the sum of the agency’s rate period reported retainer days, service days and the therapy days by 100 percent of the agency’s certified capacity. The certified capacity is calculated taking into account capacity changes throughout the year, multiplied by 100 percent of the year’s days. This adjustment will begin on July 1, 2019 and be recalculated on an annual basis based on the most current and complete 12 months of experience.
(2) For the period beginning May 1, 2021, the occupancy adjustment will be zero.
(x) Operating costs.
Provider costs related to the provision of day habilitation and residential habilitation services provided in a community residence and identified in such provider's cost reports. With the exception of live-in caregiver services, allowable operating costs shall not include the costs of board.
(y) Provider.
An individual, corporation, partnership or other organization to which OPWDD has issued an operating certificate to operate a community residence, and for which the Department of Health has issued a Medicaid provider agreement, or an individual, corporation, partnership or other organization to which OPWDD has issued an operating certificate or approval to operate a day habilitation program, and for which the department has issued a Medicaid provider agreement.
(z) Rate.
A reimbursement amount based on a computation using annual provider reimbursable cost divided by the applicable annual units of service.
(aa) Rate period.
The annual time period that rates are effective. For voluntary providers the time period is July 1st through June 30th.
(ab) Rate sheet capacity.
The number of individuals for whom a provider is certified or approved by OPWDD to provide residential habilitation.
(ac) Rebasing.
Updating cost data in the methodology, using an available and complete CFR.
(ad) Reimbursable cost.
The final allowable costs of the rate year after all audit and/or adjustments are made.
(ae) Residential habilitation.
Residential habilitation services provided in a community residence, under the home and community-based services waiver operated by OPWDD and pursuant to 14 NYCRR Subpart 635-10 and Part 671.
(af) Retainer days.
Days of medical leave or an associated day where any other institutional or in-patient Medicaid payment is made for providing services to the beneficiary. A provider is limited to being paid 14 retainer days per rate year, multiplied by certified capacity. Effective on or after May 1, 2021, retainer days will be reimbursed at a rate of 50 percent of the provider’s established rate.
(ag) Room and board.
Room means hotel or shelter type expenses including all property related costs such as rental or depreciation related to the purchase of real estate and furnishings; maintenance, utilities and related administrative services. Board means three meals a day or any other full nutritional regimen.
(ah) Service days.
A day when paid supervised IRA staff deliver residential habilitation to a person who is either present in the supervised IRA or is absent from the IRA and receives residential habilitation services from paid supervised IRA staff, and these services are of the same scope, frequency and duration as the services provided when the person is resident in the supervised IRA.
(ai) Start-up costs.
Those costs associated with the opening of a new program. Start-up costs include pre-operational rent, utilities, staffing, staff training, advertising for staff, travel, security services, furniture, equipment and supplies.
(aj) State supplement.
Amount paid to a provider to cover room and board costs in excess of SSI and Supplemental Nutrition Assistance Program (SNAP) payments.
(ak) Target rate.
The final rate in effect at the end of the transition period for each waiver service determined using the rate year final reimbursable cost for each respective provider for each respective service divided by the final total of actual units of service for all individuals, regardless of payor.
(al) Therapy day.
A therapy day is a day when the individual is away from the supervised residence and is not receiving services from paid residential habilitation staff and the absence is for the purpose of a visiting with family or friends, or a vacation. The therapy day must be described in the person’s plan of care to be eligible for payment and the person may not receive another Medicaid-funded residential or in-patient service on that day. Effective May 1, 2021 or after, a provider is limited to being paid 96 therapy days per rate year per person. All therapy days will be reimbursed at a rate of 50 percent of the provider’s established rate.
(am) Units of service.
The unit of measure for the following waiver services shall be:
(1) residential habilitation provided in a supervised community residence—daily;
(2) residential habilitation provided in a supportive community residence—monthly;
(3) day habilitation—daily.
(an) Wage equalization.
The sum of the provider average direct care hourly rate multiplied by 0.75 from the base period CFR and the applicable regional average direct care hourly rate multiplied by 0.25 from the base period CFR.
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.24 Leaves required by law
The department shall grant any leave of absence, with pay, required by law.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.24 Educational activities
The costs of educational activities, less tuition and supporting grants, shall be included in the calculation of the basic rate, provided such activities are directly related to patient care services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.24 Affiliate
A corporation or other organization related to another by owning or being owned, by common management or by a long-term lease of its properties or other control device.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.3 Exceptions, reclassification and exemptions of scheduled controlled substances
(a) Exceptions.
(1) Those nonnarcotic substances listed in section 1308.22 of title 21 of the Code of Federal Regulations, currently and as thereinafter amended, are excepted from the application of sections 3306 and 3319 of the Public Health Law.
(2) Those drugs, which are restricted by law to dispensing on prescription, listed in section 1308.32 of title 21 of the Code of Federal Regulations, currently and as thereinafter amended, are excepted from the application of sections 3306 and 3319 of the Public Health Law.
(3) Those chemical preparations and mixtures listed in section 1308.24 of title 21 of the Code of Federal Regulations, currently and as thereinafter amended, are excepted from the application of sections 3306 and 3319 of the Public Health Law.
(4) The following compounds, mixtures or preparations containing a narcotic antagonist substance having no potential for abuse, and being excepted or exempted from control under the Federal Controlled Substances Act (21 USC 801 et seq. ) are excepted from the application of sections 3306 and 3319 of the Public Health Law:
(i) naloxone and its salts; and
(ii) naltrexone and its salts.
(b) Reclassifications.
The following drugs listed in schedule II(c) of section 3306 of the Public Health Law are hereby reclassified as schedule III substances.
| Trade name or other designation | Composition | Manufacturer or supplier | | --- | --- | --- | | Mediatric—tablets, capsules and liquid | Tablet and capsule: Conjugated estrogens—equine (Premarin (R)), 0.25 mg.; Methyltestosterone, 2.5 mg.; Ascorbic Acid (Vit. C), 100 mg. (for capsules, provided as ascorbic acid, 70 mg. and as Sodium ascorbate, 30 mg.); | Ayerst | | | Cyanocobalamin, 2.5 mcg.; Thiamine mononitrate, 10.0 mg.; Riboflavin, 5.0 mg.; Niacinamide, 50.0 mg.; Pyridoxine HCl, 3.0 mg.; Calc. panto thenate, 20.0 mg.; Ferrous sulfate exsic., 30.0 mg.; Methamphetamine HCl, 1.0 mg. Liquid: (Premarin (R)) Conjugated estrogens, (U.S.P.), 0.25 mg.; Methyltestosterone, 2.5 mg.; Thiamine HCl, 5.0 mg.; Cyanocobalamin, 1.5 mcg.; Methamphetamine HCl, 1.0 mg.; Alcohol, 15%. | | | Phelantin—Kapseals | Phenobarbital (½ gr) 30 mg.; Dilantin (Diphenyl- hydantoin) (1½ gr) 100 mg.; Methamphetamine Hydrochloride 2.5 mg. | Parke-Davis |
(c) Exemptions.
The following compounds, mixtures or preparations containing an anabolic steroid listed in subdivision (h) of schedule II of section 3306 of the Public Health Law have ingredients included therein in such combinations, quantity, proportion or concentration as to reduce substantially the potential for abuse and, therefore, are exempted from the requirements of Public Health Law, article 33:
| Trade Name | Composition | Manufacturer or supplier | | --- | --- | --- | | Estratest | Esterified estrogens (1.25 mg); Methyl- testosterone (2.5 mg) | Solvay Pharmaceuticals Marietta, GA | | Estratest HS | Esterified estrogens (0.625 mg); Methyl-testosterone (1.25 mg) | Solvay Pharmaceuticals Marietta, GA | | Premarin with Methyltestosterone | Conjugated estrogens (0.625 mg); Methyltestosterone (5.0 mg) | Wyeth-Ayerst Laboratories Philadelphia, PA | | Premarin with Methyltestosterone | Conjugated estrogens (1.25 mg); Methyltestosterone (10 mg) | Wyeth-Ayerst Laboratories Philadelphia, PA |
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRIOR APPROVAL FOR CARE AND SERVICES PRIOR APPROVAL FOR CARE AND SERVICES
10 CRR-NY 85.38 Child/Teen Health Plan (also known as Child Health Assurance Program)
A free-standing diagnostic and treatment center which participates in the Medicaid program shall submit billings with the appropriate specialty codes which accurately reflect all health services provided to children eligible for the Child/Teen Health Plan (also known as Child Health Assurance Program) as defined in 18 NYCRR 501.1(a) in order to assure maximum utilization of such services.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 117 GENESEE COUNTY
10 CRR-NY 117.3 Village of Oakfield
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Laws), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Mercer Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the village of Oakfield, Genesee County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoir on Mercer Creek, which is tributary to or which serves as a source of the aforesaid water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Oakfield.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or 300 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Oakfield, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Oakfield, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Oakfield.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Oakfield. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Oakfield.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Oakfield, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the village of Oakfield.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Oakfield, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the village of Oakfield; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings, shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Oakfield.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the village of Oakfield, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or watercouse tributary to the public water supply of the village of Oakfield.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Oakfield, except by duly authorized employees of the village of Oakfield in the performance of their duties of supervision and maintenance of the public water supply of the village of Oakfield.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Village of Oakfield.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Oakfield.
(j) Inspections.
The board of trustees of the Village of Oakfield or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Oakfield or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of Chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.30 General requirements
(a) The terms eligible borrower, mortgagor or hospital as used in this Part shall mean a not-for-profit hospital or medical corporation that has entered into a regulatory agreement with the commissioner.
(b) A hospital is required to comply with all applicable provisions of law, including, but not limited to, the Private Housing Finance Law and the New York State Medical Care Facilities Finance Agency Act, the Public Health Law, the State Hospital Code and the administrative rules and regulations of the State Commissioner of Health.
(c) A hospital shall apply for the prior approval of construction of the facility in accordance with the provisions of section 2802 of the Public Health Law and the State Hospital Code.
(d) A hospital shall apply for a mortgage loan by setting forth in the application for construction the amount of the proposed mortgage loan requested for development of the project.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
RESPONSIBILITY FOR PAYMENT FOR SERVICES RESPONSIBILITY FOR PAYMENT FOR SERVICES
10 CRR-NY 43-1.10 No patient obligation to pay
(a) No tuberculosis patient or his legally responsible relatives shall be requested or required by a provider, local health official, the State, or any other party to pay personally for any portion of tuberculosis health care services received, as provided in section 2202 of the Public Health Law.
(b) No provider, local health official, the State or any other person shall inquire into the financial ability of a tuberculosis patient or his legally responsible relatives to pay for tuberculosis health care services except to determine third-party coverage.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.8 Operational period
(a) A nursing home company shall be operated in accordance with the requirements of the State Hospital Code.
(b) The operational period shall commence on the financial occupancy date declared by the State Commissioner of Health.
(c) All company records, reports and schedules required during initial occupancy shall be maintained during the operational period.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.26 Dewatering trenches
No repair to the public water system shall be made until the trench has been dewatered to a point below the mains, valves or other structures. Every effort shall be made to prevent the entrance of foreign material and seepage into the public water system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
USE OF ANIMALS USE OF ANIMALS
10 CRR-NY 55-1.4 Responsibility
(a) The individual whose name appears on the certificate of approval shall be responsible for all of the experimentation that involves the use of living animals in the designated laboratory or institution. Such individual shall designate one person to be in charge of animal care. That person shall be responsible for the animals' care regardless of whether that person is physically within or away from the laboratory or institution.
(b) The laboratory or institution shall have an animal care committee which shall be responsible for the review of the propriety of the procedures used and the scientific justification for the use of animals in experiments, tests, and investigations, including educational demonstrations.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.4 Procedures for infant hearing screening
(a) All infants born in the facility shall receive an initial hearing screening prior to discharge from the facility except as provided in section 69-8.2(c) of this Subpart.
(b) Prior to the hearing screening, parents shall be provided educational materials, supplied by the department to the facility, or consistent in content with department-supplied materials, regarding infant hearing screening.
(c) If the infant passes the hearing screening, the results shall be documented in the infant's record by the individual who performed the screening and documented in the discharge summary.
(1) The parent shall be informed of the screening results prior to the infant's discharge from the facility.
(d) The parent shall be provided educational materials, supplied by the department to the facility, on developmental milestones for communication and signs of hearing loss in young children.
(e) In the event that an infant is not screened for hearing loss prior to discharge from the facility, the program manager shall ensure that:
(1) the parent is offered the opportunity to schedule an appointment for the infant to be screened for hearing loss on an outpatient basis within four weeks from the infant's discharge from the facility. Whenever practicable, the parent shall be afforded such opportunity to schedule an outpatient screening prior to the infant's discharge from the facility;
(2) if the parent is not provided the opportunity to schedule an appointment for an outpatient screening prior to the infant's discharge from the facility following birth, a minimum of two documented attempts, either by United States mail or by telephone, excluding busy signals or no answer, shall be made to contact the parent post-discharge to schedule an appointment for an outpatient screening for the infant;
(3) if the parent agrees to schedule an appointment for an outpatient hearing screening by the facility or a provider under contract with the facility, the appointment shall be scheduled and documented in the infant's record;
(4) if the parent returns to the facility or provider under contract with the facility for an outpatient screening, the screening results shall be documented in the infant's record and reported to the department as prescribed by the commissioner; and
(5) if the parent declines to schedule an appointment for an outpatient hearing screening for the infant by the facility or by a provider under contract with the facility, such declination shall be documented in the infant's record and discharge summary:
(i) the parent shall be provided instead with a prescription for the infant to obtain an outpatient hearing screening from an article 28 facility or provider licensed by and authorized under State Education Law to perform infant hearing screening; and
(ii) the prescription shall specify that the results of the hearing screening shall be returned to the facility.
(f) If the infant fails the inpatient hearing screening, a repeat screening shall be conducted whenever possible prior to the infant's discharge from the facility to minimize the likelihood of false positive results and need for a follow-up outpatient screening.
(g) If the infant fails the inpatient screening and any repeat screening, if performed, an outpatient follow-up screening shall be performed to confirm results of the inpatient screens.
(h) If the facility has elected to conduct follow-up hearing screening either directly or through a contractual agreement, the following procedures shall be followed:
(1) the parent shall be informed of the infant's screening results by an individual trained as required in section 69-8.3(c) and (d) of this Subpart to counsel the parent(s) on the importance of a follow-up screening;
(2) the parent shall be provided with educational materials on the importance of early detection of hearing loss, supplied by or consistent with department materials;
(3) the parent shall be provided, prior to the infant's discharge, a prescription to obtain follow-up infant hearing screening post-discharge to be performed at the facility or by a provider under contract with the facility;
(4) if the parent agrees, an appointment shall be scheduled prior to the infant's discharge from the facility except under circumstances where such scheduling is not practicable, such as on weekends, or within 10 days post-discharge;
(5) the appointment shall be documented in the infant's record and discharge summary to facilitate follow-up by the infant's primary health care provider;
(6) if an infant does not present for a scheduled appointment for a follow-up screening based on the infant's failure of an inpatient screen, the facility or provider under contract with the facility shall make at least two documented attempts either by United States mail or by telephone, excluding a busy signal or no answer, to contact the parent and reschedule the appointment;
(7) if the facility or provider under contract with the facility cannot reach the family or for any other reason cannot schedule and complete a follow-up screening within 75 days from discharge, the infant shall be referred to the early intervention official in his or her county of residence as an at-risk child in accordance with section 69-4.3 of this Part, unless the parent objected to the referral at the time of the inpatient hearing screening;
(8) if the parent declines to schedule a follow-up screening with the facility or provider under contract with the facility for an infant who has failed the inpatient infant hearing screening, the following procedures shall be used:
(i) the parent(s) shall be provided with a prescription issued by the facility for the infant to obtain a follow-up screening from a provider licensed under State Education Law and authorized under such law to perform infant hearing screening:
(a) the prescription shall include a request that results of the screening be submitted back to the facility;
(ii) the parent shall be provided with a list of qualified providers of infant hearing screening, which shall consist of providers licensed under State Education Law and authorized under such law to perform infant hearing screening and article 28 facilities;
(iii) the individual counseling the parent shall document in the infant's record and discharge summary the parents' decision not to schedule an appointment with the facility and the issuance of a prescription to obtain follow-up screening from another qualified provider;
(iv) the infant's primary health care provider, when such provider is known, shall be notified of the parents' decision to obtain a follow-up outpatient screening; and
(v) if the prescription is filled and the results of the follow-up screening are returned to the facility, such results shall be documented in the infant's record.
(i) If the facility elects to refer infants who fail the inpatient hearing screening to other facilities or providers licensed under the State Education Law and authorized by such law to perform infant hearing screening on an outpatient basis, the following procedures shall be used:
(1) the parent shall be informed that the screening should be completed within four weeks from the infant's discharge from the facility if possible and not later than 12 weeks following the birth;
(2) the parent shall be provided with educational materials on the importance of early detection of hearing loss, supplied by the department to the facility, or consistent in content with department-supplied materials, and a list of licensed providers and/or article 28 facilities where infant hearing screening may be obtained;
(3) the parent shall receive a prescription for an outpatient screening by a provider licensed under the State Education Law and authorized under such law to perform infant hearing screening, or by an article 28 facility. Such prescription shall state that results shall be returned to the facility;
(4) the parent shall be informed that if results of a follow-up outpatient screening are not returned to the facility, the infant will be referred as an at-risk child to the early intervention official in their county of residence for follow-up purposes unless the parent(s) object to such a referral, in accordance with section 69-4.3 of this Part;
(5) the referral, including issuance of a prescription, shall be documented in the infant's record and discharge summary to facilitate follow-up by the infant's primary health care provider;
(6) the infant(s) primary health care provider, when such provider is known, shall be notified of the inpatient results and need for a follow-up outpatient screening; and
(7) if results of a follow-up outpatient screening are not returned to the facility within 75 days, the infant shall be referred as an at-risk child to the early intervention official in his/her county of residence for follow-up purposes, in accordance with section 69-4.3 of this Part, unless the parent has objected to such a referral.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.60 Face Coverings for COVID-19 Prevention
(a) As determined by the commissioner based on COVID-19 incidence and prevalence, as well as any other public health and/or clinical risk factors related to COVID-19 disease spread, any person who is over age two and able to medically tolerate a face-covering may be required to cover their nose and mouth with a mask or face-covering when:
(1) in a public place and unable to maintain, or when not maintaining, social distance; or
(2) in certain settings as determined by the commissioner, which may include schools, public transit, homeless shelters, correctional facilities, nursing homes, and health care settings, and which may distinguish between individuals who are vaccinated against COVID-19 and those that are not vaccinated. The commissioner shall issue findings regarding the necessity of face-covering requirements at the time such requirements are announced.
(b) Businesses must provide, at their expense, face-coverings for their employees required to wear a mask or face-covering pursuant to subdivision (a) of this section.
(c) Large-scale indoor event venues with more than five thousand attendees shall require patrons to wear face coverings consistent with subdivision (a) of this section; may require all patrons to wear a face covering irrespective of vaccination status; and may deny admittance to any person who fails to comply. This regulation shall be applied in a manner consistent with the Federal American with Disabilities Act, New York State or New York City Human Rights Law, and any other applicable provision of law.
(d) No business owner shall deny employment or services to or discriminate against any person on the basis that such person elects to wear a face-covering that is designed to inhibit the transmission of COVID-19, but that is not designed to otherwise obscure the identity of the individual.
(e) For purposes of this section face-coverings shall include, but are not limited to, cloth masks, surgical masks, and N-95 respirators that are worn to completely cover a person’s nose and mouth.
(f) Penalties and enforcement.
(1) A violation of any provision of this section is subject to all civil and criminal penalties as provided for by law. Individuals or entities that violate this section are subject to a maximum fine of $1,000 for each violation. For purposes of civil penalties, each day that an entity operates in a manner inconsistent with the section shall constitute a separate violation under this section.
(2) All local health officers shall take such steps as may be necessary to enforce the provisions of this section accordance with the Public Health Law and this Title.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.6 Modification, suspension or revocation of approvals and variances
(a) An approval or variance issued by the department pursuant to these rules and regulations may be modified, suspended or revoked at any time upon the department's initiative, on any of the grounds set forth in paragraphs (1)-(5) of this subdivision. The grounds for modification, suspension or revocation include:
(1) materially false or inaccurate statements in the approval or variance application or supporting documents;
(2) failure by the person named in the approval or variance to comply with any terms or conditions of the approval or variance;
(3) the scope of the project, as described in the application, is exceeded;
(4) newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or rules and regulations since the issuance of the existing approval or variance; or
(5) noncompliance with previously issued approval or variance conditions, orders of the commissioner, or with any provisions of the rules and regulations of the department related to the activity.
(b) The department shall send a notice of intent to modify, suspend or revoke an approval or variance to the person named in the approval or variance by certified mail, return receipt requested or by personal service. The notice shall state the alleged facts or conduct which appear to warrant the intended action.
(c) Within 15 calendar days of receipt of a notice of intent, the person named in the approval or variance may submit a written statement to the department, giving reasons why the approval or variance should not be modified, suspended or revoked, or requesting a hearing, or both. Failure by such person to timely submit a statement shall result in the department's action becoming effective on the date specified in the notice of intent.
(d) Within 15 calendar days of receipt of such person's statement, the department shall either:
(1) if a statement without a request for a hearing is submitted, rescind or confirm the notice of intent based on a review of the information provided by such person; or
(2) if a statement with a request for a hearing is submitted, notify such person of a date and place for a hearing, to be commenced not later than 60 calendar days from this notification;
(e) In the event such a hearing is held, the commissioner shall, within 30 calendar days of receipt of the complete record, issue a written decision, stating the findings and reasons therefor, to the person named in the approval or variance. The decision shall:
(1) continue the approval or variance in effect as originally issued;
(2) modify the approval or variance or suspend it for a stated period of time or upon stated conditions; or
(3) revoke the approval or variance, including, where ordered by the commissioner, removal or modification of all or any portion of a project, whether completed or not.
(f) Where the department proposes to modify an approval or variance, and the person named in the approval or variance requests a hearing on the proposed modification, the original conditions of the approval or variance shall remain in effect until a decision has been issued by the commissioner pursuant to subdivision (e) of this section. At such time the modified conditions shall take effect.
(g) Nothing in this section shall preclude or affect the commissioner's authority to use the remedy of summary abatement or to issue a cease and desist order under these rules and regulations, or any other law or regulation.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.109 Licensees and contractors of the United States Nuclear Regulatory Commission and the United States Department of Energy within the State
(a) Each person who holds a license from the United States Nuclear Regulatory Commission authorizing activities within the State shall be exempt from the requirements of this Part with respect to such activities during the period that such license is valid, provided, however, that such person:
(1) shall afford the department and health officer having jurisdiction access to all records which such person is required to maintain pursuant to the United States Nuclear Regulatory Commission's rules and regulations or pursuant to the provisions of the United States Nuclear Regulatory Commission license;
(2) shall afford the department and health officer having jurisdiction opportunity to sample effluents, and to conduct such measurement or survey of levels of radiation and radioactive contamination as will not substantially interfere with or interrupt any activities licensed by the United States Nuclear Regulatory Commission; and
(3) shall afford the department and health officer having jurisdiction access to the facilities of such person in order to accomplish the foregoing review of records, sampling of effluents and conduct of measurements or surveys.
(b) Each United States Nuclear Regulatory Commission contractor or subcontractor and each United States Department of Energy contractor and subcontractor of the following categories operating within the State shall be exempt from the requirements of this Part to the extent that such contractor or subcontractor under such contract transfers, receives, possesses or uses sources of radiation:
(1) prime contractors performing work for the United States Department of Energy at United States government-owned or controlled sites, including the transportation of sources of radiation to or from such sites and the performance of contract services during temporary interruptions of such transportation;
(2) prime contractors performing research in, or development, manufacture, storage, testing or transportation of, atomic weapons or components thereof;
(3) prime contractors using or operating nuclear reactors or other nuclear devices in a United States government-owned vehicle or vessel; and
(4) any other prime contractor or subcontractor when the State and the United States Nuclear Regulatory Commission or the United States Department of Energy jointly determine that:
(i) under the terms of the contract or subcontract, there is adequate assurance that the work thereunder can be accomplished without undue risk to the public health and safety; and
(ii) the exemption of such contractor or subcontractor is otherwise appropriate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
OFFENSES, VIOLATIONS AND ENFORCEMENT OFFENSES, VIOLATIONS AND ENFORCEMENT
10 CRR-NY 80.123 Access to records
The department and its representatives shall have access at all times to all orders, prescriptions or records required to be kept under article 33 of the Public Health Law and this Part.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.11 Notice and filing requirements
(a) All notices, EIS's and other SEQR documents shall be prepared, filed, circulated and made available as prescribed in this section.
(b) Determination of nonsignificance.
In the case of all type I actions, a notice of determination that an EIS will not be prepared, based on a determination that the proposed action will not have a significant effect on the environment (negative declaration), shall be prepared and filed as indicated below by the department, if it is lead agency. The notice shall state that it is a negative declaration for the purposes of article 8 of the Environmental Conservation Law, shall state the name and address of the department and the name and telephone number of a person who can provide further information, shall briefly and precisely describe the nature, extent and location of the action, and shall briefly state the reasons supporting determination. The department shall maintain files of the written analyses and findings leading to their determinations on all actions subject to SEQR. The notice of determination for type I actions shall be filed simultaneously as follows:
(1) with the Commissioner of Environmental Conservation at 50 Wolf Road, Albany, N.Y. 12233;
(2) with the appropriate regional office of the Department of Environmental Conservation;
(3) in the office of the chief executive officer of the political subdivision in which the action will be principally located;
(4) in the department's main office and appropriate regional or area office;
(5) if the action involves an applicant, with the applicant;
(6) if other agencies are involved in approval of the action, with each other agency. In addition, the department may:
(i) file these determinations with other agencies which may be affected by the action; and
(ii) if it is deemed appropriate upon consideration of all circumstances, provide for such public notice of these determinations as shall afford the opportunity for public response by: readily accessible files in department offices; posting on signboards; incorporation in public notices otherwise required by law; or other appropriate means.
(c) Determination of significance.
In the case of all type I and unlisted actions, a notice of determination that a draft EIS will be prepared based on a determination that the proposed action may have a significant effect on the environment (positive declaration), shall be prepared and filed as indicated below by the department, if it is lead agency. The notice shall state that it is a positive declaration for purposes of article 8 of the Environmental Conservation Law, shall state the name and address of the department and the name and telephone number of a person who can provide further information, shall briefly and precisely describe the nature, extent and location of the action, shall briefly describe the possible significant environmental effects that have been identified and shall briefly state the reasons supporting the determination. The department shall maintain files of the written analyses and findings leading to its determinations. The notice of determination shall be filed as prescribed in subdivision (b) of this section.
(d) Notices of completion of draft EIS's.
Whenever a draft EIS has been prepared, a notice of its completion shall be prepared and filed as indicated below by the department, if it is lead agency. The notice shall state that it is a notice of completion of a draft EIS, shall state the name and address of the department, and the name and telephone number of a person who can provide further information, and shall also contain the following:
(1) a brief and precise description of the action covered by the statement, the location and nature of its potential environmental impacts and effects;
(2) a statement indicating where and how copies of the statement can be obtained from the department; and
(3) a statement that comments on the statement are requested and will be received and considered by the department at a given address for a stated period (not less than 30 calendar days from the first filing and circulation of the notice of completion, or not less than 10 calendar days following a public hearing at which the environmental impacts of the proposed action are considered).
The notice of completion shall be filed as prescribed in subdivision (b) of this section, and shall be sent to the State clearinghouse and the relevant regional clearinghouse designated under Federal Office of Management and Budget circular A-95.
(e) Draft EIS's.
The draft EIS, together with the notice of its completion, shall be filed and made available for copying as follows:
(1) one copy with the Commissioner of Environmental Conservation;
(2) one copy with the appropriate regional office of the Department of Environmental Conservation;
(3) one copy with the chief executive officer of the political subdivision in which the action will be principally located;
(4) one copy in the department's main office and one copy in the appropriate regional or area office, if the department is lead agency;
(5) if other agencies are involved in the approval of the action, with each such agency;
(6) one copy with persons requesting it. Where sufficient copies of a statement are not available, the department, if it is lead agency, may charge a fee to persons requesting the statement to cover its costs in making the additional statement available; and
(7) one copy with the Secretary of State where the Department of Health action is in the coastal area.
(f) Notices of hearing.
If the department, as lead agency, determines that a hearing is to be held, then it shall prepare a notice of hearing. Such notice shall specify the time, place and purpose of the hearing, and shall contain a summary of the information contained in the notice of completion of the draft EIS. The notice of hearing shall be filed as prescribed in subdivision (b) of this section. A notice of hearing may be given in the notice of completion of the draft EIS and shall be published, at least 14 calendar days in advance of the hearing date, in a newspaper of general circulation in the area of the potential impacts and effects of the action.
(g) Notices of completion of final EIS's.
A notice of completion of a final EIS shall be prepared by the department if it is lead agency. It shall state that it is a notice of completion of a final EIS, shall state the name and address of the department, if it is lead agency, and shall contain the items prescribed in paragraphs (d)(1) and (2) of this section. It shall be filed as prescribed in subdivision (b) of this section.
(h) Final EIS's.
The final EIS, together with the notice of its completion, shall be filed in the same manner as a draft EIS.
(i) Copies of notices, statements and findings required in this Part and prepared by the department shall be retained in a file which is readily accessible for public inspection.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.2 Licensure
Reproductive tissue banks, insemination/implantation sites and semen processing facilities shall not operate unless licensed as tissue banks pursuant to Subpart 52-2 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.24 Direct assignment of costs
[ 1610 ]
(a) The direct assigning of costs is the process of identifying and assigning costs directly to the functional cost center generating those costs. Only those costs which meet the definitions and guidelines established within this section 444.7 of this Article will be directly assigned.
(b) Buildings and fixtures
[ 1611 ] The cost of all depreciation or rent/lease of buildings and fixtures is to be charged to the Depreciation and Amortization Cost Center (account 8810) and to the Leases and Rental Cost Center (account 8815), respectively, and not reported as a direct expense of specific cost centers.
(c) Salary- and payroll-related employee benefits.
[ 1612 ]
(1) The salaries and wages cost must be assigned directly to the functional cost center to which the employee is assigned (see Natural Classification Accounts, section 444.23(b) of this Article). For example, for reporting purposes the salary cost of direct nursing services, including float nurses, must be directly assigned to the patient care cost centers receiving the service. This assignment may be based on each employee's actual nursing services, hours performed within each patient care cost center multiplied by that employee's hourly salary rate while performing the direct nursing service, or based on an analysis of salary and wage expense including time and cost studies.
(2) Payroll-related employee benefits must be reported in the cost center where the applicable employee's compensation is reported. This assignment can be performed on an actual basis or upon the following basis:
(i) FICA - actual expense by cost center;
(ii) pension and retirement and health insurance (non-union) - gross salaries of participating individuals by cost center;
(iii) union health and welfare - gross salaries of participating union members by cost center;
(iv) all other payroll-related benefits - gross salaries by cost center.
(3) Non-payroll-related employee benefits are to be reported in account 8830 (Employee Benefits—Non-Payroll-Related).
(d) Medical supplies and durable medical equipment.
[ 1613 ]
(1) The invoice/inventory cost of all medical and surgical supplies for which a separate charge is made, except home program dialysis supplies, must be reported as a cost of the Medical Supplies—Sold cost center (account 7110). The related revenue must be reflected in the Medical Supplies—Sold revenue center (account 4110). Home program dialysis supplies must be reported as a cost of the appropriate home program dialysis center.
(2) Medical and surgical supplies and materials issued by Central Services and Supplies for which a separate charge is not made must be reported at invoice/inventory cost as a cost of the cost center using the supplies and materials.
(3) Effective for cost reporting periods beginning January 1, 1982, the invoice/inventory cost of all durable medical equipment sold must be reported as a cost of the Durable Medical Equipment—Sold cost center (account 7130). The related revenue must be reported in the Durable Medical Equipment—Sold revenue center (account 4130).
(4) Effective for cost reporting periods beginning January 1, 1982, the depreciation expense associated with durable medical equipment leased or rented must be reported in the Durable Medical Equipment—Leased/Rented cost center (account 7140). The related revenue must be reported in the Durable Medical Equipment—Leased/Rented revenue center (account 4140).
(5) The overhead associated with the issuance of medical supplies and durable medical equipment must be reported in the Central Services and Supplies cost center (account 8460). The cost of reusable patient chargeable supplies must remain in the Central Services and Supplies cost center.
(e) Drugs.
[ 1614 ] Pharmaceutical supplies and materials including IV solutions, admixtures, blood derivatives, etc.) issued by the Pharmacy cost center for which a separate Pharmacy charge is made must be reported for as a cost of the Drugs Sold cost center (account 7150). The related revenue must be reflected in the Drugs Sold revenue center (account 4150).
Pharmaceutical supplies and materials including IV solutions, admixtures, blood derivatives, etc.) issued by the Pharmacy for which a separate charge is not made must be reported at invoice/inventory cost as a cost of the cost center using the supplies and materials.
The overhead associated with the issuing of pharmaceutical supplies and materials (including IV solutions, admixtures, blood derivatives, etc.) must be reported in the Pharmacy cost center (account 8470). The cost of reusable patient chargeable items must remain in the Pharmacy cost center.
(f) Data processing.
[ 1615 ]
(1) All the direct costs incurred in operating an electronic data processing center, in purchasing data processing services, and/or in obtaining such services from related organizations, must be reported in the using cost centers. Direct cost which cannot be directly identified with specific functional cost centers must be assigned to the functional cost centers using such services based on each hospital's own determination of a fair and equitable assignment or allocation concept which gives appropriate recognition to the types of data processing costs incurred in their data processing center, under contract, and/or from related organizations.
(2) Effective for cost reporting periods commencing January 1, 1981 or thereafter, this cost assignment or allocation concept must be agreed to by the medical fiscal intermediary prior to the end of the reporting period. Once a basis has been approved, it will remain in effect until the provider initiates a subsequent request to change it.
(3) No prior approval is required for cost reporting periods ending December 31, 1980 or before.
(g) Central patient transportation.
[ 1616 ]
(1) Because patient transportation costs are relatively minor in most hospitals, direct assignment of this expense is not required. Such expense may be reported where incurred. However, since no patient transportation cost center is provided, those hospitals which maintain a central patient transportation department must report such expenses in the appropriate ancillary services cost centers. Patient visits or some other valid basis may be used for reclassifying such expenses.
(2) The expenses incurred in transporting patients to the Daily Hospital Services areas at the time of admission are to be assigned to the Inpatient Admitting cost center (account 8524). The expenses incurred in transporting patients who have been discharged are to be assigned to the Daily Hospital Services functional cost center from which the patient was discharged.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-4.170 Floors
(a) Floors and floor coverings of mobile food service establishments are to be maintained clean and in good repair and are to be smooth, durable and nonabsorbent. The use of sawdust, wood shavings, peanut hulls or similar material as a floor covering in food preparation and storage areas is prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.44 Betterment
An expenditure having the effect of extending the useful life of an existing fixed asset, increasing its normal rate of output, lowering its operating cost, increasing rather than merely maintaining efficiency or otherwise adding to the worth of benefits it can yield.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.3 Referrals
(a) The following primary referral sources shall, within two working days of identifying an infant or toddler who is less than three years of age and suspected of having a disability or at risk of having a disability, refer such infant or toddler to the official designated by the municipality, unless the child has already been referred or unless the parent objects: all individuals who are qualified personnel; all approved evaluators, service coordinators, and providers of early intervention services; hospitals; child health care providers; day care programs; local health units; local school districts; local social service districts including public agencies and staff in the child welfare system; public health facilities; early childhood direction centers; domestic violence shelters and agencies; homeless family shelters; and, operators of any clinic approved under article 28 of Public Health Law, article 16 of the Mental Hygiene Law, or article 31 of the Mental Hygiene Law.
(1) A primary referral source who has identified an infant or toddler suspected of having a disability shall:
(i) provide a general explanation of the services that are available under the Early Intervention Program and the benefits to the child’s development and to the family of accessing those services;
(ii) inform the parent that, unless the parent objects, their child will be referred to the early intervention official for purposes of a free screening and/or multidisciplinary evaluation or, with parent permission, a review of medical or other records to determine eligibility for services;
(iii) whenever feasible, inform the parent about such referral in their dominant language or other mode of communication; and
(iv) ensure the confidentiality of all information transmitted at the time of referral.
(2) A primary referral source who has identified an infant or toddler at risk of a disability shall:
(i) provide a general explanation of the developmental screening, home visiting, and tracking services that are available to the family, including municipal child find programs and the benefits to the child’s development and to the family of accessing those services;
(ii) inform the parent that, unless the parent objects, their child will be referred to the designated county official for the purposes of developmental screening, home visiting, and tracking services, which may include enrollment in municipal child find programs;
(iii) whenever feasible, inform the parent about such referral in their dominant language or other mode of communication; and
(iv) ensure the confidentiality of all information transmitted at the time of referral.
(3) When a parent objects to the referral the primary referral source shall:
(i) maintain written documentation of the parent’s objection to the referral and follow-up actions taken by the primary referral source;
(ii) provide the parent with the name and contact information of the early intervention official if the child is suspected of having a disability or if the child is at-risk; and
(iii) within two months, make reasonable efforts to follow-up with the parent, and if appropriate, refer the child unless the parent objects.
(b) Information transmitted in a referral from a primary referral source, for an infant or toddler suspected of having a disability or at risk of developing a disability, shall consist of only the following information, unless written consent is obtained from a parent to the transmittal of further information to the early intervention official:
(1) the child’s name, sex, race, ethnicity, and birth date;
(2) the name, address and telephone number of the parent and/or if applicable, the person in parental relation to the child;
(3) when necessary and applicable, the name and telephone number of another person through whom the parent may be contacted;
(4) if the child is being referred because he or she is at risk of developing a disability, the referral shall include an indication that the child is not suspected of having a disability, but is at risk of developing a disability in the future; and
(5) name and telephone number of the primary referral source.
(c) Referrals may be made at any time by parents via telephone, facsimile, the department's secure web site, in writing or in person.
(d) Referrals of children suspected of having a disability, which includes a developmental delay and/or a diagnosed physical or mental condition that has a high probability of resulting in developmental delay, shall be based on:
(1) the results of a developmental screening or diagnostic procedure(s); direct experience, observation, and perception of the child’s developmental progress;
(2) information provided by a parent which is indicative of the presence of a developmental delay or disability;
(3) or a request by a parent that such referral be made.
(e) Primary referral sources identified in subdivision (a) of this section shall, with parental consent, complete and transmit at the time of referral, a referral form developed by the department. The referral form shall contain information sufficient to document the primary referral source’s basis for suspecting the child has a disability or is at risk of having a disability. Where applicable, the referral form shall specify the child’s diagnosed condition, or the child’s level of functioning in one or more developmental areas, that may constitute a developmental delay that may establish the child’s eligibility for the Early Intervention Program. The primary referral source shall inform the parent of a child with a diagnosed condition that has a high probability of resulting in developmental delay, or a diagnosed level of delay consistent with eligibility requirements in section 69-4.23(a)(2) of this Subpart:
(1) that eligibility for the program may be established by medical or other records; and
(2) of the importance of providing consent for the primary referral source to transmit records or reports necessary to support the diagnosis, or, for parents or guardians of children who do not have a diagnosed condition, records or reports that would assist in determining eligibility for the program.
(f) Diagnosed physical and mental conditions with a high probability of developmental delay include:
(1) chromosomal abnormalities associated with developmental delay ( e.g., Down Syndrome);
(2) syndromes and conditions associated with delays in development ( e.g., fetal alcohol syndrome);
(3) neuromuscular disorder ( e.g., any disorder known to affect the central nervous system, including cerebral palsy, spina bifida, microcephaly or macrocephaly);
(4) clinical evidence of central nervous system (CNS) abnormality following bacterial/viral infection of the brain or head/spinal trauma;
(5) hearing impairment (a diagnosed hearing loss that cannot be corrected with treatment or surgery);
(6) visual impairment (a diagnosed visual impairment that cannot be corrected with treatment [including glasses or contact lenses] or surgery);
(7) diagnosed psychiatric conditions, such as reactive attachment disorder of infancy and early childhood; (symptoms include persistent failure to initiate or respond to primary caregivers; fearfulness and hypervigilance that does not respond to comforting by caregivers; absence of visual tracking); and
(8) emotional/behavioral disorder (the infant or toddler exhibits atypical emotional or behavioral conditions, such as delay or abnormality in achieving expected emotional milestones such as pleasurable interest in adults and peers; ability to communicate emotional needs; self-injurious/persistent stereotypical behaviors).
(g) Referrals of children at risk of having a disability shall be made based on the following medical/biological risk factors:
(1) Medical/biological neonatal risk criteria, including:
(i) birth weight less than 1501 grams;
(ii) gestational age less than 33 weeks;
(iii) central nervous system insult or abnormality (including neonatal seizures, intracranial hemorrhage, need for ventilator support for more than 48 hours, birth trauma);
(iv) congenital malformations;
(v) asphyxia (Apgar score of three or less at five minutes);
(vi) abnormalities in muscle tone, such as hyper- or hypotonicity;
(vii) hyperbilirubinemia (> 20mg/dl);
(viii) hypoglycemia (serum glucose under 20 mg/dl);
(ix) growth deficiency/nutritional problems ( e.g., small for gestational age; significant feeding problem);
(x) presence of inborn metabolic disorder (IMD);
(xi) perinatally- or congenitally-transmitted infection ( e.g., HIV, hepatitis B, syphilis);
(xii) 10 or more days hospitalization in a neonatal intensive care unit (NICU);
(xiii) maternal prenatal alcohol abuse;
(xiv) maternal prenatal abuse of illicit substances;
(xv) prenatal exposure to therapeutic drugs with known potential developmental implications ( e.g., psychotropic medications, anticonvulsant, antineoplastic);
(xvi) maternal PKU;
(xvii) risks of hearing loss based on family history, including syndromal presentation, or failure of initial newborn infant hearing screening and the child is in need of follow-up screening;
(xviii) risk of vision impairment, including family history of conditions causing blindness or severe vision impairment; and
(xiv) presence of a genetic syndrome that may confer increased risk for developmental delay, except for those syndromes such as Down syndrome which require referral of the child as suspected of having a disability in accordance with subdivisions (d) and (e) of this section.
(2) Medical/biological post-neonatal and early childhood risk criteria, including:
(i) parental or caregiver concern about developmental status;
(ii) serious illness or traumatic injury with implications for central nervous system development and requiring hospitalization in a pediatric intensive care unit for 10 or more days;
(iii) elevated venous blood lead levels (at or above 15 mcg/dl);
(iv) growth deficiency/nutritional problems ( e.g., significant organic or inorganic failure-to-thrive, significant iron-deficiency anemia);
(v) chronicity of serous otitis media (continuous for a minimum of three months);
(vi) HIV infection;
(vii) indicated case of child abuse or maltreatment.
(h) The following risk criteria may be considered by the primary referral source in the decision to make a referral:
(1) no prenatal care;
(2) parental developmental disability or diagnosed serious and persistent mental illness;
(3) parental substance abuse, including alcohol or illicit drug abuse;
(4) no well child care by six months of age or significant delay in immunizations; and/or
(5) other risk criteria as identified by the primary referral source.
(i) When the child is in the care and custody or custody and guardianship of the local social services district, the early intervention official shall notify the local social services commissioner or designee that the child has been referred.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.16 Personnel
All persons handling food are to be free from infectious disease which can be transmitted by foods, and are not to have a boil, infected cut or sore, or respiratory disease. They are to wear clean clothing, not smoke or use tobacco while handling food or in food preparation areas, and use hair restraints to minimize hair contact with hands, food and food-contact surfaces. All personnel handling food are to wash their hands with soap and water after using the toilet, smoking, eating, or when soiled. Living and sleeping quarters are to be separate from food operation areas.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.25 Disclosure of nursing quality indicators
(a) Definitions.
For purposes of this section, the following terms shall have the following meanings:
(1) Acuity means the nursing care requirements of patients or residents.
(2) Case mix means the differences in patients or residents within a population in terms of their physical and mental conditions, and the resources that are used in their care.
(3) Fall means:
(i) for general hospitals, an unplanned descent to the floor with or without injury to the patient including unassisted and assisted descents whether they result from physiological or environmental reasons; and
(ii) for nursing homes, an unintentional change in position coming to rest on the ground, floor or onto the next lower surface with or without injury to the resident including intercepted falls.
(4) Fall injury level means:
(i) for general hospitals, the degree of injury resulting from a fall and designated as moderate, major or fatal. For purposes of this subparagraph: moderate injuries involve suturing, application of steri-strips/skin glue, splinting or muscle/joint strain; major injuries involve surgery, casting or traction, or require consultation to rule out neurological or internal injury or patients with coagulopathy that receive blood products as a result of the fall; and fatal falls involve injuries that cause the patient’s death but do not include falls caused by physiologic events; and
(ii) for nursing homes, the degree of injury resulting from a fall designated as major involves bone fractures, joint dislocations, closed head injuries with altered consciousness or subdural hematoma.
(5) Healthcare setting associated infection means any localized or systemic patient condition that:
(i) resulted from the presence of an infectious agent or its toxin(s) as determined by clinical examination or by laboratory testing; and
(ii) was not found to be present or incubating at the time of admission unless the infection was related to a previous admission to the same setting.
(6) Licensed practical nurse means a person who is licensed and currently registered as a licensed practical nurse pursuant to article 139 of the New York State Education Law.
(7) Patient includes a resident of a nursing home.
(8) Patient care staff means unit-based registered nurses, licensed practical nurses and unlicensed personnel providing direct patient care greater than 50 percent of their shift.
(9) Patient day is the average number of patients a unit has per shift during a 24 hour period.
(10) Pressure ulcer means a localized injury to the skin and/or underlying tissue as a result of pressure or pressure in combination with shear acquired after admission to a healthcare facility.
(11) Registered nurse means a person who is licensed and currently registered as a registered professional nurse pursuant to article 139 of the New York State Education Law.
(12) Shift means a 24 hour period of time as a whole or divided into parts as appropriate to the reporting facility.
(13) Unit means a distinct location providing patient care in a general hospital or nursing home distinguished from other distinct locations by name, number or other patient-specific factors.
(14) Unlicensed personnel means individuals trained to function in an assistive role to nurses in the provision of patient care, as assigned by and under the supervision of the registered nurse.
(b) Nurse staffing indicators are:
(1) the total number of productive hours of care provided by patient care staff per patient day for each unit, and the number and percentage of productive hours of care provided by registered nurses, licensed practical nurses and unlicensed personnel each; and
(2) the average registered nurse and licensed practical nurse to patient ratio for each unit and on each shift.
(c) Nurse-sensitive patient outcome indicators for general hospitals are:
(1) falls with injury rate as indicated by the frequency in which falls result in a fall injury level of moderate, major or fatal per applicable unit calculated no less often than quarterly;
(2) health care acquired pressure ulcers as indicated by the percentage of patients with facility-acquired pressure ulcer(s) of the skin that are determined to be stages II, III, IV, unstageable and suspected deep tissue injury per applicable unit calculated no less often than quarterly;
(3) healthcare setting associated infection rates per applicable unit calculated no less often than quarterly for the following:
(i) central line associated blood stream infection;
(ii) catheter associated urinary tract infection; and
(iii) ventilator associated (pneumonia) event.
(d) Nurse-sensitive patient outcome indicators for nursing homes are:
(1) percent of long-stay residents who experienced one or more falls with major injury;
(2) percentage of short-stay residents who have medical conditions that predispose them to developing a facility-acquired pressure ulcer with new or worsening pressure ulcers Stage II-IV; and
(3) percentage of long-stay residents with urinary tract health care setting associated infections.
(e) Within 30 days of a written request, general hospitals and nursing homes shall provide to the requester in hard copy or an electronic copy such as a portable document format (pdf) file, the following information for a three to twelve month period of time that is not more than one year prior to the date of the request:
(1) nurse staffing indicators and nurse-sensitive patient outcome indicators specified in this section;
(2) the procedures and processes used for determining and adjusting staffing levels based on patient case mix and acuity;
(3) the final conclusions of any complaint investigations filed with any state or federal regulatory agency or accrediting agency and any citations resulting from surveys; and
(4) the sources and dates for data disclosed.
(f) Facilities shall have policies and procedures for documentation and management of requests and responses to requests under this section. Documentation of requests and responses to requests under this section shall be kept for a period of no less than two years from the date the request for information was received.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-4 MENTAL HEALTH AND SUBSTANCE USE DISORDERTREATMENT PARITY COMPLIANCE PROGRAM
10 CRR-NY 98-4.4 Mental health and substance use disorder parity compliance program
(a) Every MCO shall adopt and implement a compliance program that shall include at a minimum:
(1) designation of an appropriately experienced individual who shall:
(i) be responsible for assessing, monitoring, and managing parity compliance;
(ii) report directly to the MCO’s chief executive officer or other senior manager; and
(iii) report no less than annually to the MCO’s board of directors or other governing body, or the appropriate committee thereof, on the activities of the compliance program;
(2) written policies and procedures that implement the compliance program, and that describe how the MCO’s parity compliance is assessed, monitored, and managed, including:
(i) a system for assigning each benefit to the defined benefit classifications as required by MHPAEA;
(ii) methodologies for the identification and testing of all financial requirements and quantitative treatment limitations; and
(iii) methodologies for the identification and testing, including a comparative analysis, of all non-quantitative treatment limitations that are imposed on mental health or substance use disorder benefits;
(3) methodologies for the identification and remediation of improper practices, as described in paragraph (b)(1) of this section;
(4) a system for the ongoing assessment of parity compliance, which shall include:
(i) review of a statistically valid sample of preauthorization, concurrent, and retrospective review denials for mental health and substance use disorder benefits to ensure such determinations were consistent with the clinical review criteria approved by the commissioner of mental health or designated by the commissioner of addiction services and supports, in consultation with the superintendent of financial services and the commissioner, and that such criteria have been applied comparably to and no more stringently than criteria applied to medical or surgical benefits;
(ii) review of the comparability of coverage within each benefit classification for mental health and substance use disorder benefits to ensure that coverage for a comparable continuum of services is available for mental health and substance use disorder benefits as is available for medical or surgical benefits, including residential and outpatient rehabilitation services;
(iii) review of the percentage of services provided by out-of-network providers for mental health and substance use disorder benefits where no in-network provider was available, compared to the percentage of services provided by out-of-network providers for medical and surgical benefits where no in-network provider was available, to ensure that the processes and strategies for the recruitment and retention of mental health and substance use disorder providers are effective in reducing disparities in out-of-network use and to ensure that there is an adequate network of mental health and substance use disorder providers to provide services on an in-network basis;
(iv) review of provider credentialing policies and procedures to ensure that the documentation and qualifications required for credentialing mental health and substance use disorder providers are comparable to and applied no more stringently than the documentation and qualifications required for credentialing medical or surgical providers and to ensure that there is an adequate network of mental health and substance use disorder providers to provide services on an in-network basis;
(v) review of the average length of time to negotiate provider agreements and negotiated reimbursement rates with network providers and methods for the determination of usual, customary and reasonable charges, to ensure that reimbursement rates for mental health and substance use disorder benefits are established using standards that are comparable to and applied no more stringently than the standards used for medical or surgical benefits and to ensure that there is an adequate network of mental health and substance use disorder providers to provide services on an in-network basis;
(vi) review of MCO policies for the automatic or systematic lowering, non-payment or application of a particular coding for mental health and substance use disorder benefits to ensure that they are comparable to and applied no more than stringently than MCO policies for the automatic or systematic lowering, non-payment or application of a particular coding for medical or surgical benefits;
(vii) review of all mental health and substance use disorder medications subject to nonquantitative treatment limitations, including step-therapy protocols or other preauthorization requirements, to ensure that the factors such as cost and latency periods, processes, strategies, and evidentiary standards the insurer relied upon to determine whether to apply the nonquantitative treatment limitation were comparable to and applied no more stringently than the factors, processes, strategies, and evidentiary standards the insurer relied upon to determine whether to apply nonquantitative treatment limitations, including step therapy or other preauthorization requirements, to medications to treat medical or surgical conditions;
(viii) review of any fail-first requirements applicable to mental health or substance use disorder benefits to ensure that they are comparable to and applied no more stringently than any fail-first requirements applicable to medical or surgical benefits; and
(ix) review of any restrictions based on geographic location, facility type, provider specialty, or other criteria applicable to mental health or substance use disorder benefits to ensure that any such restriction is comparable to, and applied no more stringently than, any restriction applicable to medical or surgical benefits;
(5) a process for the actuarial certification in compliance with actuarial standards of practice, of the data used for, and the outcome of, the analyses of the financial requirements and quantitative treatment limitations applicable to mental health and substance use disorder benefits to ensure that they are no more restrictive than the predominant financial requirements and quantitative treatment limitations applied to substantially all the medical and surgical benefits;
(6) training and education on federal and state mental health and substance use disorder parity requirements for all employees, directors, or other governing body members, agents, and other representatives engaged in functions that are subject to federal or state mental health and substance use disorder parity requirements or involved in analysis as a part of the compliance program; provided that such training shall occur at least annually and shall be made a part of the orientation for such new employees, directors, or other governing body members, agents, and other representatives;
(7) the methods by which employees, directors or other governing body members, agents, and other representatives may report parity compliance issues to the individual responsible for compliance, as described in subdivision (a) of this section; provided that such methods shall include a method for anonymous and confidential reporting of potential compliance issues as they are identified; and
(8) a policy of non-intimidation and non-retaliation for good faith participation in the compliance program, including reporting and investigating potential issues and reporting to appropriate officials as provided in Labor Law sections 740 and 741.
(b) Improper practices prohibited.
(1) The following shall be considered improper practices related to mental health and substance use disorder benefits:
(i) implementing a utilization review policy that uses standards to determine the level of documentation required for utilization review of mental health or substance use disorder benefits that are not comparable to or are applied more stringently than the standards used to determine the level of documentation required for the utilization review of medical or surgical benefits, including the submission of medical records, treatment plans, or evidence of patient involvement or motivation in care or patient response to treatment;
(ii) requiring preauthorization, concurrent, or retrospective utilization review for a higher percentage of mental health or substance use disorder benefits in the absence of defined clinical or quality triggers, as compared to medical or surgical benefits;
(iii) implementing a methodology for developing and applying provider reimbursement rates for mental health or substance use disorder benefits that is not comparable to or is applied more stringently than the methodology for developing and applying provider reimbursement rates for medical or surgical benefits; and
(iv) implementing claim edits or system configurations that provide for higher rates of approval through auto-adjudication for claims for inpatient medical or surgical benefits than for inpatient mental health or substance use disorder benefits.
(2) An MCO shall monitor for and detect improper practices as described in paragraph one of this subdivision and remediate or develop a plan to remediate any improper practices as soon as practicable, but in no event later than 60 days after discovery.
(3) An MCO shall provide written notification to affected enrollees and the commissioner and conspicuously post on the MCO’s website a notice regarding any identified improper practice described in paragraph (1) of this subdivision, including a description of the MCO’s efforts to remediate the improper practice or its plan for remediation, within 60 days of discovery of the improper practice.
(c) An MCO shall be responsible for and coordinate parity compliance monitoring activities with any agents and other representatives providing benefit management services or performing utilization review activities on behalf of the MCO.
(d) Annual certification.
(1) By December 31, 2021 and annually thereafter, each MCO shall electronically submit a written certification to the commissioner that the MCO satisfactorily meets the requirements of this Subpart.
(2) Such certification shall be in a form prescribed by the commissioner and signed by the MCO’s chief executive officer or the individual responsible for assessing, monitoring, and managing the compliance program, attesting to the best of such individual’s knowledge and belief that the information contained therein is true and that a copy of the certification has been provided to the MCO’s board of directors or other governing body, or the appropriate committee thereof.
(e) Exemptions from electronic filing and submission requirements.
(1) An MCO required to make an electronic filing or a submission pursuant to this subpart may apply to the commissioner for an exemption from the requirement that the filing or submission be electronic by submitting a written request to the commissioner for approval at least 30 days before the MCO is required to submit to the commissioner the particular filing or submission that is the subject of the request.
(2) The request for an exemption shall:
(i) set forth the MCO’s NAIC number, if applicable;
(ii) identify the specific filing or submission for which the MCO is applying for the exemption;
(iii) specify whether the MCO is making the request for an exemption based upon undue hardship, impracticability, or good cause, and set forth a detailed explanation as to the reason that the commissioner should approve the request; and
(iv) specify whether the request for an exemption extends to future filings or submissions, in addition to the specific filing or submission identified in paragraph (2) of this subdivision.
(3) The MCO requesting an exemption shall submit, upon the commissioner’s request, any additional information necessary for the commissioner to evaluate the MCO’s request for an exemption.
(4) The MCO shall be exempt from the electronic filing or submission requirement upon the commissioner’s written determination so exempting the MCO, where the determination specifies the basis upon which the commissioner is granting or denying the request and to which filings or submissions the exemption applies.
(5) If the commissioner approves an MCO’s request for an exemption from the electronic filing or submission requirement, then the MCO shall make a physical filing in a form acceptable to the commissioner.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE OPERATION FOOD VENDING MACHINE OPERATION
10 CRR-NY 14-5.21 Definition of food processing establishment
A food processing establishment is a commercial establishment operated under license or permit of an appropriate regulatory authority where food is manufactured or packaged for human consumption at another establishment or place.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 106 CHEMUNG COUNTY
10 CRR-NY 106.1 City of Elmira
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to all the natural and artificial reservoirs of Hoffman Creek and all watercourses tributary thereto or ultimately discharging into said reservoirs of the public water supply of the City of Elmira.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the main storage and impounding reservoir on Hoffman Creek or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the main storage and impounding reservoir on Hoffman Creek.
(3) Wherever a linear distance of a structure or object from the reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object of the high-water mark of the reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies.
(1) No privy, privy vault, cesspool or other receptacle of any kind used for either the temporary storage or permanent deposit of human excreta shall be constructed or maintained within 200 feet of any reservoir of the water supply of the City of Elmira or within 50 feet of any watercourse tributary to such reservoir, except a properly constructed and operated sewage disposal plant as hereinafter provided for in paragraph (d)(2) of this section; provided, however, that the property on which the said receptacle is built or to be built is so located or bounded that the distance above named can be obtained within the limits of such property.
(2) Every such receptacle built on property where the distances in paragraph (1) of this subdivision cannot be obtained within the limits of said property shall be placed as far as practicable from the said reservoir or watercourse and be specially constructed of concrete or metal, enclosed in concrete or masonry to form a watertight receptacle from which no outward percolation can take place or be provided with removable watertight vessels or containers. Every such watertight receptacle or container constructed or provided in accordance with this paragraph shall be emptied and disinfected at regular intervals or as often as may be necessary to maintain them in a proper sanitary condition and to prevent any overflow from such receptacles or containers. In the case of properties occupied only during the summer season the said receptacles or containers shall in addition be emptied at the end of the summer season, disinfected with lime and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done under the supervision or in accordance with the directions of the Elmira water board and in such a manner as to effectually prevent any pollution of the water in said reservoir or watercourse.
(3) In effecting the removal of the excreta from the above mentioned watertight receptacles or containers the utmost care shall be exercised that none of the contents be allowed to escape in being transferred to the place of disposal hereinafter specified and the contents shall be thoroughly covered and transferred in a manner to cause the least possible annoyance to the occupants of the premises or of any adjoining premises.
(4) Unless otherwise specifically ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth not less than 18 inches below the surface in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance from any reservoir of not less than 300 feet and from any watercourse of not less than 200 feet.
(5) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse then the said privy or receptable for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No house slops, bath water or sewage from any source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided under paragraph (2) of this subdivision, nor any garbage, putrescible matter, kitchen wastes, refuse or waste from any creamery, cheese factory, cider mill or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted matter or liquid of any kind shall be thrown or discharged into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be allowed to escape, flow or remain upon the surface of the ground or to percolate into or through the ground within a distance of 100 feet of any reservoir or 50 feet of any watercourse.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into the reservoir or any watercourse tributary to the public water supply of the city of Elmira, shall be constructed, enlarged, altered or put in operation until plans for the same shall have been approved and a permit issued by the State Commissioner of Health allowing the discharge of such effluent and a copy of the plans, as approved, filed with the Elmira water board.
(3) No person shall bathe nor shall any cattle, poultry, swine or other animals be allowed to stand, wade, swim or be washed in the waters of any reservoir or watercourse.
(e) Animals.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or 25 feet of any watercourse, and none of the above named objects or sources of pollution shall be constructed, placed or allowed to remain where or in such manner that the drainings, leachings or washings therefrom may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a less distance than 100 feet of the reservoir or 25 feet of any watercourse, provided, however, that in case the ground on which any stable for horses or cattle is built shall be located, bounded or placed that the distances above named cannot be obtained, then the stable shall be located as far as practicable from the reservoir or watercourse and an impervious floor constructed so as to drain to one point from which a watertight pipe line shall lead to a watertight pit or receptacle, the top of which shall in all cases be above the highest known water level of the reservoir or watercourse. All urine from horses and cattle so stabled shall be led to this pit or receptacle and all the manure from this stable shall be received or deposited in a concrete manure pit that shall also be watertight. Both such pits or receptacles shall be regularly emptied and their contents so disposed of on land that no drainage, leachings or washings therefrom shall enter the reservoir or any watercourse without proper purification as indicated above in this same paragraph.
(2) No dead animals, birds, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or pass into the reservoir or any watercourse of the water supply, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach the reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet of the reservoir or 50 feet of any watercourse.
(f) [Boating and fishing.]
No boating of any kind or fishing from boats or through the ice shall be allowed in or upon the water or ice of the reservoir, and no ice cutting or trespassing whatever shall be allowed in or upon the water or ice of the reservoir, except necessary maintenance by the Elmira water board or their duly authorized representatives or employees.
(g) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of the reservoir and 100 feet of any watercourse.
(h) Cemeteries.
No interment of a human body shall be made within 300 feet of the reservoir and 100 feet of any watercourse.
(i) Inspections.
The Elmira water board or such other board, body or person as may be charged with the maintenance of the public water supply shall make or cause to be made regular and thorough inspections of the reservoir, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water board to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the Elmira water board to promptly notify the State Commissioner of Health of such violations. The Elmira water board shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(j) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the city of Elmira.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 125 MONROE COUNTY
CITIES CITIES
10 CRR-NY 125.1 City of Rochester
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as heretofore set forth, shall apply to Hemlock and Canadice lakes and to all watercourses and drainage areas tributary thereto, which serve as sources of the public water supply of the City of Rochester, Monroe County, NY.
(b) Definitions.
(1) The term lakes wherever used in this section is intended to mean and refer to Hemlock and Canadice lakes and to that part of the outlet of Canadice Lake tributary to the public water supply of the City of Rochester.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs), stream, ditch, gutter or other channel of every kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Rochester, NY.
(3) Wherever a linear distance of a structure or object from a lake or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Zones and distances.
For the purpose of graduating the severity of the subdivisions in their application to different parts of the watershed so as to conform to the varying degrees of danger to the water supply, the streams and drainage areas are divided into zones as bounded and described in the following schedules.
(1) Schedule I.
(i) Zone 1. Comprises Hemlock and Canadice Lakes and that part of the outlet of Canadice Lake from the lake to the diversion dam, together with all watercourses and drainage areas tributary thereto, north of the southerly or inlet ends of these lakes.
(ii) Zone 2. Comprises the remaining watercourses and drainage areas tributary to Hemlock and Canadice Lakes that are not included in zone 1 and which serve as sources of the public water supply of the City of Rochester.
(2) Schedule II: Least permissible distances of sources of pollution from Hemlock and Canadice lakes and tributary watercourses.
The several sources of pollution existing throughout the two zones and specified in the following subdivisions shall not be placed, maintained or allowed to remain within the following prohibited distances from Hemlock and Canadice Lakes and tributary watercourses.
| Sources of pollution as specified in the several subdivisions | | | | | | --- | --- | --- | --- | --- | | Least permissible distances from reservoirs and watercourses | | | | | | | | | Zone 1 | Zone 2 | | | Subdivision | Lakes | Watercourses | Watercourses | | (d)(1) | Privies, any type | 50 | 25 | 15 | | (d)(4) | Privies, not watertight | 100 | 50 | 50 | | (d)(6) | Burying human excreta, etc. | 300 | 300 | 300 | | (e)(1) | Sewage | 100 | 50 | 50 | | (e)(3) | Garbage, sink wastes, waste matter from dairy or cheese factory, etc. | 50 | 25 | 15 | | (f)(1) | Bathing | 500 ft. of Canadice outlet | | | | | | 500 ft. of intakes on Hemlock | | | | (f)(2) | Stable, barnyard, hogpen, etc. | 50 | 15 | 10 | | (f)(3) | Spreading compost containing human excreta | 300 | 300 | 300 | | (f)(3) | Spreading animal manure on land | 50 | 15 | 10 | | (f)(4) | Vegetable wastes | 40 | 10 | 10 | | (g) | Dead animals, offal, etc. | 100 | 75 | 50 | | (h) | Fishing, boating, ice cutting | 500 ft. of Canadice outlet | | | | | | 500 ft. of intakes on Hemlock | | | | (i) | Camps | 200 | 100 | 75 | | (j) | Cemeteries | 100 | 100 | 100 |
(d) Privies adjacent to any lakes or watercourses.
(1) No privy, privy vault, pit or receptacle of any kind, used for either the temporary storage or the permanent deposit of human excreta, shall be placed, maintained or allowed to remain within 50 feet of the lakes or within 25 feet of any watercourse in zone 1 or within 15 feet of any watercourse in zone 2, tributary to the public water supply of the City of Rochester, except the properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (e), provided, however, that the property on which the privy, privy vault, pit or other receptacle intended for the deposit of human excreta is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle, used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distances named in paragraph (1) of this subdivision cannot be obtained within the limits of such property, shall be placed as far as possible from the lakes or any watercourse tributary to the public water supply of the City of Rochester and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight vessels or receptacles are provided, they shall be placed in watertight concrete or masonry receptacles and shall be located as far as practicable from the lakes or watercourses tributary to the public water supply of the City of Rochester. All receptacles referred to in this paragraph shall be constructed only with the approval of and under the supervision of the bureau of water of the City of Rochester and so located that the tops of such receptacles shall be above the highest known water level of the lakes or tributary watercourses.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind used for either the temporary storage or permanent deposit of human excreta is especially constructed and made watertight and located nearer any lake or tributary watercourse than the distances named in paragraph (1) of this subdivision, such receptacle shall be emptied at regular intervals and disinfected as often as may be necessary to maintain it in a proper sanitary condition and to effectually prevent any overflow and in the case of the properties occupied by the owners during the summer, the said receptacles shall be emptied at least once every fall at the end of the summer season, disinfected with lime and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with directions of the bureau of water of the City of Rochester and in such a manner as to effectually prevent any pollution of the public water supply of the City of Rochester.
(4) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta which is not watertight shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any lake or within 50 feet of any watercourse tributary to the public water supply of the City of Rochester. Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed in paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (4) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles which shall at all times be deposited as set forth in paragraphs (5) and (6) of this subdivision.
(5) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance or inconvenience be caused to occupants of the premises or of the adjoining premises.
(6) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet of any lake or watercourse tributary to the public water supply of the City of Rochester.
(7) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of the subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil into any lake or watercourse tributary to the public water supply of the City of Rochester, then the said privy or receptacle for excreta or trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such places as shall be considered safe and proper by the State Commissioner of Health.
(e) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry waste, sewage or excremental matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed and operated sewage disposal plant as hereinafter provided in paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any lake or watercourse tributary to the public water supply of the City of Rochester, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (d), within 100 feet of any lake and within 50 feet of any watercourse tributary to the public water supply of the City of Rochester.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any lake or watercourse tributary to the public water supply of the City of Rochester, shall be operated, constructed, enlarged, altered or put in operation without a permit from the State Commissioner of Health. All sewage disposal plants on the watersheds of lakes or watercourses tributary to the public water supply of the City of Rochester shall be operated and maintained under the supervision of the bureau of water of the City of Rochester.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant as heretofore provided under paragraph (2) of this subdivision, shall be thrown or discharged into any lake or watercourse tributary to the public water supply of the City of Rochester. nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (d), within 50 feet of any lake and 25 feet of any watercourse in zone 1 or within 15 feet of any watercourse in zone 2 tributary to the public water supply of the City of Rochester.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any lake or watercourse tributary to the public water supply of the City of Rochester.
(f) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in Canadice Lake within 500 feet of the outlet or in that part of the Canadice outlet extending from the lake to the diversion dam nor in Hemlock Lake within 500 feet of the intakes of the public water supply nor along the shores of Hemlock Lake on property owned by the city, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in Hemlock or Canadice lake or the outlet stream of Canadice Lake, within the above described limits. No watering place of any kind shall be maintained in any was as to pollute with muddy leachings or excremental matter any streams tributary to the public water supply of the City of Rochester.
(2) No stables for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 50 feet of any lake and 15 feet of any watercourse in zone 1 or within 10 feet of any watercourse in zone 2 tributary to the public water supply of the City of Rochester.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any lake or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the City of Rochester, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 300 feet of any lake or watercourse tributary to the public water supply of the City of Rochester, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet of any lake and 15 feet of any watercourse in zone 1 or 10 feet of any watercourse in zone 2 tributary to the public water supply of the City of Rochester.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any lake or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any lake or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 40 feet of any lake and 10 feet of any watercourse tributary to the public water supply of the City of Rochester.
(g) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any lake or watercourse tributary to the public water supply of the City of Rochester, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such lake or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptable lines of drainage for a distance of 100 feet of any lake and 75 feet from any watercourse in zone 1 or 50 feet of any watercourse in zone 2 tributary to the public water supply of the City of Rochester.
(h) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Canadice Lake within 500 feet of the outlet or in that part of Canadice outlet extending from the lake to the diversion dam nor within 500 feet of the intakes at Hemlock Lake nor along the shores of Hemlock Lake on property owned by the City of Rochester, except that boating or fishing may be allowed at the south end of Hemlock Lake on city-owned property upon permit issued by the commissioner of public works, such permit being revocable at any time by the commissioner of public works.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained on private property by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 200 feet of any lake and 100 feet of any watercourse in zone 1 or 75 feet of any watercourse in zone 2 tributary to the public water supply of the City of Rochester.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 100 feet from any lake or watercourse tributary to the public water supply of the City of Rochester.
(k) Inspections.
The bureau of water of the City of Rochester or such other board as may be charged with the maintenance or supervision of the public water supply of the City of Rochester or its duly appointed representatives shall make regular and thorough inspections of the lakes, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said bureau of water to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the bureau of water to promptly notify the State Commissioner of Health of such violations. The bureau of water shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(l) General clause.
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the City of Rochester.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.7 Employee Training
(a) Department employees are to be trained with respect to responsibilities and authorization to access personal health-related, information.
(b) Employees authorized by supervisors to access personal health-related information are to be advised in writing that they shall not:
(1) examine documents or computer data containing personal health-related information unless required in the course of official duties and responsibilities;
(2) remove from the unit or copy such documents or computer data unless acting within the scope of assigned duties;
(3) discuss the content of such documents or computer data with any person unless that person has authorized access and the need to know the information discussed; and
(4) illegally discriminate, abuse or harass a person to whom personal health-related information applies.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
REGISTRATION AND CONTINUING EDUCATION REGISTRATION AND CONTINUING EDUCATION
10 CRR-NY 89.20 Registration and continuing education
(a) Each person licensed pursuant to this Part must obtain a certificate of registration from the department prior to practicing radiology in this State. The department shall register each licensee who submits a completed registration application on a form supplied by the department, pays a fee of $20 per year, and provides evidence of completion of any continuing education requirements required by this section. Every practicing radiologic technologist shall have available for review by the department or other interested parties at all places of employment a copy of his/her current certificate of registration.
(b) Each registration shall authorize a licensee to practice radiologic technology for a period of up to four years and terminate on the registrant's birth date.
(c) Beginning January 1, 2010, each radiologic technologist, when applying to register pursuant to subdivision (a) of this section, must provide evidence of continuing education equivalent to 12 credit hours for each year of the registration cycle or 48 credit hours for a four year registration period. The 48 credits may be completed any time during the 48 months preceding the start of the renewal period.
(d) Notwithstanding any provision herein to the contrary, the department may waive the continuing education requirement of a licensee who has recently completed an education program in radiologic technology pursuant to section 89.10(a)(2) of this Part, and is applying for registration for the first time. Thereafter, to reregister the radiologic technologist must provide evidence of the continuing education credits in accordance with subdivision (c) of this section.
(e) All continuing education credits must be approved by an accrediting organization approved by the department.
(f) A copy of a current certificate of registration from an accrediting organization approved by the department is acceptable evidence to meet the continuing education requirement.
(g) The department may issue a conditional registration to a registrant who does not meet the continuing education requirements of this section provided that such applicant agrees to correct the deficiency within the conditional registration period, in addition to their regular continuing education to be applied to the next registration cycle.
(1) Conditional registrations shall be for no more than 180 days and shall not be renewable
(2) Failure to complete the required continuing education credits may be considered unethical conduct by the department.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.5 Amendments and modifications
All amendments to water quality treatment district plans and modifications to the approved plan of operation must be submitted to the State for approval before adoption.
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.4 Emergency health care requirements
(a)
(1) For 5,000 to 15,000 attendees, there shall be one emergency health care facility on site, staffed by a minimum of two emergency medical technicians, one ambulance staffed by at least one emergency medical technician, and the services of a physician available to the site within 15 minutes. Documentation shall be provided showing that local, municipal and public safety officials, including police, fire and local emergency medical service personnel, have been advised of the event in writing.
(2) For 15,001 to 30,000 attendees, there shall be two emergency health care facilities onsite, each staffed by two emergency medical technicians, one ambulance onsite, staffed by at least one emergency medical technician, and the services of a physician available to the site within 15 minutes. Documentation shall be provided showing that local, municipal and public safety officials, including police, fire and local emergency medical services personnel have been advised of the event in writing.
(3) For 30,001 to 50,000 attendees, there shall be two emergency health care facilities onsite, each staffed by two emergency medical technician, two ambulances onsite, each staffed by at least one emergency medical technicians, and a physician onsite. Documentation shall be provided showing that local, municipal and public safety officials, including police, fire and local emergency medical services personnel have been advised of the event in writing.
(4) For over 50,000 attendees, there shall be two emergency health care facilities onsite, each staffed by two emergency medical technicians, three ambulances onsite, each staffed by at least one emergency medical technician, a physician onsite and a written statement shall be available describing the impact the event will have on public safety and emergency medical services in the area, which must include comments by local police, fire, emergency medical services personnel and other public safety officials who have jurisdiction to provide services.
(b) Any modification of staffing or the method of providing emergency health care facilities or the onsite ambulance requirement of paragraph (a)(1) of this section is subject to approval of the permit-issuing official.
(c) Additional emergency medical services, ambulance service, equipment, supplies and personnel, as the permit-issuing official may require because of special circumstances, including but not limited to the location and nature of the event, accessibility to existing emergency medical services systems, access and weather conditions.
(d) A chronological log and individual record for each patient receiving emergency medical care shall be maintained on a form prescribed by the permit-issuing official. A copy of each report and the log are to be maintained on file by the function sponsor for seven years and available to the department upon request.
(e) Advanced life support (ALS) services may be substituted for the physician on call or site if the ALS is at the 3 or 4 level as described in section 800.45(d) of this Title and with the approval of the permit-issuing official.
(f) The permit holder shall file any report, following the event, as may be required by the permit-issuing official.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MOBILE FOOD SERVICE ESTABLISHMENTS MOBILE FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-4.30 Definition of mobile food service establishment and pushcart
(a) A mobile food service establishment is a self-contained food service operation, located in a vehicle or a movable stand, self-or otherwise propelled, used to store, prepare, display or serve food intended for individual portion service.
(b) A pushcart is a cart or barrow, manually propelled, used to vend food intended for individual portion service.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 2 PUBLIC HEALTH NURSE 2
10 CRR-NY 11.42 Definition
The term public health nurse 2 shall mean a nurse who plans, provides, directs and evaluates nursing care in a variety of settings with the goal of improving health outcomes and is actively involved in the planning, development, provision and evaluation of public health programs designed to prevent disease and improve the health of individuals, families, specific populations, high-risk groups and/or communities. The public health nurse 2 is also involved in program administration and/or program budget development and monitoring and/or quality improvement initiatives, and/or acting as advocate and liaison for constituents.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.292 Replacement cost
(a) The cost of an acquired asset or asset part, capitalizable if the cost of its retired counterpart is removed from the asset account.
(b) The cost at current prices, in a particular locality or market area, of replacing an item or property or a group of assets.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.2 Application
These regulations apply to physicians and other persons authorized by law to order laboratory tests or to make medical diagnoses, laboratories, blood banks, tissue banks and organ procurement organizations, to persons who receive confidential HIV-related information in the course of providing any health or social service and to persons who receive confidential HIV-related information pursuant to a release. These regulations do not apply to information which was received by the commissioner under Subpart 24-1 of this Title and protected from disclosure pursuant to Public Health Law, section 206(1)(j). These regulations do not apply to insurance institutions and insurance support organizations, except as noted in section 63.6(a)(9), (10) and (12) of this Part. Health care providers associated with or under contract to a health maintenance organization or other medical services plan are subject to these regulations.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.2 Application
(a) The requirements of this part shall apply to a mobile home park maintained for the placement of five or more mobile and/or manufactured homes except;
(1) a mobile home park at which the owner/operator receives no remuneration for any occupancy thereof; or
(2) any mobile home park operation determined by the State Commissioner of Health as not being within the intent or regulation of this Part.
(b) The requirements of this Part shall not apply to a migrant labor camp as defined in Part 15 of this Title or to a temporary residence as defined in Subpart 7-1 of this Title.
Part 15 MIGRANT FARMWORKER HOUSING
STANDARDS STANDARDS
10 CRR-NY 15.6 Housing, fire hazards; maintenance
(a) Requirements for new construction.
(1) No migrant farmworker housing facility, or any portion thereof, shall be constructed or enlarged for occupancy or use, and no property shall be converted for occupancy or use as a migrant farmworker housing facility without the permit-issuing official beeing first notified in writing. The required notice of construction, enlargement or connversion shall be submitted at least 30 days prior to beginning such construction on a form approved by the Commissioner of Health. The notice may be supplemented by such further information, plans or specifications as required by the permit-issuing official.
(2) All new construction including alterations, enlargements, conversions, or relocation of mobile homes, shall conform with the Uniform Code. A certificate of occupancy, or equivalent documentation to certify the construction was completed in conformance with Uniform Code requirements, must be obtained prior to occupancy, and be available for review on request by the permit-issuing official.
(b) General requirements.
A building or structure which is part of a migrant farmworker housing facility shall be structurally safe, adequate in size for its use, and easy to keep clean. Every foundation, roof and exterior wall, door, skylight and window shall be maintained to prevent entrance by rodents, weathertight and watertight, and shall be kept in sound condition and good repair. Porches, landings, stairs, and railings shall be maintained structurally sound and in good repair. Interior floors, walls, doors; and
ceilings shall be sound and in good repair.
(c) Flooring required in buildings.
A building used for accommodation of people in a migrant farmworker housing facility shall have a floor which is constructed of smooth, readily cleanable, durable material such as sealed concrete, close-grained wood or composition material. Floors and floor covering materials shall be maintained in cleanable condition and in good repair.
(d) Sleeping quarters.
Adequate sleeping quarters shall be provided.
(1) sleeping quarters shall contain at least 50 square feet of floor area for each occupant over two years of age.
(2) The required floor area in a room used for sleeping shall consist only of that part which has a height of at least five feet, and at least 80 percent of the required floor area shall have a minimun ceiling height of at least seven feet.
(i) In all housing facilities constructed after May 1, 1997, rooms used for sleeping are required to have a minimum ceiling height of seven and one-half feet.
(3) Adequate sleeping facilities shall be provided for each person. Such facilities shall consist of beds, cribs, or bunks, complete with required springs and mattresses. Every bed, bunk, crib, bed or bunk spring, mattress, pillow, sheet, pillow case, blanket or other bed cover, provided by the operator, shall be clean and in good condition at the time of issue.
(4) Each sleeping quarters shall contain adequate space for the storage of clothes and personal possessions of each occupant. As a minimum, this space shall include 21 square feet of wall storage area which has a minimum depth of 12 inches and is equipped with clothes rods or hooks and shelving for each occupant. Other provisions which provide equivalent storage capacity for each person may be substituted.
(5) Separate sleeping quarters for persons of each sex shall be provided except in the housing of families.
(6) There shall be a clear space of at least 27 inches above the sleeping surface of a bed or bunk.
(7) When a separate partitioned sleeping area is provided for parents having one or more children two years of age or over the partition shall be of sound construction and extend a minimum of six feet above the floor.
(e) Light and ventilation.
Adequate light and ventilation shall be provided in each habitable room, and in common use rooms and in areas, including: kitchens, dining rooms, mess halls, cooking areas, hallways, stairways, laundry rooms, shower rooms, privies and toilet rooms. Adequate artificial lighting and mechanical ventilation may be provided in lieu of natural light and ventilation in toilet rooms where approved by the permit issuing official.
(1) For sleeping quarters, kitchens, cooking areas, dining rooms, mess halls, toilet rooms and privies, natural light shall be provided by windows, transoms or skylights having a total area within the casements of at least 10 percent of the floor area of the room.
(2) Provision shall be made for natural ventilation in each sleeping quarters, dining room, kitchen, cooking area, mess hall, bathroom, washroom, public space, toilet room or privy, by providing that at least 40 percent of the area within casements required for light shall be capable of being opened.
(i) In all housing constructed after May 1, 1997, it is required that 50 percent of the required window area be capable of being opened.
(3) One or more ceiling or wall-type electric light fixtures which provide adequate lighting shall be installed in each habitable room, and all common use rooms or areas including: kitchen, cooking area, dining room, mess hall, bathroom, washroom, shower room, laundry room, hallways, stairways, public space, toilet room, and at each privy. At least one separate wall-type electric duplex outlet shall be provided in addition to the required electric light fixtures in each sleeping quarters, bathroom, washroom, laundry room, cooking and eating spaces. Additional electrical circuits and outlets may be required when problems with overloading or excessive use of extension cords are identified. The electric service, wiring, and fixtures shall be properly installed in accordance with the Uniform Code and be maintained in good repair and safe condition.
(f) Stoves.
All stoves, heating units or other sources of heat using combustible fuel shall be installed and vented in such a manner as to avoid both a fire hazard and a dangerous concentration of fumes or gas.
(1) No portable heaters or stoves, other than electrical, shall be provided or used. In a room with a combustible floor, there shall be a concrete slab, metal sheet or other fireproof material on the floor under any solid fuel burning stove or heating unit, extending 18 inches beyond the perimeter of the base of the unit. Any wall, ceiling or other combustible surface or material within 18 inches of a heating unit or chimney pipe shall be adequately protected with fire proof material or moved to a distance of 36 inches or greater from the heater or pipe. Stoves and heating units intended to be provided with a stovepipe shall have such stovepipe connected to the stove and discharging to the outside air or to a chimney. A stovepipe or vent pipe passing through a combustible wall, ceiling, floor or roof shall be installed with adequate fire protection.
(2) Electric stoves and portable electric heaters, and gas fueled space or water heaters, or any other heat producing equipment and applicances shall be adequately designed, installed and maintained.
(g) Fire exits.
A building in which people sleep or eat shall be provided with ready exit in case of fire and shall have at least two exits from each occupied floor. Where sleeping quarters are occupied above the ground floor, at least one outside exit from each floor above the ground floor is required. Windows in sleeping quarters two stories or less in height may constitute a required exit, if the sill is no more than three feet above the floor, the drop from the windowsill to an unobstructed area on the ground below is less than 14 feet, and the window has a minimum openable area of four square feet with a minimum dimension of 18 inches. Every sleeping room in which 10 or more individuals sleep shall have at least two exit doors which swing in the direction of exit travel and open to the outside of the building or to an interior hall. Any stairway extending beyond two occupied floors in a building shall have tight-fitting, self-closing doors which have a minimum three quarter hour fire rating at each floor level. The doors shall swing in the direction of exit travel. Stairways shall be enclosed within smoke-tight walls. All required exit pathways shall be maintained free and clear.
(h) Fire extinguishing equipment.
A minimum of a type 2A rated fire extinguisher shall be provided in a readily accessible location not more than 100 feet from each housing unit. In addition, a minimum of a type 5BC rated extinguisher shall be provided within 30 feet of all rooms containing cooking facilities. Any extinguisher with an equivalent A: BC rating may be provided.
(i) Fire and smoke detection devices.
Each dwelling unit shall have smoke detection devices that are adequately designed, installed and maintained in accordance with the Uniform Code. Battery operated devices are acceptable in existing construction.
(j) Heating.
All habitable rooms used or occupied between September 1 and June 1, including bathrooms, shower rooms and washrooms must have heating facilities which are properly installed and maintained, and which are capable of maintaining a minimum temperature of 68 degrees Fahrenheit in each room. Heating facilities may be required by the permit issuing official at housing facilities which are occupied at times other than noted above when the room temperature falls below 68 degrees Fahrenheit. When regulation of the temperature is not controlled by the occupants, the heating facilities must be operated to maintain minimum temperature requirements in all occupied habitable rooms during the specified time period.
(1) In housing constructed after May 1, 1997, all habitable rooms shall have heating equipment which is capable of maintaining a minimum temperature of 70 degrees Fahrenheit, and a minimum temperature of 70 degrees Fahrenheit shall be maintained as required.
(k) Screening of exterior openings.
Effective screening shall be provided for all windows and exterior openings of dwelling units. Screen doors shall be tight fitting and self-closing. All screening shall be maintained in good repair.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.32 Weekly bed census data survey
(a) Definitions.
As used in this section, the following terms shall have the following meanings:
(1) Communications directory ( directory ) shall mean a listing of all organizations with access to the HCS, ordered by type, and including the identity of and contact information for individuals at each organization who:
(i) perform specific job functions identified by the department; and/or
(ii) have access to perform certain data exchange functions on the HCS.
(2) HCS coordinator shall mean the individual designated by each organization with access to the HCS to be responsible for authorizing and managing accounts and maintaining other key information about the organization’s HCS users.
(3) Health commerce system ( HCS ) shall mean the department’s secure internet portal used for communications and information exchange with organizations including nursing homes and other health care providers or any successor system used for such information exchange as required by the department.
(4) Health electronic reporting data system ( HERDS ) shall mean the data reporting application on the HCS that houses the survey or any successor system used for such reporting as required by the department.
(5) Nursing home data reporter shall mean the name of the role in the directory that provides access to an individual designated by a nursing home to use HERDS.
(6) Nursing home weekly bed census survey ( survey ) shall mean an electronic survey used by each nursing home to report its bed census to the department using HERDS.
(7) Role shall mean the term used to indicate in the directory the specific job functions and HCS data exchange functions assigned to individuals by each organization.
(b) Submission of surveys.
(1) Each nursing home shall complete the survey on HERDS on a weekly basis by indicating, for each category of bed, the total number of certified or approved beds and the number of those beds that are available. The survey shall be submitted on a weekly basis by individuals at the nursing home who are assigned to the nursing home data reporter role within the directory.
(2) Nursing homes shall report bed census data reflecting the weekly census taken every Wednesday at 12:00 a.m. The nursing home’s designated nursing home data reporter shall enter and transmit the survey census data to the department between Wednesday at 12:01 a.m. and the following Tuesday at 11:59 p.m. Instructions for the survey will be available on the HCS.
(c) Designation of nursing home data reporters.
Nursing homes shall, through their HCS coordinators, designate a sufficient number of nursing home data reporters to ensure that the survey is submitted to the department in a timely manner.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 350 ALL PAYER DATABASE (APD)
10 CRR-NY 350.1 Definitions
For the purposes of this Part, these terms shall have the following meanings:
(a) All payer database or APD means the health care database maintained by the department or its contractor that contains APD data.
(b) APD data means covered person data, claims data, and any other such data contained within standard transactions for electronic data interchange (EDI) of health care data adopted by the X12 standards organization, the National Council for Prescription Drug Programs (NCPDP) standards organization, any other organizations designated by the Federal Department and Human Services to develop and maintain standard transactions for EDI of health care data, as provided in section 1320d-2 of title 42 of the United States Code (USC) or any other Federal Law, or any other format designated by the department for the collection of such data.
(c) Claims data means:
(1) benefits and coverage data – data specifying the benefits and coverage available to a covered person, such as cost-sharing provisions and coverage limitations and exceptions;
(2) health care provider network data – data related to the health care provider and service networks associated with third-party health care payer plans and products, such as the services offered, panel size, licensing/certification, national provider identifier(s), demographics, locations, accessibility, office hours, languages spoken, and contact information;
(3) post-adjudicated claims data – data related to health care claims, including payment data, that has been adjudicated by a third-party health care payer, such as the data included in the X12 post adjudicated claims data reporting and the NCPDP post adjudication standard transactions; and
(4) other health care payment data, such as value based payment information, as determined by the department.
(d) Covered person means a person covered under a third-party health care payer contract, agreement, or arrangement that is licensed to operate in New York State by the New York State Department of Financial Services.
(e) Covered person data means data related to covered persons, such as demographics, member identifiers, coverage periods, policy numbers, plan identifiers, premium amounts, and selected primary care providers.
(f) Data user means any individual or organization that the department has granted access to APD data, with or without identifying data elements.
(g) Health care provider means a provider of medical and other health services as defined in 42 USC section 1395x(s), a provider of services as defined in 42 USC section 1395x(u), and any other person or organization who furnishes, bills, or is paid for health care in the normal course of business. This includes a clinical laboratory, a pharmacy, an entity that is an integrated organization of health care providers, and an accountable care organization described in 42 USC section 1395jjj. The term also includes atypical providers that furnish nontraditional services that are indirectly health care-related, such as personal care, taxi, home and vehicle modifications, habilitation, and respite services.
(h) Identifying data elements means those APD data elements that, if disclosed without restrictions on use or re-disclosure, would constitute an unwarranted invasion of personal privacy consistent with Federal and State standards for de-identification of protected health information.
(i) New York State agency means any New York State department, board, bureau, division, commission, committee, public authority, public benefit corporation, council, office, or other governmental entity performing a governmental or proprietary function for the State of New York.
(j) Submission specifications means specifications determined by the department for submitting covered person data and claims data to the APD, such as the data fields, circumstances, format, time, and method of reporting.
(k) Third-party health care payer means an insurer, organization, or corporation licensed or certified pursuant to article 42, 43, or 47 of the Insurance Law or article 44 of the Public Health Law; or an entity, such as a pharmacy benefits manager, fiscal administrator, or administrative services provider that participates in the administration of a third-party health care payer system, including any health plan under 42 USC section 1320d. Unless permitted by Federal Law, the term does not include self-insured health plans regulated by the Employee Retirement Income Security Act of 1974, 29 USC chapter 18, although such plans that operate in New York State may choose to participate as a third-party health care payer.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.11 Records to be kept by a tissue transplantation facility
(a) The director of each tissue transplantation service shall be responsible for records kept by the tissue transplantation facility. In addition to the records specified in Subpart 52-2 of this Part, the following records shall be kept, separate from recipient records, by the tissue transplantation facility:
(1) if performed, results of testing for bacterial and fungal contamination after tissue thawing and prior to engraftment;
(2) a disposition log allowing accurate tracking of tissue to each recipient; and
(3) records of appropriate storage and temperature monitoring of musculoskeletal tissue.
(b) A copy of the order for issuance of the musculoskeletal tissue, including the name and signature of the ordering physician or person authorized by law to order such issuance, shall be kept by the tissue transplantation facility. A record in the patient's chart shall be satisfactory documentation of such order for issuance.
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.6 Answer to finding of violation
(a) A respondent shall have seven days after receipt of service of the finding of violation within which to answer. The answer shall be made on the form and in accordance with instructions furnished to the respondent with the finding of violation.
(b) If the respondent elects to contest any of the factual allegations in the finding of violation, the respondent may include with the answer a statement of defense, mitigation, denial or explanation for each contested alleged violation. When the respondent elects a hearing on the allegations, the respondent must indicate in the answer whether witnesses will be called.
(c) If the respondent elects not to contest the factual allegations in the finding of violation, the answer shall contain an admission that the allegations are true. Such an answer shall constitute a waiver of a hearing on the existence of the facts alleged in the finding of violation and, unless the respondent indicates that an explanation will be offered, be deemed a waiver of a hearing as to the amount of any penalty.
(d) Failure of the respondent to file an answer within seven days after receipt of service of a finding of violation will constitute a waiver of the right to a hearing and authorizes the tribunal or the tribunal representative, without further notice to the respondent, to find the facts to be as alleged in the finding of violation and to render a decision and order sustaining the allegations and imposing a penalty.
(e) Allegations in a finding of violation not answered will be deemed admitted.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-5.32 Milk and milk products and substitutions; pasteurization
(a) When fluid or dry milk, fluid or dry milk products, and fluid or dry milk substitutes are used or furnished, they are to be pasteurized and are to meet the standards established by law.
(b) Milk and fluid milk products dispensed by vending machines are to be in individual containers filled and sealed at the milk processing plant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.34 Insurance
(a) A hospital shall make provision for and obtain insurance and bonds in accordance with the requirements of the State Department of Health and the State Housing Finance Agency or the State Medical Care Facilities Finance Agency.
(b) The amount, extent and endorsements of the insurance maintained, and the custody of the insurance policies, shall be in accordance with the requirements of the State Department of Health.
(c) A hospital shall provide and maintain such additional insurance as may from time to time be required by the State Department of Health.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.9 Medical exemption from immunization
If any licensed physician or health care practitioner practicing under the supervision of a licensed physician certifies that a follow-up dose of hepatitis B vaccine may be detrimental to a child's health, the requirements of this Subpart regarding follow-up immunizations shall be inapplicable until such immunization is found no longer to be detrimental to such child's health. The nature and duration of the medical exemption must be stated in the child's medical record.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.7 Hospice reimbursement for room and board provided to patients residing in a nursing facility
(a) Daily payment will be made to a hospice for Medicaid eligible patients who have elected the hospice benefit and reside in a nursing facility (see 42 USC 1396a[a][13][D]). Payment shall be made for a hospice patient to take into account the room and board furnished by the nursing facility and will be in an amount equal to 95 percent of the facility rate that would have been paid by the State to the facility in accordance with the applicable provisions of Subpart 86-2 of this Part, if the patient had not elected to receive hospice care. A hospice cannot bill for this additional amount on a day in which the patient who has elected hospice care is receiving either general inpatient or inpatient respite care. Patients covered under provisions set forth in this section must be patients who would be eligible under Medicaid for nursing facility services if he/she had not elected to receive hospice care.
(b) To be eligible to receive Medicaid payment as set forth in subdivision (a) of this section, a hospice must have a written agreement with a nursing facility under which the hospice takes full responsibility for the professional management of the patient' s hospice care, and the nursing facility agrees to provide room and board to the patient, collect any patient payment contributions, and maintain an accounting of the patient's financial contribution.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.120 Expense center
See cost center.
10 CRR-NY 441.310 Services
(a) Sold services refers to ancillary services a hospital sells to other providers of health care services, rather than directly to the other provider's patients.
(b) It may also refer to other operating expenses, ( i.e., laundry, data processing, etc.) which you sell to another organization (health care provider or commercial enterprise).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
APPROVAL OF LABORATORIES APPROVAL OF LABORATORIES
10 CRR-NY 55-1.2 Eligibility for approval
Only laboratories or institutions will be approved in which the use of living animals for the purposes set forth in section 55-1.1 of this Subpart will be under the immediate supervision of persons qualified by training and experience to conduct scientific work.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
10 CRR-NY 444.1 Preface
[3000] This Part provides a detailed description for each Balance Sheet and Income Statement account listed in the Listing of Accounts, Part 443 of this Article. A standard unit of measure and the data source for each standard unit of measure is provided for each cost center where a standard unit of measure is required. In addition, a detailed explanation is provided for the natural expense classification.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.44 Episodic payments for certified home health agency services
(a) Effective for services provided on and after May 2, 2012, Medicaid payments for certified home health care agencies (CHHA), except for such services provided to children under 18 years of age and except for services provided to a special needs population of medically complex and fragile children, adolescents and young disabled adults by a CHHA operating under a pilot program approved by the department, shall be based on payment amounts calculated for 60-day episodes of care.
(b) An initial statewide episodic base price, to be effective May 2, 2012, will be calculated based on paid Medicaid claims, as determined by the department, for services provided by all certified home health agencies in New York State during the base period of January 1, 2009 through December 31,2009.
(1) Such base price shall be calculated by grouping all Medicaid paid CHHA claims for dates of services in 2009 into 60 day episodes of care. All such 2009 episodes which include dates of service beginning in November or December of 2008 or ending in January or February of 2010 shall be included in such base price calculation. Low utilization episodes of care, as defined in subdivision (d) of this section, shall be excluded from such calculation. With regard to high utilization episodes of care, costs in excess of outlier thresholds, as determined in accordance with subdivision (e) of this section, shall be excluded from such calculation. The resulting base price shall be subject to such further adjustment as is required to comply with the aggregate savings mandated by paragraph (b) of subdivision (13) of section 3614 of the Public Health Law (PHL).
(2) The episodic base price for periods beginning on or after April 1, 2013, may be based on paid Medicaid claims for services provided by all certified home health agencies during a base year period subsequent to 2009, as determined by the department.
(3) The applicable base year for determining the base price shall be updated not less frequently than every three years.
(c) The base price paid for 60-day episodes of care shall be adjusted by an individual patient case mix index as determined pursuant to subdivision (f) of this section; and also by a regional wage index factor as determined pursuant to subdivision (h) of this section. Such case mix adjustments shall include an adjustment factor for CHHAs providing care primarily to a special needs patient population coming under the jurisdiction of the Office of People With Developmental Disabilities (OPWDD) and consisting of no fewer than 200 such patients.
(d) Notwithstanding any inconsistent provision of this section, payments for low utilization cases shall be based on the statewide weighted average of fee-for-service rates for such services, as determined by the department and as adjusted by the applicable regional wage index factor as described in subdivision (h) of this section. For purposes of this section, low utilization cases will be defined as 60 day episodes of care with a total cost of $500 or less, based on statewide weighted average fee-for-service rates paid on a per-visit, per-hour, or other appropriate historical basis.
(e)
(1) Payments for 60-day episodes of care shall be adjusted for high-utilization cases in which total costs, based on statewide weighted average fee-for-service rates as determined by the department and as paid on a per-visit, per-hour, or other appropriate historical basis, exceed outlier cost thresholds determined by the department for each case mix group. In such cases the provider will receive the adjusted episodic base payment pursuant to subdivisions (b) and (c) of this section, plus a percentage, to be determined by the department, of the cost which exceeds the outlier threshold, as adjusted by the regional wage index factor, provided, however, that such adjustment percentage is subject to such further adjustment as may be necessary to comply with the aggregate savings mandated by PHL section 3614(13)(b).
(2) The outlier threshold for each resource group, as described in subdivision (f) of this section, shall be equal to a specified percentile of all episodic claims totals for the resource group during the base period, excluding low utilization episodes. Such percentiles shall range from the 70th percentile for groups with the lowest case mix index to the 90th percentile for groups with the highest case mix index.
(f) The case mix index to be applied to each episodic claim, excluding low utilization claims, shall be based on patient information contained in the Federal Outcome Assessment Information Set (OASIS) for the episode. The patient shall be assigned to a resource group based on data that includes, but is not limited to, clinical and functional information, age group, and the reason for the assessment. A case mix index shall be calculated for each resource group based on the relative cost of paid claims during the base period.
(g) Reimbursement for maternity patients, defined as patients who are currently or were recently pregnant and are receiving treatment as a direct result of such pregnancy, may be made pursuant to this section without the submission of an OASIS form, provided that providers billing for such patients must bill in accordance with such special billing instructions as may be established by the commissioner and such patients shall be grouped in a case mix designation based on the lowest acuity resource group.
(h) The regional wage index factor (WIF) shall be computed in accordance with the following and applied to the portion of the episodic base price attributable to labor costs:
(1) Average wages shall be determined for agency health care service occupations for each of the 10 labor market regions in New York, as defined by the New York State Department of Labor.
(2) The average wages in each region shall be assigned relative weights in proportion to the Medicaid utilization for each of the agency service categories as reported in the most recently available agency cost report submissions.
(3) Based on the average wages as determined pursuant to paragraph (1) of this subdivision, as weighted pursuant to paragraph (2) of this subdivision, an index shall be determined for each region, based on a comparison of the weighted average regional wages to the statewide average wages.
(4) The department may adjust the regional WIFs proportionately, if necessary, to assure that the application of the WIFs is revenue-neutral on a statewide basis.
(i) Payments for episodes of care shall be proportionally reduced to reflect episodes of care totaling less than 60 days, provided, however, that CHHAs providing episodes of care totaling less than 60 days as a result of the following circumstances shall be reimbursed for a full 60 day episode:
(1) discharges from the CHHA resulting from a determination that the patient no longer requires CHHA care and may remain at home;
(2) transfer to a general hospital to receive acute care services;
(3) transfer to a hospice for end-of-life care; or
(4) the patient's death.
The commissioner shall monitor cases for which full payments are made for episodes of care of less than 60 days pursuant to the provisions of this subdivision and may require the CHHA to provide such information and documentation as the commissioner deems necessary to ensure quality of care.
(j) The department may require agencies to collect and submit any data deemed by the department to be required to implement the provisions of this section.
(k) Closures, mergers, acquisitions, consolidations, and restructurings.
(1) The commissioner may grant approval of a temporary adjustment to rates calculated pursuant to this section for eligible certified home health agencies.
(2) Eligible certified home health agency providers shall include:
(i) providers undergoing closure;
(ii) providers impacted by the closure of other health care providers;
(iii) providers subject to mergers, acquisitions, consolidations or restructuring; or
(iv) providers impacted by the merger, acquisition, consolidation or restructuring of other health care facilities.
(3) Providers seeking rate adjustments under this subdivision shall demonstrate through submission of a written proposal to the commissioner that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:
(i) protect or enhance access to care;
(ii) protect or enhance quality of care;
(iii) improve the cost effectiveness of the delivery of health care services; or
(iv) otherwise protector enhance the health care delivery system, as determined by the commissioner.
(4)
(i) Such written proposal shall be submitted to the commissioner at least 60 days prior to the requested effective date of the temporary rate adjustment and shall include a proposed budget to achieve the goals of the proposal. Any temporary rate adjustment issued pursuant to this subdivision shall be in effect for a specified period of time as determined by the commissioner, of up to three years. At the end of the specified timeframe, the provider shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and applicable provisions of this Subpart. The commissioner may establish, as a condition of receiving such a temporary rate adjustment, benchmarks and goals to be achieved in conformity with the provider’s written proposal as approved by the commissioner and may also require that the provider submit such periodic reports concerning the achievement of such benchmarks and goals as the commissioner deems necessary. Failure to achieve satisfactory progress, as determined by the commissioner, in accomplishing such benchmarks and goals shall be a basis for ending the provider’s temporary rate adjustment prior to the end of the specified timeframe.
(ii) The commissioner may require that applications submitted pursuant to this section be submitted in response to and in accordance with a request for applications or a request for proposals issued by the commissioner.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.138 Opioid overdose prevention programs
(a) Definitions.
(1) Opioid means an opiate as defined in section 3302 of the Public Health Law.
(2) Opioid antagonist means a drug approved by the Food and Drug Administration, that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body. The opioid antagonist is limited to naloxone or other medications approved by the department for this purpose.
(3) Opioid Overdose Prevention Program means a program the purpose of which is to train individuals to prevent a fatal opioid overdose in accordance with these regulations.
(4) Opioid overdose prevention training curriculum refers to any set of instructions, consistent with guidance from the department, which provides a person encountering a suspected opioid overdose with the steps to take for preventing a fatality, including contacting emergency medical services, administering an opioid antagonist and, where appropriate, providing resuscitation.
(5) Registered provider for the purposes of this section shall mean any of the following that have the services of both a program director and a clinical director and that have registered with the department pursuant to subdivision (b) of this section:
(i) a health care facility licensed under the Public Health Law;
(ii) a physician, physician assistant, or nurse practitioner who is authorized to prescribe the use of an opioid antagonist;
(iii) a drug treatment program licensed under the Mental Hygiene Law;
(iv) a not-for-profit community-based organization incorporated under the Not-for-Profit Corporation Law;
(v) a local health department, public safety agency, or other local or State government agency;
(vi) an institution of higher education, recognized and approved by the regents of the university of the State of New York, which provides a course of study leading to the granting of a post-secondary degree or diploma;
(vii) a business, trade, technical or other occupational school approved as such by the regents of the university of the State of New York or accredited by a nationally recognized accrediting agency or association accepted as such by the regents of the State of New York; and
(viii) a pharmacy registered in accordance with the article 137 of the Education Law.
(6) Program director means an individual who is identified to manage and have overall responsibility for the Opioid Overdose Prevention Program.
(7) Clinical director means a physician, physician assistant or nurse practitioner who is designated in an Opioid Overdose Prevention Program's registration for prescribing an opioid antagonist to individual or an identifiable pool of trained overdose responders and who provides oversight of the clinical aspects of the Opioid Overdose Prevention Program. This oversight includes serving as a clinical advisor and liaison concerning medical issues related to the Opioid Overdose Prevention Program, providing consultation on training and reviewing reports of all administrations of an opioid antagonist.
(8) Affiliated prescriber means a physician, physician assistant or nurse practitioner, who, in addition to the clinical director, is designated in an Opioid Overdose Prevention Program's registration for prescribing an opioid antagonist to individual or an identifiable pool of trained overdose responders.
(9) Trained overdose responder means any individual not otherwise permitted by law to administer an opioid antagonist, who is either:
(i) an opioid antagonist recipient as defined in PHL section 3309 who has successfully completed an opioid overdose prevention training curriculum offered by an authorized opioid overdose prevention program and has been authorized by a registered provider to possess the opioid antagonist;
(ii) a public safety officer who has completed a curriculum approved by the division of criminal justice services for purposes of intervening in opioid overdoses prior to the arrival of emergency medical services; or
(iii) a firefighter who has completed a comparable curriculum approved by the department.
(b) Registration.
(1) Registered providers may operate an Opioid Overdose Prevention Program if they obtain a certificate of approval from the department authorizing them to operate an Opioid Overdose Prevention Program and otherwise comply with the provisions of this section.
(2) Providers eligible to register to operate an Opioid Overdose Prevention Program that are in good standing may apply to the department to operate an Opioid Overdose Prevention Program on forms prescribed by the department which must include, at a minimum, the following information:
(i) the provider name, address and operating certificate or license number where appropriate;
(ii) the name, address, telephone number, fax number, e-mail address and signature of the program director;
(iii) the name, address, telephone number, fax number, e-mail address, license type, license number and signature of the clinical director;
(iv) the name, license type and license number of the affiliated prescribers, if any;
(v) the name and address of the sites at which the Opioid Overdose Prevention Program will be conducted; and
(vi) a description of the targeted population to be served and recruitment strategies to be employed by the Opioid Overdose Prevention Program.
(c) Program operation.
(1) Each Opioid Overdose Prevention Program shall have a program director who is responsible for managing the Opioid Overdose Prevention Program and shall, either directly or through a designee, at a minimum:
(i) identify a clinical director to oversee the clinical aspects of the Opioid Overdose Prevention Program;
(ii) establish the content of the program’s opioid overdose prevention training cirriculum consistent with guidance from the department;
(iii) identify and train other program staff;
(iv) select and identify persons as trained overdose responders;
(v) issue certificates of completion to trained overdose responders who have successfully completed the program’s opioid overdose prevention training curriculum however, certificates of completion of curriculum under subparagraphs (a)(9)(ii) and (iii) of this section are not required for public safety or firefighting personnel;
(vi) establish and maintain the Opioid Overdose Prevention Program’s mandated recordkeeping system;
(vii) ensure that all trained overdose responders successfully complete the program’s opioid overdose prevention training curriculum;
(viii) provide liaison with local emergency medical services and emergency dispatch agencies, where appropriate;
(ix) assist the clinical director with review of reports of all overdose responses, particularly those involving administration of an opioid antagonist;
(x) report all administrations of an opioid antagonist on forms prescribed by the department; however, public safety and firefighting personnel are required to report administrations of an opioid antagonist directly, or through their department or agency, to the department; and
(xi) report the number of trained overdose responders and the number of doses of an opioid antagonist provided on a quarterly basis on forms prescribed by the department.
(2) Each Opioid Overdose Prevention Program shall have a clinical director who is responsible for clinical oversight and liaison concerning medical issues related to the Opioid Overdose Prevention Program and, at a minimum, shall:
(i) provide clinical consultation, expertise, and oversight;
(ii) serve as a clinical advisor and liaison concerning medical issues related to the Opioid Overdose Prevention Program;
(iii) provide consultation to ensure that all trained overdose responders are properly trained;
(iv) adapt and approve opioid overdose prevention training curriculum content and protocols;
(v) review reports of all administrations of an opioid antagonist; and
(vi) designate individuals, either by name or by description, who are authorized to dispense or furnish an opioid antagonist to trained overdose responders and/or individuals who are responsible for ensuring orderly, controlled, shared access to an identifiable pool of trained overdose responders pursuant to a non-patient specific prescription.
(3) The trained overdose responders shall:
(i) complete an initial training consistent with the program’s opioid overdose prevention training curriculum;
(ii) complete a refresher training consistent with the opioid overdose prevention training curriculum at least every two years or otherwise demonstrate competence in opioid overdose recognition and response to the satisfaction of the opioid overdose prevention program director or to someone designated by the program director;
(iii) ensure that emergency medical service has been contacted when encountering a victim of a suspected drug overdose and advise responding emergency medical services personnel if an opioid antagonist has been used;
(iv) comply with protocols for response to victims of suspected drug overdose consistent with the program’s opioid overdose prevention training curriculum, or, in the case of responders who are public safety or firefighting personnel, comply with policies developed by their local public safety agency or fire department; and
(v) report all responses to victims of suspected drug overdose to the Opioid Overdose Prevention Program director or to someone designated by the program director.
(4) The opioid antagonist shall be provided or furnished to the trained overdose responder in accordance with all applicable laws, rules and regulations.
(5) The Opioid Overdose Prevention Program will maintain and provide response supplies consistent with its policies and procedures; however, these supplies must include:
(i) a mask or other barrier where rescue breathing is part of the curriculum;
(ii) an agent to prepare skin before injection where an injectable form of an opioid antagonist is used; and
(iii) instructional material required by the department, including information on how to recognize symptoms of an opioid overdose; the steps to be taken in responding to an overdose; and how to access the Office of Alcoholism and Substance Abuse Services through both a toll free number and its website.
(6) The Opioid Overdose Prevention Program’s recordkeeping system must include, at a minimum, the following elements:
(i) the names of trained overdose responders, the dates they were trained, and the dates they were furnished naloxone; however, where an opioid antagonist is furnished or dispensed by an opioid overdose prevention program pursuant to a non-patient specific prescription, the program must also maintain records on who has issued the non-patient specific prescription and which designated program staff have dispensed or furnished the opioid antagonist and/or are responsible for ensuring orderly, controlled, shared access to an identifiable pool of trained overdose responders;
(ii) program policies and procedures;
(iii) copy of the contract/agreement with the clinical director, if appropriate;
(iv) opioid antagonist administration usage reports and forms;
(v) documentation of review of administration of an opioid antagonist; and
(vi) an inventory of overdose response supplies.
(7) The Opioid Overdose Prevention Program will establish a procedure by which any administration of opioid antagonist to another individual by a trained overdose responder affiliated with an Opioid Overdose Prevention Program, shall be reported on forms prescribed by the department.
(8) Approval obtained pursuant to this section shall consist of a certificate of approval provided by the department that shall remain in effect for two years or until receipt by the authorized provider of a written notice of termination of the program from the department, whichever shall first occur. The department may renew a certificate of approval for a subsequent two-year period if the registered provider is in good standing with all applicable State and Federal licensing agencies and such provider is found to have complied with the requirements of this section.
(9) Pursuant to Public Health Law section 3309(2), the purchase, acquisition, possession or use of an opioid antagonist by an Opioid Overdose Prevention Program or a trained overdose responder in accordance with this section shall not constitute the unlawful practice of a professional or other violation under title 8 of the Education Law or article 33 of the Public Health Law.
(10) Trained overdose responders may have shared access to, and use of, an opioid antagonist so long as the following conditions are met:
(i) they are trained in accordance with these regulations;
(ii) they have a common organizational or workforce bond; and
(iii) there are policies and procedures in place within that organization or workforce that ensure orderly, controlled access to an opioid antagonist by an identifiable pool of trained overdose responders.
(11) Clinical directors and affiliated prescribers of registered providers are authorized to direct the furnishing or dispensing of an opioid antagonist to trained overdose responders pursuant to a patient-specific prescription or a non-patient specific prescription.
(12) All dispensing or furnishing of an opioid antagonist pursuant to a non-patient-specific prescription shall be to individuals who have been trained in opioid overdose recognition and response and be accompanied by documentation indicating:
(i) that the opioid antagonist has been furnished pursuant to a non-patient specific prescription;
(ii) the name of the prescriber;
(iii) the opioid antagonist being prescribed;
(iv) the date of the dispensing or furnishing; and
(v) the name of the person (or identification of the pool under subparagraph [10][iii] of this subdivision) receiving the opioid antagonist.
(d) Nothing in this section shall prevent a health care practitioner from issuing a patient-specific prescription for an opioid antagonist as otherwise permitted by law.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.8 Criteria for determining the operation of diagnostic or treatment center under article 28 of the Public Health Law
(a) Any provision of medical or health services by a provider of medical or health services organized as a not-for-profit or business corporation other than professional service corporation shall constitute the operation of a diagnostic or treatment center.
(b) It shall be prima facie evidence that a diagnostic or treatment center is being operated when any provider of medical or health services describes itself to the public as a “center,” “clinic” or by any name other than the name of one or more of the practitioners providing these services.
(c) A provider of medical or health services that does not come within subdivision (a) or (b) of this section shall be reviewed by the Commissioner of Health to determine whether medical or health services are being provided by practitioners of medicine engaged in private practice or by facility within article 28 of the Public Health Law. The following criteria shall be used in conducting such reviews:
(1) Patient contact.
Patient contact is made directly with the facility rather than the individual physician; or referral is made to the facility by the physician; or provision is made for services by the physician, not in his offices but at another location.
(2) Admission.
The decisions as to admissions are made by the facility rather than by the individual practitioner, or by referral agreement or by arrangements with physicians.
(3) Choice of physician.
When the physician is not chosen by the patient, the physician is assigned by the facility, or the patient is given a choice among several practitioners associated with or employed by the facility.
(4) Care of patients.
Care that is provided patients is the responsibility of the facility and is provided under the following conditions, among others:
(i) the facility, rather than the physician assumes responsibility for all services rendered within the facility;
(ii) central services, including but not limited to laboratory, pharmacy, X-ray and narcotics are available with no free choice of the provider of such services by the patient;
(iii) the facility insures adherence to standards;
(iv) the facility is organized into departments or has a multi-disciplined approach;
(v) the facility supplies ancillary services; or
(vi) the responsibility of the facility terminates on discharge of the patient, as distinguished from the continuing responsibility of the physician; follow-up care is not provided by or at the facility.
(5) Organization and management.
(i) Bills and charges are determined by the facility;
(ii) medical charts and patient records are maintained by the faculty;
(iii) patient care space is provided by the facility;
(iv) income distribution is determined by the facility;
(v) employees are selected as supervised by the facility;
(vi) vital records such as fetal death certificates, etc. are maintained by the facility;
(vii) bills are payable to the facility, rather than to the individual practitioner;
(viii) the scope of the services to be provided is determined by the facility, subject to regulatory limitations;
(ix) the structure is so physically extensive that it exceeds the usual space requirements of the private medical practitioner;
(x) the departmental organization is large enough to require delegation of authority to nonmedical personnel;
(xi) there is employment of other health professions such as registered nurse, physical therapist, pharmacist; or
(xii) the patient registry is more extensive than that found in the usual individual practice. Many more persons are processed than are ordinarily diagnosed or treated by physicians in the private practice of medicine.
(d) The criteria set forth in subdivision (c) of this section shall not be the sole determining factors, but indicators to be considered with such other factors that may be pertinent in particular instances. Professional expertise is to be exercised in the utilization of the criteria. Establishment shall be required where a determination is made that medical services are being provided by a facility within article 28 of the Public Health Law rather than by a private practitioner of medicine. All of the listed indicia of a facility within article 28 of the Public Health Law need not be present in a given instance. The criteria are intended to assist in determining the dominant features of the services offered.
(e) In addition to the foregoing, any facility which qualifies for an agreement to participate in the Medicare program as an ambulatory surgical center shall constitute a diagnostic and treatment center. The conditions of participation in the Medicare program as an ambulatory surgical center are contained in volume 42 of the Code of Federal Regulations, Public Health, at part 416 (42 CFR part 416), 1984 edition, published by the Office of the Federal Register, National Archives and Records Service, General Services Administration. Copies may be obtained from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. 42 CFR part 416 is available for public inspection and copying at the Records Access Office, New York State Department of Health, 10th Floor, Corning Tower Building, Empire State Plaza, Albany, NY 12237.
(f) The Department of Health may conduct such hearings as may be necessary to gather sufficient facts to make a determination under this section.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.37 Cost allocation adjustments
| Adjustment | Cost center affected | Account number | | | | --- | --- | --- | --- | --- | | (a) | Depreciation—replacement cost to historical cost | | | | | (1) | Buildings and fixtures | Depreciation and Amortization-Fixed Assets | 8810 | | | (2) | Equipment | Depreciation and Amortization— Movable Equipment | 8820 | | | (b) | Depreciation—accelerated to straight line—buildings and fixtures | Depreciation and Amortization— Fixed Assets | 8810 | | | (c) | Interest on inter-fund borrowing | | | | | (1) | Funded depreciation | (i) | Interest-Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (2) | Donor-restricted funds | (i) | Interest—Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (3) | Other (specify) | (i) | Interest—Short-Term, or | 8870 | | | | (ii) | Interest—Long-Term | 8880 | | (d) | Unincorporated business tax | Provision for Income Taxes | 9410 | | | (e) | Corporate income tax | Provision for Income Taxes | 9410 | | | (f) | Unrecovered cost of courtesy allowances to employees and dependents | Employee Benefits—Non-Payroll-Related | 8830 | | | (g) | Voluntary Agency Proficiency Testing Program | | | | | (1) | Clincial laboratory | Laboratory Services—Clinical | 7210 | | | (2) | Other (specify) | Specify | Specify | | | (h) | Grants, gifts and income for specific purpose | Specify | Specify | | | (i) | Professional standards review organization | Medical Care Review | 8740 | | | | Other (specify) | Specify | Specify | | | (j) | Amounts may be expressed as: | | | | | (1) | increases; or | | | | | (2) | decreases. | | | |
Part 441 DEFINITIONS
10 CRR-NY 441.40 Balance
(a) The difference between the total debits and the total credits of an account, or the total of an account containing only debits or credits.
(b) The equality of the total debit balances and the total credit balances of the accounts in a ledger.
(c) Agreement of the total of the account balances in a subsidiary ledger with its general-ledger control.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.3 Application information
A training provider seeking accreditation of any initial or refresher asbestos safety training program described in sections 73.5 and 73.6 of this Part shall apply to the Department of Health for each such program. Provisional accreditation shall be determined after a full review of the program application has been completed. If provisional approval is granted, a letter of provisional accreditation shall be sent to the applicant. In the case of disapproval, a letter describing the reasons for disapproval shall be sent to the applicant. Prior to disapproval, the department may request additional information to address inadequacies in the application for accreditation. If a training provider's application is disapproved, the provider may reapply for accreditation at any time. The training provider shall submit the following information to the Department of Health for review at least 45 days prior to the requested approval date:
(a) A completed copy of the appropriate Department of Health application form.
(b) A description of the training facility(ies) including a diagram or blueprint which identifies classrooms with their respective area dimensions, recordkeeping location(s), and equipment storage location(s). If records are to be stored at a location other than the training facility, the address and site specific information on the record storage room must be included.
(c) A detailed outline of the program, including the length of training, the amount of time allotted to each topic, a description of the type of teaching method for each topic, and the name(s) of the proposed instructors for each topic. For each proposed instructor include credentials demonstrating previous adult teaching experience, knowledge of the topics he/she will be teaching and/or description of relevant field experience in asbestos abatement.
(d) Copies of instructor lesson plan and transparencies, slides, and audio-visual materials to be used to supplement the program presentation. The training provider must detail in the application for accreditation those interactive/participatory teaching methods to be used and in which topic areas they will be employed.
(e) One copy of the entire student manual along with all other written materials intended to augment the student manual.
(f) A detailed description of the training provider's management and corporate structure including individual names of management personnel and corporate officers. The detailed description must include details of other business affiliations including, but not limited to, affiliations with asbestos abatement firms, environmental sampling and analysis firms and manpower brokerage firms.
(g) Evidence that the proposed training director meets the qualifications listed in subdivision 73.2(a) of this Part.
(h) A description of all materials and equipment to be used for hands-on practice exercises and demonstrations. This description shall include, but not be limited to, type and quantity of:
(1) protective clothing;
(2) personal respirators and their respective filters;
(3) high efficiency particulate absolute (HEPA) vacuum filtration equipment;
(4) negative air pressure equipment;
(5) building materials for containment and decontamination unit including, but not limited to, plastic sheeting (six millimeter in thickness), duct tape, appropriate carpentry tools, ground fault interrupters, water filtration equipment, non-asbestos material, scaffolding and ladders;
(6) asbestos abatement equipment including, but not limited to, glovebags for removing horizontal and vertical pipe insulation and for insulation on pipe elbows, tent structures, smoke test equipment, water spray devices and hand tools;
(7) sampling equipment including, but not limited to, bulk sampling devices, personal air sampling pumps and respective filters, area sampling pumps and respective filters, primary and secondary calibration devices, chain of custody forms and sample containers;
(i) A full description of a quality control program as described in subdivision 73.2(e) of this Part.
(j) A copy of the examination and its respective answer sheet and a detailed statement explaining the methodology used to develop and select the examination questions.
(k) A sample asbestos safety training program evaluation form.
(l) The training provider must submit a detailed recordkeeping procedure which identifies the type of records to be maintained as described below, the address where records will be maintained, the organization in which they will be maintained and what security measures will be implemented to ensure the integrity of the records. The training provider shall maintain all required records for a minimum of three years. Upon request, the training provider must allow a representative of the New York State Department of Health or the Department of Labor reasonable access to all required records. If a training provider ceases to conduct training, the training provider shall notify the Department of Health and give it the opportunity to take possession of that provider's asbestos training records. Students receiving training completion certificates must be informed in writing at the time of the program of any other costs they would incur if they were to request additional copies of their training completion certificates.
(1) Individual training program records must include the following:
(i) list of instructors that taught each program on each date that it was offered and the topic areas they presented;
(ii) the name of the instructor(s) who proctored and/or graded the exam for each program;
(iii) attendance roster for each session of training which must be signed by the student at the beginning and end of each session. The roster must include the times that each student arrived and departed the training session. For those students who miss any portion of the scheduled program, documentation must be included which verifies make-up of that missed portion of the program. Individuals must attend all sessions in order to satisfactorily complete the program; and
(iv) student program evaluations.
(2) Individual student records must include the following for each program attended:
(i) the name of the individual attending the program, his/her social security number or other suitable form of identification, the type of program attended and the dates of attendance;
(ii) completed sponsor copy of the DOH 2832 form;
(iii) a copy of any form letter or diploma that is issued to the student upon completion of the program;
(iv) a graded and dated examination answer sheet for each exam attempt, and with respect to repeat examinations, a narrative explaining any assistance provided to the student prior to the re-test;
(v) signed student program information memorandum specific to the program offered;
(vi) all appropriate documentation demonstrating initial and any refresher training must be included in the student file or referenced in those instances where the training sponsor has provided the initial training and all subsequent refresher training; and
(vii) documentation of valid inspector accreditation for each individual attending an initial management planner training program. This information must be verified at the time of program admission.
(3) Program accreditation file must include the following for each program offered:
(i) a copy of the department's program accreditation letter (provisional and full) for each specific program and approval letters received from New York City, United States Environmental Protection Agency (USEPA) and other States;
(ii) copies of the application form and all training program materials submitted to the department as part of the original curriculum submission;
(iii) copies of all revisions to the accredited curriculum and correspondence approving such revisions;
(iv) copies of all instructor's resumes, and the documents approving each instructor issued by the department, New York City Department of Environmental Protection, USEPA and/or other states;
(v) copies of exam questions for each program offered.
(4) Department of Health memorandum file which contains all memoranda issued by the department and pertaining to asbestos safety training;
(m) The names of the designated lead classroom instructors and lead hands-on instructors and their qualifications and topic(s)/hands-on area(s) to be taught by each instructor. The following documents must be submitted as necessary to prove that the designated instructor meets the requirements of section 73.4, including relevant educational, work experience, and training requirements:
(1) official academic transcripts; and/or
(2) one of the following:
(i) resume;
(ii) letters of reference;
(iii) instructor certification in another model plan accredited state; or
(iv) documentation of work experience; and
(3) a copy of the signed statement of employment;
(n) Changes to any aspect of the training program. The training provider must describe the procedure used to notify the department in writing of any changes in any aspect of an accredited training program prior to implementing such change. With every application for accreditation of an asbestos safety training program the training provider must certify that such notification will be given.
(o) A list of all other governmental authorities that currently approve the training course.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.11 Use of funds of the company
Funds of a nursing home company shall not be used for any purpose other than the ordinary operation of the project, without the prior written approval of the State Department of Health. Company funds shall not be invested without the approval of the State Department of Health. No loans shall be made at any time.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.3 Application
(a) The requirements of this Subpart shall apply to a camp occupied by or maintained for occupancy by 10 or more children except:
(1) any place occupied by children under 18 years of age for overnight occupancy of 72 consecutive hours or less;
(2) day camps operating less than all or part of five days in any two-week period;
(3) child care facilities licensed or registered by the New York State Department of Family Assistance, Office of Children and Family Services;
(4) activities at unscheduled or drop-in neighborhood-center settings; single-purpose activity such as athletic events, which are held for the sole purpose of tournament play or competition, and associated training practice, “special olympics,” little league baseball, Pop Warner football; and recreational activity without a specified time period of attendance required;
(5) college level educational programs provided by schools that are accredited by the Regents of the University of the State of New York;
(6) school districts, Boards of Cooperative Educational Services (BOCES) or nonpublic schools providing instruction to satisfy, enrich, accelerate or improve skills in accordance with New York State education requirements;
(7) day programs conducted for the purpose of classroom educational instruction, including but not limited to traditional academic subjects, religious instruction, and computer training, that have one or more nonpassive recreational activities with significant risk of injury when such activities are conducted as part of a one hour or less recess period constituting no more than one fifth of the program's daily operation, and which occur on a playground, in a gymnasium, or similar setting; and
(8) any operation or use of a tract of land or property determined by the State Commissioner of Health as not being within the intent of or regulated by this Subpart.
Part 15 MIGRANT FARMWORKER HOUSING
DUTIES OF PERMITTEE, RESPONSIBILITIES OF OCCUPANTS DUTIES OF PERMITTEE, RESPONSIBILITIES OF OCCUPANTS
10 CRR-NY 15.13 Miscellaneous; duties of permittee
(a) Medical emergency access.
Arrangements shall be made to assure access to adequate medical care at or readily available to the migrant farmworker housing. All occupants shall have access to an adequate communication system for summoning help in the event of a medical or safety emergency. An adequate first-aid kit shall be available for use by the occupants of the housing facility.
(b) The permittee shall be responsible for maintaining all dwelling units in a structurally sound condition which prevents infestation by rodents and insects, and shall be responsible for providing or obtaining any required extermination.
(c) Hazardous materials.
(1) Storage. No flammable or volatile liquids or materials shall be stored in or adjacent to rooms used for living purposes, except for those needed for current household use. Agriculture chemicals including pesticides shall not be stored in the housing area.
(2) Contamination of housing. Whenever the buildings of a regulated migrant farmworker housing facility are contaminated, or suspected of being contaminated by hazardous materials, chemicals or pesticides, the occupancy or use of the housing facilities may be restricted by the permit-issuing official until required decontamination and/or corrective actions are completed.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.176 Inpatient
A patient who is provided with room, board, and continuous general nursing service in an area of the hospital where patients stay overnight.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 126 MONTGOMERY COUNTY
VILLAGES VILLAGES
10 CRR-NY 126.4 Village of St. Johnsville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to Zimmerman Creek, to all natural and artificial reservoirs and to all watercourses and drainage areas tributary thereto and to the collecting basins, streams and drainage areas tributary to the springs located near Lassellsville which serve as sources of public water supply for the village of St. Johnsville.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounded intake reservoir on Zimmerman Creek and to the two spring collecting basins located near Lassellsville which serve as sources of this public water supply or any additional reservoirs which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), brook, stream, ditch, gutter or channel of any kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of St. Johnsville.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the village of St. Johnsville.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of St. Johnsville.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of St. Johnsville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of St. Johnsville.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or tributary thereof, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. No animal or poultry shall be watered in any reservoir of the public water supply of the village of St. Johnsville. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excremental matters any watercourse tributary to the public water supply of the village of St. Johnsville.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of St. Johnsville, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of St. Johnsville.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of St. Johnsville, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the village of St. Johnsville.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 50 feet before entering any watercourse tributary to the public water supply of the village of St. Johnsville.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the village of St. Johnsville.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of St. Johnsville except by the duly authorized employees of the village of St. Johnsville in the performance of their duties of supervision and maintenance of the public water supply.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the village of St. Johnsville.
(j) Inspections.
The board of water commissioners of the village of St. Johnsville or such other board as may be charged with the maintenance or supervision of the public water supply of the village of St. Johnsville or its duly appointed representative shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 85.15 Notification of adverse finding
When an adverse finding is made, the utilization review agent must immediately notify the appropriate area office of the Department of Health, Office of Health Systems Management, Long-Term Care Unit. The utilization review agent must immediately forward to the area office a copy of the most recently completed patient review forms (PRI and SCREEN) and criteria for level of care as contained in subdivision (i) of section 86-2.30 and section 400.12 of this Title, a copy of the psychosocial evaluation completed by the facility's qualified social worker indicating the patient's or resident's response to possible transfer, the information supplied by the attending physician, if any, concerning the patient's or resident's current clinical status and ability to accept transfer, and the utilization review agent physician's statement of the change in the patient's or resident's medical condition or other circumstances justifying the adverse finding.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.12 Level of care criteria
(a) New York State criteria for level of care.
(1) Minimum qualification for residential health care facility care: The patient is qualified for residential health care facility care and such care is consistent with all applicable Federal requirements as documented on the patient screening instrument (SCREEN).
(2) Skilled nursing facility care.
Patients in the following resource utilization groups meet the requirements for skilled nursing facility level of care:
Special Care A
Special Care B
Heavy Rehabilitation A
Heavy Rehabilitation B
Clinically Complex A
Clinically Complex B
Clinically Complex C
Clinically Complex D
Severe Behavioral A
Severe Behavioral B
Severe Behavioral C
Reduced Physical Functioning A
Reduced Physical Functioning B
Reduced Physical Functioning C
Reduced Physical Functioning D
Reduced Physical Functioning E
The SCREEN Form DOH 695 shall be maintained by the department, in such form and format as prescribed by the department in compliance with Federal Law, and shall be accessible at: http://www.health.state.ny.us/forms/
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 57 CONDITIONS UNDER WHICH A DOG ACTIVELY IMMUNIZED AGAINST RABIES MAY BE AT LARGE IN DESIGNATED AREAS CERTIFIED FOR RABIES
10 CRR-NY 57.3 Additional conditions to be complied with
(a) The veterinarian administering the vaccine shall give to the owner**** of the dog a signed statement which shall give the name and address of owner, and date or dates of vaccination together with the type of vaccine injected, the amount and manner of injection, name of manufacturer, lot number, and expiration date of the vaccine.
(b) The owner shall keep this statement readily available for inspection by official agents concerned with the control of rabies.
(c) The veterinarian administering the vaccine shall attach an indestructible tag securely to the collar of the dog indicating that the dog has been vaccinated against rabies, with the date of last vaccination marked on the tag, which shall be worn by the dog at all times, and which shall be of a size plainly visible at a reasonable distance for purposes of inspection by officials concerned, and readily distinguishable from the dog license tag.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.57 Capital lease
(a) A lease which meets one of the following four criteria:
(1) The present value of the minimum lease payments is 90 percent or more of the fair value of the property to the lessor.
(2) The lease term is 75 percent or more of the leased property's estimated economic life.
(3) The lease contains a bargain (less than fair value) purchase option.
(4) Ownership is transferred to the lessee by the end of the lease term.
(b) See FASB Statement No. 13 for further details.
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.9 Medical services
The operator must, without limiting its responsibility for the operation and management of the program:
(a) assign to the operator's medical board, medical advisory committee, medical director or consulting practitioner the following responsibilities regarding registrants of the program:
(1) developing and amending clinical policies;
(2) supervising medical services;
(3) advising the operator regarding medical and medically related problems;
(4) establishing procedures for emergency practitioner coverage, records and consultants; and
(5) establishing professional relationships with other institutions and agencies, such as general hospitals, rehabilitation centers, residential health care facilities, home health agencies, hospital outpatient departments, clinics and laboratories;
(b) ensure that medical services, including arranging for necessary consultation services, are provided to registrants of the program in accordance with section 415.15(b)(1), (2)(ix), (3) and (4)of this Subchapter;
(c) provide or arrange for the personal, staff or other designated practitioner to obtain a medical history and a physical examination of each registrant, including diagnostic laboratory and x-ray services, as medically indicated, within six weeks before or seven days after admission to the program;
(d) ensure that the practitioner record, date and authenticate significant findings of the medical history, physical examination, diagnostic services, diagnoses and orders for treatment in the registrant's clinical records; and
(e) ensure that orders for treatment include orders for medication, diet, permitted level of physical activity and, when indicated, special orders or recommendations for rehabilitative therapy services and other adult day health care services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
10 CRR-NY 43-1.3 Nonresidents, aliens, refugees and staff members of legations
(a) There shall be no discrimination against tuberculosis patients or contacts because of lack of United States citizenship or lack of New York State or local residence.
(b) Tuberculosis health care services for the following aliens are not eligible for payment by local health officials or the State or for payment of State aid reimbursement:
(1) officials, representatives or employees of foreign governments;
(2) officers and employees of international organizations;
(3) attendants, servants, personal employees of those listed in paragraphs (1) and (2) of this subdivision; or
(4) members of immediate families of those listed in paragraphs (1) through (3) of this subdivision.
Payments for tuberculosis health care services for these persons is the responsibility of the individual or foreign country through its appropriate representative in the United States.
(c) Refugees eligible for medical assistance in accordance with the Social Services Law and the rules and regulations thereunder shall also be eligible for tuberculosis health care services hereunder.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.9 Surrogacy program licensure fees and renewals
(a) Fees.
Upon the filing of an initial application for a license pursuant to this Subpart, the owner shall pay an application fee to the department in the amount of $1,000.
(b) Renewals.
Surrogacy program licensees shall renew their license annually by submitting the information required to be submitted under this Subpart and a renewal fee in the amount of $200. Applications for renewal shall be filed with the department, in the form and manner prescribed by the department, 90 days prior to expiration of the current license.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.16 Hazardous materials
Agricultural, commercial or household pesticides, flammable or volatile liquids and toxic chemicals shall be stored in their original or approved containers, in areas designated for their use. Storage shall be in a manner that prevents air, surface or ground water contamination and is not hazardous to facility occupants and/or the general public. Such storage shall be in compliance with applicable requirements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.36 Confidentiality of information
(a) Proprietary information submitted to NIH in connection with the approval procedures set forth in part VI, Voluntary Compliance, of the NIH Guidelines, as required for certification pursuan to subdivision (d) of section 61-1.3 of this Subpart, will be protected by NIH as provided in part VI of the NIH Guidelines.
(b) Proprietary information submitted to the commissioner will be protected as follows:
(1) An institution may designate those items of information in applications, statements or reports to the commissioner or the department made pursuant to this Subpart, not protected by patent or copyright, which the institution believes are trade secrets or are maintained for the regulation of commercial enterprise which if disclosed would cause substantial injury to the competitive position of the subject enterprise.
(2) If the department receives a request under the Freedom of Information Law for information so designated, it will promptly contact the institution to secure its views as to whether the information (or some portion) should be released.
(3) If the department decides to release the information (or some portion) in response to a Freedom of Information Law request or otherwise, the institution will be advised, and the release will not be made until the expiration of 15 business days after receipt of the request, except to the extent that earlier release in the judgment of the commissioner is necessary to protect against an imminent hazard to the public or the environment.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-1 SCREENING AND FOLLOW-UP
10 CRR-NY 67-1.3 Laboratory testing and specimen collection
(a) All blood lead tests shall be performed by:
(1) a clinical laboratory approved for toxicology-blood lead under article 5, title V of the Public Health Law;
(2) a health care practitioner’s office pursuant to Public Health Law, section 579(1) that is certified by the Centers for Medicare and Medicaid Services under regulations implementing the Federal Clinical Laboratory Improvement Amendments of 1988 (CLIA); or
(3) an entity exempt from the requirements of Public Health Law, article 5, title V pursuant to section 579(3) of that title, that holds a certificate of registration issued by the department and is authorized to conduct blood lead analyses.
(b) Venous blood is the preferred specimen for blood lead analysis and should be used for lead measurement whenever practicable.
(c) Fingerstick blood specimens are acceptable for lead screening if appropriate collection procedures are followed to minimize the risk of environmental lead contamination. Instructions regarding appropriate collection procedures for fingerstick specimens may be obtained from laboratories approved for toxicology-blood lead under article 5, title V of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.2 Distribution of bottled or bulk water
No person shall sell, offer for sale or deliver bottled or bulk water for human consumption, food preparation or culinary purposes unless certified by the commissioner in accordance with the requirements of this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 156 WYOMING COUNTY
10 CRR-NY 156.3 Village of Perry
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to Silver Lake and to all watercourses and drainage areas tributary thereto or ultimately discharging into said lake, such bodies of water being sources of the public water supply of the Village of Perry, Wyoming County, New York.
(b) Definitions.
(1) The term lake wherever used in this section is intended to mean and refer to Silver Lake.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Village of Perry.
(3) Wherever a linear distance of a structure or object from the lake or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to the lake or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 50 feet of Silver Lake or any watercourse tributary to the public water supply of the Village of Perry, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (2) of subdivision (d) of this section.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of Silver Lake or any watercourse tributary to the public water supply of the Village of Perry.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting [ continued ] distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container, which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into Silver Lake or any watercourse tributary to the public water supply of the village of Perry, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into Silver Lake or any watercourse tributary to the public water supply of the village of Perry, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into Silver Lake or any watercourse tributary thereto, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the board of water commissioners of the village of Perry.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into Silver Lake or any watercourse tributary to the public water supply of the village of Perry nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 75 feet of Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed, or placed in Silver Lake.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in Silver Lake within 500 feet of the intake of the public water supply of the village of Perry. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Perry.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 300 feet of Silver Lake or 50 feet from any watercourse tributary thereto, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter Silver Lake or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet of Silver Lake or 50 feet from any watercourse tributary to the public water supply of the village of Perry.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into Silver Lake or any watercourse tributary thereto nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Perry nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet from Silver Lake or any watercourse tributary to the public water supply of the village of Perry; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from Silver Lake or 25 feet from any watercourse tributary to the public water supply of the village of Perry.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into Silver Lake or any watercourse tributary to the public water supply of the village of Perry, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into the lake or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet from Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into Silver Lake or any watercourse tributary thereto, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach Silver Lake or any watercourse tributary thereto without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from Silver Lake or 100 feet from any watercourse tributary to the public water supply of the village of Perry.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Silver Lake within 500 feet of the intake of the public water supply of the village of Perry. All ice cutting outside of the prescribed limit shall be done only under the supervision of the board of water commissioners of the village of Perry or its duly appointed representative.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of Silver Lake or any watercourse tributary to the public water supply of the village of Perry.
(j) Inspections.
The board of water commissioners of the village of Perry or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Perry or the duly appointed representative of any such board shall make regular and thorough inspections of the lake, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 68 POISON CONTROL NETWORK
10 CRR-NY 68.6 Distributions from the Health Care Initiatives Pool for poison control center operations
(a) The monies available for distribution from the Health Care Initiatives (HCI) Pool for poison control center operations shall be distributed on a semi-annual basis in accordance with the methodology below:
(1) Population density by county, as established by the latest available decennial census data for New York State (NYS) as determined by the U.S. Census Bureau, shall be the basis for allocating available HCI pool monies for distribution to the regional poison control centers.
(2) Population density applicable to the total county geographic area served by each regional poison control center shall be determined and the center's percentage to total NYS population density shall be calculated.
(3) Available HCI pool monies shall be distributed proportionally to each regional poison control center based on the center's percentage population density served to total NYS population density.
(b) The commissioner shall consider only those applications for prospective revisions of the projected pool distributions which are in writing and are based on errors, whether mathematical or clerical, made by the department in the pool distribution calculation process. Applications made pursuant to this subdivision must be submitted within 30 days of receipt of notice of the projected pool distribution for the calendar year.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.4 Definition of contamination
Contamination means exposing food to filth, toxic substances, manual contact during service or preparation if such food will not be subsequently cooked prior to service, rodent or insect contact or infestation, or any condition which permits introduction of pathogenic microorganisms or foreign matter. Potentially hazardous foods held at temperatures between 45 degrees Fahrenheit (7.2 degrees Celsius) and 140 degrees Fahrenheit (60 degrees Celsius) for a period of time beyond that required for preparation are considered to be contaminated. Sufficient hot and cold storage facilities are to be provided and used to maintain potentially hazardous foods at required temperatures during storage. Each facility is to have a thermometer, accurate to plus or minus two degrees Fahrenheit, indicating the temperature therein.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.3 Blood, urine and saliva alcohol analysis; permits
(a) Individuals performing chemical analyses for blood, urine and saliva alcohol content may apply to the commissioner for a permit.
(b) A permit for the performance of chemical analyses for blood, urine and saliva alcohol content shall be issued by the commissioner to an applicant who:
(1) is a high school graduate and has one year of laboratory experience acceptable to the commissioner; or
(2) has satisfactorily completed two years of college study and has six months of laboratory experience acceptable to the commissioner; and
(3) demonstrates to the satisfaction of the commissioner proficiency in the chemical analyses of the alcoholic content of blood and any other sample type that the commissioner requires; and
(4) has access to appropriate laboratory facilities for the performance of such analyses.
(c) The applicant shall demonstrate proficiency in the techniques and methods of analysis by correctly analyzing and reporting results, within limits of accuracy established by the commissioner, for 75 percent of the samples for each set of proficiency tests issued by the commissioner.
(d) A permit shall be issued for a period of one year and may be renewed annually thereafter. A permit shall not be issued or renewed if, for two consecutive sets of proficiency tests, the applicant or permit holder:
(1) does not meet the proficiency requirements of this section; or
(2) fails to report proficiency test results; or
(3) reports results after three weeks from the date of distribution of proficiency test samples, except that the commissioner, for good cause, may extend such time on request made during such three-week period.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.8 Special circumstances
(a) The department may exempt a tissue bank from a specific standard contained in this Part, provided:
(1) the tissue bank has applied to the department for an exemption for limited circumstances prior to the noncompliance with the standard; and
(2) the tissue bank has demonstrated to the department that application of the standard to the bank under the limited circumstances for which an exemption is sought:
(i) is inconsistent with the provision of the particular service, as documented in properly conducted current medical or scientific research, or current scientific literature;
(ii) is incompatible with a requirement imposed by a Federal or other state's government unit which is similar to the standard for which an exemption is sought, and the department determines that the requirement imposed by the Federal or other state's governmental unit's requirement adequately protects the public health, safety, and welfare, based upon commonly accepted medical standards, properly conducted medical or scientific research, or current scientific literature; or
(iii) would prevent provision of services necessitated by a medical emergency or special medical conditions. Persons seeking an exemption pursuant to this subparagraph shall describe the nature of the emergency or special medical conditions and the exemption requested, for review on a case-by-case basis by the department. All such emergencies or special medical conditions shall be documented in the medical record, and any action taken in response which is contrary to the requirements of this Part shall be approved by the director of the tissue transplantation service.
(b) A copy of the department's approval for an exemption shall be maintained by the tissue transplantation facility and the tissue bank releasing the tissue.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-4.52 Hot storage
Enough conveniently located hot food storage facilities are to be provided and used to maintain potentially hazardous food at the required temperature during storage. Each potentially hazardous food storage facility is to have a numerically scaled indicating thermometer, accurate to plus or minus 2°F (1.1°C), available and used to measure the temperature of food stored in the facility or installed to measure the air temperature in the coldest part of the facility.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.63 Prescribing
(a) A prescription as defined by the Public Health Law means:
(1) an official New York State prescription;
(2) an electronic prescription;
(3) an oral prescription; or
(4) an out-of-state prescription, which means a prescription issued in lieu of an official prescription by a practitioner in another state who is licensed by that state to prescribe controlled substances.
(b) The use of preprinted prescriptions which indicate the controlled substance or the strength, dosage and/or quantity of the controlled substance is prohibited. Such prohibition shall not apply to printed prescriptions generated by means of a computer or an electronic medical record system, provided such printed prescriptions are generated at the time a practitioner prescribes a controlled substance for a patient.
(c)
(1) Prior to prescribing for or dispensing to a patient any controlled substance listed on schedule II, III, or IV of section 3306 of the Public Health Law, every practitioner shall consult the prescription monitoring program registry for the purpose of reviewing that patient’s controlled substance history. The patient’s controlled substance history shall be obtained from the prescription monitoring program registry no more than 24 hours prior to the practitioner prescribing or dispensing any controlled substance to that patient. A practitioner shall document such consultation in the patient’s medical chart or, if the practitioner does not consult the prescription monitoring program registry, the practitioner shall document in the patient’s medical chart the reason such consultation was not performed. Such documentation shall include the specific exception listed in paragraph (2) of this subdivision.
(i) When such consultation is not performed due to circumstances specified in subparagraph (2)(vii) of this subdivision, the practitioner shall further document in the patient’s medical chart the conditions, occurrences, or circumstances that caused such consultation in a timely manner to be unreasonable. Such documentation shall include a description of the barrier(s) to accessing the registry, and the efforts made by the practitioner to contact other designees.
(ii) When such consultation is not performed due to circumstances specified in subparagraph (2)(viii) of this subdivision, the practitioner shall further document in the patient’s medical chart a description of the circumstances supporting the practitioner’s conclusion that consultation of the registry would adversely impact the patient’s ability to obtain a prescription in a timely manner and the relationship between that delay and the patient’s medical condition.
(2) The duty to consult the prescription monitoring program registry shall not apply to:
(i) veterinarians;
(ii) a practitioner dispensing pursuant to Public Health Law section 3351(3);
(iii) a practitioner administering a controlled substance, as defined in Public Health Law section 3302(2);
(iv) a practitioner prescribing or ordering a controlled substance pursuant to Public Health Law section 3342(1) for a patient of an institutional dispenser as defined by Public Health Law section 3302 for use on the premises of, or during an emergency transfer from, the institutional dispenser;
(v) a practitioner prescribing a controlled substance in the emergency department of a general hospital, provided that the quantity of controlled substance prescribed does not exceed a five-day supply if the controlled substance were used in accordance with the directions for use;
(vi) a practitioner prescribing a controlled substance to a patient under the care of a hospice, as defined by Public Health Law section 4002;
(vii) a practitioner when:
(a) it is not reasonably possible for the practitioner to access the registry in a timely manner;
(b) no other practitioner or designee authorized to access the registry, pursuant to Public Health Law section 3343-a, is reasonably available; and
(c) the quantity of controlled substance prescribed does not exceed a five-day supply if the controlled substance were used in accordance with the directions for use;
(viii) a practitioner acting in circumstances under which consultation of the registry would, as determined by the practitioner, result in a patient's inability to obtain a prescription in a timely manner, thereby adversely impacting the medical condition of such patient, provided that the quantity of the controlled substance does not exceed a five-day supply if the controlled substance were used in accordance with the directions for use;
(ix) a situation where the registry is not operational as determined by the department or where it cannot be accessed by the practitioner due to a temporary technological or electrical failure as defined in section 80.64 of this Part. In the instance of a temporary technological or electrical failure, a practitioner shall, without undue delay, seek to correct any cause for the failure that is reasonably within his or her control; or
(x) a practitioner to whom the commissioner has granted a waiver from the requirement to consult the registry. A waiver may be issued by the commissioner based upon a showing by a practitioner that his or her ability to consult the registry in accordance with this section is unduly burdened by:
(a) technological limitations that are not reasonably within the control of the practitioner; or
(b) other exceptional circumstance demonstrated by the practitioner.
The practitioner’s showing shall include a sworn statement of facts detailing the circumstances in support of a waiver, and should be accompanied by any and all other information which would be relevant to the commissioner’s determination. As part of the application for a waiver, the practitioner shall also provide any information which would tend to negate the need for a waiver. A waiver shall be granted by the commissioner for a specified period of time, but in no event for more than one year. Subsequent waivers shall be applied for in the same manner and shall be subject to the same requirements as the original waiver. A practitioner who has been granted a waiver shall notify the department in writing within five business days upon gaining the capability to consult the prescription monitoring program registry. Without regard to the original expiration date, the waiver granted to the practitioner shall terminate within a reasonable period of time as determined by the department, allowing for the practitioner to make accommodations to begin consulting the prescription monitoring program registry.
(3) A practitioner may authorize a designee to consult the prescription monitoring program registry on his or her behalf, provided that the ultimate decision as to whether or not to prescribe or dispense a controlled substance remains with the practitioner and is reasonably informed by the relevant controlled substance history information obtained from the registry. A practitioner may only appoint a designee if:
(i) such designee is located in the State of New York when accessing the prescription monitoring program registry;
(ii) the designee is employed by the same professional practice or is under contract with such practice. For purposes of this subparagraph, professional practice shall include, but not be limited to, an institutional dispenser where the designating practitioner is employed, under contract, or otherwise has privileges or authorization to practice;
(iii) the practitioner takes reasonable steps to ensure or has actual knowledge that such designee is sufficiently competent in the use of the registry and that such designee is aware of and conforms to all relevant Federal and State privacy statutes;
(iv) the practitioner remains responsible for ensuring that access to the registry by the designee is limited to authorized purposes and occurs in a manner that protects the confidentiality of the information obtained from the registry, and the practitioner remains responsible for any breach of confidentiality; and
(v) the practitioner selects and maintains all active designees authorized to access the prescription monitoring program registry in a format acceptable to the department. Upon a designee’s relinquishment or termination of employment or authorization as a designee, a designating practitioner shall immediately notify the department, in a fashion deemed appropriate by the commissioner, of the revocation of the designee’s authorization to access the prescription monitoring program registry on the designating practitioner’s behalf.
(4) A pharmacist may consult the prescription monitoring program registry in order to review the controlled substance history of an individual for whom one or more prescriptions for controlled substances is presented to such pharmacist. A pharmacist may designate another pharmacist or a pharmacy intern as defined by section 6806 of the Education Law to consult the prescription monitoring program registry on the pharmacist’s behalf, provided that:
(i) such designee is located in the State of New York when accessing the prescription monitoring program registry and is employed by the same pharmacy or is under contract with such pharmacy; and
(ii) the designating pharmacist selects and maintains all active designees authorized to access the prescription monitoring program registry in a format acceptable to the department. Upon relinquishment or termination of employment or authorization as a designee, a designating pharmacist shall immediately notify the department, in a fashion deemed appropriate by the commissioner, of the revocation of the designee’s authorization to access the prescription monitoring program registry on the designating pharmacist’s behalf.
(d)
(1) No controlled substance prescription shall be issued prior to examination of the patient by the practitioner except as otherwise permitted by this subdivision.
(2) Once the initial examination has been completed, the frequency and necessity for future examinations prior to prescribing, either for the same acute or chronic condition, will be made by the practitioner utilizing generally accepted medical standards, including taking into account the drug to be prescribed and the patient's condition, history and disposition toward the use of controlled substances.
(3) In the temporary absence of the initial prescriber, an authorized practitioner may issue a controlled substance prescription for a patient as part of a continuing therapy if the practitioner:
(i) had direct access to the patient's medical records and such records warrant continued controlled substance prescribing; or
(ii) had direct and adequate consultation with the initial prescriber, who assures the necessity of continued controlled substance prescribing and with which the practitioner concurs. If the patient record is not available, the practitioner shall document the activity for his or her own record and shall transmit to the initial prescriber the prescription information. The initial prescriber shall include the prescription information in the patient's record.
(4) A practitioner may prescribe a controlled substance to his or her patient after review of the patient's record if the record contains the result of an examination performed by a consulting physician or hospital and such record warrants the prescribing.
(5) If a patient develops a new condition that would warrant the issuance of a prescription for a controlled substance, a practitioner may issue such prescription prior to performing an examination if:
(i) the prescribing practitioner has a previously established practitioner/patient relationship with the patient;
(ii) an emergency exists; and
(iii) the prescription does not exceed a five day supply as determined by the directions for use. An emergency means that the immediate administration of the drug is necessary for the proper treatment of the patient and that no alternative treatment is available. If the practitioner prescribes such substance orally, the practitioner must comply with the requirements of sections 80.68 and 80.70 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.15 Inspection
(a) The State licensing agency with authority for the host clinic shall have ongoing inspection responsibility for the integrated services clinic, pursuant to this Part. The purpose of the inspection is to ensure compliance with all applicable laws, rules, and regulations, as well as to determine the renewal term of the operating certificate or license, as applicable. Inspection activities shall not be duplicated.
(b) The host State licensing agency shall consult with the adjunct State licensing agency on matters specific to the provision of such add-on services, as may be necessary to assure patient health and safety. Any significant deficiencies will immediately be referred for enforcement to the responsible State licensing agency. If at any point during the inspection, findings are identified that suggest imminent risk of serious harm or injury to patients, the inspector(s) will immediately contact their supervisor, who will consult with the adjunct State licensing agency, as applicable.
(c) Inspections shall be conducted utilizing a joint-licensing instrument, developed collaboratively by the three State licensing agencies. This standardized procedure will ensure consistency of the inspection process throughout the State and provide standardized reviews of the operations and services at each integrated services clinic. All deficiencies and/or corrective action will be overseen by the monitoring State licensing agency with notice to the adjunct State licensing agency or agencies, as applicable.
(d) Each integrated services provider shall undergo an unannounced inspection which will occur prior to renewal of the operating certificate or license.
(1) At the start of the inspection, the inspector(s) will meet with integrated services clinic administrative staff to explain the purpose and scope of the inspection and request any documentation ( e.g. , policies; staffing information; etc.) that may be needed to facilitate the review.
(2) The inspection will include, but not be limited to, the following areas of review:
(i) on-site inspection of clinic appearance, conditions and general safety;
(ii) evaluation of the sponsor, its management systems, and procedures;
(iii) patient case record review;
(iv) interviews of staff and patients;
(v) examination of staffing patterns and staff qualifications;
(vi) analysis of statistical information contained in reports required to be submitted by the clinic;
(vii) compliance with the reporting requirements;
(viii) verification of staff credentials, as applicable;
(ix) incident reporting requirements; and
(x) such other operating areas of activities as may be necessary or appropriate to determine compliance with applicable laws and regulations.
(3) At the conclusion of the inspection, the inspector(s) will meet with the integrated services clinic administrative staff to discuss all deficiencies identified during the inspection.
(e) Upon completion of the inspection, a written report will be provided to the integrated services clinic which describes the results of the inspection, including each regulatory deficiency identified, if any. The provider of services shall take all actions necessary to correct all deficiencies reported. The provider of services shall submit a plan of correction to the State licensing agency with authority for the host clinic within 30 days, which states the specific actions taken or planned to achieve compliance with identified requirements. Any planned actions described in the plan of correction must be accompanied with a timetable for their implementation.
(f) If the provider of services fails, within the specified or an otherwise reasonable time, to correct any reported deficiencies, or fails to maintain satisfactory compliance with applicable laws, rules and regulations, the commissioner of the State licensing agency with authority for the host clinic may revoke, suspend or limit the operating certificate or license or levy a civil fine for such failures, in accordance with applicable regulations.
(g) Concurrently, each integrated services clinic shall undergo a fiscal viability review which will include an assessment of the financial information of the provider of services. Such information shall be submitted in intervals and in a form prescribed by the State licensing agency with authority for the host clinic, for compliance with minimum standards established by the State licensing agency, in order to determine the provider's fiscal capability to effectively support the authorized services.
(h) Providers of services that fail to meet the minimum standards of the State licensing agency with authority for the host clinic shall be required to submit a corrective action plan setting forth the specific actions to be taken to meet the minimum standards within a reasonable time frame.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT INSTALLATION AND LOCATION EQUIPMENT INSTALLATION AND LOCATION
10 CRR-NY 14-1.102 Aisles and working spaces
Unobstructed aisles and working spaces are to be provided of sufficient width to permit employees to perform their duties readily without contamination of food or food-contact surfaces by clothing or personal contact. Easily movable storage equipment, such as pallets, racks and dollies, is to be positioned to provide accessibility to working areas.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 700 GENERAL
10 CRR-NY 700.4 The role of the licensed practical nurse in intravenous therapy procedures
(a) For purposes of this section, agency shall mean an entity licensed, authorized or certified to operate pursuant to articles 36 or 40 of the Public Health Law.
(b) An agency may allow specially trained licensed practical nurses, under the supervision of a qualified registered professional nurse or physician, to perform all intravenous therapy procedures except for the administration of blood and blood products, intravenous anti-neoplastic agents, a bolus of medication by intravenous push unless it is administered in the course of chronic hemodialysis treatment as permitted in this chapter and procedures involving central venous lines.
(c) In order to utilize a licensed practical nurse to perform intravenous therapy procedures in a home setting, the agency shall require that:
(1) the licensed practical nurse has satisfactorily completed a training program and supervised clinical experience in intravenous therapy procedures in a general hospital and is assigned to perform such procedures only for patients who are considered to be medically stable;
(2) a registered professional nurse initiates and monitors all new intravenous therapy medications the patient receives and continues to administer subsequent doses if it is determined to be necessary by the registered professional nurse;
(3) a registered professional nurse who is competent and knowledgeable about the administration of intravenous medications and familiar with the patient's condition be available immediately to the licensed practical nurse by telephone for consultation; and
(4) licensed practical nurses not be assigned to handle any central venous line procedure.
(d) The agency shall ensure that licensed practical nurses allowed to perform intravenous therapy procedures have satisfactorily completed a training program, received supervised clinical experiences and demonstrated competence in the performance of intravenous therapy procedures.
(e) The training program for intravenous therapy shall include as a minimum instruction in:
(1) the agency's policies and procedures related to intravenous therapy;
(2) the agency's quality assurance and risk management program;
(3) anatomy and physiology related to intravenous therapy;
(4) the solutions and drugs used in intravenous therapy, their pharmacological action and therapeutic effects;
(5) procedures used for mixing intravenous medications and solutions;
(6) the signs and symptoms of complications and adverse reactions to intravenous therapy;
(7) the functions, use and maintenance of intravenous devices and equipment; and
(8) infection control techniques.
(f) The agency shall ensure that all intravenous therapy procedures performed by the licensed practical nurse are provided in accordance with written policies and procedures which are reviewed and updated as needed, but at least annually.
(g) The agency shall ensure that there is documentation in the licensed practical nurse's personnel file which indicates the training program attended, number of hours and content of the program, supervised clinical experiences and approval to perform intravenous therapy procedures.
(h) Inservice education programs shall be conducted to update and inform the licensed practical nurse of new intravenous therapy procedures, equipment and medications. The programs shall be conducted as often as necessary but at least on an annual basis and be documented in the personnel file of the licensed practical nurse.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.7 Procedures governing inspection and copying of records
Inspection and copying of records shall be made in the following manner:
(a) Records access requests must be reasonably described and in writing.
(b) The records access officer shall, within five business days after receipt of a request:
(1) make requested records available;
(2) deny the request in writing. Such denial should:
(i) explain the reason for the denial;
(ii) set forth the right of appeal to the records access appeals officer; and
(iii) provide the name, title, business address and telephone number of the records access appeals officer; or
(3) furnish written acknowledgment of the request and the approximate date when the request will be granted or denied.
(c) If access to records is neither granted nor denied within 10 business days after the date of acknowledgment of receipt of request, the request may be construed as a denial of access that may be appealed.
(d) If access is approved, the records access officer shall cause a search for the records requested.
(e) If the record cannot be found after diligent search, the records access officer shall so notify the requestor.
(f) Upon request, the records access officer will certify that the record is a true copy.
(g) Where applicable, nondisclosable information will be deleted from a record as authorized by the Freedom of Information Law.
(h) The original or file copies of records will not be released from departmental files.
(i) Persons requesting records in the possession of the department but which records originated in any other State or Federal agency, shall be referred to the originating agency when there is a question concerning confidentiality requirements.
(j) Persons inspecting a record shall be allowed to copy it by any means which will not damage the record.
(k) A reasonably detailed current list of any records subject to the Freedom of Information Law, shall be maintained by the department and updated semiannually.
(l) The locations where public records are available for inspection or copying pursuant to this Subpart shall be posted in conspicuous places.
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.8 Processing and storage of tissue
(a) Fresh cardiovascular tissue shall be stored in an isotonic storage medium demonstrated to maximize tissue viability in a sealed, sterile container at a temperature between one and 10 degrees Celsius for a period not to exceed 24 hours from retrieval. Storage shall take place in a refrigerator reserved for cardiovascular or other tissue intended for transplantation, equipped with a thermometer calibrated at least annually against a National Institute of Standards and Technology (NIST)-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, an NIST-certified thermometer. The temperature shall be visually monitored and recorded daily unless the refrigerator is equipped with a calibrated mechanical temperature monitor and alarm system to detect an increase in temperature to above 10 degrees Celsius or a decrease in temperature to below one degree Celsius..
(b) Cardiovascular tissue processing for cryopreservation shall be initiated under aseptic conditions within 24 hours of retrieval. Until processing, tissue shall be stored at between one and 10 degrees Celsius. Once processed, cardiovascular tissue shall be stored frozen at a target temperature of minus 100 degrees Celsius or lower with a suitable cryoprotectant in labeled containers until distributed or issued for use, in either:
(1) a freezer reserved for cardiovascular or other tissue intended for transplantation, equipped with an audible alarm to detect an increase in temperature to above the limit established by the director and a recording thermometer calibrated at least annually against an NIST-certified thermometer, or a thermometer that has been tested against, and found to be in agreement with, an NIST-certified thermometer; or
(2) a liquid nitrogen tank reserved for cardiovascular or other tissue intended for transplantation.
(c) Storage equipment shall have clearly defined and labeled areas for all cardiovascular tissue stored, and untested tissue shall be maintained in a quarantine area segregated from tissue awaiting distribution.
(d) Thermometers shall be visually monitored daily or temperatures shall be continuously monitored mechanically, and, if applicable, liquid nitrogen levels shall be checked at least twice a week for fluctuations potentially affecting the quality of the cardiovascular tissue. Temperature records and, if applicable, liquid nitrogen level records shall be available for inspection by the department for the entire period of storage and for one year afterwards.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.8 Responsibilities of the local health officer
(a) If the parent or legal guardian of a child requiring hepatitis B immunization pursuant to this Subpart is unable to pay for the services of a private physician or other authorized practitioner to administer the follow-up doses of hepatitis B vaccine, such person shall present such child to the health officer of the county in which the child resides, who shall then administer the follow-up hepatitis B vaccine without charge.
(b) The local health officer shall make a report within 30 days of initiation of follow-up and within 30 days of the completion of follow-up to the Commissioner of Health for each newborn child of a HBsAg-positive woman. Such report shall include verification of the woman's HBsAg test result and details of the child's follow-up care.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.1 Definitions
As used in this Part:
(a) Anonymous donor means a donor whose identity is unknown to the recipient.
(b) Artificial insemination means the placement of semen within the body of a recipient.
(c) Assisted reproductive procedure means a medical procedure intended to result in conception, including, but not limited to, in vitro fertilization (including intracytoplasmic sperm injection), embryo transfer and gamete intrafallopian transfer.
(d) Client-depositor means a man who deposits reproductive tissue prior to intended or potential use in artificial insemination or assisted reproductive procedures performed on his regular sexual partner, or a woman who deposits reprouctive tissue for processing into embryos and subsequent implantation into the same woman.
(e) Directed donor means a donor who is known to the recipient and who directs his or her reproductive tissue for use by a particular recipient. This includes a man providing semen to a surrogate, but who is not the regular sexual partner of the recipient.
(f) Donor means a person who provides reproductive tissue for use in artificial insemination or assisted reproductive procedures performed on recipients other than that person or that person's regular sexual partner, and includes directed donors.
(g) Reproductive tissue bank means a facility which acquires, processes, stores, distributes and/or releases reproductive tissue to an insemination/implantation site for use in artificial insemination or assisted reproductive procedures. Reproductive tissue banks include, but are not limited to, semen banks, oocyte donation programs and embryo banks.
(h) Insemination/implantation site means a location at which artificial insemination or assisted reproductive procedures are performed, using reproductive tissue from anonymous donors, directed donors and/or client-depositors. Licensed insemination/implantation sites may undertake, without additional licensure, semen processing, limited to washing, concentrating and storing of semen from patients of physicians associated with the licensed insemination/implantation sites or the patients' regular sexual partners, as well as limited semen storage (less than six months' duration).
(i) Recipient means a woman who receives reproductive tissue from a donor or client-depositor.
(j) Semen processing facility means a tissue processing facility that processes semen for use by other licensed reproductive tissue banks and insemination/implantation sites.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 152 WARREN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 152.7 Diamond Point Water District, Town of Lake George
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Smith Brook and all tributaries above the intake of the supply which now serve or which may be developed in the future to serve as sources of the public water supply of the Diamond Point Water District, Town of Lake George, Warren County, New York, and to all watercourses tributary thereto or ultimately discharging into said public water supply or its reservoirs.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) District shall mean the Diamond Point Water District.
(3) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(4) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(5) Human excreta shall mean human feces and urine.
(6) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(7) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of the reservoir or the edge, margin or precipitous bank forming the high-water mark of a watercourse.
(8) Manure shall mean animal feces and urine.
(9) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(10) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(11) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural- and nonagricultural-associated animal waste.
(12) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave or visible, infrared or ultraviolet light.
(13) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(14) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(15) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(16) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Diamond Point Water District.
(17) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(18) Sewage disposal system shall mean any system used for disposing of sewage, and includes treatment works.
(19) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(20) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(21) Trustee shall mean the town board of the Town of Lake George as trustee for the Diamond Point Water District.
(22) Watercourse shall mean every spring, stream, march, pond, reservoir or channel of water of any kind, the waters of which flow or may flow into the Diamond Point Water District public water supply.
(23) Watershed shall mean the entire drainage area contributing to the Diamond Point Water District public water supply.
(24) Water supply shall mean the public water supply of the Diamond Point Water District, Town of Lake George, Warren County, New York.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title. In addition, no clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils, nor anything that in any way or to any degree pollutes water shall be washed, rinsed or placed in the reservoir or in any watercourse tributary thereto within a distance of one mile upstream from the reservoir.
(d) Specific prohibitions.
(1) Bathing and swimming.
Bathing and swimming are prohibited within any watercourse or reservoir on the watershed.
(2) Cemeteries; dead animals.
(i) No interment of a human body shall be made within the watershed.
(ii) No dead animal, bird, fish, nor any part thereof, shall be thrown or placed into any watercourse tributary to Smith Brook above the intake of the water system; nor shall any such material be placed, maintained, or allowed to remain such that the drainage, leachings or washings therefrom may reach any watercourse without first having percolated over or through the soil in a scattered, dissipated form, and not concentrated in perceptible lines of drainage, for a linear distance of 250 feet from any such watercourse.
(iii) The burying of animals, birds, fish, etc., or parts thereof, is prohibited within a 250-foot linear distance of any reservoir or watercourse tributary to the Diamond Point Water District public water supply.
(3) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse, except in weatherproof buildings or watertight vessels.
(4) Dams.
No person shall construct a pond or erect, reconstruct or repair any dam or impoundment structure or other artificial obstruction, temporary or permanent, in or across a watercourse in the watershed without authorization from the trustee of the district.
(5) Herbicides and pesticides.
No herbicide or pesticide shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction. Any application for such permit must clearly state that the land to which the permit relates is located within the watershed.
(6) Erosion control.
(i) Erosion control procedures shall be employed where construction in the watershed will result in sediment entering Smith Brook above the water intake of the Diamond Point Water District public water supply.
(ii) Any work which will involve a change, modification, or otherwise disturb the course, channel or bed of Smith Brook above the intake of the Diamond Point Water District public water supply will require necessary permits from appropriate State regulatory agencies, as well as approval of the trustee.
(7) Human excreta and sewage.
(i) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta shall be buried in the soil on the watershed, unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy, privy vault, pit, cesspool, or similar nonwatertight receptacle of any kind for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained, or allowed to remain on the watershed. Only effluent from an approved treatment works may be discharged into the subsurface ground strata. Treatment works must have the approval of the Lake George Consolidated Board of Health and the appropriate State agency having jurisdiction.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed, or allowed to remain within a 150-foot linear distance of any reservoir or watercourse.
(vi) Watertight tanks employed for the temporary storage of sewage, if allowed to be utilized by the trustee, shall not be permitted to overflow in any amount. Licensed scavenger units shall be employed, as necessary, to service such tanks and dispose of tank contents only in approved, authorized landfills or an operating municipal sewage treatment works.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any watercourse.
(viii) Before any existing sewage disposal system is altered, or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Said plans must state in the application that the site is within the Diamond Point Water District watershed. The New York State Department of Health Waste Treatment Handbook Individual Household Systems, the Lake George Consolidated Board of Health sewerage regulations, and subparagraph (v) of this paragraph, shall comprise the criteria for approval of any proposed sewage disposal system.
(ix)
(a) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground, or owing to the height or flow of subsoil or surface water, or owing to other special local conditions, the excremental matter from any system, or from any trench, seepage disposal area, or any other place of disposal may, in the judgment of the Lake George Consolidated Board of Health and the New York State Department of Health, be washed over the surface or through the soil in an imperfectly purified condition into any watercourse, then said system or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper in the joint judgment of the Lake George Consolidated Board of Health and the New York State Department of Health.
(b) If the above limiting distance is not possible, due to lack of land area, etc., the owner shall take other corrective measures as approved by the Lake George Consolidated Board of Health and appropriate State agencies having jurisdiction.
(x) No sewage, house slops, bath water, or polluted liquid of any kind shall be thrown, placed, led, conducted, discharged or allowed to flow from any pipe, drain or ditch into any watercourse on the watershed, unless discharge is through a subsurface disposal system approved by the Lake George Consolidated Board of Health and the appropriate State agency having jurisdiction.
(8) Junkyards.
No junkyard shall be permitted within the watershed.
(9) Manure; compost heaps; animal shelters.
No stable, barnyard, hog pen, poultry house, hitching post, manure pile or compost heap shall be constructed, placed, or allowed to remain within a 250-foot linear distance of any reservoir or watercourse. None of the above-named objects or sources of pollution shall be constructed, placed, maintained or allowed to remain where, or in such a manner that, the drainage, leachings or washings therefrom may enter the reservoir or any watercourse tributary thereto without having first passed over or through such an expanse of soil as to have been properly and reasonably purified.
(10) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 16-A (Ionizing Radiation) of this Title, shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse.
(11) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(12) Refuse disposal area.
No new refuse disposal area shall be located within a 250-foot linear distance of any reservoir or watercourse on the watershed, and all such refuse disposal areas shall comply with existing town ordinances.
(13) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir within the watershed.
(14) Toxic substances.
No toxic substance shall be discharged, applied, or allowed to enter into any reservoir or watercourse, except as otherwise permitted by the provisions of paragraph (5) of this subdivision, and no container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 250-foot linear distance of any such reservoir or watercourse.
(15) Trespassing.
No trespassing shall be allowed upon the lands owned by the district, except by duly authorized personnel of the district in performing their duties of supervision and maintenance of the water supply.
(16) Other wastes.
No pollutant of any kind shall be discharged, deposited, or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground or watershed within a 250-foot linear distance of any reservoir, except as otherwise permitted by the applicable provisions of paragraph (7) of this subdivision. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The Lake George Department of Public Works or its duly authorized personnel shall maintain systematic and thorough inspection of Smith Brook above the Diamond Point Water District water supply intake, as well as the entire drainage area tributary thereto, to ascertain compliance with all the foregoing provisions. A complete and detailed report of each such inspection shall be submitted in writing, by the Lake George Department of Public Works or its duly authorized personnel, to the town board of the Town of Lake George and the Lake George Consolidated Board of Health, within 10 days after the completion of each inspection. An annual report shall be submitted to the State Commissioner of Health and the Lake George Consolidated Board of Health prior to the 30th day of January. The report shall state the number of inspections which were made, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.251 Periodic interim payment (PIP)
A plan under which the hospital receives cash payments from third-party payors (usually Medicare) in constant amounts each period. The total of these payments received over a year is the estimated cost of providing services to patients covered by the plan.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-6 VARIANCES
10 CRR-NY 128-6.1 Variances
(a) The commissioner or the first deputy commissioner may, in his or her discretion, upon written application from the applicant, grant a variance from the requirements of these rules and regulations for a regulated activity and for the alteration or modification of a noncomplying regulated activity.
(1) An application for a variance for a regulated activity or for an alteration or modification of a noncomplying regulated activity shall:
(i) identify the specific provision of the rules and regulations from which the variance is sought or identify the nature and extent of the alteration or modification of the noncomplying regulated activity;
(ii) demonstrate that the variance requested is the minimum necessary to afford relief;
(iii) demonstrate that the activity as proposed includes adequate mitigation measures to avoid contamination to or degradation of the water supply which are at least as protective of the water supply as the standards for regulated activities set forth in these rules and regulations; and
(iv) demonstrate that for the proposed use or activity for which the variance is requested, compliance with the identified provision of the rules and regulations would create a substantial hardship due to site conditions or limitations.
(2) In granting variances the commissioner or the first deputy commissioner may impose specific conditions, including evidence of financial security, time limitations and limitations on any transfer of the variance granted. In addition, the commissioner or the first deputy commissioner may grant a lesser variance than that applied for.
(3) Any proposed substantial alteration or modification of an activity that has been granted a variance under this Subpart shall require the review and approval of the department and shall comply with the provisions of this Subpart.
(4) The burden of proof for a variance shall be on the applicant.
(5) Except for a variance granted for an alteration or modification of a noncomplying regulated activity, a grant of a variance for a regulated activity shall not be deemed to make such activity a noncomplying regulated activity under these rules and regulations.
(b) An appeal of a denial of a variance for a regulated activity or a denial of a variance for an alteration or modification of a noncomplying regulated activity may be made in the manner specified in section 128-2.8 of this Part.
(c) Failure to comply with any condition of a variance for a regulated activity, or for a variance for an alteration or modification of a noncomplying regulated activity shall be a violation of these rules and regulations. The department shall review the terms and conditions of each variance granted at least once every five years to determine whether the terms and conditions of the variance have been complied with.
(d) Variances within coliform and phosphorus restricted basins.
(1) The department may grant a variance from the prohibition of locating a new wastewater treatment plant or expanding an existing wastewater treatment plant in a coliform restricted basin, or in a phosphorus restricted basin, where the department determines that conditions are resulting in the release or discharge of inadequately treated sewage into the water supply, and that there is no other feasible method of correcting such release or discharge of inadequately treated sewage except to provide a variance from such prohibition. Provided, however, that in such cases, the additional treatment capacity of the new or expanded wastewater treatment plant may only be of a size sufficient to service the area identified as the source of contamination and any immediate area of concern as limited or delineated by the department.
(2) A request for a variance from the prohibition of expanding an existing wastewater treatment plant located in a phosphorus restricted basin which does not meet the criteria set forth in paragraph (1) of this subdivision may be granted only if the applicant demonstrates that subsurface discharge is impossible and that every one kilogram of projected increase in the phosphorus load resulting from the expansion of the existing wastewater treatment plant and accompanying non-point source runoff, is offset by two kilograms of reductions in phosphorus loading within such basin provided by enhanced treatment, basin-wide phosphorus trading, and/or a watershed protection plan developed pursuant to Subpart 128-8 of this Part.
Subpart 128-9 SEVERABILITY
10 CRR-NY 128-9.1 Severability
The provisions of these rules and regulations shall be severable, and if any item, subclause, clause, sentence, subparagraph, paragraph, subdivision, section or Subpart of this Part, or the applicability thereof to any person or circumstances, shall be adjudged by any court of competent jurisdiction to be invalid, such judgment shall not affect, impair or invalidate the remainder thereof, and the application thereof, but shall be confined in its operation to the item, subclause, clause, sentence, subparagraph, paragraph, subdivision, section or Subpart thereof, or to the person or circumstance directly involved in the controversy in which such judgment shall have been rendered.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SOURCES OF WATER SUPPLY SOURCES OF WATER SUPPLY
10 CRR-NY 5-1.15 Limitation
If the information required is already available for the same source of water supply or if an emergency exists which requires the development of an emergency source, the requirements of section 5-1.14 of this Subpart shall not apply.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.16 Required standards for transfusions
(a) Transfusion services.
Every institution which performs transfusions or supplies blood to a limited transfusion service or ambulance transfusion service shall designate a physician who is a member of the staff as director of transfusion services. Such physician must be licensed and currently registered in New York State. The premises, equipment, procedure manuals, records, and all blood, blood components and derivatives shall be available for inspection by the department.
(1) It shall be the responsibility of the chief executive officer or other person in charge of each institution and of the director of transfusion services to determine that:
(i) the rules and regulations of the Council on Human Blood and Transfusion Services and the Administrative Rules and Regulations of the department and related requirements are complied with;
(ii) attending and other staff members and nurses are properly instructed regarding all required procedures;
(iii) records required by the aforesaid rules and regulations are maintained;
(iv) serious unexpected reactions and incidents involving blood components that have been issued by the transfusion service are reported to the department's Wadsworth Center, with sufficient detail to facilitate evaluation and investigation, within seven calendar days of the reaction or incident, or its discovery and, if required, to Federal authorities; and
(v) a written policy exists regarding use of blood components negative for cytomegalovirus antibody, irradiated components, leukocyte-reduced components and other specialty components. Such a policy shall include recommended indications for component use and a protocol for component processing and issuance. There shall also be a written policy on recommended indications for transfusion of whole blood, fresh frozen plasma and platelets.
(2) The institution shall report annually to the department the name(s) of the physician(s) in charge of the transfusion service.
(3) If blood components are issued to a limited transfusion service or an ambulance transfusion service, the director of transfusion services of the issuing facility and the director of the limited transfusion service or ambulance transfusion service performing the transfusion shall ensure compliance with all requirements of this Part.
(b) Each institution that performs transfusions or supplies blood to a limited transfusion service and/or an ambulance transfusion service shall have a transfusion committee that meets at least quarterly. The committee shall:
(1) be composed of at least five members;
(2) include members with expertise in clinical medicine and/or transfusion medicine and who are qualified to review the appropriateness and technical aspects of a transfusion; and
(3) review all or a representative sample of transfusions of all categories of blood and blood products issued by the facility for administration at any location, including all intraoperative and postoperative recovery procedures.
(c) Each institution, through its transfusion committee, shall establish guidelines for reservation (compatibility or crossmatching) of blood for each elective surgical procedure which has been performed there more than five times in the preceding calendar year and shall set the maximum number of hours that crossmatched blood will be held on reserve.
(d) Whole blood, red blood cells, plasma, or other components and derivatives shall be prepared and administered by methods generally accepted by the F.D.A. or American Association of Blood Banks and/or by other methods approved by the department as in conformance with generally accepted laboratory principles. No medications except physiologic saline for intravenous use shall be added to, mixed with, or administered in the same line with a blood component unless approved for this use by F.D.A. and there is documentation available to show that the addition is safe and does not adversely affect the blood component. A filter meeting F.D.A. requirements shall be incorporated into the intravenous administration set to be used for blood or blood component transfusions.
(e) In a health care setting, the person initiating transfusion of blood or blood components shall be a:
(1) physician;
(2) registered nurse;
(3) physician assistant;
(4) nurse practitioner;
(5) board-certified cardiovascular perfusionist (intraoperatively); or
(6) licensed practical nurse who has completed a transfusion training program meeting criteria specified by the department and by the New York State Education Department, when supervised by a registered nurse, physician assistant, or a physician who is immediately available on site.
(f) In a health care setting, following comparison of the unit’s label with all accompanying information, the person initiating transfusion of a blood component shall, at the patient’s side, immediately prior to initiating the transfusion, positively identify the recipient and the blood component to be transfused, using the patient’s name and a unique numerical or alphanumerical identifier. One additional person, authorized to initiate transfusion, and who is not a licensed practical nurse if the person initiating the transfusion is a licensed practical nurse, shall also so identify the recipient and the blood component, unless another procedure to ensure accurate identification is used, in which case a single identification shall be sufficient. Each identification procedure shall be documented in writing by each participant. Two persons authorized to initiate blood transfusions shall be immediately available during a blood component transfusion and for 30 minutes afterward, except for transfusion of a patient enrolled in a chronic transfusion program who has no history of adverse reactions. A blood component recipient’s vital signs shall be serially recorded, in accordance with written policies and procedures. If the person recording the vital signs is a licensed practical nurse, all measurements outside of established parameters shall be reported to a registered nurse, physician, physician assistant, or nurse practitioner for assessment and action. Such notification shall be documented.
(g) For transfusions outside a health care setting, including those in a patient’s home, but not including those in an ambulance, the person initiating the transfusion and monitoring the patient shall be a physician, registered nurse, physician assistant, or nurse practitioner. Following comparison of the blood product label with all accompanying information, this person shall, at the patient’s side, immediately prior to initiating the transfusion, positively identify the recipient and the blood product to be transfused or infused, using the patient’s name and a unique numerical or alphanumerical identifier. Each such identification procedure shall be documented in writing. A person authorized to monitor transfusions and another competent adult, other than the recipient, shall be immediately available at all times during a transfusion. Both persons shall be available for 30 minutes afterwards, except for transfusions of patients enrolled in a chronic transfusion program who have no history of adverse reactions. The recipient’s vital signs shall be monitored serially and documented, in accordance with written policies and procedures.
(h) Transfusions during transport between hospitals may be administered only by a registered nurse, nurse practitioner, physician assistant, physician, or emergency medical technician certified at the critical care or paramedic level, provided such emergency medical technician has received training in blood administration in accordance with requirements established by the department and is performing these services as part of an ambulance transfusion service approved by the department. Blood components to be issued to an ambulance transfusion service must be ordered by a health care provider caring for the patient using a standard order form approved by the department. The transfusion service issuing the blood components shall be made aware that the blood is intended for possible administration during transport between hospitals and shall be informed of the destination hospital. Blood components intended for possible administration during transport shall be packed in a suitable container validated to maintain the appropriate temperature for the anticipated duration of transport. Prior to departure, the identification of the patient and of any blood components to be transported for possible administration during transport shall be verified in accordance with subdivision (f) of this section. In addition, a registered nurse, physician assistant, nurse practitioner, or physician shall verify, at the patient’s side, the identification of the patient and all blood units, with the qualified person who will be caring for the patient during transport.
(i) Every facility or limited transfusion service performing transfusions shall provide 24-hour-a-day post-transfusion patient coverage by telephone as necessary.
(j) Each institution, through its transfusion committee, shall develop and implement procedures to encourage the use of autogeneic blood whenever medically indicated. These procedures shall include a mechanism for informing staff physicians of the risks and benefits of autogeneic blood and the options for autogeneic blood transfusion available at the institution, including, but not limited to, intraoperative blood recovery, isovolemic hemodilution and presurgical deposit, as applicable. These procedures shall also include a mechanism to encourage physicians to inform their patients of such options whenever medically indicated.
(k) If blood is warmed prior to transfusion, the warming system shall be equipped with a visible thermometer and an alarm to ensure that the blood is not warmed above the temperature specified by the director of the blood bank, in conformance with the system manufacturer's instructions. Blood warmer temperature shall be monitored and recorded on each day of use, and such records shall be available for inspection for at least five years. Maintenance and operation of blood warmers must conform to the manufacturer’s instructions.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.102 Equipment acceptable
Equipment installed in mobile food service establishments is acceptable in that establishment provided that it is in good repair, maintained in a sanitary condition, the food-contact surfaces are nontoxic and it performs its intended function in a satisfactory manner without contaminating food by normal use.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.104 Conditions of specific licenses
(a) It is hereby made a condition of each specific license:
(1) that the licensee thereunder shall comply with all applicable provisions of the State Public Health Law, of all other laws now or hereafter in effect, and with all applicable rules, regulations, codes and orders now or hereafter in effect of the department and of all appropriate regulatory agencies;
(2) that neither such license, nor any right, title or interest in, of or to such license, shall be disposed of by assignment, transfer or otherwise, either voluntarily or involuntarily, either directly or indirectly, unless the department shall, after securing complete and accurate pertinent information, have approved in uniting of such disposal;
(3) that the licensee shall confine his possession and use of licensed radioactive material to such location or locations and for such purpose or purposes as the license may authorize; provided, however, that except as otherwise provided in such license or this Part, such license shall be deemed to authorize the licensee to transfer the material covered by such license to any other person authorized to receive it by the department, the State Department of Labor, the New York City Department of Health, the United States Nuclear Regulatory Commission or any agreement state; and
(4) that the licensee shall notify the department by letter within 30 days if an authorized user, radiation safety officer or radiation therapy physicist permanently discontinues performance of duties under the license; and
(5)
(i) that each licensee shall notify the department in writing immediately following the filing of a voluntary or involuntary petition for bankruptcy under any chapter of Title 11 (Bankruptcy) of the United States Code by or against:
(a) the licensee;
(b) an entity (as that term is defined in 11 U.S.C. 101 [14]) (see section 16.200 of this Part) controlling the licensee or listing the license or licensee as property of the estate; or
(c) an affiliate (as that term is defined in 11 U.S.C. 101 [2]) (see section 16.200 of this Part) of the licensee;
(ii) this notification must indicate:
(a) the bankruptcy court in which the petition for bankruptcy was filed; and
(b) the date of the filing of the petition;
(6) that any license covering the use of special nuclear material in the course of which licensed use additional special nuclear material is produced, shall be deemed to cover any such special nuclear material so produced; provided, however, that the total quantity of special nuclear material possessed by the licensee is not sufficient to form a critical mass.
(b) The department may at any time set forth in any license or incorporate by reference therein, additional conditions, restrictions or requirements applicable to the licensee's transfer, receipt, possession or use of the radioactive material covered by such license in order to protect the public health and safety and to minimize danger to life and property from radiation hazards.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.58 Lead poisoning prevention; performance standards
(a) The local health department shall maintain a lead poisoning prevention program, which shall include, at a minimum:
(1) activities to identify risk factors for childhood lead poisoning, including locations in the municipality where exposure of children to lead is likely;
(2) activities to educate the community as to the dangers of lead toxicity;
(3) for all children aged one and two years old, and other children at risk of exposure to lead, ensuring provision of:
(i) access to blood lead testing services;
(ii) appropriate case coordination; and
(iii) environmental intervention;
(4) reporting of pertinent blood lead testing information and follow up activities in a manner acceptable to the commissioner, provided that this provision shall not be interpreted to limit the jurisdiction of the local health department to require additional reporting in accordance with local law.
(b) The cost of removal or covering lead paint or of relocating persons exposed to lead paint shall not be eligible for State aid.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.114 Drying
All equipment and utensils are to be air-dried after sanitizing.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.7 Recordkeeping
The department shall maintain on file each cooperative agreement for which a certificate of public advantage is in effect and a copy of the certificate, including any conditions imposed on it.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.61 Hicksville Water District, town of Oyster Bay
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as finally amended by chapter 510 of the Laws of 1921, as heretofore set forth, shall apply to all wells of the public water supply of the Hicksville Water District of the town of Oyster Bay, Nassau County, N. Y.
(b) [Definition.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Hicksville Water District unless especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. All such receptacles located within the limiting distance referred to in this paragraph shall be constructed only with the approval of and under the supervision of the board of water commissioners of the Hicksville Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Hicksville Water District.
(3) No cesspool, pit or other receptacle used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is watertight and so arranged and equipped that the said excreta or sewage will not overflow and is at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, except that suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage may be provided and maintained between the said limiting distances if at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable vessels or receptacles permitted under paragraphs (1) and (3) of this subdivision shall be removed and the vessels or receptacles thoroughly cleaned and deodorized as often as may be found necessary in order to maintain them or the privy or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of final disposal hereinafter specified and that the contents while being transferred shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraphs (1) and (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any well of the public water supply of the Hicksville Water District.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes or sewage or other excretal matter from any water closet, privy, receptacle or other source shall be thrown, placed, led, discharged or allowed to escape on or beneath the surface of the ground within 200 feet of any well of the Hicksville Water District, except into suitable watertight iron pipes with leaded joints connected to a sewage disposal system, plans for which have been submitted to and received the approval of the State engineer and a permit obtained from their department.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuses or waste matter from any industrial establishment nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the Hicksville Water District.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet of any well of the public water supply of the Hicksville Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well nor to be placed, piled or spread upon the surface of the ground or be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 200 feet from any well of the public water supply of the Hicksville Water District and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet from any well of the public water supply of the Hicksville Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or maintained or allowed to remain on the surface of the ground or beneath the surface of the ground within 300 feet of any well of the public water supply of the Hicksville Water District.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any well of the public water supply of the Hicksville Water District.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any well of the public water supply of the Hicksville Water District.
(i) Inspections.
The board of water commissioners of the Hicksville Water District shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.2 Health officer to file report with local board
The health officer, except in municipalities in which a different procedure is prescribed by general or special law, shall also within five days of the receipt of a complaint or of the discovery of the probable existence of a nuisance which may affect health, unless the nuisance has in the meantime been abated and the complainant satisfied, file with the local board of health:
(a) the complaint, if made in writing, or, if not in writing a summary thereof; or, if no complaint has been made, a statement of the facts, and
(b) a report showing:
(1) his findings of the facts;
(2) his opinion as to whether or not the condition constitutes a nuisance likely to affect health and whether or not such condition constitutes a violation of any local regulation in the municipality;
(3) the steps, if any, already taken to abate the nuisance;
(4) whether in his opinion the nuisance has been abated.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.30 Organ and vascularized composite allograft transplant services/programs
(a) Definitions.
For purposes of this section the following shall have the following meanings:
(1) Department shall mean the New York State Department of Health.
(2) Living donor is an individual who donates an organ or a vascularized composite allograft while alive.
(3) Organ means a human kidney, heart, liver, lung, pancreas, uterus, stomach, intestine, and/or any other tissue requiring revascularization or immunosuppression in the recipient.
(4) Organ procurement organization (OPO) means a facility or institution engaged in procuring organs and/or vascularized composite allografts for transplantation, or therapy purposes but does not include:
(i) facilities or institutions which permit procurement activities to be conducted on their premises by employees or agents of an approved organ procurement organization; or
(ii) facilities or consortia of facilities which conduct transplantation activities in accordance with article 28 of the Public Health Law when the organ is procured through an approved organ procurement organization, or from a living donor.
(5) Organ trafficking is the recruitment, transport, transfer, harboring or receipt of living or deceased persons or their organs by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving to, or the receiving by, a third party of payments or benefits to achieve the transfer of control over the potential donor, for the purpose of exploitation by the removal of organs for transplantation.
(6) Patient means either the living donor or the recipient:
(i) adult means a patient 18 years of age or older at the time of the transplant;
(ii) pediatric patient means a patient who has not reached his or her 18th birthday at the time of the transplant.
(7) Qualified mental health professional shall mean a psychiatrist, psychologist, or qualified social worker assigned to evaluate the potential recipient and/ or living donor.
(8) Qualified social worker shall mean a person who is licensed and registered by the State Education Department to practice as a licensed master social worker (LMSW) or licensed clinical social worker (LCSW), within the scope of practice defined in article 154 of the Education Law.
(9) Recipient is an individual who receives transplanted organs, or a vascularized composite allograft.
(10) Transplant center means a unit within a hospital that performs transplants, including but not limited to activities such as qualifying patients for transplant, registering patients on the national wait list, performing transplant surgery and providing care before and after transplant. A transplant center may include one or more transplant programs.
(11) Transplant commercialism is a policy or practice in which an organ is treated as a commodity, including being bought, sold, or used for material gain.
(12) Transplant program means the persons or entity that provides organ specific transplant services within a transplant center.
(13) Transplant services means the provision of organ, living donor and or vascularized composite allograft transplants and other medical and surgical specialty services required for the care of transplant recipients and living donors.
(14) Transplant tourism is travel for transplant that involves organ trafficking and/or transplant commercialism.
(15) Travel for transplant is the movement of organs, vascularized composite allografts, donors, recipients, or transplant professionals who travel across national borders for transplant purposes.
(16) Vascularized composite allograft means a contiguous segment of mixed allogeneic tissues whose relationships have been altered only at the segment boundaries and whose transplantation requires revascularization and/or immunosuppression in the recipient. Vascularized composite allografts include, but are not limited to, hand, face, and other such contiguous segments.
(b) General requirements.
Hospitals shall not admit patients for, or otherwise provide, transplantation services unless the hospital is specifically approved by the department to provide transplant services. Transplant services for pediatric patients shall only be provided in a hospital approved by the department to provide transplant services. Hospitals that provide pediatric transplant services must comply with section 405.22(a) of this Part and must develop and adhere to written policies and procedures specific to pediatric patients.
In addition, the following standards apply to all transplant centers and programs:
(1) Transplant services, or any new Institutional Review Board (IRB) approved medical/surgical treatments which involve transplant medical/surgical care including but not limited to transplant immunology, shall be performed only in hospitals approved by the department to perform such transplant services.
(2) The hospital shall be a member in good standing of the Organ and Procurement and Transplantation Network (OPTN) approved by the Secretary of the U.S. Department of Health and Human Services (HHS) and shall abide by its rules and requirements.
(3) When fully operational, to ensure quality of care, the hospital shall perform at least 10 liver transplants per year if it is to continue as an approved liver transplant program; or at least 10 human heart transplants per year if it is to continue as an approved heart transplant program; or at least 10 kidney transplants a year if it is to continue as an approved kidney transplant program; or at least 10 lung transplants per year if it is to continue as an approved lung transplant program. The department will monitor outcomes for graft and patient survival.
(4) The hospital shall participate in a patient registry program with an organ procurement organization designated by the Secretary of the U. S. Department of Health and Human Services. Before arranging for the placement of the patient on the waiting list, each facility shall inform a patient awaiting transplantation of the prohibition against being placed on multiple facility waiting lists within New York State before arranging for the placement of the patient on the waiting list.
(5) Every hospital performing transplant services shall maintain written criteria for the selection of patients for such services which shall be consistent with professional standards of practice, applied consistently, and made available to the public.
(6) The hospital shall maintain a record of:
(i) all patients who are referred for transplantation and the date of their referral;
(ii) the results of the evaluation of all candidates for transplantation which documents the reasons a candidate is determined to be either suitable or unsuitable for transplantation;
(iii) the psychosocial evaluation;
(iv) the date a suitable candidate is selected for transplantation;
(v) the reasons for, and date of, any declination of a matching organ or vascularized composite allograft offered to a potential recipient;
(vi) the date the transplantation surgery occurred;
(vii) documentation of donor and recipient blood type;
(viii) the donor’s United Network for Organ Sharing (UNOS) identification number; and
(ix) the organs or vascularized composite allografts utilized.
(7) The hospital will ensure that appropriate informed consent is obtained from both the recipient and if applicable, the living donor. The process for obtaining such consent shall include the provision of information, at a minimum of the following:
(i) the evaluation process used to determine suitability for transplant;
(ii) the surgical procedure including the post-operative period;
(iii) the availability of alternative treatments;
(iv) organ donor risk factors that could affect the success of the graft or the health of the patient, including, but not limited to, the donor’s history, condition or age of the organs or vascularized composite allografts used, and the recipient’s potential risk of contracting the human immunodeficiency virus (HIV) and other infectious diseases if the disease cannot be detected in an infected donor;
(v) if applicable, providing adequate information to the recipient to ensure his or her understanding regarding the risks to the living donor;
(vi) potential medical and psychosocial risks;
(vii) the national and transplant center outcomes for recipients;
(viii) the patient’s right to refuse transplantation, or the donor’s right to refuse to be a donor; and
(ix) the effect that provision of transplant services provided in a facility not approved as a Medicare-approved transplant center could have on the recipient’s ability to have his or her immunosuppressive drugs paid for under Medicare Part B.
(8) For procedures involving a living donor, the hospital must obtain a written attestation from the living donor attesting that the donor has not received anything of value in exchange for the donation, aside from reimbursement for expenses associated with the donation to the extent allowed by New York State and Federal law. The recipient must also attest in writing that he or she has not offered and is not aware of any offers of valuable consideration to the donor for their donation, except as allowed by New York State or Federal law.
(9) The hospital must utilize an organized system for follow-up of patients after discharge, including maintenance of records on the long-term survival of persons who have received a transplant or who have made a living donation. Transplant centers must follow the health of each donor for at least two years post-donation.
(10) The hospital shall ensure that written procedures are maintained and implemented for the receipt, identification, and verification of all organs and vascularized composite allografts for transplantation.
(11) The hospital shall develop, maintain and implement written infection control policies and procedures specific to the transplant services, as an integral part of the hospital’s infection control program.
(12) The hospital shall ensure that the infection control program utilizes sufficient professional and laboratory resources to address transplant-related transmissible infections, including discovery, identification and management of complications from organisms associated with transplants whether commonly or uncommonly encountered.
(13) Each transplant center shall develop and implement a policy for a formalized process of communication with OPOs, the center’s clinical staff, the department and as appropriate, local/city departments of health with regard to suspected and confirmed donor disease transmission. This policy shall include:
(i) identification of a patient safety contact, with coverage so that there is a person available on a 24 hour, 7 days a week, 365 days a year basis, to be the primary contact for possible disease transmission events;
(ii) a procedure to promptly contact the OPO that recovered the organ whenever a suspected disease transmission has occurred;
(iii) prompt communication and documentation when made aware of the suspected transmission;
(iv) identification of an infectious disease resource available to assist in the evaluation of a potential disease transmission; and
(v) the documentation of and notification to the transplant program director or his or her designee of the potential disease transmission, and the implementation of mechanisms to ensure that the information is acted upon in a timely manner.
(14) Every transplant center shall develop and implement a policy on travel for transplant including, transplant tourism, transplant commercialism and organ trafficking. Such policy may include:
(i) notice to all potential donors and recipients of the legal prohibitions against the sale of organs or vascularized composite allografts;
(ii) information about the medical risks of receiving an organ or vascularized composite allografts in a foreign country, in particular, the risk of infectious disease transmission to and from the recipient, the possible difficulties in obtaining recipient records related to the surgical procedure and post-operative treatment, and in cases of living donation the records regarding the donor’s social/medical history;
(iii) notice that participation in transplant commercialism and or organ trafficking may violate the laws of the countries involved as well as international treaties or conventions.
(15) Transplant centers that provide liver transplant services must join and be a member in good standing of a recognized consortium organization providing quality assurance, peer review, data sharing, and best practices collaboration activities for liver transplant services. If such a consortium(s) exists for other transplant services, such as heart or kidney, transplant centers must join the appropriate organization relevant to the transplants it performs and be a member in good standing.
(16) Review. Facilities shall allow the department, or its designee, to conduct site visits to and/or survey data and patient record reviews from existing and prospective new transplant centers.
(17) Closure.
(i) Failure to meet one or more statutory or regulatory requirements or inactivity in a program for a period of 12 months may result in actions up to and including withdrawal of approval as a transplant center.
(ii) Voluntary closure. The hospital must provide a closure plan and written notification of potential closure to the department at least 60 days prior to planned discontinuance of transplant services. Such closure plan must address and provide a means of implementation with regard to, at minimum, the following: the means by which the program's patients (including those being evaluated for transplant, wait-listed patients, transplant recipients and living donors currently being treated by the program) will be provided with written notice of the planned closure and the means by which such persons may transfer to another transplant program; the means by which the Organ Procurement and Transplant Network, operated under contract with the U.S. Department of Health and Human Services by the United Network for Organ Sharing, the Federal Centers for Medicare and Medicaid Services and the hospital’s transplant program's referral networks will be notified of the planned closure; and the means by which the program's patients (including those being evaluated for transplant, wait-listed patients, transplant recipients and living donors currently being treated by the program) will be assisted in transferring to another transplant program. No transplant service shall discontinue operation without prior written approval from the department.
(18) Notification of significant changes. A hospital must notify the department in writing within seven days of any significant changes in its transplantation services including, but not limited to:
(i) any temporary or permanent suspension of services;
(ii) departure of or change in the physician program director;
(iii) unavailability of the transplant surgeon or physician of more than 15 days, if a program is without a physician credentialed to perform one or more of the procedures or services of the transplant service as a result of such unavailability; or
(iv) inability to meet workload requirements.
(19) Data collection and reporting. Data and governmental and accrediting body reports shall be maintained for a period at least as long as that required for the retention of patient medical records under this Part, and made available to the department upon request.
(c) Organization and staffing.
(1) The director of the transplant center, in addition to the requirements in section 405.22(a)(1) of this Part, shall be a qualified specialist with previous experience and demonstrated competence in the transplant service. The director is responsible for planning, organizing, conducting, and directing the transplant center and must devote sufficient time to carry out these responsibilities including, but not limited to overseeing the transplant center's quality assurance and performance improvement (QAPI) program.
(2) Each transplant center shall have on-site a qualified transplant physician and another person who is a qualified transplant surgeon who may also fulfill the requirement as director of the service.
(3) The hospital shall provide a clinical transplant coordinator and sufficient staff to coordinate the activities of the transplant center, including patient follow-up after discharge. The clinical transplant coordinator shall be a physician, registered professional nurse, registered physician assistant, or nurse practitioner, licensed and currently registered or certified to practice in New York State.
(4) The hospital shall ensure that all staff members providing transplant services are prepared for their responsibilities through ongoing education, experience, demonstrated competence and completion of in-service education programs as needed.
(5) From admission to discharge, including post discharge follow-up, patient care evaluation, planning and management shall be performed by a multidisciplinary care team involved with the care of the patient; (which includes, at a minimum physicians, surgeons, nurses, qualified social workers, clinical transplant coordinators, nutritional services as needed and pharmacy as needed). The patient and, as appropriate, the patient’s family shall be involved and have input into the patient’s care plan.
(6) The transplant center shall make available nutritional assessments and diet counseling services to all transplant recipients and donors.
(7) The transplant center shall make psychiatric and social services available, directly or via referrals, to patients to assist with psychosocial problems of the patients, as related to the donation. Such professionals shall be skilled in individual and family counseling, shall understand the entire donation and transplantation process, and be able to provide information on financial issues and community resources.
(d) Quality assessment and performance improvement (QAPI) programs.
(1) The transplant center must develop, implement and maintain a written, comprehensive, data driven QAPI program to monitor and evaluate performance of all transplantation services, including services provided under contract or arrangement.
(2) The transplant center’s QAPI program must use objective measures to evaluate the center’s performance with regard to transplantation activities and outcomes. Outcome measures may include, but are not limited to: patient and donor selection criteria, accuracy of the waiting list in accordance with the Organ Procurement Transplantation Network (OPTN) waiting list requirements, accuracy of donor and recipient matching, patient and donor management, techniques for organ and vascularized composite allograft recovery, consent practices, patient education, patient satisfaction, and patient rights.
(3) The transplant center must take actions that result in ongoing performance improvements and track performance to ensure that improvements are sustained.
(4) A transplant center must establish and implement written policies to identify, analyze, report, address and document adverse events that occur during any phase of an organ or vascularized composite allograft transplantation case, and utilize such efforts to prevent future adverse events.
(e) Organ and vascularized composite allograft acceptance criteria.
(1) In consultation with an organ procurement organization, the hospital shall develop and uniformly apply organ and vascularized composite allograft acceptance criteria and establish written policies and procedures to ensure the medical suitability of organs and vascularized composite allografts to be transplanted. Hospitals shall also develop and uniformly apply acceptance criteria for living donors. Such acceptance criteria shall be consistent with professional standards of practice, and shall ensure that the living donor is at least 18 years of age at the time of the initial living donor evaluation. Specific medical conditions of the donor shall be determined by the transplant surgeon through the donor’s medical history, appropriate clinical laboratory testing and other confirmation methods and must be documented in the recipient’s medical record. A parent may consent to a living donation to the parent's own child, regardless of the parent's age.
(2) Written organ and vascularized composite allograft acceptance criteria shall be:
(i) specific for each type of organ or vascularized composite allograft;
(ii) shall describe those medical conditions and circumstances which would make the potential donor ineligible; and
(iii) shall describe those medical conditions for which medical discretion may be exercised.
(3) The potential recipient will be fully informed of the risks and benefits of the particular solid organ or vascularized composite allograft.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.4 Sampling for lead
(a) Paint or other similar surface coating that is peeling, cracking, blistering, flaking, chipping or powdering or is on an accessible mouthable surfaces may be sampled for lead by the following methods:
(1) At least on gram of paint or other surface coating should be collected from each surface for approved laboratory analysis;
(2) A portable X-ray florescence analyzer may be used to determine the presence of lead paint. In conducting sampling by X-ray floresence the following determinations shall apply:
(i) Where substrate correction readings are obtained, a mean reading of 1.6 milligram of lead per square centimeter or greater shall be considered as satisfactory evidence of lead paint. A mean, substrate corrected reading of less than 1.6 milligram of lead per square centimeter but more than 0.4 milligrams of lead per square centimeter shall be considered as inconclusive and in such case a sample, as described in paragraph (1) of this subdivision may be obtained. A mean substrate corrected reading of less than 0.4 milligrams of lead per square centimeter shall be considered as negitive for lead paint.
(ii) If substrate corrected readings cannot be obtained, a mean, uncorrected reading of greater than 2.0 milligrams of lead per square centimeter shall be considered as satisfactory evidence of lead paint. A mean reading of 2.0 milligrams of lead per square centimeter or less shall be considered as inconclusive and in such cases a sample, as described in paragraph (1) of this subdivision, may be obtained.
(b) Any samples of painted surfaces, paint, water, dust, soil, food, consumer products and other potential lead sources collected during an environmental investigation must be analyzed by an approved laboratory as specified by the commissioner. The sample results may be used to evaluate possible sources of lead exposure.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.4 Decertification or modification of administrative programs
(a) The administrative program of a certified local government shall be continued unless decertified or modified by the commissioner. A preliminary determination to decertify or modify shall be made at any time if the commissioner determines that the local government's administration of any element of the program is inadequate to protect the water supply.
(b) Where the commissioner has made a preliminary determination to decertify or modify a local government's administrative program pursuant to subdivision (a) of this section, a notice of proposed decertification or modification, and the reasons therefor, shall be sent by certified mail, to the designated representative of the certified local government. The certified local government may, within 10 business days of the sending of such notice, submit information addressing the reasons for decertification or modification stated in the notice. The commissioner, after receipt and consideration of any information submitted by the certified local government, shall make a final determination to continue, modify, or decertify the program within 30 business days of sending of the notice of proposed decertification or modification. Upon decertification of an administrative program the administration of the rules and regulations set forth herein shall revert to the department.
(c) A local government which has received a determination of decertification may reapply for certification after one year.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.107 Emergency services category 2—major emergency hospital
In addition to meeting the qualifications for category 3 facility, a category 2 facility must also render resuscitation and extended critical care to patients. Also, intensive nursing care and basic intensive medical care, including 24-hour blood gas determinations and inhalation therapy services should be available.
Part 445 ACCOUNT DISTRIBUTION INDEX
10 CRR-NY 445.2 Job Titles by Natural Classification Index
[4200]
| Job title | Natural account number | | --- | --- | | Accountant | .02 | | Accounting Clerk | .12 | | Accounts Receivable Clerk | .12 | | Addressing Machine Operator | .12 | | Administrative Assistant | .01 | | Administrative Secretary | .12 | | Administrator | .01 | | Admitting Officer | .01 | | Ambulance Attendant | .19 | | Ambulance Driver | .19 | | Anesthesiologist | .06 | | Animal Caretaker | .19 | | Artist | .02 | | Assistant Director | .01 | | Associate Administrator | .01 | | Audiologist | .02 | | Audiometrist | .02 | | Baker | .11 | | Biochemist | .02 | | Biochemistry Technologist | .02 | | Biomedical Technician | .02 | | Blood Bank Technologist | .02 | | Boiler Repairman | .11 | | Bookkeeper | .12 | | Business Office Manager | .01 | | Cardio-Pulmonary Technician | .02 | | Carpenter | .11 | | Cashier | .12 | | Catheterization Technician | .02 | | Chaplain | .19 | | Chef | .11 | | Clerk, General | .12 | | Clerk-Typist | .12 | | Clinical Instructor | .02 | | Clinical Coordinator | .01 | | Coding Clerk | .12 | | Collection Clerk | .12 | | Communications Coordinator | .01 | | Computer Operator | .02 | | Controller | .01 | | Cook | .11 | | Coordinator, Physical Medicine | .01 | | Corrective Therapist | .02 | | Correspondence Clerk | .12 | | Counselor, School of Nursing | .19 | | Cytotechnologist | .02 | | Dark Room Attendant | .19 | | Dental Assistant | .02 | | Dental Hygienist | .02 | | Dental Lab Technician | .02 | | Dentist | .07 | | Dialysis Technician | .02 | | Diener (Morgue Attendant) | .02 | | Dietetic Clerk | .12 | | Dietician | .02 | | Director | .01 | | Dispatcher | .12 | | Dispensary Clerk | .12 | | Duplicating Machine Operator | .12 | | Educational Therapist | .02 | | EEG Technician | .02 | | EKG Technician | .02 | | Electrical Repairman | .11 | | Electro-Medical Repairman | .11 | | Elevator Operator | .11 | | Employment Manager | .01 | | Extern | .19 | | Extractor Man | .11 | | Fellow | .08 | | File Clerk | .12 | | Fireman, Boiler | .11 | | Flatwork Finisher | .11 | | Foreman | .01 | | Grounds Keeper | .11 | | Guard | .11 | | Health Physicist | .02 | | Heart-Lung Machine Operator | .02 | | Hematologist | .02 | | Hematology Technologist | .02 | | Histologic Technician | .02 | | Histopathologist | .01 | | Hospital Admitting Clerk | .12 | | Hospital Guide | .19 | | Housekeeping Aide | .11 | | Housekeeping Attendant | .11 | | Housekeeping Crew Leader | .01 | | Illustrator | .02 | | Incinerator Man | .11 | | Industrial Engineer | .02 | | Inhalation Therapist | .02 | | Inhalation Therapy Technician | .02 | | Intern, Medical | .07 | | Instructor | .02 | | Insurance Clerk | .12 | | Interviewer | .12 | | Invoice Control Clerk | .12 | | Job Analyst | .02 | | Keypunch Operator | .12 | | Laboratory Aide | .19 | | Library Assistant | .12 | | Licensed Practical Nurse | .04 | | Mail Clerk | .12 | | Maintenance Man Helper | .11 | | Maintenance Mechanic | .11 | | Manager | .01 | | Manual-Arts Therapist | .02 | | Market-Sorter | .11 | | Medic | .09 | | Medical Illustrator | .02 | | Medical Laboratory Assistant | .19 | | Medical Librarian | .02 | | Medical Photographer | .02 | | Medical Record Clerk | .12 | | Medical Record Librarian | .01 | | Medical Record Technician | .02 | | Medical Secretary | .12 | | Medical Stenographer | .12 | | Medical Technologist | .02 | | Medical Transcriptionist | .02 | | Messenger | .12 | | Microbiologist | .02 | | Microbiology Technologist | .02 | | Morgue Attendant | .02 | | Music Therapist | .08 | | Nuclear Medical Technologist | .02 | | Nurse Anesthetist | .02 | | Nurse, Head | .01 | | Nurse, Practitioner | .09 | | Nurse, Staff (RN) | .03 | | Nursing Aide | .05 | | Occupational Therapist | .02 | | Occupational Therapy Aide | .05 | | Optometrist | .02 | | Orderly | .05 | | Orthopedic-Appliance and Limb Technician | .02 | | Orthopedic-Cast Specialist | .02 | | Orthoptist | .02 | | Painter, Maintenance | .11 | | Paramedic | .09 | | Parking Lot Attendant | .11 | | Patient Food Service Worker | .11 | | Patient Representative | .12 | | Payroll Clerk | .12 | | Personnel Assistant | .12 | | Pharmacist | .02 | | Pharmacy Helper | .12 | | Physical Therapist | .02 | | Physical Therapy Assistant | .02 | | Physician | .06 | | Physician's Assistant | .09 | | Plasterer, Maintenance | .11 | | Plumber, Maintenance | .11 | | Podiatrist | .19 | | Porter | .11 | | Presser, Hand | .11 | | Press Operator | .11 | | Printer | .02 | | Programmer | .02 | | Prosthetist-Orthotist | .02 | | Psychologist | .19 | | Public Information Specialist | .02 | | Pulmonary Function Technician | .02 | | Purchasing Agent | .01 | | Radiation Monitor | .02 | | Radiologic Technician | .02 | | Receptionist | .12 | | Recreational Therapist | .02 | | Recreation Director | .02 | | Refrigeration Mechanic | .19 | | Residence Director | .19 | | Resident, Medical | .07 | | Respiratory Therapist | .02 | | Salad and Dessert Preparer | .11 | | Seamstress | .11 | | Secretary | .12 | | Serologist | .02 | | Shaker | .11 | | Social Work Assistant—Case Aide | .19 | | Social Worker | .02 | | Speech and Hearing Therapist | .02 | | Speech Clinician | .02 | | Speech Pathologist | .02 | | Stationary Engineer | .11 | | Statistical Clerk | .12 | | Stenographer | .12 | | Stock Clerk | .12 | | Supervisor | .01 | | Surgical Technician | .02 | | Systems Analyst, Data Processing | .02 | | Tab Operator | .02 | | Telephone Operator | .12 | | Therapy Technician | .02 | | Thermograph Technician | .02 | | Training Officer | .01 | | Transcribing Machine Operator | .12 | | Truck Driver | .11 | | Tumbler Operator | .11 | | Typist | | | Veterinarian | .19 | | Wall Washer | .11 | | Ward Clerk | .12 | | Washman | .11 | | Window Washer | .11 |
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.56 Barber and beauty shop
This functional reporting center must contain all the expenses associated with providing barber and beautician services to the patients at the residential health care facility.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.24 Identification of controlled substances
(a) No controlled substances may be manufactured or delivered within this State in solid or capsule form unless it has clearly marked or printed upon each capsule or solid the national drug code number or other identifying symbol assigned to the manufacturer or distributor and the drug manufactured or distributed, or other set or sets of identifying symbols or coding as approved by the commissioner. The commissioner may except from the requirement of this subdivision controlled substances manufactured in such form as to render any imprinting thereon unreasonably difficult or impossible.
(b) Each manufacturer or distributor of controlled substances shall furnish the department with a list of all controlled substances manufactured or delivered by them within the State and the national drug code number or other symbol assigned to each such substance.
(c) No controlled substance contained within a bottle, vial, carton or other container or package for delivery to an ultimate consumer, shall be manufactured or distributed within this State unless such container or package has clearly and permanently marked or imprinted upon it:
(1) the national drug code identification number assigned to the manufacturer or distributor, or other identification number approved by the commissioner; and
(2) the national drug code number or other identification number approved by the commissioner and designated for such substance.
(d) The commissioner does hereby direct each such manufacturer or distributor to adopt the national drug code number or other identification number approved by the commissioner and assigned to each controlled substance manufactured or distributed by such licensee for the purpose of meeting the requirements of article 33, Public Health Law.
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.4 Minimum standards for individual onsite water supply systems
(a) Individual onsite water supply systems shall be designed and constructed in accordance with the standards of the State Commissioner of Health as set forth in Appendix 5-B of this Title.
(b) All treatment devices for an individual onsite water supply must be designed, constructed and installed in accordance with standards acceptable to the State Commissioner of Health as set forth in Appendix 75-B of this Title.
(c) The standards set forth in Appendix 75-C of this Title shall represent statewide water quality standards for individual onsite water supply systems. The State or county health department official having jurisdiction may require that individual onsite water supply systems be tested for compliance with the standards set forth in Appendix 75-C of this Title, and for such additional contaminants as such official determines are necessary or appropriate to protect public health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.269 Professional component
The professional services provided to patients by hospital-based physicians, as opposed to the education, research and administrative duties performed by the hospital-based physicians.
10 CRR-NY 441.131 Financially indigent patient
A patient lacking the financial ability to reasonably be expected to pay for medical services received.
Part 446 REPORTING REQUIREMENTS
STATISTICAL DATA STATISTICAL DATA
10 CRR-NY 446.14 Changes in certified bed capacity
(a) As indicated on New York State Operating Certificate; the following data is to be reported:
(1) certified beds at the beginning of the reporting period;
(2) certified beds at the end of the reporting period;
(3) date the number of certified beds changed; and
(4) certified bed days available during the reporting period.
(b) Please refer to section 446.44 (b) of this Part for all program services for which these statistics are to be reported.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.40 Intermediate care facility — mental retardation
This functional reporting center must contain all the expenses associated with the provision of safe, hygienic, sheltered living for mentally retarded patients not capable of fully independent living. Regular and frequent medical nursing services are provided.
(a) Standard unit of measure: number of patient days.
Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.4 Withdrawals or abandonment of applications and failure to satisfy contingencies
(a) An application made to the Public Health Council in accordance with this Part may, on written request of the applicant, be withdrawn prior to decision by the council at any time without prejudice to resubmission. Such resubmission shall be subject to the provisions relating to amendments.
(b) The failure, neglect or refusal of an applicant to submit documentation or information, within the stated time frame, to satisfy a contingency imposed by the Public Health Council in conjunction with the council's proposal to approve an application shall constitute and be deemed on abandonment or withdrawal of the application shall constitute and be deemed on abandonment or withdrawal of the application by the applicant without the need for further action by the council.
(c) When an applicant submits documentation or information, within the stated time frame, in an attempt to satisfy a contingency imposed by the Public Health Council but the department, on behalf of the council, does not consider the documentation or information sufficient to satisfy the contingency, the application shall be returned to the council for whatever action the council deems appropriate.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.14 Reporting of suspected rabid animals and persons exposed to them
** Action to be taken by health officer.
(a) Definitions.
(1) Health care provider shall mean any person or facility which gives primary or secondary medical care to humans.
(2) Exposure shall mean introduction of the rabies virus into the body of a human or animal. Any penetration by mouth to the skin of humans or animals constitutes a bite exposure. A nonbite exposure is a scratch, abrasion, open wound, or contamination of mucous membranes with saliva or other potentially infectious material from a rabid animal.
(3) Domestic livestock shall mean sheep, horses, cattle, goats and swine.
(4) Current vaccination shall mean the administration of a rabies vaccine suitable to the species, which meets the standards prescribed by the United States Department of Agriculture for interstate sale and is administered according to the manufacturer's instructions under the direction of a duly licensed veterinarian not later than the expiration date on the package. Current vaccination shall begin 14 days following primary vaccination, and continue for the period stated in the manufacturer's instructions.
(5) Approved vaccine shall mean any rabies vaccine which meets the standards prescribed by the United States Department of Agriculture for interstate sale.
(b) It shall be the duty of every health care provider to report immediately to the local health authority having jurisdiction the, full name, age, address and telephone number of any person under his care or observation who has been exposed to any animal suspected by the health care provider of having rabies, and all pertinent facts relating to such exposure. Such notification shall occur prior to starting rabies post exposure prophylaxis, except in those cases where prior notification would compromise the health of the patient.
(c) If no health care provider is in attendance and the person exposed is a child, it shall be the duty of the parent or guardian to make such report immediately. If the person exposed is an adult, such person shall himself make the report, or, if incapacitated, it shall be made by whomever is caring for such person.
(d) It shall be the duty of every health care provider who has cause to believe that contact has occurred with a rabid animal or animal suspected of being rabid by the health care provider which requires rabies prophylaxis subsequent to the exposure to report the initiation of such prophylaxis and all pertinent facts relating to any such bite, exposure or treatment to the local or health authority.
(e) It shall be the duty of every person having knowledge of the existence of an animal exhibiting clinical signs suggestive of rabies to report immediately to the local health authority the existence of such animal, the place where seen, the owner's name, if known, and the signs of infection suggesting rabies.
(f) Whenever, in accordance with this section, the local health authority is notified of a person who has been exposed to any dog, cat, ferret or domestic livestock, vaccinated or not, the local health authority may cause the animal to be confined for 10 days. Any costs associated with this confinement shall be an expense of the animal's owner. Such health authority may, subject to the approval of the owner, if known, cause the animal to be destroyed immediately and have the animal's head submitted to a laboratory approved by the State Commissioner of Health for examination. The dog, cat, ferret or domestic livestock whose ownership cannot be determined may be confined for 10 days, under the direction of the local health authority. Any costs associated with this confinement shall be an expense of the party seeking this confinement. Confinement of the animal, in any case, shall be subject to such conditions and instructions, and under the control of such persons, including the owner if ascertainable, that the local health authority determines will reasonably assure the continued confinement of the animal for the prescribed 10-day period. Should the confined animal develop signs of rabies within the 10-day period, it shall be destroyed under the direction of the local health authority and submitted to a laboratory approved by the State Commissioner of Health for examination. In the case of a dog, cat, ferret or domestic livestock whose ownership cannot be determined, if confinement is not possible or desirable, the animal may be destroyed immediately and an appropriate specimen shall be submitted to a laboratory approved by the State Commissioner of Health for examination.
(1) Bats and any animal other than a dog, cat, ferret or domestic livestock suspected of being rabid shall not be held for observation and shall be destroyed immediately, without injury to the head, and may be submitted upon approval of the local health authority, to a laboratory approved by the State Commissioner of Health for examination.
(g) Except as hereinafter provided, any mammalian animal which has been bitten by or in direct contact with a known rabid animal or animal suspected by the local health authority of being rabid shall be destroyed unless it shall be isolated for a period of six months either in a veterinary hospital approved by the local health authority, or in a locked enclosure approved by the local health authority as being so constructed and maintained that the animal cannot escape and cannot have contact with any other animal or human except, when absolutely necessary, with the person responsible for the care of the confined animal. Quarantine of the animal, in any case, shall be subject to such conditions and instructions, and under the control of such persons, including the owner if ascertainable, that the local health authority determines will reasonable assure the continued quarantine of the animal for the prescribed six-month period. The expense of such isolation shall be borne by the owner. Any animal currently vaccinated as defined in this section, prior to exposure, may remain at large or under the owner' s immediate control as may be required by local ordinance provided a booster injection of such approved vaccine is given within five days of the date of exposure.
(h) An animal under such restrictions shall not be removed from one health district into another prior to the conclusion of the prescribed isolation period except with the permission of the health officer from whose district such animal is to be removed and the permission of the health officer to whose jurisdiction such animal is to be transferred. The former shall give permission only after securing the consent of the health officer to whose jurisdiction the animal is to be transferred, except that if removal is to be to New York City or into another state, he shall give permission only after securing the consent of the Commissioner of Health of the State of New York. Such removal shall be by private conveyance, in Charge of a responsible person and conducted in such a manner as to prevent the escape of the animal or its coming in contact with other animals or persons.
(i) The local health authority shall report forthwith to the State district health office or county health office having jurisdiction the name, age and address of every person exposed to any animal suspected of having rabies, any incident which requires rabies prophylaxis, and all the pertinent facts relating to any such bite, exposure or treatment.
(j) Whenever any animal that has or is suspected of having rabies dies, or is killed, the local health authority may, at his discretion, cause the head of such animal to be removed and sent immediately, properly packed, with a complete history of the case, to a laboratory approved for this purpose by the State Commissioner of Health for examination.
(k) Whenever the disease rabies is confirmed by the State Wadsworth Center for Laboratories and Research in a raccoon in any county in New York State, within 30 days of notice to the county of the confirmation, all cats residing in the county who are not then actively immunized as defined in this section, must be vaccinated as outlined below. Such notice will be sent to the county's local health officer by the Commissioner of Health. Actively immunized shall mean injection of a rabies vaccine which meets the standards prescribed by the United States Department of Agriculture for interstate sale and administered according to the manufacturer's instructions under the direction of a duly licensed veterinarian. All cats in the county, three months of age or over, are to be vaccinated to prevent rabies. This section shall not apply to cats owned by a nonresident, while passing through any town, city or village for a period not exceeding 15 days, if entered in any exhibition at any cat show therein, and if confined and in immediate charge of the exhibitor, or to cats actually confined to the premises of incorporated societies, devoted to the care or hospital treatment of lost, strayed or homeless animals, or confined to the premises of public or private hospitals devoted to the treatment of sick animals, or confined for the purposes of research institutions, or to cats actually confined to the premises of a person, firm or corporation actually engaged in the business of breeding or raising cats for profit and are so licensed as a class A dealer under the Federal Laboratory Animal Welfare Act, or if such vaccination would adversely affect the health of the cat as determined by a duly licensed veterinarian. The veterinarian either administering the vaccine or responsible for supervising the vaccination shall give to the owner of the cat a signed statement. Such statement shall include the following information: name and address of the owner, date or dates of vaccination together with the type of vaccine injected and its duration of immunity, amount and manner of injection, name of manufacturer, lot number and expiration date of the vaccine. Or, if applicable, the veterinarian shall give the owner of the cat a signed statement verifying that the cat is exempt because such vaccination would adversely affect the health of the cat. Compulsory vaccination shall remain in effect until the county presents evidence to the commissioner that it has been one year since the last confirmed case of rabies in a terrestrial animal specie. Proof of rabies immunization must be shown by the owner to the local health officer whenever a cat bites a person. If the owner is unable to show such proof, the local health officer must follow the procedures outlines in subdivision (f) of this section.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.87 Protection of food in vending machines
The openings into all nonpressurized containers used for the storage of vendable food, including water, are to be provided with covers which prevent contamination from reaching the interior of the containers. These covers are to be designed to provide a flange which overlaps the openings, and are to be sloped to drain wherever the collection of condensation, moisture or splash is possible. Concave covers or cover areas are prohibited. Any port opening through the cover is to be flanged upward at least 3/16 inch, and is to be provided with an overlapping cover flanged downward. Condensation-, drip- or dust-deflecting aprons are to be provided on all piping, thermometers, equipment, rotary shafts, and other functional parts extending into the food container unless a watertight joint is provided. Such aprons are to be considered as satisfactory covers for those openings which are in continuous use. Gaskets, if used, are to be of safe materials, nonabsorbent, and are to have a smooth surface. All gasket retaining grooves are to be easily cleanable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.23 Exempt units and hospitals
(a) Physical medical rehabilitation inpatient services shall qualify for reimbursement pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if such services are provided in a hospital specializing in such services or in a distinct unit within a general hospital designated for such services and only if:
(1) such hospital or such unit qualified for exempt unit status for purposes of reimbursement under the Federal Medicare prospective payment system as of December 31, 2001; or
(2) on or before July 1, 2009, the hospital submitted a written request to the department for exempt status providing assurances acceptable to the department that the hospital or unit within the hospital meets the exempt status criteria set forth in section 2807-c(4)(e) of the Public Health Law for 2009 for periods prior to December 1, 2009.
(i) For periods on and after January 1, 2010, a hospital seeking exempt status for a hospital or a distinct unit within the hospital not previously recognized by the department as exempt for reimbursement purposes shall submit a written request to the department for such exempt status and shall provide assurances and supporting documentation acceptable to the department that the hospital or unit meets qualifying exempt status criteria in effect at the time such written request is submitted. Approval by the department of such exempt status shall, for reimbursement purposes, be effective on the January 1st following such approval, provided that the request for such exempt unit status was received at least 120 days prior to such date.
(ii) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2005 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009, not including reported direct medical education costs and physician costs, and held to a ceiling of 110 percent of the average of such costs in the region in which the facility is located, as described in subdivision (i) of this section. Such rates shall reflect trend adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(b) Chemical dependency rehabilitation inpatient services shall qualify for reimbursement pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if such services are provided in a hospital specializing in such services or in a distinct unit within a general hospital designated for such services and only if:
(1) the services provided in such hospital or unit are limited to chemical dependency rehabilitation care and do not include chemical dependency related inpatient detoxification and/or withdrawal services; or
(2) such hospital or unit is licensed to provide such services pursuant to both the Public Health Law and the Mental Hygiene Law and meets the applicable alcohol and/or substance abuse rehabilitation standards set forth in regulations.
(i) Any such unit within a hospital must be in a designated area and consist of designated beds providing only chemical dependency rehabilitation inpatient services with adequate adjoining supporting spaces and assigned personnel qualified by training and/or by experience to provide such services and in accordance with any applicable criteria regarding the provision of such services issued by the New York State Office of Alcohol and Substance Abuse Services.
(ii) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2005 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009, not including reported direct medical education costs and physician costs, and held to a ceiling of 110 percent of the average of such costs in the region in which the facility is located, as described in subdivision (i) of this section. Such rates shall reflect trend adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(c) Critical access hospitals.
(1) Rural hospitals shall qualify for inpatient reimbursement as critical access hospitals pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if such hospitals are designated as critical access hospitals in accordance with the provisions of title XVIII (Medicare) of the Federal Social Security Act.
(2) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2005 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009, and held to a ceiling of 110 percent of the average of such costs for all such designated hospitals statewide. Such rates shall reflect trend factor adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(d) Cancer hospitals.
(1) Hospitals shall qualify for inpatient reimbursement as cancer hospitals pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if such hospitals were, as of December 31, 2008, designated as comprehensive cancer hospitals in accordance with the provisions of title XVIII (Medicare) of the Federal Social Security Act.
(2) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2005 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009. Such rates shall reflect trend factor adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(e) Specialty long term acute care hospital.
(1) Hospitals shall qualify for inpatient reimbursement as specialty long term acute care hospitals pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if such hospitals were, as of December 31, 2008, designated as specialty long term acute care hospitals in accordance with the provisions of title XVIII (Medicare) of the Federal Social Security Act.
(2) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2005 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009. Such rates shall reflect trend factor adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(3) For dates of service occurring on or after April 1, 2020 through December 31, 2020, and each calendar year thereafter, an upper payment limit (UPL) payment per diem shall be added to the specialty long term acute care hospital rates (hereinafter add-ons). Such add-ons shall only apply to eligible public general hospitals or public health systems, other than those operated by the state of New York or the state university of New York, located in a city having a population of 1,000,000 or more and shall be in lieu of any aggregate UPL payment. Such add-ons shall be calculated for each hospital by dividing the hospital’s latest approved UPL demonstration payment, by its Medicaid fee-for-service specialty hospital days, as reported in its most recently submitted institutional cost report. Each hospital’s rate add-on shall be subject to and contingent upon the terms of a binding memorandum of understanding executed between the Department of Health and the public general hospital or public health system receiving an add-on, and shall be subject to termination or adjustment based on the terms of that agreement. The total amount paid for the add-on shall be included in the applicable annual UPL demonstration. If the annual UPL demonstration yields an amount that is more or less than the aggregate amount paid for the add-on, the add-on shall be adjusted to reflect the demonstration amount.
(f) Acute care children's hospitals.
Hospitals shall qualify for inpatient and outpatient reimbursement as acute care children's hospitals pursuant to section 2807-c(4)(e-2) of the Public Health Law for periods on and after December 1, 2009, only if:
(1) Such hospitals were, as of December 31, 2008, designated as acute care children's hospitals in accordance with the provisions of title XVIII (Medicare) of the Federal Social Security Act; and
(2) Such hospitals filed a discrete 2007 institutional cost report reflecting reported Medicaid discharges of greater than 50 percent of total discharges.
(i) For days of service occurring on and after December 1, 2009, the operating component of rates of payment for inpatient services, other than physician services, for facilities subject to this subdivision shall be a per diem amount reflecting the facility's reported 2007 operating costs, excluding physician costs, as submitted to the department prior to July 1, 2009. Such rates shall reflect trend factor adjustments in accordance with the applicable provisions of section 2807-c(10) of the Public Health Law.
(g) Substance abuse detoxification inpatient services.
For patients discharged on and after December 1, 2008, rates of payment for general hospitals which are certified by the Office of Alcoholism and Substance Abuse Services (OASAS) to provide services to patients determined to be in the diagnostic category of substance abuse (MDC 20, DRGs 743 through 751) will be made on a per diem basis. This includes inpatient detoxification, withdrawal, and observation services. Medically managed detoxification services are for patients who are acutely ill from alcohol and/or substance related addictions or dependence, including the need or risk for the need of medical management of severe withdrawal, and/or are at risk of acute physical or psychiatric co-morbid conditions. Medically supervised withdrawal services are for patients at a mild or moderate level of withdrawal, or are at risk for such, as well as patients with sub-acute physical or psychiatric complications related to alcohol and/or substance related dependence, are intoxicated, or have mild withdrawal with a situational crisis, or are unable to abstain yet have no past withdrawal complications. The per diem rates for inpatient detoxification, withdrawal, and observation services will be determined as follows:
(1) The operating cost component of the per diem rates will be computed using 2006 costs and statistics, excluding physician costs, as reported to the department by general hospitals prior to 2008, adjusted for inflation. The inflation factor will be calculated in accordance with the trend factor methodology described in this Subpart. The average operating cost per diem for the region in which the hospital is located will be calculated using costs incurred for patients requiring detoxification services. The operating cost component of the per diem rates will be transitioned to 2006 as follows:
(i) for the period December 1, 2008 through March 31, 2009, 75 percent of the operating cost component will reflect the operating cost component of rates effective for December 31, 2007, adjusted for inflation, and 25 percent will reflect 2006 operating costs in accordance with paragraphs (2) through (6) of this subdivision.
(ii) for April 1, 2009 through March 31, 2010, 37.5 percent of the operating cost component will reflect the December 31, 2007 operating cost component, adjusted for inflation, and 62.5 percent will reflect 2006 operating costs in accordance with paragraphs (2) through (6) of this subdivision.
(iii) for periods on and after April 1, 2010, 100 percent of the operating cost component will reflect 2006 operating costs in accordance with paragraphs (2) through (6) of this subdivision.
(2) For purposes of establishing the average operating cost per diem by region for medically managed detoxification and medically supervised withdrawal services, the regions of the state are defined as follows:
(i) New York City - Bronx, New York, Kings, Queens and Richmond Counties;
(ii) Long Island - Nassau and Suffolk Counties;
(iii) Northern Metropolitan - Columbia, Delaware, Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester Counties;
(iv) Northeast - Albany, Clinton, Essex, Fulton, Greene, Hamilton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties;
(v) Utica/Watertown - Franklin, Herkimer, Lewis, Oswego, Otsego, St. Lawrence, Jefferson, Chenango, Madison and Oneida Counties;
(vi) Central - Broome, Cayuga, Chemung, Cortland, Onondaga, Schuyler, Seneca, Steuben, Tioga and Tompkins Counties;
(vii) Rochester - Monroe, Ontario, Livingston, Wayne and Yates Counties; and
(viii) Western - Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming Counties.
(3) For each of the regions, the 2006 operating costs incurred by general hospitals in such region for providing care to inpatients requiring detoxification services, as defined by OASAS, and reported in the 2006 ICR submitted to the department prior to 2008, are adjusted by a length of stay (LOS) factor. This LOS factor reflects the loss of revenue due to the reduction of payments for services over the 5th day of stay. The total adjusted operating costs for each region, divided by the total regional days, is the average operating cost per diem for the region.
(4) The per diem rates for inpatients requiring medically managed detoxification services will reflect 100 percent of the average operating cost per diem for the region in which the hospital is located, adjusted for inflation, for the first five days of service. However, such payments will be reduced by 50 percent for services provided on the 6th through 10th day of service. No payments will be made for any services provided on and after the 11th day.
(5) Per diem rates for inpatients requiring medically supervised withdrawal services, will reflect 100 percent of the average operating cost per diem for the region in which the hospital is located, adjusted for inflation, for the period January 1, 2009 through December 31, 2009. For periods on and after January 1, 2010, the per diem rates for withdrawal services will reflect 75 percent of the average operating cost per diem for the region, adjusted for inflation, and will be reduced by 50 percent for care provided on the 6th through 10th day of service. No payments will be made for any services provided on and after the 11th day.
(6) Per diem rates for inpatients placed in observation beds, as defined by OASAS, will reflect 100 percent of the average operating cost per diem for the region in which the hospital is located, adjusted for inflation, and will be paid for no more than two days of care. After two days of care the payments will reflect the patient's diagnosis as requiring either detoxification or withdrawal services. The days of care in the observation beds will be included in the determination of days of care for either detoxification or withdrawal services. Furthermore, days of care provided in observation beds will, for reimbursement purposes, be fully reflected in the computation of the initial five days of care.
(7) Capital cost reimbursement for the general hospitals which are certified by OASAS to provide substance abuse services will be based on the current reimbursement methodology for determining allowable capital for exempt unit per diem rates. Such capital cost will be added to the applicable operating cost component as a per diem amount to establish the per diem rate for each service.
(h) Hospitals or distinct units of hospitals that fail to maintain qualifying criteria for exempt status for reimbursement purposes, as set forth in this section or in section 2807-c(4)(e-2) of the Public Health Law, shall continue to be reimbursed in accordance with such exempt status until the commencement of the next rate period, as determined by the department.
(i) Rates of payment for inpatient services for exempt distinct units of hospitals described in subdivisions (a), (b), (c), (d) and (e) of this section, for which separately identifiable 2005 reported costs data are not available, shall reflect the average reported 2005 operating cost per day for comparable exempt units, as determined by the department.
(j) Rates of payment for inpatient services described in subdivisions (a) and (b) of this section which utilize regional averages for determining a cost ceiling shall utilize regions of the State set forth in section 2807-c(4)(l)(iii)(E) of the Public Health Law and this subdivision, except that if the otherwise applicable region has less than five exempt hospitals or units in the service, facilities located in the nearest regions will be used to establish a minimum of five hospital or units for the purpose of determining ceilings. Such regions are as follows:
(1) New York City, consisting of the Counties of Bronx, New York, Kings, Queens and Richmond;
(2) Long Island, consisting of the Counties of Nassau and Suffolk;
(3) Northern Metropolitan, consisting of the Counties of Columbia, Delaware, Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester;
(4) Northeast, consisting of the Counties of Albany, Clinton, Essex, Fulton, Greene, Hamilton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington;
(5) Utica / Watertown, consisting of the Counties of Franklin, Herkimer, Lewis, Oswego, Otsego, St. Lawrence, Jefferson, Chenango, Madison and Oneida;
(6) Central, consisting of the Counties of Broome, Cayuga, Chemung, Cortland, Onondaga, Schuyler, Seneca, Steuben, Tioga and Tompkins;
(7) Rochester, consisting of the Counties of Monroe, Ontario, Livingston, Wayne and Yates;
(8) Western, consisting of the Counties of Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming.
(k) Capital cost components of per diem rates determined pursuant to this section shall be computed on the basis of budgeted capital costs allocated to the exempt hospital or distinct unit of a hospital pursuant to the provisions of section 86-1.25 of this Subpart divided by exempt hospital or unit patient days reconciled to actual total expense.
(l) New hospitals and new hospital units.
The operating cost component of rates of payment for new hospitals, or hospital units, without adequate cost experience shall be computed based on either budgeted cost projections, subsequently reconciled to actual reported cost data, or the regional ceiling calculated in accordance with subdivision (i) of this section, whichever is lower. The capital cost component of such rates shall be calculated in accordance with section 86-1.25 of this Subpart.
(m) Inpatient psychiatric services. Per diem rates of payment for a general hospital or a distinct unit of a general hospital for inpatient psychiatric services shall continue to be determined in accordance with the reimbursement methodology set forth in section 86-1.57 of this Subpart which was in effect for periods prior to December 1, 2009.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.15 Other operating revenue account descriptions
[ 3222 ]
(a) 5020
TRANSFERS FROM RESTRICTED FUNDS FOR RESEARCH EXPENSES
This account reflects the amount of transfers from restricted funds to the Operating Fund to match expenses incurred in the current period by the Operating Fund for restricted fund research activities.
(b) 5220
NURSING EDUCATION
5221
Registered Nurses
5222
Licensed Vocational (Practical) Nurses
5240
POSTGRADUATE MEDICAL EDUCATION—APPROVED TEACHING PROGRAMS 5250
POSTGRADUATE MEDICAL EDUCATION— NON-APPROVED TEACHING PROGRAMS
5260
OTHER HEALTH PROFESSION EDUCATION
5261
School of Medical Technology
5262
School of X-ray Technology
5263
School of Respiratory Therapy
5264
Administrative Intern Program
5265
Medical Records Librarian Program
These accounts (5220-5260) are used to report the revenue from the schools of nursing, postgraduate medical education, paramedical education, and other educational activities.
(c) 5280
TRANSFERS FROM RESTRICTED FUNDS FOR EDUCATION EXPENSES
This account reflects the amounts of transfers from restricted funds to the Operating Fund to match expenses incurred in the current period by the Operating Fund for restricted fund educational activities.
(d) 5320
NON-PATIENT FOOD SALES
This account is used to report the revenue earned in the hospital cafeteria for meals served to employees and others. Also included is revenue from employees and others for meals when the hospital does not operate a formal cafeteria.
(e) 5330
LAUNDRY AND LINEN SERVICES REVENUE
This account shall be used to report revenue earned by providing laundry services to other organizations (both related and nonrelated) and to employees and students housed on hospital property.
(f) 5350
SOCIAL WORK SERVICES REVENUE
This account shall be used to report revenue earned by providing social work services to patients and others.
(g) 5360
HOUSING REVENUE
5361
Employee Housing
5363
Student Housing
This account is used to report revenue from room (or cot) rentals provided for employees and students.
(h) 5440
PARKING REVENUE
Amounts received from visitors, employees and others in payment for parking privileges shall be reported in this account.
(i) 5450
HOUSEKEEPING SERVICES REVENUE
This account shall be used to report revenue earned by providing housekeeping services to other organizations (both related and nonrelated).
(j) 5610
TELEPHONE AND TELEGRAPH REVENUE
Amounts received from patients, employees and others in payment of hospital telephone and telegraph services shall be reported in this account.
(k) 5620
DATA PROCESSING SERVICES REVENUE
This account shall be used to report revenue earned by providing data processing services to other organizations (both related and nonrelated).
(l) 5690
PURCHASING SERVICES REVENUE
This account shall be used to report revenue earned by providing purchasing services to other organizations (both related and nonrelated).
(m) 5710
SALE OF ABSTRACTS/MEDICAL RECORDS
This account shall be used to report revenue earned for medical records transcript and abstract fees.
(n) 5760
DONATED COMMODITIES
Donated medicines, linen, office supplies and other materials which would normally be purchased by a hospital shall be reported at fair market value in this account. An offsetting amount is reported in an appropriate inventory account or cost center.
(o) 5770
DONATED BLOOD
Donated blood is reported at fair market value in this account. An offsetting amount is reported in the blood inventory account or Whole Blood and Packed Red Cells cost center (account 7250).
(p) 5780
CASH DISCOUNTS ON PURCHASES
The amounts of cash discounts taken by the hospital on purchases shall be reported in this account. Trade discounts, however, shall be treated as reductions in the cost of items purchased.
(q) 5790
SALE OF SCRAP AND WASTE
This account shall be used to report the revenue from the sale of scrap and waste.
(r) 5810
REBATES AND REFUNDS
This account shall be used to report the revenue from rebates and refunds of expense.
(s) 5820
VENDING MACHINE COMMISSIONS
Commissions earned by the hospital from coin-operated telephones and vending machines shall be reported in this account.
(t) 5830
OTHER COMMISSIONS
Commissions earned by the hospital, other than commissions from coin-operated telephones and vending machines shall be reported in this account.
(u) 5840
TELEVISION/RADIO RENTALS
This account shall be used to report the revenue from television and radio rentals, when the activity is hospital-conducted.
(v) 5850
NON-PATIENT ROOM RENTALS
This account is used to report revenue from room (or cot) rentals charged to non-patients.
(w) 5860
MANAGEMENT SERVICES REVENUE
This account shall be used to report revenue earned by providing management services to other organizations (both related and nonrelated).
(x) 5870
OTHER OPERATING REVENUE
This account shall be used to report other operating revenue not included elsewhere.
(y) 5880
TRANSFERS FROM RESTRICTED FUNDS FOR OTHER OPERATING EXPENSES
This account reflects the amounts of transfers from restricted funds to the Operating Fund to match expenses incurred in the current period by the Operating Fund for restricted fund activities other than the transfers from restricted funds reported in account 5020 (Transfers from Restricted Funds for Research Expenses) and account 5280 Transfers from Restricted Funds for Education Expenses).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.16 Infection control
(a) Shared health facilities shall assure that effective procedures in aseptic technique are followed by all personnel.
(b) Shared health facilities shall provide disposable covers for examination tables and for dental chair headrests and assure that such covers are changed after each patient's use.
(c) Physicians practicing in shared health facilities shall report the presence of any communicable disease as defined in section 2.1 of the State Sanitary Code, directly to the city, county or district health officer and to the department within 24 hours from the time the case is first seen by the physician.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 123.10 Lakeville Water District, Town of Livonia
See section 123.1, supra.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 48 PALLIATIVE CARE CERTIFIED MEDICAL SCHOOLS AND RESIDENCY PROGRAMS
10 CRR-NY 48.10 Definitions
(a) Palliative care shall mean the active, interdisciplinary care of patients with serious, life-threatening, advanced, or life limiting illness, focusing on relief of distressing physical and psychosocial symptoms and meeting spiritual needs. Its goal is achievement of the best quality of life for patients and families.
(b) Palliative care certified medical school shall be a Liaison Committee on Medical Education (LCME) or American Osteopathic Association (AOA) accredited medical school in New York State which is an institution granting a degree of doctor of medicine or of osteopathic medicine in accordance with regulations by the Commissioner of Education under subdivision two of section 6524 of the Education Law, and which meets the following criteria:
(1) one or more faculty does clinical work or teaching relevant to palliative care; and/or
(2) contains an element of the preclinical or clinical curriculum relevant to palliative care; and
(3) is certified by the commissioner or his or her designee in conformance with section 48.20(a) of this Part.
Relevant work, teaching, or curriculum may include, but is not limited to, didactic coursework or training related to one of the following eight domains of quality palliative care relating to populations with serious or life-threatening illnesses:
(i) structure and process of care;
(ii) physical aspects of care;
(iii) psychological and psychiatric aspects of care;
(iv) social aspects of care;
(v) spiritual, religious, and existential aspects of care;
(vi) cultural aspects of care;
(vii) care of the imminently dying patient; and
(viii) ethical and legal aspects of care.
(c) Palliative care certified residency program shall be a graduate medical education program in New York State accredited and in good standing by the Accreditation Council for Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA), and which meets the following criteria:
(1) is sponsored by one of the following specialties that have incorporated Hospice and Palliative Medicine (HPM) as a subspecialty:
(i) anesthesiology;
(ii) emergency medicine;
(iii) family medicine;
(iv) internal medicine;
(v) pediatrics;
(vi) physical medicine and rehabilitation;
(vii) psychiatry and neurology;
(viii) radiology;
(ix) surgery; or
(x) obstetrics and gynecology; and
(2) contains an element of the teaching curriculum is identified as relevant to palliative care; and
(3) is certified by the commissioner or his or her designee in conformance with section 48.20(b) of this Part.
Relevant work, teaching, or curriculum may include, but is not limited to, didactic coursework or training related to one of the following eight domains of quality palliative care, relating to populations with serious or life-threatening illnesses:
(i) structure and process of care;
(ii) physical aspects of care;
(iii) psychological and psychiatric aspects of care;
(iv) social aspects of care;
(v) spiritual, religious, and existential aspects of care;
(vi) cultural aspects of care;
(vii) care of the imminently dying patient; and
(viii) ethical and legal aspects of care.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.21 Advance directives
(a) Statement of purpose.
The New York State Health Care Proxy Law allows an adult to designate another adult, such as a trusted friend or loved one who knows the person and his/her wishes, to make treatment decisions if the adult becomes incapacitated and is unable to do so. The Health Care Proxy Law guarantees an adult's right to self-determination and the expression of this right through another adult. Advance directives also allow an adult to express his or her preference regarding health care treatment, including a desire to continue or to refuse treatment and life supports. In the absence of a health care proxy, the Family Health Care Decisions Act allows a surrogate (a family member or close friend) to make treatment decisions on behalf of a patient, in accordance with the patient’s wishes, if known, or if the patient’s wishes are not known, in accordance with the patient’s best interests. Facilities must ensure that all adult patients/residents are informed of their rights and are supported and protected as they exercise their right to formulate written or oral instructions regarding their health care in the event such adults become incapacitated and are unable to direct their own health care.
(b) Definitions.
The following words or phrases shall have the following meanings:
(1) An advance directive means a type of written or oral instruction relating to the provision of health care when an adult becomes incapacitated, including but not limited to a health care proxy, a consent to the issuance of an order not to resuscitate or other medical orders for life-sustaining treatment (MOLST) recorded in a patient's/resident's medical record, and a living will.
(2) A health care proxy means a document created pursuant to article 29-C of the Public Health Law which delegates the authority to another adult known as a health care agent to make health care decisions on behalf of the adult when that adult is incapacitated.
(3) A living will means a document which contains specific instructions concerning an adult's wishes about the type of health care choices and treatments that an adult does or does not want to receive.
(4) A health care agent or agent means an adult to whom authority to make health care decisions is delegated under a health care proxy.
(5) An adult means any person who is 18 years of age or older, or is the parent of a child, or has married.
(6) Medical orders for life-sustaining treatment (MOLST) means medical orders to provide, withhold or withdraw life-sustaining treatment. The MOLST form is an alternative form authorized by the commissioner under subdivision 6 of section 2994-dd of the Public Health Law. The MOLST form and guidance and checklists for using the MOLST form for any patient in any setting are posted on the department’s website.
(c) Facility compliance.
The facility shall ensure compliance with the requirements of law governing advance directives, including but not limited to articles 29-C, 29-CC and 29-CCC of the Public Health Law.
(d) Policies and procedures.
The facility shall be responsible for developing, implementing and maintaining written policies and procedures addressing advance directives and shall:
(1) make the following material available to each adult patient/resident, or if the adult patient/resident lacks capacity, to the family member or other adult who speaks on the patient's/resident's behalf at or prior to the time of admission to the facility as an inpatient or an outpatient and to each member of the facility's staff who provides patient/resident care. A facility need not provide these items more than once to an outpatient receiving services on a recurring basis:
(i) the description of State law prepared by the department entitled “Deciding About Health Care: A Guide for Patients and Families,” which summarizes the rights, duties and requirements of Articles 29-C, 29-CC and 29-CCC; and
(ii) the pamphlet prepared by the department entitled “Health Care Proxy: Appointing your Health Care Agent in New York State,” containing a sample health care proxy form;
(2) ensure that there is documentation in each adult's medical record indicating whether or not the adult has executed a health care proxy under article 29-C of the Public Health Law, or whether the adult has provided written or oral advance instructions about treatment to facility staff responsible for the patient's care or to facility employees upon admission;
(3) assess advance directives other than those described in articles 29-C, 29-CC and 29-CCC of the Public Health Law. Nothing herein shall be construed to require that a facility must or may not seek a court determination that any individual advance directive has been expressed in a clear and convincing manner;
(4) provide in-service education to staff involved in the provision of care including medical staff concerning the facility's policies and procedures concerned with advance directives;
(5) provide (individually or with others) education to the community on issues concerning advance directives;
(6) ensure that an adult is not discriminated against in the provision of care or otherwise discriminated against based on whether or not the adult has executed an advance directive; and
(7) in addition a nursing home shall:
(i) educate adult residents about the authority delegated under a health care proxy, what a proxy may include or omit, and how a proxy is created, revoked, or changed as requested by the resident;
(ii) ensure that each resident who creates a proxy while residing at the facility does so voluntarily; and
(iii) designate one or more individuals to educate the residents, respond to questions and assist residents in creating, revoking or changing a proxy.
(e) Medical orders for life-sustaining treatment (MOLST).
To implement a patient’s wishes regarding cardiopulmonary resuscitation (CPR) and other life-sustaining treatment, facilities may, if appropriate, utilize the department approved MOLST form for patients with serious health conditions who:
(1) want to avoid or receive any or all life-sustaining treatment; or
(2) can reasonably be expected to die within one year.
(f) Rights to be publicized.
The facility shall post in a public place in the facility the rights, duties and requirements of this section. Such statement may be included in any other statement of patient's/resident's rights required to be posted.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.12 Contract laboratory protocol personnel: qualifications
(a) To gain or maintain approval for contract laboratory protocol analyses, an environmental laboratory shall employ full-time employees qualified to perform the following functions, as set forth in the protocol:
(1) Laboratory supervisor in the specialties of gas chromatography/mass spectrometry (GC/MS), gas chromatography (GC), and/or inorganics shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and three years of relevant laboratory experience, including one year in a supervisory capacity.
(2) GC/MS operator shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and one year of experience in operating and maintaining a GC/MS data system. Three years of experience in operating and maintaining a GC/MS data system may be substituted for the educational requirement.
(3) Mass spectral interpretation specialist shall be a person with at least a bachelor's degree in chemistry or the physical sciences, who has successfully completed a specialized training course in mass spectral interpretation and has at least two years of experience in mass spectral interpretation.
(4) Pesticide residue analysis expert shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and two years of experience in operating and maintaining a gas chromatograph and interpreting gas chromatograms.
(5) Organic sample preparation supervisor shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and at least three years of organic laboratory experience, including at least one year in a supervisory capacity.
(6) Extraction/concentration expert shall be a person with at least a high school diploma, including one course in chemistry and one year of experience in an analytical chemistry laboratory.
(7) Inductively coupled plasma (ICP) spectroscopist shall be a person with at least a bachelor's degree in chemistry or the physical sciences, who has successfully completed specialized training courses in ICP spectroscopy and has two years of applied experience in ICP analysis of environmental samples.
(8) ICP operator shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and one year of experience in the operation and maintenance of ICP instrumentation; or, in lieu of the educational requirement, four years of experience in operating and maintaining ICP instrumentation.
(9) Atomic absorption (AA) operator shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and at least one year of experience in operating and maintaining AA instrumentation for flame, graphite furnace and cold vapor techniques; or, in lieu of the educational requirement, three years of experience in operating and maintaining AA instrumentation as described in this paragraph.
(10) Inorganic sample preparation specialist shall be a person with at least a high school diploma, successful completion of a college level course in general chemistry or its equivalent, and six months of experience in an analytical laboratory.
(11) Classical techniques analyst shall be a person with at least a bachelor's degree in chemistry or the physical sciences, and six months of experience in classical chemistry laboratory procedures; or, in lieu of the education requirement, two and one-half years of experience performing classical chemistry analyses.
(b) Each environmental laboratory seeking approval or wishing to maintain approval for contract laboratory protocol analysis shall have sufficient technical staff to provide continuous coverage, as appropriate, for the functions described in subdivision (a) of this section. The person or persons designated as back-up technical staff shall have at least a bachelor's degree in chemistry or the physical sciences, in addition to the following minimum experience:
(1) for organic chemistry protocols: one year of experience in each of the following areas: GC/MS operation and maintenance, for volatile and semi-volatile analyses; mass spectral interpretation; extraction; and pesticide analyses; or
(2) for inorganic chemistry protocols: one year of experience in each of the following areas: ICP operation and maintenance; AA operation and maintenance; classical chemistry analytical procedures; and sample preparation for inorganic analyses.
Note:
Requirements for laboratories engaged in testing for critical agents in environmental samples, set forth in section 55-2.13 of this Subpart adopted as an emergency regulation, shall continue in effect as promulgated, repromulgated and/or finally adopted in accordance with the State Administrative Procedure Act.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 137 PUTNAM COUNTY
10 CRR-NY 137.2 Village of Cold Spring
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 72 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to the Foundry Brook and to all watercourses entering or ultimately discharging into said stream above the intake at the lower impounding reservoir, said stream being a source of water supply of the Village of Cold Spring in Putnam County.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply furnished by the Village of Cold Spring.
(2) The term reservoir means any natural or artificially impounded body of water serving as a source of the aforesaid water supply and to any additional reservoir which may be constructed or used for the water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any reservoir or watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta located between the distances of 200 feet and 100 feet from any reservoir or watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 200 feet of any reservoir or watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (c)(3) of this section. If such watertight receptacles are used, they shall be located not less than 100 feet from any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with the plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes shall be allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 75 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person shall bathe or swim, or be allowed to bathe or swim in any reservoir or watercourse.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing or laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(k) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act though not heretofore specified which may result in contamination of any portion of the water supply of the Village of Cold Spring.
(l) Inspections.
The Village of Cold Spring or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of said village shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said village to cause copies of any rules and regulations violated to be served upon the pesons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Village of Cold Spring to promptly notify the State Commissioner of Health of such violations. The Village of Cold Spring shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with chapter 45 of the Consolidated Laws (Public Health Law), as amended, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination, is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.23 Payment
(a) Payments to adult day health care programs by State government agencies:
(1) a program may only bill for one visit per registrant per day;
(2) the majority of registrants for whom the program receives a payment made by a government agency must be in attendance for at least five hours.
(b) Payments to adult day health care programs by managed long term care plans or care coordination models:
(1) Payments shall be made in accordance with the negotiated agreement between the adult day health care program and the managed long term care plan or care coordination model.
(2) The full range of adult day health care services shall be available to registrants with a medical need for such services. Based on a registrant’s individual medical needs, as determined in the comprehensive assessment, the managed long term care plan or care coordination model may order less than the full range of adult day health care services. Nothing shall prohibit adult day health care programs and managed long term care plans or care coordination models from agreeing to reimbursement terms that reflect a registrant’s receipt of less than the full range of adult day health care services.
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.4 Ambulatory surgery services
The factors and methodology to be considered by the Public Health Council for determining the public need for ambulatory surgery services and facilities, shall include, but not be limited to those set forth in section 709.5 of this Title.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 414 NURSING HOMES—CONTINUOUS VIOLATION PENALTIES
10 CRR-NY 414.2 Criteria for continuous violation penalties
When the commissioner elects to impose continuous violation penalties, the amount of those penalties shall be based on a consideration of the consequences of substandard care of the resident(s) associated with each violation and on the harm done to the condition of the resident(s). The daily dollar amount per violation for each specific violation shall be calculated in accordance with the following criteria:
| Characteristic of the Violation | Daily Penalty | | --- | --- | | (a) If the violation continues over time harm is likely to occur, harm not requiring professional staff intervention has occurred or there is potential for harm with or without the need for professional staff intervention and the occurrence is one that should be reported to supervisory personnel or facility administration for response. | $ 600 | | (b) Harm has occurred which required professional staff intervention. | $ 800 | | (c) Physical and life threatenting harm has occurred and steps would ordinarily be taken beyond reporting to the facility administrator to prevent recurrence, such as relocation out of the facility or notification of regulatory authorities. | $1,000 |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.64 Who may issue
(a) A prescription for a controlled substance may be issued only by a practitioner who is:
(1) authorized to prescribe controlled substances pursuant to his licensed professional practice; and
(2) either registered under the Federal Controlled Substances Act and in possession of a registration number from the Drug Enforcement Administration, United States Department of Justice, or its successor agency, or exempted from such registration as an exempt official.
(b) A practitioner issuing an electronic prescription for a controlled substance, in addition to meeting the provisions as noted in subdivision (a) of this section, shall also:
(1) use an electronic prescribing application that is consistent with Federal requirements; and
(2) register the certified electronic prescribing application with the New York State Department of Health, Bureau of Narcotic Enforcement.
(c) Prescriptions excepted from any electronic prescribing requirement set forth in article 2-a of the Public Health Law include prescriptions:
(1) issued by veterinarians;
(2) issued in circumstances where electronic prescribing is not available due to temporary technological or electrical failure. For the purposes of this Part, temporary technological or electrical failure shall be defined as: any failure of a computer system, application, or device, or the loss of electrical power to that system, application, or device, or any other service interruption to a computer system, application, or device in such a manner that is reasonably prevents a practitioner from utilizing his or her certified electronic prescribing application to transmit an electronic prescription for a controlled substance in accordance with this section and Federal requirements. In the instance of a temporary technological or electrical failure, a practitioner shall, without undue delay, seek to correct any cause for the failure that is reasonably within his or her control;
(3) issued by practitioners to whom the commissioner has granted a waiver, or a renewal thereof, from the requirement to use electronic prescribing. A waiver may be issued by the commissioner based upon a showing of a practitioner that his or her ability to issue an electronic prescription in accordance with this section is unduly burdened by:
(i) economic hardship;
(ii) technological limitations that are not reasonably within the control of the practitioner; or
(iii) other exceptional circumstance demonstrated by the practitioner.
The practitioner’s showing shall include a sworn statement of facts detailing the circumstances in support of a waiver, and should be accompanied by any and all other information which would be relevant to the commissioner’s determination. The practitioner shall also provide any information which would tend to negate the need for a waiver. A waiver shall be granted by the commissioner for a specified period of time, but in no event for more than one year. A practitioner may apply for a renewal of a previously granted waiver. Any application for the renewal of a previously granted waiver shall include an updated statement of facts detailing the continuing circumstances in support of the renewal, along with any facts reasonably known to the practitioner which tend to weigh against the granting of a renewal. Any renewal granted shall be subject to the same requirements as the original waiver;
(4) issued by a practitioner under circumstances where such practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient's medical condition, provided that if such prescription is for a controlled substance, the quantity of controlled substances does not exceed a five day supply if the controlled substance were used in accordance with the directions for use; or
(5) issued by a practitioner to be dispensed by a pharmacy located outside the state.
(d) A practitioner who issues a prescription pursuant to paragraph (c)(2) of this section shall file information about the issuance of such prescription with the department as soon as practicable, but in no instance more than 72 hours following the end of the technological or electrical failure that prevented the issuance of an electronic prescription.
(e) A practitioner who issues a prescription pursuant to paragraph (c)(4) or (5) of this section shall file information about the issuance of such prescription with the department within 48 hours of the date of issue.
(f) A practitioner who has been granted a waiver pursuant to paragraph (c)(3) of this section shall notify the department in writing within five business days upon gaining the capability to issue an electronic prescription. Without regard to the original expiration date, the waiver granted to the practitioner shall terminate within a reasonable period of time as determined by the department, allowing for the practitioner to make accommodations to begin issuing electronic prescriptions.
(g) Any prescription issued pursuant to subdivision (c) of this section shall be issued as an official New York State prescription or an oral prescription in accordance with sections 80.63, 80.67, 80.68, 80.69 and 80.70 of this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-3.13 Payment of maintenance charges
The director shall render bills at suitable intervals and a final bill as soon as practicable on discharge of the patient, to the person or agency in each instance who guaranteed payment, or, if payment is to be made from public funds, to the proper fiscal officer of the agency or the county or municipality indicated.
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-2 STATE FUNDING FOR HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-2.5 Limitations on non-state sources of funding
A health systems agency may enter into agreements and contracts with and receive grant funds, contributions or donations from such entities as:
(a) local, county, and state governments;
(b) not-for-profit organizations exempt from taxation pursuant to section 501(c)(3) of title 26 of the United States Code, private industry, insurers of health services, and other organizations, excluding, however, any such entities that are providers of health care operating facilities licensed or certified pursuant to the Public Health Law or Mental Hygiene Law except as may be authorized in accordance with section 82-1.6(e)(1) of this Part; and
(c) associations of health facilities or associations of providers of health care.
Chapter I STATE SANITARY CODE
Part 12 MATERNAL AND CHILD HEALTH
PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS
10 CRR-NY 12.10 Precautions to be observed in the use of dyes and inks containing aniline or nitrobenzene or other benzene derivatives for marking diapers and hospital linens
(a) Prohibition on use.
No hospital, laundry or diaper service shall use inks or dyes containing aniline oil (aminobenzene) or oil of mirbane (nitrobenzene) or other benzene derivatives to stamp or otherwise mark diapers, sheets, gowns, towels or other clothing or linens unless the articles so marked are boiled by the agency doing the marking before they are delivered, stored or otherwise made available for use.
(b) Marking of containers.
All containers used for dyes and inks containing aniline oil or oil of mirbane or other benzene derivatives used for marking diapers and hospital linens shall bear a label which conforms with the requirements of the sections of Part 9, supra, under heading “Warning Labels on Containers of Hazardous Substances” (§ 9.20 et seq. ), and the label must also contain the statement, “DIAPERS, CLOTHING OR LINEN MARKED BY THIS DYE (OR INK) MUST BE LAUNDERED, INCLUDING BOILING, BEFORE BEING MADE AVAILABLE FOR USE.”
Part 1 GENERAL PROVISIONS
VIOLATIONS AND PENALTIES VIOLATIONS AND PENALTIES
10 CRR-NY 1.21 Noncompliance or nonconformance; penalties.**
Noncompliance or nonconformance with any provision of this Chapter constitutes a violation punishable on conviction for a first offense by a fine not exceeding $250 or by imprisonment for not exceeding 15 days, or both; and for a second or subsequent offense by a fine not exceeding $500 or by imprisonment for not exceeding 15 days, or both.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.9 Notification of adverse financial condition
(a) Every MCO required to furnish an annual audited financial report shall require the CPA to report, in writing, to the commissioner, the board of directors and the MCO’s audit committee within five business days of any determination by the CPA that the MCO has materially misstated its financial condition as reported to the commissioner as of the balance sheet date currently under audit or that the MCO does not meet the contingent reserve requirement of section 98-1.11(e) of this Part.
(b) A MCO shall ensure that, if the CPA, subsequent to the date of the audited financial report filed pursuant to this regulation, becomes aware of facts that might have affected the report, the CPA acts in accordance with professional obligations imposed by the AICPA and PCAOB.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.26 Related organizations
(a) A related organization shall be defined as any entity which the residential health care facility is in control of or is controlled by, either directly or indirectly, or an organization or institution whose actions or policies the facility has the power, directly or indirectly, to significantly influence or direct, or a special purpose organization, or where an association of material interest exists in an entity which supplies goods and/or services to the residential health care facility, or any entity which is controlled directly or indirectly by the immediate family of the operator. Immediate family shall include each parent, child, spouse, brother, sister, first cousin, aunt and uncle, whether such relationship arises by reason of birth, marriage or adoption.
(b) The costs of goods and/or services furnished to a residential health care facility by a related organization are includable in the computation of the basic rate at the lower of the cost to the related organization, or the market price of comparable goods and/or services available in the residential health care facility's region within the course of normal business operations.
(c) If the residential health care facility has incurred any costs in connection with a related organization, the final payment rate shall include the costs of such goods and/or services.
(d) A special purpose organization shall be defined as an organization which is established to conduct certain of the provider's patient-care-related or non-patient-care-related activities. The special purpose organization shall be considered to be related if:
(1) the facility controls the special purpose organization through contracts or other legal documents that allow direct authority over the organization's activities, management and policies; or
(2) the facility is, for all practical purposes, the sole beneficiary of the special organization's activities. The facility shall be considered the special purpose organization's sole beneficiary if one or more of the three following circumstances exist:
(i) a special purpose organization has solicited funds in the name of and with the expressed or implied approval of the facility, and substantially all the funds solicited by the organization were intended by the contributor or were otherwise required to be transferred to the facility or used at its discretion or direction;
(ii) the facility has transferred some of its resources to a special purpose organization, substantially all of whose resources are held for the benefit of the facility; or
(iii) the facility has assigned certain of its functions (such as the operation of a dormitory) to a special purpose organization that is operating primarily for the benefit of the facility.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.15 Employer requirements
(a) All employers subject to the provisions of the Unemployment Insurance Law, except those employers with fewer than 25 employees, shall include in any health benefits plan offered to their employees the option of membership in an HMO which provides or offers a comprehensive health services plan in accordance with the provisions of this Subpart, but only if such plan serves an area in which 25 of such employer's employees reside and the HMO has been issued a certificate of authority by the commissioner.
(b) For those employees of an employer represented by a bargaining representative, the offer of the HMO option shall be subject only to the collective bargaining process. For those employees not represented by a bargaining representative, the offer of the health maintenance organization alternative shall be made directly to the employee.
(c) Employer option.
(1) For the purposes of this section, the following definitions shall apply:
(i) Staff model/group model category:
(a) Staff model is an HMO that provides more than one half of its basic health services through physicians and other professionals who work in centralized health centers as salaried employees of the HMO and where health care is delivered at a health center owned or leased by the HMO.
(b) Group model is an HMO that provides more than one half of its basic health services through physicians and other professionals who are not salaried employees of the organization but instead are members of one or more medical groups which contract with the HMO to deliver health care at a health center.
(ii) IPA model/network model category:
(a) Independent practice association (IPA) model is an HMO organized in such a way that the physicians or other professionals are not salaried employees of the organization and contract individually or as one or more groups with an IPA which in turn contracts with the HMO to make the services of such providers available to the HMO's enrollees.
(b) Network model HMO is an HMO organized in such a way that physicians or other professionals provide health care in any combination of models as defined in subparagraphs (i) and/or (ii) of this paragraph, but does not qualify as a staff or a group model as set out in subparagraph (i) of this paragraph.
(iii) Principal office is that place of business indicated on the employer's certificate of incorporation or like instrument approved and on file with the Secretary of State.
(iv) Metropolitan region consists of the counties of Westchester, Rockland, New York, Kings, Queens, Richmond, Bronx, Nassau and Suffolk.
(2) If there is more than one HMO engaged in the provision of health services in the area in which the employees of an employer reside, then the employer shall be required to offer the option of enrollment in HMOs that are qualified under the provisions of this Subpart, pursuant to the following:
(i) if the employer has 25 or more but fewer than 200 employees, the employer shall be required to offer at least one HMO from the staff model/group model category and one HMO from the IPA model/network model category;
(ii) if the employer has 200 or more employees and the employer's principal office in this State is located outside the metropolitan region, the employer shall be required to offer at least two HMOs from the staff model/group model category and two HMOs from the IPA model/network model category;
(iii) if the employer has 200 or more employees and the employer's principal office in this State is located within the metropolitan region, the employer shall be required to offer at least two HMOs from the staff model/group model category and two HMOs from the IPA model/network model category and one additional HMO of any model;
(iv) if within any particular area of the State served by one or more HMOs in which at least 25 of an employers employees reside there are fewer HMOs by category than the employer is required to offer, then additional HMOs of other categories shall be offered; provided, however, that no employer with fewer than 200 employees shall be required to offer more than a total of two HMOs, and no employer with 200 or more employees shall be required to offer more than a total of four HMOs if the employer's principal office is not located in the metropolitan region, or five such organizations if the employer's principal office is located within the metropolitan region;
(v) in the event fewer than the required total minimum number of HMOs are available in an area, the employer shall offer all HMOs then certified to issue subscriber contracts in that area;
(vi) nothing in this subdivision shall be deemed to prohibit an employer from choosing to offer more HMOs to its employees than are required under this subdivision; and
(vii) nothing in this subdivision shall require an employer to offer to its employees an HMO which has not approached the employer seeking to be an offered HMO choice nor shall it be interpreted as prohibiting an employer from requesting that an HMO consider enrolling its employees.
(3) In determining employer size for required HMO offerings statewide, the employer shall tabulate the total number of employees at all work sites maintained by the employer within the State of New York. If, for example, an employer has 200 employees at its principal office within the metropolitan region and 25 employees at its nonmetropolitan region office, the employer is required to offer five HMOs in each area, subject to subparagraph (2)(v) of this subdivision. Work sites include, but are not limited to, principal offices, branch offices, district offices or regional offices.
(4) Any employer who knowingly fails to comply with the provisions of this subdivision shall be subject to a civil penalty of not more than $1,000 and/or subject to injunctive relief.
(d) No employer shall be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or other legally enforceable contract for the provision of health benefits between an employer and his employees.
(e) An employer contributing on behalf of employees to the cost of health benefit plan options shall contribute for any HMO option an amount which is not less than 100 percent of the dollar amount contributed by the employer for any other employee benefit option, or which is based on the same percentage that is applied to any other employer health benefits plan option premium or cost.
(f) The HMO is responsible for identifying those employers within their service area to which the option of enrollment in the HMO is to be offered, and for notifying in writing those employers to whose employees it intends to offer the HMO option.
(g) Such notification to an employer by an HMO shall indicate, where appropriate, whether an HMO intends to offer its plan to all employees of an employer who reside within its article 44 service area, or to limit its offer to the employees of a specific organizational subdivision of the employer. When one or more employees of such an employer are not covered by a collective bargaining agreement, and in the cases of public employers, the employer shall have the option of requiring that the HMO option be offered to all of those employees within the service area who are covered by the employer's existing health benefits contract.
(h) An employer, subject to and qualifying under this section, receiving written notification from an HMO of its intent to offer the HMO option, shall, within 30 days, provide written acknowledgment of the HMO's notification, and thereafter shall not unreasonably delay the actions necessary to implement the offering of the HMO alternative to employees.
(i) Material presented to the employer shall include, but not necessarily be limited to, identification of service area, an organizational chart or description of the HMO, identification of the governing authority of the HMO and the holding company of a controlled HMO, identification of the principal providers of medical and hospital services associated with the HMO, present and anticipated enrollment limitations, approved premiums for enrollees and a sample enrollee contract. If the HMO has not received approval for enrollee premiums, the information provided to the employer by the HMO must clearly show that such premiums are not yet approved by the superintendent.
(j) The HMO shall notify the employer of its intention to market the HMO option at least 90 days prior to the expiration or renewal date of an existing health benefits contract or employer- employee agreement relating to health benefits, and when a collective bargaining agreement includes health benefits, at least 90 days prior to the expiration date of such agreement. For employers with a collective bargaining agreement that is without fixed terms, or is for a fixed term but has provisions for periodically changing the conditions of employment, such agreement shall be treated as renewable on the anniversary date of the agreement or at such other times, not less than annually, as may be provided by such agreement for discussion of changes in its provisions. Existing collective bargaining agreements making no reference to the HMO option or to a particular HMO shall not relieve an employer of the statutory obligation to make the HMO option available to employees in accordance with this section.
(k) New employees beginning regular employment with an employer subject to this section shall have either seven working days or the customary period allowed by the employer, whichever is longer, to elect the health benefits option under which they desire to be covered.
(l) Employers subject to this section shall, when responding to notification by an HMO of its intent to offer the HMO option, provide the commencement date and duration of its next annual enrollment period during which employees may elect to change from coverage under one health benefits option offered to another. The HMO(s) shall initially, and on an annual basis thereafter, have access to employees for marketing purposes during such enrollment period.
(m) When an annual enrollment period has not been customarily provided, employers subject to this section shall annually provide, after the initial offering of the HMO option which results in the enrollment of employees in an HMO, an enrollment period of reasonable duration to afford employees the opportunity to elect to change their health benefits coverage to or from an HMO option offered, or to or from any other health benefits option which chooses to participate in the annual enrollment period.
(n) MCOs shall, upon request, disclose to prospective subscribers the information required to be so disclosed by section 4408 of the Public Health Law. Marketing materials to be distributed to the employees shall be clear, concise, strictly factual and accurate. Such materials shall include identification of the service area, an organizational chart or description, identification of principal providers of medical and hospital services associated with the HMO, present and anticipated enrollment limitations, enrollee premiums, a description of included services, any enrollee costs and required copayments, and any exclusions of coverage.
(o) The cost of marketing the HMO is the responsibility of the HMO, unless otherwise negotiated.
(p) The inclusion of any additional marketing material and the method of distribution of all marketing material shall be subject to negotiation between the HMO and the employer.
(q) Any material distributed by the employer relative to the health maintenance organization plan shall be subject to prior review by the HMO for accuracy.
(r) Any material to be distributed by an HMO to employees which involves comparison with or discussion of any other health benefit options offered by an employer shall be subject to prior review by the employer for accuracy.
(s) Employers required to offer the option of membership in an HMO under this section shall provide for the collection of employee premiums through payroll deductions if such payroll deduction is provided for employees choosing other health benefit options.
(t) An employer shall not discriminate against an employee who chooses the HMO option.
(u) An employer may utilize or employ a solicitor, broker, agent or other representative to advise and assist in the review, selection, marketing, offering, processing for enrollment or administration of its employees in a comprehensive health services plan(s); provided, however, that:
(1) no employer, or the solicitor, agent or employee thereof shall require payment by an HMO, or by an employee through premium payment, of any fee or commission for such services;
(2) no broker providing such services shall require payment by an employee through premium payment for such services;
(3) any requirement for payment by an employee for such services shall be clearly identified and itemized in enrollee billings, and described as separate and distinct from the premium rate payable by employees in any materials distributed to employees concerning premium rates and other required enrollee payments; and
(4) when an employer or its representative prepares for employees a comparison of health benefits options to be offered which includes one or more HMO options, such material shall be comparable in scope and depth for all options and shall include all HMO options to be offered regardless of whether an HMO has negotiated to contribute to the cost of preparing and/or distributing such material.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.4 Audits
(a) All fiscal and statistical records and reports shall be subject to audit. All underlying books, records and documentation which formed the basis for the fiscal and statistical reports, filed by the medical facility with the department, shall be kept and maintained by the facility for a period of time not less than six years from the date of filing or the date upon which the fiscal and statistical records were to be filed, whichever is the later date. In this respect, any rate of payment certified or established by the State Commissioner of Health prior to audit shall be construed to represent a provisional rate until such audit is performed and completed, at which time such rate or adjusted rate will be construed to represent the audited rate.
(b) Subsequent to the filing of fiscal and statistical reports, field audits may be conducted of the records of medical facilities in a time, manner and place to be determined by the State Department of Health. Alternatively or in addition the department may, in its sole discretion, conduct desk audits of such fiscal and statistical reports.
(c) The required fiscal and statistical reports shall be subject to audit for a period of six years from the date of their filing with the department or from the date when due, whichever is later. This limitation shall not apply to situations in which fraud may be involved, or where the provider or an agent thereof prevents or obstructs the commissioner from performing an audit pursuant to this section.
(d) Upon completion of the audit, the medical facility shall be afforded a closing conference. The medical facility may appear in person or by any one authorized in writing to act on behalf of the medical facility. The medical facility shall be afforded an opportunity at such conference to produce additional documentation in support of any modifications requested in the audit.
(e) The medical facility shall be provided with the audit report and the rate computation sheet per audit. The audit report shall be final unless within 30 days of receipt of the audit report, the medical facility initiates a bureau review of such final audit report by notifying the Division of Health Care Financing by registered or certified mail, detailing the specific items of the audit report with which the provider disagrees, and such other material as the provider wishes to submit in its behalf, and forwarding all material documentation in support of the medical facility's position.
(f) The medical facility shall be notified in writing of the determination of the controverted items of the final audit report, including a statement of the reasons for such adjustments and the appropriate citation to applicable law, regulation or policy. The audit findings as adjusted in accordance with the determination of the bureau review shall be final, except that the medical facility may, within 30 days of receipt of the determination of the bureau review, initiate a hearing to refute those items of the audit report adverse to the interests of the medical facility presenting a factual issue by serving on the commissioner, by certified or registered mail, a notice containing a statement of the legal authority and jurisdiction under which the hearing should be held, a reference to the particular sections of the statutes and rules involved and a statement of the controverted items of the audit report and bureau determination, together with copies of any documentation relied on by the medical facility in support of its position.
(1) Upon receipt of such notice the commissioner shall:
(i) designate a hearing officer to hear and recommend;
(ii) establish a time and place for such hearing;
(iii) notify the medical facility of the time and place of such hearing at least 15 days prior thereto; and
(iv) include in a notice of hearing those issues of the audit report which are controverted in the notice served on the commissioner by the medical facility.
(2) The issues and documentation presented by the medical facility at such hearing shall be limited to the factual issues and documentation presented at the bureau review.
(3) The audit report shall be presumptive evidence of its content. The burden of proof at any such hearing shall be upon the medical facility to prove by substantial evidence that the items therein contained are incorrect.
(4) The hearing shall be conducted in conformity with section 12-a of the Public Health Law and the State Administrative Procedure Act.
(5) At the conclusion of the hearing the medical facility may submit memoranda on any legal issues which it deems relevant to the proceeding. Such memoranda shall become part of the official record of the hearing.
(g) Rate revisions resulting from the procedure set forth in this section shall be made retroactive to the period or periods during which the rates based on the periods audited were established. Any resulting overpayment or underpayment shall be satisfied by either retroactive adjustment of the provisional rate paid, based on the period audited, or prospective adjustment of the current certified rate at the discretion of the State Commissioner of Health.
(h) Notwithstanding the provisions of this section, the commissioner may promulgate rate revisions based on audits completed by another State agency. Unless otherwise indicated, such audits shall not be considered final and shall not preclude conduct of a complete audit by the State Department of Health or its agent.
(i)
(1) Effective for institutional cost reports filed for report periods ending on and after December 31, 2010, the department shall establish a fee schedule for the purpose of funding audit activities authorized pursuant to this section. Such fee schedule shall be published on the New York State Department of Health website at: http://www.health.state.ny.us.Theamount of such fees shall be proportional to the amount of the total costs reported by each facility, provided, however, that minimum and maximum fee levels may be established.
(2) Additional fee obligations shall be established for facilities filing more than two institutional costs reports for a reporting period. The department may, upon written application submitted prior to the submission of such additional institutional cost reports, waive or reduce such additional fees based on a showing of financial hardship or a showing that the additional submission is necessitated by department error or other factors beyond the facility's control. Such a waiver must be in writing.
(3) Fees shall be submitted at the time of the submission of the institutional costs reports. A failure to pay such fees may be deemed by the department as constituting the non-filing of the institutional cost report and subject the facility to the rate reduction authorized pursuant to section 86-1.2(c) of this Subpart. Failure to pay the additional fee associated with the filing of additional institutional cost reports as described in paragraph (2) of this subdivision shall result in the non-utilization of such revised cost reports by the department. Delinquent fees may be collected by the department in accordance with the provisions of paragraph (h) of subdivision 18 of section 2807-c of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.226 Operating expenses
Operating expenses include all necessary and proper costs which are appropriate in developing and maintaining the operation of the patient care facilities and activities. Necessary and proper costs related to patient care are those costs which are common and accepted occurrences in the hospital operation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
INTRAVASCULAR CONTRAST MEDIA INJECTION INTRAVASCULAR CONTRAST MEDIA INJECTION
10 CRR-NY 89.40 Intravascular contrast media injection
(a) The department may issue a certificate to administer contrast media intravenously to a licensed and registered radiologic technologist who fulfills the following requirements in a manner acceptable to the department:
(1) submits an application on a form provided by the department;
(2) submits documentation demonstrating satisfactory completion of an educational program, approved by the department, that offers education and training concerning venipuncture of a person’s upper extremity in a safe and effective manner, anatomy and physiology of venipuncture sites, venipuncture instruments, intravenous solutions and related equipment, techniques of intravenous line establishment, hazards and complications of venipuncture, post puncture care, the composition and purpose of an anti-anaphylaxis tray, and the recognition of adverse reactions to intravenous administration of contrast media; and
(3) has satisfactorily completed training in cardiopulmonary resuscitation in a course sponsored by the American Red Cross, the American Heart Association or other sponsoring institution approved by the department.
(b) A radiologic technologist certified pursuant to this section may establish an intravenous line as part of a procedure requiring contrast media, administer a saline flush and inject intravenous contrast media, manually or by mechanical injector under the direct supervision of a licensed physician who is qualified in a medical specialty related to the radiological procedure.
(c) Nothing in this section shall be construed to authorize a radiologic technologist certified pursuant to this section to perform arterial puncture, to determine the type or amount of contrast media to be injected or to administer or inject any medication other than contrast media.
(d) A radiologic technologist shall administer intravascular contrast media pursuant to the healthcare facility’s established policies and procedures governing such contrast media administration and the availability of personnel and equipment to treat adverse reactions.
(e) Nothing in this section shall be construed to limit the authority of any person to administer or inject contrast media under any other law or under any rule or regulation of the commissioner, the department, the State Education Department or Board of Regents.
(f) Revocation or suspension of a license or registration shall be deemed a revocation or suspension of a certification issued pursuant to this section.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.3 Administrative responsibility
The reproductive tissue bank director shall assume overall responsibility for operation of the reproductive tissue bank. The reproductive tissue bank director shall meet the requirements of section 52-2.5(a)(2) of this Part. The training and/or experience requirements specified in section 52-2.5 of this Part shall be in the field of reproductive endocrinology, andrology, human fertility or a closely related field. The reproductive tissue bank director shall develop and implement policies and procedures consistent with this Subpart for the operation of the bank. If the reproductive tissue bank director is not a physician, a medical director who meets the requirements of section 52-2.5(a)(3) of this Part shall be retained. Except for insemination/implantation sites, reproductive tissue banks shall have a medical advisory committee, composed of at least five members with experience and expertise in the fields of human fertility, infectious disease, clinical pathology or related fields, who shall be responsible for monitoring the medical efficacy of the reproductive tissue bank and reviewing operating policies and procedures. If the bank acquires reproductive tissue from donors, a qualified microbiologist, clinical pathologist or infectious disease specialist, and a geneticist shall serve either as members of or consultants to the committee.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.1 Villages of Avon and Geneseo and Lakeville Water District, Town of Livonia
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as amended, shall apply to Conesus Lake and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the villages of Avon and Geneseo and the Lakeville Water District of the Town of Livonia, and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definitions.
(1) The term water supply means the public water supply of the villages of Avon and Geneseo and the Lakeville Water District of the Town of Livonia.
(2) The term Conesus Lake means said body of water serving as a source of the water supply of the villages of Avon and Geneseo and Lakeville Water District of the Town of Livonia.
(3) The term lake means Conesus Lake.
(4) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into Conesus Lake or into this water supply.
(5) The term linear distance means the shortest horizontal distance. The linear distance between a structure or object and a reservoir, watercourse or Conesus Lake shall be measured from the nearest point of the structure or object to the high-water mark of the reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of the watercourse or of Conesus Lake.
(6) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy, and shall include also sludge and scum from septic tanks and cesspools connected to disposal systems receiving the aforementioned feces, urine and other excretions.
(7) The term sewage means waste liquids containing human excreta, decomposing matter, or bath, kitchen or laundry waste water.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into Conesus Lake or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta or sewage shall be buried in the soil on the watershed of the water supply, unless deposited in trenches or pits at a linear distance of not less than 500 feet from the high-water mark of Conesus Lake or any watercourse, and covered with not less than 24 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow. The bottom of any trench or pit in which human excreta or sewage is deposited shall be not less than two feet above the high ground water table at the location of such trench or pit.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within a linear distance of 500 feet from the high-water mark of Conesus Lake or any watercourse except a properly constructed and operated sewage disposal plant, as hereinafter set forth in subdivision (d) of this section; provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta built or to be built on property which is so located, bounded or otherwise placed that the linear distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the boards of trustees of the villages of Avon and Geneseo and the town board of the town of Livonia, and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta or sewage located less than a linear distance of 500 feet from Conesus Lake or any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled to within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after reasonable notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) [Sewage.]
No sewage shall be discharged or allowed to flow into the lake or any watercourse or any reservoir nor deposited on or beneath the surface of the ground within a linear distance of 500 feet of the high-water mark of Conesus Lake or any watercourse except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within a linear distance of 35 feet of the high-water mark provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants constructed and operated in accordance with plans which first have been submitted to and approved by the State Commissioner of Health and in accordance with such terms and conditions as may be specified by said commissioner.
(e) [Bath water, wastes.]
No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant approved by the State Commissioner of Health as hereinbefore provided by subdivision (d), shall be discharged or allowed to flow into the lake or any watercourse nor be deposited on or beneath the surface of the ground within a linear distance of 500 feet of the high-water mark of the lake or any watercourse.
(f) [Garbage, refuse.]
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or fish or parts thereof, or any other matter that pollutes water shall be deposited in the lake or any watercourse nor on or beneath the surface of the ground within a linear distance of 500 feet of the high-water mark of the lake or any watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into the lake or any reservoir or watercourse.
(g) [Bathing, swimming.]
No person or persons shall bathe or swim or be allowed to bathe or swim in Conesus Lake within a linear distance of 500 feet of the public water supply intakes of the villages of Avon or Geneseo or the Lakeville Water District.
(h) [Animals.]
(1) No animal of any kind shall be washed or watered in the lake or any watercourse and no watering place shall be maintained in such a way as to pollute the lake or any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute the lake.
(i) [Manure.]
No manure pile shall be maintained or allowed to remain within a linear distance of 500 feet of the high-water mark of Conesus Lake or 100 feet from any watercourse.
(j) [Temporary shelters.]
(1) No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his use or for the use of his family and friends, shall be located, placed or maintained within a linear distance of 500 feet of the high-water mark of Conesus Lake or any watercourse.
(2) No hut, tent, shelter or building of any kind shall be permitted on the ice of Conesus Lake.
(k) [Cemeteries.]
No interment of a human body shall be made within a linear distance of 500 feet of the high-water mark of Conesus Lake or any watercourse.
(l) [Boats.]
Any boat equipped with toilets or receptacles for human excreta or sinks of any kind shall not be permitted upon the waters of Conesus Lake.
(m) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting the watershed of Conesus Lake shall refrain from any act, whether or not specified in these rules and regulations, which may result in contamination of the water supply or any portion thereof.
(n) [Inspection.]
The boards of trustees of the villages of Avon and Geneseo and the town board of the town of Livonia, or such other person or persons as may be charged with the operation, maintenance or supervision of the water supply or the duly appointed representative or representatives of the boards of trustees of the villages of Avon and Geneseo and the town board of the town of Livonia or of such other person or persons as may be charged with the operation, maintenance or supervision of the water supply, shall make regular and thorough inspections of the lake, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said boards of trustees and town board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with rules and regulations it shall be the further duty of said boards of trustees and town board to promptly notify the State Commissioner of Health of such violations. The boards of trustees and town board shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(o) [Penalty.]
In accordance with section 1103 of chapter 45 of the Consolidated Laws of New York State (Public Health Law), being chapter 879 of the Laws of 1953, as amended, the penalties for violations of any of the foregoing rules or regulations are specified as follows:
(1) Any person violating a rule or regulation relating to a temporary source or act of contamination shall be liable to prosecution for misdemeanor for every such violation, and on conviction thereof shall be punished by a fine not exceeding $200, or imprisonment not exceeding one year, or both.
(2) For a violation of or noncompliance with a rule or regulation relating to a permanent source or act of contamination, the State Department of Health may impose penalties not exceeding $200 for every such violation or noncompliance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.137 Function
A collection of activities having related purposes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.3 Rates for prevocational services (site-based), respite (hourly and free-standing), prevocational services (community-based), supported employment, and residential habilitation (family care)
(a) There shall be one provider-wide rate for each provider of prevocational services (site-based), except that rates for prevocational services provided to individuals identified as specialized populations by OPWDD shall be determined under section 86-13.8 of this Subpart. Adjustments may be made to the rate resulting from any final audit findings or reviews.
(b) Rates shall be computed on the basis of a full 12 month base year CFR, adjusted in accordance with the methodology as provided in this section. The rate shall include operating cost components, facility cost components, and capital cost components as identified in applicable paragraphs. Such base year may be updated periodically, as determined by DOH.
(c) Prevocational (site-based).
(1) Operating component. Allowable operating costs shall include costs identified in the consolidated fiscal reports and reimbursement for such costs shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars (including production staff) for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried direct care hours (including production staff) for each provider in a DOH region, aggregated for all such providers in such region.
(ii) Regional average employee-related component , which shall mean the quotient of the sum of vacation leave accruals and total fringe benefits for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried direct care dollars (including production staff) for each provider in a DOH region, aggregated for all such providers in such region, and such quotient shall be multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the quotient of the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider in a DOH region, aggregated by all such providers in such region, divided by the total base year salaried direct care dollars (including production staff) of all providers in a DOH region, and such quotient shall be multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative costs , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the quotient of the sum of the insurance-general and agency administration allocation for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider in a DOH region, aggregated for all providers in such region). The regional average direct care hourly rate-excluding general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (iv) of this paragraph, shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional average general and administrative component as computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of base year salaried direct care dollars (including production staff) divided by the base year salaried direct care hours (including production staff) of a provider.
(viii) Provider average employee-related component , which shall mean the quotient of the sum of vacation leave accruals and fringe benefits for the base year for each provider, divided by base year salaried direct care dollars (including production staff) of a provider, and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the quotient of the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for a provider, divided by the base year salaried direct care dollars (including production staff) of such provider, and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative costs , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the quotient of the sum of insurance-general and agency administration allocation for the base year for a provider, divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for a provider) for the base year. The provider average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Provider direct care hours , which shall mean the quotient of the sum of base year salaried direct care hours (including production staff) and base year contracted direct care hours, divided by the billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xiv) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xv) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of such provider.
(xvi) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the billed units for the base year, and such quotient shall be multiplied by the rate sheet units for the initial period for such provider.
(xvii) Regional average contracted clinical hourly wage , which shall mean the quotient of contracted clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by the base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xviii) Provider contracted clinical hours , which shall mean the quotient of a provider’s contracted clinical hours for the base year, divided by the billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xix) Provider direct care hourly rate-adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph, multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph, multiplied by 0.25.
(xx) Provider clinical hourly wage – adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xv) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xiv) of this paragraph, multiplied by 0.25.
(xxi) Provider reimbursement for direct care hourly rate , which shall mean the product of the calculated provider direct care hours as determined pursuant to subparagraph (xiii) of this paragraph and the provider direct care hourly rate-adjusted for wage equalization factor as computed in subparagraph (xix) of this paragraph.
(xxii) Provider reimbursement for clinical hourly wage , which shall mean the product of the provider salaried clinical hours as determined pursuant to subparagraph (xvi) of this paragraph and the provider clinical hourly wage-adjusted for wage equalization factor as determined pursuant to subparagraph (xx) of this paragraph.
(xxiii) Provider reimbursement from contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours as determined pursuant to subparagraph (xviii) of this paragraph and the applicable regional average contracted clinical hourly wage as determined pursuant to subparagraph (xvii) of this paragraph.
(xxiv) Provider facility reimbursement , which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, housekeeping and maintenance staff, and program administration property the base year for a provider, divided by provider billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xxv) Provider to/from transportation reimbursement , which shall mean the quotient of the to/from transportation allocation for the base year, divided by the provider billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xxvi) Provider operating revenue , which shall mean the sum of provider reimbursement for direct care hourly rate, as determined pursuant to subparagraph (xxi) of this paragraph, the provider reimbursement for clinical hourly wage as determined pursuant to subparagraph (xxii) of this paragraph, the provider reimbursement from contracted clinical hourly wage as determined pursuant to subparagraph (xxiii) of this paragraph, the provider facility reimbursement as determined pursuant to subparagraph (xxiv) of this paragraph, and provider to/from transportation reimbursement as determined pursuant to subparagraph (xxv) of this paragraph.
(xxvii) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of the operating revenue from all provider rate sheets in effect on June 30, 2015, divided by provider operating revenue, as determined pursuant to subparagraph (xxvi) of this paragraph, for all providers.
(xxviii) Total provider operating revenue-adjusted , which shall mean the product of the provider operating revenue as determined pursuant to subparagraph (xxvi) of this paragraph and the statewide budget neutrality adjustment factor for operating dollars as determined pursuant to subparagraph (xxvii) of this paragraph.
The final daily operating rate shall be determined by dividing the total provider operating revenue-adjusted, as determined by subparagraph (xxviii) of this paragraph, by the applicable provider rate sheet units for the initial period.
(2) Alternative operating component. For providers that did not submit a cost report or submitted a cost report that was incomplete for prevocational services for the base year, the final daily operating rate shall be a regional daily operating rate. This rate shall be the sum of:
(i) The product of the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (1)(vi) of this subdivision, and the applicable regional average direct care hours, which shall mean the quotient of base year salaried and contracted direct care hours (including production workers) for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(ii) the product of the applicable regional average clinical hourly wage, as determined pursuant to subparagraph (1)(xiv) of this subdivision, and the applicable regional average clinical hours, which shall mean the quotient of base year salaried and contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(iii) the applicable regional average facility reimbursement, which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance – property and casualty, housekeeping and maintenance staff, and program administration property for the base year divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(iv) the applicable regional average to/from transportation reimbursement which shall mean the quotient of the to/from transportation allocation for the base year divided by the provider billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region.
Such sum shall then be multiplied by the statewide budget neutrality adjustment factor for operating dollars as determined pursuant to subparagraph (1)(xxvii) of this subdivision.
(3) Capital component.
(i) For capital assets approved on or after July 1, 2015. OPWDD regulations under 14 NYCRR Subpart 635-6 establish standards and criteria for calculating provider reimbursement for the acquisition and lease of real property assets which require approval by the Office for People With Developmental Disabilities. The regulations also address associated depreciation and related financing expenses. The rate will include costs for actual straight line depreciation, interest expense, financing expenses, and lease cost. In no case will the total capital reimbursement associated with the capital asset exceed the total acquisition, renovation and financing cost associated with a capital asset. The asset life for building acquisitions shall be 25 years.
(ii) For capital assets approved prior to July 1, 2015. The State will identify each asset by provider, and provide a schedule of these assets identifying: total actual cost, reimbursable cost determined by the prior approval, total financing cost, allowable depreciation and allowable interest for the remaining useful life as determined by the prior approval, and the allowable reimbursement for each year of the remaining useful lives. In no case will the total reimbursable depreciation or principal amortization and total interest associated with the capital asset exceed the total acquisition, renovation and financing cost associated with a capital asset.
(iii) Notification to providers. 14 NYCRR Subpart 635-6 contains the criteria and standards associated with capital costs and reimbursement. Each provider will receive a schedule of approved reimbursable costs that is being used to establish the real property capital component of the provider’s reimbursement rate.
(iv) Rate for capital assets approved on or after July 1, 2015. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease, and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date when prevocational services are first provided at the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date when prevocational services were first provided at the site, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(v) Cost verified rates for capital assets approved on or after July 1, 2015. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Under no circumstances shall the amount included in the rate under this subparagraph exceed the amount authorized in the approval process. Capital costs shall be depreciated over a 25 year period for acquisition of properties or the life of the lease for leased sites. Capital improvements shall be depreciated over the life of the asset. The amortization of interest shall not exceed the life of the loan taken. Amortization or depreciation shall begin upon certification by the provider of such costs. Start-up costs may be amortized over a one year period beginning with site opening. If actual costs are not submitted to the State within two years from the date when prevocational services were first provided at the site, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted.
(vi) Capital reimbursement schedule. Beginning with the cost reporting period ending December 31, 2014, each provider shall submit to OPWDD, as part of the annual cost report, a capital reimbursement schedule.
This schedule will specifically identify the differences, by capital reimbursement item, between the amounts reported on the certified cost report, and the reimbursable items, including depreciation, interest and lease cost from the schedule of approved reimbursable capital costs. The provider’s independent auditor will apply procedures to verify the accuracy and completeness of the capital reimbursement schedule. The department will retroactively adjust capital reimbursement based on the actual cost verification process as described in subparagraph (v) of this paragraph.
(d) Respite (hourly and free-standing).
(1) Operating component. Allowable operating costs shall include costs identified in the consolidated fiscal reports and reimbursement for such costs shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried direct care hours for each provider in a DOH region, aggregated for all such providers in such region.
(ii) Regional average employee-related component , which shall mean the quotient of the sum of vacation leave accruals and total fringe benefits for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, and such quotient shall be multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the quotient of the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider in a DOH region, aggregated by all such providers in such region, divided by the total base year salaried direct care dollars of all providers in a DOH region, and such quotient shall be multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative costs , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the quotient of the sum of the insurance-general and agency administration allocation for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider in a DOH region, aggregated for all providers in such region). The regional average direct care hourly rate-excluding general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (iv) of this paragraph, shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional average general and administrative component as computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of base year salaried direct care dollars divided by the base year salaried direct care hours of a provider.
(viii) Provider average employee-related component , which shall mean the quotient of the sum of vacation leave accruals and fringe benefits for the base year for each provider, divided by base year salaried direct care dollars of a provider, and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the quotient of the sum of transportation related-participant staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for a provider, divided by the base year salaried direct care dollars of such provider, and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative costs , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the quotient of the sum of insurance-general and agency administration allocation for the base year for a provider, divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for a provider) for the base year. The provider average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care hourly rate-excluding general and administrative costs, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Provider direct care hours , which shall mean the quotient of the sum of base year salaried direct care hours and base year contracted direct care hours, divided by the billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xiv) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xv) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of such provider.
(xvi) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the billed units for the base year, and such quotient shall be multiplied by the rate sheet units for the initial period for such provider.
(xvii) Regional average contracted clinical hourly wage , which shall mean the quotient of contracted clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by the base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xviii) Provider contracted clinical hours , which shall mean the quotient of a provider’s contracted clinical hours for the base year, divided by the billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xix) Provider direct care hourly rate-adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph, multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph, multiplied by 0.25.
(xx) Provider clinical hourly wage – adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xv) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xiv) of this paragraph, multiplied by 0.25.
(xxi) Provider reimbursement for direct care hourly rate , which shall mean the product of the calculated provider direct care hours as determined pursuant to subparagraph (xiii) of this paragraph and the provider direct care hourly rate-adjusted for wage equalization factor as computed in subparagraph (xix) of this paragraph.
(xxii) Provider reimbursement for clinical hourly wage , which shall mean the product of the provider salaried clinical hours as determined pursuant to subparagraph (xvi) of this paragraph and the provider clinical hourly wage-adjusted for wage equalization factor as determined pursuant to subparagraph (xx) of this paragraph.
(xxiii) Provider reimbursement from contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours as determined pursuant to subparagraph (xviii) of this paragraph and the applicable regional average contracted clinical hourly wage as determined pursuant to subparagraph (xvii) of this paragraph.
(xxiv) Provider facility reimbursement , which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance – property and casualty, housekeeping and maintenance staff, and program administration property the base year for a provider, divided by provider billed units for the base year, and such quotient shall be multiplied by rate sheet units for the initial period.
(xxv) Provider operating revenue , which shall mean the sum of provider reimbursement for direct care hourly rate as determined pursuant to subparagraph (xxi) of this paragraph, the provider reimbursement for clinical hourly wage as determined pursuant to subparagraph (xxii) of this paragraph, the provider reimbursement from contracted clinical hourly wage as determined pursuant to subparagraph (xxiii) of this paragraph, and the provider facility reimbursement as determined pursuant to subparagraph (xxiv) of this paragraph.
(xxvi) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of the operating revenue from all provider rate sheets in effect on June 30, 2015, divided by provider operating revenue, as determined pursuant to subparagraph (xxv) of this paragraph, for all providers.
(xxvii) Total provider operating revenue-adjusted , which shall mean the product of the provider operating revenue as determined pursuant to subparagraph (xxv) of this paragraph and the statewide budget neutrality adjustment factor for operating dollars as determined pursuant to subparagraph (xxvi) of this paragraph.
The final daily operating rate shall be determined by dividing the total provider operating revenue-adjusted, as determined by subparagraph (xxvii) of this paragraph, by the applicable provider rate sheet units for the initial period.
(2) Alternative operating component. For providers that did not submit a cost report or submitted a cost report that was incomplete for free-standing or hourly respite services for the base year, the final daily operating rate shall be a regional daily operating rate. This rate shall be the sum of:
(i) the product of the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (1)(vi) of this subdivision, and the applicable regional average direct care hours, which shall mean the quotient of base year salaried and contracted direct care hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(ii) the product of the applicable regional average clinical hourly wage, as determined pursuant to subparagraph (1)(xiv) of this subdivision, and the applicable regional average clinical hours, which shall mean the quotient of base year salaried and contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(iii) the applicable regional average facility reimbursement, which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance – property and casualty, housekeeping and maintenance staff, and program administration property for the base year, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region.
Such sum shall then be multiplied by the statewide budget neutrality adjustment factor for operating dollars as determined pursuant to subparagraph (1)(xxvi) of this subdivision.
(3) Capital component.
(i) For free-standing respite sites.
(a) The rate shall be determined by dividing the approved annual costs by 12. Capital costs shall be determined in accordance with 14 NYCRR Subpart 635-6.
(b) The capital rate shall be paid monthly.
Note:
The provisions of this paragraph do not apply to capital approved by OPWDD prior to July 1, 2015.
(ii) Initial rate for capital assets approved on or after July 1, 2015. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease, and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date of certification of the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(iii) Cost verified rates for capital assets approved on or after July 1, 2015. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Under no circumstances shall the amount included in the rate under this subparagraph exceed the amount authorized in the approval process. Capital costs shall be depreciated over a 25 year period for acquisition of properties or the life of the lease for leased sites. Capital improvements shall be depreciated over the life of the asset. The amortization of interest shall not exceed the life of the loan taken. Amortization or depreciation shall begin upon certification by the provider of such costs. Start-up costs may be amortized over a one year period beginning with site certification. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted.
(e) Prevocational (community-based).
(1) Fee schedule. Effective July 1, 2015, prevocational (community-based) services will be reimbursed according to the fee schedule below:
| Prevocational (community-based) | | | | | | --- | --- | --- | --- | --- | | Prevocational (community-based) | Unit of service | Individual (serving 1) | Group (serving 2) | Group (serving 3+) | | 1 | Hourly | $41.57 | $25.98 | $20.78 | | 2 | Hourly | $43.92 | $27.45 | $21.96 | | 3 | Hourly | $42.90 | $26.81 | $21.45 |
(f) Supported employment.
(1) Fee schedule. Effective July 1, 2015, supported employment will be reimbursed according to the fee schedule below:
| Supported employment (intensive phase) | | | | | --- | --- | --- | --- | | OPWDD region | Unit of service | Intensive-1 (serving 1) | Intensive-2 (serving 2+) | | 1 | Hourly | $67.88 | $27.15 | | 2 | Hourly | $62.19 | $24.88 | | 3 | Hourly | $54.98 | $21.99 |
| Supported employment (extended phase) | | | | | --- | --- | --- | --- | | OPWDD region | Unit of service | Extended-1 (serving 1) | Extended-2 (serving 2+) | | 1 | Hourly | $67.88 | $27.15 | | 2 | Hourly | $62.19 | $24.88 | | 3 | Hourly | $54.98 | $21.99 |
(g) Residential habilitation (family care).
(1) Fee schedule. Effective July 1, 2015, residential habilitation (family care) will be reimbursed according to the fee schedule below:
| Residential habilitation (family care) – base fee | | | | | --- | --- | --- | --- | | DOH region | Unit of service | Fee | | | 1 | Daily | $42.06 | | | 2 | Daily | $43.61 | | | 3 | Daily | $35.58 | | | 4 | Daily | $41.53 | |
| Residential habilitation (family care) – difficulty of care (DOC) add-on | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | | | Unit of service | ISPM level 1 | ISPM level 2 | ISPM level 3 | ISPM level 4 | ISPM level 5 | ISPM level 6 | | Family care | Daily | $5.56 | $10.87 | $11.12 | $16.43 | $32.26 | $37.57 |
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.6 Reports
(a) The director shall submit to the State Commissioner of Health such narrative and statistical reports at such intervals as may from time to time be prescribed by the commissioner.
(b) The director shall send to district and local health departments, referring physicians and agencies, agencies and insurance companies providing financial sponsorship, and such other individuals and public, private, or voluntary agencies and organizations such professional reports as are in keeping with professional practices and ethics, legal requirements and limitations, and the needs of the individual patient.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.12 Prior approval requests for certain transportation for medical care and services
(a) Requests for prior approval for transportation for medical care and services may be made by the enrollee or a person authorized to act on the enrollee's behalf. Such a request may be made for a one-time appointment or for multiple appointments during a specific period of time. A request for prior approval for non-emergency ambulance transportation or transportation by ambulette must be accompanied by the order of the practitioner who is the enrollee's attending physician, nurse practitioner, or physician assistant.
(b) Payments will only be made to commercial providers of transportation that met all applicable requirements for providing the transportation services requested on the date(s) that the transportation is provided.
(c) The following criteria will be used in determining whether to approve a transportation prior approval request:
(1) whether the nature and/or severity of the enrollee's condition necessitates a mode of transportation other than that ordinarily used by the enrollee or the transportation requested is the only mode of transportation that can safely be used by the enrollee;
(2) whether the enrollee needs multiple treatments or visits over a short period of time that would cause an undue financial hardship to the enrollee or the enrollee's family if required to pay for the transportation for such visits even though the transportation being used is the same transportation used by the enrollee for other activities in his or her community;
(3) whether the geographic location of the enrollee and the provider of medical care and/or services are such that the usual mode of transportation would be inappropriate;
(4) whether the distance to be traveled for the medical care and/or services would require a large transportation expense that would result in an undue financial hardship for the enrollee or the enrollee's family;
(5) whether the need to continue a regimen of medical care or services with a specific provider requires travel outside of the geographic region in which the enrollee's community customarily obtains its medical care and services; and
(6) whether there are any other circumstances that are unique to the enrollee and support the payment of the transportation expenses requested.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.11 Quality assurance officer: qualification and responsibilities
(a) Each environmental laboratory shall appoint a quality assurance officer (however named) who shall exercise oversight of the laboratory's quality system. The individual so appointed shall have documented training, and/or experience in quality assurance and quality control procedures: be knowledgeable in the required quality system; and possess a general knowledge of analytical methods for which he or she performs data review.
(b) The quality assurance officer (and/or his or her designees) shall:
(1) serve as the focal point for the environmental laboratory's quality assurance and quality control, and be responsible for monitoring and/or review of quality control data;
(2) evaluate data objectively and perform independent assessments without outside ( e.g., managerial) influence;
(3) arrange for or conduct annual internal audits of the laboratory's entire technical operation; and
(4) notify laboratory management of any deficiencies in the quality system and monitor required corrective actions.
(c) The quality assurance officer shall have direct access to the highest level of management at which decisions are made on laboratory policy or resources, as well as to the technical director(s). The quality assurance officer shall fulfill his or her functions independently from laboratory operations for which he or she maintains quality assurance oversight; provided, however, for laboratories with limited staffing, the quality assurance officer may also be a technical director.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.166 Home office
The office of the controlling organization. This office generally incurs costs and provides services to or on behalf of the individual health facility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 151 ULSTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 151.17 Kerhonkson Water Company, Kerhonkson
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on the Zalm Kill and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Kerhonkson Water Company at Kerhonkson, Ulster County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoir on the Zalm Kill, which is tributary to or which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include, every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Kerhonkson Water Company.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (d)(2) of this section.
(2) No privy, privy vault, pit, cesspool or other receptacle which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision, and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as herinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents of the removable containers while being transported by thoroughly covered and that the least possible annoyance and inconvenience be caused to the occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (4) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Kerhonkson Water Company, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir 75 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any watercourse tributary to the public water supply of the Kerhonkson Water Company, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the Kerhonkson Water Company.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant as provided by paragraph (2) of this subdivision, shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Kerhonkson Water Company, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir tributary to the public water supply of the Kerhonkson Water Company.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim or be washed or watered in any reservoir tributary to the public water supply of the Kerhonkson Water Company, nor shall any animal or poultry be allowed to stand, wade or swim in any watercourse tributary to the public water supply of the Kerhonkson Water Company on property owned by the Kerhonkson Water Company. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 30 feet from any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Kerhonkson Water Company, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(4) No decayed or fermented fruit, vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 30 feet from any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(f) Dead animals, offal, industrial wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the Kerhonkson Water Company, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Kerhonkson Water Company, nor shall any trespassing whatever be allowed on property owned by the Kerhonkson Water Company except by duly authorized employees of the Kerhonkson Water Company in the performance of their duties of supervision and maintenance of the public water supply of the Kerhonkson Water Company.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(i) Cemeteries.
No interment of a human body shall be made nor shall any interred human body be allowed to remain within 300 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the Kerhonkson Water Company.
(j) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting the watershed tributary to the public water supply of the Kerhonkson Water Company shall refrain from any act, although not heretofore specified, which may result in contamination of any portion of the water supply.
(k) Inspections.
The said Kerhonkson Water Company or such person or persons as may be charged with the maintenance or supervision of the public water supply of the Kerhonkson Water Company or the duly appointed representatives of such company shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the said water company to promptly notify the State Commissioner of Health of such violations. The said water company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which ralate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.14 Revisions in certified rates
(a) The State Commissioner of Health may consider only those applications for revisions of certified rates which are based on:
(1) cost reports filed pursuant to section 86-2.2(e) of this Subpart. Such rate shall become effective on the first day of the 12-month period referred to in section 86-2.2(e) of this Subpart;
(2) six-month cost reports filed pursuant to sections 86-2.10(k)(6) and/or 86-2.15(e) of this Subpart. Such rate shall become effective on the first day of the six-month period referred to in sections 86-2.10(k)(6) and 86-2.15(e) of this Subpart;
(3) errors made by the department in the rate calculation process and errors in data submitted by a medical facility which have been brought to the attention of the commissioner within the time limits prescribed in section 86-2.13 of this Subpart. This paragraph shall not apply to the patient assessment process as contained in section 86-2.30 of this Subpart;
(4) significant increases in the overall operating costs of a residential health care facility resulting from the implementation of additional programs or services specifically mandated for the facility by the commissioner;
(5) significant increases in the overall operating costs of a residential health care facility resulting from capital renovation, expansion, replacement or the inclusion of new programs or services approved for the facility by the commissioner;
(6) requests for waivers of any provisions of this Subpart for which waivers may be granted by the commissioner as prescribed in specific sections;
(7) alternative means of allocating costs in the cost-finding process which have been submitted with the annual cost report (RHCF-4) and approved in accordance with section 456.2(b) and (c) of this Title; and
(8) requests for relief from the provisions of section 86-2.25 of this Subpart relating to compensation of other than the administrative type of services rendered by an operator or relative of an operator. Such request must contain sufficient documentation to demonstrate that the services rendered are necessary and are reasonably related to the efficient production of such services.
(b) An application by a residential health care facility for review of a certified rate is to be submitted on forms provided by the department and shall set forth the basis for the appeal and the issues of fact. Documentation shall accompany the application, where appropriate, and the department may request such additional documentation as determined necessary. An application based upon error shall be submitted within the time limit set forth in section 86-2.13 of this Subpart. Beginning with appeals for rate year 1983 and, on an annual basis thereafter for all subsequent rate year appeals, the commissioner shall act upon all properly documented applications for a rate year based upon errors within one year of the end of the 120-day period referred to in section 86-2.13(a) of this Subpart. The commissioner shall act upon all other properly documented applications for a rate year appeal submitted pursuant to paragraphs (1) and (3)-(7) of subdivision (a) of this section within one year of the end of the aforementioned 120-day period or the receipt of such applications, whichever date is later. In the event the department requests additional documentation, the one-year time limit shall be extended for a mutually agreed upon time period for receipt of the documentation established by the commissioner in conjunction with the residential health care facility. The deadline will be set according to the nature and quantity of documentation necessary. The one-year time limit shall not apply to rate appeals submitted pursuant to section 86-2.13(b) of this Subpart.
(1) The affirmation or revision of the rate upon such staff review shall be final, unless within 30 days of its receipt a hearing is requested, by registered or certified mail, before a rate review officer on forms supplied by the department. The request shall contain a statement of the factual issues to be resolved. The facility may submit memoranda on legal issues which it deems relevant to the appeal.
(2) Where the rate review officer determines that there is no factual issue, the request for a hearing shall be denied and the facility notified of such determination. No administrative appeals shall be available from this determination. The rate review officer, where he determines that there is factual issue, shall issue a notice of hearing establishing the date, time and place of the hearing and setting forth the factual issues as determined by such officer. The hearing shall be held in conformity with the provisions of Public Health Law, section 12-a and the State Administrative Procedure Act.
(3) The recommendation of the rate review officer shall be submitted to the Commissioner of Health for final approval or disapproval and recertification of the rate where appropriate.
(4) The procedure set forth in this subdivision shall apply to all applications for rate reviews which are pending as of April 1, 1978. Rate appeals filed prior to April 1, 1978 will not be required to be resubmitted subsequent to April 1, 1978.
(c) Any modified rate certified under paragraphs (3) and (4) of subdivision (a) of this section shall be effective on the first day of the month in which the respective change is operational.
(d) In reviewing appeals for revisions to certified rates the commissioner may refuse to accept or consider an appeal from a residential health care facility:
(1) providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council;
(2) operated by the same management when it is determined by the department that this management is providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council in one of its facilities;
(3) where it has been determined by the commissioner that the operation is being conducted by a person or persons not properly established in accordance with the Public Health Law;
(4) where a fine or penalty has been imposed on the facility and such fine or penalty has not been paid.
In such instances the provisions of subdivision (c) of this section shall not be effective until the date the appeal is accepted by the commissioner.
(e) Any residential health care facility determined after review by the State Hospital Review and Planning Council to be providing an unacceptable level of care shall have its current reimbursement rate reduced by 10 percent as of the first day of the month following 30 days after the date of the determination. This rate reduction shall remain in effect for a one-month period or until the first day of the month following 30 days after a determination that the level of care has been improved to an acceptable level, whichever is longer. Such reductions shall be in addition to any revision of rates based on audit exceptions.
(f) [ Reserved ]
(g) In order to promote labor stability in the residential health care facility industry, and to minimize the disruption of care to patients in residential health care facilities in the event of labor disputes, multi-year agreements are to be encouraged.
(1) In the case of a written multi-year commitment by a residential health care facility, a substantial number of whose employees are not represented by a labor organization, to increase compensation to all or a class of its employees on or after April 1, 1978, but before December 31, 1978, such facility may petition for a determination as to the adequacy of future revenues to meet the increased labor costs resulting from such multi-year commitment as provided in this paragraph.
(i) The petition brought by the facility shall be heard by a labor cost review panel to be comprised of one representative designated by the commissioner, one representative designated by the petitioner and a third party mutually agreed upon by the petitioner and the department (to be selected from a list of independent hearing officers designated as a commissioner's representative).
(ii) Such facility may file a petition each time an annual incremental labor cost occurs as a result of a multi-year commitment; however, no petition by or on behalf of any facility may be filed less than 12 months after the preceding petition. Any subsequent petition shall relate only to those incremental labor costs since those covered by the last petition.
(iii) The labor cost review panel shall determine the total amount by which such residential health care facility making a multi-year commitment has had increased labor costs as a result of the commitment, and shall determine the extent, if any, to which the current and projected revenues factored for labor costs are inadequate to cover such increased labor costs, provided that the panel may make no award to compensate for any disallowances. In reaching such determination, the labor cost review panel shall apply criteria agreed to by the petitioner and the department. Any areas of disagreement in the criteria shall be resolved by the panel. All such criteria and resulting recommendations are to be consistent with applicable Federal and State laws, rules and regulations.
(iv) Where the labor cost review panel determines that the multi-year commitment has increased labor costs beyond a facility's current and projected revenues factored for labor costs, the department shall certify a revised per diem Medicaid rate for such facility. No facility shall be entitled to an increase in rate with respect to the labor costs attributable to the commitment apart from the adjustment provided by this subdivision.
(v) Any facility availing itself of these procedures does so with the understanding that it is choosing said procedure as an alternative to any other administrative or judicial review, and agrees that no other administrative or judicial review will be sought from a determination of the labor cost review panel.
(vi) The procedures of the labor cost review panel shall be governed by section 12-a of the Public Health Law, except that the parties to the proceeding may agree, with the consent of the panel, to modify the procedures.
(vii) In order to activate these procedures, the facility must file a petition within 60 days of the date of promulgation of the multi-year commitment or any increase in labor costs resulting therefrom. Upon the filing of the petition, an independent hearing officer, who has been designated as the commissioner's representative, will recommend whether the commitment is reasonable. The hearing before the labor cost review panel will be convened within 30 days from the date on which the petition is received at the Office of the Deputy Director for Health Care Financing, Office of Health Systems Management, Empire State Plaza, Albany, NY.
(viii) The decision of the labor cost review panel shall require the concurrence of two of the three members hearing the matter. A decision shall be issued within 30 days from the conclusion of the hearing or final submission of any additional documents, whichever is later.
(ix) Any revision in the per diem rate of payment for government programs resulting from application of this subdivision shall be effective on the effective date of the increased labor cost as provided in the multi-year commitment.
(x) The decision of the panel will not cause the imposition of labor cost ceiling disallowances, except that ceilings for overstaffing shall be applied.
(2) In the case of a multi-year collective bargaining agreement entered into by a residential health care facility, or an association of facilities, with a representative of their employees on or after April 1, 1978, but before December 31, 1978, the association of residential health care facilities, a member facility or any facility found by the commissioner to be affected by the agreement may petition for a determination as to the adequacy of future revenues to meet the increased labor costs resulting from such collective bargaining agreement as provided in this paragraph.
(i) The petition brought by the association or facility shall be heard by a labor cost review panel to be comprised of one representative designated by the commissioner, one representative designated by the petitioner and a third party mutually agreed upon by the petitioner and the department.
(ii) Within 21 days after receipt of the first petition concerning any collective bargaining agreement, the commissioner shall promulgate a list of facilities found to be affected by the collective bargaining agreement. Any facility found so affected shall be provided with notice of, and an opportunity to present evidence before the labor cost review panel. Such facility must request such opportunity within 21 days after receipt of the notice. Any facility not on the list shall have a period of 21 days from promulgation of the list to petition the commissioner to be included as a facility affected.
(iii) The facilities, or the association on behalf of individual facilities, may file a petition each time an annual incremental labor cost occurs as a result of a collective bargaining agreement; however, no petition by or on behalf of any facility may be filed less than 12 months after the preceding petition. Any subsequent petition shall relate only to those incremental labor costs since those covered by the last petition.
(iv) The labor cost review panel shall determine the total amount by which each residential health care facility affected by the agreement has had increased labor costs as a result of the agreement, and shall determine the extent, if any, to which the current and projected revenues factored for labor costs are inadequate to cover such increased labor costs, provided that the panel may make no award to compensate for any disallowances. In reaching such determination, the labor cost review panel shall apply criteria agreed to by the petitioner and the department. Any areas of disagreement in the criteria shall be resolved by the panel. All such criteria and resulting recommendations are to be consistent with applicable Federal and State laws, rules and regulations.
(v) Where the labor cost review panel determines that the collective bargaining agreement has increased the labor costs beyond a facility's current and projected revenues factored for labor costs, the department shall certify a revised per diem Medicaid rate for each of the affected facilities. No facility shall be entitled to an increase in rate with respect to the labor costs attributable to the agreement apart from the adjustment provided by this subdivision.
(vi) Any facility or association availing itself of these procedures does so with the understanding that it, or in the case of an association, its members, are choosing said procedure as an alternative to any other administrative or judicial review, and agrees that no other administrative or judicial review will be sought from a determination of the labor cost review panel.
(vii) The procedures of the labor cost review panel shall be governed by section 12-a of the Public Health Law, except that the parties to the proceeding may agree, with the consent of the panel, to modify the procedures.
(viii) In order to activate these procedures, the association or facility must file a petition within 60 days of the date of ratification of the collective bargaining agreement or any increase in labor costs resulting therefrom. Upon the filing of the petition an independent hearing officer, who has been designated as the commissioner's representative, will recommend whether the commitment is reasonable. The hearing before the labor cost review panel will be convened within 30 days from the date on which the petition is received at the Office of the Deputy Director for Health Care Financing, Office of Health Systems Management, Empire State Plaza, Albany, NY.
(ix) The decision of the labor cost review panel shall require the concurrence of two of the three members hearing the matter. A decision shall be issued within 30 days from the conclusion of the hearing or final submission of any additional documents, whichever is later.
(x) Any revision in the per diem rate of payment for government programs resulting from application of this subdivision shall be effective on the effective date of the increased labor cost as provided in the collective bargaining agreement.
(xi) The decision of the panel will not cause the imposition of labor cost ceiling disallowances, except that ceilings for overstaffing shall be applied.
(3) Any reimbursement to a facility pursuant to this subdivision shall be dependent upon approval of Federal financial participation by the United States Department of Health, Education and Welfare.
(4) This subdivision shall expire on December 31, 1981.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.28 Physician remuneration
[ 1680 ]
(a) Due to the numerous types of financial and work arrangements between hospitals and hospital-based physicians, comparability of costs between hospitals may be significantly impaired. This section deals with the methods to be used in recording costs and revenues related to the services of hospital-based physicians.
(b) Financial arrangements.
[ 1681 ]
(1) Although the variations in financial arrangements between hospitals and hospital-based physicians are endless, there are five general types of such arrangements:
(i) Agency arrangement. The hospital bills patients for the physician's professional services, but records these billings as liabilities and the subsequent payment to the physician as a reduction of that liability. The hospital reflects no operating revenue or expense relative to the professional component.
(ii) Compensation arrangement. The hospital bills patients for the physician's contractual professional services, including this amount as hospital revenue. All cost center expenses are paid by the hospital. The hospital remits a fee or pays a salary to the physician which is included in hospital expense. The compensation arrangement can be either fixed or variable. Under a fixed compensation arrangement the physician is paid a specific dollar amount (salary) unrelated to volume of services rendered. Under the variable compensation arrangement the physician's compensation will be a percentage of departmental gross charges or net collections. The actual compensation received by the physician will vary in proportion to the number of procedures performed and to the total charges made by the hospital. This arrangement includes those physicians providing patient services in the Daily Hospital Services cost centers.
(iii) Contracted arrangement. Under this arrangement, the physician may pay any or all expenses of the cost center. The hospital bills patients for the departmental services and remits a fee to the physician. This fee would typically be designed to cover the expenses incurred by the physician and are recorded as Professional Fees (Natural classification of expense.31) regardless of the expenses incurred by the physician.
(iv) Rental arrangement. The physician bills the patients for certain of the Part A and Part B component (as defined by Medicare) and incurs all substantial direct expenses. The physician remits a fee to cover certain hospital expenses. This fee is recorded as operating revenue in the appropriate revenue center.
(v) Independent/separate arrangement. The functions are provided by an independent physician or group of physicians. Neither revenues nor expenses are incurred by the hospital. The hospital refers patients and/or specimens to the physician or group, which is usually located on separate premises. No costs are incurred and no revenue is received under this arrangement.
(2) Note.
Compensation paid to interns and residents is not to be included in the revenue producing cost centers, but must be charged to the Postgraduate Medical Education cost centers, accounts 8240 and 8250.
(c) Work arrangement.
[ 1682 ]
(1) The services provided by hospital-based physicians may be categorized into six general types.
(i) Professional component—providing direct patient care.
(ii) Education—teaching and supervising student activity in educational programs.
(iii) Research—working on research projects.
(iv) Medical care review—serving on the hospital's Medical Care Review Committee.
(v) Hospital administration—administering overall hospital activities (including hospital committees).
(vi) Cost center supervision—supervision and other activities of the cost center.
(2) When physicians are involved in more than one of the above functional activities, their remuneration, if any, must be recorded in the cost center for which services are paid. Prior to a trial balance under the Federal uniform reporting system, their remuneration must be reclassified to the appropriate cost centers.
(3) For example, if a physician is paid and spends 40 percent of his time in direct care of patients, 10 percent in educational activities, 15 percent in research, 5 percent in medical care review activities, 10 percent in administrative duties outside the department, and 20 percent in supervision of the department, the reclassification of his remuneration would be as follows:
(i) Distribution.
40 percent Physician's Professional Component (this amount must be reported in the Medical Staff Services cost center, account 8730).
10 percent Education Costs (to account 8220-8299).
15 percent Research Projects (to account 8010-8199).
5 percent Medical Care Review (to account 8740).
10 percent Hospital Administration (to account 8610).
20 percent Cost Center Supervision (remains in the cost center).
(ii) Computation. If the above physician is assigned to the Coronary Care cost center and is paid $50,000 annually, including employee benefits, the following reclassifications would be required for reporting purposes:
| Professional Component | 40% of $50,000 = $20,000—to account 8730 | | --- | --- | | Education | 10 of $50,000 = $5,000—to account 8220-8299 | | Research | 15% of $50,000 = $7,500—to account 8010-8199 | | Medical Care Review | 5% of $50,000 = $2,500—to account 8740 | | Hospital Administration | 10% of $50,000 = $5,000—to account 8610 | | Cost Center Supervisor | 20% of $50,000 = $10,000—remains in assigned cost center. |
(4) The reclassification of the professional component from the assigned cost centers to the Medical Staff Services cost center, account 8730 is necessary in order to obtain comparable direct costs between hospitals which employ physicians and hospitals which do not.
(5) The reclassification of the other components is to obtain functional comparability.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.14 Lighting and ventilation
Lighting fixtures shall be in sufficient number and properly placed so as to provide adequate illumination. The shop shall be properly and adequately ventilated.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-3 REPORTING OF BLOOD LEAD LEVELS
10 CRR-NY 67-3.1 Laboratory reporting of blood lead levels for public health follow up
(a) For purposes of this Subpart, laboratory shall mean:
(1) any laboratory that holds a permit issued in accordance with Public Health Law, article 5, title V and is authorized to conduct blood lead analyses; or
(2) an entity exempt from the requirements of Public Health Law, article 5, title V pursuant to section 579(3) of that title, that holds a certificate of registration issued by the department and is authorized to conduct blood lead analyses.
(b) Laboratories shall report the results of all blood lead analyses performed on residents of New York State to the Commissioner of Health and to the local health officers in whose jurisdictions the subjects of the tests reside. If the laboratory reports electronically to the Commissioner of Health in accordance with subdivision (e) of this section, the Department of Health shall notify the appropriate local health officer of the test results and the laboratory shall be deemed to have satisfied the reporting requirements of this section.
(c) Whenever a laboratory refers a blood lead sample to another laboratory for analysis, the laboratories may agree on which laboratory will report in compliance with this Subpart, but both laboratories will be accountable to insure that a report is made.
(d) All laboratories shall report electronically to the Commissioner of Health each blood lead analysis conducted. The report must include the subject’s name, date of birth, race, gender, address, county of residence, type of sample (venous or fingerstick) and blood lead level; the health care practitioner ordering the test, laboratory identifiers, the date the sample was collected and the date of analysis. Reporting pursuant to this subdivision shall be done using an electronic telecommunication system consistent with the technical specifications established by the department.
(e) Any laboratory not permitted in accordance with Public Health Law, article 5, title V to perform blood lead analysis which accepts a blood lead sample and refers the sample elsewhere for analysis shall transmit to the laboratory performing the analysis all of the information that is required by subdivision (d) of this section.
(f) Time limits for reporting and special notification requirements of blood lead levels in children.
(1) Laboratories shall report the results of all blood lead tests as specified in this Subpart within five business days of the date of analysis.
(2) In addition to any other reporting required by this Subpart, all laboratories shall notify the provider ordering the blood lead test of the results of any analysis in a child less than 18 years of age which is equal to or greater than 45 mcg/dL (micrograms per deciliter) within 24 hours of the analysis.
(g) Nothing in this Subpart shall be construed to relieve any laboratory from reporting results of any blood lead analysis to the physician, or other health care provider that ordered the test or to any other entity as required by State, Federal, or local statutes or regulations or in accordance with accepted standards of practice except that reporting in compliance with this Subpart shall satisfy the blood lead reporting requirements of Public Health Law, article 13, title 10 and Part 22 of this Title.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.2 Sterilization of instruments
All instruments, including collection containers, used for both sterile and clean, nonsterile retrieval of tissues shall be either licensed by the FDA for single use or be sterilized prior to each use. Heat sterilization shall be by autoclaving at 121.5 degrees Celsius for 15 minutes after the chamber of the autoclave has been evacuated and has reached that temperature, or by dry heat for two hours at 170 degrees Celsius, or by such other procedures as may be approved by the department upon submission of evidence that such other procedures are at least equally effective.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.3 Drug take back programs
Operators of Drug Take Back Program.
(a) Before implementing or modifying a drug take back program, an operator must submit a proposal to, and obtain approval of such program from, the department, in consultation with the Department of Environmental Conservation. Drug take back program proposals shall be submitted to the department in such a manner and form as determined by the department.
(b) A drug take back program proposal shall include, but is not limited to, the following:
(1) the name, address, phone, e-mail address, and any additional contact information requested by the department for the responsible person submitting the planned drug take back program and to whom the department may direct all inquiries;
(2) certification that the drug take back program will accept all covered drugs regardless of who produced them;
(3) a detailed description of the drug take back collection system which includes: information on geographic distribution (and specifically how it ensures access in rural and underserved areas), convenience for all consumers across the state, and ongoing services of the program;
(4) a detailed description of how pharmacies providing collection boxes for take back in areas outside of the counties with convenience standards will be included in the program;
(5) the name, address, phone, e-mail address, DEA number, and Bureau of Narcotic Enforcement license number, for any entity that will reverse distribute covered drugs for the drug take back program;
(6) a list of participating pharmacies and other authorized collectors, their DEA number, and their Education Department registration number (if applicable), their locations, and methods of collection, including collection receptacles, mail back programs, and other approved collection methods;
(7) a description of other approved collection methods, including drug take back events, that will be utilized to collect covered drugs;
(8) detailed policies and procedures on how the drug take back program will safely and securely track and handle collection of covered drugs through final disposal and destruction, which includes information on policies to ensure security and compliance with all applicable laws and regulations including disposal and destruction at a permitted waste disposal facility meeting Federal requirements;
(9) detailed information on the public education and outreach activities the drug take back program will undertake, which includes information on advertisement, website, signage, and other written materials;
(10) detailed descriptions of how the effectiveness of public education and outreach activities of the drug take back program will be evaluated;
(11) detailed information on how the costs of pharmacy collection and other authorized collectors of the drug take back program will be paid or reimbursed by all manufacturers involved in the proposed program, including but not limited to the following: who pays for the purchase and installation of collection receptacles, the inner liners, mail back vouchers, envelopes, packages, postage, transportation and disposal costs, communications, and public education and outreach efforts, as well as how the costs are managed and by whom;
(12) a detailed drug take back program timeline for implementation, including specific expected dates;
(13) detailed information on the methods to be used for outreach and participation by pharmacies and other authorized collectors;
(14) detailed description of the methods to be used to retain data and information necessary for reporting, pursuant to article 2-B of the Public Health Law as deemed necessary by the department. At a minimum, this must include the weight of covered drugs collected, a description of collection activities, the names and locations of all collection sites with collection method and weight collected by method, and the public education and outreach activities;
(15) a detailed list of manufacturers that are partners in the proposed drug take back program which includes: name of the manufacturer, name of the manufacturer’s parent company and any subsidiaries, mailing address, FDA labeler code, if applicable, DEA number, if applicable, and any additional identifiers as requested by the department;
(16) detailed information on how the operator will identify and resolve safety and security issues arising from the collection, transportation or disposal of covered drugs; and
(17) any additional information as required by the department to evaluate the proposal.
(c) A drug take back program operator must update its proposal and submit it to the department at least every three years, from the date of the previous department approval, in such a manner and form as determined by the department.
(d) An operator of a drug take back program shall maintain records of program details that include participating manufacturers, authorized collectors, and functions performed in accordance with such program, including but not limited to the following:
(1) the name of the manufacturer, name of the manufacturer’s parent company and any subsidiaries, mailing address, FDA labeler code and DEA number, as applicable, for each manufacturer of covered drug(s) contracted with the drug take back program and the date enrolled;
(2) the name, address, phone, e-mail address, DEA number, and Bureau of Narcotic Enforcement license number, for any entity that will reverse distribute covered drugs for the drug tack back program;
(3) the name and address of each location in which a collection receptacle is installed and the date of its installation, as well as the dates of its discontinuance, removal, or relocation;
(4) the name and address of each location providing mail back packages, and the date initiated;
(5) the total weight of covered drugs collected by each collection method annually; and
(6) any other details as the department may direct.
(e) A report shall be made within 30 days to the department upon the discontinuance of participation in the program by any manufacturer of covered drug(s) or authorized collector. If the discontinuance involves an authorized collector in a city or county described in section 60-4.2(a) of this Subpart, the report must state the resulting impact on the convenience standard.
(f) A report in such form as the department directs shall be made annually to the department, on or before August 1st, detailing for the preceding calendar year all program activities, including but not limited to the following:
(1) a list of manufacturers that participated during the reporting period that includes: name of parent company and/or subsidiary(ies), address, FDA labeler code and DEA number, as applicable, for each manufacturer of covered drug(s) contracted with the drug take back program and the date enrolled;
(2) the name, address, phone, e-mail address, DEA number, and Bureau of Narcotic Enforcement license number, for any entity that reverse distribute covered drugs for the drug take back program;
(3) a list of all pharmacies and other authorized collectors that maintained collection receptacles across the state during the reporting period that includes: DEA number, Education Department registration number (if applicable), name, address, total weight collected by method of collection, and the number of times each collection receptacle liner was replaced;
(4) a list of pharmacies and other authorized collectors that provided mail back envelopes and/or packages during the reporting period that includes: DEA number, Education Department registration number (if applicable), name, address, process for patient accessing mail back envelopes or packages, number of vouchers and/or mail back envelopes and/or packages utilized, and total weight collected by mail back envelope and/or package;
(5) a list of drug take back events held during the reporting period that includes: date of event, name of authorized collector, address, and total weight collected per event;
(6) total weight of covered drugs collected by method of collection, and by location address, as well as aggregate weights for each of the 62 counties of New York State and the cities of Buffalo, Rochester, Syracuse, and Yonkers;
(7) description of collection activities, including policies and procedures for methods of collection;
(8) description of program’s statewide outreach and public education activities, including marketing materials, public service messages, and website information;
(9) evaluation of the program and of each collection method, including an evaluation of education and outreach, an evaluation of program costs and of costs involved for each method and suggestions for overall program improvement;
(10) a list of manufacturers and authorized collectors that have discontinued participation; and
(11) additional information as determined by the department.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.63 Locust Valley Water District
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on land, owned by the district in the town of Oyster Bay and located east of the Locust Valley railroad station along the highway running from Locust Valley to Oyster Bay, which forms the source of the public water supply of the Locust Valley Water District, Nassau County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Locust Valley Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well of the public water supply of the Locust Valley Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container, which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered, and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow at a distance of not less than 500 feet from any well of the public water supply of the Locust Valley Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the suface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health) within 150 feet of any well of the public water supply of the Locust Valley Water District. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the Locust Valley Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of any well of the public water supply of the Locust Valley Water District.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Locust Valley Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the Locust Valley Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the Locust Valley Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well of the public water supply of the Locust Valley Water District.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Locust Valley Water District upon which the wells of the public water supply of the Locust Valley Water District are located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the Locust Valley Water District.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Locust Valley Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Locust Valley Water District.
(j) Inspections.
The board of water commissioners of the Locust Valley Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Locust Valley Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.15 The role of the licensed practical nurse in intravenous therapy procedures
(a) For purposes of this section, facility shall mean an entity licensed pursuant to article 28 of the Public Health Law.
(b) A facility may allow specially trained licensed practical nurses, under the supervision of a qualified registered professional nurse or physician, to perform all intravenous therapy procedures except for the administration of blood and blood products, intravenous anti-neoplastic agents, and a bolus of medication by intravenous push unless administered for chronic hemodialysis treatment.
(c) The facility shall ensure that licensed practical nurses allowed to perform intravenous therapy procedures have satisfactorily completed a training program, received supervised clinical experiences and demonstrated competence in the performance of intravenous therapy procedures.
(d) The training program for intravenous therapy shall include as a minimum instruction in:
(1) the facility's policies and procedures related to intravenous therapy;
(2) the facility's quality assurance and risk management program;
(3) anatomy and physiology related to intravenous therapy;
(4) the solutions and drugs used in intravenous therapy, their pharmacological action and therapeutic effects;
(5) procedures used for mixing intravenous medications and solutions;
(6) the signs and symptoms of complications and adverse reactions to intravenous therapy;
(7) the functions, use and maintenance of intravenous devices and equipment; and
(8) infection control techniques.
(e) The facility shall ensure that all intravenous therapy procedures performed by the licensed practical nurse are provided in accordance with written policies and procedures which are reviewed and updated as needed, but at least annually.
(f) The facility shall ensure that there is documentation in the licensed practical nurse's personnel file which indicates the training program attended, number of hours and content of the program, supervised clinical experiences and approval to perform intravenous therapy procedures.
(g) Inservice education programs shall be conducted to update and inform the licensed practical nurse of new intravenous therapy procedures, equipment and medications. The programs shall be conducted as often as necessary but at least on an annual basis and be documented in the personnel file of the licensed practical nurse.
(h) The licensed practical nurse approved to perform intravenous therapy procedures shall be under the direction of a registered professional nurse.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.9 Compensation of operators and relatives of operators
(a) Reasonable compensation for operators or relatives of operators for services actually performed and required to be performed shall be considered as an allowable cost. The amount to be allowed shall be equal to the amount normally required to be paid for the same service provided by a nonrelated employee, as determined by the State Commissioner of Health. Compensation shall not be included in the rate computation for any services which the operator or relative of the operator is not authorized to perform under New York State law and regulation.
(b) Any amount reported as compensation for services rendered by an operator or relative of an operator shall not be allowed in excess of the maximum allowance for full time services in carrying out his primary function.
(c) For purposes of subdivision (a) of this section, in determining a reasonable level of compensation for operators or relatives of operators, the commissioner may consider the quality of care provided to patients by the facility during the year in question.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.28 Disclosure of ownership
The nursing home shall make available pertinent information concerning the identity of the owner and/or governing body and in addition shall:
(a) comply with the provisions of section 401.3(b) of this Title regarding any proposed changes in the name of a business, corporation, partnership or governmental subdivision and any proposed initial use of, or change in, an assumed name of a business corporation, not-for-profit corporation, partnership, governmental subdivision or sole proprietor, operating a medical facility or fundraiser under article 28 of the Public Health Law, or any proposed substitution of the individual or individuals constituting the governing body or owner of a proprietary medical facility or any proposed change in the rights, privileges or obligations of any such person;
(b) comply with the provisions of section 600.11 of this Title regarding name changes of operators and medical facilities;
(c) provide written notice to the department, at the time of change, if a change occurs in the nursing home's administrator or director of nursing; and
(d) ensure that the notice provided in accordance with subdivision (c) of this section includes the identity of each new individual.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.100 Construction
Equipment and utensils are to be constructed of safe materials which will not contaminate or otherwise affect food. Such materials are to be resistant to denting, buckling, pitting, chipping, distortion, cracking and crazing, and are to be smooth, easily cleanable and free from breaks, open seams, cracks, chips, pits and similar imperfections. Equipment and utensils are to be free from difficult-to-clean internal corners and crevices. Food-contact surfaces are to be readily accessible for cleaning.
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PUBLIC HEALTH HAZARDS PUBLIC HEALTH HAZARDS
10 CRR-NY 14-1.10 Definition of imminent health hazard
(a) An imminent health hazard is any violation, combination of violations, condition or combination of conditions making it probable that the food or drink served to the public by the establishment or its continued operation can injure the health of the consumer or the public. Imminent health hazards include but are not limited to the conditions listed in subdivisions (b) and (c) of this section.
(b) Any of the following five violations are imminent health hazards against the public interest which require the permit-issuing official or his designated representative to order the establishment closed and all service of food stopped immediately, if not corrected at the time of the inspection while the permit-issuing official or representative of the permit-issuing official is on the premises:
(1) food is present in the establishment from an unapproved or unknown source or which is or may be adulterated, contaminated or otherwise unfit for human consumption;
(2) potentially hazardous food is held for a period longer than that necessary for preparation or service at a temperature greater than 45 degrees Fahrenheit (7.2 degrees Celsius) or less than 140 degrees Fahrenheit (60 degrees Celsius);
(3) potentialiy hazardous food exposed to consumer or other contamination is served again;
(4) toxic items are improperly labeled, stored or used; or
(5) persons with disease or infection which can be transmitted by food or drink are not restricted to prevent food contamination within the food service establishment.
(c) Any of the foliowing three conditions are violations constituting imminent health hazards which require the permit-issuing official or his designated representative to order the establishment closed and all service of food stopped immediately:
(1) if the potable water supply within a food service establishment is not in full conformance with the requirements of Part 5 of this Title, and if it reasonably appears to the permit-issuing official or his designated representative that it can result in an imminent health hazard, and if the operator does not use single-service items and bottled water from an approved source for all potable water uses, the establishment is to be ordered closed and all food service to be stopped immediately;
(2) any cross-connection or other fault in the potable water system which may permit contamination of the potable water supply is cause for an order for immediate closure and cessation of food service if it reasonably appears to the permit-issuing official or his designated representative that it can result in an imminent health hazard. In any case, all such cross-connections are to be corrected within a period of time set by the permit-issuing official, and in no case more than 30 days from the date of the inspection. If uncorrected within that time, the permit shall be suspended and the establishment ordered closed and food service stopped until all violations are corrected; or
(3) if sewage or liquid waste is not disposed of in an approved and sanitary manner, the permit-issuing official or his designated representative is to order closure and immediate cessation of all food service operations if such sewage or liquid waste contaminates any food, food storage area, food preparation area or area frequented by consumers or employees.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.93 Direct expense
The cost of any good or service that contributes to, and is readily ascribable to, product or service output. Direct expense includes salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.6 Financial disclosure and fees for services
(a) Each tissue bank and nontransplant anatomic bank shall establish and maintain complete and accurate books, financial records, documents and accounts, which shall be kept for a period of at least seven years. The department shall have access to all such records and any financial statements and audits of the bank, during normal business hours at an office of the bank located within the State of New York or, if no such office is available, at a mutually agreeable and reasonable venue for the purposes of inspection, auditing and copying.
(b) Upon request, a tissue bank or nontransplant anatomic bank shall provide the department with:
(1) a statement of the expenses of the bank, including, but not limited to, salaries, rents, equipment, utilities and travel;
(2) a statement of the revenues of the bank, including fees, grants, endowment funds and any other revenues; and
(3) a list of fees charged for all tissue services, tissues, and nontransplant anatomic parts provided by the bank.
(c) No tissue bank or nontransplant anatomic bank shall sell or otherwise transfer tissue for valuable consideration. Fees charged shall reflect only reasonable costs incurred in the provision of specific services, which shall include the fair market value of the overhead and salaries directly related to the provision of such services, actual transportation costs when transportation is provided, and other documented expenses directly related to the provision of services.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.18 Extended sick leave
(a) The department may, in its discretion, advance sick leave credits to an employee absent due to personal illness who has exhausted his accumulated sick leave credits. Such advanced sick leave credits shall be repaid, as soon as practicable after the employee's return to duty, from subsequent accumulations of time credits. The outstanding unrepaid sick leave credits advanced to any employee under the provisions of this section shall not at any time exceed a total of five days.
(b) Upon termination of the employee's services any such advance of sick leave not offset by subsequent accumulations of sick leave credits, shall be deducted from salary or wages due the employee.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.2 Certificates of approval
(a) Certificates of approval shall be issued to environmental laboratories in one or more categories, including, but not limited to:
(1) examination of potable water, including, but not limited to, the analytes listed in Part 5 of the New York State Sanitary Code;
(2) examination of nonpotable water such as wastewater and samples for water quality monitoring of lakes, streams and rivers;
(3) examination of solid waste, soil and sediment, including, but not limited to, hazardous wastes (see Environmental Conservation Law, article 27);
(4) examination of air;
(5) examination of medical marihuana (see New York State Public Health Law article 33, title 5-A); and
(6) examination of any sample, specimen or substance listed or otherwise described in section 502 of the Public Health Law.
Certificates of approval shall limit approval to specific analytes within one or more of the above categories.
(b) A certificate of approval issued to an environmental laboratory shall set forth:
(1) the nature of the approval (interim or full);
(2) the approved categories and analytes;
(3) the name of the laboratory lead technical director as defined in section 55-2.1 of this Subpart; and
(4) the expiration date of the approval, which date shall be no later than one year from the date the certificate of approval is issued, unless an earlier date is set forth on the certificate.
(c) All examinations conducted by an environmental laboratory shall employ approved methods, and shall be within the categories listed on the laboratory's current certificate of approval or on any appendices thereof. A laboratory shall employ only approved methods for which a demonstration of capability has been conducted at the same site where the method is employed.
(d) Current certificates of approval and any appendices shall be posted conspicuously in the environmental laboratory, and a copy shall, upon request, be provided by the laboratory to any person or entity requesting the services of the laboratory.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.265 Prepay
To pay for a service before its receipt or enjoyment; such prepayment, as for insurance or rent, reflecting long-established commercial practices, contrasts with accrue (or the recognition of the receipt or enjoyment of other types of services paid for after their receipt or enjoyment).
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.20 Applicability
The provisions of sections 5-1.20 through 5-1.33 of this Subpart shall apply to all public water systems, provided the systems serve 15 or more service connections or serve 25 or more persons.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.3 Granting exemptions or variations
The department may upon either the application of any interested person or the department's own initiative, grant an exemption or variation from any requirement of this Part when the department finds that such exemption or variation will not result in an undue danger to life and property from radiation hazards.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.2 Functional and responsibility concepts
[ 2010 ] In developing this Listing of Accounts, it was necessary to choose between functional and responsibility concepts of reporting. Both of these concepts result in the accumulation of the same amount of total costs. However, because organizational structures vary among hospitals, responsibility reporting would not allow for comparability. On the other hand, functions (Housekeeping, Dietary, Intensive Care, etc.) carried out by any hospital would be similar, thus a functional accounting system allows for comparability. For this reason, this Listing of Accounts is based upon functional reporting concepts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
PROVIDER CLAIM FOR PAYMENT AND EFFORTS TO DETERMINE AVAILABILITY OF THIRD-PARTY PAYERS PROVIDER CLAIM FOR PAYMENT AND EFFORTS TO DETERMINE AVAILABILITY OF THIRD-PARTY PAYERS
10 CRR-NY 43-1.8 Provider claim
(a) Providers of tuberculosis health care services may not claim payment from local health officials or the State for amounts which are eligible for payment from any other third-party payer or payers.
(b) For a tuberculosis patient who is a local charge, a provider shall submit to the local health official where the patient resides an itemized claim form for payment for tuberculosis health care services furnished to the patient who does not have full third-party coverage of the claim.
(c) For a State charge who does not have full third-party coverage, a provider shall submit an itemized claim form to the local health official where the patient resides. The health official shall verify the information on the claim form and shall forward the claim to the designee of the State Health Commissioner.
(d) The claim form shall show the charges for each of the services provided and shall deduct all amounts eligible for reimbursement or indemnification by the third-party payers.
(e) The claim form shall include the names of third-party payers or indemnitors who have paid, or are or may be responsible for making payments for part or all of the claim, and the amounts each has paid or is or may be responsible for paying.
(f) A form shall be submitted with a copy maintained by the provider, together with the claim form stating in detail the efforts made to determine whether there is third-party coverage or indemnification available for the claim. The form shall also state the efforts made to claim such reimbursements. If the provider's efforts to determine or obtain third-party reimbursement, as reported in the form are found unsatisfactory by the local health official, the provider shall make additional efforts and shall submit a supplemental form.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.0 Introduction
The following sections contain the mandatory reporting levels of functional reporting centers, standard units of measure, appropriate definitions for each center and the source for collection of data.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.322 Term endowment funds
Donated funds which by the terms of the agreement become available either for any legitimate purpose designated by the board or for a specific purpose designated by the donor upon the happening of an event or upon the passage of a stated period of time.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
DISCHARGE OF PATIENTS DISCHARGE OF PATIENTS
10 CRR-NY 88-1.21 Supervision after discharge
The final report on each patient shall make recommendations for further services and supervision which may be required after discharge. Within practical and ethical limitations, the district and local health departments and the hospital will jointly or separately provide such services when necessary, reporting to each other at intervals the progress and condition of the patient.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.242 Parent company
A controlling company having subsidiaries. Without a trade or business of its own, a parent company may also be termed a holding company.
10 CRR-NY 441.109 Empirical
Derived from experience; sometimes contrasted with rational ( i.e., derived from some plan or principle).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.3 Times, places for inspecting records and means for verifying the identity of a data subject
(a) Records shall be available for inspection and copying by data subjects/authorized representatives on every day that the offices of the department are open for the transaction of business between the hours of 8:30 a.m. and 4:45 p.m.
(b) Records may be inspected at locations designated by the appropriate records access officer, whose titles and business addresses are as set forth in section 50-1.4 of this Part.
(c) The identity of a data subject who requests access to his/her record may require verification as follows:
(1) Prior to being given access to personal information, an individual may be required to provide reasonable verification of his/her identity. No verification of identity, however, shall be required of an individual seeking access to records which are otherwise available to any member of the public under the Freedom of Information Law.
(2) In the case of an individual who seeks access or amendment in person, verification of identity will normally be made from those documents that an individual is likely to have readily available, such as an employee identification card, driver license, etc.
(3) When access or amendment is requested by mail, verification of identity may be obtained by requiring the individual to provide certain minimum identifying data, such as date of birth and some item of information in the record that only the concerned individual would likely know. If the sensitivity of the information in the record warrants, a signed and notarized statement of identity may be required.
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.61 State aid reimbursement; vector surveillance and control
The municipality must document within the State aid application, as a precondition for reimbursable vector surveillance and control (form DOH-0627-2378), conditions supporting a public health threat.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
CARRIERS AND CONTROL OF CARRIERS OF DISEASE CARRIERS AND CONTROL OF CARRIERS OF DISEASE
10 CRR-NY 2.43 Release of typhoid carriers from control restrictions
A chronic typhoid carrier may be released from restrictions only on approval of the State Commissioner of Health. A chronic carrier in whose feces typhoid bacilli have been found may be granted release only after submission of the evidence required in subdivision (a) or (b) of this section:
(a) That the gall bladder has been removed; and either:
(1) subsequent to the removal of the gall bladder, each of three specimens of the duodenal contents taken at intervals of not less than 24 hours, has been examined in an approved laboratory or in the laboratory of the State Department of Health and found to contain no typhoid bacilli; and
(2) each of at least eight successive specimens of feces and eight successive specimens of urine, taken on separate days, in a hospital or under other circumstances which do not permit of substitution, has been examined in an approved laboratory or in the laboratory of the State Department of Health and found to contain no typhoid bacilli; or
(3) subsequent to the removal of the gall bladder, each of 16 successive authenticated specimens of feces, taken at intervals of not less than 24 hours, with no more than four release specimens having been taken during any three-month period of the first post-operative year, has been examined in the laboratory of the State Department of Health and found to contain no typhoid bacilli; and
(4) each of at least eight successive specimens or urine, taken on separate days, has been examined in an approved laboratory, or in the laboratory of the State Department of Health and found to contain no typhoid bacilli.
(b) That the laboratory of the State Department of Health finds no significant Vi agglutinative properties in the blood of the carrier, and he has satisfactorily complied with the requirements for release under subdivision (a) of this section except for removal of the gall bladder.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.37 Personal tangible property
(a) A property register shall be maintained by a hospital for each type of major movable property owned.
(b) The property register may be in the form of a subsidiary equipment ledger.
(c) Entries in the property register shall be made as soon as possible after a transaction is completed. A systematic plan of recordkeeping that permits the efficient recording of purchases, transfers, trade-ins and retirements shall be used.
(d) A sample physical inventory of all items in the proper register shall be made at least once a year. The property register may be adjusted to reflect any necessary material changes resulting from the physical inventory provided that an officer of a hospital certifies to the facts of the adjustment. Adequate details of the physical inventory, adjustments and certifications shall be maintained for inspection by the State Department of Health.
(e) All property having a unit cost of $50 or more at time of purchase may be used as part payment for replacement equipment, or it may be offerd for sale on a competitive basis. If no offers are received, it may be discarded provided an officer of a hospital certifies to the facts of such disposal.
(f) An annual physical inventory of consumable supplies on hand shall be taken and recorded on the books of a hospital.
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.1 Applicability
The State homes for veterans and their dependents shall be subject to the rules of this Subpart.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.1 Definitions
(a) Adjusted volume shall mean the number of tests performed annually on New York State samples for each analyte determined and for which approval is requested, multiplied by the difficulty factor listed in section 55-3.9 of this Subpart.
(b) Analytes shall mean the total number of analytes per category for which an environmental laboratory is approved.
(c) Approval fee shall mean the annual fee charged to an environmental laboratory calculated pursuant to section 55-3.7 of this Subpart.
(d) Approval year shall mean the State fiscal year (April 1st to March 31st).
(e) For purposes of this program:
(1) Environmental testing is defined as laboratory examination of samples of drinking water, wastewater, recreational waters, natural surface water, swimming pools, air, solid waste, hazardous waste, soil or sediment or other matrices to determine the biological, chemical, physical, or radiological qualities, for the purpose of public or personal health protection or protection of the environment and natural resources.
(2) Not included in the definition of testing for purposes of fee computation are quality control testing, proficiency testing, process control testing, testing on samples taken outside New York State and testing for research and development of new methods. Process control testing includes testing for quality control purposes during a manufacturing process or testing of an affluent of waste treatment, in which tests on an alalyte are performed in addition to those required to ensure compliance with a relevant discharge requirement. Research and development testing includes tests performed in order to develop alternate testing methods for approval by the department. Process control testing and research and development testing are generally characterized by:
(i) no reporting of the analytical result to a client or outside the facility;
(ii) no charge assessment; and
(iii) no advertisement or promotion of the analysis as a service.
(3) All other tests performed in categories, subcategories or analytes for which the laboratory is approved, regardless of the purpose of the testing not otherwise excluded, must be reported for fee computation purposes.
(f) A governmental laboratory is defined as any laboratory operated by the Federal Government, a State agency, or an authority, county, city, town, village, water district, sewer district or other political subdivision of the State.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.19 Refuse storage and disposal
Adequate facilities shall be provided and maintained for the storage, handling and disposal of refuse, to prevent nuisance conditions, insect and rodent infestation and contamination of air and water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-1 APPROVAL OF LABORATORIES AND INSTITUTIONS FOR USE OF LIVING ANIMALS AND FOR REQUISITION AND ALLOCATION OF ANIMALS FROM POUNDS
USE OF ANIMALS USE OF ANIMALS
10 CRR-NY 55-1.6 Interpretation
In meeting the requirements of this Subpart for adequate sanitation, ventilation, food, temperature and space, the standards set out in the latest edition of the Guide for the Care and Use of Laboratory Animals, DHEW Publications No. (NIH) 78-23, published by the U.S. Department of Health and Human Services, shall be used as a guide.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
PRACTICE OF RADIOLOGIC TECHNOLOGY PRACTICE OF RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.1 Definitions
(a) As used in this Part, unless the context otherwise requires:
(1) Applicable regulations means this Part, and for persons and facilities located outside New York City, Part 16 of this Title and, for persons and facilities located in New York City, article 175 of the New York City Health Code.
(2) Accrediting organization means an organization accepted by the department as a reliable authority for the purpose of accrediting examinations, certifications, registrations or educational programs in the fields of radiography, radiation therapy, or nuclear medicine technology.
(3) Authorized person means a certified nurse practitioner or a duly licensed physician assistant working under the supervision of a physician.
(4) Reserved
(5) Department means the New York State Department of Health.
(6) Direct supervision means that a physician must be present in the section of the facility where the procedure is being performed and is not concurrently encumbered by responsibilities that would preclude the physician from responding to a request for assistance within a timeframe that poses no risk to the patient. The physician shall be immediately available to furnish assistance and direction throughout the performance of the procedure, and is professionally responsible for the performance of the procedure. It does not mean that the physician must be present in the room when the procedure is performed.
(7) Licensed practitioner means any person licensed or otherwise authorized under the State Education Law to practice medicine, dentistry, podiatry, or chiropractic.
(8) Negligence and/or incompetence in the practice of radiologic technology means any failure to adhere to generally accepted standards of such practice and includes, but is not limited to:
(i) failure to exercise due regard for the safety or life or health of the patient;
(ii) failure to perform radiologic tests, procedures or treatments as ordered;
(iii) failure to comply with applicable regulations or the Public Health Law;
(iv) failure to protect patients and other persons from unnecessary exposure to radiation, including failure to properly use protective devices such as mechanical patient restraints;
(v) failure to wear an identification badge, as required by this Part; or
(vi) abandonment or neglect of any patient in need of immediate medical attention without making reasonable arrangements to ensure that the patient receives such attention.
(9) Personal supervision means the physician must be in attendance in the room during the performance of the procedure.
(10) Sponsoring institution means a medical or educational organization that offers educational programs in the field of radiologic technology.
(11) Supervision means the oversight of a licensed radiologic technologist by a licensed practitioner acting within the limits specified in the law under which the practitioner is licensed.
(12) Unethical conduct is behavior that indicates unfitness to practice radiologic technology and includes, but is not limited to:
(i) engaging in the practice of radiologic technology while in an intoxicated condition or under the influence of narcotic or other drug(s) that impair consciousness, judgment or behavior;
(ii) immoral conduct while engaged in the practice of radiologic technology or immoral behavior indicating an unfitness to practice radiologic technology;
(iii) willful falsification, destruction or theft of property or records relating to the practice of radiologic technology;
(iv) unauthorized disclosure of information or records relating to a patient;
(v) discrimination in the practice of radiologic technology against any person based on race, religion, creed, national origin, gender or sexual orientation;
(vi) verbally or physically harassing, abusing or intimidating a patient or other person (including, but not limited to, sexual harassment or abuse) while on the premises of a health care facility or while practicing radiologic technology;
(vii) failure to report in writing to the department of a felony conviction by any Federal or State court within 30 days of the conviction;
(viii) failure to report in writing to the department of a conviction by any Federal or State court of a crime that is not a felony in the jurisdiction in which the conviction is had, but is substantially similar to a felony in the State of New York;
(ix) directly or indirectly offering, giving or soliciting or receiving or agreeing to receive any fee or other consideration to or from a third party for the referral of a patient or client or in connection with the performance of professional services; or
(x) being convicted of any crime consistent with the provisions of article 23-A of the Correction Law.
(13) The terms radiologic technologist , radiographer , radiation therapist , and nuclear medicine technologist mean an individual licensed and currently registered with the department pursuant to this Part.
(14) Authorized user means a physician authorized by a radioactive materials license issued under the applicable regulations to use radiopharmaceuticals for diagnostic studies and/or therapeutic treatments.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.18 Rehabilitation services
The hospital shall make available rehabilitation services consistent with the needs of the patients, which shall be designed to provide individualized, goal-oriented, comprehensive and coordinated services to minimize the effects of physical, mental, social and vocational disadvantages and to effect a realization of the patient's potential for useful and productive activity while ensuring the health and safety of the patient. Such services include but are not limited to audiology, occupational therapy, physical therapy and speech language pathology and shall be delivered in accordance with a written plan for treatment. Hospitals providing general rehabilitation services but not providing comprehensive inpatient physical medicine and rehabilitation programs shall meet the provisions of subdivisions (a) and (b) of this section. Hospitals which do provide comprehensive inpatient physical medicine and rehabilitation programs shall meet the provisions of subdivisions (a) and (c) of this section. Hospitals which provide a spinal cord injury program shall meet the provisions of subdivisions (a), (c) and (d) of this section. Hospitals which provide a traumatic head injury program shall meet the provisions of subdivisions (a), (c) and (e) of this section.
(a) Organization and staffing.
(1) There shall be a director of the service who shall have administrative responsibility for the delivery of patient care and for the supervision of the service. The director shall have the necessary knowledge, experience and capabilities to properly supervise and administer the service.
(2) Physical therapy, occupational therapy, speech-language pathology, or audiology services, if provided, shall be provided by staff who meet the qualifications specified by the governing body, and who are licensed and currently registered by the New York State Education Department.
(i) Each individual who provides rehabilitation services shall be competent to provide such services by reason of education, training, experience and demonstrated performance.
(ii) A sufficient number of qualified competent professional and support personnel shall be available to meet the needs of the patient population and the objectives of the service.
(iii) Sufficient space, equipment and facilities shall be available to support the clinical and administrative functions of the service.
(3) Written policies and procedures which describe the mechanism for the management of the rehabilitation service as well as interdepartmental relationships and communications shall be implemented.
(4) Staff orientation and inservice training shall be required, provided and documented in accordance with hospital policies and procedures.
(b) Delivery of services.
(1) The hospital shall assure that patients who require rehabilitation services are identified and that appropriate services are provided in accordance with the orders of attending physicians or other practitioners as authorized by the governing body, consistent with the New York State Education Law, to order such services. Working relationships among medical staff, nursing staff and rehabilitation service staff shall be established to ensure the identification of patients and delivery of appropriate services.
(2) Rehabilitation services shall be ordered by the attending physician or authorized practitioners and provided in accordance with a written multidisciplinary treatment plan which is based upon a functional assessment and evaluation performed and documented by a professional who is qualified under the provisions of the New York State Education Law, and shall include the diagnosis or diagnoses, precautions and contraindications, and goals of the prescribed therapy.
(i) The multidisciplinary treatment plan shall identify patient needs, establish realistic and measurable goals and identify specific therapeutic interventions by type, amount and frequency needed to maintain, restore and/or promote the patient's functioning and health, within stated time frames for achievement.
(ii) The multidisciplinary treatment plan shall be prepared by rehabilitation service staff with the involvement of the practitioner who ordered the services, the nursing staff, as well as the patient and the family to the extent possible.
(iii) The patient's progress and response to treatment shall be assessed on a timely and regular basis, in accordance with hospital policies and procedures, and documented in the patient's medical record.
(iv) Multidisciplinary treatment plans and goals shall be revised as appropriate in accordance with the assessment of the patient's progress and the results of treatment.
(v) The rehabilitation service shall monitor and evaluate the quality and appropriateness of patient care and resolve identified problems through implementation of a planned and systematic process. The process shall involve reporting to the quality assurance committee in accordance with hospital policies and procedures.
(vi) In accordance with the provisions of section 405.9(h) of this Part, rehabilitation therapy staff shall work with the attending practitioner, the nursing staff, other health care providers and agencies as well as the patient and the family, to the extent possible, to assure that all appropriate discharge planning arrangements have been made prior to discharge to meet the patient's identified needs.
(c) Comprehensive inpatient physical medicine and rehabilitation programs, if provided, shall be approved by the department and shall be organized and operated in accordance with the following:
(1) the beds shall be in a designated area forming a distinct organizational unit, shall be staffed and equipped for the specific purpose of providing a comprehensive physical medicine and rehabilitation program, and shall be used exclusively for such purpose;
(2) patients exhibiting conditions, including but not limited to the following, shall be considered as candidates for admission to a comprehensive inpatient physical medicine and rehabilitation program: severe disabling impairments of recent onset or recent progression, those being readmitted for such conditions, or those with such conditions who previously have not received comprehensive rehabilitation services;
(3) the program shall be directed by a chief of physical medicine and rehabilitation who shall be full-time with the physical medicine and rehabilitation program. The chief of physical medicine and rehabilitation shall be a board certified physiatrist or a physician who by training and experience is knowledgeable in physical and rehabilitative medicine;
(4) the attending physician for a patient admitted to the program shall be a rehabilitation physician, a physician who is board certified in physical medicine and rehabilitation or a physician who by training and experience is knowledgeable in physical medicine and rehabilitation;
(5) nursing care shall be provided under the direction of a registered professional nurse who has appropriate training and experience in rehabilitation nursing as determined by the program and the hospital;
(6) the program shall provide a core of services which includes: rehabilitation nursing, physical therapy, occupational therapy, medical social work, psychology and speech-language pathology;
(7) dependent upon the needs of the patients served, the program shall provide or make formal arrangements for the following services: dental, vocational rehabilitation, education, orthotics, prosthetics, respiratory therapy, rehabilitation engineering, driver education, audiology and therapeutic recreation;
(8) physician consultation shall be available, including but not limited to: general surgery, internal medicine, neurology, neurosurgery, opthalmology, orthopedic surgery, otorhinolaryngology, pediatrics, physicial medicine and rehabilitation, plastic surgery, psychiatry, pulmonary medicine and urology;
(9) patient care services shall be provided through a coordinated interdisciplinary team approach. Participation of members of the core team in the direct care of each patient will vary dependent upon individual patient needs. Patients shall receive a comprehensive evaluation within seven days following admission followed by regular team conferences at intervals appropriate to the treatment goals established for the patient. These conferences shall result in documentation of decisions on rehabilitation goals that meet professional standards of care, identification of services needed for the patients to progress toward those goals, and evaluation of progress toward meeting established goals;
(10) each program shall develop and implement written policies and procedures for the following: patient admission and orientation, assessment and evaluation, program management, discharge planning and follow-up;
(11) the program shall establish formalized relationships with other area hospitals and providers of comprehensive rehabilitation services, regardless of setting, which shall include provisions for consultation, inservice education, and the evaluation of common treatment protocols;
(12) programs shall have written agreements in place for the transfer of patients who need medical or specialty care not available at the hospital of admission. Transfer agreements shall be mutually agreed upon by both the transferring and receiving facility and shall be reviewed on at least an annual basis;
(13) there shall be an organized outpatient physical medicine and rehabilitation program at the hospital which shall provide a range of services equal in scope to that of the inpatient program including spinal cord and head injury programs where they are provided; and
(14) there shall be an organized program for follow-up care to maintain or improve patient health status and functioning following discharge.
(d) A spinal cord injury program, if provided, shall provide coordinated and integrated services for spinal cord injured persons, whether from trauma or disease, enabling those patients served to achieve optimal functioning;
(1) The spinal cord injury program shall be a designated unit for spinal cord injured people with a designated staff to serve the spinal cord injured patients.
(2) The spinal cord injury program shall be directed by a physician with special interest and competence in the care of those with spinal cord injury.
(3) Nursing services for the spinal cord injury program shall be provided under the direction of a registered professional nurse who has appropriate training and experience in the provision of rehabilitation nursing for spinal cord injured patients as determined by the program and the hospital.
(4) The following shall be available seven days a week, 24 hours per day: registered professional nurses, trained personnel capable of provided intermittent catheterization, as required, and respiratory therapy services.
(5) There shall be a formally organized program for patient and family spinal cord injury education regarding bladder management, bowel management, pulmonary care, skin care, instruction in medications, nutrition, access to follow-up medical care, care of equipment, and sexual counseling.
(e) A traumatic head injury program, if provided, shall be designed specifically to serve medically stable, traumatically brain injured individuals. The program shall provide goal-oriented, comprehensive, interdisciplinary and coordinated services directed at restoring the individual to the optimal level of physical, emotional, cognitive and behavioral functioning.
(1) General requirements.
The hospital shall ensure:
(i) the development and consistent application of written admission and continued stay criteria for this service which include but are not limited to the use of a generally recognized classification system for measuring each individual's physical, behavioral and cognitive level of functioning and the family's capabilities and functioning, and are consistent with the following requirements:
(a) a patient admitted for active rehabilitation shall be a person who has suffered a traumatic brain injury with structural nondegenerative brain damage, is medically stable, is not in a persistent vegetative state, demonstrates potential for physical, behavioral and cognitive rehabilitation and may evidence moderate to severe behavior abnormalities. The patient must be capable of exhibiting at least localized responses by reacting specifically but inconsistently to stimuli;
(b) a patient admitted for active coma stimulation shall be a person who has suffered a traumatic brain injury with structural nondegenerative brain damage and is in a coma. The patient may be completely unresponsive to any stimuli or may exhibit a generalized response by reacting inconsistently and nonpurposefully to stimuli in a nonspecific manner; and
(c) a patient who has diffuse brain damage caused by anoxia, toxic poisoning, cerebral vascular accident, or encephalitis may be considered appropriate for admission to this program either for active coma stimulation or active rehabilitation;
(ii) records shall be maintained for at least two years identifying persons who were determined by the facility to be ineligible for admission under the head injury program. The records shall indicate the reason for ineligibility and any referral action taken;
(iii) inservice and continuing education programs which address the medical, physical, cognitive, psychosocial and behavioral needs of head injured patients shall be conducted on a regular basis for all personnel caring for such patients;
(iv) educational programs shall be conducted for personnel not providing direct care but who come in contact on a regular basis with head injured patients. The programs should familiarize personnel with the specific needs of these patients; and
(v) education and counseling services shall be available and offered to the patient and families as needed.
(2) Program management and staffing.
There shall be distinct staffing for the direct care services in the head injury program unit.
(i) The program shall be administered by a program director who has at least two years of clinical or administrative experience in head injury rehabilitation programs. The program director shall have specific responsibilities which include, but are not limited to:
(a) administrative direction and oversight of the program;
(b) ongoing review of the program and implementation of program changes as identified; and
(c) development and implementation of educational programs on an ongoing basis for staff working with head injured patients.
(ii) A physician who has advanced training and experience in the care of the head injured shall be responsible for the medical direction and medical oversight of the head injury program and may serve as the program director.
(iii) A qualified specialist in physical medicine and rehabilitation or a physician who has training and experience in the care and rehabilitation of head injured patients shall be responsible for the care of each patient.
(iv) A primary interdisciplinary team of health care professionals with special interest, training, experience and expertise in head injury rehabilitation shall be responsible for the assessment, coordinated program and care planning, and direct services for each head injured patient. The interdisciplinary team members shall be specifically assigned to serve head injured patients and the team shall include as a minimum the following types of health care professionals:
(a) physician;
(b) registered professional nurse;
(c) physical therapist;
(d) occupational therapist;
(e) speech-language pathologist;
(f) social worker;
(g) dietitian;
(h) therapeutic recreation specialist; and
(i) clinical psychologist with training and experience in neuropsychology.
(v) Nursing services for the head injury unit shall be provided under the direction of a registered professional nurse who is certified or eligible for certification in rehabilitation nursing or who has demonstrated appropriate clinical competency, training and experience in the provision of rehabilitation nursing for head injured patients as determined by the program and the hospital.
(vi) There shall be at least one registered professional nurse with experience in rehabilitation nursing assigned to each shift on the head injury unit.
(vii) Depending upon types of patients being served and individual patient's need, the program shall provide or make formal arrangements for vocational rehabilitation services and special education services.
(3) Interdisciplinary care planning.
(i) A member of the interdisciplinary team managing the patient shall be designated to:
(a) coordinate the overall plan of care and services and identify unmet needs for each patient including discharge and follow-up plans;
(b) serve as a liaison among patient, family and staff to ensure that patient and family concerns are addressed; and
(c) serve as a liaison with the educational, social and vocational resources in the community which are serving the patient.
(ii) A written, comprehensive care plan shall be developed and implemented which establishes rehabilitation goals for each patient. The plan shall be developed on admission by the interdisciplinary team and the attending physician in consultation with the patient, the patient's family and outside agencies, as necessary. The care plan shall be reviewed at least every 14 days and modified according to the patient's needs by the interdisciplinary team. The comprehensive care plan is based upon initial and ongoing integrated, interdisciplinary assessments which shall address as a minimum, medical, dental and neurological status, nutritional status, sensorimotor capacity, the developmental needs of children and adolescents, cognitive, perceptual and communicative capacity, affect and mood, activities of daily living skills, educational or vocational capacities, sexuality issues and concerns, family unity counseling and community reintegration needs and recreation and leisure time interests.
(iii) Findings from the comprehensive care plan reviews shall be integrated into the utilization review program of the facility.
(iv) A written discharge plan shall be developed for each patient as part of the overall care plan and shall include input from all professionals caring for the patient, the patient's family, the patient if capable and, as appropriate, any outside agency or resource that will be involved with the patient following discharge.
(v) The family and patient shall receive preparation for discharge through the facility's educational and counseling services.
(vi) There shall be effective provision for follow-up care and post discharge care which shall include as a minimum, formal linkages to other sources of care and services for head- or brain-injured patients including outpatient services, residential health care facility-based services, home care service agency services and vocational education and rehabilitation services.
(4) Utilization review monitoring.
The facility shall participate with the commissioner or his designee in a program of patient care and services monitoring which shall include, but not be limited to: review of admissions, care and services provided, continued stays, and discharge planning. The facility shall furnish such records and reports at such frequency as the commissioner or his designee may require and shall make available members of the interdisciplinary patient care team for case conferences as the commissioner or his designee deems necessary.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.4 Disclosure
No employee or agent of the Department who has knowledge of personal health-related information in the course of employment, shall disclose such information to any other person unless such person is officially authorized access to the information and requires the information to perform an officially designated function.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.7 Department criminal history review
(a) After reviewing a criminal history record of an individual who is subject to a criminal history record check pursuant to this Part, the department and the provider shall take the following actions:
(1) Where a prospective employee of a provider has no criminal history information, the department shall promptly advise the provider that the department will not issue a disapproval for employment, is not directing the provider to issue a disapproval, and the provider may act on the application in its own discretion.
(2) Where the criminal history information of a prospective employee reveals a felony conviction at any time for a sex offense, a felony conviction within the past 10 years involving violence, or a conviction for endangering the welfare of an incompetent or physically disabled person pursuant to section 260.25 of the Penal Law, or where the criminal history information concerning such prospective employee reveals a conviction at any time of any class A felony, a conviction within the past 10 years of any class B or C felony, any class D or E felony defined in article 120, 130, 155, 160, 178 or 220 of the Penal Law or any crime defined in section 260.32 or 260.34 of the Penal Law or any comparable offense in any other jurisdiction, the department shall propose disapproval of such person's eligibility for employment unless the department determines, in its discretion, that the prospective employee's employment will not in any way jeopardize the health, safety or welfare of patients, residents or clients of the provider.
(i) The department shall provide to the provider and the prospective employee, in writing, a summary of the criminal history information along with the notification identified in this paragraph. Upon the provider's receipt from the department of a notification of proposed disapproval of eligibility for employment, the provider shall not allow the prospective employee to provide direct care or supervision to patients, residents, or clients of such provider until receipt of a final determination of eligibility for employment from the department.
(ii) In cases where the department determines that the prospective employee's employment will not in any way jeopardize the health, safety or welfare of patients, residents or clients of the provider and therefore neither issues a disapproval of eligibility for employment nor directs the provider to issue a disapproval, the provider may act on the application in its own discretion.
(3) Where the criminal history information of a prospective employee reveals a conviction for any crime other than one set forth in paragraph (2) of this subdivision, the department may, consistent with article 23-A of the Correction Law, propose disapproval of eligibility for employment.
(i) The department shall provide to the provider and the prospective employee, in writing, a summary of the prospective employee's criminal history information along with the notification identified in this paragraph. Upon the provider's receipt from the department of a notification of proposed disapproval of eligibility for employment, the provider shall not allow the prospective employee to provide direct care or supervision to patients, residents, or clients of such provider until receipt of a final determination from the department.
(ii) In cases where the department does not issue a disapproval of eligibility for employment, the provider may act on any application for employment in its own discretion, consistent with article 23-A of the Correction Law.
(4) Where the criminal history information of a prospective employee reveals a charge for any felony, the department shall hold the determination regarding a prospective employee's eligibility for employment in abeyance until the charge is finally resolved. Upon receipt of notification from the department of the abeyance, the provider shall not allow the prospective employee to provide direct care or supervision to patients, residents, or clients of such provider before final resolution of the criminal charge.
(5) Where the criminal history information of a prospective employee reveals a charge for any misdemeanor, the department may, after review of the severity of the misdemeanor, hold such determination in abeyance until the charge is finally resolved. If the department holds such determination in abeyance, the provider shall not allow, upon receipt of notification of such determination from the department, the prospective employee to provide direct care or supervision to patients, residents, or clients of such provider before final resolution of the criminal charge.
(b) Prior to making a final determination to disapprove a prospective employee's eligibility for employment pursuant to subdivision (a) of this section, the department shall afford the prospective employee an opportunity to explain in writing, within 30 calendar days from the date the notification was mailed to the prospective employee, why the prospective employee's eligibility for employment should not be disapproved. This notice shall be sent in a manner of mailing that is capable of verifying the date of mailing.
(c) Where the department directs a provider to disapprove eligibility for employment of a prospective employee, or terminate a temporarily approved prospective employee based on the criminal history information, the provider shall notify such prospective employee that such criminal history information is the basis of the disapproval. Such notification shall advise the prospective employee that a copy of the summary of the criminal history information provided by the department to the provider is available from the provider upon written request by the prospective employee.
(d) Documentation and confidentiality requirements.
(1) Only an authorized person(s) or his or her designee who shall be employed by the provider and the subject individual shall have access to criminal history information received by a provider pursuant to this Part. However, criminal history information may be disclosed by an authorized person(s) to other persons who directly participate in any decision by the provider with regard to such subject individual, to which this criminal history information is relevant.
(2) Each authorized person(s) and any other party to whom such criminal history information is disclosed shall keep criminal history information strictly confidential.
(3) Any party who willfully permits the release of any confidential criminal history information obtained from a criminal history record check pursuant to this section to parties not authorized to receive it in accordance with article 28-E of the Public Health Law and section 845-b of the Executive Law shall be guilty of a misdemeanor pursuant to section 12-b of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.7 Required notifications
(a) The owner, operator or manager of a shared health facility shall notify the department within 15 days of any change in:
(1) the persons, partnerships or corporations having ownership (including leasehold ownership) of the shared health facility;
(2) the persons, partnerships or corporations holding any mortgage, lien, leasehold or other security interest in the shared health facility; and
(3) the individual designated to assume functional responsibility for coordination and management of the activities within the shared health facility.
(b) The owner, operator or manager of a shared health facility shall notify the department within 15 days of:
(1) any termination of services of any practitioner in the shared health facility;
(2) the identity of each practitioner newly participating in the facility.
(c) All required notifications shall be made in writing upon forms provided, and shall contain such information as prescribed, by the department.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-2 DRUG SUBSTITUTION
10 CRR-NY 60-2.1 Establishment and publication of a list of safe, effective and therapeutically equivalent prescription drugs
(a) A list of safe, effective and therapeutically equivalent prescription drugs which may be substituted for the drug product prescribed, is hereby established and published as Safe, Effective and Therapeutically Equivalent Prescription Drugs as updated and revised pursuant to section 206 of Public Health Law.
(b) The list contains drug products, identified by manufacturers, each of which has been certified or approved by the commissioner of the Federal Food and Drug Administration as being safe and effective for its labeled indications for use and bioequivalent where bioequivalence is a real or potential issue, and are considered therapeutically equivalent provided they are:
(1) marketed under approved new drug applications or abbreviated new drug applications; and
(2) are shown to be bioequivalent in those instances where positive evidence of bioequivalency is necessary.
(c) Unless otherwise specifically noted on such drug list, therapeutic equivalence applies only to pharmaceutically equivalent drug products involving the same:
(1) active ingredient or ingredients;
(2) dosage form; and
(3) strength.
(d) Different brands of the following dosage forms are not considered pharmaceutically equivalent:
(1) enteric coated tablets;
(2) controlled release products;
(3) injectable suspensions, other than antibiotics;
(4) suppositories containing active ingredients for which systemic absorption is necessary for the therapeutic activity; and
(5) different delivery systems for aerosol and nebulizer drugs.
(e) The drug list established by this Subpart shall not apply to drug orders and prescription services of the institutional pharmacy of a hospital as defined in article 28 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.22 Inspections
The permit-issuing official and his designated representatives shall have the right of entrance and inspection of any swimming pool facility as authorized under section 1.11 of this Title. The most recent report of inspection shall be available at every pool.
Part 18 PUBLIC FUNCTIONS WITH ATTENDANCE OF OVER 5,000 PEOPLE
10 CRR-NY 18.5 Miscellaneous requirements
Bleachers or similar structures at a public function must be safe. If the public function is also a place of public assembly or other place or activity subject to regulation by the New York State Department of Labor, then the permit-issuing official may seek information from that agency to aid evaluation of the safety of such structures.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.21 Perinatal services
(a) Applicability.
This section shall apply to all general hospitals having maternity and newborn services and providing pregnancy-related care for women who are pregnant at any stage, parturient or within six weeks from delivery and for infants 28 days of age or less or, regardless of age, who are less than 2,500 grams (5½ pounds).
(b) Definitions.
For the purposes of this section:
(1) Perinatal services shall mean those services provided in a particular hospital where, as a regular practice, maternity patients and newborn infants receive care on a continuum ranging from preconception services to care during all stages of pregnancy, parturition, postpartum and neonatal care.
(2) Perinatal regionalization system shall mean the statewide organization of maternal and newborn health care services, designed as set forth in Part 721 of this Title, to ensure that mothers and newborns receive the care they need in a timely, safe and effective manner.
(3) Labor room shall mean a room for parturient patients in labor, distinct from patient bedrooms and from operating or delivery rooms.
(4) Delivery room shall mean a room distinct from patient bedrooms and set apart for the delivery of parturient patients.
(5) Single unit maternity or labor-delivery-recovery-postpartum model shall mean a model for family-centered maternity and newborn care in which labor, delivery, nursery and postpartum care are all provided in a single room and movable equipment is introduced and withdrawn from the room as required to provide services and care to the mother and neonate.
(6) Rooming-in shall mean an arrangement which allows the mother and her newborn infant to be cared for together, so that the mother may have access to her infant during all or a substantial part of the day and night, not limited to feeding times.
(7) Newborns shall mean all infants 28 days of age or less.
(8) Premature infant shall mean an infant whose gestational age at birth calculated from the first day of the last menstrual period, or using another reliable method for patients with an unreliable history, is less than 37 completed weeks or 258 completed days.
(9) Low birth weight infant shall mean an infant weighing less than 2,500 grams (5½ pounds) at birth.
(10) Normal newborn nursery shall mean a room for housing newborns who do not need intensive care and are not suspected of nor diagnosed as having any communicable condition.
(11) Neonatal intensive care unit (NICU) shall mean a room at Level II, Level III and Regional Perinatal Center perinatal care services for housing newborns, including premature infants and low birth weight infants, who require specialized care and who are not suspected of nor diagnosed as having any communicable condition.
(12) Observation nursery shall mean a room, physically separate from the normal newborn nursery, where newborns exposed to potential sources of infection and newborns suspected of but not diagnosed as having any communicable condition may be observed pending diagnosis.
(13) Isolation nursery shall mean a room, physically separate from other nurseries, for the isolation of newborns diagnosed as having any communicable condition.
(14) Family planning shall mean the planning and spacing of children by medically acceptable methods to achieve pregnancy, or prevent unintended pregnancy.
(15) Level I perinatal care service shall mean a comprehensive maternal and newborn service as defined by section 721.2(a) of this Title.
(16) Level II perinatal care service shall mean a comprehensive maternal and newborn service as defined by section 721.2(b) of this Title.
(17) Level III perinatal care service shall mean a comprehensive maternal and newborn service as defined by section 721.2(c) of this Title.
(18) Regional perinatal center (RPC) shall mean a hospital or hospitals housing a Level III perinatal care service as defined in section 721.2(d) of this Title.
(19) Perinatal affiliates shall mean Level I, Level II and Level III hospitals which have a current perinatal affiliation agreement as defined in Part 721 of this Title.
(20) Birth center shall mean a place, other than a traditional hospital childbirth unit or birthing room, where births are planned to occur away from the mother's usual residence following a normal uncomplicated pregnancy.
(21) Birthing room shall mean a hospital room designed as a homelike setting which serves as a combined labor/delivery/recovery room and where family members or other supporting persons may remain with a woman as much as possible throughout the childbirth process.
(22) Quality improvement shall mean improvement of the quality of care provided by the RPC or affiliate hospitals through initiatives and analyses designed to identify and then address potential problem areas in care in its own hospital or in affiliated hospitals, or in the region as a whole, through review of either sentinel cases or patterns of care.
(c) General requirements.
(1) Hospitals providing perinatal services shall provide such services in accordance with current standards of professional practice. Written policies and procedures shall be developed and implemented which address the following:
(i) the professional qualifications of the hospital's obstetric and pediatric staff;
(ii) the requirements for consultation with a qualified specialist when required by specific medical conditions;
(iii) the establishment and implementation of rooming-in at the option of each patient unless the establishment or implementation of such program for that patient is medically contraindicated or unless the hospital does not have sufficient facilities to accommodate all such requests;
(iv) protocols and resources available to stabilize and assess newborns for their need of neonatal intensive care; and
(v) the daily care of maternity patients and infants in the perinatal service.
(2) Medical record for each maternity patient. The medical record for each maternity patient admitted to the perinatal service shall be maintained in accordance with section 405.10 of this Part and also shall include the following:
(i) a copy or abstract of the prenatal record, if existing, including a maternal history and physical examination as well as results of maternal and fetal risk assessment, results of maternal HIV, Hepatitis B and Group B strep testing if done, and ongoing assessments of fetal growth and development and maternal health;
(ii) the results of a current physical examination performed by staff granted privileges to perform such examination that meets the requirements of section 405.9(b)(11) of this Part; and
(iii) labor and birth information including records of fetal monitoring and postpartum assessment.
(3) Medical record for each newborn. The medical record for each newborn shall be cross-referenced with the mother's medical record and contain the following additional information:
(i) newborn physical assessment, including APGAR scores, presence or absence of three cord vessels, ability to feed, vital signs and accommodation to extrauterine life;
(ii) newborn care, including the administration of eye prophylasis and vitamin K;
(iii) description of maternal-newborn interaction; and
(iv) orders for newborn screening tests, including arrangements for screening for hearing.
(4) The hospital shall ensure the transfer to the newborn's medical records of a mother's HIV test result, if one exists.
(5) The hospital shall maintain in a timely manner in the perinatal service area, a register of births, in which shall be recorded the name of each patient admitted, date of admission, date and time of birth, type of delivery, names of personnel present in the delivery room, sex, weight and gestational age of infant, location of delivery and outcome of delivery. Any delivery for which the institution is responsible for filing a birth certificate shall be listed in this register.
(6) Control of infection or other communicable condition. The provisions of section 405.11 of this Part shall apply to the perinatal service. In addition, the following requirements relating to the control of infection or other communicable conditions in the perinatal service shall be met:
(i) each patient admitted to the labor-delivery unit shall be screened for signs of, or exposure to, infection. Those with suspected or confirmed communicable conditions shall be reported to the responsible attending practitioner and the infection control officer for observation or isolation as required;
(ii) isolation precautions shall be carried out for patients in labor with confirmed or suspected infection. There shall be at least one room readily available for the use of a maternity patient requiring isolation. The hospital shall implement safe and effective isolation precautions to prevent the spread of infection and assign professional and other staff in the perinatal service in a manner that will prevent the spread of infection. Written policies and procedures shall be developed and implemented reflecting such isolation precautions;
(iii) the hospital shall adopt and implement written policies and procedures governing the placement in observation or isolation nurseries of infants exposed to or showing signs of developing an infection or communicable condition. Such policies shall not unnecessarily restrict the mother's access to her infant; and
(iv) infection control measures shall be instituted to protect infants when the care and treatment of infants requires common surfaces.
(7) Preconception services. The hospital shall develop and implement written policies and procedures for preconception services either onsite or through referral arrangements. Services shall include but not be limited to family planning, nutritional assessment and counseling, genetic screening and counseling, and identification and treatment of medical conditions that could adversely affect a future pregnancy.
(8) Hospital prenatal care activities.
(i) The hospital shall participate in and shall provide or arrange for effective prenatal care activities including conducting effective community outreach programs either directly or in collaboration with community-based providers and practitioners who provide prenatal care and services to women in the hospital service area. Activities and services of a prenatal care program shall include but not be limited to the following:
(a) active promotion of prenatal care for pregnant women during the first trimester of pregnancy and making services available to patients seeking initial care during each trimester;
(b) the initial prenatal care visit shall include a complete history, physical examination, pelvic examination, laboratory screening, initiation of patient education, screening for nutritional status, nutrition counseling and use of a standardized prenatal risk assessment tool;
(c) arrangements for repeat visits for follow-up prenatal care and education;
(d) nutrition counseling;
(e) psychosocial support services as needed;
(f) ongoing maternal and fetal risk assessment;
(g) prebooking for delivery; and
(h) providing HIV counseling and a clinical recommendation for testing to pregnant women. Counseling and/or testing, if accepted, shall be provided pursuant to Public Health Law, article 27-F. Information regarding the woman's HIV counseling and HIV status must be transferred as part of her medical history to the labor and delivery site. Women with positive test results shall be referred to the necessary health and social services within a clinically appropriate time.
(ii) To perform the activities and provide the services in subparagraph (i) of this paragraph, the perinatal service shall accommodate and coordinate services with primary care providers as follows:
(a) the hospital shall develop a memorandum of understanding with each diagnostic and treatment center, prenatal care provider who is not a member of the medical staff and prenatal care assistance program in the hospital service area. These memoranda shall establish protocols for the provision of prenatal care, testing, prebooking arrangements, timely transfer of records and other necessary services; and
(b) the hospital shall require as a condition of continuing medical staff membership that medical staff members provide to maternity patients under their care prenatal care, prebooking arrangements, testing, timely transfer of records and other necessary services. Written policies and procedures implementing this requirement shall be developed.
(iii) Hospitals shall assure the availability of prenatal childbirth education classes for all prebooked women which address as a minimum the anatomy and physiology of pregnancy, labor and delivery, infant care and feeding, breastfeeding, parenting, nutrition, the effects of smoking, alcohol and other drugs on the fetus, what to expect if transferred, and the newborn screening program with the distribution of newborn screening educational literature.
(iv) The hospital shall assure that each prebooked woman receives the hospital's maternity information leaflet as described in PHL section 2803-j, which includes a written description of available options for labor, delivery and postpartum services. The attending practitioner shall:
(a) advise the woman of options for treatment, care and technological support that are expected to be available at the time of labor and delivery together with the advantages and disadvantages of each option;
(b) answer fully any questions the woman may have regarding the options available; and
(c) obtain from the woman her informed choice of mode of treatment, care and technological support that are expected to be necessary.
(9) Hospitals in consultation with the medical staff shall develop memoranda of understanding with free-standing birth centers in their service area, upon request from such centers, for the prompt admission of women and newborns and transfer of records of any birth center patient whose assessed condition necessitates admission to the level of perinatal service provided by such hospital.
(i) Such transfer shall be accomplished in accordance with the provisions of sections 754.2(e), 754.4, 795.2 and 795.4 of this Title.
(ii) Unless already performed at a free-standing birth center, newborns transferred to a hospital shall have newborn screening performed at the hospital in accordance with Part 69 of this Title.
(iii) The hospital, as part of its quality improvement activities, shall review all maternal and/or newborn transfers from birth centers to ensure adequacy of risk assessment and care, that each transfer has been appropriately arranged, and that reasons for the transfer have been documented clearly.
(10) Quality improvement activities. In addition to the quality assurance provisions of section 405.6 of this Part, the hospital shall, in conjunction with the medical staff and the nursing staff, monitor the quality and appropriateness of patient care and ensure that identified problems are reported to the quality assurance committee together with recommendations for corrective action. In accordance with section 721.9 of this Title, the hospital shall also perform quality improvement activities in accordance with its perinatal affiliation agreement.
(11) Functioning of perinatal services.
(i) Inpatient perinatal services shall be operated as closed units with limited access to unnecessary hospital traffic.
(ii) The perinatal service shall have available: services for the identification of high-risk mothers and fetuses, continuous electronic fetal monitoring, Cesarean delivery capabilities within 30 minutes of determination of need for such procedure, anesthesia services available on a 24-hour basis, radiology and ultrasound examination, with at least one ultrasound machine immediately available for use by the labor and delivery service.
(12) Laboratory services. The perinatal service shall have immediate access to the hospital's laboratory services including a 24-hour capability to provide blood group, Rh type and cross-matching, and basic emergency laboratory evaluations. Either ABO Rh-specific or O-Rh-negative blood and fresh frozen plasma shall be available at the facility at all times. Such other procedures as may be required by the perinatal service shall be performed on a timely basis.
(13) Admissions.
(i) Women in need of medical care and services pertaining to pregnancy, delivery and the puerperal period shall be admitted to the maternity service. Such admission shall be consistent with section 405.9 of this Part.
(a) Each patient shall be attended by a licensed and currently registered obstetrician, family practitioner or licensed midwife who will be responsible for the patient's care.
(b) A patient may not be sent home without the prior knowledge and approval of her attending physician or licensed midwife.
(ii) Admission of nonobstetric patients.
(a) The hospital shall develop and implement written policies and procedures for the admission of nonobstetric female patients to the perinatal service area. The hospital shall ensure that obstetric patients take precedence over nonobstetric patients and that the safety and physical and psychological well-being of obstetric patients are not jeopardized.
(b) The following nonobstetric patients shall not be admitted to the maternity service:
(1) patients undergoing radiation therapy while they retain radioactive materials that have been administered for, or that result from, such treatment; and
(2) patients in an acute, infectious state or with signs and symptoms which may denote infection.
(c) If an acute or chronic infection or any other condition which would have contraindicated admission to the perinatal service is found during surgery or during any other period of hospitalization, the patient shall be removed from the perinatal service area.
(14) Voluntary acknowledgement of paternity for a child born out of wedlock.
(i) If a child is born to an unmarried woman and the putative father is readily identifiable to the responsible hospital staff and available, the hospital shall:
(a) provide to the child's mother and putative father documents and oral and written instructions and information necessary for such mother and father to complete an acknowledgement of paternity form in compliance with section 4135-b of the Public Health Law and section 111-k of the Social Services Law; and
(b) file the executed acknowledgement of paternity with the registrar at the same time at which the certificate of live birth is filed, if possible.
(ii) The hospital shall not be required to seek out or otherwise locate a putative father who is not readily identifiable or available.
(15) Hospitals with a perinatal care service shall participate in the perinatal regionalization system in accordance with their level of care designations under Part 721 of this Title.
(16) Each hospital providing Level I, II or III perinatal care services shall enter into a perinatal affiliation agreement with its designated RPC in accordance with Part 721 of this Title. Level I and II hospitals may also enter into transfer agreements in accordance with Part 721 with Level III hospitals.
(d) High-risk antepartum services at Level II, Level III and RPC perinatal services.
(1) Level II, Level III and/or RPC perinatal services shall develop and implement written policies and procedures to indicate where pregnant patients with obstetric, medical, or surgical complications are to be assigned to provide for their continuous observation and care.
(2) Maternal intensive care services.
(i) Hospitals providing Level I or II perinatal care services shall develop, enter into and implement written agreements with hospitals providing Level III and RPC perinatal care services for the transfer of obstetric patients whose physical conditions are evaluated as needing such higher level of care.
(ii) Hospitals which provide multiple levels of perinatal care services shall develop and implement written protocols and procedures for the in-house transfer of patients who are evaluated as requiring a level of care other than the level being provided in the area where the patient is currently located.
(iii) Evaluation of the patient's condition and need care for intensive care services shall be conducted in accordance with standardized risk assessment criteria based on generally accepted standards of practice which shall be adopted in writing and implemented uniformly throughout the perinatal service.
(iv) Level II, Level III and RPC perinatal care services shall maintain a nursing staff that is appropriately trained and adequate in size to provide specialized care to distressed mothers and infants. The number of patient care staff on duty during any shift shall reflect the volume and nature of patient services being provided during that shift.
(v) An RPC shall:
(a) offer education and training to its perinatal affiliates and associated birth centers. Education and training shall be designed to update and enhance staff knowledge and familiarity with relevant procedures and technological advances;
(b) review, in conjunction with its perinatal affiliates, all cases of patients transferred to a higher level of care to determine whether such transfers were appropriate and accomplished according to established transfer agreements; and
(c) participate in case conferences with its perinatal affiliates and associated birth centers to determine whether any non-transferred high-risk cases were handled appropriately and whether the transfer guidelines were adequate to address such circumstances;
(d) for purposes of participation in such activities, the RPC representative or representatives shall be deemed member(s) of the perinatal affiliate's quality assurance committee. RPC representatives may only access confidential patient information for quality improvement purposes through their roles on the affiliate hospitals' quality assurance committees as set forth in the affiliation agreements and these regulations. Members of hospitals' quality assurance committees must maintain the confidentiality of patient information and are subject to the confidentiality restrictions of Public Health Law section 2805-m.
(e) Intrapartum services.
(1) The hospital shall develop and implement written policies and procedures that indicate the areas of responsibility of both medical and nursing personnel for normal, high-risk, and emergency deliveries. These policies and procedures shall be reviewed yearly and made available to all staff. There also shall be written policies for the care of pregnant patients when all antepartum and postpartum beds are occupied.
(2) Written policies and procedures shall be developed and implemented governing restrictions of entry to the closed labor and delivery unit and the hospital shall ensure that, unless medically contraindicated, the patient may choose to be accompanied during labor and delivery by the father and/or other supportive person(s) who can provide emotional comfort and encouragement. Any such contraindications shall be noted in the medical record.
(3) Evaluation and preparation.
(i) In conjunction with the required updated history and physical exam, the hospital shall provide for the following:
(a) laboratory data including serologic tests for blood group, Rh type, syphillis and rubella titer;
(1) if the woman's serology is positive, a cord blood serology shall be obtained. If the sample could not be taken prior to the pregnancy's end, the serology shall be taken at the time of termination of the pregnancy;
(2) the woman shall be evaluated for the risk of sensitization to Rho (D) antigen and if the use of Rh immune globulin is indicated, an appropriate dosage thereof shall be administered to her as soon as possible within 72 hours after delivery or termination of pregnancy;
(b) an assessment of the woman's HIV status and the provision of testing in accordance with section 69-1.3(l) of this Title;
(c) an admitting physical examination which shall include the woman's blood pressure, pulse and temperature, the fetal heart rate, the frequency, duration and evaluation of the quality of the uterine contractions and which shall be recorded in the patient's medical record. An evaluation of any complications should be made. If there is suspected leakage of amniotic fluid or any unusual bleeding, the attending physician or licensed midwife shall be notified immediately before a pelvic examination is performed. When there are no complications or contraindications, qualified nursing personnel may perform the initial pelvic examination to evaluate labor status and the imminence of delivery. The physician or licensed midwife responsible for the woman's care shall be informed of her status, so that a decision can be made regarding further management; and
(d) interval assessments including physical and psychological status of the woman and fetal status.
(ii) Pharmacological or surgical induction or augmentation of labor.
(a) Qualified practitioner as referred to in this section shall mean a practitioner functioning within his or her scope of practice according to State Education Law who meets the hospital's criteria for privileging and credentialing practitioners in management of labor and delivery in accordance with the hospital's policies and procedures.
(b) Pharmacological or surgical induction or augmentation of labor may be initiated only after a qualified practitioner has evaluated the woman, determined that induction or augmentation is medically necessary for the woman or fetus, recorded the indication, obtained informed consent for induction or augmentation of labor, and established a prospective plan of management acceptable to the woman. If the qualified practitioner initiating these procedures does not have privileges to perform cesarean deliveries, a physician who has such privileges shall be contacted directly prior to initiation of the induction or augmentation and a determination made that he or she shall be available within 30 minutes of determination of the need to perform a cesarean delivery. If the patient has had a previous cesarean delivery, a physician with cesarean privileges must be immediately available during pharmacological induction or augmentation of labor.
(c) Pharmacological or surgical induction or augmentation shall be initiated by a qualified practitioner. A qualified practitioner shall initiate the induction or augmentation and shall remain with the woman for a period of time sufficient to ensure that the procedures or medication has been well-tolerated and has caused no adverse reaction. A physician capable of managing any reasonably foreseeable complications from the induction or augmentation of labor shall be available within a timeframe appropriate to the woman's needs.
(d) For pharmacological induction or augmentation of labor, the hospital shall develop and implement a written protocol for the preparation and administration of the oxytocic agent and/or other substances used to induce or augment labor.
(e) During the entire time of the labor induction or augmentation, the woman shall be monitored by staff who are trained and competent in both the monitoring of fetal heart rate and uterine contractions and interpretation of such monitoring. The monitoring shall be by either electronic fetal monitoring or auscultation. Where auscultation is used in lieu of electronic fetal monitoring, it shall be performed no less frequently than every 15 minutes during the first stage of labor and every five minutes during the second stage of labor.
(iii) No attempt shall be made to delay birth of an infant by physical restraint or anesthesia.
(iv) Each maternity patient, when present in a labor, delivery, birthing room or birth center shall be under the care of a registered professional nurse available in accordance with the patient's needs.
(v) The medical record shall be updated to note whenever the woman's choice of position for labor, use of drugs or technological support devices or mode of treatment and care cannot be honored due to medical contraindications. Standing orders for drugs or technological support devices may only be implemented after the nature and consequences of the intervention have been explained to the woman, and the woman agrees to such implementation.
(4) Delivery.
(i) Hospitals shall develop and implement policies and procedures for the delivery room that shall require at least the following:
(a) regular evaluation of maternal blood pressure and pulse both during and after delivery; and
(b) fetal heart evaluation.
(ii) Section 405.13 of this Part concerning anesthesia services shall apply to the clinical perinatal service. The anesthetist shall be informed in advance if complications with the delivery are anticipated.
(iii) The perinatal service and the medical staff shall designate in writing those situations which require consultation with and/or transfer of responsibility from a licensed midwife or a family practice physician to an obstetrician.
(iv) Alternative arrangements for the organization of the perinatal service, including but not limited to birthing rooms, birth centers or single unit maternity models, shall conform to pertinent requirements of this section and Parts 711 and 712 of this Title. Birth centers shall also conform to the patient care provisions of Part 754 of this Title.
(v) Immediate care of the newborn. The practitioner who delivers the baby shall be responsible for the immediate postdelivery care of the newborn until another qualified person assumes this duty. At all times, the newborn shall be attended by a physician or licensed midwife and shall be under the care of a registered professional nurse.
(a) Resuscitation of a distressed newborn. The hospital shall develop and implement policies and procedures for the recognition and immediate resuscitation of a distressed newborn. Level I and II perinatal care services shall accomplish this in consultation with, and with assistance of, the RPC with which the hospital has a perinatal affiliation agreement. The policies and procedures shall include the following elements:
(1) the designation of a physician to assume primary responsibility for the establishment of standards of care, review of practices, maintenance of appropriate drugs and training of personnel;
(2) approval of these policies and procedures by the directors of maternity and newborn services, anesthesia, pediatrics, nursing and by the medical staff;
(3) requirement for immediate availability of needed resuscitative equipment and personnel;
(4) presence in the delivery room of a member of the professional staff specifically qualified in newborn resuscitation;
(5) capability to provide short-term respiratory support including bag and mask ventilation;
(6) procedures for the stabilization of the distressed newborn;
(7) capability to perform endotracheal intubation and umbilical vessel catheterization. For a Level I perinatal care service, the perinatal affiliation agreement with its designated RPC shall provide for staff training to develop current staff competence in these procedures; and
(8) procedures for the preparation and transfer of the distressed newborn to a Level III or RPC perinatal care service when medically indicated.
(b) The hospital shall administer eye prophylaxis and vitamin K in accordance with sections 12.2 and 12.3 of this Title, test for phenylketonuria and other diseases and provide or arrange for newborn hearing in accordance with Part 69 of this Title.
(c) The hospital shall conduct expedited HIV testing of a newborn whose mother's HIV status is unknown at delivery in accordance with section 69-1.3(l) of this Title;
(d) A professional staff person in attendance at a delivery shall ensure proper identification of a newborn before it leaves the room where the delivery has occurred.
(1) The hospital shall ensure continuous identification of the newborn infant during the entire period of hospitalization including verification of identity after each separation and reunion of mother and newborn. In addition to the development and implementation of written policies and procedures for continuous identification, further policies and procedures shall set forth steps to be taken when the means of identification which has been placed on the newborn becomes separated from the newborn.
(2) Newborns born of different mothers shall not be present at the same time in the room where delivery/recovery takes place, unless each has previously been identified by the methods prescribed in this clause.
(e) Circumcision, which shall be an elective procedure, shall not be performed during the newborn stabilization period after birth.
(f) Postpartum care of mother.
Appropriate nursing care shall be available to the mother during the period of recovery after delivery. At all times after delivery, the mother shall have maximum access to her baby unless such access is medically contraindicated and recorded in the appropriate medical record.
(1) The mother shall be transferred to the postpartum area only after her vital signs have stabilized. The hospital shall adopt and implement policies and procedures for identifying any postpartum complications that arise and informing the responsible practitioner who shall manage complications.
(2) Postpartum monitoring shall include the following:
(i) vital signs shall be recorded on a regular basis;
(ii) fluid intake and output shall be recorded. The uterine fundus shall be frequently examined to determine if it is well contracted and whether there is excessive bleeding;
(iii) the patient's practitioner shall be notified of any unusual findings;
(iv) nursing personnel qualified to recognize postpartum emergencies and problems shall be immediately available to the patient;
(v) the father or other support person shall be allowed to remain with the mother during the recovery period unless medically contraindicated or unless the nursing staff determines that the continued presence of the individual would interfere with the continuing care of the mother or other patients;
(vi) a physical assessment of the mother shall be conducted in accordance with established protocols; and
(vii) unless medically contraindicated or unacceptable to the mother, the newborn shall remain with the mother who shall provide a preferred source of body warmth for the newborn. During this period the newborn shall be closely observed for any abnormal signs and breastfeeding shall be encouraged.
(3) Education and orientation of the mother who is planning to raise the baby.
(i) The hospital shall provide instruction and assistance to each maternity patient who has chosen to breastfeed and shall provide information on the advantages of breastfeeding and possible impacts of not breastfeeding to women who are undecided as to the feeding method for their infants. As a minimum:
(a) the hospital shall designate at least one person who is thoroughly trained in breastfeeding physiology and management to be responsible for ensuring the implementation of an effective breastfeeding program. At all times, there should be available at least one staff member qualified to assist and encourage mothers with breastfeeding;
(b) written policies and procedures shall be developed, updated, implemented, and disseminated annually to staff providing maternity or newborn care to assist and encourage the mother to breastfeed which shall include, but not be limited to:
(1) prohibition of the application of standing orders for anti-lactation drugs;
(2) placement of the newborn skin-to-skin for breastfeeding immediately following delivery, unless contraindicated;
(3) restriction of the newborn's supplemental feedings to those indicated by the medical condition of the newborn or of the mother;
(4) provision for the newborn to be fed on demand;
(5) pacifiers or artificial nipples may be supplied by the hospital to breastfeeding infants to decrease pain during procedures, for specific medical reasons, or upon the specific request of the mother. Before providing a pacifier or artificial nipple that has been requested by the mother, the hospital shall educate the mother on the possible impacts to the success of breastfeeding and discuss alternative methods for soothing her infant, and document such education;
(6) prohibition of the distribution of marketing materials, samples or gift packs that include breast milk substitutes, bottles, nipples, pacifiers, or coupons for any such items to pregnant women, mothers or their families;
(7) prohibition of the use of educational materials that refer to proprietary product(s) or bear product logo(s), unless specific to the mother’s or infant’s needs or condition; and
(8) prohibition of the distribution of any materials that contain messages that promote or advertise infant food or drinks other than breast milk.
(c) the hospital shall provide an education program as soon after admission as possible which shall include but not be limited to:
(1) the importance of scheduling follow-up care with a pediatric care provider within the timeframe following discharge as directed by the discharging pediatric care provider;
(2) the nutritional and physiological aspects of human milk;
(3) the normal process for establishing lactation, including care of the breasts, common problems associated with breastfeeding and frequency of feeding;
(4) the potential impact of early use of pacifiers on the establishment of breastfeeding;
(5) dietary requirements for breastfeeding;
(6) diseases and medication or other substances which may have an effect on breastfeeding;
(7) sanitary procedures to follow in collecting and storing human milk; and
(8) sources for advice and information available to the mother following discharge;
(d) for mothers who have chosen formula feeding or for whom breastfeeding is medically contraindicated, hospitals shall provide individual training in formula preparation and feeding techniques.
(ii) The hospital shall provide to the mother instructions in caring for herself and her baby. Topics to be covered shall include but not be limited: to self-care, nutrition, breast examination, exercise, infant care including taking temperature, feeding, bathing, diapering, infant growth and development and parent-infant relationships.
(iii) The hospital shall determine that the maternity patient can perform basic self-care and infant care techniques prior to discharge or make arrangements for postdischarge instruction.
(iv) Each maternity patient shall be offered a program of instruction and counseling in family planning, if requested by the patient, the hospital shall provide the patient with a list, compiled by the department and made available to the hospital, of providers offering the services requested.
(4) Visiting. The hospital shall develop and implement written policies and procedures regarding visiting that:
(i) do not unreasonably restrict fathers or other primary support person(s) from visitation to the mother during the recovery period;
(ii) promote family bonding by allowing regular visitation for the newborn's siblings in a manner consistent with safety and infection control; and
(iii) permit visitations by other family members and friends in a manner consistent with efficient hospital operation and acceptable standards of care.
(5) Discharge planning. The discharge of mother and newborn shall be performed in accordance with section 405.9 of this Part. In addition, prior to discharge, the hospital shall determine that:
(i) sources of nutrition for the infant and mother will be available and sufficient and if this is not confirmed, the attending practitioner and an appropriate social services agency shall be notified;
(ii) follow-up medical arrangements, consistent with current perinatal guidelines and recommendations, have been made for mother and newborn;
(iii) the mother has been informed of community services, including the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and shall make referrals to such community services as appropriate;
(iv) the mother has been instructed regarding normal postpartum events, care of breasts and perineum, care of the urinary bladder, amounts of activity allowed, diet, exercise, emotional response, family planning, resumption of coitus and signs of common complications;
(v) the mother has been advised on what to do if any complication or emergency arises;
(vi) the newborn has had a documented and complete physical examination and verification of a passage of stool and urine;
(vii) the means of identification of mother and newborn are matched. If the newborn is discharged in the care of someone other than the mother, the hospital shall ensure that the person or persons are entitled to the custody of the newborn; and
(viii) the newborn is stable; sucking and swallowing abilities are normal. Routine medical evaluation of the neonate's status at two to three days of age shall have been conducted or arranged. Newborn screening shall be conducted at time of discharge, provided discharge is greater than 24 hours after the birth, or between the third and fifth day of life, whichever occurs first, in accordance with Part 69 of this Title.
(g) High-risk neonatal care.
(1) Each hospital providing Level I, II or III perinatal care services shall enter into a perinatal affiliation agreement with its designated RPC in accordance with Part 721 of this Title. Level I and II hospitals may also enter into transfer agreements in accordance with Part 721 of this Title with Level III hospitals.
(i) The perinatal affiliation agreements and transfer agreements shall include provisions for standardized risk assessment based on generally accepted standards of practice, stabilization and resuscitation of newborns as necessary, newborn screening in accordance with Part 69 of this Title, consultation, patient transport, transfer of maternal and newborn records and any other features needed to ensure prompt and efficient transport of newborns that minimize risks and provide the newborn with needed services.
(ii) Unless medically contraindicated, mothers shall be permitted to accompany distressed newborns to receiving perinatal care facilities.
(iii) The perinatal affiliation agreements and transfer agreements shall provide for the return of the distressed newborn to the sending hospital when the condition has been stabilized and return is medically appropriate.
(iv) If transfer necessitates separating the mother and newborn, mothers who have chosen to breastfeed should be encouraged to maintain lactation and breast milk should be available to the newborn.
(2) Placement in nurseries.
(i) Healthy newborns shall be placed in a normal newborn nursery. If a newborn in a normal newborn nursery is removed temporarily from the perinatal service for any reason, the newborn may be returned to the normal newborn nursery only if infection control measures established by the hospital have been followed.
(ii) Newborns requiring specialized care shall be placed in a NICU and hospitals shall develop and implement protocols for all phases of treatment of such newborns. Newborns who are delivered in perinatal care services that are not capable of providing all necessary care and services shall be transferred to perinatal care services at hospitals that can meet the newborns' needs.
(h) Neonatal intensive care services.
(1) Neonatal intensive care services shall be provided by Level II, Level III and RPC perinatal care hospitals.
(2) Decisions regarding the appropriate level of care and the need for transport of a neonate to a higher level of care shall be made consistent with generally accepted standards of care and the hospital's perinatal affiliation agreement.
(3) Treatment of severely ill, injured, or handicapped infants with life-threatening conditions.
(i) Severely ill, injured or handicapped infants exhibiting life-threatening conditions shall be transferred to and/or treated at RPCs or other hospitals having Level III perinatal care services after consultation with that service has established that the infant might benefit from such transfer.
(ii) Level III perinatal care services and RPCs shall consult with the hospital's bioethical review committee which shall assist the service and provide guidance to staff and families in the resolution of issues affecting the care, support and treatment of severely ill, injured, or handicapped infants with life-threatening conditions. The committee:
(a) shall consist of such members of the medical staff, nursing staff, social work staff and administration as designated by the governing body and such other community-based individuals with experience in bioethical matters as may be chosen by the governing body;
(b) shall operate in accordance with written policies and procedures developed by the hospital. Such policies shall establish the protocols for organization and functioning of the committee and scope of responsibility for specified cases as well as development of general review policies governing bioethical matters. The hospital shall:
(1) ensure that the parents are fully advised regarding the infant's condition, prognosis, options for treatment, likely outcomes of such treatment and options, if any, for the discontinuance of heroic life maintenance efforts; and
(2) ensure that any decision by competent parents to continue life-sustaining efforts is implemented by the hospital; and
(c) shall, in conjunction with the attending physician(s), child protective services, the medical staff and the governing body, recommend that the hospital obtain an appropriate court order to undertake a course of treatment, in all cases when in the judgment of the committee:
(1) the parents do not have the capacity to make a decision; or
(2) the parents' decision on a course of action is manifestly against the infant's best interest.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.4 Qualified consultants
Professional services rendered by medical specialists or consultants will be approved for reimbursement only if rendered by personnel listed in the department's file of clinical consultants and, when in-hospital care is required, if the hospital meets standards set forth in section 45.8 of this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.12 Salaries or fees to officers or directors
No nursing home company shall pay any salaries or fees to any director. Salaries or fees may be paid to officers for services actually performed.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.4 Special criteria for tissue bank licensure
(a) Prior to approving an application for a license to operate a tissue bank, other than a limited tissue procurement service or a tissue transplantation facility, which acquires, processes, stores and/or distributes tissue for transplantation, transfer, artificial insemination or implantation, the department shall consider:
(1) the applicant's ability and intent to arrange for the acquisition, processing, storage and/or distribution of usable donated tissue within the designated geographic area of service;
(2) the applicant's ability to establish and maintain effective agreements for tissue acquisition with hospitals;
(3) the applicant's ability to engage and participate in systematic efforts, including professional and public education, to acquire usable tissue;
(4) the applicant's ability to establish and meet quality standards for the acquisition, processing, storage and/or distribution of tissue;
(5) the applicant's ability to arrange for the selection and testing of donors, and/or testing and processing of donated tissue;
(6) the character and competence of the tissue bank operator, the bank's officers, directors, principal stockholders and any persons with a controlling interest, including the quality of care or professional services provided by themselves or through any health care entity or business operated or controlled by such persons; and
(7) with respect to tissue banks created after June 1, 1991, the existence and activities of other tissue banks in the geographic area to be served by the applicant, and the statewide need for tissue to be distributed by the applicant, as determined by a review of the following factors, as applicable:
(i) the current and projected population characteristics of the service area, including relevant health status indicators;
(ii) normative criteria for age-specific and sex-specific rates of tissue utilization;
(iii) procedures to assure that tissues are distributed based on medical need and not preferentially distributed according to the donor or recipient's membership in a category based on race, color, creed, national origin, marital status, social organization or income, except if medically indicated; and
(iv) the need of the population served or to be served for the types of tissue services proposed for each category of tissue, and the extent to which all residents in the service area will have access to those services. The population need analysis for each proposal shall include a determination of the appropriate service area for distribution of tissues. After reviewing the evidence, the commissioner may determine that the proposed service area is not acceptable and may direct, as a condition of licensure, that additional, fewer, or different areas be served.
(b) Prior to approving an application for a license to operate a tissue transplantation facility, the department shall consider the special criteria listed in subdivision (a) of this section except for paragraphs (1), (2), (3), (5) and (7).
(c) Prior to approving an application for a license to operate a limited tissue procurement service, the department shall consider the special criteria listed in subdivision (a) of this section except for paragraphs (1), (2), (5) and (7).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 414 NURSING HOMES—CONTINUOUS VIOLATION PENALTIES
10 CRR-NY 414.3 Additional penalties
Penalties as established in this Part shall be additional and cumulative to all other penalties or remedies existing for violations of article 28 of the Public Health Law and of the rules and regulations promulgated pursuant to such article.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.8 Alternate level of care placement
(a) During the process of making determinations of coverability as specified in sections 85.1 through 85.7 of this Part, if the person designated by the Commissioner of Health decides that the patient may require placement in an alternate level of medical care upon discharge from the hospital, the designated person shall refer such case to the discharge planning unit of the hospital for appropriate placement action.
(b) During the process of making determination of coverability under sections 85.1 through 85.7 of this Part, if the person designated by the Commissioner of Health determines that the patient no longer requires inpatient hospital care but cannot be discharged except to a lesser level of medical care, he shall make a determination of noncoverability unless the hospital demonstrates that it has made and is continuing to make every effort to place the patient but without success.
(c) For all patients for whom reimbursement is claimed under medical assistance for the needy who require placement in a nursing home or health-related facility at time of discharge from a hospital, patient review forms as required by the State Department of Health must be completed by the hospital as follows:
(1)
(i) The Hospital/Community Patient Review Instrument (Hospital/Community PRI), as contained in section 400.13 of this Title, shall be completed by a registered professional nurse who has successfully completed a training program in patient case mix assessment approved by the department to train individuals in the completion of the Patient Review form (PRI) or the Hospital/Community Patient Review form (Hospital/Community PRI). The SCREEN as contained in section 400.12 of this Title shall be completed by a professional with demonstrated skills in assessing psychosocial situations, including but not limited to social work and discharge planning professionals, who has successfully completed a training program in patient case mix screening approved by the department to train individuals in the completion of the patient screening form (SCREEN); or
(ii) each hospital shall have on staff one trained and qualified assessor, and one trained and qualified screener, each as described in subparagraph (i) of this paragraph, for every 70 medical surgical beds, who shall attest to the accuracy of the patient review forms, except that no more than nine trained and qualified assessors and nine trained and qualified screeners shall be required in a hospital.
(2) The Hospital/Community PRI, as contained in section 400.13 of this Title, shall have been completed prior to or within 24 hours of the patient's assignment to alternate level of care (ALC) status, and every 15 days for the first 30 days, and every 30 days thereafter, and within 24 hours prior to the time of discharge to a skilled nursing facility or a health-related facility, unless a different schedule is contained in 18 NYCRR 505.20.
(3) The SCREEN, as contained in section 400.12 of this Title, shall have been completed prior to or within 24 hours of the patient's assignment to ALC status, and every 30 days thereafter, unless a different schedule is contained in 18 NYCRR 505.20.
(4) The Hospital/Community PRI and SCREEN, as contained in sections 400.12 and 400.13 of this Title, shall also be completed when the patient's status changes, as evidenced by a change in the patient's assigned Resource Utilization Group (RUG-II). (See Appendix 13-A, infra, for RUG-II categories.)
(5) The patient and/or the patient's designated representative shall be given an explanation of the information contained on the SCREEN, including the determination of setting for care for that particular patient.
(6) Patients younger than 16 years of age shall be assessed at the frequency specified in paragraph (2) of this subdivision, using patient review forms as required by the facility(ies) to which the patient is referred for care upon discharge.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.44 Refrigerated storage
Enough conveniently located refrigeration facilities or effectively insulated facilities are to be provided and used to maintain potentially hazardous food at required temperatures during storage. Each facility storing potentially hazardous food is to have a numerically scaled indicating thermometer accurate to plus or minus two degrees Fahrenheit (1.1 degrees Celsius), which measures air temperature in the warmest part of the unit. Recording thermometers may be used in lieu of indicating thermometers.
PURPOSE PURPOSE
10 CRR-NY 14-1.1 Purpose
The purpose of this code is to protect the public health. Owners and operators of food service establishments are to operate their premises in such a way as to avoid imminent health hazards. Health hazards in operation, when called to their attention by the representative of the permit-issuing official, are to be corrected immediately. Deficiencies, other than imminent health hazards, such as poor sanitary practices, are to be corrected in accordance with a schedule approved by the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.8 Birth and death certification; form and content
(a) The signature of those persons executing, authenticating or filing such certificates may be constructed digitally for certificates of birth and death prepared in the electronic format provided by the commissioner.
(b) A digital signature means the creation by the computer of an electronic identifier which the commissioner determines is:
(1) unique to the signer;
(2) capable of verification;
(3) under the signer’s control; and
(4) linked to data in such a manner that if the data is changed, the signature is invalidated.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.11 Computation of basic rate for facilities other than licensed free-standing ambulatory surgery centers
(a) Rates of payment for facilities other than licensed free-standing ambulatory surgery centers shall be established on a prospective basis and shall be computed on the basis of allowable fiscal and statistical data submitted by the facility for the fiscal year ended at least 15 months prior to the year for which rates are being set. Unless otherwise specified in this Subpart, the computed rates shall be all-inclusive, taking into consideration total allowable costs and total billable patient visits or procedures.
(b) Rates will be determined by applying ceiling limitations to allowable operating costs, applying the trend factor to the result, adding reimbursable capital costs, and dividing the sum by the total number of visits or procedures. In the case of proprietary facilities, a return on investment shall be added to reimbursable costs.
(c) Certification by the commissioner of reimbursement rates of payment by governmental agencies for the period April 1, 1993 through March 31, 1994 shall be extended six months, through September 30, 1994, by applying the applicable trend factors. Rates of payment shall then be for the fiscal-year period October 1st through September 30th. Approval by the commissioner of reimbursement rates for article 43 corporations shall be for the periods specified in the reimbursement formula approved by the Commissioner of Health.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.10 Required records of tissue acquisition, testing, processing and storage
Each skin bank shall maintain donation records as required by Subpart 52-2 of this Part.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.14 Recovery
Local health officials shall oversee all provider efforts to identify third-party coverage and to be able to demonstrate on audit that such third-party coverage was identified and fully utilized and that the providers adhered to the terms of this Subpart. Upon receipt of audit information by the State Health Department showing State aid overpayment, the commissioner shall deduct from the next State aid voucher the amount previously overpaid.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.14 Allowance for certified home health agencies providing a disproportionate share of bad debt and charity care
(a) Basic rates of payment by governmental agencies for voluntary nonprofit, private proprietary and publicly sponsored nonhospital based certified home health agencies which can demonstrate losses as a result of providing a disproportionate share of bad debt and charity care, shall include a bad debt and charity care allowance.
(b) The provisions of this section shall apply to rates of payment during the period July 1, 1990 through December 31, 1990, and for each calendar year period commencing on January first thereafter. The provisions of this section shall be effective, if, and as long as, Federal financial participation is available for expenditures made for the allowance for beneficiaries eligible for medical assistance under title XIX of the Federal Social Security Act.
(c) Eligibility shall be limited to voluntary nonprofit, private proprietary and publicly sponsored nonhospital based certified home health agencies which meet the following criteria:
(1) the facility must ensure the availability of patient service 24 hours a day, 7 days a week as specified in section 763.3(d) of this Title;
(2) the facility must demonstrate compliance with minimum charity care service requirements specified in section 763.11(a)(11) of this Title;
(3) the facility must receive a cost based Medicaid reimbursement rate pursuant to section 86-1.46 of this Title;
(4) the facility must be able to demonstrate upon request, that it has made reasonable efforts to maintain financial support from community and public funding sources;
(5) the facility must be able to demonstrate upon request, that it has made reasonable efforts to collect payments for services from third-party insurance payors, governmental payors and self-paying patients; and
(6) the facility must have no petition for bankruptcy filed under either chapter 7 or 11 of Title 11 of the U.S. Code. The commissioner may waive this criteria if the facility demonstrates that it is financially viable or a potentially financially viable organization with a comprehensive plan to maintain fiscal integrity.
(d) An annual aggregate amount set forth in statute (see Public Health Law, section 3614[5]) shall be allocated and distributed between public and nonpublic facilities. Publicly sponsored facilities shall receive an annual allocation of no more than 35 percent of total available funds. The commissioner may adjust the apportionment of funds to be distributed between public and nonpublic facilities. The commissioner shall consider, but not be limited to, the following factors in establishing the annual apportionment of funds to publicly sponsored facilities:
(1) the ratio of public to nonpublic base year period bad debt and charity care provided by eligible facilities as defined in paragraph (e)(2) of this section; and
(2) the differences between public and nonpublic facilities in the total allowable costs for delivering services.
(e) Allowances shall be established on a prospective basis and shall be computed on the basis of allowable fiscal and statistical data submitted by each facility for the base reporting period for the rate year for which allowances are being set. The bad debt and charity care allowance shall be paid as an addition to eligible nursing rates of payment. The amount to be paid will be calculated by dividing each eligible facility's bad debt and charity care loss by base year Medicaid nursing visits.
(1) Eligible losses will be calculated by applying a facility's Medicaid rate of payment for the rate period for which the allowance is being determined, to identified base year eligible visits or units of service.
(2) An eligible visit shall be defined as the unit of service upon which title XIX payment is based provided, however, to an individual who after a reasonable period of time appears to be unable to pay all or a portion of the payment due for the service, except for those portions of the payment due which are covered by a government agency, insurer or third-party payor, including payment made directly to the certified home health agency and indemnity or similar payment.
(3) All payments received in the base year directly for eligible visits and government and entitlement revenues obtained for the purpose of subsidizing the certified home health agency's general operating expenses shall be offset against eligible costs to arrive at an eligible loss under this section. For publicly sponsored facilities, the department shall offset all base year article 6 local assistance revenues associated with home health care operations.
(4) An annual amountof loss coverage will be calculated by applying eligible losses against the following nominal loss coverage formula:
| Percent of bad debt & charity care losses to total operating costs | Nominal percent of loss coverage | | --- | --- | | up to 3% | 50% | | 3% to6% | 75% | | 6% plus | 100% |
The nominal loss coverage percentages may be increased to not more than 100 percent for nonpublic or publicly sponsored nonhospital based certified home health agencies, if the sum of the nominal payments for all eligible nonpublic or publicly sponsored facilities is less than the amounts allocated for either group.
(5) Separate coverage ratios shall be established for nonpublic and publicly sponsored nonhospital based certified home health agencies in order to make the allocation described in subdivision (d) of this section. These coverage ratios will consist of the aggregate nominal losses for nonpublic and publicly sponsored nonhospital based certified home health agencies divided into nonpublic and publicly sponsored disproportionate share allocations, as appropriate. These coverage ratios shall be applied to each nonpublic or publicly sponsored nonhospital based certified home health agency's annual amount of bad debt and charity care loss coverage to determine the level of bad debt and charity case losses to be incorporated into each facility's Medicaid rate of payment.
(6) The department may make periodic prospective adjustments to an eligible facility's Medicaid payment to ensure that each facility receives the full amount of the allowance for which it is eligible. In no instance shall a facility receive an allowance which exceeds the maximum amount for which it is eligible under this section. In no event shall a facility receive an allowance in an amount exceeding the facility's need for financing losses associated with the delivery of bad debt and charity care.
(f)
(1) Eligible facilities shall submit to the department a supplement to the cost report used for title XIX (Medicaid) reimbursement. This supplement shall be provided by the department and must be returned to the department within 45 days from the date it is received by facilities for the 1990 and 1991 rate years. Thereafter it shall be submitted to the department with the cost report used for purposes of title XIX reimbursement. The supplement shall include, but not be limited to data related to the number of eligible visits or units of service, the costs of eligible services, patient and third party revenues associated with the eligible services, government and entitlement revenues and article 6 local assistance funding associated with charity care.
(2) Eligible facilities shall maintain statistical and financial reporting systems which permit the collection and reporting of actual visits and revenues associated with the provision of bad debt and charity care services to their patient population. All reported data will be subject to audit. The allowance may be revised based upon audit findings.
(3) Facilities shall provide assurances that they will make and shall document upon request, the reasonable efforts made to maintain financial support from community and public funding sources and to collect payments from third-party payors, governmental payors and self-pay patients.
(4) The commissioner may reduce a current allowance if it is determined that actions or decisions by a facility's management have caused a significant reduction for the rate period in the delivery of home care services to bad debt and charity care patients.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 109 COLUMBIA COUNTY
CITIES CITIES
10 CRR-NY 109.1 City of Hudson
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Taghkanic Creek, the Churchtown Reservoir, the Lone Star Quarry Reservoir and their tributaries in the Towns of Taghkanic, Greenport, Claverack, Hillsdale and Copake which now serve or which may be developed in the future to serve as sources of the public water supply of the City of Hudson, Columbia County, New York.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high watermark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high watermark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and non-putrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the City of Hudson public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the City of Hudson public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the City of Hudson public water supply.
(16) Water supply shall mean the public water supply of the City of Hudson, Columbia County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except:
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility, and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing, swimming and wading are prohibited in any reservoir or watercourse owned by the City of Hudson.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the City of Hudson.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Hudson except by duly authorized employees of the City of Hudson in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the City of Hudson within 1000 feet of the water supply intakes except by duly authorized employees of the City of Hudson in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemical.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The commissioner of public works or any person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid commissioner of public works to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with this Part, it shall be the further duty of the aforesaid commissioner of public works to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of public works shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of notices served, the number of violations abated and the general conditions of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with the provisions of section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
10 CRR-NY 442.1 Purpose
The purpose of this Part is to establish a foundation for uniform reporting by hospitals. In making their reports, hospitals will be bound by the basic principles and concepts set forth in this Article. Any reporting principles and concepts not specifically discussed herein should be reported according to generally accepted accounting principles as interpreted in the opinions of the American Institute of Certified Public Accountants (AICPA) and in the statements by the Financial Accounting Standards Board.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.185 Access
The permit-issuing official or his designated representative is to be permitted access, for purposes of inspection, at all times while the food vending commissary or food vending operation in his area of jurisdiction is in operation, whether open to the public for service of food or not. Refusal of admittance, after proper identification, is cause for action to obtain permit revocation and an order to close.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.11 Accrual reporting
[ 1310 ]
(a) In order to provide the necessary completeness, accuracy and meaningfulness in reporting data, accrual basis of accounting is required. Accrual accounting is the recognizing and recording of the effects of transactions and other events on the assets and liabilities of the hospital entity in the time periods to which they relate rather than only when cash is received or paid. For example, the writing off to expense each year of one third of the cost of a three-year insurance policy. We recognize that the immediate implementation of this policy may create a hardship for those hospitals currently on a cash basis. Because of this, a waiver of this rule will apply to cash-basis hospitals for the first two reporting periods. At the end of this grace period, all reports must be on the accrual basis. Earlier compliance is encouraged.
(b) Requests for waivers of the accrual reporting requirement will be considered where a State law requires government hospitals to use other than full accrual accounting. The fiscal intermediary, after obtaining approval from the Health Care Financing Agency (HCFA), may grant such a waiver subject to review and revocation.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.17 Vector and vermin control
The premises must be free of insect and rodent infestations that may cause a nuisance or hazard.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.20 Definitions
For the purposes of these rules and regulations, the following definitions shall apply:
(a) Arthropod shall mean a member of the phylum Arthropoda, animals with jointed appendages.
(b) Presumptive human case shall mean the occurrence of one or more of the following:
(1) California Encephalitis: Central nervous system (CNS) symptoms plus serum titers consistent with the illness for example, HI ≥ 1:40, CF ≥ 1:8 or Neut ≥ 3 logs.
(2) Eastern Equine Encephalitis (EEE): CNS symptoms and single serum titers consistent with the illness, for example, HI ≥ 1:80, CF ≥ 1:16.
(3) Rocky Mountain Spotted Fever: headache, fever, rash, history of tick exposure and positive serologies.
(4) St. Louis Encephalitis: CNS symptoms plus single serum titers consistent with the illness, for example, HI ≥ 1:80, CF ≥ 1:16.
(c) Confirmed human case shall mean the occurrence of one or more of the following:
(1) California Encephalitis: virus isolation and/or CNS symptoms plus four-fold or greater rise or fall in antibody titers.
(2) Eastern Equine Encephalitis: virus isolation and/or four-fold or greater rise or fall in antibody titers or 1.3 log rise or fall in neutralization index.
(3) Rocky Mountain Spotted Fever: Rickettsial isolation and/or four-fold or greater rise in antibody titers.
(4) St. Louis Encephalitis: virus isolation and/or CNS symptoms plus four-fold or greater rise or fall in antibody titers.
(d) Clustering shall mean multiple human cases of disease which may be considered related to each other by proximity, source or simultaneity of occurrence.
(e) Control shall mean any measure taken to reduce or eliminate a vector arthropod species or related disease threat. Control measures may include water management, use of biological agents, chemical ground application, chemical air application, or any other method used to reduce or eliminate vector arthropods.
(f) Endemic shall mean the continued presence of a disease in an area, or the cyclic reintroduction of a disease into the same area.
(g) Epidemic shall mean the occurrence of recognizable disease or illness in the human or animal host outside the endemic area or an excess incidence of the disease beyond that usual in an endemic area.
(h) Etiologic agent shall mean the pathogen responsible for causing a disease or illness.
(i) Host shall mean a man or other living animal, including birds and arthropods, which affords subsistence or lodgement to an infectious agent under natural conditions.
(j) Reservoir shall mean a human, animal or arthropod in which an infectious agent normally lives and multiplies and on which it depends primarily for survival and serves as a source of infection for a susceptible host.
(k) Response protocols shall mean the procedure followed by the NYSDH in response to a documented public health threat or emergency.
(l) Surveillance shall mean the epidemiologic study of a disease as a dynamic process involving the ecology of the infectious agent, the host, the reservoirs and the vectors as well as the complex mechanisms concerned in the spread of infections and the extent to which this spread occurs.
(m) Vector shall mean an arthropod species capable of carrying and transmitting a disease agent.
(n) Vector surveillance program shall mean the activities of any agency designed to accomplish any or all of the following:
(1) location of vector breeding areas;
(2) collection and identification of vector species
(3) determination of vector population densities;
(4) determination of vector species distribution;
(5) determination of physiologic or chronologic age composition of vector population;
(6) submission of site specific groups of vector species for etiologic agent isolation attempts;
(7) assessment of the vector population to determine the effectiveness of control measures; and
(8) compilation of data generated by any or all of the above.
(o) Commissioner shall mean the Commissioner of the New York State Department of Health.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.90 Construction
Equipment and utensils are to be constructed of safe materials which will not contaminate or otherwise affect food. Such materials are to be resistant to denting, buckling, pitting, chipping, distortion, cracking and crazing, smooth, easily cleanable and free from breaks, open seams, cracks, chips, pits and similar imperfections. Equipment and utensils are to be free from difficult-to-clean internal corners and crevices. Food-contact surfaces are to be readily accessible for cleaning.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.4 Reporting requirements
(a) Providers shall report costs and maintain financial and statistical records in accordance with 14 NYCRR Subpart 635-4.
(b) Generally accepted accounting principles (GAAP).
The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the provider unless the reporting instructions authorized specific variation in such principles. The State shall identify provider cost and providers shall submit cost data in accordance with generally accepted accounting principles (GAAP).
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.6 General project requirements
(a) Each recipient shall ensure that any project for which it receives assistance from the fund:
(1) achieves or maintains compliance with the requirements of Part 5 of this Title;
(2) employs sound and appropriate management practices; and
(3) otherwise complies with all applicable requirements of the act, the State Act, this Part, the project financing and loan agreement and all instructions issued by the department and the corporation.
(b) The department and the corporation may conduct such reviews, inspections and investigations as each may determine necessary to ensure project compliance pursuant to subdivision (a) of this section.
(c) The department or the corporation may permit a recipient to certify in writing that specified project requirements have been fulfilled where the recipient can show that such certifications are permitted by State laws and regulations. Acceptance by the department or the corporation of such a certification shall not constitute a conclusive statement by either that such certification is accurate nor shall any such acceptance preclude the department or the corporation from conducting inspection and verification of the recipient's compliance with project requirements.
(d) All contracts between the recipient and parties carrying out construction and other fund assisted activities shall provide that representatives of the department, the Office of the State Comptroller, and the corporation shall have access to the project worksite at any stage of preparation or progress and shall permit extracts and copies of project records to be made by them.
(e) All change orders shall be submitted to the department within 30 days following the date they are ordered. Any proposed change which deviates from the approved project plans and specifications for any treatment process shall require prior approval by the department. The department will notify the corporation of any approved change orders at the same time it notifies the recipient.
(f) Each recipient shall arrange for inspection of project construction under the direction of a professional engineer licensed in New York State who shall be responsible for determining whether such work has been performed in accordance with the approved project plans and specifications. Following project completion, the professional engineer shall certify to the recipient, the department, and the corporation that the construction is in accordance with the approved project plans and specifications and any approved amendments thereto.
(g) The recipient shall have or acquire such title, estate or interest in the site of the project, including, without limitation, necessary easements and rights-of-way, to ensure undisturbed use and possession during construction of the project and for the estimated operational life thereof.
(h) A recipient shall take any appropriate corrective action necessary to bring its project into compliance with the project performance standards contained in the approved engineering report for the project. A recipient may receive fund assistance, to the extent such assistance is available, for corrective action where such action is not required due to fraud, mismanagement or failure to comply with the requirements set forth in the project financing and loan agreement.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
GARBAGE AND REFUSE GARBAGE AND REFUSE
10 CRR-NY 14-5.150 Garbage and refuse storage and disposal
(a) Garbage and refuse is to be stored, handled and disposed of in a manner that protects food and food-contact surfaces from contamination and the premises from litter.
(b) Self-closing, leak-proof, easily cleanable, insect-proof and rodent-proof waste receptacles are to be provided and maintained at each food vending operation, of adequate capacity to receive used cups, cartons, wrappers, straws, closures and other items. Plastic bags and wet-strength paper bags may be used to line the receptacles. Soiled waste receptacles are to be kept clean to prevent insect and rodent attraction, or creation of a nuisance.
(c) Except for machines dispensing only packaged food with crown closures, waste receptacles are not to be located within the vending machine.
(d) Waste receptacles are not to be located in a manner that will create a nuisance or prevent space around and under the counter or enclosure from being easily cleaned and maintained. Suitable racks or cases are to be provided for multi-use containers or bottles.
(e) Containers are to be provided within all machines dispensing liquid food in bulk for the collection of drip, spillage, overflow or other internal wastes. Such machines are to be equipped with an automatic shut-off device at the waste pail, or other devices or valves which will place the machine out of operation before the waste pail overflows, except that controlled-location vending machines not connected to a water supply system, and which generate no internal liquid wastes, may be equipped with easily removable drip pans at the dispensing platform in lieu of internal waste containers and automatic shut-off devices.
(f) Containers or surfaces on which such wastes may accumulate are to be readily removable for cleaning, easily cleanable, and corrosion-resistant. If liquid wastes from drip, spillage or overflow, which originate within the machine, are discharged into a sewage system, the connection to the sewer is to be an indirect drain.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.5 Adult day health care services
(a) The operator must provide or arrange for services appropriate to each registrant in accordance with the comprehensive assessment conducted and care plan developed by the adult day health care program, or by the managed long term care plan or care coordination model that referred the registrant to the adult day health care program. At least the following program components must be available:
(1) case management;
(2) health education;
(3) interdisciplinary care planning;
(4) nursing services;
(5) nutrition;
(6) social services;
(7) assistance and supervision with the activities of daily living, such as toileting, feeding, ambulation, bathing including routine skin care, care of hair and nails; oral hygiene; and supervision and monitoring of personal safety, restorative rehabilitative and maintenance therapy services;
(8) planned therapeutic or recreational activities that reflect the interests, cultural backgrounds and the communities of the registrants and provide the registrants with choices;
(9) pharmaceutical services; and
(10) referrals for necessary dental services and sub-specialty care.
(b) The following services may also be provided:
(1) specialized services for registrants with HIV or AIDS; and
(2) religious services and pastoral counseling.
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.2 Applications for central services facility rural health network establishment
(a) An application to the Public Health Council for its approval, as required by law, shall be in writing on application forms provided by the State Department of Health, and subscribed by the chief executive officer or other officer duly authorized by the board of a corporate applicant. In the event that an application is to be submitted by an entity which necessarily remains to be legally incorporated, it shall be subscribed and submitted by one of the proposed directors. The original and eight copies of the applications shall be filed with the council.
(b) The following documents and information shall be filed:
(1) a photocopy of the proposed certificae of incorporation or certificate of amendment which shall, in all respects, conform to the applicable provisions of the Not-for-Profit Corporation Law and all other pertinent laws of the State of New York. The certificate may include and shall be limited to the following powers and purposes:
(i) perform studies, feasibility surveys and planning with respect to development and operation of such network;
(ii) implement a network operational plan upon obtaining public health council and the commissioner's approval to operate as a central services facility rural health network;
(iii) enter into agreements with non-network affiliated providers and other individuals, partnerships, associations, corporations and appropriate federal and state agencies as necessary to effectuate the purposes of the corporation;
(iv) solicit and accept grant awards and make disbursements to affiliated network providers to effectuate the purposes of the corporation;
(v) directly operate or share operational authority with a hospital or hospitals as defined in subdivision one of section 2801 of the Public Health Law upon receiving public health council approval pursuant to subdivisions two and three of section 2801-a of the Public Health Law; and
(vi) solicit contributions from the public to support the establishment or operation of hospitals.
(2) a certified copy of the applicant's certificate of doing business under an assumed name, if applicable;
(3) the applicant's proposed or amended bylaws;
(4) identification of each member of the corporation individual corporate or other;
(5) the certificate of incorporation and bylaws of each corporate member of the applicant; together with any proposed amendments thereto reflecting the member's affiliation with the applicant;
(6) the proposed network operational plan, if available;
(7) information concerning the character, experience, competency and standing in the community of the proposed incorporators, directors and officers of the corporation. An applicant to-be-formed shall identify the proposed incorporators, initial directors and those individuals to be proposed for election or appointment to the board of directors at the applicants organization meeting. An applicant's board shall at all times include an appopriate balance of representatives of the general public and consumers, and representatives of providers. Directors representative of consumers and the general public shall not be affiliated in any way with a provider of health care services; and
(8) such additional documentation and information as the council may require.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.8 Campgrounds and campsites
(a) Campsite space requirements.
A campsite shall meet the space requirements specified in either paragraph (1), (2), or (3) of this subdivision as applicable. An agricultural fairground owner may select one or more of these options when establishing campsite sizes within the agricultural fairground.
(1) The minimum area per site for campsites that existed prior to March 7, 2001 shall be either: 1,500 square feet; or, in compliance with paragraph (2) or (3) of this subdivision.
(2) New campsites constructed and existing campsites modified after March 7, 2001 shall be a minimum of 1,250 square feet. The campsites shall be large enough to allow at least a five-foot clearance between the boundaries of the campsite and the exterior surfaces of the camping unit placed on it as well as any add-on structures or appurtenances attached to it, so as to provide for a 10-foot separation distance between camping units on adjacent campsites.
(3) The minimum area per site may be less than the requirements specified in paragraphs (1) and (2) of this subdivision when:
(i) a separation distance of 10 feet or greater is maintained between camping units including any add-on structures or appurtenances attached to the camping unit; or
(ii) a separation distance of at least five feet is maintained between camping units including any add-on sturctures or appurtenances attached to the camping units; and
(a) Charcoal grills, gas grills or other open flame cooking devices cannot be used within 10 feet of any camping unit.
(b) Bonfires or recreational fires are prohibited on campsites. Such fires cannot be conducted within 25 feet of any camping unit.
(c) Adequate fire extinguishers or other extinguishing equipment shall be readily available to all camping areas. Fire extinguishers, where used, shall be installed and maintained in accordance with the recommendations of the equipment manufacturer and generally accepted standards.
(d) Fire apparatus access roads shall be provided within 300 feet of each camping unit and shall have an unobstructed width of no less than 20 feet and an unobstructed vertical clearance of not less than 13 feet 6 inches.
(b) Electrical.
(1) Installation of electrical service, wiring, and fixtures shall conform to the Uniform Code. A certificate of approval provided by a qualified electrical inspector shall be submitted for all new electrical work.
(2) The electrical service, wiring and fixtures shall be in good repair and safe condition. Where conditions indicate a need for inspection, the electrical service and wiring shall be inspected by a qualified electrical inspector, and a copy of the inspection report and certificate of approval shall be submitted to the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.39 Closures, mergers, acquisitions, consolidations and restructurings
(a) The commissioner may grant approval of a temporary adjustment to the non-capital components of rates calculated pursuant to this Subpart for eligible residential health care facilities.
(b) Eligible facilities shall include:
(1) facilities undergoing closure;
(2) facilities impacted by the closure of other health care facilities;
(3) facilities subject to mergers, acquisitions, consolidations or restructuring; or
(4) facilities impacted by the merger, acquisition, consolidation or restructuring of other health care facilities.
(c) Facilities seeking rate adjustments under this section shall demonstrate through submission of a written proposal to the commissioner that the additional resources provided by a temporary rate adjustment will achieve one or more of the following:
(1) protect or enhance access to care;
(2) protect or enhance quality of care;
(3) improve the cost effectiveness of the delivery of health care services; or
(4) otherwise protect or enhance the health care delivery system, as determined by the commissioner.
(d)
(1) Such written proposal shall be submitted to the commissioner at least 60 days prior to the requested effective date of the temporary rate adjustment and shall include a proposed budget to achieve the goals of the proposal. Any temporary rate adjustment issued pursuant to this section shall be in effect for a specified period of time as determined by the commissioner, of up to three years. At the end of the specified timeframe, the facility shall be reimbursed in accordance with the otherwise applicable rate-setting methodology as set forth in applicable statutes and this Subpart. The commissioner may establish, as a condition of receiving such a temporary rate adjustment, benchmarks and goals to be achieved in conformity with the facility's written proposal as approved by the commissioner and may also require that the facility submit such periodic reports concerning the achievement of such benchmarks and goals as the commissioner deems necessary. Failure to achieve satisfactory progress, as determined by the commissioner, in accomplishing such benchmarks and goals shall be a basis for ending the facility's temporary rate adjustment prior to the end of the specified timeframe.
(2) The commissioner may require that applications submitted pursuant to this section be submitted in response to and in accordance with a request for applications or a request for proposals issued by the commissioner.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.174 Lighting
(a) Permanent artificial light sources are to be installed and maintained to provide at least 30 footcandles of light on all food preparation surfaces and at equipment or utensil washing work levels.
(b) Permanent artificial light sources are to be installed and maintained to provide at least 20 footcandles of light at a distance of 30 inches from the floor in:
(1) utensil and equipment storage areas, lavatory and toilet areas;
(2) walk-in refrigerating units, dry food storage areas and in other areas; and
(3) dining areas during cleaning operations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.256 Physician
A doctor of medicine or of osteopathy who is fully licensed to practice medicine.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.49 Records and reports of institutional dispensers limited
(a) All nursing homes, convalescent homes, health-related facilities, homes for the aged and other facilities licensed and authorized by the department as institutional dispensers limited and authorized to possess and distribute controlled substances prescribed for individual patients in their care shall keep a record of all such drugs received in custody and dispensed to patients.
(b) A separate daily running record shall be kept of all prescribed controlled substances received, indicating the date, name and quantity of prescribed controlled substances, name of the prescriber, name of the patient, name of the pharmacy and the pharmacy prescription number of the prescription containing the controlled substance, for patients under their care.
(c) A separate record shall be maintained of the administration of prescribed controlled substances indicating the date and hour of administration, name and quantity of controlled substances, name of the prescriber, patient's name, signature of person administering and the balance of the controlled substances on hand after such administration.
(d) In an emergency situation, a controlled substance from a sealed emergency medication kit may be administered to a patient by an order of an authorized practitioner. An oral order for such controlled substance shall be immediately reduced to writing and a notation made of the condition which required the administration of the drug. Such oral order shall be signed by the practitioner within 48 hours.
(1) For purposes of this subdivision, emergency means that the immediate administration of the drug is necessary and that no alternative treatment is available.
(2) A separate record shall be maintained of the administration of controlled substances from an emergency medication kit. Such record shall indicate the date and hour of administration, name and quantity of controlled substances, name of the practitioner ordering the administration of the controlled substance, patient's name, signature of the person administering and the balance of the controlled substances in the emergency medication kit after such administration.
(3) The institutional dispenser limited shall notify the pharmacy furnishing controlled substances for the emergency medication kit within 24 hours of each time the emergency kit is unsealed, opened, or shows evidence of tampering.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-3.3 Vacancies
The director shall have authority to maintain such a number of vacancies as in his judgment will make adequate provisions for immediate admission of possible emergency cases.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.136 Controlled substances for emergency medical services: purchasing, possessing, delivering, administering, and safeguarding of controlled substances
Purchasing, possessing, delivering, administering, and safeguarding of controlled substances.
(a) Definitions.
(1) Ambulance service means an individual, partnership, association, corporation, municipality or any other legal entity or subdivision, thereof, engaged in providing emergency medical care and the transportation of sick, or injured persons by motor vehicle, aircraft or other form of transportation to or from facilities providing hospital services.
(2) Medical director means a New York State licensed physician who is responsible for authorizing treatment protocols and quality assurance activities for participating advanced life support agencies within an advanced life support system. The medical director of any advanced life support system with 10 or more advanced life support agencies and/or 100 or more advanced emergency medical technicians (AEMTS) shall designate associate physicians to provide quality assurance according to a plan submitted to and approved by the Emergency Medical Services Program.
(3) Agent means a person or persons certified as an emergency medical technician-critical care or emergency medical technician-paramedic who is appointed by an advanced life support agency, approved in writing by the medical director, and registered with the Department's Bureau of Narcotic Enforcement, to purchase, possess, and deliver controlled substances for use by an advanced life support agency.
(4) Advanced life support first response service means an organization which provides advanced life support care but does not transport patients.
(5) Advanced life support agency (ALS agency) means a certified ambulance service or certified advanced life support first response service which is authorized by the medical director of an advanced life support system to provide advanced life support care.
(6) Contracting hospital means a hospital licensed as an Institutional Dispenser class 3 which has a written agreement with one or more ALS Agencies to provide stocks of controlled substances to such services.
(7) Advanced life support system means an acute medical care system organized to provide advanced life support care on site or en route to a hospital in accordance with section 3031 of the Public Health Law.
(b)
(1) A hospital licensed as an institutional dispenser class 3 may:
(i) enter into a written agreement with an ALS agency to provide, sell or deliver stocks of controlled substances, to such agency for use in an advanced life support system; or
(ii) enter into a written agreement with an ALS agency to act as agent for such agency and supply a substock of controlled substances for use in the ALS agency's response vehicles; and
(iii) provide only those controlled substances approved by the department and the medical director.
(2) Only those ambulance services or advanced life support services meeting the conditions of and approved under this Part may possess, deliver or administer controlled substances.
(c) An ALS agency and/or its agent shall:
(1) purchase, possess, deliver or cause to be administered only those controlled substances approved and listed by the department and approved by the medical director of the advanced life support system;
(2) possess a certificate issued pursuant to article 30 of the Public Health Law;
(3) possess a class 3(c) institutional dispenser limited license from the department, except that an ALS agency, owned and operated by a hospital, is exempt from obtaining a class 3(c) institutional dispenser limited license and shall:
(i) utilize the hospital's class 3 institutional dispenser license for the delivery of controlled substances for use in any authorized response vehicle;
(ii) maintain the ALS agency's controlled substances as part of the hospital's controlled substances substock;
(iii) have the hospital act as the agent for its ambulance service;
(iv) comply with all other sections of this Part;
(4) permit only a licensed physician or a person certified pursuant to article 30 of the Public Health Law as an advanced emergency medical technician-critical care or advanced emergency medical technician-paramedic, and authorized by the medical director of the advanced life support system to receive or administer a controlled substance.
(d)
(1) Any ALS agency may be denied approval to purchase, possess, or deliver controlled substances upon a finding by the department that the approval should be denied or revoked by reason of false statements in the application, failure to provide adequate safeguards against diversion of the controlled substances, or other good and sufficient reason such as an administrative determination that article 30 or 33 of the Public Health Law or a provision of Part 800 of this Title or of this Part was violated.
(e) Agents.
(1) An ALS agency shall register an agent to purchase, possess, and deliver controlled substances, by making application to the department.
(2) The department shall issue such registration unless the department finds that the application should be denied by reason of false statements in the application, failure to provide adequate safeguards against diversion of the controlled substances, other good and sufficient reason such as an administrative determination that article 30 or 33 of the Public Health Law was violated, or conviction of one or more criminal offenses, as defined in section 800.3(ak) of this Title, unless the applicant is found eligible after a balancing of the factors set out in article 23-A of the Correction Law. In accordance with that article, no application for registration shall be denied by reason of the applicant having been previously convicted of one or more criminal offenses unless:
(i) there is a direct relationship between one or more of the previous criminal offenses and duties required of the registration; or
(ii) registering the applicant would involve an unreasonable risk to property or the safety or welfare of a specific individual or the general public. In determining these questions, the department will look at all factors listed under New York State Correction Law section 753.
(3) Such registration shall be valid for a period of two years and may be suspended or revoked upon a finding by the department that the ALS agency, agent, or its members have violated article 30 or 33 of the Public Health Law or any provision within Part 800 of this Title or any provision within this Part.
(4) Each ALS agency or its agent shall immediately notify the department and the medical director of any change in the membership, employment, or contractual relationship with the designated agent or the dispensing hospital.
(5) Such registration shall be valid only for the ALS agency and at the specified location(s) appointing the agent.
(6) An agent of an ALS agency may deliver controlled substances, only for administration by their ALS agency, to a licensed physician and individuals certified and authorized to administer controlled substances.
(f) Agents shall ensure that:
(1) Controlled substances shall be safeguarded properly and kept securely at the registered address on file with the department;
(2) All stocks and/or substocks will be made available for inspection by authorized representatives of the department;
(3) Access to controlled substances stocks shall be limited to the minimum number of individuals actually required to manage the administration, delivering and handling of such controlled substances efficiently;
(4) A plan is submitted to the department for review, modification and/or approval that details the location(s) of all stocks or substocks, the safeguarding of, access to, and security standards for all controlled substances;
(5) A quality assurance plan for the administration of controlled substances is submitted to the department; and
(6) Only a reasonable quantity of controlled substances as approved by the medical director is stored as substocks.
(g) Minimum security standards for ALS agencies, their agents and all certified and authorized individuals:
(1) Any stock or substock of controlled substances shall be maintained in a secure manner and in compliance with this Part.
(2) Any stock or substock of controlled substances shall be stored in a locked cabinet of substantial construction at the location registered with the department. The cabinet shall be stationary, be made of steel or other metal and be of sufficient size to store all controlled substances. This cabinet shall be limited to the storage of controlled substances, needles and syringes and associated records.
(3) Access to any stock or substock of controlled substances will be limited to the agent and require at least two locks with different keys.
(4) Any substock of controlled substances in an authorized response vehicle shall be stored as follows:
(i) When access to the patient compartment of an ambulance is kept locked at all times, controlled substances shall be secured in a locked cabinet using a key lock different than the patient compartment.
(ii) When the access to the patient compartment of an ambulance is not kept locked at all times or any other response vehicle is used, controlled substances must be secured in a locked box within a locked stationary cabinet under a two lock system using different keys.
(iii) The key(s) to access the cabinet where controlled substances are stored must be maintained under the direct control of a certified and authorized individual.
(iv) Controlled substances may be maintained in the direct possession and control of a certified and authorized individual at all times while such individual is on duty for the ALS agency, however, at no time shall controlled substances be carried in any personal automobile.
(v) A written change of shift inventory for any substock shall be conducted when custody of controlled substances passes between certified and authorized individuals during a shift change.
(vi) Alternative forms of securing or maintaining controlled substances in authorized response vehicles are subject to the approval of the department upon written application by the chief executive/operating officer of the ALS agency. The application must describe the alternative methods, state reasons why the alternate method is necessary and fully describe procedures for safeguarding and controlling controlled substances and limiting access to certified and authorized individuals.
(vii) Only individuals certified and authorized under this Part shall have access to controlled substances. If an agency operates at various times with different levels of personnel, all of whom are not certified and authorized, provisions shall be made to prohibit access to all controlled substances by persons who are not certified or authorized.
(h)
(1) Controlled substances may only be administered pursuant to a physician's order or a protocol authorized by the medical director and approved by the department pursuant to article 30 of the Public Health Law and section 800.15 of this Title. A copy of the approved protocol shall be on file with the department. Any change in such protocol shall be approved by the department prior to being implemented.
(2) A certified and authorized individual making any administration of a controlled substance pursuant to a physician order or protocol order shall notify a medical control location to make a record of the administration as described in paragraph (3) of this subdivision. Such notification shall be made during or immediately following the run.
(3) At any medical control location, the physician ordering or confirming the administration of a controlled substance shall make and maintain a record of such administration to include but not be limited to:
(i) physician name and signature;
(ii) date, time, and run identification;
(iii) patient name;
(iv) ALS agency name;
(v) AEMT number and name;
(vi) patient's chief complaint and presenting problem;
(vii) name of controlled substance;
(viii) dosage and route of administration;
(ix) quantity administered; and
(x) receiving hospital name and record number.
(4) Each certified and authorized individual receiving an order or using a protocol to administer a controlled substance shall make a record of the administration to include but not be limited to:
(i) ordering physician identification;
(ii) date, time, and run identification;
(iii) patient name;
(iv) ALS agency name;
(v) AEMT number and name;
(vi) patient's chief complaint and presenting problem;
(vii) name of controlled substance;
(viii) dosage and route of administration;
(ix) quantity administered; and
(x) receiving hospital name and record number.
The required record shall be the department's pre-hospital care report and any necessary supplement. A copy of the pre-hospital record shall become part of the patient's hospital record. Patient confidentiality shall be maintained at all times.
(5) A certified and authorized individual shall maintain an administration inventory record for all controlled substances. This record shall be returned to the agent before any controlled substances can be replenished.
(i) Recordkeeping requirements.
(1) Agents shall keep records of all controlled substances obtained, purchased, delivered and administered.
(2) All purchase records, including date, quantity obtained and source shall be maintained in a separate file by date received.
(3) An inventory record shall be maintained and shall include the following:
(i) the name of the controlled substance;
(ii) the name of the manufacturer and lot number;
(iii) the strength of the controlled substance;
(iv) the total amount of controlled substance stock received;
(v) the name, address, and DEA registration number of the authorized person or hospital supplying the controlled substance stock;
(vi) the date the controlled substance stock was received;
(vii) the signature of the person receiving the controlled substance stock;
(viii) the date and the amount of the controlled substance delivered to a substock;
(ix) the signature of the agent who delivered the controlled substance substock;
(x) the signature of the certified and authorized individual receiving the controlled substance substock;
(xi) the vehicle identification number or location of substock; and
(xii) the remaining amount of controlled substance on hand.
(4) A separate record shall be maintained of all nonadministered losses from any stock or substock with a brief statement describing the incident and signed by the certified and authorized individual and the agent.
(5) Partial doses remaining after the parental administration of a portion of an ampule or unit dose of a controlled substance may be destroyed and properly disposed of provided that:
(i) a notation is made on the administration record; and
(ii) the destruction is witnessed by a second certified emergency medical technician member of the ALS agency, the agent, or other licensed health care provider.
(6) An administration record shall be kept for each substock. This record will indicate the substock location and/or the vehicle identification number, the name of each controlled substance, dose and quantities furnished to the substock and:
(i) date and hour of administration;
(ii) name of patient;
(iii) run and medical control information;
(iv) dose administered;
(v) balance on hand after each administration; and
(vi) the name and signature of the administering individual.
(j) All records pertaining to controlled substances shall be kept at the location registered with the department by the ALS agency for a period of five years and shall be readily available and produced promptly for inspection by authorized representatives of the department.
(1) Within 30 days of June 30th and December 31st of each year, the ALS agency shall submit a report for that six-month period to the department signed by the agent which report shall include the following:
(i) the name, address, and telephone number of the ALS agency;
(ii) the Bureau of Narcotic Enforcement license number;
(iii) the agent's name;
(iv) the total amount of controlled substances received from the dispensing hospital;
(v) the total amount of controlled substances dispensed to personnel;
(vi) the total amount of controlled substances returned from personnel;
(vii) the total amount of controlled substances lost for any reason;
(viii) the total amount of controlled substances on hand at the end of the period; and
(ix) an actual physical inventory count of all controlled substances on hand.
(k) Responsibilities.
(1) All agents and members of an ALS agency are under a continuing duty to report immediately to the department and the medical director any loss, theft, or diversion of controlled substances.
(2) Agents and certified and authorized members of the ALS agency are responsible for the proper safeguarding and handling of controlled substances, needles and syringes.
(3) The medical director of the advanced life support system authorizing the use and administration of controlled substances shall be accountable for the proper use and administration of the controlled substances and for maintaining a quality assurance plan and protocols approved by the department.
(4) The chief executive/operating officer of the ALS agency is responsible for the proper safeguarding, handling and accountability of controlled substances and for assuring that all reports and reporting procedures are carried out in accordance with this Part. The chief executive/operating officer shall not be relieved from any responsibility under this Part as a result of any delegation of responsibility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 105 CHAUTAUQUA COUNTY
10 CRR-NY 105.2 Village of Cassadaga
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on land formerly owned by the Borden Milk Company and situated in the southwestern part of the village, which forms the source of the public water supply of the village of Cassadaga, Chautauqua County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional wells which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well.
(c) Privies adjacent to the wells.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the village of Cassadaga.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Cassadaga.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the village of Cassadaga.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matters from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other sources shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the village of Cassadaga.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 75 feet of any well of the public water supply of the village of Cassadaga.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the village of Cassadaga, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any well of the public water supply of the village of Cassadaga.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any well of the public water supply of the village of Cassadaga.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the village of Cassadaga.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Cassadaga upon which the wells of the public water supply of the village of Cassadaga are located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Cassadaga.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the village of Cassadaga.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the village of Cassadaga.
(j) Inspections.
The board of trustees of the village of Cassadaga or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Cassadaga or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.10 Quality assurance and safety
The requirements of section 52-3.5 of this Part shall be met.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.12 Radiation symbol, signs, labels, and control devices
(a) Standard radiation symbol.
Unless otherwise authorized by the department, the symbol prescribed by this section shall use the colors magenta, or purple, or black on yellow background. The symbol prescribed by the three-bladed design and shall be as illustrated below:
(1) cross-hatched area is to be magenta, or purple, or black, and
(2) the background is to be yellow.
)
(3) Exception to color requirements for standard radiation symbol. Notwithstanding the requirements of subdivision (a) of this section, licensees or registrants are authorized to label sources, source holders, or device components containing sources of radiation that are subjected to high temperatures, with conspicuously etched or stamped radiation caution symbols and without a color requirement.
(4) Additional information on signs and labels. In addition to the contents of signs and labels prescribed in this Part, the licensee or registrant shall provide, on or near the required signs and labels, additional information, as appropriate, to make individuals aware of potential radiation exposures and to minimize the exposures.
(b)
(1) Posting requirements.
(i) Posting of radiation areas. The licensee or registrant shall post each radiation area with a conspicuous sign or signs bearing the radiation symbol and the words “CAUTION, RADIATION AREA”.
(ii) Posting of high radiation areas. The licensee or registrant shall post each high radiation area with a conspicuous sign or signs bearing the radiation symbol and the words “CAUTION, HIGH RADIATION AREA” or “DANGER, HIGH RADIATION AREA”.
(iii) Posting of very high radiation areas. The licensee or registrant shall post each very high radiation area with a conspicuous sign or signs bearing the radiation symbol and words “GRAVE DANGER, VERY HIGH RADIATION AREA”.
(iv) Posting of airborne radioactivity areas. The licensee or registrant shall post each airborne radioactivity area with a conspicuous sign or signs bearing the radiation symbol and the words “CAUTION, AIRBORNE RADIOACTIVITY AREA” or “DANGER, AIRBORNE RADIOACTIVITY AREA”.
(v) Posting of areas or rooms in which licensed material is used or stored. The licensee shall post each area or room in which there is used or stored an amount of licensed material exceeding 10 times the quantity of such material specified in Appendix 16-A, Table 9 infra with a conspicuous sign or signs bearing the radiation symbol and the words “CAUTION, RADIOACTIVE MATERIAL(S)” or “DANGER, RADIOACTIVE MATERIAL(S)”.
(2) Exceptions to posting requirements.
(i) A licensee or registrant is not required to post caution signs in areas or rooms containing sources of radiation for periods of less than eight hours, if each of the following conditions is met:
(a) the sources of radiation are constantly attended during these periods by an individual who takes the precautions necessary to prevent the exposure of individuals to sources of radiation in excess of the limits established in this Part; and
(b) the area or room is subject to the licensee's or registrant's control.
(ii) Rooms or other areas in hospitals that are occupied by patients are not required to be posted with caution signs pursuant to paragraph (1) of this subdivision provided that the patients are not required to be confined for radiation protection purposes pursuant to this Part.
(iii) A room or area is not required to be posted with a caution sign because of the presence of a sealed source provided the radiation level at 30 centimeters from the surface of the sealed source container of housing does not exceed O.05 mSv (0.005 rem) per hour.
(iv) A room or area is not required to be posted with a caution sign because of the presence of a diagnostic X-ray system used solely for healing arts purposes.
(c) Labeling containers and radiation machines.
(1) The licensee or registrant shall ensure that each container of licensed material bears a durable, clearly visible label bearing the radiation symbol and the words “CAUTION, RADIOACTIVE MATERIAL” or “DANGER, RADIOACTIVE MATERIAL”. The label shall also provide information, such as the radionuclides present, an estimate of the quantity of radioactivity, the date for which the activity is estimated, radiation levels, kinds of materials, and mass enrichment, to permit individuals handling or using containers, or working in the vicinity of the containers, to take precautions to avoid or minimize exposures.
(2) Each licensee shall, prior to removal or disposal of empty uncontaminated containers to unrestricted areas, remove or deface the radioactive material label or otherwise clearly indicate that the container no longer contains radioactive materials.
(3) Each registrant shall ensure that each radiation machine is labeled in a conspicuous manner which cautions individuals that radiation is produced when it is energized.
(4) Exemptions to labeling requirements. A licensee or registrant is not required to label:
(i) containers holding licensed material in quantities less than the quantities listed in Appendix 16-A, Table 9, infra; or
(ii) containers holding licensed material in concentrations less than those specified in Appendix 16-C, Table 3, infra;
(iii) for laboratory containers, such as beakers, flasks, and test tubes, used transiently in laboratory procedures ( i.e. for a period of a few hours) in the presence of an authorized user; or
(iv) containers when they are in transport and packaged and labeled in accordance with the regulations of the U.S. Department of Transportation5; or
(v) containers that are accessible only to individuals authorized to handle or use them, or to work in the vicinity of the containers, if the contents are identified to these individuals by a readily available written record. Examples of containers of this type are containers in locations such as water-filled canals, storage vaults, or hot cells. The record shall be retained as long as the containers are in use for the purpose indicated on the record; or
(vi) installed manufacturing or process equipment, such as chemical process equipment, piping, and tanks.
(d) Control of access to high radiation areas.
(1) The licensee or registrant shall ensure that each entrance or access point to a high radiation area has one or more of the following features:
(i) a control device that, upon entry into the area, causes the level of radiation to be reduced below that level at which an individual might receive a deep dose equivalent of one mSv (0.1 rem) in one hour at 30 centimeters from the source of radiation from any surface that the radiation penetrates; or
(ii) a control device that energizes a conspicuous visible or audible alarm signal so that the individual entering the high radiation area and the supervisor of the activity are made aware of the entry; or
(iii) entryways that are locked, except during periods when access to the areas is required, with positive control over each individual entry.
(2) In place of the controls required by subparagraph (i) of this paragraph for a high radiation area, the licensee or registrant may substitute continuous direct or electronic surveillance that is capable of preventing unauthorized entry.
(3) The licensee or registrant may use alternative methods for controlling access to high radiation areas found by the department to be effective at accomplishing such control.
(4) The licensee or registrant shall establish the controls required by paragraphs (1) and (3) of this subdivision in a way that does not prevent individuals from leaving a high radiation area.
(5) The licensee or registrant is not required to control each entrance or access point to a room or other area that is a high radiation area solely because of the presence of radioactive materials prepared for transport and packaged and labeled in accordance with section 16.17 of this Part, provided that:
(i) the packages do not remain in the area longer than three days; and
(ii) the dose rate at one meter from the external surface of any package does not exceed 0.1 mSv (0.01 rem) per hour.
(6) The licensee or registrant is not required to control entrance or access to rooms or other areas in hospitals solely because of the presence of patients containing radioactive material, provided that there are personnel in attendance who are taking the necessary precautions to prevent the exposure of individuals to radiation or radioactive material in excess of the established limits in this Part and to operate within the ALARA provisions of the licensee's or registrant's radiation protection program.
(7) The registrant is not required to control entrance or access to rooms or other areas containing sources of radiation capable of producing a high radiation area as described in this paragraph if the registrant has met all the specific requirements for access and control specified in other applicable sections of these regulations, such as those regulating X-ray equipment in the healing arts and particle accelerators.
(e) Control of access to very high radiation areas.
(1) In addition to the requirements in paragraph (2) of this subdivision, the licensee or registrant shall institute additional measures to ensure that an individual is not able to gain unauthorized or inadvertent access to areas in which radiation levels could be encountered at five Gy (500 rad) or more in one hour at one meter from a source of radiation or any surface through which the radiation penetrates. This requirement does not apply to rooms or areas in which diagnostic X-ray systems are the only source of radiation, or to non-self-shielded irradiators.
(2) The registrant is not required to control entrance or access to rooms or other areas containing sources of radiation capable of producing a very high radiation area as described in paragraph (1) of this subdivision if the registrant has met all the specific requirements for access and control specified in other applicable sections of these regulations, such as those regulating X-ray equipment in the healing arts or particle accelerators.
(f) Control of access to very high radiation areas—irradiators.
(1) This subdivision applies to licensees or registrants with sources of radiation in non-self-shielded irradiators. This subdivision does not apply to sources of radiation that are used in teletherapy, in industrial radiography, or in completely self-shielded irradiators in which the source of radiation is both stored and operated within the same shielding radiation barrier and, in the designed configuration of the irradiator, is always physically inaccessible to any individual and cannot create a radiation level of five Gy (500 rad) or more in one hour at one meter in an area that is accessible to any individual.
(2) Each area in which there may exist radiation levels in excess of five Gy (500 rad) in one hour at one meter from a source of radiation that is used to irradiate materials shall meet the following requirements:
(i) Each entrance or access point shall be equipped with entry control devices which:
(a) function automatically to prevent any individual from inadvertently entering a very high radiation area; and
(b) permit deliberate entry into the area only after a control device is actuated that causes the radiation level within the area, from the source of radiation, to be reduced below that at which it would be possible for an individual to receive a deep dose equivalent in excess of one mSv (0.1 rem) in one hour; and
(c) prevent operation of the source of radiation if it would produce radiation levels in the area that could result in a deep dose equivalent to an individual in excess of one mSv (0.1 rem) in one hour.
(ii) Additional control devices shall be provided so that, upon failure of the entry control devices to function as required by subparagraph (2)(i) of this subdivision:
(a) the radiation level within the area, from the source of radiation, is reduced below that at which it would be possible for an individual to receive a deep dose equivalent in excess of one mSv (0.1 rem) in one hour; and
(b) conspicuous visible and audible alarm signals are generated to make an individual attempting to enter the area aware of the hazard and at least one other authorized individual, who is physically present, familiar with the activity, and prepared to render or summon assistance, aware of the failure of the entry control devices.
(iii) The licensee or registrant shall provide control devices so that, upon failure or removal of physical radiation barriers other than the sealed source's shielded storage container:
(a) the radiation level from the source of radiation is reduced below that at which it would be possible for an individual to receive a deep dose equivalent in excess of one mSv (0.1 rem) in one hour; and
(b) conspicuous visible and audible alarm signals are generated to make potentially affected individuals aware of the hazard and the licensee or registrant or at least one other individual, who is familiar with the activity and prepared to render or summon assistance, aware of the failure or removal of the physical barrier.
(iv) When the shield for stored sealed sources is a liquid, the licensee or registrant shall provide means to monitor the integrity of the shield and to signal, automatically, loss of shielding to a level at which it would be possible for an individual to receive a deep dose equivalent in excess of one mSv (0.1 rem) in one hour.
(v) Physical radiation barriers that comprise permanent structural components, such as walls, that have no credible probability of failure or removal in ordinary circumstances need not meet the requirements of subparagraphs (iii) and (iv) of this paragraph.
(vi) Each area shall be equipped with devices that will automatically generate conspicuous visible and audible alarm signals to alert personnel in the area before the source of radiation can be put into operation and in time for any individual in the area to operate a clearly identified control device, which must be installed in the area and which can prevent the source of radiation from being put into operation.
(vii) Each area shall be controlled by use of such procedures and devices as are necessary to ensure that the area is cleared of personnel prior to each use of the source of radiation.
(viii) Prior to the first individual's entry into each very high radiation area after any use of the source of radiation, the area shall be checked by a radiation measurement. The area may not be used unless the radiation level from the source of radiation in the area is below that at which it would be possible for an individual to receive a deep dose equivalent in excess of one mSv (0.1 rem) in one hour.
(ix) The entry control devices required in subparagraph (i) of this paragraph shall have been tested for proper functioning. (See section 16.14[h] of this Part for recordkeeping requirements.)
(a) Testing shall be conducted prior to initial operation with the source of radiation on any day, unless operations were continued uninterrupted from the previous day; and
(b) Testing shall be conducted prior to resumption of operation of the source of radiation after any unintentional interruption; and
(c) The licensee or registrant shall submit and adhere to a schedule for periodic tests of the entry control and warning systems.
(x) The licensee or registrant shall not conduct operations, other than those necessary to place the source of radiation in safe condition or to effect repairs on controls, unless control devices are functioning properly.
(xi) Entry and exit portals that are used in transporting materials to and from the irradiation area, and that are not intended for use by individuals, shall be controlled by such procedures and devices as are necessary to physically protect and warn against inadvertent entry by any individual through these portals. Exit portals for irradiated materials shall be equipped to detect and signal the presence of any loose radioactive material that is carried toward such an exit and to automatically prevent loose radioactive material from being carried out of the area.
(3) Licensees, registrants, or applicants for licenses or registrations for sources of radiation within the purview of paragraph (2) of this subdivision which will be used in a variety of positions or in locations, such as open fields or forests, that make it impracticable to comply with certain requirements of paragraph (2) of this subdivision, such as those for the automatic control of radiation levels, may apply to the Department for approval of alternative safety measures. Alternative safety measures shall provide personnel protection at least equivalent to those specified in paragraph (2) of this subdivision. At least one of the alternative measures shall include an entry-preventing interlock control based on a measurement of the radiation that ensures the absence of high radiation levels before an individual can gain access to the area where such sources of radiation are used.
(4) The entry control devices required by paragraphs (2) and (3) of this subdivision shall be established in such a way that no individual will be prevented from leaving the area.
(g) Unnecessary use of signs and labels. Cautionary signs and labels shall not be used except as required by subdivisions (b) and (c) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.10 Transactions within a holding company system affecting controlled MCOs
(a) Transactions within a holding company system to which a controlled MCO is a party shall be subject to the following guidelines:
(1) the terms of the financial transaction shall be fair and equitable to the MCO at the time of the transaction;
(2) charges or fees for services performed shall be reasonable; and
(3) expenses incurred and payments received shall be allocated to the MCO on an equitable basis in conformity with customary accounting practices consistently applied.
(b) The books, accounts and records of each party to all such transactions shall be so maintained as to clearly and accurately disclose the nature and details of the transactions, including such accounting information as is necessary to support the reasonableness of the charges or fees to the respective parties.
(c) The commissioner's and, except in the case of a PHSP, HIV SNP or PCPCP, the superintendent's prior approval shall be required for the following transactions between a controlled MCO and any person in its holding company system: sales, purchases, exchanges, loans, extensions of credit or investments the aggregate of which involves 5 percent or more of the MCO's admitted assets at last year-end. Thirty days prior notice to the commissioner and, except in the case of a PHSP, HIV SNP or PCPCP, the superintendent, is required before entering into the following transactions between a controlled MCO and any person in its holding company system; a reinsurance agreement or an agreement for rendering services on a regular or systematic basis, other than medical or management services that require prior approval under this Subpart. Such transactions may become effective unless the commissioner or the superintendent has disapproved the transaction within such period.
(d) The commissioner, in reviewing transactions pursuant to subdivision (c) of this section, shall consider whether they comply with the standards set forth in subdivision (a) of this section, and whether they may adversely affect the interests of enrollees.
(e) Nothing herein shall prevent a corporation licensed under article 43 of the Insurance Law from exercising its rights and undertaking transactions authorized by such law, provided that no such transaction shall affect or involve the corporation's Public Health Law article 44 business or line of business or resources thereof, without compliance with the provisions of this section.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.8 Evaluation and screening of the child and assessment of the child and family
(a) Evaluations and screenings.
To determine eligibility for the Early Intervention Program, a timely screening and/or multidisciplinary evaluation may be conducted to determine if the child has a developmental delay or disability, unless eligibility is established in accordance with subdivision (c) of this section.
(1) The child's parent shall have the opportunity to be present and participate in the performance of a screening, evaluation and, where applicable, assessment, unless the parent's circumstances prevent the parent's presence. If the parent’s circumstances prevent the parent’s presence, the parent shall have the opportunity to designate, in writing, another family member to be present and participate in the performance of the screening, evaluation and, where applicable, assessment.
(2) If the child’s eligibility is established in accordance with subdivision (c) of this section, a multidisciplinary assessment of the child shall, with parental consent, be conducted and a voluntary family-directed assessment shall be offered to the parent in accordance with subdivisions (f) and (g) of this section.
(b) If the child is suspected of having a developmental delay, the evaluator shall, with parental consent, conduct a screening to determine if further evaluation under the Early Intervention Program is appropriate, or conduct a multidisciplinary evaluation to determine the child’s eligibility for the Early Intervention Program. If the results of the screening demonstrate that further evaluation under the Early Intervention Program is appropriate then the evaluator shall conduct a multidisciplinary evaluation. If the screening indicates that the child is not suspected of having a disability, the child may still receive a multidisciplinary evaluation to determine eligibility for the program upon parent request. If the child is determined eligible for the Early Intervention Program, a voluntary family-directed assessment shall be offered to the parent in accordance with subdivision (g) of this section.
(1) When determining whether to conduct a screening prior to a multidisciplinary evaluation, the evaluator may rely on a recommendation from the early intervention official, a physician, or other qualified personnel. The evaluator may also conduct a screening based upon a request from the parent.
(i) Prior to a screening being conducted, the evaluator shall provide notice to the parent of the intent to conduct a screening. The notice shall inform the parent that parental consent is required to conduct a screening and of the parent’s right to request a multidisciplinary evaluation at any time during the screening process.
(ii) The purpose of a screening, if conducted, is to determine whether the child is suspected of having a disability and requires a multidisciplinary evaluation.
(2) A screening shall not be conducted if the child’s eligibility for the Early Intervention Program is established in accordance with procedures set forth in subdivision (c) of this section.
(3) The screening shall be conducted using appropriate instruments on the list of instruments approved by the department and by personnel qualified to administer those instruments.
(4) Parental consent shall be obtained prior to conducting the screening procedures.
(5) If, at any time during the screening process, the parent requests and consents to a multidisciplinary evaluation, the screening shall conclude and a multidisciplinary evaluation of the child shall be conducted even if the child is not suspected of having a disability.
(6) The evaluator shall explain the results of the screening to the parent and shall fully document the results in writing.
(i) If, based upon the screening, a child is suspected of having a disability, the child shall, with parental consent, receive a multidisciplinary evaluation to be conducted in accordance with the procedures set forth in subdivision (e) of this section. The evaluator shall discuss implications of the screening for the child’s multidisciplinary evaluation, including composition of the multidisciplinary evaluation team.
(ii) If, based upon the screening, a child is not suspected of having a disability, a multidisciplinary evaluation shall not be provided, unless requested by the parent. The early intervention official shall provide the parent with written notice of the screening results upon receipt of such results from the evaluator, which shall include information on the parent’s right to request a multidisciplinary evaluation.
(c) If a child has a diagnosed medical condition with a high probability of resulting in a developmental delay, a review of the child’s medical and other records, with parental consent, may be used by the evaluator to establish eligibility for the Early Intervention Program. If a child’s eligibility is determined in accordance with this subdivision a multidisciplinary assessment of the child shall be conducted.
(1) If the child’s eligibility is established based on a review of the child’s medical or other records, without a multidisciplinary evaluation, the evaluator shall document in writing the basis for the child’s eligibility, conduct a multidisciplinary assessment of the child and offer a voluntary family-directed assessment in accordance with procedures set forth in subdivision (g) of this section.
(d) Qualified personnel shall use informed clinical opinion when conducting a screening, evaluation and/or assessment of the child.
(1) Informed clinical opinion may be used as one factor to establish the child’s eligibility for the Early Intervention Program even when other instruments do not establish eligibility; provided, however, that the evaluator shall provide written documentation that shall include observations of the child, a detailed summary of the parent interview, and a review of pertinent medical and other records and a description of all procedures used to evaluate the child and reasons why the child meets eligibility criteria set forth in section 69-4.23(a) of this Subpart, in the evaluation report.
(2) Informed clinical opinion shall not be used to negate the results of evaluation instruments that were used to establish eligibility.
(e) If a multidisciplinary evaluation is conducted pursuant to this section, the evaluators shall obtain informed parental consent to perform the evaluation prior to initiating the evaluation procedures.
(1) The multidisciplinary evaluation team shall include two or more qualified personnel from different disciplines who are trained to utilize appropriate methods and procedures and have sufficient expertise in child development; and at least one of whom shall be a specialist in the area of the child's suspected delay or disability, if known.
(2) The multidisciplinary evaluation of the child shall utilize age-appropriate procedures and instruments on the list of standardized instruments approved by the department, unless written justification is included in the evaluation report for why such instruments are not appropriate or available for the child.
(3) The multidisciplinary evaluation shall include the following:
(i) administering the evaluation instrument;
(ii) taking the child’s history, including interviewing the parent about the child’s development and developmental progress;
(iii) identifying the child’s level of functioning in cognitive development, physical development, communication development, social emotional development, and adaptive development;
(iv) gathering information from other sources, such as family members, other caregivers, medical providers, social workers, and educators, as applicable, to understand the full scope of the child’s unique strengths and needs; and
(v) a review of medical, educational, and other records.
(4) The evaluator shall avoid making recommendations regarding frequency and duration of specific services until such time as the family's total priorities, concerns, and resources have been assessed and the plan for services to be included in the IFSP is under discussion.
(f) If a multidisciplinary assessment is conducted pursuant to this section it shall be conducted by qualified personnel and shall include the following:
(1) a review of the results of the child’s medical or other records; including reports of any previous evaluations;
(2) personal observations of the child;
(3) the identification of the child’s needs in the areas of cognitive development, physical development, communication development, social emotional development, and adaptive development;
(i) the assessment of the child's physical development shall include a health assessment including a physical examination, routine vision and hearing screening, and, where appropriate, a neurological assessment, except when:
(a) a physical examination has occurred within a sufficient timeframe, as determined by the child's age and commonly accepted examination schedules, such as those recommended by the American Academy of Pediatrics, and/or New York State Child/Teen Health Plan, and documentation of such examination is available; and
(b) no indications are present which suggest the need for re-examination, such as rapid regression in development;
(4) an assessment of the transportation needs of the child, which shall include parental ability or inability to provide transportation, health and safety concerns, and any parental concerns related to transporting the child.
(g) The evaluator shall offer the parent the opportunity to participate in a voluntary family-directed assessment. The purpose of the assessment shall be to identify the family’s resources, priorities, and concerns and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of the family’s infant or toddler with a disability. The family-directed assessment shall be conducted by qualified personnel and shall:
(1) be voluntary on the part of each family member participating in the assessment;
(2) be based on information obtained through an assessment tool and an interview with those family members who elect to participate in the assessment; and
(3) include the family’s description of its resources, priorities, and concerns related to enhancing the child’s development.
(i) The screening, evaluation and assessment procedures, including clinical observation, shall be conducted in an environment appropriate to the unique needs of the child and conducive to ensuring accuracy of results, with consideration given to the preferences of the parent. Such settings may include structured ( e.g. , clinic or office), unstructured ( e.g. , play room), and natural settings ( e.g. , the child's home).
(h) Results of the child's screening, evaluation and/or, where applicable, assessment, shall be fully shared with the parent following the completion of the screening, evaluation and/or assessment, in a manner understandable to the parent.
(i) The evaluation team shall prepare an evaluation report and written summary, which shall include the results of the multidisciplinary evaluation or assessment of the child as applicable, and the voluntary family-directed assessment if completed. The evaluation team shall submit the summary and report as soon as practicable subsequent to the evaluation or, for children who are determined eligible, no later than 30 days after the evaluation to enable convening of the individual family service plan meeting within 45 days of the date that the early intervention official received the referral. Such summary and report shall be submitted to the following individuals: the parent; early intervention official; initial service coordinator; with parental consent, the child's primary health care provider; and, with parental consent, for those children in the care and custody or custody and guardianship of the local social services commissioner, such commissioner or their designee.
(1) The evaluation report and summary shall: identify the persons performing the evaluation or, where applicable, the assessment of the child and voluntary family-directed assessment; describe the assessment process and conditions; describe the child's response; describe the family's belief about whether the child's response was optimal; identify measures and/or scores that were used; and explain these measures and/or scores.
(2) If the child is found eligible for the Early Intervention Program, the evaluation report and summary shall include a statement of the child's eligibility, including diagnosed condition with a high probability of delay, if any, and/or developmental delay in accordance with section 69-4.23(a) of this Subpart. Such statement shall describe the child’s developmental status, including objective and qualitative criteria, in sufficient detail to demonstrate how the child meets the eligibility criteria for the program in accordance with criteria set forth in section 69-4.23 of this Subpart.
(3) The parent shall have the opportunity to:
(i) discuss the child’s evaluation report and summary and, where applicable, the voluntary family-directed assessment with the evaluator or evaluators, including any concerns they may have about the evaluation and assessment process;
(ii) receive assistance in understanding these results; and
(iii) address concerns that the evaluation and, where applicable, the assessment considers their concerns and observations about their child and that such documents accurately identify family resources, priorities, and concerns.
(4) To the extent feasible, and within the confidentiality requirements prescribed in section 69-4.17(c) of this Subpart, if the parent prefers and consents to disclosure to an interpreter, the written and oral summary shall be provided in the dominant or native language or other mode of communication of the parent.
(5) A parent who disagrees with the results of an evaluation or assessment may request to obtain an additional evaluation or supplemental evaluation to the extent authorized by Federal and State laws or regulation.
(j) If a child is determined ineligible for services, including determinations that additional evaluations or supplemental evaluations are not necessary or appropriate, the parent may request a mediation or a hearing. However, the parent may not make such a request until all evaluations are complete and a determination of ineligibility has been made.
(k) With parental consent, certain evaluations may be conducted or repeated and reimbursed in accordance with this Subpart, if deemed necessary and appropriate by the early intervention official, either in conjunction with the required annual evaluation of the individualized family service plan, or more frequently under the following conditions:
(1) an observable change in the child's developmental status indicates the need for modification of the individualized family service plan or a change in eligibility status; and
(2) the parent, early intervention official, service coordinator, or provider(s) requests a re-evaluation at the six-month review of the individualized family service plan.
(l) After a child's initial multidisciplinary evaluation, any additional evaluation shall be described in the child's individualized family service plan, including the type of evaluation, projected date for the evaluation, and if known, the evaluator.
(m) Nondiscriminatory procedures shall be employed in all aspects of the evaluation and assessment processes.
(1) Responsiveness to the cultural background of the family shall be a primary consideration in all aspects of the evaluation and assessment processes.
(2) Tests and other evaluation materials and procedures shall be administered in the dominant or native language or other mode of communication of the child, unless it is clearly not feasible to do so.
(3) No single procedure or instrument may be used as the sole criteria or indicator of eligibility.
(n) An evaluation or assessment shall not include a reference to any specific provider of early intervention services.
(o) Costs for multidisciplinary evaluations and assessments shall be reimbursed in accordance with section 69-4.30(c) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.54 Public restaurant
This functional reporting center must contain all the expenses associated with the operation of a restaurant open to the general public on the premises of the residential health care facility.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
INSTITUTIONS INSTITUTIONS
10 CRR-NY 133.40 United States Military Academy at West Point
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of section 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all the reservoirs, watercourses and drainage areas tributary thereto, which serve as sources of the public water supply of the United States Military Academy at West Point, Orange County, NY.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoirs of the Queensboro and Popolopen brooks, to Queensboro and Nawahunta lakes and to the streams and watercourses between these lakes and the intake reservoirs of the public water supply of the United States Military Academy at West Point.
(2) The term watercourse wherever used in this section is intended to mean and refer to all the other ponds and lakes and to any spring, stream, ditch, gutter or other channel or watercourse, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the United States Military Academy at West Point.
(3) Wherever a linear distance of a structure or object from a reservoir or watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, except the properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (2) of subdivision (d); provided, however, that the property on which the privy, privy vault, pit or any other receptacle intended for the deposit of human excreta is built or to be built is so located, bounded or otherwise placed that the distance above mentioned can be obtained with the limits of such property.
(2) Every privy, privy vault, pit or other receptacle, used and intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained within the limits of such property, shall be placed as far as possible from any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. All receptacles referred to in this paragraph shall be so located that the tops of such receptacles shall be above the highest known water level of the reservoirs or tributary watercourses.
(3) Every privy, privy vault, pit or other receptacle used for either the temporary storage or permanent deposit of human excreta within any mine or mine shaft, the drainage from which either by gravity or pumping flows directly or indirectly into any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, shall be especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place and shall be so located and maintained as to effectually prevent washing of the excremental matter into any reservoir or watercourse tributary to the water supply of the United States Military Academy at West Point.
(4) No privy, privy vault, pit cesspool or other receptacle used for the permanent deposit of human excreta, which is not watertight, shall be constructed, located, placed, maintained or allowed to remain with 100 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point. Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by this paragraph, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (5) and (6) of this subdivision.
(5) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition, and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified, and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(6) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 300 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(7) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of the subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil into any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, then the said privy or receptacle for excreta or trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, sewage or excremental matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed and operated sewage disposal plant as hereinafter provided in paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (c), within 100 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, shall be operated, constructed, enlarged, altered or put in operation without a permit from the State Commissioner of Health. All sewage disposal plants on the watersheds of reservoirs or watercourses tributary to the public water supply of the United States Military Academy at West Point shall be operated and maintained under the supervision of the officer in charge of the supply.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any any dairy or cheese factory nor water in which milk cans have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant, as hereinafter provided under paragraph (2) of this subdivision, shall be thrown or discharged into any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface, except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (c), within 50 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in the intake reservoirs, Queensboro and Nawahunta lakes nor in the streams or watercourses between these lakes and the intake reservoirs of the public water supply of the United States Military Academy at West Point.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 25 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first have passing over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet from any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the United States Military Academy nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 300 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 25 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part hereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the United States Military Academy, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 50 feet of any reservoir or watercourse tributary to the public water supply of the United States Military Academy at West Point.
(h) Inspections.
The officer in charge of the water supply of the United States Military Academy at West Point or his duly appointed representative shall make regular and thorough inspections of the watercourses, reservoirs and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with; and it shall be the duty of the officer in charge of the water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the officer in charge of the water supply to promptly notify the State Commissioner of Health of such violations. The officer in charge of the water supply shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.7 Patients' rights
The hospital shall ensure that all patients including inpatients, outpatients and emergency service patients, are afforded their rights as set forth in subdivision (b) of this section. The hospital's responsibility for assuring patients' rights includes both providing patients with a copy of these rights as set forth in subdivision (c) of this section and providing assistance to patients to understand and exercise these rights. Each general hospital patient who has been removed but not discharged from a hospital for the mentally ill operated or licensed under the Mental Hygiene Law shall maintain his or her status and rights as a patient pursuant to article 9 of the State Mental Hygiene Law and 14 NYCRR Part 527 (Rights of Patients).
(a) Procedural requirements.
In order to assure that patients are made aware of, understand and can exercise their rights, the hospital shall meet the following requirements:
(1) each patient or the patient representative shall be given a copy of their rights as set forth in subdivision (c) of this section at the time of admission;
(2) for outpatients and emergency service patients, copies of these rights shall be provided to each patient or his/her representative;
(3) a copy of these rights shall also be posted in clearly viewed areas of the hospital, at readable heights, including the admitting office, patient floors and outpatient department and the emergency service waiting areas;
(4) inservice training shall be provided to all patient care staff to assure their knowledge and understanding of patients' rights requirements;
(5) the hospital shall communicate effectively to each inpatient or patient representative after admission an explanation of those rights and provide information on how these rights can be exercised. Patients shall be offered a choice at admission to have or to decline an in-person explanation of these rights. The hospital shall maintain documentation of such communication;
(6) the hospital shall make available designated staff to answer questions regarding patients' rights for outpatients and emergency service patients. Patients shall be notified of the availability of these services; and
(7) the hospital shall develop a language assistance program to ensure meaningful access to the hospital's services and reasonable accommodation for all patients who require language assistance. Program requirements shall include:
(i) the designation of a language assistance coordinator who shall report to the hospital administration and who shall provide oversight for the provision of language assistance services;
(ii) policies and procedures that assure timely identification and ongoing access for patients in need of language assistance services;
(iii) the development of materials that will be made available for patients and potential patients that summarize the process and method to access free language assistance services;
(iv) ongoing education and training for administrative, clinical and other employees with direct patient care contact regarding the importance of culturally and linguistically competent service delivery and how to access the hospital's language assistance services on behalf of patients;
(v) signage, as designated by the Department of Health, regarding the availability of free language assistance services in public entry locations and other public locations;
(vi) identification of language of preference and language needs of each patient upon initial visit to the hospital;
(vii) documentation in the medical record of the patient's language of preference, language needs, and the acceptance or refusal of language assistance services;
(viii) a provision that family members, friends, or non-hospital personnel may not act as interpreters, unless:
(a) the patient agrees to their use;
(b) free interpreter services have been offered by the hospital and refused; and
(c) issues of age, competency, confidentiality, or conflicts of interest are taken into account. Any individual acting as an interpreter should be 16 years of age or older; individuals younger than 16 years of age should only be used in emergent circumstances and their use documented in the medical record;
(ix) management of a resource of skilled interpreters and persons skilled in communicating with vision and/or hearing-impaired individuals;
(a) interpreters and persons skilled in communicating with vision and/or hearing-impaired individuals shall be available to patients in the inpatient and outpatient setting within 20 minutes and to patients in the emergency service within 10 minutes of a request to the hospital administration by the patient, the patient's family or representative or the provider of medical care. The Commissioner of Health may approve time limited alternatives to the provisions of this subparagraph regarding interpreters and persons skilled in communicating with vision and/or hearing-impaired individuals for patients of rural hospitals; which:
(1) demonstrate that they have taken and are continuing to take all reasonable steps to fulfill these requirements but are not able to fulfill such requirements immediately for reasons beyond the hospital's control; and
(2) have developed and implemented effective interim plans addressing the communications needs of individuals in the hospital service area;
(x) an annual needs assessment utilizing demographic information available from the United States Bureau of the Census, hospital administrative data, school system data, or other sources, that will identify limited English-speaking groups comprising more than one percent of the total hospital service area population. Translations/transcriptions of significant hospital forms and instructions shall be regularly available for the languages identified by the needs assessment; and
(xi) reasonable accommodation for a family member or patient's representative to be present to assist with the communication assistance needs for patients with mental and developmental disabilities.
(b) Hospital responsibilities.
The hospital shall afford to each patient the right to:
(1) exercise these rights regardless of the patient's language or impairment of hearing or vision. Skilled interpreters shall be provided to assist patients in using these rights;
(2) treatment without discrimination as to race, color, religion, sex, gender identity, national origin, disability, sexual orientation, age, or source of payment;
(3) considerate and respectful care in a clean and safe environment;
(4) receive emergency medical care as indicated by the patient's medical condition upon arrival at the hospital;
(5) limit the use of physical restraints to those patient restraints authorized in writing by a physician after a personal examination of the patient, for a specified and limited period of time to protect the patient from injury to himself or to others. In an emergency, the restraint may be applied only by or under the supervision of and at the direction of a registered professional nurse who shall set forth in writing the circumstances requiring the use of restraints. In such emergencies, a physician shall be immediately summoned and pending the arrival of the physician, the patient shall be kept under continuous supervision as warranted by the patient's physical condition and emotional state. At frequent intervals while restraints are in use the patient's physical needs, comfort and safety shall be monitored. An assessment of the patient's condition shall be made at least once every 30 minutes or at more frequent intervals if directed by a physician;
(6) the name of the medical staff member who has the responsibility for coordinating his/her care and the right to discuss with his/her practitioner the type of care being rendered;
(7) the name, position and function of any person providing treatment to the patient;
(8) obtain from the responsible medical staff member complete current information concerning his/her diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand. The patient shall be advised of any change in health status, including harm or injury, the cause for the change and the recommended course of treatment. The information shall be made available to an appropriate person on the patient's behalf and documented in the patient's medical record, if the patient is not competent to receive such information;
(9) receive information necessary to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, as a minimum, the specific procedure or treatment or both, the reasons for it, the reasonably foreseeable risks and benefits involved, and the alternatives for care or treatment, if any, as a reasonable practitioner under similar circumstances would disclose. Documented evidence of such informed consent shall be included in the patient's medical record;
(10) refuse treatment to the extent permitted by law and to be informed of the reasonably foreseeable consequences of such refusal;
(11) receive from the responsible medical staff or designated hospital representatives information necessary to give informed consent prior to the withholding of medical care and treatment;
(12) privacy consistent with the provision of appropriate care to the patient;
(13) confidentiality of all information and records pertaining to the patient's treatment, except as otherwise provided by law;
(14) a response by the hospital, in a reasonable manner, to the patient's request for services customarily rendered by the hospital consistent with the patient's treatment;
(15) be informed by the responsible medical staff member or appropriate hospital staff of the patient's continuing health care requirements following discharge, and before any transfer to another facility, all relevant information about the need for and all reasonable alternatives to such a transfer;
(16) prior to discharge, receive an appropriate written discharge plan and a written description of the patient discharge review process available to the patient under Federal or State law;
(17) the identity of any hospital personnel including students that the hospital has authorized to participate in the patient's treatment and the right to refuse treatment, examination and/or observation by any personnel;
(18) refuse to participate in research and human experimentation in accordance with Federal and State law;
(19) examine and receive an explanation of his/her bill, regardless of source of payment;
(20) be informed of the hospital rules and regulations that apply to a patient's conduct;
(21) be admitted to a nonsmoking area;
(22) register complaints and recommend changes in policies and services to the facility's staff, the governing authority and the New York State Department of Health without fear of reprisal;
(23) express complaints about the care and services provided and to have the hospital investigate such complaints. The hospital shall provide the patient or his/her designee with a written response if requested by the patient indicating the findings of the investigation. The hospital shall notify the patient or his/her designee that if the patient is not satisfied with the hospital's oral or written response, the patient may complain to the New York State Department of Health's Office of Health Systems Management. The hospital shall provide the telephone number of the local area office of the Health Department to the patient;
(24) obtain access to his/her medical record pursuant to the provisions of Part 50 of this Title. The hospital may impose reasonable charges for all copies of medical records provided to patients, not to exceed costs incurred by the hospital. A patient shall not be denied a copy of his/her medical record solely because of inability to pay; and
(25) receive supportive services to meet the changing care needs of the patient and the patient's family/representative provided by qualified individuals who collectively have expertise in assessing the special needs of hospital patients and their families.
(c) Patients' Bill of Rights.
For purposes of subdivision (a) of this section, the hospital shall utilize the following Patients' Bill of Rights:
Patients' Bill of Rights
As a patient in a hospital in New York State, you have the right, consistent with law, to:
(1) Understand and use these rights. If for any reason you do not understand or you need help, the hospital must provide assistance, including an interpreter.
(2) Receive treatment without discrimination as to race, color, religion, sex, gender identity, national origin, disability, sexual orientation, age, or source of payment.
(3) Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
(4) Receive emergency care if you need it.
(5) Be informed of the name and position of the doctor who will be in charge of your care in the hospital.
(6) Know the names, positions, and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.
(7) Identify a caregiver who will be included in your discharge planning and sharing of post-discharge care information or instruction.
(8) Receive complete information about your diagnosis, treatment and prognosis.
(9) Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
(10) Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet Deciding about Health Care—A Guide for Patients and Families.
(11) Refuse treatment and be told what effect this may have on your health.
(12) Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
(13) Privacy while in the hospital and confidentiality of all information and records regarding your care.
(14) Participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.
(15) Review your medical record without charge and obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
(16) Receive an itemized bill and explanation of all charges.
(17) View a list of the hospital’s standard charges for items and services and the health plans the hospital participates with.
(18) Challenge an unexpected bill through the independent dispute resolution process.
(19) Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if you request it, a written response. If you are not satisfied with the hospital's response, you can complain to the New York State Health Department. The hospital must provide you with the Health Department telephone number.
(20) Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
(21) Make known your wishes in regard to anatomical gifts. Persons 16 years of age or older may document their consent to donate their organs, eyes and/or tissues, upon their death, by enrolling in the NYS Donate Life Registry or by documenting their authorization for organ and/or tissue donation in writing in a number of ways (such as health care proxy, will, donor card, or other signed paper). The health care proxy is available from the hospital.
(d) Each hospital shall be required to post in a conspicuous place and provide a pediatric patient’s parent or other medical decision maker with a copy of a Parent’s Bill of Rights advising that, at a minimum and subject to laws and regulations governing confidentiality, that in connection with every hospital admission or emergency room visit:
(1) The hospital must ask each patient or the patient’s representative for the name of his or her primary care provider, if known, and shall document such information in the patient’s medical record.
(2) The hospital may admit pediatric patients only to the extent consistent with their ability to provide qualified staff, space and size appropriate equipment necessary for the unique needs of pediatric patients.
(3) To the extent possible given the patient’s health and safety, the hospital shall allow at least one parent/guardian to remain with the patient at all times.
(4) All test results completed during the patient’s admission or emergency room visit will be reviewed by a physician, physician assistant or nurse practitioner who is familiar with the patient’s presenting condition.
(5) Patients may not be discharged from the hospital or the emergency room until any tests that could reasonably be expected to yield “critical value” results – results that suggest a life-threatening or otherwise significant condition such that it requires immediate medical attention – are reviewed by a physician, physician assistant (PA) and/or nurse practitioner (NP) and are communicated to the patient, his or her parents or other decision-makers, as appropriate.
(6) Patients may not be discharged until they receive a written discharge plan, which will also be verbally communicated to patients, their parents or other medical decision-makers, which will identify critical value results of laboratory or other diagnostic tests ordered during the patient’s stay and identify any other tests that have not yet been concluded.
(7) The communication of critical value results and the discussion of the discharge plan must be accomplished in a manner that reasonably assures that the patient, their parents or other medical decision makers understand the health information provided in order to make appropriate health decisions.
(8) Hospitals shall provide all lab results to the patient’s primary care provider, if known.
(9) A patient, his or her parent or other medical decision maker has the right to request information about the diagnosis, possible diagnoses that were considered and complications that could develop as well as information about any contact that was made with the patient’s primary care provider.
(10) On discharge, the hospital must provide a patient, his or her parent or other medical decision maker a phone number that the patient, his or her parent or other medical decision maker could call for advice in the event that complications or questions arise.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-1 APPLICATION AND DEFINITIONS
10 CRR-NY 70-1.1 Application
The requirements of this Part shall apply to hospitals, residential health care facilities, and diagnostic and treatment centers (see section 2801 of the Public Health Law) and clinical laboratories (see section 571 of the Public Health Law).
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-7 ASSISTED LIVING PROGRAM
10 CRR-NY 86-7.4 Federal financial participation
(a) This Subpart shall be effective if, and as long as, Federal financial participation is available for medical assistance expenditures made pursuant to this Subpart.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.6 Variance and waivers
(a) Variance.
In order to allow time to comply with certain provisions of this Subpart, an operator may submit a written request to the permit-issuing official for a variance from a specific provision(s). The permit-issuing official may grant a variance for a period not to exceed one year when the health and safety of the public will not be prejudiced by the variance and where there are practical difficulties or hardships in immediate compliance with the provision. An operator must meet all terms of an approved variance including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the permit-issuing official specifies.
(b) Waiver.
In order to obtain a waiver permitting alternative arrangements that do not meet the provisions of this Subpart but do protect the health and safety of the occupants and the public, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Subpart. Such request must demonstrate to the satisfaction of the permit-issuing official that the alternate arrangements provide adequate protection of the health and safety of the patrons and public. The permit-issuing official may grant or deny a waiver after obtaining and following the recommendation of the State Department of Health, and may set conditions on such waiver. An operator must meet all terms and conditions of an approved waiver. A waiver will remain in effect unless revoked by the permit-issuing official or the facility changes operators.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.311 Specific purpose funds
Funds restricted by the donor for a specific purpose or project. Board-designated assets do not constitute specific purpose funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.4 Persons from whom records may be obtained
All requests to inspect and/or copy records subject to disclosure as provided by this Subpart are to be made to the appropriate records access officer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.36 Average daily inpatient census
Average number of inpatients (based on the daily inpatient census) present each day for a given period of time.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 94 PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS
10 CRR-NY 94.2 Supervision and scope of duties
(a) A licensed physician assistant or a registered specialist assistant may perform medical services but only when under the supervision of a physician. Such supervision shall be continuous but shall not necessarily require the physical presence of the supervising physician at the time and place where the services are performed. The licensed physician assistant or registered specialist assistant shall retain records documenting the continuous supervision by the physician who is responsible for such supervision.
(b) Medical acts, duties and responsibilities performed by a licensed physician assistant or registered specialist assistant must:
(1) be assigned to him or her by the supervising physician;
(2) be within the scope of practice of the supervising physician; and
(3) be appropriate to the education, training and experience of the licensed physician assistant or registered specialist assistant.
(c) No physician may employ or supervise more than four licensed physician assistants and two registered specialist assistants in his or her private practice.
(d) No physician may supervise more than six licensed physician assistants or registered specialist assistants or any combination thereof in a hospital setting, no matter if the licensed physician assistants or registered specialist assistants are employed or contracted by a hospital.
(e) Prescriptions, certifications and medical orders may be issued by a licensed physician assistant as provided in this subdivision when assigned by the supervising physician.
(1) A licensed physician assistant may issue prescriptions for a patient who is under the care of the physician responsible for the supervision of the licensed physician assistant. The prescription shall be issued in accordance with section 281 and article 33 of the Public Health Law and Part 80 of this Title, written on the blank form of the supervising physician and shall include the name, address and telephone number of the supervising physician and the name of the licensed physician assistant. The prescription shall also bear the name, the address, the age of the patient and the date on which the prescription was issued.
(2) A licensed physician assistant, in good faith and acting within his or her lawful scope of practice, and to the extent assigned by his or her supervising physician, may prescribe controlled substances as a practitioner under article 33 of the Public Health Law, to patients under the care of such physician responsible for his or her supervision. Licensed physician assistants may issue prescriptions for controlled substances under section 3306 of the Public Health Law provided that such prescriptions shall be issued in accordance with section 281 and article 33 of the Public Health Law and Part 80 of this Title.
(3) The licensed physician assistant shall sign all such prescriptions with his or her own name followed by the letters P.A. and his or her State Education Department license number, except that an electronic prescription must contain the electronic signature of the licensed physician assistant and shall include the name, address and telephone number of the supervising physician.
(4) A licensed physician assistant employed or extended privileges by a hospital may, if permissible under the bylaws, policies and procedures of the hospital, issue prescriptions for controlled substances listed under section 3306 of the Public Health Law on official New York State prescription forms issued to the hospital. Such prescriptions shall be issued in accordance with section 281 and article 33 of the Public Health Law and Part 80 of this Title and must include the imprinted name of the licensed physician assistant and the name of the physician responsible for his or her supervision.
(5) A licensed physician assistant employed or extended privileges by a hospital may, if permissible under the bylaws, policies and procedures of the hospital, write medical orders, including those for controlled substances, for inpatients under the care of the physician responsible for his supervision. Countersignature of such orders may be required if deemed necessary and appropriate by the supervising physician or the hospital, but in no event shall countersignature be required prior to execution.
(6) A licensed physician assistant, in good faith and acting within his or her lawful scope of practice, and to the extent assigned by his or her supervising physician, may register as a practitioner under Part 1004 of this Title to issue patient certifications for medical marijuana, to those patients under the care of such supervising physician.
(f) A physician supervising or employing a licensed physician assistant or registered specialist assistant shall remain medically responsible for the medical services performed by the licensed physician assistant or registered specialist assistant whom such physician supervises or employs.
(g) Qualified individuals may be registered as specialist assistants in the following categories:
(1) Orthopedic assistant. A specialist assistant registered in this category is an individual:
(i) who satisfactorily completed a program for the training of orthopedic assistants approved by the New York State Department of Education; or
(ii) who possesses equivalent education, training and experience. Training and experience while in military service which led to an orthopedic specialist, orthopedic cast room technician, or orthopedic clinic technician rating and two years of satisfactory experience as an orthopedic assistant working under the supervision of an orthopedic surgeon within the past five years; or completion of medical corps school and five years of satisfactory experience as an orthopedic assistant working under the supervision of an orthopedic surgeon within the past eight years may be considered equivalent education, training and experience for the purpose of registration in this category.
(2) Urologic assistant. A specialist assistant registered in this category is an individual:
(i) who satisfactorily completed a program for the training of urologic assistants approved by the New York State Department of Education; or
(ii) who possesses equivalent education, training and experience. Training and experience while in military service which led to an urology surgical technician or urological technician or clinical specialist rating and two years of satisfactory experience as an urologic assistant working under the supervision of an urologist within the past five years; or completion of medical corps school and five years of satisfactory experience as an urologic assistant working under the supervision of an urologist within the past eight years may be considered equivalent education, training and experience for the purpose of registration in this category.
(3) Acupuncture. A specialist assistant registered in this category shall be employed or supervised only by a physician authorized to administer acupuncture in accordance with the rules and regulations of the New York State Department of Education and is an individual:
(i) who satisfactorily completed a program of training in acupuncture approved by the New York State Department of Education; or
(ii) who possesses equivalent education and training acceptable to the New York State Department of Education; and
(iii) in addition to satisfying the requirements of subparagraphs (i) and (ii) of this paragraph has completed at least five years of experience in the use of acupuncture acceptable to the New York State Department of Education.
(4) Radiologic assistant. A specialist assistant in this category is an individual:
(i) who is licensed as a radiologic technologist by the New York State Department of Health; and
(ii) who satisfactorily completed a program for the training of radiologic assistants approved by the New York State Education Department.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 143 SCHOHARIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 143.2 Village of Sharon Springs
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to the pond (referred to locally as Engells Pond) and to the village reservoir below said pond and to all tributaries to said pond and reservoir, which bodies of water serve as sources of public water supply for the village of Sharon Springs, Schoharie County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to Engells Pond, to the said village reservoir and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Sharon Springs.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Sharon Springs.
(2) No privy, privy vault, pit, cesspool or other receptacle, placed or used for the permanent deposit of human excreta and which is not watertight, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of Sharon Springs.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set for in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers be thoroughly covered while being transported and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or 250 feet from any watercourse tributary to the public water supply of the village of Sharon Springs.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Sharon Springs.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Sharon Springs.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Sharon Springs.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Sharon Springs, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage watercourse tributary to the public water supply of the village of Sharon Springs.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Sharon Springs, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Sharon Springs; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Sharon Springs.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the village of Sharon Springs.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Sharon Springs.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Sharon Springs, and no trespassing whatever shall be allowed in or upon the waters or ice of any reservoir except by duly authorized employees of the village of Sharon Springs in the performance of their duties of supervision and maintenance of the public water supply of the village of Sharon Springs.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or any watercourse tributary to the public water supply of the village of Sharon Springs.
(j) Inspections.
The board of trustees of the village of Sharon Springs or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Sharon Springs or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the village of Sharon Springs.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PHYSICALLY HANDICAPPED CHILDREN PHYSICALLY HANDICAPPED CHILDREN
10 CRR-NY 85.13 Children and youth with special health care needs
For persons under the age of 21 years having conditions covered under the scope of the children and youth with special health care needs support services program, all determinations of coverability in this Part shall be made by the children and youth with special health care needs support services program county medical director, the county commissioner of health or the health services administration of the City of New York as the designee of the Commissioner of Health. Such designee may utilize any diagnosis and evaluation carried out in a center approved by the children and youth with special health care needs support services program as the second opinion upon which determination of coverability is made, or may require an additional second opinion.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.4 Sampling and management plan
(a) By December 1, 2016, all covered facilities shall adopt and implement a Legionella culture sampling and management plan for their potable water systems. New covered facilities shall adopt such a plan prior to providing services. The sampling and management plan must include at a minimum:
(1) Legionella culture sampling sites as determined by the environmental assessment;
(2) provisions requiring Legionella culture sampling and analysis at intervals not to exceed 90 days for the first year following adoption of the sampling and management plan. Thereafter, the plan shall include provisions for annual Legionella culture sampling and analysis; provided that the plan shall further require that those portions of any potable water system that serve hematopoietic stem cell transplant or solid organ transplant patients shall continue to be sampled and analyzed at intervals not to exceed 90 days;
(3) provisions requiring actions in response to Legionella culture analysis results, including all responsive actions required by Appendix 4-B of this Title, and specific time frames for such actions.
(b) In addition to the sampling required by the facility’s sampling and management plan, a covered facility shall conduct Legionella culture sampling and analysis of the potable water system in a timeframe to be determined by the department upon:
(1) a determination by the department that one or more cases of legionellosis are, or may be, associated with the facility; or
(2) any other conditions specified by the department.
(c) A covered facility shall review its sampling and management plan annually and under the following conditions:
(1) in the event that one or more cases of legionellosis are, or may be, associated with the facility;
(2) upon completion of any construction, modification, or repair activities that may affect the potable water system;
(3) upon expansion or relocation of a facility’s hematopoietic stem cell transplant and solid organ transplant units; or
(4) any other conditions specified by the department.
(d) A copy of the sampling and management plan and sampling results shall be retained in accordance with section 4-2.6 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.31 Amortization
(a) The gradual extinguishment of any amount over a period of time: as, the retirement of a debt by serial payments to the creditor or into a sinking fund; the periodic writedown of an insurance premium or a bond premium.
(b) A reduction of the book value of a fixed asset; a generic term for the depreciation, depletion, writedown or writeoff of a limited-life asset.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-2 REQUIRED SIGNAGE
10 CRR-NY 9-2.2 Required signage warning against the dangers of illegal products
Any person operating a place of business wherein e-cigarettes or e-liquids are sold or offered for sale shall post in a conspicuous place a sign, to be published by the department, that warns against the dangers of using illegal e-cigarette and e-liquid products.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.41 Independent living
This functional reporting center must contain all the expenses associated with the provision of a safe and sheltered place of living for those capable of fully independent living. Quarters are usually provided in the form of apartment complexes. Note that any housekeeping, dietary or other services provided should be reported in their respective functional cost center.
(a) Standard unit of measure: number of occupant days.
Report occupant days for all occupants assigned to this unit. Include the initial day of occupancy but not the day of vacancy.
(b) Data source.
The number of occupant days shall be taken from daily census counts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
10 CRR-NY 43-1.2 Responsibility for tuberculosis care and treatment
The local health official, where a tuberculosis patient or contact resides or is found, shall provide or secure tuberculosis health care services needed by such person. Upon notification of a tuberculosis case or suspect, the appropriate local health official shall be responsible for immediately determining if other persons may have become infected with tuberculosis by the case or suspect, and shall perform those duties and responsibilities identified in Part 2 of the State Sanitary Code. The local health official shall provide or secure health care services needed for all cases or suspects found. The local health official shall initiate preventive measures, to prevent the spread of infection or development of disease. If a case or contact resides outside of the geographic jurisdiction of the local health official to which he or she has been reported, the local health official shall transfer copies of all materials concerning that case or contract to the local health official with jurisdiction.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.8 Sanitation and maintenance
Buildings, fixtures, and other physical facilities of the plant shall be kept in good repair and shall be maintained in a sanitary condition. Cleaning operations shall be conducted in such a manner as to minimize the danger of contamination of product and product contact surfaces. Detergents, sanitizers and other materials used in cleaning and sanitizing procedures shall be free of chemical or microbiological contamination and shall be safe and effective for their intended use. Only such materials as required to maintain sanitary conditions, for use in laboratory testing procedures, for plant and equipment maintenance and operation or used in manufacturing or processing operations, shall be stored in the plant. These materials shall be identified and used only in such manner and conditions that will be safe for their intended use.
(a) Storage tanks shall, at a minimum, meet the following requirements:
(1) Inspected for cleanliness on a monthly basis and kept free of scale, evidence of oxidation and residue.
(2) Cleaned on a monthly basis by sanitizing with one of the following and flushing with finished product water:
(i) chlorine water solution of 200 parts per million (ppm) for a minimum of five minutes;
(ii) spray wet surface with 200 ppm chlorine water solution. This is to be used on surfaces that are not reached by the above soaking treatment;
(iii) bactericides, such as organic chlorine compounds and bactericidal agents containing iodine or bromine; and
(iv) 0.1 ppm ozone water solution for not less than 10 minutes contact time.
(b) Product water pipelines shall, at a minimum, meet the following requirements:
(1) Kept free of scale, evidence of oxidation and residue.
(2) Cleaned on a daily basis by sanitizing with one of the following:
(i) water containing at least 200 ppm of chlorine for a minimum of five minutes, followed by flushing with finished product water; or
(ii) the continuous recirculation of at least 0.1 ppm ozonated water.
(c) Product equipment shall, at a minimum, meet the following requirements:
(1) Cappers shall be kept free of residue and sanitized on a daily basis.
(2) Hoppers shall be kept covered, free of residue and sanitized on a daily basis.
(3) Ozone mixing tanks and equipment, soft water tanks and other associated equipment shall be inspected on a monthly basis, disassembled if necessary, cleaned and sanitized as needed.
(4) Bottle washing equipment shall be kept free of paper residue and substances which may interfere with proper operation of jets. Internal sprays shall be checked daily to assure proper timing and adequate washing of bottles.
(5) Fillers shall be kept free from scale, evidence of oxidation and residue and shall be sanitized on a daily basis. Filling and capping operations shall be so conducted as to prevent contamination of water being bottled. The filler reservoir shall be kept covered at all times.
(d) Personnel shall, at a minimum, meet the following requirements.
(1) Employees shall wear clean outer garments and caps while bottling, packaging water or sanitizing bottles and packages.
(2) Expectorating is prohibited, except into receptacles for wastewater or sewage.
(3) Before starting work and immediately after visiting a toilet, smoking, eating, drinking or any other activity that soils the hands, every person shall wash his hands and forearms with soap and warm water and thoroughly rinse them in clean water.
(4) No person affected by disease in a communicable form or while a carrier of such disease or while affected with boils, sores, infected wounds or other abnormal sources of microbiological contamination, shall knowingly be permitted to work in a bottled water plant in any capacity, if there is a reasonable possibility of finished product water becoming contaminated by such person or of disease being transmitted by such persons or other individuals.
(5) Tobacco shall not be used in any product-processing room.
(6) Eating and drinking is prohibited in product-processing rooms.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.19 Discharges by source of payment
(a) Adults and Pediatrics.
(1) Exclude Routine Newborn.
(2) Exclude Sub-Acute Care Services (account numbers 6610-6690).
(b) Routine Newborn.
(1) Born in hospital.
(2) Discharged with the mother.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.6 Permit
The permit issuing official shall issue a permit whenever he finds that an application is in proper form and contains required information, provided that on the basis of the information therein contained, the proposed location, construction, abandonment or installation will not be contrary to applicable law, rules or regulations. Such permit, may, at the discretion of the permit issuing official, direct the applicant to file a “compliance notice” as hereinafter provided.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.5 Public notification
(a) List of lead-free buildings.
By October 31, 2016, the school shall make available on its website a list of all buildings that are determined to be lead-free, as defined in section 1417 of the Federal Safe Drinking Water Act.
(b) Public notification of testing results and remediation plans.
(1) The school shall make available, on the school’s website, the results of all lead testing performed and lead remediation plans implemented pursuant to this Subpart, as soon as practicable, but no more than six weeks after the school received the laboratory reports.
(2) For schools that received lead testing results and implemented lead remediation plans in a manner consistent with this Subpart, but prior to September 6, 2016, the school shall make available such information, on the school’s website, as soon as practicable, but no more than six weeks after September 6, 2016.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.4 Application for approval
An application to the commissioner for approval of a demonstration project shall be in a format prescribed by the department. An original and eight copies of the application shall be forwarded to the Department's Project Management Unit, Corning Tower, Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237 within 45 days after issuance of the notice by the commission as referred to in section 705.3(b) of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.1 Definitions
(a) Program means the Obstetric and Pediatric Practitioner Incentive Demonstration Program, also known as the Obstetric and Pediatric Malpractice Insurance Subsidy Program, as administered by the New York State Department of Health.
(b) Obstetric practitioner means:
(1) a New York State licensed physician who is board certified or an active candidate for board certification in obstetrics;
(2) a New York State licensed physician who is board certified or eligible for board certification in family practice and who provides obstetrical services;
(3) a New York State Education Department licensed midwife or person certified to practice midwifery by the Department of Health; or
(4) a licensed registered nurse certified as an obstetric nurse practitioner by the New York State Education Department.
(c) Pediatric practitioner means:
(1) a New York State licensed physician who is board certified or eligible for board certification in pediatrics; or
(2) a licensed registered nurse certified as a pediatric nurse practitioner by the New York State Education Department.
(d) Obstetric group practice means an obstetric practitioner with an arrangement to practice with one or more other obstetric practitioners whether by partnership agreement or by forming a professional corporation.
(e) Covered services means prenatal, delivery and post-partum services provided by an obstetric practitioner or pediatric services provided by a pediatric practitioner for children under the age of one in a private individual or group practice, or in a comprehensive diagnostic and treatment center:
(1) through the prenatal care assistance program, or the medical assistance program under the Social Services Law; or
(2) to women and children who are not covered for obstetric or pediatric services by the programs set forth in paragraph (1) of this subdivision, or by private health insurance; or
(3) through a program approved by the commissioner pursuant to section 2506(4) of the Public Health Law, under which the services are provided as part of a program provided by a general hospital or a city or a county health department and without remuneration to the practitioner.
(f) Target population means pregnant women and children up to the age of one who:
(1) are eligible for the prenatal care assistance program or the medical assistance program under the Social Services Law; or
(2) are not covered for obstetric or pediatric services by the programs set forth in paragraph (1) of this subdivision or by private health insurance; or
(3) are eligible for a program approved by the commissioner pursuant to section 2506(4) of the Public Health Law under which the services are provided as part of a program provided by a general hospital or a city or a county health department and without remuneration to the practitioner.
(g) Malpractice insurance premium means the cost of professional liability insurance coverage for the contract period.
(h) Contractor means an eligible obstetric or pediatric practitioner or group practice who has contracted with the Department of Health for a subsidy.
(i) Subsidy means the amount of remuneration a contractor may receive through this program for his/her malpractice insurance premium.
(j) Designated pediatric area means a federally designated health professional shortage area or an area designated by New York State Board of Regents as a regents physician loan forgiveness area.
(k) New pediatric practitioner means a pediatric practitioner who is proposing to begin practice, or began practice, six months before or after filing an application for a subsidy, in a designated pediatric area.
(l) Additional service obstetric practitioner means an obstetric practitioner or obstetric group practice that agrees to increase the number of the target population provided covered services.
(m) Disproportionate share obstetric practitioner means an obstetric practitioner or obstetric group practice that has in the past provided and agrees to continue to provide covered services to a high number of the target population.
(n) High-number means 1/3 the average number of deliveries performed per year per obstetrician, family practitioner, or nurse midwife, as determined by the Department of Health.
(o) Full-time pediatric practice means providing patient care services at least 37.5 hours per week during at least 46 weeks per year in a designated pediatric area. Up to eight hours per week providing services to residents from the designated pediatric area in a hospital located outside the designated area may be counted towards those hours.
(p) General pediatric services means ambulatory health care services provided to children under the age of one.
(q) Comprehensive obstetrical services means prenatal, delivery and post-partum services.
(r) Application means an application for a contract submitted by an obstetric practitioner, obstetric group practice, or pediatric practitioner on forms prescribed by the department.
(s) Average obstetrical malpractice premium (AOMP) means the amount determined by the commissioner to reflect the average malpractice insurance premium per delivery for obstetricians in a geographic region.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 401 ALL FACILITIES—OPERATING CERTIFICATES
10 CRR-NY 401.2 Limitations of operating certificates
Operating certificates are issued to established operators subject to the following limitations and conditions:
(a) The medical facility shall control admission and discharge of patients or residents to assure that occupancy shall not exceed the bed capacity specified in the operating certificate, except that a hospital may temporarily exceed such capacity in an emergency.
(b) An operating certificate shall be used only by the established operator for the designated site of operation, except that the commissioner may permit the established operator to operate at an alternate or additional site approved by the commissioner on a temporary basis in an emergency. An operating certificate issued for a facility approved to provide:
(1) chronic renal dialysis services shall also encompass the provision of such services to patients at home;
(2) comprehensive outpatient rehabilitation facility (CORF) services shall also encompass the provision of the following services offsite: physical therapy, occupational therapy, speech pathology and in addition, home visits to evaluate the home environment in relation to the patient's established treatment goals; and
(3) outpatient physical therapy, occupational therapy and/or speech-language pathology services shall also encompass the provision of home visits to evaluate the home environment in relation to the patient's established treatment goals.
(c) An operating certificate shall be posted conspicuously at the designated site of operation.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-8 WATERSHED PROTECTION PLANS
10 CRR-NY 128-8.3 Watershed planning in the west of Hudson watershed
(a) The department shall establish a pilot program to evaluate the effectiveness of phosphorus offsets as a potential basis for allowing the construction of new wastewater treatment plants, or the expansion of existing plants, with a surface discharge in a phosphorus restricted basin located in the west of Hudson watershed. Such pilot program shall be limited to a term of five years, commencing on the effective date of these rules and regulations and expiring on the fifth anniversary thereof. During the term of the pilot program, the department may approve the siting of a new wastewater treatment plant, or the expansion of an existing plant, with a surface discharge in a phosphorus restricted basin located in the west of Hudson watershed, provided that the following conditions are met:
(1) The county in which the new wastewater treatment plant, or the expansion of an existing plant, is proposed to be sited has prepared, or is in the process of preparing, a comprehensive strategy, in partnership with the department and with the local governments located within the county and affected by the comprehensive strategy. The comprehensive strategy should identify existing economic resources, water quality problems, potential remedies for such problems and potential strategies and recommendations of economic development initiatives that could be undertaken to sustain local economies while remaining protective of the water supply.
(2) The applicant demonstrates that the new wastewater treatment plant, or the expansion of an existing plant, together with the offsets the applicant is proposing to make under paragraph (3) of this subdivision, is consistent with the comprehensive strategy.
(3) The applicant demonstrates, and commits to take action to insure, that every one kilogram of projected increase in the phosphorus load resulting from the new wastewater treatment plant or the expansion of an existing plant, and the accompanying non-point source runoff will be actually offset by at least three kilograms of reductions in phosphorus loading within the basin in which such new wastewater treatment plant, or the expansion of an existing plant, is located. For purposes of this subdivision, the applicant may use as an offset any phosphorus reduction funded by the Catskill Fund for the Future or achieved from stormwater pollution prevention measures installed on existing structures or impervious surfaces in a village center or hamlet and funded by the department.
(4) All new wastewater treatment plants, or expansions of existing plants, proposed to be constructed pursuant to this pilot program shall be reviewed and approved by the department.
(5) No more than three new wastewater treatment plants, or expansions of existing plants, with surface discharge shall be allowed into any phosphorus restricted basin pursuant to this pilot program. The total capacity, as constructed, of the three plants shall not exceed a maximum of 100,000 gpd aggregate surface discharge.
(6) Any wastewater treatment plant, or expansion of an existing plant, constructed pursuant to this pilot program shall be designed and operated to meet the total phosphorus effluent limit of.2 mg/l.
(b) Nothing in this Subpart is intended to constrain, limit or preclude an applicant from seeking, or the department from issuing, approval of or a variance for a proposed regulated activity under any other applicable provision of these rules and regulations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.146 Funded depreciation
See depreciation fund.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-4 MENTAL HEALTH AND SUBSTANCE USE DISORDERTREATMENT PARITY COMPLIANCE PROGRAM
10 CRR-NY 98-4.3 Definitions
For the purposes of this Subpart, the following definitions shall apply:
(a) Benefit classification means the following classifications of medical and surgical benefits and mental health and substance use disorder benefits for purposes of complying with the MHPAEA: inpatient in-network, inpatient out-of-network, outpatient in-network, outpatient out-of-network, emergency care and prescription drugs. The outpatient classification includes any subclassification of office visits.
(b) Comparative analysis means an analysis of the nonquantitative treatment limitations imposed on mental health or substance use disorder benefits to determine if such limitations are comparable to and applied no more stringently, both as written and in operation, than nonquantitative treatment limitations imposed on medical or surgical benefits within the same benefit classification. Comparative analysis includes the documented identification and assessment of the factors, processes, strategies, and evidentiary standards the MCO relied upon to determine the applicability and design of a nonquantitative treatment limitation and the processes and strategies the MCO used in operationalizing a nonquantitative treatment limitation to illustrate MCO compliance with MHPAEA.
(c) Compliance program means a mental health and substance use disorder parity compliance program.
(d) Financial requirements means deductibles, copayments, coinsurance, and out-of-pocket maximums.
(e) Latency period means the period of time that must elapse between the time at which a dose of drug is applied to a biologic system and the time at which a specified pharmacologic effect is produced.
(f) MHPAEA means the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, codified at 29 U.S.C. section 1185a, and its implementing regulations and sub-regulatory guidance.
(g) Nonquantitative treatment limitation means a qualitative limit affecting the scope or duration of benefits such as medical management standards limiting or excluding benefits based on medical necessity, or based on whether the treatment is experimental or investigational; formulary design for prescription drugs; network tier design; standards for provider admission to participate in a network, including reimbursement rates; methods for determining usual, customary, and reasonable charges; fail-first or step therapy protocols; exclusions based on failure to complete a course of treatment; and restrictions based on geographic location, facility type, provider specialty, and other criteria that limit the scope or duration of benefits.
(h) Provider means a physician, health care professional, or facility licensed, registered, certified, or otherwise authorized or accredited as required by state law.
(i) Quantitative treatment limitation means a numerical limit affecting the scope or duration of benefits.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 103 CATTARAUGUS COUNTY
VILLAGES VILLAGES
10 CRR-NY 103.4 Village of Gowanda
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 395 of the Laws of 1928, shall apply to the wells, springs and the spring-fed reservoir and drainage areas tributary thereto which serve as a source of the public water supply of the village of Gowanda, Cattaraugus and Erie counties, New York.
(b) Definitions.
(1) The term water supply wherever used in this section refers to the public water supply of the village of Gowanda, Cattaraugus and Erie counties, New York.
(2) The term wells refers to the wells now used as sources of this public water supply, which are located on land owned by the village, situated in the southwestern part of the village adjacent to and north of Hill Street, in Cattaraugus County, New York and to any wells which may be developed for the purpose of this water supply.
(3) The term springs refers to those springs which are located on land owned by the village to the southeast of the village in Erie County, New York and which are tributary to the water supply of the village of Gowanda.
(4) The term reservoir refers to the spring-fed reservoir located on land owned by the village to the southeast of the village in Erie County, New York and to any reservoirs which may be constructed as part of this water supply.
(5) The term linear distance refers to the shortest horizontal distance from the nearest point of the structure or object to the wells or springs or to the high-water mark of the reservoir.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the reservoir.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the reservoir.
(3) No human excreta shall be buried in the soil at a distance of less than 500 feet from any wells, springs or reservoir and it must be deposited in trenches or pits and, when buried at more remote location, covered with not less than 12 inches of soil in such a manner as to effectively prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 150 feet of any wells, springs or reservoir.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the limiting distance prescribed in paragraph (4) of this subdivision and the distance of 300 feet from any wells, springs or reservoir, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied before it becomes filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into the wells, springs or reservoir, the said privy, receptacle, trench or place of disposal shall, after due notice to the owner thereof, be removed to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage, bath water, sink or laundry wastes shall be discharged or allowed to flow into the reservoir or any spring nor deposited on or beneath the surface of the ground within 300 feet of any wells, springs or reservoir, except into a watertight receptacle, the contents of which shall be removed as provided by paragraph (3) of subdivision (c) or into a sewage treatment plant, plans for which shall be submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruit or vegetables, dead animals or other material that pollutes water shall be deposited in any reservoir nor on or beneath the surface of the ground within 200 feet of wells, springs or reservoir nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface of or through the ground into the wells, springs or reservoir.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in the reservoir.
(g) Places for animals.
(1) No animals or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in the reservoir or springs, and no watering place shall be maintained in such a way as to pollute the wells, springs or reservoir with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located or maintained at a distance less than 150 feet from any wells, springs or reservoir.
(h) Manure piles.
No manure pile or compost heap shall be maintained or allowed to remain within 150 feet of the wells, springs or reservoir, nor shall manure be spread on the surface of the ground on the drainage area of the reservoir within 150 feet of the reservoir or within 150 feet of any wells or springs.
(i) Fishing, boating and ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir, except by duly authorized employees of the Village of Gowanda in the performance of their duties of supervision and maintenance of the water supply.
(j) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained on the area tributary to the reservoir within a distance of 500 feet of the reservoir nor within 500 feet of the wells or springs.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet of the wells, springs or reservoir.
(l) Inspections.
The board of trustees of the Village of Gowanda or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Gowanda, or the duly appointed representatives of any such board, shall make regular and thorough inspections of the reservoirs and drainage areas tributary thereto and for the purpose of ascertaining whether the above rules and regulations are being complied with; and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the said board to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition surrounding the wells, springs and the reservoir at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act or contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.12 Confidentiality
(a) No health care plan may share an enrollee's medical and treatment records or any other confidential information, including HIV related and mental health related information, with a certified external appeal agent or a clinical peer reviewer designated by such certified external appeal agent unless the enrollee, or a person authorized pursuant to law to consent to health care for the enrollee, has signed a specific release of information for HIV, mental health and drug and alcohol abuse or otherwise appropriate release in a manner and in such form as prescribed by the commissioner and superintendent in accordance with section 2782 of the Public Health Law for confidential HIV related information and sections 33.13 and 33.16 of the Mental Hygiene Law for mental health related information and as required by any applicable Federal law or regulation.
(b) No certified external appeal agent or clinical peer reviewer designated by such certified external appeal agent shall, except as specifically authorized by an appropriate release signed by the enrollee or by a person authorized pursuant to law to consent to health care for the enrollee, divulge confidential medical and treatment information or other information obtained through the review of an external appeal to any individual or group except the certified external appeal agent to whom the appeal was assigned and, as necessary, the commissioner and superintendent.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
CHRONIC DISEASE PREVENTION CHRONIC DISEASE PREVENTION
10 CRR-NY 40-2.30 Chronic disease prevention; performance standards
(a) The local health department shall maintain a program designed to reduce the prevalence or incidence of chronic diseases and conditions such as cancer, cardiovascular diseases, diabetes, asthma, arthritis and obesity, and the underlying risk factors of tobacco use, physical inactivity and poor nutrition. The activities required in this program shall include, at a minimum:
(1) Analysis and utilization of public health data and information to shape objectives and strategies related to chronic disease prevention. This analysis shall:
(i) use available data from the community health assessment and other local assessments;
(ii) identify communities and/or neighborhoods where the population is at increased risk of chronic diseases and conditions and underlying risk factors;
(iii) identify the specific local factors and available policies, practices, underlying risk factors, and interventions that influence chronic disease;
(2) leadership of, or participation in, efforts with multiple sectors in the community to improve social and physical environments to support healthy behaviors;
(3) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting or disseminating such materials or campaigns, to reduce risk factors for chronic disease morbidity, mortality and related health disparities; and
(4) activities to promote the delivery of early detection and guideline-concordant health care by health care providers.
(b) Any and all health care services for the screening or treatment of chronic diseases are ineligible for State aid.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.5 Development period records and reports
(a) A nursing home company shall establish and maintain a uniform system of accounts during the development period as required by the accounting manual of the State Department of Health.
(b) The following reports during the development period after mortgage closing shall be submitted promptly to the State Department of Health:
(1) Quarterly reports commencing with the date of inception to and including the last day of March, June, September, and December.
(2) Each report for the period ending December 31 shall contain the opinion and certificate of an independent licensed or certified public accountant.
(3) The project shall file quarterly reports until the declaration of the final financial occupancy date by the State Commissioner of Health. The final development period report shall contain the opinion and certificate of an independent licensed or certified public accountant.
(c) All reports to the State Department of Health required by this Part shall be submitted within 60 days following the end of the reporting period or as otherwise specified by the State Department of Health.
(d) A nursing home company shall submit promptly such special reports as may from time to time be required by the State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.11 Clinical and ancillary support services
(a) Introduction.
Required clinical and ancillary support services shall include diagnostic radiology, clinical laboratory, pharmaceutical, food and dietetic and social services. The PCH shall provide or have available such services as are necessary to meet the needs of the patients and the medical staff. Such services shall meet professionally approved standards for safety and personnel qualifications.
(b) Organization and direction.
(1) Diagnostic radiology services shall be directed by a radiologist who satisfies the requirements of section 405.15(a)(4)(i) of this Title.
(2) Clinical laboratory services shall be supervised by an individual who satisfies the requirements of section 405.16(c)(1) of this Title.
(3) Pharmacy services shall be directed by a registered pharmacist who satisfies the requirements of section 405.17 of this Title.
(4) Food, dietetic and social services shall be directed by individuals who are qualified by experience or training to manage and direct such services.
(c) Operation and service delivery.
(1) Diagnostic radiology. The hospital shall maintain or have available diagnostic radiologic services, defined for the purposes of this subdivision as imaging services utilizing diagnostic radiation equipment. In addition, the hospital shall meet the standards of part 16 of the State Sanitary Code.
(i) Service delivery shall comply with the provisions of section 405.15(a)(1)-(5) of this Title.
(ii) Diagnostic imaging through the use of ultrasound devices, if provided, shall be under the supervision of the director of diagnostic radiologic services.
(2) Laboratory services shall be provided in accordance with the provisions of section 405.16(a)-(c) of this Title.
(3) Pharmaceutical services.
(i) Pharmaceutical services shall be provided in accordance with the provision of section 405.17 of this Title.
(a) PCHs/CAHs shall provide or arrange for such services through a pharmacy that is registered and operated in accordance with article 137 of the New York State Education Law and is directed by a registered pharmacist trained in the specialized functions of hospital pharmacy.
(b) For services provided off site, the PCH/CAH shall ensure the 24-hour a day availability of pharmaceuticals necessary to meet patient needs on a timely basis.
(ii) The service shall maintain, on site, a sufficient supply of drugs and biologicals, including electrolytes, fluid volume replacement solutions and other fluid supplements to meet patient needs.
(4) Food and dietetic services shall comply with the provisions of section 405.23 of this Title.
(5) Social services shall comply with the provisions of section 405.28 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.7 Default
(a) Default.
A recipient shall be placed in default if he/she has not been granted a waiver or deferral by the commissioner and:
(1) the recipient is not available to fulfill his/her service obligation on the start date; or
(2) the recipient fails, refuses or is unable to fulfill his/her service obligation; or
(3) an award is rescinded after dispersal of award monies to the recipient.
(b) Dismissal.
A recipient who is dismissed from employment or discontinues practice at the location of his/her service obligation, shall contact the Department of Health within 30 days of dismissal or discontinuance. The commissioner may reassign the recipient to an alternate underserved area. A recipient who is reassigned shall resume his/her service obligation at the alternate location within 90 days of the dismissal or discontinuance. A recipient who is reassigned and who fails to resume his/her service obligation at the alternate location within 90 days of dismissal or discontinuance shall be placed in default.
(c) Calculation of financial obligation.
An individual found to be in default will be required to pay the president, within five years from the date of default, all monies received, plus interest, plus liquidated damages, as determined by the following formula:
A = 2B (T−S) T
where “A” is the amount the president is entitled to receive; “B” is the sum of all payments made to the recipient and the interest on such amount which would be payable if at the time such awards were paid they were loans bearing interest at the maximum prevailing rate determined by the Higher Education Services Corporation; “T” is the total number of months in the recipient's period of obligated service; and “S” is the number of months of service actually rendered by the recipient. The minimum number of months in the recipient's period of obligated service shall be 24 months.
(d) The Department of Health shall advise the Higher Education Services Corporation of any default, and the Higher Education Services Corporation shall collect repayments and, where indicated, initiate action for prosecution to recover monies owed the State.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.4 Reporting requirements
(a) Providers shall report costs and maintain financial and statistical records in accordance with 14 NYCRR Subpart 635-4.
(b) Generally accepted accounting principles (GAAP).
The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the provider unless the reporting instructions authorized specific variation in such principles. The State shall identify provider cost and providers shall submit cost data in accordance with generally accepted accounting principles (GAAP).
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.19 Marketing by MLTCPs
(a) An MLTCP shall prepare a marketing plan. Marketing plans shall not be implemented without the prior written consent of the commissioner.
(b) Marketing means any activity of an MLTCP, a subcontractor of the MLTCP or individuals or entities affiliated with the MLTCP, by which information about the MLTCP is made known to potential enrollees for the purpose of persuading such persons to enroll with the MLTCP. Marketing activities are occasions during which marketing information and material regarding managed long term care and a particular MLTCP are presented. Such information may be presented through verbal exchanges and the distribution of written materials and the giving away of nominal gifts (value of $5 or less).
(c) Each marketing plan for an MLTCP submitted to the department for approval shall include but not be limited to:
(1) goals and general marketing strategy;
(2) a description of marketing activities and copies of all draft marketing materials;
(3) staffing plan including training and compensation methodology and levels;
(4) a description of how the MLTCP will meet the informational needs of eligible persons, including those who speak a language other than English as a first language and/or who have a hearing, visual, physical or cognitive impairment, and enable the person to make a voluntary and informed choice;
(5) a description of the MLTCP's monitoring activities to ensure compliance with this section; and
(6) identification of the primary marketing locations at which marketing will be conducted.
(d) Marketing materials means materials that are produced in any medium by or on behalf of an MLTCP and can reasonably be interpreted as intended to market to potential enrollees. Marketing materials may not be used by an MLTCP without the prior written consent of the commissioner, the superintendent and the director of the State Office for the Aging. Marketing materials requiring consent include:
(1) advertising, public service announcements, printed publications, and other broadcast or electronic messages designed to increase awareness of and interest in, or otherwise persuade an eligible person to enroll in an MLTCP; and
(2) any information that references the MLTCP, is intended for general distribution and is produced in a variety of print, broadcast, and direct marketing media, including, but not limited to, scripts, radio, television, billboards, newspapers, leaflets, brochures, videos, telephone books, advertising, letters, posters and the member handbook.
(e) An MLTCP is prohibited from engaging in the following practices:
(1) making unsolicited calls in person or by telephone or cold calling inquiries at the homes of eligible persons;
(2) marketing in emergency rooms, patient rooms or other service delivery sites unless requested by the eligible person;
(3) requiring providers to distribute plan specific marketing, promotional or informational materials of any kind to eligible enrollees;
(4) inappropriate marketing and enrollment encounters such as:
(i) making false statements;
(ii) deceiving, misleading or threatening an eligible person to influence or induce selection of a particular plan;
(iii) discouraging enrollment on the basis of health status or need for health care services;
(iv) signing a person's name on the enrollment agreement without consent;
(v) enrolling persons who are uninformed about the rules of the plan and/or the voluntary nature of enrollment;
(5) seeking to induce selection of an MLTCP by offering gifts which exceed a fair market value of $5;
(6) distributing new or revised marketing materials that have not been approved by the department;
(7) providing misleading or falsified information to the department or the department's designee to substantiate an applicant's eligibility for enrollment; or
(8) enrolling persons the plan is not authorized to enroll.
(f) The MLTCP must process applications for enrollment in the order in which they are received and must not discriminate on the basis of health status.
(g) Prior to enrollment in an MLTCP each enrollee must sign an enrollment agreement which indicates that the enrollee:
(1) received a copy of the member handbook which included the rules and responsibilities of plan membership and which expressly delineates covered and non-covered services;
(2) agreed to the terms and conditions for plan enrollment stated in the member handbook;
(3) understood that enrollment in the MLTCP is voluntary;
(4) received a copy of the MLTCP's current provider network listing and agreed to use network providers for covered services; and
(5) was advised of the projected date of enrollment.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.74 Approved laboratories
(a) For determining compliance with this Subpart, results of analyses, except for parameters listed in section 5-1.74(b), may be considered only if they have been performed by an environmental laboratory approved in accordance with Subpart 55-2 of this Title.
(b) Measurements for pH, temperature, conductivity, turbidity, disinfectant residual, alkalinity, calcium, orthophosphate, bromide, chlorite, total organic carbon (TOC) concentration, dissolved organic carbon concentration, ultraviolet (UV) absorption, and silica may be performed by any person with a demonstrated ability to perform these analyses. These analyses shall be conducted in accordance with 40 CFR part 141. All necessary documentation required by the approved methods shall be retained by the water system conducting the analyses for a period of 10 years.
(c) The owner of a water system shall ensure the approved environmental laboratory performing the analyses sends laboratory results to the department in a manner prescribed by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.20 Additional (paid-in) capital
Contributions of corporate stockholders credited to accounts other than capital stock; sources: an excess over par or stated value received from the sale or exchange of capital stock, an excess of par or stated value of capital stock reacquired over the amount paid therefor, or an excess from recapitalization; often displayed on the balance sheet as a separate item or in combination with par or stated value and designated paid-in capital; known also as paid-in surplus.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
CITIES CITIES
10 CRR-NY 133.1 City of Middletown
(a) Application.
The following rules and regulations shall apply to all streams, lakes and reservoirs on the drained areas tributary to the reservoirs from which water is drawn for the water supply of the City of Middletown, Orange County, NY, which are intended to comprise all watercourses entering or ultimately discharging into the Monhagen Reservoir, the Highland Reservoir and the Shawangunk Reservoir.
(b) Definitions
(1) The term reservoir whenever used in this section is intended to mean and comprise each of the above three named reservoirs.
(2) The term watercourse wherever used in this section is intended to mean and comprise every spring, stream, ditch, gutter or other watercourse of any kind, the waters of which when running, whether constantly or occasionally, eventually flow or may flow into either of the above named reservoirs.
(c) Privies adjacent to reservoirs or watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet, horizontal measurement, of the high-water mark of any reservoir or of the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta, shall be constructed, located, placed or maintained with its nearest point within 200 feet, horizontal measurement, of the waterline of any reservoir of the Middletown water supply or within 150 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(3) Every privy, privy vault, pit, cesspool or other receptacle or placed used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 200 feet, horizontal measurement, of the high-water mark of any reservoir or within the aforesaid 150 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Middletown water supply, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In affecting this removal the utmost care shall be exercised that none of the contents shall be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, the excretal matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage, house slops, bath water, excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the Middletown water supply, nor shall any such matter be placed, led, discharged or allowed to escape onto the surface of the ground or into the ground below the surface within 300 feet, horizontal measurement, from the high-water mark of any reservoir or within 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from creameries, cheese factories, laundries, no water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the Middletown water supply. Nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of the ground or into the ground below the surface within a distance of 200 feet, horizontal measurement, of any reservoir or within 150 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(3) No clothing, bedding, carpets, harness, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the Middletown water supply.
(c) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the Middletown water supply, nor shall any animal or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor to be washed therein.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 150 feet, horizontal measurement, from the high-water mark of any reservoir or less than 75 feet, horizontal measurement, from the edge, margin or precipitous bank of any watercourse of the Middletown water supply, and none of the above-named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainage, leachings or washings from the same may enter any reservoir or watercourse of the Middletown water supply without first having passed through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir nor less than 75 feet before entering any watercourse of the Middletown water supply.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from the high-water line of any reservoir nor within a distance of 200 feet from the edge, margin or precipitous bank of any watercourse of the Middletown water supply, and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of the highwater line of any reservoir nor within 75 feet of the edge, margin or precipitous bank of any watercourse of the Middletown water supply.
(4) No decayed or fermented fruits or vegetables, cider mill waste, roots, grain or other vegetables refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the Middletown water supply without first having passed over or through such an extent of soil as to have become properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or a distance not less than 50 feet before entering any watercourse of the Middletown water supply.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal nor any refuse from any slaughterhouse nor any decomposable or putrescible refuse or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the Middletown water supply, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any reservoir or watercourse of the Middletown water supply without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir and not less than 100 feet before entering any watercourse of the Middletown water supply.
(g) Boating and fishing.
(1) Boating, fishing from boats, from rafts, from the shore and through the ice are hereby prohibited in any and all of the reservoirs of the Middletown water supply.
(2) The board of water commissioners of Middletown, when necessary to regulate or diminish the number of fish in any of the reservoirs or when in their opinion such privileges may be extended without endangering the purity of the water supply, are hereby authorized to permit boating or fishing or both under explicit regulations and restrictions. Such permit, regulations and restrictions must be first approved in writing by the State Commissioner of Health.
(3) A violation or noncompliance with any of the restrictions or regulations under which such permit for boating or fishing is issued shall be construed as a violation or noncompliance with this subdivision of the rules and regulations.
(h) Penalty.
In accordance with section 70 of chapter 661 of the Laws of Laws of 1893, as amended by chapter 251 of the Laws of 1899, the penalty for each and every violation of or noncompliance with any of the above rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Part 130 ONEIDA COUNTY
VILLAGES VILLAGES
10 CRR-NY 130.4 Village of Remsen
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the spring located on land known as the Cady farm, now owned by the village of Remsen, and situated about two miles east of the village, which forms the source of the public water supply of the village of Remsen, Oneida County, N. Y.
(b) [Definitions.]
(1) The term spring wherever used in this section is intended to mean and refer to the spring now used as a source of this public water supply or to any additional spring which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the spring is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the spring.
(c) Privies adjacent to the spring.
(1) No privy, privy vault, pit, cesspool or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any spring forming the source of the public water supply of the village of Remsen.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any spring, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 300 feet of any spring forming the source of the public water supply of the village of Remsen.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged from the surface of the ground or into the ground beneath the surface within 200 feet of any spring forming the source of the public water supply of the village of Remsen.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any spring forming the source of the public water supply of the village of Remsen, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any spring without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any spring forming the source of the public water supply of the village of Remsen.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any spring; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any spring forming the source of the public water supply of the village of Remsen.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 500 feet of any spring forming the source of the public water supply of the village of Remsen.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Remsen upon which any spring forming the source of the public water supply is located and no person or persons shall enter in or upon such property except the board of trustees or any person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Remsen.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of the spring forming the source of the public water supply of the village of Remsen.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any spring forming the source of the public water supply of the village of Remsen.
(j) Inspections.
The board of trustees of the village of Remsen or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Remsen or their duly appointed representative shall make regular and thorough inspections of the spring area for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the supply at the time of the last inspection.
(k) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the village of Remsen.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.7 Other responsibilities
(a) Each program shall establish, maintain, and keep such records as are required to show compliance with this Part for a period of six years after the successful completion of training, unless otherwise directed by the department or the New York State Education Department.
(b) Each entity shall establish, maintain, and keep such records as are required to show compliance with this Part for a period of six years after the termination of a worker’s employment, unless otherwise directed by the department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.25 Education activities
The costs of educational activities, less tuition and supporting grants, shall be included in the calculation of the basic rates, provided such activities are directly related to patient care services.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS
10 CRR-NY 80.36 Additional requirements, research, instructional activities and chemical analysis
(a) Persons engaged in research of controlled substances in schedules II to V shall first obtain a class 4 license from the department and thereafter a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(b) Persons engaged in industrial or commercial processes requiring the use of controlled, substances in schedules II to V shall first obtain a class 4a license from the department and thereafter a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(c) Persons engaged in instructional activities requiring the use of controlled substances in schedules II to V shall first obtain a license from the department in class 5 and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(d) Persons conducting research with controlled substances in schedule I shall apply to the department for such research license in class 7 and file with the department three copies of a research protocol describing the research project.
(1) The research protocol shall contain all pertinent information including the objective, material, security, procedures (such as species and number of animals, daily dose regimen and route of administration) and investigators, if any.
(2) If the commissioner finds that the applicant is qualified and competent, and has furnished a satisfactory protocol, the department shall license such applicant unless he finds that the application should be denied by reason of false statements in the application, conviction of a felony relating to controlled substances suspension, revocation, or denial of the applicant's Federal license or registration, failure to provide adequate safeguards against diversion of the controlled substances from legitimate medical or scientific use or other good and sufficient reason.
(e) A person licensed to conduct research with controlled substances listed in schedule I may conduct research with only such substances in schedule I for which he has filed and had approved a research protocol.
(f) All persons conducting research and instructional activities with controlled substances listed in schedule I shall first obtain a class 7 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(g) All persons conducting analytical laboratories involving controlled substances shall first obtain a class 8 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.6 Annual review of enforcement programs
(a) The enforcement program of a certified local government shall be reviewed annually by the department. Such review shall be based upon records that demonstrate the effectiveness of the program which include objective criteria, such as:
(1) a review of notices of violation issued by the certified local government;
(2) a review of inspection reports prepared by the certified local government;
(3) a review of the determinations made by courts or administrative tribunals on notices of violation issued by the certified local government;
(4) a review of compliance with notices of violation issued by the certified local government;
(5) a review of the adequacy of financial, personnel and other resources for the previous year, and evidence of future commitment of adequate financial, personnel and other resources to continue the enforcement program in accordance with any requirements of a memorandum of understanding; and
(6) a review of such other records as the certified local government may be required to keep in accordance with a memorandum of understanding.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.7 Notice of construction, enlargement, development, improvement or conversion required; prior approval
(a) No person shall construct or enlarge for occupancy or use a campground or any portion or facility thereof, or develop or improve a property for occupancy and use as a campground, or convert a property for use or occupancy as a campground, without giving notice in writing of intent to do so to the permit-issuing official, at least 30 days before the proposed date of beginning of such construction, enlargement, development, improvement or conversion. The notice shall give the name of the city, village, or town in which the property is located, the location of the property within that area, a brief description of the proposed construction, enlargement, development, improvement, or conversion, and the name and mailing address of the person giving the notice and his or her telephone number, if any.
(b) Plans and specifications required by the permit-issuing official shall be submitted to the permit-issuing official. Construction, enlargement, development, improvement or conversion shall not commence until required plans or specifications have been approved by the permit-issuing official.
(c) All new construction including alterations, enlargements, conversions, campsite modifications or relocation of structures, shall conform with the requirements of this Subpart and the Uniform Code. The operator shall submit, prior to occupancy or use of the new facilities, a certificate of occupancy issued by the local code enforcement official, when applicable, and a construction compliance certificate. The construction compliance certificate shall state that the facilities have been constructed in accordance with the approved plans.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.36 Operational period
(a) The operational period shall commence on the financial occupancy date declared by the State Commissioner of Health and end on final repayment and satisfaction of the mortgage loan.
(b) A hospital shall be operated in accordance with the requirements of the State Hospital Code and the administrative rules and regulations of the State Commissioner of Health.
(c) The following reports for the operational period from the financial occupancy date to discharge of the mortgage lien shall be submitted promptly as required by the regulatory agreement:
(1) Quarterly reports during each calendar or fiscal year commencing with the final financial occupancy date to and including the last day of March, June, September and December.
(2) An annual report for the period ending December 31, or the fiscal year ending date if different, which shall contain the opinion and certificate of an independent licensed or certified public accountant.
(d) Quarterly reports to the State Department of Health required by this Part shall be submitted within 60 days following the end of the reporting period and annual reports required by this Part shall be submitted within 90 days following the end of the reporting period, or as otherwise specified by the regulatory agreement.
(e) All hospital records, reports and schedules required during the development period shall be maintained or submitted as the case may be, during the operational period.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.17 Operating expenses—general
[ 3230 ]
(a) Expenses are expired costs, that is, costs that have been used up in carrying on some activity during the accounting period and from which no future measurable benefit will be obtained. Hospital expenses consist primarily of employee compensation, but substantial amounts of expense are in the form of supplies used, utilities, repairs, insurance, depreciation and other items. The objective of expense accounting is to accumulate, on the accrual basis, complete and meaningful records of expenses. Within each cost center, the expenses are classified, according to natural classification by the use of the fifth and sixth digits in the numerical coding system.
(b) Hospitals are required to use in the required reports all revenue and expense accounts which have capitalized titles and which have numerical codes with a fourth digit of zero (except where noted) when such a function as defined in this manual exists, even though the activity is not separately organized within the hospital. The only circumstances under which the hospital need not report an existing zero level account are when the patient service provided in a Daily Hospital Services cost center is not provided in a discrete unit.
(c) PATIENT SERVICE EXPENSE. This group of accounts (6000 - 7999) is used to report the direct expenses incurred in providing nursing and other professional services (daily hospital services, ambulatory services and ancillary services) rendered to patients. For each nursing and other professional service revenue center account a corresponding cost center account is provided. The second, third and fourth digits of the account numbers of the related revenue and expense cost centers are the same. Comparisons of the revenue and direct expense of each nursing and other professional service center are thereby facilitated.
(d) OTHER OPERATING EXPENSE. This group of accounts (8000 - 8999) is used to report the direct expenses incurred by the research, education, general, fiscal and administrative cost centers, and various unassigned cost centers. When cost finding procedures are performed, the expenses charged to these centers are allocated to the various patient service expense cost centers to determine the full cost of providing each revenue producing service.
(e) The following pages contain detailed descriptions of the functions or types of activities to be included in each cost center, the name and definition of the applicable standard unit of measure and the data source of the standard unit of measure.
(f) STANDARD UNITS OF MEASURE. The Standard Unit of Measure is required to provide a uniform statistic for measuring costs. The Standard Unit of Measure for revenue producing cost centers (Daily Hospital, Ambulatory, and Ancillary Services) attempts to measure the volume of services rendered to patients (productive output). For non-revenue producing cost centers, the Standard Unit of Measure attempts to measure the volume of support services rendered. The Standard Unit of Measure provides a method of determining unit cost and revenue to facilitate cost and revenue comparisons among peer group health facilities. Standard Units of Measure should not be confused with allocation statistics used to allocate cost of non-revenue producing cost centers to each other and to the revenue producing centers.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.6 Variances and waivers
(a) A variance shall mean permission for an agricultural fairground owner to delay implementation of one or more provisions of this Subpart. In order to obtain sufficient time to comply with a provision of this Subpart, an agricultural fairground owner may submit a written request to the permit-issuing official for a variance. A request for a variance will be granted only if the owner demonstrates that the health and safety of the public will not be prejudiced by the variance, and that immediate compliance with the provision in question would create practical difficulty or hardship. An owner must comply with all of the terms of a variance, and comply with the requirements of this Subpart by the date specified in the variance.
(b) A waiver shall permit the use of alternative arrangements that do not satisfy one or more requirements of this Subpart, but nonetheless protect the health and safety of the agricultural fairground occupants and the public. To obtain a waiver from one or more requirements of this Subpart, an agricultural fairground owner must submit a written request to the permit-issuing official for a waiver from each such requirement; provided, however, that no waiver from the requirement that the agricultural fairground's on-site water supply be disinfected may be granted. Such request must explain how the alternate arrangements will provide adequate protection of the health and safety of the fairground occupants and public. The permit-issuing official shall obtain the approval of the State Department of Health prior to granting or denying a request for a waiver. An owner must comply with all of the terms of a waiver. A waiver will remain in effect indefinitely unless revoked by the permit-issuing official after a determination that continuation of the waiver would jeopardize public health or a person other than the recipient of the waiver commences ownership of the fairground.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.220 Nonroutine maintenance and repairs
Maintenance and repair work which is not repetitive and not performed regularly.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.1 Definitions
(a) Gross annual receipts for clinical laboratories able to segregate income.
For independent laboratories or laboratories operated within facilities which can segregate their laboratory income from total facility income, gross annual receipts shall mean the total income of the laboratory from all sources for all clinical laboratory tests performed pursuant to its permit, less any amounts paid to reference laboratories for such tests which are referred.
(b) Gross annual receipts for clinical laboratories unable to segregate laboratory income.
(1) For laboratories operated by health maintenance organizations, facilities with operating certificates issued pursuant to section 2805 of the Public Health Law, and other similar facilities which are reimbursed by third-party payors for laboratory services as part of an all inclusive facility per diem rate and which cannot segregate laboratory income from total facility income, gross annual receipts shall mean the amount computed by multiplying the total annual cost of the laboratory, by a fraction, the numerator of which is the gross revenue of the facility and the denominator of which is the gross cost of operating the facility. This amount must be further adjusted by subtracting any amounts paid to reference laboratories for such tests which are referred. Laboratories must obtain prior department approval to use this method by documenting that they are unable to segregate income.
(2) For all other clinical laboratories unable to segregate their annual income from tests performed pursuant to their New York State permit, gross annual receipts shall mean the amount the laboratory would have received had it billed the prevailing rate for these services. The prevailing rate shall mean the fee schedule for clinical laboratory services as listed on pages 5-1 through 5-14 of the Medicaid Management Information System Provider Manual for Laboratories, March 1982 edition, as published by the New York State Department of Social Services. Copies of this publication are available from the Department of Social Services, 40 North Pearl Street, Albany, NY 12243, and a copy is available for inspection and copying from the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Laboratories must obtain prior department approval to use this method by documenting that they are unable to identify laboratory income.
(c) Inspection and reference fee shall mean the fee charged to a clinical laboratory calculated by multiplying the total operating expenses of the clinical laboratory evaluation program of the Department of Health by a fraction, the numerator of which is the gross annual receipts of such laboratory and the denominator of which is the total gross annual receipts of all laboratories issued permits.
(d) Permit year shall mean July 1st to June 30th.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.52 Book of original entry
A record book, recognized by law or custom, in which transactions are successively recorded, and which is the source of postings to ledgers; a journal. Books of original entry include general and special journals, such as cashbooks and registers of sales and purchases.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.5 Topics and requirements for initial asbestos safety training programs
An accredited initial asbestos safety training program shall include at least the core topics listed in subdivision (a) of this section. Actual asbestos material shall not be used for hands-on exercises.
(a) Core topics for all initial asbestos safety training programs except management planner are:
(1) history of asbestos use;
(2) identification of asbestos:
(i) types and physical characteristics of asbestos including fiber size, aerodynamic characteristics and appearance; and
(ii) common uses and applications for asbestos-containing products;
(3) current Federal, State and local laws, regulations and guidelines concerning asbestos, including but not limited to the areas of air monitoring, recordkeeping, employee notification of exposures and mandatory worksite safety procedures;
(4) health effects of asbestos:
(i) factors affecting disease development including: properties of asbestos, how asbestos enters the respiratory and digestive systems and the abdominal and chest cavity, concentration and duration of exposure, and body defenses;
(ii) clinical signs of asbestos exposure based on visible changes in X-rays, including plaques and asbestos bodies;
(iii) asbestos-related diseases: asbestosis, lung cancer, mesothelioma and digestive system cancers (including the definitions and the concepts of risk, latency, symptoms, and diagnosis);
(iv) health risks to family members of asbestos workers;
(v) synergism between cigarette smoking and asbestos exposure; and
(vi) lack of safe exposure level;
(5) protective clothing (hands-on practice required), including disposable and nondisposable clothing, its purpose, other requirements and options, who must wear it, donning, removal, storage, handling and disposal of clothing, types of clothing such as suits, booties, hoods, gloves, eye protection, and footwear; and
(6) summary of abatement control options.
(b) Asbestos handlers training program.
The asbestos handlers training program will be presented through lectures and a variety of interactive/participatory learning methods and shall provide each student with sufficient opportunities for practice exercises to thoroughly demonstrate that the student can properly perform all aspects of asbestos work and prevent unnecessary exposure to others at the worksite and to the general public by properly constructing and maintaining temporary barriers, by properly using protective equipment, and by using proper work area clean-up, decontamination, and work disposal techniques. The program shall include, but not be limited to, the following topics:
(1) core topics as listed in subdivision (a) of this section;
(2) employee personal protective equipment (hands-on practice and demonstration required):
(i) classes and characteristics of respirator types;
(ii) limitations of respirators and their proper selection, inspection, donning, use maintenance, and storage procedures;
(iii) methods for field testing of the facepiece-to-face seal (positive and negative pressure fitting tests);
(iv) qualitative and quantitative fit testing procedures;
(v) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vi) the components of a proper respiratory protection program;
(vii) requirements pertaining to personal protective equipment (see EPA Worker Protection Rule 40 CFR part 763, subpart G; Occupational Safety and Health Act [OSHA] Asbestos Construction Standard, 29 CFR 1926.11, OSHA Respirator Standard 29 CFR 1910.134);
(viii) use of a rotometer to perform an air flow check of a powered air purifying respirator;
(3) medical monitoring:
(i) requirements for physical examinations including a pulmonary function test, chest X-rays and a medical history for each employee (see Occupational Safety and Health Act [OSHA] Medical Surveillance Guidelines for Asbestos, 29 CFR 1910.1001[1]; EPA Worker Protection Rule, 40 CFR part 763, subpart G);
(ii) frequency of medical examinations; and
(iii) employee access to records;
(4) personal hygiene:
(i) entry and exit procedures for the work area, including sequential steps of workers in clean room, shower room and equipment room;
(ii) use of showers;
(iii) sanitation including avoidance of eating, drinking, smoking and chewing (gum and tobacco) in the work area; and
(iv) potential exposures, such as family exposure;
(5) preparation of the work area (hands-on practice required):
(i) occupants;
(ii) furniture and equipment, including the removal of movable furniture and equipment, covering and sealing stationary equipment such as duct work, cleaning of furniture;
(iii) ventilation and electrical systems;
(iv) flooring;
(v) posting of signs;
(vi) electrical and ventilation system lock-out; and
(vii) pre-cleaning the work area;
(6) engineering control techniques to include a discussion of each of the following individually as they apply to installation, removal, encapsulation, enclosure, maintenance and repair (hands-on practice required):
(i) purpose, construction and maintenance of barriers and decontamination enclosure systems;
(ii) removal of non-asbestos surfacing material using proper working techniques which minimize fiber release;
(iii) use of wet methods and surfactants;
(iv) use of negative air pressure ventilation equipment;
(v) use of vacuum cleaners with high efficiency particulate absolute (HEPA) filters;
(vi) use, maintenance and clean-up of tools;
(vii) good housekeeping, such as promptly bagging asbestos debris and other housekeeping features;
(viii) use of glovebags to remove non-asbestos insulation from a horizontal pipe, vertical pipe and elbow;
(ix) emergency procedures for sudden releases;
(x) potential exposure situations; and
(xi) recommended and prohibited work practices;
(7) decontamination system (hands-on practice required) to include:
(i) construction of a decontamination enclosure system consisting of a clean room, shower and equipment room separated, in series, from each other and the work area by three airlocks. This system shall be attached to the work area;
(ii) sequential steps of workers in clean room, shower room and equipment room;
(iii) use of a shower water filtration system
(iv) direction of air flow through the rooms;
(v) security of the work area and enclosure; and
(vi) purpose and use of an entry and exit log;
(8) proper clean-up and disposal (hands-on practice required):
(i) post abatement clean-up procedures and sequence of activities;
(ii) disposal, including bagging, drumming, storage and transport;
(iii) daily work area and decontamination clean-up procedures;
(iv) clean-up of equipment; and
(v) removal of isolation barriers and decontamination enclosure system;
(9) other safety hazards that may be encountered during asbestos abatement activities and procedures to eliminate their occurrence (hands-on practice required):
(i) electrical hazards and placement of electrical cords to reduce tripping hazards;
(ii) heat stress;
(iii) air contaminants other than asbestos;
(iv) fire and explosion hazards;
(v) gasoline engines;
(vi) scaffold and ladder hazards and proper use to minimize hazards;
(vii) slips, trips and falls;
(viii) confined spaces including requirements for entry and exit procedures;
(ix) noise; and
(x) emergency procedures to follow in the event of fire and medical emergencies and failure of containment barriers;
(10) purposes and methods of asbestos air monitoring and testing (hands-on practice required):
(i) procedures to determine airborne concentrations of asbestos fibers, focusing on how personal air sampling is performed and the reasons for it;
(ii) air samples, air monitoring and personal monitoring procedures and requirements under Federal and State regulations;
(iii) sampling equipment demonstration including pumps, filters, and calibration; and
(iv) types of analysis and interpretation of analytical results including electron microscopy techniques, optical microscopy techniques, and requirements under Federal and State regulations;
(11) establishment of programs for respiratory protection;
(12) case studies: typical problems and corrective measures;
(13) relevant Federal, State and local requirements, procedures and standards (see especially OSHA Asbestos Construction Standard, 29 CFR 1926.1101; Title 12 NYCRR Part 56; EPA Asbestos Model Accreditation Plan, 40 CFR part 763, appendix C to subpart E); and
(14) program review.
(c) Operations and maintenance training program.
This program is for operations and maintenance (O and M) workers who work on minor asbestos projects but do not work on small asbestos projects or large asbestos projects. It is intended for all operations and maintenance staff of an employer who perform minor asbestos projects on the premises of that employer. This program will be a minimum of two training days. Four hours of hands-on exercises are required. This program shall include, but not be limited to:
(1) core topics as listed in subdivision (a) of this section;
(2) recognition of damage, deterioration, and delamination of asbestos material;
(3) proper methods of handling asbestos material (hands-on practice required):
(i) purpose, construction and maintenance of barriers (including glove bags);
(ii) use of wet methods and surfactants;
(iii) use of vacuum cleaners with high efficiency particulate absolute (HEPA) filters;
(iv) use, maintenance, and clean-up of tools; and
(v) good housekeeping, such as promptly bagging asbestos debris and other housekeeping features;
(4) proper clean-up and disposal (hands-on practice required):
(i) clean-up including techniques and sequence of activities; and
(ii) disposal including bagging, drumming, storage and transport;
(5) information on the use of respiratory protection as required by the EPA (see the EPA/NIOSH Guide to Respiratory Protection for the Asbestos Abatement Industry) and hands-on training in the use of respiratory protection, other protective measures, and good work practices.
(6) Medical monitoring:
(i) requirements for physical examinations including a pulmonary function test, chest X-rays and a medical history for each employee (see OSHA Medical Surveillance Guidelines for Asbestos, 29 CFR 1910.1001[1], EPA Worker Protection Rule, 40 CFR part 763, subpart G);
(ii) frequency of medical examinations; and
(iii) employee access to records.
(d) Allied trades training program.
This program is for workers who prepare or otherwise enter a contained asbestos project work area for a limited time in performing certain specialized tasks in preparation of, or ancillary to, the actual asbestos abatement. This program shall be a minimum of one and one half training days. A minimum of four hours of hands-on exercises are required. This program shall include but not be limited to:
(1) core topics listed in subdivision (a) of this section;
(2) personal hygiene:
(i) entry and exit procedures for the work area;
(ii) use of showers; and
(iii) sanitation;
(3) preparation of work area:
(i) occupants;
(ii) furniture and equipment, including the removal of movable furniture and equipment, covering and sealing stationary equipment such as duct work, cleaning of furniture;
(iii) ventilation and electrical systems;
(iv) flooring;
(v) posting of signs; and
(vi) electrical ventilation system lock-out;
(4) engineering control techniques (discuss each individually for work practices as they apply to the specialized occupations working in proximity to the actual asbestos abatement project) (hands-on practice required):
(i) purpose, construction and maintenance of barriers and decontamination enclosure systems (including glove bags);
(ii) proper working techniques for minimizing fiber release;
(iii) use of wet methods and surfactants;
(iv) use of negative air pressure ventilation equipment;
(v) use of vacuum cleaners with high efficiency particulate absolute (HEPA) filters;
(vi) use, maintenance and clean-up of tools; and
(vii) good housekeeping, such as promptly bagging asbestos debris and other housekeeping features;
(5) decontamination system (hands-on practice required):
(i) sequential steps of workers in clean room, shower room and equipment room;
(ii) direction of air flow through the rooms;
(iii) security of the work area and enclosure; and
(iv) purpose of exit and entry log;
(6) other safety hazards that may be encountered during asbestos abatement activities:
(i) electrical hazards;
(ii) heat stress;
(iii) air contaminants other than asbestos;
(iv) fire and explosion hazards;
(v) gasoline engines;
(vi) scaffold and ladder hazards;
(vii) slips, trips and falls;
(viii) confined spaces;
(ix) noise; and
(x) emergency procedures to follow in the event of fire or medical emergencies or failure of containment barriers;
(7) case studies: typical problems and corrective measures;
(8) employee personal protective equipment;
(i) classes and characteristics of respirator types;
(ii) limitations of respirators and their proper selection, inspection, donning, use, maintenance, and storage procedures;
(iii) methods for field testing of the facepiece-to-face seal (positive and negative pressure fitting tests);
(iv) qualitative and quantitative fit testing procedures;
(v) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vi) the components of a proper respiratory protection program;
(vii) requirements pertaining to personal protective equipment (see EPA Worker Protection Rule 40 CFR part 763, subpart G; OSHA Asbestos Construction Standard, 29 CFR 1926.1101; OSHA Respirator Standard, 29 CFR 1910.134);
(9) medical monitoring. OSHA requirements for pulmonary function test, chest X-rays, and a medial history for each employee.
(e) Asbestos project air sampling technician training program.
This program is for workers who perform environmental asbestos sampling by applying proper techniques and methods in the selection of sites, collection, handling, recording and chain-of-custody procedures in the transport of environmental asbestos samples which fulfill the assessment and monitoring requirements for all pre-abatement, abatement and post-abatement asbestos projects in compliance with existing regulations or in performance of investigative studies. This program shall be a minimum of two training days. Five hours of hands-on exercises are required. This program shall include but not be limited to:
(1) core topics listed in subdivision (a) of this section;
(2) principles of asbestos project abatement procedures and practices;
(3) personal hygiene:
(i) entry and exit procedures for the work area;
(ii) use of showers; and
(iii) sanitation;
(4) decontamination system (hands-on practice required):
(i) sequential steps of workers in clean room, shower room and equipment room;
(ii) direction of air flow through the rooms; and
(iii) security of the work area and enclosure;
(5) other safety hazards that may be encountered during asbestos abatement activities:
(i) electrical hazards;
(ii) heat stress;
(iii) air contaminants other than asbestos;
(iv) fire and explosion hazards;
(v) gasoline engines;
(vi) scaffold and ladder hazards;
(vii) slips, trips, and falls;
(viii) confined spaces;
(ix) noise;
(x) emergency procedures to follow in the event of fire or medical emergencies or failure of containment barriers; and
(xi) purpose of exit and entry log; and
(6) purposes and methods of asbestos bulk sampling, air monitoring and testing (hands-on practice required):
(i) proper methods of collecting bulk samples to minimize generation of airborne fibers;
(ii) air samples, air monitoring and personal monitoring procedures and requirements under Federal and State regulations;
(iii) sampling equipment demonstration including pumps, filters, and calibration in order to collect representative samples;
(iv) types of analysis and interpretation of analytical results including electron microscopy techniques, optical microscopy techniques, and requirements under Federal and State regulations; and
(v) proper chain of custody procedures for legally defensible data;
(7) information on the use of respiratory protection as required by the EPA (see the EPA/NIOSH Guide to Respiratory Protection for the Asbestos Abatement Industry) and hands-on training in the use of respiratory protection, other protection measures and good work practices.
(f) Inspector training program.
This program is for workers who collect bulk samples, survey, identify, record and report upon asbestos containing materials associated with any building or structure in compliance with existing regulations or in performance of investigative studies. The inspector training program will be presented through lectures and a variety of interactive/participatory learning methods and shall provide each trainee with sufficient opportunities for practice exercises to thoroughly demonstrate that the trainee can perform the tasks required of an inspector (see the Asbestos School Hazard Abate Reauthorization Act). The program shall include, but not be limited to the following topics:
(1) core topics listed in subdivision (a) of this section;
(2) the role of inspectors - qualifications and functions:
(i) experience and qualifications of inspectors and management planner;
(ii) functions of certified inspectors as compared to those of an accredited management planner;
(iii) inspection procedures and processes;
(iv) asbestos containing material inventory and physical assessment.
(3) legal liability and defenses:
(i) legal liabilities and responsibilities of inspectors and management planners;
(ii) comprehensive general liability policies;
(iii) claims-made and occurrence policies;
(iv) environmental and pollution liability clauses;
(v) State liability insurance requirements;
(vi) bonding and the relationship of insurance availability to bond availability;
(4) understanding the building systems:
(i) common building plan/layout;
(ii) heating, ventilation and air conditioning systems:
(a) system types, organization;
(b) common system layout;
(c) common locations of asbestos containing material on heating, ventilation and air conditioning components;
(iii) building mechanical systems:
(a) system types, organization;
(b) common system layout;
(c) common locations of asbestos containing material;
(iv) inspecting electrical systems:
(a) inspection procedures;
(b) safety precautions;
(v) reading blueprints and as-built drawings;
(5) public/employee/building occupant relations:
(i) inspection notification to the public/employee/building occupant;
(ii) warning signs;
(iii) strategies, techniques for handling building occupants and the press;
(iv) inspection scheduling strategies for minimizing disruption of building activities;
(v) education of building occupants;
(6) pre-inspection planning and review of previous inspection records:
(i) inspection scheduling and obtaining access;
(ii) building record review;
(iii) identifying homogeneous sampling areas using blueprints or as-built drawings;
(iv) consultation with maintenance or building personnel;
(v) review of previous inspections, sampling and abatement records;
(vi) the role of the inspector in exclusions for previously performed inspections;
(7) inspecting for friable and nonfriable asbestos containing material and assessing condition:
(i) processes and procedures for conducting visual inspections for asbestos containing material;
(ii) types of building materials that may contain asbestos;
(iii) determining friability sample sites;
(iv) open return air plenums and their importance in HVAC systems;
(v) assessing damage and deterioration;
(a) significant damage;
(b) potential for damage;
(c) potential for significant damage;
(d) type of damage;
(e) possible causes of damage;
(f) materials potential for disturbance;
(g) amount of suspect ACM, both in total quantity and as a percentage of the total area;
(h) accessibility;
(i) known or suspected causes of damage or significant damage; and
(j) deterioration as assessment factors;
(8) bulk sampling/documentation of asbestos in buildings (hands-on practice required):
(i) detailed discussion of the simplified sampling scheme for friable surfacing materials (see EPA 560/5-85-030a October 1985);
(ii) random distribution sampling techniques;
(iii) sampling workshop for surfacing material, thermal system insulation and non-friable materials;
(iv) techniques for bulk sampling:
(a) proper use of bulk sampling and repair equipment;
(b) patching and repairing sampling area;
(v) polarized light microscopy;
(vi) choosing an accredited laboratory;
(vii) quality control and quality assurance;
(9) inspector respiratory protection and personal protective equipment workshop (hands-on practice and demonstration required):
(i) respirator types and classes;
(ii) respirator limitations;
(iii) proper selection, inspection donning, use, storage and maintenance;
(iv) field testing facepiece-to-face seal (positive and negative fit test);
(v) qualitative and quantitative fit test procedures;
(vi) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vii) developing a respiratory protection program;
(viii) selection and use of personal protective clothing—use, storage and handling of non-disposable clothing;
(10) medical monitoring:
(i) requirements for physical examinations, including pulmonary function test, chest X-rays and a medical history for each employee (see OSHA Medical Surveillance Guidelines for Asbestos, 29 CFR 1910.1001[1]; EPA Worker Protection Rule, 40 CFR part 763, subpart G);
(ii) frequency of medical examinations; and
(iii) employee access to records;
(11) recordkeeping and writing the inspection report;
(i) sample labeling procedures and keying sample identification to sampling location;
(ii) asbestos containing material inventory procedures;
(iii) the use of photographs;
(iv) review of Federal, State and local government asbestos project forms;
(v) information required for inclusion in the management plan required for school buildings (see TSCA Title II, section 203[i][l]);
(12) review of relevant Federal, State and local government requirements (see National Emission Standards for Hazardous Air Pollutants [NESHAP: 40 CFR part 61, subparts A and M]; EPA Worker Protection Rule [40 CFR part 763, subpart G]; OSHA Asbestos Construction Standard [29 CFR 1926.1101]; OSHA respirator requirements [29 CFR 1910.134]; the Friable Asbestos in Schools Rule [40 CFR part 763, subpart F]; and article 30 of the NYS Labor Law; 12 NYCRR Part 56; this Part and other applicable State and local regulations) and differences between Federal and State requirements where they apply, and the effects, if any, on public and non-public schools or commercial or public buildings;
(13) walk-through survey workshop that includes:
(i) visual inspection procedures for inspecting buildings (on-site practice) including walls, ceilings, ducts, beams,piping, etc.;
(ii) choosing sample locations;
(iii) developing asbestos containing material inventory; and
(iv) physical building assessment; on-site discussion and classroom discussion;
(14) program review. A review of key aspects of the training program.
(g) Management planners training program.
This program is for those responsible for using data gathered by inspectors to assess the asbestos containing materials hazard in buildings, determine appropriate response actions, and develop a schedule for implementing response actions. Management planners must complete an inspector training program as defined in subdivision (f) of this section and an additional training program of at least two training days. Possession of current and valid inspector accreditation shall be a prerequisite for admission to the management planner training program. The management planner training program will be presented through lectures and demonstrations. At a minimum the following topics are to be included in these two additional training days:
(1) course overview:
(i) the role of the management planner;
(ii) operations and maintenance programs;
(iii) setting work priorities; and
(iv) protection of building occupants;
(2) evaluation/interpretation of survey results:
(i) review of Federal or State requirements for inspection and management plans (see, for example, TSCA Title II section 203[i][1]);
(ii) summarized field data and laboratory results;
(iii) comparison between field inspector's data sheet with laboratory results and site survey;
(3) hazard assessment:
(i) amplification of the difference between physical assessment and hazard assessment;
(ii) the role of the management planner is hazard assessment;
(iii) explanation of significant damage, damage, potential damage and potential significant damage;
(iv) use of a description (or decision tree) code for assessment of ACM; assessment of friable ACM; and
(v) relationship of accessibility, vibration sources, use of adjoining space, and air plenums and other factors to hazard assessment;
(4) legal implications:
(i) liability;
(ii) insurance issues specific to planners;
(iii) liabilities associated with interim control measures, in-house maintenance, repair, and removal; and
(iv) use of results from previously performed inspections;
(5) evaluation and selection of control operations:
(i) overview of encapsulation, enclosure, interim operations and maintenance, and removal;
(ii) advantages and disadvantages of each method;
(iii) response actions described via a decision tree or other appropriate method;
(iv) work practices for each response action;
(v) staging and prioritizing of work in both vacant and occupied buildings; and
(vi) the need for containment barriers and decontamination in response actions;
(6) role of other professionals:
(i) use of industrial hygienists, engineers, and architects in developing technical specifications for response actions;
(ii) any requirements that may exist for architect sign-off to plans; and
(iii) team approach to design of high-quality job specifications;
(7) developing an operations and maintenance (O&M) plan:
(i) purpose of the plan;
(ii) discussion of applicable EPA guidance documents;
(iii) what actions should be taken by custodial staff;
(iv) proper cleaning procedures;
(v) steam cleaning and high efficiency particulate aerosol (HEPA) vacuuming;
(vi) reducing disturbance of ACM;
(vii) scheduling O&M for off-hours;
(viii) rescheduling or canceling renovation in areas with ACM;
(ix) boiler room maintenance;
(x) disposal of ACM;
(xi) in-house procedures for ACM-bridging and penetrating encapsulants;
(xii) pipe fittings;
(xiii) metal sleeves;
(xiv) polyvinyl chloride (PVC), canvas, and wet wraps;
(xv) muslin with straps;
(xvi) fiber mesh cloth;
(xvii) mineral wool, and insulating cement;
(xviii) discussion of employee protection programs and staff training; and
(xix) case study in developing an O&M plan (development, implementation process, and problems that have been experienced);
(8) regulatory review:
(i) OSHA Asbestos Construction Standard;
(ii) the National Emissions Standard for Hazardous Air Pollutants (NESHAPS);
(iii) other applicable Federal regulations including, but not limited to, the National Emissions Standard for Asbestos; EPA Worker Protection Rule; and TSCA Title II; and
(iv) Article 30, Part 56 of Title 12, this Part and any other applicable State statutes or regulations;
(9) recordkeeping for the management planner
(i) use of field inspector's data sheet along with laboratory results;
(ii) ongoing recordkeeping as a means to track asbestos disturbance; and
(iii) procedures for recordkeeping;
(10) assembling and submitting the management plan:
(i) plan requirements of the EPA (see in TSCA Title II section 203[i][1]); and
(ii) the management plan as a planning tool;
(11) financing abatement actions:
(i) economic analysis and cost estimates;
(ii) development of cost estimates;
(iii) present costs of abatement versus future operations and maintenance costs; and
(iv) Asbestos School Hazard Abatement Act grants and loans, and New York State grant program;
(12) program review. A review of key aspects of the training program.
(h) Abatement project training program.
This program is for those who as project designers are responsible for determining how asbestos abatement project work should be conducted. This program shall be presented through lectures, demonstrations and a field trip. This program shall include, but not be limited to, the following topics:
(1) core topics as listed in subdivision (a) of this section;
(2) overview of abatement construction projects:
(i) abatement as a portion of a renovation project;
(ii) notification of other contractors on a multi-employer site (see OSHA requirements at 29 CFR 1926.58);
(3) safety system design specifications:
(i) design, construction and maintenance of containment barriers and decontamination enclosure systems;
(ii) positioning of warning signs;
(iii) electrical and ventilation system lock-out;
(iv) proper working techniques for minimizing fiber release;
(v) entry and exit procedures for the work area;
(vi) use of wet methods;
(vii) use of negative pressure exhaust ventilation equipment;
(viii) use of high efficiency particulate aerosol (HEPA) vacuums;
(ix) proper clean-up and disposal of asbestos;
(x) work practices as they apply to encapsulation, enclosure, and repair;
(xi) use of glove bags and a demonstration of glove bag use; and
(xii) techniques for completing an initial cleaning of the work area;
(4) field trip. Visit an abatement site or other suitable building site, including on-site discussions of abatement design and rationale for the concept of functional spaces, and building walk-through inspection, and discussion following the walk-through;
(5) employee personal protective equipment:
(i) classes and characteristics of respirator types;
(ii) limitations of respirators;
(iii) proper selection, inspection, donning, use, maintenance, and storage procedures;
(iv) methods for field testing of the facepiece-to-face seal (positive and negative pressure fitting tests);
(v) qualitative and quantitative fit testing procedures;
(vi) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vii) components of a proper respirator protection program;
(viii) selection and use of personal protective clothing; and
(ix) use, storage and handling of non-disposable clothing;
(6) additional safety hazards. Hazards encountered during abatement activities and procedures to eliminate their occurrence, including electrical hazards, heat stress, air contaminants other than asbestos, fire and explosion hazards, scaffold and ladder hazards, confined space hazards and slips, trips and falls;
(7) fiber aerodynamics and control:
(i) aerodynamic characteristics of asbestos fibers;
(ii) importance of proper containment barriers;
(iii) settling time for asbestos fibers;
(iv) wet methods in abatement;
(v) aggressive air monitoring following abatement;
(vi) aggressive air movement and negative pressure exhaust ventilation as a clean-up method;
(8) designing abatement solutions:
(i) discussions of removal, enclosure, and encapsulation methods;
(ii) asbestos waste disposal;
(9) budgeting/cost estimation:
(i) development of cost estimates;
(ii) present costs of abatement versus future operations and maintenance costs;
(iii) setting priorities for abatement jobs to reduce cost;
(10) writing abatement specifications:
(i) means and methods specifications versus performance specifications;
(ii) design of abatement in occupied buildings;
(iii) modification of guide specifications to a particular building;
(iv) worker and building occupant health/medical considerations;
(v) replacement of ACM with non-asbestos substitutes;
(vi) clearance of work area after abatement;
(vii) air monitoring for clearance;
(viii) preparation of and a need for a written project design;
(11) final clearance process for reoccupancy:
(i) discussion of the need for a written sampling rational for aggressive final air clearance;
(ii) requirements of a complete visual inspection; and
(iii) the relationship of the visual inspection to final air clearance;
(12) preparing abatement drawings;
(i) significance and need for drawings;
(ii) use of as-built drawings as base drawings;
(iii) use of inspection photographs and on-site reports;
(iv) methods of preparing abatement drawings;
(v) diagramming containment barriers;
(vi) relationship of drawings to design specifications; and
(vii) particular problems related to abatement drawings.
(13) contract preparation and administration.
(14) legal/liabilities/defenses:
(i) insurance considerations;
(ii) bonding;
(iii) hold-harmless clauses;
(iv) use of abatement contractor's liability insurance; and
(v) claims made versus occurrence policies;
(15) replacement. Replacement of asbestos with asbestos-free substitutes;
(16) role of other consultants:
(i) development of technical specification sections by industrial hygienists or engineers; and
(ii) the multi-disciplinary team approach to abatement design;
(17) occupied buildings:
(i) special design procedures required in occupied buildings;
(ii) education of occupants;
(iii) extra monitoring recommendations;
(iv) staging work to minimize occupant exposure; and
(v) scheduling of renovation to minimize exposure;
(18) relevant Federal, State, and local requirements, procedures and standards, (see the requirements of TSCA Title II: article 30 of the NYS Labor Law; 12 NYCRR Part 56; this Part; National Emission Standards for Hazardous Air Pollutants [40 CFR part 61], subparts A [General Provision] and M [National Emissions Standard for Asbestos]; OSHA standards for permissible exposure to airborne concentrations of asbestos fibers and respiratory protection [29 CFR 1910.134]; EPA Worker Protection Rule, [40 CFR part 763], subpart G; OSHA Asbestos Construction Standard [29 CFR 1926.1101]; OSHA Hazard Communication Standard [29 CFR 1926.59]; and other relevant Federal, State and local regulatory requirements);
(19) program review. A review of key aspects of the training program.
(i) Asbestos abatement contractors and supervisors training program.
A contractor may designate a supervisor to serve as his agent for the purposes of the accreditation. Supervisors include those persons who provide supervision and direction to workers engaged in asbestos removal, encapsulation, enclosure, and repair. The asbestos abatement contractors and supervisors program will be presented through lectures and a variety of interactive/participatory learning methods and shall provide each trainee with sufficient opportunities for practice exercises to thoroughly demonstrate that the trainee has the skills and knowledge necessary to evaluate, select and implement engineering control options in accordance with Federal and State requirements. Supervisors may include those individuals with the position title of foreman, working foreman, or leadman pursuant to collective bargaining agreements. The program shall include, but not be limited to, the following topics:
(1) core topics listed in subdivision (a) of this section;
(2) employee personal protective equipment (hands-on practice and demonstration required):
(i) classes and characteristics of respirator types;
(ii) limitation of respirators and their proper selection, inspection, donning, use, maintenance, and storage procedures;
(iii) methods for field testing of the facepiece-to-face seal (positive and negative pressure fitting test);
(iv) qualitative and quantitative fit testing procedures;
(v) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vi) the components of a proper respirator protection program;
(vii) selection and use of personal protective clothing;
(viii) use, storage and handling of nondisposable clothing;
(ix) requirements pertaining to personal protection equipment (see EPA Worker Protection Rule, 40 CFR part 763, subpart G; OSHA Asbestos Construction Standard, 29 CFR 1926.1101; OSHA Respirator Standard, 29 CFR 1910.134);
(x) use of a rotometer to perform an air flow check of a powered air purifying respirator;
(xi) uses and limitations of personal protective equipment ( e.g., eye protection, hard hats, gloves, footwear); and
(xii) breathing air systems including high pressure v. low pressure, testing for Grade D air and determining proper backup air volumes;
(3) state-of-the-art work practices (hands-on practice required):
(i) proper work practices for asbestos abatement activities including descriptions of proper construction and maintenance of barriers and decontamination enclosure systems;
(ii) positioning of warning signs;
(iii) electrical and ventilation system lockout;
(iv) proper working techniques for minimizing fiber release;
(v) use of wet methods;
(vi) use of negative pressure ventilation equipment;
(vii) use of high efficiency particulate air (HEPA) vacuums;
(viii) proper clean-up and disposal procedures;
(ix) work practices for removal, encapsulation, enclosure, and repair;
(x) emergency procedures for sudden releases;
(xi) potential exposure situations;
(xii) transport and disposal procedures, and recommended and prohibited work practices; and
(xiii) discussion of new abatement-related techniques and methodologies may be included;
(xiv) proper techniques for initial cleaning;
(xv) removal of non-asbestos surfacing material using proper working techniques to minimize fiber release;
(xvi) use of glovebags to remove non-asbestos thermal system insulation from a horizontal pipe, vertical pipe and elbow;
(xvii) construction of a decontamination enclosure system consisting of a clean room, shower, and equipment room separated, in series, from each other and the work area by three airlocks. This system shall be attached to the work area;
(xviii) use of a shower water filtration system;
(xix) post abatement clean-up procedures and sequence of activities; and
(xx) notification of building occupants;
(4) personal hygiene:
(i) entry and exit procedures for the work area;
(ii) use of showers;
(iii) avoidance of eating, drinking, smoking, and chewing (gum or tobacco) in the work area; and
(iv) potential exposures, such as family exposure, shall also be included;
(5) additional safety hazards that may be encountered during asbestos abatement activities and procedures to eliminate their occurrence (hands-on practice required):
(i) electrical hazards and placement of electrical cords to reduce tripping hazards;
(ii) heat stress;
(iii) air contaminants other than asbestos;
(iv) fire and explosion hazards;
(v) scaffold and ladder hazards and proper use to minimize hazards;
(vi) slips, trips, and falls;
(vii) confined spaces entry and exit procedures (see OSHA Permit Required Confined Spaces, 29 CFR 1910.146);
(viii) review of hazard assessment considerations.
(6) medical monitoring;
(i) requirements for pulmonary function test, chest X-rays and a medical history for each employee (see OSHA Medical Surveillance Guidelines for Asbestos, 29 CFR 1910.1001[1]; EPA Worker Protection Rule, 40 CFR part 763, subpart G);
(ii) frequency of medical examinations; and
(iii) employees access to records;
(7) air monitoring (hands-on practice required). Proper methods of collecting employee exposure air samples. Procedures to determine airborne concentrations of asbestos fibers, including a description of aggressive sampling, sampling equipment and methods, reasons for air monitoring, types of samples, and interpretation of results, specifically from analysis performed by polarized light, phase-contrast, and electron microscopy analyses;
(8) relevant Federal, State and local requirements, procedures and standards, (see article 30 of the New York State Labor Law; 12 NYCRR Part 56; this Part; requirements of TSCA Title II; National Emission Standards for Hazardous Air Pollutants [NESHAP] 40 CFR part 61 subparts A [General Provisions] and M [National Emission Standard for Asbestos]; OSHA standards for permissible exposure to airborne concentrations of asbestos fibers and respiratory protection [29 CFR 1910.134]; OSHA Asbestos Construction Standard [29 CFR 1926.1101]; EPA Worker Protection Rule, 40 CFR part 763, subpart G; OSHA Hazard Communication Standard [29 CFR 1926.59] and other relevant Federal, State and local regulatory requirements);
(9) respiratory protection programs and medial surveillance programs;
(10) insurance and liability issues:
(i) contractor issues;
(ii) worker's compensation coverage and exclusions;
(iii) third-party liabilities and defenses; and
(iv) insurance coverage and exclusions;
(11) recordkeeping for asbestos abatement projects (hands-on practice required):
(i) records required by Federal, State, and local agencies;
(ii) records recommended for legal and insurance purposes; and
(iii) use of a daily project logbook to document work area inspections and daily work activities;
(12) supervisory techniques for asbestos abatement activities (hands-on practice required):
(i) supervisory practices to enforce and reinforce the required work practices and discourage unsafe work practices;
(ii) use of smoke tubes to test the effectiveness of the work area barriers and the decontamination enclosure system when the negative pressure system is in operation; and
(iii) use of smoke tubes to perform glovebag seal testing;
(13) contract specifications. Discussion of key elements that are included in contract specifications; and
(14) program review. A review of key aspects of the training program.
(j) Project monitor training program.
A project monitor serves as the on-site representative of the building owner to oversee asbestos abatement work to insure that work is performed in accordance with specifications and in compliance with all Federal, State, and local laws. They may also perform the vital role of air monitoring for purposes of determining final clearance. The project monitor program will be presented through lectures and a variety of interactive/participatory learning methods and shall provide each trainee with sufficient opportunities for practice exercises to thoroughly demonstrate that the trainee has the skills and knowledge necessary to perform all tasks relevant to a project monitor. The program will consist of lectures, demonstrations, hands-on training, program review and a written examination. The hands-on training component shall be satisfied in part by incorporating the workshop component described in subparagraphs (15)(i)-(iii) of this subdivision, in which the students simulate participation in or performance of relevant job functions or activities of a project monitor. The program shall include, but not be limited to the following topics:
(1) core topics as listed in subdivision (a) of this section;
(2) employee personal protective equipment (hands-on practice and demonstration required):
(i) classes and characteristics of respirator types;
(ii) limitations of respirators and their proper selection, inspection, donning, use, maintenance, and storage procedures;
(iii) methods for field testing of the facepiece-to-face seal (positive and negative pressure fitting tests);
(iv) qualitative and quantitative fit testing procedures;
(v) variability between field and laboratory protection factors that alter respirator fit ( e.g., facial hair);
(vi) the components of a proper respiratory protection program;
(vii) use of a rotometer to perform an air flow check of a powered air purifying respirator;
(viii) uses and limitations of personal protective equipment ( e.g., eye protection, hard hats, gloves, footwear);
(ix) protective clothing selection, use and proper handling; and
(x) breathing air systems including high pressure v. low pressure, testing for Grade D air and determining proper backup air volumes;
(3) medical monitoring:
(i) requirements for physical examinations including a pulmonary function test, chest X-rays and a medical history for each employee (see OSHA Medical Surveillance Guidelines for Asbestos 29 CFR 1910.1001[1]; EPA Worker Protection Rule, 40 CFR part 763, subpart G);
(ii) frequency of medical examinations; and
(iii) employee access to records;
(4) roles and responsibilities of the project monitor, including regulatory/specification compliance monitoring, air monitoring, conducting visual inspections, and final clearance monitoring;
(5) relevant Federal, State and local asbestos requirements; interrelationships of such requirements, (see NESHAP, 40 CFR part 61, subparts A and M; Asbestos Hazard Emergency Response Act [AHERA], 40 CFR part 763, subpart E; and the EPA Worker Protection Rule, 40 CFR part 763, subpart G; OSHA Construction Industry Standard for Asbestos, 29 CFR 1926.1101; Respirator Standard, 29 CFR 1910.134; Hazard Communication Standard, 29 CFR 1926.59; and article 30 of the NYS Labor Law; 12 NYCRR Part 56; this Part; and other applicable Federal, State and local regulations).
(6) understanding building construction and building systems:
(i) building construction basics;
(ii) building physical plan layout;
(iii) understanding building systems (heat, ventilation and air conditioning (HVAC), electrical, etc.);
(iv) layout and organization;
(v) where asbestos is likely to be found on building systems; and
(vi) renovations and the effect of asbestos abatement on building systems;
(7) asbestos abatement contracts, specifications, and drawings:
(i) basic provisions of the contract;
(ii) relationships between principle parties;
(iii) establishing chain of command;
(iv) types of specifications, including means and methods, performance, proprietary and non-proprietary;
(v) reading and interpreting records and abatement drawings;
(vi) discussion of change orders; and
(vii) common enforcement responsibilities and authority of the project monitor;
(8) response actions and abatement practices:
(i) review of asbestos abatement and control techniques;
(ii) pre-work inspections;
(iii) pre-work considerations including pre-cleaning of the work area, removal of furniture, fixtures, and equipment;
(iv) shutdown/modification of building systems;
(v) construction and maintenance of containment barriers and proper demarcation of work areas;
(vi) work area entry/exit and hygiene practices;
(vii) determining the effectiveness of air filtration equipment;
(viii) techniques for minimizing fiber release including wet methods and continuous cleaning;
(ix) abatement methods other than removal;
(x) abatement area clean-up procedures;
(xi) contingency planning for emergency response; and
(xii) waste transport and disposal techniques;
(9) asbestos abatement equipment:
(i) typical equipment found on an abatement project including air filtration devices and vacuum systems;
(ii) negative pressure differential monitoring including HEPA filtration, theory of filtration, design/construction of HEPA filtration units, qualitative and quantitative performance of HEPA filtration units, sizing the ventilation requirements, location of HEPA filtration units and qualitative and quantitative tests of containment barrier integrity; and
(iii) best available technology;
(10) air monitoring strategies:
(i) sampling equipment including sampling pumps (low v. high volume), flow regulating devices (critical and limiting orifices) and use of fibrous aerosol monitors on abatement projects;
(ii) sampling media including types of filters, types of cassettes, filter orientation and storage and shipment of filters;
(iii) calibration techniques such as primary calibration standards, secondary calibration standards, temperature/pressure effects, frequency of calibration, recordkeeping, field work documentation and calculations;
(iv) air sample analysis, techniques available and limitations on their use including transmission electron microscopy (background to sample preparation and analysis, air sample conditions which prohibit analysis, recommended technique for analysis of final air clearance samples), phase contrast microscopy (background to sample preparation, and limits on the use of phase contract microscopy) and what each technique measures;
(v) analytical methodologies (see AHERA Transmission Electron Microscopy [TEM] protocol [40 CFR part 763, appendix A to subpart E], National Institute of Occupational Safety and Health [NIOSH] 7400, OSHA reference method [non-clearance] and EPA recommendation for clearance [TEM]);
(vi) sampling strategies for clearance monitoring including types of air samples (personal breathing zone v. fixed-station area), sampling location and objectives (pre-abatement, during abatement, and clearance monitoring), number of samples to be collected, minimum and maximum air volumes, clearance monitoring (post-visual inspection), (number of samples required, selection of sampling locations, period of sampling, aggressive sampling, interpretations of sampling results, calculations) and quality assurance; and
(vii) special sampling problems such as crawl spaces, acceptable samples for laboratory analysis and sampling in occupied buildings (barrier monitoring);
(11) safety and health issues other than asbestos:
(i) electrical hazards and placement of electrical cords to reduce tripping hazards;
(ii) heat stress;
(iii) air contaminants other than asbestos;
(iv) fire and explosion hazards;
(v) gasoline engines;
(vi) scaffold and ladder hazards and proper use to minimize hazards;
(vii) slips, trips and falls;
(viii) confined spaces, exit and entry procedures (see OSHA Permit Required Confined Spaces, 29 CFR 1910.146);
(ix) noise;
(x) emergency procedures to follow in the event of fire and medical emergencies and failure of containment barriers; and
(xi) hazardous materials on abatement projects;
(12) conducting visual inspections:
(i) inspections during abatement and visual inspections (see American Society for Testing and Materials [ASTM] E1368 document [Standard Practice for Visual Inspection of Asbestos Projects]);
(ii) conducting inspections for completeness of removal; and
(iii) discussion of “how clean is clean”;
(13) legal responsibilities and liabilities of project monitors:
(i) specification enforcement capabilities;
(ii) regulatory enforcement;
(iii) licensing; and
(iv) powers delegated to project monitors through contract documents;
(14) recordkeeping and report writing:
(i) developing project logs/daily logs (what should be included, who sees them);
(ii) final report preparation; and
(iii) recordkeeping;
(15) workshops:
(i) contracts, specifications and drawings. This workshop shall consist of each participant being issued a set of contracts, specifications, and drawings and then being asked to answer a series of questions and make recommendations to a project architect, engineer or to the building owner based on given conditions and these documents;
(ii) air monitoring strategies/asbestos abatement equipment. This workshop shall consist of simulated abatement sites for which sampling strategies would have to be developed ( i.e., occupied buildings, industrial situations). Through demonstrations and exhibitions the project monitor student will be able to gain a better understanding of the function of various pieces of equipment used on abatement projects (air filtration units, water filtration units, negative pressure monitoring devices, sampling pumps, calibration devices, etc.);
(iii) conducting visual inspections. This workshop shall consist of a simulated asbestos abatement work area which is intentionally constructed to contain a minimum of five violations of State and Federal requirements (see especially Title 12 NYCRR Part 56 and OSHA Asbestos Construction Standards, 29 CFR 1926.1101). Each participant will inspect the work area and be asked to identify and document the work area violations and make recommendations to correct the violations. For the purpose of conducting a final visual inspection, non-asbestos debris shall be strategically placed in the work area and each participant will be asked to locate and document the exact locations of the debris. At the conclusion of the workshop a series of questions will be asked which are designed to stimulate the participant's recall of the area.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.1 Applicability
On and after November 1, 2014, rates of reimbursement for residential habilitation services provided in community residences, including IRAs, and for day habilitation services, other than those provided by the Office for People with Developmental Disabilities, shall be determined in accordance with this Subpart.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.7 Enforcement
(a) Upon notice and opportunity of a hearing, the department may suspend or revoke a certificate of an operator. Revocation or suspension will be based on fraud or misrepresentation by the certified operator; gross incompetence or gross negligence on a particular occasion or negligence or incompetence on more than one occasion; or mental or physical incapacity of the operator to perform his or her operating duties.
(1) Suspension of certificate.
(i) Grounds for suspension. A suspendable offense may include but is not limited to:
(a) selective sampling — operator intentionally alters sampling period, in an attempt to collect samples that are not truly representative;
(b) sabotage of equipment — intentional misuse or impairment of equipment necessary to maintain treatment and/or distribution;
(c) bribery or extortion — operator accepts or offers bribes related to plant operations or uses his/her position as an operator to extort money or services from others;
(d) dangerous acts — failure to take appropriate actions necessary to provide a safe and healthful workplace or directs staff to perform activities without proper safety equipment or training;
(e) misleads — operator gives misleading statements to government officials relative to the operation of the treatment facilities and/or distribution system;
(f) lack of maintenance — failure to maintain the treatment facilities and/or distribution system to an acceptable level despite having the resources and the means to properly maintain the facility and/or distribution system;
(g) lack of process control — failure to utilize knowledge of process control techniques to optimize the operation of the treatment facility; and
(h) unauthorized modification of a facility and/or distribution system — failure to contact the State and obtain approval when any modification of the facility and/or distribution system is made.
(ii) Suspension term. A suspension term will last for a period not to exceed three years and will be based on factors such as: number of acts committed, degree of physical or environmental harm resulting from acts, degree of cooperation and other relevant information. Three suspensions in any three-year period, time period starting with the effective date of the first suspension, will result in an automatic revocation.
(iii) Conditions of reinstatement. A certificate may be reinstated upon request from the suspended operator after the operator serves his/her suspension period and has completed necessary training and/or other suspension conditions prescribed by the State.
(2) Revocation of certificate.
(i) Grounds for revocation. A revocable offense may include but is not limited to:
(a) falsifying reports — making false statements or notations on legal or official records required by the department;
(b) illegal bypassing — bypassing the entire treatment facility and sending untreated water to the distribution system, without prior approval by the State;
(c) sample tampering — knowingly collecting, preparing, or analyzing a sample that will yield results that are not representative of the actual water quality;
(d) coercion — the operator uses his/her position to force another employee to undertake an appropriate or illegal act relating to treatment plant operation and/or distribution system;
(e) plant related criminal or civil charges — the operator pleads or is found guilty of criminal or civil charges related to the operation of the treatment facility and/or distribution system; and
(f) equipment damage and harm to public — the operator operates the facility in such a manner as to cause harm to equipment or the public that the operator had reasonably available means to avoid.
(ii) Condition of reinstatement. A certificate may be reinstated upon request from the revoked operator after the operator serves his/her revocation period and has met the requirements outlined in sections 5-4.3 and 5-4.5 of this Subpart, and other revocation conditions prescribed by the department.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-1.180 Premises
(a) Food service establishments and all parts of the property used in connection with operations of the establishment are to be kept clean and free from litter, and are to be maintained in such a manner as to prevent creation of a nuisance.
(b) Only articles necessary to the operation and maintenance of the food service establishment are to be in the establishment.
(c) Unnecessary traffic of persons through the food preparation and utensil washing areas is prohibited.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.14 Enrollment of providers
The department will contract with or enter into provider agreements with providers, including providers of related laboratory and ancillary services, which demonstrate that they are qualified to provide prescription drugs.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.5 Notice of complaint
In the event that the unlawful discriminatory practice is not eliminated voluntarily, or prior to such elimination if the commissioner deems it advisable to do so, the commissioner shall cause to be issued and served on such member or members of the respondent hospital governing body as he shall consider appropriate, a written notice with a copy of the complaint, as it may have been amended, requiring the person served to answer the complaint and to appear at a hearing before the commissioner or a hearing officer designated by him, other than the investigating officer, at a place specified in the notice and at a specified time which shall be not less than 20 days subsequent to the issuance of the notice.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.4 Village of Chester
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all the reservoirs, watercourses and drainage areas tributary thereto, which serve as sources of the public water supply of the village of Chester, Orange County, N. Y.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to Walton Lake.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond, lake (other than Walton Lake), stream, ditch, gutter or other channel or permeable pipe or conduit of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into Walton Lake.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind, used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, placed or maintained in such a manner that the contents therein may gain entrance to the reservoir or any watercourse of the Chester water supply, except the properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d).
(2) The excreta collected in removable receptacles of privies shall be removed and the receptacles cleansed and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal, hereinafter specified, and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjoining premises.
(3) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, sewage or excremental matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed and operated sewage disposal plant, as hereinafter provided in paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse tributary to the public water supply of the village of Chester, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Chester shall be operated, constructed, enlarged, altered or put in operation without a permit from the State Commissioner of Health.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy or cheese factory nor water in which milk cans have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant, as hereinbefore provided under paragraph (2) of this subdivision, shall be thrown or discharged into any reservoir or watercourse tributary to the public water supply of the village of Chester, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground in any manner whereby the same may flow into the reservoir or into any watercourse of the Chester water supply.
(4) No clothing, bedding, carpets, harness, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in the reservoir or in any watercourse of the Chester water supply.
(e) [Animals.]
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain in such a location that the drainage, leachings or washings from the same may enter the reservoir or any watercourse of the Chester water supply.
(f) [Human excreta, compost.]
No human excreta or compost containing human excreta shall be thrown, placed or allowed to escape into the reservoir or watercourse nor be placed, piled or spread upon the ground in such a manner that the material shall be drained or washed into the reservoir or any watercourse of the Chester water supply.
(g) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal nor waste matter of any kind shall be thrown, placed in or allowed to pass into the reservoir or any watercourse of the Chester water supply, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach the reservoir or watercourse.
(h) Fishing, boating and ice cutting.
No person, while fishing, boating or ice cutting, shall commit any act by which the waters of the reservoir or watercourses tributary to the Chester water supply may be polluted.
(i) Inspections.
The board of trustees of the village of Chester or its duly authorized representative shall maintain regular and thorough inspections of the reservoir and watercourses tributary thereto, for the purpose of ascertaining whether the above rules and regulations are being complied with; and it shall be the duty of the board in charge of the water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board in charge of the water supply to promptly notify the State Commissioner of Health of such violations. The board in charge of the water supply shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.3 Annual review of administrative programs
(a) The administrative program of a certified local government shall be reviewed annually by the department. Such review shall be based upon records that demonstrate the effectiveness of the program which include objective criteria such as:
(1) a review of determinations on applications for approval of regulated activities;
(2) a review of the adequacy of financial, personnel and others resources for the previous year, and evidence of future commitment of adequate financial, personnel, and other resources to continue the administrative program; and
(3) a review of such other records as the certified local government may be required to keep.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.178 Intangible asset
A capital asset having no physical existence, its value being limited by the rights and anticipative benefits that possession confers upon the owner.
10 CRR-NY 441.294 Resident
A graduate of a medical/osteopathic/dental school serving an advanced period of graduate training. This may represent the first year of graduate training or any year thereafter.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
COMPANIES COMPANIES
10 CRR-NY 127.100 Hempstead and Oyster Bay Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to all wells of the public water supply of the Hempstead and Oyster Bay Water Company, Nassau County, New York.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance described by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance or inconvenience be caused to occupants of the premises or to occupants of adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any well of the public water supply of the Hempstead and Oyster Bay Water Company, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape on or beneath the surface of the ground within 200 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight receptacle shall be within 100 feet, nor any such watertight iron pipe shall be within 25 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 200 feet from any well of the public water supply of the Hempstead and Oyster Bay Water Company, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight receptacles, the contents of which are to be removed and disposed of as provided by paragraphs (4) and (5) of subdivision (c), between the limiting distances of 100 feet and 200 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet from any well of the public water supply of the Hempstead and Oyster Bay Water Company and none of the above named objects of sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well nor to be thrown, placed, piled or spread upon the surface of the ground within 500 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company; nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to remain on the surface of the ground or beneath the surface of the ground within a distance of 300 feet of any well of the Hempstead and Oyster Bay Water Company, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any well of said public water supply without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Hempstead and Oyster Bay Water Company.
(i) Inspections.
The Hempstead and Oyster Bay Water Company of the town of Hempstead or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 42.5 Cost per laboratory test
All laboratories must determine, at least every three years, the cost of each procedure done by the laboratory.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.1 Title
This Subpart shall be known and cited as the “Health Care Practitioner Referrals.”
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PERSONNEL PERSONNEL
10 CRR-NY 14-5.70 Employee health
No person is to work in a food vending machine operation:
(a) in a capacity which can result in contamination of food or food-contact surfaces with disease-causing organisms;
(b) while infected with a disease in a communicable form capable of transmission by food;
(c) who is otherwise a carrier of organisms that cause such disease; or
(d) while afflicted with a boil or infected wounds on hands, face or other exposed part of the body.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-2 STATE FUNDING FOR HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-2.1 Grants, general
The Commissioner of Health, contingent upon appropriation by the Legislature, shall annually make a grant to each health systems agency for health planning and development. A grant under this Subpart shall be made on such conditions, including the submission of the agency's budget and annual programmatic and administrative plans, as the Commissioner of Health determines is necessary and appropriate, and shall be used by the health systems agency for compensation of health systems agency personnel, collection of data, planning, and the performance of the functions of the health systems agency. A health systems agency may use grant funds to make payments under contracts with other entities to assist the health systems agency in the performance of its functions as defined in section 82-1.6 of this Part; but an agency may not use grant funds to make payments under a grant or contract with another entity for the development or delivery of health services or resources.
Chapter I STATE SANITARY CODE
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.1 All complaints to be investigated
The local health officer, upon receiving a complaint of the existence within his jurisdiction of a nuisance which may affect health, or when the probable existence of any such nuisance comes to his attention, shall make or cause to be made by his duly authorized representative an immediate and thorough investigation, and if, in his opinion, such a nuisance exists, he shall take steps to secure its voluntary abatement.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.31 Project development
(a) This section shall apply to the project development period from the inception of a project to the final financial occupancy date declared by the State Commissioner of Health.
(b) All proposed or pre-existing professional service contracts and consultant contracts shall require the written approval of the State Department of Health to be included in eligible project cost. All such contracts shall be in writing duly executed by the parties thereto.
(1) All architectural and engineering contracts shall be submitted to the State Department of Health for approval. The architect or engineer shall comply with the State Department of Health requirements including the provision of acceptable professional liability insurance, the assurance of continuity of professional services, satisfactory evidence of the ability to perform the architectural and engineering services required, and agreement to attend conferences and provide professional services as required by the State Department of Health.
(2) All attorney retainers shall be submitted to the State Department of Health for review and approval. The attorney shall comply with the State Department of Health requirements including the assurance of continuity of professional services and the agreement to attend conferences and provide professional services as required by the State Department of Health.
(3) All written consultant contracts relating to the development period shall be submitted to the State Department of Health for review and approval. The consultant shall comply with the State Department of Health requirements including the assurance of continuity of consultive services, satisfactory evidence of ability to perform the consultive services required, and agreement to attend conferences and provide consultive services as required by the State Department of Health.
(4) All professional service contracts and consultant contracts for the project shall set forth fee and payment provisions in an amount no greater than contained in the fee guidelines approved by the State Department of Health.
(c) An eligible borrower shall obtain current exempt organization certificates from the U.S Internal Revenue Service as a hospital under section 501(c)(3) of the Internal Revenue Code and statements of exemption from the State Department of Taxation and Finance.
(d) An eligible borrower shall provide acceptable topographical surveys of the project site certified by a licensed surveyor to the hospital, the hospital's title insurance company, the State Department of Health, and the State Housing Finance Agency or the State Medical Care Facilities Finance Agency in accordance with the requirements of the State Department of Health. An eligible borrower shall also provide title reports and continuations thereof covering the project site from an acceptable title insurance company, free and clear of exceptions objectionable to the State Department of Health and the State Housing Finance Agency or the State Medical Facilities Finance Agency, and certified copies of certificates of incorporation and such other corporate certificates of special acts of the legislature as required by the State Department of Health.
(e) An eligible borrower shall submit for approval a schedule of estimated development costs and capital requirements, a schedule of estimated annual expenses and income, supporting schedules of all estimated development costs and capital requirements and estimated annual expenses and income, a project cost analysis schedule and such other project statistics, space requirements and financial data as the State Department of Health may require.
(f) An eligible borrower shall conform with the bid requirements and procedures of the State Department of Health providing for competitive bidding by contractors and subcontractors and the provisions of “Supplementary Instructions to Bidders”.
(g) Construction contracts shall include the standard form of agreement between owner and contractor as amended by the State Department of Health which includes the required “Modification to Standard Form of Agreement Between Owner and Contractor”, the “Supplementary Conditions of the Contract for Construction” and such further terms, provisions and documents as may be required by the Department of Health.
(h) Payment and performance bonds acceptable to the State Department of Health shall be required to insure the faithful performance of the contract and payment for labor and the furnishing of materials for all contracts.
(i) The Department of Health may modify the requirements for hospital projects set forth in subdivisions (g) and (h) of this section for project construction completed prior to mortgage closing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.12 Emergency services
(a) General requirements for emergency services.
(1) Written protocols for the provision of emergency services by a PCH/CAH shall be developed for the area served by the PCH/CAH; they shall take into consideration the service capabilities of the PCH/CAH, the general hospital(s) with which it has a formal affiliation pursuant to section 407.1 of this Part, and other area providers, as appropriate.
(2) PCHs/CAHs shall participate in a system which assures the availability of emergency medical services on a 24-hour a day basis within a service area-wide emergency medical services system. A PCH/CAH shall maintain an instantaneous communications link with its affiliated general hospital(s) and other appropriate providers of emergency medical services, medical backup and consultation, and medical control.
(3) At a minimum, PCHs/CAHs shall maintain an adequate supply of emergency equipment, supplies, and medication readily available for treating emergency cases. The items available shall include, but need not be limited to:
(i) drugs and biologicals commonly used in life-saving procedures such as analgesics, local anesthetics, antibiotics, anticonvulsants, antidotes and emetics, serums and toxoids, antiarrhythmics, cardiac glycosides, antihypertensives, diuretics, and oral and IV electrolytes and replacement solutions (adult and pediatric); and
(ii) equipment and supplies commonly used in lifesaving and life support procedures including but not limited to airway control and ventilation devices in adult and pediatric sizes, portable (transport) mechanical ventilators, endotracheal tubes, bag/valve/mask, oxygen, tourniquets, immobilization devices, nasogastric tubes, splints, IV therapy supplies, suction machine, defibrillator, cardiac monitor, chest tubes, and indwelling urinary catheters.
(4) Emergency services shall be coordinated with appropriate area providers including ambulance providers serving the pre-hospital delivery system of the PCH's/CAH's service area.
(5) PCHs/CAHs shall establish comprehensive written procedures for screening and assessing patients to determine the most appropriate on-site treatment, for identifying cases beyond the facility's capability to treat which require safe transfer to a more appropriate facility, and for arranging such transfers.
(6) PCHs/CAHs shall maintain, or coordinate with the general hospital(s) with which it has a formal affiliation pursuant to section 407.1 of this Part, or, if a member of a rural health network, through the network, an emergency transportation system with advanced life support capability available on a 24-hour a day on call basis to provide timely inter-facility transport.
(7) PCHs/CAHs, in cooperation with other area emergency medical service providers, shall develop written procedures to allow appropriately trained PCH/CAH personnel to provide patient care on ambulances in potentially life-threatening situations where such assistance is required; and
(8) PCHs that do not provide 24-hour a day on-site emergency services shall:
(i) ensure that patients in need of emergency care arriving at the facility during non-operating hours are provided with information necessary to contact hospital personnel responsible for arranging for providing emergency care; and
(ii) ensure that EMS/ambulance personnel transporting patients are able, during operating and non-operating hours, to contact hospital personnel responsible for arranging for providing emergency care to facilitate appropriate and timely patient disposition.
(b) PCHs/CAHs shall comply with the provisions of section 405.19(b)-(e) of this Title with regard to the provision of emergency services.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 10.2 Posting regulations
The licensed owner of every barber shop and beauty parlor shall post conspicuously in the establishment a copy of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.4 Preliminary conference
If the investigating officer shall determine after investigation that probable cause exists for crediting the allegations of the complaint, he shall by conference with the parties endeavor to accomplish a voluntary elimination of the unlawful discriminatory practice involved in the complaint. If the respondent voluntarily ceases and desists from the unlawful discriminatory practice, the commissioner shall issue an order terminating the proceeding upon such terms and conditions as he shall deem proper.
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-2 MANAGEMENT OF REGULATED MEDICAL WASTE
10 CRR-NY 70-2.1 Waste management plan
Each facility shall develop, document and implement policies and procedures specific to the management of regulated medical waste generated on-site and/or treated at the facility. Such policies and procedures shall minimally include, but not be limited to: a description of the types, and method(s) for treatment and disposal, of regulated medical waste; procedures for safe handling and transport of the waste within the facility from the point of generation or intake to the point of storage and/or treatment; a description of storage areas, including, as applicable, patient care areas, which details the location, ventilation and capacity of each storage area, and the length of time waste is to be retained in each area; and the titles and contact information for persons responsible for monitoring compliance. Facilities that treat regulated medical waste on-site shall include in their regulated medical waste management plan an operation plan for each treatment system employed.
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
FACILITY OPERATIONS FACILITY OPERATIONS
10 CRR-NY 72-1.11 Additional operator responsibilities
(a) The operator shall maintain a record of each patron’s tanning visits, recording the date, duration of tanning exposure, and ultraviolet radiation device used. Each record shall be maintained for a minimum of two years and shall be available for by the permit issuing official or representative.
(b) The operator shall report certain injuries and illnesses to the PIO, and to keep a record of reportable injuries and illnesses on a form prescribed by the department, as detailed in section 72-1.7 of this Subpart. Each record shall be maintained for a minimum of two (2) years and shall be available for review by permit issuing official or representative.
(c) The operator shall maintain an equipment maintenance log as detailed in section 72-1.9(c)(11) of this Subpart. Each record shall be maintained for a minimum of two (2) years and shall be available for review by the permit issuing official or representative.
(d) The operator shall maintain records showing the results of annual timer tests as detailed in section 72-1.9(c)(2)(ii) of this Subpart. Each record shall be maintained for a minimum of two years and shall be available for review by the permit issuing official or representative.
(e) The operator shall maintain each Tanning Facilities Statement of Acknowledgement form, detailed in section 72–1.8(c) of this Subpart, and shall be available for review by the permit issuing official or representative.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.10 Accrue
To give effect to an accrual; to record revenue or expense in the reporting period to which it relates, notwithstanding that the required receipt or outlay may take place, in whole or in part, in a preceding or following accounting period.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.95 Equipment acceptable
Equipment installed in existing food service establishments is acceptable in that establishment provided that it is in good repair, maintained in a sanitary condition, the food-contact surfaces are nontoxic and it performs its intended function in a satisfactory manner without contaminating food by normal use.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.59 Certificate of deposit
(a) A formal instrument, frequently negotiable or transferable, issued by a bank as evidence of indebtedness and arising from a deposit of cash subject to withdrawal under the specific terms of the instrument: (1) demand certificates, payable upon presentation, seldom bearing interest; (2) time certificates, payable at a fixed or determinable future date, usually bearing interest at a specific rate.
(b) A formal certificate, usually printed or engraved, ordinarily negotiable or transferable, and issued by a depository or agent against the deposit of bonds or stock of a corporation under the terms of a reorganization plan or other agreement.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.2 Applicability and scope
This Part shall apply through the entire State of New York and shall represent minimum standards for individual onsite water supply and for individual onsite wastewater treatment systems.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.9 Expense detail reporting
| SHUR Account Number | Functional account name/additional reporting | | | | --- | --- | --- | --- | | (a) | 7150 | DRUGS SOLD | | | | | (1) | Pharmaceuticals | | | | (2) | All other | | (b) | 8310 | DIETARY SERVICES | | | | | (1) | Food | | | | (2) | All other | | (c) | 8320 | NONPATIENT FOOD SERVICE | | | | | (1) | Food | | | | (2) | All other | | (d) | 8400 | PLANT MAINTENANCE | | | | | (1) | Maintenance and Repairs | | | | (2) | Automotive Services | | | | (3) | Other (Specify) | | (e) | 8420 | ENERGY | | | | | (1) | Fuel Oil Number 2 | | | | (2) | Fuel Oil Number 4 | | | | (3) | Fuel Oil Number 6 | | | | (4) | Natural Gas | | | | (5) | Purchased Steam | | | | (6) | Electricity | | | | (7) | Water | | | | (8) | Other (Specify) | | (f) | 8520 | PATIENT ACCOUNTS, ADMITTING AND REGISTRATION | | | | | (1) | Patient Accounting and Cashiers | | | | (2) | Admitting Office (Inpatient and Outpatient) | | | | (3) | Collection Fees | | (g) | 8610 | HOSPITAL ADMINISTRATION | | | | | (1) | Executive Office | | | | (2) | Telephone | | | | (3) | Postage | | | | (4) | Legal Fees | | | | (5) | Accounting Fees | | | | (6) | Public Relations | | | | (7) | Personnel Office | | | | (8) | Data Processing (provided to outside concerns only) | | (h) | 8810 | DEPRECIATION AND AMORTIZATION—FIXED ASSETS | | | | | (1) | Depreciation—Fixed Assets | | | | (2) | Amortization of Leasehold Improvements | | (i) | 8830 | EMPLOYEE BENEFITS—NONPAYROLL-RELATED | | | | | (1) | Employee Health Service | | | | (2) | Other (Specify) | | (j) | 8850 | INSURANCE—OTHER | | | | | (1) | General Liability | | | | (2) | Umbrella (Excess Limits) | | | | (3) | Property | | (k) | 8860 | LICENSES AND TAXES (OTHER THAN INCOME) | | | | | (1) | Real Estate Taxes | | | | (2) | Other (Specify) | | (l) | 8993 | EMPLOYEE BENEFITS—PAYROLL-RELATED | | | | | (1) | Pension | | | | (2) | Old Age and Survivors Insurance | | | | (3) | Health Insurance | | | | (4) | Workers' Compensation Insurance | | | | (5) | Disability Insurance | | | | (6) | Unemployment Insurance | | | | (7) | Life Insurance | | | | (8) | Union Payments | | | | | (i) Pension | | | | | (ii) Health, | | | | | (iii) Disability | | | | (9) | Other (Specify) | | | | (10) | Only the total amount of each item need be reported. | | (m) | 8621 | DATA PROCESSING | | | | A reconstitution and/or accumulation of the costs related to this function (prior to compliance with section 442.24[f] of this Article) must be reported. | | | | (n) | VARIOUS | PHYSICIAN FEES | | | | The Sub-Natural Classification.31-Physician, under Natural Classification, 30-Professional Fees, must be reported by the functional cost center to which the physician is assigned. | | |
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.10 Embalming procedure
(a) The preparation for burial or other disposition of all dead human bodies shall be performed in privacy. No one shall be permitted to be present in the embalming, operating or preparation room while a dead human body is being embalmed, washed or otherwise prepared for burial or other disposition, except the following:
(1) licensed funeral directors or embalmers and their employees;
(2) duly registered funeral director students and trainees;
(3) duly authorized instructors of funeral directing schools;
(4) public officials or representatives in the discharge of their duties;
(5) duly accredited doctors or nurses;
(6) members of the immediate family of the deceased and their designated representatives.
(b) The use of any fluid or compound which contains arsenic, lead, mercury, zinc, silver, antimony or chloral or any poisonous alkaloid in the embalming of a dead human body is prohibited.
(c) All blood and excretions of a dead human body shall be disposed of in a sanitary manner.
(d) All receptacles containing embalming fluid or any poisonous or dangerous substances shall be plainly marked to indicate the contents thereof.
(e) No embalmer or funeral director shall embalm, nor shall any funeral director, undertaker or embalmer permit the embalming of a dead human body when he has information reasonably indicating that death occurred as a result of accidental, homicidal or suicidal means or other suspicious or unnatural circumstances, until the body has been duly released to him for embalming or other preparation by the proper authority.
(f) A funeral director trainee may not embalm or perform any part of embalming procedure on a dead human body unless such activity is performed under the personal supervision and instruction of a New York State licensed and registered funeral director or a New York State licensed and registered embalmer.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 153 WASHINGTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 153.1 Village of Fort Edward
(a) Privies adjacent to reservoirs, springs or watercourses.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, of the high-water mark or [ continued ] precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind, the water of which, when running, flows eventually into a reservoir of the Fort Edward public water supply.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or within 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit of human excrement which is constructed, located or maintained between the aforesaid limits of 50 and 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or 50 and 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid and from which the said excrement is not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of disposal beyond the maximum aforesaid limit shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limit.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or the floor of said privy.
(5) The excreta so collected shall be removed so as to cause the least nuisance possible and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles, nor anything which pollutes water shall be washed nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid nor shall any cattle, horses, sheep, swine or other animals be allowed to enter, wallow or stand in any reservoir, spring, stream, ditch or watercourse aforesaid.
(c) Garbage and refuse.
No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid nor shall any such substances be placed upon or below the surface of the ground where they may be washed into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark or precipitous bank thereof.
(d) Manures, composts and similar matter.
(1) No stable, pigsty, henhouse, barnyard, hog or duck yard, hitching or standing place for horses or cattle or other place where animal manure accumulates and no compost or manure heap shall be located or maintained within 100 feet of nor shall they or any watering place for horses or cattle or other animals be so arranged that the polluted drainings therefrom shall flow into any reservoir, spring, stream, ditch or watercourse aforesaid nor shall such drainings be allowed to flow through open or covered drains within 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir or within 130 feet of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so as to be washed a less distance than 50 feet over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid, without having undergone proper purification.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish, or part thereof, nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface or less than 50 feet through the subsoil in any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(f) [Cemeteries.]
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(g) Management of the reservoirs.
(1) The reservoirs of the Fort Edward public water supply shall not be unnecessarily drawn down during the warm months but shall be kept as deep and as nearly at a uniform level as possible to prevent the pollution of the water with dead organic matter.
(2) No filter or screen shall be used when in a filthy condition and liable to pollute the water in the mains, and no filter or screen shall be used at the head of the main which cannot be constantly examined and cleaned.
(h) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, a penalty of $50 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above given mandatory rules or regulations, to be recovered under the said act.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.9 Required records
(a) Complete and accurate records of tissue and nontransplant anatomic parts released shall be kept by the tissue banks or nontransplant anatomic banks distributing the tissue. Such records shall be open to inspection by the department. For all donated tissue and nontransplant anatomic parts, the donor's name, address, and any other information which would directly or indirectly identify the donor shall not be disclosed or released by the bank to any person or entity, except upon the written consent of the donor or the person authorized by law to make the donation, or to authorized employees of the department, or as permitted by law. The recipient's name, address, and any other information which would directly or indirectly identify the recipient shall not be disclosed or released by the tissue bank to any person or entity, except upon the written consent of the recipient, or except to authorized employees of the department. or as permitted by law.
(b) Complete and accurate records of tissue and nontransplant anatomic parts released for transplantation, transfer, artificial insemination, implantation, research and education shall be kept by the tissue transplantation facility or insemination/implantation site. Such records shall be open to inspection by the department and shall be kept for at least seven years after transplantation or six months after the expiration date of the tissue, whichever is longer. In cases of reproductive tissue transfer/artificial insemination/implantation, records shall be kept for at least seven years after the release of tissue not resulting in live births and 25 years for tissue resulting in live births. Nontransplant anatomic banks shall retain records for five years after release of nontransplant anatomic parts for research or education purposes. The recipient's name, address, and any other information which would directly or indirectly identify the recipient shall not be disclosed or released by the tissue transplantation facility or insemination/implantation site to any person or entity, except upon the written consent of the recipient, or except to authorized employees of the department, or as permitted by law.
(c) The following donation records shall be kept by each comprehensive tissue procurement service:
(1) donor's full name, address at time of donation, identification code, date of birth or age, and date and time of death, if a cadaveric donor;
(2) documentation of evaluation of physical condition, if a cadaveric donor;
(3) pertinent donor medical history, including, but not limited to, autopsy reports, donation questionnaires, and other donor solicitation materials;
(4) documentation of donor informed consent or consent of the person authorized by law to consent to the donation, if applicable, including such person's address, unless this record is retained by a limited tissue procurement service;
(5) date and time of collection, and description and quantity of tissue retrieved;
(6) any reported changes in donor health status, if applicable;
(7) outcome of transplantation, transfer, artificial insemination and implantation procedures, if known, and any reports from facilities using the tissue, which would affect the donor's acceptability;
(8) records specified in the Subpart specific to each category of tissue; and
(9) documentation of staff training, certification and continuing education.
(d) The following records shall be kept by each limited tissue procurement service:
(1) a record of each referral to a comprehensive tissue procurement service, including the donor's name or other identification, the date and time of referral, the name of the person making the referral, the name of the comprehensive tissue procurement service, and whether the records specified in paragraphs (2) and (3) of this subdivision have been transferred to the comprehensive tissue procurement service;
(2) medical and social history information obtained from the donor, donor's family, and other individuals, including the names of the persons obtaining and giving the information, unless this record is transferred to a comprehensive tissue procurement service; and
(3) documentation of donor informed consent or consent of the person authorized by law to consent to the donation, if applicable, including such person's address, unless this record is transferred to a comprehensive tissue procurement service.
(e) The following records shall be kept by each tissue processing facility:
(1) an acquisition log or other similar record indicating:
(i) donor's identification code and/or unique tissue product number;
(ii) name and address of the tissue bank from which the tissue was acquired;
(iii) date of receipt of the tissue; and
(iv) tissue location in the storage chamber;
(2) description of tissue received for processing;
(3) methods used for acquisition, processing, distribution and storage of the tissue;
(4) air quality measurements for critical and controlled work areas, if applicable;
(5) disposition of the tissue, including, but not limited to, distribution records, destruction logs, and autoclaving or incineration records;
(6) results of all laboratory tests performed on donors and donated tissue, including documentation of review of test results prior to release of the tissue;
(7) documentation of labeling and packaging inspection prior to tissue transport to a tissue transplantation facility or release for transplantation, transfer, artificial insemination or implantation;
(8) records specified in the Subpart specific to each category of tissue; and
(9) documentation of staff training, certification and continuing education.
(f) The following records shall be kept by each tissue storage facility:
(1) an acquisition log or other similar record indicating:
(i) donor's identification code and/or unique tissue product number;
(ii) date of receipt of tissue;
(iii) name and address of tissue bank providing the tissue; and
(iv) location of the tissue in the storage chamber; and
(2) a record of the disposition of the tissue, including, but not limited to, distribution records, destruction logs, and autoclave or incineration records.
(g) The following records shall be kept by each tissue transplantation facility or insemination/implantation site:
(1) the name of the tissue bank providing the tissue, and unique tissue product number;
(2) a description of the tissue;
(3) results of any laboratory tests performed;
(4) a log of the disposition of the tissue, including, but not limited to, name or identification code of recipient, tissue product return records, destruction logs, and autoclaving or incineration records;
(5) condition of the tissue upon receipt, including any loss noted of liquid nitrogen, dry ice, or other coolant;
(6) date of transplant, transfer, artificial insemination, or implantation;
(7) quantity of tissue used;
(8) outcome of the transplantation, artificial insemination, transfer or implantation procedure, including, but not limited to, any adverse outcome or infectious disease in the recipient, which shall be reported to the tissue bank from which the tissue was obtained; and
(9) records specified in the Subpart specific to each category of tissue.
(h) Records shall be kept by insemination/implantation sites as specified in Subpart 52-8 of this Part.
(i) Nontransplant anatomic banks which solicit, retrieve, release or store nontransplant anatomic parts shall keep the following information:
(1) if known, donor's full name, address at the time of donation, identification code, date of birth or age, and date and time of death if a cadaveric donor;
(2) documentation of donor informed consent or consent of the person authorized by law to consent to the donation, if applicable, including such person's address;
(3) records of distribution of all nontransplant anatomic parts;
(4) if applicable, name and address of the nontransplant anatomic bank from which the nontransplant anatomic part was acquired;
(5) if applicable, date of receipt of the nontransplant anatomic part from the nontransplant anatomic bank;
(6) location of nontransplant parts in storage, including documentation tracing nontransplant anatomic parts to specific donors; and
(7) if known, disposition of the nontransplant anatomic parts once their use in education or research is ended, including the names of the funeral directors, cemeteries or crematories involved in disposition.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.25 Compensation of operators and relatives of operators
(a) Reasonable compensation for operators or relatives of operators for services actually performed and required to be performed shall be considered as an allowable cost. The amount to be allowed shall be equal to the amount normally required to be paid for the same service provided by a nonrelated employee, as determined by the State Commissioner of Health. Compensation shall not be included in the rate computation for any services which the operator or relative of the operator is not authorized to perform under New York State law or regulation.
(b) Any amount reported as compensation for services rendered by an operator or relative of an operator shall not be allowed in excess of the maximum allowance for full-time services in carrying out his primary function.
(c) For purposes of subdivision (a) of this section, in determining a reasonable level of compensation for operators or relatives of operators the commissioner may consider the quality of care provided to patients by the facility during the year in question.
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.35 Initial occupancy
(a) A hospital shall obtain timely final inspections of construction and medicaid and medicare approvals. Requests for such, and the submission of an application for an operating certificate to the State Department of Health, shall be instituted six months prior to scheduled initial occupancy of the project.
(b) A hospital shall forward to the State Department of Health a final proposed schedule of estimated annual expenses and income and a supporting schedule of all entries therein no later than three months prior to initial occupancy of the project.
(c) A hospital shall submit to the State Department of Health for approval for each budget year a balanced budget of estimated annual expenses and income no later than 15 days preceding the effective date of the budget.
(d) A hospital shall obtain the prior approval of the State Department of Health for all written contracts except those approved by inclusion in the approved budget of the hospital.
(e) A hospital shall establish and maintain an inventory register of all equipment purchased as a part of the project in accordance with the requirements of the State Department of Health.
(f) Any change in or addition to the services provided by a hospital shall require prior approval as set forth in the State Hospital Code.
(g) Such other reports as may be required by the State Department of Health shall be submitted promptly.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
FAMILY HEALTH FAMILY HEALTH
10 CRR-NY 40-2.10 Family health; performance standards
(a) The local health department shall maintain a family health program designed to achieve the following goals:
(1) improve the health of persons under the age of 21, including children with special health care needs;
(2) increase the proportion of persons under the age of 21 who receive comprehensive well child primary and preventive care, including oral health care;
(3) improve birth outcomes, decrease maternal and infant mortality and morbidity, and increase the number of pregnant and postpartum women who receive early, continuous and comprehensive prenatal and postpartum care, including oral health care, and other supportive services to address risks and needs; and
(4) decrease the rate of unintended pregnancies, increase optimal spacing of pregnancies, decrease the prevalence and morbidity of sexually transmitted disease, and improve availability and accessibility of comprehensive reproductive health care and family planning services to men and women of reproductive age.
(b) To be eligible for State aid, the local health department shall conduct public health activities in the following areas:
(1) child health;
(2) maternal and infant health; and
(3) reproductive health.
(c) The activities required under this subdivision (b) of this section shall include, at a minimum:
(1) utilization of available public health data and information to shape strategies related to child health, maternal and infant health and reproductive health, including:
(i) using available data from the community health assessment, other local assessments, and local knowledge;
(ii) identifying communities and/or neighborhoods where children, women and families are potentially in need of services;
(iii) identifying any specific local factors that influence children's health status, health care needs, maternal and infant birth outcomes, unintended pregnancy, and use of reproductive health care services; and
(iv) assess currently available services;
(2) public health marketing and communication, including developing or adapting public education materials or campaigns, and promoting and disseminating such materials or campaigns, to:
(i) promote the use of comprehensive health care services for children, women and families;
(ii) promote healthy behaviors, including the preconception, prenatal, postpartum and interconception periods; and
(iii) reduce risk factors associated with poor maternal and infant outcomes, unintended pregnancy, and sexually transmitted diseases and related health disparities;
(3) information, referral and assistance to women and families in accessing and effectively utilizing available services;
(4) outreach, education, training and technical assistance for health and human service providers, designed to improve the delivery of comprehensive primary and preventive care to women and families, including, at least one annual communication to health care providers on health data and interventions related to family health;
(5) efforts with multiple sectors in the community to promote policy, environmental and systems change to address population and community level factors that influence child health outcomes and use of health care services, birth outcomes, and reproductive health outcomes and services; and
(6) activities to identify uninsured women and families and to provide such persons, either directly or through referral, with assistance with enrollment in health insurance coverage and comprehensive prenatal care, child health care, primary care services, and reproductive health services.
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.6 Records and reports
The director of the program shall maintain such records and submit such reports, including an annual report, as may be required by the commissioner. The annual report shall include the status of all former residents who have not complied with their two-year service obligation agreement.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.291 Replacement
The substitution of one fixed asset for another, particularly of a new asset for an old, or of a new part for an old part. On the books of account, the recognition of the cost of the new asset requires the elimination of the cost of the asset it replaces.
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.6 Evaluation
The hospital administration shall develop and implement procedures which provide for at least an annual written evaluation of the swing bed program to include, as a minimum, a profile of the characteristics of the patients admitted to the program, the services and degree of services drawn upon most, occupancy, length of stay and use rate, patient need and disposition upon discharge. The evaluation shall also include such items as may be identified and set forth on forms provided by the department.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PLUMBING PLUMBING
10 CRR-NY 14-5.143 Handwashing facilities
(a) Handwashing facilities are to be provided and maintained for use by food vending operation attendants and servicers. Sinks not in use for utensil or equipment washing may be used for handwashing.
(b) Each handwashing facility is to be provided with running hot and cold or tempered potable water. Self-closing or metering faucets used are to provide a flow of water for at least 15 seconds without need to reactivate the faucet. Steam mixing valves are prohibited.
(c) Each handwashing facility is to be provided with hand-cleaning soap or detergent with a sanitary storage receptacle. Individual single-service towels, warm air blowers or clean individual sections of continuous cloth are to be provided. Common towels are prohibited. Conveniently located waste receptacles are to be provided if disposable towels are used.
(d) Handwashing facilities, soap or detergent receptacles, handwashing devices and related facilities are to be kept clean and in good repair.
(e) Handwashing signs are to be posted at all employee handwashing facilities.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.248 Payroll distribution
(a) An analysis of the total amount of salaries and wages paid or accrued for a period, showing the component amounts to be charged to the various cost centers.
(b) The entry by which the amount of salaries and wages paid or accrued for a period is charged in the required detail to the accounts or records.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.13 Village of Ossining
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the well, located on land, owned by the village of Ossining, and situated approximately 110 feet north of Chappaqua Road and 125 feet west of the Pocantico River in the town of Ossining, which forms the source of the public water supply of the village of Ossining, Westchester County, New York.
(b) Definition.
(1) The term well wherever used in these rules is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) The term linear distance is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit, or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained, or allowed to remain within 200 feet of the well of the public water supply of the village of Ossining.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained, or allowed to remain within 250 feet of the well of the public water supply of the village of Ossining.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered, and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the village of Ossining.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground, or owing to the height or flow of subsurface or surface water, or other special local conditions, excremental matter from any privy or aforesaid receptacle, or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta, or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 250 feet of the well of the public water supply of the village of Ossining.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 250 feet of any well forming the source of the public water supply of the village of Ossining.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals, and no manure pile or compost heap, shall be constructed, located, placed, maintained, or allowed to remain within 250 feet of the well of the public water supply of the village of Ossining, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any spring without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered dissipated form, and not concentrated in perceptible lines of drainage for a distance of not less than 250 feet from the well of the public water supply of the village of Ossining.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of the well; and no manure or compost of any kind shall be placed, piled, or spread upon the ground within a distance of 250 feet of the well of the public water supply of the village of Ossining.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 500 feet of the well of the public water supply of the village of Ossining.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Ossining upon which the well of the public water supply of the village of Ossining is located and no person or persons shall enter in or upon such property except the personnel or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the village of Ossining.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work, or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed, or maintained within a distance of 250 feet of the well of the public water supply of the village of Ossining.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the well of the public water supply of the village of Ossining.
(j) Inspections.
(1) The board of water commissioners of the village of Ossining or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Ossining, or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Board of Water Commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health, in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served, and the general surroundings of the well at the time of the last inspection.
(2) In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the public water supply of the village of Ossining.
(k) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 447 STANDARD UNIT OF MEASURE REFERENCES
10 CRR-NY 447.2 Radiology Services
(a)
| (a) ACCOUNT NUMBER | COST CENTER TITLE | | --- | --- | | 7320 | Radiology—Diagnostic | | 7360 | Radiology—Therapeutic | | 7380 | Nuclear Medicine |
(b) The above cost centers use as the basis for the Standard Unit of Measure the Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies (RVS). Relative Value Units for unlisted BR (By Report), and RNE (Relativity Not Established) procedures are to be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. Use the “Total Unit Value”, not the “PC Unit Value”, in recording the relative value unit counts. Because the California Medical Association is no longer publishing their Relative Value Studies booklet, the Radiology/Nuclear Medicine chapter is set forth as subdivisions (c)-(g) of this section with the approval of CMA.
(c) RADIOLOGY AND NUCLEAR MEDICINE GROUND RULES
(1) GENERAL: Listed values for radiology procedures apply only when these services are performed by or under the supervision of a physician.
(i) The total unit value includes the professional component (see PC unit value below) plus the technical component. The value for injection procedure is not included except when procedure is marked with a small star (*). (See ground rule 6, below). This value is applicable in any situation in which a single charge is made to include both professional services and the technical cost of providing that service. Identification of a procedure by its 5-digit code without modifier −26 or −27 indicates that the charge includes both the “professional” and “technical” components.
(ii) The PC unit value (professional component unit value) represents the value of the professional radiological services of the physician. This includes examination of the patient, when indicated, performance and/or supevision of the procedure, interpretation and written report of the examination and consultation with the referring physician. The value for injection procedure is not included except when procedure is marked with a small star (*). (See ground rule 6, below). This component is applicable in any situation in which the physician submits a charge for these professional services only. It does not include the cost of personnel, materials, space, equipment or other facilities. To identify a charge for professional component, use the 5-digit procedure code followed by modifier −26. (See modifier −26 and Appendix 1‡ for use of modifiers.)
(iii) When this section of the RVS is used in connection with a “conversion factor” to establish fees, it must be emphasized that the SAME conversion factor cannot be applied to both the TOTAL UNIT VALUE and the PROFESSIONAL COMPONENT UNIT VALUE. Physicians who determine their fees by application of conversion factors to the unit values in this section must determine a separate factor for TOTAL UNIT VALUE and for PC UNIT VALUE.
(iv) The technical component includes the charges for personnel, materials, including usual contrast media and drugs, film or xerograph, space, equipment and other facility but excludes the cost of radioisotopes. No unit values are listed for the technical component of radiology procedures, since these are institutional charges not billed separately by physicians. To identify a charge for the technical component, use the 5-digit procedure code followed by modifier −27. (See modifier −27 and Appendix 1‡ for use of modifiers.)
(2) UNUSUAL SERVICE OR PROCEDURE: A service may necessitate skills and time of the physician over and above listed services and values. If substantiated “by report,” additional values may be warranted. (See unit value modifier −22 and rule 4, below.)
(3) UNLISTED SERVICE OR PROCEDURE: When an unlisted service or procedure is provided, the values used should be substantiated “by report.” (See rule 4 below.) Identify by unlisted procedure number in appropriate section. For a comprehensive listing, see pages 15-16.
(4) PROCEDURES LISTED WITHOUT SPECIFIC UNIT VALUES:
(i) BY REPORT “BR” ITEMS: BR in the value column indicates that the value of this service is to be determined “by report,” because the service is too unusual or variable to be assigned a unit value. Pertinent information concerning the nature, extent and need for the procedure or service, the time, the skill and equipment necessary, etc., is to furnished. A detailed clinical record is not necessary.
(ii) RELATIVITY NOT ESTABLISHED “RNE” ITEMS: RNE in the value column indicates new or infrequently performed services for which sufficient data have not been collected to allow establishment of a relative value. A report may be necessary.
(5) MATERIALS SUPPLIED BY PHYSICIAN: Identify as 99070. (Radionuclides are identified as 99069.) Supplies and materials provided by the physician (e.g., sterile trays, drugs, etc.) over and above those usually included with the office visit or other services rendered may be charged for separately. (List drugs, trays, materials or supplies provided.)
(6) INJECTION PROCEDURES: Values for injection procedures include all usual pre- and post-injection care specifically related to the injection procedure, necessary local anesthesia, placement of needle or catheter, and injection of contrast media.
Vascular injection procedures are listed in the cardiovascular section, under procedure codes 36000-36299. Other injection procedures are listed in appropriate sections. The injection procedure is included in the unit value for radiographic procedures marked with a small star (*).
(7) MISCELLANEOUS:
(i) A physician may elect to reduce the listed value of a service for a variety of reasons. To identify such charges, see modifier −52.
(ii) Examination outside of regular hours, at bedside or in operating room, may warrant an additional charge for technologist's time (see 99065, 99066).
(iii) Values for office, home and hospital visits, consultation and other medical services, anesthesia, surgical and laboratory procedures are listed in the sections entitled “Medicine,” “Anesthesia,” “Surgery” and “Pathology.”
(8) SPECIAL SERVICES AND BILLING PROCEDURES:
(i) The following services are generally not part of the basic services as listed in the RVS, but do involve additional expense to the physician for materials, for his time or that of his employees. Those services that are generally provided as an adjunct to common medical services should be charged for only when circumstances clearly warrant an additional charge over and above the usual charges for the basic services.
| | | | Unit Value | | --- | --- | --- | --- | | (ii) | 99065 | Examination outside of regular hours may warrant an additional charge for technologist's time | 1.3(R) | | (iii) | 99066 | Examination at bedside or in operating room, unless otherwise indicated, may warrant an additional charge for technologist's time | 1.3(R) | | (iv) | 99069 | Radiopharmaceutical or other radionuclide material cost. Listed values in this section do not include these costs. List the name of radiopharmiceutical, dosage and cost | BR† | | (v) | 99070 | Supplies and material provided by the physician ( e.g. , sterile trays, drugs, etc.), over and above those usually included with the office visit or other services rendered may be charged for separately. List drugs, trays, supplies or materials provided | BR† | | (vi) | 99080 | Special Reports ( e.g. . insurance forms, narrative reports, review of medical records): When information more than that necessary to establish or to clarify a patient's status is requested ( e.g. , more than the standard reporting form) or a request is made for review of medical records and report, a charge adequate to cover the value of the additional service is justifiable | BR† |
(9) UNIT VALUE MODIFIERS.
(i) Listed values for most procedures may be modified under certain circumstances as listed below. When applicable, the modifying circumstances should be identified by the addition of the appropriate “modifier code number” (including the hyphen) after the usual procedure number. The values should be listed as a single modified total for the procedure. When multiple modifiers are applicable to a single procedure, see modifier −99.
| | | | Unit Value | | --- | --- | --- | --- | | (ii) | -22 | Unusual services: When the services provided are greater than those usually required for the listed procedure, identify by adding this modifier (-22) to the usual procedure number. List modified value. May require report. | | | (iii) | -26 | Professional component: Under certain circumstances the physician may wish to submit a charge for the professional component of a procedure and not for the technical component. (See definition of professional component under ground rule 1.) Under these circumstances the professional component charge is identified by adding this modifier (-26) to the usual procedure number and valued according to the "PC unit value" for that procedure. | | | (iv) | -27 | Technical component: Under certain circumstances, a charge may be made for the technical component alone (see definition of technical component under Ground Rule 1). Under those circumstances the technical component charge is identified by adding this modifier (-27) to the usual procedure number. | | | (v) | -52 | Reduced values: Under certain circumstances, the listed value is reduced or eliminated because of ground rules, common practice. or at the physician's election ( e.g., a physician may elect to reduce the listed values in a patient with multiple injuries requiring extensive radiographic examination). Under these or similar circumstances, the services provided can be identified by their usual procedure numbers and the use of a reduced value indicated by adding this modifier (-52) to the procedure number. (Use of this modifier provides a means of reporting services at reduced charge without disturbing usual relative values.) | | | (vi) | -90 | Reference (outside) laboratory: When laboratory procedures are performed by other than the billing physician, the procedure (s) shall be identified by adding this modifier (-90) to the usual single or panel procedure number and shall be billed as charged to the physician. (For collection and handling charges, see 99007 et seq. ) | | | (vii) | -99 | Multiple modifiers: Under certain circumstances, multiple modifiers may be applicable ( e.g., a physician may perform services greater than those usually required [modifier -22]) and bill the professional component [modifier -26]). Under these circumstances, identify by adding this modifier (-99) to the usual procedure number and briefly indicate the circumstances. Value in accordance with appropriate modifiers. | BR† |
(d) DIAGNOSTIC RADIOLOGY.
(1) Definitions.
(i) Limited examination: An examination which usually includes AP and lateral views but is less than the “complete examination” defined below. This may be due to limitation of routine views by the physician; limitation for a specific purpose ( e.g., AP and lateral views on post-reduction fracture of ankle); or necessary limitation due to the condition of the patient ( e.g., single views for fractures in critically injured patient).
(ii) Complete examination: An examination which includes all of the necessary views for optimal examination of the part for the suspected condition. All listed values are for complete examinations unless otherwise indicated. Necessary additional methods of examination ( e.g., fluoroscopy, tomography, cineradiography) may be charged for separately.
| | (2) Head and Neck. | | | --- | --- | --- | | 70002 | Pneumoencephalography | 25.0 | | | (For injection procedure for pneumoencephalography, see 61053, 62286) | | | 70010 | Cisternography, positive contrast (posterior, fossa myelography | RNE° | | | (For injection procedure, see 61052, 61053) | | | 70020 | Ventriculography, air or positive contrast | 15.5 | | | (For injection procedures for ventriculography, see 61025, 61080, 61120) | | | 70022 | Stereotactic localization | BR† | | ‡70024 | Computer assisted tomography, cerebral ( e.g., EMI scan), with or without intravenous contrast, limited (2 or 3 scans) | RNE° | | ‡70025 | complete (4 scans) | RNE° | | ‡70028 | each additional scan above 4 | RNE° | | 70030 | Eye, for detection of foreign body | 5.2 | | 70040 | for localization of foreign body (70030 not included) | 8.4 | | 70050 | combined 70030 and 70040 | 10.5 | | 70100 | Mandible, limited or unilateral | 3.8 | | 70110 | complete | 5.9 | | 70120 | Mastoid(s), limited or unilateral | 3.8 | | 70130 | complete and bilateral | 7.6 | | 70134 | Internal auditory meatuses | 7.1 | | ‡70136 | Middle and inner ear, polytomography | RNE° | | 70140 | Facial bones, limited | 4.4 | | 70150 | complete, and/or orbits | 6.4 | | 70154 | with nasal bones | 7.3 | | 70160 | Nasal bones | 3.9 | | 70170 | Nasolacrimal duct (dacryocystography) | 5.9 | | | (For injection procedure for dacryocystography, see 68850) | | | 70190 | Optic foramina | 3.8 | | 70210 | Paranasal sinuses, limited | 3.1 | | 70220 | complete | 6.4 | | 70240 | Sella Turcica | 3.3 | | 70250 | Skull, limited | 3.8 | | 70260 | complete | 7.1 | | 70300 | Teeth, single view | 1.3 | | 70310 | partial examination. less then full mouth | 2.5 | | 70320 | complete examination, full mouth | 4.7 | | 70330 | Temporomandibular joints | 5.6 | | 70350 | Cephalogram (orthodontic) | RNE° | | 70360 | Neck for soft tissues | 2.7 | | †70368 | Soft palate, cineradiography or videotape | RNE° | | †70373 | Laryngography, contrast | 8.2 | | | (For injection procedure for laryngography, see 31708) | | | 70380 | Salivary gland for calculus | 3.8 | | 70390 | Sialography | 5.1 | | | (For injection procedure for sialography, see 42550) | | | ‡70400 | Orbitography, air or positive contrast | BR† | | | (For injection procedure for orbitography, see 67510) | | | †70999 | Unlisted procedure, head and neck | BR† | | | (3) Chest. | | | 71000 | Chest, "minifilm" | 1.2 | | 71010 | Chest, single view | 2.5 | | 71020 | two views | 3.8 | | †71021 | three views | 4.4 | | 71030 | complete, minimum of four views | 4.9 | | 71034 | including fluoroscopy | 6.4 | | | (For independent chest fluoroscopy, see 76000) | | | 71036 | Fluoroscopic localization for needle biopsy of intrathoracic lesion, including follow-up films | BR† | | | (For biopsy procedure, see 32420) | | | †71038 | Fluoroscopic localization for bronchial brush biopsy or fiber-optic bronchoscopy, including films | BR† | | | (For biopsy procedure, see 31717) | | | 71040 | Bronchography, unilateral | 9.1 | | 71060 | bilateral | 13.0 | | | (For injection procedure for bronchography, see 31710, 31715) | | | †71090 | Fluoroscopy and radiography for pacemaker insertion | BR† | | | (For extended room time, see 76001) | | | 71100 | Ribs, unilateral | 4.4 | | 71110 | bilateral | 5.4 | | 71120 | Sternum | 3.8 | | 71130 | Sternoclavicular joint(s) | 3.8 | | †71199 | Unlisted procedure, chest | BR† | | | (4) Spine and Pelvis. | | | 72010 | Spine, entire, survey study (AP and lateral) | 9.3 | | †72020 | Spine, any level, single view | RNE° | | 72040 | cervical, AP and lateral | 3.8 | | 72050 | complete | 6.0 | | 72052 | including flexion and extension views | 7.7 | | 72070 | thoracic | 4.4 | | 72080 | thoraco-lumbar junction | 4.4 | | 72090 | scoliosis study | 3.8 | | 72190 | lumbar, limited | 4.4 | | 72110 | lumbosacral, complete | 7.4 | | 72114 | including bending views | 9.3 | | 72120 | bending views only | 4.7 | | 72170 | Pelvis, limited | 3.1 | | 72180 | stereo | 3.8 | | 72190 | complete | 4.9 | | | (For pelvimetry, see 74710) | | | 72202 | Sacroiliac joints | 5.1 | | 72220 | Sacrum and coccyx | 4.1 | | 72250 | Myelography, lumbar or any other single levels | 11.5 | | 72270 | all levels | 18.0 | | †72275 | gas | BR† | | | (For injection procedures for myelography, see 62284) | | | 72290 | Discography, lumbar or cervical | 12.2 | | | (For injection procedures for discography, see 62290, 62291) | | | †72299 | Unlisted procedures, spine or pelvis | BR† | | | (5) Upper Extremities. | | | 73000 | Clavicle | 3.1 | | 73010 | Scapula | 3.8 | | 73020 | Shoulder, limited | 2.7 | | 73030 | complete | 3.8 | | 73040 | arthrography | 6.4 | | | (For injection procedure for arthrography, see 23350) | | | 73050 | Acromio-clavicular joints, bilateral, with or without weighted distraction | 4.4 | | 73060 | Humerus, including one joint | 3.1 | | 73070 | Elbow, limited | 2.8 | | 73080 | complete | 3.8 | | †73085 | arthrography | BR† | | | (For injection procedure, see 24220) | | | 73090 | Forearm, including one joint | 3.0 | | 73100 | Wrist, limited | 2.5 | | 73110 | complete | 3.8 | | †73115 | arthrography | BR† | | | (For injection procedure, see 25246) | | | 73120 | Hand, limited | 2.5 | | 73130 | complete | 3.5 | | 73140 | Finger(s) | 2.3 | | †73499 | Unlisted procedure, upper extremities | BR† | | | (6) Lower Extremities. | | | 73500 | Hip, unilateral, limited | 3.1 | | 73510 | complete (including AP pelvis) | 4.4 | | ‡ 73515 | bilateral, limited ( e.g., infant AP and frog lateral | 3.9 | | 73520 | bilateral, complete (including AP of pelvis) | 5.8 | | ‡ 73525 | arthrography | RNE° | | | (For injection procedures, see 27093-27094) | | | 73530 | during operative procedures up to four studies | 9.4 | | 73532 | each additional study | 1.8 | | 73550 | Femur (thigh), including one joint | 3.8 | | 73560 | Knee, limited | 2.7 | | 73570 | complete | 4.0 | | 73580 | arthorgraphy | 9.1 | | | (For injection procedure, see 27370) | | | 73590 | Tibia and fibula (leg), including one joint | 3.1 | | 73600 | Ankle, limited | 2.7 | | 73610 | complete | 3.6 | | ‡ 73615 | arthrography | RNE° | | | (For injection procedures, see 27646 | | | 73620 | Foot, limited | 2.5 | | 73630 | complete | 3.4 | | 73640 | Foot and ankle | 5.9 | | 73650 | Os calcis (heel) | 2.7 | | 73660 | Toe(s) | 2.3 | | ‡ 73999 | Unlisted procedure, lower extremities | BR† | | | (7) Abdomen. | | | 74000 | Abdomen, single view (KUB) | 2.6 | | 74010 | with additional oblique or cone view | 3.9 | | 74020 | complete, includes decubitus and/or erect view | 5.1 | | | (8) Gastrointestinal Tract. | | | 74210 | Pharynx and/or cerical esophagus | 5.4 | | 74220 | Esophagus | 5.4 | | 74230 | Pharynx and/or esophagus, by cineradiography | 7.4 | | ‡ 74242 | Upper gastronintestinal tract, with or without KUB and with or without delayed films | 9.1 | | ‡ 74243 | limited upper gastrointestinal tract ( e.g., recheck or follow-up study) | 6.4 | | 74245 | with small bowel, includes multiple serial films, with or without fluorscopy | 11.0 | | 74250 | Small bowel, includes multiple serial films with or without fluoroscopy or KUB, independent study | 8.5 | | ‡ 74260 | Duodenography, hypotonic | RNE° | | 74270 | Colon, barium enema | 7.5 | | 74275 | combined with air contrast | 11.0 | | 74280 | air contrast (independent procedure) | 8.9 | | 74290 | Cholecystography, oral | 6.0 | | 74291 | repeat examination, same study | 3.0 | | 74300 | Cholangiography, operative | 7.6 | | *74305 | post-operative (t-tube) | *7.2 | | | (For biliary duct stone extraction, see 47630 | | | *74310 | intravenous | *10.5 | | 74320 | percutaneous, transhepatic or transjugular | 9.5 | | | (For injection procedures for transhepatic cholangiography or percutaneous, see 47500; for transjugular, see 91120 | | | ‡74325 | Pneumoperitoneum, diagnostic. | RNE° | | | (For injection procedure, see 49400) | | | ‡74340 | Localization and/or manipulation of gastrointestinal tube ( e.g. duodenal aspiration, Miller-Abbot tube, small bowel biopsy, colonoscopy | RNE° | | ‡74399 | Unlisted procedure, abdomen and gastrointestinal tract | BR† | | | (9) Urinary Tract. | | | *74400 | Urography, excretory (routine IVP) | *9.4 | | *‡74406 | extended ( e.g., hypertensive, drip infusion, and/or limited tomography) | *10.5 | | *74415 | Nephrotomography (independent procedure) | *16.0 | | 74420 | Pyelography, retrograde, or unreterography, with or without KUB | 7.5 | | ‡74425 | antegrade (nephrostogram, pyelostogram, loopogram, etc.) | RNE° | | | (For injection procedure, see 50394. 50684, 50690) | | | 74430 | Cystography, contrast or chain | 5.5 | | | (For injection procedure for cystography, see 51600, 51605) | | | 74440 | Vasography, vesiculography, or epididymography | 5.5 | | | (For injection procedure, see 52010, 52110. 55300) | | | 74450 | Urethrocystography, retrograde | 6.0 | | | (For injection procedure for retrograde urethrocystography, see 51610) | | | 74455 | voiding | 8.9 | | | (For injection procedure for voiding urethrocystography, see 51600) | | | 74460 | Retroperitoneal pneumography | 7.3 | | | (For injection procedure for retroperitoneal pneumography, see 49430) | | | 74470 | Translumbar renal cyst study (contrast visualization) | 6.4 | | | (For injection procedure for translumbar renal cyst study, see 50890) | | | | (For performance of study with ultrasound guidance, see 76960) | | | | (10) Female Genital Tract. | | | | (For abdomen and pelvis, see 74000-74020, 72170-72190) | | | 74710 | Pelvimetry | 6.2 | | 74720 | Abdomen for fetal age, fetal position and/or placental localization, single view | 2.8 | | 74725 | multiple views | 4.1 | | | (For amniocentesis and injection for amniography, see 59000) | | | 74740 | Hysterosalpingography | 6.6 | | | (For injection procedure for hysterosalpinogography, see 58340) | | | 74760 | Pelvic pneumography | 6.4 | | | (For injection procedure for pelvic pneumography, see 49440) | | | ‡74799 | Unlisted procedure, genitourinary tract | BR† | | | (11) Vascular System. | | | | (i) The following nomenclature and relative values for vascular procedures permit accurate identification and description of complex as well as simple vascular studies. | | | | (ii) Serialographic procedure. A basic code number and relative value are assigned for the initial projection of each serialographic procedure and the value includes personnel, room setup, contrast material, transportation, trays, etc. The value does not include the charge for the catheterization or the injection procedure performed by the physician. Each additional serialographic projection value reflects the additional costs for subsequent projections or serialographic runs performed at the time of the initial examination whether or not they involve the same anatomical area as the initial projection. Unless otherwise indicated, bilateral procedures should be identified by the code number and description for additional serialographic projection of the part involved. | | | | (iii) This method is to be used in lieu of modifier -50 or -51 for description of multiple vascular radiologic procedures. | | | | (iv) Example I: Unilateral carotid. AP and lateral would be 75635, initial projection, plus 75638, one additional serialographic projection. | | | | (v) Example II: Bilateral carotid. AP and lateral would be 75635, initial projection, plus 75638, additional serialographic projections, times 3. | | | | (vi) Example III: If an aortoilac femoral study is performed at the conclusion of Example I or II, use number 75778, one or more additional serialographic projections. | | | | (vii) Cineradiographic Procedure. Value for cineradiographic procedures includes all projections. Injection procedures are listed in the appropriate section of Medicine or Surgery. | | | | (viii) Cardiopulmonary. | | | 75500 | Angiocardiography, bycineradiography | RNE° | | | (For injection procedure, see 93501 et seq.) | | | 75505 | by serialography (initial projection) | 26.0 | | ‡75508 | each additional serialographic projection | 7.7 | | 75510 | CO: angiocardiography for pericardial effusion (For injection procedure, see 36000) | RNE° | | ‡75550 | Coronary arterigraphy, by by cineradiography (includes all projections) (For injection procedure, see 36230) | RNE° | | ‡75555 | by serialography (initial projection) | 26.0 | | ‡75558 | each additional serialographic projection) | 7.7 | | | (For ventriculography and heart cateterization, see 93541 et seq.) | | | ‡75580 | Pulmonary arteriography, by cineradiography, (includes one or more projections) | RNE° | | | (For injection procedure, see 36013; see also 93541) | | | ‡75580 | by serialography (initial projection) | 26.0 | | ‡75588 | each additional serialography projection | 7.7 | | | Unlisted cardiopulmonary vascular procedure | BR† | | | (ix) Arteriography. | | | 75605 | Thoracic aortic arch, by serialography, Initial projection | 26.0 | | | (For injection procedure, see 36290) | | | ‡75608 | each additional serialographic projection | 7.7 | | ‡75615 | Cervico-thoracic selective ( e.g. , extracranial carotid, vertebral, thyrocervical, internal mammary, bronchial arteries, etc.) by serialography, initial projection | 26.0 | | | (For injection procedure, see 36210, 36220) | | | ‡75618 | each additional serialographic projection | 7.7 | | ‡75635 | Cerebral (carotid, vertebral), by serialography, initial projection | 26.0 | | | (For injection procedure, see 80210, 36200.) | | | ‡75638 | each additional serialographic projection | 7.7 | | ‡75760 | Abdominal aorta, without serialography | RNE° | | | (For injection procedure, see 36200) | | | ‡75761 | with serialography | 26.0 | | | each additional serialographic projection | 7.7 | | ‡75765 | Abdominal selective (celiac, superior mesenteric, renal, adrenal, lumbar, etc.), by serialography, initial projection | 26.0 | | | (For injection procedure, see 36240, 36250.) | | | ‡75768 | each additional serialographic projection | 7.7 | | ‡75770 | Aorto-iliac-femoral, without serialography | RNE° | | | (For injection procedure, see 36200) | | | ‡75775 | with serialography, initial projection | 26.0 | | ‡75778 | each additional serialographic projection | 7.7 | | ‡75780 | Extremity, without serialography | RNE° | | | (For injection procedure, see 36140, 36200) | | | †75785 | with serialography | 26.0 | | ‡75788 | each additional serialographic projection | 7.7 | | ‡75790 | Arteriovenous shunt examination ( e.g. , dialysis patient) | RNE° | | | (For injection procedure, see 36145) | | | ‡75797 | Operative angiogram, single projection | RNE° | | ‡75799 | Unlisted arteriographic procedure | BR† | | | (x) Venography. | | | ‡75900 | Superior vena cava, without serialography | RNE° | | | (For injection procedure, see 36011) | | | ‡75905 | with serialography, initial projection | 26.0 | | ‡75908 | each additional serialographic projection | 7.7 | | ‡75920 | Cervico-cephalic, selective ( e.g. , jugular parathyroid), without serialography | RNE° | | | (For injection procedure, see, 36020, 36021) | | | ‡75925 | with serialography | 26.0 | | ‡75928 | each additional serialographic projection | 7.7 | | ‡75930 | Orbital, without serialography | RNE° | | | (For injection procedure, see 36060, 36020) | | | ‡75935 | with serialography, initial projection | 26.0 | | ‡75938 | each additional serialographic projection | 7.7 | | ‡75940 | Inferior vena cava, without serialography | RNE° | | | (For injection procedure, see 36011) | | | ‡75945 | with serialography, initial projection | 26.0 | | ‡75948 | each additional serialographic projection | 7.7 | | ‡75950 | Abdominal, selective ( e.g. , renal, adrenal, hepatic), without serialography | RNE° | | | (For injection procedure, see 36020, 36021) | | | ‡75955 | with serialography, initial projection | 26.0 | | ‡75958 | each additional serialographic projection | 7.7 | | ‡75960 | Splenoportography, without serialography | RNE° | | | (For injection procedure, see 38200) | | | ‡75965 | with serialography, initial projection | 26.0 | | ‡75968 | each additional serialographic projection | 7.7 | | ‡75970 | Extremity, unilateral | 11.0 | | | (For injection procedure, see 36000, 36001) | | | ‡75971 | bilateral | 16.5 | | ‡75979 | Unlisted venous procedure | BR† | | | (xi) Lymphangiography. | | | ‡75980 | Extremity, unilateral | RNE° | | | (For injection procedure, see 38790, 38791) | | | ‡75982 | bilateral | RNE° | | ‡75985 | Complete (extremity-pelvic-abdominal, etc.) | 23.0 | | ‡75999 | Unlisted lymphatic procedure | BR† | | | (12) Miscellaneous Studies. | | | 76000 | Fluoroscopy (independent procedure) | 2.6 | | 76001 | extended physician and/or room time with periodic fluoroscopy per 30 minutes | REN° | | 76020 | Bone age studies | 3.7 | | 76040 | Bone length studies (ortho-roentgenogram | 6.2 | | 76060 | Bone survey (for metastases, metabolic survey, or long bones). | 9.3 | | †76065 | infant ( e.g. , "battered child") | 5.4 | | ‡76082 | Fistula or sinus tract study | 5.4 | | | (For injection procedure, see 20501) | | | 76090 | Mammography, unilateral | 5.4 | | 76091 | bilateral | 8.2 | | ‡76092 | by xeroradiography, unilateral | RNE° | | ‡76093 | bilateral | RNE° | | ‡76095 | Surgical specimen radiography | BR† | | 76100 | Laminography (tomography, planigraphy, body section radiography) (independent procedure) | 8.2 | | 76105 | to complement routine examination | 4.2 | | 76120 | Cineradiography (independent procedure) | 7.7 | | 76125 | to complement routine examination | 4.4 | | 76140 | Written consultation on X-ray examination made elsewhere (independent procedure) | BR† | | ‡76150 | Xeroradiography, to complement routine exam other than mammography | RNE° | | 76160 | Polaroid X-ray film (in addition to value of procedure), per film | 0.5 | | ‡76170 | Subtraction studies, per serialographic projection | 1.8 | | ‡76175 | Duplication of radiographs, per film | 0.45 | | 76180 | Transportation of portable X-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen | RNE° | | ‡76181 | more than one patient seen, per patient | BR† | | ‡76300 | Thermography | RNE° | | ‡76499 | Unlisted miscellaneous radiology procedure | BR† | | | (e) DIAGNOSTIC ULTRASOUND | | | | (1) Head, Neck. | | | ‡76500 | Midline determination (A-mode). | 7.0 | | ‡76510 | Echography, ophthalmic (A-mode) | 7.0 | | ‡76511 | with amplitude quantitation | BR† | | ‡76512 | contact scan (B-mode) | BR† | | ‡76513 | immersion scan (B-mode) | BR† | | ‡76514 | immersion (M-mode) | BR† | | ‡76515 | tomography, serial scan (B-mode, with or without A-mode and/or M-mode) | BR† | | ‡76516 | Echographic biometry ophthalmic (A-mode) | BR† | | ‡76517 | scan (B-mode) | BR† | | ‡76529 | Ophthalmic echographic foreign body localization | BR† | | ‡76535 | Thyroid sonogram (B-scan) | 13.0 | | | (2) Chest. | | | ‡76600 | Pericardial effusion (M-mode) | 7.0 | | ‡76610 | Complete echocardiogram (M-mode) includes: pericardial, mitral and aortic valves, left atrial and ventricular measurements | 13.0 | | ‡76620 | Limited echocardiogram (M-mode) (Follow-up study or any of the individual studies listed above in 76610) | 7.0 | | ‡76630 | Pleural effusion localization (A-mode) | 7.0 | | | (3) Abdomen. | | | ‡76700 | Abdomen, general survey study, includes delineation of any or all organs, and fluid collection (B-scan) | 13.0 | | ‡76705 | Abdomen, limited survey study (includes tumor follow-up for radiation or chemotherapy within 30 days of initial study) (B-scan) | 7.0 | | ‡76710 | Liver sonogram (B-scan) | 13.0 | | ‡76720 | Gallbladder sonogram (B-scan) | 13.0 | | ‡76730 | Kidneys sonogram (B-scan) | 13.0 | | ‡76740 | Pancreas sonogram (B-scan) | 13.0 | | ‡76750 | Spleen sonogram (B-scan) | 13.0 | | ‡76765 | Aorta sonogram (B-scan) | 13.0 | | ‡76770 | Retroperitoneal space sonogram (B-scan) | 13.0 | | ‡76780 | Urinary bladder (B-scan) | 13.0 | | | (4) Obstetrics andGynecology. | | | ‡76810 | Pregnancy and fetal age determination (B-scan) | 13.0 | | ‡76815 | Repeat fetal age measurement (B-scan) within 30 days of initial | 4.0 | | ‡76820 | Placental localization | 13.0 | | †76840 | Intrauterine device localization (B-scan) | 13.0 | | ‡76850 | Pelvic mass examination (B-scan) | 13.0 | | | (5) Doppler. | | | | (excludes auscultation of fetal heart | | | ‡76900 | Peripheral arterial flow study | 12.0 | | ‡76910 | Peripheral venous flow study | 12.0 | | | (6) Miscellaneous. | | | ‡76950 | Mapping study for radiation therapy (includes contour, port demarcation on patient) (B-scan) | 16.0 | | ‡76960 | Ultrasonic guidance for biopsy or aspiration (independent procedure) | 4.0 | | | (For aspiration and biopsy see appropriate section. If aspiration and biopsy are performed as part of or immediately following diagnostic B-scan, no extra charge is allowed) | | | ‡76999 | Unlisted ultrasound procedure | BR† |
(f) RADIATION THERAPY AND ONCOLOGY.
(1) Radiation therapy as listed in this section includes teletherapy ( i.e., the use of X-ray and other high-energy modalities, radium, cobalt, etc.) and brachytherapy ( i.e., the surface, intracavitary or interstitial application of contained radioactive sources). For treatment by injectable or ingestible radioactive isotopes, see section on Nuclear Medicine.
(2) The listed treatment values include initial treatment planning, initial and serial beam verification and central axis based calculations. They include normal follow-up care during the course of radiation therapy and for three months following its completion. Preliminary consultation and/or initial evaluation of the patient prior to radiation therapy are not included in the listed values. (See Medicine, 90000-90630). Complications or other circumstances requiring additional or unusual services concurrent with therapy or during the follow-up period may warrant additional charges.
(3) Definitions. For the purpose of this section, the following definitions apply:
(i) Treatment Week: Four or more treatment days in a calendar week. If three treatments or less in a week are given, use “treatment day” charge.
(ii) Simple Treatment: Treatment of benign or malignant diseases requiring simple field localization or simple beam shaping devices, single field treatment, or surface or intracavitary therapy applied without general anesthesia.
(iii) Complex Treatment: Treatment of malignant disease requiring complex field localization or use of beam shaping devices ( e.g., treatment of eyelid; mantle fields in Hodgkin's disease, etc.) or two or more fields per region or two or more regions per day, massive single dose treatment, intracavitary therapy applied with general anesthesia.
(iv) Adjunctive Radiotherapy Physics Services: The adjunctive radiotherapy physics services listed are those necessary to the conduct of radiation therapy for optimal patient care, performed in consultation with a qualified radiological physicist ( e.g., patient dosimetry, design and construction of beam shaping devices). The values for these services apply when these services are performed by a physician or by a qualified radiological physicist under the supervision of a physician.
| | (4) Teletherapy. | | | --- | --- | --- | | | (i) Per treatment schedule: | | | | Simple Treatment | | | 77000 | Superficial or orthovoltage (under 600 KVP), dermatoses, 3 fields or less, per treatment | 2.0 | | 77010 | more 3 fields, fields, per treatment | 2.4 | | 77020 | other benign lesions, per treatment | 2.5 | | 77030 | malignant lesions, per treatment | 3.6 | | 77040 | Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), per treatment | 5.0 | | 77050 | Megavoltage (3 MeV-8MeV), per treatment | 6.0 | | ‡77060 | Megavoltage (over 8MeV or electron beam), per treatment | RNE° | | | Complex Treatment | | | ‡77070 | Superficial or orthovoltage (less than 600 KVP), per treatment | BR† | | ‡77080 | Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), per treatment | 6.0 | | ‡77090 | Megavoltage (3MeV-8MeV), per treatment | 7.2 | | ‡77095 | Megavoltage (greater than 8MeV or electron beam), per treatment | BR† | | | (ii) Per treatment week schedule: | | | | Simple Treatment | | | 77110 | Superficial or orthovoltage (less than 600 KVP) per treatment week | 18.0 | | ‡77120 | Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), per treatment week | 25.0 | | 77130 | Megavoltage (3MeV-8MeV), per treatment week | 30.0 | | ‡77135 | Megavoltage (greater than 8 MeV or electron beam), per treatment week | BR† | | | Complex Treatment | | | 77210 | Superficial or orthovoltage (less than 600 KVP), per treatment week | 24.0 | | 77220 | Supervoltage (600 KVP-2MeV, including Colbalt-60 and Cesium), per treatment week | 29.0 | | 77230 | Megavoltage (3MeV-8MeV), per treatment week | 36.0 | | ‡77235 | Megavoltage (greater than 8MeV or electron beam), per treatment week | BR† | | ‡7299 | Unlisted teletherapy procedure | BR† | | | (5) Brachytherapy. | | | | (Radium and other isotope applications) | | | | (For systemic, intracavitary and interstitial injection of radioactive material, see section on Nuclear Medicine.) | | | | (The cost of providing the radioactive material is not included in the listed values. For use or purchase of radioactive source, use 99069.) | | | | Surface application of radioactive material or mold: | | | 77500 | Per application | 2.9 | | | Intracavitary application of sealed radioactive source: | | | 77520 | Simple treatment, per application | 26.0 | | 77530 | Complex treatment, per application, total care by single physician | 31.0 | | 77531 | field preparation and application only | 20.0 | | 77532 | radioactive material preparation and monitoring | 15.5 | | ‡77533 | Heyman packing, total care by single physician | BR† | | 77534 | field preparation and application only | BR† | | ‡77535 | radioactive material preparation and monitoring | BR† | | | Interstitial insertion of sealed radioactive source | | | 77540 | Simple treatment, per insertion | BR† | | 77550 | Complex treatment, per insertion | BR† | | ‡77599 | Unlisted brachytherapy services | BR† | | | (For hyperbaric pressurization, see 96200, 96201) | | | | (For chemotherapy of malignant disease, see 96030-96050) | | | | (6) Adjunctive Radiotherapy Physics Services. | | | | Isodose distributions, computer generated or otherwise: | | | ‡77901 | Teletherapy, simple (one or two fields), per plane | BR† | | ‡77902 | complex (three or more fields, fixed or moving beam, or tissue inhomogeneity), per plane | BR† | | ‡77905 | Brachytherapy, intracavitary radioactive sources, first plane | BR† | | 77906 | each additional plane | BR† | | ‡77911 | Brachytherapy, interstitial radioactive sources, first plane | BR† | | ‡77912 | each additional plane | BR† | | | Miscellaneous radiological physics services: | | | ‡77920 | In vivo dosimetry | BR† | | ‡77295 | Design and construction of beam shaping devices ( e.g. , bolus, template, blocks, compensators | BR† | | ‡77930 | Continuing radiological physics service in support of the radio-therapist in individual patient management per treatment course | BR† | | ‡77940 | Tumor localization, simple, limited simulation and limited number of localization films (does not include "port" films or simple beam verification, which are included in basic treatment charge) | BR† | | ‡77941 | Tumor localization, complex, simulation requiring multiple films and/or extensive participation of the radiologist or radiotherapist in the localization procedures | BR† | | ‡77999 | Unlisted adjunctive radio-therapyphysics procedure | BR† |
(g) NUCLEAR MEDICINE
(1) When the physician providing Nuclear Medicine services is also responsible for the preliminary diagnostic work-up and/or follow-up care of the patient, see appropriate sections for office or hospital visits, consultations and other medical, surgical, radiological and pathology services.
(2) For complex instrumental or special data handling, see ground rule 3 in this section.
(3) For all pharmaceutical or other radionuclide material costs, see 99069. The listed values in this section do not include these costs. List name of radiopharmaceutical, dosage and cost.
(4) For other supplies and material provided by the physician, see 99070.
(5) The term imaging as used in this section includes scanning, scintiphotography, scintigraphy, etc.
| | (6) Diagnostic. | | | --- | --- | --- | | | (i) Endrocrine System. | | | 78000 | Thyroid uptake, single determination | 4.0 | | 78001 | multiple determinations (as in 6 and 24 hours, etc.) | 5.3 | | ‡78003 | Thyroid stimulation, suppression or discharge (not including initial uptake studies) | 5.7 | | ‡78006 | Thyroid, imaging, with uptake, single determination | 10.0 | | ‡78007 | multiple determinations | 10.5 | | 78010 | Thyroid, imaging only | 7.2 | | ‡78015 | Thyroid carcinoma metastases, imaging, neck and chest only | 11.5 | | ‡78016 | with additional studies ( e.g. , imaging other body areas urinary recovery, etc.) | 15.5 | | | (Resin uptake T-3 or T-4[RT3U], see 84250) | | | | (Triliodothyronine [True T-3], RIA, see 83539) | | | | (T-4-thyroxin, CPB [Murphy-Pat-tee ], see 83536) | | | | (T-4-thyroxin, RIA, see 83537) | | | | (Calcitonin, RIA, see 82308) | | | ‡78070 | Parathyroid, imaging | RNE° | | | (Parathormone [parathyroid hormone], RIA, see 83970) | | | ‡78075 | Adrenal, imaging | RNE° | | | (Cortisol, RIA, plasma, see 82533) | | | | (Cortisol, RIA, urine, see 82534) | | | | (Aldosterone, double isotope technic, see 82087) | | | | (Aldosterone, RIA, blood, see 82088 | | | | (Aldosterone, RIA, urine, see 82089) | | | | (Pancreas, see 78240) | | | | (Insulin, RIA, see 83525) | | | | (Proinsulin, RIA, see 83526) | | | | (Glucagon, RIA, see 82943) | | | | (Adrenocorticotropic hormone | | | | [ACTH], RIA, see 82024) | | | | (Growth Hormone [HGH], [Somatotropin ], RIA, see 83003) | | | | (Thyroid Stimulating Hormone [TSH], RIA, see 84443) | | | | (Thyrotropin Releasing Factor, RIA, see 84444; plus long acting [LATS], see 84445) | | | | (Follicle Stimulating Hormone, see Gonadotropin, pituitary [FSH], RIA, see 83001) | | | | (Luteinizing Hormone, see Gonadotropin, pituitary [LH], [ICSH], RIA, see 83002) | | | | (Prolactin level [Mammotropin], RLA, see 84146) | | | | (Oxytocin level, see Oxytocinase, RIA, 83951) | | | | (Vasopressin level, see Vasopressin [antidiuretic Hormone], RIA, see 84588) | | | ‡78099 | Unlisted endocrine procedure | BR† | | | (ii) Hematopoietic, Reticuloendothelial and Lymphatic System. | | | ‡78102 | Bone marrow, imaging, limited area | BR† | | ‡78103 | multiple areas | BR† | | ‡78104 | whole body | RNE° | | 78110 | Blood or plasma volume, single sampling | 5.0 | | 78111 | multiple sampling | 7.0 | | | (For dye method, see 84610) | | | 78120 | Red cell mass determination, single sampling | 9.4 | | 78121 | multiple sampling | 10.0 | | | (see also 84610) | | | 78130 | Red cell survival study ( e.g. , 51 Cr) | RNE° | | 78135 | plus splenic and/or hepatic sequestration | RNE° | | 78140 | Red cell splenic and/or hepatic sequestration | RNE° | | 78160 | Plasma radio-iron disappearance (turnover) rate | RNE° | | 78170 | Radio-iron, red cell utilization | RNE° | | 78180 | Radio-iron, body distribution and storage pools | RNE° | | | (Cyanocobalamine [Vitamin B-12], RIA, see 82611) | | | | (Folic acid [folate] serum, RIA, see 82746) | | | | (Human Hepatitis Antigen, Hepatitis Association Agent [Australian antigen] [HAA], RIA, see 86287) | | | ‡78185 | Spleen, imaging only, static | 13.5 | | | (If combined with liver study, use procedures 78215 and 78216) | | | ‡78186 | with vascular flow | RNE° | | ‡78195 | Lymphatics and lymph glands imaging | BR† | | ‡78199 | Unlisted procedure, hematopoietic, RE and lymphatic | BR† | | | (iii) Gastrointestinal System. | | | ‡78201 | Liver, imaging, static | 13.5 | | ‡78202 | with vascular flow | RNE° | | | (For spleen imaging only, use 78185 and 78186) | | | ‡78215 | Liver and spleen, imaging, static | 15.0 | | ‡78216 | with vascular flow of liver and/or spleen | RNE° | | ‡78220 | Liver function ( e.g. , with radioiodinated rose bengal), with serial images | 15.5 | | ‡78221 | with probe technique | BR† | | ‡78225 | Liver-lung study, imaging ( e.g. , for subphrenic abscess) | 27.0 | | ‡78230 | Salivary glands, imaging, static | RNE° | | ‡78231 | with serial views | RNE° | | ‡78240 | Pancreas, imaging | 23.0 | | ‡78270 | Vitamin B-12 absorption studies | | | | ( e.g. , Schilling test) without intrinsic factor | 5.3 | | ‡78271 | with intrinsic factor | 5.3 | | ‡78280 | Gastrointestinal blood loss study | RNE° | | ‡78282 | Gastrointestinal protein loss ( e.g. 51 Cr Albumin) | RNE° | | ‡78285 | Gastrointestinal fat absorption study ( e.g. , radioiodinated triolein) | RNE° | | ‡78286 | Gastrointestinal fatty acid absorption study ( e.g. , radioiodinated oleic acid) | RNE° | | | (Gastrin, RIA, see 82941) (Intrinsic factor level, see 84231) | | | | (Carcinoembryonic antigen level, RIA, see 86151) | | | ‡78299 | Unlisted gastrointestinal procedure | BR† | | | (iv) Musculoskeletal System. | | | 78300 | Bone imaging, limited area ( e.g. , skull, pelvis, etc.) | 11.5 | | 78305 | multiple areas | 16.0 | | ‡78307 | whole body | 20.0 | | ‡78380 | Joints, imaging | RNE° | | ‡78399 | Unlisted musculoskeletal procedure | BR† | | | (v) Cardiovascular System. | | | ‡78401 | Cardiac blood pool, imaging, static | | | | ( e.g., as for pericardial effusion) | 13.0 | | ‡78402 | with vascular flow | RNE° | | ‡78405 | Myocardium, imaging | BR† | | ‡78435 | Cardiac flow study, imaging ( i.e., angiocardiography) | RNE° | | ‡78445 | Vascular flow study, imaging (i.e., angiography) | RNE° | | ‡78455 | Venous thrombosis study | RNE° | | ‡78470 | Cardiac output (see also 93561-93562) | RNE° | | ‡78490 | Tissue clearance studies | RNE° | | | (Digoxin, RIA, see 82643) | | | | (Digitoxin [digitalis], RIA, see 82640) | | | ‡78499 | Unlisted cardiovascular procedure | BR† | | | (vi) Respiratory System. | | | ‡78580 | Pulmonary perfusion imaging, particulate | 17.5 | | ‡78581 | gaseous | BR† | | ‡78582 | with ventilation, rebreathing and washout | BR† | | ‡78590 | Pulmonary ventilation imaging, aerosol | BR† | | ‡78591 | gaseous, single breath, single projection | RNE° | | ‡78592 | multiple projections ( e.g., anterior, posterior, lateral views) | RNE° | | ‡78593 | with rebreathing and washout with or without single breath, single projection | 15.0 | | ‡78594 | multiple projections ( e.g., anterior, posterior, lateral views) | BR† | | ‡78599 | Unlisted respiratory procedure | BR† | | | (vii) Nervous System. | | | ‡78600 | Brain, imaging, limited procedure, static | 17.5 | | ‡78601 | with vascular flow | 20.0 | | ‡78605 | complete, static | 19.0 | | ‡78606 | with vascular flow | 23.0 | | ‡78610 | vascular flow study only | 5.7 | | ‡78630 | Cerebrospinal fluid flow, imaging, cisternography (not including introduction of material, e.g., for lumbar puncture, see 62288, etc.) | 24.0 | | ‡78635 | ventriculography | 24.0 | | ‡78640 | myelography | RNE° | | ‡78945 | shunt evaluation | 24.0 | | ‡78650 | CSF leakage | 21.0 | | ‡78699 | Unlisted procedure, nervous system | BR† | | | (viii) Genitourinary System | | | ‡78700 | Kidney, imaging, static | 12.0 | | ‡78701 | with vascular flow | 17.0 | | ‡78704 | with function study ( i.e., imaging renogram) | 19.0 | | ‡78707 | with vascular flow and function study | 28.0 | | 78715 | Kidney, vascular flow | RNE° | | ‡78720 | Kidney, function study (i.e., renogram) | 8.0 | | ‡78721 | with serial images | 11.5 | | ‡78725 | Kidney function study, clearance | BR† | | | (Renin [Angiotensin I], RIA, see 84244; Angiotensin II, RIA, see 82163) | | | ‡78730 | Urinary bladder residual study | RNE° | | ‡78740 | Ureteral reflux study | RNE° | | | (Estradiol, RIA, see 82670; see also 82677 and 82679) | | | | (Progesterone, RIA, see 84144) | | | | (Testosterone, blood, RIA, see 84403) | | | | (Testosterone, urine, RIA, see 84405) | | | ‡78770 | Placenta, imaging | 8.7 | | ‡78775 | localization ( e.g., radioiodinated HSA) | 7.2 | | | (See also 74720, 74725 and 76820) | | | | (Lactogen, placental [HPL] chorionic somatomammotropin, RIA, see 83632) | | | | (Chorionic gonadotropin, RIA, see 82998) | | | ‡78799 | Unlisted genitourinary procedure | BR† | | | (ix) Miscellaneous Studies. | | | ‡78800 | Tumor localization ( e.g., gallium, selenomethionine, etc.), limited area | RNE° | | | (For specific organ, see appropriate heading) | | | ‡78801 | multiple areas | RNE° | | ‡78802 | whole body | RNE° | | ‡78899 | Miscellaneous unlisted procedure | BR† | | | (7) Therapeutic. | | | | (Preliminary and follow-up diagnostic tests not included. For these services, see appropriate sections.) | | | | (For radiopharmaceutical or other radionuclide material costs, see 99069) | | | | (For procedures involving radioactive sealed sources and surface application of radioactive material, see Radiation Therapy) | | | 79000 | Hyperthyroidism, initial evaluation of patient and administration of radionuclide | 28.0 | | 79001 | subsequent, each | 13.5 | | 79020 | Thyroid suppression, evaluation of patient and administration of radionuclide | 28.0 | | ‡79030 | Thyroid carcinoma, ablation of gland | BR† | | ‡79035 | therapy, for metastases | BR† | | 79100 | Polycythemia vera, chronic leukemia, etc., per treatment | 11.5 | | 79200 | Intracavitary radioactive colloid therapy | BR† | | 79300 | Interstitial radioactive colloid therapy | BR† | | 79400 | Therapy, e.g., for metastases to bone (non-thyroid) | BR† | | ‡79499 | Unlisted therapeutic procedure | BR† | | | (For chemotherapy procedure, see 96030-96055) | |
BR† By report; see ground rule 4(a) for detailed information.
RNE° Relativity not established; see ground rule 4(b) for detailed information.
‡ Code number new to 1974 revision of CRVS.
□ Relativity for professional component of service only.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.10 Enforcement
(a) The department or local health department may require any owner to conduct Legionella culture sampling and analysis, following a determination, based upon epidemiologic data or laboratory testing, that one or more cases of legionellosis are or may be associated with a cooling tower.
(b) An officer or employee of the department or local health department may enter onto any property to inspect a cooling tower for compliance with the requirements of this Subpart, in accordance with applicable law, and may take water samples as part of such inspections.
(c) Where an owner does not register, have a maintenance program and plan, obtain certification, disinfect, perform or obtain culture sampling and analysis, or inspect a cooling tower within the time and manner set forth in this Subpart, the department or local health department may determine that such condition constitutes a nuisance and may take such action as authorized by law. The department or local health department may also take any other action authorized by law.
(d) A violation of any provision of this Subpart is subject to all civil and criminal penalties as provided for by law. Each day that an owner remains in violation of any provision of this Subpart shall constitute a separate and distinct violation of each such provision.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.53 Dental radiographic installations
(a) Equipment.
(1) The protective tube housing shall be of diagnostic type.
(2) Diaphragms or cones shall be used for restricting the useful beam to the area of clinical interest and shall provide at least the same degree of protection as is required of the tube housing.
(3) For intra-oral radiography the diameter of the useful beam at the face of the patient shall not exceed three inches.
(4) A cone or spacer frame shall provide a source-skin distance of not less than seven inches with equipment operating above 50 kVp or four inches with equipment operating at 50 kVp or below for intra-oral radiography.
(5) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(6) A device shall be provided to terminate the exposure after a preset time interval or exposure. The exposure switch shall be of the dead-man type, and where protective barriers are required shall be so arranged that it cannot be operated outside the shielded area.
(7) Each installation shall be so arranged that the operator can stand at least six feet from the patient, the X-ray tube, and the useful beam during exposure. A protective barrier shall be provided where the operator can not stand at least six feet away from the patient, the X-ray tube and the useful beam during exposures.
(8) The tube head shall remain stationary when placed in the exposure position.
(b) Conditions for operation of equipment.
(1) The film shall not be held by the dentist or technician during the exposure.
(2) Only the patient shall be in the useful beam.
(3) Neither the tube housing, pointer nor cone shall be hand-held during the exposure.
(4) Only persons required for the radiographic procedure shall be in the radiographic room during the exposure.
(5) For extra-oral radiography, the X-ray film used as the recording medium during the X-ray examination shall show substantial evidence of cut-off (beam delineation).
(6) Gonadal shielding of not less than 0.5 mm lead equivalent shall be used for patients who have not passed the reproductive age during radiographic procedures in which the gonads are in the useful beam.
(c) Special installations.
(1) Panoramic installations are dental installations which consist of a tube head with a collimator providing a narrow (1-2mm) useful beam and an extra-oral film carrier which are interlocked in their motion about the patient.
(i) Equipment.
(a) The protective tube housing shall be of diagnostic-type.
(b) Diaphragms or cones shall be used for restricting the useful beam to the area of clinical interest and shall provide the same degree of protection as is required of the tube housing.
(c) The aluminum equivalent of the total filtration in the useful beam shall not be less than that shown below:
| Operating kVp | Minimum total filter (Inherent plus added) | | --- | --- | | Below 50 kVp | 0.5 mm aluminum | | 50-70 kVp | 1.5 mm aluminum | | Above 70 kVp | 2.5 mm aluminum |
(d) A device shall be provided to terminate the exposure after a preset time interval or exposure. The exposure switch shall be of the dead-man type.
(e) Each installation shall be provided with a protective barrier for the operator or shall be so arranged that the operator can stand at least six feet from the patient, the X-ray tube, and the useful beam.
(ii) Conditions for operation of equipment. Only the patient shall be in the useful beam.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-7 TINTED GLASS IN MOTOR VEHICLES
10 CRR-NY 69-7.1 Medical conditions for which an exemption from restrictions on tinted glass may be issued
The following medical conditions, when their existence is certified by a physician, physician assistant or nurse practitioner, justify granting an exemption from the limits on light transmittance found in Vehicle and Traffic Law, section 375(12-a)(b), provided that personal protective measures such as sun protective clothing, sunscreen, or eye protective devices do not offer adequate protection:
Albinism;
chronic actinic dermatitis/actinic reticuloid;
dermatomyositis;
lupus erythematosus;
porphyria;
xeroderma pigmentosum;
severe drug photosensitivity, provided that the course of treatment causing the photosensitivity is expected to be of prolonged duration;
photophobia associated with an ophthalmic or neurological disorder; and
any other condition or disorder causing severe photosensitivity in which the individual is required for medical reasons to be shielded from the direct rays of the sun.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-3 DESIGNATION OF UNDERSERVED AREAS
10 CRR-NY 47-3.1 Underserved areas
For purposes of section 903(2)(a) of the Public Health Law, the Resident Loan Repayment Program; section 903(2)(b) of the Public Health Law, the Physician Loan Repayment Program; and, section 904 of the Public Health Law, the Primary Care Practitioner Scholarship Program, underserved areas shall be located in New York State and shall include the following:
(a) areas designated by the Federal government as a Health Professional Shortage Area;
(b) not-for-profit diagnostic and treatment centers, with an operating certificate issued pursuant to section 401.1 of this Title which serve the medically indigent and Medicaid-eligible persons;
(c) facilities participating in state-supported rural health networks;
(d) programs receiving Federal title 10 funding;
(e) Department of Health approved Prenatal Care Assistance Programs;
(f) facilities or programs supported by the Department of Health Primary Care Services Grant Program, pursuant to section 2807 of the Public Health Law;
(g) school-based clinics providing primary care services;
(h) Department of Health designated AIDS service sites;
(i) State operated facilities;
(j) facilities and service sites operated by county health departments;
(k) sites serving the homeless or Native Americans;
(l) facilities licensed by the Office of Alcoholism and Substance Abuse Services;
(m) managed care plans approved by the commissioner;
(n) other sites, areas and facilities determined by the commissioner to have a significant need for additional primary care physicians and primary care practitioners.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 445 ACCOUNT DISTRIBUTION INDEX
10 CRR-NY 445.1 Introduction
[4000]
(a) The account distribution index serves as a reference for proper classification of supplies and services expenses.
(b) [4100] The account distribution index is divided into two sections. Section 445.2 of this Part, “Job Titles by Natural Classification Index”, lists various job titles and the natural classification of salaries and wages to which they must be charged as expenses. For example, the job title “accountant” requires that the salaries of an accountant must be charged to the natural classification.02 (Technician and Specialist).
(c) Section 445.3 of this Part, “Supplies and Services by Natural Expense Classification Index”, lists various types of supplies and services and the cost center and natural classification to which they must be charged as expenses. In many cases, the cost center which originally receives the supply items is not the cost center to which the supply expense must be charged. For instance, although nonchargeable sutures may be received in the Central Service and Supply cost center and charged to inventory, upon requisition they are sent to an Operating Room cost center and their cost must be transferred interdepartmentally to that using cost center. It is this using cost center which is indicated in the Supplies and Services by Natural Expense Classification Index. All medical and surgical supplies and equipment expense related to patient chargeable items is to be charged to the Medical Supplies Sold cost center (account 7110), regardless of the cost center which actually issues the supplies. In order to have a matching of revenue and expense, the revenue related to the patient-chargeable supplies is to be credited to the Medical Supplies Sold revenue center (account 4110). All drug expense related to patient-chargeable pharmacy items is to be charged to the Drugs Sold cost center (account 7150) regardless of the cost center which actually issues the item. The revenue related to the patient-chargeable item is to be credited to the Drugs Sold revenue center (account 4150).
(d) Many of the items listed are not referenced to a single cost center, but to the “using” or “appropriate” cost center. These are items commonly used in more than one cost center, whose cost must be recorded directly or by interdepartmental transfer to the using cost center.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.7 Injury and illness incident reporting
A full report of any injury or illness incident occurring at a bathing beach shall be reported by the owner/operator to the permit-issuing official within 24 hours and recorded in a logbook. This shall include all incidents occurring at a bathing facility which:
(a) result in death;
(b) require resuscitation;
(c) require referral to a hospital or other facility for medical attention; or
(d) is a bather illness associated with bathing water quality.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.8 Tribunal representatives
(a) Except as otherwise provided by statute, the tribunal representatives conducting hearings are authorized to:
(1) accept pleas to, and hear and determine, allegations by the department of violations of the provisions of the Public Health Law, the State Sanitary Code (Chapter I of this Title), and pertinent provisions of the administrative rules and regulations of the department;
(2) examine witnesses and receive evidence;
(3) administer oaths and affirmations;
(4) sign and issue subpoenas in the name of the department at the request of any party, requiring attendance and giving of testimony by witnesses and production of books, papers, documents and other evidence; such subpoenas shall be regulated by the Civil Practice Law and Rules;
(5) provide for taking of testimony by deposition;
(6) regulate the course of the hearings, set the time and place for continued hearings, and fix the time for filing of briefs and other documents;
(7) determine whether or not to offer a stipulation as provided in section 76.9 of this Part;
(8) impose fines, penalties, permit revocations, permit suspensions or closure as authorized;
(9) order abatement of violations, and a schedule for such abatement;
(10) order reinspection of the facility to determine compliance with the Stae Sanitary Code and orders for abatement.
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.3 Pre-application procedure
(a) Prospective applicants seeking financial assistance from the fund must first submit a pre-application to the department in the format required by the department. Information required for the pre-application includes:
(1) a written request from an individual with sufficient authority to act on behalf of the applicant that the project be listed in the intended use plan;
(2) a description of the project, including a discussion of the existing deficiencies of the public water system and the corrective effect the proposed project will have on that system's drinking water quality;
(3) a project schedule and project cost estimate; and
(4) such other information and material as the pre-applicant deems necessary for the department to determine a project's eligibility for assistance from the fund.
(b) An applicant will receive written notification from the department if it fails to submit sufficient information for the department to process the pre-application. The department will identify any such deficiency and the applicant may submit supplemental material to complete the pre-application.
(c) A project may not be eligible for fund assistance in a given annual funding cycle if the applicant has failed to complete its pre-application within the time prescribed by the department.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-8 WATERSHED PROTECTION PLANS
10 CRR-NY 128-8.4 Permanent phosphorus offset program
(a) Upon completion of the pilot programs set forth in sections 128-8.2(g) and 128-8.3(a) of this Subpart, the department may determine, based on the results of the pilot program or of other studies conducted in the watershed that:
(1) phosphorus offsets sought pursuant to sections 128-8.2(g) and 128-8.3(a) of this Subpart have been achieved and that a permanent phosphorus offset program should be established, with such conditions as may be appropriate based on the results of the pilot program or other studies conducted in the watershed;
(i) pending completion of any necessary rulemaking for the continuation of a permanent phosphorus offset program, including any appropriate modifications thereto, the department may allow the construction of new wastewater treatment plants with surface discharges into phosphorus restricted basins located outside of the 60-day travel time on a case-by-case basis pursuant to the standards set forth in section 128-6.1 of this Part and subject to such conditions as may be appropriate based upon the results of the pilot program and other studies conducted in the watershed; or
(2) there is insufficient data on which to make a determination that phosphorus offsets have been achieved; therefore, the time frame for the pilot programs shall be extended for a period not to exceed five years to allow for the acquisition of further data. Nothing contained in this subdivision shall allow for an increase in the number or size of the wastewater treatment plants allowed pursuant to the pilot programs as set forth in sections 128-8.2(g) and 128-8.3(a) of this Subpart; and
(3) in the west of Hudson watershed, in any permanent phosphorus offset program, provided the applicant demonstrates, and commits to take action to insure, that every one kilogram of projected increase in the phosphorus load resulting from the new wastewater treatment plant or the expansion of an existing plant, and the accompanying non-point source runoff will be actually offset by at least three kilograms of reductions in phosphorus loading within the basin in which such new wastewater treatment plant, or the expansion of an existing plant, is located, the applicant may use as an offset any phosphorus reduction funded by the Catskill Fund for the Future or achieved from stormwater pollution prevention measures installed on existing structures or impervious surfaces in a village center or hamlet and funded by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.20 Accounting for pledges
[ 1410 ] All pledges, less a provision for amounts estimated to be uncollectible, must be included in the hospitalapos;s accounting records. If unrestricted, they must be recorded as nonoperating revenue in the period the pledge is made. If part of the pledge is to be applied during some future period, that part must be recorded in the period the pledge is received as deferred revenue. If restricted, they must be recorded as an addition to the appropriate restricted fund balance. See Hospital Audit Guide.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.1 Applicability
This Part shall apply to all adjudicatory proceedings to which the Department of Health is a party brought pursuant to the Public Health Law, unless there is a specific statute or regulation to the contrary. This Part shall not apply to proceedings brought pursuant to Part 76, Public Health Administrative Tribunal, of this Title.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.1 Enforcement; public health hazards and other violations
(a) Enforcement.
The enforcement procedures delineated in sections 12, 12-a, 16, 206, 225, 308, 309, 348, 373, 1308, 1393 and 1395 of the Public Health Law shall be followed where the permit-issuing official or his representative determines that closing of a children's camp is necessary to protect the public health or safety of the occupants of the camp. Where a public health hazard is found on the property, the building or portion of the property constituting the hazard shall be placarded against occupancy until the hazard is corrected. The closure provisions of Part 14 of this Title shall be utilized for public health hazards occurring in food service facilities. When a placard is used to protect the occupants from a public health hazard, it shall be conspicuously posted at each entrance or walkway leading to the portion of the property that constitutes the hazard. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law. The permit-issuing official or his representative shall inspect the premises within three working days of posting the placard to assure compliance with terms of the order, and shall inspect the premises within two working days of notification that the hazard has been eliminated to remove them after verifying the correction.
(b) Public health hazards.
(1) A public health hazard is any condition which could be expected to be responsible for illness, physical injury or death.
(2) Any of the following violations are public health hazards which require the permit- issuing official or his designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(i) supervision of children is not in accordance with the supervisory or personnel qualification standards prescribed in sections 7-2.5, 7-2.11 and 7-2.25 of this Subpart resulting in a child not being protected from any unreasonable risk to his or her health or safety;
(ii) on-site potable water system serving the children's camp contains contaminants in excess of the maximum contaminant levels prescribed in Part 5 of this Title or section 7-2.6(e) of this Subpart;
(iii) use of an unapproved or contaminated water supply source;
(iv) treatment of the water system, required for disinfection or removal of contaminants, is not continuous;
(v) disinfection which is inadequate to destroy harmful microorganisms or to maintain a specified chlorine residual;
(vi) presence of cross connections or other faults in the water distribution or plumbing systems which result, or may result, in the contamination of the potable water supply;
(vii) insufficient quantity of water to meet drinking or sanitary demands;
(viii) sewage on the ground surface in areas accessible to children or which may contaminate food or pollute a source of water supply or a bathing beach;
(ix) implementation of the medical requirements of the camp safety plan not under the supervision of a camp health director; at camps for children with developmental disabilities, as defined in section 7-2.2(d)(1) of this Subpart, medication is not under the supervision of licensed or certified personnel;
(x) passengers transported in the bed of a truck or trailer or in any other portion of a vehicle that is not designed for passenger occupancy; children transported without counselor supervision in a vehicle;
(xi) camp swimming pool or bathing beach not under the direct supervision of the camp aquatics director or his assistant;
(xii) allowing swimming or incidental water immersion which is not in accordance with section 7-2.11(a)(1), (5)(iii) or (j) of this Subpart;
(xiii) minimum safety equipment in Part 6 of this Title not provided at the waterfront or swimming pool. Depth markings not provided at a swimming pool or a bathing beach as required by Part 6 of this Title;
(xiv) failure to provide fencing or other security during nonuse of a pool;
(xv) failure to use personal flotation equipment during boating or other waterfront activities;
(xvi) failure to establish and enforce the Buddy System and Board System or other method generally accepted as providing a similar or equivalent level of bather safety during swim periods;
(xvii) permitting diving in hazardous areas;
(xviii) failure to restrict non-swimmers to water less than chest deep except as allowed under section 7-2.11(a) of this Subpart;
(xix) riflery conducted without adequate supervision or on a range hazardous to campers or the general public;
(xx) archery or horseback riding not under the direction of competent instructors with equipment and facilities installed and maintained to eliminate hazards;
(xxi) overcrowding of sleeping quarters resulting in inadequate spacing of bunks or in blockage of fire exits; failure to supervise children in sleeping quarters;
(xxii) failure to provide two fire exits where required or blockage of a required fire exit by locking or other obstruction;
(xxiii) failure to provide a fire alarm system in multi-story buildings;
(xxiv) installation of stoves or heating equipment constituting a fire hazard or inadequate venting of fumes;
(xxv) failure to properly store flammable liquids and toxic substances;
(xxvi) failure to maintain firefighting equipment in working order;
(xxvii) failure to implement the camp safety plan resulting in a child not being protected from any unreasonable risk to his or her safety; or
(xxviii) any other item deemed to be a public health hazard by the permit-issuing official under this Subpart or part 5, 6 or 14 of the Sanitary Code.
(c) Other violations.
Violations of other sections of this Subpart or of other Parts of this Chapter are also subject to a penalty upon conviction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
MORTGAGE LOAN CHARGES MORTGAGE LOAN CHARGES
10 CRR-NY 87.20 General
The State Department of Health governmental supervising agency charges set forth in this Part shall be applicable to nursing homes constructed under the provisions of article 28-A of the Public Health Law and nonprofit hospitals modernized or constructed pursuant to the provisions of article 28-B of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
PUBLIC HEALTH HAZARDS PUBLIC HEALTH HAZARDS
10 CRR-NY 14-4.20 Definition of imminent health hazard
(a) An imminent health hazard is any violation, combination of violations, condition, or combination of conditions making it probable that the food or drink served to the public by the establishment or its continued operation can injure the health of the consumer or the public.
(b) Any of the following violations are imminent health hazards against the public interest which require the permit-issuing official or his designated representative to order the establishment closed and all service of food stopped immediately if not corrected at the time of the inspection while the permit-issuing official or representative of the permit-issuing official is present:
(1) food is present from an unapproved or unknown source or which is or may be adulterated, contaminated, or otherwise unfit for human consumption;
(2) potentially hazardous food is held for a period of time longer than that necessary for preparation or service at a temperature greater than 45°F (7.2°C) or less than 140°F (60°C);
(3) potentially hazardous food which has been served to another consumer or which has been exposed to other contamination is served again;
(4) toxic items are improperly stored or used;
(5) persons with disease or infection which can be transmitted by food or drink are engaged in preparing, handling, serving or otherwise contaminating food at the food service operation;
(6) the potable water is not in conformance with the requirements of Part 5 of this Title, and it reasonably appears to the permit-issuing official or his designated representatve that it can result in an imminent health hazard;
(7) any cross-connection or other fault in the potable water system may permit contamination of the potable water supply, and it reasonably appears to the permit-issuing official or his designated representative that it can result in an imminent health hazard; or
(8) sewage or liquid waste is not disposed of in a sanitary manner acceptable to the permit-issuing official.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 140 ST. LAWRENCE COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 140.15 Star Lake Water District, town of Fine
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of the Public Health Law shall apply to Star Lake and to all watercourses entering said lake situated in the county of St. Lawrence, said lake being a source of water supply of the Star Lake Water District.
(b) [Definitions.]
Wherever a linear distance of a structure or object from the lake or watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of Star Lake or to the edge, margin or precipitious bank forming the ordinary high-water mark of such watercourse.
(c) [Human excreta, wastes, compost, etc.]
(1) No privy, cesspool, septic tank, tile field, subsurface leaching area, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta and no bath water, laundry wastes, sewage or other excremental matter from any water closet and no garbage, putrescible matter, kitchen or sink waste and no stable, barnyard or other places for domestic animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 50 feet of Star Lake or any watercourse tributary thereto forming the source of the public water supply of the Star Lake Water District, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter said lake or watercourse without having first passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from the shore line of Star Lake or a watercourse thereof, forming the source of the public water supply of the Star Lake Water District.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, sewage, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into Star Lake or a watercourse thereof, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice of the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 250 feet of the shore line of Star Lake or watercourse and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 100 feet of Star Lake or watercourse forming a source of the public water supply of the Star Lake Water District.
(d) Inspections.
The town board of the town of Fine or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Star Lake Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding Star Lake for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board to promptly notify the State Commissioner of Health of such violations. The town board of the town of Fine shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general sanitary condition at the time of the last inspection.
(e) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the Star Lake Water District.
(f) Penalty.
In accordance with section 70 of the Public Health Law, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
HUMAN USES OF RADIOACTIVE MATERIALS HUMAN USES OF RADIOACTIVE MATERIALS
10 CRR-NY 16.200 Material incorporated by reference
(a) Documents.
The following documents, referenced in this Part, are available for review and copying through the Records Access Officer, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, New York 12237:
(1) 49 CFR parts 170 through 189;
(2) 10 CFR parts 20, 21, 30, 32, 35, 39, 40, 70, 71 and 73; and
(3) 21 CFR part 1020.
(b) Availability of documents.
All the Code of Federal Regulations (CFR) documents are available from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.12 Disposition of unused tissue
(a) Skin that is not used by the tissue transplantation facility immediately after thawing may be refrigerated at between one and 10 degrees Celsius in isotonic or nutrient medium demonstrated to maximize tissue viability for a period of up to seven days. Such skin may be issued for transplantation to the same patient to whom the skin was originally assigned, but shall not be refrozen. Thawed skin that is not used within seven days shall be discarded, or used for education or research purposes authorized by Public Health Law section 4302.
(b) Skin determined to be unsuitable for transplantation, or education or research purposes shall be discarded pursuant to Part 70 of this Title. Packaging of skin for destruction shall be designed to obscure the contents.
(c) Skin returned by the tissue transplantation facility for possible reissuance shall meet all storage and transport requirements of this Part. The skin bank shall not reissue tissue returned by the tissue transplantation facility, unless written criteria approved by the tissue bank medical director are met.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-3.4 Procedure for filing application
Pertinent professional information about prospective patients should be provided by a physician, hospital, clinic, or appropriate public agency. This information should be submitted for the guidance of the hospital staff in determining suitability for admission and subsequently in the evaluation and treatment of the patient. No specific form is required for this purpose. Referrals should be addressed to the director of the hospital, who will notify the referring source, of action taken.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.35 Packaging of smoked fish and smoked fish products
No person shall package, distribute, sell, offer for sale or deliver smoked fish or smoked fish products packaged so that oxygen is excluded unless the product has been heat processed after packaging at a temperature and for a time sufficient to destroy all spores of Clostridium botulinum and is packaged in such a fashion that subsequent bacterial contamination is prevented. If not packaged so that oxygen is excluded or if not heat processed to destroy Clostridium botulinum spores and packaged so as to prevent subsequent bacterial contamination, the smoked fish or smoked fish product shall be immediately refrigerated and maintained at a temperature of 38 degrees Fahrenheit or less without interruption until sold to the ultimate consumer.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.10 Rermination of a demonstration project
In addition to any other basis upon which an operating certificate or an approval of construction may be cancelled, terminated, withdrawn, or annulled pursuant to article 28 of the Public Health Law and this Chapter, an applicant's approval to participate in a medical technology demonstration project may be cancelled or terminated by the commissioner if:
(a) the applicant deviates significantly from its approved demonstration project design or protocols without approval from the commissioner;
(b) there is a significant change in the information or assurances contained in the application which were relevant factors upon which the application was granted favorable recommendation by the technical advisory groups and approved by the commissioner; or
(c) the applicant submits a written request to withdraw from the demonstration and the request is approved by the commissioner. A request to terminate a demonstration project prior to its scheduled completion must include documentation of at least one of the following factors:
(1) that sufficient evidence of the costs associated with and benefits of the technology is available; or
(2) that continuation of the project would result in serious financial hardship to the facility.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.62 Claims and method of payment; State aid for physically handicapped children
(a) For local health departments, State aid for authorized medical services for physically handicapped children shall be paid at 50 percent of net expenses, where net expenses means total expenses less revenues received for such services. State aid may be withheld if, on post-audit and review, the commissioner finds that a medical service rendered was not in conformance with a plan submitted by the municipality or that the recipient of the medical service was not a physically handicapped child as defined in section 2581 of the Public Health Law.
(b) For American Indian children residing on a reservation, State aid for authorized medical services for physically handicapped children shall be paid at 100 percent of net expenses for such services.
(c) To receive State aid, the clerk of the board of supervisors or other similar governing body of each county, or chief fiscal officer of the City of New York, shall quarterly transmit to the commissioner a certified statement stating the amount expended for the purposes specified herein, the date of each expenditure and date of service, and the purpose for which it was made.
(d) To receive State aid, complete claims for physically handicapped children must be received by the commissioner within two years of the date of service.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 140 ST. LAWRENCE COUNTY
VILLAGES VILLAGES
10 CRR-NY 140.1 Village of Canton
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions to sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs of the Barringer, Collar, Barrett, O'Brien, Allen, Matthews and Dinsdale springs and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Canton, St. Lawrence County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refers to all impounding and storage reservoirs used for the collection or storage of the flow from the above named springs which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of Canton.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of Canton, N. Y.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the village of Canton, N. Y.
(3) No cesspool, pit or other receptacle used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is watertight and so arranged and equipped that the said excreta or sewage will not overflow and is at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided, except that suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage may be provided and maintained between the said limiting distances if at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable vessels or receptacles permitted under paragraph (3) of this subdivision shall be removed and vessels or receptacles thoroughly cleaned and deodorized as often as may be found necessary in order to maintain them or the privy or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of final disposal hereinafter specified and that the contents while being transferred shall be effectively covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Canton.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed sewage disposal plant approved by the State Department of Health, as required by law, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of Canton, nor shall any such matters be thrown, placed, led, discharged or allowed to escape on or beneath the surface of the ground except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c) within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the village of Canton.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry, water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 200 feet from any reservoir or within 100 feet from any watercourse tributary to the public water supply of Canton.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or tributary thereof nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or tributary thereof nor be washed therein. No animals or poultry shall be watered in any reservoir of the public water supply of the village of Canton. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Canton.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or within 200 feet of any watercourse tributary to the public water supply of Canton, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the village of Canton.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Canton nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir nor within 300 feet of any watercourse tributary to the public water supply of the village of Canton and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet from any reservoir or within 100 feet from any watercourse or ditch tributary to the public water supply of the village of Canton.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Canton.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the village of Canton.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained with a distance of 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the village of Canton.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the village of Canton.
(j) Inspections.
The board of water commissioners of the village of Canton shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.109 Confidential communications
For the purpose of duties arising out of article 33 of the Public Health Law and provisions of this Part, no communication made to a practitioner shall be deemed confidential within the meaning of the Civil Practice Law and Rules relating to confidential communications between such practitioner and patient.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.12 Allowance for diagnostic and/or treatment centers providing a disproportionate share of bad debt and charity care
(a) Basic rates of payment by governmental agencies for voluntary nonprofit or publicly sponsored diagnostic and/or treatment centers which provide a comprehensive range of primary health care services and can demonstrate losses as a result of providing a disproportionate share of bad debt and charity care shall include a bad debt and charity care allowance. In addition, a diagnostic and/or treatment center which is approved as a preferred primary care center may be eligible for a supplemental allowance. The supplemental allowance shall be based on losses associated with the delivery of bad debt and charity care incurred by a preferred primary care provider to the extent such losses exceed any losses associated with the delivery of bad debt and charity care incurred for 1993 or if later, the year immediately preceding the year in which the diagnostic and/or treatment center is first designated as a preferred primary care provider.
(b) The provisions of this section shall apply to rates of payment for rate periods during the periods July 1, 1990 through March 31, 1991; April 1, 1991 through March 31, 1992, April 1, 1992 through March 31, 1993 and April 1, 1993 through September 30, 1994 and for each fiscal year period commencing on October first thereafter for the distribution of the bad debt and charity care allowance, ant to rates of payment during the period January 1, 1994 through March 31, 1994 and each fiscal year period commencing on April 1st thereafter for preferred primary care providers who are eligible to receive a supplemental allowance.
(c) Eligibility shall be limited to voluntary nonprofit and publicly sponsored diagnostic and/or treatment centers for the initial distribution of bad debt and charity care allowance and to diagnostic and/or treatment centers designated as preferred primary care providers for the supplemental allowance which meet the following criteria:
(1) the facility must demonstrate that it is licensed to provide primary medical care, must primarily provide a comprehensive range of primary care and related support services;
(2) the facility must be able to demonstrate on forms prescribed by the commissioner that a minimum of 15 percent of total clinic threshold visits reported for the base year were eligible visits as defined in paragraph (e)(2) of this section;
(3) the facility must be able to demonstrate that it has made reasonable efforts to maintain financial support from community and public funding sources;
(4) the facility must be able to demonstrate that it has made reasonable efforts to collect payments for services from third-party insurance payors, governmental payors and self-paying patients;
(5) the facility must receive an all-inclusive cost-based Medicaid reimbursement rate in accordance with section 86-4.11 of this Subpart;
(6) the facility must have no petition for bankruptcy filed under either chapter 7 or chapter 11 of title 11 of the U.S. Code. The commissioner may waive this criteria if the facility demonstrates that it is financially viable or a potentially financially viable organization with a comprehensive plan to maintain fiscal integrity.
(d) An annual aggregate amount set forth in statute (see Public Health Law, section 2807[2] [f]) shall be allocated and distributed to publicly sponsored and voluntary nonprofit diagnostic and/or treatment centers.
(e) Allowances shall be established on a prospective basis and shall be computed on the basis of allowable fiscal and statistical data submitted by the facility for the fiscal year ended at least 15 months prior to the year for which allowances are being set. The bad debt arid charity care allowance shall be paid as an addition to the facility's rate of payment. The amount to be paid will be calculated by dividing each eligible facility's bad debt and charity care loss by base year Medicaid threshold visits.
(1) Eligible losses will be calculated by applying a facility's Medicaid rate of payment for the rate period for which the allowance is being determined, to identified base year eligible visits or units of service.
(2) An eligible visit shall be defined as the unit of service upon which title XIX payment is based provided, however, to an individual who after a reasonable period of time appears to be unable to pay all or a portion of the payment due for the service, except for those portions of the payment due which are covered by a government agency, insurer or third-party payor, including payment made directly to the diagnostic and/or treatment center and indemnity or similar payment.
(3) All payments received in the base year directly for eligible visits, government and entitlement revenues obtained for the purpose of subsidizing the diagnostic and/or treatment center's general operating expenses and any supplemental allowance received by a diagnostic and/or treatment center designated as a preferred primary care provider shall be offset against eligible costs to arrive at an eligible loss under this section.
(4) An annual amount of loss coverage will be calculated by applying eligible losses against the following nominal loss coverage formula:
| Percent of eligible bad debt and charity care clinic visits to total visits | Percent of nominal loss coverage | | --- | --- | | up to 15% | 50% | | 15% to 30% | 75% | | 30% plus | 100% |
The nominal loss coverage percentages may be increased to not more than 100 percent for voluntary nonprofit or publicly sponsored diagnostic and/or treatment centers if the sum of the nominal payments for all eligible voluntary nonprofit or public diagnostic and/or treatment centers is less than the amounts allocated for nonpublic or public agencies.
(5) Separate coverage ratios shall be established for voluntary nonprofit and publicly sponsored diagnostic and/or treatment centers in order to make the allocation described in subdivision (d) of this section. These coverage ratios will consist of the aggregate nominal losses for voluntary nonprofit and publicly sponsored diagnostic and/or treatment centers, divided into nonpublic and publicly sponsored disproportionate share allocations, as appropriate. These coverage ratios shall be applied to each voluntary nonprofit or publicly sponsored diagnostic and/or treatment center's annual amount of bad debt and charity care loss coverage to determine the level of bad debt and charity case losses to be incorporated into each facility's Medicaid rate of payment.
(6) The department may make periodic prospective adjustments to an eligible facility's Medicaid payment to ensure that each facility receives the full amount of the allowance for which it is eligible. In no instance shall a diagnostic and/or treatment center receive an allowance which in the aggregate exceeds the maximum amount for which it is eligible under this section. In no event shall a facility receive an allowance in an amount exceeding the facility's need for financing losses associated with the delivery of bad debt and charity care.
(f)
(1) Eligible facilities shall submit to the department a supplement to the cost report used for title XIX (Medicaid) reimbursement. This supplement shall be provided by the department and must be returned to the department within 45 days from the date it is received by facilities for the 1990 and 1991 rate years and thereafter shall be returned to the department with the cost report used for purposes of title XIX reimbursement. The supplement shall include but not be limited to the number of eligible visits or units of service, the costs of eligible services, patient and third-party revenues associated with the eligible services, government and entitlement revenues and article 2 and article 6 Local Assistance funding associated with charity care as part of its annual reporting process.
(2) Eligible facilities shall collect and report actual threshold visits and revenues associated with the provision of bad debt and charity care services to their patient population. All reported data will be subject to audit. The allowance may be revised based upon audit findings.
(3) Facilities shall provide assurances that they will make and shall document upon request, the reasonable efforts made to maintain financial support from community and public funding sources and to collect payments from third-party payors, governmental payors and self-pay patients.
(4) The commissioner may retroactively reduce a facility's allowance if it is determined that actions or decisions by a facility's management have caused a significant reduction for the rate period in the delivery of comprehensive primary health care services to bad debt and charity care patients.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.60 Central Park Water District, town of Oyster Bay
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of the Public Health Law shall apply to all wells located on lands owned by Central Park Water District, situated in the town of Oyster Bay, county of Nassau, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed in said Central Park Water District for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privy, bathwater, laundry wastes, sewage and other excremental matter, garbage, putrescible matter, kitchen and sink wastes, stable, barnyard manure, compost heap.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta and no bath water, laundry wastes, sewage or other excremental matter from any water closet, and no garbage, putrescible matter, kitchen or sink wastes and no stable, barnyard or other places for domestic animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well forming the source of the public water supply of the said Central Park Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without having first passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any well forming the source of the public water supply of the said Central Park Water District.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsurface or surface water or other special local conditions, sewage, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health or of the Commissioner of Health of the Nassau County Health Department, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health or the Commissioner of Health of the Nassau County Health Department.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil within a distance of 250 feet of any well; and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 100 feet of any well forming the source of the public water supply of the said Central Park Water District.
(d) Trespassing.
No trespassing shall be allowed upon the property of the said Central Park Water District upon which the wells of the public water supply of the said subdivision known as Central Park Water District are located and no person or persons shall enter in or upon such property except the officers and directors of Central Park Water District or any person or persons who may be duly charged with the maintenance of the public water supply or except such other persons as may be authorized to enter said property by the Central Park Water District.
(e) Inspections.
The board of commissioners of the Central Park Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Central Park Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of commissioners to promptly notify the State Commissioner of Health and the Commissioner of Health of the Nassau County Health Department of such violations. The board of commissioners shall report to the State Commissioner of Health and the Commissioner of Health of the Nassau County Health Department in writing annually, on the first of January, the result of the regular inspections made during the proceeding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(f) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the Central Park Water District.
(g) [Penalty.]
In accordance with section 70 of the Public Health Law, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to the permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.271 Provider
An individual or institution which gives medical care. Institutional providers include a hospital, skilled nursing facility and intermediate care facility. Individual providers include individuals (physicians, dentists, etc.) who practice independently of institutional providers and whose primary activity is the provision of health care to individuals.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 71 REQUIREMENTS FOR VENT-FREE GAS SPACE HEATING APPLIANCES
10 CRR-NY 71.4 Effective date
This regulation shall be effective on the date of publication in the State Register (August 12, 1998).
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.4 Permit
(a) No person shall operate a children's camp, or cause or allow the same to be operated, without a permit from the permit-issuing official.
(b) The permit-issuing official is the State Health Commissioner or his designee and those persons defined as officers in subdivision 4 of section 1392 of the Public Health Law.
(c) Application for a permit to operate a children's camp shall be made by the operator to the permit-issuing official at least 60 days before the first day of operation. Such applications shall:
(1) include a written camp safety plan, as defined in section 7-2.5(n) of this Subpart, which accurately describes the camp's medical, fire safety and general safety provisions, training provided to camp staff and the orientation for campers. The plan must be reviewed annually by the camp operator and updated as required to maintain compliance with current standards. Plans that are updated must be submitted to the permit-issuing official. In any year in which an update is not required, the camp operator must submit written affirmation to the permit-issuing official that the approved plan remains up-to-date and complete; and
(2) be filed when the name, ownership or operator of the camp is changed.
(d) The permit-issuing official shall issue a permit if the children's camp conforms or will conform at the time of operation to the requirements of this Subpart and will not present a danger to the health and safety of the camp occupants. An applicant's past history of compliance or noncompliance will be a consideration in evaluating each of the previously mentioned criteria. The person to whom the permit is issued shall comply with this Subpart and with all conditions stated in the permit and shall allow the permit-issuing official or his representative to enter the premises to ascertain compliance. The permit-issuing official may, at his discretion, deem either of the following an inspection of the facility to ascertain that the camp conforms or will conform with the requirements of this Subpart at the time of operation:
(1) the permit-issuing official or his representative has inspected the facility and determined that it conforms or will conform with the requirements of this Subpart; or
(2) the camp meets the following conditions:
(i) the permit-issuing official has determined it has previously operated in a manner sufficient to assure that no unreasonable risk to the health and safety of camp attendees occurred; and
(ii) the operator has submitted a completed and certified self-inspection of the camp as directed by the State Health Commissioner.
(e) Effective until March 31, 2011, the fee for a permit is $100. Municipal operations and organizations for charitable, philanthropic or religious purposes are exempt from this fee. Effective April 1, 2011, the fee for a permit is $200. Municipal operations and organizations for charitable, philanthropic or religious purposes are exempt from this fee.
(f) A permit shall not be transferable or assignable. It shall be posted in a conspicuous place on the premises.
(g) A permit may be denied, revoked or suspended by the permit-issuing official or the State Commissioner of Health if the children's camp is maintained, operated or occupied in violation of the Public Health Law or this Chapter. Before denial, suspension or revocation of a permit, or after receipt of a notice of violation, the permittee shall have the right to appeal to the permit-issuing official, except that when a public health hazard exists, a permit may be temporarily suspended pending a hearing. A permit will also be revoked upon request of the operator or upon abandonment of the camp. Following the revocation, an application shall be filed for a new permit before resumption of operation.
(h) A permit shall expire one year from the date of issuance, at the close of a camp's normal operating season, upon a change of the operator, a date stipulated by the permit issuing official, or upon revocation. No permit shall expire during the camping period except by revocation.
(i) A separate permit shall not be required for a bathing beach, swimming pool or food service operated as part of a children's camp for which a permit is required under this Subpart.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.101 General licenses.13
General licenses provided in Appendix 16-A, Table 6, infra, are effective without the filing of an application with or the issuance of a licensing document by the department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.8 Distribution of human milk
Facilities shall distribute human milk only upon receipt of a written order from a licensed physician.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.15 Toilets, lavatories and utility sinks
(a) General requirements.
Toilet facilities shall be provided. These facilities shall be constructed of cleanable materials, and maintained in a sanitary condition and in good repair.
(b) A minimum of four toilets, two per sex, shall be provided at all campgrounds. Additional toilets shall be provided as follows:
(1) Campsites without individual sewer connections. One toilet per sex for each additional 25 campsites or fraction thereof, after the first 25 campsites, located within 500 feet of each campsite.
(2) Campsites with individual sewer connections. One toilet per sex for each additional 75 campsites after the first 25 campsites, located within 500 feet of each campsite.
(3) Urinals may be substituted for up to one-third of the required toilets in the male facilities for campgrounds constructed or enlarged after the effective date of this Subpart. For campgrounds operating prior to the effective date of this Subpart, one-half of the required toilets for males may be urinals.
(c) For every two toilets, one handwash facility shall be provided. Handwash facilities shall be located in close proximity to the toilets.
(d) Utility sinks for disposal of dishwater shall be provided and conveniently located.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.301 Revenue
Sales of products, merchandise and services, and earnings from interest, dividends and wages.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.3 Village of Cooperstown
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Otsego Lake and all watercourses tributary thereto or which may be developed in the future to serve as sources of the water supply of the Village of Cooperstown in the Towns of Otsego, Middlefield and Springfield. The aforesaid described watershed shall exclude any areas not within Otsego County and, in addition, shall also exclude Allen Lake and its tributary watercourses.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for the deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Agricultural-associated animal waste storage area shall mean land used for the temporary or permanent deposition of agricultural-associated animal waste where said deposition is not directly for the purpose of fertilization.
(4) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(5) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(6) Human excreta shall mean human feces and urine.
(7) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(8) Lake shall mean Otsego Lake.
(9) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the optimum high-water mark of Otsego Lake, defined as 1,194 feet, 11 inches above sea level; or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(10) Manure shall mean animal feces and urine.
(11) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(12) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(13) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave or visible, infrared or ultraviolet light.
(14) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(15) Receptacle shall mean a septic tank, privy, pit, cesspool, leaching cesspool, filter bed, or other container used for the storage or processing of sewage or waste matter.
(16) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, glass and metal containers, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(17) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(18) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment, which is normally carried off in sewers or waste pipes.
(19) Sewage disposal system shall mean any system used for disposing of sewage, and includes treatment works.
(20) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(21) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(22) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the Village of Cooperstown water supply.
(23) Watershed shall mean the entire drainage area contributing water to the Village of Cooperstown water supply located within the County of Otsego and the Towns of Otsego, Middlefield and Springfield, but excluding Allen Lake and its tributary watercourses.
(24) Water supply shall mean the public water supply of the Village of Cooperstown.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste storage areas.
No agricultural-associated animal waste storage area shall be located within a 250-foot linear distance of the lake or its tributary watercourses. Beyond that distance such area shall be maintained in such manner that surface runoff, to the best of the agriculturist's ability, will not carry animal waste directly into the lake or its watercourses.
(2) Bathing and swimming.
Use of soap or detergents while bathing or swimming is prohibited in the lake or any watercourse on the watershed.
(3) Cemeteries.
No interment of a human body shall be made within a 50-foot linear distance of the lake or its watercourses. Any interment made beyond 50 feet but within a 250-foot linear distance of Otsego Lake or its watercourses shall be in a hermetically sealed vault.
(4) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the lake or its watercourses, except in weatherproof buildings or watertight vessels.
(5) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into the lake or its watercourses, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(6) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into Otsego Lake or any of its watercourses on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(iii) No human excreta or sewage shall be buried in soil on the watershed, unless deposited in trenches or pits at a linear distance of not less than 250 feet from the lake or its watercourses, with minimal vertical distance of five feet from the bottom of any trench or pit to groundwater, and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into the lake or its watercourses by rain or melting snow.
(iv) No untreated sewage, nor any industrial waste, shall be discharged or allowed to flow into the lake or any watercourse, nor deposited on or beneath the surface of the ground within 100 feet of the lake or any watercourse, except into watertight receptacles.
(v) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed or placed within a 100-foot linear distance of the lake or any tributary watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility;
unless written permission has first been granted by the authorized representative of the officers or boards having the management and control of the watershed. Prerequisites for such permission shall be rough plans and specifications for the structure or installation and a soil percolation test taken on the site of the installation or leaching area. The provisions and restrictions of this rule shall not apply to any property or installation subject to more stringent or restrictive laws or regulations of the State Department of Health or other State agency.
(vi) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system on a newly developed property shall be constructed, placed or rebuilt within a 100-foot linear distance of the lake or its watercourses.
(vii) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(viii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of the lake or watercourse. All such transportable receptacles shall be provided with drip-proof connections and tight-fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph, or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(ix) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the Board of Water Commissioners of the Village of Cooperstown. Standards for waste treatment works as published from time to time by the New York State Department of Health shall comprise the criteria to approve any proposed sewage disposal system. For existing systems that cannot meet these standards due to lot restrictions, the guidelines shall be as outlined by the Board of Water Commissioners.
(x) Whenever, in the opinion of the Board of Water Commissioners of the Village of Cooperstown or its agent, excremental matter from a privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into the lake or any tributary watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, or reconstructed in accordance with subparagraph (ix) of this paragraph.
(7) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the lake or any watercourse, and not within a 1,000-foot linear distance of the lake or any watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(8) Solid waste.
(i) Junkyards. No junkyards shall be permitted within a 250-foot linear distance of the lake or tributary watercourse.
(ii) Refuse. No refuse shall be deposited in the lake or any watercourse, nor on or beneath the surface of the ground within 250 feet of the lake or any watercourse, nor in such manner that it can be washed by rain or melting snow or otherwise over the surface or through the ground into the lake or the watercourse.
(iii) Refuse disposal area. No new refuse disposal areas shall be located within a 500-foot linear distance of the lake or tributary watercourse. All refuse disposal areas on the watershed shall comply with the regulations governing their operation as outlined by 6 NYCRR Part 360.
(iv) Refuse from boats. No excreta, garbage, slops, nor decomposable matter of any kind, nor any bottles or metal cans of any kind, shall be thrown, discharged or allowed to escape or pass into the lake from any power boat, steamer, launch, yacht, sailboat, houseboat, rowboat, canoe or raft. Any boat of any type or description having water closets, permanent or temporary toilet accommodations, or galley facilities, shall be provided with removable watertight receptacles, which shall be regularly emptied under the same restrictions as set forth in subparagraphs (6)(iii) and (viii) of this subdivision.
(9) Structures.
No shanty, hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of the lake or any watercourse in the watershed, except with the name, address and telephone number of the owner posted. Such buildings shall be removed by the date fixed by the Board of Water Commissioners of the Village of Cooperstown. No structure will be permitted within 200 feet, horizontally, of the Village of Cooperstown water intake.
(10) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the lake or watercourse.
(e) Exclusions.
These rules and regulations shall not apply to any disposal facility whose operation is governed by a permit issued by the Department of Environmental Conservation or the State Department of Health.
(f) Inspections.
(1) The Board of Water Commissioners of the Village of Cooperstown, or any person or persons charged with the maintenance or supervision of the public water supply system, shall by its officers or their duly appointed representative, make regular and thorough inspections of Otsego Lake watercourses and watershed to ascertain whether these rules and regulations are being complied with.
(2) It shall be the duty of the aforesaid Board of Water Commissioners of the Village of Cooperstown to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not comply within a reasonable time with the rules and regulations, it shall be the further duty of the aforesaid Board of Water Commissioners of the Village of Cooperstown to promptly notify the State Commissioner of Health of such violations.
(3) The aforesaid Board of Water Commissioners of the Village of Cooperstown shall report to the State Commissioner of Health in writing annually, prior to the 30th of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(g) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-9 LIMITED HOME CARE SERVICES AGENCIES
10 CRR-NY 86-9.2 Computation of the rates of payment
(a) For purposes of this Subpart, rates of payment for Level II personal care services shall be calculated for two regions: a downstate region to consist of Bronx, Kings, New York, Queens and Richmond Counties and an upstate region to consist of all other counties in New York State. For purposes of this Subpart, rates of payment for registered professional nurse services shall be calculated for two regions: a downstate region to consist of Rockland, Westchester, Nassau, Suffolk, Bronx, Kings, New York, Queens and Richmond Counties and an upstate region to consist of all other counties in New York State.
(b) For each region, the unit of measure for which a limited home care services agency may bill for services rendered is a quarter hour.
(c) For purposes of this Subpart, the rate of payment for Level II personal care services for the downstate region shall be the weighted average January 1, 1997 Level II personal care rate for the downstate region. For purposes of this Subpart, the rate of payment for Level II personal care services for the upstate region shall be the weighted average January 1, 1997 Level II personal care rate for the upstate region for direct care and training, capital, and criminal checks, plus no more than 15 percent of such rate for administrative expenses.
(d) For purposes of this Subpart, the rate of payment for registered professional nurse services for the downstate region for the administration of subcutaneous and/or intramuscular injections and application of sterile dressings shall be the average January 1, 1997 fee established for nursing services rendered by a registered professional nurse on a private practitioner basis for the downstate region. For purposes of this Subpart, the rate of payment for registered professional nurse services for the upstate region for the administration of subcutaneous and/or intramuscular injections and application of sterile dressings shall be the average January 1, 1997 fee established for nursing services rendered by a registered professional nurse on a private practitioner basis for the upstate region.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.105 Emergency service category 4—basic emergency services
A physician beyond the first postdoctoral year and a registered nurse anesthetist or anesthesiologist must be available within 15 minutes of being called. Physicians with expertise in anesthesiology, surgery, internal medicine, pediatrics and obstetrics must be available within two minutes. The facility should have an ICU with 24-hour staffing by at least one registered nurse trained in emergency lifesaving techniques.
10 CRR-NY 441.306 Self-responsible (self-pay) patient
A patient who pays either all or part of his hospital bill from his own funds as opposed to third-party funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.14 COVID-19 confirmatory testing - coroners and medical examiners
Whenever a coroner or medical examiner has a reasonable suspicion that COVID-19 was a cause of death, but no such test was performed within 14 days prior to death in a nursing home or hospital, or by the hospice agency, the coroner or medical examiner shall administer a COVID-19 test within 48 hours after death, whenever the body is received within 48 hours after death. Such test shall be performed using rapid testing methodologies to the extent available. The coroner or medical examiner shall report the death to the department immediately after and only upon receipt of such test results, through a means determined by the department. Notwithstanding the foregoing, no test shall be administered if the next of kin objects to such testing. Should the coroner or medical examiner lack the ability to perform such testing expeditiously, the coroner or medical examiner may request assistance from the State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 707 PHYSICIAN'S ASSISTANTS AND SPECIALIST'S ASSISTANTS
10 CRR-NY 707.3 General standards
Medical facilities employing or extending privileges to registered physician's assistants, registered specialist's assistants or both shall:
(a) Employ or extend privileges only to physician's assistants and specialist's assistants who are currently registered with the New York State Department of Education.
(b) Designate in writing the licensed and currently registered staff physician or physicians responsible for the supervision and direction of each physician's assistant and specialist's assistant employed or extended privileges. No physician shall be designated to supervise and direct more than six physician's assistants or specialist's assistants or a combination thereof.
(c) Employ or extend privileges only to physician's assistants and specialist's assistants whose training and experience are within the scope of practice for which the physician or physicians to whom they are assigned are qualified.
(d) Be approved for providing the specialized medical services for which the specialist's assistant is employed or extended privileges and employ and extend privileges only to specialist's assistants whose training and experience are appropriate to the delivery of the specialized service.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 146 STEUBEN COUNTY
CITIES CITIES
10 CRR-NY 146.1 City of Hornell
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 695 of the Laws of 1911, and as heretofore set forth, shall apply to Seeley Creek and Limestone Creek and to all watercourses entering or discharging into said streams above the point where water is or shall be diverted for purposes of the public water supply of the city of Hornell.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and distributing reservoirs now built on Seeley Creek and to any additional reservoirs which may be constructed on Seeley Creek or any of its tributaries and to any reservoirs which may be constructed on Limestone Creek.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs), stream, ditch, gutter or other channel of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the water supply of the said city of Hornell.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 150 feet of any reservoir or watercourse of the water supply of the city of Hornell.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 200 feet of any reservoir or watercourse of the water supply of the city of Hornell.
(3) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta which is constructed, located, placed, maintained or allowed to remain within the limiting distance prescribed and stated by paragraph (2) of this subdivision from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacle permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and of the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 600 feet, horizontal measurement, from the high-water mark of any reservoir or from the edge, margin or precipitous bank of any watercourse of said water supply.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow either of subsoil or of surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or excremental matter from any water closet, privy or cesspool shall be thrown, placed, led, conducted, discharged or allowed to escape or flow from any pipe, drain or ditch either directly or indirectly into any reservoir or watercourse of the water supply of the city of Hornell, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground below the surface within 500 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the city of Hornell; nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the city of Hornell within 300 feet of any such reservoir or watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the city of Hornell.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the city of Hornell, nor shall any animal or poultry be allowed to stand, wade, wallow or swim in said reservoir or watercourse, nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or watercourse of the water supply of the city of Hornell; and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having been passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 300 feet before entering any such reservoir or watercourse.
(3) No human excrement or compost containing human excrement shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 600 feet from any reservoir or watercourse of the water supply of the city of Hornell; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse or* any kind shall be thrown, placed or discharged or allowed escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the city of Hornell without first having been passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in preceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the city of Hornell; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(g) Fishing, boating and ice cutting.
No fish shall be taken from any reservoir or watercourse nor shall any person fish in any reservoir or watercourse or through the ice upon the same nor trespass upon the waters of any reservoir or watercourse or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the city of Hornell in the exercise of their duties in the management and operation of the reservoirs; nor shall any ice cutting or other operation incident thereto be allowed on any part of the reservoirs which form or are tributary to the source of public water supply of the city of Hornell except by permission and under rigid inspection and supervision of the board of public works of the city of Hornell.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers or for any other purpose shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the city of Hornell.
(i) Inspection.
The board of public works of the city of Hornell shall make regular and thorough inspection of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of public works to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if the persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of public works to promptly notify the State Commissioner of Health of such violations. The board of public works shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general sanitary condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.18 Claims submission
(a) Providers shall submit claims for drugs or services within 90 days of the date of service in the manner and form proscribed by the program in order to receive reimbursement.
(b) The department will not be obligated to pay claims submitted more than 90 days after the date of service. Claims submitted later than 90 days with written justification may be considered for payment if funds are available.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.14 Garbage; refuse
Garbage and refuse shall be collected, handled and disposed of in a sanitary manner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.12 Payments for extended hours of operation
for visits occurring on and after January 1, 2009, by hospital outpatient clinics and diagnostic and treatment centers otherwise subject to this Subpart, which are scheduled and occur on evenings, weekends and holidays as defined by the department, a supplemental APG payment amount, as determined in accordance with section 86-8.7 of this Subpart, shall be added on to the otherwise applicable payment amount for each such visit.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.3 Admission, patient assessment, planning and services
(a) The hospital administration shall develop and implement policies and procedures governing admission from the hospital's acute care unit(s), other hospital acute care unit(s), and the community, patient assessment, patient length of stay, patient care planning, and the provision of 24-hour nursing services and other services for the swing bed program which include as a minimum but are not limited to the following:
(1) the completion of the hospital and community patient review instrument (H/C-PRI) and SCREEN prior to admission, and the PRI and SCREEN for admission review and continued stay review purposes for patients otherwise eligible for nursing home admission and whose expected length of stay does not exceed 60 days in coordination with procedures for discharge planning;
(2) patient's rights, including admission, transfer, and discharge rights as set forth in Part 415 of this Title;
(3) patient care services and management in accord with the requirements governing patient behavior and facility practices as set forth in Part 415 of this Title; and
(4) patient care and services in accord with a multidisciplinary assessment of needs.
(b) A written, individualized, comprehensive care plan based upon the patient's assessed needs shall be developed and implemented which includes but is not limited to:
(1) assistance and/or supervision, when required, with activities of daily living, such as toileting, feeding, ambulation, bathing including routine skin care, care of hair and nails, and oral hygiene;
(2) rehabilitation therapy services as the patient's needs indicate;
(3) dental services as the patient's needs indicate;
(4) social services as the patient's medically related social and emotional needs indicate; and
(5) an activities program involving community, interpersonal and self-care functions appropriate and sufficient in scope to the needs and interests of each patient to sustain physical and psychosocial functioning.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 5-1.1 Definitions
As used in this Subpart, the following words and terms shall have the stated meaning, except as otherwise specifically provided:
(a) -log treatment means the reduction of a specified proportion of viruses, bacteria, protozoa or other organisms present in drinking water expressed as factors of 10, through disinfection (inactivation) and/or removal. For example, three-log treatment removes or inactivates 999 out of 1,000 organisms or 99.9 percent.
(b) Action level means the concentration of copper or lead that when exceeded triggers actions to be taken by a water system.
Copper action level = 1.3 milligrams per liter
Lead action level = 0.015 milligrams per liter
(c) Approved method means an analytical method, including sample preparation, of proven reliability which has been approved, or given similar recognition by the United States Environmental Protection Agency (EPA) or a New York State regulatory program in environmental or public health protection, for the specific purpose for which the method is to be used. Methods approved by the department pursuant to section 55-2.5 of this Title shall be deemed approved methods.
(d) Auxiliary source means a source of water supply which is not normally used but which has been approved for use by the department or other State agencies having jurisdiction, and has been developed for use when the normal source or sources fail to meet the water supply requirements.
(e) Backflow means a flow condition, induced by a pressure differential, which causes the reversal of flow of water or other liquids, solids, and/or gases into the distribution pipes of a potable water supply from any source other than the intended potable water source.
(f) Backflow prevention device tester (or tester ) means a person who has met the certification requirements and been issued a certification as specified in section 5-1.31 of this Subpart.
(g) Bag filter means a pressure-driven separation device that removes particulate matter larger than one micrometer using an engineered porous filtration media.
(h) Bank filtration means a water treatment process that uses a well to recover surface water that has naturally infiltrated into ground water through a river bed or bank(s). Infiltration is typically enhanced by the hydraulic gradient imposed by a nearby pumping water supply or other well(s).
(i) Cartridge filter means a pressure-driven separation device that removes particulate matter larger than one micrometer using an engineered porous filtration media.
(j) Clean compliance history means a record of no MCL violations for E. coli , no total coliform or E. coli monitoring violations, no treatment technique trigger exceedances, and no treatment technique violations under section 5-1.52 table 6 of this Subpart.
(k) Coagulation means a process using coagulants and mixing by which colloidal and suspended material are destabilized and agglomerated into flocs.
(l) Combined distribution system means the interconnected distribution system consisting of the distribution systems of wholesale systems and of the consecutive systems that receive finished water.
(m) Commissioner means the Commissioner of Health of the State of New York.
(n) Community water system (CWS) means a public water system which serves at least five service connections used by year-round residents or regularly serves at least 25 year-round residents.
(o) Comprehensive performance evaluation (CPE) is a thorough review and analysis of a treatment plant's performance-based capabilities and associated administrative, operation and maintenance practices. For purposes of compliance with section 5.172(c)(2)(iv) of this Subpart, the CPE must consist of at least the following components: assessment of plant performance; evaluation of major unit processes; identification and prioritization of performance limiting factors; assessment of the applicability of comprehensive technical assistance; and preparation of a CPE report.
(p) Consecutive system means a public water system that receives some or all of its finished water from one or more wholesale systems. Delivery may be through a direct connection or through the distribution system of one or more consecutive systems.
(q) Contaminant means any physical, chemical, microbiological or radiological substance or matter in water.
(r) Conventional filtration means a series of processes including coagulation, flocculation, sedimentation and filtration.
(s) Corrective action means the action(s) taken by a water system consistent with the requirements of this code including one or more of the following: correcting significant deficiencies; providing an alternate source of water; removing source(s) of contamination; providing treatment; or other action acceptable to the State.
(t) Corrosion inhibitor means a substance capable of reducing the corrosivity of water toward metal plumbing materials, especially lead and copper, by forming a protective coating on the interior surface of these materials.
(u) Cross-connection means an actual or potential connection between a potable water system and any other source or system through which a water supply could be contaminated.
(v) CT means the product of the free residual disinfectant concentration (C) in milligrams per liter determined before or at the first customer, and the corresponding disinfectant contact time (T) in minutes, expressed by the formula (C) × (T) = CT. Disinfectant contact time (T), is the time that it takes for water to move from the point of disinfectant application or the previous point of residual disinfectant measurement to a point before or at the point where residual disinfectant concentration (C) is measured.
(w) Cyber attack means deliberate actions to target computer information systems, infrastructures, computer networks, computer controlled mechanical devices and/or personal computers by various means of malicious acts that either steal, alter, disrupt or damage a target by gaining access into a susceptible electronic or electromechanical device.
(x) Department means the New York State Department of Health.
(y) Designated representative means the health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, the State regional health director, or district director having jurisdiction; a public health director or public health engineer qualified as duly appointed pursuant to Part 11 of this Title; or a county health commissioner, or county health director having the powers and duties prescribed in section 352 of the Public Health Law, or any other individual so designated by the commissioner.
(z) Disinfection station means a facility consisting of one or more points where water is routinely treated with an oxidant for disinfection, odor control or other purposes including the inactivation of pathogenic organisms and excluding treatment on a raw water transmission main.
(aa) Distribution point means a sampling point representative of drinking water within the distribution system.
(ab) Diatomaceous earth filtration means a process resulting in substantial particulate removal which a precoat cake of diatomaceous earth filter media is deposited on a support membrane (septum), and while the water is filtered by passing through the cake on the septum, additional filter media known as body feed is continuously added to the feed water to maintain the permeability of the filter cake.
(ac) Direct filtration means a series of processes including coagulation and filtration but excluding sedimentation resulting in substantial particulate removal.
(ad) Dose equivalent means the product of the absorbed dose from ionizing radiation and such factors as account for differences in biological effectiveness because of the type of radiation and its distribution in the body as specified by the International Commission on Radiological Units and Measurements (ICRU).
(ae) Dual sample set means a set of two samples collected at the same time and same location, with one sample analyzed for total trihalomethanes (TTHM) and the other sample analyzed for haloacetic acids (five) (HAA5).
(af) Dwelling unit means one or more rooms with provisions for living, sanitary and sleeping facilities arranged for the use of one family.
(ag) Effective corrosion inhibitor residual means a concentration sufficient to form a protective coating on the interior walls of a pipe.
(ah) Emergency source means a source of water supply which is not the regular source or auxiliary source and which is developed during an emergency for temporary use.
(ai) Enhanced coagulation means the addition of sufficient coagulant for improved removal of disinfection byproduct precursors by conventional filtration treatment.
(aj) Entry point means a representative sampling location after the last point of treatment but before the first consumer connection.
(ak) Fecal indicator means a microorganism (for example a bacteriophage, coliphage, or bacterium) that is used to determine the sanitary quality of drinking water and the likelihood of the presence of pathogen contamination from the waste of warm-blooded animals. The most commonly used fecal indicator is Escherichia coli (E. coli) .
(al) Filter profile is a graphical representation of individual filter performance, based on continuous turbidity measurements or total particle counts versus time for an entire filter run, from startup to backwash, that includes an assessment of filter performance while another filter is being backwashed.
(am) Filtration means a process for removing particulate matter from water by passage through porous material.
(an) Finished water means water that is introduced into the distribution system of a public water system and is intended for distribution and consumption without further treatment, except as necessary to maintain water quality in the distribution system ( e.g. , booster disinfection, addition of corrosion control chemicals).
(ao) First draw tap sample for lead and copper means a one liter sample of water collected from a cold water tap after the water has stood in the plumbing system for at least six hours and is collected without flushing the tap.
(ap) Flocculation means a process to enhance agglomeration or collection of smaller floc particles into larger, more easily settleable particles through gentle stirring by hydraulic or mechanical mechanisms.
(aq) GAC10 means granular activated carbon filter beds with an empty-bed contact time of 10 minutes based on average daily flow and a carbon reactivation or replacement frequency of every 180 days, except that the reactivation frequency for GAC10 used as a best available technology for compliance with total trihalomethanes (TTHM) and haloacetic acids (five) (HAA5) maximum contaminant levels (MCLs) shall be 120 days.
(ar) GAC20 means granular activated carbon filter beds with an empty-bed contact time of 20 minutes based on average daily flow and a carbon reactivation frequency of every 240 days.
(as) Gross alpha particle activity means the total radioactivity because of alpha particle emission as inferred from measurements on a dry sample.
(at) Gross beta particle activity means the total radioactivity because of beta particle emission as inferred from measurements on a dry sample.
(au) Groundwater directly influenced by surface water, also known as groundwater under the direct influence of surface water, or GWUDI, means any water beneath the surface of the ground which exhibits significant and rapid shifts in water characteristics such as turbidity, temperature, conductivity or pH which closely correlates to climatological or surface water conditions and/or which contains microorganisms, algae, large diameter (three microns or greater) pathogens or insect parts of a surface water origin.
(av) Groundwater source means a source of water supply taken from a groundwater aquifer and developed in accordance with section 5-1.22 of this Subpart, but shall not include an admixture of surface water or water exposed to the ground surface. Any groundwater source at a system that uses surface water or groundwater under the direct influence of surface water that does not receive treatment as described in section 5-1.30(b) of this Subpart, prior to the first customer, is subject to all requirements applicable to groundwater systems and groundwater sources.
(aw) Groundwater system means a public water system that uses only groundwater, excluding any surface water or groundwater under the direct influence of surface water.
(ax) Haloacetic acids (five) (HAA5) mean the sum of the concentrations in milligrams per liter of five specific haloacetic acid compounds, rounded to two significant figures after addition. The five haloacetic acids that comprise the HAA5 are monochloroacetic acid, dichloroacetic acid, trichloroacetic acid, monobromoacetic acid, and dibromoacetic acid.
(ay) Internal protection means isolation of a fixture, area or zone which requires backflow prevention at the source of the cross-connection or potential hazard, in accordance with the New York State Uniform Fire Prevention and Building Code and/or the local plumbing and building codes.
(az) Large water system means a water system that serves more than 50,000 persons.
(ba) Lead service line means a service line made of lead which connects the water main to the building inlet and any lead appurtenances connected to the lead service line.
(bb) Lead service line sample means a one liter sample for lead, collected after the water has stood in the service line for at least six hours. The sample must be collected directly from a tap on the service line or by calculating and wasting the amount of water in the plumbing system from the sampling point to the service line. At a single family structure, the sample may be collected by running the water until there is a significant change in water temperature.
(bc) Level 1 assessment means an evaluation to identify the possible presence of sanitary defects, defects in distribution system coliform monitoring practices, and, when possible, the likely reason that the system triggered the assessment.
(bd) Level 2 assessment means an evaluation conducted by an individual approved by the State, to identify the possible presence of sanitary defects, defects in distribution system coliform monitoring practices, and, when possible, the likely reason that the system triggered the assessment. A Level 2 assessment provides a more detailed examination of the system (including the system’s monitoring and operational practices) than a Level 1 assessment, through the use of more comprehensive investigation and review of available information, additional internal and external resources, and other relevant practices.
(be) Locational running annual average or LRAA means the average of sample analytical results during the previous four calendar quarters for samples taken at a particular monitoring location.
(bf) Man-made beta particle and photon emitters means all radionuclides emitting beta particles and/or photons, except the daughter products of thorium-232, uranium-235 and uranium-238, listed in Maximum Permissible Body Burdens and Maximum Permissible Concentration of Radionuclides in Air or Water for Occupational Exposure, National Bureau of Standards Handbook 69, as amended August 1963, U.S. Department of Commerce. Copies of this publication are available from N.C.R.P. Publications, 7910 Woodmont Avenue, Bethesda, MD, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237.
(bg) Maximum contaminant level (MCL) means the maximum permissible level of a contaminant in water which is delivered to any user of a public water system. For entry point turbidity and inorganic chemicals listed in section 5-1.52, tables 1 and 2, of this Subpart, the maximum permissible level is measured at the point of entry to the distribution system. For organic chemicals with MCLs listed in section 5-1.52, table 3, of this Subpart, the MCL is measured at the individual sources, unless otherwise specified by the State. Substances added to the water by the user, and limited to the premises of the user, are excluded from this definition.
(bh) Maximum residual disinfectant level (MRDL) means a level of disinfectant measured at a consumer's tap, above which the possibility of unacceptable health effects exists.
(bi) Maximum total trihalomethane potential (MTP) means the maximum concentration of total trihalomethane produced in a given water containing a free chlorine residual after seven days at a temperature of 25 degrees Celsius or above.
(bj) Medium water system means water system that serves greater than 3,300 and less than or equal to 50,000 persons.
(bk) Membrane filtration means a pressure- or vacuum-driven separation process in which particulate matter larger than one micrometer is rejected by an engineered barrier, primarily through a size-exclusion mechanism, and which has a measurable removal efficiency of a target organism that can be verified through the application of a direct integrity test. This definition includes the common membrane technologies of microfiltration, ultrafiltration, nanofiltration, and reverse osmosis.
(bl) Method Detection Limit (MDL) means the minimum concentration of a substance that can be measured and reported with 99 percent confidence that the analyte concentration is greater than zero and is determined from analysis of a sample in a given matrix containing the analyte.
(bm) Noncommunity water system (NCWS) means a public water system that is not a community water system.
(bn) Nontransient noncommunity water system (NTNC) means a public water system that is not a community water system but is a subset of a noncommunity water system that regularly serves at least 25 of the same people, four hours or more per day, for four or more days per week, for 26 or more weeks per year.
(bo) Optimal corrosion control treatment means the corrosion control treatment that reduces the lead and copper concentrations at users' taps to the lowest reasonably achievable level while insuring that the treatment does not cause the water system to violate part 5 of the State Sanitary Code or cause adverse health or operational effects.
(bp) Person means an individual, corporation, company, association, partnership, State agency, municipality including a county, or Federal agency.
(bq) Picocurie means that quantity of radioactive material producing 2.22 nuclear transformations per minute.
(br) Plant intake means the works or structures at the head of a conduit through which water is diverted from a source, such as a river or lake, into the treatment plant.
(bs) Potable water means a water which meets the requirements established by this Subpart.
(bt) Point of use means the free-flowing outlet of the ultimate user of a public water system.
(bu) Practical Quantitation Limit (PQL) means the practical and routinely achievable method-specific measurable concentration limit achieved by a laboratory with a high degree of certainty (>99.9 per cent confidence) in the results.
(bv) Presedimentation means a preliminary treatment process used to remove gravel, sand, and other particulate material from the source water through settling before the water enters the primary clarification and filtration processes in a treatment plant.
(bw) Principal organic contaminant (POC) means any organic chemical compound belonging to the following classes, except for trichloromethane (chloroform), dibromochloromethane, bromodichloromethane, tribromomethane (bromoform) and any other organic contaminant with a specific MCL listed in section 5-1.52, table 3 of this Subpart:
(1) halogenated alkane: compound containing carbon (C), hydrogen (H) and halogen (X) where X = fluorine (F), chlorine (Cl), bromine (Br) and/or iodine (I), having the general formula CnHyXz, where y + z = 2n + 2; n, y and z are integer variables; n and z are equal to or greater than one and y is equal to or greater than zero;
(2) halogenated ether: compound containing carbon (C), hydrogen (H), oxygen (O) and halogen X (where X = F, Cl, Br and/or I) having the general formula CnHyXzO, where y + z = 2n + 2; the oxygen is bonded to two carbons; n, y and z are integer variables; n is equal to or greater than two, y is equal to or greater than zero and z is equal to or greater than one;
(3) halobenzenes and substituted halobenzenes: derivatives of benzene which have at least one halogen atom attached to the ring and which may or may not have straight or branched chain hydrocarbon, nitrogen or oxygen substituents;
(4) benzene and alkyl- or nitrogen-substituted benzenes: benzene or a derivative of benzene which has either an alkyl- and/or a nitrogen-substituent;
(5) substituted, unsaturated hydrocarbons: a straight or branched chain unsaturated hydrocarbon compound containing one of the following: halogen, aldehyde, nitrile, amide; and
(6) halogenated nonaromatic cyclic hydrocarbons: a nonaromatic cyclic compound containing a halogen.
(bx) Process compliance monitoring means the State-approved measurements and records of water system operation and/or water quality parameters that demonstrate the effectiveness of the treatment process(es) employed by the public water system to achieve a treatment technique requirement.
(by) Protective device means an approved double check valve assembly, reduced pressure zone assembly, air gap or other type or method of backflow protection accepted by the department.
(bz) Public health hazard means an existing or imminent condition which can be responsible for or cause illness, injury or death and for which immediate corrective or remedial action is required. Public health hazards include, but are not limited to, the following:
(1) an Escherichia coli (E. coli) MCL violation, or failure to test for E. coli after any repeat sample tests positive for colirom;
(2) a nitrate/nitrite MCL violation, of failure to take a confirmation sample within 24 hours for nitrate or nitrite after an initial sample exceeds the MCL;
(3) an acute MRDL violation for chlorine dioxide as specified in section 5-1.52 table 3A of this Subpart, or failure to take the required samples in the distribution system the day after the MRDL is exceeded at the entry point as specified in section 5-1.52 table 15A of this Subpart;
(4) turbidity violations or exceedances specified in section 5-1.78(d)(3) of this Subpart and determined by the State to present an existing or imminent condition which can be responsible for or cause illness, injury or death and for which immediate corrective or remedial action is required;
(5) use of an unapproved or contaminated water supply source;
(6) insufficient quantity of water to meet drinking or sanitary demands;
(7) hazardous or toxic chemical contamination;
(8) disinfection which is inadequate to destroy harmful microorganisms or to maintain a specified chlorine residual;
(9) disruption of water service of four hours or more, determined by the State to present an existing or imminent condition which can be responsible for or cause illness, injury or death and for which immediate corrective or remedial action is required;
(10) cross-connections of sufficient hazard to adversely affect the health of a water consumer; and
(11) any other conditions, including a waterborne disease outbreak, determined to be a public health hazard by the commissioner.
(ca) Public notification means disseminating information about a problem with a public water system in a form and manner consistent with section 5-1.78 of this Subpart.
(cb) Public water system means a community, noncommunity or nontransient noncommunity water system which provides water to the public for human consumption through pipes or other constructed conveyances, if such system has at least five service connections or regularly serves an average of at least 25 individuals daily at least 60 days out of the year. Such term includes:
(1) collection, treatment, storage and distribution facilities under control of the supplier of water of such system and used with such system; and
(2) collection or pretreatment storage facilities not under such control which are used with such system.
(cc) Raw water means water immediately before the first or only point of disinfection or other treatment.
(cd) Regular source means a source of water supply which is normally used and is approved by the department and other State agencies having jurisdiction.
(ce) Rem means the unit dose equivalent from ionizing radiation to the total body or any internal organ or organ system.
(cf) Millirem (MREM) means 0.001 of a rem.
(cg) Reporting period means a time period designated by the State for determining maximum contaminant level compliance.
(ch) Sanitary defect means a defect that could provide a pathway of entry for microbial contamination into the distribution system or that is indicative of a failure or imminent failure in a barrier that is already in place.
(ci) Sanitary survey means an onsite review of a water system including the water source, facilities, equipment, operations maintenance, and monitoring compliance of a public water system to evaluate the adequacy of the system, its sources and operations and the distribution of safe drinking water. The survey must include evaluation of the following components: source; treatment; distribution system; finished water storage; pumps, pump facilities, and controls; monitoring, reporting, and data verification; system management and operation; and operator compliance with State requirements. Review of each of these categories of system operation need not be completed in a single visit.
(cj) Seasonal system means a non-community water system that is not operated as a public water system on a year-round basis and starts up and shuts down at the beginning and end of each operating season.
(ck) Sedimentation means a process for removal of solids before filtration by gravity or separation.
(cl) Service connection means the pertinent pipes, valves and fittings that connect a distribution system to a consumer's facility.
(cm) Service protection means the installation of a protective device or method of backflow protection at the service connection, commensurate with the degree of hazard of the consumer’s potable water system. Service protection is also known as containment.
(cn) Significant deficiency means a defect in a system’s design, operation or maintenance, or a failure or malfunction of its source, treatment, storage, or distribution, that causes or is reasonably expected to cause the introduction of contamination into water delivered to consumers. Significant deficiencies also include: loss of ability to deliver an adequate quantity of water; inadequate barriers of protection including failure of monitoring; conditions that pose an obvious security risk to the water system; or any other condition with the potential to cause a future public health hazard ( i.e. before the next scheduled sanitary survey).
(co) Single family structure means a building constructed as a single-family residence that is currently used as either a residence or a place of business.
(cp) Slow sand filtration means a process involving passage of raw water through a bed of sand at low velocity resulting in particulate removal by physical or biological mechanisms.
(cq) Small water system means a water system that serves 3,300 or fewer persons.
(cr) Source of water supply means any groundwater aquifer or watercourse from which water is taken either periodically or continuously for drinking, culinary or food-processing purposes, or which has been designated for present or future use as a source of water supply for domestic or municipal purposes.
(cs) State means the State Commissioner of Health, or his designated representative.
(ct) State notification means notifying the State by telephone, facsimile (FAX) copy, e-mail or other means about the existence or potential existence of a public health hazard, or the existence of any other violation or situation that may pose a risk to public health.
(cu) Supplier of water means any person who owns or operates a public water system.
(cv) Surface water means all water open to the atmosphere and subject to surface runoff.
(cw) SUVA means the UV absorption at 254 nanometers (measured in 1/meters) divided by the dissolved organic carbon concentration (measured in mg/l). SUVA is an indicator of the humic content of water and the ability of the water to be treated for the removal of disinfection byproduct precursors.
(cx) Tier 1 notification means the category for public notifications that are required within 24 hours of learning of a public health hazard. Section 5-1.78(c) of this Subpart lists the specific requirements for Tier 1 notifications.
(cy) Tier 2 notification means the category for public notifications that are required within 30 days of learning of a violation or situation with the potential to have serious adverse effects on human health after long term exposure, such as most MCL, MRDL and treatment technique violations that are not public health hazards. Section 5-1.52 table 13 of this Subpart lists violations and situations that require Tier 2 notification; section 5-1.78(d) of this Subpart lists the specific requirements for Tier 2 notifications.
(cz) Tier 3 notification means the category for public notifications that are required within one year (30 days for transient noncommunity water systems) of learning of a less serious violation or situation that does not require a Tier 1 or Tier 2 notification, such as most monitoring violations. Section 5-1.52 table 13 of this Subpart lists violations and situations that require Tier 3 notification; section 5-1.78(e) of this Subpart lists the specific requirements for Tier 3 notifications.
(da) Total organic carbon (TOC) means total organic carbon in mg/l, measured by converting organic carbon to carbon dioxide, rounded to two significant figures.
(db) Total trihalomethane (TTHM) means the sum of the concentration of trichloromethane (chloroform), dibromochloromethane, bromodichloromethane and tribromomethane (bromoform).
(dc) Transient noncommunity water system (TNC) means a noncommunity water system that does not regularly serve at least 25 of the same people over six months per year.
(dd) Treatment technique means any minimum treatment or action specified by this Part or designated by the State as necessary to prevent the entry of contamination into or to reduce the level of a contaminant in drinking water delivered by a public water system.
(de) Two-stage lime softening means a process in which chemical addition and hardness precipitation occur in each of two distinct unit clarification processes in series prior to filtration.
(df) Uncovered finished water storage facility means a tank, reservoir, or other facility used to store water that will undergo no further treatment to reduce microbial pathogens except residual disinfection and is directly open to the atmosphere.
(dg) Unspecified organic contaminant (UOC) means any organic chemical compound not otherwise specified in this Subpart.
(dh) Virus means a virus of fecal origin which is infectious to humans by waterborne transmission.
(di) Violation means failure to comply with or conform to the provisions of this Subpart.
(dj) Waterborne disease outbreak means the occurrence of acute infectious illness epidemiologically associated with the ingestion of water from a public water system.
(dk) Watercourse means any surface water listed in 6 NYCRR, Chapter 10.
(dl) Water supply emergency plan means a plan approved by the State and filed with the State at such location as specified by the commissioner. The plan shall address the actions to be taken by a water supplier to anticipate water supply emergencies and the steps to be taken to ensure the delivery of potable water during a water supply emergency.
(dm) Water treatment plant means any plant or equipment which, through the addition of chemicals or through aeration, ion exchange, demineralization, coagulation, sedimentation or filtration, or through any other means or combinations of treatment, shall change the physical, chemical, radiological or microbiological quality of water.
(dn) Wholesale system means a public water system that treats source water as necessary to produce finished water and then delivers some or all of that finished water to another public water system. Delivery may be through a direct connection or through the distribution system of one or more consecutive systems.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.1 Definitions
As used in this Part:
(a) Human milk bank means an organized service for the selection of donors and the collection, processing, storage or distribution of human breast milk for infants or children other than the donor's own infant.
(b) Donor means a lactating woman who voluntarily contributes milk to a human milk bank for use by an infant or child other than her own. A donor shall not receive remuneration for the donation of milk.
(c) Human milk transfer station means the location at which containers of human breast milk are held temporarily between the donation site and the human milk bank.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.101 Equipment and utensils; materials permitted and prohibited
(a) Materials, including food-grade plastics used in the construction and repair of equipment and utensils, are to be nontoxic, not affected by foods, cleaning compounds, or such other substances which may be found in the use environment, nonabsorbent and durable under normal use. They are not to impart odor, color or taste nor to contribute to the contami nation of food, and are to maintain their original properties under repeated use. Painted food-contact surfaces are prohibited.
(b) Hard maple or other equivalent nonabsorbent material meeting the above criteria may be used for cutting boards and work surfaces, and are to be maintained in a smooth, clean condition.
(c) Tubing conveying beverages or beverage ingredients is to be fabricated from safe materials. All lines conducting carbon dioxide gas are to be stainless steel, food-grade plastic or other material that will not produce toxic substances when exposed to carbon dioxide or carbonated water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.6 Variances and waivers
(a) Variance.
In order to allow time to comply with certain provisions of this Subpart, an operator may submit a written request to the PIO for a variance from a specific provision(s) when the health and safety of the public will not be prejudiced by the variance, and where there are substantial practical difficulties or substantial fiscal hardships in immediate compliance with the provision(s). An operator must meet all terms of an approved variance including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the PIO specifies.
(b) Waivers.
In order to obtain a waiver allowing alternative arrangements that do not meet the provisions of this Subpart but do protect the health and safety of the public, an operator may submit a written request to the PIO for a waiver from a specific provision(s) of this Subpart. Such requests must demonstrate that the alternate arrangements provide adequate protection of the health and safety of the public. The PIO shall obtain and be guided by the recommendation of the department prior to granting or denying a waiver. An operator must meet all terms of an approved waiver. A waiver will remain in effect indefinitely unless revoked by the PIO or the facility changes operators.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.13 Minimum security standards for nonpractitioner handling; schedule I and II controlled substances
Schedule I and II raw materials, bulk materials awaiting further processing, and finished products shall be stored in one of the following secure storage areas:
(a) Where small quantities permit, in a safe of GSA class 5 rated or equivalent. If the safe weighs less than 750 pounds it shall be bolted or cemented to the floor or wall in such a way that it cannot readily be removed. The safe shall, where required by the commissioner, be equipped with tamper-proof closed circuit alarm system approved by Underwriter's Laboratories, which when unauthorized entry is attempted, transmits a signal directly to a central protection company, a local police agency which has a legal duty to respond or a 24-hour control station operated by the registrant.
(b) A vault constructed or under construction before April 1, 1973 and approved by the commissioner which is of substantial construction with a steel door, combination or key lock and an alarm system.
(c) A vault constructed on or after April 1, 1973 which meets the following specifications or their equivalent as determined by the commissioner:
(1) Walls, floors and ceilings constructed of at least eight inches of reinforced concrete or other substantial masonry, reinforced vertically and horizontally with one-half inch steel rods tied six inches on center, or the structural equivalent to such reinforced walls, floors and ceilings.
(2) The door of the vault shall contain a multiple-position combination lock or the equivalent, a relocking device or equivalent and steel plate with a thickness of at least one-half inch. (The GSA class 5 rated steel door meets all of the qualifications for the vault door.)
(3) The vault, if operations require it to remain open for frequent access shall be equipped with a "day gate" or the equivalent, which is self-closing and self-locking. If the operation requires only that the vault be opened infrequently, such as to remove raw material in the morning and return raw material at night, and is always relocked immediately after use, a "day gate" is not required.
(4) The walls or perimeter of the vault shall be equipped with a tamper-proof closed circuit alarm approved by Underwriter's Laboratories which, when unauthorized entry is attempted, transmits a signal directly to a central station protection company, a local police agency which has a legal duty to respond or a 24-hour control station operated by the registrant. If necessary, due to local conditions or other problems, holdup buttons shall be placed at strategic points of entry to the perimeter area of the vault.
(5) The vault door shall be equipped with a contact switch.
(6) The vault shall have one of the following:
(i) complete electrical lacing of the walls, floor and ceiling;
(ii) sensitive ultrasonic equipment within the vault;
(iii) sensitive sound accumulator system; or
(iv) such other device designated to detect illegal entry as may be approved by the department.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.110 Cleaning frequency
(a) Food-contact surfaces are to be washed, rinsed and sanitized before use and after any interruption of operations and when contamination may have occurred.
(b) Equipment and utensils used for the preparation of potentially hazardous foods are to be washed, rinsed and sanitized before use each day and during the day when required to protect food from contamination. The food-contact surfaces of grills, griddles and similar cooking devices and the cavities and door seals of microwave ovens are to be cleaned at least once a day. This does not apply to hot oil cooking equipment and hot oil filtering systems. Food-contact surfaces of all cooking equipment are to be kept free of encrusted grease deposits and other accumulated soil.
(c) Nonfood-contact surfaces of equipment are to be cleaned as often as necessary to keep the equipment free of accumulations of dust, dirt, food particles and other debris.
(d) Clean and sanitized equipment and utensils, including single-service articles, are to be protected from contamination at all times prior to use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.23 Records and reports
(a) Manufacturers records.
Manufacturers shall keep records of all controlled substances manufactured, received, disposed of or distributed by them, which shall include date of manufacture, type and quantity of drug manufactured.
(1) Records of drugs received shall indicate the date of receipt, type and quantity of drug received, and the name and address of supplier of such drug.
(2) Records of drugs disposed of or distributed shall indicate date of disposal or distribution, name and address of the person receiving such drugs and type and quantity of such drugs.
(b) Distributors, importers and exporters records.
Distributors, importers and exporters shall keep records of all controlled substances received, disposed of or distributed by them.
(1) Records of drugs received shall indicate the date of receipt, type and quantity of drug received, and the name and address of supplier of such drug.
(2) Records of drugs disposed of or distributed shall indicate the name and address of persons receiving such drugs and the type and quantity of such drugs.
(c) Purchase requests.
Manufacturers or distributors may sell schedule III, IV and V controlled substances to authorized practitioners, pharmacies, institutional dispensers or other authorized persons on a written request submitted by the purchaser on his professional or business stationery or on a written order submitted by a representative of the vendor. All such purchase requests shall indicate the name and address of the vendor, the name and address of the vendee, Drug Enforcement Administration registration number, date of the order, type and quantity of drug ordered. Schedule I and II drugs shall be ordered on an official Federal order form only.
(d) Invoice required.
The manufacturer or distributor shall furnish the vendee with each shipment of controlled substances an invoice in duplicate, or separate itemized list of all such drugs sold, which shall include the name and address of the vendor, the name and address of the vendee, date of shipment or delivery, type and quantity of drug sold.
(e) Record maintenance.
Manufacturers and distributors shall maintain all required records of controlled substances in a separate file or in such a manner as will make them readily available for inspection by authorized representatives of the Bureau of Narcotic Enforcement, New York State Department of Health.
(f) Reports.
Manufacturers and distributors shall report to the department, in a manner approved by the department, information from the sale of controlled substances. Such information shall be filed electronically with the Bureau of Narcotic Enforcement, utilizing a transmission format acceptable to the department. The information filed with the department shall include, but not be limited to:
(1) the manufacturer's or distributor's name, address, phone number, DEA registration number and controlled substance license number issued by the department;
(2) the name, address and DEA registration number of the entity to whom the controlled substance was sold;
(3) the date of the sale of the controlled substance;
(4) the name and National Drug Code (NDC) of the controlled substance sold; and
(5) the number of containers and the strength and metric quantity of controlled substance in each container of controlled substance sold.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.22 Recoveries of expense
Operating costs shall be reduced by the cost of services and activities which are not properly chargeable to patient care. In the event that the commissioner determines that it is not practical to establish the costs of such services and activities, the income derived from them may be substituted for their costs. The activities and services covered by this provision include, but are not limited to:
(a) drugs and supplies sold to other than facility patients;
(b) telephone and telegraph services for which a charge is made;
(c) discount on purchases;
(d) sale of scrap;
(e) employee cafeterias;
(f) vending machines;
(g) operation of parking facilities for community convenience;
(h) lease of office and other space to concessionaires; and
(i) sale of silver from X-ray films.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.20 Ancillary services expenses description
[ 3270 ]
(a) 7010 LABOR AND DELIVERY SERVICES
(1) Function. Labor and Delivery services are provided by specially trained personnel to patients in Labor and Delivery, including prenatal care in labor, assistance in delivery, postnatal care in recovery, and minor gynecological procedures, if performed in the Delivery suite. Additional activities include, but are not limited to, the following:
Comforting patients in the labor and delivery and recovery rooms; maintaining aseptic techniques; preparing for deliveries and surgery; cleaning up after deliveries to the extent of preparation for pickup and disposal of used linen, gloves, instruments, utensils, equipment and waste; arranging sterile setup for deliveries and surgery; preparing patient for transportation to delivery room and recovery room; enforcing of safety rules and standards; monitoring of patients while in recovery.
(2) Description. This cost center contains the direct expenses incurred in providing care to maternity patients in labor, delivery, and recovery rooms. Included as direct expenses are: salaries and wages, employee benefits, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of procedures. Report multiple births as one procedure. Include Caesarean sections only when they are performed in delivery room. Caesarean sections performed in the Surgical suite shall be included in the operating room statistics. Stillbirths are counted as procedures. Infants born outside the hospital building are not to be classified as a procedure unless care was rendered in the Labor and Delivery Services. Whenever obstetrical and gynecological procedures such as abortions, D & C's, etc. are performed in Labor and Delivery, each procedure performed is counted as one.
(4) Data source. The number of procedures shall be an actual count obtained from medical records, or as maintained by Labor and Delivery.
(b) Surgical Services Group.
(1)
7040
SURGERY SERVICES
7041
General Surgery
7042
Open Heart Surgery
7043
Neurosurgery
7044
Orthopedic Surgery
7045
Kidney Transplant
7046
Other Organ Transplants
7049
Other Operating Room Services
(i) Function. Surgical Services are provided to inpatients, and outpatients if the hospital uses a common operating room for both inpatients and outpatients, by physicians and specially trained nursing personnel who assist physicians in the performance of surgical and related procedures during and immediately following surgery. Additional activities include, but are not limited to, the following:
Comforting patients in the operating room; maintaining aseptic techniques; scheduling operations in conjunction with surgeons; assisting surgeon during operations; preparing for operations; cleaning up after operations to the extent of preparation for pickup and disposal of used linen, gloves, instruments, utensils, equipment and waste; assisting in preparing patients for surgery; inspecting, testing and maintaining special equipment related to this function; preparing patient for transportation to recovery room; counting of sponges, needles and instruments used during operation; enforcing of safety rules and standards.
(ii) Description. These cost centers contain the direct expenses incurred in providing surgical services to patients. When a common operating room is used for both inpatients and outpatients, the direct costs for both are to remain in this cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of surgery minutes. Surgery minutes is the difference between starting time and ending time, defined as follows:
Starting time is the beginning of anesthesia administered in the room in which the procedure is to be performed (or surgery if anesthesia is not administered or if anesthesia is not administered in the operating room). Ending time is the end of surgery.
(iv) Data source. The number of surgery minutes shall be an actual count obtained from the operating room log.
(2) 7060 RECOVERY SERVICES
(i) Function. Recovery Services are provided by specially trained personnel immediately following surgery, including monitoring of patients while recovering from anesthesia. Additional activities include, but are not limited to, the following:
Comforting patients in the recovery room, maintaining aseptic techniques, monitoring of vital life signs, operating of specialized equipment related to this function, administering specified medication, observing patient's condition until all effects of the anesthesia have passed, preparing patient for transportation to acute care or intensive care units.
(ii) Description. This cost center contains the direct expenses incurred in monitoring of patients while recovering from anesthesia. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of recovery room minutes. Recovery room minutes is the difference between time of admission to recovery room and time of discharge from the unit.
(iv) Data source. The number of recovery room minutes shall be an actual count maintained by the recovery room.
(3) 7080 ANESTHESIOLOGY
(i) Function. Anesthesia services are rendered in the hospital by, or under the direction of, either a physician trained in anesthesia or the operating surgeon. Additional activities include, but are not limited to, the following:
Recording kind and amount of anesthetic administered; conducting physical examination of patients; observing patient's condition until all effects of the anesthesia have passed; obtaining laboratory findings before anesthetic is administered; administering treatment to patients having symptoms of post-anesthetic complication; accompanying patient to recovery room or intensive care unit; prescribing pre- and post-anesthesia medication; establishing and carrying out safeguards for administration of anesthetics.
(ii) Description. This cost center contains the direct expenses incurred in administering anesthetics under the direction of a physician. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of anesthesia minutes. Anesthesia time begins when the anesthesiologist begins to prepare the patient for the induction of anesthesia in the operating room or in an equivalent area, and ends when the anesthesiologist is no longer in personal attendance, that is, when the patient may be placed under post-operative supervision.
(iv) Data source. The number of anesthesia minutes shall be an actual count maintained by the Anesthesiology cost center.
(c) Medical Supplies and Equipment Group.
(1) 7110 MEDICAL SUPPLIES SOLD
(i) Description. The Medical Supplies Sold cost center is used for the accumulation of the invoice cost of all medical and surgical supplies sold directly to patients. The invoice/inventory cost of nonchargeable supplies and equipment issued by the Central Services and Supplies cost center (Account 8460) to other cost centers shall be reported in the using cost centers. If medical and surgical supplies are sold in other hospital cost centers, the cost of those items must be reported in to this cost center. The overhead cost of preparing and issuing medical and surgical supplies and equipment sold directly to patients must be reported in the Central Services and Supplies cost center (account 8460). The applicable portion of such overhead will be allocated to this cost center during the cost allocation process. The cost of reusable patient chargeable supplies must be reported in the Central Services and Supplies cost center. Do not report in this cost center the cost of durable medical equipment sold, leased or rented. Such costs are to be reported in accounts 7130 and 7140, Durable Medical Equipment—Sold, and Durable Medical Equipment—Leased/Rented, respectively.
(ii) Standard unit of measure: none required; not applicable.
(iii) Effective date. Relative to the separation of Durable Medical Equipment (accounts 7130 and 7140) from this cost center, the effective date is cost reporting periods beginning in 1982 and thereafter.
(2) 7130
DURABLE MEDICAL EQUIPMENT—SOLD
(i) Description. The Durable Medical Equipment—Sold cost center is used to report the invoice/inventory costs of all durable medical equipment sold directly to patients. Durable Medical Equipment includes but is not limited to: hospital beds, wheelchairs, trapeze bars, oxygen tents, intermittent positive breathing machines, etc. Include in the appropriate Home Program Dialysis cost center the cost of dialysis and supportive equipment sold. The overhead cost of preparing and issuing durable medical equipment sold directly to patients and others must be reported in the Central Services and Supplies cost center (account 8460).
(ii) Standard unit of measure; none required; not applicable.
(iii) Effective date. Reporting periods beginning in 1982 and thereafter.
(3) 7140
DURABLE MEDICAL EQUIPMENT—LEASED/RENTED
(i) Description. The Durable Medical Equipment—Leased/Rented cost center is used to report depreciation expenses related to the durable medical equipment leased or rented directly to patients and others. Durable medical equipment includes but is not limited to: hospital beds, wheelchairs, trapeze bars, crutches, canes, oxygen tents, intermittent positive breathing machines, exercycles, heat lamps, flotation mattresses, bed baths, etc. Include home program dialysis equipment and support in the appropriate Home Program Dialysis cost center. The overhead cost of preparing and issuing durable medical equipment leased and rented to patients and others must be reported in the Central Services and Supplies cost center (account 8460).
(ii) Standard Unit of Measure; none required; not applicable.
(iii) Effective date. Reporting periods beginning in 1982 and thereafter.
(d) 7150 DRUGS SOLD
(1) Description. The Drugs Sold cost center is used for the accumulation of the invoice/inventory cost of all pharmaceuticals, intravenous solutions and blood derivatives sold directly to patients. The invoice/inventory cost of non-chargeable drugs (pharmaceuticals, blood derivatives and I.V. solutions) issued by the Pharmacy (account 8470) to other cost centers shall be reported in the using cost centers. If such items are sold in other cost centers, the cost of those items must be transferred to this cost center. The overhead cost of preparing and issuing drugs sold directly to patients must be accumulated in the Pharmacy cost center (account 8470). The applicable portion of such overhead will be allocated to this cost center during the cost allocation process.
(2) Standard Unit of Measure: none required; not applicable.
(e) Laboratory Services Group.
(1)
7210
LABORATORY SERVICES—CLINICAL
7211
Chemistry
7212
Hematology
7213
Immunology (Serology)
7214
Microbiology (Bacteriology)
7215
Procurement and Dispatch
7216
Urine and Feces
7219
Other Clinical Laboratories
(i) Function. These cost centers perform diagnostic and routine clinical laboratory tests necessary for the diagnosis and treatment of hospital patients. Additional activities include, but are not limited to, the following:
Transporting specimens from nursing floors and operating rooms; drawing of blood samples; caring for laboratory animals and equipment; maintaining quality control.
(ii) Description. These cost centers contain the direct expenses incurred in the performance of laboratory tests necessary for diagnosis and treatment. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording Workload Measurement Units, workload units related to quality control standards, calibration standards and specimen collection, duplicates and repeats for which a patient is not charged are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.
(iv) Data source. The number of workload measurement units shall be an actual count maintained by the laboratory.
(2) 7230
LABORATORY SERVICES—PATHOLOGICAL
7231
Cytology
7232
Histology
7233
Autopsy
7239
Other Pathological Laboratories
(i) Function. These cost centers perform diagnostic and routine laboratory tests on tissues and cultures necessary for the diagnosis and treatment of hospital patients. Additional activities include, but are not limited to, the following:
Mortuary operation, autopsy; transportation of specimens from nursing floors and operating rooms; care of laboratory animals and equipment; maintenance of quality control standards; preparation of samples for testing.
(ii) Description. These cost centers contain the direct expenses incurred in the performance of diagnostic and routine tests on tissues and cultures. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording Workload Measurement Units, workload units related to quality control studies, calibration standards and specimen collection, and repeats for which a patient is not charged, are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.
(iv) Data source. The number of workload measurement units shall be an actual count maintained by the laboratory.
(3) 7250 WHOLE BLOOD AND PACKED RED CELLS
(i) Function. This cost center procures and collects whole blood and packed red cells. Also included in the recruitment of donors.
(ii) Description. This cost center contains the direct expense incurred in procuring whole blood and packed red cells, drawing blood and recruiting and paying donors. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses. Do not include in this cost center the expenses incurred in performing tests on blood ( i.e., typing, crossmatching, etc.). These expenses must be reported in Laboratory Services—Clinical (account 7210). The cost of blood derivatives is to be reported in account 7150, Drugs Sold (if the patient is charged), or the using cost center (if the patient is not charged).
The cost of blood (amount paid or fair market value) is reported in this cost center, or an inventory account if applicable, rather than netted against revenue or cleared through an agency account. When blood is purchased, cost is the amount paid. The service fee charged by the outside blood sources is not reported here but reported in Blood Processing and Storing (account 8480). When blood is donated, cost is its fair market value at the date of donation and an offsetting amount is reported in Donated Blood (account 5770).
If replacement blood is received by the hospital blood bank, the original amount charged the patient is reported in this cost center and removed from the patient's account (Accounts and Notes Receivable, account 1030).
(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition).
(iv) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.
(4) 7260 BLOOD PROCESSING AND STORING
(i) Function. This cost center processes, preserves, stores, and issues whole blood and packed red cells after it has been procured. Additional activities include, but are not limited to, the following:
Plasma fractionation; freezing and thawing blood; maintaining inventory control.
(ii) Description. This cost center contains the direct expenses incurred in processing, storing, and issuing whole blood and packed red cells after it has been procured. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services and other direct expenses. Include in this cost center the cost of spoiled or defective blood, and the service fee charged by outside blood sources, whether or not the blood is replaced. Do not include in this cost center the expenses incurred in performing tests on blood ( i.e., typing, crossmatching, etc.). These expenses must be reported in Laboratory Services—Clinical (account 7210). The cost of blood and packed red cells must be reported in the Whole Blood and Packed Red Cells cost center (account 7250). The cost of blood derivatives must be in the Drugs Sold cost center (account 7250) if the patient is charged, or the using cost center if the patient is not charged.
(iii) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition).
(iv) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.
(f) 7290 ELECTROCARDIOGRAPHY
(1) Function. This cost center operates specialized equipment to record graphically electromotive variations in actions of the heart muscle; record graphically the direction and magnitude of the electrical forces of the heart's action; and/or record graphically the sounds of the heart for diagnostic purposes. Additional activities include, but are not limited to, the following:
Wheeling portable equipment to patients' bedside; explaining test procedures to patient; operating specialized equipment; inspecting, testing and maintaining special equipment; attaching and removing electrodes from patient.
(2) Description. This cost center contains the direct expenses incurred in performing electrocardiographic examinations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel.
(4) Data source. The number of workload measurement units shall be an actual count maintained by this cost center.
(g) 7310 CARDIAC CATHETERIZATION LABORATORY
(1) Function. The Cardiac Catheterization Laboratory provides special diagnostic procedures such as catheterization required for care of patients with cardiac conditions.
(2) Description. This cost center shall contain the direct expenses incurred in providing cardiac catheterization diagnostic examinations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(3) Standard Unit of Measure: number of procedures. Count each cardiac catheterization procedure for which a charge is made as one procedure.
(4) Data source. The number of procedures shall be the actual count maintained by the Cardiac Catheterization Laboratory.
(h) Radiology Services Group.
(1) 7320
RADIOLOGY—DIAGNOSTIC
7321
Angiocardiography
7322
Ultrasonography
7339
Radiology—Diagnostic—Other
(i) Function. This cost center provides diagnostic radiology services as required for the examination and care of patients under the direction of a qualified radiologist. Diagnostic radiology services include the taking, processing, examining and interpreting of radiography, ultrasonograms, and fluorographs. Additional activities include, but are not limited to, the following:
Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains the direct expenses incurred in providing diagnostic radiology services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: relative value units. Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and “BR” (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. (Count “Total Unit Value”, not “PC Unit Value”.)
(iv) Data source. The number of relative value units shall be the actual count maintained by the Radiology—Diagnostic cost center.
(2) 7340 CT SCANNER
(i) Function. The CT (computed tomographic) Scanner function provides computed tomographic scans of the head and other parts of the body.
(ii) Description. This cost center shall contain the direct expenses incurred in providing CT scans. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of procedures. Count each computed tomographic scanner procedure as one procedure. Count only those procedures which are charged for. A patient procedure is defined as the initial scan and any additional scans of the same anatomical area during a single visit.
(iv) Data source. The number of procedures shall be the actual count maintained by the CT Scanner cost center.
(3) 7360 RADIOLOGY—THERAPEUTIC
(i) Function. This cost center provides therapeutic radiology services as required for the care and treatment of patients under the direction of a qualified radiologist. Therapeutic radiology services include therapy by radium and radioactive substances. Additional activities include, but are not limited to, the following:
Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains the direct expenses incurred in providing therapeutic radiology services. Included in these direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: relative value units. Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and “BR” (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimates by qualified personnel. (Count “Total Unit Value”, not “PC Unit Value”.)
(iv) Data source. The number of relative value units shall be the actual count maintained by the Radiology—Therapeutic cost center.
(4) 7380
NUCLEAR MEDICINE
7381
Nuclear Medicine—Diagnostic
7382
Nuclear Medicine—Therapeutic
(i) Function. This cost center provides diagnosis and treatment by injectable or ingestible radioactive isotopes as required for the care and treatment of patients under the direction of a qualified physician. Additional activities include, but are not limited to, the following: Consultation with patients and attending physician; radioactive waste disposal; storage of radioactive materials.
(ii) Description. This cost center contains the direct expenses incurred in providing nuclear medicine services to patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: relative value units. Radiology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and “BR” (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel. (Count “Total Unit Value”, not “PC Unit Value”.)
(iv) Data source. The number of relative value units shall be the actual count maintained by the Nuclear Medicine cost center.
(i) 7420 RESPIRATORY THERAPY
(1) Function. Respiratory therapy is the administration of oxygen and certain potent drugs through inhalation of positive pressure and other forms of rehabilitative therapy as prescribed by physicians. This function is performed by specially trained personnel who initiate, monitor and evaluate patient performance, cooperation and ability during testing procedures. Additional activities include, but are not limited to, the following:
Assisting physician in performance of emergency care; reviving and maintaining patients' vital life signs; maintaining open airways, breathing, and blood circulation; maintaining aseptic conditions; transporting equipment to patients' bedsides; observing and instructing patients during therapy; visiting all assigned patients to ensure that physicians' orders are being carried out; inspecting and testing equipment; enforcing safety rules; and calculating test results.
(2) Description. This cost center contains the direct expenses incurred in the administration of oxygen and other forms of therapy through inhalation. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. Oxygen charges would be reported as one per day regardless of service time. All-inclusive rate hospitals should count treatments as if a charge were to be made.
(4) Data source. The number of treatments shall be the actual count maintained by the Respiratory Therapy cost center.
(j) 7440 PULMONARY FUNCTION TESTING
(1) Function. This cost center tests patients through measurement of inhaled and exhaled gases and analysis of blood, and evaluation of the patient's ability to exchange oxygen and other gases. This function is performed by specially trained personnel who initiate, monitor and evaluate patient performance, cooperation and ability during testing procedures.
(2) Description. This cost center contains the direct expenses incurred in the performance of patient and laboratory testing necessary for diagnosis and treatment of pulmonary disorders. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: workload measurement units. Laboratory Workload Recording Method, published by College of American Pathologists (use the latest edition). In recording workload measurement units, workload units related to quality control standards, calibration standards, and specimen collection, duplicates and repeats for which a patient is not charged are not to be counted. Workload units for unlisted procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel.
(4) Data source. The number of workload measurement units shall be an actual count maintained by the Pulmonary Function Testing cost center.
(k) 7460
NEUROLOGY—DIAGNOSTIC
7461
Electroencephalography
7462
Electromyography
(1) Function. This cost center provides diagnostic neurology services such as electroencephalography and electromyography. Specialized equipment is used to record electromotive variations in brain waves and to record electrical potential variation for diagnosis of muscular and nervous disorders. Additional activities include, but are not limited to, the following:
Wheeling portable equipment to patient's bedside; explaining test procedures to patient; operating specialized equipment; inspecting, testing and maintaining special equipment; attaching and removing electrodes from patients.
(2) Description. This cost center contains the direct expenses incurred in providing diagnostic neurology services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: relative value units. Diagnostic Neurology Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies. Relative value units for unlisted and “BR” (By Report) procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel.
(4) Data source. The number of relative value units shall be the actual count maintained by the Neurology—Diagnostic cost center.
(l) Therapy Services Group.
(1) 7510 PHYSICAL THERAPY
(i) Function. The Physical Therapy cost center provides patient evaluation and therapeutic activities, patient education and home visits. The cost center provides patient evaluations by performing and interpreting tests and measurements of cardiovascular, neuromuscular and musculoskeletel functions and establishes treatment programs. Treatment is administered through the use of therapeutic agents which employ the physical, chemical and other properties of air, water, electricity, sound and light. Specific evaluative and therapeutic activities provided by this cost center include, but are not limited to, the following:
Application of manual and electrical muscle and range of motion measurement; evaluation and fitting of prosthetic, orthotic and other assistive devices; functional testing and training; perceptual and sensory evaluations; planning and executing therapeutic exercise programs for increasing strength, endurance, coordination and range of motion; gait analysis and training; instruction and counseling patients and families.
(ii) Description. This cost center contains the direct expenses incurred in maintaining a physical therapy program, including home care. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.
(iii) Standard Unit of Measure: number of relative value units and patient visits. The standard unit of measure will be the relative value units developed by the American Physical Therapy Association (see Part 447 of this Article). The number of relative value units counted per visit indicates the extent to which the cost center resources were used during a patient and resident visit. In addition to relative value units, the number of physical therapy patient visits must be reported. A patient visit is one appearance of a patient regardless of the number of evaluation, therapeutic and patient education activities performed during that appearance. Also included as patient visits are the home visits made by physical therapists. See account 6910 for a definition of home visits.
(iv) Data source. The number of relative value units shall be the actual count maintained by the Physical Therapy cost center.
(2) 7530 OCCUPATIONAL THERAPY
(i) Function. Occupational Therapy is the application of purposeful, goal-oriented activity in the evaluation, diagnosis and/or treatment of persons whose function is impaired by physical illness or injury, emotional disorder, congenital or developmental disability, or the aging process, in order to achieve optimum functioning, to prevent disability and to maintain health. Specific occupational therapy services include, but are not limited to, education and training in activities of daily living (ADL); the design, fabrication and application of orthoses (splints); sensorimotor activities; the use of specifically designed crafts; guidance in the selection and use of adaptive equipment; therapeutic activities to enhance functional performance; prevocational evaluation and training; and consultation concerning the adaptation of physical environments for the handicapped. These services are provided to individuals or groups, to both inpatients and outpatients and to home-bound patients.
(ii) Description. This cost center contains the direct expenses incurred in maintaining an occupational therapy program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of treatments (1980). Count each procedure as one treatment. In group sessions, the number of treatments would be equal to the number of patients in the group. Count only those procedures which are charged for.
(iv) Standard Unit of Measure: number of relative value units (1981). The standard unit of measure will be the relative value units developed by the American Occupational Therapy Association and is used at the association's request (see Part 447 of this Article). Relative value units for unlisted procedures should be reasonably estimated on the basis of other comparable procedures or estimated by qualified personnel.
(v) Data source. The number of treatments shall be obtained from an actual count maintained by the Occupational Therapy cost center.
(vi) Effective date. Relative to the Standard Unit of Measure for this cost center, the relative value units developed by the American Occupational Therapy Association will be effective July 1, 1981. For 1980 reporting purposes, report the “Number of Treatments” in accordance with the above definition.
(3) 7550 SPEECH-LANGUAGE PATHOLOGY
(i) Function. This cost center provides and coordinates services to persons with impaired functional communication skills. This includes the evaluation and management of any existing disorders of the communicative process centering entirely or in part on the reception and production of speech and lang age related to organic and/or nonorganic factors. Professional services provided by this cost center are group-ed into a minimum of three major areas: Diagnostic Assessment and Evaluation—including clinical appraisal of speech, voice and language competencies, through standardized and other tests, to determine need for and types of rehabilitation required; Rehabilitative Treatment—including planning and conducting treatment programs, on an individual or group basis, to develop, restore or improve communicative efficiency of persons disabled in the processes of speech, voice and/or language; and continuing Evaluation/Periodic Reevaluation—including both standardized and informal procedures to monitor progress and verify current status. Such activities may be coordinated with medical evaluation and treatment of hospitalized patients. Additional activities include, but are not limited to, the following: preparation of written diagnostic, evaluative and special reports; provision of extensive counseling and guidance to communicatively handicapped individuals and their families; and maintaining specialized equipment utilized in evaluation and treatment, such as auditory training instruments and speech-production prostheses.
(ii) Description. This cost center contains the direct expenses incurred in maintaining a Speech-Language Pathology cost center. Any expenses related to the sale of speech prostheses or other communication aids must not be included here, but accounted in the Medical Supplies Sold cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Units of Measure: number of sessions. Count each evaluation and each treatment session for which there is a charge as one session. For group activities, count as one session each patient participating in the session. Also included are sessions with home-bound patients.
(iv) Data source. The number of sessions shall be obtained from an actual count maintained by the Speech-Language Pathology cost center.
(4) 7570 RECREATIONAL THERAPY
(i) Function. Recreational Therapy services include the employment of sports, dramatics, arts and other recreational programs to stimulate the patients' recovery rate. Additional activities include, but are not limited to, the following:
Conducting and organizing instrumental and vocal musical activities and directing activities of volunteers in respect to these functions.
(ii) Description. This cost center contains the direct expenses incurred in maintaining a program of recreational therapy. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. For group activities, count as one treatment each patient in group.
(iv) Data source. The number of treatments shall be obtained from an actual count maintained by the Recreational Therapy cost center.
(5) 7580 AUDIOLOGY
(i) Function. This cost center provides and coordinates services to persons with impaired peripheral and/or central auditory function. This includes the detection and management of any existing communication handicaps centering in whole or in part on the hearing function. Some of the activities of this cost center are: audiologic assessment (including basic audiometric testing and screening, examination for site of lesion, nonorganic hearing loss and various parameters of auditory processing abilities essential for communication function); hearing aid evaluation, selection, orientation, adjustment and other technical related services; and audiologic habilitation and rehabilitation including the development, remediation or conservation of receptive and expressing language abilities. Such activities are coordinated with medical evaluation and treatment of hospital patients. Additional activities include, but are not limited to, the following:
Demonstrating and evaluating amplification devices and alerting systems; evaluating excessively noisy environments, writing special reports; providing extended counseling and guidance; inspecting, testing and maintaining special equipment.
(ii) Description. This cost center contains the direct expenses incurred in maintaining an Audiology cost center. The expense related to the sale of hearing aids must not be included here but accounted in the Medical Supplies Sold cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of procedures. Count each procedure for which a charge is made as one procedure. Based on the recommendations of the American Speech and Hearing Association, these procedures should include audiometric screening and identification; basic audiologic testing (including pure tone and speech threshold tests, speech disrimination tests and basic impedence tests); audiologic evaluation for site of lesion (including Bekesy audiometry, tone decay tests, loudness balance tests, special impedence tests, SISI test, distorted speech tests, competing speech tests and other measures of peripheral and central auditory structures); audiologic evaluation for nonorganicity; pediatric audiologic assessment (including conditional response audiometry, play audiometry, and soundfield response assessment); electrophysiologic audiologic measures (including electroencephalographic, brainstem and electrocochleographic procedures); hearing aid evaluation and selection; audiologic hibilitation (including hearing aid orientation, counseling, analysis of auditory processing abilities, auditory and visual communication training, speech, language and hearing therapy); and audiologic technical services including hearing aid adjustment, electroacoustic evaluation, noise survey, special report writing, etc.).
(iv) Data source. The number of procedures shall be obtained from an actual count maintained by the Audiology cost center.
(6) 7590 OTHER PHYSICAL MEDICINE
(i) Function. Other Physical Medicine includes educational and therapeutic activities related to the treatment, habilitation and rehabilitation of patients with neuromuscular and musculoskeletal impairments. Include milieu therapy in this cost center. Such activities are those not required to be included in the Physical Therapy, Occupational Therapy, Speech-Language Pathology, Recreational Therapy and Audiology cost centers.
(ii) Description. This cost center contains the direct expenses incurred in providing physical medicine activities not specifically required to be included in another cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Unit of Measure: number of treatments. Count each procedure for which a charge is made as one treatment.
(iv) Data source. The number of treatments shall be obtained from an actual count maintained by the Other Physical Medicine cost center.
(7) 7670
PSYCHIATRIC/PSYCHOLOGICAL SERVICES
7671
Individual Therapy
7672
Group Therapy
7673
Family Therapy
7674
Biofeedback Training
7675
Psychological Testing
7676
Shock Therapy
7689
Other Psychiatric/Psychological Services
(i) Function. This cost center provides psychiatric and psychological services such as individual, group and family therapy to adults, adolescents and families; biofeedback training; psychological testing; and shock therapy.
(ii) Description. This cost center contains the direct expenses incurred in providing psychiatric and psychological services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(iii) Standard Units of Measure: number of treatments. Count each procedure for which a charge is made as one treatment. For group sessions, count as one treatment each patient participating in the session.
(iv) Data source. The number of treatments shall be obtained from an actual count maintained by this service.
(m) 7710
RENAL DIALYSIS
7711
Hemodialysis
7713
Peritoneal Dialysis
7715
Patient Dialysis Training
7719
Other Dialysis
(1) Function. Renal Dialysis is the process of cleaning the blood by the use of an artificial kidney machine or other method. Additional activities include, but are not limited to, the following:
Wheeling portable equipment to patient's bedside; explaining procedures to patient; operating dialysis equipment; inspecting, testing and maintaining special equipment.
(2) Description. This cost center contains the direct expenses incurred in providing inpatient and outpatient Renal Dialysis services in the hospital. Report all Home Program Dialysis expenses in accounts 6810 and 6820, as appropriate. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.
(3) Standard Unit of Measure: number of treatments. Count each treatment for which a charge is made as one treatment regardless of the length of the treatment.
(4) Data source. The number of treatments shall be the actual count maintained by the Renal Dialysis cost center.
(n) 7730 KIDNEY ACQUISITION
(1) Function. This cost center acquires, stores and preserves all human kidneys for eventual transplantation. Unlike other ancillary services, the total cost of kidney acquisition is not accumulated in any one patient care cost center. Therefore, only the costs which are not properly includable in another cost center are to be included in this cost center.
(2) Description. This cost center contains the direct expenses incurred in acquiring, storing and preserving human kidneys. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of kidneys acquired. Count each kidney acquired as one.
(4) Data source. The number of kidneys acquired shall be the actual count maintained by the Kidney Acquisition cost center.
(o) 7750 OTHER ORGAN ACQUISITION
(1) Function. This cost center acquires, stores and preserves all human organs (except kidneys) for eventual transplantation. Unlike other ancillary services, the total cost of organ acquisition is not accumulated in any one patient care cost center. Therefore, only the costs which are not properly includable in another cost center are to be included in this cost center.
(2) Description. This cost center contains the direct expenses incurred in acquiring, storing and preserving human organs. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
(3) Standard Unit of Measure: number of organs acquired. Count each organ acquired as one.
(4) Data source. The number of organs acquired shall be the actual count maintained by the Organ Acquisition cost center.
(p) 7910 OTHER ANCILLARY SERVICES. This cost center contains the direct expenses incurred in providing ancillary services other than those required to be included in other specific cost centers. Included are expenses incurred in providing formal education to school age psychiatric inpatients. Related revenue must be included in the Other Ancillary Services revenue center (account 4910). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses, and transfers.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.1 Purpose
The purpose of this regulation is to define requirements for the assessment and abatement of conditions conducive to lead poisoning.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.14 Conduct of MCO in connection with the preparation of required reports and documents
(a) Any director or officer of a MCO, or any other person acting under the direction thereof, shall not, directly or indirectly:
(1) make or cause to be made a materially false or misleading statement to a CPA in connection with any audit, review or communication required under this Subpart; or
(2) omit to state, or cause another person to omit to state, any material fact necessary in order to make statements made, in light of the circumstances under which the statements were made, not misleading to a CPA in connection with any audit, review or communication required under this Subpart.
(b) Any officer or director of a MCO, or any other person acting under the direction thereof, shall not directly or indirectly take any action to coerce, manipulate, mislead or fraudulently influence any CPA engaged in the performance of an audit pursuant to this Subpart if that person knew or should have known that the action, if successful, could result in rendering the MCO’s financial statements materially misleading, including any action taken at any time with respect to the professional engagement period to coerce, manipulate, mislead or fraudulently influence a CPA:
(1) to issue or reissue a report on a MCO’s financial statements that is not warranted in the circumstances (due to material violations of statutory accounting principles prescribed by the superintendent, generally accepted auditing standards, or other professional or regulatory standards);
(2) not to perform audit, review or other procedures required by generally accepted auditing standards or other professional standards;
(3) not to withdraw an issued report; or
(4) not to communicate matters to a MCO’s audit committee.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
DESIGNATION OF CASES DESIGNATION OF CASES
10 CRR-NY 2.2 Definitions
Definitions shall include the following:
(a) For public health reporting purposes, hospital-associated infections shall include an outbreak or increased incidence of disease due to microbiological agents or their toxic products occurring in patients or persons working in the hospital. Any non-reportable hospital-associated infections must be handled nonetheless by hospitals and their infection control committees.
(b) Case shall mean a person who has been diagnosed as having a particular disease or condition. The diagnosis may be based on clinical judgment, signs and symptoms combined with known exposure based on the best available evidence of transmissibility to a case or suspected case, and/or on laboratory evidence, as applicable.
(c) Suspected case shall mean a person who has been determined as possibly having a particular disease or condition. A suspected case may be based on signs and symptoms, signs and symptoms combined with known exposure based on the best available evidence of transmissibility to a case or suspected case, and/or on laboratory evidence, as applicable. The term suspected case shall include persons under investigation, consistent with any guidance that the Commissioner of Health may issue with respect to a particular disease.
(d) An outbreak is defined as an increased incidence of disease above its expected or baseline level. As the number of cases which indicate the presence of an outbreak vary according to the infectious agent, size and type of population exposed, previous exposure or lack of exposure to the disease, and time and place of occurrence, the expected or baseline level of disease shall be assessed by hospitals and their infection control committees as directed in section 405.11 of this Title. While an outbreak usually involves several cases of illness ( e.g., food-borne poisoning, influenza), it may consist of just one case for certain rare and/or serious diseases ( e.g., botulism, measles).
(e) As used in this Part, local health authority is defined as the health officer of a county, part-county, city, town, village, consolidated health district, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law.
(f) As used in this Part, the term approved laboratory or laboratory approved for the examination shall mean, as the case may be, a laboratory possessing either a certificate of approval for the specified examination issued by the State Commissioner of Health under the authority of title 1 of article 5 of the Public Health Law or a permit for the specified examination issued by said commissioner under the authority of title 5 of said article.
(g) As used in this Part, the term vaccinia disease shall mean:
(1) persons with vaccinia infection due to contact transmission; and
(2) persons with the following complications from vaccination: eczema vaccinatum, erythema multiforme major or Stevens-Johnson syndrome, fetal vaccinia, generalized vaccinia, inadvertent inoculation, ocular vaccinia, post-vaccinial encephalitis or encephalomyelitis, progressive vaccinia, pyogenic infection of the vaccination site, and any other serious adverse events ( i.e., those resulting in hospitalization, permanent disability, life-threatening illness or death).
(h) Contact shall mean any person known to have been sufficiently associated with a case or suspected case that, based on the best available evidence of transmissibility, such person has had the opportunity to contract a particular disease or condition.
(i) Isolation shall mean the physical separation and confinement of an individual or group of individuals who are infected or reasonably determined by the State Commissioner of Health or local health authority to be infected with a highly contagious disease or organism, for such time as will prevent or limit the transmission of the reportable disease or organism to non-isolated individuals, in the clinical judgment of the State Commissioner of Health, or of the local health authority and consistent with any direction that the State Commissioner of Health may issue.
(j) Quarantine shall mean the physical separation and confinement of an individual or groups of individuals who are reasonably determined by the State Commissioner of Health or local health authority to have been exposed to a highly contagious communicable disease, but who do not show signs or symptoms of such disease, for such time as will prevent transmission of the disease, in the clinical judgment of the State Commissioner of Health, or of the local health authority and consistent with any direction that the State Commissioner of Health may issue.
(k) Home quarantine or home isolation shall mean quarantine or isolation in a person’s home, consistent with this Part and any direction that the State Commissioner of Health may issue;
(l) Congregate quarantine shall mean quarantine at a location operated or contracted by the State or local health authority, consistent with this Part and any direction that the State Commissioner of Health may issue, where multiple persons are quarantined;
(m) Highly contagious communicable disease shall mean a communicable disease or unusual disease that the State Commissioner of Health determines may present a serious risk of harm to the public health, for which isolation or quarantine may be required to prevent its spread.
(n) Monitor shall mean contacting a person who is the subject of an isolation or quarantine order by the State Department of Health or local health authority, to ensure compliance with the order and to determine whether such person requires a higher level of medical care, consistent with any direction that the State Commissioner of Health may issue.
(o) Mandatory quarantine shall mean quarantine pursuant to a legal order consistent with this Part.
(p) Voluntary quarantine shall mean quarantine pursuant to a voluntary agreement with a public health authority.
(q) Confinement shall mean enforcement of an isolation or quarantine order through the use or possible use of law enforcement personnel.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.221 Not-for-profit
A corporation as defined in section 102 of the Not-for-Profit Corporation Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.2 Early intervention official’s or public health officer’s role in the child find system
(a) The early intervention official shall:
(1) make all reasonable efforts to identify and locate eligible children within their municipality;
(2) coordinate efforts to identify, locate and track children conducted by other agencies responsible for services to infants and toddlers and their families;
(3) provide for identification, tracking and screening of children at risk of developmental delay, using available resources and such other resources as the commissioner shall commit to this purpose.
(i) The municipality shall designate either the early intervention official or the public health officer to receive all early intervention referrals. If the public health officer is designated to receive referrals, and is not the early intervention official, he or she shall promptly transmit the referral of children suspected of having a developmental delay to the early intervention official.
(b) If a child is referred to the Early Intervention Program fewer than 45 days before the child’s third birthday and is potentially eligible for services under section 4410 of the Education Law, the early intervention official, with parental consent, shall refer the child to the committee on preschool special education (CPSE) of the local school district in which the child resides and, is not required to conduct an evaluation, assessment, or initial IFSP meeting for the child.
Chapter III PUBLIC WATER SUPPLIES
Subchapter C WATER SUPPLY SOURCES
Part 170 SOURCES OF WATER SUPPLY
10 CRR-NY 170.1 Statement
The rules contained in this Part, together with the watershed rules and regulations hereinbefore set forth in Parts 100 through 158, have been promulgated to protect sources of water supply dedicated for present or future public beneficial use for domestic and municipal purposes.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.6 Participation of health care facilities
(a) One year from the effective date of this regulation, general hospitals as defined in section 2801(10) of the Public Health Law, and two years from the effective date of this regulation, all health care facilities as defined in section 18(c)(1) of the Public Health Law, including those who hold themselves out as urgent care providers, utilizing certified electronic health record technology under the Federal Health Information Technology for Economic and Clinical Health Act (HITECH), must become qualified entity participants in order to connect to the SHIN-NY through a qualified entity, and must allow private and secure bi-directional access to patient information by other qualified entity participants authorized by law to access such patient information. Bi-directional access means that a qualified entity participant has the technical capacity to upload its patient information to the qualified entity so that it is accessible to other qualified entity participants authorized to access the patient information and that the qualified entity participant has the technical capacity to access the patient information of other qualified entity participants from the qualified entity when authorized to do so.
(b) The New York State Department of Health may waive the requirements of subdivision (a) of this section for health care facilities that demonstrate, to the satisfaction of the New York State Department of Health:
(1) economic hardship;
(2) technological limitations or practical limitations to the full use of certified electronic health record technology that are not reasonably within control of the health care provider; or
(3) other exceptional circumstances demonstrated by the health care provider to the New York State Department of Health as the commissioner may deem appropriate.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.281 Religious corporation
A corporation organized under the Religious Corporations Law, and other religious agencies and organizations, and charities, agencies and organizations operated, supervised or controlled by or in connection with a religious organization.
10 CRR-NY 441.112 Encounter
A face-to-face contact between a patient and a provider who has primary responsibility for assessing and treating the condition of the patient at a given contact and exercises independent judgment in the care of the patient.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.2 Definitions
The following words or terms when used in this Subpart shall have the following meanings:
(a) Admitted assets means assets recognized and accepted by the State Insurance Department under article 13 of the Insurance Law in determining the solvency of insurors. Admitted assets shall be the sole basis for determining compliance with any applicable financial requirement or quantitative limitation imposed upon an MCO, as further specified in Insurance Department Regulation 172 (11 NYCRR Part 83).
(b) Article 44 service area means the geographic area, defined by counties or other geographic subdivisions, identified in the application for a certificate of authority to operate an MCO for which there is identified a provider network capable of providing comprehensive health services of sufficient availability and accessibility to the projected enrolled population within the meaning of article 44 of the Public Health Law and this Subpart, as approved by the commissioner. Enrollment within the article 44 service area must be offered to any eligible persons who work or reside within the service area, except that for MLTCPs and, for programs authorized by title XIX, enrollment may be offered only to eligible persons who reside within the service area.
(c) Capitation means a payment made on a per enrollee basis.
(d) Care management within an MLTCP means a process which assists enrollees with establishing a written care plan and accessing necessary covered services. It also provides referral to and coordination of other medical, social, educational, psychosocial, financial and other services in support of the care plan irrespective of whether such services are covered by the plan.
(e) Commissioner means the Commissioner of Health of the State of New York.
(f) Community rating means a rating methodology in which the premium for all persons covered by a policy or contract form is the same based on the experience of the entire pool of risks covered by that policy or contract form without regard to age, sex, health status or occupation. Refunds, rebates, credits or dividends based on such factors are also prohibited.
(g) Comprehensive health services means:
(1) for HMOs and PHSPs, all those health services which an enrolled population might require in order to be maintained in good health, and shall include, but shall not be limited to, physician and other provider services (including consultant and referral services), inpatient and outpatient hospital services, diagnostic laboratory and therapeutic and diagnostic radiologic services, and emergency and preventive health services, including providing HIV counseling and recommending voluntary HIV testing to pregnant women, which counseling and testing shall be conducted pursuant to Public Health Law, article 27-F, referring HIV positive persons for necessary, clinically appropriate services, and services required to be covered under article 43 of the Insurance Law;
(2) for MLTCPs, health and long-term care services, including but not limited to, primary care, acute care, home and community based and institution based long-term care and ancillary services that are necessary to meet the needs of persons whom the plan is authorized to serve. However, consistent with the provisions of section 4403-f of the Public Health Law, while an MLTCP may provide less than comprehensive services, it remains subject to the provisions of this Subpart;
(3) for PCPCPs, comprehensive primary and preventive care and case management of inpatient, emergency room and specialty services; and
(4) for HIV SNPs, all those health and supportive services provided as necessary to meet the specialized needs of the persons whom the plan is authorized to serve by providers with appropriate training and experience in the care, treatment and prevention of HIV/AIDS, as determined by the commissioner. These comprehensive services include, but are not limited to, those described in paragraph (1) of this subdivision, those set forth in subdivision (8) of section 4403-c of the Public Health Law and the following: primary care services by a qualified HIV specialist; HIV primary and secondary prevention and risk reduction services; treatment adherence services; HIV SNP case management; and access and referral to community health and social service providers that support members' ability to sustain wellness and adhere to treatment regimes. Such term may also be further defined by agreement with enrolled populations to provide for additional benefits necessary, desirable or appropriate to meet their health care needs.
(h) Comprehensive health services plan or plan means a plan through which each member of an enrolled population is entitled to receive comprehensive health services in consideration for a basic advance or periodic charge.
(i) Comprehensive HIV special needs plan or HIV SNP means an MCO certified pursuant to section 4403-c of article 44 of the Public Health Law which provides or arranges for the provision of comprehensive health and supportive services and specialized HIV care to HIV positive persons and their related children up to the age of 19, as defined in the HIV SNP contract with a local social services district (LDSS) or the commissioner, who are eligible to receive benefits under title XIX or other public programs.
(j) Control, which shall be synonymous with the terms controlling, controlled by and under common control with, means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities or voting rights, by contract (except a commercial contract for goods or nonmanagement services) or otherwise; but no person shall be deemed to control another person solely by reason of his or her being an officer or director of such other person. Control shall be presumed to exist if any person directly or indirectly owns, controls or holds the power to vote 10 percent or more of the voting securities or voting rights of any other person, or is a corporate member of a not-for-profit corporation.
(k) Controlled MCO means any proposed or certified MCO that is controlled directly or indirectly by a holding company.
(l) Controlled person means any person, other than a controlled MCO, that is controlled directly or indirectly by a holding company.
(m) Department means the Department of Health of the State of New York.
(n) Enrolled population means a group of persons which receives comprehensive health services from an MCO in consideration for a basic advance or periodic charge. An enrolled population is composed of enrollees who are entitled by contract to receive comprehensive health services from the MCO. Except for HMOs, MCOs may only enroll certain populations as authorized in the Public Health Law.
(o) Enrollee means an individual who has entered into a contractual relationship with the MCO, or an individual on whose behalf a contractual arrangement has been entered into with the MCO, under which the MCO assumes the responsibility for the provision to the individual of comprehensive health services.
(p) Enrollment means the act of an individual signing a contract, or having someone sign it on his or her behalf, which obligates the MCO to provide comprehensive health services, and which obligates the individual enrolling, or someone on his or her behalf, to pay a periodic premium or fee for all covered services. A signature may be made electronically to the extent permitted by applicable law and regulation.
(q) Governing authority of the MCO means the policymaking body that is responsible for the operation of an MCO, including:
(1) the policymaking body of a public MCO;
(2) the board of directors or trustees of a corporation;
(3) partners of a partnership operating an MCO;
(4) the owners of a proprietary business operating an MCO; and
(5) the members, or managers who are also members of a limited liability company. Managers who are not members of a limited liability company participate in the management of an MCO pursuant to the provisions of section 98-1.11 of this Subpart governing management contracts, and in no way comprise the governing authority.
(r) Health Maintenance Organization or HMO means any person, natural or corporate, or any groups of such persons who enter into an arrangement, agreement or plan, or any combination of arrangements or plans, which proposes to provide or offer, or which does provide or offer, a comprehensive health services plan to individuals and groups.
(s) HIV SNP case management means a process which includes clinical coordination and medical/clinical case management in consultation with the PCP, service utilization monitoring, assessment and service plan development that address identified patient needs, case manager involvement in quality assurance and quality improvement and non-intensive HIV psychosocial case management as defined by the department.
(t) HIV specialist primary care provider or HIV specialist PCP means a primary care provider who meets the qualifications for HIV Specialist as defined by the Medical Care Criteria Committee of the department's AIDS Institute.
(u) Holding company means any person who directly or indirectly controls any proposed or certified MCO.
(v) Holding company system means a holding company together with a controlled MCO and/or controlled persons.
(w) Independent practice association or IPA means a corporation, limited liability company, or professional services limited liability company, other than a corporation or limited liability company established pursuant to article 28, 36, 40, 44 or 47 of the Public Health Law, which contracts directly with providers of medical or medically related services or another IPA in order that it may then contract with one or more MCOs and/or workers' compensation preferred provider organizations to make the services of such providers available to the enrollees of an MCO and/or to injured workers participating in a workers' compensation preferred provider arrangement. An IPA may also be considered a provider within the meaning of section 4403(1)(c) of the Public Health Law, but only for the purpose of and to the extent it shares risk with an MCO and/or the IPA's contracting providers, and shall be considered a provider for the purposes of section 98-1.21(a)(1) and (2) of this Subpart. An IPA may be certified as an accountable care organization pursuant to article 29-E of the Public Health Law and Part 1003 of this Title, and upon obtaining a certificate of authority may contract with third party health care payers defined in section 1003.2(x) of this Title. To the extent allowed under New York’s Partnership Plan section 1115(a) Medicaid demonstration extension, as amended April 14, 2014, an IPA may participate in a Performing Provider System (PPS) established as part of a Delivery System Reform Incentive Payment (DSRIP) program project.
(x) Managed care organization or MCO means an HMO, PHSP, HIV SNP and, where specified in this Subpart, PCPCP and MLTCP. An HIV SNP may be an entity that is independently incorporated and certified to operate an HIV SNP or an incorporated and certified MCO that is issued a separate certificate of authority to operate the HIV SNP.
(y) Managed long term care plan or MLTCP means an entity that has received a certificate of authority pursuant to section 4403-f of the Public Health Law to provide or arrange for health and long term care services on a capitated basis for a population which the plan is authorized to enroll.
(z) Management contractor means any person, other than staff employed by the MCO, entering into an agreement with the governing authority of an MCO for the purpose of managing the day-to-day operations of the MCO.
(aa) Material change to a contract between an MCO and a provider or an IPA, other than a management contract, means:
(1) any change to a required contract provision or appendix as per contract guidelines issued by the commissioner;
(2) any change to or addition of a risk sharing arrangement, other than the routine trending of fees or other reimbursement amounts;
(3) any proposed addition of an exclusivity, most favored nation or non-compete clause;
(4) any proposed subcontracting of the existing contractual obligations of an IPA;
(5) any proposed subcontracting of the statutory or regulatory responsibilities of an MCO, and
(6) any proposed revocation of an approved delegation as set forth in paragraphs (4) and (5) of this subdivision.
(bb) Medical director, other than the medical director of a utilization review agent as defined in section 4900 of the Public Health Law who shall be licensed by at least one of the United States, means a New York State-licensed physician whose responsibilities include, but are not limited to, the supervision of the quality assurance and improvement and utilization review programs and advising the governing authority on the adoption and enforcement of policies concerning medical services.
(cc) Net premium income means the gross amount of revenue derived from premiums less any returned premium.
(dd) Person means an individual, partnership, corporation, any other legal entity, including a joint venture, or any combination of the foregoing acting in concert.
(ee) Premium means the amount of money the MCO charges each enrollee or payer for the specified benefit package.
(ff) Prepaid health services plan or PHSP means a provider, including a not-for-profit corporation established to operate a hospital pursuant to article 28 of the Public Health Law, a government agency or an entity or group of entities, other than a shared health facility, seeking to provide comprehensive health care services which has received a special purpose certificate of authority pursuant to section 4403-a of the Public Health Law to deliver comprehensive health care services on a prepaid contractual basis either directly, or through an arrangement, agreement or plan or combination thereof to an enrolled population which is substantially composed of persons eligible to receive benefits under title XIX or other public programs.
(gg) Primary care partial capitation provider or PCPCP means a qualified individual medical services provider or a county or entity comprised of medical services providers offering comprehensive primary and preventive care and case management of inpatient, emergency room and specialty services to persons eligible to receive benefits under title XIX and to enroll in managed care plans.
(hh) Primary care practitioner or PCP means a physician or other licensed provider who supervises, coordinates and provides initial and basic care to enrollees and maintains continuity of care for enrollees.
(ii) Referral means the internal mechanism utilized by the MCO to allow members to access needed services.
(jj) Reinsurance means a transaction whereby the reinsuror, for a consideration, agrees to indemnify the MCO, or other provider, against all or part of the loss which the latter may sustain under the subscriber contracts which it has issued.
(kk) Risk-sharing means the contractual assumption of liability by the health care provider or IPA by means of a capitation arrangement or other mechanism whereby the provider or IPA assumes financial risk from the MCO for the delivery of specified health care services to enrollees of the MCO.
(ll) Superintendent means the Superintendent of Insurance of the State of New York.
(mm) Title XIX , as referenced in this Subpart, means any federally authorized Medicaid program under such title of the Social Security Act and any programs authorized by State law that cover the Medicaid population, specifically, titles 11 and 11-D of article 5 of the Social Services Law.
(nn) Title XXI, as referenced in this Subpart, means any federally authorized Child Health Insurance Program under such title of the Social Security Act and any programs authorized by State law that cover the State's Child Health Plus population, specifically, title I-A of article 25 of the Public Health Law.
(oo) Transitional period shall for the purposes of subparagraph (i) of paragraph (e)(1) of subdivision (6) of section 4403 of the Public Health Law mean a period commencing on the date a provider's contractual obligation to provide services to an MCO's enrollees terminates and ending no more than 90 days thereafter.
(pp) HARP ( health and recovery plan ) means a line of business operated by an MCO to administer the full continuum of mental health, substance use disorder, and physical health services covered under the Medicaid State Plan as well as the enhanced Home and Community Based Services benefits (1915[i]) for adults with serious mental illness (SMI) and/or substance uses disorders (SUDs) who meet eligibility requirements.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.7 Responsibilities of the specialty care center director
The specialty care center director shall be responsible for submitting to the testing laboratory, within the time frame for each condition as directed by the testing laboratory, the diagnostic evaluation, test results and treatment plan for each newborn referred to the specialty care center based on the newborn screening panel results. The specialty care center director shall ensure compliance with the following procedures:
(a) The specialty care center shall provide education, identify resources and any additional assistance to the newborn’s parent(s).
(b) The specialty care center shall provide consultation and assistance to hospitals, responsible providers, the testing laboratory and other health care providers upon request.
(c) The specialty care center shall provide initial and subsequent case information, case management, treatment plan, specimens and other information for tracking and follow-up reviews to the testing laboratory, when requested.
(d) The specialty care center shall submit written and/or electronic notification to the testing laboratory 30 days prior to the effective date of appointment of a new director or change in the location of the specialty care center. Such information shall be provided on a form prescribed by the department.
(e) The specialty care center shall provide the testing laboratory with the names and contact information for all personnel, annually, and within 90 days of any request from the testing laboratory for such information. Such information shall be provided on a form prescribed by the department.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.7 Appeals of denial of access to records
(a) Any person who has been denied access to records by the records access officer may appeal such denial in writing within 30 business days to the records access appeals officer.
(b) The time for deciding on an appeal by the records access appeals officer shall commence upon receipt of the written appeal, which shall identify:
(1) the date and location of request for records;
(2) the records to which the requestor was denied access; and
(3) the name and return address of the requestor.
(c) The records access appeals officer shall, within seven business days of the receipt of a written appeal, review the matter and affirm, modify or reverse the denial.
(d) If the records access appeals officer determines that the denial of access was erroneous, he/she shall instruct the records access officer to allow prompt inspection or copying of the record as requested.
(e) If the records access appeals officer affirms or modifies the denial, communicate the reasons in writing by either first class mail or certified mail, return receipt requested, to the person making the appeal and inform such person of the right of judicial appeal.
(f) The records access appeals officer shall immediately forward to the Committee on Open Government a copy of such appeal and the determination thereon.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.10 Village of Maybrook
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the infiltration gallery and wells which comprise the source of the public water supply of the Village of Maybrook. Said infiltration gallery and wells are located on land owned by the Village of Maybrook. The infiltration gallery and three wells are located off County Road 4, along Beaverdam Brook, in the Town of Hamptonburgh about a mile southwest of the Village of Maybrook, and one well is located off Route 208 at the village park. These rules shall also apply to any other infiltration gallery, spring or well which may be developed for the purposes of supplying water to the Village of Maybrook.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Infiltration gallery shall mean infiltration galleries located on land owned by the Village of Maybrook along the Beaverdam Brook in the Town of Hamptonburgh and used as a source of water supply by the village.
(6) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(7) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the infiltration gallery or the wells.
(8) Manure shall mean animal feces and urine.
(9) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(10) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(11) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, and industrial and municipal waste and agricultural-and nonagricultural-associated animal waste.
(12) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(13) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(14) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(15) Refuse diposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant, or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage.
(18) Sludge lagoon shall mean a pond used to hold sludge from municipal or industrial treatment works or septic tanks.
(19) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(20) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(21) Watercourse shall mean every spring, stream, marsh or channel of water on the watershed tributary or contributing water to Beaverdam Brook.
(22) Water supply shall mean the public water supply of the Village of Maybrook.
(23) Watershed shall mean the drainage area contributing water to the Beaverdam Brook.
(24) Wells shall mean any well now used as a source of water supply for the Village of Maybrook or any additional wells which may be constructed in the future as a source for such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 500-foot linear distance of the infiltration gallery or the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 1,000-foot linear distance of the infiltration gallery or the wells, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within a 1,000-foot linear distance of the infiltration gallery or the wells, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 500-foot linear distance of the infiltration gallery or the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the infiltration gallery or the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 500-foot liner distance of the infiltration gallery or the wells, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 100-foot linear distance of the infiltration gallery or the wells.
(5) Junkyards.
No junkyard shall be located within a 500-foot linear distance of the infiltration gallery or the wells.
(6) Manure piles.
No manure piles or compost heap shall be maintained or allowed to remain within a 500-foot linear distance of the infiltration gallery or the wells; nor shall manure be spread on the surface of the ground on the drainage area of the infiltration gallery within a 500-foot linear distance of the infiltration gallery or the wells.
(7) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located or maintained at a distance less than 500 feet from the infiltration gallery or the wells.
(8) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 1,000-foot linear distance of the infiltration gallery or the wells, or otherwise disposed of by any other means within a 1,000-foot to a 2,000-foot linear distance of the infiltration gallery or the wells unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(9) Refuse.
No refuse shall be deposited in the infiltration gallery nor on or beneath the surface of the ground within a 500-foot linear distance of the infiltration gallery nor in such a manner of or through the ground into the infiltration gallery or the wells.
(10) Refuse disposal area.
No refuse shall be located within a 1,000-foot linear distance of the infiltration gallery or the wells.
(11) Sludge lagoons.
No sludge lagoon shall be located within a 1,000-foot linear distance of the infiltration gallery or the wells.
(12) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 1,000-foot linear distance of the infiltration gallery or the wells, except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(13) Trespassing.
No trespassing shall be allowed upon the property of the Village of Maybrook upon which the infiltration gallery and wells are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Maybrook.
(14) Other wastes.
No pollutant of any kind shall otherwise be discharged, deposited, or allowed to flow into the watercourse or on or beneath the surface of the ground on the watershed within 500 feet of the infiltration gallery, except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(e) Inspection.
The board of trustees of the Village of Maybrook or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Maybrook or the duly appointed representative of any such board shall make regular and thorough inspections of the infiltration gallery and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with; and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the said board to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding yer, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition surrounding the infiltration gallery at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.230 Operating revenue
Operating revenue includes revenue directly related to the rendering of patient care services and revenue from nonpatient care services to patients and sales and activities to persons other than patients.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.9 Technical supervisor; qualifications and certification
(a) The commissioner may authorize certification of an applicant as technical supervisor for a period of four years, provided such applicant submits satisfactory evidence through the training agency that he/she meets the following qualifications:
(1) thirty semester hours of college credits, including eight semester hours of chemistry;
(2) certification as an operator of the breath analysis instrument(s) to be supervised, or possession of equivalent experience or training to qualify as an operator; and
(3) satisfactory completion of a technical supervisor's course, the content of which shall include:
(i) advanced survey of current information concerning alcohol and its effect on the human body (one hour);
(ii) operational principles and theories applicable to the program (two hours);
(iii) breath analysis instrument maintenance and calibration (two hours);
(iv) legal aspects of chemical testing (one hour); and
(v) principles of instruction (two hours); or
(4) training and experience equivalent to a technical supervisor's course and acceptable to the commissioner.
(b) A technical supervisor's certificate may be terminated by the commissioner based on documented evidence that the technical supervisor's performance is not in keeping with the best interests of the breath alcohol testing program.
(c) A technical supervisor shall have responsibility for:
(1) breath analysis instrument operator training, competency evaluation and periodic examination to ensure maintenance of technical knowledge and proficiency;
(2) maintenance, including calibration of breath analysis instruments and equipment under his/her supervision and preparation and standardization of chemicals used for testing and/or evaluation of such chemicals, by direct performance of such tasks or by delegating performance to another person with demonstrated competency, but who need not be qualified as a technical supervisor; provided, however, whenever such tasks are so delegated, the technical supervisor shall review the work product to ensure that the assigned designee's performance meets expectations; and
(3) periodic inspection of breath analysis instrument performance.
(d) A technical supervisor's certificate may be renewed for a period of four years upon submission of a written application and statement that he/she has carried out his/her duties in accordance with this Part. Suspension or revocation pursuant to section 59.8 of this Part of a breath analysis instrument operator's permit held by a technical supervisor shall result in suspension or revocation, respectively, of the individual's certification as a technical supervisor.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.3 Permit for operation, inspections, access
(a) The operation of an agricultural fairground without a permit is prohibited unless the commissioner has determined, pursuant to section 7-5.2 of this Subpart, that compliance with the requirements of this Subpart is not necessary to protect public health.
(b) Application for permit.
An application for a permit to operate an agricultural fairground shall be submitted by a person who owns an agricultural fairground to the permit-issuing official at least 30 days before initial operation or the expiration of an existing permit.
(c) An application for a permit to operate an agricultural fairground may be denied when the applicant has previously failed to comply with one or more requirements of this Subpart, the agricultural fairground is a potential source of danger to the general public or persons at the agricultural fairground, or the agricultural fairground does not comply with one or more requirements of this Subpart.
(d) A permit to operate an agricultural fairground shall be issued for a period of not more than one year from the date of issue. A conditional permit may be issued in recognition of partial use of the fairground facility. A permit shall not be transferable or assignable and shall expire upon a change of the owner of the agricultural fairground, upon the date stipulated by the permit-issuing official or upon its revocation.
(e) Revocation, suspension.
A permit to operate an agricultural fairground may be revoked or suspended by the permit-issuing official or the State Commissioner of Health if the agricultural fairground for which the permit was issued is found to have been maintained, operated or occupied in violation of the Public Health Law, the State Sanitary Code, or the sanitary code of the health department having jurisdiction over the agricultural fairground. A permit may be revoked upon request of the permittee or upon abandonment of operation.
(f) Any permit-issuing official, and his or her designees, shall be allowed entry at any reasonable time to inspect any property operated or believed to be operated as an agricultural fairground.
(g) A separate permit for a food service establishment, temporary residence or campground operating within the agricultural fairground shall not be required unless such food service establishment, temporary residence or campground is operated by a person other than the owner of the agricultural fairground.
(h) A permit to operate an agricultural fairground shall be posted in a conspicuous place on the premises.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.55 Capital asset
(a) An asset intended for continued use or possession.
(b) Common subclassifications are:
(1) land, buildings and equipment, leaseholds (fixed assets);
(2) goodwill, patents, trademarks, franchises (intangibles);
(3) investments in affiliated companies.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.186 Embargo
(a) The permit-issuing official or his designated representative may, by written order, place an embargo order on any food which he determines or has reason to believe to be contaminated, unfit for human consumption, or from an unapproved source. Such food may not be used, sold, donated, discarded, repackaged or otherwise disposed of until such embargo is lifted by the permit-issuing official, his designated representative, or court of competent jurisdiction. The permit-issuing official shall provide the owner of the food embargoed, or the representative of the owner, an opportunity to be heard within 15 calendar days after the date of order of embargo. The hearing officer, based on the evidence produced at such hearing, will make a recommendation to the permit-issuing official that he vacate the order or embargo, or may, by written order, direct the embargoed food, or any part of it, to be continued to be held under embargo pending further testing, analysis or court action, to be destroyed, to be denatured and rendered inedible, to be released for return to a food processing plant for further processing, or to be released to another regulatory agency. The permit-issuing official will consider the hearing officer's recommendation in determining the disposition of the embargoed food.
(b) The owner of the food embargoed shall be deemed to have received notice of embargo and hearing at the time the notice of embargo and hearing is delivered to any of his employees or agents.
(c) The permit-issuing official or his designated representative may take representative samples of the suspected food for analysis upon payment of retail value of the sample taken.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.14 Request for patient review instrument (PRI) data
(a) For purposes of this section, PRI data shall mean that data submitted by a residential health care facility on the PRI forms submitted pursuant to section 86-2.30 of this Part.
(b) All requests for PRI data shall be processed pursuant to section 400.18 of this Part.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.127 Fidelity bond
Insurance against losses arising from dishonest acts of employees involving money, merchandise or other property.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 118 GREENE COUNTY
10 CRR-NY 118.3 Village of Coxsackie
L. 1893, ch. 661
(a) [Human excreta.]
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind, the water in which, when running, flows eventually into a reservoir of the public water supply of the village of Coxsackie.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir or within 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse, as aforesaid.
(3) Every privy or place for the deposit of human excreta which is constructed, located or maintained between the aforesaid limits of 50 and 250 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir or 50 and 130 feet, horizontal measurement, from the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid and from which the said excreta is not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of disposal beyond the maximum aforesaid limit shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limit.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or floor of said privy.
(5) The excreta so collected shall be removed so as to cause the least possible nuisance and shall be so disposed of that they can not be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink waste, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid nor shall any cattle, horses, sheep, swine or other animals be allowed to enter, wallow or stand in any reservoir, spring, stream, ditch or watercourse aforesaid.
(c) Garbage and refuse.
No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be placed upon or below the surface of the ground where they may be washed into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark or precipitous bank thereof.
(d) Manures, composts and similar matter.
(1) No stable, pigsty, henhouse, stableyard, barnyard, hogyard, duckyard, hitching or standing place for horses or cattle nor any compost or manure heap nor other place where animal manure accumulates shall be located or maintained within 100 feet of any reservoir, spring, stream, ditch or watercourse aforesaid. These and also watering places for horses or cattle or other animals must be so arranged that the polluted drainings therefrom shall not flow into any such reservoirs, springs, streams, ditches or watercourses without having undergone proper purification. Such drainings shall not be allowed to flow through open or covered drains within 50 feet of the highwater mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse as aforesaid without having undergone proper purification.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir or within 130 feet of the high-water mark or precipitous bank of any stream, spring, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so as to be washed a less distance than 50 feet over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish, or part thereof, nor any filty or impure matter, nor any decayed fruit or vegetable substance, nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface or less than 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid, without having undergone proper purification.
(f) [Cemeteries.]
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(g) Management of the reservoirs.
(1) The reservoirs of the Coxsackie public water supply shall not be unnecessarily drawn down during the warm months but shall be kept as deep and as nearly at a uniform level as possible to prevent the pollution of the water with dead organic matter.
(2) No filter or screen shall be used when in a filthy condition and liable to pollute the water in the mains, and no filter or screen shall be used at the head of the main which cannot be constantly examined and cleaned.
(h) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, a penalty of $50 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above-given mandatory rules or regulations, to be recovered under the said act.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter N PROFESSIONAL MEDICAL AND DENTAL SERVICES
Part 91 EXCESS LIABILITY INSURANCE POOL: PHYSICIANS AND DENTISTS
10 CRR-NY 91.1 Required excess malpractice coverage
(a) The provisions of this Part shall be contingent upon extension of L. 1986, ch. 266, or upon enactment of permanent statutory authority. The provisions of this Part shall apply to excess insurance coverage for medical or dental malpractice occurrences during the period July 1, 1986 through June 30, 1987, and annual periods beginning July 1st thereafter. The Superintendent of Insurance and the Commissioner of Health shall create and oversee a hospital excess liability pool, and the superintendent and commissioner, or their designee, shall from funds available in such pool purchase a policy or policies for excess insurance coverage or equivalent excess coverage in a form previously approved by the Superintendent of Insurance for medical or dental malpractice occurrences between July 1, 1986 and June 30, 1987, and annual periods beginning July 1st, thereafter, for physicians or dentists certified eligible pursuant to this Part or reimburse the hospital where the hospital purchases equivalent excess coverage for medical or dental malpractice occurrences between July 1, 1987 and June 30, 1988, and annual periods beginning July 1st, thereafter, for physicians or dentists certified eligible pursuant to this Part participating in a voluntary attending physician (channeling) program. Such physicians or dentists must have in force an individual policy, from an insurer licensed in the State, of primary malpractice insurance coverage in amounts of no less than $1 million for each claimant and $3 million for all claimants under that policy during the period of such excess coverage for such occurrences or be endorsed as additional insureds under a hospital professional liability policy which is offered through a voluntary attending physician (channeling) program previously permitted by the Superintendent of Insurance during the period of such excess coverage for such occurrences. During this period, the policy for excess coverage shall, when combined with the physician's or dentist's primary malpractice insurance coverage or coverage provided through a voluntary attending physician (channeling) program, total an aggregate level of $2 million for each claimant and $6 million for all claimants from all such policies in such years.
(b) Equivalent excess coverage.
(1) Equivalent excess coverage shall mean:
(i) a policy or policies of insurance, approved by the Superintendent of Insurance, or such other form of coverage previously permitted by the Superintendent of Insurance for voluntary attending physician (channeling) programs insuring a physician or dentist against medical or dental malpractice with an aggregate level of coverage providing not less than $2 million for each claimant and $6 million for all claimants during the policy period. Such coverage limits shall be reduced by payments made on behalf of such physician or dentist under a hospital professional liability policy written pursuant to a voluntary attending physician (channeling) program previously permitted by the Superintendent of Insurance, in an amount not to exceed $2 million for each claimant and $6 million for all claimants during such policy period for each such physician or dentist; or
(ii) an individual policy or policies of insurance, approved by the Superintendent of Insurance, or such other form of coverage previously approved by the Superintendent of Insurance for the purposes of providing equivalent excess coverage in accordance with section 19 of Chap. 294 of the Laws of 1985 purchased by a hospital insuring a physician or dentist against medical or dental malpractice with an aggregate level of coverage providing not less than $1 million for each claimant and $3 million for all claimants during such policy period. Such coverage shall be in excess of primary malpractice coverage in effect on an individual policy written by an authorized insurer with limits of not less than $1 million for each claimant and $3 million for all claimants during such policy period.
(2) Every plan pursuant to subparagraph (1)(i) of this subdivision for such equivalent excess coverage shall provide for payment only after coverage available through the voluntary attending physician (channeling) program has been exhausted during such policy period.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.8 Designation of lead agency and determination of significance for unlisted actions
(a) The provisions of this section shall govern the designation of lead agency and determination of significance for all unlisted actions. These provisions are designed to simplify the SEQR procedure that applies to unlisted actions.
(1) When the department is reviewing an unlisted action, coordinated review is required only when it determines that an EIS will be prepared. If the department determines that the unlisted action will not have a significant effect on the environment, coordinated review and notification is strictly optional. However, if the department or applicant wants to finalize, in the shortest possible time, lead agency status and the agency's determination of nonsignificance, the department or applicant may follow the notification procedures specified in subdivision (d) of this section. Unless and until written notification of lead agency status and determination of significance has been given to all other involved agencies, each subsequent involved agency shall make its own determination of significance and may require an EIS.
(2) When the optional coordinated review is not employed for unlisted actions and the lead agency status is not confirmed, the department's determination of nonsignificance can be superseded at any time, until one of the following occurs:
(i) all involved agencies receive written notification pursuant to subdivision (d) of this section and fail to respond to the notice within the prescribed time period; or
(ii) all involved agencies have issued all final decisions on the action.
(b) An EAF shall be submitted when requested by the department but is not required in connection with every unlisted action. An applicant may, instead, submit a short form EAF. If, however, after considering a completed short form EAF, the department has insufficient information on which to base its determination of the environmental significance of an action, the applicant shall submit a standard form EAF.
(c) As early as possible in the formulation of plans for an unlisted action to be directly undertaken, or within 15 days of receipt of a complete application for funding or approval of an unlisted action, the department shall make a initial determination of the significance of the action in accordance with sections 97.13 and 97.14 of this Part.
(d) The department or applicant, if it chooses to coordinate the review of involved agencies and promptly designate a lead agency and confirm initial determinations of significance, may ascertain, exercising all due diligence, all other involved agencies and notify such agencies of the initial determination, supplying them with a copy of any EAF and any applications which have been prepared, and reasons supporting the initial determination.
(e) If, within 15 calendar days from the date of mailing notification described in subdivision (d) of this section, no involved agency submits a written objection to the department, the department shall be the lead agency and shall:
(1) follow the provisions of section 97.9 of this Part if it has determined an EIS is required; or
(2) maintain a file of its determination and supporting reasons available for public inspection, if it has determined an EIS is not required.
(f) If, within 15 calendar days from the date of notification described in subdivision (d) of this section, any involved agency submits a written objection to the department's determination to be the lead agency, it shall be the responsibility of all involved agencies to follow the procedures prescribed in subdivisions (d) and (e) of section 97.7 of this Part, and subdivisions (d) and (e) of section 617.6 of 6 NYCRR, for designation of lead agency. The department, if it is lead agency, shall then determine significance of the action and, if appropriate, proceed as described in section 97.9 of this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.17 Exclusion of outlier and transfer costs
(a) In calculating rates pursuant to this Subpart, high-cost outlier costs from hospitals with ancillary and routine charges schedules shall be excluded from the statewide base price and shall equal 100 percent of the excess costs above the high cost outlier threshold which shall be developed using acute Medicaid operating costs derived from the base period used to calculate the statewide base price. The Medicaid discharges to be applied to the high-cost outlier thresholds shall be those that occurred in the base period used to calculate the statewide base price.
(b) In calculating rates pursuant to this Subpart, transfer case costs shall be excluded from the statewide base price by excluding the transfer discharges that occurred in the base period used to calculate the statewide base price, except for those transfer cases that are assigned to a DRG specifically identified as a DRG for transferred patients only.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.90 Machine construction
(a) The vending machine is to be of sturdy construction and the exterior is to be designed, fabricated, finished and maintained to be easily cleanable and minimize the entrance of insects and rodents. The exterior of the machine is to be kept clean.
(b) Door and panel access openings to the food and container storage spaces of the machine are to be tight-fitting and, when necessary, gasketed to prevent the entrance of dust, moisture, insects and rodents.
(c) Ventilation louvers and openings into vending machines are to be effectively screened. Screening material for openings into food and container storage spaces of the machine are to be not less than 16 mesh to the inch or equivalent. Screening material for openings into condenser units which are separated from food and container storage spaces are to be not less than 8 mesh to the inch or equivalent.
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.24 Sanitation of equipment and implements
(a) Hair brushes, combs and all other implements used on a customer shall be kept clean and sanitary at all times and shall undergo thorough cleansing after serving each customer.
(b) After handling a customer affected with an eruption, or whose skin is broken out, or is inflamed, or contains pus, the instruments shall be effectively cleaned, washed with soap or a detergent and water, then rinsed with water having a temperature of at least 170 degrees Fahrenheit or allowed to remain for five minutes in alcohol (70 per cent—80 per cent) or some other equally efficient disinfectant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.4 Pharmacies engaged in drug take back
Notwithstanding any provision of section 60-4.1 of this Subpart, for the purposes of this section, a pharmacy shall also include any pharmacy located in the state and that, though not required to by article 2-B of the Public Health Law, voluntarily participates in an authorized drug take back program. Pharmacies participating in drug take back shall:
(a) Be properly registered under section 6808 of the Education Law or, in the case of non-resident pharmacies, be registered under section 6808-b of the Education Law.
(b) If maintaining an onsite collection receptacle, modify existing registration to obtain authorization from the DEA to be a collector.
(c) Comply with all Federal laws and regulations concerning the disposal of controlled substances.
(d) Notify the department and any contracted drug take back program operator, as applicable, within 30 days of drug take back program discontinuance or change of address of collection activity.
(e) If maintaining a collection receptacle:
(1) utilize a collection receptacle that meets the requirements of section 60-4.5 of this Subpart and all applicable Federal laws and regulations;
(2) collection receptacle placement:
(i) receptacles accessible to the public, shall be located in the immediate proximity of the registered pharmacy area where prescription drugs are stored and be easily and regularly monitored by the pharmacist or pharmacy staff; or
(ii) receptacles located in a residential health care facility shall be located in a secured area regularly monitored by residential health care facility employees;
(3) ensure proper operation of the collection receptacle, which includes but is not limited to periodic monitoring to determine when it is full; removing and replacing the inner liner when it is full; and arranging for delivery of sealed inner liners and their contents to a reverse distributor’s registered location by common or contract carrier pickup or by reverse distributor pickup;
(4) ensure that receptacle box liners that are removed are safely and securely stored until retrieved by the reverse distributor or by common or contract carrier;
(5) ensure that pharmacy employees do not handle drugs for disposal, review the contents of the collection receptacle, remove, count, weigh, consume, repurpose, restock, redispense, resell, or touch items placed in the collection receptacle;
(6) ensure the sealed inner liners and their contents are shipped to a reverse distributor's registered location by common or contract carrier or by licensed reverse distributor pick-up at the licensed pharmacy's or residential health care facility’s premises.
(f) Report to the department immediately, and in any event within 24 hours of discovery of tampering with, or damage to, a collection receptacle, or diversion or theft of deposited contents, or any tampering with, damage to, or theft of a removed liner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.7 Treatment planning
(a) Behavioral health treatment planning is an ongoing process of assessing the behavioral health status and needs of the patient, establishing his or her treatment and rehabilitative goals, and determining what services may be provided by the program to assist the patient in accomplishing these goals. An integrated services provider offering behavioral health services shall provide patient-centered treatment planning for each patient as set forth in this section. The treatment planning process is a means of reviewing and adjusting the services necessary to assist the patient in reaching the point where he or she can pursue life goals, without impediment resulting from his or her illness. The treatment planning process includes, where appropriate, a means for determining when the patient's goals have been met to the extent possible in the context of the programs offered by the integrated services provider, and planning for the appropriate discharge of the patient from the program.
(b) Patient participation in treatment planning shall be documented by the signature of the patient or the signature of the person who has legal authority to consent to care on behalf of the patient or, in the case of a child, the signature of a parent, guardian, or other person who has legal authority to consent to health care on behalf of the child, as well as the child, where appropriate, provided, however, that the lack of such signature shall not constitute noncompliance with this requirement if the reasons for non-participation by the patient are documented in the treatment plan. The patient's family and/or collaterals ( i.e. , significant others) may participate as appropriate in the development of the treatment plan and shall be specifically identified in the treatment plan.
(c) Each patient must have a written patient-centered treatment plan developed by the responsible clinical staff member and patient. Standards for developing a treatment plan include, but are not limited to:
(1) for mental health or substance use disorder behavioral care host models, treatment plans shall be completed no later than 30 days after admission. For primary care host models, treatment plans shall be completed no later than 30 days after the decision to begin any mental health and/or substance use disorder services beyond pre-admission services;
(2) notwithstanding other provisions of this section, services provided to a recipient enrolled in a managed care plan which is certified by the commissioner or a commercial insurance plan which is certified or approved by the Superintendent of Financial Services, treatment plans shall be prepared pursuant to the requirements of the managed care plan or commercial insurance plan;
(3) if the patient is a minor, the treatment plan must also be developed in consultation with his/her parent or guardian unless the minor is being treated without parental consent as authorized by MHL section 22.11 or 33.21, as applicable;
(4) for patients moving directly from one program offered by an integrated services provider to another program offered by the same provider, whether or not it is a program approved to provide integrated services, the existing treatment plan may be used if there is documentation that it has been reviewed and, if necessary, updated within 14 days of transfer.
(d) The treatment plan shall include physical health, behavioral health, and social services needs. In addition, specific consideration of the need for health home care coordination should be noted when appropriate.
(e) The treatment plan shall include identification and documentation of the following:
(1) patient-identified problem areas specified in the admission assessment;
(2) treatment goals for these problem areas (unless deferred);
(3) objectives that will be used to measure progress toward attainment of treatment goals and target dates for achieving completion of treatment goals;
(4) methods and treatment approaches that will be utilized to achieve the goals developed by the patient and primary counselor;
(5) schedules of individual and group counseling;
(6) each diagnosis for which the patient is being treated at the program;
(7) descriptions of any additional services ( e.g. , vocational, educational, employment) or off-site services needed by the patient, as well as a plan for meeting those needs; and
(8) the signature of the qualified health professional, or other licensed individual within his/her scope of practice, involved in the treatment and responsible for review of the treatment plan.
(f) All treatment plans shall be reviewed and updated as clinically necessary based upon the patient’s progress, changes in circumstances, the effectiveness of services, and/or other appropriate considerations. Such reviews shall occur no less frequently than every 90 days or by the next occasion when a service is to be provided to the patient, whichever shall be later. For services provided to a recipient enrolled in a managed care plan which is certified by the commissioner or a commercial insurance plan which is certified or approved by the Superintendent of Financial Services, treatment plans may be reviewed pursuant to such other plan requirements as shall apply.
(g) Treatment plan reviews shall include the input of relevant staff, as well as the recipient, family members and collaterals, as appropriate. The periodic review of the treatment plan shall include the following:
(1) assessment of the progress of the patient in regard to the mutually agreed upon goals in the treatment plan;
(2) adjustment of goals and treatment objectives, time periods for achievement, intervention strategies or initiation of discharge planning, as appropriate;
(3) an evaluation of physical health status; and
(4) the signature of the qualified health professional, or other licensed individual within his/her scope of practice, involved in the treatment and responsible for review of the treatment plan.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.1 Purpose
The purpose of this Subpart is to apply audit and reporting standards upon managed care organizations (MCOs). These standards are modeled on the standards imposed on public companies by the Sarbanes-Oxley Act of 2002.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.52 Sale of food forbidden in certain cases.*
When a case of diphtheria, streptococcal sore throat (including scarlet fever), shigellosis (bacillary dysentery), salmonella infection (including paratyphoid fever), or typhoid fever exists on any farm or dairy producing milk, cream, butter, cheese, or other milk products, no such substances shall be sold or delivered from such farm or dairy, except to a plant in which all the milk, cream or milk products before delivery to the consumer, are:
(a) pasteurized; or
(b) made into evaporated milk, condensed milk, dried milk, butter or cheese, in the process of which the milk or the product undergoes heating equivalent to pasteurization; or
(c) made into cheese which is allowed to ripen or cure at a temperature of not less than 35 degrees Fahrenheit for a period of not less than 60 days.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.7 Injury and illness reporting and recordkeeping requirements
(a) A full report of specific injuries or illnesses occurring as a result of using an ultraviolet radiation device shall be made by the operator to the PIO within 24 hours of notification of its occurrence. Reportable injuries and illnesses shall include:
(1) all eye injuries requiring medical attention;
(2) all burns requiring medical attention;
(3) any other injury or illness incident resulting from the use of an ultraviolet radiation device for which medical care has been obtained.
(b) Details of any reportable injury or illness shall be entered on a form prescribed by the department. Forms shall be maintained at the tanning facility for a minimum of two years and must be available for review by the PIO.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
STANDARDS STANDARDS
10 CRR-NY 15.7 Water
Every water supply serving a migrant farmworker housing facility shall comply with requirements of Part 5 of this Title, and, in addition, shall meet the following requirements:
(a) The water supply shall not exceed the maximum contaminant levels in sections 5-1.51 and 5-1.52 contained in Subpart 5-1 of this Title.
(b) Minimum standards.
Potable water shall be adequate in quantity and quality and shall be readily available to occupants of the property. Only potable water shall be so delivered or piped as to be easily accessible.
(c) Source Protection.
All potable water sources and distribution systems shall be designed, located, constructed and maintained to provide protection against contamination or pollution. All pumps, piping, fixtures and appurtenances shall be adequately installed and maintained to protect against contamination of any water source.
(d) Connections prohibited.
There shall be no physical connection between the potable water supply and any non potable water supply. Any fixture, installation or equipment which is subject to back-siphonage shall be adequately installed and maintained to protect against contamination of any water source.
(e) A minimum pressure of 20 pounds per square inch, at peak demand, shall be maintained in all parts of the distribution system.
(f) Reports on water treatment.
When a water treatment process is required to maintain adequate water quality, accurate and complete reports on the operation of the treatment system shall be maintained daily and submitted at least monthly to the permit issuing official on a form supplied for this purpose.
(g) Interruptions, changes in sources or treatments.
Any incident or condtion which effects the quantity or quality of the onsite potable water supply shall be reported to the permit issuing official within 24 hours of occurrence. There shall be no changes made to the source, or method of treatment of a potable water supply, either temporary or permanent, without first receiving approval from the permit issuing official. An adequate supply of potable water must be provided and maintained during all times of operation.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.17 Lighting and electrical requirements
(a) Lighting or other electrical circuits provided in the spray pad area must be protected by ground-fault circuit interrupters in accordance with the Uniform Code.
(b) Defects in the electrical system, including overhead lights and their respective lenses, shall be immediately repaired.
(c) Portable electrical devices, such as announcing systems and radios within the reach of patrons on the spray pad, shall be prohibited.
(d) At all indoor spray pads and spray pads used at night, surface lighting shall be adequate to allow an observer to clearly see the spray pad and deck.
(e) Operators of existing spray grounds shall possess a certificate of electrical compliance with the Uniform Code issued by the New York Board of Fire Underwriters or equivalent certifying agency.
(f) No overhead electrical wiring shall pass within 20 feet horizontally of the spray pad.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 139 ROCKLAND COUNTY
COMPANIES COMPANIES
10 CRR-NY 139.15 Haverstraw Water Supply Company (New York Water Service Corporation)
(a) [Application.]
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs of the Haverstraw Water Supply Company (New York Water Service Corporation), Haverstraw, New York, and to all watercourses tributary thereto or ultimately discharging into said reservoirs, except as noted specifically in subdivisions (e) and (f).
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Haverstraw Water Supply Company (New York Water Service Corporation).
(2) The term reservoir means the reservoirs serving as sources of water supply of the villages of Haverstraw and West Haverstraw and portions of the town of Stony Point, Rockland County, New York, and shall include any additional reservoir which may be constructed or used for said water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of a watercourse.
(5) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(7) For the purpose of regulating bathing, fishing, boating and ice cutting (restricted under subdivisions [e] and [f]) according to the danger of pollution arising in proportion to the remoteness from the intake on Cedar Pond Brook of the Haverstraw Water Supply Company (New York Water Service Corporation) the drainage area will be considered as consisting of two separate districts as follows:
(i) District A shall include that portion of the watershed tributary to Cedar Pond Brook between the water works intake and a point two miles upstream from this intake, and also all the watershed tributary to any reservoirs on other watercourses which serve as sources of water supply of the Haverstraw Water Supply Company (New York Water Service Corporation).
(ii) District B shall include the remaining area tributary to Cedar Pond Brook beyond the point two miles upstream from the water works intake.
(c) [Human excreta]
(1) No human excreta shall be deposited, thrown or placed in or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 300 feet from any reservoir or watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 50 feet of any reservoir or watercourse of the water supply of the Haverstraw Water Supply Company (New York Water Service Corporation), except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (1) of subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(5) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 150 feet of any reservoir or watercourse of the water supply of the Haverstraw Water Supply Company (New York Water Service Corporation). Every privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta, built or to be built on property which is so located, bounded, or otherwise placed that the distance mentioned above in this paragraph cannot be obtained, shall be placed as far as possible from any reservoir or watercourse of the water supply of the Haverstraw Water Supply Company (New York Water Service Corporation) and then only with the approval and under the supervision of said company and in such a manner as effectually to prevent any pollution of the public water supply.
(6) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta, which is constructed, located, maintained or allowed to remain within the limiting distance prescribed and stated by paragraph (5) of this subdivision from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth. Every privy or receptacle of any kind for the storage or deposit of human excreta, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (1) of subdivision (d), built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constucted or installed only with the approval and under the supervision of the Haverstraw Water Supply Company (New York Water Service Corporation), Haverstraw, New York, and in such manner as effectually to prevent any pollution of the public water supply.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) [Sewage, wastes, refuse.]
(1) No house slops, bath water, sewage or excremental matter from any water closet, privy or cesspool shall be thrown, placed, led, conducted, discharged or allowed to escape or flow from any pipe, drain or ditch either directly or indirectly into any reservoir or watercourse of the water supply of the Haverstraw Water Supply Company (New York Water Service Corporation), nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground below the surface within 300 feet of any such reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or 75 feet of any watercourse.
(3) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(e) [Bathing.]
(1) Within District A, no person shall be allowed to bathe in any reservoir or watercourse nor shall any animal or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein.
(2) Within District B, bathing will be permitted in reservoirs and watercourses, providing said bathing is carried on in strict accordance with rules and regulations which may be established by the Haverstraw Water Supply Company (New York Water Service Corporation), subject to review and amendment by the State Commissioner of Health, for the sanitary protection of their water supply and providing a filtration plant for this water supply is in operation.
(f) [Fishing, boating, ice cutting.]
(1) Within District A, no fish shall be taken from any reservoir or watercourse, nor shall any person fish in any reservoir or watercourse or through the ice upon the same nor trespass upon the waters of any reservoir or watercourse or the ice thereon nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the Haverstraw Water Supply Company (New York Water Service Corporation) in the exercise of their duties in the management and operation of the reservoirs; nor shall any person or persons cut or remove any ice from any of the reservoirs within District A which form or are tributary to the sources of the public water supply furnished by the Haverstraw Water Supply Company (New York Water Service Corporation).
(2) Within District B, fishing, boating and ice cutting may be carried on providing such operations are conducted with strict sanitary precautions for adequately safeguarding the waters of this public water supply and providing said operations are carried on in strict accordance with such rules and restrictions as may be established by the Haverstraw Water Supply Company (New York Water Service Corporation), subject to review and amendment by the State Commissioner of Health.
(g) [Animals.]
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(h) [Manure.]
No manure pile shall be maintained or allowed to remain within 150 feet of any reservoir or 50 feet of any watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) [Camps.]
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained on his own property by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the water supply.
(j) [General clause.]
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(k) [Inspections.]
The Haverstraw Water Supply Company (New York Water Service Corporation) or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the Haverstraw Water Supply Company (New York Water Service Corporation) shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Haverstraw Water Supply Company (New York Water Service Corporation) to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said Haverstraw Water Supply Company (New York Water Service Corporation) to promptly notify the State Commissioner of Health of such violations. The Haverstraw Water Supply Company (New York Water Service Corporation) shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.25 Leave for civil defense duties
Upon certification by the State Director of Civil Defense of the necessity for the participation in State or local civil defense drills of an employee enrolled as a civil defense volunteer and required to perform civil defense duties pursuant to the State Defense Emergency Act, the department may allow such employee to absent himself from his position, without loss of pay or charge against leave credits, for such time as is necessary for participation in such drills, but not exceeding cumulatively five work days per calendar year.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.11 Treatment
All spray grounds shall be equipped with a recirculation system which includes filtration and disinfection facilities to provide water quality consistent with the bacteriological, chemical and physical standards required in Section 6-3.19 of this Subpart. The filtration and chemical treatment systems for the spray pad treatment tank must operate 24 hours a day.
(a) Recirculation rate.
The spray pad treatment tank water must be re-circulated and treated in accordance with the approved design rates.
(b) Filtration.
(1) Sand filters.
(i) High-rate sand filters (pressure or vacuum) can be operated at a filter rate up to 15 gallons per minute (gpm)/square foot (sf).
(ii) Filter air release valves shall be opened daily or more frequently if necessary to remove air, which collects in the filters.
(iii) Sand filters shall be backwashed at a flow rate of 12 to 15 gpm/sf or at the design rate recommended by the manufacturer.
(2) Diatomaceous earth filters.
(i) Diatomaceous earth filters shall be properly maintained and operated according to the manufacturer's instructions and at a filter rate not to exceed two gpm/sf with body feed or 1.5 gpm/sf without body feed.
(ii) Diatomaceous earth filter backwash water must discharge to the sewer system through a separation tank. The separation tank sludge shall be disposed of or treated as a solid waste material in accordance with local and State laws, rules and regulations.
(3) Cartridge filters.
(i) Cartridge filters shall be operated at a filter rate not to exceed a maximum of 0.375 gpm/sf.
(ii) Cleaning of cartridge filters must be in accordance with the manufacturer's recommendations. One complete spare set of cartridges shall be available at all times to facilitate cleaning.
(4) Flow measurement. All flow meters shall be maintained in accordance with provisions in section 6-3.24(f)(8) of this Subpart.
(c) Disinfection/chemical treatment.
An automatic controller is required for monitoring and adjusting the level of free residual disinfectant and pH in the spray pad treatment tank. The following chemical disinfectants have been approved for use in spray grounds:
(1) Disinfection with chlorine. When calcium hypochlorite or sodium hypochlorite are used to disinfect a spray pad and the spray pad treatment tank the dose of chlorine or chlorine compound shall be sufficient to maintain a concentration of at least 2.0 mg/l free chlorine throughout the system including the treatment tank and water emanating from the spray features. A free chlorine residual of 10.0 mg/l shall not be exceeded in any spray pad treatment tank during use. All chlorine solutions shall be added to the spray pad water by chemical feed equipment conforming with standards contained in section 6-3.24(h)(1) of this Subpart.
(i) Handling of calcium hypochlorite. When calcium hypochlorite is used as a disinfectant, extreme caution must be taken in the handling and mixing of the chemical to avoid possible fire and explosion hazards. A dry, aboveground, locked storage area shall be provided. Clean inert materials shall be used, and mixing must be by pouring the chemical into water and never by pouring water into the chemical.
(2) Disinfection with bromine. When bromine is used as the disinfectant, the following shall be followed:
(i) bromine shall be fed on a continuous basis;
(ii) a concentration of at least 4.4 mg/l bromine residual shall be maintained throughout the system including the spray pad treatment tank water and water emanating from the spray features; and
(iii) solid-stick or tablet-type bromine (brom-chlor-dimethyl-hydantoin) shall be used with feed equipment conforming to the standards contained in section 6-3.24(h)(iv) of this Subpart.
(3) Disinfection with ultraviolet light. Ultraviolet light disinfection is required in addition to an approved chemical disinfectant listed in this section and shall be used as follows, unless another treatment process has been approved in accordance with section 6-3.24(h)(3)(i) of this Subpart:
(i) ultraviolet light shall be used to disinfect water provided to the spray pad in accordance with the approved plans and specifications;
(ii) ultraviolet light disinfection systems shall have a properly calibrated light intensity meter, automatic water flow shutoff in the event the light intensity decreases below the manufacturer's recommended level for the flow rate and an alarm to advise the attendant of a system malfunction;
(iii) the ultraviolet light units shall be cleaned in accordance with the manufacturer's recommendations;
(iv) the ultraviolet light unit's ultraviolet light intensity meter reading shall be monitored and recorded as least two times daily. When the output intensity falls below the setpoint intensity, conditions causing decreased ultraviolet light intensity at the sensor shall be evaluated and corrected. The ultraviolet lamp(s) shall be replaced when the decreased ultraviolet light intensity is due to lamp failure;
(v) an operation log shall be maintained at the facility and entries shall be made for dates and type of maintenance and repair, including cleaning, lamp replacement, etc.; and
(vi) lamps shall be replaced in accordance with manufacturer's recommendations.
(4) Positive feed equipment shall be provided for pH control and the spray pad treatment tank water pH shall be maintained between 7.2 and 7.8.
(5) Other disinfectants. Disinfectants other than those listed above may be used only if the State Commissioner of Health determines they are safe and effective when used in accordance with the manufacturer's directions.
(6) Test kits/testing. DPD test kits with reagents no more than one year old capable of measuring pH and chlorine or bromine residuals, shall be available at each spray ground. Tests shall be conducted and recorded for pH and free and total chlorine or bromine residual at the beginning, during, and at the end of each use period. Where required, reagents for alkalinity and hardness tests shall be available. Where ozone generating equipment is installed, ozone testing shall be conducted in accordance with section 6-3.24(h)(5)(i) of this Subpart.
(d) Chemicals.
Only chemicals approved for water supply use by the U.S. Environmental Protection Agency, as food additives by the U.S. Food and Drug Administration, or by the State Commissioner of Health, shall be used in spray grounds. Where equipment for chemical addition is required, it shall be installed and operated in accordance with section 6-3.24(h) of this Subpart. All chemical containers, including those used with chemical feeders, must be clearly labeled regarding their contents.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 148.26 Youngsville Water District, town of Callicoon
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Killian Brook and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Youngsville Water District, in the town of Callicoon, Sullivan County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoir on Killian Brook, which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Youngsville Water District.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Youngsville Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the Youngsville Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the Youngsville Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Youngsville Water District, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 200 feet of any watercourse tributary to the public water supply of the Youngsville Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Youngsville Water District, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Youngsville Water District.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the Youngsville Water District.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the Youngsville Water District. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Youngsville Water District.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Youngsville Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Youngsville Water District.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Youngsville Water District, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or of any watercourse tributary to the public water supply of the Youngsville Water District; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the Youngsville Water District.
(4) No decayed or fermented fruit, roots, grain or vegetables and no cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and no* concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or watercourse tributary to the public water supply of the Youngsville Water District.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the Youngsville Water District, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the Youngsville Water District.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Youngsville Water District, except by duly authorized employees of the Youngsville Water District in the performance of their duties of supervision and maintenance of the public water supply of the Youngsville Water District.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Youngsville Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Youngsville Water District.
(j) Inspections.
The board of water commissioners of the Youngsville Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Youngsville Water District or the duly appointed representative of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promply notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.12 Special circumstances
(a) The department may exempt a hematopoietic progenitor cell bank from a specific standard contained in this Subpart, provided:
(1) the hematopoietic progenitor cell bank has requested an exemption under limited circumstances prior to the noncompliance with the standard; and
(2) the hematopoietic progenitor cell bank has demonstrated to the department that application of the standard to such bank under the limited circumstances for which the exemption is sought:
(i) is inconsistent with the provision of the particular service, as documented in properly conducted current medical or scientific research, or current scientific literature;
(ii) is incompatible with a requirement imposed by a Federal or other state's government unit which is similar to the standard for which the exemption is sought, and the department determines that the requirement imposed by the Federal or other state' s governmental unit adequately protects the public health, safety and welfare, based upon commonly accepted medical standards, properly conducted medical or scientific research, or current scientific literature; or
(iii) would prevent or impair the provision of services necessitated by a medical emergency or special medical condition. Hematopoietic progenitor cell banks seeking an exemption pursuant to this subparagraph shall describe the nature of the emergency or special medical condition and the exemption requested, for review on a case-by-case basis by the department. All such emergencies or special medical conditions shall be documented in the medical record, and any action taken in response which is contrary to the requirements of this Subpart shall be approved by the director of the hematopoietic progenitor cell transplantation service.
(b) A copy of the department's approval for an exemption shall be maintained by the hematopoietic progenitor cell transplantation facility and the hematopoietic progenitor cell bank releasing the cells.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
ISOLATION, QUARANTINE AND RESTRICTION ISOLATION, QUARANTINE AND RESTRICTION
10 CRR-NY 2.33 Removal of cases of communicable diseases from one health district to another restricted
Except as hereinafter provided no person affected with a highly communicable disease (as defined in section 2.1 of this Part) shall be removed from one health district into another except with the permission of the city, county or district health officer from whose district such person is removed and the permission of the city, county or district health officer to whose jurisdiction such person is to be transferred. The former shall give permission only after securing the consent of the health officer to whose jurisdiction the person is to be transferred except that the latter's permission need not be obtained if the patient is brought into a municipality solely for hospitalization in an institution approved by that municipality's health officer for admission of the type of case in question. Such removal shall be by means of a private conveyance, in charge of a responsible person and conducted in such manner as to prevent the exposure of other persons to the patient.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.2 Application
The requirements of this Subpart shall apply to all activities and uses at an agricultural fairground and any action by the holder of a permit to operate an agricultural fairground that impacts the agricultural fairground; provided, however, that the requirements of this Subpart shall not apply to an agricultural fairground for which the commissioner has determined that compliance with these requirements is not necessary to protect public health. In making such determination, the commissioner shall consider at least the following factors: the nature of the activities at the fairground, the duration of the activities at the fairground, the use of the water system at the fairground, the presence of animals at the fairground, fairground animal waste handling practices, and the extent to which the fairground is subject to the regulations of other governmental agencies.
Part 1 GENERAL PROVISIONS
GENERAL POWERS AND DUTIES OF HEALTH OFFICERS GENERAL POWERS AND DUTIES OF HEALTH OFFICERS
10 CRR-NY 1.11 Right of entrance and inspection.*
No person shall interfere with or obstruct the entrance to any house, building, vessel, or other premises by the State Commissioner of Health, or local health officer, or the authorized representative of either, in the discharge of his official duties; nor shall any person interfere with or obstruct the inspection or examination of any occupant of any such house, building, vessel, or other premises by the State Commissioner of Health, or local health officer, or the authorized representative of either, in the discharge of his official duties.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.6 Responsibilities of home care services workers
(a) Home care services workers have the following responsibilities:
(1) workers must retain in good order their certificate of successful completion of training and display it to a prospective employer when requested;
(2) if a worker discovers that a training program or entity incorrectly entered information regarding the worker in the registry, the worker must provide corrected information, including any verification of the change that may be requested, to the training program or entity;
(3) if any information required for the registry changes, the worker must inform the program or entity of the changes and provide verification of the change as requested by the program or entity;
(4) if a worker changes his or her name, the worker must provide proof of the name change to the program or entity. The program or entity will change the worker’s name in the registry and must retain a copy of the proof submitted in the entity’s permanent records. Appropriate proof of change of name includes copy of a certificate of marriage, decree of divorce, or other court order authorizing a person to change his or her name.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.3 Tissue procurement services
(a) A facility that engages in donor selection and solicitation, and retrieval of skin shall be licensed by the department as a comprehensive tissue procurement service.
(b) A facility whose tissue acquisition activities are limited to donor selection and solicitation by its own staff shall be licensed by the department as a limited tissue procurement service.
(c) Comprehensive tissue procurement services retrieving skin from cadaveric donors shall maintain written standard operating procedures that assure that the retrieval environment, including, but not limited to, walls, floors and permanent equipment, is suitable for aseptic retrieval and adequate to prepare an aseptic field. A working sink shall be available.
(d) Skin retrieval shall be performed only by trained retrieval technicians under the supervision of the director of a licensed comprehensive tissue procurement service. The director of the licensed comprehensive tissue procurement service shall be responsible for developing policies, procedures and standards for the educational background, training, certification and continuing education of retrieval technicians. Documentation of compliance with this requirement and the standards developed shall be maintained.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.6 Hearings
(a) Necessary hearings shall be conducted by the Public Health Council, a committee of the council, or a person designated by the council.
(b) Requests for hearings by applicants shall be made within 20 days after notification that such request may be made. If such request is made by the State Hospital Review and Planning Council, it must be made within 10 days subsequent to the meeting of such council which took place after notification that such request may be made.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.8 Medical requirements
(a) Health personnel.
The camp operator shall submit the name of the designated camp health director to supervise health and sanitation. Such director may be a physician, nurse practitioner, physician assistant, registered nurse, licensed practical nurse, emergency medical technician, or other person acceptable to the permit-issuing official. At a children's overnight camp, the camp health director shall be on-site. At a summer day camp or traveling summer day camp, the camp health director shall be available as specified in the camp's approved safety plan. If not on-site, the camp health director shall designate an assistant as specified in the camp's approved safety plan.
(1) Camp health director. The camp health director or designee(s) shall possess:
(i) a current certificate in an acceptable first aid training program as defined in section 7-2.2(m) of this Subpart; and
(ii) a current certificate in an acceptable cardiopulmonary resuscitation (CPR) training program as defined in section 7-2.2(n) of this Subpart.
(2) Additional first aid and CPR-certified staff. First aid and CPR-certified staff shall be on-site to respond to medical emergencies and assist the camp health director, as detailed in the camp's approved safety plan. Staff possessing current certifications in first aid and CPR, as described in paragraph (1) of this subdivision, shall be available as follows:
(i) At a children's overnight camp, in addition to the camp health director (or designee[s]) possessing these certifications:
(a) one staff member for each 200 campers shall possess a current first aid certificate; and
(b) one staff member for each 200 campers shall possess a current CPR certificate. Where a camp's qualified aquatics staff remain on-site and area available to respond to emergencies, they may be counted toward meeting this CPR requirement.
(ii) At a summer day camp or a traveling summer day camp:
(a) one on-site staff member for each 200 campers shall possess a current first aid certificate. The first aid certified camp health director or designee may be counted toward meeting this first aid requirement. If only one first aid certified staff member is required, and this person is absent, a similarly certified first aid certified staff member shall be on-site to meet this first aid requirement.
(b) In addition to the camp health director or designee, one staff member for each 200 campers shall possess a current CPR certificate. Where a camp's qualified aquatics staff remain on-site and are available to respond to emergencies, they may be counted toward meeting this CPR requirement.
(b) An overnight camp shall be provided with an infirmary having hot and cold flowing water, examining room, isolation and convalescent space, bathroom with flush toilets and showers and medical supplies or have alternate provisions for infirmary services included in the camp safety plan. Summer day camps and children's traveling summer day camps shall provide a holding area reasonably satisfactory to the permit-issuing official for all ill or injured children.
(c)
(1) A current confidential medical history, including the child's immunization record which shall include immunization dates against diphtheria, haemophilus influenza type b, hepatitis b, measles, mumps, poliomyelitis, rubella, tetanus and varicella (chicken pox), shall be kept on file for every camper and updated annually. The camper's and staff's family or other responsible person's name, address and telephone to contact during an emergency shall be kept on file.
(2) An overnight camp shall provide parents/guardians of campers attending camp for seven or more consecutive nights with written information about meningococcal meningitis and with a copy of an immunization response form that has been approved by the State Commissioner of Health.
(i) The written information must include:
(a) a description of meningococcal meningitis and means of transmission;
(b) the benefits, risks and effectiveness of immunization; and
(c) the availability and estimated cost of immunization, including an indication of whether or not the camp offers meningococcal meningitis immunization services.
(ii) The immunization response form must be submitted annually, kept on file at camp, document that the parent/guardian has received and reviewed the meningococcal meningitis information and certifies that either:
(a) the camper has been immunized against meningococcal meningitis within the past 10 years; or
(b) the parent or guardian understands the risk of meningococcal meningitis and the benefits of immunization, and has decided that the camper will not obtain immunization against meningococcal meningitis.
(d) All camper and staff injuries, illnesses and reportable diseases shall be reported to the camp health director and recorded in the medical log. All camper and staff injuries or illnesses which result in death or which require resuscitation, admission to a hospital or the administration of epinephrine, camper and staff exposures to animals potentially infected with rabies, camper injuries to the eye, head, neck or spine which require referral to a hospital or other facility for medical treatment, camper injuries where the victim sustains second or third degree burns to five percent or more of the body, camper injuries which involve bone fractures or dislocations, camper lacerations requiring sutures, camper physical or sexual abuse allegations and all camper and staff illnesses suspected of being water-, food-, or air-borne, or spread by contact, shall be reported within 24 hours to the permit-issuing official. Any camper or staff member suspected of having a communicable disease shall be suitably isolated.
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.10 Water supply
An adequate supply of hot and cold water from a municipal or satisfactory private source shall be provided for service for customers, cleanliness of employees, and for washing floors, walls, ceiling and equipment.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 136.6 Village of Unadilla
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing springs and such springs as may be developed in the future on the property of the Village of Unadilla, Otsego County, New York, such springs being the sources of public water supply of said village.
(b) Definitions.
(1) The term water supply means the public water supply of the Village of Unadilla, Otsego County, New York.
(2) The term springs means the springs now used as sources of this public water supply or any springs developed in the future as additional sources of this public water supply, which are located on said property now owned by said village.
(3) The linear distance of a structure or object from a spring is the shortest horizontal distance from the nearest point of the structure or object to the spring.
(c) Human excreta.
(1) No privy cesspool septic tank subsurface leaching tile or receptacle of any kind for the storage deposit or disposal of human excreta or sewage shall be constructed placed maintained or allowed to remain within 200 feet of any spring.
(2) No human excreta or sewage shall be so stored, disposed of or discharged onto the surface of the ground so that the material will drain or be washed by rain or melting snow to points within 200 feet of any spring.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any spring, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes.
No cesspool, pit or receptacle of any kind for the storage, deposit or disposal of bath water, sink or laundry wastes garbage refuse, manure or putrescible matter shall be constructed, placed, maintained or allowed to remain within 200 feet of any spring.
(e) Animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any spring.
(f) Manure.
No manure or manure pile shall be maintained or allowed to remain within 200 feet of any spring.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Village of Unadilla upon which the springs of the public water supply are located, and no person shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties, or such other persons as may be authorized to enter said property by the said village.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 200 feet of any spring.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of any spring.
(j) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Village of Unadilla.
(k) Inspections.
The Village of Unadilla, its officers or their duly appointed representatives, shall make regular and thorough inspections of the area surrounding the springs for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid village to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Village of Unadilla to promptly notify the State Commissioner of Health of such violations. The Village of Unadilla shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served, the general surroundings of the springs at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.5 Finding of violation
(a) The regulatory proceeding will begin with service of a signed finding of violation issued by a department inspector. Service of the finding of violation will be made to conform to the requirements of section 12-a of the Public Health Law for service of a notice of hearing. An inspection report of the departmental inspector may be used in whole or part as the department's description of alleged violations.
(b) The finding of violation shall contain:
(1) a short and plain statement of facts found which are alleged to constitute a violation, including the dates when such facts were observed;
(2) specific reference to the provisions of the Public Health Law, State Sanitary Code or pertinent provisions of the administrative rules and regulations alleged to have been violated;
(3) information adequate for a respondent to calculate the maximum penalty assessable if the facts are found to be as alleged;
(4) notification that a hearing will be held at a place designated by the department not less than 15 days after service of the finding of violation, and further notice that failure to appear at the time and place designated for the hearing will constitute a default in appearance by the respondent and that a decision and order will be rendered and issued on the record established by the hearing;
(5) information adequate to apprise the respondent of the provisions relating to answers set forth in section 76.6 of this Part;
(6) a statement that the respondent will be given a reasonable opportunity to be heard by written or oral argument on issues of law and fact;
(7) a description of how the proceedings may be resolved by stipulation agreement between the department and the respondent and payment of a specific monetary fine in lieu of a hearing.
(c) The tribunal or tribunal representatives may allow amendments by the respondent and the department. These amendments must be reasonably within the scope of the original finding of violation or recognize occurrences subsequent to the date of the original finding of violation and be relevant to the alleged violations.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.2 Financial and statistical data required
(a) Each LTHHCP shall complete and file, with the New York State Department of Health and/or its agent, annual financial and statistical report forms supplied by the department and/or its agent. LTHHCP certified for title XVIII of the Federal Social Security Act (Medicare) shall use the same fiscal year for title XIX of the Federal Social Security Act (Medicaid) as is used for title XVIII. All LTHHCP's must report their operations from January 1, 1978 forward on a calendar-year basis. For a LTHHCP also certified as an AHCP, a combined annual financial and statistical report shall be submitted for both programs.
(b) Based on the financial report, the facility will be required to convert all allowable costs to a visit/hourly cost basis for the services it will be providing.
(c) All required financial and statistical reports shall be submitted to the department. Such reports shall indicate the time period within which such report shall be filed.
(d) In the event a LTHHCP fails to file the required financial and statistical reports on or before the due dates, or as the same may be extended by the department, the State Commissioner of Health shall reduce the current rate paid by State governmental agencies by two percent for a period beginning on the first day of the calendar month following the due date of the required reports and continuing until the last day of the calendar month in which the required reports are filed.
(e) In the event that any information or data which an LTHHCP has submitted to the State Department of Health on required reports, budgets or appeals for rate revisions, intended for use in establishing rates, is inaccurate or incorrect, whether by reason of subsequent events or otherwise, such agency shall forthwith submit to the department a correction of such information or data which meets the same certification requirements as the document being corrected. Failure to do so shall subject the LTHHCP to the provisions of subdivision (d) of this section.
(f) A cost report shall be filed in accordance with this section by each new program with budget based rates for the first six-month period during which the program has achieved 75 percent of the approved patient case load. This report shall be filed and properly certified within 120 days following the end of the six-month period covered by the report. All new programs shall follow the requirements of subdivision (a) of this section, and complete and file a report at the end of the first calendar year after admission of its first patient. Facilities that have filed cost reports in accordance with the provisions of this subdivision shall be deemed to have adequate cost experience for the purpose of establishing a prospective cost-based rate.
(g) If the financial and statistical reports required by this Subpart are determined to be incomplete, inaccurate or incorrect, the LTHHCP will have 30 days from the date of receipt of notification to provide the corrected or additional data. Failure to file the corrected or additional data within 30 days, or within such period as extended by the commissioner, will result in application of subdivision (d) of this section.
(h) Each LTHHCP shall file with the New York State Department of Health a complete copy of the Department of the Treasury, Internal Revenue Service Form 990, for that facility. The Form 990 shall be submitted to the department no later than 30 days following the annual filing with the Internal Revenue Service. Failure to submit the Form 990 shall result in application of the provisions set forth in subdivision (d) of this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.174 Income statement
An accounting statement which reflects the financial results of a hospital during an accounting period. The data for this statement are accumulated in the revenue and expense accounts.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.82 Materials permitted and prohibited
(a) Materials, including food-grade plastics, used in the construction and repair of food vending machines are to be nontoxic, not affected by foods, cleaning compounds, or such other substances which may be found in the use environment, nonabsorbent and durable under normal use. They are not to impart odor, color or taste, nor to contribute to the contamination of food, and are to maintain their original properties under repeated use. Painted food-contact surfaces are prohibited.
(b) Materials are to be of sufficient weight and thickness to permit cleaning and sanitizing.
(c) Tubing conveying beverages or beverage ingredients is to be fabricated from safe materials.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.9 Nursing services
The PCH/CAH shall have an organized nursing service with a written plan of administrative authority which delineates responsibilities for patient care.
(a) Organization.
The director of the nursing service shall be a licensed registered nurse with appropriate education and experience. He or she shall be responsible for the operation of the service, credentialing of nursing staff and the determination of the types, numbers, and mix of nursing personnel and support staff necessary to provide nursing care for all patients admitted to the hospital.
(b) Staffing and delivery of care.
The nursing service shall have adequate numbers of licensed registered nurses, licensed practical nurses and other personnel to provide nursing care to all patients as needed. There shall be supervisory and staff personnel for each department or nursing unit to ensure the immediate availability within 20 minutes of a registered nurse for bedside care of any patient.
(1) The PCH shall be capable of providing 24-hour a day nursing care furnished or supervised by a registered nurse and shall have a licensed practical nurse or registered nurse on duty at all times, except for PCHs that have in effect a 24-hour a day nursing waiver granted by the Federal government.
(2) CAHs shall not be required to provide nursing staff when there are no inpatients in the CAH.
(3) PCHs shall comply with the provisions of section 405.5(a)(3)-(e)(2) of this Title.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
HUMAN USES OF RADIOACTIVE MATERIALS HUMAN USES OF RADIOACTIVE MATERIALS
10 CRR-NY 16.123 Specific licenses for certain medical uses of byproduct materials
(a) Purpose and scope.
This section contains requirements for the medical uses of byproduct materials that are subject to specific licenses. These requirements are in addition to, and not a substitute for, other requirements in this Part. Any license issued prior to the effective date of this regulation that references subdivision (b) of this section shall be deemed to reference subdivision (d) of this section.
(b) Definitions.
Whenever used in this section, or in Federal regulations incorporated herein, the following terms shall have the following meanings:
(1) Authorized medical physicist means an individual who is authorized to practice medical physics pursuant to article 166 of the Education Law and:
(i) meets the definition and the training requirements for an authorized medical physicist set forth in 10 CFR sections 35.2, 35.51 and 35.57; or
(ii) is named as a radiation therapy physicist on a medical use radioactive materials license issued by the department and meets the requirements set forth in 10 CFR section 35.59.
(2) Authorized nuclear pharmacist means an individual who is authorized to practice pharmacy pursuant to article 137 of the Education Law and:
(i) meets the requirements for an authorized nuclear pharmacist in 10 CFR sections 35.55(a) and 35.59; or
(ii) is identified as an authorized nuclear pharmacist on:
(a) a specific license issued by the Nuclear Regulatory Commission or agreement state that authorizes medical use or the practice of nuclear pharmacy;
(b) a permit issued by a Nuclear Regulatory Commission master material licensee that authorizes medical use or the practice of nuclear pharmacy;
(c) a permit issued by a Nuclear Regulatory Commission or agreement state broad scope medical use licensee that authorizes medical use or the practice of nuclear pharmacy; or
(d) a permit issued by a Nuclear Regulatory Commission master material license broad scope medical use permittee that authorizes medical use or the practice of nuclear pharmacy; or
(iii) is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has been authorized to identify authorized nuclear pharmacists; or
(iv) was a nuclear pharmacist preparing only radioactive drugs containing accelerator-produced radioactive material, and the individual practiced at a pharmacy at a Federal government agency or federally recognized Indian tribe before November 30, 2007 or at all other pharmacies before August 8, 2009, or an earlier date as noticed by the Nuclear Regulatory Commission.
(3) Authorized user means an individual who is authorized to practice medicine pursuant to article 131 of the Education Law and:
(i) meets the applicable requirements in 10 CFR sections 35.59 and 35.190(a), 35.290(a), 35.390(a), 35.392(a), 35.394(a), 35.490(a), 35.590(a) or 35.690(a); or
(ii) is identified as an authorized user on:
(a) a Nuclear Regulatory Commission or agreement state license that authorizes the medical use of byproduct material;
(b) a permit issued by a Nuclear Regulatory Commission master material licensee that is authorized to permit the medical use of byproduct material;
(c) a permit issued by a commission or agreement state specific licensee of broad scope that is authorized to permit the medical use of byproduct material; or
(d) a permit issued by a commission master material license broad scope permittee that is authorized to permit the medical use of byproduct material.
(4) Medical use means the intentional internal or external administration of byproduct material or the radiation from byproduct material to patients or human research subjects under the supervision of an authorized user.
(5) Positron emission tomography facility is a facility operating a cyclotron or accelerator for the purpose of producing PET radionuclides.
(6) Prescribed dosage means the specified activity or range of activity of unsealed byproduct material as documented in a written directive, or in accordance with the directions of the authorized user for procedures performed pursuant to 10 CFR sections 35.100 and 35.200. Further details concerning this referenced code are contained in subdivision (c) of this section.
(7) Prescribed dose means:
(i) for gamma stereotactic radiosurgery, the total dose as documented in the written directive;
(ii) for teletherapy, the total dose and dose per fraction as documented in the written directive;
(iii) for manual brachytherapy, either the total source strength and exposure time or the total dose, as documented in the written directive; or
(iv) for remote brachytherapy afterloaders, the total dose and dose per fraction as documented in the written directive.
(8) Radiation safety officer means an individual who:
(i) meets the requirements set forth in 10 CFR sections 35.50(a) or (c)(1) and 35.59; or
(ii) is identified as a radiation safety officer on a specific medical use license issued by the Nuclear Regulatory Commission or agreement state or a medical use permit issued by a Nuclear Regulatory Commission master material licensee.
(9) Sealed source means any byproduct material that is encased in a capsule designed to prevent leakage or escape of the byproduct material.
(10) Treatment site means the anatomical description of the tissue intended to receive a radiation dose, as described in a written directive.
(c) Approved medical uses of byproduct materials.
A licensee may use byproduct materials on human beings for the particular uses set forth below, provided that the licensee meets all applicable requirements of this Part:
(1) use of unsealed byproduct material for uptake, dilution and excretion studies;
(2) use of unsealed byproduct material for imaging and localization studies;
(3) use of unsealed byproduct material for which a written directive is required;
(4) use of sources for manual brachytherapy;
(5) use of sealed sources for diagnosis;
(6) use of sealed source in a remote afterloader unit, teletherapy unit or gamma stereotactic radiosurgery unit; or
(7) other specific medical uses of byproduct material or radiation from byproduct material, as licensed by the department.
(d) Federal standards.
All licensees shall comply with the provisions of the following Federal regulations, which are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein: title 10 of the Code of Federal Regulations, part 35, Medical Use of Byproduct Material. This code is published by the Office of the Federal Register National Archives and Records Administration. Copies may be obtained from the Superintendent of Documents, United States Government Printing Office, Washington, DC 20402. This code is available for copying and inspection at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Notwithstanding any provision herein to the contrary, if a conflict occurs between the above referenced CFR and other provisions in this Part, compliance with the more restrictive regulation is required.
(e) General requirements applicable to all licensees authorized to use byproduct materials for medical purposes.
(1) Recordkeeping requirements. A licensee shall comply with all recordkeeping requirements set forth in subpart L (Records) of part 35 of 10 CFR. Further details concerning this referenced code are contained in subdivision (c) of this section.
(2) Reporting requirements. A licensee shall comply with all reporting requirements set forth in subpart M (Reports) of part 35 of 10 CFR as revised herein as follows:
(i) in sections 35.3045(c) and 35.3047(c), replace phrase "NRC Operations Center" with "Department";
(ii) in sections 35.3045(d) and 35.3047(d), replace “By an appropriate method listed in section § 30.6(a) of this chapter, the licensee shall submit a written report to the appropriate NRC Regional Office listed in section 30.6 of this chapter” with “shall submit a written report to the Department”;
(iii) in sections 35.3045(g)(1) and 35.3047(f)(1), replace the term "NRC" with "Department"; and
(iv) in section 35.3067, replace “The report must be filed with the appropriate NRC Regional Office listed in section 30.6 of this chapter, by an appropriate method listed in section 30.6(a) of this Chapter, with a copy to the Director, Office of Federal and State Materials and Environmental Management Programs.” with “The report shall be filed with the Department”.
(3) Training and experience requirements. A licensee shall ensure that all staff who are involved in the use of byproduct material pursuant to a specific license have the training and experience required by this Part.
(4) Other general requirements. A licensee shall comply with requirements set forth in 10 CFR sections 35.5, 35.6, 35.11(a) and (b), 35.24(b), (e), (f) and (g), 35.27, 35.40, 35.41, 35.49, 35.60, 35.61, 35.63, 36.67, 35.69, 35.70, 35.75, 35.80, 35.92 as modified herein as follows: in section 35.27(a)(1) and (b)(1), replace “19.12 of this chapter” with “16.13(c) of this Part”.
(f) Requirements for the use of unsealed byproduct material for uptake, dilution and excretion studies.
A licensee shall use unsealed byproduct material for uptake dilution and excretion studies only if authorized to do so by a specific license issued by the department and provided that the licensee complies with 10 CFR sections 35.100 and 35.190 and all applicable provisions of this Part.
(g) Requirements for the use of unsealed byproduct material for imaging and localization studies.
A licensee shall use unsealed byproduct material for imaging and localization studies only if authorized to do so by a specific license issued by the department and provided that the licensee complies with 10 CFR sections 35.200, 35.204 and 35.290 and other applicable provisions of this Part.
(h) Requirements for the use of unsealed byproduct material for which a written directive is required.
A licensee shall use unsealed byproduct material for which a written directive is required only if authorized to do so by a specific license issued by the department and provided that the licensee complies with subpart E (Unsealed Byproduct Material-Written Directive Required) of part 35 of 10 CFR and other applicable provisions of this Part.
(i) Requirements for the use of sources for manual brachytherapy.
A licensee may use sources for manual brachytherapy only if authorized to so by a specific license issued by the department and provided that the licensee complies with subpart F (Manual Brachytherapy) of part 35 of 10 CFR.
(j) Requirements for the use of sealed sources for diagnosis.
A licensee may use sealed sources for diagnosis only if authorized to do so by a specific license issued by the department and provided that the licensee complies with subpart G (Sealed Sources for Diagnosis) of part 35 of 10 CFR and other applicable provision of this Part.
(k) Use of sealed source in a remote afterloader unit, teletherapy unit or gamma stereotactic radiosurgery unit.
A licensee may use a sealed source in a remote afterloader unit, teletherapy unit or gamma stereotactic radiosurgery unit only if authorized to so by a specific license issued by the department and provided that the licensee complies with subpart H (Photon Emitting Remote Afterloader Units, Teletherapy Units and Gamma Stereotactic Radiosurgery Units) of part 35 of 10 CFR and other applicable provisions of this Part.
(l) Other medical uses of byproduct material or radiation from byproduct material.
A licensee may use byproduct material or a radiation source approved for medical use which is not specifically addressed in paragraphs (b)(1) through (6) of this section if the licensee submits to the department information required by 10 CFR section 35.12(b) through (d) and the licensee has received written approval from the department in a specific license or license amendment and uses the material in accordance with specific conditions that the department deems necessary or desirable for the safest medical use of the material.
(m) General use license.
Any licensee who is licensed for one or more of the types of medical uses specified in paragraphs (b)(1) through (6) of this section also is authorized to use radioactive material under the general license in Appendix 16-A, table 6, item (i) infra, for the specified "in vitro" uses without filing Form GEN 373 as required by Appendix 16-A, table 6, item (i), subdivision (2), infra, provided, however, that the licensee is subject to the other provisions of Appendix 16-A, table 6, item (i), infra.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.191 Leasehold
An interest in land, buildings and equipment under the terms of a lease, normally classified as a (tangible) fixed asset.
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.16 Deductions from revenue account descriptions
[ 3223 ]
(a) In many instances, the hospital receives less than its full established charges for the services it renders. It is essential that reporting information reflect both the gross revenue and revenue adjustments resulting from inability to collect established charges for services provided. These revenue adjustments are called Deductions from Revenue and are of the following primary categories:
(1) Provisions for bad debts.
These deductions represent the estimated amount of current revenue that will not be realized as a result of credit losses.
(2) Contractual adjustments.
These adjustments represent the difference between full established charges for individual services and the contractual rates received or to be received from third-party payors for services rendered.
(3) Charity service.
These deductions represent the difference between full established charges and amounts received or to be received from indigent patients, voluntary agencies or governmental units on behalf of specific indigent patients.
(4) These deductions are reported under two accounts. One account is used to report those charges pertaining to compliance with the Hill-Burton Hospital and Medical Facilities Construction Plan, and another one for all other uncompensated charity care charges.
(5) Policy discounts.
These deductions represent adjustments for items such as courtesy allowances and employee discounts from the hospital's full established charges for services.
(6) Administrative adjustments.
These adjustments represent amounts of patient service revenue posted but not billed to patients because the cost of billing and collection would exceed the amounts received.
(b) The above items must be reported as deductions from gross operating revenue on an accrual basis rather than as expenses.
(c) 5900
PROVISION FOR BAD DEBTS
This account shall contain the hospital's periodic estimates of the amounts of accounts and notes receivable that are likely to be credit losses. The estimated amount of bad debts may be based on an experience percentage applied to the balance of accounts receivable or the amount of charges to patients' accounts during the period, or it may be based on a detailed aging and analysis of patients' accounts.
(d) 5910
CONTRACTUAL ADJUSTMENTS—MEDICARE
5911
Medicare - Part A
5912
Medicare - Part B
5920
CONTRACTUAL ADJUSTMENTS—MEDICAID
5930
CONTRACTUAL ADJUSTMENTS—BLUE CROSS
5940
CONTRACTUAL ADJUSTMENTS—OTHER
(1) These accounts must be used to report the differential (if any) between the amount, based on the hospital's full established rates, of contractual patients' charges for hospital services which are rendered during the reporting period and are covered by the contract, and the amount received and to be received from third-party agencies in payment of such charges, including adjustments made at year-end, based upon Cost Reports submitted.
(2) Prior period contractual revenue adjustments, as appropriate, will also be reported in these accounts rather than in the Fund Balance or Retained Earnings accounts.
(3) Should the hospital receive more than its established rates from an agency, the differential is reported in these accounts.
(e) 5950
CHARITY/UNCOMPENSATED CARE—HILL-BURTON
5960
CHARITY/UNCOMPENSATED CARE—OTHER
(1) These accounts are used to report the differential between the amount, based on the hospital's full established rates, of charity/uncompensated care patients' bills for hospital services and the amount (if any) to be received from such patients in payment for such services.
(2) Account 5950 shall be used to report the charges applicable to any charity/uncompensated care which is being used to comply with requirements of the Hill-Burton Hospital and Medical Facilities Construction Plan.
(3) When the hospital receives lump-sum grants or subsidies (rather than specific payments for individual patients' bills) from governmental or voluntary agencies for the care of medically indigent patients, the amount of the lump-sum grant or subsidy must be reported under “Restricted Donations and Grants for Indigent Care” (account 5970).
(f) 5970
RESTRICTED DONATIONS AND GRANTS FOR INDIGENT CARE
This account is used to report voluntary and governmental agency grants or subsidies for the care of nonspecified medically indigent patients during the current reporting period.
(g) 5980
ADMINISTRATIVE, COURTESY AND POLICY DISCOUNTS AND ADJUSTMENTS
This account shall be used to report write-offs of debit or credit balances in patients' accounts in which the cost of billing or refunding exceeds the amount of the account balance. In addition, reductions in the nature of courtesy allowances and employee discounts, from the hospital's established rates for services rendered, must be reported in this account.
(h) 5990
OTHER DEDUCTIONS FROM REVENUE
Other deductions from revenue which are not included elsewhere must be reported in this account.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.20 Add-ons to the case payment rate per discharge
Rates of payment computed pursuant to this Subpart shall be further adjusted in accordance with the following:
(a) A direct graduate medical education (GME) payment per discharge shall be added to the case payment rates of teaching general hospitals after the application of SIW and WEF adjustments to the statewide base price and shall be calculated for each hospital by dividing the facility's total reported Medicaid direct GME costs by its total reported Medicaid discharges pursuant to section 86-1.16(b)(2) of this Subpart. Direct GME costs shall be those costs defined in section 86-1.15(f)(1) of this Subpart, derived from the same base period used to calculate the statewide base price for the applicable rate period and trended forward to such rate period in accordance with applicable provisions of section 2807-c(10) of the Public Health Law, and shall be excluded from the cost included in the statewide base price.
(b)
(1) An indirect GME payment per discharge shall be added to the case payment rates of teaching general hospitals after the application of SIW and WEF adjustments to the statewide base price and shall be calculated by multiplying such rates by the indirect teaching cost percentage determined by the following formula:
(1 – (1 / (1 + 1.03(((1+ r) ^0.0405) – 1))))
where "r" equals the ratio of residents and fellows to beds based on the medical education statistics for the hospital for the period ended June 30, 2005 as contained in the survey document submitted by the hospital to the department as of June 30, 2009 and the staffed beds for the general hospital reported in the 2005 institutional cost report and submitted to the department no later than June 30,2009, but excluding exempt unit beds and nursery bassinettes.
(2) Indirect GME costs are those costs defined in section 86-1.15(f)(2) of this Subpart, derived from the same base period used to calculate the statewide base price for the applicable rate period and trended forward to such rate period in accordance with applicable provisions of section 2807-c(10) of the Public Health Law, and shall be excluded from computation of the statewide base price. The amount of such exclusion shall be determined by multiplying the total reported Medicaid costs less reported direct GME costs by the following formula:
1.03(((1 + r) ^0.0405) –1)
where "r" equals the ratio of residents and fellows to beds as determined in accordance with paragraph (1) of this subdivision.
(c) A non-comparable payment per discharge shall be added to case payment rates after the application of SIW and WEF adjustments to the statewide base price and shall be calculated for each hospital by dividing the facility's total reported Medicaid costs for qualifying non-comparable cost categories by its total reported Medicaid discharges pursuant to section 86-1.16(b)(2) of this Subpart. Non-comparable hospital costs are those costs defined in section 86-1.15(l) of this Subpart, derived from the same base period used to calculate the statewide base price for the applicable rate period and trended forward to such rate period in accordance with applicable provisions of section 2807-c(10) of the Public Health Law, and shall be excluded from the cost included in the statewide base price.
(d) For dates of service occurring on or after April 1, 2020 through December 31, 2020, and each calendar year thereafter, an upper payment limit (UPL) payment per discharge shall be added to the case payment rates after the application of SIW and WEF adjustments to the statewide base price (hereinafter, add-ons). Such add-ons shall only apply to eligible public general hospitals or public health systems, other than those operated by the state of New York or the state university of New York, located in a city having a population of 1,000,000 or more and shall be in lieu of any aggregate UPL payment. Such add-ons shall be calculated for each hospital by dividing the hospital’s latest approved UPL demonstration payment, by its Medicaid fee-for-service acute discharges, as reported in its most recently submitted institutional cost report. Each hospital’s add-on shall be subject to and contingent upon the terms of a binding memorandum of understanding executed between the Department of Health and the public general hospital or public health system receiving an add-on, and shall be subject to termination or adjustment based on the terms of that agreement. The total amount paid for the add-on shall be included in the applicable annual UPL demonstration. If the annual UPL demonstration yields an amount that is more or less than the aggregate amount paid for the add-on, the add-on shall be adjusted to reflect the demonstration amount.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.78 Public notification
(a) General public notification requirements.
Each owner or operator of a public water system must provide public notification for public health hazards, and for all MCL, MRDL, treatment technique, monitoring and testing procedure violations, and for other situations posing a risk to public health. Public notification requirements are divided into three tiers to take into account the seriousness of the violation or situation and any potential adverse health effects that may be involved. The form, manner, frequency, and other requirements for each tier are described in subdivisions (c)-(e) of this section. Section 5-1.52 table 13 of this Subpart lists the required public notification (Tier 1, Tier 2, or Tier 3) for specific violations and other situations posing a risk to public health.
(1) Public water systems that sell or otherwise provide drinking water to other public systems ( i.e., to consecutive systems) are required to give public notice to the owner or operator of the consecutive system; the consecutive system is responsible for providing public notification to the persons it serves.
(2) If a public water system can show that a violation in a portion of the distribution system is physically or hydraulically isolated from other parts of the distribution system, then with written permission from the State the system may limit the notice to only persons served by that portion of the system that is out of compliance.
(3) The public water system, within 10 days of completing the public notification requirements under this Subpart for the initial public notification and any repeat notices, must submit to the State a certification that it has fully complied with the public notification regulations. The public water system must include with this certification a representative copy of each type of notice distributed, published, posted, and made available to the persons served by the system and to the media. Copies of public notices and certificates issued pursuant to this paragraph must be kept by the supplier of water for three years after issuance.
(4) Public notification is required when a significant deficiency is identified at a public water system that is not required to prepare an annual water supply statement (report), as directed in section 5-1.72(e) and (f) of this Subpart. If the water system has been notified by the State of a significant deficiency and it has not been corrected as directed or approved by the State, the system must notify its customers in a format prescribed or approved by the State. Notice must be provided if any significant deficiency has not been corrected within 12 months of State notification or as otherwise directed by the State. The system must continue to inform the public until the significant deficiency is corrected.
(b) Content, presentation, and standard language requirements for all public notifications.
(1) When a public water system has a violation or a situation posing a risk to public health, other than operating under a variance or exemption, the public notification must include the following elements:
(i) a description of the violation or situation, including the contaminant of concern, and (as applicable) the contaminant level;
(ii) when the violation or situation occurred;
(iii) any potential adverse health effects from the violation or situation, including the standard language under subparagraph (4)(i) or (ii) of this subdivision, whichever is applicable;
(iv) the population at risk, including subpopulations particularly vulnerable if exposed to the contaminant in their drinking water;
(v) whether alternative water supplies should be used;
(vi) what actions consumers should take, including when they should seek medical help, if known;
(vii) what the system is doing to correct the violation or situation;
(viii) when the water system expects to return to compliance;
(ix) the phone number of the water system owner, operator, or designee of the public water system as a source of additional information concerning the notice;
(x) the phone number of the county or district health department which has jurisdiction over the water system; and
(xi) a statement included in notices distributed by mail or direct delivery to encourage the notice recipient to distribute the public notice to other persons served, using the standard language under subparagraph (4)(iii) of this subdivision.
(2) When a public water system operates under a variance or exemption, each public notice must include the following elements:
(i) an explanation of the reasons for the variance or exemption;
(ii) the date on which the variance or exemption was issued;
(iii) a brief status report on the steps the system is taking to install treatment, find alternative sources of water, or otherwise comply with the terms and schedules of the variance or exemption; and
(iv) a notice of any opportunity for public input in the review of the variance or exemption.
(3) Notice presentation. Each public notice required by this section:
(i) must be displayed in a conspicuous way (where applicable);
(ii) must not contain overly technical language or very small print;
(iii) must not be formatted in a way that defeats the purpose of the notice;
(iv) must not contain language which nullifies the purpose of the notice; and
(v) must contain information for non-English speaking consumers, where appropriate. For systems serving a large proportion of non-English speaking consumers, as determined by the State, the notice must contain information prescribe by the State in the appropriate language(s) expressing the importance of the notice.
(4) Standard language.
(i) Mandatory health effects language must be included in the notification for MCL and MRDL violations, treatment technique violations, and violations of the condition of a variance or exemption. The mandatory health effects language will be developed by the department and provided to the supplier of water by the State.
(ii) Standard language for monitoring and testing procedure violations. Public water systems must include the following language in their notice, including the language necessary to fill in the blanks, for all monitoring and testing procedure violations listed in section 5-1.52 table 13 of this Subpart: We are required to monitor your drinking water for specific contaminants on a regular basis. Results of regular monitoring are an indicator of whether or not your drinking water meets health standards. During (compliance period), we "did not monitor or test" or "did not complete all monitoring or testing" for (contaminant[s]), and therefore cannot be sure of the quality of your drinking water during that time.
(iii) Standard language to encourage distribution of the public notice to all persons served, when the notice is distributed by mail or direct delivery: Please share this information with all the other people who drink this water, especially those who may not have received this notice directly (for example, people in apartments, nursing homes, schools, and businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail.
(iv) Standard language for repeated failure to conduct Cryptosporidium monitoring: We are required to monitor the source of your drinking water for Cryptosporidium. Results of the monitoring are to be used to determine whether water treatment at the (treatment plant name) is sufficient to adequately remove Cryptosporidium from your drinking water. We are required to complete this monitoring and make this determination by (required bin determination date). We “did not monitor or test” or “did not complete all monitoring or testing” on schedule, and therefore, we may not be able to determine by the required date what treatment modifications, if any, shall be made to ensure adequate Cryptosporidium removal. Missing this deadline may, in turn, jeopardize our ability to have the required treatment modifications, if any, completed by the deadline required, (date). For more information, please call (name of water system contact) of (name of water system) at (phone number).
(v) Standard language for failure to determine bin classification or mean Cryptosporidium level: We are required to monitor the source of your drinking water for Cryptosporidium in order to determine by (date) whether water treatment at the (treatment plant name) is sufficient to adequately remove Cryptosporidium from your drinking water. We have not made this determination by the required date. Our failure to do this may jeopardize our ability to have the required treatment modifications, if any, completed by the required deadline of (date). For more information, please call (name of water system contact) of (name of water system) at (phone number).
(c) Tier 1 notification requirements (public health hazards, as defined in section 5-1.1[bz] of this Subpart, require Tier 1 notification). The supplier of water shall:
(1) provide public notification no later than 24 hours after the system learns of a public health hazard;
(2) initiate consultation with the State no later than 24 hours after the public water system learns of the public health hazard, and comply with any additional notification requirements established as a result of the consultation (including using additional forms of delivery for the initial notification, the duration of the posted notices, or any repeat notices);
(3) notify by telephone the chief administrative or elected official of the city, village or town, wherein the public water system is located, and the local law enforcement department having jurisdiction in the area served by the public water system, that a public health hazard exists. If there is a potential for the public health hazard to cross political boundaries, all potentially impacted chief administrative or elected officials and local law enforcement departments in the political subdivisions, served by the public water system, must also be notified; and
(4) provide the notice in a form and manner reasonably calculated to reach all persons served (including residential, transient, and nontransient users) in the required time period. Water systems are to use one or more of the following forms of delivery:
(i) appropriate broadcast media (such as radio and television);
(ii) posting of the notice in conspicuous locations throughout the area served by the water system;
(iii) hand delivery of the notice to persons served by the water system; or
(iv) another delivery method approved in writing by the State.
(d) Tier 2 notification requirements (section 5-1.52 table 13 of this Subpart lists violations and situations that require Tier 2 notification).
(1) The supplier of water must provide public notification no later than 30 days after the system learns of a violation or situation that requires Tier 2 notification. If the public water system corrects the violation within 30 days, the State may allow additional time for the initial notice of up to three months from the date the system learns of the violation.
(2) The supplier of water must repeat the notice every three months as long as the violation or situation persists. If the public notice is posted, the notice must remain in place as long as the violation or situation persists, but in no case less than seven days.
(3) The supplier of water must provide the notice in a form and manner reasonably calculated to reach all persons served in the required time period.
(i) Unless directed otherwise by the State in writing, community water systems must provide notice by: mail or other direct delivery to each customer receiving a bill, and to other service connections to which water is delivered by the public water system; and by any other method reasonably calculated to reach other persons regularly served by the system if they would not normally be reached by mail or direct delivery.
(ii) Unless directed otherwise by the State in writing, noncommunity water systems must provide notice by posting the notice in conspicuous locations, and by any other method(s) reasonably calculated to reach other persons served by the system if they would not normally be reached by posting.
(4) For the turbidity violations or exceedances specified in subparagraphs (i)-(iii) of this paragraph, the supplier of water must consult with the State no later than 24 hours after the public water system learns of the violation or exceedance to determine whether a Tier 1 notification is required to protect public health. When consultation does not take place within the 24 hour period, the water system must distribute a Tier 1 notification no later than 48 hours after the system learns of the violation or exceedance. Consultation with the State is required for:
(i) a violation of the two day average maximum allowable turbidity at the entry point pursuant to section 5-1.52 table 4 of this Subpart;
(ii) a violation resulting from a single exceedance of the maximum allowable turbidity for filter effluent pursuant to section 5-1.52 table 4A of this Subpart; and
(iii) a single raw water turbidity exceedance of 5 NTU for systems operating under the avoidance criteria in section 5-1.30(c) of this Subpart.
(5) Consultation with the State is required within 24 hours after a groundwater system or groundwater source learns of any of the following:
(i) a fecal indicator positive sample from the source(s) as specified in section 5-1.52 table 6 of this Subpart;
(ii) a significant deficiency that is considered to constitute a public health hazard; or
(iii) failure of four-log virus treatment by the water system that is not resolved within four hours.
The State will determine whether Tier 1 notification is required to protect public health. When consultation does not take place within the 24-hour period, the water system must distribute Tier 1 notification no later than 48 hours after the system learns of the violation or exceedance.
(6) For repeated failure to conduct Cryptosporidium monitoring, failure to determine bin classification, or failure to calculate mean Cryptosporidium, each notification shall also include a description of what the system is doing to correct the violation and when the system expects to return to compliance or resolve the situation.
(e) Tier 3 notification requirements (section 5-1.52 table 13 of this Subpart lists violations and situations that require Tier 3 notification).
(1) The supplier of water for community and nontransient noncommunity water systems must provide public notification no later than one year after the system learns of a violation or situation that requires Tier 3 notification. The supplier of water for transient noncommunity water systems must provide public notification no later than 30 days after the system learns of a violation or situation that requires Tier 3 notification. If the public water system operates seasonally, the public notification must also be provided before the system closes for the season.
(2) The supplier of water must repeat the notice annually for as long as the violation or situation persists. If the public notice is posted, the notice must remain in place as long as the violation or situation persists, but in no case less than seven days.
(3) The supplier of water may use a single public notice for multiple violations or situations that require Tier 3 notification, as long as the timing requirements of paragraph (1) of this subdivision are met. Community water systems may use the annual water supply statement (report) (see section 5-1.72[e]-[h] of this Subpart) to provide Tier 3 notification.
(4) The supplier of water must provide the initial notice and any repeat notices in a form and manner reasonably calculated to reach all persons served in the required time period.
(i) Unless directed otherwise by the State in writing, community water systems must provide notice by: mail or other direct delivery to each customer receiving a bill, and to other service connections to which water is delivered by the public water system; and by any other method reasonably calculated to reach other persons served by the system if they would not normally be reached by mail or direct delivery.
(ii) Unless directed otherwise by the State in writing, noncommunity water systems must provide notice by posting the notice in conspicuous locations, and by any other method(s) reasonably calculated to reach other persons served by the system if they would not normally be reached by posting.
(f) Notice to new billing units or new customers.
Community water systems must give a copy of the most recent public notice for any continuing violation, the existence of a variance or exemption, or other ongoing situations requiring a public notice to all new billing units or new customers prior to or at the time service begins.
(g) Information on unregulated contaminants.
Nontransient noncommunity water systems that are required to monitor for contaminants listed in section 5-1.52 table 16 of this Subpart, must post a notice that identifies a person and telephone number to contact for information on the monitoring results. The notice must be posted in conspicuous locations and no later than 12 months after the results are known.
(h) Notice by the State on behalf of the public water system.
The State may make public notification if the State determines that the public's interest will be best served, or if the State determines that the supplier of water is not acting or cannot act in a timely manner. The State may charge and collect from the supplier of water the cost of making such notification. However, the supplier of water remains legally responsible for ensuring that the requirements of this section are met.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
STATISTICAL DATA STATISTICAL DATA
10 CRR-NY 446.13 Visits
(a) Please report all visits in the following Ambulatory Care Service Areas:
(1) Emergency Services (account 6710)
(2) Clinic Services (account 6720)
(3) Home Program Dialysis Equipment—100% (account 6810)
(4) Home Program Dialysis Equipment—Other (account 6820)
(5) Ambulatory Surgery (account 6830)
(6) Psychiatric Day/Night (account 6840)
(7) Ambulance Services (account 6850)
(8) Other Ambulatory Services (account 6860)
(9) Free Standing Clinic (account 6870)
(10) Home Health Services
(i) Skilled Nursing Care (account 6910)
(ii) Medical Social Services (account 6920)
(iii) Home Health Aides (account 6930)
(iv) Other Home Health (account 6990)
(11) Kidney Dialysis (account 6860, 6720 or 7710, as appropriate)
(i) Renal Dialysis
(ii) Peritoneal Dialysis
(b) Discrete Medicaid rates for specialty clinics.
(1) Report these separately from the remainder of account 6720.
(2) Examples:
(i) MMTP Clinic;
(ii) Alcoholism Clinic;
(iii) Other (Specify).
(c) Program Service Areas to be reported:
(1) Total Inpatient Visits
(2) Outpatient Visits. Please refer to section 446.44(c) of this Part for all program services for which these statistics are to be reported.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.14 Computation of time
In computing any period of time prescribed or allowed by this Part, the day that the period of time begins will not be included but the last day of the period will be included unless it is a Saturday, Sunday or legal holiday, in which event the next business day will be included. Whenever a party has the right or is required to do some act within a prescribed period of time after the service of a document and the document is served by mail, three days will be added to the prescribed period of time.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.22 Return of investment for proprietary LTHHCPs
(a) In computing the allowable costs of a proprietary LTHHCP, there shall be included a reasonable return on average equity capital. The percentage to be used in computing this allowance shall be a rate determined annually by the commissioner as reasonably related to the then current money market.
(b) The average equity capital associated with the LTHHCP shall be that amount that is allocated from a related organization to the extent that the bases of allocation of average equity capital to the LTHHCP are consistent with regulations applicable to cost reporting of the related organization.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.6 Conservatism
[ 1150 ] Conservatism is a quality of judgment to be exercised in evaluating the uncertainties and risks present in the hospital entity to assure that reasonable provisions are made for potential losses in the realization of recorded assets and in the settlement of actual and contingent liabilities. However, conservatism is not a justification for deliberate understatement.
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 711 GENERAL STANDARDS OF CONSTRUCTION
10 CRR-NY 711.3 Site requirements
(a) Each health facility shall be easily accessible to patients or residents, staff and visitors and to service vehicles such as fire protection apparatus. Health facility grounds shall have paved roads and walkways to provide access to all public and service entrances, including loading docks. Emergency department entrances shall be conspicuously marked to facilitate access from public roads and streets. Access to emergency entrances shall not conflict with other vehicular or pedestrian traffic.
(b) Health facilities shall be located with due regard to the accessibility by public transportation for patients, staff and visitors and the availability of competent medical and surgical consultation.
(c) Off-street parking shall be made available for patients, staff and visitors.
In urban areas where a health facility is accessible by public transportation, the commissioner may waive the requirement for off-street parking, if compliance with this requirement is burdensome or unnecessary because adequate parking exists to accommodate patients, staff and visitors.
(d) In earthquake prone regions, health facilities that are subdivided into separate structural units by seismic joints, each unit shall be provided with an exit stairway to permit evacuation from the building without traversing the seismic joints. Special care shall be taken to anchor fixed equipment, suspended ceilings, light fixtures and similar items to minimize hazard to occupants and damage to the equipment and building during an earthquake. Storage shelves and racks holding breakable or fragile supplies shall be designed to retain their contents when subject to the lateral forces of an earthquake.
(e) If a health facility is located in a flood plain, the commissioner may require that the health facility comply with any, or all, of the following:
(1) Health facility footings, foundations, and structural frame shall be designed to be stable under flood conditions.
(2) A helicopter landing pad shall be located on the facility roof and shall be structurally sound and suitable for safe helicopter evacuations of patients and staff.
(3) The health facility shall be designed and capable of providing services necessary to maintain the life and safety of patients and staff if floodwaters reach the 100-year flood crest level and shall include the following:
(i) electrical service, emergency power supply, heating, ventilating and sterilizers;
(ii) main internal communication capability, including nurses' call systems and the fire alarm system;
(iii) dietary service;
(iv) an acceptable alternate to the normal water supply system;
(v) an acceptable emergency means of storage and/or disposal of sewage, biological waste, and garbage;
(vi) emergency department service; and
(vii) x-ray service.
(4) No floor level or basement shall be located below the 100-year flood crest level, unless specifically approved by the commissioner. On those floor levels or basements that the commissioner approves to be below the 100-year flood crest level:
(i) all new partitions shall be constructed without void such as solid concrete, solid concrete block, or other solid material;
(ii) no new carpeting shall be installed; and
(iii) the following services and equipment shall not be provided or located in such area:
(a) medical records storage area;
(b) medical records library;
(c) surgical suite; and
(d) such other services and fixed equipment that the commissioner may determine, taking into consideration patient safety and cost of replacement.
(5) Storage of available building plans of the existing buildings shall be above the 100-year flood crest level.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.96 Definitions relating to equipment and utensils
(a) Approved means acceptable under conditions of use to the permit-issuing official, based on the determination of conformance to appropriate standards and good public health practice.
(b) Easily cleanable means readily accessible and of material and finish fabricated so that residues may be completely removed by normal cleaning methods.
(c) Equipment is all stoves, ranges, hoods, meatblocks, tables, counters, refrigerators, sinks, dishwashing machines, steamtables and similiar items, other than utensils, used in the operation of a food establishment.
(d) Food-contact surfaces are the surfaces of equipment, utensils, kitchenware and tableware which are normally contacted by food, or which food may contact and drain back into food or onto food-contact surfaces.
(e) Kitchenware is all multi-use utensils other than tableware used in the storage, preparation, transfer, conveyance or service of food.
(f) Non-food-contact surfaces are surfaces other than food-contact surfaces.
(g) Single-service articles are items intended by the manufacturer to be discarded after using item once for eating, drinking or as a container.
(h) Tableware is all multi-use eating and drinking utensils.
(i) Utensil is any tableware and kitchenware used in the storage, preparation, transfer or service of food.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.10 Certification criteria for ignition interlock devices
(a) A manufacturer of ignition interlock devices shall apply to the department to certify a device for use in New York State. The application shall be on a form or format specified by the department with documents appended as necessary to provide the requisite information, and shall include, but not be limited to:
(1) name and address of the manufacturer, and contact information including, identification of a person to respond to department inquiries;
(2) name and model of the ignition interlock device;
(3) a detailed description of the ignition interlock device, including: instructions for its installation and operation; technical specifications, including, but not limited to, accuracy; calibration stability; data security; and capability for data collection and recording, tamper detection, and retesting, and unsupervised operation in a range of environmental conditions;
(4) the manufacturer's statement that all ignition interlock devices of the same make and model sold or offered for sale or lease, for which certification is sought, meet the requirements of this Part; and
(5) a certificate or other document from an insurance carrier licensed in New York State demonstrating that the manufacturer holds product liability insurance with minimum liability limits of $1 million per occurrence and $3 million aggregate. The documentation shall include the issuing company's statement that at least 30 days notice will be provided to the department whenever the issuing company intends to cancel the insurance before the policy's expiration date. Liability coverage shall include defects in product design and materials, as well as in manufacture, calibration, installation and removal of devices.
(b) The manufacturer shall provide the testing laboratory with:
(1) six representative instruments of each ignition interlock device model for which certification is sought, from which the testing laboratory shall select at least two for testing;
(2) instructions for device installation and operation; and
(3) a description of the device's capabilities, including, but not limited to: security; data collection and recording; tamper detection; circumvention prevention; retesting; and unsupervised operation in a range of environmental conditions.
(c) At the request of a manufacturer of ignition interlock devices, the commissioner shall certify the ignition interlock device for use in New York State, provided the manufacturer:
(1) demonstrates, through arrangements with a testing laboratory, that the model meets or exceeds the model specifications for breath alcohol ignition interlock devices adopted by NHTSA and published in the Federal Register on April 7, 1992 (57 Fed. Reg. 11772 - 11787, available for public inspection and copying at the Department of Health Records Access Office, Corning Tower, Empire State Plaza, Albany, NY 12237);
(2) demonstrates, through arrangements with a testing laboratory, that the device meets the model specifications specified in paragraph (1) of this subdivision when calibrated to a set point of 0.025% BAC;
(3) has requested certification for a device that employs fuel cell technology or another technology with demonstrated comparable accuracy and specificity;
(4) has demonstrated that the certified device can and would be installed to allow normal operation of the vehicle after it is started, except as specifically approved by the department; and
(5) has demonstrated compliance with all the requirements of this Part.
(d) Certification shall be effective as of the date of its issuance.
(e) Certified ignition interlock devices installed in vehicles shall be uniquely serial-numbered.
(f) Each certification shall cover only one model of ignition interlock device. Modifications to a model of a device, without regard to the manufacturer's assigning a new model number, shall be reported to the department as required in section 59.12 of this Part.
(g) The department may deny, suspend or revoke the certification of an ignition interlock device for reasons including:
(1) the device does not meet the requirements for certification specified in this Part, including but not limited to, the commissioner's determination that the testing laboratory misrepresented a device's meeting such requirements;
(2) the manufacturer has failed to comply with any requirement of this Part or of 9 NYCRR Part 358;
(3) substantial evidence exists that devices manufactured, sold, leased, offered for sale or leased, or installed in vehicles do not function in accordance with the specifications in this Part or are easily circumvented or tampered with;
(4) substantial evidence exists that the manufacturer has not made adequate provision for effective and timely maintenance, inspection, calibration and repair of installed devices;
(5) the manufacturer is no longer in the business of manufacturing devices;
(6) the manufacturer fails to retain the required product liability insurance, including through cancellation or non-renewal;
(7) the manufacturer has been convicted of a crime or offense related to fraud; or
(8) the ignition interlock device does not meet Federal model specifications for breath alcohol ignition interlock devices adopted by NHTSA after the specifications referred to in paragraph (c)(1) of this section are adopted.
(h) Notice of an ignition interlock device's certification, discontinuation, suspension and revocation shall be published in the State Register , and shall be provided promptly to the Division of Probation and Correctional Alternatives. The commissioner shall make available a list of certified ignition interlock devices upon request.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.218 Nonprofit corporation
An incorporated charity, or any corporation operated under a policy by which no stockholder or trustee shares in the profits or losses, if any, of the enterprise.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
DESIGNATION OF CASES DESIGNATION OF CASES
10 CRR-NY 2.1 Communicable diseases designated: cases, suspected cases and certain carriers to be reported to the State Department of Health
(a) When used in the Public Health Law and in this Chapter, the term infectious, contagious or communicable disease, shall be held to include the following diseases and any other disease which the commissioner, in the reasonable exercise of his or her medical judgment, determines to be communicable, rapidly emergent or a significant threat to public health, provided that the disease which is added to this list solely by the commissioner's authority shall remain on the list only if confirmed by the Public Health and Health Planning Council at its next scheduled meeting:
Amebiasis
Anthrax
Arboviral infection
Babesiosis
Botulism
Brucellosis
Campylobacteriosis
Chancroid
Chlamydia trachomatis infection
Cholera
Cryptosporidiosis
Cyclosporiasis
Diphtheria
E. coli 0157:H7 infections
Ehrlichiosis
Encephalitis
Giardiasis
Glanders
Gonococcal infection
Group A Streptococcal invasive disease
Group B Streptococcal invasive disease
Hantavirus disease
Hemolytic uremic syndrome
Hemophilus influenzae (invasive disease)
Hepatitis (A; B; C)
Herpes infection in infants aged 60 days or younger (neonatal)
Hospital-associated infections (as defined in section 2.2 of this Part)
Influenza (laboratory-confirmed)
Legionellosis
Listeriosis
Lyme disease
Lymphogranuloma venereum
Malaria
Measles
Melioidosis
Meningitis
Aseptic
Hemophilus
Meningococcal
Other (specify type)
Meningococcemia
Monkeypox
Mumps
Pertussis (whooping cough)
Plague
Poliomyelitis
Psittacosis
Q Fever
Rabies
Rocky Mountain spotted fever
Rubella
Congenital rubella syndrome
Salmonellosis
Severe or novel coronavirus
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), including Pediatric Multi-system Inflammatory Syndrome, or any other complication suspected of being associated with SARS-CoV-2 infection
Severe Acute Respiratory Syndrome (SARS)
Middle East Respiratory Syndrome (MERS)
Other (specify type)
Shigellosis
Smallpox
Staphylococcal enterotoxin B poisoning
Streptococcus pneumoniae invasive disease
Syphilis, specify stage
Tetanus
Toxic Shock Syndrome
Trichinosis
Tuberculosis, current disease (specify site)
Tularemia
Typhoid
Vaccinia disease (as defined in section 2.2 of this Part)
Viral hemorrhagic fever
Yersiniosis
(b) Upon receipt of a report made pursuant to section 2.10 of this Part, the city, county or district health officer shall retain a copy in his record of the reports of such communicable diseases as the State Commissioner of Health may direct, and shall retain these copies until their destruction is authorized by the State Commissioner of Health, and shall forward a copy of all reports immediately to the State Department of Health. In lieu of an individual report of each case, the city, county or district health officer may, with the written consent of the State Commissioner of Health, make such summarized reports as the commissioner may require.
(c) Any disease outbreak or unusual disease shall also be reported to the State Department of Health as provided in subdivision (b) of this section. Unusual disease is defined as a newly apparent or emerging disease or syndrome of uncertain etiology that a health care provider or the State Commissioner of Health has reason to believe could possibly be caused by a transmissible infectious agent or microbial toxin.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 112 DUTCHESS COUNTY
VILLAGES VILLAGES
10 CRR-NY 112.3 Village of Fishkill
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Laws), as finally amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs, watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, serving as sources of the public water supply of the village of Fishkill, Dutchess County, New York.
(b) Definitions.
(1) The term water supply wherever used in this section means the public water supply of the village of Fishkill, Dutchess County, New York.
(2) The term reservoir means all natural or artificial reservoirs serving as a source of the aforesaid water supply.
(3) The term watercourse means a spring, pond, stream, marsh or channel of any kind, the waters of which flow or may flow into the water supply.
(4) The linear distance of a structure or object from the reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the reservoir or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from the reservoir or any watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 300 feet of the reservoir or any watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta, located between the limiting distance of 300 feet, prescribed in paragraph (4) of this subdivision, and the distance of 500 feet from the reservoir or any watercourse, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into the reservoir or any watercourse, the said privy, receptacle, trench or place of disposal shall, after due notice to the owner thereof, be removed to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage, bath water, sink or laundry wastes shall be discharged or allowed to flow into the reservoir or any watercourse nor deposited on or beneath the surface of the ground within 500 feet of the reservoir or any watercourse, except into watertight receptacles or into a sewage treatment plant, plans for which shall have been submitted to and approved by the State Commissioner of Health. If such watertight receptacles are used, they shall be located not less than 300 feet from the reservoir or any watercourse and the contents removed and disposed of as provided by paragraph (3) of subdivision (c).
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or other material that pollutes water shall be deposited in the reservoir or any watercourse nor on or beneath the surface of the ground within 300 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface of or through the ground into the reservoir or any watercourse.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in the reservoir.
(g) Places for animals.
(1) No animals or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in the reservoir, and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such manner that the drainings, leachings or washings therefrom shall pollute the reservoir or any watercourse.
(h) Manure.
No manure or manure pile shall be maintained or allowed to remain within 300 feet of the reservoir or any watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Fishing, boating and ice cutting.
No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir except by duly authorized employees of the village of Fishkill in the performance of their duties of supervision and maintenance of the water supply.
(j) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of the reservoir or any watercourse tributary to the water supply.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the reservoir or any watercourse tributary to the public water supply.
(l) Inspections.
The board of trustees of the village of Fishkill or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Fishkill or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoir, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the said board to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.112 Definition of sanitization; general requirements
Sanitization is effective bactericidal treatment by heat or chemical means, acceptable to the Commissioner of Health, which destroys pathogens on surfaces treated.
(a) The following are acceptable methods of sanitizing in a mobile food service establishment:
(1) immersion for at least one minute in a clean solution containing at least 50 parts per million of available chlorine and a temperature of at least 75°F (23.9°C);
(2) immersion for at least one minute in a clean solution containing at least 12.5 parts per million of available iodine and having pH not higher than 5.0 and at a temperature of at least 75°F (23.9°C);
(3) immersion in a clean solution containing any other chemical sanitizing agent acceptable to the State Commissioner of Health that will provide the equivalent bactericidal effect of a solution containing at least 50 parts per million of available chlorine as hypochlorite at a temperature of at least 75°F (23.9°C) for one minute; or
(4) swabbing with a solution of at least twice the strength required for that sanitizing solution when used for immersion.
(b) Chemicals used for sanitizing are not to have concentrations which will leave toxic residues on surfaces treated. A test kit or other device is to be provided and used that accurately measures the parts per million concentration and pH when required of the solution used.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.19 General records
The operator must:
(a) maintain on the premises of the program or facility the following written records, which must be easily retrievable and must include, but need not be limited to, the following:
(1) a chronological admission register consisting of a daily chronological listing of registrants admitted by name with relevant clinical and social information about each, including as a minimum, name, address, next of kin, attending practitioner, principal diagnosis, and the place from which each registrant was admitted;
(2) a chronological discharge register consisting of a daily chronological listing of registrants discharged by name, the reason for discharge and the place to which the registrant was discharged;
(3) a daily census record consisting of a summary report of the daily registrant census with cumulative figures for each month and each year; and
(4) general records in conformance with section 415.30(e)-(o) of this Subchapter;
(b) ensure that each record includes non-medical information consisting of:
(1) all details of the referral and registration;
(2) identification of next of kin, family and sponsor;
(3) the person or persons to be contacted in the event of emergency;
(4) accident and incident reports;
(5) non-medical correspondence and papers pertinent to the registrant's participation in the program; and
(6) a fiscal record including copies of all agreements or contracts.
(c) maintain as public information, available for public inspection, records containing copies of all financial and inspection reports pertaining to the adult day health care services that have been filed with or issued by any governmental agency for six years from the date such reports are filed or issued.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 104 CAYUGA COUNTY
10 CRR-NY 104.1 City of Auburn and Town of Owasco
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Owasco Lake and its tributaries, which is a source of the public water supply for both the City of Auburn and the Town of Owasco, Cayuga County, New York, and to all watercourses tributary thereto or which may ultimately discharge into said lake.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for the deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Agricultural-associated animal waste storage area shall mean land used for the temporary or permanent deposition of agricultural-associated animal waste where said deposition is not directly for the purpose of fertilization.
(4) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(5) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(6) Human excreta shall mean human feces and urine.
(7) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(8) Lake shall mean Owasco Lake.
(9) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the optimum high-water mark of the lake or to the edge, margin or precipitous bank forming the optimum high-water mark of a watercourse.
(10) Manure shall mean animal feces and urine.
(11) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(12) Optimum high-water mark shall mean 717.13 feet above sea level using United States Geological Survey datum.
(13) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(14) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural-and nonagricultural-associated animal waste.
(15) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave or visible, infrared or ultraviolet light.
(16) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(17) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(18) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(19) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(20) Sewage disposal system shall mean any system used for disposing of sewage, and includes treatment works.
(21) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(22) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing, or disposing of sewage.
(23) Watercourse shall mean every spring, stream, marsh or channel of water of any kind numbered on the latest Owasco Lake Watershed Base Map of the Central New York Regional Planning and Development Board.
(24) Watershed shall mean the entire drainage area contributing water to Owasco Lake.
(25) Water supply shall mean the public water supply of both the City of Auburn and Town of Owasco, New York, from Owasco Lake.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste area.
No agricultural-associated animal waste area shall be located within a 250-foot linear distance of the lake or watercourse. Beyond that distance such area shall be maintained in such manner that surface runoff will not carry agricultural-associated animal waste directly into the lake or watercourse.
(2) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the lake or watercourse.
(3) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the lake or watercourse, except in weatherproof buildings or watertight vessels.
(4) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into the lake or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(5) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into Owasco Lake or any watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed. Composted sludge, pursuant to a permit issued by an appropriate State or local agency having jurisdiction, if any, shall be allowed.
(iii) No human excreta or sewage shall be buried in soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from the lake or watercourse, with a minimum vertical distance of five feet from the bottom of any trench or pit to groundwater, and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into the lake or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 100-foot linear distance of the lake or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having Jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or rebuilt within a 100-foot linear distance of the lake or watercourse. All systems constructed must have a vertical distance of at least two feet from the lowest portion of the system to the high-water mark. An exemption may be granted by the county health department for the repair of an existing system within 100 linear feet of the lake or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of the lake or watercourse. All such transportable receptacles shall be provided with drip-proof connections and tight-fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has beeen approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works are published from time to time by the appropriate State agency having jurisdiction over such facility, and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(ix) When an existing subsurface sewage disposal system fails, the entire system must be inspected and the site thoroughly evaluated in a manner acceptable to the appropriate State or county health agency having jurisdiction over such facility, prior to modifications or alterations to the existing system.
(x) No sewage or polluted liquid of any kind shall be discharged or allowed to flow beneath the surface of the ground on the watershed, except into watertight pipes connected to a sewage disposal system or holding tank approved in accordance with subparagraph (iv) of this paragraph.
(xi) In-house composting facilities of the type that make use of human excreta, wash-waters and sink wastes will be acceptable, provided that properly designed systems for the disposal of gray water are included within the plans for their construction and are approved by the appropriate State or county health agency having jurisdiction over such facilities.
(6) Junkyards.
No junkyard shall be permitted within a 100-foot linear distance of the lake or watercourse.
(7) Manure.
Manure shall not be field-spread within 75 feet of the lake or watercourse unless it is plowed underground on the same day it is spread.
(8) Radioactive material.
No radioactive material of any quantity shall be buried or in any other manner disposed of within the Owasco Lake watershed.
(9) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the lake or watercourse.
(10) Refuse disposal areas.
No new refuse disposal areas shall be located within 500 feet of the lake or watercourse. All refuse disposal areas on the watershed shall comply with the regulations governing their operation as outlined by Part 360 of Title 6 of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(11) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice within 500 feet of any water supply intake by either the City of Auburn or the Town of Owasco.
(12) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the lake or watercourse, except as otherwise permitted by the provisions of subparagraph (5)(x) of this subdivision.
(13) Other wastes.
No pollutant of any kind shall be discharged, deposited, or allowed to flow into the lake or watercourse or on or beneath the surface of the ground or watershed within 500 feet of the lake or watercourse, except as otherwise permitted by the provisions of subparagraph (5)(x) of this subdivision. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspection.
The mayor and council of the City of Auburn and the town board of the Town of Owasco, or any person or persons charged with the maintenance or supervision of the public water supply system, shall by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid local governments to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid local governments to promptly notify the State Commissioner of Health of such violations. The aforesaid local governments shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.2 General requirements for infant hearing screening programs and responsibilities of the administrative officers or designees of facilities
(a) Each facility shall administer an infant hearing screening program, directly or by contract pursuant to section 400.4 of this Title, as required by this Part and as generally described in subdivision (b) of this section, except for those facilities identified in subdivision (c) of this section.
(1) Facilities that establish a contract(s) with providers of infant hearing screening shall designate a staff member responsible for contract management and general oversight of the program.
(2) Contracts may be established for the conduct of inpatient and/or outpatient infant hearing screening.
(3) Contractors must be article 28 facilities or health care providers licensed under State Education Law and authorized under such law to perform infant hearing screening.
(4) Contractors shall have the capacity to meet general requirements for infant hearing screening programs as set forth in subdivision (b) of this section.
(b) General requirements of an infant hearing screening program are:
(1) the conduct of inpatient infant hearing screening prior to discharge from the facility;
(2) communication of results of infant hearing screenings to parents by designated personnel, including provision of written materials supplied by the department;
(3) the conduct of follow-up infant hearing screening or provision of referrals to obtain follow-up screening on an outpatient basis for those infants who fail or do not receive infant hearing screening prior to discharge from the facility. On an annual basis, facilities shall notify the department whether the facility will conduct follow-up infant hearing screening or provide referrals for infants to obtain such screening from another facility or provider licensed under State Education Law and authorized to provide infant hearing screening;
(4) referral of infants who are suspected of having a hearing loss as defined in this Part to the Early Intervention Program for appropriate evaluation and early intervention services pursuant to section 69-4.3 of this Part including, but not limited to:
(i) providing a general explanation of the Early Intervention Program and the purpose of referral and the parents' right to object to the referral;
(ii) ensuring confidentiality of referral information transmitted; and
(iii) transmitting of personally identifying information as necessary to ensure follow-up;
(5) the reporting of aggregate data on infant hearing screenings to the department upon department request, in a format and frequency prescribed by the commissioner; and
(6) the establishment of facility quality assurance protocols as necessary pursuant to section 405.6 of this Title to determine and evaluate the effectiveness of the program in ensuring all infants are screened for hearing loss.
(c) Facilities with 400 or fewer births annually, based on a three-year rolling average, may provide referrals for infants to receive hearing screening from an article 28 facility or a provider licensed under State Education Law and authorized under such law to perform infant hearing screening.
(1) Such referrals shall include a prescription issued by the facility, including a request for results of the screening to be returned to that facility, for infants to receive hearing screening from an article 28 facility or a provider licensed under State Education Law and authorized under such law to provide infant hearing screening.
(2) Such facilities shall submit screening results returned to the facility by the outpatient provider as required by the department to determine the effectiveness of referral procedures in ensuring infants are screened for hearing loss.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 103 CATTARAUGUS COUNTY
VILLAGES VILLAGES
10 CRR-NY 103.3 Village of Franklinville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land owned by the village and situated in the northern part of the village, adjacent to and east of State highway to Buffalo, which from a source of the public water supply of the village of Franklinville, Cattaraugus County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well of the public water supply of the village of Franklinville.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed maintained or allowed to remain within 300 feet of any well of the public water supply of the village of Franklinville.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply at the village of Franklinville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage, street sweepings, car washings or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraph [4] and [5] of subdivision [c] or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health) within 300 feet of any well of the public water supply of the village of Franklinville. It is provided, however, that no such watertight iron pipe shall be located within 50 feet of any well of the public water supply of the village of Franklinville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the village of Franklinville.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well of the public water supply of the village of Franklinville, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any well of the public water supply of the village of Franklinville.
(2) No human excreta, or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground nor buried in the soil within a distance of 500 feet of any well; and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 150 feet of any well of the public water supply of the village of Franklinville.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well of the public water supply of the village of Franklinville.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Franklinville upon which any well of the public water supply of the village of Franklinville is located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the village of Franklinville.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the village of Franklinville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the village of Franklinville.
(j) Inspections.
The board of water commissioners of the village of Franklinville or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Franklinville or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceeding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.5 Registration of shared health facilities
(a) Application for the registration of a shared health facility shall be made upon forms prescribed by the department and shall contain the information required therein.
(b) Each operator of a shared health facility shall apply for renewal of the registration not earlier than 90 days and not later than 30 days prior to the expiration of the current facility registration.
(1) Applications for registration of shared health facilities shall be obtained from the department regional office having responsibility for the administration and supervision of the Medical Assistance Program in the local social services district in which the shared health facility is located.
(2) The shared health facility registration and registration number shall be issued in the name of the facility and the facility operator, and shall not be transferred or discontinued except upon written approval or demand of the department.
(3) A shared health facility registration, issued pursuant to the application specified in this section, shall be issued for a period not to exceed two years, shall be used by the facility operator only for the designated place of operation and shall be prominently posted within the designated premises.
(4) The department may verify the information submitted on the application for a registration. Such verification may be by onsite visit to the applicant operator's premises and may include interview of any owner, operator, practitioner, provider, purveyor, patient or employee encountered on the premises, inspection of any business records, patient records, leases or other contracts executed by any provider or purveyor maintaining a professional practice or business on the premises, and any equipment or instruments used therein.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.4 Contents of annual audited financial report
(a) The annual audited financial report shall report the financial position of the MCO as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for the year then ended in conformity with statutory accounting practices prescribed, or otherwise permitted, by the New York State Department of Financial Services pursuant to 11 NYCRR Part 83. In addition, a company may comply by filing statements prepared in accordance with generally accepted accounting principles, provided that appropriate reconciliation is made as required by section 307 of Insurance Law. The annual audited financial report shall include the following:
(1) report of CPA;
(2) balance sheet reporting admitted assets, liabilities, capital and surplus;
(3) statement of operations;
(4) statement of cash flow; and
(5) statement of changes in capital and surplus.
(b) Notes to financial statements shall be those required by the appropriate Annual Statement Instructions and those accounting practices and procedures to be followed as specified in 11 NYCRR Part 83 and shall include a reconciliation of differences, if any, between the audited statutory financial statements and the annual statement filed pursuant to section 98-1.16 of this Part with a written description of the nature of these differences.
(c) The MCO shall prepare the financial statements included in the audited financial report in a form and using language and groupings substantially the same as the relevant sections of the annual statement of the MCO filed with the commissioner, and the financial statement shall be comparative, presenting the amounts as of December 31st of the current year and the amounts as of the immediately preceding December 31st. In the first year in which a MCO is required to file an audited financial report, the comparative data may be omitted.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.12 Operating revenue—other operating revenue
[3214] This group of accounts (5010 - 5890) is used to report all operating revenues other than those that are directly associated with patient care.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.10 Village of Mount Kisco
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as last amended by chapter 879 of the Laws of 1953, shall apply to all existing wells and such additional wells and reservoirs on the property of the Village of Mount Kisco and to Byram Lake and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Village of Mount Kisco and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definitions.
(1) The term water supply means the public water supply of the Village of Mount Kisco.
(2) The term well means any well now used as a source of the water supply of the Village of Mount Kisco or any additional well which may be constructed on the property of the Village of Mount Kisco.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The term reservoir includes any natural or artificial lake or pond.
(5) The linear distance of a structure or object from a well, reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(6) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(7) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) [Human excreta.]
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into any well, reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply, unless deposited in trenches or pits at a distance of not less than 200 feet from any well, reservoir or tributary watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any well or within 50 feet of any reservoir or tributary watercourse except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (1) of subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any well, reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any well, reservoir or watercourse. All privies or receptacles within the limiting distances referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of trustees of the village of Mount Kisco and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 50 feet and 200 feet of any well, reservoir or tributary watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the board of trustees of the village of Mount Kisco or of the State or Westchester County Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the board of trustees of the village of Mount Kisco or the State or Westchester County Commissioner of Health.
(d) [Sewage, sink wastes, garbage, etc.]
(1) No sewage shall be discharged or allowed to flow into any reservoir or tributary watercourse nor deposited on or beneath the surface of the ground within 50 feet of any reservoir or tributary watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within 25 feet of any reservoir or tributary watercourse provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State or Westchester County Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by paragraph (1) of this subdivision, shall be discharged or allowed to flow into the well, reservoir or any watercourse nor be deposited on or beneath the surface of the ground within 50 feet of any reservoir or tributary watercourse.
(3) No garbage, refuse, putrescible matter, decayed fuits* or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in any well, reservoir or watercourse nor on or beneath the surface of the ground within 50 feet of any well, reservoir or tributary watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any well, reservoir or watercourse.
(e) [Bathing, boating, animals, manure, etc.]
(1) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or tributary watercourse owned by and which is a part of the public water supply of the village of Mount Kisco.
(2) No boating, or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse to the public water supply owned by the village of Mount Kisco except by persons duly authorized by the board of trustees of the village of Mount Kisco.
(3) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir or any tributary watercourse and no watering place shall be maintained in such a way as to pollute any well, reservoir or tributary watercourse with excremental matter.
(4) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute any well, reservoir or any tributary watercourse.
(5) No manure pile shall be maintained or allowed to remain within 50 feet of any well, reservoir or tributary watercourse.
(f) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(g) [Inspections.]
The board of trustees of the village of Mount Kisco or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the board shall make regular and thorough inspections of the wells, reservoirs, lake, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of trustees to promptly notify the State and the Westchester County Commissioners of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(h) [Penalty.]
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.12 Surgical services
If surgical services are provided, the hospital shall develop and keep current and implement effective written policies and procedures regarding staff privileges consistent with provisions set forth in section 405.4 of this Part, the performance of surgical procedures, the maintenance of safety controls and the integration of such services with other related services of the hospital to protect the health and safety of the patients in accordance with generally accepted standards of medical practice and patient care. Such policies and procedures shall be reviewed and updated as necessary, but at a minimum biennially.
(a) Organization and direction.
The surgical service shall be directed by a physician who shall be responsible for the clinical aspects of organization and delivery of all in-patient and ambulatory surgical services provided to hospital patients. That physician or another individual qualified by training and experience shall direct administrative aspects of the service.
(1) The operating room shall be supervised by a registered professional nurse or physician who the hospital finds qualified by training and experience for this role.
(i) Nursing personnel shall be on duty in sufficient number for the surgical suite in accordance with the needs of patients and the complexity of services they are to receive.
(ii) A registered professional nurse qualified by the hospital and by training and experience in operating room nursing shall be present as the circulating nurse in any and each separate operating room where surgery is being performed for the duration of the operative procedure. Nothing in this section precludes a circulating nurse from leaving the operating room as part of the operative procedure, leaving the operating room for short periods; or, in accordance with employee rules or regulations, being relieved during an operative procedure by another circulating nurse assigned to continue the operative procedure.
(iii) Licensed practical nurses and surgical technologists may perform scrub functions and may assist in circulating duties under the supervision of the circulating nurse who is present in the operating room for the duration of the procedure, in accordance with policies and procedures established by the medical staff and the nursing service and approved by the governing body.
(2) Surgical privileges shall be delineated for all practitioners performing surgery in accordance with the competencies of each practitioner as required by section 405.4 of this Part. The surgical service shall maintain a roster of practitioners specifying the surgical privileges of each practitioner. The hospital shall assure that the privileges of the practitioner are commensurate with his or her training and experience.
(3) In accordance with written policies and procedures developed and implemented by the medical staff and approved by the governing body, in any procedure presenting unusual hazard to life based on the individual patient risk factors and complexity of the procedure, there shall be present and scrubbed as first assistant a physician designated by the medical staff and the governing body as being qualified to assist in major surgery.
(4) The surgical service policies shall clearly outline requirements for orientation and continuing education programs for all staff and compliance with such requirements shall be considered at the time of performance evaluation. Such training or continuing education programs will be established that are relevant to care provided, but will, at a minimum include instruction in safety precautions, equipment usage and inspections, infection control requirements, cardiopulmonary resuscitation and patients' rights requirements pertaining to surgical/anesthesia consents.
(5) The director shall, in conjunction with the medical staff, monitor the quality and appropriateness of patient care and ensure that identified problems are reported to the quality assurance committee and are resolved.
(6) Precautions shall be clearly identified in written policies and procedures specific to the department and the post anesthesia care unit (PACU) and include but are not limited to:
(i) safety regulations posted;
(ii) routine inspection and maintenance of equipment;
(iii) availability in the operating room suites and PACU of appropriate resuscitation, airway and monitoring equipment including a resuscitation cart with age and size appropriate medications, equipment and supplies; and
(iv) control of traffic in and out of the operating room suites and accessory services to eliminate through traffic.
(b) Operation and service delivery.
Policies governing surgical services shall be designed to assure the achievement and maintenance of generally accepted standards of medical practice and patient care. The policies shall assure that service and equipment routinely available in the operating suite and PACU are age and size appropriate.
(1) The operating room register shall be kept complete and up-to-date.
(2) There shall be a complete history and physical work-up in the chart of every patient prior to any surgery except emergency surgery. Each record shall document a review of the patient's overall condition and health status prior to any surgery including the identification of any potential surgical problems and cardiac problems. If this has been dictated, but not yet recorded in the patient's chart, there shall be a statement to that effect and an admission note in the chart by the practitioner who admitted the patient. Such reports shall be signed to attest to the adequacy and currency of the history and physical or countersigned by the attending surgeon, prior to surgery.
(3) Informed consent shall be obtained from the patient, and a properly executed informed consent form for the operation that includes the identification of the practitioner(s) performing the surgical procedure(s) shall be in the patient's chart before surgery except in emergencies in accordance with section 405.7 of this Part.
(4) An operative report describing techniques, findings, complications, tissues removed or altered and the general condition of the patient shall be written or dictated immediately following surgery and signed by the surgeon.
(5) Findings of any pathology reports shall be recorded in the patient's medical record and a procedure established and implemented for reporting unusual findings to the patient's attending practitioner or surgeon.
(6) All infections of clean surgical cases shall be recorded and reported to the infection control officer. A procedure shall be developed and implemented for the investigation of such cases.
(c) Voluntary termination of pregnancy.
(1) No termination of pregnancy shall be performed until a woman has had a complete physical examination with appropriate tests for a positive pregnancy and a determination of gestational age including the use of sonography where there is a question of gestational age.
(2) The standards for preprocedure examination, post-procedure evaluation, counseling for family planning services and birth control options, evaluation, treatment, and determination of blood group and Rh type established in section 756.3 of this Title shall be applicable to all terminations of pregnancy performed in hospitals.
(3) When a patient is admitted for an induced termination of pregnancy, the determination of blood group and Rh type shall have been made prior to the admission and shall have been recorded in the patient's chart. If not done, such determination shall be made as soon after admission as practicable, and prior to the termination of pregnancy. The patient shall be evaluated for the risk of sensitization to Rho(D) antigen, and if the use of Rh immune globulin is indicated, and the patient consents, an appropriate dosage thereof shall be administered to her as soon as possible within 72 hours after the termination of pregnancy.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.119 Expense
Expired cost; any item or class of cost of (or loss from) carrying on an activity; a present or past experience defraying a present operating cost or representing an irrecoverable cost or loss.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.4 Exemption of certain radiation sources from the requirements of this Part
Any person is hereby exempted from the requirements of this Part to the extent that such person transfers, receives, possesses, installs, operates or uses any of the radioactive materials, radiation equipment or items containing radioactive material listed in Appendix 16-A, Table 1, infra.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.46 Board-designated assets
Unrestricted assets set aside by the governing board for specific purposes or projects.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.2 Definitions
The following words or terms shall have the following meanings when used in this Subpart:
(a) Attending physician means, for the purpose of requesting an external appeal of an experimental or investigational treatment or service, a licensed, board-certified or board-eligible physician who is qualified to practice in the area of medicine or in the specialty appropriate to treat an enrollee's life-threatening or disabling condition or disease who has recommended a service or treatment that is the subject of a request for external appeal. For enrollees covered by a health care plan with no out-of-network option, the attending physician must either participate in the enrollee's health care plan or must be a physician to whom the enrollee's health care plan referred the enrollee.
(b) Confidential HIV related information means any information in the possession of a person who provides one or more health or social services or who obtains the information pursuant to a release of confidential HIV related information, concerning whether an individual has been the subject of an HIV related test, or has HIV infection, HIV related illness or AIDS, or information which identifies or reasonably could identify an individual as having one or more of such conditions, including information pertaining to such individual's contacts.
(c) Final adverse determination means an adverse determination which has been upheld by a utilization review agent with respect to a proposed health care service following a standard appeal, or an expedited appeal where applicable, pursuant to section 4904 of the Public Health Law. If a health care plan offers two levels of internal appeals, a final adverse determination shall mean the adverse determination of the first level appeal.
(d) Material familial affiliation means any relationship as a spouse, child, parent, sibling, spouse's parent, spouse's child, child's parent, child's spouse, or sibling's spouse.
(e) Material financial affiliation means any financial interest of more than five percent of total annual revenue or total annual income of a certified external appeal agent or officer, director, or management employee thereof; or clinical peer reviewer employed or engaged thereby to conduct any external appeal. The term material financial affiliation shall not include revenue received from a health care plan by:
(1) a certified external appeal agent to conduct an external appeal pursuant to section 4914 of title II of article 49 of the Public Health Law and the Insurance Law; or
(2) a clinical peer reviewer for health care services rendered to enrollees.
(f) Material professional affiliation means any physician-patient relationship, any partnership or employment relationship, a shareholder or similar ownership interest in a professional corporation, or any independent contractor arrangement that constitutes a material financial affiliation with any expert or any officer or director of the independent organization.
(g) Retrospective adverse determination means a determination for which utilization review was initiated after health care services have been provided. Retrospective adverse determination does not mean an initial determination involving continued or extended health care services or additional services for an enrollee undergoing a course of continued treatment prescribed by a health care provider pursuant to section 4903(3) of the Public Health Law.
(h) Utilization review means the review to determine whether health care services that have been provided, are being provided or are proposed to be provided to a patient, whether undertaken prior to, concurrent with or subsequent to the delivery of such services, are medically necessary. A health care plan's denial of coverage of a health care service as defined in section 4900(5)(b) of the Public Health Law, whether made initially or on appeal under title I of article 49 of the Public Health Law, on the basis that the health care service is experimental or investigational, is a determination that the health care service is not medically necessary, provided however, that such health care service would otherwise be a covered benefit.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.10 Compliance with standards
(a) Hematopoietic progenitor cell procurement services and/or processing facilities shall allow admission to representatives of the department for the purpose of inspecting the premises and evaluating operating procedures, equipment and records, including financial records and lists of physicians or facilities to whom or to which hematopoietic progenitor cells are released, to determine compliance with the standards in this Subpart. If the commissioner determines that a significant likelihood exists that adequate safeguards are not implemented, the department may require that cells not be released pending a hearing. Such hearing shall commence within 15 days of any suspension pursuant to this section.
(b) Whenever requested, a hematopoietic progenitor cell bank shall submit to the department reports containing such information and data concerning the bank's activities as may be required by this Subpart. Such reports shall be signed by the director of the hematopoietic progenitor cell bank.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 36 DELAYED REGISTRATION OF AN UNRECORDED BIRTH
MAKING OF CERTIFICATES MAKING OF CERTIFICATES
10 CRR-NY 36.7 Making of the certificate of birth in all other cases
If the physician or midwife who attended the birth has died or cannot be located and if neither of the parents can be conveniently reached or if both parents have died, the following procedure should apply:
(a) If the person whose birth it is desired to register is under 18 years of age, the certificate shall be made by the guardian of such person.
(b) If the person whose birth it is desired to register is 18 years of age or over, the certificate shall be made by that person.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.11 CPA’s letter of qualifications
Every MCO subject to this Subpart shall retain a CPA who agrees by written contract with such MCO to comply with the provisions of this section and section 98-1.16 of this Part. The contract must specify:
(a) that the CPA is independent with respect to the MCO and is acting in conformity with the standards of the CPA’s profession, such as contained in the Code of Professional Ethics and pronouncements of the AICPA and the Rules of Professional Conduct of the New York Board of Public Accountancy, or similar code and meets the definition of a CPA set forth in section 98-3.2(e) of this Subpart;
(b) That the CPA understands the annual audited financial report, that the CPA’s opinion thereon will be filed in compliance with this Subpart and that the commissioner will be relying on this information in the monitoring and regulation of the financial condition of the MCO;
(c) that the CPA consents to the requirements of section 98-3.12 of this Subpart and that the CPA consents and agrees to make available the work papers for review by the commissioner; and
(d) a representation that the CPA is in compliance with the requirements of section 98-3.6 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.2 Application; project scope and concept
(a)
(1) The applicant shall transmit to the project management unit, at the department's central office in Albany, nine copies of the application in a format determined by the commissioner setting forth the scope and concept of the project. A copy of the application shall be transmitted by the department to the health systems agency having geographic jurisdiction over the area in which the applicant's facility is located:
(i) Except as provided for under subparagraph (ii) of this paragraph with respect to facility leases, any expenditure to effect construction and/or commencement of construction, other than those costs directly attributable to the preparation of the application, prior to the issuance of approval of the application pursuant to this Part shall not be considered an allowable cost for reimbursement pursuant to any of the provisions of Part 86 of this Title, even if the application eventually is approved.
(ii) Notwithstanding the provisions of subparagraph (i) of this paragraph, if an applicant, prior to obtaining approval for the application, entered into an arms-length lease with an unrelated party for space in an existing facility or building, which space is the subject of the application and which has an asset value that does not exceed $4,000,000, the capital costs associated with the leased space which are approved under the application and which costs are attributable in accordance with generally accepted accounting principles to the time period subsequent to the approval of the application, shall be eligible for reimbursement in accordance with the applicable provisions of Part 86 of this Title. Any capital costs associated with such leased space which are attributable to the time period prior to the approval of the application shall not be reimbursable pursuant to any of the provisions of Part 86 of this Title.
(2) Those applicants that have indicated in their service and capital needs inventory problems whose projected solutions exceed $15 million in total basic cost of construction should, before filing a certificate of need application, have received a site visit report prepared by the Department of Health and have completed the Capital Architectural and Program Alternatives review process. As a result of this alternative review process, a preferred solution will be identified by the department and, if agreed to by the applicant and incorporated into an application, will expedite processing of the application to the commissioner and/or the Public Health Council for action. In the event the applicant has not agreed to the department's designation of the preferred solution, the applicant shall, when filing its application, indicate the preferred solution as well as the solution it is seeking approval for.
(b) The application setting forth the scope and concept of the project shall include the following if applicable:
(1) identifying information setting forth the location, type of the proposed construction, and disclosing any interest in the operation and any interest in the ownership of the property interests of the proposed construction;
(2) a description of the site, including a topographic map, United State Geological Survey, published by the United States Department of Interior Geological Survey, 7½-minute series, unless not published for such site, in which case 15-minute series shall be acceptable;
(3) an outline of the construction proposal, including a description of the program and the bed capacity by type of service to be provided;
(4) an estimate of the total basic cost of construction predicated upon a construction start date that coincides with the filing date of the application and a projection of such total basic cost of construction together with a projection of the total project costs to the completion of the proposed construction schedule;
(5) a proposed time period for construction which shall state a time to commence and complete construction, including a time period for each distinct phase. An acceptable time frame shall be determined by the department after consultation with the applicant and shall be made a condition of any approval or contingent approval. If, after consultation, an acceptable time period cannot be agreed upon, the commissioner shall establish a time period as a condition of approval;
(6) an outline of the proposed financing of the total project costs, including the source of any Federal or State financial support;
(7) a statement whether the project is consistent with the institution's long-range capital plan;
(8) a narrative description of the programmatic and/or architectural solution of each functionally discrete component of the project, including the following when relevant to the proposal:
(i) justification of the need for the proposed change, and a determination of its relative priority when compared with the applicant's other needed services and programs;
(ii) how the solution has taken advantage of opportunities for the efficient and economic reuse and recycling of existing physical plant resources, where feasible and appropriate;
(iii) how the solution could be adapted to accommodate changes in emerging technology;
(iv) the proposed plan for the organization and operation of the facility;
(v) the number and types of personnel to be employed as a result of the project; and
(vi) any special or unusual services, programs or equipment to be provided, including a description of health professional teaching programs associated with the solution;
(9) an architectural program for the project;
(10) architectural drawings, including if applicable:
(i)
(a) schematic architectural and engineering design drawings, including site plan, room-by-room layouts of each floor in an appropriate scale, showing the relationship of the various departments or services to each other. The major exit corridors, exit stair locations and pedestrian and service circulation patterns shall be indicated along with existing buildings, if additions or alterations are part of the project. In addition, applications shall include typical sections and elevations, single-line diagrams of proposed building systems if applicable, or outline descriptions of heating, ventilation and air conditioning, electrical power, lighting and communications systems, plumbing, fire protection, materials handling and transportation systems, dietary, water supply and sewage systems and preliminary layouts of mechanical equipment rooms and riser diagrams and outline specifications; and
(b) a functional stack diagram which includes square footages, type of construction and estimated cost of equipment for each functional area displayed and, where appropriate, the relative cost of each area as well as the total construction cost for each discrete physical structure involved and a set of single-line freehand sketches of each floor in an appropriate scale, showing the relationship of the various departments or services to each other. The major exit corridors, exit stair locations and pedestrian and service circulation patterns shall be indicated, along with existing buildings if additions or alterations are part of the project;
(ii) a list in outline form of functional project components, including the enumeration of primary treatment spaces and the area to be included in each component;
(iii) a description of the functional and locational relationships among each related but discrete component;
(iv) the current and proposed bed capacity of the facility by the type of bed, indicating the total number of existing and proposed beds and nursing units and the type of room distribution ( e.g., single or multi-bed rooms), the number of each, and the patient or resident capacity of the institution upon completion of construction;
(v) a description of proposed alterations or additions to existing structures;
(vi) a description of the energy sources, type and location of engineering systems which will be used for heating, cooling, ventilation and electrical distribution;
(vii) a description of the proposed method of transport of clean and soiled materials and wastes;
(viii) a description of the intended dietary systems; and
(ix) a description of methods intended for water supply and sewage.
(c) Such other information pertinent to the project as the commissioner, State Hospital Review and Planning Council, Public Health Council or health systems agency may require.
(d) All applications transmitted pursuant to this section shall be:
(1) subscribed by the chief executive officer or other officer so authorized by the board of a corporate applicant, a general partner or proprietor of a medical facility, or, where an application is to be submitted by a municipal medical facility, the president or chairman of the board of the facility, or the chief executive officer if there is no board; and
(2) with respect to applications involving full review or the reduction or deletion of licensed beds and/or services, the application shall be accompanied by a certified copy of a resolution of the board of a corporate applicant authorizing the undertaking which is the subject of the application and the subscribing and submission thereof by an appropriate designated individual.
(e)
(1) After receipt and review of the application setting forth the scope and concept of the project, the commissioner, after considering the recommendations of the local health systems agency and the State Hospital Review and Planning Council, shall make a determination. If the application is approved, the applicant shall be notified of such approval together with any contingencies or conditions therein. The applicant, upon receipt of such approval, may proceed with the application pursuant to section 710.4 of this Part.
(2) If the commissioner proposes to disapprove a project or make a determination contrary to the recommendation of the local health systems agency, the opportunity to request a hearing shall be afforded to the appropriate party before a decision is made.
(3)
(i) The commissioner may, during the processing of an application, propose to disapprove the application solely on the basis that the facility is not currently in substantial compliance with all applicable codes, rules and regulations or that the adequacy of financial resources and sources of future revenue has not been demonstrated in advance of his consideration of the other criteria under Public Health Law, section 2802 without, however, waiving his right to consider such criteria at a later date.
(ii) In the event the commissioner, upon the recommendation of the State Hospital Review and Planning Council, proposes to disapprove an application solely on the basis that the facility is not currently in substantial compliance with all applicable codes, rules and regulations or that the adequacy of financial resources and sources of future revenue has not been demonstrated and the applicant then requests a hearing, the commissioner may direct the completion of the other reviews required by Public Health Law, section 2802, the results of which shall be presented to the State Hospital Review and Planning Council for its recommendation, which reviews may then be considered at the hearing. If the commissioner directs the completion of such reviews, a copy of the report containing the results of the reviews shall be mailed to the applicant at least 60 days prior to the date set for hearing.
(iii) In the event the commissioner proposes to disapprove an application solely on the basis that the facility is not currently in substantial compliance with all applicable codes, rules and regulations or that the adequacy of financial resources and sources of future revenue has not been demonstrated and the State Hospital Review and Planning Council does not concur with such proposed disapproval, the application shall be returned to the department without a formal recommendation. The commissioner shall then direct the completion of the other reviews required by Public Health Law, section 2802, and shall return the application to the State Hospital Review and Planning Council for its formal recommendations.
(4) Before a health systems agency may make a recommendation to the commissioner relative to an application, it must have first provided notice to all interested parties of the receipt of such application, together with a brief description thereof. For purposes of this paragraph, interested parties shall mean all persons, entities, agencies or other organizations, located within the health systems agency's geographic area, that have requested, in writing to such agency, notification of the applications pending review by the agency.
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.3 Fire and safety
(a) Buildings and equipment shall be maintained and operated so as to prevent fire and other hazards to personal safety.
(b) The facility shall comply with the pertinent provisions of NFPA 101, Life Safety Code. Further details concerning this referenced material are contained in section 711.2(a) of this Title.
(c) The facility shall comply with the pertinent provisions of NFPA 99, Standard for Health Care Facilities. Further details concerning this referenced material are contained in section 711.2(a) of this Title.
(d) The facility shall maintain a procedure to investigate fires. A written report of the investigation containing all pertinent information shall be made. The report shall remain on file for not less than six years.
(e) The facility shall maintain a procedure for reporting to a designated administrative officer on a standard form adopted for the purpose, all accidents to patients, staff, employees or visitors. The report shall include all pertinent information and shall be kept on file for not less than six years after the occurrence was reported.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.302 Revenue center
An account for accumulating revenue consistent with the functional definition of the matching cost center.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.6 Utilities
The operator shall be responsible for the installation and maintenance of park utilities, in accordance with applicable State and local regulations or generally accepted standards. The operator shall also be responsible for the proper connection of park utilities to each home.
(a) Water supply.
(1) Drinking water shall be adequate in quantity, of a quality which the permit-issuing official approves as complying with the applicable requirements of Part 5 of this Title, and shall be readily available to occupants of the property. Nonpotable water shall not be accessible to park occupants.
(2) A minimum water pressure of 20 pounds per square inch shall be provided at the riser pipe of each site at all times.
(3) A water service connection consisting of a service box with a shut-off valve installed below the frost line and a three-quarter inch riser pipe shall be supplied on each site. Surface drainage shall be diverted from the connection. The park operator shall be responsible for maintaining the shut-off and riser pipe, except where the responsibility for the riser pipe has been transferred to the mobile home occupant by formal written agreement. Such formal written agreement shall be available for review by the permit-issuing official.
(4) The riser pipe shall be provided with a watertight seal when not connected to a home.
(b) Sewage facilities.
Facilities shall be provided and maintained for the satisfactory treatment and/or disposal of sewage.
(1) All sewage facilities shall be designed, constructed, and maintained in accordance with the appropriate standards of the Departments of Health or Environmental Conservation.
(2) No construction of new or modified facilities shall commence until approval from the agency having jurisdiction in writing has been received by the operator. All construction shall be in accordance with approved plans.
(3) Each site shall be provided with a minimum four-inch sewer pipe below the ground surface and a four-inch rise pipe.
(4) The connecting pipe (minimum of three-inch diameter) from the mobile home to the riser pipe shall be noncollapsible and semirigid. All connections shall be watertight.
(5) The rise pipe shall be provided with a watertight seal when not connected to a mobile home.
(6) Inadequately treated sewage on the surface of the ground shall be prohibited.
(7) The operator shall be responsible for maintaining the sewage system to include the riser pipe. The connecting pipe shall also be the responsibility of the operator unless the responsibility has been transferred to the mobile home occupant by formal written agreement. Such formal written agreement shall be available for review by the permit-issuing official.
(c) Utilities other than water and sewage.
Distribution systems for electricity, including the mobile home service equipment and feeder assembly, gas and fuel oil shall be in accordance with applicable State and local regulations or generally accepted standards. The operator shall be responsible for maintaining these systems, including the connection to each home, unless such responsibility has been transferred to the mobile home occupant by formal written agreement. Such formal agreement shall be available for review by the permit-issuing official.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.19 Bathing beach design standards
0.0 Introduction. These standards are to be used by public health officials, design engineers and architects, and the owners and operators of bathing beaches for the design of new or modified bathing beaches regulated by this Subpart. These standards are enacted to ensure adequate design and establishment of bathing beaches, reflecting current safety and sanitary requirements. These standards are applicable to all bathing beaches located on ponds, lakes, streams or other bodies of water in the State.
1.0 Definitions.
1.1 Bathing beach shall mean a bathing place, together with any buildings and appurtenances, and the water and land areas used in connection therewith, at a pond, lake, stream or other body of fresh or salt water which is used for bathing or swimming with the express or implied permission or consent of the owner or lessee of the premises or which is operated for a fee or any other consideration or which is openly advertised as a place for bathing or swimming.
1.2 Uniform Code shall mean the New York State Uniform Fire Prevention and Building Code, 9 NYCRR Subtitle S, Chapter I.
1.3 Adequate shall mean sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
2.0 Submission of plans.
2.1 General. Preliminary plans and the engineer' s report should be submitted for review prior to the preparation of final plans. No approval for construction shall be issued until final, complete, detailed plans and specifications have been submitted to the permit-issuing official (PIO) and are approved. Documents submitted for formal approval shall contain sufficient information to demonstrate to the permit-issuing official that the proposed bathing beach, or improvements thereto, will meet the design standards specified in this section, and shall include, but not be limited to:
2.1.1 Detailed description of the watershed, with location and identification of all potential sources of contamination, including any anticipated future development.
2.1.2 Location of access roads, parking, buildings, water supplies, sanitary and storm sewers, electrical and telephone services and the proposed facilities relative to existing facilities.
2.1.3 Date, address, name, professional seal, and signature of the designing engineer or architect.
2.1.4 Location relative to nearest population center with service facilities, such as medical, fire protection and communication.
2.1.5 Maximum and average attendance and swimmer loads.
2.1.6 Source, quality, quantity and characteristics of water.
2.1.7 Area designations, bottom slopes and materials.
3.0 Sanitary survey report. A report reflecting the results of a sanitary survey shall include the following information:
3.1 Watershed supplying bathing area. A map shall depict the watershed, including but not limited to existing waste-water discharges, landfills or other facilities that may have an impact on water quality, adjacent land use and major physical contours, highways, etc. The extent of the watershed to be mapped should be based upon knowledge of the characteristics of the watershed. All potential sources of pollution and waste-water discharges must be shown.
3.2 Plot maps. A map drawn to scale, showing the actual bathing beach location, dimensions, contours, existing land use and waste-water discharges within 10,000 feet of the proposed beach, unless otherwise required by the PIO.
3.3 Water level. Seasonal or anticipated water level variations.
3.4 Sources of contamination. Listing of type and size of existing and potential sources of contamination, volume, occurring only with specific weather conditions, and the concentration of the materials in the effluent that might adversely affect the bathing beach water. The potential for contamination during and after storm events must be included.
3.5 Weather and topographical influences. Prevalent wind direction during bathing season, rainfall, current measurement, topography, or unusual factors.
3.6 Bathing beach water quality. A history of the bacteriological quality, pH, and the turbidity of the proposed body of water shall be researched from all possible sources. The results of at least one set of representative bacterial samples, pH tests, and turbidity tests each week for a period of eight weeks shall be included. Eight sets of samples shall include at least one set after heavy rains consisting of daily samples for a five-day period.
3.7 Physical and chemical. The physical and chemical quality of bathing water, including objectionable color, odor, taste and other substances capable of producing unusual quality problems. A history of any unusual quality problems encountered in the bathing water should be included.
3.8 Biological. The biological quality of bathing area water, including objectionable vegetation, infectious snails, and poisonous or dangerous aquatic organisms, shall be discussed.
3.9 Fishing, boating or canoeing. Location of boat traffic, marinas or boat dockage area, any canoeing activity or fishing.
3.10 Auxiliary water source. Location, flow rate of auxiliary water source to augment low flow.
4.0 Design. The following criteria shall be used for establishing a bathing beach:
4.1 Location. The suitability of the site shall be established by a sanitary survey.
4.2 Area. The water surface area of the body of water where the beach is developed shall be at least one acre. When the area is less than four acres and 100 gallons per bather per day of natural flow- through in the bathing area is lacking, a source of dilution water of at least 100 gallons per bather per day must be provided with minimum water quality meeting the provisions of section 6-2.15 of this Subpart.
4.3 Bather use. A minimum of 25 square feet of water surface per bather shall be provided. At least 75 square feet per bather must be provided in the area over four feet deep.
4.4 Land area. At least 35 square feet of land area per bather should be provided.
4.5 Bottom slopes. For depths up to four feet, the slope shall be uniform and not exceed 1:10. For greater depths, the slope should not exceed 1:3.
4.6 Bottom materials. The bottom up to a water depth of six feet shall consist of sand, pea gravel or other similar material.
4.7 Area designations.
4.7.1 Location of lines. Marker lines with buoys shall be provided at all beaches. except Great Lakes or ocean beaches, to designate the perimeter, the separation of shallow and deep-end areas at a depth of three to four feet, the diving area, and dropoffs, radical changes in slopes or underwater obstructions. A separate wading area up to two feet deep, designated by lines, should be provided.
4.7.2 Installation. Lines shall have floats at five-foot intervals and be securely anchored, and have buoys no more than 25 feet apart and at points where lines are joined.
4.7.3 Depth markers. Clearly visible depth markers shall be provided at all the diving boards, platforms and similar facilities, together with warning signs stating “No Diving” where depth is less than eight feet.
4.8 Diving facilities.
4.8.1 Platforms. Floating diving piers and fixed platforms shall be constructed with a visible 12-inch air space under maximum feasible load. There shall be as little underwater construction as is consistent with adequate support. All braces and struts shall be designed to prevent entrapment of bathers. For solid flotation devices such as foam blocks, no air space is required.
4.8.2 Depths. Diving from rafts, piers or other platforms shall be prohibited, unless a minimum water depth of eight feet is provided and maintained for a distance of at least 10 feet forward of the diving direction. For a diving board or other device three or less feet above the water, the depth at the end of it, and for 10 feet beyond it, shall be 10 feet. For heights above water greater than three feet, the depths at those locations shall be 12 feet and 20 feet beyond it. No diving device more than 10 feet above water shall be installed.
4.9 Water currents. Water currents in the bathing area shall not exceed three feet/second.
4.10 Sewage discharges. No waste-water discharges from sewage treatment plants, combined sewers or other sources shall be permitted within 750 feet of the bathing beach.
4.11 Water quality. Bathing beaches shall meet the water quality criteria for bacteriological, physical and chemical quality specified below.
4.11.1 Bacteriological quality. Based on the mean of the logarithms of the results of five or more samples collected in a 30 day period, the upper value for the density of bacteria shall be:
4.11.1.1 2,400 total coliform bacteria per 100 ml; or
4.11.1.2 200 fecal coliform bacteria per 100 ml; or 4.11.1.3 33 enterococci per 100 ml for freshwater; or
4.11.1.4 35 enterococci per 100 ml for marine water; or
4.11.1.5 126 E. coli per 100 ml for freshwater ( E. coli is not to be used as an indicator in marine water)
4.11.2 Chemical quality. The water shall be free of chemical substances capable of creating toxic reactions, skin or membrane irritations to the general public.
4.11.3 Physical quality—water clarity. In all bathing areas, except the Great Lakes or ocean beaches, it shall be possible to see an eight-inch black-and-white disk in four feet of water. Clarity tests should be performed at a four-foot depth in the bathing area at a minimum of three different locations. A map depicting test locations, dates of sampling and current conditions should be submitted.
4.12 Electrical requirements.
4.12.1 Wiring shall conform to the New York State Uniform Fire Prevention and Building Code, 9 NYCRR Subtitle S, Chapter I, and the requirements of the appropriate regulatory agency. A certificate shall be submitted for all new electrical work.
4.12.2 Overhead clearance. No overhead electrical wiring shall pass within 20 feet horizontally of the bathing beach water line.
5.0 Bathhouse.
5.1 General. Adequate toilet and handwashing facilities shall be provided for all bathing beaches.
5.2 Bathhouse design. Floors of the bathhouse shall be of smooth-finished material with nonslip surfaces, impervious to moisture, cleanable and sloped at least one-fourth inch per foot to drains. Carpeting shall not be permitted in shower and toilet areas or other areas receiving bathers. Junctions between walls and floors shall be coved. Walls and partitions shall be of smooth, impervious materials, free from cracks or open joints. Partitions between dressing cubicles shall terminate at least 10 inches above the floor or shall be placed on continuous raised masonry or concrete bases at least four inches high. Lockers shall be set either on solid masonry or concrete bases at least four inches high or on legs with bottom of locker at least 10 inches above the floor. Lockers shall be vented.
5.3 Fixture requirements. An adequate number of toilet and handwashing facilities shall be provided.
5.3.1 Fixtures. Plumbing fixtures and installations shall be in accordance with the Uniform Code.
5.4 Water supply. The source and quality of water supply serving the plumbing fixtures, including drinking fountains, lavatories and showers, shall after treatment meet the applicable requirements of Part 5 of this Title for potable water.
5.5 Drinking fountains. Where drinking fountains are provided, at least one drinking fountain for each 500 feet distance or for every 1,000 users or fraction thereof should be provided. The drinking fountains shall be of slanting-jet type with surrounding guard, nonsubmersible opening. These shall be located at a convenient point and shall be supplied with a minimum of 20 psi adequate water pressure.
5.6 Waste-water disposal. Waste water from a bathhouse or related facilities shall be discharged to a municipal sewerage system, when available. If not available, the substitute system shall be approved by the State Commissioner of Health or such other agency having jurisdiction over sewage plan approval.
5.7 Suits and towels. Where towels and/or swimming suits are provided, facilities shall be provided to launder, store and sanitize these items after each usage.
5.8 Hose bibbs. Hose bibbs with vacuum breakers must be provided within the bathhouse to enable the entire area to be flushed with a 50-foot hose.
5.9 Ventilation. All enclosed places, dressing rooms, shower rooms and toilets shall be ventilated by natural or mechanical means to provide a minimum of two air changes per hour.
6.0 Safety provisions.
6.1 Signs. For beaches using Supervision Level I or IIb aquatic supervision, when no lifeguard is on duty at a beach, a legible sign or signs stating “No Lifeguard on Duty—Swimming Prohibited” shall be posted. The sign shall be a minimum 36″ × 24″ in size, with letters at least two inches high. “No Swimming” signs shall be posted at areas not permitted/approved for bathing on property adjoining the designated bathing area that is owned or under the control of the permit holder.
6.2 Lifesaving equipment. Lifesaving equipment shall be provided as required in section 6-2.17(b) of this Subpart.
6.2.1 Boats/Boards. An adequate rescue board or an adequate boat shall be provided at all beaches where Supervision Level I or IIb aquatic supervision is required.
6.2.1.1 Where bathing is permitted more than 150 feet from the bathing shoreline, lifesaving patrol boats or offshore lifesaving stations shall be provided. Each such boat shall be at least 12 feet long, equipped with pin oars, one life pole or shepherd’s-crook type of pole having blunt ends, and one ring or torpedo buoy or rescue tube and life vests. Such boats shall be used for patrol, search and rescue purposes only.
6.2.2 Equipment at lifeguard station.
6.2.2.1 Elevated lifeguard chairs shall be located as close as practicable to the bathing area shoreline to provide a clear, unobstructed view of the bathing area.
6.2.2.2 A rescue tube or torpedo buoy with six feet of line, or a rescue can with 500-foot hauling line.
6.2.3 Maintenance. Safety equipment shall have its function plainly marked, and shall be kept in good repair and in ready condition. Bathers or others shall not be permitted to tamper with or use such equipment for any other than its intended use, or remove it from its established location.
6.3 Communication. A telephone(s) or other means of communication, with numbers posted of nearest squad, physician, ambulance, police agency and hospital, shall be provided at each beach.
6.4 Emergency care room. Every bathing beach capable of accommodating 500 swimmers and bathers shall have a readily accessible room or area designated and equipped for emergency care. Such room shall be equipped with at least the following: running potable water, a cot or bed, with blankets and sheets, advanced first aid supplies at least equivalent to 24 units, and resuscitation equipment.
6.5 Solid waste. An adequate number of leak-proof solid waste receptacles with self-closing lids shall be placed in the beach area.
6.6 Dangerous objects on beach. Glass containers shall not be permitted on the beach.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-4 REQUIREMENTS FOR ALTERNATIVE REGULATED MEDICAL WASTE TREATMENT SYSTEMS
10 CRR-NY 70-4.1 Approval of technology
(a) No alternative treatment system shall be used to treat regulated medical waste without approval by the Commissioner of Health of the treatment technology pursuant to Subpart 70-5 of this Part. In the approval of an alternative treatment technology, the department shall specify the scope of the approval, including, but not limited to, the type(s) of waste and/or waste composition for which the system has been approved.
(b) No regulated medical waste other than that of a type and composition specified in the Commissioner of Health's approval of an alternative treatment technology shall be treated using the approved technology.
(c) No facility shall use an alternative treatment system to render harmless, dispose of or otherwise handle, in the same or different loads than regulated medical waste, material other than the regulated medical waste for which the system received approval, unless the facility, jointly with the system manufacturer, demonstrates to the department that the system is effective in treating regulated medical waste and that the system is not impacted adversely by the facility's use of the system for purposes other than treating regulated medical waste.
(d) An autoclave used to treat human tissue(s), human and animal organs, and/or animal body parts shall require approval as an alternative treatment system pursuant to Subpart 70-5 of this Part. An autoclave operated at a residence time, temperature and/or pressure other than those prescribed in Subpart 70-3 of this Part shall require approval as an alternative treatment system pursuant to Subpart 70-5 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.198 Materiality
The relative importance, when measured against a standard of comparison, of all items (cumulative by cost center or account) included in or omitted from books of account or financial statements, or any procedure or change in procedure that conceivably might affect such statements. An amount is material if its exclusion from or inclusion in an accounting statement would make it misleading.
10 CRR-NY 441.83 Date of change in certified bed capacity—decrease
(a) Partial decertification of beds in a unit.
The date proposed in the hospital's letter of intent to decertify filed with the Department of Health and subsequently approved.
(b) Retroactive decertification of part or all of a unit.
The date promulgated by the Department of Health.
(c) Full decertification of beds in a unit.
The date the last patient was discharged from the unit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.3 Responsibilities of the CEO of a hospital
The CEO shall ensure that the hospital complies with the following procedures:
(a) The hospital shall inform the parent(s) of each newborn born in the hospital, or admitted to the hospital within the first 28 days of life, of the purpose and need for newborn screening, and shall provide newborn screening educational materials made available by the department.
(b) Specimen collection forms shall be properly stored in a cool and dry environment prior to use.
(c) The hospital shall collect a satisfactory specimen from every newborn between 24 and 36 hours after birth, except under the following circumstances:
(1) If a newborn is less than 24 hours of age at the time of discharge from the birth hospital, the birth hospital shall collect an initial satisfactory specimen prior to discharge. The birth hospital shall schedule and collect a repeat specimen from the newborn between 48 and 72 hours after birth.
(2) If a newborn is transferred to another hospital, the birth hospital shall collect an initial satisfactory specimen from the newborn prior to transfer, submit the satisfactory specimen to the testing laboratory, and provide written and/or electronic notification to the receiving hospital that a specimen was collected. The receiving hospital shall collect any repeat specimens from the newborn following transfer that are required by the testing laboratory. If the newborn is less than 24 hours of age when the birth hospital collects the satisfactory specimen, the receiving hospital shall collect a repeat specimen from the newborn between 48 and 72 hours after birth.
(3) If a newborn requires admission to an intensive medical care unit prior to the collection of a satisfactory specimen, the hospital shall collect an initial satisfactory specimen upon admission to the unit and shall submit the satisfactory specimen to the testing laboratory. The hospital shall collect a repeat specimen between 48 and 72 hours after birth and shall submit the repeat specimen to the testing laboratory. The hospital shall collect a third satisfactory specimen upon discharge or at 28 days after birth, whichever comes first, designate it a repeat specimen, and submit the repeat specimen to the testing laboratory.
(4) If a newborn requires transfusion or total parenteral nutrition (TPN), the hospital shall collect an initial satisfactory specimen prior to any transfusion or administration of TPN and shall submit the satisfactory specimen to the testing laboratory. If a specimen is not collected prior to transfusion and/or TPN, the hospital shall wait to collect an initial satisfactory specimen until 72 hours after administration of a transfusion and/or TPN and submit the specimen to the testing laboratory. The hospital shall schedule and collect a repeat specimen no later than 120 days after the date of final transfusion and/or TPN, and submit the repeat specimen to the testing laboratory.
(5) If a newborn is admitted to the hospital within the first 28 days of life and no specimen has been previously collected, the hospital shall collect a satisfactory specimen upon admission and submit it to the testing laboratory.
(d) All specimens shall be air dried thoroughly on a flat nonabsorbent surface for a minimum of three hours prior to forwarding to the testing laboratory.
(e) All specimens, including repeat specimens, shall be submitted to the testing laboratory within 24 hours of collection to ensure the specimens are received by the testing laboratory no later than 48 hours after collection using the testing laboratory's delivery service or an equivalent arrangement.
(f)
(1) When notified by the testing laboratory that a repeat specimen is required, the hospital shall notify the parent(s) and responsible provider within one business day that a repeat specimen is required from the newborn. The hospital shall collect the repeat specimen, pursuant to guidance issued by the testing laboratory, and submit it to the testing laboratory as soon as practicable.
(2) If the responsible provider documented on the initial specimen collection form is no longer responsible for the newborn’s care, the hospital shall identify a new provider, notify the new provider of the need for a repeat specimen, and submit the contact information for the new provider to the testing laboratory.
(3) If the hospital is unable to obtain a repeat specimen, the hospital shall submit written and/or electronic documentation to the testing laboratory describing the steps taken by the hospital to notify the parent(s) and responsible provider that a repeat specimen(s) was required. The hospital shall submit this documentation to the testing laboratory no later than 90 days after receiving notification from the testing laboratory that a repeat specimen was required.
(g) If a satisfactory specimen or a repeat specimen is not collected due to newborn mortality, the hospital shall submit a written and/or electronic notification to the testing laboratory within five days after death.
(h) The hospital shall submit all information required by the testing laboratory using an electronic format determined by the department, provided that:
(1) specimen collection forms shall be submitted as directed by the testing laboratory; and
(2) a hospital may request an exemption from electronic submission by demonstrating, to the department’s satisfaction, that the requirement imposes an undue burden.
(i) The hospital shall document on the newborn’s health record the LAB I.D., as it appears on the specimen collection form, the date and time of specimen collection, and all screening results.
(j) The hospital shall document the LAB I.D., as it appears on the specimen collection form, on any discharge summary, and shall transmit a copy of the screening results or a copy of the discharge summary to the responsible provider.
(k) Before performing any tasks relating to collection of specimens, an employee shall complete comprehensive specimen collection training. The employee shall complete such training annually thereafter. The hospital shall retain documentation of completion of all such training.
(l) The hospital shall provide the testing laboratory with the names and contact information for its hospital administrative designee(s) and medical designee(s), annually; within 90 days of any request from the testing laboratory; and within 30 days of a change of designee. Such information shall be provided on a form prescribed by the department.
(m) The hospital shall establish written policies and procedures, which shall be available for the department’s review, for:
(1) the collection, storage, tracking and shipping of specimens; and
(2) the tracking and disposition of test results.
(n) The hospital shall comply with the following additional requirements for HIV testing:
(1) the hospital shall obtain written documentation of any HIV testing and treatment during the current pregnancy and include such documentation in the mother’s health record. The hospital shall counsel the mother consistent with such testing;
(2) if no HIV test result is documented in the health record of a mother and the mother’s HIV status during the current pregnancy is unknown, the hospital shall immediately arrange an expedited HIV test of the mother with her consent, or if the mother declines testing for herself, arrange for expedited HIV antibody screen for the newborn with results available as soon as practicable, but no later than 12 hours after the mother provides consent for testing or, if she does not consent, 12 hours after the time of the newborn's birth;
(3) the hospital shall maintain in the newborn’s health record the newborn’s HIV test result in accordance with article 27-F of the Public Health Law;
(4) the hospital shall determine the need for, and ensure provision of, HIV prophylaxis and/or treatment per standard of care to prevent transmission to the infant, and shall record such in both the mother’s and newborn’s health records;
(5) the hospital shall transmit a copy of the newborn's HIV test result to the responsible provider. For any newborn with a result indicating exposure to HIV, the hospital shall coordinate with the responsible provider to arrange appointments for follow up care with a provider experienced in the treatment of HIV;
(6) the hospital shall submit to the department any specimen(s) necessary to confirm the HIV infection status of the newborn; or submit documentation of confirmatory test results from a laboratory permitted pursuant to section 574 of the Public Health Law;
(7) the hospital shall collect and provide authorized department staff with such data as the department may require for program evaluation and, in the case of HIV exposed newborns, patient follow-up;
(8) the hospital shall submit to the department information related to HIV testing and treatment history of mothers and newborns for the purposes of medical audits. Such information shall be kept confidential as required by section 206(1)(j) of the Public Health Law; and
(9) the hospital shall provide the department with the names and contact information for an HIV administrative designee(s) and a hospital appointed HIV medical designee(s):
(i) annually;
(ii) within 90 days of any request from the testing laboratory; and
(iii) within 30 days of a change of designee.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.3 Confidentiality
All information which may identify an applicant which is received by the program will be confidential and can only be used when necessary for supervision, monitoring or administration of the program. Information received by any contractor, his agents, employees, or by any other person or agency concerning applicants or participants in the program is confidential and may not be disclosed without the written approval of the Uninsured Care Program director, who shall approve disclosure only in conformance with article 27-F of the Public Health Law and the Federal standards with respect to the privacy and security of individually identifiable health information contained in Part 164 of title 45 of the Code of Federal Regulations .
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.13 Sewage system
(a) All waste water from a swimming pool shall be discharged in such a manner that waste water cannot be siphoned, flooded or otherwise discharged into the pool.
(b) The sanitary sewer serving the swimming pool shall discharge to a public sewer system or other approved disposal system.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.9 Revocation, limitation and annulment of approval's of establishment
(a) An approval of establishment to operate as a central services facility rural health network may be revoked, limited or annulled by the Public Health Council if it finds:
(1) that the established operator has been found guilty of fraud or deceipt in procuring such approval of establishment or has made statements or furnished information in support of the application which were not true, accurate, or complete in any material respect;
(2) that the operating certificate of a hospital operated by a central services facility rural health network established pursuant to section 680.10 of this Part has been revoked, limited or annulled pursuant to the applicable provisions of law;
(3) that a hospital operated by a central services facility rural health network established pursuant to section 680.10 of this Part caused or allowed a patient to be subjected to violence or abuse by an employee, consultant, volunteer or other person serving in any capacity in the hospital or that a hospital has failed to comply with the provisions of article 28 of the Public Health Law or the rules and regulations promulgated thereunder;
(4) that the established operator has been convicted in a court of competent jurisdiction, either within or without the State, of a crime;
(5) that the operator has transferred operating control of the central services facility rural health network, or a hospital which it operates, within the meaning of section 405.1(c) of this Title without Public Health Council approval;
(6) that the established operator has granted any person convicted of a crime relating to hospital activities the authority to direct or cause the direction of the operations, management or policies of the corporation or a hospital operated by the corporation;
(7) that the established operator has failed to comply with any condition, limitation or other requirement imposed by this Part or as part of, or in conjunction with, the approval of the establishment;
(8) that a final disapproval to operate as a central services facility rural health network has been issued by the commissioner; or
(9) that the commissioner has revoked approval of a central services facility rural health network operational plan in accordance with section 408.4(a) of this Title.
(b) For purposes of this section, established operator shall include a central services facility rural health network and any incorporator, director, established member or officer thereof whose application for establishment has been approved, regardless of whether the commissioner has approved the corporation's network operational plan.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.3 Emergencies
The director shall have the authority to waive any of the prescribed requirements for admission when in his judgment an emergency exists requiring immediate admission of a patient.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-9 STANDARD INFANT AUTOPSY PROCEDURES
10 CRR-NY 69-9.1 Definition
Autopsy means a post-mortem external and internal physical examination conducted in accordance with the laws of New York State, as well as the performance of needed special studies. Infant autopsies are to be performed in accordance with the State of New York Infant Autopsy Protocol.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.16 Compliance
It is the responsibility of the clinical laboratory and the health services purveyor to establish, including by appropriate documentation, that any practice between the two entities complies with this Subpart. Upon request from the department, the health services purveyor and/or the clinical laboratory shall make such documentation available for inspection and copying. If requested by the clinical laboratory, such documentation shall be eligible for exemption from disclosure under the Freedom of Information Law (article 6 of the Public Officers Law), pursuant to the authority in section 89(5) of the Public Officers Law.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.20 Hazardous materials
Agricultural, commercial or household pesticides and toxic chemicals shall be stored and/or used to cause no air, surface water or ground water pollution or be hazardous to the occupants of the camp. They shall be stored in their original containers in areas designated for such use.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.4 Additional information to be submitted
(a) After the issuance of the approval of the application by the commissioner, the applicant shall submit, to the Bureau of Architectural and Engineering Review, with a copy of the transmittal letter to the project management unit for information, the following:
(1) one set of design development drawings which has been reviewed and approved by the applicant's chief executive officer or equivalent person. Such drawings shall be in sufficient detail to ensure consistency with the detailed functional and operational requirements of this Title and the National Fire Protection Association's codes and standards set forth in Part 711 of this Title. The applicant shall advise the department one month in advance of its intent to file such drawings;
(2) an updated functional stack diagram which includes square footages, type of construction and estimated cost of equipment and construction for each functional area displayed and, where appropriate, the relative cost of each area as well as the total construction cost for each discrete physical structure involved; and
(3) draft contracts relating to construction costs included in the total basic cost of construction as defined in section 710.1 of this Part.
(b) In addition to those items specified in subdivision (a) of this section, the applicant must submit to the project management unit eight copies of the following information:
(1) any financial information which may have an impact on the feasibility of the project;
(2) any information that may have an impact on quality of care issues;
(3) the method and terms of any permanent financing for the project; and
(4) the updated total project costs as defined in section 710.1 of this Part in a format prescribed by the commissioner if different than previously approved by the commissioner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.5 Eligibility for coverage
(a) An applicant must be confirmed as medically eligible to participate in the program. The Department of Health will confirm medical eligibility based upon information received from the applicant and the applicant's clinical practitioner or their designee. The applicant's clinical practitioner or their designee will be required to submit information regarding an applicant's medical condition on a State-approved form consistent with their scope of practice.
(b) Financial eligibility will be based upon the available household income.
(1) In order to be eligible, an applicant's available household income must be equal to or less than 500 percent of the amount under the annual United States Department of Health and Human Services poverty guidelines for the applicant's family size. Federal poverty guidelines are published annually by the Department of Health and Human Services in the Federal Register.
(2) Applicants must provide income information for a reasonable period prior to application. Applicants who are self-employed must provide business records for the three months prior to application indicating type of business, gross income and net income.
(c) Full and proper use shall be made of existing public and private medical and health services and facilities for obtaining therapeutic drugs, medical services, and related supplies and equipment for the treatment or prevention of HIV or AIDS.
(d) An applicant or recipient of assistance may be required as a condition of eligibility or continued eligibility to assign any rights they may have for coverage benefits under any health insurance policy or group health plan to the department.
(e) In order to be eligible for ADAP Plus Insurance Continuation, an applicant must have:
(1) a health insurance policy that is determined to be cost effective by the department, based on the cost of premiums, limitations of coverage ( i.e., deductible caps, co-payments) and estimates of the monetary value of projected utilization and reimbursement under the insurance policy; and
(2) a premium cost that is more than four percent of the applicant's available household income, if the applicant's available household income is greater than 200 percent of the amount under the annual United States Department of Health and Human Services poverty guidelines for the applicant's family size.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 147.1 Greenlawn Water District, town of Huntington
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well located on land owned by the Greenlawn Water District and situated on a plot of ground in the unincorporated village of Centerport in the town of Huntington, 350 feet north of the Huntington-Northport Road at the head of Northport Harbor, or to any additional wells which may be constructed on this property which forms the source of the public water supply of the Greenlawn Water District, town of Huntington, Suffolk County, NY.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the Greenlawn Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Greenlawn Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the Greenlawn Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [c][4] and [5] of this section, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health) within 200 feet of the well of the public water supply of the Greenlawn Water District. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of the well of the public water supply of the Greenlawn Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [c][4] and [5] of this section) within 200 feet of the well of the public water supply of the Greenlawn Water District.
(e) Animals, manure, compost, etc.
(1) No manure pile or compost heap shall be located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Greenlawn Water District and no such manure pile or compost heap shall be located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from the well of the public water supply of the Greenlawn Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of the well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of the well of the public water supply of the Greenlawn Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of the well of the public water supply of the Greenlawn Water District.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Greenlawn Water District upon which the well of the public water supply of the Greenlawn Water District is located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Greenlawn Water District.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of the well of the public water supply of the Greenlawn Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the well of the public water supply of the Greenlawn Water District.
(j) Inspections.
The board of water commissioners of the Greenlawn Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Greenlawn Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.194 Enforcement
(a) Operation of a food service establishment without a permit is a violation of this Subpart. The permit-issuing official or his designated representative may order any food service establishment or operation in his jurisdiction, operating without a valid permit, to close and cease all food operations immediately, and to remain closed until the establishment or operation has obtained and displays a valid permit.
(b) For serious, repeated or persistent violations of any of the requirements of this Subpart, or for interference with the permit-issuing official or his designated representative in the performance of his duties, the permit may be revoked after notice and an opportunity for a hearing has been provided by the permit-issuing official.
(c) The permit-issuing official may suspend a permit and order immediate cessation of operations and service of food at a food service establishment within his jurisdiction when in his opinion continued operation is an imminent hazard to public health. Any person so ordered is to comply immediately, and within 15 days is to be provided with an opportunity to be heard and to present proof that continued operation does not constitute a danger to the public health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.6 Standards for initial and ongoing service coordinators
(a) All agencies and individuals approved to provide early intervention service coordination shall fulfill those functions and activities necessary to assist and enable an eligible infant and toddler and parent to receive the rights, procedural safeguards and services that are authorized to be provided under State and Federal law, including other services not required under the Early Intervention Program, but for which the family may be eligible.
(1) Each eligible infant and toddler and their family shall be provided with one service coordinator who shall be responsible for:
(i) coordinating all services across agency lines; and
(ii) serving as the single point of contract in helping parents to obtain the services and/or assistance they need.
(b) Service coordination shall be an active ongoing process that involves:
(1) assisting parents of eligible infants and toddlers in gaining access to the early intervention services and other services identified in the individualized family service plan, including making referrals to providers for needed early intervention services and other services identified in the IFSP, and scheduling appointments for infants and toddlers with disabilities and their families;
(2) ensuring the individualized family service plan outcomes and strategies reflect the family's priorities, concerns and resources, and that changes are made as the family's priorities, concerns and resources change;
(3) coordinating the provision of early intervention services and other services (such as educational, social, and medical services for other than diagnostic and evaluation purposes) that the infant or toddler and the family needs or is receiving;
(4) facilitating the timely delivery of early intervention services as soon as possible after written parental consent for the services in the IFSP is obtained; and
(5) continuously seeking the appropriate services and situations necessary to benefit the development of the child for the duration of the child's eligibility.
(c) Specific service coordination activities shall include:
(1) coordinating the performance of evaluations and assessments;
(2) facilitating and participating in the development, review and evaluation of individualized family service plans;
(3) conducting referral and other activities to assist families in identifying available Early Intervention Program service providers;
(4) coordinating, facilitating, and monitoring the delivery of early intervention services to ensure that the services are provided and in a timely manner;
(5) conducting follow-up activities to determine that appropriate early intervention services are being provided and in a timely manner;
(6) informing families of their rights and procedural safeguards;
(7) informing families of the availability of advocacy services;
(8) coordinating with medical and health care providers, including a referral to appropriate primary health care providers as needed;
(9) coordinating the funding sources for services required under this Subpart; and
(10) facilitating the development of a transition plan to preschool services if appropriate or to other available supports and services.
(d) In a format prescribed by the department, initial and ongoing service coordinators shall obtain and update at least quarterly, and parents shall provide, any information and documentation necessary to establish an eligible child’s third party payor coverage and the nature and extent of such coverage, including coverage through the medical assistance program, other State governmental insurance or benefit program, and/or other policy, plan, or contract under which the child has coverage. Such service coordinators shall transmit such information and documentation to the early intervention service provider and early intervention official within 14 calendar days of receipt.
(1) Service coordinators shall obtain written parental consent for the exchange of information with the insurer regarding available benefits and to facilitate claiming and payment.
(2) Service coordinators shall submit a written request to, and shall obtain from, the insurer information on the extent of benefits available to the covered child under the child’s third party payor coverage, in accordance with applicable State laws and regulations. The service coordinator shall transmit such information, in a format prescribed by the department, to the early intervention service provider and early intervention official within 14 calendar days of receipt.
(3) Service coordinators shall obtain, and parents shall provide, a written referral from a primary health care provider as documentation of the medical necessity of each early intervention service and shall, within 14 calendar days of receipt, forward this documentation to the early intervention service provider(s) delivering the service(s) to which the written referral applies and to the early intervention official.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.20 Separability
If any provision of this Subpart is held invalid, such invalidity shall not affect other provisions which shall be given effect without the invalid provisions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.9 Obligation of local health authority
Upon being notified by a principal or person in charge of a school of the exclusion from school of one or more children for lack of acceptable evidence of immunization, it shall be the responsibility of the local health authority to either:
(a) cooperate with the school authorities to provide a time and place, within two weeks of the exclusion, at which the appropriate immunization or immunizations may be administered, by a health practitioner as defined in section 66-1.1(e) of this Subpart; or
(b) notify the commissioner that the required immunizations will not be administered either by local health authority or school, and that the cost of doing so by the agents of the commissioner may be recovered from the amount of State aid to which the local health authority would otherwise be entitled.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.22 Alternate level of care payments
(a) Hospitals shall be reimbursed for ALC days at the appropriate 1987 group average operating cost component of rates of payment for hospital-based residential health care facilities established pursuant to Subpart 86-2 of this Part trended to the rate year. The determination of the group average operating rate for hospital-based residential health care facilities shall be based on the combination of residential health care facilities as follows:
(1) the downstate group consisting of residential health care facilities located in the five boroughs of New York City and Nassau, Suffolk, Westchester and Rockland Counties;
(2) the upstate group consisting of all other residential health care facilities in the State.
(b) Hospitals that convert medical/surgical beds to residential health care beds shall be reimbursed for services provided in the converted beds in accordance with Subpart 86-2 of this Part.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.15 Transportation
During transportation, food is to be protected from contamination, including maintenance of hot or cold temperature requirements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM
10 CRR-NY 85.20 Definitions
As used in the sections under the heading “Nonprescription Drugs in the Medicaid Program” (§ 85.20 et. seq. of this Part), unless the context otherwise requires:
(a) Nonprescription drug means a drug, commonly referred to as a nonlegend or over the counter drug, which may be sold at retail by a pharmacy to the general public. Neither Federal law nor regulations of the commissioner require that such drugs be distributed or dispensed on prescription. The provisions of Education Law, section 6810(1) and the first unnumbered paragraph of section 6816 are not applicable to the sale, distribution or dispensing of such nonprescription drugs.
(b) Medical assistance program means the New York State medical assistance to the needy program (Medicaid) authorized by article 5, title 11 of the Social Services Law.
(c) Commissioner means the Commissioner of Health of the State of New York.
(d) Package size of nonprescription drug means the amount of medication required to fill a request or order for such drug. Under the medical assistance program, reimbursement for nonprescription drugs shall not be greater than the price for the available manufacturers' package or unit size which most closely corresponds to the quantity requested on such written request or order.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.41 Corrosion control treatment steps and requirements
(a) Each system shall complete the applicable corrosion control treatment requirements found in subdivision (c) of this section unless it is deemed to have optimized corrosion control as provided under subdivision (b) of this section.
(b) Optimized corrosion control.
A system is deemed to have optimized corrosion control and is not required to complete the applicable corrosion control treatment steps identified in this section if the water system satisfies the criteria specified in one of the paragraphs (1) through (3) of this subdivision. Any such system deemed to have optimized corrosion control under this subdivision, and which has treatment in place, shall continue to operate and maintain optimal corrosion control treatment and meet any requirements that the State determines appropriate to ensure optimal corrosion control treatment is maintained.
(1) Any water system that serves 50,000 or fewer people is considered to have optimal corrosion control treatment if the water system meets the lead and copper action levels during each of two consecutive six-month monitoring periods conducted in accordance with section 5-1.42 of this Subpart.
(2) Any water system may be deemed by the State to have optimized corrosion control treatment if the system demonstrates to the satisfaction of the State that it has conducted activities equivalent to applicable corrosion control steps. Water systems deemed to have optimized corrosion control under this paragraph shall operate in compliance with State-designated optimal water quality parameters and continue to conduct lead and copper tap and water quality parameter sampling in accordance with sections 5-1.42(b)(3) and 5-1.43(b)(3) of this Subpart. A system shall provide information to the State to support a determination under this subdivision which includes, but is not limited to:
(i) the results of all samples collected for each of the water quality parameters in section 5-1.43 of this Subpar;
(ii) a report explaining the test methods used by the water system to evaluate the corrosion control treatments listed in subdivision (c)(3)(ii) of this section, the results of all tests conducted, and the basis for the system's selection of optimal corrosion control treatment;
(iii) a report explaining how corrosion control has been installed and how it is being maintained to insure minimal lead and copper concentrations at consumers' taps; and
(iv) the results of first draw lead and copper tap water samples collected in accordance with section 5-1.42 of this Subpart for two consecutive six-month monitoring periods after corrosion control has been installed.
(3) A water system is deemed to have optimized corrosion control if it meets the copper action level and can demonstrate:
(i) the difference between the results of the 90th percentile tap water lead level and the highest source water lead level is less than 0.005 mg/L for two consecutive six-month monitoring periods. The 90th percentile tap water lead level shall be sampled in accordance with section 5-1.42 of this Subpart and source water lead level shall be sampled in accordance with section 5-1.44 of this Subpar; and
(ii) a system’s highest source water lead level is below the method detection limit, and the 90th percentile tap water lead level is less than or equal to 0.005 mg/L for two consecutive 6-month monitoring periods.
(4) Any water system deemed to have optimized corrosion control in accordance with this section shall continue monitoring for lead and copper in tap water no less frequently than once every three calendar years using the reduced number of sites specified in section 5-1.42(a)(3) of this Subpart and collecting the samples at times and locations specified in section 5-1.42(c) of this Subpart, unless it meets the requirements for a nine year waiver as specified in section 5-1.42(f) of this Subpart.
(5) Any system triggered into corrosion control because it is no longer deemed to have optimized corrosion control under this section shall implement corrosion control treatment in accordance with the deadlines in paragraph (c)(2) of this section. Any such system serving more than 50,000 persons shall adhere to the schedule specified in paragraph (c)(2) of this section for systems serving 50,000 or fewer persons, with the time periods for completing each step being triggered by the date the system is no longer deemed to have optimized corrosion control under this section.
(6) Any water system deemed to have optimized corrosion control shall notify the State in writing, pursuant of section 5-1.48(i) of this Subpart, of any upcoming long-term change in treatment or addition of a new source. The water system shall obtain approval from the State before implementing the addition of a new source or long-term change in water treatment. The State may require any such system to conduct additional monitoring or to take other action the State deems appropriate to ensure that such systems maintain minimal levels of corrosion in the distribution system.
(c) Corrosion control treatment steps and deadlines.
(1) A system serving more than 50,000 persons shall complete the following corrosion control treatment steps, unless it is deemed to have optimized corrosion control as provided in paragraphs (b)(2) and (3) of this section:
(i) Step 1. The water system shall conduct initial first draw lead and copper tap sampling and water quality parameter sampling in accordance with sections 5-1.42 and 5-1.43 of this Subpart. If the lead or copper action level exceeds the 90th percentile, the water system shall conduct source water sampling in accordance with section 5-1.44 of this Subpart within a schedule specified by the State.
(ii) Step 2. The water system shall complete corrosion control studies as specified by the State within 18 months after the end of the monitoring period during which the system exceeds one of the action levels.
(iii) Step 3. The water system shall install optimal corrosion control treatment within 24 months after the State designates such treatment.
(iv) Step 4. After installation of optimal corrosion control treatment, the water system shall complete first draw lead and copper tap sampling and water quality parameter follow-up sampling in accordance with sections 5-1.42(b)(2) and 5-1.43(b)(2) of this Subpart during the two consecutive six-month monitoring periods immediately following installation of treatment.
(v) Step 5. After State designation of water quality parameters for optimal corrosion control treatment, the water system shall operate in compliance with State-designated optimal water quality parameter values in accordance with subdivision (g) of this section; and continue to conduct first draw lead and copper tap sampling and water quality parameter sampling in accordance with sections 5-1.42(b)(3) and 5-1.43(b)(3) of this Subpart.
(2) Systems serving 50,000 or fewer persons. Except as provided in subdivision (b) of this section, a system that serves 50,000 or fewer persons shall complete the following corrosion control treatment steps:
(i) Step 1. The water system shall conduct initial first draw lead and copper tap sampling in accordance with section 5-1.42 within a schedule specified by the State. If the lead or copper action level is exceeded at the 90th percentile the water system shall conduct water quality parameter sampling and source water sampling in accordance with sections 5-1.43 and 5-1.44.
(ii) Step 2. The water system shall recommend optimal corrosion control treatment within six months after the end of the monitoring period during which the system exceeds one of the action levels. Within 12 months after the end of the monitoring period during which a system exceeds the lead or copper action level, the State may designate optimal corrosion control treatment or require the system to perform corrosion control studies. If the State requires corrosion control studies to be conducted, the water system shall complete corrosion control studies as specified in paragraph (3) of this subdivision.
(a) Systems serving populations greater than 3,300 but less than 50,000 shall perform such studies within 18 months after the end of the monitoring period during which the system exceeds the lead or copper action level.
(b) Systems serving 3,300 or fewer persons shall perform such studies within 24 months after the end of the monitoring period during which the system exceeds the lead or copper action level.
(iii) Step 3. The water system shall install optimal corrosion control treatment within 24 months after the State designates such treatment.
(iv) Step 4. After installation of optimal corrosion control treatment, the water system shall complete first draw lead and copper tap sampling and water quality parameter follow-up sampling in accordance with sections 5-1.42(b)(2) and 5-1.43(b)(2) of this Subpart during the two consecutive six-month monitoring periods immediately following installation of treatment.
(v) Step 5. After State designation of water quality parameters for optimal corrosion control treatment, the water system shall operate in compliance with State-designated optimal water quality parameter values in accordance with subdivision (g) of this section; and continue to conduct first draw lead and copper tap sampling and water quality parameter sampling in accordance with sections 5-1.42(b)(3) and 5-1.43(b)(3) of this Subpart.
(3) Content of corrosion control studies. Corrosion control studies shall follow methods that include but are not limited to the following:
(i) an evaluation of the effectiveness of each of the following treatments, and, if appropriate, combinations of the following treatments using standard engineering tests on other systems of similar size, water chemistry and distribution system configuration:
(a) alkalinity and pH adjustment;
(b) calcium hardness adjustment; and
(c) the addition of a phosphate or silicate based corrosion inhibitor at a concentration sufficient to maintain an effective residual concentration in all test tap samples;
(ii) measurements of appropriate water quality parameters to assess performance of corrosion control including: lead; copper; pH; alkalinity; calcium; conductivity; temperature; silica or orthophosphate;
(iii) an assessment of effectiveness of treatment including the potential for adverse effects on other water quality treatment processes; and
(iv) identification of the optimal corrosion control treatment(s) for the system, including a rationale of the treatment steps for consideration by the State.
(4) Conditions for ceasing treatment steps. Any water system that serves 50,000 or fewer people and that is required to complete the corrosion control steps due to its exceedance of the lead or copper action level, may cease completing the treatment steps whenever the water system meets both action levels during each of two consecutive six-month monitoring periods. The lead and copper results from both monitoring periods shall be submitted to the State for approval for ceasing treatment steps. If an action level is exceeded in a later monitoring period the water system shall complete the remaining applicable treatment steps.
(d) Designation of optimal corrosion control treatment.
Based upon consideration of available information including, where applicable, corrosion control studies performed under subdivision (c) of this section and a system's proposed treatment alternative, the State will either:
(1) approve the corrosion control treatment option recommended by the system; or
(2) require alternative corrosion control treatment(s) as specified by the State. The State may also ask for additional information or modifications.
(e) Installation of optimal corrosion control.
Each system shall properly install and operate throughout its distribution system the optimal corrosion control treatment(s) approved by the State under subdivision (d) of this section.
(f) State review of treatment and designation of optimal water quality control parameters.
Based upon a review of the results of lead and copper tap water samples and water quality parameter samples submitted to the State by the water system from both before and after the installation of optimal corrosion control treatment, the State shall determine whether the system has properly installed and operated the optimal corrosion control treatment, and designate water quality parameter values, or a range of values, within which the system must operate. Such water parameters shall include:
(1) a minimum value or a range of values for pH measured at each entry point to the distribution system;
(2) a minimum pH value, measured in all tap samples. Such value shall be equal to or greater than 7.0, unless the State determines that meeting a pH level of 7.0 is not technologically feasible or is not necessary for the system to optimize corrosion control;
(3) if a corrosion inhibitor is used, a minimum concentration or a range of concentrations for the inhibitor, measured at each entry point to the distribution system and in all tap samples, that the State determines is necessary to form a passivating film on the interior walls of the pipes of the distribution system;
(4) if alkalinity is adjusted as part of optimal corrosion control treatment, a minimum concentration or a range of concentrations for alkalinity, measured at each entry point to the distribution system and in all tap samples; and
(5) if calcium carbonate stabilization is used as part of corrosion control, a minimum concentration or a range of concentrations for calcium, measured in all tap samples.
The values for the applicable water quality control parameters listed above shall be those that the State determines to reflect optimal corrosion control treatment for the system. The State may designate values for additional water quality control parameters determined by the State to reflect optimal corrosion control for the system. The State shall notify the system in writing of these determinations and explain the basis for its decisions.
(g) Continued operation and maintenance.
(1) All systems optimizing corrosion control shall continue to operate and maintain optimal corrosion control treatment, including maintaining water quality parameters at or above minimum values or within ranges designated by the State under subdivision (f) of this section for all samples collected in accordance with sections 5-1.43(b)(3) and (c) of this Subpart. Compliance with the requirements of this paragraph shall be determined every six months, as specified in section 5-1.42(b)(3) of this Subpart. A water system is out of compliance with the requirements of this paragraph if it has excursions for any State-designated parameter on more than nine days during any six-month period. An excursion occurs whenever the daily value for one or more of the water quality parameters measured at a sampling location is below the minimum value or outside the range designated by the State. The State has the discretion to delete results of obvious sampling errors from this calculation. Daily values are calculated as follows:
(i) On days when more than one measurement for the water quality parameter is collected at the sampling location, the daily value shall be the average of all results collected during the day regardless of whether they are collected through continuous monitoring, grab sampling, or a combination of both.
(ii) On days when only one measurement for the water quality parameter is collected at the sampling location, the daily value shall be the result of that measurement.
(iii) On days when no measurement is collected for the water quality parameter at the sampling location, the daily value shall be the daily value calculated on the most recent day on which the water quality parameter was measured at the sample site.
(2) Modification of State treatment decisions. A water system may request a modification of its State designated optimal corrosion control treatment. The request shall be submitted in writing and include the reason for the modification along with supporting data.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.36 Licensed midwife services
(a) Definitions.
As used in this section:
(1) Licensed midwife means a person who is granted a license by the State Education Department and provides care pursuant to article 140 of the State Education Law.
(2) Licensed midwife services means those services which are concerned with the management of the care of mothers and newborns throughout the maternity cycle as well as primary preventive reproductive health care of essentially healthy women.
(3) Maternity cycle means a period limited to pregnancy, labor, birth, and the immediate postpartum period not to exceed six weeks.
(4) [ Reserved ]
(5) Department means the New York State Department of Health.
(b) Provision of care.
Licensed midwife services shall be available as medically indicated to eligible medical assistance recipients.
(c) Who may provide care.
Licensed midwife services shall be provided by a licensed midwife or by a person practicing out-of-state who meets the qualifications for participation as a licensed midwife in the title XIX program in the state in which he or she is practicing.
(d) Where care may be provided.
Licensed midwife services may be provided in a hospital on an inpatient or outpatient basis, in a treatment and diagnostic center, in the office of the licensed midwife or collaborating/consulting physician or in the recipient's home.
(e) [ Reserved ]
(f) Reimbursement.
(1) Reimbursement for services provided by an independently practicing licensed midwife shall be in accordance with fees developed by the department and approved by the State Director of the Budget.
(2) Services provided by a licensed midwife who is salaried by a medical facility that is reimbursed for services on a cost-related basis shall not be reimbursed on a fee-for-service basis if the cost for the licensed midwife's salary is included in the facility's cost based rate.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.8 Contact notification
(a) When contact notification is conducted based on the mandated reporting of cases of HIV infection, HIV-related illness and AIDS and the reporting of known contacts of such cases, and/or provided by the protected individual, all information collected in the course of these contact notification activities, including screening to assess risk of domestic violence, shall be kept confidential as required by Public Health Law, article 21, title III, and shall not be disclosed except when in the judgment of the public health official necessary to other authorized public health officials for conducting accurate and complete epidemiological monitoring of the HIV/AIDS epidemic and for conducting contact notification activities except that contact names and locating information may be disclosed to public health officials in other jurisdictions when necessary to notify the contact: no information about the protected individual will be released to any person in this process. Disclosures and notifications shall be made as follows:
(1) Physicians and other persons required to report as provided for in section 63.4 of this Part must indicate on the reporting form whether they have conducted post-test counseling and an assessment of the risk of domestic violence in conformance with a domestic violence screening protocol developed by the commissioner, whether they plan to undertake contact notification activities, have completed notification of contacts or are making a referral for partner notification assistance to authorized public health officials. If the physician or other mandated reporter chooses to conduct notification, the results of those activities, including information specified by the commissioner on forms supplied by the commissioner, or their equivalent, must be forwarded to the appropriate authorized public health official, pursuant to section 63.4 of this Part.
(2) The commissioner shall forward initial reports from physicians and other mandated reporters, including the names and addresses of the reported case and of the known contacts, and/or contacts provided by the protected person, the status of provider initiated contact notification activities and the determination of risk of domestic violence, if any, to the authorized public health official in the county where the reported case resides.
(3) Consistent with guidelines acceptable to the commissioner in conformance with article 21 of the Public Health Law, authorized public health officials, upon determination that the reported case, reported contacts, or any other case merits contact notification in order to protect the public health, shall make a good faith effort to seek the cooperation of the protected individual to name contacts they wish to have notified, to notify the known contacts and to inform the public health official in the jurisdiction where any additional contacts reside, when necessary to notify such contacts. No information about the protected individual will be released to any person in this process.
(b) Authorized public health officials shall consider the following as important factors in determining the priority for which cases merit contact notification in order to protect the public health:
(1) reported contacts, including spouses known to the reporting physician or other diagnostic provider, or who the protected individual wishes to have notified, unless the provider certifies that these known contacts have already been notified;
(2) protected individuals who are newly diagnosed with HIV infection; and
(3) protected individuals who were previously diagnosed with HIV infection, and who show evidence of: being out of medical care; not being virally suppressed; recent sexually transmitted diseases; or having recently moved into New York State.
(c) In cases which merit contact notification, if an indication of risk of domestic violence has been identified, pursuant to a protocol acceptable to the commissioner, the authorized public health official, in consultation with the reporting physician, must be satisfied in his/her professional judgment that reasonable arrangements, efforts or referrals to address the safety of affected persons have been made if and when the notification is to proceed. Such consultation shall also consider information, if available, requested from the protected person, or from a domestic violence service provider pursuant to a signed release.
(d) Authorized public health officials shall conduct contact notification activities consistent with guidelines acceptable to the commissioner which will recognize the special needs of adolescents, individuals in residential and institutional settings, and other vulnerable populations.
(e) Authorized public health officials will respond to all requests from HIV infected individuals and their health care providers for assistance in notifying contacts.
(f) When contact notification is conducted by authorized public health officials, such officials shall:
(1) confirm that post-test counseling of the protected person is completed;
(2) when communication with the protected person is necessary, communicate with the protected person in a confidential, private and safe manner to seek cooperation in contact notification activities, to verify the information about the identity or location of known contacts, to conduct or confirm a screen for domestic violence and if applicable, to make referrals regarding domestic violence, prior to any notification of contacts. If communication cannot be made in a confidential, private and safe manner, it shall be deferred until these requirements can be met; and
(3) in circumstances where the protected individual cannot be contacted for post-test counseling or declines to be assessed for risk of domestic violence in relation to known contacts, the authorized public health official shall make the determination of whether to proceed with notification of known contacts, in consultation with the reporting physician.
(g) All persons notifying contacts shall provide counseling or make referrals or appointments for counseling and testing as appropriate. Such counseling must address coping emotionally with potential exposure to HIV, domestic violence issues, an explanation regarding the nature of HIV infection and HIV-related illness, availability of anonymous and confidential testing, information on preventing exposure or transmission of HIV infection, information regarding discrimination problems that might occur as a result of disclosure of HIV-related information, and legal protections against such disclosures. All notifications shall be in person, except where circumstances reasonably prevent doing so, e.g., at the request of the contact.
(h) If a protected person is now deceased, contacts ( e.g., spouse) are known to the physician and the physician believes the protected person had not informed such contacts, the physician or his/her agent may notify such contacts or shall request the authorized public health official to notify the contacts, without identifying the protected individual to the contact.
(i) A physician or authorized public health official shall have no obligation to identify or locate any contact, except as provided pursuant to Public Health Law article 21, title III. No criminal sanction or civil liability shall arise against a physician, his/her employer or designated agent, health facility, health care provider or authorized public health official for the disclosure of confidential HIV-related information to a contact or to a person consenting to health care for the contact when in compliance with article 27-F, or for the failure to disclose such information to a contact or to a person consenting to health care for the contact.
(j) Municipal health commissioners must provide HIV contact notification services and shall forward to the department, summary data and all identifiable information related to notification activities upon completion of such activity unless otherwise determined by the commissioner. Information identifying the contact collected in the course of contact notification activities by authorized public health officials shall not be maintained at the State or local level for longer than administratively necessary. The department or local health department shall establish a records retention and disposition schedule for destruction of these records.
(k) For the purposes of notifying contacts under Public Health Law section 2782(1)(d), blood transfusion and organ and tissue transplantation present a risk of HIV transmission. Notifying contacts potentially exposed to HIV through tissues, organs, or transfused blood under a federally mandated recipient notification program or guidelines acceptable to the commissioner shall be sufficient to meet the notification requirements of article 21, title III and article 27-F. Blood banks, organ procurement organizations, and tissue banks may disclose the HIV status of a donation to a donor's provider for the purposes of notifying known contacts of a donor.
(l) When contact notification is initiated by a physician not related to reporting mandates or article 21, title III, but based on authority to notify an identified spouse, sex partner, hypodermic needle and syringe partner under Public Health Law section 2782(4), physicians or their agents and authorized public health officials may conduct contact notification as follows:
(1) a physician or his/her agent may, without the protected person's consent, notify such contact or report such contact to the authorized public health official for the purpose of notifying a contact when:
(i) the physician believes disclosure is medically appropriate and a significant risk of infection may exist to the contact;
(ii) the protected person has been counseled to notify his/her contacts or the physician has taken all reasonable efforts to attempt to counsel the person; and
(iii) domestic violence screening in accordance with the screening protocol has been applied;
(2) the physician must inform the protected person of the physician's intent to notify such contacts and of their responsibility to report the case and such contacts to the commissioner, and inform the protected person that he/she may express a preference whether contact notification shall be made by the physician or authorized public health official, and that the protected individual's name or other information about them is not disclosed to any person during the contact notification process;
(3) if the protected person's preference is for the authorized public health official to notify contacts or if the protected person's preference is for the physician to notify contacts but the physician chooses not to do so, he/she shall notify the protected person of his/her decision to contact the authorized public health official and shall forward names and addresses of the case and contacts to the authorized public health official, who shall take reasonable measures to notify such contacts. If the protected person's preference is for the physician to notify contacts and the physician elects to do so, the physician or his/her agent may then notify contacts; and
(4) the physician must report to the authorized public health official regarding the success or failure of such efforts, including the names and addresses of the cases and contacts. If contacts have not been notified or notification cannot be verified by the physician or his/her agent, public health officers shall take reasonable measures to inform the contact as set forth in subdivisions (b) through (g) of this section.
(m) When the requirements of this section have been met, physicians and other diagnostic providers may disclose HIV-related information, without a release of confidential HIV-related information, to physicians or other diagnostic providers of persons whom the protected individual may have exposed to HIV under the circumstances noted below that present a risk of transmission of HIV, except that disclosures related to exposures of emergency response employees governed by Federal law shall continue to be governed by such law:
(1) the incident must involve exposure to blood, semen, vaginal secretions, breast milk, tissue or the following body fluids: cerebrospinal, amniotic, peritoneal, synovial, pericardial and pleural;
(2) a person has contact with the body substances, as noted in paragraph (1) of this subdivision, of another to mucus membranes ( e.g. , eyes, nose, mouth), non-intact skin ( e.g., open wound, skin with a dermatitis condition, abraded areas) or to the vascular system. Examples of such contact may include needlesticks, puncture wound injuries and direct saturation or permeation of non-intact skin by potentially infectious substances. These circumstances shall not include those delineated in section 63.10(d) of this Part; and
(3) the exposure incident occurred to staff, employees or volunteers in the performance of employment or professional duties:
(i) in a medical or dental office;
(ii) in a facility regulated, authorized or supervised by the Department of Health, Office of Mental Health, Office for People With Developmental Disabilities, Office of Children and Family Services, Office of Alcoholism and Substance Abuse Services, Department of Corrections and Community Supervision; or
(iii) involved an emergency response employee, paid or volunteer, including an emergency medical technician, a firefighter, a law enforcement officer ( e.g., police, probation, parole officer) or local correctional officer or medical staff;
(4) an incident report documenting the details of the exposure, including witnesses to the incident, if any, is on record with supervisory staff;
(5) a request for disclosure of HIV status is made to the provider of the source or to the medical officer designated by the facility by the exposed person or by the provider of the exposed person as soon as possible after the alleged exposure if a decision relating to the initiation or continuation of post-exposure prophylactic treatment is being considered;
(6) documentation of the request is placed in the medical record of the exposed person; and
(7) if the provider of the source or the medical officer designated by the facility determines that a risk of transmission has occurred or is likely to have occurred in the reasonable exercise of his/her professional judgment, the provider or medical officer may release the HIV status of the source, if known. The provider or medical officer may consult with the municipal health commissioner or district health officer to determine whether a risk of transmission exists. If consultation occurs, both the provider and the local health officer must be in agreement if the HIV information is to be disclosed. In the disclosure process the name of the source shall not be provided to the exposed person. Redisclosure of the HIV status of the source is prohibited except when made in conformance with Public Health Law article 21, title III.
(n) In cases of anonymous testing of an occupational exposure source patient who is deceased, comatose or otherwise unable to provide consent, and no person authorized to consent on behalf of the source person is immediately available, as provided for in Public Health Law section 2781(6)(e), the results of such anonymous test, but not the identity of the source person, shall be disclosed only to the attending health care professional of the exposed person solely for the purpose of assisting the exposed person in making appropriate decisions regarding post-exposure medical treatment. The results of the test shall not be disclosed to the source person or placed in the source person's medical record.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.6 Fees
On or before September 15th, the department will review the annual cost of the clinical laboratory inspection program as initially estimated. Fees will be adjusted when any change results in an increase or decrease in fees of more than $100 per laboratory. If an adjustment is required, the department shall notify the laboratories of any additional fees or credits by October 15th. Any additional fees are payable not later than 30 days after the date of the notification statement. Credits shall be applied to the next regular payment.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.14 Walls and ceilings of food preparation areas
(a) Ceilings are to be made of wood, canvas, or other materials that protect the interior of the establishment from the weather. Walls and ceilings of food preparation areas are to be constructed in a way that prevents the entrance of insects. Screening material used for walls, doors or windows is to be at least 16 mesh to the inch. Doors to food preparation areas are to be solid or screened and are to be self-closing.
(b) Counter-service openings shall be provided with tight-fitting solid or screened doors or windows or shall be provided with fans installed and operated to restrict the entrance of flying insects. Counter-service openings are to be kept closed except when in actual use.
(c) Where other effective methods of fly control, acceptable to the permit-issuing official are employed, or at a time of the year when there is no insect problem, the screening requirements of subdivisions (a) and (b) of this section will not apply.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.46 Lead service line replacement
(a) Water systems that fail to meet the lead action level in tap samples collected after installing corrosion control treatment and/or source water treatment (whichever occurs later) shall replace lead service lines in accordance with the requirements of this section. Water systems that fail to install optimal corrosion control treatment in accordance with section 5-1.41(c) of this Subpart or source water treatment in accordance with section 5-1.45(a)(2) of this Subpart by the date(s) specified by the State may be required to begin replacement of lead service lines.
(b) Determining number of lead service lines for replacement.
(1) A water system shall replace annually at least seven percent of the initial number of lead service lines in its distribution system. The initial number of lead service lines is the number of lead lines in place at the time the replacement program begins. The system shall identify the initial number of lead service lines in its distribution system, including an identification of the portion(s) owned by the system, based on materials evaluation, including the evaluation required under section 5-1.42(a) of this Subpart and relevant legal authorities ( e.g. , contracts, local ordinances) regarding the portion owned by the system. The first year of lead service line replacement shall begin on the first day following the end of the monitoring period in which the action level was exceeded in tap sampling referenced in subdivision (a) of this section. If monitoring is required annually or less frequently, the end of the monitoring period is September 30th of the calendar year in which the sampling occurs. If an alternate monitoring period applies, then the end of the monitoring period will be the last day of that period.
(2) A water system is not required to replace an individual lead service line if the results of all samples representative of water in the lead service line, collected in accordance with section 5-1.42(a)(2)(iii) of this Subpart, are less than or equal to 0.015 mg/L.
(3) The total number of lines replaced, either entirely or partially per subdivision (c) of this section, shall equal at least seven percent of the initial number of lead lines identified under paragraph (1) of this subdivision or the percentage specified by the State as per subdivision (d) of this section.
(4) Any water system resuming a lead service line replacement program after the cessation of its lead service line replacement program as allowed by subdivision (f) of this section shall update its inventory of lead service lines to include those sites that were previously determined not to require replacement through the sampling provision under subdivision (c) of this section. The system will then divide the updated number of remaining lead service lines by the number of remaining years in the program to determine the number of lines that shall be replaced per year (7-percent lead service line replacement is based on a 15-year replacement program). For those systems that have completed a 15-year lead service line replacement program, the State will determine a schedule for replacing or re-testing lines that were previously tested under the replacement program if the system re-exceeds the action level.
(c) A water system shall replace the portion of the lead service line that it owns. In cases where the system does not own the entire lead service line, the system shall notify the owner of the line, or the owner’s authorized agent, that the system will replace the portion of the service line that it owns and shall offer to replace the owner’s portion of the line. A system is not required to bear the cost of replacing the privately-owned portion of the line, where the owner chooses not to pay the cost of replacing the privately-owned portion of the line, or where replacing the privately- owned portion would be precluded by State, local or common law. A water system that does not replace the entire length of the service line also shall complete the following tasks:
(1) At least 45 days prior to commencing with partial replacement of a lead service line, the water system shall provide notice to the resident(s) of all buildings served by the line explaining that they may experience a temporary increase of lead levels in their drinking water, along with guidance on measures consumers can take to minimize their exposure to lead. The State may allow the water system to provide notice of less than 45 days prior to commencing partial lead service line replacement, if such replacement is done in conjunction with emergency repairs. In addition, the water system shall inform the resident(s) served by the line that the system will, at the system’s expense, collect a sample from each partially-replaced lead service line that is representative of the water in the service line for analysis of lead content, as prescribed in section 5-1.42(a)(2)(iii) of this Subpart, within 72 hours after the completion of the partial replacement of the service line. The system shall collect the sample and report the results of the analysis to the owner and the resident(s) served by the line within three business days of receiving the results. Mailed notices post-marked within three business days of receiving the results shall be considered on time.
(2) The water system shall provide the information required by paragraph (1) of this subdivision to the residents of individual dwellings by mail or by other methods approved by the State. In instances where multi-family dwellings are served by the service line, the water system shall have the option to post the information at a conspicuous location.
(d) The State shall require a system to replace lead service lines on a shorter schedule than that required by this section, taking into account the number of lead service lines in the system, where a shorter replacement schedule is feasible. The State shall make this determination in writing and notify the system of its finding within six months after the system is triggered into lead service line replacement based on monitoring results referenced in subdivision (a) of this section.
(e) Any water system may cease replacing lead service lines whenever first draw tap water samples meet the lead action level during each of two consecutive six-month monitoring periods. If subsequent rounds of first draw tap water sampling exceed the lead action level the water system shall recommence replacing lead service lines in accordance with subdivision (b) of this section.
(f) To demonstrate compliance with subdivisions (a) through (d) of this section, a system shall report to the State the information specified and no later than the schedule described in 40 CFR 141.90(e).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.30 Eligibility for State aid
State aid shall be paid for approved vector surveillance and vector surveillance and control programs that:
(a) have been approved in advance of implementation by the commissioner or his designee and operated in accordance with that approval;
(b) have been conducted by county or part-county departments of health or county boards of health or municipal agencies which have been designated by the county or part-county health department or county board of health for vector surveillance or vector surveillance and control programs;
(c) have operated vector surveillance programs only or have had vector surveillance and vector control activities concurrently; and
(d) have been the subject of a determination of significance pursuant to the State Environmental Quality Review Act, article 8 of the Environmental Conservation Law and the implementing regulations issued thereunder.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.26 Utilization review
(a) Hospitals shall comply with Federal regulations regarding utilization review. Such regulations shall include section 482.30 of the Code of Federal Regulations (42 CFR part 482).
(b) All patients admitted to units having an operating certificate granted by the New York State Division of Alcoholism and Alcohol Abuse for the operation of an acute care alcoholism program or inpatient rehabilitation program shall be subject to the admission, continuation of stay, care plan, staffing, services and discharge requirements of applicable State regulations. Such regulations include requirements of 14 NYCRR Parts 374 and 381.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.250 Pediatric patient
A patient less than 14 years old.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.1 Filing of complaint
A person claiming to be aggrieved by an unlawful discriminatory practice as defined in subdivision 1 of section 206-a of the Public Health Law may file with the commissioner at the principal office of the department a written complaint signed and verified by the complainant personally, or by his attorney if the material allegations of the complaint are within the attorney's personal knowledge.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.1 Definitions
As used in this Subpart:
(a) Facility shall mean all free-standing ambulatory care facilities, diagnostic and/or treatment centers and clinics that are subject to article 28 of the Public Health Law, provided that such facility has been established by the Public Health Council and possesses a valid operating certificate issued by the Commissioner of Health. Rates of reimbursement for hospital-based facilities shall be governed by Subpart 86-1 of this Part.
(b) Free-standing ambulatory care facility, diagnostic and/or treatment center and clinic shall mean a medical facility with one or more organized health services not part of an inpatient hospital facility or vocational rehabilitation center, which is primarily engaged in providing services to out-of-hospital or ambulatory patients by or under the supervision of a physician or dentist, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition.
(c) Commissioner shall mean the New York State Commissioner of Health.
(d) Department shall mean the New York State Department of Health.
(e) Bureau shall mean the Bureau of Ambulatory Care Reimbursement in the department.
(f) Article 43 corporation shall mean a corporation organized and operating pursuant to article 43 of the Insurance Law.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
INVESTIGATIONS AND DETERMINATIONS INVESTIGATIONS AND DETERMINATIONS
10 CRR-NY 2.6 Investigations and response activities
(a) Except where other procedures are specifically provided in law, every local health authority, either personally or through a qualified representative, shall immediately upon receiving a report of a case, suspected case, outbreak, or unusual disease, investigate the circumstances of such report at any and all public and private places in which the local health authority has reason to believe, based on epidemiological or other relevant information available, that such places are associated with such disease. Such investigations and response activities shall, consistent with any direction that the State Commissioner of Health may issue:
(1) verify the existence of a disease or condition;
(2) ascertain the source of the disease-causing agent or condition;
(3) identify unreported cases;
(4) locate and evaluate contacts of cases and suspected cases, as well as those reasonably expected to have been exposed to the disease;
(5) collect and submit, or cause to be collected or submitted, for laboratory examination such specimens as may furnish necessary or appropriate information for determining the source of disease, or to assist with diagnosis; and furnish or cause to be furnished with such specimens pertinent data on forms prescribed by the State Commissioner of Health, including but not limited to the history of cases, physical findings and details of the epidemiological investigation;
(6) examine the processes, structures, conditions, machines, apparatus, devices, equipment, records, and material within such places that may be relevant to the investigation of disease or condition;
(7) instruct a responsible member of a household or entity, as applicable, to implement appropriate actions to prevent further spread of a disease; and
(8) take any other steps to reduce morbidity and mortality that the local health authority determines to be appropriate.
(b) When a case or suspected case of a disease, condition, outbreak, or unusual disease occurs in any business, organization, institution, or private home, the person in charge of the business, organization, institution or the home owner, as well as any individuals or entities required to report pursuant to section 2.10 and 2.12 of this Part, shall cooperate with the State Department of Health and local health authorities in the investigation of such disease, condition, outbreak, or unusual disease.
(c) Investigation updates and reports.
(1) Upon request of the State Department of Health, the local health authority shall submit updates and reports on outbreak investigations to the State Department of Health. The content, timeframe, and manner of submission of such updates shall be determined by the State Department of Health.
(2) The local health authority shall complete investigation reports of outbreaks within 30 days of the conclusion of the investigation in a manner prescribed by the State Commissioner of Health, unless the State Commissioner of Health prescribes a different time period.
(d) Commissioner authority to lead investigation and response activities.
(1) The State Commissioner of Health may elect to lead investigation and response activities where:
(i) residents of multiple jurisdictions within the State are affected by an outbreak of a reportable disease, condition, or unusual disease; or
(ii) residents in a jurisdiction or jurisdictions within the State and in another state or states are affected by an outbreak of a reportable disease, condition, or unusual disease; or
(iii) an outbreak of an unusual disease or a reportable disease or condition involves a single jurisdiction with the high potential for statewide impact.
(2) Where the State Commissioner of Health elects to lead investigation and response activities pursuant to paragraph (1) of this subdivision, local health authorities shall take all reasonable steps to assist in such investigation and response, including supply of personnel, equipment or information. Provided further that the local health authority shall take any such action as the State Commissioner of Health deems appropriate and that is within the jurisdiction of the local health authority. Any continued investigation or response by the local health authority shall be solely pursuant to the direction of the State Commissioner of Health, and the State Commissioner of Health shall have access to any investigative materials which were heretofore created by the local health authority.
Part 23 SEXUALLY TRANSMISSIBLE DISEASES (STD)
10 CRR-NY 23.4 Minors
When a health care provider diagnoses, treats or prescribes for a minor, without the consent or knowledge of a parent or guardian as permitted by section 2305 of the Public Health Law, neither medical nor billing records shall be released or in any manner be made available to the parent or guardian of such minor without the minor patient’s permission. In addition to being authorized in accordance with section 2305 of the Public Health Law to diagnose, treat or prescribe for a person under the age of 18 years without the consent or knowledge of the parent or guardian of such person where the individual is infected with a sexually transmitted disease, or has been exposed to infection with a sexually transmitted disease, health care practitioners may (as authorized by their scope of practice) render medical care related to other sexually transmitted diseases without the consent or knowledge of the parent or guardian.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 141 SARATOGA COUNTY
10 CRR-NY 141.5 Village of Ballston Spa
(a) Application.
The rules and regulations set forth in this section and enacted in accordance with the provisions of section 1100-1107 of the Public Health Law shall apply to the Village of Ballston Spa's reservoirs and all watercourses tributary thereto or which may ultimately discharge into said reservoirs or which may be developed in the future to serve as sources of the water supply to the Village of Ballston Spa.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Ballston Spa water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plants, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Ballson Spa, N.Y.
(17) Watercourse shall mean every spring, stream, marsh, or chanel of water of any kind which flow or may flow into the Village of Ballston Spa, N.Y. water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Ballston Spa, N.Y. water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any resrvoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or persticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except ( a ) watertight receptacles; ( b ) water-flushed toilets connected by a watertight pipe to a sewae disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and ( c ) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir, or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Ballston Spa, N.Y.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Ballston Spa, N.Y. except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Ballston Spa, N.Y. within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Ballston Spa, N.Y. in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Ballston Spa, N.Y.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The trustees of the Village of Ballston Spa, N.Y., or any other person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid trustees of the Village of Ballston Spa, N.Y. to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the Village of Ballston Spa, N.Y. to promptly notify the Commissioner of Health of such violations. The aforesaid trustees of the Village of Ballston Spa, N.Y. shall report to the Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceeding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.1 Applicability
The provisions of this Part shall apply to hospitals with outpatient departments and to independent out-of-hospital health facilities which accept primary responsibility for health supervision and medical care of patients.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 107 CHENANGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 107.2 Village of Bainbridge
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 602 of the Laws of 1927, shall apply to Yaleville Creek, to all natural and artificial reservoirs and to all watercourses and drainage areas tributary thereto which serve as sources of the public water supply of the village of Bainbridge, Chenango County, N. Y.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to all impounding and storage reservoirs used for the collection or storage of the flow from the above named creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Bainbridge.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(2) No privy, privy vault, pit, cesspool or other receptacle, placed or used for the permanent deposit of human excreta, which is not watertight, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjoining premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the village of Bainbridge.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or of surface water or other special local conditions, excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Bainbridge, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or within 150 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage or dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of the village of Bainbridge, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground below the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 250 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the village of Bainbridge.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe nor shall any animal or poultry be allowed to stand, wallow, wade or swim nor be washed in any reservoir or watercourse tributary to this public water supply. No animal or poultry shall be watered in any reservoir tributary to the public water supply of the village of Bainbridge. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Bainbridge.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Bainbridge, and none of the above named objects or sources of pollution shall be so constructed, located, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Bainbridge.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Bainbridge, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the village of Bainbridge, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or within 25 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the village of Bainbridge.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of Bainbridge, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the village of Bainbridge.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Bainbridge, except by the duly authorized employees of said village of Bainbridge in the performance of their duties of supervision and maintenance of its public water supply.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir of 300 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 400 feet of any reservoir or 200 feet of any watercourse tributary to the public water supply of the village of Bainbridge.
(j) Inspections.
The board of water commissioners of the village of Bainbridge or such other board, person or persons who may be charged with the maintenance or supervision of the public water supply of the village of Bainbridge or their duly appointed representative shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 602 of the Laws of 1927, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 154 WAYNE COUNTY
10 CRR-NY 154.6 Village of Savannah
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Village of Savannah, Wayne County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the storage and impounding reservoir which is tributary to or which serves as the source of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind, the waters of which when running whether continuously or occasionally flow or may flow into the public water supply of the Village of Savannah.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(2) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Village of Savannah, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, garage or stable wastes or sewage or other excremental matter from any water closet, privy, receptacle or other source shall be thrown, placed, led, discharged or allowed to escape on or beneath the surface of the ground within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 100 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(3) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse tribtuary to the public water supply nor shall any animals or poultry be allowed to stand, wallow, wade or swim nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the Village of Savannah is prohibited. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any watercourses tributary to the public water supply of the Village of Savannah.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse tributary to the public water supply of the Village of Savannah nor be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse tributary to the public water supply of the Village of Savannah without first having passed over or through such an extent of soil as to have been properly purified and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain on the surface of the ground or beneath the surface of the ground within 200 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the Village of Savannah.
(i) Inspections.
The board of trustees of the Village of Savannah or such other board as may be charged with the maintenance or supervision of the public water supply of the village shall make regular and thorough inspections of the reservoir, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the reservoir, watercourses and drainage areas tributary to the public water supply of the Village of Savannah at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.14 Optional services
A Primary Care Hospital (PCH) may offer additional special services, for which it is able to provide appropriate technical and human resources, in order to respond to community need or to assure quality in the delivery of services, Optional services may include but are not limited to ambulatory surgery, inpatient surgery under anesthesia, full range laboratory services, full range imaging services, radiation oncology and nuclear medicine, full range pharmacy services, physical medicine and rehabilitation services, respiratory care services, perinatal services, mental health services, blood bank/transfusion services, or special care services. Such services may only be provided if approved by the Commissioner of Health pursuant to sections 407.2(a) and 407.3(c) of this Part and the applicable provisions of Part 710 of this Title.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.53 Book value
(a) The net amount at which an asset or asset group appears on the books of account, as distinguished from its market value or some intrinsic value.
(b) The face amount of a liability less any unamortized discount and expense.
(c) As applied to capital stock:
(1) the book value of the net assets;
(2) in a corporation, the book value of the net assets, divided by the number of outstanding shares of capital stock.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.13 Prior approval for treatment with a specialty drug
A request for prior approval of treatment with a specialty drug must be accompanied by a written statement from the enrollee’s treating physician stating why treatment with the specialty drug is necessary, what other alternatives have been tried or explored, and what testing the enrollee has undergone for purposes of determining whether treatment with the specialty drug is appropriate and safe for the enrollee. All requests for prior approval for treatment with a specialty drug will be reviewed by the pharmacy benefits manager for the fund administrator and a determination will be made within three business days of receipt of all necessary information from the enrollee’s treating physician.
10 CRR-NY 69-10.5 Claims submission process
(a) All providers providing services to an enrollee must accept assignment of payment from the fund.
(b) The claims submission process will include both electronic and manual options for submission of claims.
(c) The unique enrollee identifier must be included in the designated area of the claim form.
(d) Claims shall be submitted within 90 days of the date of service and will be paid within 45 days of receipt of an acceptable claim form. A request for permission to submit a claim later than 90 days from the date of service maybe granted by the fund administrator upon a showing of good cause for the delay.
Subpart 69-5 APPROVAL OF RAPE CRISIS PROGRAMS FOR THE PURPOSE OF RAPE CRISIS COUNSELOR CERTIFICATION
10 CRR-NY 69-5.7 Technical assistance
The department of Health shall provide technical assistance to approved rape crisis programs to implement training programs in accordance with the minimum standards set forth in this Subpart.
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.12 Monitoring of approved service providers (including evaluators, service providers and service coordinators)
(a) Providers and municipalities shall be monitored on a periodic basis on a schedule determined by the department and shall comply with all department requirements for monitoring, including timely provision of all applicable records in a format requested by the department or the department’s agent or contractor.
(b) Monitoring procedures shall be used to identify any non-compliance, deficiencies, and need for improvement and shall include any procedures determined necessary by the department to fulfill its obligations to oversee and monitor the Early Intervention Program, and may include, but not be limited to, any of the following components:
(1) on-site visits and desk reviews;
(2) interviews with personnel responsible for the administration and/or provision of early intervention services;
(3) where applicable and practicable, interviews with parents of children who received early intervention services from the provider, or parents of eligible children who reside in the municipality responsible for ensuring that early intervention services contained in an IFSP are provided to the eligible child and the child’s family;
(4) a review of any of the following:
(i) child records, including: child referral information; evaluation reports; individualized family service plans; where applicable, physician referrals for early intervention services; transition plans; session notes; progress notes; and any other documents related to a child’s and family’s participation in the EIP, as requested;
(ii) data systems and other electronic record-keeping system reviews as determined necessary to assess compliance with the provisions of title II-A of article 25 of the Public Health Law and this Subpart, including confidentiality requirements;
(iii) where applicable, personnel records, including the status of licensure, certification, or registration of qualified personnel, and required clearances, such as the Statewide Central Register on Child Abuse and Neglect;
(iv) where applicable, the organizational structure of the provider agency and staffing requirements and patterns, including supervision of employees, in-service training, and oversight of contracted providers;
(v) quality assurance procedures used to monitor the quality, consistency, and service delivery practices, including mechanisms for parent involvement in planning and participating in early intervention services;
(vi) procedures used to evaluate parent experiences and satisfaction with early intervention services, such as parent surveys and exit interviews; and
(vii) where applicable, the status of any corrective action plans for any previously identified non-compliance and deficiencies, including verification of correction of non-compliance and identified deficiencies.
(c) When non-compliance or deficiency is identified through one or more monitoring procedures, the department may ensure compliance is attained and maintained by implementing actions that include, but are not limited to, the following:
(1) require submission of a corrective action plan by the provider or municipality and timely correction to address non-compliance and deficiency;
(2) impose conditions on the provider’s participation in the Early Intervention Program;
(3) impose monetary fines or penalties, which may include the withholding or adjustment of State aid reimbursement owed to the provider or municipality; or
(4) initiate proceedings under section 69-4.24 of this Subpart to revoke, suspend, limit, or annul the approval of a provider.
(d) A municipality may monitor evaluators and providers of early intervention services to eligible children who reside in such municipality. Such monitoring may include site visits:
(1) The service coordinator shall report to the municipality, in a format and frequency determined by the municipality, on the delivery of services to an eligible child in accordance with the child’s individualized family service plan.
(i) The municipality may submit a written request to the parent, in accordance with section 69-4.17(b) of this Subpart, requesting that the parent select a new service coordinator, if the municipality finds that the service coordinator has not been fulfilling his or her responsibilities to the child and family or that services have not been provided in accordance with the child’s individualized family service plan. If the parent consents to the request, the individualized family service plan shall be reviewed, in accordance with procedures set forth in section 69-4.11(b) of this Subpart, and amended to include the name of the new service coordinator responsible for implementation of the individualized family service plan.
(ii) The municipality may require the service coordinator to select a new provider of service if the municipality finds that services have not been delivered in accordance with the child’s individualized family service plan. In such cases, the early intervention official shall provide written notice to the parent of the determination, in accordance with procedures set forth in section 69-4.17(b) of this Subpart.
(2) If the early intervention official determines that the evaluator has not complied with the Public Health Law or requirements in section 69-4.8 of this Subpart in conducting an evaluation to determine eligibility, the early intervention official may require that the evaluator immediately submit additional documentation to support the eligibility determination of a child for the Early Intervention Program. If the evaluator does not provide the requested documentation, or the documentation provided continues to be inconsistent with the requirements of the Public Health Law or this Subpart, the early intervention official may require that the parent select another evaluator to conduct a multidisciplinary evaluation to determine whether the child meets eligibility criteria for the Early Intervention Program.
(3) The municipality may implement additional procedures to monitor providers that conduct evaluations and deliver services, including service coordination, to children residing in the municipality, to ensure adherence to the provisions of title II-A of article 25 of the Public Health Law and this Subpart.
(i) The municipality shall coordinate the scheduling and monitoring of providers with the department to minimize the administrative burden on providers.
(ii) The municipality shall inform the department of findings of provider monitoring, including any corrective actions imposed on the provider, required timelines for correction, and verification of corrective actions.
(e) Fiscal auditing.
For purposes of this section, providers mean evaluators and providers of early intervention services approved to deliver services to eligible children and their families.
(1) Each municipality may conduct an audit, in accordance with applicable State laws and regulations, of approved providers who conduct evaluations and provide early intervention services to children residing in the municipality. The municipality shall submit the results of any such audit to the commissioner for review and, if warranted, adjustments in State aid reimbursement, as well as for recovery by the municipality of its share of any disallowances identified in such audit.
(i) All audits will be based upon these and other applicable regulations and generally accepted accounting principles.
(ii) Audits may include a comprehensive review of all financial records and related documentation.
(2) Prior to the initiation of such audit, the early intervention official shall ascertain that neither the department nor the municipality where evaluations are conducted and services are provided has performed or intends to perform such an audit within six months.
(3) A full fiscal audit shall be performed by the municipality.
(4) Where appropriate, auditing shall be performed in conjunction with the department to avoid unnecessary duplication of audit procedures.
(5) Results of the audit shall be made available upon request of any other municipality making payments under the Early Intervention Program to the approved evaluator or provider.
(6) No other municipality may conduct an additional audit for the time period specified above.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.33 Asset
Any owned physical object (tangible) or right (intangible) having economic value to its owner; an item or source of wealth expressed, for accounting purposes, in terms of its cost, depreciated cost, or fair market value at date of donation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.20 Suspension of the fund
(a) When the fund's current liabilities equal or exceed 80 percent of the fund's assets, as determined by the actuarial calculation performed under section 69-10.19 of this Subpart, the fund administrator shall suspend enrollment in the fund and new enrollments will no longer be accepted.
(b) When the fund's current liabilities no longer equal or exceed 80 percent of the fund's assets, as determined by the actuarial calculation performed under section 69-10.19 of this Subpart, the fund administrator shall resume enrollment in the fund and new enrollments will be accepted if otherwise eligible.
(c) The fund administrator will provide prompt notice on the fund administrator's website of any suspension or reinstatement of enrollment.
(d) Once enrolled, a qualified plaintiff will remain in the fund for his or her lifetime, and will not be impacted by a suspension in enrollment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.92 Depreciation fund
Money or marketable securities set aside for the purpose of replacing or providing assistance in replacing depreciable fixed assets.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 93 IMPROPER PRACTICES IN HOSPITAL STAFF APPOINTMENTS AND EXTENSION OF PROFESSIONAL PRIVILEGES
10 CRR-NY 93.4 Response by the hospital
(a) The hospital shall provide the Public Health Council with a response to the complaint no later than 30 days from receipt of the notice sent to the hospital by the Public Health Council.
(b) At the time the hospital response is filed with the Public Health Council, the hospital must also provide the complainant with a complete copy of the hospital response.
(c) An affirmation by the hospital, stating that the hospital has provided the complainant with a copy of the entire hospital response, must accompany the information transmitted to the Public Health Council.
(d) Further information may be provided by the complainant and/or the hospital only upon the request or with the permission of the Public Health Council. If such information is provided, a copy shall be sent by the party providing the information to the opposing party.
(e) The hospital shall treat its responses to the complaint as confidential.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.1 Searches and certifications without fees
The New York State Department of Health shall make searches and issue certifications and certified copies of birth, death, and marriage records without charge to:
(a) local or State organizations of war veterans in connection with claims for soldiers' burial fees, markers for soldiers' graves, and securing relief for veterans or their families;
(b) applicants for enlistment in the U.S. armed services or the merchant marine;
(c) persons of any age filing applications with the State employment bureau;
(d) persons residing in Canada applying to Canadian authorities for public relief or veterans' claims, providing the province of Canada in which applicant resides furnishes similar information gratis to persons residing in the United States;
(e) children under the age of 16—limited to certifications of birth;
(f) persons who were either adopted or whose paternity was established by law, limited to a certification of birth or certificate of birth registration made out in the name by which the person is designated in the adoption or filiation papers at the time a new birth certificate is prepared pursuant to section 4138 of the Public Health Law;
(g) State or municipal departments for official purposes.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PLUMBING PLUMBING
10 CRR-NY 14-1.143 Handwashing facilities
(a) Adequate handwashing facilities are to be provided and maintained in or adjacent to toilet rooms, and in food preparation areas. Sinks not in use for food storage, preparation or processing or not in use for utensil or dishwashing may be used for handwashing.
(b) Each handwashing facility is to be provided with running hot and cold or tempered potable water. Self-closing or metering faucets used are to provide a flow of water for at least 15 seconds without need to reactivate the faucet. Steam mixing valves are prohibited. In new construction or extensively altered installations, handwashing facilities are to be provided with hot and cold water tempered by means of a mixing valve or combination faucet.
(c) Each handwashing facility is to be provided with hand-cleaning soap or detergent with a sanitary storage receptacle. Individual single-service towels, warm air blowers or clean individual sections of continuous cloth are to be provided. Common towels are prohibited. Conveniently located waste receptacles are to be provided if disposable towels are used.
(d) Handwashing facilities, soap or detergent receptacles, handwashing devices and related facilities are to be kept clean and in good repair.
(e) Handwashing signs are to be posted at all employee handwashing facilities.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.2 Hazardous substances and hazardous wastes
(a) Unless otherwise permitted by these rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge, of hazardous substances or hazardous wastes into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
(b) New storage facilities or new tanks at an existing facility for the storage of hazardous substances regulated under Part 596 of Title 6 NYCRR, and new process tanks, as defined in section 596.(c)(35) of Title 6 NYCRR, which would be regulated under Part 596 of Title 6 NYCRR if not for the exemption of process tanks under section 596.1(b)(3)(i) of Title 6 NYCRR, are prohibited within the limiting distance of 100 feet of a watercourse or wetland, or within the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake, except as provided in subdivision (d) of this section.
(c) The owner or operator of a new facility, or a new or substantially modified tank at an existing facility, for the storage of hazardous substances which is regulated under Part 596 of Title 6 NYCRR and which is located between the limiting distance of 100 and 250 feet of a watercourse or wetland, must comply with the following conditions:
(1) The owner or operator shall submit to the department a copy of any registration forms required by sections 596.2(d) and (e) of Title 6 NYCRR and any notification forms required by section 596.2(f) of Title 6 NYCRR at the time such forms are submitted to the New York State Department of Environmental Conservation. When, on an emergency basis, new storage tanks are installed or existing storage tanks are substantially modified in order to protect public health, safety or the environment, the owner or operator shall notify the department no later than two hours after the decision is made by the owner or operator to install or substantially modify the tank.
(2) The owner or operator shall submit to the department a copy of any spill prevention report required to be prepared or updated by section 598.1(k) of Title 6 NYCRR, within 30 days of preparing or updating such report.
(3) Failure to comply with the provisions of section 596.6 of Title 6 NYCRR (spill response, investigation and corrective action) is a violation of these rules and regulations.
(4) Failure to comply with Part 599 of Title 6 NYCRR (Standards for New or Modified Hazardous Substance Storage Facilities) is a violation of this Part.
(d) Subdivision (b) of this section shall not apply to:
(1) The storage of any hazardous substance that is a noncomplying regulated activity, including the replacement in kind of an existing storage tank provided that the replacement tank is designed and installed in compliance with Federal, State and local law. To the extent practicable, the new tank shall be located outside of the limiting distances of 100 feet of a watercourse or wetland, or outside of the limiting distance of 500 feet of a reservoir, reservoir stem, or controlled lake;
(2) The storage of hazardous substances where such storage is necessary to operate a wastewater treatment plant approved by the department; and
(3) The storage of hazardous substances where such storage is made necessary by construction of a new facility or the alteration or modification of an existing facility used in connection with the operation of a public water supply system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.1 Purpose
Funds allocated will be for the continuation and expansion of approved family practice residency training programs and will not be paid directly to individual family practice residents.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.12 Severability
If any provisions of this Subpart or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Subpart or the application thereof to other persons, entities, and circumstances.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.205 Medical staff classification—courtesy
Certain doctors are designated as courtesy members when they have retired. They have privileges consistent with their abilities and qualifications.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.5 Fire safety
(a) Construction.
(1) Park-owned buildings shall be constructed in accordance with the applicable New York State Building Construction Codes and the New York State Fire Prevention Code (9 NYCRR), or their successor(s), including the list of generally accepted standards.
(2) Any mobile home built after January 15, 1974 that does not meet the State Code for Construction and Installation of Mobile Homes (9 NYCRR) shall not be installed in a mobile home park.
(3) Any mobile home built after June 15, 1976 that does not meet the U.S. Department of Housing and Urban Development Mobile Home Construction and Safety Standard (CFR, title 24, part 280) shall not be installed in a mobile home park.
(b) Spacing.
Homes and accessory buildings or structures installed after the effective date of this code shall be situated such that a minimum separation distance of 10 feet exists to any home, building or structure on any other site or parcel of land.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.9 Foreign diplomatic personnel
No medical services shall be approved for State aid reimbursement under this program for any staff member of a foreign legation, consulate, embassy or mission, or for any child of such staff member who resides with such staff member. Provision of medical services shall be the responsibility of the foreign country through its appropriate representative in the United States.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.10 Identification of supplemental data
The following sections contain an outline of all the reporting requirements not previously detailed in other sections of this Manual. Principally, this section contains the data requirements previously required by the Uniform Statistical Report, the Institutional Cost Report, and/or the Supplement to the Institutional Cost Report.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
GARBAGE AND REFUSE GARBAGE AND REFUSE
10 CRR-NY 14-4.151 Receptacles
Pushcart operators are to furnish and maintain refuse receptacles for wastes generated by their own operations and for wrapping materials or single-service articles furnished consumers.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 112 DUTCHESS COUNTY
DEPARTMENTS DEPARTMENTS
10 CRR-NY 112.20 Hyde Park Fire Department
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to Crum Elbow Creek from its sources to the intake of the water purification plant and to all natural and artificial reservoirs on the aforementioned creek and all watercourses tributary thereto or ultimately discharging into said creek and reservoirs, these bodies of water being sources of the public water supply of the Hyde Park Fire Department.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the reservoir on Crum Elbow Creek formed by the dam at the intake of the water supply of the Hyde Park Fire Department or to any additional reservoir which may be constructed or used for the purpose of this water supply,
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond, lake (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the Hyde Park Fire Department.
(3) Whenever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the Hyde Park Fire Department, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d).
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable <[continued]> watertight removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth under paragraph (5) of this subdivision.
(4) The excreta collected in the aforesaid removable vessels or receptacles permitted under paragraph (3) of this subdivision shall be removed and the vessels or receptacles thoroughly cleaned and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid removable vessels or receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department and in such a manner and at such a place as to effectually prevent its being washed over the surface of or through the ground in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Hyde Park Fire Department.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or to other special local condition, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or thetrench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes and other matter.
(1) No house slops, bath water, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant, as hereinafter provided under paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse tributary to the public water supply of the Hyde Park Fire Department nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 150 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir, or watercourse tributary to the public water supply of the Hyde Park Fire Department, shall be constructed, enlarged, altered or put in operation until plans for the same shall have been submitted to and approved by the State Engineer and a permit issued by the State Commissioner of Health allowing the discharge of such effluent as required by law and a copy of the plans, as approved, filed with the Hyde Park Fire Department.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow or percolate into any reservoir or watercourse within a distance of 100 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(4) No clothing, bedding, carpets, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Hyde Park Fire Department.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall bathe nor shall any animals or poultry be allowed to swim, wade or stand nor be washed in any reservoir of the Hyde Park Fire Department nor in any watercourse tributary thereto within three miles, measured along the stream above the intake of the water purification plant of the Hyde Park Fire Department. This shall not, however, be construed to prohibit animals from being watered in any portion of the watercourses tributary to the public water supply of the Hyde Park Fire Department, but no watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or within 50 feet of any watercourse tributary to the public water supply of the Hyde Park Fire Department and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Hyde Park Fire Department, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir nor within 200 feet of any watercourse tributary to the public water supply of the Hyde Park Fire Department, and no manure or compost of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or tributary watercourse nor placed, piled or spread upon the ground nor buried into the soil within a distance of 200 feet from any reservoir or within 25 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the Hyde Park Fire Department, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(g) Fishing, boating and ice cutting.
(1) No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the whole or any part of any reservoir of the public water supply of the Hyde Park Fire Department.
(2) No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed on Crum Elbow Creek or its tributaries except by written permission from the Hyde Park Fire Department and in strict compliance with the regulations to be adopted by said department. All ice cutting shall be done under the rigid inspection and supervision of the Hyde Park Fire Department.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the Hyde Park Fire Department.
(j) Inspections.
The Hyde Park Fire Department of Hyde Park or such other board, body or person as may be charged with the maintenance of the public water supply shall make or cause to be made regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with and it shall be the duty of said fire department to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Hyde Park Fire Department to promptly notify the State Commissioner of Health of such violations. The said fire department shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of noncompliance with any of these rules and regulations which relate to a permanent source or act of continuation is hereby fixed at $100.
Part 148 SULLIVAN COUNTY
VILLAGES VILLAGES
10 CRR-NY 148.3 Village of Woodridge
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to East Pond and all watercourses tributary thereto or which may ultimately discharge into said East Pond or which may be developed in the future to serve as sources of the water supply to the Village of Woodridge.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal wastes and agricultural- and nonagricultural-associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as source of the public water supply of the Village of Woodridge.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(18) Toxic substance shall mean any toxic substance as so defined by section 4801(2) of the Public Health Law.
(19) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(20) Water supply shall mean the public water supply of the Village of Woodridge.
(21) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the Village of Woodridge water supply.
(22) Watershed shall mean the entire drainage area contributing water to the Village of Woodridge water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides, pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No agricultural- or nonagricultural-associated animal wastes shall be spread or deposited on any of the watershed property owned by the Village of Woodridge.
(v) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(vi) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vii) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(viii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(ix) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (vi) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Woodridge.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Woodridge except by duly authorized employees of the Village of Woodridge in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Woodridge.
(iv) No admittance by anyone for any purpose except by duly authorized employees of the Village of Woodridge in the performance of their duties of supervision and maintenance of the water supply. All watershed lands shall be posted and trespassers will be prosecuted.
(8) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(9) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(10) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Woodridge.
(11) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(12) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility. Cutting of any wood, grass or other vegetation on watershed lands shall not be permitted unless authorization has been obtained from the New York State Department of Health.
(e) Inspections.
The village board or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representatives make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law. The village board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.12 Village of Tarrytown
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Tarrytown, Westchester County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Tarrytown.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse tributary to the public water supply of the village of Tarrytown.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or to remain within 150 feet of any watercourse tributary to that reservoir known as the lower lake nor within 75 feet of any watercourse tributary to that reservoir known as the upper lake, said bodies of water being tributary to the public water supply of the village of Tarrytown.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition in such a manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Tarrytown.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Tarrytown, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir nor within 150 feet of any watercourse tributary to that reservoir known as the lower lake nor within 75 feet of any watercourse tributary to that reservoir known as the upper lake, said bodies of water being tributary to the public water supply of the village of Tarrytown.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Tarrytown.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Tarrytown is prohibited; nor shall any such watering be allowed in any watercourse tributary to this water supply within 1,000 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Tarrytown.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Tarrytown, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the village of Tarrytown.
(3) No human excreta, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Tarrytown; nor shall such human excreta, compost or other matter containing the same be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of Tarrytown, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Tarrytown.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 50 feet before entering any watercourse tributary to the public water supply of the village of Tarrytown.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 150 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the village of Tarrytown.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs. No ice cutting shall be done except with the permission and under the rigid inspection and supervision of the board of water commissioners. No skating shall be allowed except upon the upper lake and only at specifically stated times under the strict supervision of the board of water commissioners. During such skating periods the board of water commissioners shall provide police patrol to prevent any infringement of these rules and regulations and shall post at frequent and conspicuous intervals around the lake suitable signs containing subdivisions (d) and (g) of the rules and regulations.
(h) [Camps.]
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Tarrytown.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Tarrytown.
(j) [Inspections.]
The board of water commissioners of the village of Tarrytown shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.334 Unit of service
(a) A unit of measure, often commonly accepted for determining average cost, time or efficiency, thus making possible:
(1) comparisons of one operation with another or with the same operation in a preceding period; and
(2) estimates of future operations.
(b) Synonymous with standard unit of measure.
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.6 Small hospital reduced reporting requirements
[ 2380 ]
(a) Small hospital is defined as a hospital or hospital -health service complex that has had, for the three accounting periods preceding the reporting period, average annual hospital admissions of less than 4,000.
(b) Such hospitals, at their option, may report less detail than that required for hospitals with average annual admissions of 4,000 or more. The reporting forms are the same for both small and large hospitals. However, small hospitals would group cost ceners as specified below:
(1) Report as Plant Operation and Maintenance (account 8410) the combination of the following cost centers:
(i) Plant Maintenance (account 8400);
(ii) Plant Operation (account 8410);
(iii) Security (account 8430);
(iv) Parking (account 8440).
(2) Report as Patient Accounts (account 8520) the combination of the following cost centers:
(i) Patient Accounts (account 8520);
(ii) Admitting (account 8530);
(iii) Registration (account 8540).
(3) In place of the combination referred to in paragraph (2) of this subdivision, Hospital Administration (account 8610) may be reported by the combination of the following cost centers:
(i) General Accounting (account 8510):
(ii) Patient Accounts (account 8520);
(iii) Admitting (account 8530);
(iv) Registration (account 8540);
(v) Hospital Administration (account 8610);
(vi) Purchasing and Stores (account 8690);
(vii) Medical Staff Administration (account 8720).
(c) Paragraph (b)(1) of this section and either paragraph (b)(2) or (b)(3) must be utilized if this “small hospital” option is utilized.
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.8 Balance sheet reporting
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Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 456 COST-FINDING PRACTICES AND PROCEDURES
10 CRR-NY 456.4 Sampling technique
(a) The following allocation bases may be sampled for the functional reporting centers indicated, rather than having actual cost allocation statistics accumulated for a full year:
(1) dry and clean pounds distributed (Laundry and Linen);
(2) hours of service (Medical Records) (Medical Staff Services) (Social Services);
(3) time spent (Medical Director's Office);
(4) total hours of nursing service (Nursing Administration);
(5) costed requisitions (Pharmacy) (Central Service Supply);
(6) assigned time (Housekeeping); and
(7) the allocation basis for any cost center not having direct costs, but which receives indirect costs as a result of the cost-finding process.
(b) The sampling plan used by the residential health care facility need not conform to the strict mathematical concepts inherent to statistical sampling. The recommended approach to be used to sample statistics used as an allocation basis is as follows:
(1) A minimum of eight calendar weeks will be selected each year for the accumulation of data.
(2) These eight weeks will be representative of the full year. In order to achieve this, the facility will select a two-week block (14 consecutive days) within each fiscal quarter for the collection of data.
(3) The same two-week block need not be used for all statistics.
(4) During the testing period, actual counting, weighing, etc. will be done for all shifts involved in the particular area.
(c) Periods of unusual circumstances should be avoided as test weeks. The principle of representative samples is the ultimate goal.
(d) It should be noted that sampling techniques may only be utilized for those statistical bases indicated above and only with respect to cost allocation. Statistics utilized for the standard unit of measure may not be sampled.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.2 Village of East Bloomfield, Ontario County
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells and springs which comprise the source of the public water supply of the Village of East Bloomfield. Said wells and springs are located on land owned by the Village of East Bloomfield and are situated about 600 feet westerly of Michigan Street and 700 feet northerly of Main Street in the village.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well or spring.
(7) Manure shall mean animal feces or urine.
(8) Nonagricultural animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural and nonagricultural associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial or industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision (2) of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Village of East Bloomfield.
(20) Wells or springs shall mean any well or spring now used as a source of water supply for the Village of East Bloomfield or any additional well or spring which may be developed at this point in the future as a source for such water supply.
(21) Regulated zone shall mean that area beyond the distances hereinafter specified but within the area bounded and described as follows:
(i) On the north by an east-west line perpendicular to Michigan Street and 500 feet north of the water pump house; on the east by a north-south line parallel to Michigan Street and about 1,100 feet east of the water pump house, being also the west line of the Village of Holcomb regulated zone; on the south by an east-west line parallel to and 1,800 feet south of the centerline of Gauss Road; and on the west by a north-south line which is the centerline of Bailey Road and the northerly projection of the centerline of Bailey Road.
(ii) A map showing the limits of the regulated zone is available for inspection at the village public works department offices and at the New York State Department of Health, Bureau of Public Water Supply, Albany, NY.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural waste.
No manure or offal shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the wells or springs. Within the regulated zone, manure or offal may be spread if approved by the village.
(2) Cemeteries.
No interment of a human body shall be permitted within a 300-foot linear distance of the wells or springs.
(3) Chloride salt.
No storage of chloride salt shall be permitted within a 1,000-foot linear distance of the wells or springs. Within the regulated zone, chloride salt must be stored in such a manner to prevent storm water or snowmelt from dissolving the chloride salt and carrying the solution into the underlying soil formations. Such chloride salt shall be covered in a manner reasonably acceptable to the village.
(4) Farm or domestic animals.
No quartering of farm animals or commercial penning of domesticated animals shall be permitted within a 500-foot linear distance of the wells or springs.
(5) Herbicides and pesticides.
No herbicides or pesticides, except short-term biodegradable type for residential use, shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells or springs unless a permit has been obtained from the appropriate municipality or State agency having jurisdiction. No bulk storage of herbicides or pesticides for commercial use is permissible within the regulated zone.
(6) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle for temporary storage or permanent disposal of human excreta and sewage shall be constructed, located, placed, maintained or allowed to remain within a 1,000-foot linear distance of the wells or springs.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 500-foot linear distance of the wells or springs.
(iii) Collection and transport of sewage or polluted liquid shall only be allowed in watertight pipes or containers which shall be approved by the appropriate State agency having jurisdiction. Ultimate disposal shall be to a treatment works or disposal site approved by the State Department of Environmental Conservation. Within the regulated zone, subsurface disposal systems shall only be allowed if reviewed and approved by the village and a permit has been granted by the appropriate State agency having jurisdiction over such facility.
(7) Junkyards.
No junkyards shall be located within a 500-foot linear distance of the wells or springs. Within the regulated zone, no refuse disposal or disposal of oil, gasoline, battery acid, etc. from junkyards shall be permitted upon or beneath the surface of the ground.
(8) Major earthworks or commercial excavations.
No activity involving major earthworks or commercial excavations shall be permitted within a 1,000-foot linear distance of the wells or springs. Within the regulated zone, no such work which will penetrate the underlying water table or change the course of ground water shall be permitted.
(9) Petroleum products.
No storage containers shall be permitted below ground, and no storage containers shall be permitted above ground in excess of 30 gallons, within a 350-foot linear distance of the wells or springs. No storage containers shall be permitted below ground in excess of 500 gallons, and no storage containers shall be permitted above ground in excess of 30 gallons unless set on a concrete slab with low curb to contain spills or leakage, within a 700-foot linear distance of the wells or springs but beyond 350 feet. Within the regulated zone, below-ground storage in excess of 1,000 gallons is permissible if constructed and monitored as follows:
(i) Owners of all new tanks will be required to obtain a permit from the village. The permit will indicate the methods for installing and testing new tanks. The conditions of such permit shall be subject to review and approval by the State Department of Health.
(ii) Only tanks approved by the American Petroleum Institute will be acceptable for new construction.
(iii) Owners of tanks for storage of gasoline, diesel fuel, etc., which is pumped to cars, trucks or other movable equipment, shall keep daily records of usage and delivery of fuel. These records shall be kept on file, for inspection by the village, and a copy sent to the village public works department every three months.
(10) Radioactive material.
No radioactive material shall be disposed of by burial in the soil within a 1,000-foot linear distance of the wells or springs, or within the regulated zone.
(11) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells or springs.
(12) Toxic substances.
No storage of toxic substances, except as permitted by the provision of paragraph (9) of this subdivision, shall be permitted within a 1,000-foot linear distance of the wells or springs.
(13) Trespassing.
No trespassing shall be allowed upon the property of the village upon which the wells and springs are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the village.
(14) Other wastes.
No pollutant of any kind shall otherwise be discharged or deposited upon the property of the Village of East Bloomfield upon which the wells or springs are located.
(e) Inspections.
The village board, or its duly authorized village representative, shall make regular and thorough inspections of the area surrounding the wells and springs to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the State Commissioner of Health of such violations. The aforesaid village board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the wells and springs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Part 111 DELAWARE COUNTY
VILLAGES VILLAGES
10 CRR-NY 111.3 Village of Walton
(a) Privies adjacent to reservoirs, springs or watercourses.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 25 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse which when running flows eventually into a reservoir of the Walton water supply.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 150 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit of human excreta, which is constructed, located or maintained between the aforesaid limits of 25 and 150 feet, horizontal measurement, from the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse as aforesaid, and from which the said excrement is not at once removed automatically by means of suitable watertight pipes or conduits to some place of disposal beyond the said maximum limits, shall be arranged in such manner that all such excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which shall admit of convenient removal to some place of ultimate disposal beyond the said maximum limits.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or floor of the privy.
(5) The excreta so collected shall be removed so as to cause the least nuisance possible and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of the surface or subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptable for human excreta may be washed over the surface or through the subsoil into a reservoir or into any spring, stream, ditch or watercourse aforesaid without having been thereby, in the opinion of the State Department of Health, sufficiently purified, then the said privy, cesspool or other receptacle shall, after due notice to the owner thereof, be removed to such greater distance from said high-water mark as shall be considered safe and proper by the Department of Health.
(b) House slops, sink waste, laundry water and other similar sewage.
(1) No sewage, house slops, sink waste, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid.
(3) No garbage or putrescible refuse of any kind be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such polluted matter be thrown, buried or discharged into the ground below the surface in any manner whereby the same or any washings from the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without flowing through the earth for a distance of at least 50 feet, horizontal measurement, to the highwater mark or precipitous bank of any reservoir or of any spring, stream, ditch or watercourse flowing into any reservoir of the water supply of the Village of Walton, NY
(c) Manure, composts and similar matter.
(1) No stable, pigsty, henhouse, barnyard, hog or duck yard, hitching or standing place for cattle or horses or other place where animal manure accumulates and no compost or manure heap shall be located or maintained within 125 feet of, nor shall they or any watering place for horses, cattle or other animals be so arranged that the polluted drainings therefrom shall be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement, nor flow into or through covered drains within 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No human excreta nor compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir, spring, stream, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so that they may be washed a less distance than 250 feet over the surface of the ground or 50 feet through the subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone purification.
(d) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird, fish nor any part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill or other manufactory shall be thrown or allowed to run directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface less than 250 feet or through the subsoil less than 50 feet into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Cemeteries.
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(f) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.22 Suspicious orders
The licensee shall establish and operate a system to disclose to the licensee suspicious orders for controlled substances and inform the department of such suspicious orders. Suspicious orders shall include, but not be limited to, orders of unusual size, orders deviating substantially from a normal pattern, and others of unusual frequency.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.21 Direct admissions from emergency room
(a) To the specific discrete unit under each Daily Hospital Service Area.
(1) Acute Care Services (accounts 6010-6290).
(2) Intensive Care Services (accounts 6310-6410).
(3) Nursery Services (account 6510 or 6520).
(4) Sub-Acute Care Services (accounts 6610-6690).
(b) Total must agree with the difference between Emergency Services visits reported per section 446.20(a)(1)(iii) and section 446.20(a)(2) of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.13 Physical containment levels; P3 level
(a) Laboratory practices.
(1) Laboratory doors shall be kept closed while experiments are in progress.
(2) Work surfaces shall be decontaminated following the completion of the experimental activity, and immediately following spills of organisms containing recombinant DNA molecules.
(3) All laboratory wastes shall be steam-sterilized (autoclaved) before disposal. Other contaminated materials, such as glassware, animal cages, laboratory equipment, and radioactive wastes, shall be decontaminated by a method demonstrated to be effective before washing, reuse, or disposal.
(4) Mechanical pipetting devices shall be used; pipetting by mouth is prohibited.
(5) Eating, drinking, smoking, and storage of food are not permitted in the laboratory area in which recombinant DNA materials are handled.
(6) Persons shall wash their hands after handling organisms containing recombinant DNA molecules and when they leave the laboratory.
(7) Care shall be exercised to minimize the creation of aerosols. For example, manipulation such as inserting a hot inoculating loop or needle into a culture, flaming an inoculation loop or needle so that it splatters, and forceful ejection of fluids from pipettes or syringes shall be avoided.
(8) Contaminated materials that are to be steam-sterilized (autoclaved) or decontaminated at a site away from the laboratory shall be placed in a durable leak-proof container, which is closed before removal from the laboratory.
(9) Entry into the laboratory shall be through a controlled access area. Only persons who have been advised of the nature of the research being conducted shall enter the controlled access area. Only persons required on the basis of program or support needs shall be authorized to enter the laboratory. Such persons shall be advised of the nature of the research being conducted before entry, and shall comply with all required entry and exit procedures.
(10) Persons under 16 years of age shall not enter the laboratory.
(11) The universal biohazard sign shall be posted on the controlled access area door and on all laboratory doors when experiments requiring P3-level containment are in progress. Freezers and refrigerators or other units used to store organisms containing recombinant DNA molecules shall also be posted with the universal biohazard sign.
(12) An insect and rodent control program shall be instituted.
(13) Laboratory clothing that protects street clothing (e.g., long-sleeve solid-front or wrap-around gowns, no-button or slip-over jackets) shall be worn in the laboratory. Front-button laboratory coats are unsuitable. Laboratory clothing shall not be worn outside the laboratory and shall be decontaminated before it is sent to the laundry.
(14) Raincoats, overcoats, topcoats, coats, hats, caps, and such street outerwear shall not be kept in the laboratory.
(15) Gloves shall be worn when handling materials requiring P3 containment. They shall be removed aseptically immediately after the handling procedure and decontaminated.
(16) Animals and plants not related to the experiment shall not be permitted in the laboratory.
(17) Vacuum outlets shall be protected by filter and liquid disinfectant traps.
(18) Use of hypodermic needle and syringe shall be avoided when alternative methods are available.
(19) The laboratory shall be kept neat and clean.
(20) If experiments involving other organisms which require lower levels of containment are to be conducted in the same laboratory concurrently with experiments requiring P3-level physical containment, they shall be conducted in accordance with all P3-level laboratory practices.
(b) Containment equipment.
(1) Biological safety cabinets shall be used for all equipment and manipulations that produce aerosols (e.g., pipetting, dilutions, transfer operations, plating, flaming, grinding, blending, drying, sonicating, shaking, centrifuging), where these procedures involve organisms containing recombinant DNA molecules, except where equipment design provides for containment of the potential aerosol.
(2) Laboratory animals held in a P3 area shall be housed in partial-containment caging systems, such as horsfall units, open cages placed in ventilated enclosures, solid-wall and -bottom cages covered by filter bonnets, or solid-wall and -bottom cages placed on holding racks equipped with ultraviolet radiation lamps and reflectors. (Note: Conventional caging systems may be used, provided that all personnel wear appropriate personal protective devices. These shall include, at a minimum, wrap-around gowns, head covers, gloves, shoe covers, and respirators. All personnel shall shower on exit from areas where these devices are required.)
(3) Alternative selection of containment equipment.
Experimental procedures involving a host-vector system that provides a one-step higher level of biological containment than that specified can be conducted in the P3 laboratory using containment equipment specified for the P2 level of physical containment. Experimental procedures involving a host-vector system that provides a one-step lower level of biological containment than that specified can be conducted in the P3 laboratory using containment equipment specified for the P4 level of physical containment. Alternative combinations of containment safeguards are shown in Table I.
Table I
POSSIBLE COMBINATIONS OF CONTAINMENT SAFEGUARDS
| Classification of experiment | Alternate combinations of physical and biological containment | | | | | | --- | --- | --- | --- | --- | --- | | Physical Containment | | | | | | | Physical containment | Biological containment* | Laboratory design specified for: | Laboratory practices specified for: | Containment equipment specified for: | Biological containment | | P3 | HV2 | P3 | P3 | P3 | HV2 | | | HV2 | P3 | P3 | P4 | HV1 | | P3 | HV1 | P3 | P3 | P3 | HV1 | | P3 | HV1 | P3 | P3 | P2 | HV2 |
*
See section 61-1.16 for description of biological containment.
(c) Special laboratory design.
(1) The laboratory shall be separated by a controlled access area from areas that are open to unrestricted traffic flow. A controlled access area is an anteroom, a change room, an air lock or any other double-door arrangement that separates the laboratory from areas open to unrestricted traffic flow.
(2) The surfaces of walls, floors, and ceilings shall be readily cleanable. Penetrations through these surfaces shall be sealed or capable of being sealed to facilitate space decontamination.
(3) A foot-, elbow-, or automatically operated hand-washing facility shall be provided near each primary laboratory exit area.
(4) Windows in the laboratory shall be sealed.
(5) An autoclave for sterilization of wastes and contaminated materials shall be available in the same building (and preferably within the controlled laboratory area) in which organisms containing recombinant DNA molecules are used.
(6) The laboratory shall have a ventilation system that is capable of controlling air movement. The movement of air shall be from areas of lower contamination potential to areas of higher contamination potential ( i.e., from the controlled access area to the laboratory area). If the ventilation system provides positive pressure supply air, the system shall operate in a manner that prevents the reversal of the direction of air movement or shall be equipped with an alarm that would be actuated in the event that reversal in the direction of air movement were to occur. The exhaust air from the laboratory area shall not be recirculated to other areas of the building unless the exhaust air is filtered by HEPA filters or equivalent. The exhaust air from the laboratory area can be discharged to the outdoors without filtration or other means for effectively reducing an accidental aerosol burden provided that it can be dispersed clear of occupied buildings and air intakes.
(7) The treated exhaust-air from class I and class II biological safety cabinets may be discharged either to the laboratory or to the outdoors. The treated exhaust-air from a class III cabinet shall be discharged directly to the outdoors. If the treated exhaust-air from these cabinets is to be discharged to the outdoors through a building exhaust air system, it shall be connected to this system so as to avoid any interference with the air balance of the cabinet and the building ventilation system.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 454 FUNCTIONAL REPORTING
10 CRR-NY 454.1 Introduction and concepts
(a) This Part discusses the overall concepts, principles, and other factors involved in the preparation and submission of financial and statistical information for the uniform financial reporting program for residential health care facilities in New York State. Uniform reporting is defined as the identification and reporting of all financial and related statistical data in a uniform manner consistent with the definitions set forth in this Article. All residential health care facilities in New York State will be required to adopt the policies, methodologies and practices presented in this section in preparing and submitting their uniform reports to the State.
(b) The revenue and expense portion of uniform reporting includes:
(1) alignment and classification of revenue and expense on a functional (activity) basis, rather than by organizational unit;
(2) application of a uniform standard unit of measure to the functional reporting center for an expression of revenue or expense per unit of activity; and
(3) cost finding, involving the systematic allocation of expenses on a statistical basis between centers which serve or are directly related to the activity performed in another center.
(c) This Part presents overall concepts, definitions of the functional revenue and expense reporting centers and standard units of measurement for the identified centers.
(d) The cost-finding methods, including segregation of costs and statistical bases for allocation, are discussed in Part 456 of this Article.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.58 Capitalize
(a) To record and carry forward into one or more future periods any expenditure, the benefits or proceeds from which will then be realized.
(b) To add to a fixed asset account the cost of plant additions, improvements and expenditures having the effect of increasing the efficiency or yield of a capital asset or making possible future savings in cost from its use.
(c) To transfer surplus to a capital-stock account, as the result of the issue of a stock dividend, a recapitalization, or, under the laws of some states, resolution of the board of directors.
(d) To discount or calculate the present worth of the projected future earnings of an asset or business.
10 CRR-NY 441.88 Deferred charge
An expenditure not recognized as a cost of operations of the period in which incurred but carried forward to be written off in one or more future periods.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.4 Village of Phelps, Ontario County
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to a shallow well with pump house and radial collector pipes (hereinafter well system) which will comprise a source of the public water supply of the Village of Phelps (hereinafter village). Said well to be located on land owned by Leon W. Adams and is situated on the west side of Lester Road, in the village.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the horizontal separation between the centroid of the well system and the nearest point of the structure or object in question. The well system centroid is located on the centerline of the central collector pipe, 44 feet south of the pump house. A map showing the location of the well system and its centroid is available at the village office.
(7) Manure shall mean animal feces and urine.
(8) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(9) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural-associated animal wastes.
(10) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(11) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(12) Refuse shall mean all putrescible and, nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid, commercial and industrial wastes.
(13) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agriculural associated animal wastes resulting from the operation of such farm are deposited.
(14) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(15) Sewage disposal system shall mean any system used for disposing of sewage.
(16) Toxic substance shall mean any toxic substance as so defined by subdivision (2) of section 4801 of the Public Health Law.
(17) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(18) Water supply shall mean the public water supply of the Village of Phelps.
(19) Well shall mean any well now used or which may be developed in the future as a source of water supply for the village.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be permitted within a 300-foot linear distance.
(2) Chloride salt storage.
No bulk storage shall be permitted within a 500-foot linear distance.
(3) Herbicides and pesticides.
No herbicides or pesticides, except short-term biodegradable type for residential use, shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance unless a permit has been obtained from the appropriate State agency having jurisdiction. No bulk storage of herbicides or pesticides for commercial use permitted within a 1,500-foot linear distance.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle for temporary storage or permanent disposal of human excreta and sewage shall be permitted within a 300-foot linear distance.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground within a 300-foot linear distance.
(iii) Collection and transport of sewage or polluted liquid shall only be allowed in watertight pipes or containers which shall be approved by the appropriate State agency. Ultimate disposal shall be at a treatment works or disposal site approved by the New York State Department of Environmental Conservation.
(iv) No subsurface disposal of sewage or polluted liquid from existing onsite systems shall be permitted within a 300-foot linear distance. Future subsurface disposal systems within a 500-foot linear distance shall only be allowed if reviewed and approved by the village and a permit has been granted by the appropriate State agency having jurisdiction over such facility.
(5) Petroleum products.
No storage containers permitted below ground and no storage containers permitted above ground in excess of 30 gallons, within a 250-foot linear distance. No storage containers permitted below ground in excess of 500 gallons and no storage containers permitted above ground in excess of 30 gallons unless set on a concrete slab with a low curb to contain spills or leakage, within a 1,000-foot linear distance, but beyond 250 feet.
(6) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance.
(7) Toxic substances.
No storage of toxic substances, except as permitted by the provisions of paragraph (6) of this subdivision shall be permitted within a 1,000 foot linear distance.
(8) No junkyards shall be permitted within a 300-foot linear distance.
(9) Farm or domestic animals.
No quartering of farm animals or commercial penning of domesticated animals shall be permitted within a 300-foot linear distance.
(10) Major earthworks or commercial excavations.
No activity involving major earthworks or commercial excavations shall be permitted within a 1,000-foot linear distance.
(11) Radioactive material.
No radioactive material shall be disposed of by burial in the soil within a 1,000-foot linear distance.
(12) Trespassing.
No trespassing shall be allowed upon the property leased or owned by the village upon which the well is located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the village.
(e) Inspections.
The village board or their duly authorized village representative, shall make regular and thorough inspections of the area surrounding the well to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with the provisions of section 1102 of the Public Health Law. The aforesaid village board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding well at the time of the last inspection.
(f) Penalties for violations.
Penalties for the violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.7 Administration and direction
(a) Every tissue bank other than a tissue transplantation facility or limited tissue procurement service shall have a tissue bank director. The tissue bank director shall develop and implement policies and procedures for the operation of the bank, consistent with this Subpart and the Subparts for each category of tissue. If the tissue bank director is not a physician, a medical director who is a physician shall be retained.
(b) Except for transplantation facilities, insemination/implantation sites, and limited tissue procurement services, every tissue bank shall have a medical advisory committee, composed of persons with training and experience in tissue banking or a closely related field, as well as at least one member with infectious disease expertise, and with the qualifications specified in the Subpart(s) for each category of tissue, if any.
(c) Medical direction of a tissue bank, other than a tissue transplantation facility or limited tissue procurement service, shall be provided by a physician, designated as the medical director, in consultation with the medical advisory committee, if applicable.
(d) The tissue bank director, if one is required, in consultation with the medical director, if not the same person, and the medical advisory committee, if one is required, shall monitor the medical efficacy of the tissue banking program and shall, as a minimum, develop:
(1) medical criteria for allogeneic donor participation;
(2) quality control and quality assurance standards; and
(3) procedures to assure that tissues from allogeneic donors are distributed based on medical need and not preferentially distributed according to the donor's or recipient's membership in a category based on race, color, creed, ii national origin, marital status, social organization or income except if medically indicated.
(e) The tissue bank director shall be responsible for donor selection and the technical/ scientific operation of the bank, including recruitment of sufficient numbers, training, and supervision of all personnel performing tissue acquisition, processing, storage or distribution activities.
(f) The tissue bank director shall be responsible for ensuring that the tissue transplantation facility or insemination/implantation site performing each transplant, artificial insemination, transfer, or implantation is advised of the donor's applicable medical history and tissue processing methods used, so that recipient counseling may be provided if indicated.
(g) The medical director of each insemination/implantation site shall be responsible for ensuring that the individual performing each artificial insemination, transfer or implantation is advised of the donor's significant medical history.
(h) The tissue bank director, medical director and owner(s) shall be responsible for compliance with this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.2 Health service areas
(a) Geographical description.
Health service areas have been established for health systems agencies such that:
(1) the area is a geographic region appropriate for the effective planning and development of health services, determined on the basis of factors including population and the availability of resources to provide all necessary health services for residents of the area;
(2) the boundaries of health service areas have been determined so as to recognize the differences in health planning and health services development needs between metropolitan and nonmetropolitan areas;
(3) in order for a bi-state health service area to be designated, a bi-state planning agreement must be established. The bi-state planning agreement shall include but need not be limited to the following provisions: standards for equitable representation of board membership from each state; boundaries that are consistent with medical trade patterns; provisions for financial support from each state; and comparable policies and procedures to be implemented by the bi-state health systems agency in evaluating the availability and need for hospital or other health care facilities or services and governing the collection of data and statistics for health planning. Any such bi-state agreement shall be signed by the executives of each state.
(b) The geographical boundaries and territorial extent of the health services areas in New York State for health systems agencies are based on county groupings, approved by the governor, as described below:
Area 1: the counties of Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Orleans, Niagara, and Wyoming.
Area 2: the counties of Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, and Yates.
Area 3: the counties of Cayuga, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, and Tompkins.
Area 4: the counties of Broome, Chenango, Tioga, Bradford, Sullivan and Susquehanna provided a bi-state planning agreement with the State of Pennsylvania exists.
Area 5: the counties of Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Washington, and Warren.
Area 6: the counties of Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, and Westchester.
Area 7: the counties of Bronx, Kings, New York, Queens, and Richmond.
Area 8: the counties of Nassau and Suffolk.
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.10 Responsibilities of hospitals
(a) In addition to their responsibilities specified under other sections of this Part, hospitals shall provide such information, facilities and services as requested by the persons designated by the Commissioner of Health to make determinations of coverability or decisions on appeal under sections 85.1 through 85.9 and section 85.13 of this Part.
(b) Hospitals shall designate an employee of the hospital to serve as liaison with the persons designated by the Commissioner of Health to make determinations of coverability or noncoverability or decisions on appeal under sections 85.1 through 85.9 and section 85.13 of this Part.
(c) Hospitals shall maintain copies of all notices of determinations of benefit coverability and noncoverability and notifications of decisions on appeal made by the commissioner's designees under this Part and given to the hospital. The hospital shall make such copies available for review by persons designated by the Commissioner of Health, the State Department of Social Services or local social services districts.
(d) Hospitals shall record on each claim for reimbursement under medical assistance for the needy for inpatient hospital care the period or periods of time approved as covered benefits by the commissioner's designee under this Part and shall certify on each claim that reimbursement is being requested only for inpatient hospital care determined to be a covered benefit by the commissioner's designee or that a determination is not required under this Part.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.8 Administration of a tissue transplantation facility
(a) Each tissue transplantation service director shall develop and implement policies and procedures for operation of the tissue transplantation service consistent with this Subpart and the Subparts for each category of tissue.
(b) The tissue transplantation service director shall, at a minimum, develop:
(1) quality assurance procedures and standards; and
(2) procedures to assure that tissues are issued for transplantation based on medical need and not preferentially distributed according to the donor's or recipient's membership in a category based on race, color, creed, national origin, marital status, social organization or income, except if medically indicated.
(c) The tissue transplantation service director shall be responsible for ensuring that the physician performing each transplant or transfer is advised of the donor's significant medical history if provided by the tissue bank supplying the tissue, and the processing methods used, so that recipient counseling may be provided if indicated.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.1 Scope
All general hospitals and residential health care facilities as defined in article 28 of the Public Health Law (collectively, “covered facilities”) shall comply with this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 120 HERKIMER COUNTY
CITIES CITIES
10 CRR-NY 120.1 City of Little Falls
(a) Application.
The following rules and regulations shall apply to the following reservoirs belonging to the public water supply of the City of Little Falls, NY, and to all lakes, ponds, streams and other watercourses tributary thereto: Beaver Brook Reservoir, Spruce Creek Reservoir, Klondike Reservoir and the distributing reservoir near the City of Little Falls.
(b) Definitions.
(1) The term reservoir wherever used in this this is intended to mean and comprise every natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter the public water supply of the city of Little Falls.
(2) The term watercourse wherever used in this section is intended to mean and comprise every spring, stream, ditch, gutter or other watercourse of any kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into either of the above-named reservoirs of the public water supply of the City of Little Falls, N.Y.
(3) Wherever distances from reservoirs or watercourses are mentioned, they are intended to mean the horizontal distances from the high-water line of such reservoir or the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to reservoirs or watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained with its nearest point within 50 feet of any reservoir or watercourse of the Little Falls water supply.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 250 feet of any reservoir or watercourse of the Little Falls water supply. For points one mile or more distant upstream from the Beaver Brook Reservoir, Spruce Creek Reservoir, and Klondike Reservoir, on tributaries thereto, the above restricted distances shall be 150 feet and for points four miles or more up stream from these reservoirs the restricting distance shall be 50 feet.
(3) Every privy, privy vault, pit, cesspool or any other receptacle or place used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 250 feet, 150 feet and 50 feet, horizontal measurement, of the high-water mark of any reservoir or watercourse of the Little Falls water supply, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacle shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of the Little Falls water supply.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or such receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the Little Falls water supply nor shall any such matter be placed, led, discharged or allowed to escape onto the surface of the ground or into the [ continued ] ground below the surface within 300 feet, horizontal measurement, from the high-water mark of any reservoir or within 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Little Falls water supply.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste from creameries, cheese factories, laundries nor waste water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the Little Falls water supply. Nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may percolate, leach or flow into any reservoir or watercourse of the Little Falls water supply within 100 feet, horizontal measurement, of the high-water line of any reservoir or any watercourse of the Little Falls water supply.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the Little Falls water supply.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the Little Falls water supply, nor shall any animal or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor to be washed therein. Points distant two miles or more up stream from the Beaver Brook Reservoir, Spruce Creek Reservoir and Klondike Reservoir, on tributaries thereof, are exempt from this restriction.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 150 feet, horizontal measurement, from the high-water mark of any reservoir or any watercourse of the Little Falls water supply, andnone of the above named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainage, leachings or washings from the same may enter any reservoir or watercourse of the Little Falls water supply without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir or watercourse of the Little Falls water supply. For points distant one mile or more up stream from Beaver Brook Reservoir, Spruce Creek Reservoir and Klondike Reservoir, on tributaries thereof, this restricting distance shall be 100 feet; for points four miles or more distant up stream from these reservoirs the restricting distance shall be 50 feet.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from the high-water line of any reservoir or watercourse of the Little Falls water supply.
(4) No manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of the high-water line of any reservoir or watercourse of the Little Falls water supply. For points one mile or more distant up stream from the Beaver Brook Reservoir, Spruce Creek Reservoir and Klondike Reservoir, on the tributaries thereof, this restricting distance shall be 100 feet; and points four miles or more up stream from these reservoirs are exempt from this restriction.
(5) No decayed or fermented fruit or vegetable, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the Little Falls water supply without first having passed over or through such an extent of soil as to become properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or watercourse of the Little Falls water supply. Points one mile or more distant up stream from the Beaver Brook Reservoir, Spruce Creek Reservoir and Klondike Reservoir, on tributaries thereof, are exempt from this restriction.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal nor refuse from any slaughterhouse nor any decomposible or putrescible refuse or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the Little Falls water supply, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any reservoir or watercourse of the Little Falls water supply without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir or watercourse of the Little Falls water supply. For points distant one mile or more up stream from the Beaver Brook Reservoir, Spruce Creek Reservoir and Klondike Reservoir, this restricting distance shall be 100 feet; and points four miles or more distant up stream from these reservoirs may have this restricting distance reduced to 50 feet.
(g) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, the penalty for each and every violation of or noncompliance with any of the above rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.28 Podiatry
This functional reporting center must contain all the expenses associated with the provision of specialized diagnostic and therapeutic procedures in treatment of a patient by a podiatrist and/or podiatry staff. Additional activities include but are not limited to the following: examination of patients; consulting with patients and attending physicians.
(a) Standard unit of measure: number of visits.
A visit is defined as medical attention provided by the podiatry department regardless of whether the patient visits the podiatry department or is visited in his room by the podiatrist and/or podiatry staff.
(b) Data source.
The number of visits shall be an actual count maintained by the podiatry department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.8 Required records
(a) Complete and accurate records of hematopoietic progenitor cells released for transplantation shall be kept for seven years by the hematopoietic progenitor cell procurement service, processing facility and transplantation service using the sample. Such records shall be open to inspection by the department. For all donated hematopoietic progenitor cells, the donor's name, address, and any other information that would directly or indirectly identify the donor shall not be disclosed or released by the bank to any person or entity, except upon the written consent of the donor or the person authorized by law to make the donation, or to authorized employees of the department, or as permitted by law. The recipient's name, address, and any other information that would directly or indirectly identify the recipient shall not be disclosed or released by the hematopoietic progenitor cell bank to any person or entity, except upon the written consent of the recipient, or except to authorized employees of the department, or as permitted by law.
(b) Records to be kept by the hematopoietic progenitor cell procurement service shall include, but not be limited to, the following information:
(1) donor's full name, address, age, sex, and identification code, as well as documentation of donor or donor's mother informed consent;
(2) date and volume of hematopoietic progenitor cells collected;
(3) any adverse reaction of the donor and its outcome;
(4) medical history and results of all required clinical laboratory tests and of the physical examination performed;
(5) disposition of hematopoietic progenitor cells;
(6) documentation of sterility testing and viability and recovery checks if performed; and
(7) medical director's authorization for the collection.
(c) Records to be kept by the hematopoietic progenitor cell processing facility shall include, but not be limited to, the following information:
(1) donor's identification code, date and amount of cells collected;
(2) results of all clinical laboratory tests performed;
(3) methods used for processing, preserving, storage and transport of the hematopoietic progenitor cells, including manufacturer's name and lot numbers of all reagents used in processing or preserving the cells;
(4) temperature records of the storage chamber;
(5) records of visual inspection of the hematopoietic progenitor cell specimens at the time of freezing and thawing;
(6) specimen location in the storage chamber;
(7) methods used for hematopoietic progenitor cell preservation, storage and transport; and
(8) disposition of the cells.
(d) Whenever hematopoietic progenitor cells are released for transplantation, the following records shall be maintained by the hematopoietic progenitor cell transplantation facility:
(1) name of the hematopoietic progenitor cell bank providing the cells, description of the specimen, and condition of the cells and shipping container upon receipt, including any loss noted of liquid nitrogen, dry ice or other coolant;
(2) if applicable, any extenuating circumstances that warrant acceptance of hematopoietic progenitor cells from donors who test positive;
(3) medical history and results of all tests, and of the physical examination performed on the donor, if applicable;
(4) disposition of the hematopoietic progenitor cells, including date and time released, and name of recipient;
(5) outcome of the transplantation procedure, including, but not limited to, any adverse outcome or infectious disease in the recipient; and
(6) if applicable, records documenting storage and temperature monitoring of hematopoietic progenitor cells, in accordance with the requirements in section 58-5.7 of this Subpart.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.4 Penalties
A violation of any provision of this Part is subject to all civil and criminal penalties as provided for by law. For purposes of civil penalties, each packet, individual container or other separate unit of synthetic phenethylamine or synthetic cannabinoid, or product containing the same, that is possessed, manufactured, distributed, sold, or offered for sale, shall constitute a separate violation under this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.8 Professional courtesy
The provision of clinical laboratory services by a clinical laboratory for health services purveyors, their families, or their employees, agents, or fiduciaries at a charge which is below the lower of the applicable Medicare fee schedule amount or the national limitation amount as defined by the Medicare program for such services is consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.12 Swimming pools, bathing beaches and recreational aquatic spray grounds
(a) A plan for a new or modified aquatic facility shall be submitted to the permit-issuing official at least 60 days prior to beginning construction. A swimming pool, bathing beach, or recreational aquatic spray ground operated as part of a temporary residence for the use of the occupants, guests, invitees or employees shall require the approval of the permit-issuing official, and must be constructed, maintained and operated so as to comply with the applicable provisions of Part 6 of this Title.
(b) Aquatic facilities operated by a person other than the temporary residence operator shall require a separate permit to operate in accordance with Part 6 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.33 Speech and hearing therapy
This functional reporting center must contain all expenses associated with the utilization of modalities and tests of speech and hearing therapy and rehabilitation nursing in a coordinated and integrated program of services under the direction and prescription of a physician. Additional activities include but are not limited to the following: evaluation by conducting diagnostic tests; consultations, prescriptions, and carrying out prescriptions; assisting patients with personal needs; and participation in discharge coordination as required by code.
(a) Standard unit of measure: number of treatments.
Count the number of treatments for each modality or procedure provided to a patient. When a combination of modalities and procedures is provided, the count shall include the individual modality(ies) and procedure(s).
(b) Data source.
The number of treatments shall be obtained by an actual count maintained by the speech and hearing therapy department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.133 Hypodermic syringes and needles; certificate of need
(a) The following are authorized to possess hypodermic syringes and hypodermic needles, provided they file with the commissioner a certificate of need and obtain a written authorization from the commissioner to possess and use such hypodermic syringes and needles:
(1) educational institutions, which also must comply with section 811 of the Education Law and file a separate certificate of need with the Commissioner of Education; and
(2) persons engaged in commercial, industrial or agricultural activities.
(b) The certificate of need shall set forth the names of individuals authorized by the educational institution or commercial or industrial firms to have custody of the hypodermic syringes and needles to be used in connection with their activities and the names of individuals designated as responsible for supervision of the use of such hypodermic syringes and needles.
(c) Any administrative officer of the institution or firm filing a certificate of need may be designated as responsible for the custody of hypodermic syringes and needles used on their premises. It shall be the duty of the designated custodial administrative officer to provide for safeguards and maintenance of records of receipt and disposition of all hypodermic syringes and needles acquired or possessed by the institution or firm.
(d) The head of any department, laboratory or division of an educational institution or commercial, agricultural or industrial firm filing a certificate of need may be designated as the person responsible for supervising the use of hypodermic syringes and needles used within the institution or firm. It shall be the responsibility of such designated person to supervise the use of hypodermic syringes and needles by students or other members of such institutions or firms and to keep and maintain records of all hypodermic syringes and needles used under his supervision.
(e) Any change in designated custodial or supervisory personnel shall be reported within 30 days to the department.
(f) Location of use.
The location of authorized use of hypodermic syringes and needles includes any classroom, laboratory, lecture hall, department or division, designated by the institution or the firm in its certificate of need on file with the department. Any change in designated location of use shall be reported within 30 days to the department.
(g) Storage.
(1) Hypodermic syringes and needles shall be stored in a locked secure place. In no instance shall spring or combination dial locks be employed.
(2) Reserve or main stock shall be kept in double cabinets under locked protection of suitable locks and keys. Both cabinets, inner and outer, shall be stationary.
(3) Hypodermic syringes and needles not in reserve, not in main stocks, and not in use, shall be kept under suitable locked protection.
(h) Records.
(1) A record of all purchases of hypodermic syringes and needles shall be maintained.
(2) Main storage records shall include a running inventory of all hypodermic syringes and needles indicating type, size and number of each item purchased, distribution made, balance on hand, and date of receipt or disposition.
(3) An annual physical inventory shall be taken each June 30th and entered in the running inventory record.
(4) A record of all hypodermic syringes and needles destroyed shall be kept, indicating the type, size, and number of each item destroyed, the date of destruction, and the person by whom destroyed. The records shall be kept for a period of two years from the date of the transaction. Every such record shall list hypodermic syringes and needles lost or stolen, indicating kind and number and the date of discovery of such loss or theft. A report of such loss or theft, and other pertinent related facts, shall be made immediately upon discovery to the department.
(i) Disposal of hypodermic syringes and needles.
(1) All hypodermic syringes and needles which are no longer usable or required shall be disposed of in a manner consistent with universal precautions so as to be rendered inoperable.
(2) Procedures for disposal may include but are not limited to placement of such syringes, needles and disposable units in a leak-proof, puncture resistant container prior to disposal.
(j) Inspection.
All records and stocks of hypodermic syringes and needles maintained by educational institutions or commercial or industrial firms shall be readily available and promptly produced for inspection by authorized representatives of the State Commissioner of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.263 Premature nursery
A separate facility, approved by the State, used exclusively for the care of infants whose birth weight is 2,500 grams or less.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.8 Rate corrections
(a) Arithmetic or calculation errors will be adjusted accordingly in instances that would result in an annual change of $5,000 or more in a provider’s annual reimbursement for ICFs/DD.
(b) In order to request a rate correction in accordance with subdivision (a) of this section, the provider must send to the Department of Health its request by certified mail, return receipt requested, within 90 days of the provider receiving the rate computation or within 90 days of the first day of the rate period in question, whichever is later.
Subpart 86-7 ASSISTED LIVING PROGRAM
10 CRR-NY 86-7.1 Definitions
As used in this Subpart, the following words shall have the following meanings:
(a) Assisted living program shall mean an entity as defined in paragraph (a) of subdivision (1) of section 461-1 of the Social Services Law.
(b) Services shall mean all services for which full payment to an assisted living program is included in the rate of payment which shall consist of the following: nursing services, personal care services, home health aide services, physical therapy, occupational therapy, speech therapy, medical supplies and equipment not requiring prior approval, personal emergency response services and adult day health care in a program approved by the commissioner and which the assisted living program shall provide directly, or arrange for the provision of, through contract(s) with a social services district, a long term home health care program or a certified home health agency, or other qualified providers.
(c) Patient classification groups shall mean patient categories contained in the classification system, Resources Utilization Groups-II (RUG-II), which identifies the relative resource consumption required by different types of residential health care facility (RHCF) patients as specified in Appendix 13-A, infra.
(d) Regions shall mean the 16 regions within the State into which residential health care facilities are grouped, by county, as identified in Appendix 13-A, infra.
(e) Rate of payment shall mean the capitated per diem rate of reimbursement established pursuant to this Subpart for governmental agencies for services provided directly by an assisted living program or provided through contract(s) with eligible providers.
(f) Per diem shall mean the unit of measure denoting services rendered to one patient between the census taking hour on two successive days. In computing per diems, the day of admission shall be counted but not the day of discharge. When a patient is admitted and discharged on the same day, this period shall be counted as one per diem.
(g) Roll factor shall mean the cumulative result of multiplying one year's trend (inflation) factor times one or more other year's trend factor which is used to inflate costs from a base period to a rate period.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 414 NURSING HOMES—CONTINUOUS VIOLATION PENALTIES
10 CRR-NY 414.1 System of penalties
Pursuant to Public Health Law, section 2803(6), a system of penalties of up to $1,000 per day for continuing for violations of rules and regulations promulgated pursuant to article 28 of the Public Health Law pertinent to the operation of nursing homes and pertaining to resident care in those nursing homes is established in this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 113 ERIE COUNTY
INSTITUTIONS INSTITUTIONS
10 CRR-NY 113.35 Gowanda State Hospital at Collins
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 Laws of 1926, shall apply to all natural and artificial reservoirs on the north branch of Clear Creek and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Gowanda State Hospital at Collins, Erie County, New York.
(b) Definitions.
(1) The term reservoir whenever used in this section is intended to mean and refer to all storage and impounding reservoirs on Clear Creek which are tributary to or which shall serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purposes of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs), stream, ditch, gutter or other channel of any kind, the waters of which when running whether continuously or otherwise eventually flow or may flow into the public water supply of the Gowanda State Hospital.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourses.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 300 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the Gowanda State Hospital, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d).
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 500 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Gowanda State Hospital.
(3) No cesspool, pit or other receptacle of any kind which is used for the deposit or storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents while being transferred from the privy to the place of disposal shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted, under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital and in such a manner and at such a place as to effectually prevent its being washed over the surface of or through the ground in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Gowanda State Hospital.
(6) Whenever, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or to other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Gowanda State Hospital nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraphs (3) and (4) of subdivision (c), within 500 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Gowanda State Hospital.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any reservoir or watercourse tributary to the public water supply of the Gowanda State Hospital shall be constructed, enlarged, altered or put in operation until plans for the same shall have been submitted to and approved by the State engineer and a permit issued by the State Commissioner of Health, allowing the discharge of such effluent as required by law and a copy of the plans, as approved, filed with the Department of Mental Hygiene.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape, flow or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow or percolate into any reservoir or watercourse within a distance of 300 feet from any reservoir or within 100 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital.
(4) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Gowanda State Hospital.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall bathe nor shall any animal be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir of the public water supply of the Gowanda State Hospital. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the Gowanda State Hospital.
(2) No stable for cattle or horses, barnyards, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Gowanda State Hospital, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet to any reservoir or 100 feet to any watercourse tributary to the public water supply of the Gowanda State Hospital.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Gowanda State Hospital; nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 12 inches below the surface within a distance of 500 feet from any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Gowanda State Hospital; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 500 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet before entering any reservoir or 50 feet before entering any watercourse tributary to the public water supply of the Gowanda State Hospital.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the water or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or 500 feet from any watercourse tributary to the public water supply of the Gowanda State Hospital.
(j) Inspections.
The superintendent of the Gowanda State Hospital or such other persons as may be charged with the maintenance of the public water supply of the hospital shall make or cause to be made regular and thorough inspections of the reservoir, streams and drainage area tributary thereto for the purposes of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said superintendent to cause copies of any rules or regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the superintendent of the hospital to promptly notify the State Commissioner of Health of such violations. He shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of notices served and the sanitary conditions of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 451 DEFINITIONS
10 CRR-NY 451.1 Accelerated depreciation
Method of depreciation which generates a greater amount of expense in the earlier life of an asset, and less expense in the later years, than the straight-line method. The purposes for adopting such a method would be:
(a) operation of plant or equipment at more than normal speed, use or capacity;
(b) a useful or economic life materially less than physical life;
(c) an excessive cost being written off during what is estimated to be the high-price period; and
(d) tax advantages arising from the use of declining-balance and sum-of-the-years methods.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.50 Fees and revenue; quarterly reporting
Each local health department shall:
(a) make every reasonable effort to collect fees and third-party billings revenue;
(b) maintain a written protocol for third-party billing and for assessment and collection of fees, including follow-up procedures for unpaid claims; and
(c) report quarterly to the commissioner, with its State aid claim, each category of revenue collected.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.17 Allowable costs
(a) To be considered as allowable in determining reimbursement rates, costs shall be properly chargeable to necessary patient care. Except as otherwise provided in this Subpart, or in accordance with specific determination by the commissioner, allowable costs shall be determined by the application of the principles of reimbursement developed for determining payments under title XVIII of the Federal Social Security Act (Medicare) program.
(b) Allowable cost shall include a monetary value assigned to services provided by religious orders and for services rendered by an owner and operator of a residential health care facility.
(c) Allowable costs may not include amounts in excess of reasonable or maximum title XVIII of the Federal Social Security Act (Medicare) costs or in excess of customary charges to the general public. For purposes of this determination, customary charges to the general public shall equal an average of the applicable charges weighted by patient days. This provision shall not apply to services furnished by public providers free of charge or at a nominal fee.
(d) Allowable costs shall not include expenses or portions of expenses reported by individual residential health care facilities which are determined by the commissioner not to be reasonably related to the efficient production of service because of either the nature or amount of the particular item.
(e) Any general ceilings applied by the commissioner, as to allowable costs in the computation of reimbursement rates, shall be published in a hospital memorandum or other appropriate manner.
(f) Allowable costs shall not include costs not properly related to patient care or treatment which principally afford diversion, entertainment or amusement to owners, operators or employees of residential health care facilities.
(g) Allowable costs shall not include any interest charged related to rate determination or penalty imposed by governmental agencies or courts, and the costs of policies obtained solely to insure against the imposition of such a penalty.
(h) Allowable costs shall not include the direct or indirect costs of advertising, public relations or promotion except in those instances where the advertising is specifically related to the operation of the residential health care facility and not for the purpose of attracting patients.
(i) Allowable costs shall not include costs of contributions or other payments to political parties, candidates or organizations.
(j) Allowable costs shall include only that portion of the dues paid to any professional association which has been demonstrated, to the satisfaction of the commissioner, to be allocable to expenditures other than for public relations, advertising or political contributions. Any such costs shall also be subject to any cost ceilings that may be promulgated by the commissioner.
(k) Allowable costs shall not include any element of cost as determined by the commissioner to have been created by the sale of a residential health care facility.
(l) Allowable costs shall not include the interest paid to a lender related through control, ownership, affiliation or personal relationship to the borrower, except in instances where the prior approval of the Commissioner of Health has been obtained.
(m) Allowable costs shall be reduced by income earned for Medicare part B eligible services to the extent that Medicaid has paid for these services.
(n) Allowable costs shall include any fee assessed by the commissioner on a residential health care facility, for the purpose of providing revenue for the account established pursuant to chapter 1021 of the Laws of 1981. The reimbursement rate for a facility shall reflect the cost of the annual fee prior to collection of the fee through the rate of reimbursement.
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.7 Section 86-8.7 APGs and relative weights
(a) The table of APG weights, procedure based weights and units, and APG fee schedule fees and units for each effective period are published on the New York State Department of Health website at: http://www.health.state.ny.us/health_care/medicaid/rates/apg/docs/apg_payment_components.xls
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.2 Construction
Terms not defined in this Subpart are defined in Subpart 52-1 of this Part. Nontransplant anatomic banks shall apply to the department for licensure and otherwise comply with all applicable provisions of Subpart 52-2 of this Part.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-8 HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING
10 CRR-NY 58-8.4 HIV result reporting requirements
(a) No clinical laboratory shall notify a physician or other person legally authorized to receive the result that an HIV test is positive solely on the basis of HIV antibody screening, except that a clinical laboratory may report a preliminary finding of HIV infection as provided in section 58-1.8 of this Part. Results for specimens found non-reactive by HIV antibody screening may be reported to the physician who ordered the testing or other person legally authorized to receive the result.
(b) For HIV diagnostic testing, a report of preliminary finding of HIV infection shall prominently and clearly state that the finding is preliminary, that results of confirmatory testing will follow, and that such confirmatory results must be considered in making a diagnosis related to HIV infection.
(c) No blood, tissue or organ donor, or consenting next of kin shall be notified that an HIV test result is positive solely on the basis of HIV antibody screening.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.41 Specialized programs for residents with neurodegenerative diseases
(a) General.
(1) Specialized program shall mean a discrete unit with a planned array of services, staffing, equipment and physical facilities designed to serve individuals with neurodegenerative diseases, and approved pursuant to Part 710 of this Title. The program shall provide goal-directed, comprehensive and interdisciplinary services directed at attaining or maintaining the individual at his or her highest practicable level of physical, affective, behavioral, psychosocial and cognitive functioning.
(2) For purposes of this section, neurodegenerative disease shall mean Huntington’s disease or amyotrophic lateral sclerosis.
(3) For purposes of this section, and consistent with the requirements of section 415.11 of this Part, the program shall have an interdisciplinary resident care team consisting of, at a minimum, the resident’s physician, a registered professional nurse with responsibility for the resident and, depending on the resident’s diagnosis, needs and symptoms, other appropriate staff in disciplines determined to meet the resident’s needs which may include staff assigned to the unit as set forth in subdivision (e) of this section.
(4) The program shall be located in a nursing unit which is specifically designated for this purpose and physically separate from other facility units. Residents of the unit shall have access to all of the facility’s recreational and therapeutic resources, including those resources that are not located in the unit.
(5) The facility shall ensure that sufficient space, equipment and facilities are available to support the clinical, education and administrative functions of the program in accordance with the standards set forth in Parts 711 and 713 of this Title.
(6) In addition to the implementation of the quality assessment and assurance plan for this program as required by section 415.27 of this Part, the facility shall participate with the department in an evaluation of the efficacy and effectiveness of the program and its impact on residents, families and staff. The facility shall collect data and furnish records, reports and data in a format requested by the department and shall make members of the interdisciplinary resident care team available for participation in the evaluation, as requested by the department. The facility shall submit such information to the department for the period ending December 31st, no later than 90 days following the end of the calendar year, annually through calendar year 2021.
(7) This section shall be implemented as a Quality Assessment and Performance Improvement (QAPI) project, as described in guidance from the Federal Centers for Medicare and Medicaid Services.
(b) Admission.
(1) The facility shall develop written admission criteria for the specialty unit to include the criteria in paragraph (2) of this subdivision and take into account the facility’s goals and objectives regarding outcomes ( e.g., minimizing self-inflicted injuries/falls, chorea-related trauma, hospitalization [length of stay], emergency department utilization, bed hold, and satisfaction surveys of residents with neurodegenerative diseases staff, families, and others) for residents who live in the specialty unit. The facility shall evaluate the effects of its admission criteria on its success in achieving its goals and objectives for the unit and report its findings to the department no later than 90 days following the end of the calendar year, annually through calendar year 2021.
(2) At a minimum, for residents admitted to the unit, there shall be documented evidence in the resident’s medical record that:
(i) the resident has been diagnosed with neurodegenerative disease based on a medical evaluation by a physician as determined by highly suggestive family history, neurological testing, genetic testing when available, formal consultation setting and/or formal neurological diagnostic consultation;
(ii) the resident cannot be managed and is not safe, and his or her needs cannot be met, in an available, less restrictive setting; and
(iii) the resident has the ability to benefit from the specialized care and services available in the unit.
(c) Assessment and care planning.
(1) Any assessment of a potential resident must include the admission criteria described in paragraph (b)(2) of this section. Where feasible, one or more members of the staff of the specialty unit shall conduct an evaluation of the home or current residence, living situation or inpatient setting of the future resident and his or her family prior to admission to discuss care needs. For purposes of this paragraph, feasible means the resident’s home or other setting is within reasonable travel distance (in terms of round trip travel time) from either the facility or the home(s) of the staff member(s) conducting the home evaluation. Results of an evaluation shall be used to identify preliminary approaches and interventions appropriate for the resident for purpose of preparing a resident’s care plan.
(2) A care plan shall be prepared by the interdisciplinary resident care team for each resident, taking into account input from the resident and the resident’s family or caregivers, in conformance with the timeframes set forth in section 415.11 of this Part. Each resident’s care plan shall include care and services that are therapeutically beneficial to the resident, appropriate to the resident’s interests and selected by the resident or resident’s caregiver as appropriate. The care plan may require environmental accommodations, as well as results from any evaluation of the home or current residence, living situation, or inpatient setting of the resident.
(3) Based on the resident’s response to therapeutic interventions, as well as the progression of the disease and its impact on the resident’s functioning, health and psychosocial status, the resident shall be reassessed and the care plan, including the discharge plan described in subdivision (d) of this section, shall be reviewed and modified at least once a month for the first three months following admission and then quarterly or upon any significant change in the resident’s condition thereafter. The care plan shall be reviewed by at least three members of the interdisciplinary resident care team and shall include at least one certified nurse aide who is assigned to the resident on a permanent basis.
(4) Facility or unit staff shall initiate a discussion of advance directives in accordance with the provisions of section 400.21 of this Title with the resident and the resident’s family member or other adult, consistent with such section, as soon as practicable following the decision to admit the resident to the unit.
(d) Discharge.
(1) The facility shall develop written discharge criteria for the specialty unit, which at a minimum shall address the provisions of paragraph (5) of this subdivision.
(2) The resident and his or her family and caregivers shall be notified of discharge criteria upon admission.
(3) A written discharge plan shall be developed within 30 days of admission for each resident as part of the overall care plan and shall include input from all professionals caring for the resident, the resident’s family and caregivers, as appropriate, and any outside agency or resource anticipated to be involved with the resident following discharge. The discharge plan shall be reviewed and modified at least once a month for the first three months following admission and then quarterly or upon any significant change in the resident’s condition thereafter.
(4) When the interdisciplinary resident care team determines that discharge of a resident to another facility or community-based program is appropriate, a discharge plan shall be implemented which is designed to assist and support the resident, family and caregivers in the transition to the new setting. The resident, his or her family, and caregivers, as appropriate, shall receive preparation for discharge from the specialty unit through the facility’s educational and counseling services.
(5) The resident shall be discharged to a less restrictive setting when he or she no longer meets the minimum admission criteria for the unit set forth in paragraph (b)(2) of this section or meets other discharge criteria established pursuant to paragraph (1) of this subdivision.
(6) The facility shall evaluate the effects of its discharge criteria on its success in achieving its goals and objectives for the unit and report its findings to the department no later than 90 days following the end of the calendar year, annually through calendar year 2021.
(7)
(i) The facility shall have a written agreement with a general hospital or hospitals providing for the transfer of residents in need of emergency or acute inpatient care services. Such hospital(s) shall have expertise in caring for individuals with neurodegenerative diseases, except in cases where a general hospital with such expertise is not available within a distance and time considered reasonable by accepted emergency medical standards.
(ii) In the event a resident of a specialty unit requires transfer to a general hospital:
(a) When feasible and practicable, a resident who is transferred to a hospital shall be accompanied by an informed member of the program’s direct care staff to ensure continuity of care. For purposes of this paragraph, feasible means that round trip travel time between the facility and the hospital is reasonable.
(b) When it is not feasible for a staff member to accompany the resident to the hospital, the resident’s physician, or the specialty unit’s medical director, or their designee, shall communicate with a physician or another health care practitioner at the receiving hospital at the time of the transfer.
(c) In either case, the staff member or physician shall provide to the receiving hospital appropriate documentation and other information that may be needed at the time of transfer to ensure continuity of care.
(d) The resident shall be given priority readmission status to the unit as his or her condition may warrant.
(e) All transfers shall be conducted in compliance with all other applicable law, including without limitation, section 415.3(h) of this Part.
(e) Program/unit staffing requirements.
(1) The facility shall maintain a level of direct care staff to residents that is appropriate for the required degree of care for the residents in the program unit.
(2) The facility shall ensure that any direct care staff assigned to the unit have been thoroughly trained and educated with regard to the special needs of unit residents, are competent to work in the unit, and are familiar to unit residents.
(3) The assignment of direct care staff must be sufficient to enable timely and appropriate care as determined by resident assessment and to protect both resident and staff safety. In addition to the staff assigned to the unit as specified in this subdivision, the facility shall make available other staff as necessary for the provision of care and services set forth in each resident’s care plan.
(4) The unit shall be managed by a program coordinator who has formal education, training and experience in the administration of a program that focuses on the care and management of individuals with neurodegenerative diseases. The program coordinator shall be dedicated only to the specialty unit. The program coordinator shall be responsible for the operation and oversight of the program. Other responsibilities of the program coordinator shall include:
(i) planning for and coordination of direct care and services;
(ii) screening prospective admissions;
(iii) developing and implementing in-service and continuing education programs, in collaboration with the interdisciplinary resident care team, for all staff in contact or working with these residents;
(iv) participating in the facility's decisions regarding resident care and services that affect the operation of the unit; and
(v) ensuring the development and implementation of a program plan and policies and procedures specific to this program.
(5) A physician who preferably has specialized training in the care of individuals with neurodegenerative diseases shall be responsible for the medical direction and medical oversight of this program and shall assist with the development and evaluation of policies and procedures governing the provision of medical services in this unit. If, at the time the physician is appointed as medical director of the unit, he or she does not have experience in providing care to individuals with neurodegenerative diseases, he or she shall have access to physicians who do have such experience.
(6) A psychiatrist shall be available on staff or on a consulting basis (including via telemedicine in conformance with applicable law) to the residents and to the program at a level consistent with residents’ care plans. The facility shall exercise best efforts to utilize a psychiatrist who has clinical experience working with individuals who have neurodegenerative diseases.
(7) A clinical psychologist or a licensed clinical social worker shall be available on staff or on a consulting basis (including via telemedicine in conformance with applicable law) to staff, residents, and residents’ family members and caregivers at a level consistent with residents’ care plans. The facility shall exercise best efforts to utilize a clinical psychologist or a licensed clinical social worker who has clinical experience working with individuals who have neurodegenerative diseases.
(8) A social worker shall be available either on staff or on a consulting basis to work with the residents, staff and family as needed. The facility shall exercise best efforts to utilize a social worker who has experience working with individuals who have neurodegenerative diseases.
(9) There shall be at least one registered professional nurse readily available during each shift in the unit. The facility shall exercise best efforts to utilize registered professional nurses who have training and experience in caring for individuals with neurodegenerative diseases. This registered professional nurse may not be the specialty unit program coordinator required under paragraph (4) of this subdivision.
(10) A therapeutic recreation specialist certified by a nationally recognized body which is acceptable to the department shall be responsible for the therapeutic recreation program.
(11) A respiratory therapist shall be available to residents who are no longer able to maintain normal oxygen and carbon dioxide levels.
(f) Program/unit service and environmental requirements.
(1) The program shall consist of a variety of medical, behavioral, counseling, recreational, exercise, nutritional and other services appropriate to the needs of each individual resident.
(2) Specific services that shall be available to residents who need them include but are not limited to: neurology; pulmonary specialist; psychotherapy; physical, occupational, respiratory and speech therapy; specialized eating and nutritional interventions to maximize independence and prevent unplanned weight loss and dehydration; technology to enable the resident to communicate effectively with staff, family members, caregivers, friends, and other residents; and oral care. Consults as needed shall be provided by but are not limited to surgical, podiatry, optometry, ophthalmology, orthopedic, cardiac, gastroenterology, dental, and hearing licensed professionals.
(3) The therapeutic recreation program shall incorporate the principles of rehabilitation, occupational, physical, nutritional, and speech therapies.
(4) Appropriate activities that accommodate individual residents’ interests shall be available at times that accommodate their waking hours.
(5) Support groups for staff, residents, and residents’ family members and caregivers shall be established and facilitated by the social worker or other counseling professional.
(6) The environment shall be customized to meet the needs and characteristics of residents and minimize injuries to residents and staff.
(i) Each resident’s living space shall be customized to safely accommodate his or her specific movement and motor control characteristics, and changes in movement and motor control characteristics as the resident’s disease evolves.
(ii) Such customization may include, but is not limited to, padding around hard surfaces that could harm the resident, staff or visitors; self-protective equipment such as soft helmet, elbow and knee pads; broda chairs (including shower/commode, bariatric, geriatric and glider chairs) with HD special padding if needed; and adequate space to accommodate high amplitude involuntary movements without injury to either the resident, staff or visitors.
(iii) The unit shall include, in their new construction designs, small recreational and dining room areas where residents can be with their families in privacy and comfort.
(iv) Units shall include central bathing and toilet facilities that can accommodate two-person assists. In-room toilets and bathing accommodations shall be modified or restricted to ensure resident safety and privacy as described in subparagraphs (i) and (ii) of this paragraph.
(7) The unit shall be equipped and staff shall be trained as necessary for the provision and management of non-invasive ventilation for residents for whom this service is appropriate. Supervision shall be provided by a respiratory therapist and pulmonary specialist.
(8) Residents shall not be prevented from participating in research projects and clinical trials that have been approved by an Institutional Review Board (IRB) that is registered with the Federal Office of Human Research Protection (OHRP) in the United States Department of Health and Human Services and in compliance with the human subjects research requirements at 45 CFR part 46 as determined by OHRP. To the extent practicable, facilities may facilitate residents’ participation in such research and trials by, for example, becoming trial sites, providing transportation to the trial site, providing assistance to enroll in the research, and working with families to facilitate participation.
(9) The facility shall provide outdoor access to residents.
(g) Program/unit training requirements.
(1) The facility shall ensure that all staff assigned to the direct care of the residents have pertinent experience or have received training in the care and management of people with neurodegenerative diseases.
(2) Training shall be appropriate to the functions and responsibilities of specific staff in the unit and shall include but not be limited to:
(i) the neurodegenerative disease itself, e.g., signs and symptoms, genetics, diagnosis, management, progression/history of the disease, prognosis and epidemiology;
(ii) how each type of staff can contribute to better quality of care and quality of life for residents;
(iii) injury prevention for the resident, staff and visitors;
(iv) creating an organized environment that minimizes stressors, maintains routines and encourages/maximizes independent functioning and decision-making;
(v) ensuring adequate hydration and nutrition; and
(vi) providing and encouraging cognitive stimulation and socialization through passive and active participation in appropriate activities.
(3) Families and informal supports, including the resident’s friends and caregivers, shall also have access to this training as appropriate to their activities in the unit.
(4) The facility shall ensure that educational programs are conducted for staff who do not provide direct care but who come in contact with the residents on a regular basis such as housekeeping and dietary aides. The educational programs shall familiarize staff with the goals of the specialty unit and the needs of residents with neurodegenerative diseases.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.3 Village of Livonia
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to the storage reservoir on Marrowback Brook and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoir, these bodies of water being sources of the public water supply of the village of Livonia, Livingston County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the reservoir on Marrowback Brook or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), streams, ditch, gutter or other channel of every kind, the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the village of Livonia.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any lake, reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to this public water supply.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to this public water supply.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles thoroughly cleaned and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any reservoir or watercourse tributary to this public water supply.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local condition, excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse tributary to this public water supply, then the said privy or receptacles for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to this public water supply, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow upon the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to this public water supply.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to this public water supply, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (5) of subdivision (c), within 100 feet from any reservoir or within 75 feet from any watercourse tributary to this public water supply.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to this public water supply.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse tributary thereof, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. No animals or poultry shall be watered in any reservoir or in any watercourse tributary to this water supply within 500 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any streams tributary to this public water supply.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or less than 75 feet from any watercourse tributary to this public water supply, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or less than 75 feet from any watercourse tributary to this public water supply.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any lake or into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to this public water supply, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a depth less than 12 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to this public water supply and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or within a distance of 50 feet from any watercourse tributary to this public water supply.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or less than 30 feet before entering any watercourse tributary to this public water supply.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, birds, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to this public water supply, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such rservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to this public water supply.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or trespassing whatever shall be allowed in or upon reservoirs tributary to this public water supply except by the duly authorized employees of the village of Livonia in the performance of their duties of supervision and maintenance of the public water supply. Notices relative to the foregoing restriction shall be conspicuously posted by the village of Livonia.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to this public water supply.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or from any watercourse tributary to this public water supply.
(j) Inspections.
The board of water commissioners of the village of Livonia or any such board as may be charged with the maintenance or supervision of the public water supply of the village of Livonia or its duly appointed representative shall make regular and thorough inspections of all reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.4 Alternative cost allocation bases—sequence of allocation
(a) Effective dates.
(1) For cost reporting periods ending December 31, 1981 and before, alternative cost allocation bases/sequence of allocation may be utilized without the prior approval of the Medicare fiscal intermediary. When utilizing an alternative cost allocation base or sequence of allocation, full documentation as to the necessity, appropriateness, and methodology utilized must be provided. The criteria in subdivision (d) of this section must be met. This requirement applies to all third-party payors.
(2) For cost reporting periods beginning on January 1, 1982 and thereafter, when a hospital wishes to change its allocation basis for a particular cost center or the order in which the cost centers are allocated, because it believes the change will result in more appropriate and more accurate allocations, the hospital must make a written request to its Medicare fiscal intermediary for approval of the change and submit reasonable justification for such change no later than 90 days prior to the beginning of the cost reporting period for which the change is to apply. This requirement will apply to all cost-finding methods and all third-party payors.
(b) The Medicare fiscal intermediary's approval of a hospital's request will be furnished to the hospital in writing. Where the Medicare fiscal intermediary approves the hospital's request for an alternative basis or sequence of allocation, the change must be applied to the cost reporting period for which the request was made and to all subsequent cost reporting periods unless the intermediary approves a subsequent request for change by the hospital. The effective date of any change of basis or sequence of allocation will be the beginning of the first cost reporting period for which the request has been made.
(c) In reviewing the hospital's request, the Medicare fiscal intermediary will apply the following criteria:
(1) Basis of allocation.
(i) The hospital must agree to maintain and report all statistics needed for the recommended basis of allocation as well as the alternative basis of allocation. The hospital will report the recommended basis on an additional completed Worksheet, prominently marked at the top “Original Recommended Basis”. For New York State reporting purposes, this requirement is effective for cost reporting periods beginning in 1980. For Medicare reporting purposes, this requirement is effective for cost reporting periods beginning in 1981.
(ii) Any alternative basis of allocation expressed solely in terms of percentages will be not acceptable.
(iii) Any alternative basis of allocation must be supported by auditable statistics that are maintained on a regular basis.
(iv) The alternative basis of allocation must directly relate to the provision of services by the affected cost center.
(v) The alternative basis of allocation must produce a clearly more accurate allocation of cost than the recommended basis of cost. For example, the recommended basis of allocation for cafeteria costs is full-time equivalent employees. If the provider chooses to maintain an alternative basis of allocation of sales value of meals served to employees by functional cost center, a more accurate allocation would result. Alternatively, the recommended basis of allocation for laundry is pounds of laundry; however, the use of the number of items issued would not result in a more accurate allocation of costs.
(vi) Only one statistical basis of allocation may be used for each cost center.
(2) Sequence of allocation. The sequence of allocation of step-down cost finding is based upon the assumption that a cost center furnishes more services to the cost centers that follow it in the sequence of allocation than it receives from the cost centers that precede it in the sequence of allocation, and that a cost center receives more services from the cost centers that precede it in the sequence of allocation than it furnishes to the cost centers that follow it in the sequence of allocation. In order to justify the use of an alternative sequence of allocation, a provider must establish through auditable records that the dollar value of goods and services exchanged among cost centers is different than that contemplated in the sequence recommended in the cost reporting forms.
(d) Alternative cost allocation bases or the sequence of allocation, utilized in accordance with this section, must be utilized across all third-party payors.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.11 Variances and waivers
(a) Variances.
In order to allow time for compliance with this Subpart, an owner may submit a written application to a local health department for a variance from any provision of this Subpart, for a period not exceeding 90 days, accompanied by an explanation of why such variance will not present a danger to public health. With the approval of the department, the local health department may approve such application for a variance in writing, subject to any conditions that the department or local health department may deem appropriate to protect public health. The local health department or department may revoke such variance upon a determination that the variance may present a danger to public health.
(b) Waivers.
The department may issue a written general or specific waiver with respect to any provision of this Subpart, subject to any conditions the department may deem appropriate, where the department is satisfied that such waiver will not present a danger to public health. The department may revoke such waiver upon a determination that the waiver may present a danger to public health.
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.3 Supplementary reports of certain birth defects for epidemiological surveillance; filing
(a) Every physician, nurse practitioner authorized to diagnose birth defects, physician assistant authorized to diagnose birth defects, midwife, and hospital as defined in article 28 of the Public Health Law, providing health care to a pregnant woman or a child under two years of age, who diagnoses an embryo, fetus or child as having one or more of the birth defects listed in Table 1 of this section shall file a supplementary report with the State Commissioner of Health within 10 days of diagnosis thereof.
(b) Every physician, nurse practitioner authorized to diagnose birth defects, physician assistant authorized to diagnose birth defects, midwife, and hospital as defined in article 28 of the Public Health Law, providing health care to a pregnant woman or a child under 10 years of age, who diagnoses an embryo, fetus or child as having one or more of the birth defects listed in Table 2 of this section shall file a supplementary report with the State Commissioner of Health within 10 days of diagnosis thereof.
(c) Every clinical laboratory that conducts diagnostic testing on New York State residents to detect or confirm the diagnosis of genetic or chromosomal anomalies listed in Tables 1 and 2 shall, upon detecting or confirming such a genetic anomaly, file a supplementary report with the State Commissioner of Health within 30 days of detection or confirmation.
(d) Such report shall be on such forms, which may include electronic forms, as may be prescribed by the commissioner to facilitate epidemiological investigation and surveillance.
TABLE 1 – BIRTH DEFECTS AND GENETIC DISEASES FOR WHICH REPORTING IS REQUIRED TO AGE 2
Malignant neoplasm of kidney
Malignant neoplasm of eye
Malignant neoplasm of brain
Malignant neoplasm of other endocrine systems
Congenital leukemia
Hemangioma
Lymphangioma
Neurofibromatosis
Teratoma
Congenital hypothyroidism
Disorders of thyroid, congenital and hereditary
Diabetes Mellitus, neonatal
Disorders of the pituitary gland, congenital and hereditary
Adrenogenital syndrome
Testicular dysfunction, congenital and hereditary
Dwarfism
Other congenital endocrine disorders
Metabolic and Immunity Disorders, congenital and hereditary
Hereditary Hemolytic anemias
Aplasic anemias, congenital and hereditary
Coagulation defects, congenital and hereditary
Primary thrombocytopenia, congenital and hereditary
Diseases of white cells, congenital and hereditary
Methemoglobinemia, congenital and hereditary
Hereditary diseases of the central nervous system
Extrapyramidal disease and abnormal movement disorders, congenital and hereditary
Spinocerebellar Disease, congenital and hereditary
Anterior horn cell disease, congenital and hereditary
Infantile cerebral palsy
Infantile spasms
Cerebral cysts, congenital
Multiple cranial nerve palsies, congenital
Hereditary peripheral neuropathy
Hereditary muscular dystrophies and other myopathies
Hereditary optic atrophy
Duane’s syndrome
Endocardial fibroelastosis
Wolf-Parkinson-White syndrome
Major anomalies of jaw size
Inguinal hernia
Femoral hernia
Nephrotic syndrome, congenital
Nephrogenic diabetes insipidus, congenital
Dyschromia, congenital
Anencephalus and similar anomalies
Spina bifida
Birth defects of the nervous system
Birth defects of the eye
Birth defects of the ear, face, neck
Birth defects of the heart
Birth defects of the circulatory system
Birth defects of the respiratory system
Cleft palate and cleft lip
Birth defects of the upper alimentary tract
Birth defects of the digestive system
Birth defects of the urinary system
Birth defects of the genital organs
Birth defects of the limbs
Congenital musculoskeletal deformities
Other congenital musculoskeletal anomalies
Birth defects of the integument
Birth defects of the spleen
Birth defects of the adrenal gland
Birth defects of other endocrine glands
Multiple birth defects
Anomaly, multiple, Not Otherwise Specified
Deformity, multiple, Not Otherwise Specified
Genetic anomalies
Chromosomal anomalies
Fetal Alcohol Syndrome
Situs Inversus
Conjoined twins
Hamartoses
Birth defect syndromes affecting multiple systems
Noxious influences affecting the fetus via placenta
Amniotic band syndrome
Infections specific to the perinatal period
Hemolytic disease due to RH isoimmunization
Neonatal hepatitis
TABLE 2 – BIRTH DEFECTS AND GENETIC DISEASES FOR WHICH REPORTING IS REQUIRED TO AGE 10
Hereditary muscular dystrophies and other myopathies
Birth defects of the heart
Genetic anomalies
Chromosomal anomalies
Fetal Alcohol Syndrome
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.10 Transportation
(a) Passengers shall only be transported in portions of vehicles that are designed for passenger occupancy. Transportation in the bed of a truck or trailer shall be prohibited.
(b) There shall be at least one counselor in any vehicle transporting children, who may also be the driver.
(c) Every vehicle used for transporting staff or campers shall have required registration and inspection stickers and be equipped with at least a first-aid kit, tools, fire extinguisher and flares or reflective triangles that are labeled with a Federal DOT symbol or a statement that the device complies with all Federal motor vehicle safety standards.
(d) The driver of any camp vehicle shall be at least 18 years old and possess a current driver's license.
(e) Seat belts shall be utilized by all passengers in vehicles so equipped.
(f) Occupancy of a vehicle shall be limited to its rated capacity.
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.9 Recordkeeping
The owner of a cooling tower shall maintain records for at least three years of all sampling and analyses; disinfection schedules and applications; inspection findings, deficiencies, and corrective actions; and certifications. An owner shall maintain a copy of the maintenance program and plan required by this Subpart on the premises where a cooling tower is located. Such records and plan shall be made available to the department or local health department immediately upon request.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.13 Tissue storage facilities
(a) A facility which stores musculoskeletal tissue shall be licensed by the department as a tissue storage facility. The musculoskeletal tissue bank shall keep the department fully informed of the number and type of tissue storage facilities operating under its direction.
(b) All musculoskeletal tissue shall be stored and monitored in accordance with the provisions of sections 52-5.8 and 52-5.9(b), (c), (d) and (e) of this Subpart.
(c) Temperature records or liquid nitrogen level records shall be available for inspection by the department for the entire period of musculoskeletal tissue storage and for one year afterwards.
(d) Musculoskeletal tissue products shall be distributed in accordance with the requirements of this Part, and all records related to the inspection, distribution and transport of tissues shall be open to inspection by the department and shall be kept for at least seven years or six months after the expiration date of the tissue, whichever is the longer time.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.11 Operational and financial requirements for MCOs
(a) The functions, activities and services undertaken and performed pursuant to the MCO's article 44 certificate of authority shall be clearly distinguished from any other function, activity or service through the maintenance of separate records, reports and accounts for each such MCO function, activity or service. The records, reports and accounts of each MCO shall be maintained separately from those of other persons or MCOs in a holding company system. All records pertaining to the article 44 certified MCO shall be maintained in New York State.
(b) No funds shall be transferred or loaned from the MCO article 44 business to any other business, function or contractor of the MCO, or to any subsidiary or member of the MCO's holding company system or to any member or stockholder without the prior approval of the commissioner and, except in the case of a PHSP, HIV SNP, PCPCP or MLTC, the superintendent. Repayment of any such approved loans, to the extent required, shall be made in accordance with schedules approved by the superintendent and commissioner. Any such transfers or loans shall require a certification by the MCO that such transfer or loan is in compliance with and does not violate any provision of any applicable law or regulation. However, distributions from an MCO to any member or stockholder shall not be subject to the provisions of this subdivision to the extent that such distribution was for the sole purpose of reimbursing at least one of the members or stockholders for income taxes paid resulting from income received by the MCO, or in the case where one of the members or stockholders is a not-for-profit corporation, the proportionate share of the distribution attributable to each member or stockholder; such a distribution shall be permissible without the prior approval of the commissioner as long as both prior to and subsequent to the distribution, the MCO has reserves in excess of minimum requirements as prescribed by this Part; and such distribution is consistent with a tax allocation agreement entered into between the MCO and its members or stockholders.
(1) No such transfer or loan shall be approved if the net worth of the MCO after the transfer or loan would fall below 12.5 percent of its annual net premium income, and all such transfers and loans must be accompanied by projections submitted by the MCO showing that its net worth shall continue to meet or exceed 12.5 percent of annual net premium income for two calendar years following the transfer or loan.
(2) Notwithstanding the provisions of paragraph (1) of this subdivision, no such proposed transfer or loan made by any MCO that received 75 percent or more of its net premium income from the New York State Medicaid, Family Health Plus, and Child Health Plus programs during the last calendar year shall be approved if the net worth of the MCO after such transfer or loan would fall below 15 percent of its annual net premium revenue, and all such transfers and loans must be accompanied by projections submitted by the MCO showing that its net worth shall continue to meet or exceed 15 percent of annual net premium revenue for two calendar years following the transfer or loan.
(3) In order to ensure the availability of quality health services for an enrolled population, the commissioner may waive the provisions of paragraphs (1) and (2) of this subdivision should the proposed transfer of funds or loan be used to purchase a controlling interest, or a substantial portion of the assets, of an MCO certified to operate under article 44 of the Public Health Law.
(c) No HMO which is organized as a stock corporation shall declare or distribute any dividend on its capital stock, except out of earned surplus, unless upon prior application therefore, the commissioner, with the advice of the superintendent, approves such distribution. No such company shall declare or distribute any dividend to shareholders which, together with all such dividends declared or distributed by it during the prior 12-month period, exceeds the lesser of 10 percent of its capital and surplus (net worth), as shown by its last statement on file with the commissioner, or 100 percent of adjusted net investment income for such period unless, upon prior application therefore, the commissioner, with the advice of the superintendent, approves a greater dividend payment based upon his/her finding that the insurer will retain sufficient surplus to support its obligations and writings. For the purposes of this section, adjusted net investment income means net investment income for the 12 months immediately preceding the declaration or distribution of the current dividend increased by the excess, if any, of net investment income over dividends declared or distributed during the period commencing 36 months prior to the declaration or distribution of the current dividend and ending 12 months prior thereto; surplus means the amount of the HMO's admitted assets in excess of its capital and its liabilities; and surplus and net worth shall include any voluntary reserves, or any part thereof, which are not required by law; earned surplus means the portion of the surplus that represents the net earnings, gains or profits, after deduction of all losses, that have not been distributed to the shareholders as dividends, or transferred to stated capital or capital surplus or applied to other purposes permitted by law, but does not include unrealized appreciation of assets.
(d) Nothing herein shall prevent a corporation licensed under article 43 of the Insurance Law from exercising its rights and undertaking transactions authorized by such law, provided that no such transaction shall affect or involve the corporation's Public Health Law article 44 business or line of business or resources thereof, without compliance with the provisions of this section.
(e)
(1) Except for a PCPCP, a certified operating MCO, or an MCO that is initially commencing operations, shall maintain a reserve, to be designated as the contingent reserve.
(i) The contingent reserve for an HMO, PHSP or HIV SNP shall be equal to and shall not exceed:
(a) 5 percent of net premium income for the first calendar year subsequent to the effective date of this Subpart;
(b) 6.5 percent of net premium income for the second calendar year subsequent;
(c) 7.5 percent of net premium income for the third calendar year subsequent;
(d) 8.5 percent of net premium income for the fourth calendar year subsequent;
(e) 9.5 percent of net premium income for the fifth calendar year subsequent;
(f) 10.5 percent of net premium income for the sixth calendar year subsequent;
(g) 11.5 percent of net premium income for the seventh calendar year subsequent;
(h) 12.5 percent of net premium income for calendar years thereafter.
(ii) Notwithstanding the provisions of subparagraph (i) of this paragraph, the contingent reserve applicable to net premium income generated from the Medicaid managed care, Health and Recovery Plans (HARPs) and HIV SNP programs shall be:
(a) 7.25 percent of net premium income for 2011;
(b) 7.25 percent of net premium income for 2012;
(c) 7.25 percent of net premium income for 2013;
(d) 7.25 percent of net premium income for 2014;
(e) 7.25 percent of net premium income for 2015;
(f) 7.25 percent of net premium income for 2016;
(g) 7.25 percent of net premium income for 2017;
(h) 7.25 percent of net premium income for 2018;
(i) 7.25 percent of net premium income for 2019;
(j) 7.25 percent of net premium income for 2020;
(k) 7.25 percent of net premium income for 2021;
(l) 7.25 percent of net premium income for 2022;
(m) 8.25 percent of net premium income for 2023;
(n) 9.25 percent of net premium income for 2024;
(o) 10.25 percent of net premium income for 2025;
(p) 11.25 percent of net premium income for 2026;
(q) 12.5 percent of net premium income for 2027;
(r) 12.5 percent of net premium income for calendar years after 2027.
The provisions of this subparagraph shall not apply to HMOs and PHSPs beginning operations in 2016 or after.
(iii) Upon an HMO, PHSP or HIV SNP reaching its maximum contingent reserve of 12.5 percent of its net premium income for a calendar year, it must continue to maintain its contingent reserve at this level thereafter. Such contingent reserve requirement shall be deemed to have been met if the net worth of the HMO, PHSP or HIV SNP, based upon admitted assets, equals or exceeds the applicable contingent reserve requirement for such calendar year.
(2) Except for PCPCPs, any applicant for certification as an MCO must establish a contingent reserve in an amount equal to 5 percent of projected net premium income for its initial calendar year of operations prior to commencing operations. For each subsequent year of operations, except for an MLTCP, it must increase its contingent reserve according to the schedule set forth above.
(3) Except for PCPCPs, if such MCO reinsures part of its risk under any or all of its contracts by means of a reinsurance contract approved by the superintendent, with the advice of the commissioner, as an appropriate substitute for a portion (up to 50 percent) of the required contingent reserve increase, then the required increase to the contingent reserve at the end of any calendar year may be reduced up to the amount of the premium paid by such MCO for such reinsurance during such calendar year.
(4) Such contingent reserve may be additionally offset by up to 50 percent of the required level at the end of each calendar year by means of a reinsurance agreement approved by the superintendent with the advice of the commissioner.
(5) Except for PCPCPs, such contingent reserve may, after application therefor by the MCO and approval thereof by the superintendent and/or commissioner, as appropriate, be reduced below the amount required to be maintained by this subdivision, provided that no such reduction, except in the event of an epidemic or other catastrophe resulting in extraordinary hospital or medical utilization, shall, in the case of such MCO having a net premium income for the preceding calendar year of (i) less than $10 million, or (ii) $10 million or more, reduce the contingent reserve below an amount equal to 75 percent and 50 percent, respectively, of the amount required to be maintained by subparagraph (i) of this paragraph. Any reduction so authorized by the superintendent and/or commissioner, as appropriate, shall be restored within a period of not more than three years in accordance with a plan, submitted by the MCO and approved by the superintendent and/or commissioner, as appropriate, which shall provide that such restoration shall be in addition to, and not in lieu of, the increase in the contingent reserve herein required, which increase must be made in every year except the year in which a reduction in the contingent reserve is approved by the superintendent and/or commissioner, as appropriate.
(6) In the case of MLTCPs, the superintendent, in consultation with the commissioner, may exclude from the contingent reserve calculation premium income derived from chronically ill individuals who are covered by the title XIX program and are confined to a nursing facility.
(f)
(1) Except for PCPCPs, each MCO shall establish a deposit in the form of an escrow account for the protection of enrollees (including enrollee health care service claim obligations), in the form of a trust account with a custodian, without preference or priority to any beneficiary entitled to share therein, that shall be either a member of the Federal Reserve System located in New York State or a New York State chartered bank or trust company. The superintendent, with the advice of the commissioner, shall approve the form of the deed of trust and all amendments thereto. The assets deposited in the escrow account shall be valued according to their current fair market value, and shall consist only of cash, certificates of deposit, and investments of the types specified in section 1404(a)(1) and (2) of the New York Insurance Law. The amount deposited in the escrow account shall be adjusted annually by the last day of March of each calendar year and shall be equal to the greater of the following:
(i) five percent of the estimated expenditures for health care services for the calendar year conforming to the year of filing; or
(ii) $100,000.
(2) As of the 30th day of April of each year, the custodian shall furnish a statement to the commissioner and superintendent, identifying the assets that are held in trust as of the 31st day of March of such year, including the estimated fair market value of such assets. To the extent that the deposit required as described above for any calendar year is less than the deposit held in the deed of trust, the State Insurance Department shall approve withdrawal of any excess funds in the escrow account.
(3) In the case of an MLTCP, such escrow account may, at the discretion of the superintendent in consultation with the commissioner, be reduced below the amount required to be maintained by this subdivision based on the financial condition of the MLTCP and the provision of less than comprehensive services as defined in this Subpart. In no event will a reduction of greater than 50 percent of the amount required by this subdivision be granted.
(4) A reduction granted to an MLTCP pursuant to paragraph (3) of this subdivision will remain in effect as long as the underlying requirements, agreements and safeguards submitted to the superintendent in support of such reduction remain in effect. Proposed changes to any of these items must be submitted to the superintendent by the MLTCP at least 30 days prior to their effective date for a new determination pursuant to paragraph (3) of this subdivision.
(g) Except in the case of an HMO operated by a corporation licensed under article 43 of the Insurance Law which also operates a Public Health Law, article 44 line of business, no less than one third of the members of the governing authority of an MCO shall be composed of residents of New York State.
(1) Within one year of the MCO becoming operational, no less than 20 percent of the members of the governing authority shall be enrollees of such MCO, except that:
(i) in the case of a PHSP or MLTCP, enrollee or consumer representatives may be substituted for enrollees;
(ii) in the case of a PCPCP, such requirements shall apply only if the PCPCP has a separate body, for example a local social services district, that functions as a governing authority;
(iii) an HMO, PHSP, PCPCP or MLTCP may, as an alternative to or in addition to subparagraphs (i) and (ii) of this paragraph, establish an enrollee advisory council which is representative of the HMO's, PHSP's, PCPCP's or MLTCP's enrollment and which has direct input to the governing authority;
(iv) in the case of an MCO that operates an HIV SNP as one of its lines of business or as its sole line of business, the governing authority must include at least one person with HIV infection to serve as a consumer representative.
(2) Employees of the MCO, providers of health services or persons having a business relationship with the MCO may not serve as enrollee or consumer representatives.
(h) The governing authority of the MCO shall be responsible for establishment and oversight of the MCO's policies, management and overall operation, regardless of the existence of any management contract.
(i) The governing authority shall not delegate the following elements of management authority to another person:
(1) direct independent authority to hire or terminate the chief executive officer;
(2) adoption of budgets and independent control of the books and records;
(3) authority over the disposition of assets and the authority to incur on behalf of the MCO liabilities not normally associated with the day to day operation of the MCO;
(4) independent adoption and/or enforcement of policies affecting the operation of the MCO and the delivery of health care services;
(5) oversight by the MCO of any management functions delegated to a management contractor pursuant to the provisions of this section or section 98-1.18 of this Subpart; and
(6) pursuant to section 98-1.21(b)(1) of this Subpart, primary responsibility for the development and implementation of the MCO's fraud and abuse prevention plan.
(j) The elements of management authority described in paragraphs (1) through (8) of this subdivision may be delegated to another person only pursuant to a management contract approved by the commissioner. An MCO shall not enter into any agreement delegating management authority except pursuant to a management contract which complies with the requirements of subdivisions (h) through (s) of this section and section 98-1.18 of this Subpart. No management contract shall be approved if the governing authority of the MCO does not retain sufficient authority and control to discharge its responsibility as the governing authority of the MCO, including the authority to discharge the management contractor.
(1) maintenance of the books and records;
(2) disposition of assets and the incurring of liabilities normally associated with the day to day operations of the MCO;
(3) implementation of policies affecting the delivery of health care services;
(4) claims payment;
(5) implementation of the MCO's budgets and provision for annual audits;
(6) quality assurance and improvement, except that when a provider risk sharing arrangement is entered into between the MCO and a management contractor or an entity related to the management contractor, the MCO may delegate either utilization review activity or quality assurance and/or quality improvement functions, but not both, to that management contractor or to an entity related to that management contractor. Assisting in the implementation of the MCO's quality assurance activities and functions is not considered a delegation. If the contractor has decision making authority and responsibility for the implemented functions, it is considered a delegation of quality assurance. For the purposes of this subdivision, an entity related to the management contractor is defined as an entity which is under common ownership and/or control with or has control of or is controlled by the management contractor. An MCO shall not contract with a management contractor to conduct quality assurance and/or quality improvement functions on the MCO's behalf unless the management contractor utilizes the MCO's quality assurance and quality improvement standards or unless the MCO approves the management contractor's quality assurance and quality improvement standards. The MCO shall not approve of the management contractor's standards for quality assurance and quality improvement unless the standards are substantially equivalent to those of the MCO and to those of other management contractors which have contracted with the MCO to conduct quality assurance and improvement, and such standards have been approved by the commissioner;
(7) any utilization review activity, except that when a provider risk sharing arrangement is entered into between the MCO and a management contractor or an entity related to the management contractor, the MCO may delegate either utilization review activity or quality assurance and/or quality improvement functions, but not both, to that management contractor, or to an entity related to that management contractor as defined in paragraph (6) of this subdivision. An MCO shall not contract with a management contractor to conduct utilization review activity on its behalf unless the management contractor is utilizing the MCO's clinical review standards for utilization review or unless the MCO has approved of the management contractor's clinical review standards. The MCO shall not approve of the management contractor's clinical review standards unless they are substantially equivalent to those of the MCO and to those of other management contractors performing similar functions for the same or similar services. All utilization review processes must comply with article 49 of the Public Health Law and must be approved by the commissioner. Utilization review may only be delegated to a registered utilization review agent, as defined in article 49 of the Public Health Law; and
(8) pursuant to section 98-1.21(b)(1) of this Subpart, all or part of the functions of the special investigations unit, which include investigation of cases of suspected fraudulent and abusive activity and fraud and abuse prevention and reduction activities under the MCO's fraud and abuse prevention plan.
(k) A proposed management contract must be submitted to the department for its prior approval at least 90 days prior to the management contract's proposed effective date. Management contracts shall be effective only with the prior written consent of the commissioner, and shall include the following:
(1) a clear description of the proposed role of the MCO's governing authority and the elements of authority proposed to be delegated to the management contractor during the term of the proposed management contract. The description shall clearly reflect retention by the governing authority of the MCO of ongoing responsibility for statutory and regulatory compliance;
(2) a provision that clearly recognizes that the responsibilities of the governing authority of the MCO are in no way lessened by entering into a management contract, and that any powers not specifically delegated to the management contractor through the provisions of the contract remain with the governing authority of the MCO;
(3) a clear acknowledgment of the authority of the commissioner to terminate the contract pursuant to subdivision (o) of this section;
(4) a provision listing procedures and requirements which shall be established by the MCO for ongoing monitoring by the MCO of the implementation of the contract and the MCO's fiscal stability, level of services provided and quality of care rendered during the term of the contract, including requirements for periodic reporting by the manager;
(5) a provision that annual reports on the financial operations and any other operational data requested by the governing authority of the MCO, the commissioner or superintendent, will be provided by the management contractor;
(6) a provision stating that the management contract approved by the department shall be the sole agreement between the management contractor and the governing authority of the MCO for the purpose of management of the MCO and payment to the management contractor for management services, and that any amendments or revisions to the management contract shall be effective only with the prior written consent of the commissioner;
(7) specification of payment terms that are reasonable and do not jeopardize the financial security of the MCO;
(8) a provision whereby the parties agree that any changes to the contract required by the commissioner will be made by the parties immediately upon receipt of written notice from the commissioner; and
(9) a provision whereby the parties agree to terminate the management contract within 60 days, in accordance with subdivision (o) of this section, upon receipt of written notice from the commissioner.
(l) In addition to a proposed written contract complying with the provisions of subdivisions (h) through (s) of this section and section 98-1.18 of this Subpart, the governing authority of the MCO seeking to enter into a management contract shall submit to the department the following:
(1) documentation indicating that the proposed management contractor holds all necessary approvals to do business in New York State including, as appropriate, an application for authority to do business in New York State filed with the Secretary of State;
(2) proposed terms of the management contract, including but not limited to the term and purposes of the agreement, identification of the contractor's responsibilities, and descriptions of all staffing to be provided, major equipment, computer and information systems, required reports, performance criteria, a termination provision, projected costs and any management or other fee to be charged by the management contractor;
(3) evidence of the management contractor's financial stability;
(4) information necessary to determine the character and competence of the proposed management contractor, its controlling persons, officers and directors, owners, members or managers of a limited liability company and any medical director proposed by the management contractor for the general or medical management of the MCO and/or for utilization review activities, including evidence that all MCOs and health care facilities managed or operated by the management contractor, in or out of New York State, have provided a substantially consistent high level of care during the term of their management contract or operating certificate. The department may conduct a limited review of character and competence where the agreement delegates management activities involving only a single medical service such as dental, vision or chiropractic services, or delegates limited management responsibility such as utilization review. For the purposes of this paragraph, a limited review shall consist of a review of the proposed management contractor's past performance as a management contractor or in any other capacity performing any of the functions set forth in subdivision (j) of this section, as well as the character and competence of the officers and directors, members or managers of a limited liability company and partners of the contractor, and, if the proposed delegated management activity is either medical management or utilization review, the medical director of the proposed management contractor; and
(5) except for PCPCPs, evidence that it is financially feasible for the MCO to enter into the proposed management contract for the term of the contract, recognizing that the costs of the contract are subject to the approval of the commissioner and superintendent. To demonstrate evidence of financial feasibility, such MCO shall submit projected operating and capital budgets for the required periods. Such budgets shall be consistent with any previously submitted, certified financial statements and be subject to future audits. However, no review of financial feasibility shall be required where:
(i) the agreement delegates management activities for limited services such as dental, vision, behavioral health and chiropractic services, and the management fee is equal to no more than 25 percent of the MCO's total administrative costs; or
(ii) the agreement delegates a limited scope of management activities, such as utilization review, for some, most or all medical services and the management fee is equal to no more than 25 percent of the MCO's total administrative cost.
(m) The term of a management contract shall be limited to five years and may be renewed only when authorized by the commissioner, provided compliance with this section and the following provisions can be demonstrated:
(1) that the goals and objectives of the contract have been met within specified time frames;
(2) that the quality of care provided by the MCO during the term of the contract has been maintained or has improved; and
(3) that any reporting requirements contained in the management contract have been met.
Any application for renewal shall be submitted at least 90 days prior to the expiration of the existing contract.
(n) Any termination or non-renewal of a management contract shall require the prior written approval of the commissioner following 90 days prior written notice. The governing authority of the MCO shall, within the terms of the contract, retain the authority to discharge the management contractor for cause or based on mutual agreement between the MCO and the management contractor. The governing authority of the MCO shall provide a plan for the management of the MCO subsequent to the discharge, to be submitted with 90 days prior notification to the department of the MCO's decision to discharge the management contractor. The department shall be given at least 90 days prior written notice by the MCO of all terminations whether initiated by the MCO or the manager. Termination may be upon less than 90 days notice provided it is demonstrated to the satisfaction of the commissioner prior to termination that circumstances exist which justify more immediate termination.
(o) A management contract shall terminate and be deemed cancelled, without financial penalty to the governing authority of the MCO or the MCO itself, not more than 60 days after notification to the governing authority of the MCO and the management contractor by the department of a determination that the MCO is not providing adequate care or otherwise assuring the health, safety and welfare of the enrollees.
(p) In the event that the management contractor proposes to subcontract any management functions, the subcontractor must be a signatory to the management contract which must expressly provide for the subcontracting of management functions to the subcontractor. The subcontractor will be subject to the provisions of this Subpart to the same extent as the management contractor, including all termination provisions, provided that the subcontractor may also be terminated by the management contractor upon at least 90 days notice and with the prior written approval of the commissioner.
(q) Any MCO which commits or engages in any of the following acts shall be subject to action against its certificate of authority and/or civil penalties under the authority of sections 12 and 4404 of the Public Health Law and section 98-1.8 of this Subpart;
(1) the governing body of the MCO delegates one or more management functions without having effected such delegation pursuant to a management contract approved by the commissioner;
(2) the governing body of the MCO fails to retain ongoing responsibility for statutory and regulatory compliance;
(3) the governing body of the MCO allows the management contractor to assume responsibilities which cannot be delegated by the governing authority of the MCO;
(4) the governing body of the MCO enters into more than one agreement with the management contractor for the purpose of management of the MCO and/or payment to the management contractor for management services;
(5) the management contract is amended without the prior written approval of the commissioner;
(6) the management contractor is discharged without the prior approval of the commissioner;
(7) the MCO fails to comply with a direction from the commissioner to terminate the management contractor;
(8) the MCO or the management contractor subcontracts delegated functions without the approval of the commissioner; or
(9) the MCO fails to comply or maintain compliance with any other requirements of article 44 of the Public Health Law and this Subpart.
(r) Where the MCO has delegated claims payment to a management contractor, including an IPA, the management contractor shall compensate contracted providers in a timely manner consistent with the provisions of section 3224-a of the Insurance Law; provided, however, that nothing herein shall limit the liability of an MCO pursuant to such law for any failure to pay providers in accordance with the provisions of such law. The MCO may, in its contract with the management contractor, require the management contractor to indemnify the MCO for all claims and payments made by the MCO as a result of the management contractor's failure to make timely payments to providers in a manner consistent with section 3224-a of the Insurance Law.
(s) Any management contract approved by the commissioner and entered into by an MCO and a management contractor prior to the effective date of this subdivision shall remain in effect for the term of the contract. In no event shall such a management contract remain in effect for more than five years from its effective date, nor shall such a management contract be renewed without complying with the provisions of this Subpart and without receiving the prior written approval of the commissioner in accordance with this Subpart. No written interim consultative agreement entered into between a proposed management contractor and an MCO prior to the effective date of this subdivision shall remain in effect for more than 90 days following the effective date of this subdivision. An existing contract which, upon the effective date hereof qualifies as a management contract pursuant to the provisions of subdivision (j) of this section, shall be amended to comply with the provisions of this section relating to management contracts and submitted for approval prior to its renewal pursuant to the terms thereof or within one year of the effective date hereof, whichever first occurs.
(t) An MCO may employ salaried solicitors and accept business from licensed insurance brokers and agents for business other than title XIX, and title XXI, and title 11 of article 5 of the Social Services Law and title I-A of article 25 of the Public Health Law, respectively, on a commission basis; provided, however, that:
(1) HMOs shall comply with section 4312 of the State Insurance Law with respect to accepting business from licensed insurance brokers and agents on a commission basis;
(2) no MCO, for its commercial line of business, shall pay a fee or commission to a broker or agent who has not agreed to provide information concerning its arrangements with participating employers to the MCO upon request;
(3) any broker or agent selling MCO coverage shall be licensed by the Insurance Department as an insurance broker or agent;
(4) no MCO shall accept more than 10 percent of an individual or group premium, which shall be refundable in the event enrollment is denied by such MCO, from a broker or agent unless upon such acceptance an individual, or group subject to any waiting period permitted in this Subpart concerning the commencement of coverage, is enrolled and entitled to receive comprehensive health services pursuant to a contract approved by the Superintendent of Insurance; and
(5) any fees or commission rates payable by an MCO to a broker or agent, which shall be at the same rate for all brokers and agents utilized by such MCO, shall be reviewed by the Superintendent of Insurance as part of the MCO's rate filing process and pursuant to any other applicable provisions of the Insurance Law and regulations.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.3 Registration
(a) The department may issue a certificate of registration to a sponsoring institution with an educational program that is recognized by the department as leading to licensure as a radiologic technologist if a sponsoring institution fulfills the following requirements in a manner acceptable to the department:
(1) files an application for registration with the department on such forms as the department may prescribe;
(2) provides documentation describing the sponsoring institution’s financial resources, instructional curriculum, faculty, classroom and clinical facilities, student policies and administrative organization;
(3) passes a site inspection of the sponsoring institution's administrative, didactic and clinical facilities conducted by the department, the Joint Review Committee on Education in Radiologic Technology or other accrediting body approved by the department; and
(4) upon request, provides documentation from any accrediting organization of any certification or approval of the educational program.
(b) In the event that the department finds deficiencies in an educational program offered by a sponsoring institution seeking a certificate of registration, the department may issue a provisional certificate of registration to a sponsoring institution if the sponsoring institution agrees in writing to correct deficiencies in the educational program within a period of time specified by the department.
(c) The department may deny, revoke or suspend a certificate of registration or a provisional certificate of registration upon a determination by the department that:
(1) the sponsoring institution has not, or is not likely to comply with this Part, applicable regulations, or the Public Health Law;
(2) the sponsoring institution has not complied with the standards and policies of the accrediting organization that approved or recognized its educational program; or
(3) the educational program does not have any students for a period of two successive years. The department shall notify the sponsoring institution of its intent to deny, revoke or terminate a certificate of registration or provisional certificate of registration. The sponsoring institution may, within 30 days of notification, petition the department in writing for a review. The sponsoring institution shall then be given the opportunity to be heard by the commissioner or his or her designee.
(d) A sponsoring institution whose registration has been suspended or revoked pursuant to this section shall not be eligible to apply for a new registration until such time as the deficiencies have been corrected to the satisfaction of the department.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.5 Water and sewage
(a) Every existing and proposed water supply serving a mass gathering shall comply with the maximum contaminant levels and the applicable turbidity requirements contained in Subpart 5-1 of this Title and, in addition, shall meet the following requirements:
(1) Drinking water shall be adequate in quantity, of a quality which the permit-issuing official approves as complying with at least the applicable requirements of Part 5 of this Title, and shall be readily available to occupants of the property. Drinking water only shall be so delivered or piped as to be easily accessible. Nonpotable water shall not be easily accessible.
(2) A well or spring source of drinking water shall be constructed, located and protected against pollution in a manner approved by the permit-issuing official or the State Commissioner of Health as properly designed against contamination. A pipe, pump or other outlet delivering drinking water shall be of an adequate type and installation, and provisions shall be made for proper disposition of wastewater.
(3) There shall be no physical connection between a pipe carrying drinking water and a nonpotable water supply. Fixtures, installations or equipment from which back-siphonage may occur, shall not be supplied water from a pipe carrying drinking water.
(4) A common drinking utensil shall not be provided. Drinking fountains shall be of adequate sanitary design and construction.
(5) Where a water treatment process is employed, records of such treatment shall be properly maintained on a daily basis and submitted at least monthly to the permit-issuing official, on such forms as he or the commissioner may direct.
(6) Any interruption in treatment of a drinking water supply shall be reported immediately to the permit-issuing official. No change in the source or method of treatment of a drinking water supply shall be made without first notifying and securing the approval of the permit-issuing official.
(7) A minimum water pressure of 20 pounds per square inch, at peak demand, shall be maintained at all points in the distribution system.
(b) Facilities shall be provided and maintained for the satisfactory treatment and/or disposal of sewage. In addition, such facilities shall meet the following requirements:
(1) A plan for proposed new or modified facilities for the satisfactory treatment and/or disposal of sewage shall be submitted to the permit-issuing official or the State Department of Health when the individual system treats a daily flow of less than 1,000 gallons of sewage. Plans for new or modified facilities designed to treat a daily sewage flow of 1,000 gallons or more shall be submitted to the Department of Environmental Conservation for approval.
(2) A permit or approval in writing for the discharge of sewage or sewage effluent as provided by the plans shall be obtained from the permit-issuing official or other official having jurisdiction.
(3) No construction shall be commenced for new or modified facilities for the treatment and/or disposal of sewage until such permit or approval in writing has been received by the operator. Construction shall be in accordance with approved plans.
(4) The presence of inadequately treated sewage on the surface of the ground is prohibited.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.9 Environmental impact statement procedures
(a) The department shall, when it is lead agency for an action involving an applicant, and has determined that an EIS is required, immediately notify the applicant and all other involved agencies, in accordance with section 97.11 of this Part, in writing, that it is the lead agency and that an EIS is required. If the applicant does not exercise its option to prepare the draft EIS, the department shall prepare it, cause it to be prepared or terminate its review of the action.
(b) When the applicant prepares the draft EIS, the draft EIS shall be submitted to the department, if it is lead agency, which shall determine whether to accept it as satisfactory with respect to its scope, content and adequacy for purposes of this Part.
(c) The department, if it is lead agency, and has completed a draft EIS or has accepted a draft EIS prepared by an applicant, shall file a notice of completion of the draft EIS and a copy of the draft EIS in accordance with the requirements set forth in section 97.11 of this Part. The department shall specify a commenting period on the draft EIS, to be not less than 30 calendar days.
(d) When the department, if it is lead agency, has completed a draft EIS or when it has accepted a draft EIS prepared by an applicant, it will determine whether or not to conduct a public hearing concerning the action. In determining whether or not to hold a hearing, the department shall consider the degree of interest shown by other persons in the action, and the extent to which a public hearing can aid the agency decisionmaking processes by providing a forum for, or an efficient mechanism for the collection of, public comment.
(1) If a hearing is to be held, the department shall file the notice thereof in accordance with section 97.11 of this Part. Such notice may be contained in the notice of completion of the draft EIS. The notice of hearing shall also be published, at least 14 calendar days in advance of the public hearing, in a newspaper of general circulation in the area of the potential impacts and effect of the action.
(2) The hearing shall commence not less than 15 calendar days nor more than 60 calendar days after the filing of the draft EIS pursuant to section 97.11 of this Part. When a SEQR hearing is to be held, it shall be incorporated into existing hearing procedures wherever practicable.
(e) Except as provided in paragraphs (1) and (2) of this subdivision, the department if it is lead agency, shall prepare or cause to be prepared a final EIS, within 45 calendar days after the close of any hearing or within 60 calendar days after the filing of the draft EIS, whichever last occurs.
(1) If the proposed action has been withdrawn or if, on the basis of the draft EIS or hearing, the department, if it is lead agency, has determined that the action will not have a significant effect on the environment, no final EIS need be prepared. Notice of such determination shall be filed in accordance with section 97.11 of this Part.
(2) The last date for preparation of the final EIS may be extended:
(i) where it is determined that additional time is necessary to prepare the statement adequately;
(ii) where problems with the proposed action requiring material reconsideration or modification have been identified; or
(iii) for other good cause.
(f) Notice of completion of the final EIS and copies of the final EIS shall be filed in accordance with section 97.11 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.2 Governing body
(a) The established operator shall be legally responsible for the quality of patient care services, for the conduct and obligations of the hospital as an institution and for ensuring compliance with all Federal, State and local laws.
(b) Organization and operation.
(1) The hospital shall have a governing body legally responsible for directing the operation of the hospital in accordance with its mission. If a hospital does not have an organized governing body, then the person or persons legally responsible for the conduct of the hospital shall carry out the functions specified in this Part that pertain to the governing body. Hospitals operated by governmental organizations, with the exception of those sponsored by the Federal government, shall provide written notification to the commissioner of their designated governing bodies and the legal authority establishing these designations. No contracts/arrangements or other agreements may limit or diminish the responsibility of the governing body in any way.
(2) The governing body, in order to achieve and maintain generally accepted standards of professional practice and patient care services in the hospital, shall establish, cause to implement, maintain and, as necessary, revise its practices, policies and procedures for the ongoing evaluation of the services operated or delivered by the hospital and for the identification, assessment and resolution of problems that may develop in the conduct of the hospital.
(3) All officers, directors, trustees, partners, or sole proprietors of the governing body shall participate in orientation and continuing education programs addressing the mission of the institution, their roles and responsibilities, patients' rights, and the organization, goals and operation of the hospital's quality assurance program.
(4) The governing body shall adopt written bylaws reflecting its legal responsibility and accountability to the patients and its obligation to the community it was established to serve. The bylaws shall specify at least the following:
(i) the role and purpose of the hospital;
(ii) the duties and responsibilities of the governing body;
(iii) the responsibilities of any governing body committees including the requirement that minutes reflect all business conducted, including findings, conclusions and recommendations;
(iv) the relationships and responsibilities of the governing body, hospital administration, and the medical staff, and the mechanism established by the governing body for holding such parties accountable;
(v) the mechanisms for adopting, reviewing and revising governing body bylaws; and
(vi) the mechanisms for formal approval of the organization, bylaws, rules and regulations of the medical staff and its departments in the hospital.
(5) Meetings of the governing body shall be held in order for the governing body to evaluate the conduct of the hospital, including the care and treatment of patients as well as its own performance. Based on these evaluations, the governing body shall take necessary actions sufficient to correct noted problems. A record of all governing body proceedings which reflects all business conducted, including findings, conclusions and recommendations, shall be maintained for review and analysis.
(6) The governing body shall establish and maintain a coordinated program which integrates the review activities of all hospital services for the purpose of enhancing the quality of patient care and identifying and preventing malpractice.
(c) Compliance with Federal, State and local laws.
(1) The hospital shall comply with all applicable Federal, State and local laws, including the New York State Public Health Law, Mental Hygiene Law, and the Education Law.
(2) The governing body shall take all appropriate and necessary actions to monitor and restore compliance when deficiencies in the hospital's compliance with statutory and/or regulatory requirements are identified, including but not limited to monitoring the chief executive officer's submission and implementation of all plans of correction.
(d) Chief executive officer.
The governing body shall appoint a chief executive officer who is responsible to the governing body for the management of the hospital. This function shall not be delegated to or shared with any organization except under a management authority contract approved by the commissioner pursuant to section 405.3 of this Part.
(1) The chief executive officer shall be qualified for his/her responsibilities through education and experience.
(2) The governing body shall assure the chief executive officer's effective performance through ongoing documented monitoring and evaluation of that performance against written criteria developed for the position. Such criteria shall include the hospital's compliance with statutory and regulatory requirements, the corrective actions required and taken to achieve such compliance, and the maintenance of corrective actions to achieve continued compliance in previously deficient areas.
(e) Medical staff.
The governing body shall:
(1) determine, in accordance with State law, which categories of health care practitioners are eligible candidates for appointment to the medical staff;
(2) appoint a physician, referred to in this Part as the medical director, who is qualified for membership on the medical staff and who shall be responsible for directing the medical staff organization in accordance with provisions of section 405.4 of this Part. Such appointment shall be made after consultation with the medical staff. In making such appointment the governing body may consider an individual who is a clinical department chairperson, an elected president of the medical staff, a medical staff committee chairperson, or any other person who meets the requirements for appointment set forth in this paragraph. The medical director may carry out his or her duties on either a full or part-time basis and on a salaried or nonsalaried basis as determined by the governing body and may report to the governing body directly, or to the governing body through the chief executive officer or through another route as determined by the governing body;
(3) ensure the implementation of written criteria for selection, appointment and reappointment of medical staff members and for the delineation of their medical privileges. Such criteria shall include standards for individual character, competence, training, experience, judgment, and physical and mental capabilities;
(4) ensure that staff membership or professional privileges in the hospital are not dependent solely upon certification, fellowship, or membership in a speciality body or society;
(5) appoint members of the medical staff after considering the recommendations of the existing members of the medical staff in accordance with written procedures, as established by hospital and medical staff bylaws;
(6) ensure that actions taken on applications for medical staff appointments and reappointments including the delineation of privileges are put in writing;
(7) ensure that the medical staff has written bylaws;
(8) approve medical staff bylaws and any other medical staff rules and regulations;
(9) require that members of the medical staff abide by the rules, regulations and bylaws of the hospital;
(10) ensure that the medical staff is accountable to the governing body for the quality of care provided to patients; and
(11) require that members of the medical staff practice only within the scope of privileges granted by the governing body.
(f) Care of patients.
The governing body shall require that the following patient care practices are implemented, shall monitor the hospital's compliance with these patient care practices, and shall take corrective action as necessary to attain compliance:
(1) every patient of the hospital, whether an inpatient, emergency service patient, or outpatient, shall be provided care that meets generally acceptable standards of professional practice;
(2) every patient is under the care of a health care practitioner who is a member of the medical staff;
(3) patients are admitted to the hospital only on the recommendation of a licensed practitioner permitted to admit patients to a hospital;
(4) a physician, or a licensed physician assistant under the general supervision of a physician, or a nurse practitioner in collaboration with a physician, is on duty at all times in the hospital except that the commissioner may approve substitute coverage, for all or part of each day, by each patient's attending physician when these physicians are immediately available to the hospital by telephone, and available in person or by telemedicine within 30 minutes as needed, upon a hospital demonstrating to the commissioner that:
(i) all patients are medically stable and patients who become medically unstable are promptly transferred to an appropriate receiving hospital in accordance with section 400.9 of this Title;
(ii) the hospital does not operate an emergency service; and
(iii) the entire hospital has less than 25 approved beds.
(5) a physician shall be responsible for the care of each patient with respect to any medical or psychiatric problem that is present on admission or develops during hospitalization;
(6) hospitals which conduct, or propose to conduct, or otherwise authorize human research on patients or other human subjects shall adopt and implement policies and procedures pursuant to the provisions of Public Health Law, article 24-A for the protection of human subjects;
(7) hospitals shall have available at all times personnel sufficient to meet patient care needs; and
(8) hospitals shall have in place evidence-based protocols for the early recognition and treatment of patients with severe sepsis and septic shock that are based on generally accepted standards of care as required by section 405.4(a) of this Part.
(g) Physical plant.
The governing body is responsible for providing a physical plant equipped and staffed to maintain the needed facilities and services for patients in compliance with construction standards contained in Article 2 of Subchapter C of this Chapter (Medical Facility Construction), and for correcting deficiencies cited by regulatory agencies.
(h) Hospital service contracts.
The governing body shall be responsible for services furnished in the hospital whether or not they are furnished by outside entities under contracts. The governing body shall ensure that a contractor of services (including one for shared services and joint ventures) furnishes services that permit the hospital to comply with all applicable codes, rules and regulations.
(1) The governing body shall ensure that the services performed under a contract are provided in a safe and effective manner, in accordance with the requirements of section 400.4 of this Subchapter.
(2) The hospital shall maintain a list of all contracted services, including the scope and nature of the services provided.
(i) As used in this Part to describe the duties or obligations of the governing body of a hospital, the words “assure” or “ensure” shall not affect the standard of liability in damages of a hospital corporation's board of directors, or the board's individual members, beyond the standard set forth in statutory and/or case law applicable in this State.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
STATISTICAL DATA STATISTICAL DATA
10 CRR-NY 446.12 Accommodation classification
(a) Private rooms and two-or-more-bed rooms. The following data is to be reported:
(1) discharges
(2) patient days (census); and
(3) certified bed capacity.
(b) Please report these statistics for your total inpatient Daily Hospital Services, excluding:
(1) Nursery Services (accounts 6510 and 6520); and
(2) Sub-Acute Care Services (accounts 6610 through 6690).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.13 Local early intervention coordinating councils
(a) A local early intervention coordinating council shall be established in each municipality and shall consist of the following members appointed by the early intervention official:
(1) at least four parents of children with disabilities age birth through 12 years of age;
(2) at least three public or private providers of early intervention services;
(3) at least one child care provider or representative of child care providers;
(4) the chief executive or their designees of the municipalities departments of social services, health and mental hygiene; and, a representative from the local developmental disabilities services office; and
(5) a representative from one or more committees on preschool special education of local school districts in the municipality.
(b) If membership requirements cannot be reasonably met, the early intervention official may submit a written request to the commissioner for a waiver of such requirements.
(c) The local early intervention coordinating council shall meet in open forum accessible to the general public preferably quarterly, but in no event less than every six months. The early intervention official shall ensure appropriate public notice of the meeting, which shall include its purpose, date, times and location. The notice shall be within a sufficient time period prior to the meeting to enable public participation.
(d) The local early intervention coordinating councils shall advise their early intervention officials regarding:
(1) the planning for, delivery and evaluation of the early intervention services for eligible children and their families, including methods to identify and address gaps in services;
(2) the identification of service delivery reforms necessary to promote the availability of early intervention services within natural environments:
(3) the coordination of public and private agencies; and
(4) such other matters relating to early intervention policies and procedures within the municipality as are brought to its attention by parents, providers, public agencies, or others.
(e) The council will report annually to the early intervention official on the adequacy of the early intervention system to ensure the availability of family centered, coordinated services; and interface with other existing planing bodies that serve like populations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.31 Physical therapy
This functional reporting center must contain all the expenses associated with employing therapeutic exercises and massage and utilizing effective properties of heat, light, cold water and electricity for diagnosis and rehabilitation of patients with neuromuscular, orthopedic and other impairments. Such services are provided in a coordinated and integrated program under the direction and prescription of a physician or a registered physical therapist. Additional activities include but are not limited to the following: the provision of clinical and consultative services; the direction of patients in the use, function and care of braces, artificial limbs and other devices; prescribing therapeutic exercises; counseling patients and their relatives; organizing and conducting medically prescribed physical therapy programs; applying diagnostic muscle tests; administering whirlpool and compact baths; changing linen on physical therapy department beds and treatment tables; assisting patients in changing clothes and other personal needs and participating in discharge coordination as required by the code.
(a) Standard unit of measure: number of treatments.
(1) A treatment should be synonymous with a visit. The treatment would consist of one or more modalities and/or procedures rendered during one patient visit. If a patient received two such visits in one day, that would constitute two treatments. The main difference between a skilled (or rehabilitative) treatment and a maintenance visit lies in the purpose and method of provision. A skilled treatment is rendered with the expectation of improving the patient's condition and is given by the licensed therapist or under the therapist's direct supervision. A maintenance procedure is designed to help keep the patient at his/her present level of function and is most often performed by ancillary personnel and does not require direct supervision. Maintenance procedures, for the most part, do not require the therapist's skills and do not utilize the more refined modalities or procedures.
(2) For purposes of reporting under this Article, a count of the total number of treatments, both skilled and maintenance, will be required. However, facilities must also maintain statistics which segregate skilled treatments from maintenance procedures as they will be required for reporting to the Department of Health for other purposes, i.e., management assessment, PMR/IPR's and surveys.
(b) Data source.
The number of treatments shall be an actual count maintained by the physical therapy department.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.50 Bond premium
The net amount yielded by the sale of a bond or class of bonds in excess of its face value. On the books and balance sheet of the issuer it appears as a deferred credit.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.2 Definition
New medical technology and health services demonstration projects. For purposes of this Chapter, a new medical technology and health services demonstration project shall mean a time limited project approved under section 2802 of the Public Health Law and this Subchapter to evaluate the medical efficacy, safety, cost effectiveness and efficiency of, and need for, an innovation in medical technology including, but not limited to, equipment and services, in or by a medical facility, that has not yet been generally recognized and accepted by the medical profession and institutional health care industry as a usual and customary modality of providing patient diagnosis, care, treatment or other health services.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 102 BROOME COUNTY
10 CRR-NY 102.1 Chenango Water District No. 1, Town of Chenango
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to all wells located on land owned by the district located east of Kattelville Road on the north side of Clark Street on what is known as the Macomber site, forming the source of the public water supply of the Chenango Water District No. 1, Town of Chenango, Broome County, NY.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply and to any additional wells which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Chenango Water District No. 1.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 175 feet of any well of the public water supply of the Chenango Water District No. 1.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified, and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not [ continued ] less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any well of the public water supply of the Chenango Water District No. 1.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 175 feet of any well of the public water supply of the Chenango Water District No. 1, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c) or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health. It is provided, however, that no such watertight receptacle or any such watertight iron pipe shall be within 100 feet of any well of the public water supply of the Chenango Water District No. 1.
(e) Trespassing.
No trespassing shall be allowed upon the property upon which any well of the public water supply of the Chenango Water District No. 1 is located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Chenango Water District No. 1.
(f) [General clause.]
In addition to observing the foregoing requirements all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the Chenango Water District No. 1.
(g) Inspections.
The board of water commissioners of the Chenango Water District No. 1 or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Chenango Water District No. 1 or their duly appointed representatives shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(h) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
RESIDENTIAL RIGHTS AND SERVICES RESIDENTIAL RIGHTS AND SERVICES
10 CRR-NY 415.3 Residents' rights
(a) The facility shall ensure that all residents are afforded their right to a dignified existence, self-determination, respect, full recognition of their individuality, consideration and privacy in treatment and care for personal needs, and communication with and access to persons and services inside and outside the facility. The facility shall protect and promote the rights of each resident, and shall encourage and assist each resident in the fullest possible exercise of these rights as set forth in subdivisions (b)-(i) of this section. The facility shall also consult with residents in establishing and implementing facility policies regarding residents' rights and responsibilities.
(1) The facility shall advise each member of the staff of his or her responsibility to understand, protect and promote the rights of each resident as enumerated in this section.
(2) The facility shall fully inform the resident and the resident's designated representative both orally and in writing in a method of communication that the individuals understand of the resident's rights and all rules and regulations governing resident conduct and responsibilities during the stay in the facility. Such notification shall be made prior to or upon admission and during the resident's stay. Receipt of such information, and any amendments to it, shall be acknowledged in writing. A summary of such information shall be provided by the department and posted in the facility in large print and in language that is easily understood.
(3) The written information provided pursuant to paragraph (2) of this subdivision shall include, but not be limited to a listing of those resident rights and facility responsibilities enumerated in subdivisions (b) through (i) of this section. The facility's policies and procedures shall also be provided to the resident and the resident's designated representative upon request.
(4) The facility shall communicate to the resident an explanation of his or her responsibility to obey all reasonable regulations of the facility and to respect the personal rights and private property of other residents.
(5) Any written information required by this Part to be posted shall be posted conspicuously in a public place in the facility that is frequented by residents and visitors, posted at wheelchair height.
(b) Admission rights.
The nursing home shall protect and promote the rights of residents and potential residents by establishing and implementing policies which ensure that the facility:
(1) shall not require a third-party guarantee of payment to the facility as a condition of admission, or expedited admission, or continued stay in the facility;
(2) shall not charge, solicit, accept or receive, in addition to any amount otherwise required to be paid by third-party payors, any gift, money, donation or other consideration as a precondition of admission, expedited admission or continued stay in the facility except that arrangements for prepayment for basic services not exceeding three months shall not be precluded by this paragraph;
(3) shall not require residents or potential residents to waive their rights to Medicare or Medicaid benefits;
(4) shall not require oral or written assurance that residents or potential residents are not eligible for, or will not apply for, Medicare or Medicaid benefits;
(5) shall obey all pertinent State and local laws which prohibit discrimination against individuals entitled to Medicaid benefits;
(6) may require an individual who has legal access to a resident's income or resources available to pay for facility care, to sign a contract, without incurring personal financial liability, to provide the facility payment from the resident's income or resources;
(7) may charge a resident who is eligible for Medicaid for items and services the resident has requested and received, and that are not specified at the time of admission as included in basic nursing home services, so long as the facility gives proper notice of the availability and cost of these items and services to the resident and does not condition the resident's admission or continued stay on the request for and receipt of such additional items and services; and
(8) may solicit, accept or receive a charitable, religious or philanthropic contribution from an organization or from a person unrelated to the resident, or potential resident, only to the extent that the contribution is not a condition of admission, expedited admission, or continued stay in the facility.
(c) Right to information on home and community-based services.
The nursing home shall ensure that all residents are provided with information on home and community-based services and community transitions programs that may be available to support the resident in returning to the community. To ensure that all residents are afforded the right to exercise their right to live in the most integrated setting, the facility shall:
(1) advise all residents upon admission, of their right to live in the most integrated and least restrictive setting, with considerations for the resident’s medical, physical, and psychosocial needs;
(2) provide all residents upon admission with information on home and community-based services and community transition programs;
(3) refer all residents to the local contact agency or a community-based provider of the resident or designated representative’s choosing whenever the resident requests information about returning to the community, or whenever the resident requests to talk to someone about returning to the community during any State or Federally mandated assessment;
(4) post in a public area of the facility, at wheelchair height, contact information for the local contact agency;
(5) have staff available to discuss options for discharge planning, with consideration for the resident’s medical, physical, and psychosocial needs; and
(6) ensure that all discharge activities align with subdivision (i) of this section.
(d) Protection of legal rights.
(1) Each resident shall have the right to:
(i) exercise his or her rights as a resident of the facility and as a citizen or resident of the United States and New York State including the right to vote, with access arranged by the facility and to this end may voice grievances without discrimination or reprisal for voicing the grievances, and have a right of action for damages or other relief for deprivations or infringements of his or her right to adequate and proper treatment and care established by any applicable statute, rule, regulation or contract;
(ii) recommend changes in policies and services to facility staff and/or to any outside representatives, free of interference, coercion, discrimination, restraint or reprisal from the facility and to obtain prompt efforts by the facility to resolve grievances the resident may have, including those with respect to the behavior of other residents;
(iii) exercise his or her individual rights or have his or her rights exercised by a person authorized by State law;
(iv) inspect all records including clinical records, pertaining to himself or herself within 24 hours after oral or written request to the facility and, after receipt of such records for inspection, to purchase at a cost which is the lower of the cost incurred by the facility in production of the record or 75 cents per page, photocopies of the records or any portions of them upon request and two working days advance notice to the facility. The designated representative who has authority to make health care decisions for the resident shall likewise have access to the resident's records in accordance with this subparagraph, State law and the rights of a competent resident to deny such access. A resident or such designated representative shall not be denied access to the clinical record solely because of inability to pay,
(v) examine the results of the most recent survey of the facility conducted by Federal or State surveyors including any statement of deficiencies, any plan of correction in effect with respect to the facility and any enforcement actions taken by the Department of Health. The results shall also be made available by the facility for examination. They shall be made available in a place readily accessible to residents and designated representatives without staff assistance;
(vi) receive information from agencies acting as resident advocates, and be afforded the opportunity to contact these agencies;
(vii) be free from verbal, sexual, mental or physical abuse, corporal punishment and involuntary seclusion, and free from chemical and physical restraints except those restraints authorized in accordance with section 415.4 of this Part;
(viii) exercise his or her civil and religious liberties, including the right to independent personal decisions and knowledge of available choices, which shall not be infringed; and
(ix) request, or have the resident's designated representative request, and be provided information concerning his or her specific assignment to a patient classification category as contained in Appendix 13-A of this Title, entitled, “Patient Categories and Case Mix Indices Under Resource Utilization Group (RUG-II) Classification System.”
(2) With respect to its responsibilities to the resident the facility shall:
(i) furnish a written description of legal rights which includes:
(a) a description of the manner of protecting personal funds, under section 415.26(h) of this Part; and
(b) a statement that the resident may file a complaint with the facility or the New York State Department of Health concerning resident abuse, neglect, mistreatment and misappropriation of resident property in the facility. The statement shall include the name, address and telephone number of the office established by the department to receive complaints and of the State Office for the Aging Ombudsmen Program;
(ii) promptly notify the resident and the resident's designated representative when there is:
(a) a change in room. Except when the medical condition of the resident requires an immediate room change or an emergency situation has developed, such change in room shall require prior notice and consultation with the resident as well as reasonable accommodation of any resident needs or preferences;
(b) a change in roommate assignment which shall be acceptable, where possible, to all affected residents; or
(c) a change in resident rights under Federal or State law or regulations as specified in this section;
(iii) record and periodically update the address and phone number of the resident's designated representative;
(iv) provide immediate access to any resident by the following:
(a) any representative of the Secretary of Health and Human Services;
(b) any representative of the Department of Health;
(c) the resident's responsible physician;
(d) ombudsmen who are duly certified and designated by the State Office for the Aging;
(e) representatives of the Commission on Quality of Care for the Mentally Disabled which is responsible for the protection and advocacy system for developmentally disabled individuals and mentally ill individuals;
(f) immediate family or other relatives of the resident, subject to the resident's right to deny or withdraw consent at any time;
(g) personal caregiving visitors , as defined in section 2801-h(1) of the Public Health Law and pursuant to criteria specified in paragraph (3) of this subdivision, including those providing compassionate caregiving , as defined in section 2801-h(1) of the Public Health Law and pursuant to criteria specified in paragraph (4) of this subdivision; and
(h) others who are visiting with the consent of the resident, subject to reasonable restrictions and the resident's right to deny or withdraw consent at any time;
(v) post the names, addresses and telephone numbers of all pertinent State client advocacy groups and provide reasonable access to any resident by any entity or individual that provides health, social, legal or other services to the resident, subject to the resident's right to deny or withdraw consent at any time;
(vi) comply with the provisions of Part 411 of this Title regarding Ombudsmen Access to Residential Health Care Facilities; and
(vii) inform residents of the facility's visiting hour policies.
(3) Personal caregiving visitors.
(i) During a public health emergency declared under section 24 or section 28 of the Executive Law, the facility must continue to allow residents to access their designated personal caregiving visitors, notwithstanding any restrictions or prohibitions relating to residential health care visitation resulting from the declared public health emergency, subject to the following restrictions:
(a) If a facility has reasonable cause to believe that a resident will not benefit from accessing their designated personal caregiving visitors, and such reasoning has been documented in the resident’s individualized comprehensive plan of care, a facility may require a health or mental health professional duly licensed or certified in New York State under the Education Law, and who need not be associated with the nursing home, including but not limited to a physician, registered nurse, licensed clinical social worker, psychologist, or psychiatrist, to provide a written statement that the personal caregiving will substantially benefit the resident’s quality of life, including a statement from such medical provider that the personal caregiving visitation will enhance the resident’s mental, physical, or psychosocial well-being, or any additional criteria evidencing a benefit to quality of life as determined by the department. Such written statements from the medical provider shall be maintained in the resident’s individualized comprehensive plan of care.
(b) Notwithstanding any provision of this subparagraph, a facility may temporarily suspend or limit personal caregiving visitors to protect the health, safety and welfare of residents if: the declared public health emergency is related to a communicable disease and the department determines that local infection rates are at a level that presents a serious risk of transmission of such communicable disease within local facilities; the facility is experiencing temporary inadequate staffing and has reported such staffing shortage to the Department of Health and any other state or Federal agencies as required by law, regulation, or other directive; or an acute emergency situation exists at the facility, including loss of heat, loss of elevator service, or other temporary loss of an essential service. Provided, however, that in the event a facility suspends or limits personal caregiving visitation pursuant to this clause, the facility shall notify residents, all designated personal caregiving visitors, and the applicable department regional office of such suspension or limitation and the duration thereof within 24 hours of implementing the visitation suspension or limitation. Additionally, for each day of the suspension or limitation, the facility shall document the specific reason for the suspension or limitation in their administrative records. The facility shall further provide a means for all residents to engage in remote visitation with their designated personal caregiving visitor(s), including but not limited to phone or video calls, until such time that the suspension or limitation on personal caregiving visitation has ended.
(c) Notwithstanding any provision of this subparagraph, a facility may prohibit a personal caregiving visitor from entering if the facility has reasonable cause to believe that permitting the personal caregiving visitor to meet with the resident is likely to pose a threat of serious physical, mental, or psychological harm to such resident. In the event the facility determines that denying such personal caregiving visitor access to the resident is in the resident’s best interests pursuant to this subparagraph, the facility must document the date of and reason for visitation refusal in the resident’s individualized comprehensive plan of care, and on the same date of the refusal the facility shall communicate its decision to the resident and their designated representative. Further, a facility may refuse access to or remove from the premises any personal caregiving visitor who is causing or reasonably likely to cause physical injury to any facility resident or personnel.
(ii) The facility shall develop written policies and procedures to ask residents, or their designated representatives in the event the resident lacks capacity, at time of admission or readmission, or for existing residents within 14 days of the effective date of this paragraph, which individuals the resident elects to serve as their personal caregiving visitor during declared public health emergencies. A resident shall be entitled to designate at least two personal caregiving visitors at one time.
(iii) The facility shall maintain a written record of the resident’s designated personal caregiving visitors in the resident’s individualized comprehensive plan of care, and shall document when personal caregiving and compassionate caregiving is provided in the resident’s individualized comprehensive plan of care.
(iv) As part of its ongoing review of a resident’s comprehensive plan of care, the facility shall regularly inquire of all current residents, or their designated representative if the resident lacks capacity, whether the facility’s current record of designated personal caregiving visitors remains accurate, or whether the resident, or their designated representative if the resident lacks capacity, wishes to make any changes to their personal caregiving visitor designations. The facility shall update the resident’s individualized comprehensive plan of care with the date the facility sought updates from the resident and indicate any changes to the resident’s personal caregiving visitor designations therein. Such inquiries shall be made no less frequently than quarterly and upon a change in the resident’s condition; upon review of a facility’s visitation policies and procedures, the department may also require the facility inquire of any resident whether the facility’s current record of designated personal caregiving visitors remains accurate.
(v) The facility shall require all personal caregiving visitors to adhere to infection control measures established by the facility and consistent with any guidelines from the department, or in the absence of applicable department guidance, consistent with long term care facility infection control guidelines from the U.S. Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. Such infection control measures may include, but need not be limited to:
(a) testing all personal caregiving visitors for any communicable disease that is the subject of the declared public health emergency, which may include rapid on-site testing or requiring the visitor to present a negative test result dated no more than seven days prior to the visit;
(b) checking the personal caregiving visitor’s body temperature upon entry to the facility, and denying access to any visitor with a temperature above 100 degrees Fahrenheit;
(c) conducting health screenings of all personal caregiving visitors upon entry to the facility, including screenings for signs and symptoms of any communicable disease that is the subject of the declared public health emergency or any other communicable disease which is prevalent in the facility’s geographic area, and recording the results of such screenings;
(d) requiring all personal caregiving visitors to don all necessary personal protective equipment appropriately, and providing such personal protective equipment to all personal caregiving visitors; and
(e) enforcing social distancing between persons during visitation, including personal caregiving visitation, except as necessary to provide personal caregiving by the personal caregiving visitor for the resident.
(vi) The facility shall establish policies and procedures regarding the frequency and duration of personal caregiving visits and limitations on the total number of personal caregiving visitors allowed to visit the resident and the facility at any one time. Such policies shall not be construed to limit access by other visitors that would otherwise be permitted under State or Federal law or regulation. The facility shall ensure its policies and procedures respect resident privacy and take into account visitation protocols in the event a resident occupies a shared room. In establishing frequency and duration limits, the facility policy shall ensure that residents are able to receive their designated personal caregiving visitors for the resident's desired frequency and length of time, and any restrictions on that desired frequency and duration must be:
(a) attributable to the resident's clinical or personal care needs;
(b) necessary to ensure the resident’s roommate has adequate privacy and space to receive their own designated personal caregiving visitors; or
(c) because the desired visitation frequency or duration would impair the effective implementation of applicable infection control measures, including social distancing of at least six feet between the visitors and others in the facility, having sufficient staff to effectively screen all personal caregiving visitors and monitor visits to ensure infection control protocols are being followed throughout, and having a sufficient supply of necessary personal protective equipment for all personal caregiving visitors.
(4) Compassionate caregiving.
(i) In the event a resident experiences a long-term or acute physical, mental, or psychosocial health condition for which, in the opinion of the resident, their representative, or a health care professional (including but not limited to a physician, registered nurse, licensed clinical social worker, psychologist, or psychiatrist), a compassionate caregiving visitor would improve the resident’s quality of life, the resident or their representative shall designate at least two compassionate caregiving visitors at one time, and the facility shall record such designation in the resident’s individualized comprehensive plan of care. A resident’s designated personal caregiving visitors may also provide compassionate caregiving.
(ii) Situations in which a resident is eligible for a compassionate caregiving visitor include but are not limited to the following:
(a) end of life;
(b) the resident, who was living with their family before recently being admitted to an adult care facility, is struggling with the change in environment and lack of physical family support;
(c) the resident is grieving after a friend or family member recently passed away;
(d) the resident needs cueing and encouragement with eating or drinking, and such cueing was previously provided by family and/or caregiver(s), and the resident is now experiencing weight loss or dehydration; and
(e) the resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).
(iii) Compassionate caregiving visitation shall be permitted at all times, regardless of any general visitation restrictions or personal caregiving visitation restrictions in effect in the facility. Provided, however, that the facility shall require compassionate caregiving visitors to be screened for communicable diseases prior to entering the facility and visits must be conducted using appropriate social distancing between the resident and visitor if applicable based on guidance from the department or the U.S. Centers for Disease Control and Prevention; if, however, personal contact would be beneficial for the resident’s mental or psychosocial well-being, the facility shall establish policies and procedures to ensure that such necessary physical contact follows appropriate infection prevention guidelines, including the visitor’s use of personal protective equipment and adhering to hand hygiene protocols before and after resident contact, and that the physical contact is limited in duration.
(5) The department shall have discretion to review and require modifications to a facility’s personal caregiving visitation and compassionate caregiving visitation policies and procedures to ensure conformity with paragraphs (3) and (4) of this subdivision and any applicable visitation guidelines issued by the department or the Centers for Medicare and Medicaid Services.
(e) Right to privacy.
Each resident shall have the right to:
(1) personal privacy and confidentiality of his or her personal and clinical records which shall reflect:
(i) accommodations, medical treatment, written and telephone communications, personal care, associations and communications with persons of his or her choice, visits, and meetings of family and resident groups. Resident and family groups shall be provided with private meeting space and residents shall be given access to a private area for visits or solitude. Such requirement shall not require the facility to provide a private room for each resident; and
(ii) the resident's right to approve or refuse the release of personal and clinical records to any individual outside the facility except when:
(a) the resident is transferred to another health care institution; or
(b) record release is required by law;
(2) privacy in written communications, including the right to:
(i) send and receive mail promptly that is unopened; and
(ii) have access to stationery, postage and writing implements at the resident's own expense; and
(3) regular access to the private use of a telephone that is wheelchair accessible and useable by hearing impaired and visually impaired residents;
(f) Right to clinical care and treatment.
(1) Each resident shall have the right to:
(i) adequate and appropriate medical care, and to be fully informed by a physician in a language or in a form that the resident can understand, using an interpreter when necessary, of his or her total health status, including but not limited to, his or her medical condition including diagnosis, prognosis and treatment plan. Residents shall have the right to ask questions and have them answered;
(ii) refuse to participate in experimental research and to refuse medication and treatment after being fully informed and understanding the probable consequences of such actions;
(iii) choose a personal attending physician from among those who agree to abide by all federal and state regulations and who are permitted to practice in the facility;
(iv) be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident's well-being;
(v) participate in planning care and treatment or changes in care and treatment. Residents adjudged incompetent or otherwise found to be incapacitated under the laws of the State of New York shall have such rights exercised by a designated representative who will act in their behalf in accordance with State law; and
(vi) self-administer drugs if the interdisciplinary team, as defined by section 415.11 of this Part, has determined for each resident that this practice is safe.
(2) With respect to its responsibilities to the resident, the facility shall:
(i) inform each resident of the name, office address, phone number and specialty of the physician responsible for his or her own care;
(ii) except in a medical emergency, consult with the resident immediately if the resident is competent, and notify the resident's physician and designated representative within 24 hours when there is:
(a) an accident involving the resident which results in injury requiring professional intervention;
(b) a significant improvement or decline in the resident's physical, mental, or psychosocial status in accordance with generally accepted standards of care and services;
(c) a need to alter treatment significantly; or
(d) a decision to transfer or discharge the resident from the facility as specified in subdivision (i) of this section; and
(iii) provide all information a resident or the resident's designated representative when permitted by State law, may need to give informed consent for an order not to resuscitate and comply with the provisions of section 405.43 of this Title regarding orders not to resuscitate. Upon resident request the facility shall furnish a copy of the pamphlet, Do Not Resuscitate Orders - A Guide for Patients and Families.
(g) Residential rights.
Each resident shall have the right to:
(1) refuse to perform services for the facility. The resident may perform such services, if he or she chooses, only when:
(i) there is work available in the facility that the resident is capable of safely performing;
(ii) the facility has documented the need or desire for work in the plan of care;
(iii) the plan specifies the nature of the services performed and whether the services are voluntary or paid;
(iv) compensation for paid services is at or above prevailing rates; and
(v) the resident agrees to the work arrangement described in the plan of care;
(2) retain, store securely and use personal possessions, including some furnishings, and appropriate clothing, as space permits, unless to do so would infringe upon the rights or health and safety of the resident or other residents in which case the facility shall explore alternatives through discussion with the resident, the resident council or interdisciplinary care team, and provide or assist in the arrangement of storage for possessions. The resident shall have the right to locked storage space in his or her room;
(3) share a room with his or her spouse, relative or partner when these residents live in the same facility and both consent to the arrangement. If a spouse, relative or partner resides in a location out of the facility, the resident shall be assured of privacy for visits;
(4) participate in the established residents' council;
(5) meet with, and participate in activities of social, religious and community groups at his or her discretion; and
(6) receive, upon request, kosher food or food products prepared in accordance with the Hebrew orthodox religious requirements when the resident, as a matter of religious belief, desires to observe Jewish dietary laws.
(h) Financial rights.
(1) Each resident shall have the right to manage his or her financial affairs or authorize in writing the facility to manage personal finances in accordance with section 415.26(h)(5) of this Part. The facility may not require residents to deposit their personal funds with the facility;
(2) With respect to its responsibilities to the resident, the facility shall:
(i) inform each resident who is entitled to Medicaid benefits, in writing, at the time of admission to the nursing home or, when the resident becomes eligible for Medicaid of:
(a) the items and services that are included in nursing home services under the State plan and for which the resident may not be charged;
(b) those other items and services that the facility offers and for which the resident may be charged, and the amount of charges for those services; and
(c) the clear distinction between the two lists required by clauses ( a ) and ( b ) of this subparagraph;
(ii) inform each resident when changes are made to the items and services specified in clauses ( a ) and ( b ) of subparagraph (i) of this paragraph;
(iii) inform each resident verbally and in writing before, or at the time of admission, and periodically when changes occur during the resident's stay, of services available in the facility and of charges for those services, including any charges for services not covered by sources of third party payment or by the facility's basic per diem rate; and
(iv) prominently display in the facility written information, and provide to residents and potential residents oral and written information about how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for previous payments covered by such benefits as well as a description of the requirements and procedures for establishing eligibility for Medicaid, including the right to request an assessment which will determine the extent of a couple's nonexempt resources at the time of institutionalization and attribute to the community spouse an equitable share of resources which cannot be considered available for payment toward the cost of the institutionalized spouse's medical care in his or her process of spending down to Medicaid eligibility levels.
(i) Transfer and discharge rights.
Transfer and discharge shall include movement of a resident to a bed outside of the certified facility whether that bed is in the same physical plant or not. Transfer and discharge shall not refer to movement of a resident to a bed within the same certified facility, and does not include transfer or discharge made in compliance with a request by the resident, the resident’s legal representative or health care agent, as evidenced by a signed and dated written statement, or those that occur due to incarceration of the resident.
(1) With regard to the transfer or discharge of residents, the facility shall:
(i) permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless such transfer or discharge is made in recognition of the resident's rights to receive considerate and respectful care, to receive necessary care and services, and to participate in the development of the comprehensive care plan and in recognition of the rights of other residents in the facility:
(a) the resident may be transferred only when the interdisciplinary care team, in consultation with the resident or the resident's designated representative, determines that:
(1) the transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met after reasonable attempts at accommodation in the facility;
(2) the transfer or discharge is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility;
(3) the safety of individuals in the facility is endangered; or
(4) the health of individuals in the facility is endangered;
(b) transfer and discharge shall also be permissible when the resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare, Medicaid or third-party insurance) a stay at the facility. For a resident who becomes eligible for Medicaid after admission to a facility, the facility may charge a resident only allowable charges under Medicaid. Such transfer or discharge shall be permissible only if a charge is not in dispute, no appeal of a denial of benefits is pending, or funds for payment are actually available and the resident refuses to cooperate with the facility in obtaining the funds;
(c) transfer or discharge shall also be permissible when the facility discontinues operation and has received approval of its plan of closure in accordance with subdivision (i) of section 401.3 of this Title;
(ii) ensure complete documentation in the resident's clinical record when the facility transfers or discharges a resident under any of the circumstances specified in subparagraph (i) of this paragraph. The documentation shall be made by:
(a) the resident's physician and, as appropriate, interdisciplinary care team when transfer or discharge is necessary under subclause ( 1 ) or ( 2 ) of clause ( a ) of subparagraph (i) of this paragraph; and
(b) a physician when transfer or discharge is necessary due to the endangerment of the health of other individuals in the facility under subclause ( 3 ) of clause ( a ) of subparagraph (i) of this paragraph;
(iii) before it transfers or discharges a resident:
(a) notify the resident and designated representative, if any, and, if known, family member of the resident of the transfer or discharge and the reasons for the move in writing and in a language and manner the resident and/or family member understand;
(b) record the reasons in the resident's clinical record; and
(c) include in the notice the items described in subparagraph (v) of this paragraph;
(iv) provide the notice of transfer or discharge required under subparagraph (iii) of this paragraph at least 30 days before the resident is transferred or discharged, except that notice shall be given as soon as practicable before transfer or discharge, but no later than the date on which a determination was made to transfer or discharge the resident, under the following circumstances:
(a) the safety of individuals in the facility would be endangered;
(b) the health of individuals in the facility would be endangered;
(c) the resident's health improves sufficiently to allow a more immediate transfer or discharge;
(d) an immediate transfer or discharge is required by the resident's urgent medical needs;
(e) the transfer or discharge is the result of a change in the level of medical care prescribed by the resident’s physician; or
(f) the resident has not resided in facility for 30 days;
(v) include in the written notice specified in subparagraph (iii) of this paragraph the following:
(a) the reason for transfer or discharge;
(b) the specific regulations that support, or the change in Federal or State law that requires, the action;
(c) the effective date of transfer or discharge;
(d) the location to which the resident will be transferred or discharged;
(e) a statement that the resident has the right to appeal the action to the State Department of Health, which includes:
(1) an explanation of the individual’s right to request an evidentiary hearing appealing the decision;
(2) the method by which an appeal may be obtained;
(3) in cases of an action based on a change in law, an explanation of the circumstances under which an appeal will be granted;
(4) an explanation that the resident may remain in the facility (except in cases of imminent danger) pending the appeal decision if the request for an appeal is made within 15 days of the date the resident received the notice of transfer/discharge;
(5) in cases of residents discharged/transferred due to imminent danger, a statement that the resident may return to the first available bed if he or she prevails at the hearing on appeal; and
(6) a statement that the resident may represent him or herself or use legal counsel, a relative, a friend, or other spokesman;
(f) the name, address and telephone number of the State long term care ombudsman;
(g) for nursing facility residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals established under part C of the Developmental Disabilities Assistance and Bill of Rights Act;
(h) for nursing facility residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill individuals established under the Protection and Advocacy for Mentally Ill Individuals Act;
(vi) provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility, in the form of a discharge plan which addresses the medical needs of the resident and how these will be met after discharge, and provide a discharge summary pursuant to section 415.11(d) of this Title; and
(vii) permit the resident, their legal representative or health care agent the opportunity to participate in deciding where the resident will reside after discharge from the facility.
(2) The department shall grant an opportunity for a hearing to any resident who requests it because he or she believes the facility has erroneously determined that he or she must be transferred or discharged in accordance with the following:
(i) The resident has the right to:
(a) request a hearing to appeal the transfer or discharge notice at any time within 60 days from the date the notice of transfer or discharge is received by the resident;
(b) remain in the facility pending an appeal determination if the appeal request is made within 15 days of the date of receipt of the transfer or discharge notice;
(c) a post-transfer/discharge appeal determination if the resident did not request an appeal determination within 15 days of the date of receipt of the transfer or discharge notice;
(d) return to the facility to the first available semi-private bed if the resident wins the appeal, prior to admitting any other person to the facility; and
(e) represent him or herself, or use legal counsel, a relative, a friend or other spokesman.
(ii) The resident or the resident’s representative as described in clause (i)( e ) of this paragraph must be given the opportunity to:
(a) examine at a reasonable time before the date of the hearing, at the facility, and during the hearing, at the place of the hearing:
(1) the contents of the resident’s file including his/her medical records; and
(2) all documents and records to be used by the facility at the hearing on appeal;
(b) bring witnesses;
(c) establish all pertinent facts and circumstances;
(d) present an argument without undue interference; and
(e) question or refute any testimony or evidence, including the opportunity to confront and cross-examine adverse witnesses.
(iii) All hearings must be conducted in accordance with article 3 of the State Administrative Procedure Act, and in accordance with the following:
(a) the presiding officer shall have the power to obtain medical assessments and psychosocial consultations, and the authority to issue subpoenas;
(b) the nursing home shall have the burden of proof that the discharge or transfer is/was necessary and the discharge plan appropriate;
(c) an administrative hearing must be scheduled within 90 days from the date of the request for a hearing on appeal; and
(d) the parties must be notified in writing of the decision and provided information on the right to seek review of the decision, if review is available.
(3) The facility shall establish and implement a bed-hold policy and a readmission policy that reflect at least the following:
(i) At the time of admission and again at the time of transfer for any reason, the facility shall verbally inform and provide written information to the resident and the designated representative that specifies:
(a) the duration of the bed-hold policy during which the resident is permitted to return and resume residence in the facility; and
(b) the facility's policies regarding bed hold periods, which must be consistent with subparagraph (iii) of this paragraph, permitting a resident to return.
(ii) At the time of transfer of a resident for hospitalization or for therapeutic leave, a nursing home shall provide written notice to the resident and the designated representative, which specifies the duration of the bed hold policy described in subparagraph (i) of this paragraph.
(iii) A nursing home shall establish and follow a written policy under which a resident whose hospitalization or therapeutic leave exceeds the bed hold period is readmitted to the facility immediately upon the first availability of a bed in a semi-private room if the resident:
(a) requires the services provided by the facility; and
(b) is eligible for Medicaid nursing home services.
(iv) A nursing home shall establish and follow a written policy under which a resident who has resided in the nursing home for 30 days or more and who has been hospitalized or who has been transferred or discharged on therapeutic leave without being given a bed-hold is readmitted to the facility immediately upon the first availability of a bed in a semi-private room if the resident:
(a) requires the services provided by the facility; and
(b) is eligible for Medicaid nursing home services.
(4) With regard to the assurance of equal access to quality care, the facility shall establish and maintain identical policies and practices regarding transfer, discharge and the provision of all required services for all individuals regardless of source of payment.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.309 Sinking fund
See retirement of indebtedness funds.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
INSECT AND RODENT CONTROL INSECT AND RODENT CONTROL
10 CRR-NY 14-4.160 Insect and rodent control
The interior of pushcarts and mobile food service establishments are to be free of insects, rodents, harborage, and insect or rodent breeding conditions. Openings to the outside are to be protected against the entrance of insects and rodents. Pesticides are not to be used in place of or as a substitute for proper sanitation.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 360 SURGE AND FLEX HEALTH COORDINATION SYSTEM ACTIVATION DURING A STATE DISASTER EMERGENCY DECLARATION
10 CRR-NY 360.2 Surge and Flex Health Care Coordination System requirements
(a) In the event of a declared State disaster emergency, the commissioner shall have all necessary authority to activate the Surge and Flex Health Care Coordination System (hereinafter Surge and Flex System), including the following:
(1) Increase bed capacity.
At the commissioner’s direction, health care facilities shall increase by at least 50 percent and up to 100 percent the number of acute care beds and/or change the service categories of beds certified or otherwise approved in any entity regulated by the department. At the commissioner’s direction, health care facilities shall postpone all non-essential elective procedures or allow such procedures only pursuant to such conditions as the commissioner may determine. The department shall approve temporary changes at regulated health care facilities to physical plants, to facilitate the increased capacity and shall expedite review of construction applications related to temporary locations, provided that schematics are filed with the department and patient safety is maintained.
(2) Enhanced staffing capacity.
Health care facilities shall establish plans to meet enhanced staffing levels sufficient to ensure that the increased bed capacity has adequate staffing. The commissioner may further expand or modify criteria for staffing. Health care facilities shall have access to a State-run portal for staffing needs identifying both volunteers and available staff; whether licensed or registered in New York State, or authorized or licensed to practice in any other state or Canada.
(3) Availability of supplies and PPE.
Health care facilities shall maintain and actively manage a supply of personal protective equipment (PPE) appropriate for use during a declared health emergency that could last at least 90 days pursuant to this section and section 405.11(g) of this Title. The commissioner shall have all necessary authority to re-distribute the resources of a regulated entity if there is a determination that such resources are limited and in order to preserve the health and safety of New Yorkers, including:
(i) requiring that any medical or other equipment that is held in inventory by any entity in the State, or otherwise located in the State, be reported to the department, in a form and with such frequency as the commissioner may determine, but at minimum every 24 hours;
(ii) requiring that the patient census be reported to the department, in a form and with such frequency as the commissioner may determine, but at minimum every 24 hours;
(iii) for any infectious and communicable disease, ensuring that testing results are reported immediately if positive, and four times per day if such testing results are negative via the electronic clinical laboratory reporting system, or any other form and frequency as the commissioner may determine;
(iv) suspending or restricting visitation, in accordance with the need to conserve PPE, and subject to such conditions or limitations as the commissioner may determine.
(4) Statewide coordination.
(i) Discharging, transfer, and receiving of patients. Health care facilities regulated by the department shall, if directed to do so by the commissioner, rapidly discharge, transfer, or receive patients, while protecting the health and safety of such patients and residents, and consistent with the Emergency Medical Treatment and Active Labor Act (EMTALA). The department shall coordinate with health care facilities to balance individual facility patient load, and may promulgate further directives to specify the method and manner of transfer or discharge.
(ii) Designating health care facilities as trauma centers. The department is authorized to designate an entity as a trauma center; extend or modify the period for which an entity may be designated as a trauma center; or modify the review team for assessment of a trauma center; or change the level of acuity designation or health services of a facility or other determination about patient care as appropriate, including restricting admission or treatment to patients with a particular diagnosis.
(iii) Maintaining a statewide health care data management system. Health care facilities or systems shall report as directed by the department any information necessary to implement the Surge and Flex System ( e.g. available hospital beds, equipment available and in use) and the department shall use that data in order to monitor, coordinate, and manage during the emergency.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.34 Stroke services
(a) Definitions.
The following terms when used in this section shall have the following meanings:
(1) Stroke patient means a patient exhibiting the signs and symptoms of a suspected stroke.
(2) Certifying organization means an accrediting organization approved by The Centers for Medicare and Medicaid Services (CMS), that has applied to the department and has been approved by the department to certify that a hospital meets the criteria to provide advanced stroke care.
(3) Certified stroke center means a general hospital that has successfully completed a stroke center certification with a certifying organization.
(4) Designated stroke center means a certified stroke center approved by the department to operate as a designated stroke center under this section.
(b) General provisions.
(1) General hospitals may choose to participate in the designated stroke center program under this section.
(2) Only a certified stroke center may apply for stroke center designation from the department.
(3) No hospital shall hold itself out to the public as having a stroke center designation unless it has a stroke center designation under this section.
(c) Certifying organization application.
Accrediting organizations may apply, in a format determined by the department, to be approved as certifying organizations. Upon review of the application, the department may approve certifying organizations to perform stroke center certification.
(d) Stroke center designation.
Hospitals seeking stroke center designation shall:
(1) Obtain and maintain continuous stroke center certification from a certifying organization. The department may participate in any onsite visits conducted by the certifying organization during certification and recertification.
(2) Submit an application to the department with a copy of the certifying organization’s certification and supporting documents. When determining whether to approve a certified stroke center as a designated stroke center, the department may take other criteria into consideration, including but not limited to investigations by Federal or State oversight agencies.
(e) Issuing authority.
The department shall make the final determination on all applications for stroke center designation. The department shall provide written notification to a hospital when an application for a stroke center designation is approved. If an application for stroke center designation is denied, the department shall provide written notification and a rationale for the denial, and shall allow additional opportunities for the hospital to apply for a stroke center designation.
(f) Withdrawal of stroke center designation.
(1) The department may withdraw a hospital’s stroke center designation upon notice to a designated stroke center if:
(i) the designated stroke center does not comply with State or Federal regulations relating to stroke centers;
(ii) the designated stroke center fails to comply with its certifying organization’s certification requirements and certification lapses;
(iii) the designated stroke center requests withdrawal of stroke center designation.
(2) Before withdrawing a stroke center designation pursuant to subparagraph (1)(i) or (ii) of this subdivision, the department shall provide the designated stroke center with a written notice containing a statement of deficiencies. If the designated stroke center fails to adopt a plan of correction acceptable to the department within 30 days, the department may withdraw the hospital’s stroke center designation.
(3) If a hospital no longer maintains stroke center designation, the hospital shall immediately notify affected parties and provide the department with a written plan describing specific measures it has taken to alter its arrangements and protocols under subdivision (i) of this section within 30 days of a withdrawal of stroke center designation.
(g) Transition period.
(1) Hospitals designated as stroke centers by the department prior to the effective date of this section shall have two years from the effective date of this section to initiate the stroke center certification process with a certifying organization approved by the department. The process is initiated when a hospital enters into a contractual agreement with a certifying organization. Once the hospital has entered into a contractual agreement with a certifying organization, the hospital shall have one year to complete the certification process.
(2) Any hospital that does not initiate the stroke center certification process with a certifying organization within two years of the effective date of this section shall no longer maintain a stroke center designation and may no longer hold themselves out as a designated stroke center.
(3) The Department may extend the transition period specified in paragraphs (1) and (2) of this subdivision as deemed necessary. The Department will notify all impacted hospitals of any decision to extend the transition period.
(h) Coordination agreement.
Designated stroke centers shall communicate and coordinate with one another to ensure appropriate access to care for stroke patients, in accordance with a written coordination agreement. The department may issue guidance to specify the provisions of coordination agreements. Designated stroke centers shall have policies and procedures in place for timely transfer and receipt of stroke patients to and from other hospitals consistent with section 405.19 of this Part. Transport of stroke patients to the appropriate receiving hospital shall be in accordance with State Emergency Medical Advisory Committee (SEMAC) approved EMS protocols developed and adopted pursuant to subdivision two of section 3002-a of the Public Health Law.
(i) Emergency medical services providers; assessment and transportation of stroke patients to designated stroke centers.
Designated stroke centers shall work with emergency medical services agencies to ensure that stroke center destination protocols are consistent with protocols adopted by the State Emergency Medical Advisory Committee, the State Emergency Medical Services Council (SEMSCO), the Regional Emergency Medical Advisory Committee (REMAC), and the Regional Emergency Medical Services Council (REMSCO).
(j) The department shall maintain and post on its public web page a list of designated stroke centers. The department shall notify the State EMS advisory bodies and EMS regions via established communication networks whenever there is a change to a hospital stroke center designation, including but not limited to a new designation or a withdrawal of designation.
(k) Reporting of data and quality of care initiatives.
(1) Each designated stroke center shall submit data, as requested by the department, that shall be sufficient to determine the performance of the hospital and the system of care on at least an annual basis and in a format determined by the department.
(2) The department shall define the data elements to be reported.
(3) Each designated stroke center shall conduct stroke quality improvement activities including, but not limited to:
(i) evaluation of the quality and appropriateness of care provided;
(ii) participation in regional and statewide quality improvement activities, including but not limited to activities conducted by the Regional Emergency Medical Advisory Committee, consistent with section 3006 of the Public Health Law;
(iii) analysis of data to identify opportunities for improvement; and
(iv) integration of these activities with the hospital’s quality assurance program, as required by section 405.6 of this Part.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.145 Funded debt
Debt evidenced by outstanding bonds or long-term notes.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.95 Commissaries
(a) All mobile food service establishments and pushcarts are to be serviced only at a commissary operated under a valid permit issued under Subpart 14-1 of this Part or operated under license or permit of an appropriate regulatory authority at a frequency necessary to maintain the sanitary conditions of the mobile unit or pushcart, and in any event at least daily for pushcarts and every 72 hours for mobile food service establishments.
(b) All food served by mobile food service establishments and pushcarts is to be obtained from its commissary or other source meeting the requirements of section 141.31 of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.5 Maximum fees
State aid for service rendered will not be paid in excess of the fees included in the schedule of maximum fees established by the State Department of Health.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.1 Purpose
The rules contained in this Subpart have been promulgated to provide protection for persons served by nonpublic water supplies, and to conform to the requirements of the County Law and the Town Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.140 Fund accounting
Maintenance of separate and/or group accounts for health facility resources according to spending objectives set by donors, other outside sources or the governing body.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-1.12 Charge for maintenance and treatment
The director shall, from time to time, determine what shall be the hourly, daily or weekly rate per patient for maintenance and treatment and, when such rate has been approved by the State Commissioner of Health, it shall be the basis of all charges for treatment, care and maintenance. In place of or in addition to the foregoing rates, the director may create special charge rates for persons admitted as part of a specific written research protocol.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.194 Listing of accounts
A systematically arranged list of accounts applicable to a specific concern, giving names and numbers. See also chart of accounts.
10 CRR-NY 441.244 Patient care services revenue
The hospital's full established charges for services rendered to patients regardless of amounts actually paid to the hospital by or in behalf of patients.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.1 Definitions
Except where different meanings are expressly specified, the terms used in this Part shall have the meanings set forth in Public Health Law, section 3302.
(a) Authorized practitioner and practitioner means practitioner as such term is defined in the Public Health Law, section 3302(28) and shall include certified nurse practitioners and licensed midwives certified by the Education Department to prescribe and administer drugs. The term shall also include registered physician’s assistants certified by the Education Department.
(b) GSA means the United States General Services Administration.
(c) Department means the Department of Health of the State of New York.
(d) Commissioner means the Commissioner of Health of the State of New York.
(e) Bureau of Narcotic Enforcement means the Bureau of Narcotic Enforcement of the Department of Health of the State of New York.
(f) Drug Enforcement Administration registration number means such number assigned by the Drug Enforcement Administration, United States Department of Justice, or its successor agency, to a practitioner, authorized practitioner, or any person authorized to manufacture, distribute, sell, dispense or administer controlled substances.
(g) Automated dispensing system means a system approved by the department that performs operations or activities, other than compounding or administration, relative to the storage, packaging, counting, labeling, and dispensing of controlled substances, and which collects, controls, and maintains all transaction information.
(h) Digital signature means a record created when a file is algorithmically transformed into a fixed length digest that is then encrypted using an asymmetric cryptographic private key associated with a digital certificate. The combination of the encryption and algorithm transformation ensure that the signer's identity and the integrity of the file can be confirmed.
(i) Electronic signature means the creation of an electronic identifier ( i.e. , an electronic sound, symbol, or process, attached to or logically associated with an electronic record and executed or adopted by a person with the intent to sign the record) in accordance with regulations of the commissioner and the Commissioner of Education.
(j) Written prescription , for the purposes of this Part, and issued in New York State, shall mean an official New York State prescription form.
(k) Compliance with the requirements of this Part does not alter the responsibilities of the practitioner, pharmacist or pharmacy to comply with any applicable Federal law or regulation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.22 Critical care and special care services
(a) General provisions.
Critical care and special care services are those services which are organized and provided for patients requiring care on a concentrated or continuous basis to meet special health care needs. Each service shall be provided with a concentration of professional staff and supportive services that are appropriate to the scope of services provided.
(1) The direction of each service, unless otherwise specified in this section, shall be provided by a designated member of the medical staff who has received special training and has demonstrated competence in the service related to the care provided.
(2) The provision of all critical care and special care services shall be in accordance with generally accepted standards of medical practice. The hospital shall ensure that written policies are developed by the medical staff and the nursing service and implemented for all special care and critical care services.
(i) The written policies and procedures shall be reviewed at least annually and revised as necessary and shall include at a minimum the following: infection control protocols, safety practices, admission/discharge protocols and an organized program for monitoring the quality and appropriateness of patient care, with identified problems reported to the hospital- wide quality assurance program and resolved.
(ii) The written protocols for patient admission to and discharge from a critical care or special care unit shall include:
(a) criteria for priority admissions;
(b) alternatives for providing specialized patient care to those patients who require such care but who, due to lack of space, or other specified reasons such as infection or contagious disease, are not eligible for admission according to unit policy; and
(c) guidelines for the timely transfer and referral of patients who require services that are not provided by the unit.
(3) Each critical care unit shall be organized as a physically and functionally distinct entity within the hospital.
(i) Access shall be controlled in order to regulate traffic, including visitors, in the interest of infection control.
(ii) Emergency equipment and an emergency cart within each unit shall contain appropriate drugs and equipment, as determined by the medical staff and pharmacy service.
(4) When critical or special care services are provided to pediatric patients, opportunities shall be provided for education, socialization, and play pertinent to the growth and development needs of these patients, unless medically contraindicated.
(b) Pediatric intensive care unit (PICU) services.
(1) Definitions.
(i) PICU. A PICU is a physically separate unit that provides intensive care to pediatric patients (infants, children and adolescents) who are critically ill or injured. A PICU must be staffed by qualified practitioners competent to care for critically ill or injured pediatric patients.
(ii) Qualified practitioner. Qualified practitioner as referred to in this section shall mean a practitioner functioning within his or her scope of practice according to State Education Law who meets the hospital’s criteria for competence, credentialing and privileging practitioners in the management of critically ill or injured pediatric patients.
(2) General.
(i) A PICU must be approved by the department. The governing body of a hospital that provides PICU services must develop written policies and procedures for operation of the PICU in accordance with generally accepted standards of medical care for critically ill or injured pediatric patients. The PICU shall:
(a) provide multidisciplinary definitive care for a wide range of complex, progressive, and rapidly changing medical, surgical, and traumatic disorders occurring in pediatric patients;
(b) have a minimum average annual pediatric patient number of 200/year;
(c) have age and size appropriate equipment available in the unit; and
(d) provide medical oversight for interhospital transfers of critically ill or injured patients during transfer to the receiving PICU.
(ii) Organization and direction. The PICU shall be directed by a board certified pediatric medical, surgical, or anesthesiology critical care/intensivist physician who shall be responsible for the organization and delivery of PICU care and has specialized training and demonstrated competence in pediatric critical care. Such physician in conjunction with the nursing leadership responsible for the PICU shall participate in administrative aspects of the PICU. Such responsibilities shall include development and annual review of PICU policies and procedures, oversight of patient care, quality improvement activities, and staff training and development.
(a) All hospitals with PICUs must have a physician, notwithstanding emergency department staffing, in-house 24 hours per day who is available to provide bedside care to patients in the PICU. Such physician shall be at least a post graduate year three in pediatrics or anesthesiology. This physician must be skilled in and be credentialed by the hospital to provide emergency care to critically ill or injured children.
(b) The PICU shall have, at a minimum, a physician at the level of post graduate year two or above and/or physician assistant and/or nurse practitioner with specialized training in pediatric critical/intensive care assigned to the unit 24 hours/day, 7 days/week with an attending pediatric, medical, surgical or anesthesiology critical care/intensivist available within 60 minutes.
(c) An attending pediatric medical, surgical, or anesthesiology critical care/intensivist physician shall be responsible for the oversight of patient care at all times.
(d) The PICU shall provide registered professional nursing staffing sufficient to meet critically ill or injured pediatric patient needs, ensure patient safety and provide quality care.
(e) PICU physician and nursing staff shall have successfully completed a course and be current in pediatric advanced life support (PALS) or have current equivalent training and/or experience to PALS.
(iii) Quality performance. The hospital shall have an organized quality assessment performance improvement (QAPI) program for PICU services. Such program shall require participation by all clinical members of the PICU team and include: monitoring of volume and outcomes, morbidity and all case mortality review, regular multidisciplinary conferences including all health professionals involved in the care of PICU patients.
(iv) Closure. Failure to meet one or more regulatory requirements or inactivity in a program for a period of 12 months or more may result in actions, including, but not limited to, the department’s withdrawal of approval for the hospital to serve as a PICU.
(v) Voluntary closure. The hospital must give written notification, including a closure plan acceptable to the department, at least 90 days prior to planned discontinuance of PICU services. No PICU shall discontinue operation without first obtaining written approval from the department.
(vi) Notification of significant changes. A hospital must notify the department in writing within seven days of any significant changes in its PICU services, including, but not limited to:
(a) any temporary or permanent suspension of services; or
(b) difficulty meeting staffing or workload requirements.
(c) [ Reserved ]
(d) Burn unit/center.
(1) Personnel and staffing.
(i) A burn unit/center shall designate a director who is a board-certified or board-admissible general or plastic surgeon with one additional year of specialized training in burn therapy or equivalent experience in burn patient care.
(ii) Staff for the burn unit/center shall include:
(a) a head nurse of the facility who is a registered professional nurse, with two years intensive care unit or equivalent training and a minimum of six months burn experience;
(b) one registered professional nurse for every two intensive care patients at all times;
(c) one registered professional nurse for every three nonintensive care patients at all times;
(d) on staff, or through formal arrangement, a physical therapist and occupational therapist with a minimum of three months training or six months experience in burn treatment available as needed;
(e) staff or through formal arrangement a registered dietician available as needed;
(f) on staff, or through formal arrangement, a medical social worker responsible for referral and follow-up care and individual and group counseling available as needed; and
(g) a psychologist and/or psychiatrist available as needed.
(iii) The burn unit/center shall be responsible for training facility staff and other personnel within the service area on emergency treatment procedures, assessment of total body surface area affected, and the classification of burns and triage protocols.
(2) Operation and service delivery.
(i) Each burn unit/center shall have a minimum of six beds.
(ii) Each burn unit/center shall treat a minimum of 50 patients with major burn injury to moderate uncomplicated burn injury per year.
(iii) The burn unit/center shall refer patients for whom there are no available beds to another burn unit/center which can provide the care needed.
(iv) Each burn unit/center shall have available, either through direct control or through a network of clearly identified relationships, a system of land and/or air transport which will bring severe burn victims to the unit/center.
(v) Each burn unit/center shall have a designated area for providing specialized intensive care and an operating room easily accessible within the hospital.
(vi) Reviews of each patient with major burn injury or moderate uncomplicated burn injury shall be undertaken on a weekly basis by the burn care team.
(e) Alternate level of care.
(1) Organization and staffing.
(i) Patients on each service of the hospital who have been assigned alternate level of care status shall be congregated on a single care unit when there are 10 or more such persons on the service. Patients for whom discharge is anticipated within 14 days and patients whose identified needs cannot be safely and effectively met on this unit need not be transferred to the congregate unit and shall not be counted in the 10-patient threshold.
(ii) If the hospital can demonstrate to the department that it can fully meet the needs of patients assigned alternate level of care status without congregating such patients, it may provide such services in accordance with a plan approved by the department in lieu of meeting the requirements of subparagraph (i) of this paragraph.
(iii) The hospital shall appoint a staff person who has administrative responsibility for the delivery of patient care services to patients assigned alternate level of care status and for the supervision of the services whether or not they are provided by congregate care units.
(iv) The appointed staff person shall monitor and evaluate the quality and appropriateness of care provided to alternate level of care patients and shall ensure that identified problems are resolved and are reported, as appropriate, to the hospital-wide quality assurance program.
(2) Delivery of services.
(i) The hospital shall provide each patient assigned to alternate level of care status care and services in accordance with a multidisciplinary assessment of needs in order to promote the patient's independence and health.
(a) A written individualized, comprehensive care plan based upon the patient's assessed needs shall include, but not be limited to:
(1) medical and nursing care;
(2) assistance and/or supervision, when required, with activities of daily living, such as toileting, feeding, ambulation, bathing including routine skin care, care of hair and nails, and oral hygiene;
(3) rehabilitation therapy services as the patient's needs indicate;
(4) an activities program appropriate to the needs and interests of each patient to sustain physical and psychosocial functioning; and
(5) other clinical care and supportive services to meet the needs of patients.
(b) The written individualized comprehensive care plan shall be developed and implemented by all of the qualified professionals whose services are required by the patient under the supervision and coordination of the patient's attending physician and with the involvement of the patient and the family to the extent possible, in accordance with the patient's wishes.
(c) The comprehensive care plan shall establish realistic and measurable goals for short- and long-term care needs, and shall identify the type, amount and frequency of care and services needed to maintain, restore and/or promote the patient's functioning and health within stated time frames for achievement.
(f) Acquired immune deficiency syndrome (AIDS) centers.
(1) Definition.
An AIDS center shall mean a hospital approved by the commissioner pursuant to Part 710 of this Title as a provider of designated, comprehensive and coordinated services for AIDS patients in accordance with the requirements of this section. These services shall include inpatient, outpatient, community and support services for the screening, diagnosis, treatment, care and follow-up of patients with AIDS.
(2) Administrative requirements.
The hospital shall ensure that:
(i) integrated and comprehensive services are provided onsite to include, as a minimum, the following:
(a) a designated patient care unit for AIDS patients, except that the commissioner may waive this requirement, under a plan acceptable to the commissioner for placing patients in other than a designated unit, if the AIDS center meets all other requirements of this section and the hospital can demonstrate:
(1) that it is unable, due to structural or space limitations, to place the AIDS patients in a designated unit; or
(2) specific programmatic or operational reasons why it is preferable not to use a designated unit or not practicable to have a designated unit for AIDS patients;
(b) an outpatient clinic program for screening, diagnostic and treatment services for AIDS patients; and
(c) emergency services, available 24 hours a day, for treatment of AIDS patients;
(ii) other health care services, as appropriate, are provided directly or through contract for AIDS patients, to include at least the following:
(a) home health care, provided through a home care services agency licensed or certified under article 36 of the Public Health Law, made available 24 hours a day, 7 days a week; and
(b) personal care services;
(iii) all reasonable efforts are made to provide or arrange for the following services and programs to meet the needs of the AIDS patients:
(a) residential health care;
(b) hospice services provided through a hospice certified under article 40 of the Public Health Law; and
(c) residential living programs;
(iv) diagnostic and therapeutic radiology services and other specialized services are made available to meet the needs of AIDS patients;
(v) inservice education programs which address the medical, psychological and social needs specific to AIDS patients are conducted for all hospital personnel caring for AIDS inpatients;
(vi) infection control policies and procedures pertinent to AIDS are developed and implemented as an integral part of the hospital-wide infection control program;
(vii) a quality assurance program, which includes a review of the appropriateness of care for patients with AIDS, is developed and implemented as an integral part of the overall quality assurance program;
(viii) at the request of the department, it shall participate in clinical research programs approved by the hospital's institutional review board/human research review committee;
(ix) resource information about AIDS shall be available to the public, and educational programs are provided for particular high-risk populations in their service area; and
(x) a crisis intervention program shall be made available in coordination with other existing community services.
(3) Patient referral, admission and discharge.
The hospital shall ensure that:
(i) policies and procedures are developed and implemented which address admission criteria for AIDS patients, referral mechanisms and coordinated discharge planning;
(ii) only patients who meet the admission criteria for AIDS are admitted to the designated patient care unit;
(iii) services which the center provide are available to all persons regardless of age, race, color, creed, sex, sexual orientation, disability, national origin or ability to pay;
(iv) there are transfer agreements in effect with other hospitals in accordance with section 400.9 of this Title for the acceptance of referrals or the transfer of AIDS patients in need of specialized services available at the center; and
(v) professional staff responsible for planning patient discharges, referrals or transfers shall have available current information regarding home care programs, institutional health care providers and other support services within the hospital's primary service area.
(4) Patient management plan.
The hospital shall ensure that:
(i) a multidisciplinary team, whose composition reflects inpatient and outpatient care services, operating in conjunction with the attending physician:
(a) shall be responsible for each AIDS patient;
(b) shall include, as appropriate to the needs of the AIDS patient, health care professionals from nursing, nutritional, mental health and social work services; and
(c) whenever practicable, the AIDS patient is assigned to the same multidisciplinary team;
(ii) a comprehensive patient management plan is developed by the multidisciplinary professional team, the patient, and when appropriate, home health care or other nonacute long-term care representatives, in consultation with the patient's family and other individuals with significant personal ties to the patients, which:
(a) shall reflect the ongoing psychological, social, functional and financial needs of the patient and is oriented to posthospital, ambulatory care and community support services;
(b) shall be based on the patient's illness, prescribed treatments and the individual patient's needs and choices;
(c) shall be reviewed and updated to reflect the patient's changing needs and current status;
(d) shall include transfer or discharge and follow-up plans coordinated by the multidisciplinary team or the case manager;
(e) shall be forwarded with the patient upon discharge or transfer for posthospital care; and
(f) shall evaluate the extent to which the patient or patient's personal support system can provide or arrange to provide for identified care needs of the patient in the home situation;
(iii) a case manager shall be designated from the multidisciplinary team to be responsible for coordinating the health care services and plan for each AIDS patient; and
(iv) a mechanism shall be established to assure periodic reviews and updates of the patient management plan in conjunction with other agencies involved with, or responsible for, the care of the AIDS patient.
(5) Medical director.
The hospital shall appoint a physician who:
(i) shall be a qualified physician with special training in infectious diseases, oncology or other appropriate subspecialty;
(ii) shall direct and coordinate all medical services provided in the AIDS center;
(iii) shall ensure the implementation of the quality assurance program as specified in subparagraph (2)(vii) of this subdivision;
(iv) shall ensure that all members of the health care team participate in the quality assurance program;
(v) shall ensure that interdisciplinary rounds that include the health care professionals responsible for the patient's total care are made on a timely and sufficiently frequent basis as determined by each patient's needs;
(vi) shall ensure that other qualified physician specialists are available for consultation as indicated by the patient's condition; and
(vii) shall ensure that routine dental services are available for AIDS patients.
(6) Quality assurance monitoring.
(i) The commissioner shall monitor and evaluate the quality and appropriateness of care provided to AIDS patients by the AIDS center through mechanisms which include, but are not limited to, the monitoring and evaluation of patient management plans, utilization reviews and quality assurance programs.
(ii) The department and its AIDS Institute shall develop criteria for assessing the effectiveness of AIDS centers in providing care that meets the special needs of AIDS patients.
(7) Construction requirements.
The designated patient care unit shall be a discrete unit which complies with the requirements of section 712.2 of this Title, except as modified by the following:
(i) maximum patient room capacity shall be two beds, except that more than two beds per room may be allowed under a protocol based on patient diagnosis and approved by the commissioner;
(ii) patient room temperature shall be capable of being maintained between 70 and 80°F. Individual room air-conditioning units may be used; and
(iii) each patient care unit shall have at least one functional dayroom with space commensurate with the needs of the patients.
(g) Comprehensive and extended screening and monitoring services for epilepsy.
(1) Definition.
Comprehensive and extended screening and monitoring services for epilepsy shall mean a planned combination of services including inpatient and outpatient care which shall include, but not be limited to: electroencephalographic monitoring, selection of appropriate anticonvulsant medication through neuropharmacological monitoring, surgical interventions, if indicated, and management of a patient's psychological and social needs through a coordinated interdisciplinary team approach. For purposes of this section, extended screening and monitoring services are considered rehabilitative care.
(2) Comprehensive and extended screening and monitoring services for epilepsy shall be provided in a hospital approved by the commissioner pursuant to Part 710 of this Title as a provider of such services. The purpose of these services is to treat and rehabilitate patients with uncontrolled seizures in order to restore and promote them to their optimal level of functioning.
(3) Administrative requirements.
The hospital shall ensure that:
(i) policies and procedures be developed and implemented which address the provision and coordination of care between the inpatient unit and the outpatient unit for comprehensive and extended screening and monitoring services for patients with epilepsy;
(ii) a physician is appointed to direct the service, who is a qualified neurologist and who has demonstrated competence in the services and care provided to patients with epilepsy;
(iii) an interdisciplinary team of health care professionals with training and experience in the treatment of epilepsy shall be responsible for assessing patients and planning, providing and coordinating care. The interdisciplinary team shall include as a minimum the following types of health care professionals: neurologist, neurosurgeon, registered professional nurse, pharmacist, psychiatrist with training in neuropsychiatry, psychologist with training in neuropsychology, social worker, dietician, physical therapy, occupational therapist, and dentist;
(iv) consultative services of a neurologist with experience in pediatrics shall be made available as needed;
(v) the service shall provide or make formal arrangements for vocational rehabilitation services and special education services for patients who can benefit from such services;
(vi) comprehensive and extended screening and monitoring services for epilepsy shall include clinical services with staff specialized in electroencephalography, cable telemetry and neuropharmacological monitoring of anticonvulsant drugs; and
(vii) as part of the hospital's quality assurance program, the comprehensive epilepsy service shall implement a system for evaluating the quality and appropriateness of patient care and patient outcomes. Reports summarizing the outcomes from the quality assurance program for these services shall be submitted to the department on an annual basis.
(h) Pediatric and maternal human immunodeficiency virus (HIV) services.
(1) Applicability.
(i) AIDS centers designated in accordance with subdivision (g) of this section which have pediatric and/or maternity services shall provide specialized services for infants, children, adolescents, and pregnant women who are infected with human immunodeficiency virus (HIV) or who are HIV antibody positive and comply with the pertinent provisions of this subdivision as well as those in subdivision (g).
(ii) Hospitals not designated as AIDS centers in accordance with subdivision (g) may be approved to provide specialized services for infants, children, adolescents, and pregnant women who are infected with human immunodeficiency virus (HIV) or who are antibody positive, if the hospital:
(a) is in an area of high prevalence of HIV infection in children and women as evidenced by the hospital's newborn HIV seropositivity rate and the hospital's discharge rate for pediatric and maternal HIV related disorders;
(b) provided care in the past to pediatric and maternal HIV patients;
(c) demonstrates that it is unable to meet the requirements for full designation under subdivision (g) of this section; and
(d) complies with the requirements of this subdivision and subdivision (g) of this section, except for the definition of AIDS center in paragraph (g)(1) and except for the administrative requirement regarding designated patient care units in clause (g)(2)(i)( a ).
(iii) A patient shall be eligible for services if the patient is an infant, child, adolescent or a pregnant woman who is infected with HIV or is HIV antibody positive, whether or not the patient has progressed to symptomatic HIV related illness.
(iv) For purposes of these regulations, family shall include the patient's immediate kin, legal guardian or anyone with significant personal ties to and who resides with the patient.
(2) Organization of services.
The hospital shall ensure that:
(i) patients who require HIV related services are identified and referred for care by the pediatric and maternal HIV services;
(ii) obstetrical, pediatric and medical services develop and implement procedures to coordinate the clinical care of pediatric and maternal HIV patients to ensure the voluntary identification of potentially affected patients and family members and the delivery of appropriate services;
(iii) an organizational plan and policies and procedures are developed and implemented which address interdepartmental relationships and communications between the pediatric and maternal HIV services;
(iv) patient care services are provided through a coordinated interdisciplinary team approach. Inpatient and outpatient services shall be organized to preclude unnecessary hospitalization and to ensure continuity of care. A member of the interdisciplinary team managing the patient shall be designated as the individual patient's and family's case manager and shall be responsible for serving as a liaison among patient, family, staff and resources in the community and responsible for coordinating the comprehensive family management plan;
(v) services are family-centered and, in addition to the inpatient services, include the following ambulatory care and community support services: dental, substance abuse treatment, family planning, infusion therapy, mental health, neurodevelopmental evaluation, nutrition, rehabilitation therapies, prenatal care and primary care services;
(vi) other health and related human services are provided or arranged for as appropriate to meet the personal, social, educational, developmental and financial needs of these patients, including as a minimum:
(a) personal services such as caregiver support, day care, homemaker, housekeeper, transitional residential living programs, respite and transportation to and from needed services;
(b) referral for legal services as appropriate to the needs of the patient;
(c) identification and referral of children and adolescents in need of foster care and adoption services;
(d) financial services such as emergency support, food stamps, housing assistance, medical assistance, public assistance, Social Security Disability, Supplemental Security Income and Special Supplemental Food Program for Women, Infants and Children; and
(e) education and developmental services such as early intervention and therapeutic day care services;
(vii) a comprehensive family management plan is developed and implemented to address the medical, nursing, nutritional, functional, developmental, educational, psychological, social and financial needs of the patient and family, which plan:
(a) integrates the patient management plans as specified in subdivision (g) of this section with plans addressing the needs of the family; and
(b) documents the assessment and the monitoring of the patient's and family's needs with reassessment as necessary.
(3) Patient referral, admission and discharge.
The hospital shall ensure that:
(i) services begin at the time of the patient's entry into the pediatric and maternal HIV service program and continue until the patient chooses not to participate in the pediatric and maternal HIV service; or relocates outside the pediatric and maternal HIV service catchment area; or transfers to another AIDS center or pediatric and maternal HIV service; or expires;
(ii) admission criteria include provisions for the assignment of pediatric and adolescent patients to a unit appropriate for the developmental needs of the patient; and
(iii) written policies and procedures are established and implemented for the pediatric and maternal HIV service to include voluntary HIV counseling and testing.
(i) Secure units for tuberculosis patients including detainees.
(1) Definition.
Secure unit for tuberculosis patients including detainees shall mean a designated patient care unit specifically designed to treat patients who have been diagnosed with active tuberculosis. Hospitals shall provide such patients with safe and adequate care within such unit in accordance with procedures approved by the commissioner. Patients eligible for admission to such units shall include:
(i) patients who have been found to be noncompliant with medical regimens and legally remanded to such unit who shall receive priority admission to and retention in such unit. The rights of such patients to leave such units shall be restricted in accordance with the order legally remanding them to such units; and
(ii) other patients requiring acute care for active tuberculosis but not legally remanded for treatment, including intensified treatment for those individuals with multiple drug resistant tuberculosis. Such patients shall retain rights to voluntary egress from and entrance to such units in accordance with generally accepted medical practice and consistent with the rights of patients in other units of the hospital.
(2) Staffing and operation.
A secure unit for tuberculosis patients including detainees shall:
(i) maintain staff that are adequate in number and trained, including continuing education and inservice training, to perform all necessary activities related to the treatment and care of such patients with tuberculosis;
(ii) implement procedures to identify, diagnose and treat patients who exhibit signs and symptoms of infectious disease including the use of appropriate isolation practices;
(iii) consist of an environmentally sound physical plant in accordance with current, generally accepted standards of infection control practices specifically relating to tuberculosis. Such practices shall address ventilation, air dilution, and the provision of adequate and appropriate isolation facilities; and
(iv) provide adequate and effective personal protective devices to any persons at risk of exposure to infectious tuberculosis. Such protective devices shall be utilized and monitored through a respiratory program which shall ensure training, proper use and/or fit of such appropriate devices in accordance with generally accepted standards of practice.
(3) Approval.
Hospitals wishing to operate secure units for tuberculosis patients including detainees, for which construction approval pursuant to Part 710 of this Title is not otherwise required, shall apply to the Commissioner of Health for approval to operate such units pursuant to section 710.1(c)(5) of such Part specifically requiring a limited review.
(j) Tuberculosis treatment center—for legally detained tuberculosis patients.
(1) Definition.
Tuberculosis treatment center for legally detained tuberculosis patients shall mean a designated patient unit or site specifically designed to treat and contain those patients who have been remanded pursuant to applicable statute, for treatment, care, and observation for active tuberculosis. Hospitals shall be equipped and staffed with safeguards approved by the commissioner as adequate to contain these patients and prevent elopement or escape.
(2) Admission, transfer and discharge.
(i) Patients shall be admitted to such center only when:
(a) such patients require a reduced level of medical care with such care needs expected to continue for an extended period of time;
(b) such patients do not require the greater intensity of services provided by a secure unit for tuberculosis patients as defined in subdivision (j) of this section; and
(c) such center has the capability to meet the ongoing medical, nursing and psycho-social needs of the patient.
(ii) Patients shall be transferred from such center to a secure unit for tuberculosis patients at a hospital operating such unit when:
(a) a change in the patient's medical condition necessitates movement to a unit providing more intense services;
(b) security for the legally remanded patient during transfer can be assured; and
(c) the patient and the patient's designated representative have been notified of the pending transfer. Such notification shall be given as soon as possible after the need for transfer has been documented.
(iii) Patients shall be discharged from such center only when treatment goals have been met in accordance with the order legally remanding them to the center.
(3) Staffing and operation. A tuberculosis treatment center for legally detained tuberculosis patients shall:
(i) maintain staff that are adequate in number and qualifications to perform all necessary activities related to the care and treatment of such patients with active tuberculosis. The staff shall be from those disciplines that provide the training necessary to meet the medical/nursing and psycho-social aspects of the care necessary for these patients;
(ii) implement procedures to diagnose, treat and monitor patients who exhibit signs and symptoms of infectious disease, including the use of appropriate isolation practices;
(iii) consist of an environmentally sound physical plant in accordance with current, generally acceptable standards of infection control specifically relating to tuberculosis. Such plant design shall include adequate dilutional ventilation, safe exhaust/discharge of potentially contaminated air, and the provision of adequate isolation facilities with appropriate directional air flow;
(iv) provide adequate and effective security control systems which will safely contain the legally detained patient and prevent elopement or escape of such patient;
(v) provide adequate and effective personal protective devices to any persons at risk of exposure to an infectious tuberculosis patient. Such protective devices shall be utilized and monitored through a respiratory program which shall adequately train individuals in the proper use and/or fit of such appropriate devices in accordance with generally accepted standards of practice;
(vi) monitor employees for tuberculosis infection on an ongoing basis and review aggregate results of such monitoring; and
(vii) monitor environmental controls to ensure proper functioning.
(4) Approval. Hospitals wishing to operate a tuberculosis treatment center for legally detained tuberculosis patients for which construction approval pursuant to Part 710 of this Title is not otherwise required, shall apply to the Commissioner of Health for approval to operate such centers pursuant to section 710.1(c)(5) of such Part, which provides for a limited review.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.2 Application for admission
(a) Applications for admission to New York State veterans homes shall be made on forms provided by the department, and such applications shall be presented to the board of visitors and accepted, rejected or otherwise acted upon by them according to this Subpart and the provisions of the Public Health Law.
(b) Each applicant for admission shall furnish a certification of all property of which he or she is possessed and of all sources of income. Following admission, each resident shall be required to furnish further certification as to such facts annually.
(c) Each application for admission shall be accompanied by a report of a recent medical examination and by the certification of a physician designated or approved by the department that the applicant requires either skilled nursing care or health-related care. The medical report shall be reviewed by the medical staff to determine, on the basis of such report, whether the applicant's physical condition appears to be such that he or she requires care in the skilled nursing facility or the health-related facility, as the case may be.
(d) Preference in admissions to those otherwise qualified shall be given to those in the greatest need for the services available at the facility within the preferences established by article 26-A of the Public Health Law; otherwise, so far as practicable, applicants shall be admitted in the order determined by the date of the application.
(e) Residents may be discharged from the facility when the resident's need for care has ended and the director of the home can find a setting for the resident where his or her health care and other needs can be met. A resident admitted prior to October 1, 1989 may remain even though his or her condition improves and he or she no longer requires skilled nursing or health related facility care.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 440 APPLICABILITY AND PURPOSE
10 CRR-NY 440.1 Applicability
(a) This Article is applicable to all medical facilities covered by the term general hospital as defined in article 28, section 2801, subdivision 11 of the Public Health Law.
(b) The term general hospital means a hospital engaged in providing medical or medical and surgical services primarily to inpatients, by or under the supervision of a physician, on a 24-hour basis, with provisions for admission or treatment of persons in need of emergency care, and with an organized medical staff and nursing service, including facilities providing services relating to particular diseases, injuries, conditions or deformities. The term general hospital shall not include a residential health care facility, public health center, diagnostic center, treatment center, outpatient lodge, dispensary and laboratory or central service facility serving more than one institution.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.11 Laboratory tests to be performed prior to tissue transplantation
The tissue transplantation service shall culture the corneal-scleral rim at the time of tissue transplantation for aerobic and anaerobic bacterial contamination.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.17 Allowable costs
(a) To be considered as allowable in determining reimbursement rates, costs shall be properly chargeable to necessary patient care. Except as otherwise provided in this Subpart, or in accordance with specific determination by the commissioner, allowable costs shall be determined by the application of the principles of reimbursement developed for determining payments under title XVIII of the Federal Social Security Act (Medicare) program.
(b) Allowable costs shall include a monetary value assigned to services provided by religious orders and for services rendered by an owner and operator of a LTHHCP.
(c) Allowable costs shall not include amounts in excess of reasonable or maximum title XVIII of the Federal Social Security Act (Medicare) costs or in excess of customary charges to the general public. This provision shall not apply to services furnished by public providers free of charge or at a nominal fee.
(d) Allowable costs shall not include expenses or portions of expenses reported by individual LTHHCP which are determined by the commissioner not to be reasonably related to the efficient production of long-term home health care services because of either the nature or the amount of the particular item.
(e) Allowable costs shall not include costs not properly related to patient care or treatment which principally afford diversion, entertainment or amusement to owners, operators or employees of LTHHCPs.
(f) Allowable costs shall not include any interest charged related to rate determination or penalty imposed by governmental agencies or courts, and the costs of policies obtained solely to insure against the imposition of such a penalty.
(g) Allowable costs shall not include costs of contributions or other payments to political parties, candidates or organizations.
(h) Allowable costs shall include only that portion of the dues paid to any professional association which has been demonstrated, to the satisfaction of the commissioner, to be allocable to expenditures other than for public relations advertising or political contributions.
(i) Allowable costs shall not include the interest paid to a lender related through control, ownership, affiliation, or personal relationship to the borrower, except in instances where the prior approval of the Commissioner of Health has been obtained.
(j) Allowable costs shall be reduced by income earned for Medicare Part B eligible services.
(k) Allowable costs shall include those costs allocated to the LTHHCP from a related organization to the extent that:
(1) those costs are reasonably related to the efficient production of long-term home health care services; and
(2) the bases of allocation of such costs are consistent with regulations applicable to the cost reporting of the related organization.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.4 General requirements
(a)
(1) Each provider shall assure that criminal history information is requested, received, reviewed, and acted upon in a timely manner. Each provider shall designate one authorized person or, when necessary to assure compliance with this Part more authorized persons, and shall submit the name, position and contact information for each authorized person to the department in the form and format required by the department.
(2) A provider may request the designation of more authorized persons, as provided for in paragraph (1) of this subdivision, with the basis for such request. The department shall determine the reasonableness of such request weighing the need for maintaining confidentiality of the criminal history information against the provider's administration of criminal history record checks.
(b) Each provider shall develop and implement written policies and procedures related to conducting criminal history record checks. Such policies and procedures shall include criteria for:
(1) determining whether a particular prospective employee is subject to a criminal history record check;
(2) protecting the safety of persons receiving services from temporary employees as follows:
(i) residential health care facilities shall ensure that temporary employees do not have unsupervised physical contact with patients, by utilizing a person employed by the provider on the same nursing unit as the temporary employee but such person employed by the provider need not be employed in the same department as the temporary employee. Such person must know the identity and assignment of each temporary employee so supervised in the residential health care facility at all times. Supervision must be documented in writing on a weekly basis and maintained in the temporary employee's personnel folder;
(ii) certified home health agencies, licensed home care service agencies, and long term home health care programs shall provide appropriate direct observation and evaluation of the temporary employee by utilizing an individual employed by such provider with a minimum of one year's experience working in a provider certified, licensed or approved under article 36 of the Public Health Law. Such observation and evaluation shall occur on a weekly basis provided, however, that such direct observation and evaluation shall occur on-site in the home the first week by a licensed health care professional, senior aide or other paraprofessional who meets the one year requirement of employment in home care and at least once every other week thereafter by an individual meeting the minimum one year experience as set forth in this subparagraph. On alternate weeks direct observation and evaluation may be on-site in the home or by phone call to the patient or the patient's representative. The results of such observations shall be documented in the temporary employee's personnel file and shall be maintained;
(iii) if the temporary employee is working under contract with another provider certified, licensed or approved under article 36 of the Public Health Law, such contract provider's appropriate direct observation and evaluation of the temporary employee, as described in this subparagraph, shall be considered sufficient for the purposes of complying with this paragraph. The results of such observations shall be documented in the temporary employee's personnel file and shall be maintained;
(iv) Adult homes, enriched housing programs, and residences for adults shall provide appropriate direct observation and evaluation of the temporary employee by utilizing an individual employed by the provider to conduct on-site supervision. Such individual must know the identity and assignment of each temporary employee so supervised in the adult home, enriched housing program, or residence for adults at all times. Supervision must be documented in writing on a weekly basis and maintained in the temporary employee’s personnel folder.
(v) Hospice programs certified under article 40 of the Public Health Law shall provide appropriate direct observation and evaluation of the temporary employee by utilizing an individual employed by such provider with a minimum of one year's experience working for a provider certified, licensed or approved under article 40 the Public Health Law or through a contract with another provider certified, licensed or approved under article 36 of the Public Health Law. Such observation and evaluation shall occur on a weekly basis provided, however, that such direct observation and evaluation shall occur on-site in the home the first week by a licensed health care professional, senior aide or other paraprofessional who meets the one year requirement of employment in home care or hospice and at least once every other week thereafter by an individual meeting the minimum one year experience as set forth in this subparagraph. On alternate weeks direct observation and evaluation may be on-site in the home or by phone call to the patient or the patient’s representative. The results of such observations shall be documented in the temporary employee’s personnel file and shall be maintained.
(3) providing notice to the department when a person ceases to be a subject individual since the person is no longer employed or used by the provider or such person's job duties no longer meet the definition of employee set forth in section 402.3(i) of this Part to provide direct care or supervision to patients, residents, or clients of the provider in the form, format and manner required by the department.
(c) No person who has been fingerprinted pursuant to this Part, whose fingerprints remain on file with the division, shall be required to undergo fingerprinting for purposes of a new criminal history record check required by this Part.
(d) Nothing in this Part shall be construed or interpreted to in any way diminish the integrity of any collective bargaining agreement negotiated on or before April 1, 2005 between a provider and any certified or authorized collective bargaining agent for employees, or to diminish rights which accrue to such employees pursuant to such agreements.
(e) No provider shall seek, directly or indirectly, to obtain from a prospective employee, temporary employee or employee compensation in any form for the payment of the fees or any provider or facility costs associated with obtaining the criminal history record check required by this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
FISCAL RESPONSIBILITIES FISCAL RESPONSIBILITIES
10 CRR-NY 88-3.10 Guarantee of expense
Adequate guarantee of payment of the charges for hospitalization is required in each instance. This may consist of a statement of personal financial responsibility to be signed by the patient or a member of his family; or payment of charges incurred at the end of each treatment day in the case of outpatients; or financial coverage in appropriate form from another public agency, a recognized private or voluntary agency, or an insurance company.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.32 Nurse aide competency exam
(a) Definitions.
For purposes of this section, the following definitions shall apply:
(1) Rate shall mean the aggregate governmental payment to the facility per patient day as defined in section 86-2.8 of this Subpart.
(2) Nurse aide trainee shall mean a person as defined in section 414.1(b)(8) of this Title.
(3) Nurse aide shall mean a person as defined in section 414.1(b)(7) of this Title.
(4) Program coordinator shall mean a person as defined in section 414.1(b)(26) of this Title.
(5) Primary instructor shall mean a person as defined in section 414.1(b)(27) of this Title.
(6) Clinical skills evaluator shall mean a person as defined in section 414.1(b)(28) of this Title who is qualified to administer the clinical section of the nurse aide competency exam.
(7) The competency examination shall mean the clinical skills examination and the written or oral competency examination required of nurse aides by section 2803-j of the Public Health Law.
(b) For the rate period July 2, 1989 through June 30, 1990 an amount shall be added to each residential health care facility's rate to compensate facilities for the cost of the fees charged facilities for the nurse aide competency exam.
(c) The estimated initial amount added to each residential health care facility's rate shall be determined as follows:
(1) The percentage of the number of full time equivalent (FTE) nurse aides in each facility to the number of FTE nurse aides in all residential health care facilities shall be calculated.
(2) This percentage shall be applied to the estimated number of nurse aides working in all residential health care facilities.
(3) The product shall then be multiplied by the estimated cost of testing for each nurse aide.
(4) This amount shall be divided by the number of patient days in each residential health care facility, multiplied by two and then added to the residential health care facility's rate.
(d) The department shall determine the actual cost of the examination for each facility and adjust the estimated initial amount to the actual amount in a rate no later than July 1, 1990.
(e) The costs of the fees of the clinical skills evaluator and/or the program coordinator/primary instructor shall consist of the estimated training fee multiplied by three. Each residential health care facility shall receive this estimated amount in the manner described in paragraph (c)(4) of this section and the actual amount shall be determined and the rate adjusted not later than July 1, 1990.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 640 PROCEDURES FOR APPROVAL OF THE DEVELOPMENT OF COMPREHENSIVE HEALTH SERVICES AND THE ESTABLISHMENT OF SUCH FACILITIES
10 CRR-NY 640.4 Applications for establishment of comprehensive health services facilities
An applicant for approval of establishment to provide a comprehensive health services facility shall make application for the approval of the Public Health Council of such establishment in accordance with the provisions of Parts 600, 610, 620 and 630 of this Title, as applicable.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.16 Medical education
This functional reporting center must contain all expenses associated with organized medical education programs approved by the American Medical Association that provide medical clinical education to interns and residents. Additional activities include but are not limited to the following: providing services of interns and residents; selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling students regarding professional, personal and educational problems.
(a) Standard unit of measure: number of students.
Number of students in the program(s). This number should be appropriately weighted for students who are not in the program for the entire year, and for those who do not undertake a full workload as defined by the program.
(b) Data source.
The number of students shall be determined from the education department's records.
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.4 General requirements for operation
(a) An operator must:
(1) provide services to registrants consistent with the requirements of this Title and Part and other applicable statutes and regulations;
(2) provide appropriate staff, equipment, supplies and space as needed for the administration of the adult day health care program in accordance with the requirements of this Part; and
(3) provide each registrant with a copy of a bill of rights specific to operation of the adult day health care program. These rights include, but are not limited to:
(i) confidentiality, including confidential treatment of all registrant records;
(ii) freedom to voice grievances about care or treatment without discrimination or reprisal;
(iii) protection from physical and psychological abuse;
(iv) participation in developing the care plan;
(v) written notification by the program to the registrant at admission and following the continued-stay evaluation of the services the registrant shall receive while attending the adult day health care program; and
(vi) freedom to decide whether or not to participate in any given activity.
(b) Administration.
Without limiting its responsibility for the operation and management of the program, the operator must designate a person responsible for:
(1) coordinating services for registrants with services provided by community or other agency programs, including but not limited to certified home health agencies, social services agencies, clinics and hospital outpatient departments and services; provided, however, with respect to registrants referred to the adult day health care program by a managed long term care plan or care coordination model, the coordination of such services shall be the responsibility of the managed long term care plan or care coordination model; and
(2) day-to-day direction, management and administration of the adult day health care services, including but not limited to:
(i) assigning adequate and appropriately licensed personnel to be on-duty at all times when the program is in operation to ensure safe care of the registrants;
(ii) assigning and supervising activities of all personnel to ensure that registrants receive assistance in accordance with their plans of care;
(iii) ensuring supervision of direct care staff in accordance with State rules and regulation;
(iv) arranging for in-service orientation, training and staff development; and
(v) maintaining records in accordance with provisions of sections 400.2 and 415.3(d)(1) of this Title.
(c) Policies and procedures for service delivery.
The operator must:
(1) establish and implement written policies and procedures, consistent with the approved application for operation of the adult day health care program, concerning the rights and responsibilities of registrants, the program of services provided to registrants, use of physical structures and equipment, and the number and qualifications of staff members and their job classifications and descriptions;
(2) ensure that written policies and procedures, consistent with current professional standards of practice, are developed and implemented for each service and are reviewed and revised as necessary;
(3) develop protocols for each involved professional discipline to indicate when the service of such discipline should be included in the registrant assessment;
(4) ensure that professional personnel are fully informed of, and encouraged to refer registrants to, other health and social community resources that may be needed to maintain the registrant in the community; provided, however, with respect to registrants referred to the adult day health care program by a managed long term care plan or care coordination model, such referrals shall be the responsibility of the managed long term care plan or care coordination model;
(5) establish and implement written policies for the storage, cleaning and disinfection of medical supplies, equipment and appliances;
(6) establish and implement written policies and procedures concerning refunds and prepayment for basic services in accordance with existing rules and regulations;
(7) establish and implement written policies and procedures concerning transfer and affiliation agreements covering registrants that are consistent with the standards specified in section 400.9 of this Subchapter; and
(8) provide in such agreement(s) reasonable assurance of assistance to each registrant in transferring to inpatient or resident status in a residential health care facility whenever the registrant is deemed by a practitioner to be medically appropriate for such care.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.110 Notification by licensee
Persons licensed or certified pursuant to article 33 of the Public Health Law and persons authorized to possess controlled substances in connection with his authorized activities shall promptly notify the department of:
(a) each incident or alleged incident of theft, loss or possible diversion of controlled substances manufactured, ordered, distributed or possessed by such person; a form of this purpose furnished by the department shall be filed with the Bureau of Narcotic Enforcement, New York State Department of Health;
(b) any charge or proceeding brought in any court or before any governmental agency, State or Federal, in which it is alleged that the licensee, its employees, subsidiaries, managing officers, or directors has failed to comply with the provisions of the Federal Controlled Substances Act or the laws of any State relating to controlled substances.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-2 OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
10 CRR-NY 47-2.3 Amount of subsidy
(a) A new pediatric practitioner may receive a subsidy in an amount equal to his/her malpractice insurance premium for the contract period up to a maximum of $10,000.
(b) An additional service obstetric practitioner may receive a subsidy equal to the AOMP for each delivery to a member of the target population during the contract period above the number of deliveries of the target population performed during the calendar year prior to the date of original application, proportioned to the contract period. A maximum of $30,000 per year is allowed per obstetric practitioner in a solo or group practice who qualifies under section 47-2.2(b) of this Subpart which will be prorated for shorter contract periods. The number of deliveries performed by a group practice will be based on the total number performed by all practitioners in the group.
(c) A disproportionate share obstetric practitioner may receive a subsidy equal to the AOMP for each member of the target population delivered during the contract period over the minimum number of deliveries of the target population considered a disproportionate share, proportioned to the contract period. A maximum subsidy of $10,000 per year will be allowed per obstetric practitioner in a solo or group practice who qualifies under section 47-1.2(c) of this Part which will be prorated for shorter contract periods. The number of deliveries performed by a group practice will be based on the total number performed by all practitioners in the group.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.25 Intraoperative and postoperative blood recovery and normovolemic hemodilution
(a) Blood recovered intraoperatively or postoperatively from a person or collected for normovolemic hemodilution shall not be transfused into another person.
(b) Methods for intraoperative or postoperative recovery of blood and for normovolemic hemodilution shall be safe and aseptic, and shall ensure accurate identification of all blood collected. The equipment used shall be operated according to the manufacturer's instructions, shall be pyrogen-free, shall include a filter capable of retaining particles potentially harmful to the recipient, and shall prevent air embolism. If the blood is warmed prior to reinfusion, the warming system shall be equipped with a visible thermometer and an alarm to ensure that the blood is not warmed above the temperature specified in a written protocol, in conformance with the system manufacturer's instructions.
(c) A complete written protocol for collection and processing of recovered blood and for normovolemic hemodilution, approved by the director of transfusion services, shall be maintained and followed. The protocol shall include criteria for selection of suitable patients and determination of dosage of ancillary agents used, as well as procedures for prevention and management of adverse reactions.
(d) If recovered blood or blood collected for normovolemic hemodilution is removed from the immediate premises for processing or storage, identification procedures shall be in place to ensure its transfusion into the intended recipient.
(e) If not immediately transfused, recovered blood shall be stored under one of the following conditions:
(1) at one to 24 degrees Celsius for up to six hours after initiating the collection; or
(2) at one to six degrees Celsius under monitored conditions for up to 24 hours, provided that storage at one to six degrees Celsius is begun within six hours of initiating the collection and the blood is washed under sterile conditions.
(f) Blood collected for normovolemic hemodilution shall be stored under one of the following conditions prior to initiation of transfusion:
(1) at one to 24 degrees Celsius for up to eights hours after initiating the collection; or
(2) at one to six degrees Celsius under monitored conditions for up to 24 hours, provided storage at one to six degrees Celsius is begun within eight hours of initiating the collection.
(g) Untested recovered blood and blood collected for normovolemic hemodilution which are kept in the blood bank shall be stored in a specially designated area separate from other units and prominently labeled with the patient's name and a label "Caution: Untested Blood" or similar wording.
(h) Transfusion of blood recovered postoperatively or from post-traumatic patients shall commence within six hours of the initiation of the collection, or if not, the blood shall be discarded.
(i) All records of transfusions of blood recovered intraoperatively or postoperatively shall be available to the department for inspection for at least seven years after each transfusion. Summary records, listing the patient's name, the medical record number and procedures performed, shall be kept of all such procedures, separate from the patient's chart.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.25 Return on investment
(a) In computing the allowable costs of a proprietary facility, there shall be included an allowance for a reasonable return on the average equity capital representing the owner's investment for the provisions of patient care. The percentage to be used in computing the allowance shall be a rate determined annually by the commissioner to be reasonably related to the then current money market.
(b) Equity capital is the net worth of the provider adjusted for those assets and liabilities which are not related to the provision of patient care. Equity capital consists of the provider's investment in plant, property and equipment, net of depreciation and noncurrent debt related to the investment or deposited funds, and net working capital for necessary and proper operation of patient care activities.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.19 Limitations on application of radiation to humans.9
(a) Diagnostic X-ray equipment.
No person other than a professional practitioner, as defined in section 16.2(a)(85) of this Part; a physician's assistant working under the authority of a physician in accordance with article 37 of the Public Health Law; or, a certified nurse practitioner working in accordance with article 139 of the Education Law, within a practice agreement with a physician, or under the authority of a medical director or medical board in an article 28 facility, shall direct or order the application of radiation from radiation equipment, as defined in section 16.2(a)(97) of this Part, to a human being. No person other than a professional practitioner; as defined in section 16.2(a)(85) of this Part; or a licensed and registered radiologic technologist, or, student currently enrolled in an approved program of study in diagnostic radiologic technology, and under direct supervision by a professional practitioner or licensed radiologic technologist; shall position patients, set techniques or apply such radiation to a human being. Such direction or order to apply, or application of, radiation shall be in the course of the practitioner's professional practice and shall comply with the applicable provisions of Part, 89 of this Title and article 35 of the Public Health Law of the State of New York.
(1) Unlicensed dental assistants may operate dental radiographic equipment for intraoral and panographic dental X-ray procedures only under the supervision of a licensed dentist pursuant to the applicable provisions of section 89.45 of this Title and of paragraph (4) of subdivision (c) of section 3515 of the Public Health Law of the State of New York.
(b) X-ray therapy equipment.
No person other than a qualified physician shall direct or order the application of radiation from X-ray therapy equipment, as defined in paragraph (97) of section 16.2(a) of this Part to a human being. Nor shall any person other than a qualified physician, or a licensed and registered radiation therapist or a student currently enrolled in an approved program of study in radiation therapy technology, and under direct supervision of a qualified physician or licensed radiation therapist; position patients, set technique or apply radiation therapy to a human being. Such direction or order to apply, or application of, radiation shall be in compliance with the applicable provisions of Part 89 of this Title and article 35 of the Public Health Law.
(c) Radioactive materials.
No person other than a physician named in a license issued pursuant to section 16.100 of this Part, or a physician under his/her tutelage shall direct or order the use of radioactive materials specified in section 16.123(b)(1), (2), (3) and (4) of this Part, or in section 16.122 of this Part for human use; nor shall any person other than a physician, dentist, or podiatrist named in a license issued pursuant to section 16.100 of this Part direct or order the use of radioactive materials specified in section 16.123(b)(5) of this Part for human use; nor shall anyone other than these persons, or a person working under their direction or order, administer radioactive materials or the radiation therefrom to humans. Such direction or order, or administration of radioactive materials or radiation shall be in the course of the physician's, dentist's or podiatrist's practice and shall comply with the following:
(1) the provisions of the radioactive materials license issued pursuant to section 16.100 of this Part, and the provisions of the license or other authorization of the practitioner under the Education Law of the State of New York and all regulations pertinent thereto;
(2) the applicable provisions of Part 89 of this Title and article 35 of the Public Health Law of the State of New York; and
(3) the provisions of section 16.103(b) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 700 GENERAL
10 CRR-NY 700.3 Assessment of long-term care patients
(a)
(1) For patients who require placement or continued stay in a nursing home or health- related facility, the Hospital/Community PRI or the PRI shall be completed by a registered professional nurse who has successfully completed a training program in patient case mix assessment approved by the department to train individuals in the completing of the patient review form (PRI) as contained in section 86-2.30(i) of this Title, or the Hospital/Community patient review form (Hospital/Community PRI) as contained in section 400.13 of this Title. For patients who require placement or continued stay in a nursing home or a health-related facility, the SCREEN shall be completed by a professional with demonstrated skills in assessing psychosocial situations, including but not limited to social work and discharge planning professionals, who has successfully completed a training program in patient case mix screening approved by the department to train individuals in the completion of the patient screening form (SCREEN), as contained in section 400.12 of this Title; or
(2) Each general hospital shall have on staff trained and qualified screener(s) and assessor(s) in such numbers as specified in section 85.8(c)(1)(ii) of this Title, who shall be responsible for and attest to the accuracy of Hospital/Community PRI's, PRI's and SCREEN's as contained in sections 400.13, 86-2.30(i) and 400.12 of this Title, respectively. Each residential health care facility shall have on staff trained and qualified screener(s) and assessor(s) who shall be responsible for and attest to the accuracy of PRI's and SCREEN's.
(b) The commissioner may waive the requirements of this section or any part thereof for recognized demonstration projects to effect the development of additional knowledge and experience in different types of assessments for long-term care patients.
(c) The patient and/or the patient's designated representative shall be given an explanation of the information contained on the SCREEN, including the determination of setting for care for that particular patient.
(d) Residential health care facilities not participating in the Medicare and Medicaid programs (titles XVIII and XIX of the Federal Social Security Act) are required to complete the PRI and SCREEN forms for prior to admission and admission review purposes pursuant to sections 730.2(a), 740.2(b), 781.11(a) and 741.14(a) of this Title. The continued stay review requirements of sections 731.11(b), (f) and 741.14(b), (f) of this Title shall not apply. An alternate schedule for completion and submission of the forms may be established by the commissioner for such continued stay review requirements.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE OPERATION FOOD VENDING MACHINE OPERATION
10 CRR-NY 14-5.23 Definition of law
Law means and includes Federal, State and local statutes, ordinances and regulations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-1 NEW YORK STATE HEALTH SERVICE CORPS
10 CRR-NY 47-1.9 Administration
(a) Acceptance and service agreement.
Prior to being certified for payment, successful applicants must sign a written acceptance of the award and a service agreement describing the conditions of the award, the service obligation, and the terms of repayment.
(b) Disbursements and collections.
The Higher Education Services Corporation will be responsible for disbursements to or on behalf of the scholarship recipient. A State Health Service Corps recipient is required to comply with all administrative and reporting requirements established by the Higher Education Services Corporation.
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.1 Definitions
The following definitions shall apply to this Subchapter unless the context otherwise requires:
(a) Board means the Board of Examiners of Nursing Home Administrators as provided for in article 28-D of the Public Health Law.
(b) Department means the New York State Department of Health.
(c) Commissioner means the Commissioner of Health of the State of New York.
(d) Secretary means the officer or employee of the department designated by the commissioner to act as secretary to the board.
(e) Advisory council means the body broadly representative of the health professions and the public established by the commissioner pursuant to subdivision 8 of section 2896-a of the Public Health Law.
(f) Nursing home administrator means an individual who has fulfilled all of the requirements of and has been duly granted a license by the New York State Board of Examiners of Nursing Home Administrators.
(g) Nursing home means a facility issued an operating certificate as a nursing home pursuant to article 28 of the Public Health Law.
(h) License means certification of an applicant who has met the requirements of the law, rules and regulations entitling him to serve, act, practice and otherwise hold himself or herself out as a duly licensed nursing home administrator.
(i) Temporary license means a license issued by the board, under such conditions and limitations as it shall determine, for a single period not to exceed six months to an applicant of good moral character and suitability, over 21 years of age, who meets such other standards as are established by the board, who has paid the application fee as specified in Public Health Law article 28-D and who is designated by the owner, operator or other governing authority to administer a facility during a period when due to resignation, death or incapacity or for some other reason the position of nursing home administrator has been unexpectedly vacated. Such temporary licensee shall be subject to the supervision of a licensed and currently registered New York State nursing home administrator as determined by the board. This provision may not be used in conjunction with or to extend the provisions of section 415.26(a) of this Title permitting the facility to operate without a licensed and registered administrator for a period greater than six months.
(j) Practice of nursing home administration means planning, organizing, directing, managing the operation and implementing the policies of, a nursing home, including but not limited to making operating decisions, ensuring fiscal responsibility, providing general supervision, employing and discharging staff, programming, and ongoing evaluation of the care and services provided in the nursing home to ensure the health and safety of the residents, visitors and staff and, where appropriate, integrating the services of the nursing home with the community's health resources.
(k) Course of study in nursing home administration means a course or courses of study, including completion of a board approved Administrator-in-Training (AIT) Program or board approved alternative, in institutional administration approved by the board.
(l) Registration means the biennial registration as required by all licensed nursing home administrators pursuant to the provisions of codes, rules and regulations established by the board. Only licensed nursing home administrations with a current registration may practice nursing home administration.
(m) Unethical conduct, for the purpose of section 2897 of the Public Health Law, shall include, but not be limited to:
(1) violation of any of the provisions of law pertaining to the licensing and registration of nursing home administrators or the rules and regulations of the board pertaining thereto;
(2) violation of any of the provisions of law or codes, rules or regulations of the licensing authority or agency of the State having jurisdiction of the operation and licensing of nursing homes;
(3) conviction of a crime;
(4) practicing fraud, deceit or misrepresentation in securing or procuring a nursing home administrator license and registration;
(5) practicing fraud, deceit or misrepresentation in the capacity of a nursing home administrator;
(6) immoral conduct while engaged in the practice of nursing home administration; immoral behavior indicating an unfitness to practice nursing home administration; or immoral conduct permitted by a nursing home administrator in a nursing home under his/her supervision;
(7) willful falsification, destruction or theft of property or records related to the practice of nursing home administration;
(8) committing acts of misconduct in the operation of a nursing home;
(9) habitual drunkenness;
(10) addiction to the use of narcotic drugs;
(11) wrongfully transferring or surrendering possession, either temporarily or permanently, of a license or certificate as a nursing home administrator to any other person;
(12) being guilty of fraudulent, misleading or deceptive advertising;
(13) falsely impersonating another licensee of a like or different name;
(14) failure to exercise true regard for the safety, health and life of patients/residents;
(15) unauthorized disclosure of information relating to a patients/residents or his or her records; and
(16) unlawful discrimination in respect to patients/residents, employees or staff.
(n) Administrator of record (AOR) means the individual who is charged with and has responsibility for the general administration of a nursing home, whether or not such individual has an ownership interest in such home, and whether or not his or her function and duties are shared with one or more other individuals.
(1) Each nursing home must designate one New York State licensed and currently registered nursing home administrator as the facility AOR consistent with the requirements of section 415.26(a) of this Title.
(2) In the case of an acting administrator, appointed under the provisions of section 415.26(a)(3) of this Title, the AOR shall be the supervising administrator designated pursuant to such provisions.
(o) Qualifying field experience shall mean the verified full-time, minimum of 35 hours per week, service on the staff of a qualifying article 28 in-patient health care facility as defined by the board, in an administrative position within the five-year period preceding approval of the licensure application.
(1) Such experience must be obtained above the department head level but not above the AOR, requiring the candidate to actively participate in the day-to-day administration, direction, and operation of the facility at the facility level requiring the daily supervision of the department heads of multiple (two or more) major departments or services areas.
(2) The position must include substantial supervisory responsibilities for patient care and facility staff and be compensated at a salary commensurate with the level of responsibility claimed.
(3) At least one major department or service area must directly impact on the provision of patient care or services. Major department and services areas with direct impact on the provision of patient care or services as defined by the board for the purpose of licensure experience are:
(i) dietary/food services;
(ii) nursing services;
(iii) rehabilitation services (including all of physical therapy, occupational therapy, speech and audio therapy and recreational therapy); and
(iv) social services (including all of admissions, discharge planning and social service program).
(p) Active participation in the administration, direction and operation of a qualifying health care facility shall mean the daily participation in the management decisions that affect multiple (two or more) major departments or service areas as defined in this Part, within the facility and directly impacts the provision of care and services to the patients in the facility.
(q) Code of Ethics for New York State Nursing Home Administration shall mean the expectations of conduct for licensed nursing home administrators adopted by the board. The Code of Ethics should not be construed as all-encompassing or as denial of the existence of other responsibilities or practices.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 102 BROOME COUNTY
10 CRR-NY 102.2 Hillcrest Water District No. 1, town of Fenton
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land, owned by the Hillcrest Water District No. 1, and situated along the bank of the abandoned Chenango Canal in the western part of the district, which form the source of the public water supply of the Hillcrest Water District No. 1 of the town of Fenton, Broome County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface within 150 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well of the public water supply of the Hillcrest Water District No. 1, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any well of the public water supply of the Hillcrest Water District No. 1.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Hillcrest Water District No. 1, upon which any well of the public water supply of the Hillcrest Water District No. 1 is located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Hillcrest Water District No. 1.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Hillcrest Water District No. 1.
(j) Inspections.
The board of water commissioners of the Hillcrest Water District No. 1 or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Hillcrest Water District No. 1 or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being compiled with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination, is hereby fixed at $100.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 360 SURGE AND FLEX HEALTH COORDINATION SYSTEM ACTIVATION DURING A STATE DISASTER EMERGENCY DECLARATION
10 CRR-NY 360.4 Clinical laboratory testing
(a) In the event of a declared State disaster emergency, the commissioner shall have all necessary authority to:
(1) authorize clinical laboratories to operate temporary collecting stations to collect specimens from individuals.
(b) In addition, and to the extent consistent with any Executive Order issued by the Governor, the commissioner shall have all necessary authority to:
(1) waive permit requirements for clinical laboratories and establish minimum qualifications to allow non-permitted clinical laboratories to accept and test specimens from New York State, provided that such laboratories must meet any Federal requirements;
(2) establish minimum qualifications of individuals that may perform clinical laboratory tests, provided that such persons meet Federal requirements;
(3) allow clinical laboratories to accept specimens without an order, subject to a plan approved by commissioner to ensure the result of any tests are reported to the patient or the patient’s personal representative and there will be appropriate follow up with the patient based on the results;
(4) authorize licensed pharmacists to order clinical laboratory tests, consistent with Federal law, including certificate of waiver requirements;
(5) permit licensed pharmacists to be designated as qualified healthcare professionals for the purpose of directing a limited service laboratory, pursuant to section 579 of the Public Health Law;
(6) permit licensed pharmacists to order and administer clinical tests.
(c) Prioritization of clinical laboratory tests.
In the event the declared State disaster emergency requires utilization of clinical laboratory testing at a rate that exceeds available capacity, no laboratory shall perform such test unless the test has been ordered consistent with the testing prioritization published by the commissioner.
(d) Reporting of results of any communicable disease during a Surge and Flex period shall be made immediately via the Electronic Clinical Laboratory Reporting system, if positive, and on a schedule as determined by the commissioner if negative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.5 Hospital and related medical care
Reimbursement for inpatient and outpatient care rendered by hospitals and other facilities established pursuant to article 28 shall be made at rates not to exceed those established for patients eligible for medical assistance (Medicaid).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 408 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS (CSFRHN)
10 CRR-NY 408.2 Network operational plans (NOP)
(a) Network operational plan shall mean a written plan, including periodic updates of such a plan, prepared by a CSFRHN, with the involvement of consumers unaffiliated with health care providers, describing the steps to be taken by such network and its participating providers to enhance access, by residents of the affected rural area, including special populations, to necessary health care services while promoting cost efficiencies in the provision of services.
(b) The commissioner shall not approve a network operational plan until he/she has considered the recommendations of the HSA(s) having jurisdiction in the region in which the network intends to operate and is satisfied that the plan complies with the provisions of section 2957 of the Public Health Law, and meets the following requirements:
(1) establishes an organizational structure that includes a decisionmaking structure representative of participating providers and consumers, mission statement, goals, operating principles, and written agreements between the network and all affiliated providers, copies of which shall be submitted with a proposed plan;
(2) provides for the delivery of at least acute care, comprehensive primary care, and emergency medical care;
(3) ensures the provision of appropriate high quality health care services in accordance with prevailing standards of care and practice. At a minimum the plan shall demonstrate that:
(i) the roles and responsibilities of the network and its participating providers in quality assurance/improvement activities are identified. Quality assurance/improvement activities conducted by the network on behalf of one or more of its participating providers shall be specifically delineated;
(ii) a strategy for monitoring, coordinating and assuring that the quality assurance/improvement programs of network participants comply with existing criteria and standards applicable to participants. At a minimum this strategy shall assure that:
(a) both process and outcome based measures are included in network provider quality assessment programs;
(b) a network-wide communication and information system, or plans for such system, is available and contains the capacity to track patients throughout the system and provide network providers with the necessary information to enhance continuity of care; and
(c) procedures will be in place that delineate the duties and responsibilities of medical/professional and ancillary support staff necessary to ensure the provision of high quality services by network provider;
(4) ensures that all potential patients in the network service area have access to necessary services. At a minimum the plan shall provide assurances that:
(i) residents of the network service area shall be provided with information sufficient to make them aware of available services;
(ii) providers of the three required minimum services are located so as to ensure reasonable access to services by all residents of the area served by the network as determined by the commissioner; and
(iii) on-call systems are in place to provide 24-hour a day coverage within the network for at least the three required minimum services in settings appropriate to patient needs;
(5) provides for the efficient and effective coordination of affiliated network providers in planning and evaluating both the integration and provision of services. At a minimum this element of a network operational plan shall include:
(i) an organizational structure, or plans for such structure, for ensuring coordination among network members and other appropriate agencies involved in planning for health and health related services in the network's service area; and
(ii) a coordinated system for developing and using community service plans, county municipal health plans, and other appropriate existing or proposed health plans such as those of appropriate state and regional agencies including the HSAs;
(6) provides for the pooling and sharing of existing resources to facilitate greater system efficiencies; and
(7) establishes terms and conditions to ensure that no hospital, physician or other licensed or certified health care provider operating in good standing, serving the network service area, and willing to meet the terms and conditions of the network as defined in the network operational plan, shall be denied the ability to participate therein. Such terms and conditions may include, but need not be limited to, a prospective participant's ability to deliver services in accordance with prevailing standards of care and/or practice and a participant's willingness to participate in coordinated network quality assurance and improvement programs, peer review programs, credentialing systems, utilization review programs, medical record systems, consultation services, specialty services, communications systems and data collection systems. Such terms and conditions may also include provisions for the payment and reimbursement of services provided by network participants.
(c) Periodic updates and revisions of network operational plans.
The governing board of a central services facility rural health network shall annually review the network's operational plan, and amend it as necessary subject to the prior approval of the commissioner.
(1) When an operational plan is proposed to be amended, the network shall simultaneously notify the commissioner and the health systems agency (HSA) having geographical jurisdiction in the region in which the network operates or intends to operate regarding all such proposed amendments. The network shall also provide reasonable prior notification to the public, by publication in a newspaper of general circulation in the service area, and through such other media as the network deems appropriate, of all significant amendments as described below.
(2) If, upon review, the commissioner finds that such amendment(s) are significant, he shall not issue a determination concerning such amendment(s) until he has received the recommendations of the health systems agency having jurisdiction. Significant amendments shall include but need not be limited to those materially affecting any of the criteria set forth in subdivision (3) of section 2957 of the Public Health Law, additions or deletions of network participants and changes in the geographic area being served by the network. In the event that a significant overlap in the service areas of two or more CSFRHNs is proposed, the commissioner may require one or more of the CSFRHNs to amend its defined service area.
(d) Upon request of a CSFRHN, through its proposed network operational plan, or a proposed amendment thereto, the commissioner may permit the network to make application for, or fulfill regulatory requirements on behalf of, network participating providers for purposes including, but not necessarily limited to, certificate of need, quality assurance, reimbursement, and professional credentialing and privileging.
(e) All amendments shall be described in an annual report which shall be submitted to the commissioner no later than March 31st of the following year. Such report shall describe in detail the manner and extent to which a network and its affiliated providers have achieved the efficiencies proposed in the network operational plan and have effected increased access to necessary health care services.
(f) No CSFRHN shall discontinue operation or implementation of a network operational plan unless it has first received the commissioner's approval of a plan of closure pursuant to section 401.3(g)-(j) of this Title.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
ADMINISTRATIVE ADMINISTRATIVE
10 CRR-NY 415.30 General records
The nursing home shall maintain information necessary to permit the production of the following records immediately upon request and any other records required by the provisions of this Chapter:
(a) a chronological listing of residents admitted, by name, with identifying information and the place from which the resident is admitted or transferred;
(b) a chronological listing of residents discharged, by name, including the reason for discharge, adequate identifying information and the place to which the resident is discharged or transferred;
(c) a daily census record consisting of a summary report of the daily resident census with cumulative figures for each month and each year;
(d) a resident personal nonmedical record consisting of an appropriate record for each resident, including identification of next of kin, family and sponsor, all details of the referral and admission and nonmedical correspondence and papers concerning the resident;
(e) a general fiscal record for each resident, including copies of all agreements or contracts, account records, and a current inventory of personal property held in safekeeping;
(f) an accident and incident record which shall include a clear description of every accident and any other incident involving behavior of a resident or staff member that poses a threat to a resident or staff member, the resident's version of the accident or incident unless the resident objects or is unable to give a report due to his/her medical condition, names of individuals involved and a description of medical and other services provided, by whom such are provided, and the steps taken to prevent recurrence, with a copy of the resident's version as reported given to the resident and/or the resident's designated representative;
(g) personnel records for each employee, including the administrator, containing all available pre-employment information, orientation and full in-service record;
(h) personnel policies, including statements of all policies affecting personnel and a job description for each staff position;
(i) financial records which identify all income by source and describe all expenditures by category;
(j) records for nursing service administration, including:
(1) a nursing service organization chart;
(2) a master plan for staffing; and
(3) a nursing service policies and procedures manual;
(k) records for the dietary service, including:
(1) a plan for organization, management and day-to-day operation;
(2) a master plan and weekly work schedules for staffing;
(3) a current diet manual;
(4) written and dated menus for normal and therapeutic diets, as served; and
(5) receipted invoices for food and supplies;
(l) records for activities program, including:
(1) name and qualifications of the activities director;
(2) a current roster of residents participating in the program as well as a record of resident attendance and participation at each activity for the preceding twelve months; and
(3) service policies and procedures.
(m) records for each specialized rehabilitative therapy service, including:
(1) service policies and procedures;
(2) a statistical summary, including but not limited to the frequency, type and duration of treatments given, number of residents treated and number of residents admitted and discharged from the service; and
(3) service budgets and equipment inventory;
(n) a record of staff medical policies, including any bylaws, rules and regulations adopted by the nursing home; and
(o) transfer or affiliation agreements consisting of all contracts, agreements, arrangements, understandings, and records of all efforts to establish same with hospitals, nursing homes, home health agencies, and other health institutions, agencies and services regarding the transfer of residents between the nursing home and such institutions or agencies.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 155.57 Town of Harrison, Water District No. 1
(a) Application.
The rules and regulations herein set forth, duly made and enacted in accordance with the provisions of section 1100-1107 of the Public Health Law shall apply to the well which comprises the source of the public water supply of the Town of Harrison, Water District No. 1. Said well is located on land owned by Water District No. 1, Town of Harrison and is situated between the westerly side of Silver Lake Avenue and the Shores of St. Marys Lake in the Town of Harrison.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the centerline of the well.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Town of Harrison, Water District No. 1.
(16) Well shall mean the well now used as a source of this water supply or to any additional well(s) which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any approval or permit which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Chapter.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed or allowed to remain within a 250-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the well; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the well.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the well, unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the well.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the well.
(7) Toxic chemicals.
After the rules become effective, no container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the well.
(8) Trespassing.
No trespassing shall be alowed upon the property of Water District No. 1, Town of Harrison upon which the well is located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by authority of Water District No. 1, Town of Harrison.
(e) Inspections.
Water District No. 1, Town of Harrison or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the area surrounding the well to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Water District No. 1, Town of Harrison to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Water District No. 1, Town of Harrison to promptly notify the State Commissioner of Health of such violations. The aforesaid Water District No. 1, Town of Harrison shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 452 BASIC CONCEPTS, REPORTING PRINCIPLES AND SPECIALIZED REPORTING AREAS
10 CRR-NY 452.3 Reporting principles
(a) Accrual reporting.
In order to provide complete, accurate and uniform financial data, all residential health care facilities, including governmental institutions, must report such data on the accural basis. If differences between the results of accruing an item and reporting that item on a cash basis are immaterial, accural reporting of that item would be waived. Within these guidelines, therefore, employee vacation, sick time, holidays and personal time must be accrued when there is reasonable assurance that a liability does exist and will be liquidated.
(b) Matching of revenue and expenses.
(1) Subject to the limitations of subdivision (a) of this section, revenue must be reported in the period earned, i.e., when the services are rendered and a legal claim arises for the services. Deductions from revenue, including contractual adjustments, are to be given accounting recognition in the same period that the related revenues were recorded.
(2) Revenue derived from services must be matched with the cost of providing those services.
(3) Revenue and expenses should be matched for each cost center within the residential health care facility. Therefore, the cost of functions and activities within each cost center are to be included in accounts designated for that cost center. Revenue relative to such functions and activities must be included in the matching revenue accounts.
(4) For those institutions that record charges on an all-inclusive rate basis (a flat charge regardless of services performed), a center-by-center matching of cost and revenue at the cost center level would be impossible. Therefore, for these institutions, the matching of cost and revenue should be accomplished at the program level. This, however, does not preclude such institutions from recording their costs in the proper cost center. In addition, revenue from patients should be reported at gross (the full established rate charged to a private patient) with a contractual allowance to reflect the difference between the full rate and the amount received from third-party payors. If the institution is on an all-inclusive rate basis (a flat charge for all services), then the gross rate would be the all-inclusive flat charge. If, however, the institution utilized a fee-for-service basis (a separate charge for each service provided), the gross charge for each service and patient must be reflected.
(c) Fund accounting.
Many residential health care facilities receive funds from donors which are restricted as to use. These funds must be accounted for separately as restricted funds. This does not preclude the pooling of assets for investment purposes. Restricted funds generally fall into three categories: endowment funds, plant replacement and expansion funds, and specific purpose funds. However, certain facilities may also have agency funds to account for funds held for patients. The accounts within each restricted fund are self-balancing, as each fund requires separate fiduciary accountability. The following paragraphs outline the conditions and events which require separate accountability and the required accounting treatment for transactions within the established funds.
(1) Unrestricted Fund.
(i) The Unrestricted Fund is used to account for funds derived from the day-to-day activities of the residential health care facility and unrestricted contributions. Funds which originate from unrestricted gifts or previously accumulated income may de desiggnated by the governing board for special uses. If the governing board designates funds in this manner, it should be recognized that the board also has the authority to rescind its action. For this reason, such funds should be accounted for in the Unrestricted Fund as “board-designated funds”. A separate structure of accounts in the Unrestricted Fund has been provided for these assets.
(ii) The term restricted should not be used in connection with board or other internal appropriations or designations of funds.
(2) Endowment funds.
(i) Funds classified as endowment include:
(a) pure endowments (principal is to remain intact in perpetuity); and
(b) term endowments (principal is available for use upon the passage of time or the occurrence of an event).
(ii) When term endowments become available to the governing board for unrestricted purposes, they should be reported as nonoperating revenue; if these funds are restricted, they should be transferred to the appropriate restricted fund.
(iii) Income earned on endowment fund investments should be accounted for in accordance with donors' instructions if restricted, or as nonoperating revenue in the Unrestricted Fund if not restricted.
(iv) Under section 513 of the New York State Not-for-Profit Corporation Law, realized gains from the sale of endowment fund assets may be available for the general use of the residential health care facility, provided that the amount of fair value of the principal of such assets as of the end of the fiscal year in which the gains are recorded is not less than the amount of fair value of such assets at the time they were originally received by the home. Realized gains that were treated as additions to principal before the effective date of this section of law, September 1, 1970, may be available to the residential health care facility under the aforementioned conditions in an amount not to exceed 20 percent of such gains in one year.
(3) Plant Replacement and Expansion Funds.
(i) Resources restricted by donors and other third-parties for the acquisition or construction of plant assets or the reduction of related debt must be accounted for in the Plant Replacement and Expansion Fund.
(ii) When expenditures for plant assets are made by the Unrestricted Fund for the Plant Replacement and Expansion Fund, a transfer must be made from the Plant Replacement and Expansion Fund to match such expenditures if such funds are available.
(iii) Due to/due from accounts are to be used only as an interim measure, and must be reduced within a reasonable period of time by a transfer of physical assets (generally cash or investments) between the respective funds.
(iv) If expenditures for plant assets are made in the Plant Replacement and Expansion Fund, the plant assets must be transferred to the Unrestricted Fund, with the accompanying credit made to the Operating Fund Balance—Transfers from restricted funds for capital outlays. In the Plant Replacement and Expansion Fund, fund balance would be debited, and a cash account credited. No entry would be made to the interfund payable or receivable accounts.
(v) Income earned and any net realized gains on investments should be reflected as an addition to the fund balance if so specified by the donor. If available for general operating purposes, they should be included in nonoperating revenue in the Unrestricted Fund.
(4) Specific Purpose Fund.
(i) Funds received which are restricted for a specific purpose should be accounted for in a separate restricted fund (Specific Purpose Fund). These resources must be recorded as other operating revenue in the period in which expenditures are made for the purpose specified by the donor.
(ii) Income earned and any net realized gains on investments should be recorded as an addition to fund balance if required to conform to the donor's instructions or as nonoperating revenue of the Unrestricted Fund if such revenue is available for general purposes.
(d) Investments in marketable securities.
Investments in marketable securities are to be valued at cost if purchased or, if acquired by donation, at the fair market value at the date of the gift. If there is evidence of a permanent decline in value, an appropriate reduction in carrying value must be made.
(e) Pooled investments.
(1) Investments of various funds may be pooled unless prohibited by law or the terms of a donation or grant. Gains/losses and investment income on pooled investments should be distributed to participating funds on a basis utilizing market value.
(2) The distribution of the income for the first year would be based on each participating fund's percentage of the pool, based on its contribution at market value at the initiation of the pool. For subsequent periods, the distribution percentage for the income and gains on pooled investments for each of the participating funds would be based on the market value of the investment pool as of the date of the last addition. Each time an addition is made to the investment pool, a new distribution basis must be calculated. This is also true for any reductions to the pool. All gains/losses and investment income from the beginning of the accounting period up to the date of the addition must be determined and distributed on the basis prior to the addition. Any gains/losses and investment income subsequent to an addition would be distributed on the new basis until another addition or reduction is made.
(f) Inventories.
(1) Inventories reflect the cost of unused residential health care facility supplies and should be carried at cost or market, whichever is lower. Any generally accepted cost method ( e.g., FIFO, LIFO, average, etc.) may be used as long as it is consistent with that of the preceeding reporting period. Cost of inventories based on the last invoice price is not an acceptable method for determining such cost.
(2) Perpetual inventory record systems are recommended. Physical valuations must be made at least once a year and the accounting records and perpetual records, if applicable, adjusted to such valuations. Physical valuations on a cycle basis are acceptable if perpetual inventory record systems are used by the residential health care facility.
(3) Inventory usage records of some sort should be maintained for all inventories that are distributed and used by more than one department or cost center in the residential health care facility. It is recommended that a formal requisition system be used for this purpose.
(4) Where inventory had not been recorded in the past, the cumulative effect of establishing such amounts will be reflected in accordance with generally accepted accounting principles.
(5) While the taking of a physical inventory is mandated, the independent public accountant shall determine whether or not they should observe the physical evaluation of inventory for the purpose of expressing an opinion on the financial statements.
(g) Accounting for property, plant and equipment.
(1) Classification of fixed asset expenditures.
Property, plant and equipment and related liabilities must be recorded in the Unrestricted Fund, since segregation in a separate fund would imply the existence of restrictions on the use of the asset. Costs of construction in progress and related liabilities should be recorded in or transferred to the Unrestricted Fund as incurred except for assets and liabilities related to the proceeds of debt. For those areas, refer to paragraph (n)(3) of this section.
(2) Basis of valuation.
Property, plant and equipment must be recorded on the basis of cost. Cost shall be defined as historical cost or fair market value at the date of gift, for donated property, less any applicable salvage value.
(3) Accounting control.
To maintain accounting control over capital assets of the residential health care facility, a plant asset ledger should be maintained as part of the general accounting records. Some items of equipment should be treated as individual units within the plant ledger when their individuality and unit cost justify such treatment. Other items of equipment, if they are similar and are used in a single cost center, may be grouped together and treated as a single unit within the ledger. The plant ledger should be segregated by cost center so that the cost of equipment and the related depreciation for each center is available. Those providers who are not able to identify historical costs and depreciation by department for major movable acquisitions prior to January 1, 1978, may use square feet net to allocate depreciation by department. All additions to major movable equipment as of January 1, 1978 and thereafter must be identified by cost center.
(4) Capitalization policy.
Each residential health care facility must set a standard policy with respect to the capitalization of its depreciable assets. This policy, excluding minor equipment, must meet the following specifications:
(i) The minimum capitalization policy must follow the guidelines and amounts required in the Medicare regulations.
(ii) Normal repair and maintenance and modernization to maintain depreciable assets should not be capitalized if the life of the asset is not materially extended.
(iii) Significant alterations and renovations should be capitalized and depreciated over the expected useful lives, which should not exceed the lives of the assets to which they are fixed.
(5) Minor equipment.
Minor equipment includes such items as wastebaskets, bedpans, syringes, catheters, silverware, mops, buckets, etc. The general characteristics of this equipment are: (i) in general, no fixed location, and subject to use by various departments within a residential health care facility; (ii) comparatively small in size and unit cost; (iii) subject to inventory control; (iv) fairly large quantity in use; and (v) generally, a useful life of approximately three years or less. The cost of minor equipment is to be reported in accordance with Medicare regulations.
(6) Interest expense during period of construction.
Frequently, residential health care facilities borrow funds to construct new facilities or to modernize and expand existing facilities. Interest costs incurred during the period of construction must be capitalized as a part of the cost of the construction. The period of construction is considered to extend to the date the constructed asset is put into use. When proceeds from a construction loan are invested and income is derived from such investments during the construction period, the amount of interest expense to be capitalized must be reduced by the amount of such income.
(7) Depreciation policies.
(i) Depreciation on plant assets used in the residential health care facility's operations should be recorded as an operating expense in the Unrestricted Fund. The straight-line method of depreciation must be used for uniform reporting.
(ii) The estimated lives used in computing depreciation should be taken from the recommendations made in the Estimated Useful Lives of Depreciable Hospital Assets, published by the American Hospital Association (© 1973), or other acceptable sources. However, with the rapidly changing technology in residential health care facilities, these recommendations may not be all-inclusive; in which case, the expertise of the manufacturer or other reliable source may be considered subject to approval by the New York State Department of Health.
(iii) Each residential health care facility must establish, and consistently follow, a policy relative to the amount of depreciation to be taken in the year of acquisition on normal annual additions. Examples of acceptable policies are:
(a) recording first-year depreciation based upon the number of actual months the asset was in use during the first year;
(b) recording one half of the annual depreciation expense in the years of acquisition and disposal, regardless of the date of acquisition;
(c) recording no depreciation in the year of acquisition and a full year's depreciation in the year of disposal; or
(d) recording a full year's depreciation expense if the asset was acquired in the first half of the year. If the asset was acquired in the last half of the year, no depreciation expense would be recognized in the year of acquisition.
The above alternatives are acceptable for normal annual additions to plant assets. However, when major construction projects are completed and capitalized, first-year depreciation must be computed based upon the actual number of months the asset was in use, if the application of any other method results in a material mismatching of revenue and expense in the initial year.
(8) Disposal of plant assets.
Plant assets may be retired voluntarily, or disposed of by sale, trade or abandonment, or involuntarily lost as a result of casualty such as fire or storm. At the date of the retirement or disposal, the cost of the asset and its related accumulated depreciation must be removed from the accounts. Any resulting gain or loss on the retirement or disposal is to be reported as nonoperating revenue/expense.
(h) Investment tax credit.
(1) As contained in APB Opinion No. 2, issued by the American Institute of Certified Public Accountants, the investment tax credit may be accounted for in one of the following manners:
(i) the allowable investment credit may be taken as a reduction of Federal income taxes in the year in which the credit arises (flow-through method); or
(ii) the allowable investment credit may be reflected in net income over the productive life of the asset and not in the year in which it is placed in service (deferral method).
(2) Once a residential health care facility has applied one of these methods, that method must be used consistently thereafter.
(i) Leases.
Often a facility will obtain the use of land, buildings, or equipment by entering into an agreement to lease them from an outside party. In some cases, a lease is merely obtaining the use of an asset for a specified period; however, under certain conditions a lease is considered to be, in substance, a purchase of property. For determination of the acceptable accounting treatment for leases, reference should be made to Accounting for Leases—Statement of Financial Accounting Standards No. 13.
(j) Timing differences.
Timing differences result when accounting policies and practices used in an organization's accounting differ from those used for reporting operations to governmental units collecting taxes or to outside agencies making payments based upon the reported operations. These differences must be recorded on the residential health care facility's records when they arise. The references relative to their acceptable accounting treatment are as follows:
(1) income tax allocation—accounting principles—Board Opinions Nos. 11, 23 and 24;
(2) third-party cost reimbursement—timing differences—Hospital Audit Guide.
(k) Accounting for pledges.
All pledges, less a provision for amounts estimated to be uncollectible, should be included in the residential health care facility's records. If unrestricted, they should be recorded as nonoperating revenue. If restricted, they should be recorded as an addition to the appropriate restricted fund balance.
(l) Self-insurance.
Self-insurance by a residential health care facility for potential losses due to malpractice claims, asserted or otherwise, places all or part of the risk of such losses on the residential health care facility rather than insuring against all or part of such losses with an independent insurer. Accruing for self-insured losses is governed by the Financial Accounting Standards Board's Statement No. 5, Accounting for Contingencies.
(1) Paragraph 8 of that statement indicates that “an estimated loss from a loss contingency can only be accrued as a charge to income if both of the following conditions are met:
(i) “Information available prior to issuance of the financial statements indicates that it is probable that an asset had been impaired or a liability had been incurred at the date of the financial statements. It is implicit in this condition that it must be probable that one or more future events will occur confirming the fact of the loss.
(ii) “The amount of loss can be reasonably estimated.”
(2) Paragraphs 29 and 30 of that statement state:
(i) “An enterprise may choose not to purchase insurance against risk of loss that may result from injury to others, damage to the property of others, or interruption of its business operations. Exposure to risks of those types constitutes an existing condition involving uncertainty about the amount and timing of any losses that may occur, in which case a contingency exists. . .
(ii) “Mere exposure to risks of those types, however, does not mean that an asset has been impaired or a liability has been incurred. The condition for accrual in paragraph 8(a) is not met with respect to loss that may result from injury to others, damage to the property of others, or business interruption that may occur after the date of an enterprise's financial statements. Losses of those types do not relate to the current or a prior period but rather to the future period in which they occur. Thus, for example, an enterprise with a fleet of vehicles should not accrue for injury to others or damage to the property of others that may be caused by those vehicles in the future, even if the amount of those losses may be reasonably estimable. On the other hand, the conditions in paragraph 8 would be met with respect to uninsured losses resulting from injury to others or damage to the property of others that took place prior to the date of the financial statements, even though the enterprise may not become aware of those matters until after that date, if the experience of the enterprise or other information enables it to make a reasonable estimate of the loss that was incurred prior to the date of its financial statements.”
(3) For the purposes of this Article, a reasonable estimate of current and prior unasserted self-insurance claims can only be made by an independent professional qualified to make such valuations. If an estimate is obtained, such amount should be recorded on the books of the residential health care facility.
(m) Other related organizations.
Auxiliaries, guilds, fund-raising groups and other related organizations frequently assist residential health care facilities. If such organizations are independent and are characterized by their own charter, bylaws, tax-exempt status and governing board, or a sufficient combination of these characteristics, to demonstrate their independent existence from the residential health care facility, the financial reporting of these organizations should be separate from reports of the residential health care facility. If such organizations are under the control of (or common control with) residential health care facilities and handle residential health care facility resources, their financial reports should be combined with those of the residential health care facility.
(n) Debt financing for plant replacement and expansion purposes.
Debt financing for plant replacement and expansion programs may take many forms. Under the terms of most debt financing agreements, the debtor is required to perform or is prohibited from performing certain acts. In many instances, such financing gives rise to special accounting treatment because of discounts and premiums on bond issues, financing charges, formal restrictions on debt proceeds, sinking and other required funds.
(1) Discounts and premiums on bond issues.
Discounts and premiums arising from the issue of bonds must be amortized over the life of the related issue(s). For reporting purposes, bond discounts must be reported as a reduction of the related debt (Bonds Payable—New of Unamortized Discount). Bond premium must be reported as Other Deferred Credits.
(2) Financing charges.
All costs of obtaining debt financing other than discounts ( e.g., legal fees, underwriting fees, special accounting costs) should be recorded as deferred costs and amortized over the life of the related debt.
(3) Accounting for debt proceeds.
(i) Debt agreements which finance plant replacement and expansion programs may or may not require formal segregation of debt proceeds prior to their use. Proceeds which are not required to be formally segregated prior to their uses should be reported as other noncurrent assets in the unrestricted funds. However, proceeds which require formal segregation have been recorded in several ways, specifically:
(a) as a separate restricted fund which includes all of the attendant liabilities and any required equity contribution, as in the case of financing through New York State Housing Finance Agency; or
(b) as part of the restricted plant replacement and expansion funds, which include all of the attendant liabilities; or
(c) the liabilities are reflected in the unrestricted fund and only the proceeds are reflected in a restricted fund. The proceeds, however, are not considered as an addition to the restricted fund balance but rather as a liability to the unrestricted fund. This liability is reduced as the proceeds are used for their intended purposes.
(ii) For the purposes of this Article, all funds received from debt arrangements which require formal segregation and/or separate accountability shall be reported in the plant replacement and expansion funds until such time as the project is completed and used. This fund will include all construction in progress costs and all liabilities related to the debt arrangement and construction project.
(iii) There may be instances where a portion of a restricted project's costs are to be funded from unrestricted resources. In these instances, any unrestricted funds required for the project will be transferred to the plant replacement and expansion funds and considered to be part of the depreciation funding requirement for the period in which the transfer of such assets will be accounted for as an interfund receivable/liability between the unrestricted funds and the plant replacement and expansion funds, rather than additions/reductions to the fund balances of such funds.
(iv) When the project is completed, the assets and liabilities of the project will be transferred to the appropriate unrestricted fund asset and liability accounts, except for any residual liquid assets that may be restricted for future specified use under the debt agreement. Such excess restricted assets must remain in the plant replacement and expansion funds. However, if the source of such excess funds is the proceeds of the debt financing arrangement, an interfund receivable/liability must be established between the unrestricted fund and the plant replacement and expansion funds, since the debt financing liability will be in the unrestricted funds. Any income generated from the investment of such funds will be either added to the appropriate plant replacement and expansion fund balance if restricted, or added to nonoperating revenue in the unrestricted funds if available for general purposes.
(v) The aforementioned treatment of restricted project funds would be applicable to New York State Housing Financing Agency (article 28-A) financing, New York State Dormitory Authority financing, and any other financing which requires segregation and/or separate accountability of project funds.
(4) Sinking and other required funds.
(i) These funds are usually established to comply with loan provisions whereby specific deposits are to be used to insure that adequate funds are available to meet future payments of: ( a ) interest and principal (retirement of indebtedness funds); or ( b ) property insurance, related taxes, repairs and maintenance costs, equipment replacement (escrow funds). Funds of this nature may also be required to be held by trustees outside the residential health care facility. Income generated from the investment of such funds may be immediately available to the residential health care facility or such income may be held by the trustee for some future designated purpose.
(ii) For the purpose of this Article, all sinking and other required funds will be accounted for in the following manner:
(a) All fund assets, whether trusted or otherwise, will be reported in the plant replacement and expansion funds. However, if the source of such funds is either the proceeds from debt financing and the liability is a part of the unrestricted funds, or previously unrestricted resources, then the transfer of such assets to the plant replacement and expansion fund must be accounted for as an interfund receivable/liability.
(b) All income generated from the investment of such funds will be reported, as earned, in appropriate plant replacement and expansion fund balance. When such income is available for the replacement of assets, reduction of debt or payment of operating expenditures, it will be reported as a transfer from the appropriate plant replacement and expansion fund balance to the unrestricted fund balance.
(5) Article 28-A residential health care facilities.
(i) Many residential health care facilities have been organized under article 28-A of the Public Health Law and have been/are subject to the accounting treatment described in the Accounting Manual for Nursing Home Companies, published by the New York State Department of Health. Certain accounting procedures set forth in the article 28-A manual were promulgated to reflect reimbursement policies rather than Generally Accepted Accounting Principles (GAAP). This Article, as of its effective date, will provide the accounting policies and procedures to be followed by all 28-A facilities.
(ii) The major differences in accounting treatment between this Article and the 28-A manual have been set forth below:
(a) An article 28-A residential health care facility accounts for a development period, which is the period from the inception of the residential health care facility to the day preceding the permanent financial occupancy date. Included in the development period in an initial occupancy period, which is the period commencing with the first of the month prior to the admission of the first patient and ending with the day preceding the permanent financial occupancy date.
(1) The permanent financial occupancy date is declared by the Commissioner of Health or his designee after a facility has had patients for several months. The development period may be as long as several years.
(2) During the development period, certain costs, including interest, architect fees, legal fees, accounting fees, etc., are recorded as other development period costs and are capitalized and included on he facility's balance sheet. After receipt of the permanent financial occupancy date, these costs are depreciated over a determined period of time.
(3) For the purpose of reporting to the State under this Article, these development period costs must be allocated to the project assets and depreciated over the life of the respective assets.
(b) The Accounting Manual for Nursing Home Companies suggests that retroactive adjustments from third-party payors be recorded as other operating revenue. As set forth in the Hospital Audit Guide, published by the American Institute of Certified Public Accountants, Generally Accepted Accounting Principles require retroactive adjustments from third-party payors to be recorded as an adjustment to the contractual allowance account(s).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.5 Genealogical research; method of disclosure; searches
(a) Information from records of birth, death and marriage may be provided for genealogical research purposes, subject to the restrictions of this Part, in the form of an uncertified copy or abstract upon written application and payment of the applicable statutory fees, which are contained in Public Health Law, sections 4173 and 4174 and Domestic Relations Law, sections 19 and 20-a. If a search discloses no record, the applicant shall be required to pay the specified fee for the time spent for the search for the record and for a certification that the search disclosed no record. Information will not be released if it is to be used for commercial or profitmaking purposes.
(b) Record searches shall be conducted only by the following persons in the files maintained by their respective agencies:
(1) authorized employees of the Department of Health;
(2) a local registrar, deputy registrar, or an authorized employee of the registrar; and
(3) a town or city clerk, deputy clerk, or an authorized employee of the town or city clerk.
(c) Information may be released subject to the following limitations:
(1) no information shall be released from a record of birth which has been placed in a confidential file pursuant to Public Health Law, section 4138;
(2) no information shall be released from a record of birth unless the record has been on file for at least 75 years and the person to whom the record relates is known to the applicant to be deceased;
(3) no information shall be released from a record of death unless the record has been on file for at least 50 years; and
(4) no information shall be released from a record of marriage unless the record has been on file for at least 50 years and the parties to the marriage are known to the applicants to be deceased.
(d) The time periods specified in paragraphs (2), (3) and (4) of subdivision (c) of this section are waived if the applicant is a descendant or has been designated to act on behalf of a descendant of the person whose record is being requested. A descendant is a person in the direct line of descent such as a son, daughter, grandson or granddaughter. The applicant shall provide documentation of descendancy prior to the release of information in those instances where a waiver of the waiting period is requested. A party acting on behalf of a descendant shall further provide documentation that the descendant authorized the party to make such application.
(e) All uncertified copies, abstracts or information issued for genealogical research purposes shall be clearly marked with the statement “for genealogical purposes only.”
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.5 Hospital inpatient admissions
(a) Tuberculosis health care services provided in a hospital shall be based on prevailing standards of professional practice for the care of tuberculosis.
(b) An inpatient admission of a tuberculosis patient to a hospital for treatment of tuberculosis may be made when a person has severe symptoms attributed to tuberculosis, presents diagnostic problems or presents difficulties in drug treatment selection.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.30 Institution; responsibilities
Except as otherwise provided by subdivision (c) of section 61-1.3 of this Subpart, the institution shall:
(a) submit to the commissioner a written assurance complying with the requirements of paragraph (2) of subdivision (a) of section 61-1.3 of this Subpart unless it possess a certificate pursuant to subdivision (b) or (d) of said section;
(b) establish an institutional biosafety committee (IBC) that meets the requirements of section 61-1.31 of this Subpart;
(c) ensure that the institutional biosafety committee is fulfilling its responsibilities at all times;
(d) ensure compliance of recombinant DNA activity with the requirements of this Subpart;
(e) if the institution is engaged in recombinant DNA activity at the P3 or P4 containments level, appoint a biological safety officer (BSO), who shall be a member of the IBC and carry out the duties specified in section 61-1.32 of this Subpart;
(f) ensure that all principal investigators (PIs) comply with the provisions of section 61-1.33 of this Subpart;
(g) ensure appropriate training for the IBC chairperson and members, the BSO, principal investigators (PIs), and laboratory staff regarding the requirements of article 32-A of the Public Health Law and this Subpart, their implementation and laboratory safety;
(h) determine, in consultation with the local public health office when appropriate, the necessity and extent of health surveillance of personnel involved in recombinant DNA activity, including, but not limited to records of agents handled, active investigation of illnesses of personnel working with or exposed to recombinant DNA, and maintenance of serial serum samples;
(i) report within 30 days to the commissioner any significant problems with and violations of this Subpart and significant recombinant DNA activity-related accidents and illnesses, unless the institution determines that the PI or IBC has done so; and
(j) upon request, make available to the public any documents submitted to or received from the commissioner which he is required to make available to the public ( e.g., reports of violations of this Subpart and of significant recombinant DNA activity-related accidents, and directives to modify projects). If comments are made by members of the public on IBC actions, the institution shall forward to the commissioner both the comments and the IBC's response.
Note:
See NIH Laboratory Safety Monograph for additional medical surveillance information.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.4 Surrogacy program conflicts of interest
(a) Surrogacy programs shall, as a condition of licensure, develop and maintain policies to avoid conflicts of interest while facilitating, arranging, and engaging in the services contemplated in a surrogacy agreement.
(b) The surrogacy program’s conflict of interest policy shall apply to all personnel of the surrogacy program, including but not limited to owners, employees, and contractors, who help to facilitate, arrange, or engage in any service contemplated in a surrogacy agreement.
(c) Such conflict of interest policies shall prohibit, at a minimum, the following conduct:
(1) any sort of kickback or making or receiving a referral for a fee, except for fair market value fees paid by a surrogacy program to an employee or independent contractor of the surrogacy program solely for promoting the surrogacy program and identifying potential surrogates;
(2) fee-splitting;
(3) financially benefitting from a referral, including a family member benefitting from a referral;
(4) ordering or arranging for excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient;
(5) making self-referrals, that is, referrals to health care providers with which the surrogacy program has financial relationships (other than financial relationships that would be commercially reasonable even if no referrals were made between the parties); and
(6) entering into an arrangement with a clinical laboratory under which the clinical laboratory does not directly bill the patient as required by Public Health Law section 586.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.16 Procedures for picking up, receiving and opening packages
(a) Each licensee who expects to receive a package containing quantities of radioactive material in excess of the type A2 quantities specified in Appendix 16-B, Table 1 of this Title, shall make arrangements:
(1) to receive the package when the carrier offers it for delivery; or
(2) to receive notification of the arrival of the package at the carrier's terminal and to pick up the package expeditiously.
(b) Each licensee, upon receipt of a package containing radioactive material in quantities described in subdivision (a) of this section, or any package that shows evidence of damage or leaking shall monitor the external surfaces of the package for radioactive contamination; and shall survey all packages for radiation levels and shall make other surveys as may be required by section 16.10 of this Part. The licensee shall perform the monitoring as soon as practical after receipt of the package, but not later than three hours after the package is received during the licensee's normal working hours, or not later than three hours from the beginning of the next working day if it is received after working hours.
(c) The licensee shall immediately notify the final delivery carrier and the department if packages, other than those transported by exclusive use vehicle, are found to have any of the conditions in paragraphs (1) and (2) of this subdivision. Notification to the department shall be made by telephone as well as by telegram, mailgram or facsimile.
(1) Removable radioactive contamination in excess of 0.01 microcuries (22,000 dpm) (0.37 KBq) per 100 square centimeters on the external surfaces of the package; or
(2) Radiation levels at one meter from the external surface of the package in excess of 0.01 rem (10 mrem) (0.1mSV) per hour.
(d) Each licensee shall:
(1) establish and maintain written procedures for the safe opening of packages in which radioactive material is received that include consideration given to special instruction for the type of package being opened; and
(2) ensure that the procedures are followed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.3 Registered residents
(a) Every candidate for funeral director licensure, upon entering employment as a registered resident as required by the provisions of the Public Health Law, shall register with the department, within two weeks from the date of the beginning of such employment, on a form prescribed by the department.
(b) No funeral firm shall be approved to employ a registered resident unless the manager, or sponsor designated by the manager, submits satisfactory evidence and a signed statement, on a form provided by the department, that:
(1) the residence shall be under the supervision of a manager or sponsor designated by the manager, who is licensed and registered as a funeral director or undertaker and embalmer, and who is regularly employed by the funeral firm;
(2) during the 12 months immediately preceding the date of beginning of the proposed residency period of the applicant, the funeral firm in which the registered resident is to be employed has had, and has serviced or handled, at least 40 cases directly for, and pursuant to engagement by, the respective families or friends of the decedent, exclusive of cases of stillborn children and exclusive of cases serviced or handled for and on behalf of, or in conjunction with, other funeral firms. These 40 cases may be a total of all cases done by branches and/or affiliate funeral firms;
(3) the funeral establishment in which the registered resident is to be employed contains adequate facilities for embalming as required by the department pursuant to its rules and regulations; and
(4) residence practice in connection with funeral arrangements shall consist of observing, instruction, taking of preliminary information and exposure to the sale of service and merchandise.
(c) The registered residency shall be of a grade and character satisfactory to the department and, in additon thereto:
(1) the registered resident shall serve for not less than the period required by law;
(2) the registered resident shall serve on a full-time work schedule which shall be of sufficient scope to include training in all aspects of funeral service;
(3) the registered resident and the manager or the sponsor designated by the manager shall jointly file quarterly reports with the department, on forms provided by the department. Reports are due immediately after the end of each quarter, and shall be signed and mailed to the Albany office of the department with a copy sent to the appropriate department area office representative within 10 days following the end of the quarter. Reports mailed thereafter may be accepted if, in the judgment of the department, a justifiable cause existed for delay;
(4) the registered resident, manager or sponsor designated by the manager shall report to the department, on a form provided by the department, any change in manager or sponsor or discontinuance or completion of residency within 10 days after such occurrence;
(5) the registered resident shall carry with him at all times while engaged in activities relative to the residency, a pocket card issued to him by the department. In the event of loss or destruction thereof, a duplicate pocket card shall be issued by the department; and
(6) the registered resident shall be subject to all provisions of article 34 of the Public Health Law, the administrative rules and regulations, and other laws relating to funeral directing.
(d) If the employer funeral firm fails to comply with the provisions of the law and with these regulations to the satisfaction of the department, the department may refuse to register registered residents from such funeral firm for such period as the department may prescribe.
(e) After or during the serving of a one-year period as a registered resident, the department may direct either or both the registered resident, the manager or the sponsor, to appear, at a time and place designated by the department, for an oral interview to determine the resident's qualifications for full licensure.
(f) After or during the serving of a one-year period as a registered resident, the resident shall appear for an examination on New York State laws, rules and regulations relating to funeral directing as provided for in section 3421(4)(d) of the Public Health Law.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-3.2 Emergencies
The director shall have the authority to waive any of the prescribed requirements for admission when in his judgment an emergency exists requiring immediate admission of a patient.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.7 Application review process
(a) Applications will be subject to full review, consistent with the requirements of Part 710 of this Subchapter, affording the State Hospital Review and Planning Council an opportunity to submit its recommendations prior to a decision by the commissioner. The commissioner shall approve a limited number of applications sufficient to evaluate any identified innovation in medical technology.
(b) Notwithstanding section 600.9(c) of this Title, in the case of an application for a new medical technology and health services demonstration project where the portion of the total project cost which is directly related to the new medical technology or health service exceeds $100 million, the commissioner may approve the use of innovative forms of financing, provided that:
(1) sufficient or affordable financing is not available from more traditional sources; and
(2) the new medical technology or health service has the potential to substantially improve treatment for one or more life threatening medical conditions, based on scientific evidence;
(3) the project will provide access to the medical technology or health service for underserved populations, including Medicaid beneficiaries and uninsured individuals.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.17 Disqualification for bias
(a) A hearing officer and, in hearings governed by Public Health Law section 230, a committee member, shall be disqualified for bias. For purposes of this section, bias shall exist only when there is an expectation of pecuniary or other personal benefit from a particular outcome of the case or when there is a substantial likelihood that the outcome of the case will be affected by a person's prior knowledge of the case, prior acquaintance with the parties, witnesses, representatives, or other participants in the hearing, or other predisposition with regard to the case. The appearance of impropriety shall not constitute bias and shall not be a grounds for disqualification. Hearing officers and committee members are presumed to be free from bias.
(b) A hearing officer or committee member may disqualify himself/herself for bias on his/her own motion. A party seeking disqualification for bias had the burden of demonstrating bias. The party seeking disqualification shall submit to the hearing officer an affidavit pursuant to SAPA section 303 setting forth the facts establishing bias. Mere allegations of bias shall be insufficient to establish bias.
(c) The hearing officer shall rule on the request for disqualification.
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.80 Claiming State aid
Counties with State aid applications approved in advance of implementation shall submit vouchers for vector surveillance and/or vector control activities through the same procedure and at the same rate as State aid for general public health work, pursuant to Part 40 of this Title.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 143 SCHOHARIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 143.4 Village of Richmondville
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the Cobleskill Creek, the upper and lower reservoirs, and all watercourses tributary thereto or which may ultimately discharge into said reservoirs, or which may be developed in the future to serve as sources of the water supply of the Village of Richmondville.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Agricultural-associated animal waste area shall mean land used for the deposition of agricultural-associated animal waste on the surface of the ground for fertilization purposes.
(3) Agricultural-associated animal waste storage area shall mean land used for the temporary or permanent deposition of agricultural-associated animal waste where said deposition is not directly for the purpose of fertilization.
(4) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(5) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(6) Human excreta shall mean human feces and urine.
(7) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(8) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or the edge, margin and steep bank forming the ordinary high-water line of a watercourse.
(9) Manure shall mean animal feces and urine.
(10) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(11) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(12) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste and agricultural- and nonagricultural-associated animal waste.
(13) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(14) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(15) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(16) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(17) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Village of Richmondville.
(18) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(19) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(20) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(21) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(22) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the water supply of the Village of Richmondville.
(23) Watershed shall mean the entire drainage area contributing water to the water supply of the Village of Richmondville.
(24) Water supply shall mean the public water supply of the Village of Richmondville.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural-associated animal waste area.
No agricultural associated animal waste area shall be located within a 250-foot linear distance of any reservoir or watercourse. Beyond that distance, such area shall be maintained in such manner that surface runoff will not carry agricultural-associated animal waste directly into the reservoir or watercourse.
(2) Agricultural-associated animal waste storage area.
No agricultural-associated animal waste storage area shall be located within a 250-foot linear distance of any reservoir or watercourse.
(3) Cemeteries.
No interment of a human body shall be made within a 250 foot-linear distance of any reservoir or watercourse.
(4) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(5) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(6) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed. Composted sludge, pursuant to a permit issued by an appropriate State or local agency having jurisdiction, if any, shall be allowed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and with minimal vertical distance of five feet from the bottom of any trench or pit to groundwater and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 100-foot linear distance of any reservoir or watercourse, except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or rebuilt within a 100-foot linear distance of any reservoir or watercourse. All systems constructed must have a vertical distance of at least two feet from the lowest position of the system to the high-water mark. An exemption may be granted by the county health department for the repair of any existing system within 100 linear feet of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with drip-proof connections and tight-fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency havng jurisdiction over such facility. Standards for waste treatment works are published from time to time by the appropriate State agency having jurisdiction over such facility, and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(ix) When an existing subsurface sewage disposal system fails, the entire system must be inspected and the site thoroughly evaluated in a manner acceptable to the appropriate State or county health agency having jurisdiction over such facility, prior to modifications or alterations to the existing system.
(x) No sewage or polluted liquid of any kind shall be discharged or allowed to flow beneath the surface of the ground on the watershed except into watertight pipes connected to a sewage disposal system or holding tank approved in accordance with subparagraph (iv) of this paragraph.
(xi) In-house composting facilities of the type that make use of human excreta, wash-waters and sink wastes will be acceptable, provided that properly designed systems for the disposal of gray water are included within the plans for their construction and are approved by the appropriate State or county health agency having jurisdiction over such facilities.
(7) Junkyards.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(8) Manure.
Manure shall not be field-spread within 75 feet of the reservoir or watercourse unless it is plowed underground the same day it is spread.
(9) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(10) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Richmondville.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Richmondville within a 1,000-foot linear distance of the water supply intakes, except by duly authorized employees of the Village of Richmondville in the performance of their duties of supervision and maintenance of the water supply.
(11) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(12) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(13) Structures.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Richmondville.
(14) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(15) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground or watershed within 500 feet of any reservoir or watercourse, except as otherwise permitted by the provisions of subparagraph (6)(x) of this subdivision. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The board of trustees of the Village of Richmondville, or any person or persons charged with the maintenance or supervision of the public water supply system, shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.19 Records to be kept when derivatives are infused
The following information shall be included on the recipient's chart or in records maintained in the blood bank or pharmacy:
(a) product name, manufacturer, lot number, and expiration date;
(b) documentation of visual inspection prior to infusion;
(c) name of person administering the product;
(d) documentation of identification of the recipient;
(e) date of infusion and quantity of material infused; and
(f) description of any adverse reaction and the results of related investigation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.1 General
For the purposes of this Article, the following terms shall have the following meanings.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.3 Rates for residential habilitation services and for day habilitation services
(a) There shall be one provider-wide rate for each provider of residential habilitation service and one provider-wide rate for each provider of day habilitation services, except that rates for residential habilitation or day habilitation services provided to individuals identified as specialized populations by OPWDD shall be determined under section 86-10.8 of this Subpart. Adjustments may be made to the rate resulting from any final audit findings or reviews.
(b)
(1) The State will set rates for services delivered to individuals with developmental disabilities as described below for the following three services, effective July 1, 2019:
(i) residential habilitation – supervised IRA (certified site);
(ii) residential habilitation – supportive IRA (certified site);
(iii) day habilitation – group and supplemental group.
(2) Rates shall be computed on the basis of a full 12 month base year CFR, adjusted in accordance with the methodology as provided in this section. The rate shall include operating cost components, facility cost components and capital cost components as identified in applicable subdivisions. Such base year may be updated periodically, as determined by the department.
(c) Components of rates for residential habilitation provided in supervised community residences.
(1) Operating component. The operating component shall be based on allowable operating costs identified in the consolidated fiscal reports. The operating component shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation-supportive IRA, day habilitation services and intermediate care facility for the developmentally disabled services (ICF/DD), divided by base year salaried direct care hours for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation- supportive IRA, day habilitation services and ICF/DD services.
(ii) Regional average employee-related component , which shall mean the sum of vacation leave accruals and total fringe benefits for the base year for each provider in a DOH region, aggregated for all such providers in such region, such sum to be divided by base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, and then multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the sum of transportation related-participant staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider in a DOH region, aggregated by all such providers in such region. Such sum shall be divided by the total base year salaried direct care dollars of all providers in a DOH region, and then multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the sum of the insurance-general and agency administration allocation for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider in a DOH region, aggregated for all providers in such region). The regional average direct care hourly rate-exclusive of general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (iv) of this paragraph shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage, as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional average general and administrative component computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of base year salaried direct care dollars divided by the base year salaried direct care hours of a provider.
(viii) Provider average employee-related component , which shall mean the sum of vacation leave accruals and fringe benefits for the base year for each provider, divided by base year salaried direct care dollars of a provider, such quotient to be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment , other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for a provider. Such sum shall be divided by the base year salaried direct care dollars of such provider and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the sum of insurance-general and agency administration allocation the base year for the base year for a provider, such sum to be divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for a provider). The provider average direct care hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage, as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Statewide average direct care hours per person , which shall mean the total salaried and contracted direct care hours for the base year for all providers divided by total capacity for all providers, as such capacity is determined from the rate sheets for the base year and as pro-rated for partial year sites.
(xiv) Statewide average direct hours per provider , which shall mean the product of the statewide average direct care hours per person, as determined pursuant to subparagraph (xiii) of this paragraph, the applicable E-Score factor of a provider, the applicable provider acuity factor and the applicable provider rate sheet capacity for the base year, as pro-rated for partial year sites.
(xv) Statewide budget neutrality adjustment factor for hours , which shall mean the quotient of the total salaried and contracted direct care hours for the base year for all providers, divided by the total of statewide average direct hours for all providers as determined pursuant to subparagraph (xiv) of this paragraph.
(xvi) Calculated direct care hours , which shall mean the product of the statewide average direct care hours per provider, as determined pursuant to subparagraph (xiv) of this paragraph, and the statewide budget neutrality adjustment factor for hours, as determined pursuant to subparagraph (xv) of this paragraph. Such product shall then be divided by the rate sheet capacity for the base year, pro-rated for partial year sites and such quotient multiplied by rate sheet capacity for the initial period.
(xvii) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xviii) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of a provider.
(xix) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the rate sheet capacity for the base year, pro-rated for partial year sites, such quotient to be multiplied by the rate sheet capacity for the initial period for such provider.
(xx) Regional average contracted clinical hourly wage , which shall mean the quotient of base year contracted clinical dollars of each provider in a DOH region divided by the base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xxi) Provider contracted clinical hours , which shall mean the quotient of base year contracted clinical hours of a provider divided by rate sheet capacity for the base year, pro-rated for partial year sites, such quotient to be multiplied by rate sheet capacity for the initial period.
(xxii) Provider direct care hourly rate-adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph multiplied by 0.25.
(xxiii) Provider clinical hourly wage-adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xviii) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xvii) of this paragraph multiplied by 0.25.
(xxiv) Provider reimbursement for direct care hourly rate , which shall mean the product of the calculated direct care hours, as determined pursuant to subparagraph (xvi) of this paragraph, and the provider direct care hourly rate-adjusted for wage equalization factor, as computed in subparagraph (xxii) of this paragraph.
(xxv) Provider reimbursement for clinical hourly wage , which shall mean the product of the provider salaried clinical hours, as determined pursuant to subparagraph (xix) of this paragraph and the provider clinical hourly wage-adjusted for wage equalization factor, as determined pursuant to subparagraph (xxiii) of this paragraph.
(xxvi) Provider reimbursement for contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours, as determined pursuant to subparagraph (xxi) of this paragraph and the applicable regional average contracted clinical hourly wage, as determined pursuant to subparagraph (xx) of this paragraph.
(xxvii) Provider operating revenue , which shall mean the sum of the provider reimbursement from direct care hourly rate, as determined pursuant to subparagraph (xxiv) of this paragraph, the provider reimbursement from clinical hourly wage, as determined pursuant to subparagraph (xxv) of this paragraph, and the provider reimbursement from contracted clinical hourly wage, as determined pursuant to subparagraph (xxvi) of this paragraph.
(xxviii) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of the operating revenue from all provider rate sheets in effect on June 30, 2014, divided by provider operating revenue for all providers, as computed in subparagraph (xxvii) of this paragraph.
(2) Alternative operating cost component. For providers that did not submit a cost report or submitted a cost report that was incomplete for residential habilitation services for the base year, the final daily operating rate shall be a regional daily operating rate. This rate shall be the sum of:
(i) The product of the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (1)(vi) of this subdivision, and the applicable regional average direct care hours , which shall mean the quotient of salaried and contracted direct care hours for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by the rate sheet capacities for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region divided by 365, or 366 in the case of a leap year.
(ii) The product shall then be added to the product of the applicable regional average clinical hourly wage, as determined pursuant to subparagraph (1)(xvii) of this subdivision and the applicable regional average clinical hours , which shall mean the quotient of salaried and contracted clinical hours for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by the rate sheet capacities for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region divided by 365, or 366, in the case of a leap year.
(iii) Provider operating revenue is calculated as follows: add applicable reimbursement from regional direct care hourly rate, as computed in subparagraph (i) of this paragraph, and applicable reimbursement from regional clinical hourly wage, as computed in subparagraph (ii) of this paragraph.
(iv) Total provider operating revenue – adjusted is calculated as follows: multiply applicable provider operating revenue, as computed in subparagraph (iii) of this paragraph, by applicable budget neutrality adjustment.
(v) Target regional daily operating rate is calculated as follows: divide the sum of applicable total provider operating revenue-adjusted, as computed in subparagraph (iv) of this paragraph, and applicable adjustments as computed in section 86-10.5 of this Subpart, by the applicable rate period capacity for the initial period. Divide such quotient by 365, or in the case of a leap year 366. This rate will be in effect until such time that the provider has submitted a cost report for a base year which will be used in the calculation of a subsequent rate period.
Such sum shall be multiplied by the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (1)(xxviii) of this subdivision to determine the final regional daily operating rate.
(3) Facility cost component. The facility cost component shall include allowable facility costs identified in the consolidated fiscal reports, and shall be inclusive of the following components:
(i) Provider facility reimbursement , which shall mean the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance-property and casualty, housekeeping and maintenance staff, and program administration property, for the base year for a provider divided by rate sheet capacity for the base year, pro-rated for partial year sites and such quotient multiplied by rate sheet capacity for the initial period.
(ii) The final monthly State supplement shall be calculated in accordance with paragraph (6) of this subdivision, divided by 12.
(4) Alternative facility cost component. For providers that did not submit a cost report or submitted a cost report that was incomplete for residential habilitation services provided in a supervised community residence for the base year, the final monthly facility rate shall be a regional monthly facility rate which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance-property and casualty, housekeeping and maintenance staff, and program administration property for the base year divided by the rate sheet capacity for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region. Such quotient shall be multiplied by rate sheet capacity for the initial period. The final monthly State supplement shall be calculated in accordance with paragraph (6) of this subdivision, divided by 12.
(5) Capital component.
(i) Capital costs shall be determined pursuant to 14 NYCRR Subpart 635-6.
Note:
The provisions of this paragraph do not apply to capital approved by OPWDD prior to July 1, 2014.
(ii) Initial rate. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date of certification of the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date of certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(iii) Cost verified rates. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Capital costs approved on or after November 1, 2014 shall be amortized over a 25 year period for acquisition of properties or the life of the lease for leased sites. Amortization shall begin upon certification by the provider of such costs. For community residences start-up costs may be amortized over a one-year period beginning with site certification.
(iv) Renovations of existing provider owned residential programs shall be funded through the residential reserve for replacement (RRR).
(6) Adjustments. Rates described in this subdivision shall be subject to a reimbursement offset. Such offset shall be determined as follows:
(i) The sum of the total provider facility reimbursement revenue, as determined by subparagraph (3)(i) of this subdivision, and the capital reimbursement, as determined by paragraph (5) of this subdivision.
(ii) Supplemental security income, as determined by 14 NYCRR 671.7(b)(9)(xxii), annualized and multiplied by a provider’s initial period rate sheet capacity.
(iii) Supplemental nutrition assistance, as determined by 14 NYCRR 671.7(b)(10)(i)( e ), and multiplied by 12, such product to be multiplied by a provider’s initial period rate sheet capacity.
(iv) The sum of subparagraphs (ii) and (iii) of this paragraph shall be deducted from the amount determined pursuant to subparagraph (i) of this paragraph. If such amount is negative, the State Supplement will be equal to zero. If such amount is positive, a provider shall receive the State supplement amount multiplied by the statewide budget neutrality factor for State supplement as calculated below.
(v) Statewide budget neutrality factor for State supplement, which shall mean the sum of the State supplement from all provider rate sheets in effect on June 30, 2014 less six million dollars consistent with the savings plan developed by the workgroup established pursuant to chapter 53 of the Laws of 2013, divided by the sum of the State supplement for all providers, as calculated pursuant to subparagraph (iv) of this paragraph.
If the sum of the State supplement from all provider rate sheets in effect on June 30, 2014 is lower than the sum of the State supplement for all providers as calculated pursuant to subparagraph (iv) of this paragraph then the statewide budget neutrality factor shall be applied. If such sum is greater, then no statewide budget neutrality factor for State supplement shall be applied.
(7) Adjustments for July 1, 2014 through October 31, 2014. The department shall calculate the amount of reimbursement each provider would have received for July 1st through October 31, 2014 for services under the methodology described in the November 1, 2014 amendments to this Subpart. The department or OPWDD shall pay each provider the difference between such reimbursement and the amount the provider was entitled to receive under this Subpart in effect from July 1st to October 31, 2014.
(d) Components of rates for residential habilitation provided in supportive community residences.
(1) Operating component. The operating component shall be based on allowable operating costs identified in the consolidated fiscal reports, and shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation-supportive IRA, day habilitation services and ICF/DD services, divided by base year salaried direct care hours for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation-supportive IRA, day habilitation services and ICF/DD services.
(ii) Regional average employee-related component , which shall mean the sum of vacation leave accruals and total fringe benefits for the base year for each provider in a DOH region, aggregated for all such providers in such region, such sum to be divided by salaried direct care dollars for the base year for each provider in a DOH region, aggregated for all such providers in such region, and then multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the sum of transportation related-participant staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider in a DOH region, aggregated by all such providers in such region. Such sum shall be divided by the total base year salaried direct care dollars for all providers in a DOH region, and then multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the sum of the insurance-general and agency administration allocation for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider in a DOH region, aggregated for all such providers in such region). The regional average direct care hourly rate-exclusive of general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (iv) of this paragraph shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage, as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional average general and administrative component computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of salaried direct care dollars divided by the salaried direct care hours of a provider.
(viii) Provider average employee-related component , which shall mean the sum of vacation leave accruals and fringe benefits of each provider, divided by a provider’s salaried direct care dollars, such quotient to be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars of a provider. Such sum shall be divided by the salaried direct care dollars of such provider and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the sum of insurance-general and agency administration allocation for a base year for a provider, such sum to be divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for a provider). The provider average direct care hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage, as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Statewide average direct care hours per person , which shall mean the total base year salaried and contracted direct care hours for all providers divided by total capacity for all providers, as such capacity is determined from the rate sheets for the base year and as pro-rated for partial year sites.
(xiv) Statewide average direct hours per provider , which shall mean the product of the statewide average direct care hours per person, as determined pursuant to subparagraph (xiii) of this paragraph, the applicable provider acuity factor and the applicable provider rate sheet capacity for the base year, as pro-rated for partial year sites.
(xv) Statewide budget neutrality adjustment factor for hours , which shall mean the quotient of the total base year salaried and contracted direct care hours for all providers, divided by the total of statewide average direct hours for all providers, as determined pursuant to subparagraph (xiv) of this paragraph.
(xvi) Calculated direct care hours , which shall mean the product of the statewide average direct care hours per provider, as determined pursuant to subparagraph (xiv) of this paragraph, and the statewide budget neutrality adjustment factor for hours, as determined pursuant to subparagraph (xv) of this paragraph. Such product shall then be divided by the rate sheet capacity for the base year, pro-rated for partial year sites and such quotient multiplied by rate sheet capacity for the initial period.
(xvii) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xviii) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of such provider.
(xix) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the rate sheet capacity for the base year, pro-rated for partial year sites, such quotient to be multiplied by the rate sheet capacity for the initial period for such provider.
(xx) Regional average contracted clinical hourly wage , which shall mean the quotient of base year contracted clinical dollars of each provider in a DOH region, aggregated for all such providers in such region, divided by the base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xxi) Provider contracted clinical hours , which shall mean the quotient of a provider’s contracted clinical hours for the base year divided by rate sheet capacity for the base year, pro-rated for partial year sites, such quotient to be multiplied by rate sheet capacity for the initial period.
(xxii) Provider direct care hourly rate-adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph multiplied by 0.25.
(xxiii) Provider clinical hourly wage-adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xviii) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xvii) of this paragraph multiplied by 0.25.
(xxiv) Provider reimbursement for direct care hourly rate , which shall mean the product of the calculated direct care hours, as determined pursuant to subparagraph (xvi) of this paragraph, and the provider direct care hourly rate-adjusted for wage equalization factor, as computed in subparagraph (xxii) of this paragraph.
(xxv) Provider reimbursement for clinical hourly wage , which shall mean the product of the provider salaried clinical hours, as determined pursuant to subparagraph (xix) of this paragraph and the provider clinical hourly wage-adjusted for wage equalization factor, as determined pursuant to subparagraph (xxiii) of this paragraph.
(xxvi) Provider reimbursement for contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours, as determined pursuant to subparagraph (xxi) of this paragraph and the applicable regional average contracted clinical hourly wage, as determined pursuant to subparagraph (xx) of this paragraph.
(xxvii) Provider operating revenue , which shall mean the sum of the provider reimbursement from direct care hourly rate, as determined pursuant to subparagraph (xxiv) of this paragraph, the provider reimbursement from clinical hourly wage, as determined pursuant to subparagraph (xxv) of this paragraph, and the provider reimbursement from contracted clinical hourly wage, as determined pursuant to subparagraph (xxvi) of this paragraph.
(xxviii) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of the operating revenue from all provider rate sheets in effect on June 30, 2014, divided by provider operating revenue for all providers, as computed in subparagraph (xxvii) of this paragraph.
(xxix) Total provider operating revenue-adjusted is calculated as follows: multiply applicable provider operating revenue, as computed in subparagraph (xxvii) of this paragraph, by applicable budget neutrality adjustment factor found on the Department of Health’s website. The final monthly operating rate shall be determined by dividing the total provider operating revenue-adjusted, as determined pursuant to this subparagraph, by the applicable rate sheet capacity for the initial period and such quotient to be further divided by 12.
(2) Alternative operating cost component. For providers that did not submit a cost report or submitted a cost report that was incomplete for residential habilitation provided in a supportive community residence for the base year, the final monthly operating rate shall be a regional monthly operating rate. This rate shall be the sum of:
(i) The product of the applicable regional average direct care hourly rate , as determined pursuant to subparagraph (1)(vi) of this subdivision, and the applicable regional average direct care hours, which shall mean the quotient of base year salaried and contracted direct care hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the rate sheet capacities for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region divided by 12.
(ii) The product shall then be added to the product of the applicable regional average clinical hourly wage , as determined pursuant to subparagraph (1)(xvii) of this subdivision and the applicable regional average clinical hours, which shall mean the quotient of salaried and contracted clinical hours for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by the rate sheet capacities for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region divided by 12.
(iii) Provider operating revenue is calculated as follows: add applicable reimbursement from regional direct care hourly rate, as computed in subparagraph (e)(2)(i) of this section, and applicable reimbursement from regional clinical hourly wage, as computed in subparagraph (e)(2)(ii) of this section.
(iv) Total provider operating revenue – adjusted is calculated as follows: multiply applicable provider operating revenue, as computed in subdivision (c) of this section, by applicable budget neutrality adjustment xxviii. The final target regional monthly operating rate is then calculated as follows: divide the sum of applicable total provider operating revenue-adjusted, as computed in subparagraph (e)(2)(iv) of this section and applicable adjustments as computed in section 86-10.5 of this Subpart, by the applicable rate period capacity for the initial period. divide such quotient by 12. This rate will be in effect until such time that the provider has submitted a cost report for a base year which will be used in the calculation of a subsequent rate period.
Such sum shall be multiplied by the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (1)(xxviii) of this subdivision to determine the final regional monthly operating rate.
(3) Facility cost component. The facility cost component shall include allowable facility costs identified in the consolidated fiscal reports and shall be inclusive of the following components:
(i) Provider facility reimbursement , which shall mean the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance-property and casualty, housekeeping and maintenance staff, and program administration property from the base year, divided by rate sheet capacity for the base year, pro-rated for partial year sites and such sum multiplied by rate sheet capacity for the initial period.
(ii) The final monthly State supplement shall be calculated in accordance with paragraph (6) of this subdivision, divided by the applicable rate sheet capacity for the initial period and such quotient to be further divided by 12.
(4) Alternative facility cost component. For providers that did not submit a cost report or submitted a cost report that was incomplete for residential habilitation services provided in a supportive community residence for the base year, the final monthly facility rate shall be a regional monthly facility rate which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance – property and casualty, housekeeping and maintenance staff, and program administration property for the base year divided by the rate sheet capacity for the base year, pro-rated for partial year sites for each provider in a DOH region, aggregated for all such providers in such region. Such quotient shall be multiplied by rate sheet capacity for the initial year. The final monthly State supplement shall be calculated in accordance with paragraph (6) of this subdivision, divided by the applicable rate sheet capacity for the initial period and such quotient to be further divided by 12.
(5) Capital cost component.
(i) Capital costs shall be included in the rate at the lower of the amount determined under 14 NYCRR Subpart 635-6.
Note:
The provision of this paragraph do not apply to capital approved by OPWDD prior to July 1, 2014.
(ii) Initial rate. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease, and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date of certification of the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(iii) Cost verified rates. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Capital costs approved on or after November 1, 2014 shall be amortized over a 25 year period for acquisition of properties or the life of the lease for leased sites. Amortization shall begin upon certification by the provider of such costs. For community residences start-up costs may be amortized over a one-year period beginning with site certification.
(iv) Renovations of existing provider owned residential programs shall be funded through the residential reserve for replacement (RRR).
(6) Adjustments. Rates described in this subdivision shall be subject to a reimbursement offset. Such offset shall be determined as follows:
(i) The sum of the total provider facility reimbursement, as determined by subparagraph (3)(iii) of this subdivision, and the capital reimbursement, as determined by paragraph (5) of this subdivision.
(ii) Supplemental security income, as determined by 14 NYCRR 671.7(b)(9)(xxi), annualized and multiplied by a provider’s initial period rate sheet capacity.
(iii) Supplemental nutrition assistance, as determined by 14 NYCRR 671.7(b)(10)(ii), and multiplied by 12, such product to be multiplied by a provider’s initial period rate sheet capacity.
(iv) The sum of subparagraphs (ii) and (iii) of this paragraph shall be deducted from the amount determined pursuant to subparagraph (i) of this paragraph. If such amount is negative, the State supplement will be equal to zero. If such amount is positive, a provider shall receive the State supplement amount multiplied by the statewide budget neutrality factor for State supplement as calculated below.
Statewide budget neutrality factor for State supplement, which shall mean the sum of the State supplement from all provider rate sheets in effect on June 30, 2014, divided by the sum of the State supplement for all providers, as calculated pursuant to subparagraph (iv) of this paragraph.
If the sum of the State supplement from all provider rate sheets in effect on June 30, 2014 is lower than the sum of the State supplement for all providers as calculated pursuant to subparagraph (iv) of this paragraph then the statewide budget neutrality factor shall be applied. If such sum is greater, then no statewide budget neutrality factor for State supplement shall be applied.
(7) Adjustments for July 1, 2014 through October 31, 2014. The department shall calculate the amount of reimbursement each provider would have received for July 1st through October 31, 2014 for services under the methodology described in the November 1, 2014 amendments to this Subpart. The department or OPWDD shall pay each provider the difference between such reimbursement and the amount the provider was entitled to receive under this Subpart in effect from July 1st to October 31, 2014.
(e) Day habilitation—group and supplemental.
(1) Operating component. Allowable operating costs shall include costs identified in the consolidated fiscal reports and reimbursement for such costs shall be inclusive of the following components:
(i) Regional average direct care wage , which shall mean the quotient of base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation- supportive IRA, day habilitation services and ICF/DD services, divided by base year salaried direct care hours for each provider in a DOH region, aggregated for all such providers in such region, for all residential habilitation-supervised IRA, residential habilitation- supportive IRA, day habilitation services and ICF/DD services.
(ii) Regional average employee-related component , which shall mean the sum of vacation leave accruals and total fringe benefits for the base year for each provider in a DOH region, aggregated for all such providers in such region, such sum to be divided by base year salaried direct care dollars for each provider in a DOH region, aggregated for all such providers in such region, and then multiplied by the applicable regional average direct care wage as determined by subparagraph (i) of this paragraph.
(iii) Regional average program support component , which shall mean the sum of transportation related-participant staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for each provider in a DOH region, aggregated by all such providers in such region. Such sum shall be divided by the total base year salaried direct care dollars of all providers in a DOH region, and then multiplied by the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph.
(iv) Regional average direct care hourly rate-excluding general and administrative , which shall mean the sum of the applicable regional average direct care wage as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, and the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph.
(v) Regional average general and administrative component , which shall mean the sum of the insurance-general and agency administration allocation for the base year for each provider in a DOH region, aggregated for all such providers in such region, divided by (the sum of total program/site costs and other than to/from transportation allocation, less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for the base year for each provider in a DOH region, aggregated for all providers in such region). The regional average direct care hourly rate-exclusive of general and administrative costs, as determined pursuant to subparagraph (iv) of this paragraph, shall then be divided by (one minus the applicable regional average general and administrative quotient), from which the applicable regional average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (iv) of this paragraph shall be subtracted.
(vi) Regional average direct care hourly rate , which shall mean the sum of the applicable regional average direct care wage, as determined pursuant to subparagraph (i) of this paragraph, the applicable regional average employee-related component as determined pursuant to subparagraph (ii) of this paragraph, the applicable regional average program support component as determined pursuant to subparagraph (iii) of this paragraph, and the applicable regional general and administrative component computed in subparagraph (v) of this paragraph.
(vii) Provider average direct care wage , which shall mean the quotient of base year salaried direct care dollars divided by the base year salaried direct care hours of a provider.
(viii) Provider average employee-related component , which shall mean the sum of vacation leave accruals and fringe benefits for the base year for each provider, divided by base year salaried direct care dollars of a provider, such quotient to be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(ix) Provider average program support component , which shall mean the sum of transportation related-participant, staff travel, participant incidentals, expensed adaptive equipment, sub-contract raw materials, participant wages-non-contract, participant wages-contract, participant fringe benefits, staff development, supplies and materials-non-household, other-OTPS, lease/rental vehicle, depreciation-vehicle, interest-vehicle, other-equipment, other than to/from transportation allocation, salaried support dollars (excluding housekeeping and maintenance staff) and salaried program administration dollars for the base year for a provider. Such sum shall be divided by the base year salaried direct care dollars of such provider and such quotient shall be multiplied by the provider average direct care wage as computed in subparagraph (vii) of this paragraph.
(x) Provider average direct care hourly rate-excluding general and administrative , which shall mean the sum of the provider average direct care wage as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, and the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph for each provider.
(xi) Provider average general and administrative component , which shall mean the sum of insurance-general and agency administration allocation for the base year for a provider, such sum to be divided by (the sum of total program/site costs and other than to/from transportation allocation less the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, total property-provider paid, housekeeping and maintenance staff, salaried clinical dollars, and contracted clinical dollars for a provider). The provider average direct care hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall then be divided by (one minus the applicable provider average general and administrative quotient), from which the provider average direct care wage hourly rate-excluding general and administrative, as computed in subparagraph (x) of this paragraph, shall be subtracted.
(xii) Provider average direct care hourly rate , which shall mean the sum of the provider average direct care wage, as determined pursuant to subparagraph (vii) of this paragraph, the provider average employee-related component as determined pursuant to subparagraph (viii) of this paragraph, the provider average program support component as determined pursuant to subparagraph (ix) of this paragraph, and the provider average general and administrative component as determined pursuant to subparagraph (xi) of this paragraph.
(xiii) Provider direct care hours , which shall mean the sum of base year salaried direct care hours and base year contracted direct care hours, such sum to be divided by the billed units for the base year. Such sum to be multiplied by rate sheet units for the initial period.
(xiv) Regional average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by base year salaried clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xv) Provider average clinical hourly wage , which shall mean the quotient of base year salaried clinical dollars of a provider divided by base year salaried clinical hours of such provider.
(xvi) Provider salaried clinical hours , which shall mean the quotient of base year salaried clinical hours of a provider, divided by the billed units for the base year, such quotient to be multiplied by the rate sheet units for the initial period for such provider.
(xvii) Regional average contracted clinical hourly wage , which shall mean the quotient of contracted clinical dollars for each provider in a DOH region, aggregated for all such providers in such region, divided by the base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region.
(xviii) Provider contracted clinical hours , which shall mean the quotient of a provider’s contracted clinical hours for the base year divided by the billed units for the base year, such quotient to be multiplied by rate sheet units for the initial period.
(xix) Provider direct care hourly rate-adjusted for wage equalization factor , which shall mean the sum of the provider average direct care hourly rate, as determined pursuant to subparagraph (xii) of this paragraph multiplied by 0.75 and the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (vi) of this paragraph multiplied by 0.25.
(xx) Provider clinical hourly wage-adjusted for wage equalization factor , which shall mean the sum of the provider average clinical hourly wage, as determined pursuant to subparagraph (xv) of this paragraph, multiplied by 0.75 and the applicable regional average clinical hourly wage, as computed in subparagraph (xiv) of this paragraph multiplied by 0.25.
(xxi) Provider reimbursement for direct care hourly rate , which shall mean the product of the calculated direct care hours, as determined pursuant to subparagraph (xiii) of this paragraph, and the provider direct care hourly rate-adjusted for wage equalization factor, as computed in subparagraph (xix) of this paragraph.
(xxii) Provider reimbursement for clinical hourly wage , which shall mean the product of the provider salaried clinical hours, as determined pursuant to subparagraph (xvi) of this paragraph and the provider clinical hourly wage-adjusted for wage equalization factor, as determined pursuant to subparagraph (xx) of this paragraph.
(xxiii) Provider reimbursement from contracted clinical hourly wage , which shall mean the product of the provider contracted clinical hours, as determined pursuant to subparagraph (xviii) of this paragraph and the applicable regional average contracted clinical hourly wage, as determined pursuant to subparagraph (xvii) of this paragraph.
(xxiv) Provider facility reimbursement , which shall mean the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation equipment, insurance-property and casualty, housekeeping and maintenance staff, and program administration property the base year for a provider and such sum to be divided by provider billed units for the base year. Such sum to be multiplied by rate sheet units for the initial period.
(xxv) Provider to/from transportation reimbursement, which is calculated as follows: effective July 1, 2018 and only for the rate period July 1, 2018 through June 30, 2019, all providers will receive a survey requesting prospective reimbursement data for provider to/from transportation. Only those providers having a signed and negotiated multi-year transportation contract inclusive of the period January 1, 2017 through December 31, 2017 for calendar year filers and July 1, 2017 through June 30, 2018 for fiscal year filers will need to submit the completed survey to DOH. The budgets will be reviewed and compared to the most current and available cost report. A determination of appropriate reimbursement will be made by DOH and that result will be included in the July 1, 2018 rates. A reconciliation of this funding will be performed with a reimbursement adjustment made in the rate period July 1, 2019 through June 30, 2020 utilizing the July 1, 2017 through June 30, 2018 and January 1, 2017 through December 31, 2017 CFRs. In subsequent rate periods, to/from transportation will be updated on an annual basis by utilizing the most current available CFR. Divide to/from transportation allocation (CFR1 line 68b) by applicable provider billed units. Multiply by rate period authorized units.
(xxvi) Provider operating revenue , which shall mean the sum of provider reimbursement from direct care hourly rate, as determined pursuant to subparagraph (xxi) of this paragraph, the provider reimbursement from clinical hourly wage, as determined pursuant to subparagraph (xxii) of this paragraph, the provider reimbursement from contracted clinical hourly wage, as determined pursuant to subparagraph (xxiii) of this paragraph, the provider facility reimbursement, as determined pursuant to subparagraph (xxiv) of this paragraph, and provider to/from transportation reimbursement, as determined pursuant to subparagraph (xxv) of this paragraph.
(xxvii) Statewide budget neutrality adjustment factor for operating dollars , which shall mean the quotient of all provider rate sheets in effect on June 30, 2014, divided by provider operating revenue, as determined pursuant to subparagraph (xxvi) of this paragraph, for all providers.
(xxviii) Total provider operating revenue- adjusted , which shall mean the product of the provider operating revenue, as determined pursuant to subparagraph (xxvi) of this paragraph and the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (xxvii) of this paragraph.
The final daily operating rate shall be determined by dividing the total provider operating revenue-adjusted, as determined by subparagraph (xxviii) of this paragraph, by the applicable provider rate sheet units for the initial period.
(2) Alternative operating component. For providers that did not submit a cost report or submitted a cost report that was incomplete for day habilitation services for the base year, the final daily operating rate shall be a regional daily operating rate. This rate shall be the sum of:
(i) The product of the applicable regional average direct care hourly rate, as determined pursuant to subparagraph (1)(vi) of this subdivision and the applicable regional average direct care hours , which shall mean the quotient of salaried and base year contracted direct care hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(ii) the product of the applicable regional average clinical hourly wage, as determined pursuant to subparagraph (1)(xiv) of this subdivision and the applicable regional average clinical hours , which shall mean the quotient of salaried and base year contracted clinical hours for each provider in a DOH region, aggregated for all such providers in such region, divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(iii) the applicable regional average facility reimbursement , which shall mean the quotient of the sum of food, repairs and maintenance, utilities, expensed equipment, household supplies, telephone, lease/rental equipment, depreciation, insurance – property and casualty, housekeeping and maintenance staff, and program administration property for the base year divided by the billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region; and
(iv) the applicable regional average to/from transportation reimbursement , which shall mean the quotient of the to/from transportation allocation for the base year divided by the provider billed units for the base year for each provider in a DOH region, aggregated for all such providers in such region. Such sum shall then be multiplied by the statewide budget neutrality adjustment factor for operating dollars, as determined pursuant to subparagraph (1)(xxvii) of this subdivision.
(3) Capital component.
(i) For capital assets approved on or after July 1, 2014. OPWDD regulations under 14 NYCRR Subpart 635-6 establish standards and criteria for calculating provider reimbursement for the acquisition and lease of real property assets which require approval by the Office for People with Developmental Disabilities. The regulations also address associated depreciation and related financing expenses. The rate will include costs for actual straight line depreciation, interest expense, financing expenses, and lease cost. In no case will the total capital reimbursement associated with the capital asset exceed the total acquisition, renovation and financing cost associated with a capital asset. The asset life for building acquisitions shall be 25 years.
(ii) For capital assets approved prior to July 1, 2014. The State will identify each asset by provider, and provide a schedule of these assets identifying: total actual cost, reimbursable cost determined by the prior approval, total financing cost, allowable depreciation and allowable interest for the remaining useful life as determined by the prior approval, and the allowable reimbursement for each year of the remaining useful lives. In no case will the total reimbursable depreciation or principal amortization and total interest associated with the capital asset exceed the total acquisition, renovation and financing cost associated with a capital asset.
(iii) Notification to providers. 14 NYCRR Subpart 635-6 contains the criteria and standards associated with capital costs and reimbursement. Each provider will receive a schedule of approved reimbursable costs that is being used to establish the real property capital component of the provider’s reimbursement rate.
(iv) Initial rate for capital assets approved on or after July 1, 2014. The rate shall include the approved appraised costs of an acquisition or fair market value of a lease, and estimated costs for renovations, interest, soft costs and start-up expenses. Such costs shall be included in the rate as of the date of certification of the site, continuing until such time as actual costs are submitted to the State. Estimated costs shall be submitted in lieu of actual costs for a period no greater than two years. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted. The department may retroactively adjust the capital component.
(v) Cost verified rates for capital assets approved on or after July 1, 2014. The provider shall submit to the State supporting documentation of actual costs. Actual costs shall be verified by the State reviewing the supporting documentation of such costs. A provider submitting such actual costs shall certify that the reimbursement requested reflects allowable capital costs and that such costs were actually expended by such provider. Under no circumstances shall the amount included in the rate under this subparagraph exceed the amount authorized in the approval process. Capital costs shall be depreciated over a 25 year period for acquisition of properties or the life of the lease for leased sites. Capital improvements shall be depreciated over the life of the asset. The amortization of interest shall not exceed the life of the loan taken. Amortization or depreciation shall begin upon certification by the provider of such costs. Start-up costs may be amortized over a one year period beginning with site certification. If actual costs are not submitted to the State within two years from the date of site certification, the amount of capital costs included in the rate shall be zero for each period in which actual costs are not submitted.
(vi) Capital reimbursement reconciliation schedule. Beginning with the cost reporting period ending December 31, 2014, each provider shall submit to OPWDD, as part of the annual cost report, a capital reimbursement reconciliation schedule. This schedule will specifically identify the differences, by capital reimbursement item, between the amounts reported on the certified cost report, and the reimbursable items, including depreciation, interest and lease cost from the schedule of approved reimbursable capital costs. The provider’s independent auditor will apply procedures to verify the accuracy and completeness of the capital reimbursement reconciliation schedule. The department will retroactively adjust capital reimbursement based on the actual cost verification process as described in subparagraph (iv) of this paragraph.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.2 Other laws, codes, rules and regulations
Medical facilities issued operating certificates or certificates of approval shall comply with all pertinent Federal laws and regulations enacted pursuant thereto, applicable State law, including the Public Health Law and the Mental Hygiene Law and codes, rules and regulations having general application.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.3 Reclassification for cost finding purposes
(a) Reclassifications for Medicaid cost finding purposes.
(1) In many instances the reclassifications made to conform to the principles of functional reporting (see section 446.2 of this Part) are not conducive to the proper allocation of cost during the cost finding process. For example, nonroutine maintenance must be assigned to the Plant Maintenance (account 8400) cost center to accomplish the functional reporting of expense. The basis to be used for cost finding is Net Square Feet. If the cost of nonroutine maintenance is allocated on the basis of Net Square Feet, the resulting distribution of this expense would include cost centers for which no nonroutine maintenance was performed. A better allocation of the cost of nonroutine maintenance would be accomplished by reclassifying this cost out of the functional cost center to the cost centers for which nonroutine maintenance was performed, prior to utilizing Net Square Feet to allocate the remaining cost to the other appropriate functional cost centers.
(2) Therefore, reclassifications of the direct expenses of functional cost centers may be made to other functional cost centers for cost finding purposes when that direct expense is obtainable. Estimates, time studies, sampling or other means may not be used as a basis for reclassification. The required Cost Allocation statistics must be used to allocate costs remaining in the functional cost centers after reclassifications are made.
(b) Reclassifications for Medicare cost finding purposes.
(1) Other Health Profession Education (account 8260). This expense account consists of the direct costs of organized educational programs such as school of medical technology, school of X-ray technology, administrative intern program, etc. The total direct expenses included in Other Health Profession Education must be reclassified to the costs centers directly affected by the educational programs; for example, the cost of the school of X-ray technology must be reclassified to the appropriate radiology cost centers.
(2) Medical Care Review (account 8740). This expense account consists of the costs incurred in providing peer review, quality assurance, utilization review, professional standards review, and medical care evaluation functions. Only utilization review costs of the hospital-based skilled nursing facility should be reclassified as follows: If the scope of the review covers all patients, all allowable costs should be reclassified in this column to Other Administrative and General. If the scope of the review covers only Medicare patients or Medicare title V and title XIX patients, reclassify to Other Administrative and General all allowable costs other than physicians' compensation. The reasonable compensation paid to the physicians for their services on utilization review committee is to be allocated 100 percent to the health care programs. The reasonable compensation paid to the physicians will be adjusted out by the Worksheet—Adjustment Prior to Cost Finding, and will be included on the Worksheet—Computation of Net Cost of Covered Services.
(3) Insurance—Hospital and Professional Malpractice (account 8840). This expense account consists of the direct costs incurred by the provider for hospital and professional malpractice insurance. This provides for reclassifying the general and administrative expense directly related to malpractice losses. All allowable and nonallowable uninsured malpractice losses and related expenses, either through deductible or coinsurance provision, or as a result of an award in excess of reasonable coverage limits, or as a governmental provider, must be reclassified to the malpractice insurance account.
(4) Insurance—Other (account 8850). This expense account consists of expenses incurred in maintaining insurance policies, except for professional and hospital malpractice insurance and employee benefit insurance. Insurance cost applicable to fixed assets and movable equipment must be reclassified to the applicable cost center. Any insurance expense which cannot be identified to a specific cost center will be reclassified to Administrative and General.
(5) Licenses and Taxes (other than income taxes) (account 8860). This expense account consists of the business license expense and tax expense incidental to the operation of the hospital. Licenses and taxes (other than income taxes) applicable to fixed assets and movable equipment must be reclassified to the applicable cost center. Any licenses and taxes which cannot be identified to a specific cost center and are related to the general overall operation of the hospital must be reclassified to the Administrative and General account.
(6) Interest Short-Term (account 8870). This expense account consists of interest expense related to borrowings for hospital operations. The full amount of cost must be reclassified to Administrative and General.
(7) Interest Long-Term (account 8880). This expense account consists of all interest incurred on capital, mortgages and other loans for the acquisition of property, plant and equipment. Interest on Mortgage Loans will be reclassified to Depreciation, Amortization, Fixed Assets. Interest on Movable Equipment will be reclassified to Depreciation, Amortization, Movable Equipment.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.18 Fire safety
(a) Building standards.
All construction, equipment installation and fire safety practices required by this section shall be operated and maintained in accordance with the Uniform Code.
(b) Fire alarm systems and emergency procedures.
(1) Buildings used for sleeping by 50 or more persons, or buildings two stories or more in height used for sleeping, shall have a fire alarm system, that when activated sounds an alarm which can be heard throughout the camp. Buildings three stories or more in height used for sleeping shall be protected with an automatic fire detection system, including smoke detectors installed in corridors, assembly areas, storage rooms, stairways and heat detection devices installed in kitchens.
(2) At least one single station smoke detecting alarm device shall be installed on or near the ceiling in each sleeping unit. Battery-operated devices are acceptable. Tents and lean-to's are not required to be equipped with these devices.
(3) Portable audible/visual smoke detectors shall be provided in all sleeping quarters occupied by visually or audibly impaired campers. Hard wiring of audible/visual detectors into an existing central closed circuit alarm system shall be permitted in lieu of such portable detectors. Tents and lean-to's are not required to be equipped with these devices.
(4) Fire drills shall be held within the first 48 hours of each camping session and periodically thereafter in accordance with the camp safety plan. A log with drill dates and times must be maintained and verified by the camp director. It must be available for inspection at all times.
(5) The camp operator shall be responsible for the regular inspection of all fire protection facilities and equipment.
(c) Means of egress.
(1) The means of egress from all structures shall be maintained in an unobstructed, easily traveled condition at all times, and protected from hazardous areas such as heating plant, kitchen and flammable storage.
(2) Sleeping quarters with an occupancy of 15 or more persons shall be provided with at least two separate means of egress located as far apart as practical. Each door shall swing in the direction of egress. Windows in a sleeping quarter two stories or less in height may be substituted for one approved exit, provided the sill is not more than three feet above the floor and the drop from the windowsill to an unobstructed area on the ground is less than 14 feet.
(3) Two separate means of egress shall be provided from each floor of a multi-story building. In buildings constructed prior to September 1, 1978, dead-end corridors up to 35 feet in length are acceptable. An exitway shall lead to an outside exterior stairway or to an interior smoke-tight passageway having a minimum of three-quarter hour fire-resistant construction and leading to the outdoors at grade. Stairs extending beyond two occupied floors shall have a self-closing, tight door at each floor level.
(4) Except for an individual room, a door containing hardware and forming part of a means of egress shall be nonlocking against egress and operable with a single motion in the direction of egress. The use of hooks and eyes, bolts, bars and similar devices is prohibited; widths of exit doors shall be a minimum of 28 inches.
(5) All assemblage areas, including a recreation room, dining hall or chapel, shall have at least two means of egress acceptable to the permit-issuing official and doors shall comply with the requirements of paragraph (4) of this subdivision.
(6) Exits from a room occupied by 15 or more persons, or exits not readily visible to the occupants, shall be identified by lighted exit signs, including directional signs where needed.
(7) Emergency lighting shall be provided for halls, stairways and exit signs where required by the permit-issuing official.
(d) Heating.
Stoves or other heat sources, where provided, shall be installed and maintained in accordance with the manufacturer's instructions to avoid fire hazards and dangerous concentrations of fumes or gas. Water heaters shall not be installed in sleeping quarters.
(e) Other precautions.
(1) Containers of gasoline, kerosene and other flammable materials shall be labeled and stored in a separate locked and unoccupied building. Oil-base paints and thinners shall be stored in approved-type paint lockers or in a separate building.
(2) All tents shall be of the fiber-impregnated flame-retardant variety or equivalent.
(3) Fire extinguishers and other firefighting equipment acceptable to the permit-issuing official shall be provided, inspected and tagged by the camp operator prior to the camp season. The equipment shall be maintained in operating condition at all times.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.43 Fresh fruit washing
Fresh fruits which may be eaten without peeling are to be thoroughly washed in potable water at the packing plant by the processor, or at the commissary before being placed in the vending machine for dispensing. The washed fruit is to be protected from contamination after the washing process.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.3 Emergencies
Any of the prescribed requirements for admission may be waived on behalf of an applicant ostensibly qualified for admission in an emergency requiring the immediate admission of the applicant.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.5 Approval of service coordinators, evaluators, and service providers
(a) Individuals and agencies shall apply to the department for approval to provide evaluations, service coordination services, or early intervention services. The department may reapprove providers, but no more frequently than every five years from the date of approval or subsequent reapproval. Upon receipt of notification from the department, an agency or individual shall apply for reapproval if the agency or individual wishes to continue providing services in the Early Intervention Program. The department shall consider applications for approval and reapproval utilizing the criteria set forth in paragraph (4) of this subdivision.
(1) Payee providers shall be enrolled and, as applicable, recertified as providers in the medical assistance program in accordance with the procedures for such enrollment and recertification established by the department, and shall provide documentation of the provider’s enrolled and, if applicable, recertification status upon the department’s request.
(2) Approved agency providers shall submit on a periodic basis consolidated fiscal reports to the department upon request. Approved individual providers shall submit information on revenues and expenses upon request of and on a form developed by the department.
(3) On or before September 1, 2010, all approved providers shall be in compliance with the criteria set forth in paragraph (4) of this subdivision.
(4) Approval and reapproval of individuals and agencies shall be based on the following criteria:
(i) character and competence of the individual, or for agency providers, the owners, officers, including the chief executive officer and chief financial officer, members, shareholders who own 10 percent or more of the voting shares in the agency, directors or sponsors, the program director and other key employees, and the board of directors of a not-for-profit entity as determined by the department;
(ii) documented fiscal viability of the agency;
(iii) for individual providers, proof of current certificate, license, or registration in one of the disciplines set forth in section 69-4.1(al) of this Subpart and documentation of a minimum of 1,600 clock hours prior to the date of application to the department for approval, delivering such service to children under five years of age in an early intervention, clinical pediatric, early childhood education program, which may include relevant experience obtained as part of a supervised educational program and/or clinical internship as a prerequisite for professional licensure, certification, or registration, and provided that such experience must have included direct experience in delivering services to children with disabilities and their families;
(iv) for agency providers, identification of all employees who will provide Early Intervention Program services, and where applicable, the employees' licenses, registrations, certifications, national provider identification numbers and expiration dates and such other information as may be required by the department;
(v) for agency providers, identification of all State-approved agency and individual contractors who will be utilized to provide services and where applicable, the persons' licenses, registrations, certifications, national provider identification numbers and expiration dates and other information as may be required by the department;
(vi) for agency providers, a quality assurance plan that is approved by the department for each type of service offered by the agency, including evaluations and service coordination;
(vii) for agency providers, documentation that the agency has in its employment, or in accordance with this paragraph, will have in its employment, the following personnel:
(a) a professional employed on a full time basis who shall serve as the program director for the agency whose duties may include Early Intervention Program service delivery in addition to administration and oversight responsibilities. The program director shall have a minimum of two years of full-time equivalent experience in an early intervention, clinical pediatric, or early childhood education program serving children ages birth to five years of age, provided that:
(1) such experience shall have included direct experience in delivering services to children with disabilities and their families; and
(2) at least one year of such experience shall have been in the delivery of services to children less than three years of age and their families;
(b) a minimum of two qualified personnel or service coordinators who meet qualifications established in section 69-4.4 of this Subpart, in addition to the Early Intervention Program director, each of whom provides evaluations, service coordination, or services to individuals with disabilities for a minimum of twenty hours each per week;
(c) a professional or professionals who hold a license, certification, or registration in the type of service offered by the agency whose responsibilities include monitoring and overseeing implementation of the quality assurance plan for that service as developed by the agency in accordance with subparagraph (3)(vii) of this subdivision;
(d) for purposes of this subdivision, if the agency applying for initial approval has not, at the time of application, employed the personnel required in this paragraph, the agency may verify that it will employ such personnel within three months of approval and receive a conditional three months of approval. At the end of the three-month period, the agency shall submit documentation of the employment of such personnel in accordance with said requirements. If the agency does not provide sufficient documentation at the end of the three month period that it meets the requirements of this subparagraph, the agency's approval shall be void ab initio and the agency shall not be authorized to provide services in the Early Intervention Program;
(e) an agency applying for reapproval shall, at the time of application, submit documentation that it has in its employment the personnel required in this paragraph;
(viii) adherence to, and for purposes of reapproval, evidence of demonstrated compliance with all applicable Federal and State laws, regulations, standards and guidelines;
(ix) delivery of services on a 12-month basis and flexibility in the hours of service delivery, including weekend and evening hours in accordance with eligible childrens' IFSPs;
(x) agreement to participate and, for purposes of reapproval, evidence of participation in continuing professional and clinical education relevant to early intervention services, including services and clinical issues unique to children less than three years of age, and in-service training on state and local policies and procedures of the Early Intervention Program, including department-sponsored training;
(xi) adherence to, and for purposes of reapproval, demonstrated compliance with the confidentiality requirements applicable to the Early Intervention Program as set forth in Federal and State law and regulations;
(xii) provision of copies of all organizational documents requested by the department and documentation of licensure or approval granted to the individual or agency by other regulatory agencies;
(xiii) for the purposes of reapproval, documentation that corrective actions required by the department have been implemented and non-compliance corrected to the satisfaction of the department;
(xiv) provision of such additional pertinent information or documents necessary for approval or reapproval, as requested by the department.
(5) In addition to the criteria set forth above, for reapproval of an agency or individual, the department may also consider:
(i) any actions taken against the provider's license, certification, or registration, any criminal convictions, or any actions taken pursuant to section 69-4.24 of this Subpart;
(ii) the results of any investigations performed by the department pursuant to section 69-4.17(i) of this Subpart;
(iii) the results of monitoring reviews, complaint investigations and fiscal audits performed by the department, municipalities or either of their agents; and
(iv) other information and documents pertinent to the provider's character and competence.
(b) Agencies shall apply to the department for approval to use applied behavior analysis (ABA) aides to assist in the provision of ABA services in accordance with section 69-4.25 of this Subpart. In addition to the criteria set forth in paragraph (a)(4) of this section, the department shall also consider the following in determining whether to grant such approval:
(1) submission of written policies and procedures as described in section 69-4.25(a)(6) of this Subpart that are approved by the department and include, but are not limited to the following:
(i) A plan to ensure that all employees and subcontractors who will be delivering ABA services receive initial and ongoing training in content areas approved by the department and directly related to ABA.
(ii) A description of the methods by which the agency will verify that employed ABA aides will meet the criteria established in section 69-4.25(e) of this Subpart and verify that ABA aides will be employed and supervised in accordance with section 69-4.25 of this Subpart.
(iii) Documentation that team meetings will be required and convened by supervisory personnel for all employees and subcontractors delivering ABA services, in accordance with section 69-4.25 of this Subpart.
(iv) A description of the methods by which the agency will ensure the quality and effectiveness of ABA services and the health and safety of eligible children.
(2) A table of organization, including employed supervisor(s), employed ABA aides, and employed and subcontracted qualified personnel who will provide ABA services to eligible children, including the planned ratio of children to employed supervisors and employed ABA aides.
(c) If there is a transfer, assignment, or other disposition of 10 percent or more of an interest or voting rights in the approved agency provider; or if there is a transfer, assignment, or other disposition of less than 10 percent of an interest or voting rights in the approved agency provider, but the transfer, assignment, or other disposition together with all prior transfers, assignments, or other dispositions within the last 5 years subsequent to the date of the agency provider’s approval by the department would, in the aggregate, involve 10 percent or more of an interest in the approved agency provider, the approved agency provider shall notify the department as soon as practicable, but no later than 5 business days after the intended effective date of the transfer, assignment, or other disposition. The notice shall include a statement as to whether the approved agency provider intends to continue to participate in the Early Intervention Program. Upon receipt of such notice, the department may determine that the approved agency provider must initiate a reapproval process.
(d) Providers approved and reapproved to deliver early intervention evaluations, service coordination services and Early Intervention Program services shall meet with or otherwise communicate with parents and other service providers, including participation in case conferencing and consultation. Agencies shall further require that its employees comply with the provisions of this section and require compliance with this subdivision in its contracts with individual providers.
(e)
(1) Approved providers shall not disseminate, or cause to be disseminated on their behalf, marketing materials that are false, deceptive, or misleading. Upon the department's request, providers shall periodically submit copies of marketing materials for review. Marketing materials that do not comply with the provisions of this subdivision may be a basis for action against the provider's approval in accordance with the provisions of section 69-4.24 of this Subpart. The department shall develop standards on appropriate marketing materials and shall require that marketing materials that seek to promote or advertise Early Intervention Program evaluations or services adequately inform parents or guardians of potentially eligible or at-risk children less than three years of age about the Early Intervention Program. Marketing materials that seek to promote or advertise Early Intervention Program evaluations or services shall include the following statements or their equivalent:
(i) Clear identification that the Early Intervention Program, and early intervention services available through the Early Intervention Program, are for children less than three years of age who have or are suspected of having a developmental delay and/or disability.
(ii) A statement that the Early Intervention Program is a public program funded by New York State and county governments.
(iii) A statement that all children must be referred to the municipality to access Early Intervention Program services, and including the municipal agency's telephone number.
(iv) Clear identification of the provider referenced in the marketing and advertising materials, and an accurate statement that the provider is approved as a provider of Early Intervention Program services and that it is in an agreement with the department to deliver Early Intervention Program services.
(v) A statement that all services provided under the Early Intervention Program are provided at no out-of-pocket cost to parents, but that health insurance subject to New York State Insurance Law may be accessed for reimbursement for early intervention services provided to eligible children and their families.
(vi) A statement that eligibility for the Early Intervention Program can be determined only by approved evaluators under an agreement with the department.
(vii) A statement that if a child is found eligible for the Early Intervention Program, all needed early intervention services must be identified by the IFSP team, including the parent and the early intervention official.
(viii) A statement that authorization from the early intervention official is required for a qualified early intervention provider to furnish early intervention services to the child.
(ix) A statement that when early intervention services are delivered in child care settings or community locations that require a fee, the parent is responsible for paying any associated costs with such access to child care or community locations.
(2) Service coordinators, evaluators and approved providers, and any individual or entity which performs paid or unpaid marketing activities related to Early Intervention Program services on their behalf, shall not engage in any marketing and advertising practices that offer incentives, or could be construed or appear to offer incentives of any kind to the parents or relatives of an eligible or potentially eligible child, or to the service coordinator, evaluator, the referral source, or other approved providers authorized to deliver services to an eligible or potentially eligible child, that attempts to or would appear to influence selection of a service cooridnator, evaluator or provider of services.
(3) Approved agency providers shall not offer incentives or appear to offer incentives to its employees or subcontractors in the form of payment, performance evaluations, or other awards or benefits that are based on the number of referrals and/or services authorized under the Early Intervention Program.
(f) Approved individuals shall notify the department within two business days if his or her license is suspended, revoked, limited or annulled, regardless of whether the suspension or limitation is stayed. Approved individuals and agencies shall notify the department within two days if a contract the provider holds with an agency provider is terminated for any reason. Approved agency providers shall ensure that services are delivered by those authorized to do so and shall only employ or contract with individuals who are licensed, registered or certified in compliance with applicable provisions of law, in one of the disciplines set forth in section 69-4.1(al) of this Subpart.
(g) Approved providers shall comply with title VI of the Civil Rights Act of 1964, section 504 of the Federal Rehabilitation Act of 1973, and all other State and Federal statutory and constitutional non-discrimination provisions which prohibit discrimination on the basis of race, color, national origin, handicap, age, sex, religion and marital status.
(h) All applicants shall receive written notice of their approval or reapproval to deliver service coordination services, evaluations, and/or Early Intervention Program services, and that an agreement with the department may be required to participate in the Early Intervention Program.
(i) Approved providers shall notify the department in writing of any changes made subsequent to approval or reapproval of professional license, certificate, or registration; or for agency providers, transfers, assignments, or other dispositions of less than 10 percent of an interest or voting rights of the agency; identification; address and location; and catchment area.
(j) An approved agency or individual provider who intends to cease providing service coordination services, evaluations or early intervention services, or in the case of an agency, intends to cease ownership, possession or operation of the agency, or chooses to voluntarily terminate status as an approved service coordination, evaluation and/or service provider agency, shall:
(1) submit to the department and early intervention official written notice of such intention and a plan for transition of children not less than 90 days prior to the intended effective date of such action; and
(2) collaborate with municipalities and the department to ensure a smooth transition of eligible children and their families to other approved providers.
(k) Municipalities shall provide the department with such information or documentation as requested and in a content, format and frequency determined by the department.
(l) Agency providers shall periodically, upon request of the department, provide the department with information on its State-approved agency and individual employees and contractors utilized by the agency in the provision of Early Intervention Program services. Information to be provided includes the provider's name, license, registration or certification, national provider identification number and expiration dates, and other such information as may be required by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.204 Medical staff classification—consulting
Physicians of recognized professional ability in their specialty, but who are not members of the attending staff.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
RESPONSIBILITY FOR PAYMENT FOR SERVICES RESPONSIBILITY FOR PAYMENT FOR SERVICES
10 CRR-NY 43-1.9 Extent of responsibility for payment
(a) The local health official of the jurisdiction where a tuberculosis patient resides shall be responsible to pay providers for health care services rendered to a local charge tuberculosis patient when such services are authorized and provided in accordance with this Subpart, except:
(1) The maximum charges which the local health official shall be responsible for are the rates for the Medical Assistance Program established in accordance with the provisions of section 2807 of the Public Health Law and fees for services established in the State medical fee schedule for medical assistance.
(2) Amounts eligible for reimbursement or indemnification from any third-party payer shall not be paid by the local health official. Such amounts shall be deducted by the local health official from the charges billed by the provider or the established rates and/or fees in the State medical fee schedule for the health care services rendered, whichever are less.
(3) When a person has been admitted as an inpatient to a hospital for the treatment of a nontuberculous disease or condition and is subsequently found to have tuberculosis which requires inpatient care and treatment, a local health official has no responsibility to pay for care and treatment prior to the date of diagnosis of tuberculosis. If the person requires tuberculosis care and treatment, but hospitalization is not justified, the local health official shall not be responsible for hospitalization costs.
(4) If, upon review of a claim, the local health official determines that a tuberculosis patient had or was eligible for third-party coverage or indemnification and that the provider failed to make a good faith effort to determine whether there was such coverage or indemnification, the local health official may deny payment of the claim.
(5) A person who volunteers to assume and pay for the cost of tuberculosis health care services hereunder shall be liable therefor.
(b) The State of New York shall be responsible to pay providers for health care services rendered to a State charge tuberculosis patient in accordance with the terms of this Subpart, with the same exceptions as described in subdivision (a) of this section.
(c) Subsequent to paying a provider for services, if a local health official or the State determines that a provider did not make a good faith effort to obtain third-party payer coverage or indemnification that was available, the local health official or the State shall require the provider to repay an amount equivalent to the amount of such third-party payer coverage or indemnification.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.135 Fringe benefit
See employee benefit.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.90 Variance from a maximum contaminant level
(a) The supplier of water may request, and the department may grant, one or more variances from an MCL contained in sections 5-1.51 and 5-1.52 tables 1, 3, 5 and 7 of this Subpart to any public water system based on a finding that:
(1) because of characteristics of the raw water sources which are reasonably available to it, the public water system cannot meet the requirements respecting such MCL despite application of the best available technology, treatment techniques or other means which are generally available, taking costs into consideration; and
(2) the granting of a variance will not result in an unreasonable risk to health.
(b) At the time of the granting of the variance, the department shall prescribe, and the supplier of water shall follow, a schedule for:
(1) compliance, including increments of progress, to meet each MCL covered by the variance; and
(2) implementation of such control measures as the department may require.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.3 Time requirements for compliance
No institution shall permit any student to attend such institution in excess of 30 days without complying with section 66-2.2 of this Subpart, except that for a student from out of state or another country who can show a good faith effort to comply with section 66-2.2 of this Subpart may attend the institution for 45 days. Prior to August 1, 1991, the applicable 30- and 45-day periods shall be extended to 60 and 90 days, respectively.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-2 DRUG SUBSTITUTION
10 CRR-NY 60-2.2 Omissions from the list of safe, effective and therapeutically equivalent prescription drugs
The omission of a drug product from the list of drug products in no way automatically implies that such product is known to be therapeutically nonequivalent to other similar products nor that it is ineffective. Such omission shall indicate that an appropriate bioequivalence standard for all pharmaceutical equivalents of such drug has not yet been established, or that appropriate evidence that the standard has been met by such product has not been submitted to the Food and Drug Administration.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.7 Required laboratory tests on donors and donated tissue
All required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state tissue procurements, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulatory authority, the United States Health Care Financing Administration, or by the department.
(a) Blood samples from all allogeneic ocular tissue donors shall be tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type (HIV-2) and hepatitis C virus (HCV), as well as for hepatitis B surface antigen (HBsAg), for purposes of donor selection.
(b) All ocular tissue from living donors, except corneal tissue, shall be quarantined for six months. After such time and prior to the distribution of the tissue for transplantation, the donor shall be retested for HBsAg and antibodies to HCV, HIV-1, and HIV-2 and tested for antibodies to hepatitis B core antigen (anti-HBc).
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.17 Lighting and electrical requirements
(a) Lighting or other electrical circuits provided in the pool area must be protected by ground- fault circuit interrupters in accordance with the Uniform Code. These devices may be required at an existing pool constructed prior to March 31, 1973, when the permit-issuing official determines it is necessary to protect the safety of bathers.
(b) Defects in the electrical system, including underwater lights, overhead lights and their respective lenses, shall be immediately repaired.
(c) Portable electrical devices, such as announcing systems and radios within the reach of bathers, shall be prohibited.
(d) Windows and lighting equipment shall be adjusted to prevent glare and excessive reflection on the pool surface. Illumination levels must be maintained in accordance with provisions in section 6-1.29, item 7.0, of this Subpart.
(e) Underwater lights shall allow an observer on the pool deck to clearly see all portions of the pool, including the bottom.
(f) When underwater lighting is not provided and night swimming is permitted, surface lighting shall be adequate to allow an observer on the pool deck to clearly see the pool bottom.
(g) Operators of existing pools shall possess a certificate of electrical compliance with the Uniform Code issued by the New York Board of Fire Underwriters or equivalent certifying agency.
(h) Adequate emergency lighting shall be provided at swimming pools where night swimming is allowed and indoor pools where no natural light is present. For outdoor pools, a portable battery-powered artificial light source is acceptable and shall be adequate and maintained to facilitate swimming pool evacuation.
(i) No overhead electrical wiring shall pass within 20 feet horizontally of the swimming pool.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.6 Disposition of nontransplant anatomic parts
(a) All users of nontransplant anatomic parts, including whole body users, shall dispose of whole body remains, body segments, organs and tissue in accordance with existing state standards for such disposition. Users may return whole bodies or body segments to the whole body acquisition service from which the material was originally obtained.
(b) Disposition of whole bodies and body segments shall be consistent with instructions provided in the consent document.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.102 Research, instructional activities and chemical analysis
Persons conducting research, instructional activities or chemical analysis of controlled substances shall keep records required by article 33 of the Public Health Law, and as otherwise provided by this Part and in particular section 80.36.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.11 Prior approval for private duty nursing
(a) A request for private duty nursing in the hospital or in the home must be accompanied by a physician's written order and treatment plan.
(b) In a hospital setting, the physician's order must state that the enrollee is in need of individual and continuous care beyond that available by the staff of a hospital, including that which is available in the hospital's critical care area.
(c) For nursing services to be provided in the enrollee's home, the physician's order must state either that there is no approved home health agency available to provide the intermittent or part-time nursing services needed by the enrollee or that the enrollee is in need of individual and continuous care beyond that available from an approved home health agency. The fund administrator may request such periodic treatment plans and other medical information as he or she determines the particular circumstances warrant prior to approving additional periods of private duty nursing.
(d) In an emergency situation, the treating physician may order the services of a private duty nurse for no more than two nursing days and immediately submit a prior approval request for private duty nursing services on behalf of the enrollee on an expedited basis pursuant to section 69-10.15 of this Subpart.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.28 Related organizations
(a) A related organization shall be defined as any entity which the LTHHCP is in control of or is controlled by, either directly or indirectly, or an organization, or institution whose actions or policies the LTHHCP has the power, directly or indirectly, to significantly influence or direct the actions or policies of an organization or institution or a special purpose organization or where an association of material interest exists in an entity which supplies goods and/or services to the LTHHCP, or any entity which is controlled directly or indirectly by the immediate family of the operator. Immediate family shall include each parent, child, spouse, brother, sister, first cousin, aunt and uncle, whether such relationship arises by reason of birth, marriage or adoption. A special purpose organization shall be defined as an organization which is established to conduct certain of the provider's patient-care-related or non-patient-care-related activities. The special purpose organization is considered to be related if:
(1) the LTHHCP controls the special purpose organization through contracts or other legal documents that allow direct authority over the organization's activities, management and policies; or
(2) the LTHHCP is, for all practical purposes, the sole beneficiary of the special organization's activities. The LTHHCP shall be considered the special purpose organization's sole beneficiary if one or more of the three following circumstances exist:
(i) a special purpose organization has solicited funds in the name of and with the expressed or implied approval of the LTHHCP, and substantially all the funds solicited by the organization were intended by the contributor' or were otherwise required to be transferred to the provider or used at its discretion or direction;
(ii) the LTHHCP has transferred some of its resources to a special purpose organization, substantially all of whose resources are held for the benefit of the provider; or
(iii) the LTHHCP has assigned certain of its functions (such as the operation of a dormitory) to a special purpose organization that is operating primarily for the benefit of the LTHHCP.
(b) The costs of goods and/or services furnished to a LTHHCP by a related organization are includable in the computation of the basic rate at the lower of the cost to the related organization or the market price of comparable goods and/or services available in the LTHHCP's region within the course of normal business operations.
(c) If the LTHHCP has incurred any costs in connection with a related organization, the final payment rate shall include the costs of such goods and/or services.
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.6 Limitations of care and discharges
(a) The care of any individual shall be limited to the services available at the facility, except as otherwise permitted by section 88-2.2 of this Subpart.
(b) If any veteran requires care for an acute illness and is entitled to care in a veterans' hospital, he or she may utilize the resources of such a veterans' hospital, where feasible and practical, provided such care is available and he or she can be admitted.
(c) Individuals may be discharged to responsible relatives or to any facilities of the Federal government, the State or its subdivisions, when the facility is inadequate to provide the proper care required by a mental or physical condition of the individual.
(d) Individuals may be discharged when they shall have achieved maximum benefits from the services of the facility as determined by the director. Individuals desiring to leave before achieving maximum benefits shall sign a statement releasing the facility, the New York State Department of Health and the State of New York from any liability which might result from such discharge. Patients may be discharged for noncompliance with facility rules, misbehavior or noncooperation, as determined by the director.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.103 Earned
Realized or accrued as revenue through sales of goods, services performed, or the lapse of time.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.6 Variance and waivers
(a) Variance.
The permit-issuing official may, on written application and after review, grant a variance from a specific provision of this Subpart, subject to appropriate conditions which shall include a time schedule for compliance when such variance is in harmony with the general purposes and intent of this Part, and when there are practical difficulties or unnecessary hardship in complying with such provision.
(b) Waiver.
The permit-issuing official may waive, in writing, any of the requirements of this Subpart, and include the waiver as a condition of the permit to operate, when it reasonably appears that the public health will not be endangered by granting of such waiver and adequate alternative provisions have been made to protect the safety of the bathers and the public. A copy of the waiver and description of the alternative provisions shall be submitted by the permit-issuing official to the State Commissioner of Health at the time of issuance. Such waiver shall remain in effect for a period of time concurrent with the operating permit, unless sooner revoked for cause.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.1 Definitions
As used in this Part:
(a) Administrative designee means an individual employed by the hospital, and designated on a form prescribed by the department, to assist with administrative aspects of compliance with this Subpart and Subpart 69-6 of this Title, including but not limited to storing, handling, collecting and transporting specimens.
(b) Birth attendant means the physician, nurse practitioner, licensed midwife or other person who attends a non-hospital birth and who is required to register the birth of a child pursuant to section 4130 of the Public Health Law.
(c) Chief executive officer or CEO means the individual appointed by the governing body of a hospital to manage the hospital and its health care services.
(d) Department means the New York State Department of Health.
(e) LAB I.D. means the unique specimen identifier included on the specimen collection form.
(f) Medical designee means a licensed physician or other licensed healthcare provider employed by the hospital, and designated on a form prescribed by the department, to receive and act upon newborn screening program results in the absence of the responsible provider.
(g) Parent means the newborn's parent, legal guardian or other person legally responsible for the health and well-being of the newborn.
(h) Public health officer means the Commissioner of Health, public health director, or equivalent officer of a county or of the City of New York.
(i) Repeat specimen means a satisfactory specimen taken subsequent to an initial satisfactory specimen.
(j) Responsible provider means the physician or other licensed health care provider named on the specimen collection form, or the newborn’s primary health care provider as identified to the testing laboratory.
(k) Satisfactory specimen means a blood specimen submitted to the testing laboratory on a complete and legible specimen collection form prescribed by the department, collected consistent with the guidance provided by the testing laboratory and submitted in a condition suitable for testing.
(l) Specialty care center means a health care facility established under article 28 of the Public Health Law that is approved and certified by the department to provide treatment and/or services to children.
(m) Specimen collection form means the current FDA approved medical device for blood specimen collection prescribed and provided by the department for use in the newborn screening program.
(n) Testing laboratory means the New York State Department of Health Wadsworth Center Newborn Screening Program.
Subchapter S LAND ACQUISITION
Part 99 PAYMENTS TO AN OWNER OR TENANT OF RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY UPON APPLICATION FOR ALLOWANCE OF MOVING EXPENSES IN VACATING PROPERTY ACQUIRED BY THE DEPARTMENT OF HEALTH
10 CRR-NY 99.3 General provisions
Application for payment of moving expenses shall be made to the State Commissioner of Health upon forms prescribed by him and shall be accompanied by such information and evidence as he may require, and payment of such will be made to eligible persons under the circumstances and to the extent set forth below:
(a) General provisions applicable to both residential and commercial moves.
(1) When there has been an approval of a property acquisition program and property appropriation maps have been filed in the Department of State and the occupant of the property has been notified of such pending acquisition by the State or an agreement of purchase has been executed by the property owner and delivered to the State, the eligible persons are authorized to proceed with the relocation.
(2) Moving expenses shall not include any cost of construction or improvement at the new location to replace property for which compensation was made in the acquisition of right-of-way.
(3) In case of a partial taking of right-of-way by the State, removal from the area being acquired to a remainder area shall be considered a relocation eligible for the collection of moving expenses if removal of personal property of an eligible person is necessary.
(4) Moving expenses shall not include any indirect losses or losses due to negligence.
(5) Where an eligible individual or family occupy bona fide living quarters on the same premises as a business concern (including the operation of a farm) or a nonprofit organization they may be considered as a separate eligible person in determining the amount of payment for residential moving costs.
(6) After an eligible person has vacated the property, no moving expense payments will thereafter be eligible to any party with respect to the subsequent occupancy of the same property.
(b) General provisions applicable only to commercial moves.
(1) The relocation payments in which the State funds may participate may not exceed $3,000 in the case of an owner or tenant of commercial property which shall include property owned or occupied by an individual, family, business concern (including the operation of a farm), and nonprofit organization. In the case of a business organization, if the distance, measured by a straight line, from the point from which such business or organization was displaced to the point of relocation, exceeds 50 miles, the amount which State funds will compensate shall not exceed the cost of moving 50 miles or the cost of moving beyond the New York State boundary line if such boundary is within 50 miles.
(2) In the case of moving a business concern, nonprofit organization or the operation of a farm, any necessary storage during the adjustment of improvements, but not in excess of six months, may be considered as part of the moving costs.
(c) General provisions applicable only to residential moves.
The relocation payments in which the State funds may participate may not exceed $300 in the case of an individual or family occupying residential property and shall be made in accordance with the schedule of payments in fixed amounts as set forth herein, in lieu of payments of reasonable and necessary actual expenses.
(2) Providing a building or structure acquired by acquisition is returned to the owner under an agreement of adjustment as a part of the consideration in the claim, the owner will not be entitled to collect moving expenses unless all or a very substantial amount of his personal effects, furniture, and household equipment are removed from the structure before the building itself is moved, in which case the number of rooms from which the furniture and household equipment are removed will be counted in accordance with the schedule of fixed moving expenses outlined below.
(3) Providing an agreement of adjustment is made with the owner of a trailer or mobile home which has been acquired by the State as real property and the trailer or mobile home is returned to the owner under an agreement of adjustment as part of the consideration in the claim, no allowance will be made to the owner upon the removal of the entire trailer or mobile home from the premises unless it is necessary to remove all of his personal effects, household equipment and furniture from the trailer or mobile home before it is moved.
(4) Where more than one eligible individual or family occupy the same premises and move to new locations, each eligible individual or family may qualify for relocation; however, their joint claim for moving expenses shall not exceed the fixed moving expenses for the total number of rooms occupied jointly by such persons.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.5 Award rescission and deferrals
(a) Award rescission.
An award may be rescinded by the commissioner if:
(1) prior to full payment of an award, the recipient withdraws from the primary care practitioner program or otherwise fails to maintain enrollment;
(2) prior to full payment of an award, the recipient fails to maintain good academic standing;
(3) the recipient is convicted of any felony or a lesser offense related to professional activity; or
(4) the recipient is found to have provided fraudulent or willfully misrepresented information in the application or supporting documents.
(b) If, prior to full payment of an award, the recipient fails to complete and return a payment application and any required supplementary documentation as required by the Higher Education Services Corporation or fails to report to the Higher Education Services Corporation and the Department of Health at least annually and as may be necessary to implement the program on such forms and at such times as required by the president and the commissioner, the commissioner may deny full or partial payment of an award.
(c) Award deferral.
An award may be postponed or deferred temporarily by the commissioner because of one or more of the conditions described in subdivisions (a) and (b) of this section if the commissioner determines that the condition will be corrected within a reasonable time or that the circumstances warrant a deferral rather than a rescission.
(d) The commissioner will notify the president of any award rescissions or deferrals.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.211 Net
Diminished by all relevant and commonly associated deductions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
NURSING HOME COMPANIES NURSING HOME COMPANIES
10 CRR-NY 87.9 Real and personal tangible property
(a) A property register will be maintained by a nursing home company for each type of real and personal tangible property owned other than the original purchase price of the project land and the original construction cost of the structure.
(b) The property register will contain the following information on an item basis:
(1) item inventory number;
(2) location of item by room or area;
(3) location of item bcost center;
(4) description of item;
(5) related purchase order number;
(6) date item received;
(7) payment check number;
(8) date of payment;
(9) manufacturer's serial number, if any;
(10) depreciation—current year;
(11) accumulated depreciation—cumulative;
(12) salvage value; and
(13) item net delivered or installed cost.
(c) Entries in the property register will eb made as soon as possible after a transaction is completed. A systematic plan of record-keeping that permits the efficient recording of purchases, transfers, trade-ins and retirements must be in existence.
(d) The types of real and personal tangible property described in subdivision (a) of this section are as follows:
(1) Other land costs representing the cost of all material improvements to the land after passage of title to a nursing home company other than improvements included in the original construction cost.
(2) Building repairs and improvements representing the complete cost of all material repairs and improvements made to the structure after completion of the building contract and any related approved change orders.
(3) Group I property, representing the installed cost of all furnishings and/or equipment which is permanently attached to the building.
(4) Group II property, representing the delivered cost of all movable furnishings and/or equipment having a useful life of five or more years.
(5) Group III property, representing the delivered cost of all movable furnishings and/or equipment having a useful life of less than five years and a unit cost of less than $50.
(e) A physical inventory of all items in the property register will be made at least once a year. The property register may be adjusted to reflect any necessary material changes resulting from the physical inventory, provided that an officer of a nursing home company certifies to the facts of the adjustment. Adequate details of the physical inventory, adjustments and certifications will be maintained for inspection by the State Department of Health.
(f) All property having a unit cost of $50 or more at time of purchase may be used as part payment for replacement equipment, or it may be offered for sale on a competitive basis. If no offers are received, it may be discarded provided an officer of a nursing home company certified to the facts of such disposal.
(g) An annual physical inventory of consumable supplies on hand must be taken and recorded on the books of a nursing home company.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 152 WARREN COUNTY
CITIES CITIES
10 CRR-NY 152.1 City of Glens Falls
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 695 of the Laws of 1911, and as heretofore set forth shall apply to all streams, lakes and reservoirs of the drainage areas tributary to the reservoirs from which water is drawn for the water supply of the City of Glens Falls, Warren County, New York, which are intended to comprise all watercourses entering or ultimately discharging into the Wilkie, Keenan and Butler reservoirs.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and to refer to the impounding and distributing reservoirs on the streams used as a source of water supply by the city and to any additional reservoirs which may be constructed on said streams or on any of their tributaries.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the main distributing reservoirs), stream, ditch, gutter or other channel of every kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the water supply of the said City of Glens Falls.
(3) Whenever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or water course.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any reservoir or watercourse of the water supply of the City of Glens Falls.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with its nearest point within 200 feet of any reservoir or watercourse of the water supply of the City of Glens Falls.
(3) Every privy, privy vault, pit or other receptacle or place, used for the temporary storage of human excreta, which is constructed, located, maintained or allowed to remain between the limiting distances of 75 feet and 200 feet, as provided by paragraphs (1) and (2) of this subdivision, from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place or ultimate disposal as hereinafter provided, shall be arranged in such a manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified, and that the contents while being transferred from the privy to the place of disposal shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and of the adjoining premises.
(5) Unless otherwise specifically ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging into the soil in such place and manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow and at distances not less than 400 feet from any reservoir or watercourse of the City of Glens Falls.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse of the water supply of the City of Glens Falls, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 400 feet of any reservoir or watercourse.
(2) No garbage, putrescible matter, kitchen or sink waste, refuse or waste water from any creamery, cheese factory, laundry, nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the water supply of the city of Glens Falls, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the water supply of the city of Glens Falls within 150 feet of any such reservoir or watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that may pollute water shall be washed, rinsed or placed in any reservoir or watercourse of the water supply of the city of Glens Falls.
(e) Bathing animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the water supply of the city of Glens Falls nor shall any animals or poultry be allowed to stand, wallow, wade or swim in said reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet from any reservoir or watercourse of the water supply of the city of Glens Falls and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such manner that the drainings, leachings or washings from the same may enter such reservoir or watercourse without first having passed over through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or watercourse.
(3) No human excreta, cesspool, compost or other matter containing same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 400 feet from any reservoir or watercourse or the water supply of the city of Glens Falls, and no manure or compost of any kind shall be placed, piled or spread upon the ground within 200 feet of any such reservoir or watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the water supply of the city of Glens Falls without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered or dissipated form, not concentrated in perceptible lines of drainage, for a distance of not less than 150 feet before entering any such reservoir or watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse of the water supply of the city of Glens Falls, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach such reservoirs or watercourse without first having percolated over or through the soil in a scattered, dissipated form, not concentrated in perceptible lines of drainage, for a distance of not less than 200 feet before entering such reservoir or watercourse.
(g) Fishing, boating and ice cutting.
No fish shall be taken from the impounding or distributing reservoirs nor shall any person fish in said reservoirs or through the ice upon the same nor trespass upon the water or ice thereof nor maintain or use any boat or boats thereon except the officials or duly authorized employees of the city of Glens Falls in the exercise of their duties in the management and operation of the reservoirs; nor shall any ice cutting or other operations incident thereto be allowed on any of the reservoirs which form or are tributary to the sources of the public water supply of the city of Glens Falls, except by permission and under rigid inspection and supervision of the board of water commissioners of the city of Glens Falls.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within 500 feet of any reservoir or watercourse of the water supply of the city of Glens Falls.
(i) Cemeteries.
No interment of a human body shall be made within 200 feet of any reservoir or watercourse of the public water supply of the city of Glens Falls.
(j) Inspections.
The board of water commissioners of the city of Glens Falls shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules or regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 695 of the Laws of 1911, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.7 Payment for outpatient and related service
Fees for outpatient and related service may not exceed those established in the department's schedule of maximum fees.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.4 Permit to operate a mobile home park required; application, issuance, revocation, posting
(a) No person shall operate any mobile home park or cause or allow the same to be occupied without a permit to do so from the permit-issuing official.
(b) Application for a permit to operate a mobile home park shall be made to the permit-issuing official, on a form and in a manner prescribed by the State Commissioner of Health, by the person who will operate the mobile home park. Application for a permit to operate a mobile home park shall be made at least 30 days before the first day of proposed operation of such mobile home park. In the event of an intended change of the operator of a mobile home park, the new operator shall apply for a permit before the change is effected. The operator shall notify, in writing, the permit-issuing official of any change in the name of a mobile home park within 30 days after such change.
(c) The permit-issuing official shall issue a permit on a form prescribed by the State Commissioner of Health for the operation of a park if he finds that the park will not be a potential source of danger to the health and safety of the occupants of the park or the general public and if he finds that the park or the proposed operation thereof conforms or will conform to the requirements of this Part. The permit issued for the operation of a mobile home park shall expire upon a change of the owner or operator of the mobile home park or upon the revocation of the permit or upon the date specified on the permit by the permit-issuing official.
(d) A permit shall not be transferable or assignable.
(e) A permit may be revoked by the permit-issuing official or the State Commissioner of Health if he finds that the mobile home park for which the permit was issued is maintained, operated or occupied in violation of law, this Chapter, or the sanitary code of the health district in which the mobile home park is located. A permit shall also be revoked upon request of the permittee or upon abandonment of operation.
(f) A permit issued for the operation of a mobile home park shall be posted in a conspicuous place on the premises or be readily available upon request.
(g) Temporary permit.
The permit-issuing official may issue a temporary permit to operate a park that does not or will not comply with the requirements of this Part subject to the following conditions:
(1) the applicant for a permit to operate shall file a statement of intention to comply with the requirements of this Part within 90 days;
(2) there will be no adverse effect on the health and safety of park occupants or any other person during this period;
(3) the temporary permit shall prescribe the terms, requirements or conditions upon which the park may be temporarily operated; and
(4) a temporary permit shall expire on the date designated by the permit-issuing official, but not later than 90 days after the date of issuance.
(h) A separate permit and fee may be required for a children's camp, bathing beach, swimming pool, temporary residence or a service food establishment operated as part of a mobile home park.
(i) The permit-issuing official may establish procedures for the exchange of information with other State or local government agencies having responsibility for making health or safety inspections of buildings, including mobile home parks as defined in this Part, and may utilize the information provided by any such agency in making a determination regarding the issuance of a permit required by this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.7 Recordkeeping
The school shall retain all records of test results, lead remediation plans, determinations that a building is lead-free, and waiver requests, for 10 years following the creation of such documentation. Copies of such documentation shall be immediately provided to the department, local health department, or State Education Department, upon request.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED
10 CRR-NY 40-2.61 Authorized radiation-producing equipment inspection program; performance standards
Where a local health department has been certified to maintain a radiation producing equipment inspection program pursuant to Part 16 of this Title, the municipality shall conduct such program consistent with that Part.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.3 Monitoring
(a) All schools shall test potable water for lead contamination as required in this Subpart.
(b) First-draw samples shall be collected from all outlets, as defined in this Subpart. A first-draw sample volume shall be 250 milliliters (mL), collected from a cold water outlet before any water is used. The water shall be motionless in the pipes for a minimum of 8 hours, but not more than 18 hours, before sample collection. First-draw samples shall be collected pursuant to such other specifications as the department may determine appropriate.
(c) Initial first-draw samples.
(1) For existing buildings in service as of September 6, 2016, schools shall complete collection of initial first-draw samples according to the following schedule:
(i) for any school serving children or students in any of the levels prekindergarten through grade five, collection of samples is to be completed by September 30, 2016;
(ii) for any school serving children or students in any of the levels grades six through twelve that are not also serving children or students in any of the levels prekindergarten through grade five, and all other applicable buildings, collection of samples is to be completed by October 31, 2016.
(2) For buildings put into service after September 6, 2016, initial first-draw samples shall be performed prior to occupancy; provided that if the building is put into service between the effective date of this Subpart but before October 31, 2016, the school shall have 30 days to perform first-draw sampling.
(3) Any first-draw sampling conducted consistent with this Subpart that occurred after January 1, 2015 shall satisfy the initial first-draw sampling requirement.
(d) Continued monitoring. Schools shall collect first-draw samples in accordance with subdivision (b) of this section again in 2020 or at an earlier time as determined by the commissioner. Schools shall continue to collect first-draw samples at least every five years thereafter or at an earlier time as determined by the commissioner. All such sampling will be conducted according to procedures as determined by the commissioner.
(e) All first-draw samples shall be analyzed by a laboratory approved to perform such analyses by the department’s Environmental Laboratory Approval Program (ELAP).
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH DIRECTOR PUBLIC HEALTH DIRECTOR
10 CRR-NY 11.180 Applicability
In counties of less than 250,000 population, when not inconsistent with the public health needs of the county as determined by the State Commissioner of Health, a public health director may be employed in lieu of a commissioner of health.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-1.34 Microbiological standards; potentially hazardous foods
(a) The State Commissioner of Health may designate, by administrative order, the names and types of foods which are potentially hazardous and subject to microbiological standards established by him.
(b) No person is to manufacture, produce, pack, possess, sell, offer for sale, deliver or give away any potentially hazardous food of the name or type designated pursuant to subdivision (a) of this section, if such food contains any fecal coliform, salmonella, shigella or other pathogenic microorganisms or their toxic products.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.53 Fees and revenue; deduction and offset
All revenues collected by the local health department or the contractor shall be deducted from eligible expenditures to produce a net amount of expenditures eligible for State aid, except that municipalities may provide accounting documentation for the withholding from deduction any earned revenue attributable to projects and services ineligible for State aid reimbursement, as enumerated in section 40-2.3 of this Part. The commissioner may exclude such revenue from deduction limited to documentation submitted.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.3 Exemptions
The provisions of this Part prohibiting the possession of any synthetic phenethylamine or synthetic cannabinoid, or product containing the same shall not apply to:
(a) public officers or their employees in the lawful performance of their official duties requiring possession of synthetic phenethylamines or synthetic cannabinoids, or products containing the same;
(b) temporary or incidental possession by employees or agents of persons lawfully entitled to possession, or persons whose possession is for the purpose of aiding public officers in performing their official duties;
(c) a person in the employ of the United States government or of any state, territory, district, county, municipal or insular government, obtaining or possessing synthetic phenethylamines or synthetic cannabinoids, or products containing the same, by reason of his or her official duties;
(d) common carriers or warehousemen, while engaged in lawfully transporting or storing synthetic phenethylamines or synthetic cannabinoids, or products containing the same, or to any employee of the same within the scope of his or her employment;
(e) laboratories with a Federal Drug Enforcement Administration (DEA) license to purchase and use schedule I controlled substances for research and/or analytical testing; and
(f) manufacturers that are registered with the DEA to synthesize and distribute controlled substances.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.34 Audit
(a) The examination of contracts, orders and other original documents for the purpose of substantiating individual transactions before their settlement.
(b) Any systematic investigation or appraisal of procedures or operations for the purpose of determining conformity with prescribed criteria; the work performed by an internal auditor.
(c) Auditing.
An exploratory, critical review by a public accountant of the underlying internal controls and accounting records of a business enterprise or other economic unit, precedent to the expression by him of an opinion of the propriety (“fairness”) of its financial statements.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.10 Maximum contaminant levels
(a) The MCLs listed in section 5-6.11 of this Subpart shall not be exceeded.
(b) The owner or operator of the bottled or bulk water facility is responsible for completion of the sampling and analytical requirements set forth in this Subpart. At the discretion of the State, analyses performed by the State may be used for monitoring purposes.
(c) If the result of a monitoring sample analysis exceeds the MCL for a physical contaminant, except for turbidity or an inorganic chemical contaminant, except for nitrate, the owner or operator of the bottled or bulk facility shall collect and analyze three more samples from the same production run, when feasible, but no later than 24 hours of learning of a potential violation. An MCL violation occurs when the average, rounded to the same number of significant figures as the MCL in question, of the four results exceeds the MCL. For nitrate, the owner or operator of the bottled or bulk water facility shall collect and analyze one more sample from the production run, when feasible, but no later than 24 hours of learning of a potential violation. An MCL violation occurs when the average of the two results exceeds the MCL.
(d) If the result of a monitoring sample analysis exceeds the MCL for the general organic chemical contaminants, the owner or operator of the bottled or bulk facility shall collect and analyze one to three more samples from the same production run, when feasible, but no later than 24 hours of learning of a potential violation. An MCL violation occurs when at least one of the confirming samples is positive and the average of the initial sample and all the confirming samples exceeds the MCL.
(e) The commissioner may exempt bottled water from the chemical and radiological MCLs based on justification, submitted by the owner or operator of the bottled water facility, that granting of the exemption would not result in public health hazard. If an exemption is granted, an appropriate label, approved by the commissioner, shall be conspicuously placed on all bottles and/or containers of such exempted bottled water produced, distributed and/or sold within New York State in accordance with section 56.12(b) of this Subpart.
(f) All analyses for general organic chemicals must be performed in accordance with the U.S. Environmental Protection Agency (EPA) Methods 502.1, 503.1, 524.1, 524.2 or 502, at a detecton limit not to exceed 0.0005 milligrams per liter. If the State has reason to believe that an MCL has been violated, the potenial exists for an MCL violation or the contaminant may present a risk to public health, principal organic contaminant analyses shall also include EPA Methods 504, 625, 604, 605, 608, 609, 611 or 612, as appropriate. EPA Methods 502.1, 503.1, 524.1, 524.2, 502.2 and 504 mean, respectively, “Volatile Halogenated Organic Compounds in Water by Purge and Trap Gas Chromatography;” “Volatile Aromatic and Unsaturaed Organic Compounds in Water by Purge and Trap Gas Chromatography;” “Volatile Organic Compounds in Water by Purge and Trap Gas Chromatography/Mass Spectrometry;” “Volatile Organic Compounds in Water by Purge and Trap Capillary Column Gas Chromatography/Mass Spectrometry,” “Volatile Organic Compounds in Water by Purge and Trap Capillary Gas Chromatography with Photoionization and Electrolytic Conductivity Detectors in Series;” and “Measurement of 1,2-Dibromoethance (EDB) and 1,2-Dibromo-3-chloropropane (DBCP) in Drinking Water by Microextraction and Gas Chromatography.” These methods are contained in “Methods for Determination of Organic Compounds in Finished Drinking Water and Raw Source Water,” September 1986. Copies of this publication can be obtained from Environmental Monitoring and Support Laboratory, EPA, Cincinnati, OH 45268, and a copy is available for inspection and copying at the offices of the Records Access Officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. EPA Methods 604, 605, 608, 609, 611, 612 and 625 mean respectively “Methods for Organic Chemical Analysis of Municipal and Industrial Wastewater; Method 604 - Phemols; Method 605 - Benzidines; Method 608 -Organochlorine Pesticides and PCBs; Method 609 - Nitroaromatics and Isophorone; Method 611 - Haloethers; Method 612 - Chlorinated Hydrocabons; and Method 625 - Base/Neutrals and Acids.” These methods are contained in 40 CFR Part 136 as published in the Federal Register, Volume 49, page 43250, No. 209, Friday, October 26, 1984. Copies of this publication are available from U.S. Environmental Protection Agency, Public Information Reference Unit, 401 M Street, SW, Washington, DC 20460 and a copy is available for inspection and copying at the offices of the Records Access Officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-5 APPROVAL OF ALTERNATIVE TREATMENT TECHNOLOGIES FOR USE IN NEW YORK STATE
10 CRR-NY 70-5.2 Limitations and voiding of approval
(a)
(1) Approval shall be limited to the specific system model or version authorized by the Commissioner of Health, and shall be valid for a period not to exceed two years, renewable every two years.
(2) A renewal application shall be filed no later than 180 calendar days prior to expiration of an existing approval.
(3) Each renewal application shall identify all installations of approved technology(ies) for the applicant manufacturer in New York State.
(b) Approval shall be limited to the waste materials and components, operating parameters and conditions, including the introduction of other materials into a load, specified in the efficacy testing data submitted to and approved by the department.
(c) Approval shall become void upon any change to the system by the manufacturer that may adversely affect the system's efficacy, as determined by the department. Such change shall include, but not be limited to, claims that the technology is able to render harmless, dispose of, or otherwise handle wastes and materials, concurrent with regulated medical waste loads or in different loads, other than the type(s) of regulated medical waste for which the technology was approved.
(d) The department may require the submission of additional information and specific data as may be pertinent to demonstrating safety and efficacy of the alternative technology.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.8 Waivers
(a) A school may apply to the local health department for a waiver from the testing requirements of this Subpart, for a specific school, building, or buildings, by demonstrating in a manner and pursuant to standards determined by the department, that:
(1) prior to the publication date of these regulations, the school conducted testing that substantially complied with the testing requirements of this Subpart;
(2) any needed remediation, including re-testing, has been performed; and
(3) the lead level in the potable water of the applicable building outlets are currently below the action level.
(b) Local health departments shall review applications for waivers for compliance with the standards determined by the department. If the local health department recommends approval of the waiver, the local health department shall send its recommendation to the department, and the department shall determine whether the waiver shall be issued.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.31 Institutional biosafety committee; composition and duties
(a) An institutional biosafety committee (IBC) shall be composed of not less than five persons, approved by the commissioner, who collectively have experience and expertise in recombinant DNA technology and the capability to assess the safety of proposed recombinant DNA activity and any potential risk to public health or the environment. At least two members shall not be affiliated with the institution (apart from their membership on the IBC) and shall represent the interest of the surrounding community with respect to health and protection of the environment. Members meet this requirement if, for example, they are officials of State or local public health or environmental protection agencies, members of other local governmental bodies, or persons active in medical, occupational health, or environmental concerns in the community. The biological safety officer (BSO), mandatory when activity is being conducted at the P3 and P4 levels, shall be a member. The membership should include individuals with expertise in recombinant DNA technology, biological safety and physical containment and include, or have available as consultants, persons knowledgeable in institutional commitments and policies, applicable law, standards of professional conduct and practice, community attitudes and the environment. At least one member should be from the laboratory technical staff. No member of a committee may be involved (except to provide information requested by the IBC) in the review or approval of activity in which he or she has been, or expects to be, engaged, or has a direct or conflicting interest.
(b) IBC meetings and minutes of meetings shall be open to the public, consistent with protection of privacy and proprietary interests.
(c) On behalf of the institution, the IBC shall:
(1) review for compliance with this Subpart all recombinant DNA activity as specified in section 61-1.20 of this Subpart conducted at or sponsored by the institution, and approve those activities that it finds are in conformity with this Subpart. This review shall include:
(i) an independent assessment of the containment levels required by this Subpart for the proposed activity; and
(ii) an assessment of the facilities, procedures and practices, and of the training and expertise of the recombinant DNA personnel;*
(2) notify the principal investigator (PI) of the results of their review;
(3) lower containment levels for certain experiments as specified in section 61-1.20 of this Subpart: class III-B-2;
(4) set containment levels as specified in section 61-1.20 of this Subpart: class III-B-4-b and III-B-5;
(5) review periodically recombinant DNA activity being conducted at the institution, to ensure that the requirements of this Subpart are being fulfilled;
(6) adopt emergency plans covering accidental spills and personnel contamination resulting from such activity;*
(7) report within 30 days to the appropriate institutional official and to the commissioner any significant problems with or violations of this Subpart, and any significant recombinant DNA activity-related accidents or illnesses, unless the IBC determines that the PI has done so;
(8) maintain appropriate records, including copies of proposals reviewed, minutes of IBC meetings, reports of accidents and illnesses, and records of periodic review;
(9) authorize initiation of no experiment not explicitly covered by this Subpart until NIH establishes the containment requirement; and
(10) perform such other functions as may be delegated to the IBC by the institution consonant with its responsibilities.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.43 Head injury
This functional reporting center must contain all the expenses associated with a planned combination of services provided in a residential health care facility unit as a provider of specialized services for head injured patients.
(a) Standard unit of measure: number of patient days.
Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.4 Enforcement
(a) Permits and placarding.
(1) Operation of a bathing beach without a permit is a violation of this Subpart. The permit-issuing official may order any bathing beach operating without a permit to close and remain closed until the facility has obtained and displays a valid permit.
(2) The enforcement procedures delineated in sections 12, 12-a, 12-b, 16, 308, 309, 1303-1305 and 1308 of the Public Health Law may be used, as appropriate. Where a public health hazard is found, the bathing beach shall be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of bathers. When a placard is used, it shall be conspicuously posted at all entrances leading to the bathing beach. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law.
(3) Within 15 days of placarding of a facility, the operator of such facility shall be provided with an opportunity to be heard and present proof that continued operation of the facility does not constitute a danger to the public health. The hearing shall be conducted by the permit- issuing official or his designated hearing officer.
(4) The permit-issuing official or his designated representative shall inspect the premises, within two working days of notification that the hazard has been eliminated, to remove the placards after verifying the correction.
(b) Public health hazards.
Any of the following violations are public health hazards which require the permit-issuing official or designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(1) failure to provide adequate supervision of the beach as prescribed in section 6-2.17 of this Subpart;
(2) overhead electrical wires within 20 feet horizontally of the bathing beach;
(3) failure to provide all lifesaving equipment at beach;
(4) use of unapproved or contaminated water supply sources for potable water use;
(5) failure to meet water quality standards contained in section 6-2.15 of this Subpart;
(6) the existence of sewage and waste-water discharges in the bathing area;
(7) failure to properly delineate swimming area boundaries;
(8) failure to provide signs indicating swimming is prohibited when the bathing beach is closed or unsupervised; and
(9) any other condition determined to be a public health hazard by the permit-issuing official.
(c) Other violations.
Violations of other sections of this Subpart or of other Parts of this Chapter are also subject to a penalty.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.115 Equity ownership
(a) The interest of an owner in property or in a business or other organization, subject, in case of liquidation, to prior claim of creditors.
(b) The interest (paid-in capital and retained earnings) of a stockholder or of stockholders collectively in a corporation; proprietorship.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-5.30 Definitions of foods; contamination; potentially hazardous food; hermetically sealed container
(a) Food is any edible substance, ice, beverage or ingredient used or intended for use or for sale in whole or in part for human consumption.
(b) Contamination means exposing food to filth, toxic substances, manual contact during preparation if such food will not be subsequently cooked prior to service, transportation, display, while being held for service or during servicing of machines, rodent or insect contact or infestation, or any condition which permits introduction of pathogenic microorganisms or foreign matter. Potentially hazardous foods held at temperatures between 45°F (7.2°C) and 140°F (60°C) either for a period of time exceeding that reasonably required for preparation or held in a vending machine which is operating with its food holding compartment between 45°F (7.2°C) and 140°F (60°C) for a period of more than 30 minutes, are considered to be contaminated. Contaminated food is considered adulterated.
(c) Potentially hazardous food is any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea, cooked potato, cooked rice or other ingredients, including synthetic ingredients, in a form capable of supporting:
(1) rapid and progressive growth of infectious, or toxigenic microorganisms; or
(2) the slower growth of C. botulinum.
The term does not include foods with a water activity (Aw) value of 0.85 or less or a hydrogen ion concentration (pH) level of 4.6 or below.
(d) A hermetically sealed container is a container which is designed and intended to be secure against the entry of microorganisms and to maintain its content after processing.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.34 Supplemental indigent care distributions
(a) For the period prior to December 31, 2009:
(1) $307 million shall be distributed to facilities designated by the department as teaching hospitals as of December 31, 2008, to compensate such facilities for Medicaid and self-pay losses pursuant to the following schedule of payments:
| Hospital | Calendar year 2009 $307,000,000 uninsured distribution to teaching hospitals | | --- | --- | | ALBANY MEDICAL CENTER HOSPITAL | $7,207,099 | | ST PETERS HOSPITAL | $1,001,662 | | ALBANY MEDICAL CENTER SOUTH CLINICAL CAMPUS | $3,880 | | UNITED HEALTH SERVICES, INC | $1,140,730 | | OLEAN GENERAL HOSPITAL | $24,817 | | ERIE COUNTY MEDICAL CENTER | $597,922 | | MERCY HOSPITAL OF BUFFALO | $319,739 | | ROSWELL PARK MEMORIAL INSTITUTE | $1,652,987 | | KALEIDA HEALTH | $4,938,527 | | HIGHLAND HOSPITAL OF ROCHESTER | $2,845,852 | | ROCHESTER GENERAL HOSPITAL | $3,553,825 | | STRONG MEMORIAL HOSPITAL | $11,695,895 | | THE UNITY HOSPITAL OF ROCHESTER | $572,019 | | GLEN COVE HOSPITAL | $471,540 | | WINTHROP UNIVERSITY HOSPITAL | $6,071,885 | | SOUTH NASSAU COMMUNITIES HOSPITAL | $530,429 | | NASSAU UNIVERSITY MEDICAL CENTER | $1,783,090 | | NORTH SHORE UNIVERSITY HOSPITAL | $13,118,952 | | ST FRANCIS HOSPITAL OF ROSLYN | $425,667 | | ST ELIZABETH MEDICAL CENTER | $7,889 | | FAXTON - ST LUKE'S HEALTH CARE | $23,436 | | COMMUNITY-GENERAL HOSPITAL OF GREATER SYRACUSE | $196,351 | | ST JOSEPHS HOSPITAL HEALTH CENTER | $2,697,040 | | UNIVERSITY HOSPITAL SUNY HEALTH SCIENCE CENTER | $6,987,635 | | CROUSE HOSPITAL | $958,865 | | MARY IMOGENE BASSETT HOSPITAL | $472,619 | | ELLIS HOSPITAL | $960,657 | | ST CHARLES HOSPITAL | $249,445 | | UNIVERSITY HOSPITAL AT STONY BROOK | $13,197,922 | | HUNTINGTON HOSPITAL | $64,200 | | GOOD SAMARITAN HOSPITAL OF WEST ISLIP | $589,318 | | BENEDICTINE HOSPITAL | $459,898 | | KINGSTON HOSPITAL | $430,512 | | MOUNT VERNON HOSPITAL | $115,045 | | SOUND SHORE MEDICAL CENTER | $155,810 | | WESTCHESTER MEDICAL CENTER | $16,611,342 | | BRONX-LEBANON HOSPITAL CENTER | $37,193 | | JACOBI MEDICAL CENTER | $2,082,896 | | MONTEFIORE HOSPITAL & MEDICAL CENTER | $24,605,332 | | LINCOLN MEDICAL & MENTAL HEALTH CENTER | $3,019,391 | | NORTH CENTRAL BRONX HOSPITAL | $754,891 | | BROOKLYN HOSPITAL | $5,938,856 | | CONEY ISLAND HOSPITAL | $995,496 | | KINGS COUNTY HOSPITAL CENTER | $3,882,475 | | LONG ISLAND COLLEGE HOSPITAL | $3,448,174 | | NY METHODIST HOSPITAL OF BROOKLYN | $3,807,310 | | KINGSBROOK JEWISH MEDICAL CENTER | $121,313 | | WYCKOFF HEIGHTS HOSPITAL | $1,230,117 | | STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL CENTER | $4,116,253 | | WOODHULL MEDICAL AND MENTAL HEALTH CENTER | $876,601 | | INTERFAITH MEDICAL CENTER | $831,511 | | BELLEVUE HOSPITAL CENTER | $2,636,659 | | BETH ISRAEL MEDICAL CENTER | $12,615,285 | | HARLEM HOSPITAL CENTER | $ 2,002,465 | | HOSPITAL FOR SPECIAL SURGERY | $3,247,177 | | LENOX HILL HOSPITAL | $12,658,212 | | MANHATTAN EYE EAR AND THROAT | $416,294 | | MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES | $5,831,787 | | METROPOLITAN HOSPITAL CENTER | $1,570,125 | | MOUNT SINAI HOSPITAL | $18,689,832 | | NY EYE AND EAR INFIRMARY | $407,797 | | ST LUKES - ROOSEVELT HOSPITAL CENTER | $8,823,583 | | SVCMC ST VINCENTS-MANHATTAN | $5,342,595 | | GOLDWATER MEMORIAL HOSPITAL | $10,006 | | COLER MEMORIAL HOSPITAL | $639 | | NYU HOSPITALS CENTER | $13,483,008 | | NEW YORK PRESBYTERIAN HOSPITAL | $27,337,202 | | ELMHURST HOSPITAL | $2,226,463 | | JAMAICA HOSPITAL | $1,185,404 | | LONG ISLAND JEWISH-HILLSIDE MEDICAL CENTER | $18,206,316 | | QUEENS HOSPITAL CENTER | $554,077 | | NY MED CTR OF QUEENS | $3,178,354 | | FOREST HILLS HOSPITAL | $1,334,742 | | STATEN ISLAND UNIVERSITY HOSPITAL | $5,084,762 | | RICHMOND UNIVERSITY MEDICAL CENTER | $2,274,908 |
(2) $25 million shall be distributed to non-major public hospitals having Medicaid discharges of 40 percent or greater as determined by the commissioner from data reported in each hospital's 2007 annual cost report, to compensate each hospital's decrease in Medicaid revenue resulting from the trend factor reductions and the inpatient reimbursement methodology changes reflected in this Subpart pursuant to the following schedule of payments:
| Hospital | Safety net hospitals distribution (hospitals > 40% Medicaid discharges) | | --- | --- | | BRONX-LEBANON HOSPITAL CENTER | $ 5,881,790 | | LUTHERAN MEDICAL CENTER | $ 3,164,515 | | BETH ISRAEL MEDICAL CENTER | $ 2,516,139 | | WYCKOFF HEIGHTS HOSPITAL | $ 1,994,409 | | JAMAICA HOSPITAL | $ 1,749,749 | | MAIMONIDES MEDICAL CENTER | $ 1,612,982 | | BROOKDALE HOSPITAL MEDICAL CENTER | $ 1,306,401 | | ST BARNABAS HOSPITAL | $ 1,173,571 | | INTERFAITH MEDICAL CENTER | $ 1,172,036 | | ST JOHNS RIVERSIDE HOSPITAL | $ 869,254 | | FLUSHING HOSPITAL AND MEDICAL CENTER | $ 806,993 | | NORTH GENERAL HOSPITAL | $ 666,114 | | NEW YORK DOWNTOWN HOSPITAL | $ 590,133 | | BROOKLYN HOSPITAL | $ 553,751 | | KALEIDA HEALTH – WOMEN AND CHILDRENS HOSPITAL | $ 481,839 | | EPISCOPAL HEALTH SERVICES, INC | $ 375,993 | | SHEEHAN MEMORIAL EMERGENCY HOSPITAL, INC | $ 65,384 | | BLYTHEDALE CHILDRENS HOSPITAL | $ 18,946 |
(b) For annual periods beginning on and after January 1, 2010:
(1) From regional allotments specified below, $269.5 million shall be distributed to non-major public teaching hospitals on a regional basis to cover each eligible facility's proportional regional share of 2007 uncompensated care, as defined in section 2807-k(5-a)(c) of the Public Health Law and offset by disproportionate share payments received by each facility during calendar year 2010 in accordance with sections 2807-k and 2807-w of the Public Health Law and subdivision (a) of this section:
| Region | Revised regional distribution | | --- | --- | | Long Island | $ 31,171,915 | | New York City | $181,778,400 | | Northern Metropolitan | $ 14,526,351 | | Northeast | $ 8,130,067 | | Utica/Watertown | $ 502,271 | | Central | $ 10,052,989 | | Rochester | $ 16,615,910 | | Western | $ 6,722,096 | | Statewide | $269,500,000 |
(2) $25 million shall be distributed to non-major public hospitals having Medicaid discharges of 40 percent or greater as determined by the commissioner from data reported in each hospital's 2007 annual cost report in accordance with the methodology and schedule of payments set forth in paragraph (a)(2) of this section.
(3) $24.5 million shall be distributed as non-Medicaid grants to non-major public academic medical centers pursuant to the following schedule of payments:
| Hospital | Major academic centers for excellence distributions | | --- | --- | | NEW YORK PRESBYTERIAN HOSPITAL | $10,672,716 | | MOUNT SINAI HOSPITAL | $ 4,998,485 | | STRONG MEMORIAL HOSPITAL | $ 4,104,745 | | NYU HOSPITALS CENTER | $ 2,396,578 | | ALBANY MEDICAL CENTER HOSPITAL | $ 2,327,476 |
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.6 Amendment of pleadings
Any party may amend or supplement a pleading at any time prior to the submission of the hearing officer's report to the commissioner, or to the appropriate board or council, by leave of the hearing officer, if there is no substantial prejudice to any other party. Any party may amend or supplement a pleading at any time prior to a hearing committee's final determination and order pursuant to Public Health Law, section 230(10), by leave of the hearing officer if there is no substantial prejudice to any other party.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.15 Nonphysician education
This functional reporting center must contain all the direct expenses associated with State-approved schools for educating professional people other than physicians. Additional activities include but are not limited to the following: student assistance; selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining an education library and student personnel records; counseling students regarding their professional, personal and educational problems; selecting faculty personnel; assigning and supervising students in on-the-job training; and administering aptitude tests and other tests for counseling and selection purposes.
(a) Standard unit of measure: number of students.
Number of students enrolled in the program(s). This number should be appropriately weighted for students who do not attend for the entire school year, and for those who do not undertake a full education workload as defined by the program.
(b) Data source.
The number of students shall he determined from the education department's records.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.16 Rehabilitative services
Facilities shall provide or obtain rehabilitative services such as audiology, speech therapy, speech-language pathology, and occupational therapy for every resident it admits in accordance with the resident's comprehensive plan of care to obtain or maintain the highest practicable physical well-being in accordance with generally accepted standards of rehabilitative care and services.
(a) Provision of services.
If specialized rehabilitative services are required in the resident's comprehensive plan of care, the facility shall:
(1) provide the required services; or
(2) obtain the required services from an outside resource, in accordance with section 400.4 of this Title, who is a provider of specialized rehabilitative services.
(b) Qualifications.
Specialized rehabilitative services shall be provided by qualified personnel pursuant to the written order of a physician.
(c) Organization.
The facility shall designate an occupational therapist, physical therapist and speech-pathologist to assist the facility in the development and implementation, in cooperation with nursing and medical services, of written policies and procedures for rehabilitative services within the facility which:
(1) establish restorative and maintenance rehabilitation as components of interdisciplinary resident care planning and treatment;
(2) establish a system of determining rehabilitative goals for each resident based on the resident's need relative to his or her physical and mental level of functioning, the overall plan of care for the resident and the resident preferences. These treatment goals shall range on a continuum, progressing from all specialized restorative rehabilitative services to routine maintenance rehabilitation; and
(3) establish a system to monitor the maintenance of optimum levels of functioning for those residents who have been discharged from a formal rehabilitative program and who are on a maintenance program primarily provided by nursing staff on the floor.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.5 Administrative services
This functional reporting center must contain all the expenses associated with the overall management of the facility, including the office of the administrative director, management fees, public relations, auxiliaries or volunteer groups, messenger services, purchasing, governing board, information and paging activities, maintaining all insurance policies (except employee benefit insurance), licenses and taxes, and working capital interest. Additional activities include but are not limited to the following: provision of staff support to the board; charting the flow of patients through residential health care facility services; projecting daily census for budgets; pickup and delivery of mail within the residential health care facility; printing and duplication of forms and reports; operation of the communications system within the facility, including the telephone switchboard and related telephone services; receipt and processing of requisitions; monitoring perpetual supply items; obtaining quotes from selected vendors and monitoring receipt of supplies; receiving, storing and delivering materials, equipment and supplies to various departments; recruitment, employee selection, salary and wage administration; fringe benefit program administration; procurement of temporary help; scheduling and recordkeeping relative to employee visits and pre-employment and post-illness employee physicals.
(a) Standard unit of measure: total operating expenses.
The total operating expenses of the facility less depreciation and lease costs for land, buildings and fixed equipment, and interest on capital debt.
(b) Data source.
The costs shall be determined for the general accounting records.
Article 2 HOSPITALS
Part 408 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS (CSFRHN)
10 CRR-NY 408.3 Administration
(a) Upon establishment in accordance with the provisions of Part 680 of this Title, a central services facility rural health network shall establish a board of directors responsible for directing the operation of the network in accordance with all applicable regulations and guidelines for networks. The board shall:
(1) include equitable representation from the individual governing bodies and medical/professional or administrative staff of participating network providers;
(2) include consumer representation consisting of individuals unaffiliated with health care providers other than as purchasers of health care services; and
(3) maintain an appropriate balance of provider representatives and consumers residing in the rural area served by the network on the CSFRHN's board of directors.
(b) The CSFRHN board shall adopt written bylaws reflecting its responsibility, accountability and obligations to the community it was established to serve. The bylaws shall include:
(1) a description of the organization's service area and office locations;
(2) the purposes of the organization;
(3) a description of the duties, number and qualifications of directors, the appointment/election process, terms, or the processes for removing and filling vacancies and addressing conflicts of interest, and the compensation of directors;
(4) definitions of consumer and provider representatives on the board of directors;
(5) a list of officers and their responsibilities; and
(6) the mechanisms for adopting, reviewing and revising the bylaws.
(c) The CSFRHN board of directors shall ensure that reports and other documentation required for active supervision by the commissioner, as required in section 408.4 of this Part, shall be submitted in a timely fashion and that any additional requests for information deemed necessary to assess a network's degree of compliance with the intent and purposes of the network development program shall be provided upon request.
(d) CSFRHNs may, pursuant to the provisions of section 2952 of the Public Health Law and guidelines developed by the commissioner, directly receive grants and reimbursement for planning and coordination of services and may also directly receive global budgets, pooling arrangements and/or capitation payments on behalf of participating providers.
(e) A CSFRHN may submit applications for rate enhancements or regulatory waivers to promote the successful implementation and operation of the network pursuant to section 2952 of the Public Health Law, regulations promulgated pursuant thereto and guidelines established by the commissioner.
(f) Operation of hospitals.
(1) With the prior approval of the Public Health Council, pursuant to Parts 600 and 680 of this Title, central services facility rural health networks may directly operate a hospital.
(2) Central services facility rural health networks established to directly operate a hospital shall be subject to the provisions of all applicable Parts of this Title concerning facility operations and reimbursement.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.11 Accrued depreciation
The total depreciation incurred by an asset or asset group, based on customary or fairly determined rates or estimates of useful life, now generally referred to as accumulated depreciation.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.6 Variance and waivers
(a) Variance.
The permit-issuing official may, on written application and after review, grant a variance from a specific provision of this Subpart subject to appropriate conditions which shall include a time schedule for compliance where such variance is in harmony with the general purposes and intent of this Subpart, and where there are practical difficulties or unnecessary hardship in complying with such provision.
(b) Waiver.
The permit-issuing official may waive, in writing, any of the requirements of this Subpart, and include the waiver as a condition of the permit to operate, when it reasonably appears that the public health will not be endangered by granting of such waiver and adequate alternative provisions have been made to protect the safety of the bathers and the public health. A copy of the waiver and description of the alternative provisions shall be submitted by the permit- issuing official to the State Commissioner of Health at the time of issuance. Such waiver shall remain in effect for a period of time, concurrent with the operating permit, unless sooner revoked for cause by the permit-issuing official.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PURPOSE PURPOSE
10 CRR-NY 14-5.1 Purpose
(a) The purpose of this code is to protect the public health. Food vending machines are to be maintained and operated in such a way as to avoid health hazards.
(b) This code does not apply to machines rending merchandise other than food or beverages.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 120 HERKIMER COUNTY
VILLAGES VILLAGES
10 CRR-NY 120.3 Village of Frankfort
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on or fed by Money Gulf and Moyer creeks and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs and to the wells which have been developed or may be developed in the neighborhood of Moyer Creek within the village of Frankfort, such bodies of water and wells being sources of the public water supply of the village of Frankfort, Herkimer County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoirs on or fed by Money Gulf or Moyer creeks which are tributary to or which serve as a source of the aforesaid public water supply and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), streams, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Frankfort.
(3) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(4) Wherever a linear distance of a structure or object from a reservoir or from a watercourse or from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse or to the nearest well.
(c) Privies adjacent to any reservoir, watercourse or well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or 50 feet of any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or within 100 feet of any watercourse or within 200 feet of any well, tributary to the public water supply of the village of Frankfort.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any reservoir, watercourse or well tributary to the public water supply of the village of Frankfort.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir, watercourse or well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse tributary to the public water supply of the village of Frankfort, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any reservoir or 100 feet of any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Frankfort, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any reservoir or 50 feet of any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Frankfort.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Frankfort. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Frankfort.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir, 25 feet of any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir, any watercourse or any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse or 200 feet from any well tributary to the public water supply of the village of Frankfort.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Frankfort, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir, watercourse or well tributary to the public water supply of the village of Frankfort; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 25 feet of any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse or within 200 feet of any well tributary to the public water supply of the village of Frankfort.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste mater of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of Frankfort, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir, watercourse or well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir, watercourse or well tributary to the public water supply of the village of Frankfort.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Frankfort, except by duly authorized employees of the village of Frankfort in the performance of their duties of supervision and maintenance of the public water supply of the village of Frankfort.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir, watercourse or well tributary to the public water supply of the village of Frankfort.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir, watercourse or well tributary to the public water supply of the village of Frankfort.
(j) Inspections.
The board of water commissioners of the village of Frankfort or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Frankfort or the duly appointed representative of any such board shall make regular and thorough inspections of the reservoirs, watercourses, wells and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 24 ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Subpart 24-2 PROHIBITED FACILITIES
10 CRR-NY 24-2.3 Closure
In addition to any other power they may have under any applicable law, ordinance or regulations, the State Health Commissioner, local health officers and local boards of health may close any such facilities or establishments as constituting a public nuisance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.12 Cafeteria
This functional reporting center must contain all the expenses associated with procurement, storage, processing and delivery of food and nourishment to personnel and visitors in compliance with public health regulations, including vending machine operation. Additional activities include but are not limited to the following: preparation of food, food service, maintenance of vending machines, and operation of the cafeteria to serve employees and visitors. Note that when distributing shared (common) kitchen costs between this center and the Patient Food Service functional center, the reclassification criteria do not apply. See the special rules which are detailed in section 455.11(b) of this Part.
(a) Standard unit of measure: equivalent cafeteria meals served.
An equivalent meal count is determined by total cafeteria dollar sales divided by the average sales price of a full meal served at noon. The average sales price of a full meal should include meat, potato, vegetable, salad, beverage and dessert. Count a free meal to an employee (or other nonpatient) as a full meal.
(b) Data source.
The average sales price of a full meal shall be determined by an estimate based upon cafeteria prices and appropriately weighted for price changes during the year. Dollar sales in the cafeteria are maintained in general accounting. Free meals are to be determined by an actual count maintained by cafeteria personnel.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.2 Physician eligibility
(a) Eligibility.
To be eligible to receive a Physician Loan Repayment Program award, a physician must:
(1) be a primary care physician, emergency medicine physician or other physician specialist determined by the commissioner to be in short supply;
(2) be licensed in New York;
(3) agree to practice in an underserved area for a minimum of two years;
(4) agree to apply award monies received toward repaying all or part of recipient's qualifying debt; and
(5) complete, sign, and file an application with the department on such forms and within such timeframes specified by the department. All required supplementary documentation shall be filed as directed. Incomplete or illegible applications may be rejected.
(b) A physician may be eligible for a maximum of four annual awards.
(c) Ineligibility.
A physician will be ineligible for an award if:
(1) the physician has a service obligation to the federal government or other entity which could require service outside of New York State;
(2) the physician is fulfilling a service obligation under the Regents Physician Loan Forgiveness Program or a federally-funded loan repayment program for the period for which a Physician Loan Repayment Program Award is requested; or
(3) the physician is in default on the repayment of a guaranteed student loan or in default under the terms of any other governmentally administered scholarship or financial aid program and the individual refuses to allow the New York State Higher Education Services Corporation to directly apply the award to the defaulted account(s).
(d) Selection criteria.
The Department of Health shall consider the following factors in selecting recipients:
(1) the need for a physician specializing in the same specialty as the applicant in the underserved area where the applicant proposes to fulfil his/her service obligation;
(2) prior experience in serving the medically indigent or other underserved populations; and
(3) appropriateness of the applicant’s education and training to meet the needs of the underserved area in which the applicant proposes to fulfill his/her service obligation.
(e) Number.
The Department of Health shall award up to 100 new awards per year.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.14 Notification
Any person who owns or operates a bottled or bulk water facility must notify the State by telephone, facsimile (FAX) copy or other means when feasible, but no later than 24 hours of learning of the existence or potential existence of a violation of section 5-6.11 of this Subpart.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.20 Definitions of food service establishment and caterer
(a) A food service establishment is a place where food is prepared and intended for individual portion service and includes the site at which the individual portions are provided, whether consumption occurs on or off the premises. The term excludes food processing establishments, retail food stores, private homes where food is prepared or served for family consumption, and food service operations where a distinct group mutually provides, prepares, serves and consumes the food such as a “covered-dish supper” limited to a congregation, club or fraternal organization.
(b) A caterer is a person who prepares, furnishes, or prepares and furnishes food intended for individual portion service at the premises of the consumer, whether such premises are temporary or permanent. A caterer is considered a food service establishment operator and is required to operate in conformance with this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.5 Governing body
A health systems agency shall have a governing body which shall have exclusive authority to perform the health systems agency functions described in section 82-1.6 of this Subpart. The governing body shall mean the board of directors of the health systems agency or a standing committee designated by the board of directors.
(a) Responsibilities.
The governing body shall be responsible for:
(1) appointing an executive director who shall be responsible for the internal affairs of the health systems agency including matters related to the staff of the agency and the agency's budget;
(2) the approval or disapproval of the agency's annual budget, health systems and other plans, reports, and products prepared by the agency as appropriate;
(3) issuing an annual report concerning the activities of the agency, and making the report readily available to the residents of the health service area and to the various communications media serving the area;
(4) performing any other duties and functions of the health systems agency required by law; and
(5) approving major planning initiatives not specifically required in section 82-1.6 of the Subpart.
(b) Meetings.
The governing body shall:
(1) meet at a minimum four times per calendar year;
(2) hold public meetings as if it were a public body to conduct the business of the agency;
(3) give adequate notice to the public of such meetings;
(4) provide an opportunity for parties directly affected by a decision of the agency to request a public meeting and, when good cause is shown, to conduct a public meeting for the purpose of considering additional information provided by the affected party(ies); and
(5) act by vote of at least a majority of the members of the governing body present at the time of the vote, provided a quorum is present at such time. (A quorum for the governing body shall be not less than a majority of its members.)
(c) Composition.
Each health systems agency shall establish a process for the selection of the members of its governing body which assures a rotation of membership and that the members are broadly representative of the residents of the health service area and that the participation of such residents is encouraged and facilitated. A member of the governing body shall serve no more than two consecutive fixed terms of three years each in any period of 12 consecutive years or no more than a total of six years in any 12-year period. Persons appointed as board members prior to March 1, 1990 shall be eligible to serve a full term subject to the conditions and limitations of section 2904 of the Public Health Law. Full compliance with this requirement shall be required as of March 1, 1993. The membership of the board of directors of a health systems agency and any executive committee designated by the board of directors shall meet the following criteria:
(1) A majority (but not more than sixty percent of the members) shall be (i) residents of the health service area served by the agency who are consumers of health care, and (ii) broadly representative of the health service area and shall include individuals representing the principal social, economic, linguistic, handicapped, ethnic and racial populations and geographic areas of the health service area and major purchasers of health care, including labor organizations and business corporations, in the area. A consumer shall mean a person who is not a provider of health care as defined in accordance with section 82-1.1(d) of this Subpart. Full compliance with this requirement shall be required as of March 1, 1993.
(2) The remainder of the members shall be residents of, or have their principal place of business in, the health service area served by the agency who are providers of health care and who, to the extent practicable, are representative of the variety of disciplines and interests of the health care system including (i) physicians, dentists, nurse practitioners, licensed midwives, licensed nurses, optometrists, podiatrists, physician's assistants, and other health professionals; (ii) health facilities; (iii) health care insurers; (iv) health professional schools; (v) the allied health professions; and (vi) other providers of health care. Not less than one-half of the providers of health care of the governing body of a health systems agency shall be direct providers of health care and of such direct providers of health care, at least one shall be a person engaged in the administration of a health facility.
(3) At least 60 percent of board membership shall be nominated by local government, local provider organizations and local community organizations.
(4) The members shall (i) include public elected officials or other representatives of units of general purpose local government in the agency's health service area and representatives of public and private agencies in the area concerned with health; (ii) include persons who reside in nonmetropolitan areas within the health services area proportionate to the percentage of residents of the area who reside in nonmetropolitan areas; (iii) include persons who are knowledgeable about mental hygiene services; and (iv) if the agency serves an area in which there are one or more health maintenance organizations, include at least one member who is representative of such organizations.
(5) To the extent practicable, all standing committees, subcommittees, and advisory groups appointed by the governing body of the health systems agency shall be appointed in such a manner as to provide broad representation in such a manner that a majority of the members shall be consumers of health care.
(d) Conflicts of interest.
(1) Annual statement. Each member of the governing body and staff shall submit annually to such governing body a written statement identifying all health facilities in which he or a member of his family has an interest, financial or otherwise, whether as owner, officer, director, fiduciary, employee or consultant, or supplier of goods or services where the health facility or health facilities represent a significant portion of the business of the supplier. For purposes of this subdivision, family shall, at a minimum, include a spouse and dependent children. Each health systems agency may expand the definition of family in their bylaws. The chair of the governing body shall distribute to each member and staff a copy of the annual statements submitted by all other members and staff.
(2) Pending matters. Each health systems agency shall adopt bylaws regarding disclosure and conflicts of interest which shall provide at a minimum:
(i) Disqualification. Where a member of the governing body and standing committees or his family has an interest, financial or otherwise, whether as owner, officer, director, fiduciary, employee or consultant of a health facility under consideration, or supplier of goods or services regarding a health facility under consideration where the health facility represents a significant portion of the business of the supplier, that member shall identify such interest and shall not participate in any vote on the matter.
(ii) Disclosure and possible disqualification. Where a member of the governing body and standing committees or his family has any of the aforesaid interests in a health facility, the status of which might reasonably be affected by another health facility under consideration before the body and which serves or is proposed to serve the same community or service areas as does the health facility in which the member of his family has an interest, or in any event where a member has an interest or association which might reasonably raise suspicion among the public that participation by him in the matter under consideration would be in violation of his trust, he shall, at the time of formal consideration of such matters before the body, disclose such interests or association so that the chair and, if necessary, the body can then determine whether his participation in the discussion of or vote on the matter would be proper.
(iii) Procedure. Prior to discussion or vote, all actual or potential conflicts shall be announced and, where appropriate, explained by the members holding such conflicts. In the case of disqualification, the members holding such conflicts shall absent themselves from the meeting during the period when the matter is under formal consideration unless the body, upon request of the member for good cause, by affirmative vote of the majority of those present determines to permit such member to remain. The minutes of each meeting of the body shall reflect all disclosures regarding conflicts of interest as well as the abstention from voting of the interested member.
(3) Advisory groups. Each health systems agency shall adopt conflicts of interest bylaws for advisory groups which advise the governing body or its standing committees.
(e) Records.
(1) The governing body of each health systems agency shall ensure that records and data of the agency are available, upon request, to the public, other than records or data that would not be subject to disclosure if the agency were a public agency subject to the Freedom of Information Law (article 6 of the Public Officers Law). Such records include, but are not limited to, applications and related documents concerning the establishment or construction of health facilities as defined in this Subpart. Records, or portions thereof, which are not subject to disclosure shall be kept confidential.
(2)
(i) Routine requests for access to records in which it appears clear that the requested information is disclosable shall be processed by the health systems agency.
(ii) Requests for access to records in which there is a question as to whether the information is subject to disclosure shall be forwarded to the Department of Health's records access officer, Corning Tower, Empire State Plaza, Albany, NY 12237 for a determination.
(3) A health systems agency may impose a reasonable charge for all inspections and copies, not exceeding the costs incurred by such agency.
(f) Other requirements.
Each health systems agency shall:
(1) submit a semi-annual report to the Senate and Assembly health committees, and the commissioner detailing the activities of each agency during that reporting period;
(2) annually submit a copy of its operating budget to the chairman of the Senate Finance Committee, the chairman of the Assembly Ways and Means Committee, the Director of the Budget and the Commissioner of Health. Such operating budget shall contain information detailing contributions received and the type and sources of contributions eligible for matching grants;
(3) provide for such fiscal control consistent with generally accepted accounting principles as the commissioner may require to assure proper disbursement of, and accounting for, funds received by the health systems agency from the State and other sources; and
(4) retain for a period of six years and permit the commissioner, the State Comptroller and the Attorney General, or their duly authorized representatives, to have access for the purpose of audit, inspection and copying to all books, documents, papers, accounts and records pertinent to the disposition of funds received by the health systems agency from the State and other sources.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-3 PROHIBITION ON THE SALE OF ELECTRONIC LIQUIDS WITH CHARACTERIZING FLAVORS
10 CRR-NY 9-3.4 Severability
If any provisions of this Subpart or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Subpart or the application thereof to other persons, entities, and circumstances.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.7 Extension of hospital stay
(a) To be a covered benefit under medical assistance for the needy as provided in section 365-a(2)(b) of the Social Services Law, any inpatient stay which exceeds the period of time determined to be a covered benefit under sections 85.1 through 85.6 of this Part and under this section but does not exceed a total of 20 days or, if for rehabilitation of physical disability as described in subdivision (a) of section 85.5 of this Part, a total of 40 days, shall be subject to a determination of extended coverability. Such determination shall be made by a person designated by the Commissioner of Health, shall be made prior to the expiration of the previously determined period of covered benefit and shall be for a specified period of time not to exceed applicable length of stay norms for comparable patients which have been authorized by the Commissioner of Health or the 20th day of stay, whichever is less. If the stay is for rehabilitation of physical disability as described in subdivision (a) of section 85.5 of this Part, such specified period of time shall not exceed the 40th day of stay. Determination of extended coverability shall be based upon existence of medical conditions which can be treated only by continued care on an inpatient hospital basis as documented in the patient's medical record.
(b) While making a determination of coverability, if the person designated by the Commissioner of Health determines that during a previously determined period of covered benefit, the care, supplies and services actually provided did not require provision on an inpatient hospital basis, the designated person may make a determination of noncoverability as to part or all of such previously determined period of covered benefit under medical assistance for the needy.
(c) A determination of benefit coverability under this section shall be made by a designated physician or nonphysician under a designated physician's supervision. A determination of noncoverability shall be made only by a designated physician. If such determination of noncoverability is made, any inpatient hospital care, supplies or services provided beyond the previously determined period of covered benefit shall not be a covered benefit under medical assistance for the needy.
(d) Notice of determination shall be given to the patient's physician, the hospital administrator and, if there is a determination of noncoverability, to the patient.
(e) The patient's physician or hospital administrator may, within three days of the date of such notification, appeal a determination on noncoverability in writing to the physician or physicians designated by the commissioner for such purpose. Notification of the decision on appeal shall be given to the patient's physician, the hospital administrator and the patient. If the determination of noncoverability is affirmed on appeal, any inpatient hospital care, supplies, or services provided beyond the previously determined period of covered benefit shall not be a covered benefit under medical assistance for the needy.
(f) Any hospital care, services or supplies covered as a benefit under this section shall be subject to length of stay limitations of section 85.5 of this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.62 Jericho Water District, town of Oyster Bay
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as heretofore set forth, shall apply to all wells of the public water supply of the Jericho Water District of the town of Oyster Bay, Nassau County, N. Y.
(b) [Definition.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit, cesspool or receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the Jericho Water District.
(2) No privy, privy vault, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the Jericho Water District.
(3) No cesspool, pit or other receptacle used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is watertight and so arranged and equipped that the said excreta or sewage will not overflow and is at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, except that suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage may be provided and maintained between the said limiting distances if at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable vessels or receptacles permitted under paragraph (3) of this subdivision shall be removed and the vessels or receptacles thoroughly cleaned and deodorized as often as may be found necessary in order to maintain them or the privy or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of final disposal hereinafter specified and that the contents while being transferred shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any well of the public water supply of the Jericho Water District.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water, or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the trench or place or disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry, garage or stable wastes or sewage or other excretal matter from any water closet, privy, receptacle or other source shall be thrown, placed, led, discharged or allowed to escape on or beneath the surface of the ground within 200 feet of any well of the Jericho Water District, except into suitable watertight iron pipes with leaded joints connected to a sewage disposal system, plans for which have been submitted to and received the approval of the State engineer and a permit obtained from this department.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any industrial establishment nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon the surface of the ground or be allowed to escape or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the Jericho Water District.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet of any well of the public water supply of the Jericho Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any well nor to be placed, piled or spread upon the surface of the ground or be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 200 feet from any well of the public water supply of the Jericho Water District and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet from any well of the public water supply of the Jericho Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or maintained or allowed to remain on the surface of the ground or beneath the surface of the ground within 300 feet of any well of the public water supply of the Jericho Water District.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any well of the public water supply of the Jericho Water District.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any well of the public water supply of the Jericho Water District.
(i) Inspections.
The board of water commissioners of the Jericho Water District shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.22 Clinical records
(a) The facility shall maintain clinical records for each resident in accordance with accepted professional standards and practice. The records shall be:
(1) complete;
(2) accurately documented;
(3) readily accessible; and
(4) systematically organized.
(b) Clinical records shall be retained for six years from the date of discharge or death or for residents who are minors, for three years after the resident reaches the age of majority (18).
(c) The facility shall safeguard clinical record information against loss, destruction, or unauthorized use.
(d) The facility shall keep confidential all information contained in the resident's records, regardless of the form or storage method of the records, except when release is required by:
(1) transfer to another health care institution;
(2) law; or
(3) the resident.
(e) The facility shall permit each resident to inspect his or her records and obtain copies of such records in accordance with the provisions of section 415.3(c)(1)(iv) of this Part.
(f) The clinical record shall contain:
(1) sufficient information to identify the resident;
(2) a record of the resident's comprehensive assessments;
(3) the plan of care and services provided;
(4) the results of any preadmission screening conducted by the State;
(5) progress notes by all practitioners and professional staff caring for the resident; and
(6) reports of all diagnostic tests and results of treatments and procedures ordered for the resident.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.8 Conditional prior approval for emods to prospective primary residences
(a) An emod may be conditionally approved for a prospective primary residence of an enrollee, including new construction, provided payment is conditioned upon the following:
(1) the fund administrator approves the Emods to be made to the specified property in accordance with the requirements of this section;
(2) the enrollee or the enrollee’s custodial guardian has or obtains lawful title to the property to which the Emods are to be made;
(3) installation or construction of the emod is completed; and
(4) the fund administrator has received a post-modification evaluation stating that the modification meets the enrollee’s functional needs and is in compliance with the initial evaluation, including adherence to safety and all applicable building code standards.
(b) Any emod approved by the fund administrator must meet all applicable State and local building codes.
(c) The fund administrator may not approve any emod that:
(1) constitutes an improvement to the home that is not medically necessary to ensure the health, welfare and safety of the enrollee by enabling him or her to function with greater independence in the community and/or by helping him or her to avoid institutionalization; or
(2) does not comply with Americans with Disabilities Act (“ADA”) Accessibility Standards or Guidelines or the Fair Housing Act, if applicable, or has not been determined to be safe by a rehabilitative evaluation agency or specialist or a building contractor as required in paragraph (d)(3) of this section.
(d) An application for a conditional approval for an emod to a prospective primary residence shall include the following documentation:
(1) a written statement from the enrollee’s treating physician on the physician’s letterhead explaining why the emod requested is medically necessary;
(2) a comprehensive evaluation of the proposed project by a rehabilitative evaluation agency, rehabilitative specialist, or an independent building contractor who has significant experience working with ADA building standards and accessibility guidelines, including a copy of the floor plan which indicates the specific location in which the emod will be built or installed. The evaluation must specify: a description of the proposed emod; the need for the emod; the reason the proposed emod was selected; whether it is the most cost effective approach to fulfilling the enrollee’s need for the emod; and whether there are any safety concerns associated with the proposed emod and if so, how they will be addressed. The evaluation must also explain how the materials to be used in constructing the emod are cost effective in comparison to alternative materials; and
(3) if the residence is to be constructed or is under construction, a statement from the contractor or the party who completed the comprehensive evaluation describing how the construction of the home is designed to minimize the cost of the emods to be installed, such as reducing the amount of deconstruction necessary by leaving appropriate spaces for installation of the emod. Payment for emods to new construction shall not include the cost of removing any avoidable barrier to the enrollee’s access that is created by the floor plan or during the construction process.
(e) Once the request has been reviewed by the fund administrator, the fund administrator shall notify the enrollee or person authorized to act on the enrollee’s behalf in writing which services or items have been conditionally approved and/or denied and inform the enrollee or person authorized to act on the enrollee’s behalf of the bidding process that is required prior to the fund administrator approving payment for the emod. The enrollee or person authorized to act on the enrollee’s behalf is then required to obtain a minimum of three acceptable bids from qualified contractors. With respect to new construction to which the enrollee or the enrollee’s custodial guardian has not yet taken title, the requirement for bidding may be satisfied by the general contractor obtaining three acceptable bids for the emods to be constructed which must then be submitted to the fund administrator.
(f) Once the fund administrator receives from the enrollee, person authorized to act on the enrollee’s behalf, or the general contractor, a minimum of three acceptable bids from qualified contractors, the fund administrator shall evaluate the qualifications of each bidder and the content of each bid to determine whether each bid is acceptable. In determining whether a bidding contractor is qualified, the fund administrator will take into account whether the contractor has any outstanding judgments on file and whether any complaints have been upheld against the contractor by the Better Business Bureau or the New York State Department of Law. If the enrollee lives in another state or in the District of Columbia, the same type of investigation will be undertaken in that jurisdiction.
(g) An acceptable bid is one that includes:
(1) a description of the scope of work and specifications of the emod;
(2) proof of appropriate and adequate insurance for the duration of the project; and
(3) a statement signed by the contractor or a person duly authorized to sign for the contractor that the work will be done in a workmanlike manner, using materials suitable for purposes of the project and the safety of the enrollee and household members, and will comply with all applicable building and zoning laws.
(h) If less than three bids are submitted, a written explanation of why three acceptable bids were not obtained must be provided, as well as a written explanation of how the determination was made that the one or two bids being considered are reasonably priced.
(i) If the two lowest comparable bids are within 10 percent of each other, the enrollee or his or her legally authorized representative may choose one of the two lowest bids. If there is more than a 10 percent difference between the two lowest comparable bids, the fund administrator shall choose the bid that represents the best value for both the fund and the enrollee based on factors including not only the price offered by each bidder but also the quality, durability, extent of any warranties provided, safety of the product itself, and workmanship offered by each bidder. The successful bidder will be notified after the fund administrator or a designee of the fund administrator:
(1) discusses the bids received with the enrollee or the person authorized to act on the enrollee’s behalf and the reasons why a particular bid is chosen by the fund administrator; and
(2) obtains the written consent of the enrollee or the person authorized to act on the enrollee’s behalf to have the emod constructed or installed by that bidder.
If the enrollee or the person authorized to act on the enrollee’s behalf disagrees with the fund administrator’s decision, the enrollee or his or her authorized representative can request a review of the fund administrator’s decision.
(j) Any change from either the specifications in terms of alternative or substitute equipment or the scope of work involved in the modification that will result in a cost increase from the bid price will require approval from the fund administrator.
(k) Payment for the emod shall include the cost of the comprehensive evaluation of the proposed project, the evaluation of required bids if the fund administrator finds it necessary to engage an outside expert, the evaluation of the completed emod, a one year maintenance contract, if deemed appropriate by the fund administrator, as well as the cost of construction or installation of the emod itself.
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.5 Inspection and inspection fees
(a) A person operating a tanning facility shall allow the department and PIO representatives access to conduct inspections and access to all equipment and records as may be necessary to determine compliance with these rules at any time the facility is in operation.
(b) An inspection fee not to exceed $200 per ultraviolet radiation device will be charged once per biennial licensing period.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
OPERATION AND SUPERVISION OPERATION AND SUPERVISION
10 CRR-NY 6-2.17 Supervision—personnel and equipment
(a) Personnel.
(1)
(i) When a bathing beach is part of a temporary residence or a campground, as defined in Part 7 of this Title, the operator must provide either Supervision Level I, IIb, III, or IV acquatic supervision. Supervision Level I must be provided at temporary residence ocean surf beaches. When Supervision Level III or IV is selected, on-premise CPR certified staff is not required. The temporary residence or campground operator must notify the permit-issuing official in writing of the supervision level selected and at least 15 days before making any subsequent changes to the supervision level selected for each bathing beach.
(ii) When Supervision Level III or IV is selected, the operator of a temporary residence or campground bathing facility described in subparagraph (i) of this paragraph shall not allow the use of the temporary residence or campground bathing facility by persons other than registered overnight patrons of the temporary residence or campground and their guests.
(2) The supervision level required at each bathing beach, other than those described in paragraph (1) of this subdivision, will be determined based on the following:
(i) Supervision Level I is required at ocean surf beaches.
(ii) Supervision Level IIb is required when any of the following are present: water depth within the designated bathing area is five feet or greater; diving boards; flotation devices (other than those bearing a U.S. Coast Guard Type I-III label); bottom conditions hazardous to bathers; aquatic amusements; bathing area perimeter is 50 feet or more from shore; beach bottom slope is steeper than 1:8; slides that discharge into the water.
(iii) Supervision Level IV is required when the water depth within the designated bathing area is less than five feet and the bathing area perimeter is less than 50 feet from the shore.
(3) Aquatic supervisory staff must meet the requirements of section 6-2.20 of this Subpart. When a facility voluntarily provides supervisory staff or a supervision level exceeding those required by this section, all the requirements of this Subpart relative to supervision are applicable.
(4) At least one aquatic supervisory staff person having at least the required supervision level shall be provided for each 50 yards of beach front or fraction thereof at bathing beaches required to use Supervision Levels I and II. Sufficient aquatic supervisory staff must be provided for visual surveillance of the entire bathing area(s) open for swimming.
(i) At ocean surf beaches, at least one supervision level I aquatic supervisory staff possessing a current certificate of training in the operation and use of an automated external defibrillator approved by a nationally-recognized organization or the State emergency medical services council shall be present at all hours of beach operation. Records of the training shall be maintained available for review during inspections.
(5) Additional aquatic supervisory staff may be required by the permit-issuing official whenever it is necessary for the protection of the beach patrons (bathers). Factors, including but not limited to: beach shape; diving board use; patron decorum, patron alcohol consumption; and, bathing facilities used primarily for the developmentally disabled may be the basis for increased coverage.
(6) The aquatic supervisory staff at beaches required to have Supervision Levels I-III shall be at the beachfront, providing direct supervision of the bathers.
(7) The aquatic supervisory staff shall be engaged only in activities that involve direct supervision of bathers. When instructional activities occur and the aquatic supervisory staff is also providing the instruction, additional staff meeting at least Supervision Level III requirements must be provided when the instructional activities may be reasonably expected to distract required aquatic supervisory staff from direct supervision of all bathers.
(8) Beaches required to use Supervision Levels I and II aquatic supervisory staff shall provide a supervising lifeguard when the facility is required to provide three or more aquatic supervisory staff.
(9) The facility operator shall be responsible for verification of aquatic supervisory staff qualifications. Copies of the certifications or other document(s) showing possession of such qualifications shall be kept on file at the site and made available to the department upon request.
(10) A bathing beach permitted to use Supervision Level IV shall comply with the following bathing beach use rules:
(i) Two or more adults (18 years of age or older) must be present at the beach when the bathing facility is in use, with at least one adult on the beachfront.
(ii) Supervision Level IV bathing beach personnel shall be on premises at all times the beach is in use and will conduct at least one visual beachfront check prior to operation/use. The visual check shall confirm the beach is in compliance with the requirements of this Subpart, including safety equipment and water conditions. Upon completion of these inspections the personnel signs or initials the log, and records the time of inspection and number of persons using the facility. A log is to be provided and maintained by the facility operator to record the time of periodic inspection(s) and other required information.
(iii) Children less than 16 years of age must at all times be accompanied by a parent or guardian or similar adult responsible for their safety and behavior while at the bathing facility.
(iv) A free, conveniently located telephone must be provided at the facility with posted numbers for the nearest emergency service (police, fire department, ambulance, hospital).
(v) Required safety equipment must be provided at site.
(vi) Warning signs of a minimum 36″ × 24″ size with safety conditions and methods for summoning CPR certified individual, when CPR trained staff is required, must be posted. The warning sign must state:
Two or more adults (18 years of age or older) must be present at the beach when the bathing facility is in use, with at least one adult on the beachfront.
Children less than 16 years of age must at all times be accompanied by an adult responsible for their safety and behavior while at the bathing facility.
Swim only within the designated bathing area.
Method of summoning on-premise CPR staff (only where CPR trained staff is required).
Location of free telephone and numbers to contact.
(vii) The bathing facility operator shall provide to all patrons a written statement or brochure. Only patrons who have received this statement may use the bathing facility. The brochure or statement must state at least the following:
NEVER SWIM ALONE. A minimum of two adults, 18 years of age or older, must be present whenever this swimming facility is in use.
THERE IS NO SUBSTITUTE FOR ADEQUATE SUPERVISION. Children under 16 years of age must be accompanied by a parent or guardian.
IN AN EMERGENCY, NOTIFY THE FACILITY OPERATOR AND CONTACT HELP AS SOON AS POSSIBLE. A free telephone is provided at this facility (define location). Telephone numbers for the nearest emergency medical service are posted.
Only use this facility during posted hours of operation and swim only in the designated bathing area.
Don’t drink alcohol and swim.
(b) Lifesaving equipment and safety lines.
(1) Lifesaving equipment shall be readily accessible at all bathing beaches. Minimum equipment shall include:
(i) a first aid kit, which may be any commercially prepared 24-unit kit or, a supply of bandaids, bandage compresses and self-adhering gauze bandages; and a pocket face mask or face shield with a one way valve to assist with CPR;
(ii) at Supervision Level I and IIb bathing beaches: one rescue tube or a torpedo buoy with an attached line for each lifeguard required by this section; a rescue board or lifeboat in compliance with section 6-2.19, item 6.2.1 (board/boat specifications) of this Subpart and a full size commercially available spine board or a spine board six feet long and a minimum 16 inches wide provided with straps to aid in immobilization of a victim and hand holds; and
(a) At ocean surf beaches, at least one automated external defibrillator shall be provided by the operator and maintained on-site. The beach operator shall implement a PAD program as defined in section 6-2.2(i) of this Subpart and maintain the following records on-site for inspection:
(1) a copy of the collaborative agreement between an emergency health care provider and the ocean surf beach operator;
(2) a copy of the notification to the regional emergency medical services council of the existence, location, and type of automated external defibrillator; and
(3) the records of automated external defibrillator maintenance and testing specified by the manufacturer's standards;
(iii) at Supervision Level IV bathing beaches or temporary residence bathing beaches using Supervision Level III in accordance with section 6-2.17(a)(1)(ii) of this Subpart: one U.S. Coast Guard approved ring buoys at least 18 inches in diameter fitted with a quarter- inch diameter line a length of 50 feet, and a reaching pole, 15 feet long.
(2) Each lifeguard stand shall be equipped with a whistle or megaphone, and an umbrella or sunshade.
(3) Elevated lifeguard chair(s) shall be provided at all level I and IIb beaches. A minimum of one chair is required for each 50 yards of supervised beach front or at locations described in the approved safety plan as required by subdivision (c) of this section. Elevated lifeguard chairs shall be located to provide a clear unobstructed view of the bathing area. Where swimming or diving is permitted more than 150 feet from the shoreline, lifesaving patrol boats or offshore lifesaving stations shall be provided.
(4) Safety equipment shall have its function plainly marked, and shall be kept in ready condition.
(5) Floating lines shall mark the boundaries of the swimming, wading and diving areas in accordance with the provisions of section 6-2.19, item 4.7, of this Subpart. Swimming shall be prohibited outside the marked area.
(6) A bathing beach with consistent actual bather use of 500 or more bathers shall have and maintain a readily accessible building for emergency care. This building shall be equipped with an advanced first aid kit and a resuscitator.
(c) Safety plan.
Operators of bathing beaches must develop, update and implement a written beach safety plan, consisting of: procedures for daily bather supervision, injury prevention, reacting to emergencies, injuries and other incidents, providing first-aid and summoning help. At ocean surf beaches, the safety plan shall be developed in consultation with an individual having adequate ocean surf lifeguarding experience. The safety plan shall be approved by the permit-issuing official and kept on file at the beach. Approval will be granted when all the components of this section are addressed so as to protect the health and safety of the bathers, and the plan sets forth procedures to insure compliance with this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 118 GREENE COUNTY
10 CRR-NY 118.1 Village of Athens
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Hollister Lake and all watercourses tributary thereto or which may ultimately discharge into said Hollister Lake or which may be developed in the future to serve as sources of the water supply to the Village of Athens.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Athens water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Athens.
(17) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flow or may flow into the Village of Athens water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Athens water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Athens.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Athens except by duly authorized employees of the Village of Athens in the performance of their duties of supervision and maintenance of water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Athens within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Village of Athens in the performance of their duties of supervision and maintenance of the water supply. Fishing elsewhere on the reservoir will be by permit only. Permits will be issued at the discretion of the board of trustees of the Village of Athens.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Athens.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The board of trustees of the Village of Athens or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees of the Village of Athens to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees of the Village of Athens to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees of the Village of Athens shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.12 Federal financial participation
The rates of payment made for inpatient hospital services rendered to title XIX recipients established in accordance with the methodology contained in this Subpart shall be contingent upon Federal financial participation (FFP) and approval.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.103 Definitions relating to equipment and utensils
(a) Approved means that under conditions of use the State Commissioner of Health, based on evaluation of the physical characteristics and usual usages, has determined it to be in conformance with good public health practices.
(b) Easily cleanable means readily accessible and of material and finish fabricated so that residues may be completely removed by normal cleaning methods.
(c) Equipment is all stoves, ranges, hoods, tables, counters, refrigerators, sinks and similar items other than utensils, used in the operation of a mobile food establishment.
(d) Food-contact surfaces are the surfaces of equipment, utensils, kitchenware and tableware which are normally contacted by food or which food may contact and drain back into food or onto food-contact surfaces.
(e) Food-grade when used as a description means that the material, object, equipment or item is nontoxic, will not contribute any contaminant to food through migration or its own deterioration under usual conditions of regular use, and is constructed or fabricated to perform its intended function in an acceptable manner.
(f) Kitchenware is all multi-use utensils other than tableware used in the storage, preparation, transfer, conveyance or service of food.
(g) Nonfood-contact surfaces are surfaces other than food-contact surfaces.
(h) Single-service articles are items intended by the manufacturer to be discarded after using item once for eating or drinking.
(i) Tableware is all multi-use eating and drinking utensils.
(j) Utensil is any tableware and kitchenware used in the storage, preparation, transfer or service of food.
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.93 Service connections
Service connections through an exterior wall of the machine, including water, gas, electrical and refrigeration connections, are to be grommeted or closed to prevent the entrance of insects and rodents. Service connections to machines vending potentially hazardous food are to be such as to discourage their unauthorized or unintentional disconnection.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.273 Psychiatric inpatient service
The care of psychiatric inpatients; the hospital must also employ specially trained personnel to staff this service, and at least one psychiatrist must be on the medical staff.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 700 GENERAL
10 CRR-NY 700.1 Title
This Subchapter shall be known and may be cited as the “State Hospital Code.”
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 123 LIVINGSTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 123.5 Village of Dansville (surface supply)
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to Mill Creek and all watercourses tributary thereto or which may ultimately discharge into said Mill Creek or the surface sources which may be developed in the future to serve as sources of the water supply to the Village of Dansville, Livingston County.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir, or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal or agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the public water supply of the Village of Dansville.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Village of Dansville.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the Village of Dansville water supply.
(18) Watershed shall mean the entire drainage area contributing water to the Village of Dansville water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse, except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed, unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse, and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle, or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph, or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility, and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse, and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Dansville.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Dansville except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing, hunting or trapping shall be allowed on the watershed, except pursuant to a valid permit issued by the Water Department of the Village of Dansville. In exchange for the privilege of trapping, hunting and/or fishing on the land and at the storage dam only, situated in Steuben County, owned by the Water Department of the Village of Dansville, Livingston County, New York, the permit holder shall agree to the following rules governing this privilege:
(a) there shall be no littering;
(b) there shall be no fires;
(c) there shall be no boats or floats of any kind, whereby a person can venture beyond the shoreline;
(d) there shall be no fishing through ice, or venturing onto the ice for any purpose;
(e) a new permit must be obtained annually;
(f) each permit is issued for one person only and may not be transferred to any other person, unless his or her signature and license number are listed on this permit and recorded in the office of the Water Department of the Village of Dansville;
(g) there shall be no camping or staying overnight on these lands; and
(h) any holder of a permit may ask anyone found on these lands to show their permit and any person having a permit must show same to any permit holder requesting to see it.
Any permit holder that breaks any of the rules governing these lands shall have his or her permit revoked and be deemed a trespasser subject to fine.
(7) Solid waste.
(i) Junkyards. No junkyards shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Dansville.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The Village of Dansville Board of Trustees or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this Part are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.6 Swimming pools and bathing beaches
A swimming pool or bathing beach operated as a part or facility of a mass gathering for the use of occupants, guests, invitees or employees shall be constructed, maintained and operated so as to comply with the provisions of Part 6 of this Title.
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.7 Notice of construction, enlargement, development, improvement or conversion required; prior approval
(a) Prior to construction of structures for overnight occupancy, a campground or campsites food service, water and sewage facilities, including alterations, enlargements, conversions, or relocation of such structures, campsites or facilities, the owner shall submit written notice of intent to the permit-issuing official at least 30 days prior to the commencement of work. The notice shall contain the name of the city, village, or town in which the property is located, the street address of the development, improvement, or conversion, and the name, mailing address, and telephone number of the person giving the notice.
(b) Upon review of the notice submitted in accordance with subdivision (a) of this section and to determine whether the proposed construction, enlargement, development, improvement or conversion will be consistent with the requirements of this Subpart, the permit-issuing official may require the submission of plans and specifications for review and approval. No such work shall commence until all required plans and specifications have been approved by the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.4 Responsibilities of clinical laboratories
Clinical laboratories shall:
(a) report immediately any initially reactive HBsAg test result from a blood specimen marked “mother/delivery” to the requesting health care provider or health care facility; and
(b) report any positive HBsAg test result to the local health officer within 24 hours (see section 2102 of the Public Health Law).
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.1 Permit
(a) Permit means a clinical laboratory or blood bank issued by the Commissioner of Health. No clinical laboratory or blood bank shall be issued a permit in a category unless:
(1) its director or assistant director holds a certificate of qualification in the category for which the permit is sought;
(2) the laboratory has been inspected and has corrected any deficiencies found; and
(3) the laboratory has successfully participated in all required proficiency examinations or remedial activities in the categories sought.
(b) A clinical laboratory or blood bank shall perform only those tests that are within the categories stated on its permit. Specimens for all other tests shall be referred to a clinical laboratory with a permit in the appropriate category. Categories of tests shall be designated according to the following procedures or specialties:
(1) one or more of the following subspecialities of microbiology: bacteriology, virology, mycology, parasitology and mycobacteriology;
(2) hematology;
(3) blood services—diagnostic immunohematology collection and/or transfusion;
(4) one or more of the following subspecialties of clinical biochemistry: clinical chemistry, blood pH and gases, endocrinology and therapeutic substance monitoring/quantitative toxicology;
(5) histopathology or one or more of the following subspecialties: dermatopathology and oral pathology;
(6) cytopathology;
(7) urinalysis;
(8) one or more of the following subspecialities of toxicology: drug analysis-qualitative, blood lead and erythrocyte protoporphyrin, forensic toxicology, and chlorinated hydrocarbons;
(9) cytogenetics;
(10) human immunodeficiency virus (HIV) testing;
(11) histocompatibility;
(12) diagnostic immunology;
(13) cellular immunology;
(14) oncofetal antigens; and
(15) other specific tests or procedures as designated by the department.
(c) In performance of laboratory procedures stated on its permit, a blood bank shall meet the appropriate requirements in Subpart 58-2 and sections 58-1.2 through 58-1.6, 58-1.9, 58-1.10 and 58-1.11 of this Subpart.
(d) A provisional permit shall be available which shall be valid for a period determined by the department to be sufficient to enable the department to assess the proficiency or lack of proficiency of the laboratory in the categories sought. The provisional permit may be renewed pending issuance or denial of a permit if initial proficiency test results are inconclusive.
(1) A clinical laboratory or blood bank initially applying for a permit may be issued a provisional permit when the laboratory meets the following conditions:
(i) a valid and complete permit application has been filed; and
(ii) application and reference fees have been paid; and
(iii) the director or assistant director holds a Certificate of Qualification in all categories sought; and
(iv) the laboratory has been inspected by the department and has provided satisfactory evidence of correction of any deficiencies found.
(2) Provisional permits shall not be available in the categories of cytogenetics-general, mycology, mycobacteriology, human immunodeficiency virus screening and/or confirmatory testing or virology.
(3) A clinical laboratory or blood bank which has failed to demonstrate its proficiency in testing specimens in a category may, after successful participation in a remediation program, including proficiency testing, be granted a provisional permit.
(4) If the director or any owner of the laboratory applying for a provisional permit has ever directed or owned a laboratory which has had its permit revoked, suspended, limited or annulled, or which has an enforcement proceeding against it pending at the time of application for a provisional permit, a provisional permit shall not be issued. Owner shall include any individual, corporation, partner or other person holding a 10 percent or more interest in the laboratory.
(5) Provisional permits may be revoked, suspended, limited or annulled, or the holder thereof may be censured, reprimanded or otherwise disciplined in accordance with the Public Health Law, including section 577 thereof.
(6) A provisional permit in a category may be converted to a permit when the laboratory has demonstrated to the satisfaction of the department its proficiency in testing specimens in that category.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
LOCAL HEALTH OFFICER LOCAL HEALTH OFFICER
10 CRR-NY 11.1 Definition
The term local health officer shall mean:
(a) a commissioner of health as defined in section 11.10 of this Part;
(b) a public health director as defined in section 11.181 of this Part;
(c) the health director of a county, appointed pursuant to and subject to the provisions of section 356 of the Public Health Law; or
(d) the officer of a city having a population of less than 50,000, town, village or consolidated health district who administers and manages public health programs within such jurisdiction and who has the general powers and duties specified in the Public Health Law.
PUBLIC HEALTH DIRECTOR PUBLIC HEALTH DIRECTOR
10 CRR-NY 11.182 Qualifications
(a) A public health director shall possess:
(1) a master's degree in public health from a regionally accredited or New York State-registered college or university that demonstrates the core competencies of a public health education (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavior sciences) or a masters degree in a related field from a regionally accredited or New York State-registered college or university. Related fields include public health nursing, health administration, community health education or environmental health; and
(2) two years of administrative experience in a health-related organization or government agency that demonstrates that the candidate possesses the knowledge and skills necessary to administer public health programs including workforce and budget management, effective communication, effective establishment and implementation of policy or business goals, and compliance with legal requirements.
(b) All appointments to the position of public health director and the appointment and arrangements for the medical consultant are subject to the approval of the State Commissioner of Health.
(c) Candidates who do not meet the education or experience requirements of this section may be conditionally approved for an appointment of two years by the State Commissioner of Health with an opportunity for two additional one-year conditional renewals. Final approval of these candidates shall be contingent on satisfactory progress in meeting a public health education or experience plan developed in conjunction with and approved by the State Commissioner of Health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 156 WYOMING COUNTY
10 CRR-NY 156.1 Village of Arcade
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all springs which now serve or which will be developed to serve as sources of public water supply of the Village of Arcade, Wyoming County.
(b) Definitions.
Definitions of terms wherever used in this section:
(1) The term water supply means the public water supply of the Village of Arcade.
(2) The term spring means either of the four springs now serving as sources of water supply for the Village of Arcade and also to any springs which may be developed to serve as sources of water supply for the Village of Arcade.
(3) The linear distance of a structure or object from a spring is the shortest horizontal distance from the nearest point of the structure or object to the spring.
(4) The term human excreta means feces, urine and other excretions commonly disposed or by the so-called dry system as typified by the ordinary privy.
(5) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) [Human excreta.]
(1) No human excreta shall be deposited, thrown or placed on the surface of the ground at any point within 500 feet of any spring nor in such manner that it can be washed by rain, melting snow or otherwise over the surface of the ground into any spring.
(2) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any spring and covered with 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(3) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any spring, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (1) of subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(4) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (3) of this subdivision cannot be obtained, shall be placed as far as possible from any spring and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any spring. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval of the board of trustees of the village of Arcade and in such a manner as effectually to prevent any pollution of the public water supply.
(5) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 200 feet and 300 feet of any spring shall be arranged so that all excreta will be received in a suitable watertight receptacle, or removable container, which shall be emptied when filled within six inches of the top. The contents if disposed of on the watershed shall be buried as set forth in paragraph (2) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any spring, the said privy, receptacle, trench or place of disposal shall be removed after due notice to the owner thereof to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged or allowed to flow into any spring nor deposited on or beneath the surface of the ground within 300 feet of any spring except in watertight sewers and sewer appurtenances constructed or installed with the approval and under the supervision of the board of trustees of the village of Arcade. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any spring nor be deposited on or beneath the surface of the ground within 200 feet of any spring.
(3) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in any spring nor on or beneath the surface of the ground within 200 feet of any spring nor in such manner that it can be washed by rain, melting snow or otherwise over the surface of the ground into any spring.
(e) Animals, poultry, etc.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any spring and no watering place shall be maintained in such a way as to pollute any spring with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may pollute any spring.
(f) Manure.
No manure pile shall be maintained or allowed to remain within 200 feet of any spring.
(g) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any spring.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any spring.
(i) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act though not heretofore specified which may result in contamination of any portion of the water supply.
(j) Inspections.
The board of trustees of the village of Arcade or such other person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the springs and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violation. If such persons served do not immediately comply with the rules and regulations it shall be the further duty of said board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 112 DUTCHESS COUNTY
VILLAGES VILLAGES
10 CRR-NY 112.4 Village of Wappingers Falls
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such additional wells as may be developed in the future on the property of the village of Wappingers Falls, Dutchess County, New York, such wells being the sources of public water supply of the village of Wappingers Falls.
(b) Definitions.
(1) The term well whenever used in this section means any well now used as a source of this public water supply or any additional well which may be constructed on the property of the village of Wappingers Falls for the purpose of this water supply.
(2) Wherever the linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No privy, cesspool, septic tank, subsurface leaching tile or receptacle of any kind for the storage, deposit or disposal of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(2) No human excreta or sewage shall be so stored, disposed of or discharged onto the surface of the ground so that the material will drain or be washed by rain or melting snow to points within 200 feet of any well.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Bath water, waste, refuse.
No cesspool, pit or receptacle of any kind for the storage, deposit or disposal of bath water, sink or laundry wastes, garbage, refuse, manure or putrescible matter shall be constructed, placed, maintained or allowed to remain within 200 feet of any well.
(e) Animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 200 feet of any well.
(f) Trespassing.
No trespassing shall be allowed upon the property of the village of Wappingers Falls upon which the wells of the public water supply are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said village.
(g) General clause.
In addition to observing the foregoing requirements all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the village of Wappingers Falls.
(h) Inspections.
The village of Wappingers Falls, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid village to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the village of Wappingers Falls to promptly notify the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.6 Deferrals and waivers
(a) Deferral.
The commissioner may delay or defer the service obligation start date, the service obligation, and/or the repayment obligation of a recipient due to extreme hardship. Extreme hardship includes, but is not limited to, serious illness or injury of the recipient or a member of the recipient's immediate family or other circumstances beyond the control of the recipient that would make it extremely difficult or impossible for the recipient to fulfill the service obligation or repayment requirements.
(b) Waiver.
The commissioner may waive all or part of the service obligation and/or any repayment obligation incurred by a recipient due to extreme hardship.
(c) Prescribed forms.
A request for a deferral or waiver of a service obligation and/or repayment obligation must be submitted in writing on forms prescribed by the commissioner. The commissioner may request sworn statements and appropriate documentation to support the recipient's request.
(d) The commissioner shall notify the president of any service and/or repayment obligation deferrals or waivers.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.1 Academic requirements for funeral director examination
(a) Applicants for examination pursuant to section 3421(1) of the Public Health Law shall submit evidence of satisfactory completion of a course of collegiate-level study in funeral service, as required by section 3421(2)(b) of the Public Health Law, consisting of not less than 60 semester credits or 90 quarter credits in an institution or institutions approved by the department or approved by an accrediting agency recognized by the department. The approved course of study shall consist of the following curriculum:
| Area of study | Hours | Examples of courses (illustrative only) | | --- | --- | --- | | Mortuary Arts & Sciences and Related Academic Disciplines | 22 semester credit or 33 quarter credit | Embalming. Restorative Art, Anatomy, Chemistry, Microbiology, Pathology, Personal and Public Health, Biology, Practicum. | | Funeral Service Education and Related Academic Disciplines | 22 semester credit or 33 quarter credit | Funeral Service Orientation, Funeral Counseling, Funeral Directing, Funeral Home Management, Funeral Merchandising, Funeral Home Accounting, Business and Mortuary Law, Practicum. | | Electives (Institutional Requirements) | 16 semester credit or 24 quarter credit | |
(b) The department shall accept, in lieu of completion of a course of collegiate-level study in funeral service as described in subdivision (a) of this section, satisfactory evidence that the applicant possesses an Associate or higher degree in funeral service awarded by an institution approved by the department or approved by an accrediting agency recognized by the department.
(c) Any applicant for examination pursuant to section 3421(1) of the Public Health Law may submit evidence that:
(1) prior to October 17, 1983, he/she was enrolled in a college or university approved by the State Education Department or approved by an accrediting organization recognized by the department;
(2) he/she completed a general course of study consisting of not less than 30 semester credits;
(3) such general course of study was completed by October 17, 1987; and
(4) he/she began funeral service study within one year of completion of such general college study.
(d) Upon submission of the evidence contained in subdivision (c) of this section, the department shall, whenever it benefits the applicant, substitute, in lieu of completion of a course of collegiate-level study in funeral service as described in subdivision (a) of this section, the satisfactory completion of the following course of study consisting of 42 2/3 semester credits or 64 quarter credits in an institution or institutions approved by the department or approved by an accrediting agency recognized by the department.
| Area of study | Hours | Examples of courses (illustrative only) | | --- | --- | --- | | Mortuary Arts & Sciences and Related Academic Disciplines | 22 1/3 semester credit or 32 quarter credit | Embalming, Restorative Art, Anatomy, Chemistry, Microbiology, Pathology, Personal and Public Health, Biology, Practicum. | | Funeral Service Education and Related Academic Disciplines | 16 semester credit or 24 quarter credit | Funeral Service Orientation, Funeral Counseling, Funeral Directing, Funeral Home Management, Funeral Merchandising, Funeral Home Accounting, Business and Mortuary Law, Practicum. | | Electives (Institutional Requirements) | 51/3 semester credit or 8 quarter credit | |
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.1 Definitions
As used in this Part:
(a) Adult day health care is defined as the health care services and activities provided to a group of registrants with functional impairments to maintain their health status and enable them to remain in the community.
(b) Registrant is defined as a person:
(1) who is not a resident of a residential health care facility, is functionally impaired and not homebound, and requires supervision, monitoring, preventive, diagnostic, therapeutic, rehabilitative or palliative care or services but does not require continuous 24-hour-a-day inpatient care and services, except that where reference is made to the requirements of Part 415 of this Subchapter, the term resident as used in Part 415 shall mean registrant;
(2) whose assessed social and health care needs can satisfactorily be met in whole or in part by the delivery of appropriate services in the community setting; and
(3) who has been accepted by an adult day health care program based on an authorized practitioner's order or a referral from a managed long term care plan or care coordination model and a comprehensive assessment conducted by the adult day health care program or by the managed long term care plan or care coordination model.
(c) Program is defined as an approved adult day health care program located at a licensed residential health care facility or an approved extension site.
(d) Operating hours for an adult day health care program are defined as the period of time that the program must be open, operational, and providing services to registrants in accordance with the approval granted by the department. Each approved adult day health care session must operate for a minimum of five hours duration, not including time spent in transportation, and must provide, at a minimum, nutritional services in the form of at least one meal and necessary supplemental nourishment, and planned activities. In addition, an ongoing assessment must be made of each registrant's health status by the adult day health care program, or by the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, in order to provide coordinated care planning, case management and other health care services as determined by the registrant's needs.
(e) Visit is defined as an individual episode of attendance by a registrant at an adult day health care program during which the registrant receives adult day health care services in accordance with his/her care plan. A registrant's individual visit may be fewer than five hours or longer than five hours depending on the assessed needs of the registrant. Registrants referred by a managed long term care plan or care coordination model will receive services as ordered by those entities in conformance with those entities’ comprehensive assessment after discussion and consultation with the adult day health care program.
(f) Registrant capacity is defined as the total number of registrants approved by the department for each session in a 24-hour day.
(g) Operator of an adult day health care program is defined as the operator of a residential health care facility that is approved by the department to be responsible for all aspects of the adult day health care program.
(h) Practitioner is defined as a physician, nurse practitioner or a physician's assistant with physician oversight.
(i) Department means the New York State Department of Health.
(j) Commissioner means the commissioner of the New York State Department of Health.
(k) Care coordination model means a program model that meets guidelines specified by the commissioner that support coordination and integration of services pursuant to section 4403-f of the Public Health Law.
(l) Comprehensive assessment means an interdisciplinary comprehensive assessment of a registrant completed in accordance with section 425.6 of this Part by the adult day health care program, or an interdisciplinary comprehensive assessment, approved by the department, completed by the managed long term care plan or care coordination model that referred the registrant to the adult day health care program.
(m) Care plan means the care plan developed in accordance with section 425.7 of this Part by the adult day health care program.
(n) Unbundled services/payment option means the ability of an adult day health care program to provide less than the full range of adult day health care services to a functionally impaired individual referred by a managed long term care plan or care coordination model based on the registrant’s comprehensive assessment. The full range of adult day health care services as described in this Part will be available to all registrants enrolled in the adult day health care program.
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.6 Hearings
(a) Necessary hearings shall be conducted by the Public Health Council, a committee of the council, or a person designated by the council.
(b) Requests for hearings by applicants shall be made within 20 days after notification that such request may be made. If such request is made by the State Hospital Review and Planning Council or by a Regional Hospital Review and Planning Council, it must be made within 10 days subsequent to the meeting of such council which took place after notification that such request may be made.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.5 Validated examinations
The department will require any person applying for certification as a water treatment operator, water treatment assistant operator or distribution system operator to take a written, oral and/or practical skills validated examination to determine the applicant's skills, knowledge, ability and judgement. The results of the examination, and the requirements of sections 5-4.3 and/or 5-4.4 of this Subpart, will serve as the basis for approval or disapproval of such application.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NUTRITIONIST PUBLIC HEALTH NUTRITIONIST
10 CRR-NY 11.130 Definition
The term local public health nutritionist shall mean a person who plans, develops, implements and evaluates nutrition services within the community and is actively involved in the planning, development, provision and evaluation of nutritional programs and services designed to prevent disease and improve the health of individuals, families, and communities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 71 REQUIREMENTS FOR VENT-FREE GAS SPACE HEATING APPLIANCES
10 CRR-NY 71.3 Requirements
(a) Manufacturers of vent-free gas space heating appliances shall produce shipping carton labels for vent-free gas space heating appliances that prominently and clearly display, in bold type no smaller than 14 point, the following language:
Caution:
This appliance is a supplemental heat source and should not be the primary heat source. This appliance must be installed and serviced according to the manufacturer's instructions and local and State building codes. Select a model with appropriate heat output using sizing guidelines provided by the manufacturer. Using a heater with greater heat output than recommended may be harmful to your health. As with other fuel burning appliances, local building codes may require installation of a carbon monoxide detector in your home.
Sellers of vent-free gas space heating appliances shall ensure that this label is on the outside of each vent-free gas heating appliance shipping carton and is prominently and clearly displayed, in bold type no smaller than 14 point, on or near each vent-free gas space heating appliance on display at a point-of-sale.
(b) Within four years of the effective date of this regulation, manufacturers of vent-free gas space heating appliances shall produce shipping carton labels for vent-free gas space heating appliances that prominently and clearly display, in bold type no smaller than 14 point, information on the vent-free gas space heating appliance's measured carbon monoxide and nitrogen dioxide emission rates as a percentage of the carbon monoxide and nitrogen dioxide emission rate standards referenced in a recognized industry standard for vent-free gas space heating appliances. Sellers of vent-free gas space heating appliances shall ensure that this label is on the outside of each vent-free gas space heating appliance shipping carton and is prominently and clearly displayed, in bold type no smaller than 14 point, on or near each vent-free gas space heating appliance on display at a point-of-sale. The Commissioner of Health must have determined that the methods and procedures used to develop the carbon monoxide and nitrogen dioxide emission rates for the label represent:
(1) normal operating conditions for the vent-free gas space heating appliance;
(2) a reliable analytical method; and
(3) an accurate statistical measure of actual emission rates.
(c) Sizing guidelines prepared by manufacturers of vent-free gas space heating appliances shall be provided at the point-of-sale by sellers of vent-free gas space heating appliances. The sizing guidelines shall be easy to understand, concise and include sample calculations illustrating the method used to select a properly-sized vent-free gas space heating appliance.
Chapter I STATE SANITARY CODE
Part 24 ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Subpart 24-2 PROHIBITED FACILITIES
10 CRR-NY 24-2.2 Prohibited facilities
No establishment shall make facilities available for the purpose of sexual activities where anal intercourse, vaginal intercourse or fellatio take place. Such facilities shall constitute a threat to the public health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 111 DELAWARE COUNTY
VILLAGES VILLAGES
10 CRR-NY 111.2 Village of Fleischmanns, Delaware County
(a) Application.
The rules and regulations set forth in this section and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells and springs which comprise the source of the public water supply of the Village of Fleischmanns, Delaware County. Said wells and springs are located on land and rights-of-way owned by the Village of Fleischmanns, and are situated as follows:
(1) Well No. 1—southeasterly corner of the Village of Fleischmanns, southerly of Emory Brook.
(2) Well No. 2—southeast corner of village, northerly of Emory Brook.
(3) Well No. 3—adjacent to the village ballpark.
(4) Well No. 4—northeasterly corner of the village reservoir lot in the Town of Middletown, southerly of New York State Route 28.
(5) Well Nos. 5 and 6—southwesterly corner of village, easterly of Depot Street.
(6) Springs—all springs are located along the southern edge of the village reservoir property and also along the Penn Central Railroad right-of-way between New York State Route 28 and Green Hill Road, all in the Town of Middletown.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well or spring.
(7) Manure shall mean animal feces or urine.
(8) Nonagricultural associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal wastes and agricultural and nonagricultural associated animal wastes.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial or industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfills, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Village of Fleischmanns.
(20) Wells or springs shall mean any well or spring now used as a source of water supply for the Village of Fleischmanns or any additional well or spring which may be constructed as a source for such water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural waste.
No manure or offal shall be deposited or spread upon or beneath the surface of the ground within a 150-foot linear distance of the wells or springs.
(2) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells or springs.
(3) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells or springs, except in weatherproof buildings or watertight vessels.
(4) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells, or springs unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(5) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle for either temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 150-foot linear distance of the wells or springs.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 150-foot linear distance of the wells or springs.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 150-foot linear distance of the wells or springs; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells or springs.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells or springs, and not within a 500-foot to 1,000-foot linear distance of the wells or springs unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the wells and springs.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the wells and springs.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the wells or springs.
(8) Toxic chemicals.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells or springs, except as may otherwise be permitted under the provisions of this subdivision.
(9) Trespassing.
No trespassing shall be allowed upon the property of the Village of Fleischmanns upon which the wells or springs are located and no person or persons shall enter in or upon such property, except the person or persons authorized to enter said property by the Village of Fleischmanns.
(e) Inspections.
The trustees of the Village of Fleischmanns or any person or persons charged with the maintenance or supervision of the public water supply system shall, by duly appointed village officers or representatives, make regular and thorough inspections of the area surrounding the wells or springs to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid trustees of the Village of Fleischmanns to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the Village of Fleischmanns to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees of the Village of Fleischmanns shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the wells and springs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.7 Site size
After the effective date of this Part, any site established at a new or existing park shall be a minimum of 5,000 square feet. Additional area shall be provided where needed to meet the requirements of sections 17.5(b) and 17.6(b)(1) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.79 Current liability
A short-term debt, regardless of its source, including any liability accrued and deferred and unearned revenue that is to be paid out of current assets or is to be transferred to income within one year. The currently maturing portion of long-term debt is thus classified unless it is to be paid from a sinking fund or other noncurrent asset source.
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.23 Food and dietetic services
The hospital shall have an organized dietary department that is directed and staffed by an adequate number of qualified personnel. The hospital shall ensure that each patient’s dietary needs are considered and correlated with physician’s orders and with the patient’s overall health status and that quality nutritional care is provided to patients.
(a) General.
(1) The hospital food and dietetic services, including cafeterias and snack bars, shall be operated in conformance with the sanitary requirements of Part 14 (Service Food Establishments) of Chapter I (State Sanitary Code) of this Title.
(2) Nutritional needs of patients shall be met in accordance with recognized dietary practices and in accordance with orders of the practitioner or practitioners responsible for the care of the patients.
(b) Organization.
The department shall be directed on a full-time bases by an individual who, by education or specialized training or experience, is knowledgeable about food service management.
(1) The director shall be responsible to the chief executive officer or his/her designee for the daily management of the dietary services, including quality food production, service and staff supervision and management.
(2) The director shall ensure that:
(i) overall coordination and integration of the therapeutic and administrative aspects of dietetic services are maintained; and
(ii) the quality, safety and appropriateness of the dietetic department/service functions are monitored, evaluated and that appropriate actions based upon findings are taken.
(3) The director shall ensure that relevant orientation and inservice education programs are conducted for dietetic personnel and, as appropriate, for other hospital personnel that shall include, at a minimum, personal hygiene, safety and infection control requirements and proper methods of waste disposal.
(4) The director shall be responsible for the development and implementation of policies and procedures concerning the scope and conduct of dietetic services which include:
(i) nutritional care policies and procedures which are developed by a qualified dietitian;
(ii) personal hygiene and health of dietetic personnel; and
(iii) infection control measures to minimize the possibility of contamination and transfer of infection.
(5) A dietitian, full-time, part-time or on a consultant basis shall supervise the nutritional aspects of patient care and assure that quality nutritional care is provided to patients.
(6) Dietetic services shall be provided by a sufficient number of administrative and technical personnel competent in their respective duties.
(c) Diets.
There shall be a systematic record of diets and menus, consistent with the physician’s orders which meet the needs of the patients.
(1) Therapeutic diets shall be prescribed by the practitioner or practitioner’s responsible for the care of the patients.
(2) A current therapeutic diet manual approved by the dietitian and medical staff shall be readily available to all medical, nursing and food services personnel.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.12 Matching of revenue and expenses
[ 1320 ]
(a) Determination of the net income of an accounting period requires measurements of revenue, revenue deductions and expenses associated with the period. Hospital revenue must be recorded in the period in which it is earned; that is, in the time period during which the services are rendered to patients and a legal claim arises for the value of the services.
(b) Once the revenue determination is made, a measurement must be made of the amount of expense incurred in rendering the services on which the revenue determination was based. Unless there is such a matching of revenue and expense, the reported net income of a period is meaningless.
(c) The requirement that revenue deductions must also be matched properly against the gross revenues of the reporting period is sometimes overlooked. During the reporting period, patients' accounts receivable will be debited and revenue accounts will be credited, at the hospital's full established rates, for all services rendered to patients. Some of these accounts receivable will remain unpaid at the end of the reporting period. A majority of these accounts will be collected in cash from the patients or from their third-party payors, but the remainder eventually will be written off as deductions from revenue.
(d) It is important that these revenue deductions be given accounting recognition in the same period that the related revenues were recorded, even though certain of these revenue deductions cannot be precisely determined.
(e) Revenue and expenses are to be matched not only for the hospital as a whole, but also for each cost center. The cost center is an accounting device for accumulating items of cost or revenue that have common characteristics. A cost center may or may not be a department within the hospital. A cost center such as depreciation is an example where the cost center would not be a department of the hospital. The costs of the functions and activities included in each cost center description are to be included in the cost center. Revenue relative to such functions and activities must be included in the matching revenue center. For example, expenses related to the clinical laboratory functions (activities) are included in the Laboratory Services - Clinical cost center (account 7210) and related revenue are to be included in Laboratory Services -Clinical revenue center (account 4210).
(f) Some hospitals record revenue on an all-inclusive rate basis (a rate based on type of accommodation regardless of the utilization of ancillary services). Utilization of an inclusive rate system results only in a modification of the patient billing and revenue accounting system. It does not eliminate the need to report expenses in the proper cost center. Those institutions which record charges on an all-inclusive rate basis are not required to report gross patient revenue for each patient care services revenue center. An all-inclusive rate charging system is where the hospital's total charges consist of a rate based on type of accommodation multiplied by length of stay regardless of the utilization of ancillary services.
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.17 Gross charges by source of payment
(a) Report gross charges at the hospital's full published rates.
(b) Include Daily Hospital Services (accounts 6010 through 6690).
(c) Include Ambulatory Services (accounts 6710 through 6990).
(d) Include Ancillary Services (accounts 7010 through 7910).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-1.91 Equipment and utensils; materials permitted and prohibited
(a) Materials, including food-grade plastics used in the construction and repair of equipment and utensils are to be nontoxic, not affected by foods, cleaning compounds, or such other substances which may be found in the use environment, nonabsorbent and durable under normal use. They are not to impart odor, color or taste nor contribute to the contamination of food, and are to maintain their original properties under repeated use. Painted food-contact surfaces are prohibited.
(b) Hard maple or other equivalent nonabsorbent material meeting the above criteria may be used for cutting blocks and cutting boards, baker's tables and work surfaces, and are to be maintained in a smooth, clean condition.
(c) Canvas, cloth and other porous material, other than for single-service use, are prohibited as a food-contact surface.
(d) Materials are to be of sufficient weight and thickness to permit cleaning and sanitizing.
(e) Tubing conveying beverages or beverage ingredients is to be fabricated from food-grade materials.
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.4 Maintenance program and plan
(a) By September 1, 2016, and thereafter prior to initial start-up of a newly installed cooling tower, the owner shall obtain or update a maintenance program and plan for each cooling tower, developed in accordance with section 7.2 of Legionellosis: Risk Management for Building Water Systems ( ANSI/ASHRAE 188-2015 ), 2015 edition with final approval date of June 26, 2015, at pages 7-8, incorporated herein by reference. The latest edition of ASHRAE 188-2015 may be purchased from the ASHRAE website (www.ashrae.org) or from ASHRAE Customer Service, 1791 Tullie Circle, NE, Atlanta, GA 30329-2305. E-mail: [email protected]. Fax: 678-539-2129. Telephone: 404-636-8400, or toll free 1-800-527-4723. Copies are available for inspection and copying at: Center for Environmental Health, Corning Tower Room 1619, Empire State Plaza, Albany, NY 12237.
(b) In addition, the maintenance program and plan shall include the following elements:
(1) a schedule for routine bacteriological culture sampling and analysis to assess microbiological activity at intervals not to exceed 30 days while the cooling tower is in use, and that requires additional bacteriological culture sampling and analysis, as needed, to validate process adjustments;
(2) a schedule for routine Legionella culture sampling and analysis within 14 days of seasonal start-up and, thereafter, at intervals not to exceed 90 days while the cooling tower is in use. Cooling towers in use year-round must sample at intervals not to exceed 90 days, and within two weeks after start-up following maintenance;
(3) in addition to the routine Legionella culture sampling and analysis required by paragraph (2) of this subdivision, conditions that require immediate Legionella culture sampling and analysis, which shall include, but are not limited to:
(i) power failure of sufficient duration to allow for the growth of bacteria;
(ii) loss of biocide treatment of sufficient duration to allow for the growth of bacteria;
(iii) failure of conductivity control, or any other control methods, to maintain proper cycles of concentration;
(iv) a determination by the department or local health department that one or more cases of legionellosis is or may be associated with the cooling tower, based upon epidemiologic data or laboratory testing; and
(v) any other conditions specified by the department or local health department.
(4) provisions requiring immediate and appropriate action, including remedial action, in response to bacteriological and Legionella culture analyses. For Legionella culture analyses, such provisions shall include, but not be limited to, taking all responsive actions required by Appendix 4-A of this Title, including contacting the local health department within 24 hours pursuant to the conditions specified in section 4-1.6 of this Subpart;
(5) provisions requiring that any and all Legionella culture analyses must be performed in accordance with section 4-1.5 of this Subpart;
(6) a shutdown and disinfection plan for removing or permanently discontinuing use of a cooling tower;
(7) provisions requiring treatment and manual or automated flushing of any piping, basin, sump, or wetted surface during idle conditions; and
(8) provisions requiring cleaning and disinfection prior to startup of a stagnant cooling tower that has been shut down without treatment and recirculation for more than five consecutive days.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.2 Notification to applicants and participants of a right to a conference and fair hearing
(a) Local agencies shall notify applicants and participants in writing at the time of application and at the time of denial of participation or disqualification from the program of the right to a conference and if there is no resolution of the issue at the conference, a fair hearing and the method by which a conference and fair hearing may be requested. For individuals who are disqualified, the notification shall be served at least 15 days prior to termination of participation.
(b) The written notification of the denial of participation or disqualification from the WIC program shall be on a form supplied or approved by the department and shall include:
(1) a description of the adverse action and the reason(s) for it;
(2) a statement indicating that the request for a conference and if there is no resolution of the issues at the conference, a fair hearing may be made verbally or in writing to the department for a fair hearing and to the local agency for a conference and may be made by the participant or applicant or other representative of same;
(3) a listing of the office locations and phone numbers where requests for a conference and fair hearing may be made;
(4) notification that the participant must request a conference within seven days and a fair hearing within 60 days from the date the notice of adverse decision is served. Failure to make a timely request for a conference shall result in a waiver of the right to a conference. Failure to make a timely request for a fair hearing shall result in a waiver of the right to a fair hearing;
(5) an explanation of the rules and regulations governing participation in the WIC program and a citation of those rules and regulations;
(6) an explanation of the purposes and procedures of fair hearings and conferences;
(7) a statement that the participant or representative may present positions or arguments at the conference and fair hearing and that a representative may be a relative, friend, legal counsel or other spokesperson; and
(8) for participants whose benefits are being terminated during the certification period, a statement that if an appeal is made within 15 days of the notification of the termination, the benefits shall continue until the fair hearing decision is made or the certification periods ends, whichever occurs first.
(c) Notification described in subdivision (a) of this section shall not be required at the end of a certification period.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-1.1 Eligibility for admission
The purpose of the hospital is to provide integrate and coordinated medical, social, psychological, vocational, and educational services for the comprehensive rehabilitation of persons who are or are likely to become handicapped or disabled. A person of any age is eligible for admission for inpatient or outpatient evaluation or care, provided that he appears to have reasonable potential for benefiting from the services of the hospital. Such determination shall be made by the director of the hospital. Patients whose sole or principal need is for domiciliary or custodial care shall not be eligible for admission. A person who does not reside in the State of New York or who was not present in the State when his handicap or disability originated may be admitted to the hospital provided that such admission is to a special demonstration or investigative unit funded in part for such purposes by the Federal government, another State or any other public or private agency not receiving New York financial assistance or is for investigation as part of a special research protocol as determined by the director.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 126 MONTGOMERY COUNTY
VILLAGES VILLAGES
10 CRR-NY 126.3 Village of Fultonville
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to the well located near the reservoir on land owned by the village, which well forms the source of the public water supply of the Village of Fultonville, Montgomery County, New York. The rules shall apply also to any additional well which may be constructed on land owned by the village in the vicinity of the reservoir for the purpose of this public water supply.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well forming the source of the public water supply of the Village of Fultonville.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well forming the source of the public water supply of the Village of Fultonville.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well forming the source of the public water supply of the Village of Fultonville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well forming the source of the public water supply of the Village of Fultonville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface within 100 feet of any well forming the source of the public water supply of the Village of Fultonville.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well forming the source of the public water supply of the Village of Fultonville, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any well forming the source of the public water supply of the Village of Fultonville.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind not containing human excreta shall be placed, piled or spread upon the ground within a distance of 100 feet of any well forming the source of the public water supply of the Village of Fultonville. ( continued )
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 500 feet of any well forming the source of the public water supply of the village of Fultonville.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village upon which any well of the public water supply of the village of Fultonville is located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Fultonville.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well forming the source of the public water supply of the village of Fultonville.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any well forming the source of the public water supply of the village of Fultonville.
(j) Inspections.
The board of trustees of the village of Fultonville or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Fultonville or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the village of Fultonville.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.5 Decisions
(a) Copies of the resolution of the Public Health Council approving or disapproving on application shall be transmitted to the applicant, the State Hospital Review and Planning Council and the Commissioner of Health.
(b) Copies of a notice that the council in considering the disapproval of an application or action contrary to the recommendation of the State Hospital Review and Planning Council and affording an oportunity to request a public hearing shall be transmitted to the applicant, the State Hospital Review and Planning Council and the Commissioner of Health.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.39 Specialized programs for residents requiring behavioral interventions
(a) General.
(1) Specialized programs for residents requiring behavioral interventions (the program) shall mean a discrete unit with a planned combination of services with staffing, equipment and physical facilities designed to serve individuals whose severe behavior cannot be managed in a less restrictive setting. The program shall provide goal-directed, comprehensive and interdisciplinary services directed at attaining or maintaining the individual at the highest practicable level of physical, affective, behavioral and cognitive functioning.
(2) The program shall serve residents who are a danger to self or others and who display violent or aggressive behaviors which are typically exhibited as physical or verbal aggression such as clear threats of violence. This behavior may be unpredictable, recurrent for no apparent reason, and typically exhibited as assaultive, combative, disruptive or socially inappropriate behavior such as sexual molestation or fire setting.
(3) The program shall be located in a nursing unit which is specifically designated for this purpose and physically separate from other facility residents. The unit shall be designed in accordance with the provisions as set forth in Subpart 713-2 of this Title.
(4) The facility shall have a written agreement with an inpatient psychiatric facility licensed under the Mental Hygiene Law to provide for inpatient admissions and consultative services as needed.
(5) In addition to the implementation of the quality assessment and assurance plan for this program as required by section 415.27 of this Part, the facility shall participate with the commissioner or his or her designee in a review of the program and resident outcomes. The factors to be reviewed shall include but not be limited to a review of admissions, the care and services provided, continued stays, and discharge planning. The facility shall furnish records, reports and data in a format as requested by the commissioner or his or her designee and shall make available for participation in the review, as necessary, members of the interdisciplinary resident care team.
(b) Admission.
(1) The facility shall develop written admission criteria which are applied to each prospective resident. As a minimum, for residents admitted to the program, there shall be documented evidence in the resident's medical record that:
(i) the resident's behavior is dangerous to him or herself or to others;
(ii) the resident's behavior has been assessed according to severity and intensity;
(iii) within 30 days prior to the date of application to the program, the resident has displayed:
(a) verbal aggression which constitutes a clear threat of violence towards others or self; or
(b) physical aggression which is assaultive or combative and causes or is likely to cause harm to others or self; or
(c) persistently regressive or socially inappropriate behavior which causes actual harm;
(iv) various alternative interventions have been tried and found to be unsuccessful;
(v) the resident cannot be managed in a less restrictive setting; and
(vi) the prospective resident has the ability to benefit from such a program.
(2) Prior to admission, the facility shall fully inform the resident and the resident's designated representative both orally and in writing about the program plan and the policies and procedures governing resident care in this unit. Such policies and procedures shall at a minimum include a statement that the resident's right to leave or be discharged from the program shall be consistent with the rights of other residents in the facility.
(c) Assessment and care planning.
(1) The interdisciplinary team shall have determined preliminary approaches and interventions to the severe behavior and recorded them in the resident care plan prior to admission to the unit.
(2) Each resident's care plan shall include care and services which are therapeutically beneficial for the resident and selected by the resident when able and as appropriate. The care plan shall be prepared by the interdisciplinary team, as described in section 415.11 of this Part, which shall include psychiatrist, psychologist, or social worker participation as appropriate to the needs of the resident.
(3) Based on the resident's response to therapeutic interventions, the care plan including the discharge plan shall be reviewed and modified, as needed, but at least once a month.
(d) Discharge.
(1) A proposed discharge plan shall be developed within 30 days of admission for each resident as part of the overall care plan and shall include input from all professionals caring for the resident, the resident and his or her family, as appropriate, and any outside agency or resource that will be involved with the resident following discharge.
(2) When the interdisciplinary team determines that discharge of a resident to another facility or community-based program is appropriate, a discharge plan shall be implemented which is designed to assist and support the resident, family and caregiver in the transition to the new setting. Program staff shall be available post-discharge to act as a continuing resource for the resident, family or caregiver.
(3) The resident shall be discharged to a less restrictive setting when he or she no longer meets the admission criteria for this program as stated in subdivision (b) of this section.
(4) A resident discharged to an acute care facility shall be accompanied by a member of the program's direct care staff during transfer. He or she shall be given priority readmission status to the program as his or her condition may warrant.
(5) There shall be a written transfer agreement with any nursing home of origin which allows for priority readmission to such transferring facility when a resident is capable of a safe discharge.
(e) Resident services and staffing requirements.
(1) The program shall consist of a variety of medical, behavioral, counseling, recreational, exercise, and other services to help the resident control or redirect his or her behavior through interventions carried out in a therapeutic environment provided on-site.
(2) There shall be dedicated staffing in sufficient numbers to provide for the direct services in the unit and to allow for small group activities and for one-on-one care.
(3) The unit shall be managed by a program coordinator who is a licensed or certified health care professional with previous formal education, training and experience in the administration of a program concerned with the care and management of individuals with severe behavioral problems. The program coordinator shall be responsible for the operation and oversight of the program. Other responsibilities of the program coordinator shall include:
(i) the planning for and coordination of direct care and services;
(ii) developing and implementing inservice and continuing education programs, in collaboration with the interdisciplinary team, for all staff in contact with or working with these residents;
(iii) participation in the facility's decisions regarding resident care and services that affect the operation of the unit; and
(iv) ensuring the development and implementation of a program plan and policies and procedures specific to this program.
(4) A physician who has specialized training and experience in the care of individuals with severe behavioral or neuropsychiatric conditions shall be responsible for the medical direction and medical oversight of this program and shall assist with the development and evaluation of policies and procedures governing the provision of medical services in this unit.
(5) A qualified specialist in psychiatry who has clinical experience in behavioral medicine and experience working with individuals who are neurologically impaired shall be available on staff or a consulting basis to the residents and to the program.
(6) A clinical psychologist with at least one year of training in neuropsychology shall be available on staff or a consulting basis to the residents and to the program.
(7) A social worker with experience associated with severe behavioral conditions shall be available either on staff or a consulting basis to work with the residents, staff and family as needed.
(8) Other than the program coordinator, there shall be at least one registered professional nurse deployed on each shift in this unit who has training and experience in caring for individuals with severe behaviors.
(9) A full-time therapeutic recreation specialist shall be responsible for the therapeutic recreation program.
(10) The facility shall ensure that all staff assigned to the direct care of the residents have pertinent experience or have received training in the care and management of individuals with severe behaviors.
(11) The facility shall ensure that educational programs are conducted for staff not providing direct care but who come in contact with these residents on a regular basis such as housekeeping and dietary aides. The programs shall familiarize staff with the program and the residents.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.15 Bathhouse and toilet facilities
(a) General.
Toilet facilities and lavatories shall be provided at a swimming pool, except when such facilities are available within 300 feet of the pool or within one floor level above or below the swimming pool area.
(b) Walls and floors of the bathhouse shall be kept clean and free from cracks or open joints. The floors shall be well drained.
(c) All fixtures within the bathhouse shall be maintained in a clean and sanitary condition at all times.
(d) All toilet facilities and dressing rooms shall be ventilated and maintained.
(e) Showers, when provided, shall be supplied with water at a temperature of at least 90°F and no more than 110°F at a rate of at least 1.5 gallons per minute per shower head. Thermostatic, tempering or mixing valves shall be kept in good operation to prevent scalding of the users. Shower curtains shall be kept clean. Soap shall be provided.
(f) All lavatories shall be provided with soap, paper towels or electrical hand-drying units, and covered waste receptacles. Suitable sanitary napkin receptacles shall be provided in toilet facilities used by females.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.225 On-call pay (standby)
Standby pay is compensation to an employee for being available to work.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.36 Scheduled short-term care
(a) Residential health care facilities which provide scheduled short-term care for residents in accordance with Part 410 of this Title shall be paid a per diem rate of reimbursement for such services which is the average per diem rate of reimbursement for the facility as established pursuant to this Subpart.
(b) The requirements of sections 86-2.11 and 86-2.30 of this Subpart relating to resident assessments and the submission of case mix information to the department shall not apply to scheduled short-term care in accordance with Part 410 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.101 Due from other funds
A receivable for money loaned, stores issued, work performed, or services rendered to or for the benefit of another fund.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.7 Title XVIII (Medicare) certification
Any facility eligible for title XVIII (Medicare) certification providing services to patients insured under title XIX which is not, or ceases to be, a title XVIII provider of care shall have its current reimbursement rate reduced by 10 percent. This rate reduction may remain in effect until the first day of the month following certification of such a provider by the title XVIII program. Such rate reductions shall be in addition to any revision of rates based on audit exceptions.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS RESEARCH, INSTRUCTIONAL ACTIVITIES AND CHEMICAL ANALYSIS
10 CRR-NY 80.38 Records; instructional activities
Persons authorized to possess and use controlled substances for instructional activities shall keep a record of all controlled substances received and used by them.
(a) The record shall include date of receipt, name and address of vendor, type and quantity of drug received. A duplicate invoice or separate itemized list furnished by the vendor for schedule III, IV and V controlled substances will be sufficient to meet this record requirement providing it contains all the information required and is maintained in a separate file. Duplicate copies of Federal order forms for schedule I and II substances shall also be maintained.
(b) A record of controlled substances used shall include the name of the person authorized to control and use such drugs, the date, type and quantity of drug and signature of the user.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.243 Part A and Part B services
Medicare benefits are payable from two trust funds. Part A services, which, in general, are those rendered by institutions, are reimbursed from funds derived from payroll tax. Part B services, generally medical and surgical physicians services, and outpatient treatment and diagnosis are reimbursed from the fund created by voluntary premium payments and general Federal revenues.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.11 Resident assessment and care planning
Upon admission and periodically thereafter the facility shall conduct a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity. Based on the results of these assessments, the facility shall develop and keep current an individualized comprehensive plan of care to meet each resident's needs.
(a) Comprehensive assessments.
(1) The facility shall conduct a comprehensive assessment of each resident's needs, which describes the resident's capability to perform daily life functions and identifies significant impairments in functional capacity. All comprehensive assessments completed after April 1, 1991 shall be recorded on a uniform data instrument designated by the Department of Health.
(2) The comprehensive assessment shall include at least the following information:
(i) medically defined conditions and prior medical history;
(ii) medical status measurement;
(iii) physical and mental functional status;
(iv) sensory and physical impairments;
(v) nutritional status and requirements;
(vi) special treatments or procedures;
(vii) discharge potential;
(viii) mental and psychosocial status;
(ix) dental condition;
(x) activities potential;
(xi) rehabilitation potential;
(xii) cognitive status; and
(xiii) drug therapy.
(3) Frequency.
Comprehensive assessments shall be conducted:
(i) no later than 14 days after the date of admission;
(ii) promptly after a significant improvement or decline in the resident's physical, mental or psychosocial status in accordance with generally accepted standards of care and services; and
(iii) in no case less often than once every 12 months for each resident.
(4) Review of assessments.
Professional staff shall examine each resident no less than once every three months, and as appropriate, revise the resident's comprehensive assessment to assure the continued accuracy of the assessment.
(5) Use.
The results of the comprehensive assessment shall be used by the interdisciplinary care team as defined in subparagraph (c)(2)(ii) of this section to develop, review, and revise the resident's comprehensive plan of care, under subdivision (c) of this section.
(b) Accuracy of assessments.
(1) Coordination.
(i) Each assessment shall be conducted or coordinated, with the participation of appropriate health professionals.
(ii) Each assessment shall be conducted, or coordinated, by a registered professional nurse who signs and certifies the completion of the assessment.
(2) Certification.
Each individual who completes a portion of the assessment shall sign and certify the accuracy of that portion of the assessment.
(3) Penalty for falsification.
An individual who willfully and knowingly certifies (or causes another individual to certify) a material and false statement in a resident assessment shall be subject to civil money penalties under Federal statutes and regulations.
(4) Use of independent assessors.
If the department determines, under a survey or otherwise, that there has been a knowing and willful certification of false statements under paragraph (3) of this subdivision, the department shall require remedial measures, which may include but not be limited to requiring that resident assessments under this section be conducted and certified at the facility's expense by individuals who are independent of the facility and who are approved by the department.
(c) Comprehensive care plans.
(1) The facility shall develop a comprehensive care plan for each resident that includes measurable objectives and timetables to meet each resident's medical, nursing and mental and psychosocial needs that are identified in the comprehensive assessment.
(i) The care plan shall reflect a consideration of the resident's ability to self-administer drugs safely.
(ii) The facility shall clearly document those instances in which recommended items or services are not made part of the comprehensive care plan due to the stated contrary wishes of a competent resident or a designated representative who has the authority to make health care decisions for a resident who lacks capacity.
(2) A comprehensive care plan shall be:
(i) developed within seven working days after completion of the comprehensive assessment;
(ii) prepared by an interdisciplinary team that includes the attending physician, a registered professional nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs, and with the participation of the resident and the resident's family or legal representative to the extent practicable; and
(iii) periodically reviewed and revised as necessary by an interdisciplinary team of qualified persons after each comprehensive assessment or reassessment.
(3) The services provided or arranged by the facility shall:
(i) meet generally accepted standards of care and service; and
(ii) be provided by qualified persons in accordance with each resident's written plan of care.
(d) Discharge summary.
When the facility anticipates discharge, the facility shall prepare a discharge summary that includes:
(1) a recapitulation of the resident's stay;
(2) a final summary of the resident's status to include information set forth in paragraph (a)(2) of this section, at the time of the discharge that shall be available for release to authorized persons and agencies, with the consent of the resident or legal representative; and
(3) a post-discharge plan of care that shall be developed with the participation of the resident and his or her family, which will assist the resident to adjust to his or her new living environment and assure that needed medical and supportive service have been arranged and are available to meet the identified needs of the resident.
(e) Patient assessment and annual resident review (PASARR).
The facility shall conduct, at least annually, a review of residents with known or suspected mental impairment of mental retardation utilitizing the pertinent portions of the SCREEN instrument set forth in section 400.12 of this Title. Residents screened as mentally impaired or mentally retarded by this process shall be referred to the commissioner's designee for evaluation of the need for active treatment for mental impairment or mental retardation and for need for nursing home services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.10 Equivalencies
Equivalent training or course work shall be that training or course work which covers the concepts of disease transmission, scientifically accepted principles and practices for infection control, and engineering and work practice control as detailed in the syllabus. Equivalent course work or training must emphasize the bidirectional aspect of disease transmission.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-3 CLINICAL LABORATORY INSPECTION AND REFERENCE FEES
10 CRR-NY 58-3.5 Suspension or nonrenewal of laboratory permit
Knowing and/or willful failure to meet the quarterly payment requirement will result in suspension or nonrenewal of the laboratory permit.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.5 Environmental testing and reporting
An approved laboratory shall examine paint and any other environmental samples according to generally accepted scientific methods specified by the commissioner and shall report the results of all lead analyses to the designated representative in whose jurisdiction the samples were collected.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
OFFENSES, VIOLATIONS AND ENFORCEMENT OFFENSES, VIOLATIONS AND ENFORCEMENT
10 CRR-NY 80.125 Fraud and deceit
(a) No person shall:
(1) obtain or attempt to obtain a controlled substance prescription or a controlled substance, or procure or attempt to procure the administration of a controlled substance:
(i) by fraud, deceit, misrepresentation or subterfuge;
(ii) by the use of a forged or altered prescription or written order;
(iii) by the concealment of a material fact; or
(iv) by the use of a false name or the giving of a false address;
(2) willfully make a false statement in any prescription, order, report or record required by this Article;
(3) falsely assume the title of, or represent himself to be, a manufacturer, wholesaler, pharmacy, pharmacist, intern, nurse, physician, dentist, veterinarian or other authorized person, for the purpose of obtaining a controlled substance;
(4) make or utter any false or forged prescription or false or forged written order;
(5) affix any false or forged label to a package or receptacle containing controlled substances; or
(6) willfully transmit an electronic prescription using an application or application provider that the practitioner knows does not comply with Federal requirements or is otherwise non-compliant.
(b) Possession of a false or forged controlled substance prescription by any person other than a pharmacist in the pursuance of his profession shall be presumptive evidence of his intent to use the same for the purpose of illegally obtaining a controlled substance.
(c) Any person who, in the course of treatment, is supplied with controlled substances or a prescription therefor by one physician and who, without disclosing the fact, is supplied during such treatment with controlled substances or a prescription therefor by another physician shall be guilty of a violation of this Part.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.11 Records to be kept when blood is collected for autogeneic or allogeneic transfusion
(a) Every blood bank shall maintain records of each container of blood or blood components collected or prepared therein. The records shall contain the following information:
(1) donor's full name, address, age, sex and identifying code;
(2) date and amount of blood collected;
(3) any adverse reaction of the donor;
(4) signature of or other unique identifier provided by the phlebotomist;
(5) results of all tests performed on a sample from the donor or a unit;
(6) disposition of the blood or blood components;
(7) for autogeneic donation, documentation of written or verbal consent of the donor-patient's health care provider if donation takes place prior to anticipated surgery or medical procedure, of the physician responsible for collection or his/her designee, and of the donor-patient. If the blood is to be considered for allogeneic use, the donor shall sign a consent form giving consent for such use, specifying procedures for release of the unit by the health care provider, and stating that to the best of the donor's knowledge, the blood is safe for use by others; and
(8) if a donor is determined to be unsuitable for donation based on donor history, laboratory test results or implication in a case of transfusion-transmitted disease according to the protocol of the blood collection service, a record of the donor's name and identifying information. Blood from such a donor shall not be released, even if results of testing on subsequent donations are negative, unless the donor has been approved for reentry into the donor pool by the director of the blood bank or designee who is a physician.
(b) Blood banks and transfusion services shall file a Blood Services Activity Report annually with the department.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.60 Applicability
Surface water systems or systems using ground water under the direct influence of surface water that are community or nontransient noncommunity water systems, serve 15 or more service connections or serve 25 or more persons, and use conventional filtration treatment shall operate with enhanced coagulation to achieve the total organic carbon (TOC) percent removal levels specified in section 5-1.63 of this Subpart, unless the system meets the alternative compliance criteria described in section 5-1.62 of this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.13 Adjustments to provisional rates based on errors
(a) Errors resulting from submission of fiscal and statistical information by a residential health care facility may be corrected if brought to the attention of the State Commissioner of Health within 120 days of receipt of the commissioner's initial rate computation sheet. Errors on the part of the State Department of Health resulting from the rate computation process may be corrected if brought to the attention of the commissioner within 120 days of receipt of the commissioner's initial rate computation sheet. Subsequent errors on the part of the State Department of Health resulting from the revision of a rate may be corrected if brought to the attention of the commissioner within 30 days of receipt of the commissioner's revised rate computation sheet. In no event, however, shall a facility have less than 120 days from receipt of the initial rate computation sheets to bring errors to the attention of the commissioner.
(b) Rate appeals pursuant to this section, if not commenced within 120 days of receipt of the commissioner's initial rate computation sheet, may be initiated at time of audit of the base year cost figures at or prior to the audit exit conference. Such rate appeals shall be recognized only to the extent that they are based upon errors in the cost and/or statistical data submitted by the residential health care facility, or by revisions initiated by a third-party fiscal intermediary, or in the case of a governmental facility, by the sponsor government or errors made by the Department of Health.
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.7 Audits
(a) All fiscal and statistical records and reports shall be subject to audit. In this respect, any rate of payment certified by the State Commissioner of Health based on the initial submission of base-year data and reports will be construed to represent a provisional rate until such audit is performed and completed, at which time such rate or adjusted rate will be construed to represent the final rate. In addition to verifying costs as reports, this audit will determine if the cost per visit or hour presented by the provider have, in fact, been those used in monthly chart billings.
(b) Subsequent to the filing of required fiscal and statistical reports, field audits shall be conducted of the records of LTHHCP in a time and manner to be determined by the department.
(c) The required fiscal and statistical reports shall be subject to audit for a period of six years from the date of their filing with the department. This limitation shall not apply to situations in which fraud may be involved.
(d) Upon completion of the audit, the LTHHCP shall be afforded a closing conference. The LTHHCP may appear in person or by anyone authorized in writing to act on behalf of the LTHHCP. The LTHHCP shall be afforded an opportunity at such conference to produce additional documentation in support of any modifications requested in the audit.
(e) The LTHHCP shall be provided with the final audit report, the rate computation sheet and any resulting revision of the rate of reimbursement, which shall be final unless, within 30 days of receipt of the final audit report, the long-term home health care program initiates a bureau review of such final audit report by notifying the Division of Health Care Financing, by registered or certified mail, detailing the specific items of the audit report with which the provider disagrees and such other material as the provider wishes to submit in its behalf, and forwarding all material documentation in support of the LTHHCP's position.
(f) The LTHHCP shall be notified in writing of the determination of the controverted items of the final audit report, including a statement of the reasons for such adjustments and the appropriate citation to applicable law, regulation or policy. The rate as adjusted in accordance with the determination of the bureau review shall be final, except that the LTHHCP may, within 30 days of receipt of the determination of the bureau review, initiate a hearing to refute those items of the audit report adverse to the interests of the LTHHCP presenting a factual issue by serving on the commissioner, by certified or registered mail, a notice containing a statement of the legal authority and jurisdiction under which the hearing should be held, a reference to the particular sections of the statutes and rules involved, and a statement of the controverted items of the audit report and bureau determination, together with copies of any documentation relied on by the LTHHCP in support of its position.
(1) Upon receipt of such notice, the commissioner shall:
(i) designate a hearing officer to hear and recommend;
(ii) establish a time and place for such hearing; and
(iii) notify the LTHHCP of the time and place of such hearing at least 15 days prior thereto. The issues and documentation presented by the LTHHCP at such hearing shall be limited to the factual issues and documentation presented at the bureau review.
(2) The final audit report shall be presumptive evidence of its content. The burden of proof at any such hearing shall be upon the LTHHCP to prove by substantial evidence that the items therein contained are incorrect.
(3) The hearing shall be conducted in conformity with section 12-a of the Public Health Law and the State Administrative Procedure Act.
(4) At the conclusion of the hearing, the LTHHCP may submit memoranda on any legal issues which it deems relevant to the proceeding. Such memoranda shall become part of the official record of hearing.
(g) Rate revisions resulting from the procedure set forth in this section shall be made retroactive to the period or periods during which the rates based on the periods audited were established.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.9 Hearings on cease and desist orders
(a) Any person who receives a cease and desist order may request a hearing on the order by submitting a petition in writing to the commissioner and to the Office of Administrative Trials and Hearings (OATH) within seven days of receipt of the cease and desist order. The petition for a hearing shall state the name and address of the petitioner and shall include a short and plain statement of the matters to be adjudicated, identifying the activity that is the subject of the order, the location of the activity, and the date of the cease and desist order. A copy of the order shall be attached to the petition. In addition, a completed OATH intake sheet shall be included with the petition. Blank intake sheets are available from the department.
(b) Upon receipt of the petition for a hearing, OATH shall schedule a hearing promptly in the district of the department where the activity that is the subject of the order allegedly occurred, and at a time and date which shall not exceed 15 days from the date of receipt by OATH of the petition for a hearing unless the parties and the ALJ agree to another location and date, except that hearings may be held at the department's offices in Valhalla, New York for petitions relating to regulated activities in the east of Hudson watershed and at the department's offices in Kingston, New York for petitions relating to regulated activities in the west of Hudson watershed. Notice of such hearing shall be provided in writing to the petitioner and to the department.
(c) A petition for a hearing shall not stay compliance with the cease and desist order, and it shall continue to be the duty of the petitioner to discontinue the activity pursuant to the terms of the order. Failure to do so shall be a violation of the order and these rules and regulations.
(d) At the hearing, the petitioner shall have the burden of proving that the activity that is the subject of the order does not come within the provisions of sections 128-2.1(a)(5) and 128-2.7(a)(5) of this Subpart.
(e) The failure of the petitioner to appear at the time, date and place set forth in the notice of hearing shall constitute a default of the right to a hearing on the cease and desist order. The department shall provide a notice of default in writing to the petitioner within five days of the petitioner's failure to appear.
(f) The hearing shall be held before an ALJ. The ALJ shall cause a record of the hearing to be made, and shall make a report to the commissioner within 10 days of the close of the hearing record, setting forth the appearances, the relevant facts and arguments presented at the hearing, findings of fact and conclusions of law, and a recommendation as to whether the order should be continued, modified or vacated and the reasons therefor. Transcripts of the record of the hearing shall be made available at the petitioner's request and expense.
(g) Within 10 days of receipt of the recommendation of the ALJ, the commissioner may continue, vacate, or modify the order. If the commissioner does not act, the ALJ's recommendation shall be deemed adopted.
(h) The results of the hearing on the cease and desist order shall be without prejudice to the right of a person to apply for an approval or variance for a regulated activity under these regulations, and shall also be without prejudice to the authority of the department or any other person to take action on account of any violation of law, rule, regulation or order arising out of the events, situations or circumstances which led to the issuance of the order.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.7 Designation of lead agency and determination of significance for type I actions
(a) The provisions of this section shall govern the designation of lead agency and determination of significance for all type I actions.
(b) An EAF shall be completed for every type I action which is directly undertaken, funded or approved by the department unless an acceptable draft EIS has already been or will be prepared on the action. No EAF shall be considered complete unless it contains a list prepared by the applicant of all other involved agencies which the applicant has been able to ascertain, exercising all due diligence.
(c) Actions involving only the department.
When the department proposes to directly undertake an action which does not require funding or approval from any other agency, or receives an application to fund or approve an action over which no other agencies have approval authority, it shall be the lead agency, and shall determine the significance of the action in accordance with sections 97.13 and 97.14 of this Part within the following time periods:
(1) If the department is directly undertaking the action, it shall determine the significance of the action as early as possible in the design or formulation of the action.
(2) If the department has received an application for funding or approval of the action, it shall determine the significance of the action within 15 calendar days of its receipt of the complete application, an EAF, and any additional information it deems necessary to make that determination.
(d) Actions involving the department and other agencies.
(1) When the department proposes to directly undertake an action which requires funding or approval from one or more other agencies, or receives an application for funding or approval which other agencies have approval authority over, it shall, as soon as possible, mail the completed EAF and a copy of any application it has received to all involved agencies, notifying them that within 30 calendar days of the date the EAF was mailed to them, a lead agency must be designated by agreement among them. The following criteria, in order of importance, shall be used to designate lead agency:
(i) whether the anticipated impacts of the action being considered are primarily of statewide, regional or local significance, i.e., if such impacts are of primarily local significance, all other considerations being equal, the local agency involved shall be lead agency;
(ii) which agency has the broadest governmental powers for investigation into the proposed action; and
(iii) which agency has the greatest capability for providing the most thorough environmental assessment of the proposed action.
(2) The department, if it is a lead agency, shall determine the significance of the action in accordance with sections 97.13 and 97.14 of this Part within 15 days of its designation as lead agency, or within 15 days of its receipt of any information it may need to make the determination of significance, whichever occurs later, and shall immediately notify all other involved agencies of its determination.
(e) Actions for which lead agency cannot be designated by agreement.
If, within the 30-day period allotted for designation of a lead agency, the department and other agencies are unable to agree upon which agency shall be the lead agency, then the lead agency shall be determined as provided in 6 NYCRR 617.6.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.9 Distribution of tissue products
(a) Except as provided in section 52-3.4 of this Part, musculoskeletal tissue shall not be made available for allogeneic transplantation if:
(1) the donor's blood tests repeatedly reactive in approved screening tests for HBsAg, or antibodies to HIV-1, HIV-2, HCV, or, unless the tissue is to be virally inactivated, antibodies to HTLV-I; or
(2) the donor's blood reacts positively to approved tests for syphilis, unless confirmatory testing is negative.
(b) Freeze-dried processed musculoskeletal tissue distributed by a processing or storage facility shall be visually inspected for cracks, contamination, or extraneous material prior to distribution. If tissue container seals are broken or there is evidence that proper temperature has not been maintained, tissue shall not be distributed for transplantation. Container vacuums shall be determined to be satisfactory by testing with a spark generator.
(c) Musculoskeletal tissue shall be transported by the tissue bank or its agents, or by staff or agents of the tissue transplantation facility. A signed form shall be kept on file at the tissue bank documenting the identification of tissue distributed, including the names of both the person(s) releasing the tissue and the person(s) receiving the tissue.
(d) Musculoskeletal tissue in transit from a tissue processing or storage facility to a tissue transplantation facility shall be maintained at the applicable storage temperature specified in section 52-5.8 of this Subpart. Tissue stored at a tissue transplantation facility shall be maintained, until immediately prior to transplantation, at minus 20 degrees Celsius or lower for a maximum of six months, and minus 40 degrees Celsius for longer periods. Storage shall be in a freezer reserved for musculoskeletal or other tissue intended for transplantation, or blood intended for transfusion.
(e) Musculoskeletal tissue and its labeling and packaging shall be visually inspected prior to its distribution by the tissue processing facility. The tissue shall be inspected by the tissue transplantation facility immediately upon receipt and again after thawing, if frozen. If the physical appearance is abnormal, or there is indication or suspicion of overt microbial contamination, the tissue shall not be utilized for transplantation. In the case of frozen tissue, the period of time between thawing and use shall not exceed 24 hours if tissue is refrigerated at between one and 10 degrees Celsius, or four hours if not refrigerated.
(f) Musculoskeletal tissue shall be issued by the tissue transplantation facility only upon a written order by a licensed physician or other person authorized by law to order tissue. Documentation of such order shall be on a dedicated tracking record or on the recipient's medical record. Issuance of musculoskeletal tissue shall be recorded in a disposition log and shall allow accurate tracking of tissue to each recipient.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.13 Certified home health agency rates
(a) Effective January 1, 1988, reported costs and statistics for a facility's annual fiscal period ending two years prior to the rate period, trended pursuant to section 86-1.58 of this Subpart, shall be used in computing Medicaid rates for care provided by community-based home health agencies. No amount may be included in a rate that is in excess of the agency charges or in excess of 110 percent of the weighted average cost of all community-based agencies in their group. For hospital-based home health agencies, no amount may be included in a rate that is in excess of 110 percent of the weighted average cost of community-based agencies in their area.
(b) The commissioner shall establish separate payment rates for home care nursing services provided by Certified Home Health Agencies (CHHAs) and Long Term Home Health Care Programs (LTHHCPs) to patients diagnosed with Acquired Immune Deficiency Syndrome (AIDS) as defined by ICD-9 codes 042, 043 and 044. Such rates shall be regional service prices increased by a case mix adjustment factor to reflect the additional resource utilization needed in home care treatment of AIDS patients in excess of resource utilization needed for an average mix of home care patients.
(1) Regional nursing service prices shall be computed based upon average nursing costs per visit calculated by aggregating the base year allowable costs and statistics reported by community based certified home health agencies located within each of four regions; provided, however, that effective with rate periods commencing January 1, 1990, the calculation of regional nursing service prices pursuant to this paragraph shall also incorporate base year allowable costs and statistics for LTHHCPs. The regions shall be New York City Region which is comprised of New York, Kings, Queens, Richmond, Bronx, Westchester, Rockland and Putnam Counties; Nassau-Suffolk Region which is comprised of Nassau and Suffolk Counties; Rural Region which is comprised of all Non-Standard Metropolitan Statistical Area counties; All Other Metropolitan Region which is comprised of all counties not included in the other regions.
(2) For agencies in the All Other Metropolitan Region group only, the base price will be adjusted by Wage Index Factors. Wage Index Factors shall be calculated for and applied to each of the Standard Metropolitan Statistical Areas (SMSA) within the All Other Metropolitan Region. The SMSA's are:
(i) Albany-Schenectady-Troy;
(ii) Syracuse;
(iii) Binghamton;
(iv) Buffalo;
(v) Elmira;
(vi) Glens Falls;
(vii) Niagara Falls;
(viii) Orange County;
(ix) Poughkeepsie;
(x) Rochester;
(xi) Utica-Rome;
The wage index factor shall be determined by weighting the registered nurse, licensed practical nurse and nurse's aide salary categories based upon the proportion of skilled and aide visits. The labor portion of the base price shall be multiplied by the respective wage index factor for each of the eleven SMSA's in the All Other Metropolitan Region group.
(3) The base regional service prices computed in accordance with this subdivision shall be increased by a trend factor developed in accordance with section 86-1.58 of this Subpart.
(4) The trended regional nursing service prices shall be increased by an AIDS case mix adjustment factor of 1.2988 to arrive at regional nursing service rates for homecare services provided by CHHAs and LTHHCPs to patients diagnosed with AIDS.
(5) Adjustments to regional nursing service prices established by this subdivision shall be limited to annual adjustments made pursuant to paragraphs (1) and (3) of subdivision (b) of this section.
(c) The department shall establish a cap on reimbursable base year administrative and general costs equal to 30% of total reimbursable base year operational costs of a provider of services, excluding a provider of services reimbursed on an initial budget basis, and a new provider, excluding changes in ownership or changes in name, who begins operations in the year prior to the year which is used as a base year in determining rates of payment. The cap on administrative and general costs shall be applied after the application of the weighted average cost of all community-based agencies in their group area, described in this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.308 Share of pooled investments
The proportion of pooled investments, including accumulated gains or losses owned by a particular fund, usually expressed by a number (units) indicating the fractional ownership of total shares in the pool or by a percentage expressing the portion of the total pool owned by the particular fund.
10 CRR-NY 441.106 Emergency services category 3—general emergency services
In addition to the requirements for category 4 facility, a category 3 facility should have 24-hour in-house physician coverage and in-house storage of whole blood or packed red cells.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.10 Reporting cases or suspected cases or outbreaks of communicable disease by physicians
It shall be the duty of every physician to report to the city, county or district health officer, within whose jurisdiction such patient resides, the full name, age and address of every person with a suspected or confirmed case of a communicable disease, any outbreak of communicable disease, any unusual disease or unusual disease outbreak and as otherwise authorized in section 2.1 of this Part, together with the name of the disease if known, and any additional information requested by the health officer in the course of an investigation pursuant to this Part, within 24 hours from the time the case is first seen by him, and such report shall be by telephone, facsimile transmission or other electronic communication if indicated, and shall also be made in writing, except that the written notice may be omitted with the approval of the State Commissioner of Health. When a case which is required to be reported under section 2.1 of this Part occurs in a State institution or a facility licensed under article 28 of the Public Health Law, the person in charge of the institution or facility shall report the case to the State Department of Health and to the city, county or district health officer, in whose jurisdiction such institution is located.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.38 Long-term ventilator dependent residents
Facilities which admit and care for residents who require nursing home care and continuous or intermittent use of a ventilator shall comply with the following additional requirements pertinent to the care of those residents.
(a) General.
The facility shall develop and implement admission, resident care management, transfer and discharge policies and procedures that promote delivery of medical, nursing and respiratory care services consistent with generally accepted standards of professional practice.
(1) Residents shall be congregated within the facility in a single nursing care unit.
(2) Services shall be directed at restoring each resident to his or her optimal level of functioning and assisting each resident to achieve maximum independence from mechanical ventilation.
(3) The facility shall have a transfer agreement with a general hospital which:
(i) is located within 20 minutes travel time of the facility;
(ii) is equipped and staffed for the acute care and management of ventilator dependent patients; and
(iii) has granted privileges to pulmonary care physicians to admit and care for ventilator dependent residents who may require hospital admission.
(4) Laboratory, mental health and diagnostic radiology services appropriate to the needs of the residents shall be readily available either directly or by arrangement.
(5) The facility shall have an effective program of preventive and periodic maintenance of ventilator equipment which meets or exceeds the manufacturer's requirements for the equipment and prevents the spread of infections and communicable disease.
(b) Resident care services.
(1) Physician supervision:
(i) the care of the resident shall be directed by a physician who is a qualified specialist in pulmonology; and
(ii) this physician or other physicians qualified by training and pertinent experience in the care and clinical management of persons requiring respiratory care and requiring use of ventilators shall be available to attend to such residents seven days-a-week, twenty-four hours a day. One of these physicians shall see and evaluate the resident as often as necessary but not less than every other week.
(2) All resident care staff shall receive orientation and training appropriate to the care of the ventilator dependent residents to whom they are assigned.
(3) One or more registered professional nurses on each shift shall be assigned to provide care to ventilator dependent residents.
(4) Respiratory therapists shall be available as needed to meet the needs of the residents.
(5) Rehabilitation therapy services shall be available at the facility to meet the needs of the residents.
(6) The facility shall maintain specific supplies appropriate to meeting the care needs of the residents.
(7) Residents shall be assessed as to their ability to be weaned from their ventilatory dependence. Those residents who are assessed as potentially able to be weaned from dependence on support with mechanical ventilation or whose daily use of ventilator support may be reduced shall receive an active program of therapy and other supportive services designed for that resident to reduce or eliminate his or her need for use of a ventilator.
(8) Residents shall be assessed as to their ability to be discharged to home or to a home-like setting with or without supportive services. When such potential is identified, the facility shall initiate an active program of therapy and other supportive services designed to assist the resident in the transition to the new setting. Facility discharge planning staff shall arrange for any home modifications, equipment or assistance expected to be required of the resident in the new setting and document these arrangements in the resident clinical record.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.38 Transition pool for 2010-2013 period
(a) Subject to the availability of Federal financial participation, the commissioner may, for rate periods effective on and after October 20, 2010, increase inpatient Medicaid fee-for-service rates subject to this Subpart for the following periods and in the following amounts:
(1) for the period October 20, 2010 through March 31, 2011, up to $37,500,000;
(2) for the period April 1, 2011 through March 31, 2012, up to $75,000,000;
(3) for the period April 1, 2012 through March 31, 2013, up to $50,000,000;
(4) for the period April 1, 2013 through March 31, 2014, up to $25,000,000.
(b) The distributions authorized pursuant to this section shall be made available through a reduction, as determined by the commissioner, in the statewide base price as otherwise computed in accordance with this Subpart.
(c) Hospitals eligible for distributions pursuant to this section shall be public and nonpublic general hospitals with Medicaid inpatient discharges equal to or greater than 17½ percent as reported for the 2007 period.
(d) Funds allocated pursuant to this section shall be allocated to eligible hospitals pursuant to a formula, as determined by the commissioner, such that, to the extent of funds available, no hospital's reduction in total Medicaid fee-for-service inpatient revenue for the corresponding rate periods, as a result of the application of otherwise applicable rate-setting methodologies in effect for such periods, exceeds a percentage reduction as determined by the commissioner.
(e) Hospitals receiving funds pursuant to this section that did not previously receive funds to facilitate improvements in hospital operations and finances beginning on December 1, 2009, shall, as a condition for eligibility for such funds, adopt a resolution of the board of directors of each such hospital setting forth its current financial condition, including ongoing board oversight, and shall, after two years, issue a report as adopted by each such board of directors setting forth what progress has been achieved regarding such improvement, provided, however, if such report fails to set forth adequate progress, as determined by the commissioner, the commissioner will deem such facility ineligible for further distributions pursuant to this section and will redistribute such further distributions to other eligible facilities in accordance with the provisions of this section. The commissioner shall be provided with copies of all such resolutions and reports.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.2 Abandonment
The complete retirement of a fixed asset from service, following salvage or other reclaiming of removable parts.
10 CRR-NY 441.339 Visit
The physical appearance of an outpatient at a hospital complex is recognized as contributing one visit regardless of the number of diagnostic and/or therapeutic services the patient receives or the number of sections (clinics), operating rooms, laboratories and treatment areas in which he/she receives them. The classification of the visit ( i.e., emergency, clinic, etc.) will be determined by the first location where service is rendered. A patient referred from a physician's office exclusively for a specific ancillary service or services is classified as one referred ambulatory visit. A laboratory examination of a specimen sent in by a physician for his/her patient shall be included as one referred ambulatory visit.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.51 Destruction of foods in certain cases
When a case of diphtheria, streptococcal sore throat (including scarlet fever), superficial staphyloccal infection, amebiasis or shigellosis, salmonellosis, infectious hepatitis, poliomyelitis or typhoid exists on any farm or dairy producing milk, cream, butter, cheese, other foods likely to be consumed raw, the State Commissioner of Health or the city, county or district health officer may destroy or order the destruction of any such foods which in his opinion may have been infected.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 107 CHENANGO COUNTY
CITIES CITIES
10 CRR-NY 107.1 City of Norwich
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Chenango Lake, all natural and artificial reservoirs on Ransford Creek, all wells and watercourses tributary thereto or which may ultimately discharge into said Chenango Lake and Ransford Creek reservoirs or affect water quality of wells or which may be developed in the future to serve as sources of the public water supply to the City of Norwich.
(b) Definitions of components of the public water supply.
(1) Lake shall mean Chenango Lake.
(2) Reservoir shall mean any and all natural or artificial lakes or ponds, except Chenango Lake as defined in paragraph (1) of this subdivision, which are tributary to or serve as a source of the public water supply to the City of Norwich.
(3) Watercourse shall mean every spring, stream, marsh or channel, including portions of Ransford Creek, which flow or may flow into the public water supply to the City of Norwich.
(4) Watershed shall mean the entire drainage area contributing to the public water supply to the City of Norwich.
(5) Well shall mean all wells which are now used as a source of this water supply or any additional wells which may be public water supply to the City of Norwich.
(c) General definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(2) Distances referred to in these rules are linear distances and shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of the lake or reservoir, to the edge, margin, or steep bank forming the ordinary high water mark of a watercourse or to the extension of the centerline of the well. All distances presented are metric; those in parentheses are the approximate English system equivalents.
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric or the like.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, cellar dirt, dead animals, offal, and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include land used for the depositing of refuse from a single family, a member of which is the owner, occupant, or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, prviate or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fill or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(d) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(e) Specific prohibitions.
(1) Animals.
No owner shall allow his animal to enter, graze or remain upon land owned by the City of Norwich in the reservoir, well, and watercourse areas or to stand, wallow, wade, swim or be washed or watered in any reservoir or watercourse.
(2) Cemeteries.
No interment of a human body shall be made within 75 meters (246.1 feet) of the lake, any reservoir, well or watercourse.
(3) Chloride salt.
No chloride salt shall be stored within 150 meters (492.1 feet) of the lake, any reservior, well or watercourse except in weather-proof buildings or watertight vessels.
(4) Gutters.
No culverts, gutters, pipes or ditches, which are used to divert or collect surface water runoff or to drain the road, shall empty into the lake within 150 meters (492.1 feet) of any water supply intakes.
(5) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, or applied on the watershed or allowed to remain within 150 meters (492.1 feet) of any well, or allowed to enter the lake, any reservoir, well, or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(6) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into the lake, any reservoir, or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil unless deposited in trenches or pits at a distance not less than 100 meters (328.1 feet) from the lake, any reservoir, well or watercourse and covered with not less than 30 centimeters (11.8 inches) of soil in such a manner as to effectively prevent its being washed into the lake, any reservoir, well or watercourse by rain or melting snow.
(iv) No privy, privy receptacle, or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within 30 meters (98.4 feet) of the lake or any watercourse, within 60 meters (196.9 feet) of any reservoir, or within 75 meters (246.1 feet) of any well except:
(a) stored in watertight receptacles;
(b) disposed of in water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; or
(c) treated in a properly designed, constructed, and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility. Under no circumstances shall any facility for the deposit, movement, treatment, or storage of human excreta or sewage be within 15 meters (49.2 feet) of the lake or any watercourse or within 30 meters (98.4 feet) of any reservoir or well.
(v) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within 75 meters (246.1 feet) of any well; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within 10 meters (32.8 feet) of any well.
(vi) No portion of a seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 30 meters (98.4 feet) of the lake or any watercourse or within 30 meters (98.4 feet) of any reservior or well.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of the lake, any reservoir, well or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal, such that the least possible annoyance and inconvenience shall be caused to the occupants of the premises or the adjacent premises. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed, and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed or within 150 meters (492.1 feet) of any well, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility.
(7) Radioactive material.
No radioactive material shall be disposed of by burial in the soil at any point within the watershed, well or water distribution areas.
(8) Recreation.
(i) Bathing and swimming. No bathing or swimming shall be allowed in any reservior or watercourse owned by the City of Norwich.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Norwich.
(iii) Camping. No camp, tent, building or other structure for the occupancy by transients or by laborers or for any other use except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within 90 meters (295.3 feet) of the lake.
(iv) Fishing. No fishing shall be allowed in or upon any reservoir owned by the City of Norwich.
(v) Exception. The preceding subparagraphs (ii), (iii) and (iv) of this paragraph shall not apply to persons duly authorized by the City of Norwich Board of Water Commissioners who are performing their duties of supervision or maintenance of the public water supply to the City of Norwich.
(9) Solid waste.
(i) Junkyards. No junkyard shall be located within 75 meters, 246.1 feet) of the lake, any reservoir, well or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within 75 meters (246.1 feet) of the lake, any reservoir, well or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within 150 meters (492.1 feet) of the lake, any reservoir, well or water watercourse.
(10) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within 150 meters (492.1 feet) of the lake, any reservoir, well or watercourse.
(11) Miscellaneous.
(i) Trespassing and structures. No trespassing or structures of any kind, except a waterworks structure, shall be permitted upon land owned by the City of Norwich in the reservoir, well and watercourse areas. The foregoing shall not apply to persons duly authorized by the City of Norwich Board of Water Commissioners to enter upon such property.
(ii) Washing and rinsing. Nothing may be washed or rinsed in, and no water from such washing or rinsing shall be allowed to enter the lake, any reservoir, well or watercourse.
(12) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into the lake, any reservoir, well or watercourse, or on or beneath the surface of the ground on the watershed within 150 meters (492.1 feet) of the lake, any reservoir, well or watercourse. This restriction shall not apply to the effluent from a treatment works that has been approved by the appropriate State agency having jurisdiction over such facilities.
(f) Inspections.
(1) Access.
(i) The City of Norwich Board of Water Commissioners must be notified during and at the conclusion of the alteration or construction of any sewage disposal system or treatment works on the watershed or within 150 meters (492.1 feet) of any well so that the said Board of Water Commissioners or its duly authorized representatives may inspect such alteration or construction to determine its adequacy and conformance with these regulations.
(ii) Owners of any property within the watershed must, at a reasonable hour, allow the aforesaid Board of Water Commissioners or its duly authorized representatives free access to such property for the inspection of sewage disposal systems or treatment works to ascertain whether such systems or works are in compliance with these regulations.
(2) Authority.
The City of Norwich Board of Water Commissioners or any person or persons charged with the maintenance or supervision of the public water supply of the City of Norwich shall by its officers or their duly appointed representatives make regular and thorough inspections of the lake, reservoirs, wells, watercourses, and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid Board of Water Commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same along with notices of such violations. If such persons do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Board of Water Commissioners to promptly notify the State Commissioner of Health of such violations.
(3) Reports.
The City of Norwich Board of Water Commissioners shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed and the area surrounding the wells at the time of the last inspection.
(g) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law, the text of which is set forth as follows:
§ 1103. Violation; penalties.
(1) If any rule or regulation promulgated pursuant to section one thousand one hundred of this chapter relates to a temporary source or act of contamination, any person violating such rule or regulation shall be liable to prosecution for misdemeanor for every such violation, and on conviction thereof shall be punished by a fine not exceeding two hundred dollars, or imprisonment not exceeding one year, or both.
(2) If any rule or regulation promulgated pursuant to section one thousand one hundred of this chapter relates to a permanent source or act of contamination, the department may impose penalties for the violation thereof or the noncompliance therewith, not exceeding two hundred dollars for every such violation or noncompliance.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.340 Wing
A distinct part of a building consisting of an architecturally subordinate extension of a building with a corridor connecting the main building and the extension. A wing could also be represented by the addition of one or more floors to an existing building.
Part 447 STANDARD UNIT OF MEASURE REFERENCES
10 CRR-NY 447.3 Neurology—Diagnostic Services
| (a) ACCOUNT NUMBER | COST CENTER TITLE | | --- | --- | | 7460 | Neurology—Diagnostic |
(b) The above cost center uses as the basis for the Standard Unit of Measure the applicable procedures from the Neuro-Muscular section of the Medicine Relative Values as determined by the California Medical Association, 1974 California Relative Value Studies (RVS). Relative Value Units for unlisted, BR (By Report), and RNE (Relativity Not Established) procedures are to be reasonably estimated by qualified personnel. Because the California Medical Association is no longer publishing their Relative Value Studies booklet, the applicable procedures from the Neuro-Muscular section of the Medicine chapter are set forth below with the approval of CMA.
| | | | Unit value | | --- | --- | --- | --- | | (1) | 95819 | Electroencephalogram (EEG), standard or portable, same facility | 20.0 | | (2) | 95821 | portable, to an alternate facility | 30.0 | | (3) | 95822 | sleep | 30.0 | | (4) | 95823 | physical or pharmacological, activation | 30.0 | | (5) | 95824 | cerebral death evaluation recording | BR | | (6) | 95826 | intracerebral (depth) EEG | BR | | (7) | 95827 | all night sleep recording | BR | | (8) | 95860 | Electromyography, one extremity and related para-spinal areas | 20.0 | | (9) | 95861 | two extremities and related paraspinal areas | 36.0 | | (10) | 95863 | three extremities and related paraspinal areas | 44.0 | | (11) | 95864 | four extremities and related paraspinal areas | 52.0 | | (12) | 95867 | cranial nerve supplied muscles, unilateral | RNE | | (13) | 95868 | bilateral | RNE | | (14) | 95869 | limited study of specific muscles, e.g., external and sphincter, thoracic spinal muscles, etc. | BR |
Part 441 DEFINITIONS
10 CRR-NY 441.3 Accelerated payments
Amounts received where delays in payments by an intermediary for covered services rendered to beneficiaries have caused financial difficulties for the hospital, or where a hospital has incurred a temporary delay in its bill processing beyond the provider's normal billing cycle.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.7 Default
(a) A recipient shall be placed in default if he/she has not been granted a deferral or waiver by the commissioner, and:
(1) the recipient fails to complete the primary care residency program; or
(2) the recipient is not available to fulfill his or her service obligation on the service obligation start date; or
(3) the recipient resigns, is dismissed from employment, or otherwise fails, refuses, or is unable to fulfill the service obligation; or
(4) an award is rescinded after dispersal of monies to a recipient.
(b) Calculation of financial obligation.
A recipient found to be in default will be required to pay the president, within five years from the date of default, all monies received, plus interest, plus liquidated damages, as determined by the following formula:
A= 2B (T−S) T
where “A” is the amount the president is entitled to receive; “B” is the sum of all payments made to the recipient and the interest on such amount which would be payable if, at the time such awards were paid, they were loans bearing interest at the maximum prevailing rate determined by the Higher Education Services Corporation; “T” is the total number of months in the recipient's period of obligated service; and “S” is the number of months of service actually rendered by the recipient. The total number of months in the recipient's period of obligated service is calculated by multiplying by 12 the number of annual awards received by the recipient.
(c) The Department of Health shall advise the Higher Education Services Corporation of any default, and the Higher Education Services Corporation shall collect repayments and, where indicated, initiate action for prosecution to recover monies owed the State.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.6 Alternative containers
Funeral firms must make an unfinished wooden box or alternative container available for direct cremations, if they arrange direct cremations.
Subchapter S LAND ACQUISITION
Part 99 PAYMENTS TO AN OWNER OR TENANT OF RESIDENTIAL PROPERTY OR COMMERCIAL PROPERTY UPON APPLICATION FOR ALLOWANCE OF MOVING EXPENSES IN VACATING PROPERTY ACQUIRED BY THE DEPARTMENT OF HEALTH
10 CRR-NY 99.5 Actual moving expenses for business concerns
Moving expenses for business concerns, nonprofit organizations and operation of a farm will be allowed on the basis of actual costs as evidenced by receipted bills from recognized movers or in the case of an owner or tenant performing the moving himself, on the basis of the cost of hiring equipment and personnel at prevailing rates in the community for that type of equipment and personnel. All books and records kept by the owner or tenant shall be subject to review and audit by a State representative during reasonable business hours all of which shall be documented in form satisfactory to the Commissioner of Health. Such moving costs shall not include the moving of any fixtures or equipment that were considered as part of the realty in the acquisition of the premises and likewise such costs shall not include any charges at the new location for electric wiring, or plumbing nor for the remodeling, redecorating or reinforcing of the new structure to accommodate the equipment or stock of the individual business concern, nonprofit organization or in the operation of a farm. Whenever moving is performed by a licensed mover operating under regulatory authority, the amount paid as reimbursement for actual moving expenses shall not be in excess of the tariffs filed by such mover with either the Interstate Commerce Commission or the State Public Service Commission as the case may be.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.12 Agricultural activities
Any intentional, knowing or reckless act or omission that in the course of an agricultural activity significantly increases pollutants in the water supply is prohibited.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.192 Term of permits; nontransferable
(a) Permits will be issued for a period of time not to exceed two years. The permit-issuing official will determine the term of the permit based on the record of compliance of the establishment, the potential for risk to public health presented by operation of the establishment, and whether the establishment has an acceptable self-inspection program. After due notice and an opportunity for a hearing, the permit-issuing official may at any time change the term of any permit.
(b) Permits are nontransferable from one owner or operator to another, or from one establishment location to another.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.51 Fees and revenue; services for which fees are charged
(a) Environmental health services . Each local health department must charge a fee for the granting of a permit, inspections and other services prerequisite to the issuance of a permit:
(1) x-ray and radioactive materials (authorized programs only);
(2) food service establishments (all types);
(3) camps and recreation facilities;
(4) individual water and sewerage;
(5) realty subdivisions;
(6) mobile home parks;
(7) community and noncommunity water systems;
(8) tanning facilities;
(9) bathing beaches;
(10) swimming pools;
(11) recreational aquatic spray grounds;
(12) temporary residences (hotels/motels/bungalow colonies/cottage colonies, cabins);
(13) mass gatherings and public functions;
(14) children’s camps;
(15) agricultural fairgrounds;
(16) migrant farm worker housing;
(17) multipurpose recreational facility;
(18) plan review.
(b) Clinic health services . Where third-party reimbursement is not available, the local health department shall charge a fee for the following clinic health services, regardless of whether such services are provided directly or by contract. Subject to section 40-1.52(b) of this Part, where third-party reimbursement is available, the local health department shall ensure that every reasonable effort is made to collect such reimbursement and any relevant co-payments.
(1) Sexually transmitted diseases, consistent with Public Health Law section 2304.
(2) HIV counseling, testing, diagnosis and prevention.
(3) Family planning.
(4) Prenatal and postpartum care.
(5) Primary care for children less than 21 years of age.
(6) Immunization.
(c) Tuberculosis control . Fees for clinical health services related to tuberculosis control shall be governed by Part 43 of this Title.
(d) Rabies control . Local health departments shall make every reasonable effort to collect third-party reimbursement for the clinical health services for rabies control, when such services are provided by the local health department.
(e) Nothing in this section shall be deemed as prohibiting local health departments from charging fees for other public health services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.228 Operating income (or profit)
The excess of the revenues of a business enterprise over the expenses pertaining thereto, excluding income and expense derived from sources other than its regular activities.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 107 CHENANGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 107.3 Village of Oxford
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well, located on land owned by the village, and situated in the southwesterly part of the village, just north of the Delaware, Lackawanna and Western Railroad right-of-way and about 50 yards west of Water Street, which forms a source of the public water supply of the village of Oxford, Chenango County, New York.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 75 feet of the well of the public water supply of the village of Oxford.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of the well of the public water supply of the village of Oxford.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the village of Oxford.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c] or into suitable watertight iron pipes with tight leaded joints, a permit for which has been granted by the State Commissioner of Health) within 150 feet of the well of the public water supply of the village of Oxford. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the village of Oxford.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 150 feet of the well of the public water supply of the village of Oxford.
(e) Animals, manure, compost, etc.
(1) No permanent stable or pen for cattle or horses, no barnyard, pigpen or poultry house or yard and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the village of Oxford, and no pen for the temporary retention of cattle, horses, pigs or other animals shall be constructed, located, placed, maintained or allowed to remain within 60 feet of the well of the public water supply of the village of Oxford and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may flow over the ground within 60 feet of the well or may enter the well without first having passed through such an extent of soil as to have been properly purified.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of any well of the public water supply of the village of Oxford.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the village of Oxford.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Oxford upon which the well of the public water supply of the village of Oxford is located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision and maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Oxford.
(h) Inspections.
The board of trustees of the village of Oxford or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Oxford or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.232 Original cost
Outlay for an asset by its owner, not including any adjustments of cost arising from post-acquisition alterations, improvements or depreciation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.37 Submission of resident assessments
(a) Effective November 1, 1992 and thereafter, residential health care facilities shall submit to the department the data contained in the comprehensive assessment and review of assessments (quarterly reviews) required to be completed by facilities in accordance with section 415.11 of this Title and section 483.20 of 42 CFR (Minimum Data Set Plus for Nursing Home Resident Assessment and Care Screening [MDS +]), using a telecommunications process based on electronic mail or if directed by the department, other electronic medium such as computer tape or floppy disc. This submission shall be made consistent with the department' s data submission specifications for the MDS + and shall use the department-provided submission preparation computer software when preparing the MDS + data for transmission.
(1) Electronic submission of the MDS + data shall occur no later than six weeks after the assessment start date which the facility indicates in section A of the MDS + document.
(2) The electronic submissions shall include all assessments and quarterly reviews with an assessment start date of November 1, 1992 and thereafter, completed by the facilities in accordance with section 415.11 of this Title.
(b) Residential health care facilities shall reproduce the MDS + discharge notification, supplied initially by the department, in sufficient numbers and submit to the department the data contained therein for each resident when the resident is permanently discharged from the facility. The facility shall submit such data within four weeks of discharge using a telecommunications process based on electronic mail or, if directed by the department, other electronic medium such as computer tape or floppy disc.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.3 Definition and cooking of potentially hazardous food; product thermometers
(a) All food used by a temporary food service establishment is to be wholesome, safe for human consumption, and obtained from sources that comply with laws relating to food and food labeling. Fluid milk and milk products used or served are to be pasteurized and obtained from sources that comply with laws relating to milk processing and labeling. All foods which are not readily identifiable are to be labeled to identify the food by common name. Only clean, whole eggs, with shell intact and free from cracks or checks, or pasteurized liquid, frozen, or dry eggs or pasteurized dry egg products are to be used. All containers in which shell eggs are received must identify the source.
(b) Potentially hazardous food means any food that consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea, cooked potato, cooked rice or other ingredients including synthetic ingredients, in a form capable of supporting:
(1) rapid and progressive growth of infectious or toxigenic microorganisms; or
(2) the slower growth of C. botulinum.
The term does not include foods with a water activity (Aw) value of 0.85 or less, or a hydrogen ion concentration (pH) level of 4.6 or below.
(c) Temporary food service establishments may only serve food which requires limited preparation requiring only seasoning and cooking. The preparation or service of other potentially hazardous foods, including pastries filled with cream or synthetic cream, custards, and similar products, and salads or sandwiches containing meat, poultry, eggs, or fish is prohibited except if prepared under approved conditions, transported and stored at a temperature of 45 degrees Fahrenheit (7.2 degrees Celsius) or below, or at a temperature of 140 degrees Fahrenheit (60 degrees Celsius) or above, in approved facilities, and served without contamination to the consumer. Intact shell egg temperatures shall be considered acceptable if ambient storage temperature is 45 degrees Fahrenheit (7.2 degrees Celsius) or less. The permit-issuing official, or his designated representative, may require that food be served directly in the unopened container in which it was packaged unless the equipment and operations are adequate to protect food from contamination.
(d) Food is to be protected from contamination in the establishment at all times including storage, preparation, and display to patrons. Food is to be prepared and served with no bare hand contact unless the food will be subsequently heated to 140 degrees Fahrenheit (60 degrees Celsius) or greater for foods that were not previously heated or to 165 degrees Fahrenheit (73.9 degrees Celsius) or greater for foods that are being heated for a second or subsequent time. Convenient and suitable utensils and/or sanitary gloves are to be provided and used to prepare or serve food to eliminate bare hand contact and prevent contamination. Waxed paper, napkins or equivalent barrier to prevent hand contact can also be used to serve food.
(e) All parts of potentially hazardous foods requiring cooking are to be heated to at least 140 degrees Fahrenheit (60 degrees Celsius), except:
(1) poultry, poultry stuffing, stuffed meats and stuffing containing meat are to be heated in an uninterrupted manner so all parts are at least 165 degrees Fahrenheit (73.9 degrees Celsius);
(2) pork and food containing pork are to be heated so all parts of the food are at least 150 degrees Fahrenheit (65.6 degrees Celsius);
(3) rare roast beef and/or rare beef steaks are to be heated to an internal temperature of at least 130 degrees Fahrenheit (54.4 degrees Celsius), unless otherwise ordered by the consumer. When meat or fish are served raw, the consumer is to be so notified;
(4) shell eggs or foods containing shell eggs are to be heated to 145 degrees Fahrenheit (62.8 degrees Celsius) or greater unless an individual consumer requests preparation of a shell egg or food containing shell eggs in a style such as raw, poached or fried which must be prepared at a temperature less than 145 degrees Fahrenheit in order to comply with the request;
(5) every part of ground meat or foods containing ground meat are to be heated to at least 158 degrees Fahrenheit (69.4 degrees Celsius), unless a consumer requests preparation of a single order of ground meat or food containing ground meat which must be prepared at a temperature less than 158 degrees Fahrenheit in order to comply with the request.
(f) Metal stem-type, numerically scaled indicating thermometers, accurate to plus or minus two degrees Fahrenheit (1.1 degrees Celsius) are to be provided and used to determine that proper internal cooking, holding or refrigeration temperatures of all potentially hazardous foods are achieved and maintained.
(g) For the purposes of this subdivision, liquid nitrogen shall mean nitrogen in its cryogenic liquid form, which comes in direct contact with food or is used as a food additive. Dry ice shall mean carbon dioxide in its solid form, which comes in direct contact with food or is used as a food additive.
(1) Only food-grade liquid nitrogen or dry ice may be added to food.
(2) Liquid nitrogen, used in the preparation of food, shall be evaporated completely or the operator shall ensure that all residual liquid nitrogen is drained prior to service.
(3) Dry ice, used in the preparation of food, shall be sublimated completely prior to service or the operator shall ensure no residual dry ice is served to the patrons.
(4) Liquid nitrogen or dry ice shall not be added to any food before service, such that a fog or smoke effect remains at time of service or is created during eating.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 135 OSWEGO COUNTY
10 CRR-NY 135.2 Village of Pulaski
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing springs and such springs as may be developed in the future on the property of the village of Pulaski, located immediately west of Richland, Oswego County, New York, such springs being the sources of public water supply of said village.
(b) Definition of terms.
Whenever used in this section:
(1) The term water supply means the public water supply of the village of Pulaski, Oswego County, New York.
(2) The term springs means the springs now used as sources of this public water supply or any springs developed in the future as additional sources of this public water supply, which are located on said property now owned by said village.
(3) The linear distance of a structure or object from a spring is the shortest horizontal distance from the nearest point of the structure or object to the spring.
(c) Human excreta.
(1) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 150 feet of any spring.
(2) Every privy or receptacle for the storage or deposit of human excreta, located between the prescribed 150 feet and 200 feet from any spring, shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of in accordance with the provisions of paragraph (4) of this subdivision so that no insanitary conditions will be created.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal and sewage or wastes from any place of disposal referred to in paragraphs (1) and (2) of subdivision (d) may be washed through the soil in an imperfectly purified condition into any spring, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(4) The excreta collected in the aforesaid watertight receptacles permitted under paragraph (2) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent its being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any spring.
(d) Sewage.
(1) No sewage shall be discharged nor deposited nor allowed to be discharged or deposited on or beneath the surface of the ground within 200 feet of any spring except into watertight receptacles, the contents of which shall be removed before overflowing in such a manner as to prevent the pollution of the ground about the receptacle. No such watertight receptacle shall be located nearer than 175 feet from any spring.
(2) No bath water, sink or laundry wastes shall be discharged or deposited or allowed to be discharged or deposited on or beneath the surface of the ground within 150 feet of any spring.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or other material or wastes that pollute water shall be deposited or allowed to be deposited on or beneath the surface of the ground within 150 feet of any spring, nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the springs.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 150 feet of any spring.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 150 feet of any spring.
(h) Trespassing.
No trespassing shall be allowed upon the property of the Village of Pulaski upon which the springs of the public water supply of said village are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said village.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any spring.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of any spring.
(k) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(l) Inspections.
The Village of Pulaski, its officers or their duly appointed representative, shall make regular and thorough inspections of the area surrounding the springs for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid village to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Village of Pulaski to promptly notify the State Commissioner of Health of such violations. The aforesaid village shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the springs at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanant source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.11 Physical containment levels; P1 level
(a) Laboratory practices.
(1) Laboratory doors shall be kept closed while experiments are in progress.
(2) Work surfaces shall be decontaminated daily, and immediately following spills of organisms containing recombinant DNA molecules.
(3) All biological wastes shall be decontaminated before disposal. Other contaminated materials, such as glassware, animal cages and laboratory equipment, shall be decontaminated before washing, reuse or disposal.
(4) Mechanical pipetting devices shall be used; pipetting by mouth is prohibited.
(5) Eating, drinking, smoking, and storage of foods are not permitted in the laboratory area in which recombinant DNA materials are handled.
(6) Persons shall wash their hands after handling organisms containing recombinant DNA molecules, and when they leave the laboratory.
(7) Care shall be taken in the conduct of all procedures to minimize the creation of aerosols.
(8) Contaminated materials that are to be decontaminated at a site away from the laboratory shall be placed in a durable leak-proof container, which is closed before removal from the laboratory.
(9) An insect and rodent control program shall be instituted.
(10) The use of laboratory gowns, coats or uniforms is discretionary with the laboratory supervisor.
(11) Use of the hypodermic needle and syringe shall be avoided when alternative methods are available.
(12) The laboratory shall be kept neat and clean.
(b) Containment equipment.
Special containment equipment is not required at the P1 level.
(c) Special laboratory design.
Special laboratory design is not required at the P1 level.
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.1 Scope
These regulations govern the application and eligibility determination process for the Uninsured Care Programs and establish the rights and responsibilities of applicants, participants, providers, and contractors in that process.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.13 Deductions from operating revenue
[ 1330 ]
(a) In many instances, the hospital receives less than its full established charges for the services it renders. It is essential that reporting information reflect both the gross revenue and revenue “adjustments” resulting from inability to collect established charges for services provided.
(b) These revenue adjustments are called Deductions from Revenue and are of the following primary categories:
(1) Provision for bad debts.
These deductions represent the estimated amount of current revenues that will not be realized as a result of credit losses.
(2) Contractual adjustments.
These adjustments represent the difference between full established charges for individual services and the contractual rates received or to be received from third-party payors for services rendered.
(3) Charity service.
These deductions represent the difference between full established charges and amounts received or to be received from indigent patients, voluntary agencies or governmental units on behalf of specific indigent patients.
(4) Policy discounts.
These deductions represent adjustments for items such as courtesy allowances and employee discounts from the hospital's full established charges for services.
(5) Administrative adjustments.
These adjustments represent amounts of patient service revenue posted but not billed to patients because the cost of billing and collection would exceed the amounts received.
(c) The above items must be recorded and reported as deductions from gross operating revenue on an accrual basis rather than as expenses.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-10 APPENDICES
10 CRR-NY 128-10.1 Watershed maps
(a) The watershed area for the New York City water supply lies in the parts of the following counties and towns that are delineated on Map 128-A.1:
(1) Delaware County: In the towns of Andes, Bovina, Colchester, Delhi, Deposit, Franklin, Hamden, Harpersfield, Kortright, Masonville, Meredith,Middletown, Roxbury, Sidney, Stamford, Tompkins, Walton.
(2) Dutchess County: In the towns of Beekman, East Fishkill, Pawling.
(3) Fairfield County (Connecticut): In the towns of Danbury, Greenwich, New Fairfield, Ridgefield, Sherman.
(4) Greene County: In the towns of Ashland, Halcott, Hunter, Jeweh, Lexington, Prattsville, Windham.
(5) Putnam County: In the towns of Carmel, Kent, Patterson, Putnam Valley, Southeast.
(6) Schoharie County: In the towns of Broome, Conesville, Gilboa, Jefferson.
(7) Sulliven County: In the towns of FalIsburg, Liberty, Neversink.
(8) Ulster County: In the towns of Denning, Hardenburgh, Hurley, Kingston, Marbletown, Olive, Rochester, Shandaken, Wawarsing, Woodstock.
(9) Westchester County: In the towns of Bedford, Cortlandt, Harrison, Lewisboro, Mount Kisco, Mount Pleasant, New Castle, North Castle, North Salem, Pound Ridge, Somers, Yorktown.
(b) The watershed areas for the New York City water supply that lie within the 60-day travel time to intake are delineated on Map 128-A.2
(1) In the East-of-Hudson System, the entire reservoir and controlled lake drainage basins of Boyds Corner, Croton, Kensico, Lake Gleneida, Muscoot, West Branch, and parts of the reservoir drainage basins of Amawalk, Cross River, Croton Falls, and Titicus are within the 60-day travel time to intake.
(2) In the West-of-Hudson System, the entire reservoir drainage basin of Rondout, and parts of the reservoir drainage basins of Ashokan, Cannonsville, Neversink and Pepacton are within the 60-day travel time to intake.
(c) The reservoir drainage basins for each reservoir are delineated on Map 128-A.3.
(d) Detailed maps of each area within the 60-day travel time to intake are available at the New York State Department of Health and the regional offices listed in section 128-1.5 of this Part.
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Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.31 Cross-connection control
(a) The supplier of water shall implement a service protection program (also known as containment) which includes the following:
(1) requiring a protective device commensurate with the degree of hazard posed by any service connection;
(2) requiring the user of such connections to submit plans for the installation of protective devices to the supplier of water and/or the State for approval; and
(3) assuring all protective devices are inspected and tested by a certified backflow prevention device tester, as prescribed in subdivision (b) of this section, at the time of initial installation, after each repair, and annually thereafter. Records of such tests shall be made available to, reviewed by, and maintained by the supplier of water. All protective device tests and inspections shall be conducted by a certified backflow prevention device tester (“tester”).
(b) A certified backflow prevention device tester shall meet the following requirements:
(1) Initial certification and renewal requirements. Initial and/or renewal certifications for a certified backflow prevention device tester will be issued by a department-approved entity, when the applicant provides proof of satisfactory completion of a department-approved certified backflow prevention training course. The certification shall be valid for a period of three years.
(2) Conditions of certification.
(i) Upon issuance of a certification by a department-approved entity, the tester shall inform the department and the department-approved entity, within 30 days, of any changes in address or employment.
(ii) The department has the authority to require any individual applying for certification or renewal certification as a certified backflow prevention device tester or any certified backflow prevention device tester to take a written, oral and/or practical skills validated examination, if the department deems such examination to be reasonably necessary to determine the applicant’s qualifications or to determine the certified tester’s knowledge, skills, ability and judgment. The results of the examination may be the sole basis for approval, disapproval or suspension of such certification or the basis for additional requirements, deemed appropriate by the department, before certification will be issued or reinstated.
(3) Recertification requirements.
(i) An individual that allows his or her certification renewal to lapse after the expiration date is no longer certified to test applicable protective devices as outlined in this Subpart. If the individual meets the requirements outlined in this subdivision, within one year of the expiration date, the certification will be reinstated with a renewal period starting upon the date of expiration of the original certification and ending three years later.
(ii) An individual that allows his or her certification renewal to lapse for more than one year after the expiration date will be required to repeat the initial certification requirements set forth in paragraph (1) of this subdivision.
(c) Enforcement.
Upon notice and opportunity for a hearing, a tester’s certification may be suspended or revoked. Revocation or suspension may be based on, but not limited to, fraud or misrepresentation by the certified tester; gross incompetence or gross negligence on a particular occasion; or negligence or incompetence on more than one occasion. Examples of such conduct include, but are not limited to:
(1) making false statements or notations on legal or official records required by the department; or
(2) providing misleading statements to government officials or agents of the government regarding protective device testing/certification.
(d) The supplier of water may not allow a user to establish a separate source of water. However, if a user justifies the need for a separate source of water, the supplier of water shall protect the public water system from such separate source of water by ensuring that such source does not pose a hazard in the following manner:
(1) by requiring the user to regularly examine the quality of the separate water source;
(2) by approving the use of only those separate water sources which are properly developed, constructed, protected and found to meet the requirements of sections 5-1.51 and 5-1.52 of this Subpart; and
(3) by filing such approvals with the State annually.
(e) All users of a public water system shall prevent cross-connections between the potable water piping system and any other piping system within the premises by installing internal protection in accordance with the New York State Uniform Fire Prevention and Building Code and/or the local plumbing and building codes.
(f) Any installation, service, maintenance, testing, repair or modification of a protective device shall be performed in accordance with the provisions of any relevant county, city, town or village plumbing code. All individuals who perform testing of protective devices shall be certified in accordance with subdivision (b) of this section.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.35 Central services supply
This functional reporting center must contain all the expenses associated with the preparation and issuance of medical and surgical supplies and equipment to patients and other functional reporting centers, and the cost of medical/surgical supplies and equipment charged to patients and the cost of non-billable medical supplies distributed to the various floors as stock. Additional activities include but are not limited to the following: requisitioning and issuing appropriate supply items required for patient care; preparing sterile irrigating solutions; collecting, assembling, cleaning, sterilizing and redistributing reusable items; and cleaning, assembling, maintaining and issuing of portable apparatus.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.10 Service model options
(a) The department of Health, State early intervention service agencies, and early intervention officials shall make reasonable efforts to ensure the full range of early intervention service options are available to eligible children and their families.
(1) The following models of early intervention service delivery shall be available:
(i) home and community based individual/collateral visits: the provision by appropriate qualified personnel of early intervention services to the child and/or parent or other designated caregiver at the child's home or any other natural environment in which children under three years of age are typically found (including day care centers and family day care homes);
(ii) facility-based individual/collateral visits: the provision by appropriate qualified personnel of early intervention services to the child and/or parent or other designated caregiver at an approved early intervention provider's site;
(iii) parent-child groups: a group comprised of parents or caregivers, children, and a minimum of one appropriate qualified provider of early intervention services at an early intervention provider's site or a community-based site ( e.g., day care center, family day care, or other community settings);
(iv) group developmental intervention: the provision of early intervention services by appropriate qualified personnel to a group of eligible children at an approved early intervention provider’s site or in a community-based setting where children under three years of age are typically found (this group may also include children without disabilities); and
(v) family/caregiver support group: the provision of early intervention services to a group of parents, caregivers (foster parents, day care staff, etc.) and/or siblings of eligible children for the purposes of:
(a) enhancing their capacity to care for and/or enhance the development of the eligible child; and
(b) providing support, education, and guidance to such individuals relative to the child's unique developmental needs.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.111 Inventory; required substances
Controlled substances listed in section 3306 of the Public Health Law are designated as inventory required substances and a biennial inventory shall be prepared and maintained in accordance with the provisions of section 80.112 of this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM NONPRESCRIPTION DRUGS IN THE MEDICAID PROGRAM
10 CRR-NY 85.21 Establishment of list of reimbursable, nonprescription drugs
Pursuant to section 365-a of the Social Services Law nonprescription drugs included in the therapeutic categories listed in this section may be reimbursed in the New York State Medical Assistance Program.
Product
(a) Analgesic and Antipyretic
(1) Acetaminophen
(2) Acetylsalicylic Acid
(3) Ibuprofen
(b) Antacid
(c) Antivertigo
(1) Dimenhydrinate
(d) Cough and Cold
(1) Phenylephrine Hydrochloride
(2) Guaifenesin and/or Decongestant and/or Antitussive
(3) Non-narcotic Antitussants and/or Antihistamine
(4) Antihistamine and Decongestant
(5) Non-narcotic Antitussants and/or Upper Respiratory Combinations of Antihistamines and Decongestants
(6) Decongestant
(7) Sodium Chloride Nasal Drops/Spray
(e) Dermatological
(1) Bacitracin
(2) Neomycin
(3) Tolnaftate
(4) Aluminum Acetate
(5) Hydrocortisone
(f) Family Planning
(1) Contraceptive
(g) Fecal Softener and Laxatives
(1) Milk of Magnesia
(2) Heavy Mineral Oil
(3) Docusate, Calcium, Potassium or Sodium
(4) Bisacodyl
(5) Bulk Laxatives
(6) Barium Enema Prep Kit
(7) Senna
(h) Hematinic
(1) Ferrous Sulfate
(2) Ferrous Gluconate
(i) Insulin
(j) Vitamin/Mineral
(1) ACD with or without iron
(2) Multi-vitamin with or without iron
(3) Therapeutic Vitamins with or without Minerals
(4) Prenatal Vitamins
(5) Ascorbic Acid
(6) Calcium
(7) Pyridoxine Hydrochloride
(8) Vitamin D
(9) Thiamine Hydrochloride
(10) Magnesium
(11) Nicotinic Acid
(k) Basic Aluminum Carbonate Products (only for persons with diagnosis of chronic renal disease)
(l) Ocular/Oral Lubricants
(1) Lubricant Ophthalmic
(2) Sodium Chloride Ophthalmic
(3) Artificial Tears
(4) Saliva Substitute
(m) Anti-Diarrheal Product
(1) Kaolin-Pectin Combination
(2) Attapulgite Suspension
(3) Loperamide HCI
(4) Polycarbophil
(n) Antihistamine(s)
(o) Enzyme
(1) Pancreatic Tablets
(p) Pediculicide
(q) Emetic
(1) Ipecac Syrup
(r) Smoking Cessation
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 620 INCORPORATIONS AND TRANSFERS OF PROPRIETARY BUSINESSES
10 CRR-NY 620.1 Establishment of business corporations
Persons seeking the approval of the Public Health Council for the formation of a business corporation to be established as the operator of a hospital shall file, in addition to the requirements of Part 600 of this Subchapter, information, documents and data as follows:
(a) A photocopy of the executed proposed certificate of incorporation which shall, in all respects, conform to the applicable provisions of the Business Corporation Law and all other pertinent laws of the State of New York. Such certificate of incorporation shall contain provisions to the following effect:
(1) The corporate powers and purposes shall be limited to the ownership and operation, or operation, of a hospital or hospitals specifically named and the location or locations of which are specifically designated by street address, city, town, village or locality and county; provided, however, that the corporate powers and purposes may also include the ownership and operation, or operation, of a hospice or hospices, as defined in article 40 of the Public Health Law, a certified home health agency or licensed home care services agency or agencies as defined in article 36 of the Public Health Law, or a health maintenance organization as defined in article 44 of the Public Health Law; if the corporation has received all approvals required under such law to own and operate, or operate, such hospice or hospices, home care services agency or agencies or health maintenance organization.
(2) The location of the principal office of the corporation which shall be at the same address as a hospital, hospice, home care services agency or health maintenance organization which is to be operated by the corporation in the State of New York.
(3) No person may own 10 percent or more of the stock of the corporation who has not been approved for the ownership of such stock by the Public Health Council.
(4) All stock certificates of the corporation shall bear on the face thereof the following:
(i) no person shall own 10 percent or more of the stock of the corporation unless he has been approved for such ownership by the Public Health Council;
(ii) a statement that any transfer, assignment or other disposition of 10 percent or more of the stock or of 10 percent of the voting rights thereunder of the corporation or the transfer, assignment or other disposition of the stock or voting rights of the corporation which results in the ownership or control of more than 10 percent of the stock or voting rights thereunder of the corporation by any person shall be subject to approval by the Public Health Council; and
(iii) a statement that no stock or voting rights thereunder of the corporation may be owned or controlled by another corporation.
(5) Stock shall consist of one class of common stock only.
(b) An affidavit from each applicant setting forth:
(1) that he is to be the sole beneficial owner of the voting shares of which he is to be the holder of record in the proposed corporation;
(2) the number of voting shares in the proposed corporation of which he is to be the holder of record; and
(3) that all stock authorized by the certificate of incorporation will be issued and outstanding.
(c) The proposed stock certificate, bearing imprinted on the face thereof legend that any transfer, assignment or other disposition of 10 percent or more of the stock or of the voting rights thereunder of the corporation, or the transfer, assignment or other disposition of the stock or voting rights of the corporation which results in the ownership or control of more than 10 percent of the stock or voting rights thereunder of the corporation by any person shall be subject to approval by the Public Health Council, and that another corporation is prohibited by law from owning or controlling any of the stock or voting rights thereunder of the corporation.
(d) Information as to the character, experience, competency and standing in their community of the proposed incorporators and directors.
(e) Such additional pertinent information or documents necessary for the Public Health Council's consideration, as requested.
(f) The person, or partners, who are operating a proprietary nursing home, in accordance with the provisions of applicable law, may apply to the Public Health Council for its approval of the incorporation of such business. In addition to the aforesaid requirements for business corporations, the applicant for such approval shall file a copy of the document giving approval of the establishment of the applicant as operator of the nursing home, or proof that such nursing home was being operated by the applicant, in accordance with applicable provisions of law.
(g) The ownership or control by another corporation of any of the stock or voting rights thereunder of the corporation shall constitute sufficient grounds for the revocation, limitation or annulment of the approval of establishment.
(h) Within 30 days after approval of establishment, the corporation shall furnish to the New York State Department of Health a list of the names of all of the shareholders of the corporation, duly certified by the secretary of the corporation as to completeness and accuracy, and shall thereafter furnish such a certified list at annual intervals. Failure to comply with the provisions of this subdivision shall constitute sufficient grounds for the revocation, limitation or annulment of the approval of establishment.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.249 Payroll records
The records relating to the authorization, computation, distribution and payment of wages and salaries. They include payrolls, time slips, time-clock cards, withholding authorizations, cancelled payroll checks or receipts for wages paid, wage and salary authorizations and individual earnings records.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.23 Definition of law
Law means and includes Federal, State and local statutes, ordinances and regulations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 7 HOME HEALTH AGENCIES; TREATMENT CENTERS AND DIAGNOSTIC CENTERS
Part 430 LICENSED HOME CARE SERVICES AGENCIES AND CERTIFIED HOME HEALTH AGENCIES
10 CRR-NY 430.1 Applicability
Licensed home care services agencies, certified home health agencies and long-term home health care programs shall comply with the standards for such agencies set forth in the State Hospital Code, Subchapter C of this Chapter.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
STANDARDS STANDARDS
10 CRR-NY 15.5 Location, grounds
(a) Location.
All migrant farmworker housing facilities shall be well drained, and be free of depressions where water may pool and stagnate. The site shall be located where disposal of sewage can be provided in a safe, sanitary manner which neither creates nor is likely to create a public health nuisance or health hazard.
(b) Grounds.
The grounds of a migrant farmworker housing facility shall be maintained in a clean and sanitary condition, and be free of noxious plants. Driveways and access roads shall be maintained to allow free and safe vehicular access to the property.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 7-1.18 Linens and bedding
Every guest room shall be provided with an adequate supply of clean towels, sheets and pillowcases that are changed on a regular schedule, not to exceed one week between changes, except at facilities where housekeeping is the responsibility of the occupant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.21 Good faith inquiry
The licensee shall make a good faith inquiry either to the department or the Drug Enforcement Administration, United States Department of Justice to determine that a person is licensed to possess a controlled substance before distributing any such controlled substance to a person who the licensee does not know to be licensed to possess the controlled substance.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.114 Drainboards
Drainboards of adequate size are to be provided and used for the proper handling of soiled items prior to washing and of clean items following sanitization. Drainboards are to be self-draining and to be located and constructed so that they do not interfere with the proper use of the dishwashing facilities. Use of easily movable tables for the storage of soiled items or the use of easily movable tables for the storage of clean items following sanitization is allowed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.41 Hospital quality contribution
(a) For the period July 1, 2011 through March 31, 2012 a quality contribution shall be imposed on the inpatient revenue of each general hospital that is received for the provision of inpatient obstetrical patient care services in an amount equal to 2.4 percent of such revenue, as defined in section 2807-d(3)(a) of the Public Health Law.
(b) For the period on and after April 1, 2012, a quality contribution shall be imposed on the inpatient revenue of each general hospital that is received for the provision of inpatient obstetrical patient care services in an amount equal to 1.6 percent of such revenue, as defined in section 2807-d(3)(a) of the Public Health Law.
(c) For the purposes of computing revenue subject to this section, inpatient obstetrical patient care services shall also include services related to the care of newborns, but shall exclude neonatal intensive care services.
(d) The funds collected pursuant to this section shall be subject to and administered in accordance with the provisions of section 2807-d-1 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-2 HEALTH CARE FACILITIES
10 CRR-NY 4-2.7 Enforcement
(a) The department may conduct an assessment and/or Legionella culture sampling and analysis of the potable water system at any time.
(b) A violation of any provision of this Subpart is subject to all civil and criminal penalties as provided for by law. Each day that an owner remains in violation of any provision of this Subpart shall constitute a separate and distinct violation of each such provision.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.16 Active medical staff
Hospital-based and nonhospital-based physicians, other than interns and residents who are voting members of and can hold office in the medical staff organization of the hospital.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.10 Building maintenance/grounds
(a) Containers of flammable or combustible liquids must be stored, handled and dispensed in accordance with appropriate provisions of the Uniform Code.
(b) A campground shall be located so that adequate surface drainage of campsites is provided during the period of operation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.2 Eligibility for an award
(a) To be eligible to receive a Resident Loan Repayment Program award, an individual must:
(1) be a resident in good standing in the second or third year of residency training in a program that is designated as a Primary Care Residency Program by the council and which was so designated prior to July 1st of the year in which the individual began such residency training;
(2) have begun his/her Primary Care Residency Program as a first or second year student after January 1, 1994;
(3) be eligible to apply for licensure upon satisfactory completion of his/her residency training, and meet the character and moral standards required for licensure as a physician;
(4) agree to seek licensure in New York State at least four months prior to the anticipated completion of his/her Primary Care Residency Program;
(5) agree to practice primary care in an underserved area for one year for each annual award received;
(6) agree to apply award monies toward repaying all or part of a recipient's qualifying debt; and
(7) complete, sign, and file an application with the Department of Health on forms specified by the department at least six months prior to the beginning of the residency year for which an award is requested or by a later date specified by the commissioner. All required supplementary documentation shall be filed as directed. Incomplete or illegible applications may be rejected.
(b) An individual will be ineligible to become a resident loan repayment recipient if:
(1) the individual has received a scholarship or loan for his/her medical education which includes a service obligation that may require service outside of New York State;
(2) the individual is identified by the New York State Higher Education Services Corporation as being in default on the repayment of a guaranteed student loan or as being in default under the terms of any other governmentally administered scholarship or financial aid program and the individual refuses to allow the New York State Higher Education Services Corporation to directly apply the award to the defaulted account(s); or
(3) the individual is in a residency program with a program default rate higher than five percent. However, the commissioner may waive this provision if less than 30 recipients have completed their training in the program.
(c) To maintain eligibility for an award, the resident loan repayment recipient must:
(1) be a participant in good standing in the Primary Care Residency Program;
(2) report to the Department of Health and the Higher Education Services Corporation annually and as may be necessary to implement the program on such forms and at such times as required by the commissioner and the president; and
(3) provide required documentation regarding qualifying debt.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
CITIES CITIES
10 CRR-NY 100.1 City of Albany
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Hannacrois and Basic Creeks and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the City of Albany, Albany County, New York.
(b) Definitions.
(1) The term reservoir whenever used in this section is intended to mean and refer to the impounding and storage reservoirs on Hannacrois and Basic Creeks which are tributary to or with serve as sources of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond, lake (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Albany.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the City of Albany, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (2) of subdivision (d), provided, however, that the property on which the privy, privy vault, pit or any other receptacle intended for the deposit of human excreta is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle, used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained within the limits of such property, shall be placed as far as possible from any reservoir or watercourse and specially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of water supply or bureau of water of the city of Albany and so located that the tops of such receptacles shall be above the highest known water level of the reservoirs or watercourses.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind or any vessel, can or other container, used for either the temporary storage or the permanent disposal of human excreta, is specially constructed and made watertight, and located nearer any reservoir or watercourse than the distances named in paragraph (1) of this subdivision, such receptacles shall be emptied at regular intervals and disinfected as often as may be necessary to maintain them in a proper sanitary condition and effectually to prevent any overflow. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the directions of said board of water supply or bureau of water and in such manner as to effectually prevent any pollution of the water supply of the city of Albany.
(4) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Albany.
(5) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (4) of this subdivision. shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (6) and (7) of this subdivision.
(6) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(7) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (5) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 400 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the city of Albany.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the city of Albany, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Albany.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into Hannacrois or Basic creeks or any watercourse tributary to the public water supply of the city of Albany, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the said board of water supply or bureau of water.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant as provided by paragraph (2) of this subdivision, shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the city of Albany, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Albany.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir tributary to the public water supply of the city of Albany.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the city of Albany. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the city of Albany.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Albany, and none of the above named objects or sources of pollution shall be constructed, located, placed, except for fertilizing purposes, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passsed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the city of Albany.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the city of Albany, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Albany; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the city of Albany.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the city of Albany.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the city of Albany, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the city of Albany.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the city of Albany, except by duly authorized employees of the city of Albany in the performance of their duties of supervision and maintenance of the public water supply of the city of Albany.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Albany.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Albany.
(j) Inspections.
The said board of water supply or bureau of water of the city of Albany or such other board, person or persons as may be charged with the maintenance or supervision of the publc water supply of the city of Albany or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water supply or bureau of water to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the said board of water supply or bureau of water to promptly notify the State Commissioner of Health of such violations. The said board of water supply or bureau of water shall report to the State Commissioner of Health in writing, annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting a watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the city of Albany.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.8 Application to construct a water well
An application for permission to construct a water well shall be submitted by the applicant or his agent and contain the following information:2
(a) name and address of the applicant;
(b) legal or other description adequate to locate the property and the well;
(c) name and address of the water well contractor;
(d) estimated depth in feet and method of construction;
(e) purpose for which well is to be used and desired yield;
(f) proposed diameter of the well and drillhole in inches;
(g) type and depth of the proposed well casing;
(h) approximate distance and relative elevation to well of any potential sources of ground water pollution which may be located within 200 feet of such well including, without limitation, the following: privy, sewage seepage pit, sewage filter bed, sewage disposal field, underground sewers, septic tank, storm water drain, building foundation drain, milk house drain outlet, manure pile, barn gutter, silo, abandoned well, other well, sink hole, cow yard, hog lot, chicken yard, other animal yard, stone quarry, mine, rock outcrop, rain water cistern, solid waste disposal site, calcium or salt piles;
(i) distance to well from existing and proposed structures, as well as property lines located within 100 feet;
(j) statement of whether site is subject to flooding; and
(k) statement regarding the availability of a public water supply.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.11 Provider and purveyor leases
(a) Each shared health facility operator shall file with the department a true copy of any lease and any renewal of a lease executed by the facility operator and any provider or purveyor practicing his profession in the facility. If a lease or lease renewal is verbally made, the operator shall file with the department an accurate written account of the terms of such verbal agreement signed by all parties to such agreement.
(b) Copies of existing provider and purveyor leases shall be submitted to the department together with the application for registration of a shared health facility. Leases or lease renewals executed subsequent to the initial issuance of a facility registration shall be filed with the department within 15 days of execution.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.6 Transition periods and reimbursement
(a) Transition to new methodology.
The reimbursement methodology described in this Subpart will be phased-in over a three-year period, with a year for purposes of the transition period meaning a 12 month period from July 1st to the following June 30th, and with full implementation in the beginning of the fourth year. During this transition period, the base operating rate will transition to the target rate according to the phase-in schedule immediately below. The base operating rate will remain fixed and the target rate, as determined by the reimbursement methodology in this Subpart, will be updated to reflect rebasing of cost data, trend factors and other appropriate adjustments.
| | | Phase-in percentage | | --- | --- | --- | | Transition year | Base operating rate | Target rate | | Year One (July 1, 2014 – June 30, 2015) | 75% | 25% | | Year Two (July 1, 2015 – June 30, 2016) | 50% | 50% | | Year Three (July 1, 2016 - June 30, 2017) | 25% | 75% | | Year Four (July 1, 2017 – June 30, 2018) | 0% | 100% |
(b) Transition from monthly to daily units of service.
Reimbursement for residential habilitation provided in supervised community residences shall be according to a daily unit of service. From the period beginning July 1, 2014 through June 30, 2015, providers that receive reimbursement of residential habilitation in supervised community residences pursuant to this Subpart shall determine and report to the department retainer days, therapeutic leave days and vacant bed days.
(1) Retainer days shall mean days during which an individual is on medical leave from the community residence, or associated days when any other institutional or in-patient Medicaid payment is made for providing services to the individual. For the period beginning July 1, 2014 through June 30, 2015, retainer days shall be reimbursed at zero dollars.
(2) Therapeutic leave days shall mean days during which an individual is away from the community residence and is not receiving services from residential habilitation staff, and the absence is for the purpose of visiting with family or friends, or a vacation. Therapeutic leave days shall be reimbursed at the level described in subdivision (a) of this section.
(3) Vacant bed days shall mean days for which the provider is unable to bill due to a resident moving from one residential site to another, or due to a resident passing away.
At the midpoint of the initial period and again at the conclusion of the period ending June 30, 2015, the department will reconcile the services recorded under the retainer days in order to determine the amount of reimbursement owed to the provider. Providers shall be paid for retainer days at the level described in subdivision (a) of this section. Providers shall not be paid for more than 14 retainer days per annual period for any one individual. Providers will be paid for vacant bed days at 75 percent of the level described in subdivision (a) of this section, up to a maximum of 90 days per bed.
(c) For periods subsequent to June 30, 2015:
(1) The daily rate, as determined pursuant to this Subpart excluding section 86-10.8, will be adjusted to include an occupancy factor. For the period beginning May 1, 2021, the occupancy adjustment will be zero percent.
(2) Retainer days shall be reimbursed at the daily rate as determined pursuant to subparagraph (1) of this paragraph. Such reimbursement shall be limited to 14 days per rate year, multiplied by certain capacity. Effective on or after May 1, 2021, Retainer days will be reimbursed at a rate of 50 percent of the provider’s established rate.
(3) Therapeutic leave days shall be reimbursed per individual at the daily rate as determined pursuant to subparagraph (1) of this paragraph. Effective May 1, 2021, a provider is limited to being paid 96 therapy days per rate year per person. All therapy days will be reimbursed at a rate of 50 percent of the provider’s established rate. The therapy day must be described in the person’s plan of care to be eligible for payment and the person may not receive another Medicaid-funded residential or in-patient service on that day.
(4) Effective May 1, 2021, the methodology will update cost data within four years from the previous rebase utilizing an available and complete CFR. Thereafter, the department will follow a rate cycle utilizing the base period CFR. For years in which the department does not update the base year, the department will update to-from transportation from the CFR and update property using an available and complete CFR.
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.3 Definitions
As used in this Part, the following words and phrases shall have the following meanings:
(a) Individual onsite water supply system means an onsite water system intended to serve a single parcel of land, which is not supplied by a public water supply as defined in Part 5 of this Title.
(b) Individual onsite wastewater treatment system means an onsite facility serving a single parcel of land and treating sewage or other liquid wastes for discharge into the groundwaters of the State.
(c) General waiver means a waiver that exempts any portion of the standards for individual onsite water supply and/or for individual onsite wastewater treatment systems because of unique local conditions.
(d) Specific waiver means a waiver granted in an individual situation because of a hardship or other circumstance that makes it impractical to comply with a standard for individual onsite water supply or for individual onsite wastewater treatment systems.
(e) Local waiver means a waiver that allows the routine use of alternative-type wastewater treatment system(s) by a municipality.
(f) Design professional means a person licensed to practice engineering or architecture in New York State by the State Education Department in accordance with article 145 or article 147 of title VIII of the New York State Education Law, respectively, and who is currently registered with the New York State Education Department.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRENATAL CARE SERVICES PRENATAL CARE SERVICES
10 CRR-NY 85.47 Alternate level of care placement—trial discharge
Trial discharges from an acute care hospital to a specialty rehabilitation hospital or a physical medicine and rehabilitation unit of a general hospital shall be in accordance with subdivisions (a), (c) and (d) of this section. Trial discharges from an acute care hospital to mental health facilities licensed under article 31 of the Mental Hygiene Law or to a residential health care facility (RHCF), licensed under article 28 of the Public Health Law shall be in accordance with subdivisions (b), (c) and (d) of this section.
(a) Hospitals shall receive Medicaid reimbursement at the alternate level of care (ALC) rate as established by section 2807-c of the Public Health Law for patients readmitted to such acute care hospitals from a specialty rehabilitation hospital or physical medicine and rehabilitation unit of a general hospital pursuant to the following requirements:
(1) The initial admission to the acute care hospital complied with the requirements of 18 NYCRR 505.20(b)(7).
(2) The purpose of the trial discharge to the specialty rehabilitation hospital or physical medicine and rehabilitation unit of a general hospital was to evaluate the facility's ability to care for that patient.
(3) The patient's acute care hospital medical record and discharge plan fully documented the reason for the trial discharge as well as the possibility of readmission if the trial discharge was unsuccessful.
(4) The specialty rehabilitation hospital or physical medicine and rehabilitation unit of a general hospital determined, in writing, that the facility does not have the capability to meet the patient's assessed needs.
(5) The patient's readmission to the acute care hospital occurred within 30 calendar days from the date of the original discharge to the receiving facility.
(b) Hospitals shall receive Medicaid reimbursement at the alternate level of care (ALC) rate for patients readmitted to such acute care hospitals from mental health facilities licensed under article 31 of the Mental Hygiene Law or RHCF's licensed under article 28 of the Public Health Law pursuant to the following requirements:
(1) The initial admission to the acute care hospital complied with the requirements of 18 NYCRR 505.20(b)(7).
(2) The patient who was discharged by the acute care facility to a nursing home or mental health facility for the purpose of a trial discharge had a documented history, as evidenced in the patient's hospital record, of alcohol or substance abuse, behavioral problems or psychiatric illness and is under treatment for one of these conditions.
(3) The purpose of the trial discharge to the mental health facility or RHCF was to evaluate the facility's ability to care for the patient.
(4) The patient's acute care hospital medical record and discharge plan fully documented the reason for the trial discharge as well as the possibility of readmission if the trial discharge was unsuccessful.
(5) The written evaluation by the mental health facility or the RHCF determined that the facility does not have the capability to meet the patient's assessed needs.
(6) The patient's readmission to the acute care hospital occurred within 30 calendar days from the date of the original discharge to the RHCF or mental health facility except for RHCF residents who assert their rights under section 415.3(h)(1)(iv) of this Title.
(c) The acute care hospital and the receiving facility shall establish, in writing, mutually acceptable arrangements for the implementation of the patient's trial discharge and possible return including but not limited to responsibility for transferring medical records, transportation of patient, education of patient's family regarding trial discharge process, and notification between facilities if the patient is to be returned to the acute care hospital.
(d) Nothing in this section shall be construed to limit in any manner, patients'or residents' rights as guaranteed to hospital, RHCF, and mental health facility patients and residents by applicable law or regulation.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.9 Local agency violation of the WIC program
(a) A local agency shall be considered in violation of the WIC program if it:
(1) fails to submit to the department, obtain approval for, or fully implement a nutrition education plan;
(2) diverts money budgeted for administrative expenses to nonbudgeted administrative items;
(3) fails to monitor food vendors under contract at a frequency prescribed by the department;
(4) fails to submit reports as required by the department;
(5) fails to contract with a food vendor when directed to do so by the department; or
(6) otherwise does not comply with the terms of its agreement with the department.
(b) When a local agency is found in violation of the WIC program, it may be subject to one or more of the following penalties:
(1) reduction of reimbursement by 1/6 of the administrative budget for failure to fulfill its contractual responsibilities for nutrition education;
(2) reduction of reimbursement for costs of activities which were not authorized under the terms of the agreement with the State agency;
(3) a civil penalty of up to $1,000 per violation, pursuant to section 12 of the Public Health Law;
(4) termination of the agreement with the department; or
(5) any other penalty prescribed by the Public Health Law.
(c) No local agency may be disqualified from participation except on 60 days' written notice of the disqualification.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.196 Embargo
(a) The permit-issuing official or his designated representative may, by written order, place an embargo order on food which he determines or has reason to believe to be contaminated, unfit for human consumption, or from an unapproved source. Such food may not be used, sold, donated, discarded, repackaged or otherwise disposed of until such embargo is lifted by the permit-issuing official, his designated representative, or court of competent jurisdiction. The permit-issuing official shall provide the owner of the food embargoed, or the representative of the owner, an opportunity to be heard within 15 calendar days after the date of order of embargo. The hearing officer, based on the evidence produced at such hearing, will make a recommendation to the permit-issuing official that he vacate the order of embargo or, by written order, direct the embargoed food, or any part of it, to be continued to be held under embargo pending further testing, analysis or court action, to be destroyed, to be denatured and rendered inedible, or to be released for return to a food-processing plant for further processing or to be released to another regulatory agency. The permit-issuing official will consider the hearing officer's recommendation in determining the disposition of the embargoed food. The owner of the food embargoed shall be deemed to have received notice of embargo and hearing at the time the notice of embargo and hearing is delivered to any of his employees or agents.
(b) The permit-issuing official or his designated representative may take representative samples of the suspected food for analysis upon payment of retail value of the sample taken.
Part 16 IONIZING RADIATION
HUMAN USES OF RADIOACTIVE MATERIALS HUMAN USES OF RADIOACTIVE MATERIALS
10 CRR-NY 16.120 Specific licenses for the use of radioactive materials on human beings
An application seeking a specific license for use of radioactive materials on human beings shall be approved if all of the following criteria are satisfied:
(a) The application is completed, signed by an appropriate individual, and submitted to the department.
(b) The applicant is an individual, corporation, partnership or other entity that is legally authorized to do business in New York State. If the applicant is seeking a specific license pursuant to section 16.123 of this Part, the applicant shall be legally authorized to practice medicine in New York State or operate a hospital as defined in section 2801 of the Public Health Law.
(c) The applicant satisfies the requirements set forth in section 16.103 of this Part.
(d) The applicant demonstrates to the satisfaction of the department that it has adequate facilities for clinical care of patients.
(e) The applicant demonstrates to the satisfaction of the department that its facilities will be appropriately equipped and staffed and will be operated as required by this Part.
(f) The applicant provides additional information as requested by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.192 Liability
(a) An amount owing by one person (a debtor) to another (a creditor), payable in money, or in goods or services: the consequence of an asset or service received or a loss incurred or accrued; particularly, any debt (1) due or past due (current liability), (2) due at a specified time in the future ( e.g., funded debt, accrued liability), or (3) due only on failure to perform a future act (deferred income, contingent liability).
(b) The title of the credit half of a balance sheet, often including net worth as well as obligations to outsiders; when thus used, the inference is that the organization reflected in the balance sheet has a status independent of both its creditors and its owners—to whom it must account in the amounts shown.
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.6 Organization and administration
(a) A provider may promote itself as an integrated services provider if the provider has been properly certified by an appropriate State licensing agency, pursuant to this Part.
(b) Governing authority.
(1) The established governing authority shall be legally responsible for the quality of patient care services, for the conduct and obligations of the integrated services provider and for ensuring compliance with all Federal, State and local laws, including the New York State Public Health Law, Mental Hygiene Law, and the Education Law.
(2) In order to achieve and maintain generally accepted standards of professional practice and patient care services, the governing authority shall establish, cause to implement, maintain and, as necessary, revise its practices, policies and procedures for the ongoing evaluation of the services operated or delivered by the integrated services providers and for the identification, assessment and resolution of problems that may develop in the conduct of the program.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.1 Statement of purpose
The purpose of this Subpart is to set forth the methods and procedures governing the availability. location and nature of those records of the New York State Department of Health subject to the provisions of article 6A of the Public Officers Law, known as the Personal Privacy Protection Law. and the rules of the Committee on Open Government.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.6 Hearing
(a) Any time within 30 days of the receipt of a copy of a determination made pursuant to this Part, a person named in such determination as having committed an act of physical abuse, neglect or mistreatment, or as having failed to report such an incident, may request in writing that the commissioner amend or expunge the record of such report, to the extent such report applies to such person, or such written determination.
(b) If the commissioner does not comply with such request within 30 days, such person shall have the right to a fair hearing to determine whether the record of the report or the written determination should be amended or expunged on the grounds that the record is inaccurate or the determination is not supported by the evidence.
(c) The burden of proof in such hearing shall be on the department.
(d) Whenever information is expunged, the commissioner shall notify any official notified pursuant to this Part that the information has been expunged.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.191 Pre-operational review
It is the responsibility of the operator of a food service establishment to construct, equip, furnish, maintain and operate the food service establishment under his control in compliance with the requirements of this Subpart and other applicable laws, rules and regulations. Prior to constructing, major renovation, or commencing operation of a food service establishment, the permit-issuing official may require all food service establishments under his control to submit sketches or plans showing the floor layout, equipment, plumbing, ventilation, refuse storage facilities, sewage disposal facilities and similar information. Submission and review of plans does not relieve the operator of a food service establishment or his successor from meeting all requirements of this Subpart.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.23 General requirements
(a) Care of suits and towels.
All bathing suits and towels furnished or rented shall be washed with a detergent in hot water, rinsed and thoroughly dried after each use.
(b) Posting regulations.
Signs stating the following shall be posted conspicuously at the spray pad or enclosure/entrance and in the dressing rooms of all spray grounds:
(1) the hours that a spray pad is open;
(2) that spray pad use is prohibited at any other time;
(3) individuals with diarrhea shall not use the spray pad;
(4) spray features use recirculated water, do not drink;
(5) children who are not toilet trained must wear a swim diaper covered by rubber pants;
(6) no animals on or near spray pad; and
(7) pollution of the spray pad area is prohibited. Urinating, discharge of fecal matter, expectorating or blowing the nose in any spray pad is prohibited.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.64 Operational evaluation levels
(a) If a system exceeds the operational evaluation level at any monitoring location when the sum of the two previous quarters’ TTHM results plus twice the current quarter’s TTHM result, divided by 4 to determine the average, exceeds 0.080 mg/L, or when the sum of the two previous quarters’ HAA5 results plus twice the current quarter’s HAA5 result, divided by 4 to determine the average, exceeds 0.060 mg/L.
(b) If a system exceeds the operational evaluation level, it shall conduct an operational evaluation and submit a written report of the evaluation to the State no later than 90 days after being notified of the analytical result that caused the exceedance of the operational evaluation level. The written report shall be made available to the public upon request.
(c) The operational evaluation shall include an examination of the operational practices for system treatment(s) and the distribution system, including storage tank operations, excess storage capacity, distribution system flushing, changes in sources or source water quality, and treatment changes or problems that may contribute to TTHM and HAA5 formation and what steps could be considered to minimize future exceedances.
(1) A system may request, and the State may allow, limiting the scope of the evaluation if the system is able to identify the cause of the operational evaluation level exceedance.
(2) The request to limit the scope of the evaluation does not extend the schedule in subdivision (b) of this section for submitting the written report. The State shall approve this limited scope of evaluation in writing, and the system shall keep that approval with the completed report.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.2 Financial and statistical data required
(a) Each medical facility shall complete and file with the department and/or its agent annual financial and statistical report forms supplied by the department and/or its agent. Medical facilities certified for title XVIII (Medicare) shall use the same fiscal year for title XIX (Medicaid) and title B (children's bureau programs) as is used for title XVIII. All other medical facilities must report their operations on a calendar-year basis.
(b) Financial and statistical reports required by this Subpart shall be submitted to the department and/or its agent no later than five months following the close of the fiscal period. Extensions of time for filing reports may be granted by the commissioner upon application received prior to the due date of the report only in those circumstances where the medical facility establishes, by documentary evidence, that the reports cannot be filed by the due date for reasons beyond the control of the facility.
(c) In the event a medical facility fails to file the required financial and statistical reports on or before the due dates, or as the same may be extended pursuant to subdivision (b) or (e) of this section, or fails to comply with the provisions of subdivision (k) of this section, the commissioner shall reduce the current rate paid by State governmental agencies by two percent for a period beginning on the first day of the calendar month following the original due date of the required reports and continuing until the last day of the calendar month in which the required reports are filed.
(d) In the event that any information or data which a facility has submitted to the department on required reports, budgets or appeals for rate revisions intended for use in establishing rates is inaccurate or incorrect, whether by reason of subsequent events or otherwise, such facility shall forthwith submit to the department a correction of such information or data which meets the same certification requirements as the document being corrected.
(e) If the financial and statistical reports required by this Subpart are determined by the department or its agent to be incomplete, inaccurate or incorrect, the facility will have 30 days from date of receipt of notification to provide the corrected or additional data. Failure to file the corrected or additional data within 30 days, or within such period as extended by the commissioner, will result in application of subdivision (c) of this section.
(f) Specific additional data related to the rate setting process may be requested by the commissioner. These data, which may include but are not limited to, those for use in a wage geographic differential survey, a peer grouping data survey, a medical supplies survey, a malpractice insurance survey, a graduate medical education survey and a quarterly utilization survey, must be provided by the medical facility within 30 days from the date of receipt of notification to supply such information. The commissioner must supply to each facility, prior to the start of each rate period, a preliminary listing of the data that will be required. Failure to submit the additional data shall result in application of the provisions of subdivision (c) of this section, unless the medical facility can prove by documentary evidence that the data being requested is not available.
(g) General hospitals shall submit to the commissioner at least 120 days prior to the commencement of each revenue cap year, a schedule of anticipated capital-related inpatient expenses for the forthcoming year pursuant to the provisions of section 86-1.25 of this Subpart.
(h) General hospitals with exempt psychiatric units shall submit hospital data regarding patients in such units as required by the Office of Mental Health (see 14 NYCRR Part 580).
(i) Each medical facility shall file with the department a complete copy of the Department of the Treasury, Internal Revenue Service Form 990, for that facility. The Form 990 shall be submitted to the department no later than 30 days following the annual filing with the Internal Revenue Service. Failure to submit the Form 990 shall result in application of the provisions of subdivision (c) of this section.
(j) Generally accepted accounting principles.
The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the medical facility, unless the reporting instructions authorize specific variation in such principles.
(k) Accountant's certification.
With regard to institutional cost reports filed for report years prior to 2010, the institutional cost report shall be certified by an independent licensed public accountant or an independent certified public accountant. The minimum standard for the term independent shall be the standard used by the State Board of Public Accountancy.
(l) Certification by operator, officer or official.
(1) The institutional cost report shall be certified by the operator of a proprietary medical facility, an officer of a voluntary medical facility, or the public official responsible for the operation of a public medical facility.
(2) The form of the certification required in paragraph (1) of this subdivision shall be as prescribed in the annual fiscal and statistical report forms provided by the commissioner.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.5 Personnel, supervision and camp safety plan
(a) Each children's camp shall have a camp director, who may also be the camp operator, responsible for supervising the camp program. Minimum qualifications shall be:
(1) bachelor's degree, or at least 25 years of age for an overnight camp and 21 years for a summer day or traveling summer day camp;
(2) at least 24 weeks of previous administrative or supervisory experience in camping or equivalent experience acceptable to the State Commissioner of Health;
(3) a notification from the Department of Social Services State Central Register of Abuse and Maltreatment that the director has not been subject of an investigation report; and
(4) the submission of a form entitled Prospective Children's Camp Director Certified Statement Relative to the Conviction of a Crime or the Existence of a Pending Criminal Action, as developed by the commissioner, and a determination by the local permit-issuing official that the camp director has no criminal conviction record for which:
(i) there is a direct relationship between one or more of the criminal offenses and the applicant's employment as a camp director; and
(ii) employment as a camp director would involve an unreasonable risk to the property or to the safety or welfare of camp participants or the general public.
(b) Counselors shall be at least 18 years of age at a children's overnight camp, and at least 16 years of age at a summer day or traveling summer day camp, and may include both specialty and general counselors. In addition, the counselor shall either have experience in camping and supervision of children, or have completed a training course acceptable to the permit-issuing official. It shall be the responsibility of the camp operator to verify a prospective counselor's background and character through reasonable and diligent inquiries, including but not limited to character references submitted.
(1) During passive activities the ratio of counselors to campers shall be no greater than 1:25. A passive activity is defined as an activity which takes place in a defined area, where participants are spectators or have limited mobility and use no tools or equipment (other than computers). Examples of passive activities include but are not limited to: religious instruction, storytelling, coloring, viewing movies or drama, singing and board games. The camp's passive activities must be described in the camp's approved safety plan. Supervision ratios must be reinstated to the code required level at the conclusion of the passive activity.
(c) At an overnight camp, unless specified otherwise in section 7-2.11 of this Subpart for specialty activities and trips, the ratio of counselors to children eight years of age and over shall be 1:10; for children younger than eight years of age, the ratio shall be 1:8; a maximum of 20 percent of the total required counselors may be 17 years of age.
(1) During the hours campers are resting or sleeping, the supervision ratio may be modified based on the arrangement, size, and location of the sleeping area(s) and potential for visual and/or verbal supervision, to a level accepted by the permit-issuing official and described in the camp's approved safety plan; provided in all circumstances that:
(i) supervision is adequate to protect the campers from any unreasonable risk to their health or safety; and
(ii) at least one counselor is present on every level used for resting or sleeping in a multi- story building. Supervision ratios must be reinstated to the code required level at the conclusion of the resting or sleeping period.
(d) At a summer day or traveling summer day camp, the general ratio of counselors to children shall be 1:12. Counselor-to-camper ratios as indicated in section 7-2.11 of this Subpart for specialty activities and trips must be met at all times during such specialty activities. The permit-issuing official may be more restrictive in specifying counselor-to-camper ratios if such official deems it reasonable and necessary for camper safety.
(e) Camp aquatics director.
A camp aquatics director shall oversee all swimming activities that occur at swimming pools and bathing beaches operated as part of a children's camp. This person shall supervise lifeguards, progressive swimming instructors, and counselors with bather supervision responsibilities during swimming activities; and implement the camp safety plan. The camp aquatics director shall:
(1) be at least 21 years of age;
(2) have a minimum of:
(i) one season of previous experience as a camp aquatics director at a New York State children's camp; or
(ii) two seasons of previous experience consisting cumulatively of at least 12 weeks as a children's camp lifeguard, as specified in subdivision (g) of this section, at a swimming pool or bathing beach which had more than one lifeguard supervising it at a time; or
(iii) at least 18 weeks of previous experience as a lifeguard, as specified in paragraph (g)(2) of this section, at a swimming pool or bathing beach which had more than one lifeguard supervising it at a time;
(3) effective until December 31, 2011 possess current certification:
(i) as a progressive swimming instructor, as defined in subdivision (f) of this section; or
(ii) as a qualified lifeguard, as defined in subdivision (g) of this section, possessing lifeguard certification specific to the type of bathing facility at the children's camp; or
(iii) in a training course for lifeguard supervision and management that meets the requirements specified in section 6-1.31(e) or 6-2.20(e) of this Title;
(4) effective January 1, 2012 have successfully completed a training course in lifeguard supervision and management that meets the requirements specified in section 6-1.31(e) or 6-2.20(e) of this Title;
(5) have annually reviewed and documented the review of the camp's safety plan for swimming; and
(6) possess a current certificate in an acceptable cardiopulmonary resuscitation (CPR) training program as defined in section 7-2.2(n) of this Subpart.
(f) Progressive swimming instructor.
As described in the camp's approved safety plan, a progressive swimming instructor must assess the swimming ability of each camper prior to allowing the child to participate in aquatic activities. A progressive swimming instructor must be either:
(1) a water safety instructor currently certified by the ARC; or
(2) possess a current certificate issued by a certifying agency determined by the State Commissioner of Health to provide an adequate level of similar training.
(g) Qualified lifeguard.
Qualified lifeguards shall actively supervise participants in the camp's aquatic activities, as detailed in the camp's approved safety plan. While on duty at the waterfront, qualified lifeguards shall not be engaged in duties or activities which distract them from the direct supervision of the waterfront. A qualified lifeguard shall:
(1) be at least 17 years of age, except:
(i) for a maximum of 50 percent of the required total number of lifeguards on-duty who may be at least 16 years of age; and
(ii) lifeguards required for wilderness swimming who must be at least 18 years of age; and
(2) meet lifeguarding, first aid and CPR certification requirements as detailed in Part 6 of this Title:
| Bathing facility type | Minimum lifeguard supervision level | | --- | --- | | | | | Ocean Surf | Supervision Level I | | Pool Only | Supervision Level IIa | | Pool and/or Beach | Supervision Level IIb |
(h) Trip leader.
A trip leader shall be at least 18 years of age and have participated in at least three camp trips in a similar program activity as a children's camp staff member or have experience and training in the activity which the permit-issuing official has determined to be equivalent to three camp trips. Trip leaders for wilderness, equestrian, boating and similar specialized activities shall be competent in the activity. A trip leader of a camp trip with an itinerary that includes an activity where emergency medical care is not readily available and/or an activity such as wilderness hiking, camping, rock climbing, horseback riding, bicycling, swimming and/or boating, shall possess or be accompanied by staff who possesses a current certificate in an acceptable first aid training program as defined in section 7-2.2(m) of this Subpart, and a current certificate in an acceptable cardiopulmonary resuscitation (CPR) training program as defined in section 7-2.2(n) of this Subpart.
(i) Activity leader.
An activity leader shall be competent in the activity being conducted. Activity leaders of an activity that includes wilderness hiking, camping, rock climbing, horseback riding, bicycling, swimming and/or boating shall be at least 18 years of age. When a camp activity is conducted at a location where the camp staff certified in first aid and CPR in accordance with section 7-2.8(a) of this Subpart are not readily available, an activity leader shall possess or be accompanied by staff who possesses a current certificate in an acceptable first aid training program as defined in section 7-2.2(m) of this Subpart, and a current certificate in an acceptable cardiopulmonary resuscitation (CPR) training program as defined in section 7-2.2(n) of this Subpart.
(j) Riflery instructors shall have a current instructor's certificate issued by the National Rifle Association or its equivalent generally accepted as providing a similar or equivalent level of riflery skill.
(k) Counselor-in-training (CIT).
A CIT or junior counselor is a camper who is assigned to an on-duty counselor or other staff member to assist, as described in the camp's approved safety plan, in performing specific duties. A CIT may not independently supervise campers, and shall be supervised as a camper. All CITs shall receive training specific to their duties, and camper orientation. A maximum of 10 percent of the total number of counselors required by subdivisions (b) and (d) of this section may be CITs, provided:
(1) CITs at a children's overnight camp are at least 16 years of age and have at least two seasons' prior experience as a camper; and
(2) CITs at a summer day or traveling summer day camp are at least 15 years of age and have at least two seasons' prior experience as a camper.
(l) Records identifying staff qualifications shall be maintained in the camp for inspection by the permit-issuing official or his designated representative. The camp operator shall ascertain whether an employee or volunteer is listed on the New York State Division of Criminal Justice Services (DCJS) Sex Offender Registry prior to the day such employee or volunteer commences work at camp and annually thereafter prior to their arrival at camp. A written record of the employee and volunteer names that were submitted to the DCJS for checking against the Sex Offender Registry and DCJS’s search results shall be kept on file at the site and made available to the permit-issuing official upon request.
(m) No individual known to be a carrier of a communicable disease shall be employed at a children's camp.
(n) Camp safety plan.
The camp operator must develop, review annually and update, as required, a camp safety plan, which shall be submitted for review and approval to the permit-issuing official as described in section 7-2.4(c)(1) of this Subpart. A camp safety plan shall be considered satisfactory for approval when it is found to include all the information required in this section and accurately reflects the children's camp's compliance with this Subpart. The camp's approved safety plan shall be implemented by the camp operator and kept on file at the children's camp. The camp safety plan shall consist of, at a minimum, a table of contents and the following components:
(1) personnel: chain of command; staff job descriptions; and a procedure for verification of staff qualifications;
(2) facility operation and maintenance: water supply; sewage treatment system; lightning risk assessment; transportation; housing; grounds; food protection; and waterfront physical facility maintenance (if on-site aquatic activities are provided);
(3) fire safety: evacuation of buildings and property, assembly, supervision, and accounting for campers and staff; fire prevention; coordination with local fire officials; fire alarm and detection systems and their operation, maintenance, and routine testing; type, location and maintenance of fire extinguishers; inspection and maintenance of exits; required fire drills and log; electrical safety; and reporting to the permit-issuing official within 24 hours fires which destroy or damage any camp building, or which result in notification of the fire department, or are life or health threatening. A copy of this segment of the approved camp safety plan must be submitted to the local fire district or department;
(4) medical requirements: review of camper confidential medical histories to address restrictions and special needs; initial health screening of campers; daily health surveillance of campers; procedures for providing basic first aid, handling medical emergencies, including outbreaks and procedures for response to allegations of child abuse; identification of and provisions for medical, nursing and emergency medical services; identity, qualifications and outline of duties of health director and health personnel certified in first aid and CPR; description of health center; storage and administration of medicines; location and use of first aid and CPR supplies; maintenance of a medical log; description of universal precautions for bloodborne pathogens; reporting of illness and injuries, including camper abuse/allegations to the permit-issuing official within 24 hours; and provisions to supervise sanitation at the children's camp;
(5) general and activity specific safety: description of the required camper supervision, including general supervision, between activities, for passive activities, during sleeping and rest hours, transportation and for emergencies. Safety requirements and supervision must be discussed for specific camper activities, including but not limited to, swimming, boating, horseback riding, rope or challenge courses, archery, riflery, camp trips, wilderness activities and any activity in which incidental water immersion occurs;
(6) staff training: training curriculum outline; tour of camp; description of camp hazards; chain of command; procedures for camper supervision and discipline; child abuse recognition and reporting; provisions for first aid and emergency medical assistance; reporting of camper injury and illness; buddy system; lost swimmer plan (if camp has an aquatics program); lost camper plan; lightning plan; fire safety and fire drills; camp evacuation procedures; activity specific training for assigned activities; camp trips (if provided); and process to document training attendance; and
(7) camper orientation: orientation curriculum outline; tour of camps; description of camp hazards; reporting illness, injury and other incidents; buddy system; lost camper plan; fire drills and evacuation; lightning plan; camp trips; and process to document orientation attendance.
(o) The camp operator shall provide adequate supervision. Adequate supervision shall mean:
(1) supervision such that a camper is protected from any unreasonable risk to his or her health or safety, including physical or sexual abuse or any public health hazard; and
(2) as a minimum, there shall exist visual or verbal communications capabilities between camper and counselor during activities and a method of accounting for the camper's whereabouts at all times.
(p) The camp operator shall provide, with any enrollment application forms and/or enrollment contract forms mailed or delivered to a person for purposes of enrollment of a child for any children's camp, a written statement and/or brochure outlining the rights and responsibilities of campers and camp operators and declaring:
(1) that such camp is required to be permitted to operate by the New York State Department of Health;
(2) that such camp is required to be inspected twice yearly; and
(3) the address where inspection reports concerning such camps are filed.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.22 Statewide perinatal data system
(a) All hospitals and freestanding birthing centers which provide care and services to parturient women and/or neonates shall participate in the statewide perinatal data system by providing required information in accordance with this section. Facilities contributing data to the system may only access data from the system in accordance with this section and other applicable laws and regulations.
(b) As used in this section the following terms shall have the following meanings:
(1) The statewide perinatal data system (SPDS) shall mean the electronic maternal and newborn data collection and analysis system established and maintained by the Department of Health which includes the data elements, organized in modules, which comprise the New York State certificate of live birth for births occurring in New York State outside of New York City, or the New York City certificate of live birth for births occurring in New York City, and other data elements which relate to maternal and newborn health and care in hospitals and free-standing birthing centers.
(2) The core module shall be the New York State certificate of live birth, a data set consisting of elements specified by the Commissioner of Health and collected for all parturient women and newborns in New York State outside of New York City; and for births occurring in New York City, the core module shall be the New York City certificate of live birth, a data set consisting of elements specified by the New York City Commissioner of Health and Mental Hygiene and collected for all parturient women and newborns in New York City.
(3) The supplemental module shall mean a set of data supplied by the patient consisting of data elements specified by the Commissioner of Health in consultation with the Commissioner of the New York City Department of Health and Mental Hygiene. Supplemental module data elements shall be related to quality of prenatal care and maternal factors that may be related to birth outcomes.
(4) The high risk obstetric module shall mean a data set consisting of data elements that provide clinically-relevant information on pregnant women who are referred to obstetricians for specialty care in the antepartum period or who are transported to a higher level facility for delivery or care in the antepartum, intrapartum or postpartum period. Elements will be as specified by the Commissioner of Health in consultation with the Commissioner of the New York City Department of Health and Mental Hygiene concerning all pregnant women identified as having high risk pregnancies, inclusive of maternal transports to higher levels of care. The data elements shall supplement core module data, providing additional data on clinical risk status and interventions for high risk births.
(5) The high risk neonatal module (NICU module) shall mean a data set consisting of data elements that provide clinically-relevant information on the neonate at the time of entry to the neonatal intensive care unit. The elements will be as specified by the Commissioner of Health in consultation with the Commissioner of the New York City Department of Health and Mental Hygiene and data will be collected on all neonates entering all special care and intensive care nurseries for longer than four hours. The high risk neonatal module shall also include information on all newborns who die in the delivery room, in transit to the neonatal special or intensive care unit, and in the neonatal special or intensive care units. The data elements shall supplement core module data, providing additional data on clinical risk status and interventions for high risk newborns.
(6) The newborn Medicaid eligibility module shall consist of the Medicaid client identification number (CIN) and other Medicaid-specific information as specified by the Commissioner of Health, and shall be available solely to authorized Office of Medicaid Management staff and departmental staff authorized to help maintain the SPDS files and the programming required thereby.
(7) De-identified patient data shall mean data from which individual patient names have been expunged and other identifiers have been modified so that there is no reasonable basis to believe that individual patients can be identified by using such data except by the facility which provided the patient care and services.
(8) Quality improvement shall mean any use or analysis of SPDS data that identifies for further investigation any poor outcomes potentially amenable to intervention (sentinel events), trends by hospital, hospital level or region, potential problem areas or any issues with quality of care; and further, may lead to improvement of the care provided by the regional perinatal center, its affiliate hospitals or regional perinatal system providers through development of initiatives designed to address the potential problems identified, or to improve the quality of the data collected via the SPDS.
(9) Target area for a community-based organization under contract to the New York State Department of Health shall mean the organization's specified area of operation and/or influence as noted in their current contract.
(c) Participation in the statewide perinatal data system (SPDS).
(1) All hospitals and freestanding birthing centers that provide perinatal health care services shall participate in the statewide perinatal data system. All live births shall be entered into the state perinatal data system. For births occurring in New York City, the core module shall be implemented on January 1, 2007.
(2) Each hospital and freestanding birthing center shall submit core module data to the agency responsible for collecting birth records. In addition, all hospitals shall submit data from the supplemental module, the high risk obstetric module, and the Medicaid eligibility module, and, if the hospital has a neonatal special or intensive care unit, from the high risk neonatal module as well, to the department in a form and manner prescribed by the department. The hospital shall be responsible for retaining signed consent forms, if any, for at least six years. The hospital will only transmit data as required under the regulations and any additional data for which it has consent, when consent is needed. Data elements in the system shall address the following:
(i) mother's Medicaid information to be used only to determine newborns' Medicaid eligibility;
(ii) public health surveillance of birth outcomes; and
(iii) improvement of prenatal, obstetric, and newborn care for mothers and infants.
(3) New York City Department of Health and Mental Hygiene will continue to exercise oversight of the use and release of the New York City birth certificate and the information contained therein. Nothing contained herein shall abridge the authority of the New York City Department of Health and Mental Hygiene to maintain the New York City Vital Records System. Nothing contained herein shall abridge the authority of the New York State Department of Health to maintain the New York Vital Records System outside of New York City.
(4) Access to SPDS data shall be limited to staff authorized by the Department of Health, and in the case of core module data for births occurring in hospitals and freestanding birthing centers located in New York City, staff authorized by the New York City Department of Health and Mental Hygiene, in the following settings for the purposes specified. Identifying SPDS information may be disclosed to authorized staff when and to the extent the disclosure is consistent with the Public Health Law, and for core module data from New York City consistent with applicable New York City law and regulations, and necessary to conform to an identified requirement of the Public Health Law or one of its implementing regulations and when that disclosure is not otherwise prohibited or restricted by or inconsistent with the Public Health Law or its implementing regulations.
(i) Authorized staff of a facility shall have access to data submitted to the SPDS by that facility, with the exclusion of the Medicaid eligibility module; use of data shall conform with facility policies regarding use of confidential data.
(ii) A regional perinatal center shall have access to de-identified data submitted to the SPDS by its perinatal affiliates, with the exclusion of the Medicaid eligibility module, with a unique identifier that can be linked to identifying information only by the originating hospital for reference in evaluation of patient outcomes as specified in section 721.9 of this Title. De-identified data may also be used to monitor regional trends.
(iii) A comprehensive prenatal/perinatal services network or other community-based organization under contract to the Department of Health may be given access to available selected aggregate core and supplemental module data about births within its target area with all patient and provider identifiers eliminated. The level of aggregation and/or the geographic area targeted must ensure that no patients or providers are able to be identified from the data provided. Data shall be used only in furtherance of the organization's role in assessing and improving perinatal health in their target area, as specified in their contract with the department.
(iv) Staff authorized by the Department of Health shall have access to individual-level perinatal data system data reported by hospitals and freestanding birthing centers except in the case of core module data for births occurring in hospitals and freestanding birthing centers located in New York City, where staff access to core module data will be authorized by the New York City Department of Health and Mental Hygiene. For births occurring in hospitals and freestanding birthing centers located in New York City, SPDS data, including core and supplemental modules, shall be available to the New York City Department of Health and Mental Hygiene.
(v) Regional perinatal centers, affiliate hospitals and freestanding birthing centers with access to the data in the statewide perinatal data system (SPDS) shall not use the data for purposes other than quality improvement as defined in these regulations. SPDS data is confidential and must be appropriately secured by the regional perinatal centers, affiliate hospitals and freestanding birthing centers and shall not be redisclosed, except to the department or its authorized agents or contractors.
(d) The commissioner shall waive for up to one year, upon request from the New York City Department of Health and Mental Hygiene on behalf of the facilities located within that vital records registration district, the data collection requirements of this section under the following circumstances:
(1) An application for a waiver must be submitted that:
(i) is received at least three months before the effective date of the SPDS in the registration district;
(ii) identifies the financial, administrative or other hardship which necessitates the request;
(iii) describes the measures to be taken to eliminate the hardship and the anticipated completion date of those measures; and
(iv) assures continued access by hospitals to data comparable to that required in this section prior to implementation of SPDS.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.9 Appeals of denial of access to records
(a) Except as provided for in section 50-1.8 of this Subpart, any person who has been denied access to records by the records access officer may appeal such denial in writing within 30 days to the records access appeals officer.
(b) The time for deciding on an appeal by the records access appeals officer shall commence upon receipt of the written appeal, which shall identify:
(1) the date and location of request for records;
(2) the records to which the requester was denied access; and
(3) the name and return address of the requester.
(c) The records access appeals officer shall, on receipt, forward a copy of the appeal to the Committee on Open Government and within 10 business days review the matter and affirm, modify or reverse the denial.
(d) If the records access appeals officer determines that the denial of access was erroneous, he/she shall instruct the records access officer to allow prompt inspection or copying of the record as requested.
(e) If the records access appeals officer affirms or modifies the denial, he/she shall communicate the determination and reasons in writing to the person making the appeal and inform such person of the right of judicial appeal with a copy to the Committee on Open Government.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-3 PROHIBITION ON THE SALE OF ELECTRONIC LIQUIDS WITH CHARACTERIZING FLAVORS
10 CRR-NY 9-3.2 Possession, manufacture, distribution, sale or offer of sale of flavored e-liquid prohibited
It shall be unlawful for any individual or entity to possess, manufacture, distribute, sell or offer for sale any flavored e-liquid or product containing the same.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.196 Embargo
(a) The permit-issuing official or his designated representative may, by written order, place an embargo order on food which he determines or has reason to believe to be contaminated, unfit for human consumption, or from an unapproved source. Such food may not be used, sold, donated, discarded, repackaged or otherwise disposed of until such embargo is lifted by the permit-issuing official, his designated representative, or court of competent jurisdiction. The permit-issuing official shall provide the owner of the food embargoed, or the representative of the owner, an opportunity to be heard within 15 calendar days after the date of the order of embargo. The hearing officer, based on the evidence produced at such hearing, will make a recommendation to the permit-issuing official that he may vacate the order of embargo, or may, by written order, direct the embargoed food, or any part of it, (1) to be continued to be held under embargo pending further testing, analysis or court action, (2) to be destroyed, (3) to be denatured and rendered inedible, (4) to be released for return to a food processing plant for further processing, (5) to be released to another regulatory agency, or (6) to other appropriate action. The permit-issuing official will consider the hearing officer's recommendation in determining the disposition of the embargoed food. The owner of the food embargoed shall be deemed to have received notice of embargo and hearing at the time the notice of embargo and hearing is delivered to any of his employees or agents.
(b) The permit-issuing official or his designated representative may take representative samples of the suspected food for analysis upon payment of the retail value of the sample taken.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.2 Accounting entity
[ 1110 ] A fundamental reporting concept is that of the accounting entity or unit. For reporting purposes, the hospital is presumed to be an entity capable of buying, selling and taking other economic actions which are to be accounted for separately from the personal affairs of those responsible for the hospital's administration. The hospital itself is the primary unit for which the accounting records are maintained. However, most departments of the hospital usually assume sufficient importance to require separate treatment as subordinate entities or units of accountability for planning and control purposes.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 120 HERKIMER COUNTY
VILLAGES VILLAGES
10 CRR-NY 120.6 Village of Middleville
(a) Privies adjacent to reservoirs, springs or watercourses.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse of any kind, the water of which when running flows eventually into a reservoir of the Middleville public water supply.
(2) No privy, vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or within 130 feet, horizontal measurement, of the high-water make or precipitous bank of any spring, stream, ditch or watercourse as aforesaid.
(3) Every privy or place for the deposit of human excreta, which is constructed, located or maintained between the aforesaid limits of 50 and 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir or 50 and 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse as aforesaid and from which the said excrement is not at once removed automatically by means of suitable watertight pipes or conduits to some place of disposal beyond the maximum aforesaid limits, shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limits.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or floor of said privy.
(5) The excreta so collected shall be removed so as to cause the least nuisance possible and shall be so disposed of that they cannot be washed either over the surface or through the subsoil into any reservoir, spring, stream, ditch or watercourse of any kind as aforesaid and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into a reservoir or any spring, stream, ditch or watercourse aforesaid without having been thereby, in the judgment of the State Department of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Department of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which milk cans, clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into a reservoir or into any spring, stream, ditch or watercourse aforesaid nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into the reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement, or into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No clothing, animals, vehicles nor anything which pollutes water shall be washed, nor shall any person bathe in any reservoir, spring, stream, ditch or watercourse aforesaid.
(3) No garbage or putrescible refuse of any kind shall be thrown or discharged directly into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall any such substances be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through the earth for a distance of at least 50 feet, horizontal measurement, to the high-water mark or precipitous bank of any reservoir or of any spring, stream, ditch or watercourse flowing into any reservoir placed upon or below the surface of the ground where they may be washed into any spring, reservoir, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark or precipitous bank thereof.
(c) Manure, composts and similar matter.
(1) No stable, pigsty, henhouse, barnyard, hog or duckyard, hitching or standing place for cattle or horses or other place where animal manure accumulates and no compost or manure heap shall be located or maintained within 100 feet of nor shall they or any watering place for horses, cattle or other animals be so arranged that the polluted drainings therefrom shall be thrown or discharged upon the surface of the ground at any point within 250 feet of any such reservoir, spring, stream, ditch or watercourse aforesaid; nor shall any such polluted liquid be discharged into the ground below the surface in any manner whereby the same may flow into any reservoir, spring, stream, ditch or watercourse aforesaid without percolating through earth for a distance of at least 50 feet, horizontal measurement, nor flow into or through open or covered drains within 50 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark or precipitous bank of a reservoir or within 130 feet of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse aforesaid, and no manures or composts of any kind shall be deposited so that they may be washed at less distance than 250 feet over the surface of the ground or 50 feet through subsoil into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone purification.
(d) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substance nor any waste products, putrescible matter or polluted waters from any slaughterhouse, dairy, creamery, cider mill, sawmill or other manufactory shall be thrown or allowed to run into any reservoir, spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface less than 250 feet or through the subsoil less than 50 feet into any reservoir, spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Cemeteries.
No interment of a human body shall be made within 500 feet of the high-water mark or precipitous bank of any reservoir, spring, stream, ditch or watercourse aforesaid.
(f) Management of the reservoirs.
(1) The reservoirs of the Middleville public water supply shall not be unnecessarily drawn down during the warm months, but shall be kept as deep and as nearly a uniform level as possible, to prevent the pollution of the water with dead organic matter.
(2) No filter or screen shall be used when in a filthy condition and liable to pollute the water in the mains; and no filter or screen shall be used at the head of the main which cannot be constantly examined and cleaned.
(g) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, a penalty of $50 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above-given mandatory rules, to be recovered under the said act.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.15 Definitions
As used in this Subpart, the following definitions shall apply:
(a) Diagnosis related groups (DRGs) shall mean the all-patient-refined (APR) classification system which utilizes diagnostic related groups with assigned weights that incorporate differing levels of severity of a patient's condition and the associated risk of mortality, and reflects such factors as the patient's medical diagnosis, severity level, sex, age, and procedures performed.
(b) DRG case-based payment per discharge shall mean the payment to be received by a hospital for all inpatient services, except for physician services, rendered to each patient based on the DRG to which that patient has been assigned, as determined by multiplying the statewide base price by the applicable service intensity weight (SIW) and facility-specific wage equalization factor (WEF) and as further adjusted for teaching hospitals by the inclusion of reimbursement for direct and indirect graduate medical education (GME) costs and for all hospitals, the inclusion of non-comparable costs.
(c) Service intensity weights (SIWs) are the cost weights established such that the SIW for any given DRG indicates the relative cost of the average cost of the patient in the DRG as compared to the average cost of all patients in all DRGs. Weights are developed using cost data from Medicaid fee-for-service, Medicaid managed care and commercial payors as reported to the Statewide Planning and Research Cooperative System (SPARCS).
(d) Case mix index (CMI) shall mean the relative costliness of a hospital's case mix relative to the case mix of all other hospitals as reflected in the weighted aggregate SIW for the hospital.
(e) Reimbursable operating costs shall mean reported operating costs which relate to the cost of providing inpatient hospital services to Medicaid patients, adjusted for inflation between the base period used to determine the statewide base price and the rate period in accordance with trend factors determined pursuant to the applicable provisions of section 2807-c(10) of the Public Health Law, but excluding the following costs:
(1) ALC costs;
(2) exempt unit costs;
(3) transfer costs; and
(4) high-cost outlier costs.
(f) Graduate medical education (GME).
(1) Direct GME costs shall mean the reimbursable salaries, fringe benefits, non-salary costs and allocated overhead for residents, fellows, and supervising physicians trended to the rate year by the applicable provisions of section 2807-c(10) of the Public Health Law.
(2) Indirect GME costs shall mean an estimate of the costs associated with additional ancillary intensiveness of medical care, more aggressive treatment regimens, and increased availability of state-of-the-art testing technologies resulting from the training of residents and fellows.
(g) High-cost outlier costs for payment purposes shall mean 100 percent of the hospital's charges converted to cost, using the hospital's most recent ratio of cost-to-charges that exceed the DRG specific high-cost thresholds calculated pursuant to section 86-1.21 of this Subpart.
(h) Alternate level of care (ALC) services shall mean those services provided by a hospital to a patient for whom it has been determined that inpatient hospital services are not medically necessary, but that post-hospital extended care services are medically necessary, consistent with utilization review standards, and are being provided by the hospital and are not otherwise available.
(i) Exempt hospitals and units shall mean those hospitals and units that are paid per diem rates of payment pursuant to the provisions of section 86-1.23 of this Subpart, rather than receiving per discharge case-based rates of payment.
(j) The wage equalization factor (WEF) shall mean the mechanism to equalize hospital salary and fringe benefit costs to account for the differences in the price of labor among hospitals and groups of hospitals.
(k) Statewide base price shall mean the numeric value calculated pursuant to section 86-1.16 of this Subpart which shall be used to calculate DRG case-based payments per discharge as defined in subdivision (b) of this section.
(l) Non-comparable adjustments shall mean those base year costs that are passed through the statewide base price calculation and applied to the case-based rate of payment as an add-on payment. The following shall be considered non-comparable adjustments:
(1) Medicaid costs associated with ambulance services operated by a facility and reported as inpatient costs in the institutional cost report. Effective October 1, 2020, these costs shall exclude ground emergency transportation services costs that are being reimbursed pursuant to chapter 56 of the Laws of 2020; and
(2) Medicaid costs associated with hospital-based physicians at hospitals designated under the Medicare program as meeting the criteria set forth in section 1861(b)(7) of the Federal Social Security Act; and
(3) Medicaid costs associated with schools of nursing operated by the facility and reported as inpatient costs in the institutional cost report.
(m) Transfers.
For purposes of transfer per diem payments, a transfer patient shall mean a patient who is not discharged as defined in this section, is not transferred among two or more divisions of merged or consolidated facilities, is not assigned to a DRG specifically identified as a DRG for transferred patients only, and meets one of the following conditions:
(1) is transferred from an acute care facility reimbursed under the DRG case-based payment system to another acute care facility reimbursed under this system; or
(2) is transferred to an out-of-state acute care facility; or
(3) is a neonate who is being transferred to an exempt hospital for neonatal services.
(n) Discharges , as used in this Subpart, shall mean those inpatients whose admission to the facility occurred on or after December 1, 2009, and:
(1) the patient is released from the facility to a nonacute care setting;
(2) the patient dies in the facility; or
(3) the patient is transferred to a facility or unit that is exempt from the case-based payment system, except when the patient is a newborn transferred to an exempt hospital for neonatal services and thus classified as a transfer patient pursuant to this section; or
(4) the patient is a neonate being released from a hospital providing neonatal specialty services back to the community hospital of birth for weight gain.
(o) Arithmetic inlier length of stay (ALOS) shall mean the arithmetic average of the number of days a patient is in the hospital per admission as calculated by counting the number of days from and including the day of admission up to, but not including the day of discharge. The ALOS shall be calculated for each DRG on a statewide basis.
(p) Hospital , as used in this Subpart, shall mean general hospital as defined in section 2801(10) of the Public Health Law.
(q) Charge converter shall mean the ratio of cost to charges using total inpatient costs and total inpatient charges as reported by the hospital in its annual institutional cost reports submitted to the department.
(r) IPRO shall mean the Island Peer Review Organization, Inc., a New York not-for-profit corporation providing health related services.
(s) Medicaid, for the purpose of this Subpart, shall mean Medicaid fee-for-service and Medicaid managed care for the period beginning October 1, 2010.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY EDUCATIONAL PROGRAMS IN RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.4 Educational program standards
(a) In addition to meeting all applicable provisions of this Part, a sponsoring institution with an educational program registered with the department shall:
(1) ensure that the educational program curriculum includes current didactic and clinical standards set by the American Society of Radiologic Technologists, the Society of Nuclear Medicine or other accrediting organization approved by the department;
(2) ensure that clinical training will occur at hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations or other accrediting organizations approved by the department or at other clinical facilities approved by the department;
(3) conform to all provisions relating to radiation safety standards as prescribed in applicable regulations;
(4) submit or make available to the department such information or records as the department requests and shall permit the department to perform site inspections.
(b) The sponsoring institution shall ensure, as applicable, that, while engaging in clinical practice:
(1) all radiography students are under the supervision of diagnostic radiologists;
(2) all radiation therapy students are under the supervision of a radiation oncologist; and
(3) all nuclear medicine technology students are under the supervision of an authorized user.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 117 GENESEE COUNTY
10 CRR-NY 117.2 Village of LeRoy (Mud Creek)
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as heretofore set forth, shall apply to all natural and artificial reservoirs on Mud Creek and to all water courses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of LeRoy, Genesee County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Mud Creek which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the village of LeRoy.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacle permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at some suitable point off the watershed tributary to the public water supply of the village of LeRoy.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta, or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any matter either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of LeRoy, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 200 feet of any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils, not anything that pollutes water, shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of LeRoy is prohibited; nor shall any such watering be allowed in any watercourse tributary to the water supply within 1000 feet up stream from the impounding reservoir on Mud Creek. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of LeRoy.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of LeRoy nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of LeRoy.
(j) Inspections.
The board of water and light commissioners of the village of LeRoy shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with and it shall be the duty of said board of water and light commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water and light commissioners to promptly notify the State Commissioner of Health of such violations. The board of water and light commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.49 Homemaker
This functional reporting center must contain all the expenses associated with the provisions of domestic services to patients at their place of residence. Additional activities include but are not limited to the following functions which can be performed under this program at the patient's residence: housekeeping, dietary, maintenance, laundry and linen, and patient education.
(a) Standard unit of measure: number of homemaker visits.
The number of homemaker visits shall be the number of homemaker patients visited at their place of residence by representatives of the homemaker program.
(b) Data source.
The number of homemaker visits shall be the actual count obtained from homemaker services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.17 Exclusions
Any payment or billing transaction authorized by the Direct Billing Law (see Public Health Law, section 586) shall not be rendered illegal by any provisions of Public Health Law, section 587 or this Subpart.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.16 Certificate of need and other requirements
Nothing in this Subpart shall relieve parties from any responsibility for compliance with laws or regulations governing certificate of need or other approval or notice submission requirements.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 406 RURAL HOSPITAL SWING BED DEMONSTRATION
10 CRR-NY 406.4 Transfer and affiliation agreements
The hospital administration shall implement requirements governing transfer and affiliation agreements as set forth in section 400.9 of this Title. In accordance with such agreements and for hospitals with more than 49 beds when a nursing home notifies such hospital of available bed(s), the hospital shall transfer the swing bed patient to the RHCF within five weekdays (excluding weekends and holidays) of the availability date unless the patient's physician certifies that a transfer is not medically appropriate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.13 Direct billing
(a) Nothing contained in Public Health Law, section 586 or this Subpart shall be construed to prohibit a clinical laboratory from sending a bill to or receiving payment for clinical laboratory services from the health services purveyor who ordered the clinical laboratory services, provided that:
(1) the clinical laboratory receives the name and/or other information relating to the test subject if the clinical laboratory is obligated to report such name and/or other information to the State or a local health department under State law or regulation;
(2) the bill for the clinical laboratory services shall be directed to the test subject or a payor expressly permitted by Public Health Law, section 586 or this Subpart;
(3) the amount of the bill for clinical laboratory services shall be disclosed to the test subject or a payor expressly permitted by Public Health Law, section 586 or this Subpart, and documentation of the disclosure shall be maintained by the health services purveyor who ordered the clinical laboratory services;
(4) if payment is made for the clinical laboratory services to the health services purveyor who ordered the clinical laboratory services, the payment amount must be equal to the amount stated in the clinical laboratory bill; and
(5) one of the following situations must apply:
(i) the cost of the clinical laboratory service is included in the usual and customary purchase price of a test kit that is approved by the Federal Food and Drug Administration to be commercialized as a test kit that includes a collection device, specimen transport materials, and the clinical laboratory service; or
(ii) the clinical laboratory services are performed in relation to: a termination of pregnancy; testing for a sexually transmissible disease; HIV-related testing; drug abuse screening; or other tests specifically approved by the department where law or regulation recognizes the need for a heightened level of confidential protection of health information relating to the test subject.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-1 NEWBORN SCREENING FOR PHENYLKETONURIA AND OTHER DISEASES
10 CRR-NY 69-1.6 Responsibilities of the public health officer
Public health officers shall ensure collection of a satisfactory specimen when directed by the testing laboratory and shall ensure compliance with the following procedures:
(a) The public health officer shall inform the newborn's parent(s) of the purpose and need for newborn screening, and shall provide newborn screening educational materials made available by the department.
(b) Specimen collection forms shall be properly stored in a cool and dry environment prior to use.
(c) All specimens shall be air dried thoroughly on a flat nonabsorbent surface for a minimum of three hours prior to forwarding to the testing laboratory. All specimens shall be forwarded to the testing laboratory within 24 hours of collection to ensure delivery of specimens to the testing laboratory no later than 48 hours after collection.
(d) If a satisfactory specimen or a repeat specimen is not collected due to newborn mortality, the public health officer shall submit a written and/or electronic notification to the testing laboratory within five days after death.
(e) The public health officer shall submit all information required by the testing laboratory using an electronic format determined by the department, provided that:
(1) specimen collection forms shall be submitted as directed by the testing laboratory; and
(2) the public health officer may request an exemption from electronic submission by demonstrating, to the department’s satisfaction, that the requirement imposes an undue burden.
(f) If the public health officer is unable to obtain a repeat specimen, the public health officer shall submit written and/or electronic documentation to the testing laboratory describing the steps taken by the public health officer to notify the parent(s) and responsible provider that a repeat specimen(s) was required. The public health officer shall submit this documentation to the testing laboratory no later than 90 days after receiving notification from the testing laboratory that a repeat specimen was required.
(g) Before performing any tasks relating to collection of specimens, the public health officer, and any staff under his or her supervision performing specimen collection, shall complete comprehensive specimen collection training, and shall complete such training annually thereafter. The public health officer shall retain documentation of all such training.
(h) The public health officer shall establish written policies and procedures, which shall be available for the department’s review, for:
(1) the collection, storage, and shipping of specimens; and
(2) the tracking and disposition of test results.
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.4 Case management
(a) Case management means functions, including but not limited to:
(1) conducting an initial assessment and periodic reassessments of the enrollee's medical needs;
(2) evaluating the enrollee's strengths, informal support system and environmental factors relevant to his/her care;
(3) reviewing information provided by the enrollee, the enrollee's informal support system, and current providers (including any school related or habilitation services) regarding the services presently being provided to the enrollee and any existing gaps in the services being provided to the enrollee;
(4) establishing a comprehensive, written case management plan to assist the enrollee or the enrollee’s caregiver to manage the delivery of all qualifying health care services needed by the enrollee;
(5) assisting an enrollee or the enrollee’s caregiver to obtain services set forth in the case management plan for the enrollee through referral to agencies or persons qualified to provide those services;
(6) assisting the enrollee with any forms necessary for the receipt of or payment for services;
(7) assisting crisis intervention in the event that the enrollee has emergency service needs;
(8) developing and maintaining a list of alternative provider sources that may be available to the enrollee in the event of service disruption, and making that list available upon the request of the enrollee or the enrollee’s caregiver; and
(9) monitoring the services provided under the case management plan, by:
(i) verifying that the services identified in the case management plan are being received by the enrollee in the amount and frequency specified in the case plan; and
(ii) documenting the case record regarding the enrollee's medical condition and progress made;
if the enrollee already has a case manager in another health related program, the fund administrator’s case manager shall coordinate the enrollee's care in conjunction with the other case manager.
(b) Case manager qualifications.
A case manger shall have significant experience or educational training in health or social services, preferably including work experience or a practicum that involved the performance of assessments and the development of case management plans. Voluntary or part-time experience that can be verified will be accepted on a pro rata basis.
(c) Case manager reassignment.
An enrollee or person acting on an enrollee's behalf can request a change in case manager at anytime by submitting a written request for reassignment on a form provided by the fund administrator. Reassignments will occur as promptly as possible based on case manager availability and existing caseloads.
(d) Responsibilities of an enrollee, or enrollee's parent, guardian or legal representative.
The enrollee or the enrollee's parent, guardian or legal representative is responsible for participating in an initial case management conference and subsequent, periodic case management conferences on a schedule determined by the needs of the enrollee. The repeated failure of the responsible individual to participate in necessary case management conferences may result in the fund administrator not processing any claims or requests until compliance with this requirement occurs.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT INSTALLATION AND LOCATION EQUIPMENT INSTALLATION AND LOCATION
10 CRR-NY 14-1.101 Equipment installation
(a) Equipment, unless easily movable, is to be:
(1) sealed to the floor;
(2) installed on a raised platform of concrete or other smooth masonry, in a way that meets all the requirements for sealing or floor clearance; or
(3) elevated on legs to provide at least a six-inch (15.2-centimeter) clearance between the floor and the equipment.
(b) Equipment is easily movable if it is mounted on wheels or casters; has no utility connection or has a utility connection that disconnects quickly, or has a flexible utility line of sufficient length to permit the equipment to be moved for easy cleaning.
(c) Equipment is to be sealed to adjoining equipment or adjacent walls and ceilings unless sufficient space is provided for easy cleaning between, behind and above each unit of fixed equipment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.307 Self-insurance
The assumption by a hospital of a risk arising out of the ownership of property or from other cause.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO LOCAL HEALTH OFFICIALS FOR RECEIVING STATE AID FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.11 State aid for tuberculosis
(a) Expenses incurred by a local health official for health care services rendered to tuberculosis patients in accordance with the terms of this Subpart shall be eligible for State aid reimbursement.
(b) Such aid shall be provided to local health official through the same procedures and at the same rate as State aid for general public health work, pursuant to Part 40 of this Title.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.4 Method of payment of approval fee
Payment for the approval fee must be made 30 days after billing, except that a laboratory may elect to make four equal payments with the first payment due 30 days after billing (the “first payment date”), the fourth payment due February 15th of the State fiscal year to which the billing relates, and the remaining two payments due on dates equidistant between the first and fourth payment dates. Nothing herein precludes making full payment before these dates.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 37 HANDLING OF BODIES OF PERSONS DYING ON COMMON CARRIERS
10 CRR-NY 37.1 Removal of body
A special stop may be made by a common carrier for the purpose of removing a body, but, in any event, it shall be removed at the first regular stop where an attendant is on duty and where there are known to be facilities for handling the corpse.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.62 COVID-19 testing requirements
(a) As determined by the commissioner based on COVID-19 incidence and prevalence, as well as any other public health and/or clinical risk factors related to COVID-19 disease spread, the commissioner may require routine COVID-19 testing in certain settings, which may include schools, homeless shelters, correctional facilities, nursing homes, and health care settings, and which may distinguish between individuals who have received full vaccination against COVID-19 and those who have not. Such testing determination may also include alternatives to testing as well as prevention protocols pending test results based on symptoms and/or exposure in certain settings.
(1) Entities subject to routine COVID-19 testing pursuant to a commissioner’s determination may accept documentation demonstrating full vaccination in lieu of imposing such testing requirements, if permitted in a commissioner’s determination. Full vaccination , for the purposes of this section, shall be determined by the department in accordance with applicable Federal guidelines and recommendations. Unless otherwise specified by the department, documentation of full vaccination must include the manufacturer, lot number(s), date(s) of vaccination; and vaccinator or vaccine clinic site, in one of the following formats:
(i) record prepared and signed by the licensed health practitioner who administered the vaccine, which may include a CDC COVID-19 vaccine card;
(ii) an official record from one of the following, which may be accepted as documentation of immunization without a health practitioner’s signature: a foreign nation, NYS Countermeasure Data Management System (CDMS), the NYS Immunization Information System (NYSIIS), City Immunization Registry (CIR), a department-recognized immunization registry of another state, or an electronic health record system;
(iii) Excelsior Pass; or
(iv) any other documentation determined acceptable by the department.
(2) Entities subject to a commissioner’s determination pursuant to this section shall document testing or vaccination in appropriate records in accordance with applicable privacy laws and submit data and information related thereto to the department in a manner and format set forth in such determination.
(3) The commissioner shall issue findings regarding the necessity of testing requirements at the time such requirements are announced.
(b) Enforcement and penalties.
(1) All local health officers shall take such steps as may be necessary to assist with the enforcement of the provisions of this section in accordance with the Public Health Law and this Title.
(2) A violation of any provision of this section is subject to all civil and criminal penalties as provided for by law. Entities that violate this section are subject to a maximum fine of $1,000 for each violation. For purposes of civil penalties, each day that an entity operates in a manner inconsistent with the section shall constitute a separate violation under this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.6 Collection and storage of human milk
(a) The human milk bank shall supply presterilized, leak-proof containers and container seals to the donor.
(b) Containers shall be accompanied by an affixed tag which shall show the donor's identification number, and the date and time the milk was collected. When frozen milk is held at a transfer station, this tag shall also identify the station, and the date and time of receipt and transport of the milk.
(c) Milk shall be transported and stored so that it is protected from contamination, thawing and refreezing. Milk in liquid form shall be maintained at a temperature between one and six degrees Celsius, but shall be stored in liquid form for no longer than 48 hours. If milk is frozen, it shall be maintained at minus 20 degrees Celsius or below for a maximum storage period of six months, unless the medical advisory committee specifically approves a longer storage period. Household freezers with automatic defrost cycles shall not be used for such storage. Frozen milk shall be utilized within 48 hours of thawing and discarded thereafter if not utilized.
(d) The physical facilities of the human milk bank shall minimize the potential for contamination, as follows:
(1) the human milk bank shall be located in a distinct, identifiable area with a separate refrigerator and/or freezer provided for human milk; and
(2) refrigerators and freezers shall be equipped with a thermometer calibrated at least annually against a National Institute of Standards and Technology (NIST)- certified thermometer, or with a thermometer that has been tested against, and found to be in agreement with, a NIST-certified thermometer. The thermometer shall be either visually or mechanically monitored daily for fluctuations in temperature affecting the quality of the milk. Temperature records shall be maintained and made available for inspection for at least one year after collection of the milk.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.12 Prohibited practices—additional requirements
(a) The fee for letting of space, provision of services by supporting staff and employees, use or control of equipment or for other considerations necessary for the provision of medical care and services shall not be calculated or paid as a percentage of the earnings or billings of the providers or purveyors for services rendered on the facility premises.
(b) No purveyor, whether or not located in a building which houses a shared health facility shall directly or indirectly offer, pay or give to any provider, and no provider shall directly or indirectly solicit, request, receive or accept from any purveyor any sum of money, credit or other valuable consideration for:
(1) recommending or procuring goods, services or equipment of such purveyor; or
(2) directing patronage or clientele to such purveyor; or
(3) influencing any person to refrain from using or utilizing goods, services or equipment of any purveyor.
(c) No provider or purveyor shall demand or collect from any patient compensation for care or services in excess of the fee specified in the appropriate program fee schedule.
(d) No purveyor shall provide to a patient eligible to receive or receiving benefits under the provisions of the program any services, equipment, pharmaceutical or other medical supplies differing in quantity in any other respect from that described in the payment invoice submitted by such purveyor to the department. No purveyor shall provide to any patient eligible to receive or receiving under the provisions of the program any services, equipment, pharmaceutical or medical supplies differing in quality, quantity or in any other respect from that prescribed by the provider
(e) No provider or purveyor in a shared health facility or personn employed in a facility shall refer a patient to another provider or purveyor located in such facility unless there is a medical need for such referral and unless the records of the referring provider or purveyor pertaining to such patient clearly sets forth the justification for such referral.
(f) Every provider or purveyor practicing in a shared health facility who treats a patient referred to him by another provider practicing in the same facility shall communicate in writing to the referring provider the diagnostic evaluation and the therapy rendered. The referring provider or purveyor shall incorporate such information into the patient's permanent record.
(g) The invoice submitted to the program by the provider or purveyor to whom such patient has been referred shall:
(1) contain the name and program number of the referring provider or purveyor; and
(2) identify the medical problem or condition which necessitated the referral.
(h) All provider and purveyor invoices submitted to the program for reimbursement for services rendered at a shared health facility shall:
(1) contain the registration code of the facility at which the service was performed
(2) clearly identify the provider or purveyor who provided the service; and
(3) be signed by the provider or purveyor only after the service has been performed.
(i) Invoices submitted to the program for care, supplies or services rendered at a shared health facility lacking a valid, current registration issued by the department are not eligible for reimbursement by the program.
(j) All orders issued by providers for ancillary clinical services, including but not limited to X-rays, electrocardiograms, clinical laboratory services, electroencephalograms, as well as orders for medical supplies and equipment, shall contain the registration number assigned to the facility at which the order was written.
(k) Any pharmacy maintaining a business in or adjacent to the building in which a shared health facility is located shall prominently post a notice informing patients that all pharmaceuticals prescribed in the program may be obtained at any pharmacy of the patient's choice enrolled in the program.
(l) No purveyor who maintains a business in the building in which a shared health facility is located shall maintain a door or window opening into the space occupied by the facility, except where the profession of a provider permits the provider to function simultaneously as a purveyor.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.50 Registration of installations with radiation equipment; notification of transfer of radiation equipment
(a) No person shall establish, maintain or operate any radiation installation at which is located or used any radiation equipment in operable condition or intended to be used, unless such installation has been registered as evidenced by a current certificate of registration issued to the operator thereof by the department or has been registered in an alternate manner accepted by the department in accordance with subdivision (j) of this section.10
(b) Application for the registration of a radiation installation as described in subdivision (a) of this section shall be made by the operator thereof to the department on a written form and in a manner prescribed by the department. The times for making application shall be as follows:
(1) for an installation not in registered status, between 60 and 30 days prior to the establishment of the installation;
(2) for an installation in registered status with a current certificate of registration, between 60 and 30 days prior to the expiration of such certificate unless the certificate is revoked or the installation is discontinued upon or before the expiration of the certificate; and
(3) for an installation with respect to which either the operator or location is changed, between 60 and 30 days prior to such change.
(c) The department may withhold, suspend or revoke a certificate of registration if it finds that:
(1) the information submitted in the application is incorrect or incomplete; or
(2) the fees for registration and/or the certificate have not been paid as required; or
(3) the installation is, has been or will be established, maintained or operated in violation of the State Public Health Law, the State Sanitary Code (Chapter I of this Title) or any other applicable law, rule, regulation or order; or
(4) the certificate has not been issued correctly.
(d) A certificate of registration shall be issued for a limited period of time extending from the date of issuance to the date of expiration as specified on the certificate. The length of such period of time shall not exceed two years except that the department may issue a certificate of registration for a longer period of time in order to stagger expiration dates for administrative purposes.
(e) The certificate of registration issued for a radiation installation to the operator thereof shall expire upon:
(1) the expiration date specified on the certificate; or
(2) revocation by the department; or
(3) a change of the operator; or
(4) a change in location of the radiation installation if it is not a mobile unit; or
(5) a change in the name of the installation; or
(6) the discontinuance of the installation.
(f) A certificate of registration shall not be transferable or assignable.
(g) An unexpired certificate of registration issued for a radiation installation shall be conspicuously posted at the installation and made available by the operator, upon request, to the department, the health officer having jurisdiction, or other person or agency making a survey of the installation pursuant to section 16.10(a)(1) of this Part.
(h) The certificate of registration shall not imply endorsement or approval by the department and shall not be used to advertise or promote business.
(i) The operator of a radiation installation shall keep correct and complete the information submitted in his application for registration by reporting to the department in writing within 10 days any change affecting such information.
(j) The department may accept, in lieu of registration with the department, registration with the New York City Department of Health. Acceptance of registration may be done only for radiation installations surveyed under an inspection program conducted by the New York City Department of Health, as described in paragraph (1) of subdivision (a) of section 16.10 of this Part. As a condition of the department's acceptance of registration pursuant to this section, the registering agency shall furnish to the department in writing, at such times and in such form as the commissioner may prescribe, pertinent information concerning the registration of each and every radiation installation registered by the agency. The information furnished to the department shall cover at least those items contained in the department's application form for registration of a radiation installation.
(k) The distributor, retailer or other agent who sells, leases, transfers, loans or installs X-ray or fluoroscopic equipment or other radiation equipment subject to the registration requirements of this section shall notify the department, in writing within 10 days after making such sale, lease, transfer, loan or installation on, and in accordance with the instructions of, a form prescribed by the department.
(l) No person shall make, sell, lease, transfer, loan or install radiation equipment subject to the registration requirements of this section or the supplies used in connection with such equipment unless such supplies and equipment, when placed in operation and used, will meet the requirements of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.8 Default
(a) Causes.
A recipient of an award will be placed in default if the recipient has not been granted a waiver or deferral by the commissioner and:
(1) the recipient fails to complete a primary care practitioner program;
(2) the recipient is not available to begin the service obligation on the reporting date;
(3) the recipient resigns, is dismissed from employment, or otherwise fails, refuses or is unable to fulfill the service obligation; or
(4) the scholarship award is rescinded pursuant to section 47-6.5(a) of this Subpart, after dispersal of scholarship monies to, or on behalf of, the recipient.
(b) Calculation of financial obligation.
An individual found to be in default will be required to pay the president, within five years from the date of default, all monies received, plus interest, plus liquidated damages, as determined by the following formula:
A = 2B (T−S) T
where “A” is the amount the president is entitled to recover; “B” is the sum of all payments made to, or on behalf of, the recipient and the interest on such amount which would be payable if, at the time such awards were paid, they were loans bearing interest at the maximum prevailing rate determined by the Higher Education Services Corporation; “T” is the total number of months in the recipient's period of obligated service; and “S” is the number of months of service actually rendered by the recipient.
(c) The Department of Health shall advise the Higher Education Services Corporation of any default, and the Higher Education Services Corporation shall collect repayments and, where indicated, initiate action for prosecution to recover monies owed the State.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
HANDWASHING HANDWASHING
10 CRR-NY 14-4.141 Pushcart handwashing facilities
Pushcarts are to have handwashing facilities for the operator. This handwashing facility is to be a supply of clean, potable water, soap or detergent, a receptacle to hold waste water and paper towels.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.32 Biological safety officer; duties
The institution shall appoint a BSO if it engages in recombinant DNA activity at the P3 or P4 containment level. The officer shall be a member of the institutional biosafety committee (IBC). His or her duties shall include (but need not be limited to):
(a) ensuring through periodic inspections that laboratory standards are rigorously followed;
(b) reporting to the IBC and the institution all significant problems with and violations of this Subpart and all significant recombinant DNA activity-related accidents and illnesses of which the BSO becomes aware, unless the BSO determines that the principal investigator (PI) has done so;
(c) developing emergency plans for dealing with accidental spills and personnel contamination, and investigating recombinant DNA activity laboratory accidents;
(d) providing advice on laboratory security;
(e) providing technical advice to the PI and IBC on recombinant DNA activity safety procedures.
Note:
See NIH Laboratory Safety Monograph for additional information on the duties of the BSO.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.10 Responsibilities of certified external appeal agents
(a) Within 24 hours of receiving assignment from the superintendent of a request for external appeal, certified external appeal agents shall send notification of such assignment to the enrollee requesting an external appeal or on whose behalf an external appeal is requested, the enrollee's health care plan, the attending physician, as applicable, and, in the case of a provider initiated appeal of a retrospective adverse determination, the enrollee's health care provider. The certified external appeal agent shall include in such notification:
(1) a request for any additional documentation that may be available to support the appeal;
(2) the address to which any required or additional documentation should be sent;
(3) whether the appeal is a standard or expedited appeal; and
(4) for purposes of notifying the enrollee's health care plan, as applicable, copies of the documents relied upon by the enrollee's attending physician to establish medical and scientific evidence that the recommended health care service(s) is likely to be more beneficial to the enrollee than any covered standard health care service or procedure.
(b) Certified external appeal agents shall make a final determination on nonexpedited external appeals within 30 days of receiving the request for external appeal from the superintendent, provided that, in the event that the certified external appeal agent requests additional documentation from the enrollee, the enrollee's health care plan, the enrollee's attending physician or health care provider, other than the documentation requested pursuant to subdivision (a) of this section, the certified external appeal agent shall have an additional five business days from receipt of the request for external appeal from the superintendent within which to make a final determination. Certified external appeal agents shall notify the superintendent if additional documentation has been requested.
(c) Certified external appeal agents shall make a final determination on expedited external appeals within three days of receiving the request for external appeal from the superintendent.
(d) In addition to the requirements in section 4914(2)(d) of the Public Health Law and section 4914(b)(4) of the Insurance Law, the external appeal agent shall consider any documentation submitted by the enrollee or the enrollee's designee, the enrollee's attending physician, the enrollee's health care plan or the enrollee's health care provider that is pertinent to the external appeal under review provided that such documentation is submitted by the earlier of:
(1) within 45 days from when the enrollee or, in the case of a provider initiated retrospective appeal, the enrollee's health care provider received notice that the health care plan made a final adverse determination or within 45 days of the date from when the enrollee received a letter from the health care plan affirming that both the enrollee and the enrollee's health care plan jointly agreed to waive the internal appeal process; or
(2) prior to the external review agent's final determination on the appeal. A certified external appeal agent may not reconsider an appeal for which a final determination has been made based upon receipt of additional information subsequent to such final determination.
(e) The certified external appeal agent shall forward to the enrollee's health care plan any documentation received by the certified external appeal agent that is pertinent to an appeal that has been referred to the agent by the superintendent. Any such documentation that, in the opinion of the certified external appeal agent, constitutes a material change from the documentation upon which the utilization review agent based its adverse determination or upon which the health care plan based its denial shall be forwarded immediately, but no later than 24 hours after receipt of such documentation, to the enrollee's health care plan, with notification that such documentation represents a material change, for consideration pursuant to section 4914(2)(a) of the Public Health Law and section 4914(b)(1) of the Insurance Law. In the event of receipt of such material documentation, for other than expedited appeals, the certified external appeal agent shall not issue a determination for up to three business days or until the health care plan has considered such documentation and amended, reversed or confirmed the adverse determination, whichever is earlier.
(f) For each external appeal determination made by a certified external appeal agent, the medical director of the certified external appeal agent shall certify that:
(1) the certified external appeal agent and each clinical peer reviewer assigned to review the external appeal followed appropriate procedures as defined in section 4914 of the Public Health Law and Insurance Law, this section and the certified external appeal agent's application and, as applicable, conditions for certification;
(2) all clinical peer reviewers met the criteria for conducting the external review pursuant to subdivision 2 of section 4900 of the Public Health Law and subdivision (b) of section 4900 of the Insurance Law; and
(3) for each clinical peer reviewer assigned to review the external appeal, a duly signed and notarized attestation which affirms, under penalty of perjury, that no prohibited material affiliation exists with respect to such clinical peer reviewer's participation in the review of the external appeal pursuant to section 98-2.6(e)-(f) and (h) of this Subpart, is on file with the certified external appeal agent. Such attestation shall be in such form as prescribed by the commissioner and superintendent.
(g) Certified external appeal agents shall forward copies of appeal determination notification letters sent to health care plans and enrollees pursuant to section 4914(2)(b) and (c) of the Public Health Law and section 4914(b)(2) and (3) of the Insurance Law to the enrollee's health care provider, if applicable, and to the commissioner and superintendent. Such notification letters shall include:
(1) a clear statement of the health care plan's responsibility in regard to provision of the contested health care service(s) to the enrollee;
(2) a statement attesting that no prohibited material affiliation existed with respect to the clinical peer reviewers; and
(3) with respect to a medical necessity appeal determination, the reasons for the determination which shall include a discussion of the health care plan's clinical standards, the information provided concerning the patient, the attending physician's recommendation, and applicable generally accepted practice guidelines developed by the Federal government, national or professional medical societies, boards and associations which were used in making the determination; or
(4) with respect to an experimental or investigational treatment or service appeal determination, a statement as to whether the proposed health service or treatment is likely to be more beneficial than any standard treatment or treatments for the enrollee's life-threatening or disabling condition or disease; or
(5) with respect to a clinical trial appeal determination, a statement as to whether the clinical trial is likely to benefit the enrollee in the treatment of the enrollee's condition or disease.
(h) Certified external appeal agents shall enclose a request for payment with the copy of the appeal notification letter sent to the health care plan.
(i) Certified external appeal agents shall not be relieved of responsibility for making a determination with respect to an assigned external appeal on the basis that the enrollee no longer has coverage with the health care plan that denied the health care service(s) that is the subject of the appeal. However, a health care plan will not be required to pay the patient costs of any health service(s) or procedure(s) that is the subject of an external appeal for enrollees who no longer have coverage with such health care plan unless and to the extent that such health care service(s) was provided while the enrollee had coverage with the health care plan.
(j) In addition to the information required by section 4916(2) of the Public Health Law and section 4916(b) of the Insurance Law, certified external appeal agents shall include in the annual report a description of each external appeal assigned to such certified external appeal agent by the superintendent, including a summary of the clinical justification for the agent's determination, and any other information required by the commissioner and/or superintendent.
(k) In no event shall the certified external appeal agent provide the health care plan with a copy of the enrollee's application for an external appeal or divulge to the health care plan, the enrollee, the enrollee's attending physician or health care provider the names of the clinical peer reviewers assigned to the appeal. However, such information shall be made available upon request to and upon audit or examination by the commissioner and superintendent. Nothing herein is intended to preclude access to such information during court proceedings.
(l)
(1) Upon requesting an external appeal, the enrollee, the enrollee's designee or the enrollee's health care provider shall acknowledge that the determination of the external appeal is binding on the plan and the enrollee, and shall agree not to commence any legal proceeding against an external appeal agent or clinical peer reviewer to review a determination made by such external appeal agent or clinical peer reviewer pursuant to article 49 of the Public Health Law or article 49 of the Insurance Law; provided, however, that the foregoing shall not limit any rights the enrollee, the enrollee's designee or the enrollee's health care provider may have with respect to bringing an action for damages for bad faith or gross negligence or with respect to bringing an action against the enrollee's health care plan.
(2) As specified in Public Health Law section 4914(3) and Insurance Law section 4914(c), no external appeal agent or clinical peer reviewer conducting an external appeal shall be liable in damages to any person for any opinions rendered by such external appeal agent or clinical peer reviewer upon completion of an external appeal conducted pursuant to article 49 of the Public Health Law or article 49 of the Insurance Law, unless such opinion was rendered in bad faith or involved gross negligence.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.2 General standards
Facilities providing ambulatory services shall conform to all applicable provisions of this Chapter, including, but not limited to, meeting the standards for adequate child health services, the educational and training needs of any interns and residents and the requirements for review of medical records.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.164 Historical cost
The amount of cash or cash equivalent given in exchange for properties or services at the time of acquisition (see basis of valuation in section 442.10 of this Article).
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.24 Approval of fluoridation of public water systems
Fluorine compounds shall not be added to a public water system until a written application has been submitted to, and written approval is granted by, the State.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.130 Financial statements
A balance sheet, income statement, funds statement, statement of changes in financial position, or any supporting statement or other presentation of financial data derived from accounting records.
10 CRR-NY 441.48 Bond
(a) A certificate of indebtedness, in writing and often under seal.
(b) An obligation in writing, binding one or more parties as surety for another.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
EXEMPT PERSONS EXEMPT PERSONS
10 CRR-NY 89.30 Persons exempt
(a) Dental assistants.
(1) A person acting as a dental assistant shall be exempt from licensure as a radiologic technologist when operating the following equipment under the supervision of a dentist for the sole purpose of routine oral radiography in which the X-ray beam is limited to the patient’s head:
(i) conventional radiographic dental equipment in which the diameter of the X-ray beam at the patient’s face is limited to not more than three inches;
(ii) panoramic radiographic dental equipment; and
(iii) conebeam computed tomography equipment after demonstrating satisfactory completion of a training program approved by the department or one provided by the equipment manufacturer. Conebeam computed tomography equipment must be performed under the direct supervision of a dentist.
(2) Nothing in this Part shall be construed to apply to the practice of the profession of dental hygiene, including the use of X-ray, by persons duly licensed as dental hygienists by the State Education Department or by students enrolled in and under the supervision of the faculty of an educational program in dental hygiene registered by the State Education Department.
(b) Podiatry assistants.
A person authorized to provide supportive services to a licensed podiatrist pursuant to section 7006(4) of the State Education Law is exempt from licensure as a radiologic technologist when operating a podiatry X-ray unit under the direct supervision of the podiatrist for the sole purpose of routine radiography of the podiatrist’s patient’s foot.
(c) A person employed at a local correctional facility, as defined by Correction Law section 2(16), is exempt from licensure as a radiologic technologist when operating body imaging scanning equipment that applies ionizing radiation to humans for purposes of screening inmates committed to such facility, in connection with the implementation of such facility’s security program.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.54 Duties of undertakers
(a) It shall be the duty of every person taking charge of the preparation for burial of the body of any person to ascertain whether such person died of a communicable disease, and if such person died of plague, it shall be his duty to cause it promptly to be placed in a coffin or casket, which shall then be immediately and permanently closed. This section shall not be construed to prohibit the embalming of any such body, but if the body is to be embalmed the undertaker shall cause such embalming to be done immediately upon taking charge of the body. Immediately after the embalming he shall cause such body to be placed in a coffin or casket as hereinabove directed.
(b) After handling, embalming, or preparing for burial the body of a person dead of a communicable disease, such parts of the person's garments, and utensils or other articles of the undertaker or his assistants, as may have been liable to contamination with infective material, shall be immediately cleansed or disinfected or sterilized.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.30 Ambulatory services
The essential characteristic of ambulatory services is that the patients come to or are brought to a facility of the hospital for a purpose other than admission as an inpatient. Ambulatory services include emergency services, clinical services, ambulance services and home health services, but exclude ancillary services.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PERSONNEL PERSONNEL
10 CRR-NY 14-5.72 Personnel training
The permit-issuing official may establish and conduct or designate training programs and require owners and/or operators of food vending machine operations to attend them.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.14 Village of Walden
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all wells which now serve or which will be developed to serve as sources of public water supply of the Village of Walden, Orange County, NY.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Village of Walden.
(2) The term well means either of the wells now serviing as sources of water supply for the Village of Walden and also any wells which may be developed to serve as sources of water supply for the Village of Walden.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(4) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(5) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Human excreta.
(1) No human excreta shall be deposited, thrown or placed on the surface of the ground at any point within 200 feet of any well nor in such manner that it can be washed by rain, melting snow or otherwise over the surface of the ground into any well.
(2) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any well and covered with 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(e) Privies.
(1) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 150 feet of any well except a properly constructed and operated sewage disposal plant, as hereinafter set forth in subdivision (f) of this section; provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained, shall be placed as far as possible from any well and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any well. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval of the board of trustees of the Village of Walden and in such a manner as effectually to prevent any pollution of the public water supply.
(3) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 150 feet and 200 feet of any well shall be arranged so that all excreta will be received in a suitable watertight receptacle, or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (d)(2) of this section.
(4) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(f) Sewage.
No sewage shall be discharged or deposited on or beneath the surface of the ground within 200 feet of any well, except in watertight sewers and sewer appurtenances constructed or installed with the approval and under the supervision of the board of trustees of the Village of Walden. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(g) Sink and laundry wastes.
No bath water, sink or laundry wastes or polluted liquid of any kind shall be deposited on or beneath the surface of the ground within 100 feet of any well.
(h) Garbage, refuse.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited on or beneath the surface of the ground within 200 feet of any well nor in such manner that it can be washed by rain, melting snow or otherwise over the surface of the ground to a point within 200 feet of any well.
(i) Animals, poultry, stables.
(1) No watering place for animals or poultry shall be maintained in such a way as to pollute any well with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may pollute any well.
(j) Manure.
No manure pile shall be maintained or allowed to remain within 100 feet of any well.
(k) Camps.
No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well.
(l) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(m) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(n) Inspections.
The board of trustees of the Village of Walden or such other person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the well and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(o) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 408 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS (CSFRHN)
10 CRR-NY 408.1 Definition
(a) A central services facility rural health network (CSFRHN) shall be a not-for-profit corporation established pursuant to article 28 of the Public Health Law, and representative of health care providers within the network through board representation, membership and written agreements or any combination thereof, for the purpose of operating a rural health network. Such network board shall also include representatives of the general public residing in the area served by the central services facility rural health network.
(1) A CSFRHN may plan, and upon approval of its network operational plan by the Commissioner of Health, coordinate, provide or arrange for the provision of health care services to residents of the rural area served by the network, may also perform administrative services for providers participating in the network pursuant to such network operational plan.
(i) At a minimum, the health care services provided or arranged for by a CSFRHN shall include acute care, comprehensive primary care, and emergency care.
(ii) A CSFRHN may provide or arrange for such other medical, public health or health related services for which it or any affiliated provider has received all requisite approvals.
(2) Administrative services performed on behalf of participating providers must be provided in accordance with all applicable requirements, including sections 405.3(f), 600.9(d) and 400.4 of this Title, and may include, but need not be limited to, emergency medical services training, credentialing, payroll, purchasing and billing services, recruitment of qualified professionals, oversight and support of the network's communication, medical transportation, quality assurance, risk management, peer review, electronic data sharing, managed care systems oversight, performance of studies, planning, and solicitation and acceptance of grants. Such services shall be provided when necessary to effectuate the purposes of the CSFRHN and only pursuant to written agreement between the parties.
(b) Service area.
CSFRHNs shall serve a specified rural area as identified in its network operational plan. Rural areas are defined as any county with less than 200,000 persons or any town which has a population of less than 200 persons per square mile, or, if approved by the commissioner, any town which has a population of less than 250 persons per square mile.
(i) The service area of a CSFRHN shall encompass only the towns for which the network can assure the availability of at least the minimum services defined in subparagraph (a)(1)(i) of this section.
(ii) Providers located outside of a CSFRHN service area may participate in a network if determined by a CSFRHN to be capable of serving the residents of such rural area comprising the CSFRHN's service area and agree in writing to comply with the provisions of the network's operational plan. Residents of a service area are not precluded from obtaining services from providers that are not affiliated with a network.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.317 Sub-acute care services
Services provided to patients who require a level of nursing care less than acute, including residential care.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
OPERATORS OPERATORS
10 CRR-NY 10.30 Cleanliness of operators
The hands of the operator shall be thoroughly washed with soap and warm water before serving each customer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.24 Charges in connection with certain health care facility financings
Public Health Law, §§ 2868, 2881; Public Authorities Law, § 2976-a(3)
In connection with the issuance of bonds, notes, or other obligations issued by public benefit corporations (which for purposes of this section shall include the Dormitory Authority of the State of New York and industrial development agencies [IDAs] created pursuant to title 1 of article 18-A of the General Municipal Law or any other provision of law) for the financing of hospital projects approved by the commissioner for which reimbursement is provided pursuant to article 28 of the Public Health Law, the commissioner shall charge for the operational period for such financing which shall be from occupancy date to mortgage discharge, an annual charge of three- tenths of one percent of the mortgage loan, for inspection, regulation, supervision and audit payable monthly to the State Department of Health by the owner or operator of the hospital project. Adjustments of charges for the operational period shall be made by adjusting future operational period payments. For purposes of this section, the term hospital shall have the same meaning as is set forth in section 2801(1) of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.2 Definitions
(a) An applicant is a person who has directly or by a representative applied in writing to the New York State Department of Health.
(b) An application is the process by which a person indicates, in writing on a Department of Health approved form, his/her desire to receive assistance.
(c) Resident means a person domiciled within the State.
(d) Authorized representative means any person authorized by an applicant or participant to act on his/her behalf.
(e) Period of coverage.
Coverage for assistance for each individual program component is effective as specified in the individual's notification of eligibility. Coverage will terminate under the following circumstances:
(1) the applicant indicates in writing that they no longer need or desire assistance;
(2) the department determines that a change in the participant's circumstances or residence has affected their eligibility;
(3) the participant has died or cannot be located; and
(4) funding for the Uninsured Care Programs is exhausted.
(f) Program means the Uninsured Care Programs, as defined by the AIDS Institute, including the following service components:
(1) AIDS Drug Assistance Program, which provides coverage of medications;
(2) ADAP Plus, which provides coverage for ambulatory care services;
(3) ADAP Plus Insurance Continuation, which pays for insurance premiums for eligible individuals who have cost effective insurance policies; and
(4) the HIV Home Care Program, which provides coverage for home care services.
(g) Household.
The applicant, and persons legally responsible for the applicant, and persons for whom the applicant is legally responsible, shall be considered part of the household.
(h) Income means total gross income of the household. Income shall include: monetary compensation for services, including wages, salary, commissions, or fees; net income from self-employment; unemployment insurance compensation; government civilian employee or military retirement or pension, including veteran's payments; pensions or annuities; alimony or child support payments; regular contributions from persons not living in the household; net royalties; social security benefits; dividends or interest on savings or bonds; income from estates or trusts; net rental income; public assistance or welfare payments; cash or any other income resource.
(i) Available household income means the applicant's household income after deducting the amount paid by the applicant under the Federal Insurance Contributions Act for Social Security and Medicare and the cost of health care coverage paid by the applicant.
(j) Provider means a medical provider, including a pharmacy, hospital, clinic, clinical practitioner, laboratory or home health care agency.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-2 STATE FUNDING FOR HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-2.4 Accounting
The health systems agency shall maintain full and complete books, records and accounts, consistent with generally accepted accounting principles, pertinent to the receipt and disposition of state grant funds and other funds. Such books, records and accounts shall be retained for a period of six years from the date of disbursement of such grant funds and other funds by the health systems agency and shall at all times be made available for audit, inspection and copying by the Commissioner of Health, the State Comptroller and the Attorney General, or by their duly authorized representatives.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.16 Notification and investigation of outbreaks
(a) Whenever there shall occur in any municipality an outbreak of illness, it shall be the duty of the city, county or district health officer to report immediately by telephone, telegram or in person the existence of such an outbreak to the State Department of Health. The city, county or district health officer shall exercise due diligence in ascertaining the existence of such outbreaks or the unusual prevalence of diseases, and shall immediately investigate the causes of same. A report of such investigation shall be forwarded to the Department of Health within 30 days of the end of the outbreak.
(b) Provided that when such an outbreak occurs in a State institution, the person in charge of such institution shall report the outbreak immediately by telephone, facsimile transmission, or other electronic communication, or in person to the State Department of Health and to the city, county or district health officer in whose jurisdiction the institution is located.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.11 Payor of last resort
In all cases, the Adult Cystic Fibrosis Assistance Program shall be the payor of last resort.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.105 Bear Ridge Lake Corporation
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of the Public Health Law shall apply to all wells located on lands owned by Bear Ridge Lake Corportion, situated in the county of Westchester.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as source of this public water supply or to any additional well which may be constructed in said subdivision known as Bear Ridge Lake for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privy, bathwater, laundry wastes, sewage and other excremental matter, garbage, putrescible matter, kitchen and sink wastes, stable, barnyard manure, compost heap.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta and no bath water, laundry wastes, sewage or other excremental matter from any water closet and no garbage, putrescible matter, kitchen or sink wastes and no stable, barnyard or other places for domestic animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well forming the source of the public water supply of the said subdivision known as Bear Ridge Lake, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without having first passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any well forming the source of the public water supply of the said subdivision known as Bear Ridge Lake.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, sewage, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health or of the Commissioner of Health of the Westchester County Health Department, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health or the Commissioner of Health of the Westchester County Health Department.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 250 feet of any well; and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 100 feet of any well forming the source of the public water supply of the said subdivision known as Bear Ridge Lake.
(d) Trespassing.
No trespassing shall be allowed upon the property of the said subdivision known as Bear Ridge Lake upon which the wells of the public water supply of the said subdivision known as Bear Ridge Lake are located and no person or persons shall enter in or upon such property except the officers and directors of Bear Ridge Lake Corporation or any person or persons who may be dully charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the Bear Ridge Lake Corporation.
(e) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the subdivision known as Bear Ridge Lake.
(f) Inspections.
The board of directors of Bear Ridge Lake Corporation or such other board, person or persons as may be charged with the maintenance or [ continued ] supervision of the public water supply of the subdivision known as Bear Ridge Lake or their duly appointed representative shall make regular and thorough inpections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of directors to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of directors to promptly notify the State Commissioner of Health and the Commissioner of Health of the Westchester County Health Department of such violations. The board of directors shall report to the State Commissioner of Health and the Commissioner of Health of the Westchester County Health Department in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(g) Penalty.
In accordance with section 70 of the Public Health Law, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 456 COST-FINDING PRACTICES AND PROCEDURES
10 CRR-NY 456.2 Statistics and sampling
(a) A standard statistical allocation has been set forth for each functional reporting center. This prescribed minimum statistic must be reported based on residential health care facility records for functional reporting centers which have their own direct costs as well as centers which may receive only indirect costs as a result of cost finding.
(b) Alternative statistics may be developed and utilized for cost allocation of a functional center if such alternative basis had been used in the past and approved through audit by the third-party reimbursement agency auditor.
(c) However, a residential health care facility utilizing an alternative statistical basis must also report the minimal acceptable statistics set forth in this Part. A residential health care facility wishing to change its statistical allocation basis at any time in the future must collect the data and submit same to the New York State Department of Health, or other body if established, for approval as an exception to the approved cost allocation basis before it can be used. See procedure for same in Part 457 of this Article. Once an alternative statistic is used, it must remain in use until approval is given to alter the approved statistical basis.
(d) It is understood that in some instances a residential health care facility may not be able to accumulate the statistics for a full year. Under these circumstances, the residential health care facility may use a sample for accumulation of the data. A discussion of the sampling technique is presented in section 456.4 of this Part. The minimum mandated statistical basis for cost allocation is presented in section 456.3. A more precise definition for the compilation of the data is provided in section 456.5.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.5 Responsibilities of the health care providers attending newborn children
(a) Health care providers attending newborn children of a woman with a positive HBsAg test result shall offer or cause to be offered immunizing doses of hepatitis B vaccine and hepatitis B immune globulin for each such newborn child within 12 hours of birth unless a licensed physician or health care practitioner practicing under the supervision of a licensed physician determines that the child is not physiologically stable to permit immunization. In such cases the hepatitis B vaccine and hepatitis B immune globulin shall be administered when the child becomes physiologically stable to permit immunization.
(b) Health care providers attending newborn children of a pregnant woman admitted for delivery without a HBsAg test result available shall offer or cause to be offered immunizing doses of hepatitis B vaccine and hepatitis B immune globulin for each such newborn child immediately upon receiving a blood test result showing that the woman has a positive HBsAg test.
(c) If a woman's HBsAg test result is not available and her newborn child is to be discharged from the health care facility or 48 hours has elapsed since birth and if, in the health care provider's medical judgement the mother has a reasonable likelihood of being positive for HBsAg, the provider shall offer or cause to be offered for such a newborn child, immunizing doses of hepatitis B vaccine and hepatitis B immune globulin.
(d) After administering hepatitis B vaccine or hepatitis B immune globulin to a newborn child, the health care provider shall record in the child's medical record the date and time of immunization and the dosage, the manufacturer's lot number and the sites of injection for hepatitis B vaccine and hepatitis B immune globulin and shall provide the woman with a certificate of immunization for her child stating the immunizing agents administered and the dates of administration.
Chapter I STATE SANITARY CODE
Part 23 SEXUALLY TRANSMISSIBLE DISEASES (STD)
10 CRR-NY 23.1 List of sexually transmitted diseases
The following are groups of sexually transmitted diseases (STDs) and shall constitute the definition of sexually transmitted diseases for the purpose of this Part and section 2311 of the Public Health Law:
Group A
Facilities referred to in section 23.2 of this Part must provide diagnosis and treatment as provided in section 23.2(c) of this Part for the following STDs:
Chlamydia trachomatis infection
Gonorrhea
Syphilis
Non-gonococcal Urethritis (NGU)
Non-gonococcal (mucopurulent) Cervicitis
Trichomoniasis
Lymphogranuloma Venereum
Chancroid
Granuloma Inguinale
Group B
Facilities referred to in section 23.2 of this Part must provide diagnosis and treatment, including prevention services, as provided in section 23.2(d) of this Part for the following STDs:
Human Papilloma Virus (HPV)
Genital Herpes Simplex
Human Immunodeficiency Virus (HIV)
Group C
Facilities referred to in section 23.2 of this Part must provide diagnosis and treatment as provided in section 23.2(e) of this Part for the following STD:
Pelvic Inflammatory Disease (PID) Gonococcal/Non-gonococcal
Group D
Facilities referred to in section 23.2 of this Part must provide diagnosis and treatment as provided in section 23.2(f) of this Part for the following STDs:
Yeast (Candida) Vaginitis
Bacterial Vaginosis
Pediculosis Pubis
Scabies
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.56 Injury prevention and control; performance standards
The local health department shall maintain a program designed to reduce morbidity and mortality associated with injuries, utilizing reasonably available data. The program shall include, at a minimum, development and implementation of education programs to inform the public and providers of measures to avoid intentional and unintentional injury.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ATTENDANCE ATTENDANCE
10 CRR-NY 84.11 Record of attendance
All employees are required to maintain a daily record of absences and time and leave credits earned and used in accordance with these rules. A daily record of attendance shall be maintained during the period covered by the school calendar and for any periods during which an employee may receive compensation which is in addition to his regular salary.
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.8 Out-of-state care
Out-of-state care will not be approved for State-aid reimbursement unless specific exception is made by the Commissioner of Health.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.16 Fencing/enclosure
All spray pads shall be enclosed within a fence or other barrier to prevent access by patrons and animals when the spray pad is not supervised. Access to the spray pad shall be prevented when the spray pad is not supervised.
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.9 Anchoring
Anchoring systems may be required by the permit issuing official. Anchoring systems shall be installed when required by any other local or State law, rule or regulation. When anchoring is required, the operator shall be responsible for the proper installation of anchoring systems.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.3 Radioactive materials
Unless otherwise permitted by these rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge, of radioactive materials into the environment (including into groundwater), and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this section that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.170 Floors
Floors and floor coverings of food storage, food preparation equipment, utensil washing areas, and floors of walk-in refrigerating units, dressing rooms, locker rooms, toilet rooms and vestibules, are to be maintained clean and in good repair and are to be smooth, durable, and nonabsorbent. The use of anti-skid floor covering is acceptable when necessary for safety reasons.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.12 Hearing officer's report
For matters governed by Public Health Law, sections 230, 230-a and 230-b, the hearing officer shall submit the hearing panel's signed final report not more than 52 days after the last day of hearing if service will be effectuated by mail and not more than 58 days after the last day of hearing if service will be effectuated personally. In all other matters, within 60 days of the close of the records, including receipt of the transcript, if any, the hearing officer should prepare his report and submit it to the commissioner or to the appropriate board or council, and to all parties.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-4.181 Commissary
A mobile food service establishment and pushcart commissary is to meet the requirements of this Subpart and Subpart 14-1 of this Part and is to be constructed, equipped and maintained so that:
(a) the interior of the building is clean, free from rodents and insects, odors, pooled water, garbage, debris and unncessary materials and equipment;
(b) there is adequate space in the building to permit access for cleaning of the largest mobile unit, separate from storage areas for food, ingredients, equipment, tableware and utensils;
(c) acceptable cleaning and sanitizing facilities are provided, including storage for cleaned equipment and utensils which protects them from contamination;
(d) lighting is not less than 30 foot-candles at working surfaces in food handling and equipment cleaning areas;
(e) toilet and adjacent handwashing facilities are readily available to all employees of mobile units and the depot, together with lockers for clothing and personal possessions;
(f) storage facilities are constructed and maintained to prevent contamination of all materials and supplies, including mixes, flavors, syrups, edibles, single-service items;
(g) a supply of hot and cold potable water under pressure is available whenever needed in quantities required for sanitation and other operations;
(h) all plumbing is constructed and installed in a manner to protect the water supply, food, equipment and utensils from contamination;
(i) all waste, sewage and waste water is disposed of in a system accepted by the permit-issuing official without contamination of the premises; and
(j) the entire premises is operated and maintained in a sanitary condition, does not create a nuisance, and is not a potential source of contamination.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SANITARIAN PUBLIC HEALTH SANITARIAN
10 CRR-NY 11.110 Definitions
(a) The term public health sanitarian shall mean a person who applies the principles of the natural and social sciences for the detection, evaluation, control and management of those factors in the environment which influence the public's health.
(b) The term natural science shall mean a science such as biology, chemistry or physics that deals with the objects, phenomena, or laws of nature and the physical world. It shall include all physical and biological sciences.
(c) The term applied science shall mean science based courses in environmental technology, sanitation technology, medical technology, public health, infection control or food science.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT LOCAL HEALTH OFFICIAL RECORDS AND REPORTS TO STATE HEALTH DEPARTMENT
10 CRR-NY 43-1.16 Return of a tuberculosis patient to location of residence
(a) A New York State resident who is receiving tuberculosis health care services in another state and desires to return to New York State shall be referred to the local health official where the patient resides. The information requested of the other state by the local health official regarding the patient, shall include at least the following:
(1) medical history including sufficient clinical data to indicate need for further care and treatment of tuberculosis;
(2) a statement that the patient is physically able to travel without harm to himself or others, and arrangements have been made for his transfer to New York State.
(3) information for residence verification;
(4) a statement indicating the patient's willingness to return to New York State for further care and treatment of tuberculosis; and
(5) names and addresses of individuals who will assume responsibility for the patient.
(b) Once residence is established and the patient is able and willing to return, final arrangements for transfer shall be made by the local health official directly with the authorities of the other state.
(c) When a nonresident tuberculosis patient is willing and able to return to the political subdivision in which the patient resides in another state or country, the local health official where the patient's provider is located, or the commissioner's designee, shall make arrangements with the health official of the political subdivision in which the patient resides so that the patient can be met on return and be provided the health care services needed. Copies of provider reports shall also be forwarded to said health official.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.1 Purpose
The purpose of this Subpart is to assure a sanitary, healthful and safe environment for the public when using recreational aquatic spray grounds.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.332 Trust fund
A fund held by one person (trustee) for the benefit of another pursuant to the provisions of a formal trust agreement.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.3 Eligibility criteria
(a) To be eligible for medical care reimbursement for cystic fibrosis and/or medical insurance premium payment through this program, such individual:
(1) shall be at least 21 years old;
(2) shall have been diagnosed as having cystic fibrosis;
(3) shall have resided in New York State for a minimum of 12 continuous months immediately prior to application for services from the Adult Cystic Fibrosis Assistance Program;
(4) shall not be eligible for medical benefits under any group or individual health insurance policy;
(5) shall not be eligible for medical assistance (Medicaid) pursuant to title 11 of article five of the Social Services Law solely due to earned income;
(6) shall submit an application and provide such other information, including documentation of net annual income, as required by the commissioner; and
(7) shall pay annually seven percent of his or her net annual income toward the cost of medical care related to cystic fibrosis and/or the cost of annual health insurance premiums at such intervals as are agreed upon by an authorized representative of the commissioner.
(b) To be a partially eligible individual for whom medical care reimbursement for cystic fibrosis and/or medical insurance premium payment will be provided through this program on a supplemental basis, such individual shall meet all criteria of a fully eligible individual except that a partially eligible individual shall have medical care reimbursement benefits available under a group or individual health insurance policy which does not provide full coverage for the care and treatment of cystic fibrosis.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.14 Accrued revenue
Revenue earned, but neither received nor past due.
10 CRR-NY 441.100 Donated services
The services performed by personnel who receive no compensation or partial compensation for their services. The equivalent of an employer-employee relationship must exist between the institution and the individual donating the services. The term is usually applied to services rendered, by members of religious orders, societies or similar groups, to institutions operated by or affiliated with such institutions.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 101 ALLEGANY COUNTY
10 CRR-NY 101.1 Village of Alfred
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, shall apply to all wells, which form the source of the public water supply of the village of Alfred, Allegany County, N.Y.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from any well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit, pipe or other receptacle of any kind used for the deposit, storage and conveyance of human excreta shall be constructed, located, placed or allowed to remain within 75 feet of any well.
(2) Every privy, privy vault, pit or other receptacle of any kind used for the deposit or storage of human excreta located between 75 feet and 150 feet of any well, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(3) Whenever the aforesaid watertight receptacles become filed within six inches of the top, said receptacles shall be emptied and the contents disposed of as hereinafter provided. In effecting this removal, none of the contents shall be allowed to escape while being transported to the place of disposal hereinafter specified.
(4) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (2) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with no less than 12 inches of soil in such a manner as effectually to prevent its being washed over the surface [ continued ] of the ground by rain or melting snow and at a distance of not less than 500 feet from any well.
(5) Whenever it shall be found that, owing to the character of the soil or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, etc.
(1) No bath water, laundry wastes, sewage or polluted liquid of any kind shall be discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraphs (3) and (4) of subdivision (c), within 150 feet of any well.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 150 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well.
(3) No dead animal, bird, fish or any part thereof nor any offal of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 100 feet of any well.
(e) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 150 feet of any well of the public water supply of the village of Alfred.
(f) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any well of the public water supply of the village of Alfred.
(g) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the public water supply of the village of Alfred.
(h) Inspections.
The board of trustees of the village of Alfred or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Alfred or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health, in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.106 New Rochelle Water Company
(a) [Application.]
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to Pocantico Lake and/or to any reservoirs which have been or may be constructed to serve as sources or any part of the public water supply of the New Rochelle Water Company and to all watercourses, the water from which is tributary to or discharged into Pocantico Lake or said reservoirs.
(b) [Definitions.]
(1) The term water supply means the public water supply of the New Rochelle Water Company.
(2) The term reservoir means Pocantico Lake serving as the source of the water supply and any reservoir which has been or may be constructed to serve as any part of the water supply of the New Rochelle Water Company.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) [Human excreta.]
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into any reservoir or any tributary watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any reservoir or any tributary watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or any tributary watercourse, unless such privy or receptacle shall contain or be a watertight receptacle, removable or otherwise, and no sewage shall be discharged or allowed to flow into any reservoir or any tributary watercourse nor upon the surface of the ground at any point on the watershed of the supply nor disposed beneath the surface of the ground within 100 feet thereof, except into a watertight receptacle, removable or otherwise, from which privy or receptacle no outward percolation can take place and which shall be emptied when filled up to within six inches of the top. If the contents of any such privy or receptacle shall be disposed of on the watershed, such contents shall be buried as set forth in paragraph (3) of this subdivision. All such privies and receptacles referred to in this paragraph shall be placed as far as possible (within said limiting distance) from any such reservoir or tributary watercourse, as the property to which such privy or receptacle is appurtenant shall permit, and shall be constructed or installed only with the approval and under the supervision of the New Rochelle Water Company and in such manner as effectually to prevent any pollution of the water supply. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State or Westchester County Commissioner of Health.
(5) Whenever, in the opinion of the State or Westchester County Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or tributary watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State or Westchester County Commissioner of Health.
(d) [Bath water, sink wastes, garbage, etc.]
(1) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by paragraph (4) of subdivision (c), shall be discharged or allowed to flow into any reservoir or any tributary watercourse nor be deposited beneath the surface of the ground within 50 feet of any reservoir or any tributary watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof, oil wastes or any other matter that pollutes water shall be deposited in any reservoir or tributary watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir or any tributary watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or tributary watercourse.
(e) [Bathing, boating, animals, manure, etc.]
(1) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or in any tributary watercourse except in such bathing places as may be operated in accordance with the State Sanitary Code [Chapter I of this Title] and under the supervision of the State or Westchester County Commissioner of Health.
(2) No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse of the public water supply, except by duly authorized officers or employees of the New Rochelle Water Company.
(3) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir or any tributary watercourse and no watering place shall be maintained in such way as to pollute any reservoir or tributary watercourse with excremental matter.
(4) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute any reservoir or any tributary watercourse.
(5) No manure pile shall be maintained or allowed to remain within 150 feet of any reservoir or any tributary watercourse.
(f) [Camps.]
No camp, tent, building or other structure for the occupancy of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or any tributary watercourse.
(g) [Cemeteries.]
No interment of a human body shall be made within a distance of 200 feet of any reservoir or any tributary watercourse.
(h) [General clause.]
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(i) [Inspections.]
The New Rochelle Water Company or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of said company shall make regular and thorough inspections of all reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said water company to promptly notify the State and Westchester County commissioners of health of such violations. The water company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.52 Fees and revenue; calculation
(a) For all fees, the calculation of fees shall be based on the cost to the municipality of providing the service and shall not exceed the cost to the local health department of providing the service for which the fee is to be charged.
(b) For those clinic health services for which a fee is authorized, the fee to the individual shall be based upon the ability of the recipient to pay. A sliding fee schedule shall be established for this purpose and made available to all recipients of service.
(c) The local health department may request the commissioner’s approval to waive fee assessments, based on documentation that charging a fee would create a substantial barrier to obtaining the public health service. The commissioner's decision on whether or not to grant such waivers shall be conclusive.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.25 Electroencephalogy
This functional reporting center must contain all the expenses associated with the operation of specialized equipment to record electromotive variations in brain waves on an electroencephalograph for diagnosis. Additional activities include but are not limited to the following: wheeling portable equipment to patients' bedside; explaining test procedures to patient; operating electroencephalograph equipment; inspecting, testing and maintaining special equipment.
(a) Standard unit of measure: CAP workload measurement units.
Reference: section 455.23(a) of this Part.
(b) Data source.
The number of workload measurement units shall be an actual count maintained by the laboratory.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 118 GREENE COUNTY
10 CRR-NY 118.4 Town of Prattsville, Greene County
(a) Application.
The rules and regulations set forth in this section duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the Huntersfield Creek and all watercourses tributary thereto or which may ultimately discharge into said Huntersfield Creek or which may be developed in the future to serve as sources of the water supply of the Town of Prattsville, Greene County.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(7) Manure shall mean animal feces or urine.
(8) Nonagricultural associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal wastes, and agricultural and nonagricultural associated animal wastes discharged into water.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Town of Prattsville's water supply.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage.
(18) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(19) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(20) Water supply shall mean the public water supply of the Town of Prattsville.
(21) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the Town of Prattsville's water supply.
(22) Watershed shall mean the entire drainage area contributing to the Town of Prattsville's water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Agricultural waste.
No manure or offal shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(3) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse, except in weatherproof buildings or watertight vessels.
(4) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(5) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained, or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works, as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph, shall comprise the criteria to approve any proposed sewage disposal system.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency having jurisdiction and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Town of Prattsville.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Town of Prattsville except by duly authorized employees of the town in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Town of Prattsville within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the Town of Prattsville in the performance of their duties of supervision and maintenance of the water supply.
(8) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourses.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse, except as may otherwise be permitted under the provisions of this subdivision.
(10) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Town of Prattsville.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The commissioner of the Town of Prattsville water district or any person or persons charged with the maintenance or supervision of the public water supply system shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid commissioner of said water district to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid commissioner of such water district to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of such water district shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Part 144 SCHUYLER COUNTY
10 CRR-NY 144.1 Village of Montour Falls
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as last amended by chapter 879 of the Laws of 1953, shall apply to Johns Creek and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the village of Montour Falls, Schuyler County, New York, and to all watercourses tributary thereto or ultimately discharging into said Johns Creek.
(b) Definition of terms.
(1) The term water supply means the public water supplies of the village of Montour Falls in Schuyler County, New York.
(2) The term watercourse means every spring, pond, stream, marsh, road, ditch or channel of any kind, the waters of which flow or may flow into this water supply.
(3) The linear distance of a structure, tank, pit or object from the watercourse is the shortest horizontal distance from the nearest point of the structure, tank or object to the edge, margin or precipitous bank forming the ordinary high-water mark of a watercourse.
(4) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(5) The term sewage means waste liquids containing human excreta and decomposing matters, waste liquids from bathrooms, kitchens or laundries or polluted liquids of any kind in or from the drainage system or sewer of a dwelling or any structure occupied for commercial purposes.
(6) The term receptacle means septic tanks, privy pits, cesspools, leaching cesspools, filter beds or other containers used for the storage or processing of excreta, sewage or waste matters.
(7) The minimum capacity for any septic tank to be installed either new or as a replacement on the watershed shall be 500 gallons.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta, either raw or partially decomposed such as may be dipped, pumped or shoveled from a privy, septic tank, cesspool or other receptacle, shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from a watercourse and covered with not less than 18 inches of soil in such a manner as to effectively prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed or maintained or allowed to remain within 75 feet of any watercourse, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (8) of this subdivision, provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta built or to be built on property which is so located, bounded or otherwise placed that the distances in paragraph (4) of this subdivision cannot be obtained shall be placed as far as possible from a watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from a watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the duly authorized representative of the officers or boards having the management and control of the potable water supplies defined above and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within 75 feet of any watercourse built or to be built according to the provisions of paragraph (5) of this subdivision shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision. In the case of properties occupied only during the summer season, the said receptacles shall be emptied when necessary and also at the end of the summer season, disinfected and left empty during the winter. The work of emptying these receptacles shall be done in such manner as to effectually prevent any pollution of the public water supply.
(7) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(8) No sewage, as defined under the term sewage above, nor any industrial waste, so classified by the Water Pollution Control Board under the State Department of Health, shall be discharged or allowed to flow into any watercourse nor deposited on or beneath the surface of the ground within 75 feet of any watercourse except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of this subdivision, provided, however, that the property on which the receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of this subdivision. The restrictions and limiting distances shall not apply to sewage treatment plants or waste treatment systems installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(d) Sewage.
No privy or receptacle of any kind for the storage, deposit or treatment of excreta, sewage or other waste matter shall be installed, repaired or replaced on any property situated on the watershed where such installations are or will be more than 75 feet from any watercourse unless written permission has first been granted by the authorized representative of the officers or boards having the management and control of the watershed. Prerequisites for such permission shall be rough plans and specifications for the structure or installation and a soil percolation test taken on the site of the installation or leaching area. The provisions and restrictions of this subdivision shall not apply to any property or installation subject to more stringent or restrictive laws or regulations of the State Department of Health or other State agency.
(e) Garbage, refuse and dead animals.
No garbage, refuse, putrescible matter, decomposed fruits and vegetables, dead animals or parts thereof or any other matter that pollutes water shall be deposited in any watercourse nor on or beneath the surface of the ground within 75 feet to any watercourse nor in such manner that it can be washed by rain or melting snow or otherwise over the surface or through the ground into any watercourse.
(f) Bottles and cans.
In the interest of public safety, no bottles, jars, jugs, metal cans, drums or similar objects shall be deposited in any watercourse nor on or beneath the surface of the ground within 50 feet of any watercourse nor in such a manner that the object or material can be washed by rain or melting snow or otherwise over the surface of the ground into any watercourse.
(g) Place for animals.
(1) No animal or poultry shall be allowed to stand, wade, swim or be washed or watered in the water of the Johns Creek within 300 feet of a public water supply intake, and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leaching or washings therefrom may pollute the creek or any watercourse.
(3) No manure pile shall be maintained or allowed to remain within 75 feet of any watercourse nor in such a condition as to pollute any watercourse.
(h) Camps, tents and trailers.
(1) No camp, tent, building or other structure for the occupancy of transients or for the housing of laborers engaged in construction or agricultural work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 50 feet of any watercourse.
(2) No camp, tent, trailer or other structure for the personal use of the owner or the personal use of family, friends or tenants shall be located, placed or maintained within a distance of 50 feet of any watercourse without first complying with the provisions of paragraphs (4) through (8) of subdivision (c) and subdivision (d) for the proper disposal of excreta, sewage and waste matter.
(i) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(j) Inspections.
The officers or boards having the management and control of the public water supplies defined above or such boards or person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of such boards or persons shall make regular and thorough inspections of the watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the officers or boards having the management and control of the public water supplies defined above to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons do not immediately comply with the rules and regulations, it shall be the further duty of said officers or boards having the management and control of the public water supplies defined above to promptly notify the State Commissioner of Health of such violations. The officers or boards having the management and control of the public water supplies defined above shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the inspections which have been made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
(1) In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
(2) The penalty for each and every violation of or noncompliance with any of these rules and regulations which does not relate to a permanent source or act of contamination is hereby fixed at $25.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.10 Unlicensed activity
(a) Except as provided for in section 80.5 of this Part, no person shall act as a manufacturer, distributor, importer or exporter of controlled substances in this State without first having obtained a license from the department.
(b) Holders of licenses in such categories shall register with the appropriate Federal agency or agencies in the comparable controlled substances schedules and license class provided for under Federal regulations.
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
STATE AID LIMITATIONS STATE AID LIMITATIONS
10 CRR-NY 42.11 Laboratory services ineligible for reimbursement
State aid will not be provided on the cost of:
(a) laboratory services eligible for reimbursement by Medicaid, Medicare and other third-party payors, and laboratory services unrelated to the eligible services described in this Part; or those provided to private practitioners or others where the municipal laboratory is providing services available from a private, commercial laboratory;
(b) laboratory services of a blood bank;
(c) laboratory services of a medical examiner when the medical examiner's office is not eligible for State aid reimbursement;
(d) laboratory services not included within the scope of subdivision (a), (b) or (c) of section 42.10 of this Part;
(e) construction or purchase of a building;
(f) rental of space utilized by a laboratory if such rentals are payable to the same municipality as operates the laboratory. Expenditures for non-capital maintenance and operation of costs for space utilized by a laboratory may be included if such facility is owned by the same city or county as operates the laboratory;
(g) depreciation and interest on funding of the space utilized by a laboratory in a building owned by the same city or county as operates the laboratory;
(h) malpractice or personal liability insurance purchased by counties or cities for protection of laboratory employees;
(i) direct or apportioned cost of services provided by other agencies of the county or city to the laboratory;
(j) other costs that the State Commissioner of Health may deem inappropriate.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 113 ERIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 113.2 Village of Gowanda
See section 103.4, supra.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.47 Notification and public education requirements
(a) Notification of results to consumers.
All water systems shall provide notice of the individual tap results from lead tap water monitoring carried out under the requirements of section 5-1.42 of this Subpart to the persons served by the water system at the specific sampling site from which the sample was taken ( i.e. , the occupants of the residence where the tap was tested). Water systems that exceed the lead action level shall sample the tap water of any customer who requests it in accordance with subdivision (i) of this section.
(1) Notice shall be provided as soon as practical, but no later than 30 days after the system learns of the tap monitoring results.
(2) Notice shall be provided either by mail or by another method approved by the State.
(3) Notice shall include the lead levels for the tap that was tested, an explanation of the health effects of lead, a list of steps consumers can take to reduce exposure to lead in drinking water, and contact information for the water utility. The notice shall also provide the maximum contaminant level goal and the action level for lead and the definitions for these two terms from section 5-1.72(f) of this Subpart.
(b) Public education material content and delivery.
A water system that exceeds the lead action level based on tap water samples collected in accordance with section 5-1.42 of this Subpart shall deliver public education materials in accordance with paragraphs (1) and (2) of this subdivision.
(1) Content of public education materials.
(i) Community water systems and nontransient noncommunity water systems. Water systems shall include the following elements in printed materials ( e.g. , brochures and pamphlets) in the same order as listed below. In addition, language in clauses ( a ) through ( b ) and ( f ) of this subparagraph shall be included in the materials, exactly as written, except for the text in brackets in these clauses for which the water system shall include system-specific information. Any additional information presented by a water system shall be consistent with the information below and be in plain language that can be understood by the general public. Water systems shall submit all written public education materials to the State for approval prior to delivery.
(a) IMPORTANT INFORMATION ABOUT LEAD IN YOUR DRINKING WATER. [Insert Name of Water System] found elevated levels of lead in drinking water in some homes/buildings. Lead can cause serious health problems, especially for pregnant women and young children. Please read this information closely to see what you can do to reduce lead in your drinking water.
(b) Health effects of lead. Lead can cause serious health problems if too much enters your body from drinking water or other sources. It can cause damage to the brain and kidneys, and can interfere with the production of red blood cells that carry oxygen to all parts of your body. The greatest risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the effects of lead on the brain with lowered IQ in children. Adults with kidney problems and high blood pressure can be affected by low levels of lead more than healthy adults. Lead is stored in the bones, and it can be released later in life. During pregnancy, the child receives lead from the mother’s bones, which may affect brain development.
(c) Provide information on sources of lead.
(1) explain what lead is;
(2) explain possible sources of lead in drinking water and how lead enters drinking water. Include information on home/building plumbing materials and service lines that may contain lead.
(3) discuss other important sources of lead exposure in addition to drinking water ( e.g. , lead-based paint).
(d) Discuss the steps consumers can take to reduce their exposure to lead in drinking water:
(1) encourage running the water to flush out lead;
(2) explain concerns with using hot water from the tap and specifically caution against the use of hot water for preparing baby formula;
(3) explain that boiling water does not reduce lead levels;
(4) discuss other options consumers can take to reduce exposure to lead in drinking water, such as alternative sources or treatment of water;
(5) suggest that parents have their child’s blood tested for lead.
(e) Explain why there are elevated levels of lead in the system’s drinking water (if known) and what the water system is doing to reduce the lead levels in homes/buildings in this area.
(f) For more information call us at [Insert Your Number] [(If Applicable), or visit our website at [Insert Your website Here]]. For more information on reducing lead exposure around your home/building and the health effects of lead, visit EPA’s website at http://www.epa.gov/lead or contact your health care provider.
(ii) Community water systems. In addition to including the elements specified in this paragraph, community water systems shall:
(a) tell consumers how to get their water tested;
(b) discuss lead in plumbing components, the difference between low lead and lead free, the requirement to use lead-free materials, and the standards that materials shall meet in order to be considered lead free.
(iii) Each water system required to deliver public education materials through additional means specified in subparagraphs (2)(i) through (ii) of this subdivision shall include additional content as determined in consultation with the State.
(2) Delivery of public education materials.
(i) For public water systems serving a large proportion of non-English speaking consumers, as determined by the State, the public education materials shall contain information in the appropriate language(s) regarding the importance of the notice or contain a telephone number or address where persons served may contact the water system to obtain a translated copy of the public education materials or to request assistance in the appropriate language.
(ii) A community water system that exceeds the lead action level and that is not already conducting public education tasks under this section, shall conduct the following public education tasks within 60 days after the end of the monitoring period in which the exceedance occurred. For systems that are required to conduct monitoring annually or less frequently, the end of the monitoring period is September 30th of the calendar year in which the sampling occurs or, if the State has established an alternate monitoring period, the last day of that period:
(a) deliver printed materials meeting the content requirements of subdivision (a) of this section to all bill paying customers;
(b) contact consumers who are most at risk by delivering education materials that meet the content requirements of subdivision (a) of this section as follows:
(1) contact the State for information regarding community based organizations serving target populations and deliver education materials to all appropriate organizations along with an informational notice that encourages distribution to all the organization’s potentially affected customers or community water system’s users as determined in consultation with the State;
(2) contact customers who are most at risk by delivering materials to the following organizations that are located within the water system’s service area, along with an informational notice that encourages distribution to all the organization’s potentially affected customers or community water system’s users:
(i) public and private schools or school boards;
(ii) women, infants and children (WIC) and Head Start programs;
(iii) public and private hospitals and medical clinics;
(iv) pediatricians;
(v) family planning clinics;
(vi) local welfare agencies;
(3) make a good faith effort to locate the following organizations within the service area and deliver materials, along with an informational notice that encourages distribution to all potentially affected customers or users. The good faith effort to contact at-risk customers may include requesting a specific contact list of these organizations from the State:
(i) licensed childcare centers;
(ii) public and private preschools;
(iii) obstetricians-gynecologists and midwives;
(c) no less often than quarterly, provide information on or in each water bill as long as the system exceeds the action level for lead. The message on the water bill shall include the following statement exactly as written except for the text in brackets for which the water system shall include system-specific information: [Insert Name of Water System] found high levels of lead in drinking water in some homes. Lead can cause serious health problems. For more information please call [Insert Name of Water System] [or visit (Insert Your website Here)]. The message or delivery mechanism can be modified in consultation with the State; specifically, the State may allow a separate mailing of public education materials to customers if the water system cannot place the information on water bills;
(d) post material meeting the content requirements of subdivision (a) of this section on the water system’s website if the system serves a population greater than 100,000 or if the water system maintains a publicly accessible website;
(e) submit a press release to newspaper, television and radio stations;
(f) in addition to the other requirements of this section, systems shall implement at least three activities from one or more categories listed below. The educational content and selection of these activities must be determined in consultation with the State:
(1) public service announcements;
(2) paid advertisements;
(3) public area informational displays;
(4) e-mails to customers;
(5) public meetings;
(6) household deliveries;
(7) targeted individual customer contact;
(8) direct material distribution to all multi-family homes and institutions;
(9) other methods approved by the State.
(c) As long as a community water system exceeds the action level, it shall repeat the activities pursuant to paragraphs (1) through (4) of this subdivision.
(1) A community water system shall repeat the tasks contained in subdivisions (a), (b) and (f) of this section every 12 months.
(2) A community water system shall repeat tasks contained in this subdivision with each billing cycle.
(3) A community water system serving a population greater than 100,000 shall post and retain material on a publicly accessible website pursuant to subdivision (d) of this section.
(4) The community water system shall repeat the tasks in clauses (b)(2)(ii)( a ), ( b ) and ( d ) of this section twice every 12 months on a schedule agreed upon with the State. The State may allow activities in clause (b)(2)(ii)( b ) of this section to extend beyond the 60-day requirement if needed for implementation purposes on a case-by-case basis; however, this extension must be approved in writing by the State in advance of the 60-day deadline.
(d) A nontransient noncommunity water system that exceeds the lead action level and that is not already conducting public education tasks under this section shall conduct the following public education tasks within 60 days after the end of the monitoring period in which the exceedance occurred. For systems that are required to conduct monitoring annually or less frequently, the end of the monitoring period is September 30th of the calendar year in which the sampling occurs or, if the State has established an alternate monitoring period, the last day of that period:
(1) post informational posters on lead in drinking water in a public place or common area in each of the buildings served by the system; and
(2) distribute informational pamphlets and/or brochures on lead in drinking water to each person served by the nontransient noncommunity water system. The State may allow the system to utilize electronic transmission in lieu of or combined with printed materials as long as it achieves at least the same coverage.
(e) A nontransient noncommunity water system shall repeat the tasks contained in subdivision (d) of this section at least once during each calendar year in which the system exceeds the lead action level. The State may allow activities in this section to extend beyond the 60-day requirement if needed for implementation purposes on a case-by-case basis; however, this extension must be approved in writing by the State in advance of the 60-day deadline.
(f) A water system may discontinue delivery of public education materials if the system has met the lead action level during the most recent six-month monitoring period. Such a system shall recommence public education in accordance with this section if it exceeds the lead action level during any subsequent monitoring period.
(g) A community water system may use only the text specified in subparagraphs (b)(1)(i) and (ii) of this section in lieu of the text in subparagraphs (b)(1)(i) through (iii) of this section, and to perform the tasks listed in subdivisions (d) and (e) of this section in lieu of the tasks in subparagraph (b)(2)(ii) and paragraph (3) of this section if:
(1) the system is a facility, such as a prison or a hospital, where the population served is not capable of or is prevented from making improvements to plumbing or installing point of use treatment devices;
(2) the system provides water as part of the cost of services provided and does not separately charge for water consumption; and
(3) the State has not directed the water system to conduct broader distribution of education material as needed if in its judgment education materials are not reaching the system’s consumers.
(h) A community water system serving 3,300 or fewer people may limit certain aspects of their public education programs as follows:
(1) With respect to the requirements of clause (b)(2)(ii)( f ) of this section, a system serving 3,300 or fewer shall implement at least one of the activities listed in that clause.
(2) With respect to the requirements of clause (b)(2)(ii)( b ) of this section, a system serving 3,300 or fewer people may limit the distribution of the public education materials required under that clause to facilities and organizations served by the system that are most likely to be visited regularly by pregnant women and children.
(3) With respect to the requirements of clause (b)(2)(ii)( e ) of this section, the State may waive this requirement for systems serving 3,300 or fewer persons as long as system distributes notices to every household served by the system.
(i) Consumer requests for lead sampling.
A water system that fails to meet the lead action level on the basis of tap samples collected in accordance with section 5-1.42 of this Subpart shall provide assistance in determining lead levels at the tap of any customer who requests it. Systems may collect and analyze the samples, but are not obligated to incur expenses. Systems are also not obligated to collect and analyze samples itself, but shall provide information about laboratories providing this service.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.3 Changes in existing program
(a) Applications for approval of changes in the program, including but not limited to substantial changes in the physical plant, space and utilization thereof, the extent and type of services provided, and the program's registrant capacity, must be submitted to the department in writing and must conform with the provisions of Part 710 of this Chapter.
(b) Written requests for additional program sessions must be based on the number and needs of registrants and be approved by the department.
(c) An operator may not discontinue operation of services to registrants without:
(1) notifying each registrant and making suitable plans for alternate services for each registrant; and
(2) receiving written approval from the commissioner in accordance with Part 710 of this Chapter. The application to discontinue services must set forth the specific intended date of discontinuance and the intended plans for alternate services to registrants.
(d) The operator of an approved adult day health care program must notify the department of the program’s election of the unbundled services/payment option in writing thirty days before commencement of this option.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.18 Recoveries of expense
(a) Operating costs shall be reduced by the costs of services and activities which are not properly chargeable to patient care. In the event that the Commissioner of Health determines that it is not practical to establish the costs of such services and activities, the income derived therefrom may be substituted for costs of these services and activities. Examples of activities and services covered by this provision include, but are not limited to, the following:
(1) discount on purchases;
(2) tuitions and other payments for educational service, and other services not directly related to LTHHCP services; and
(3) lease of office and other space to concessionaires providing services not related to LTHHCP service.
(b) Operating costs shall be reduced by the actual revenue received from services and activities which are provided to employees at less than cost, as a form of fringe benefit. Examples of activities and services covered by this provision include, but are not limited to, drugs and supplies sold or provided to employees.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.5 Equipment, supplies and services
(a) The provision at less than fair market value of equipment and supplies by a clinical laboratory to a health services purveyor is prohibited, except that a clinical laboratory may offer to provide, and a referring health services purveyor may accept, directly related equipment and supplies.
(b) A clinical laboratory may offer to perform, and a referring health services purveyor may accept, directly related services, unless prohibited by this Subpart.
(c) Any equipment and supplies provided to a health services purveyor by a clinical laboratory, which is used in a manner prohibited by this Subpart and which is in the possession of the health services purveyor at the time this Subpart becomes effective, shall be returned to the clinical laboratory by the health services purveyor or reclaimed by the clinical laboratory within 60 days of the effective date of this Subpart.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 40-2.3 Projects and services ineligible for State aid
Activities, services, and costs that are ineligible for State aid include, but are not limited to, the following:
(a) Activities and services involving other agencies.
(1) Joint activities. If joint State-local or Federal-local activities have been approved in the State aid Application, the portion financed from State funds, other than State aid under this section, and Federal funds will be excluded from consideration for reimbursement.
(2) Activities carried out by any other agency. The cost of activities for which any other government agency has been given legal responsibility.
(b) Health care programs and services.
(1) Primary care and medical treatment, except as specified in this Subpart.
(2) Hospitals and other health facilities. The construction, establishment, maintenance and operation of hospitals, clinics, laboratories, dispensaries or similar facilities, except for the costs of providing eligible public health services in public health clinics as specified in section 40-2.2 of this Subpart.
(3) The cost of inpatient hospital care of patients with communicable disease, except tuberculosis and syphilis patients.
(4) Home health services provided by a local health department, except for public health home visiting as described in this Subpart.
(5) Laboratory services unrelated to eligible services. The cost of laboratory services related to public health services that are ineligible for State aid are also ineligible for State aid.
(6) Emergency medical service or Ambulance service. The maintenance and operation of emergency medical service and ambulance service or the dispatching of ambulances.
(7) Medical examiner programs, services or activities.
(8) Jail medical services. The cost of providing routine medical treatment to inmates of jails operated by the local health department or in the municipality, including routine admission screenings and primary care to inmates older than 21 years of age.
(9) Any and all health care services for the screening or treatment of chronic diseases.
(c) Environmental health programs and services.
(1) The cost of abatement, remediation, management in place or any action that removes a public health nuisance from a property, or the cost of relocating persons exposed to public health nuisances, consistent with section 40-2.55 of this Subpart.
(2) The cost of removal or covering lead paint or of relocating persons exposed to lead paint, consistent with section 40-2.58 of this Subpart.
(d) Infrastructure and administration costs.
(1) Treatment plants and other facilities. The construction, maintenance and operation of water or waste water treatment plants, swimming pools and bathing beaches, and public bathhouses.
(2) Treatment of water supplies. The cost of treatment of public water supplies, including costs of chemicals for fluoridation.
(3) Garbage and refuse disposal facilities. The cost of construction, maintenance and operation of facilities for garbage and refuse collection, incineration or disposal and air cleaning facilities.
(4) Plumbing inspection. Plumbing inspection for the purpose of checking conformity with building code provisions.
(5) Boards of examiners. Compensation or expenses paid to boards of examiners ( e.g. , boards of examiners for plumbers and barbers).
(6) Insurance coverage of local health department employees. The cost of personal liability or malpractice insurance purchased by the local health department or the cost of funded self-insurance for such liability when such expense is related to protection against personal liability or malpractice of its employees.
(7) Real property. The cost of acquisition or development of real property.
(8) Depreciation and interest on funding, including:
(i) The cost of depreciation of the space utilized by a health agency in a building owned by the same municipality that operates the health agency.
(ii) The cost of interest on the funding of buildings utilized by a health agency and owned by the same municipality that operates the health agency.
(9) Rent paid to city or county. All rent for space utilized for health agency purposes, if such rent is payable to the same municipality that operates the health agency.
(10) Indirect costs and fringe benefits. Contributions by the local health department for indirect costs and fringe benefits, including but not limited to contractor fringe and indirect costs, employee retirement funds, health insurance, workers' compensation, and Federal old age and survivor's insurance.
(e) Other programs and services that the commissioner reasonably determines are not eligible under this Part.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.4 Capital cost reimbursement and rate add-ons
(a) A capital cost component shall be added to Medicaid payments made pursuant to this Subpart and computed in accordance with the following:
(1) the computation of the capital cost component for payments for general hospital outpatient and emergency services shall remain subject to otherwise applicable statutory provisions as set forth in subparagraphs (i) and (ii) of paragraph (g) of subdivision 2 of section 2807 of the Public Health Law;
(2) the computation of the capital cost component for payments for diagnostic and treatment center services shall remain subject to otherwise applicable statutory provisions as set forth in paragraph (b) of subdivision 2 of section 2807 of the Public Health Law;
(3) the computation of the capital cost component for payments for ambulatory surgery services provided by hospital-based and free-standing ambulatory surgery centers shall be the result of dividing the total amount of capital cost reimbursement paid to such facilities pursuant to section 86-4.40 of this Part for the 2005 calendar year for the upstate region and for the downstate region and then dividing each such regional total amount by the total number of claims paid pursuant to section 86-4.40 of this Part within each such region for the 2005 calendar year.
(b) For dates of service occurring on or after April 1, 2020 through December 31, 2020, and each calendar year thereafter, an upper payment limit (UPL) payment per visit shall be added to emergency department rates (hereinafter, add-ons). Such add-ons shall only apply to public general hospitals or public health systems, other than those operated by the state of New York or the state university of New York, located in a city having a population of 1,000,000 or more and shall be in lieu of any aggregate UPL payments. Such add-ons shall be calculated for each hospital by dividing the hospital’s latest approved UPL demonstration payment by its Medicaid fee-for-service emergency department visits, as reported in its most recently submitted institutional cost report. Each hospital’s add-ons shall be subject to and contingent upon the terms of a binding memorandum of understanding executed between the Department of Health and the public general hospital or public health system receiving an add-on, and shall be subject to termination or adjustment based on the terms of that agreement. The total amount paid for the add-on shall be included in the applicable annual UPL demonstration. If the annual UPL demonstration yields an amount that is more or less than the aggregate amount paid for the add-on, the add-on shall be adjusted to reflect the demonstration amount.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.15 Expedited prior approval process
(a) An expedited prior approval determination will be made within two business days of receiving a prior approval request of a physician on the physician's letterhead that states that the enrollee has an emergency need for a service or item that requires prior approval and the reason that the service or item is needed on an expedited basis and any other supporting documentation provided by the physician.
(b) The service or item may be provided to the enrollee in an emergency situation when there is no one from the fund administrator available to approve the request, provided that an expedited approval request is submitted within two business days of the determination of the emergency need. A claim for the provision of the service or item for the period from the time the emergency need was determined to the time of issuance of the review determination, if applicable, can be submitted to the fund administrator for payment, provided that there are no delays as the result of an untimely submission of supporting documentation or a request for an extension of time on the part of the enrollee or any person acting on the enrollee’s behalf.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
TOWNS TOWNS
10 CRR-NY 133.21 Town of Crawford
(a) Application.
The rules and regulations set forth in this section, duty made and enacted in accordance with the provisions of sections 110-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Town of Crawford. Said wells are located on land owned by the Town of Crawford on a parcel bearing Orange County Tax Map Identification No. 8-2-62, being on the southeast side of New York State Route 302 in the Town of Crawford and, on a parcel bearing Orange County Tax Map Identification No. 8-2-63.221, being on the south side of New York State Route 52, in the Town of Crawford.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural associated animal wastes shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, garbage, sewage sludge, chemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing or refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural-associated animal wastes resulting from the operation of such farm are deposited.
(15) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(16) Sewage disposal system shall mean any system used for disposing of sewage.
(17) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(18) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(19) Water supply shall mean the public water supply of the Town of Crawford.
(20) Wells shall mean wells now used as a source of water supply for the Town of Crawford or any additional wells which may be constructed at these points as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticide or herbicide shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained, or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquids of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 25-foot linear distance of the wells.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of the wells.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(7) Refuse.
No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the wells.
(8) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(9) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(10) Trespassing.
No trespassing shall be allowed upon the property of the Town of Crawford upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Town of Crawford.
(11) Other wastes.
No pollutant of any kind shall be discharged or deposited upon the property of the Town of Crawford upon which the wells are located except as otherwise permitted by the provisions of subparagraph (4)(iii) of this subdivision.
(e) Inspections.
The Town Board of the Town of Crawford or any person or persons charged with the maintenance or supervision of the public water supply system shall make regular and thorough inspections of the area surrounding the wells to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid Town Board of the Town of Crawford to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Town Board to promptly notify the State Commissioner of Health of such violation. The aforesaid Town Board of the Town of Crawford shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well(s) at the time of the last inspection.
(f) Penalties for violation.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
STANDARDS STANDARDS
10 CRR-NY 15.9 Sewerage
(a) General requirements.
Facilities shall be provided and maintained for the satisfactory disposal or treatment and disposal of sewage.
(b) Submission of plans.
A plan for proposed new or modified sewage treatment facilities shall be submitted to the permit-issuing official at least 30 days prior to beginning construction.
(c) Plan approval and construction.
A permit or written approval for the sewage system plans shall be obtained from the permit issuing official or the NYS Department of Environmental Conservation. No construction of new or modified sewage treatment facilities shall be commenced until such permit or written approval has been received by the permittee. Construction shall be in accordance with the approved plans.
(d) Inadequately treated sewage.
The presence of inadequately treated sewage on the surface of the ground shall not be allowed. Any discharge occurring in an area frequented by the camp occupants, or which contaminates food service areas, or results in contamination of a potable water supply is an imminent hazard which requires immediate correction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.2 Application and enrollment process
(a) An application for enrollment into the fund may be submitted by:
(1) a qualified plaintiff;
(2) a person who is authorized to act on a qualified plaintiff's behalf; or
(3) a defendant in a medical malpractice claim or action that results in a court-approved settlement or judgment issued on or after April 1, 2011, stating that the plaintiff sustained a "birth-related neurological injury."
(b) An application for enrollment shall be submitted on the application form provided by the fund administrator, which may be obtained either by downloading it from the fund administrator's website or by requesting a form from the fund administrator by phone, or by making a written request. The completed application shall be accompanied by the following:
(1) a medical release form, which shall be in compliance with applicable laws and regulations pertaining to patient confidentiality and shall be made available by the fund administrator, and signed by a person authorized to act on the plaintiff's or claimant's behalf;
(2) a certified copy of the court-approved settlement or judgment including all documents and/or exhibits referenced in the settlement or judgment;
(3) documentation regarding the specific nature and degree of the applicant's birth-related neurological injury or injuries, including diagnoses and impact on the applicant's activities of daily living and instrumental activities of daily living. A copy of the life plan or the summary provided by the applicant's treating physician or other such documentation that was provided to the court in support of the settlement agreement or as part of the applicant's medical malpractice action and contains the required information or any other documentation submitted on behalf of the enrollee for purposes of enrollment in another health related program can be provided in lieu of submitting entirely new documentation, provided that such documentation still accurately reflects the applicant's condition;
(4) documentation in the form of copies of medical records that supports the allegation that the applicant’s injuries, condition or impairments occurred as a result of oxygen deprivation, a mechanical injury or other action or failure to act during the birth delivery admission;
(5) the names, addresses, and phone numbers of all providers providing services to the applicant at time of enrollment; and
(6) documentation of all other present sources of health care coverage or reimbursement, including commercial insurance and/or government program(s).
(c) Documentation submitted on behalf of the applicant for purposes of enrollment in another health related program also may be submitted for purposes of paragraphs (b)(4) and (5) of this section if the documentation is still current.
(d) Upon receipt of an application, the fund administrator shall review the court approved settlement or the judgment, whichever is applicable, to ensure that the document states that the plaintiff or claimant has been deemed or found to have sustained a birth-related neurological injury as defined in section 69-10.1 of this Subpart and that the settlement or judgment provides that, in the event the plaintiff becomes an enrollee of the fund, all future medical expenses of the plaintiff or claimant will be paid by the fund in lieu of that portion of the settlement or award that provides for payment of future medical expenses. If the language regarding the nature of the injury and/or the fund being the payor of the future medical expenses of the plaintiff or claimant is missing or is not clear, the application shall not be considered complete and the fund administrator shall inform the applicant to go back to the court that approved the settlement or issued the judgment to add clarifying language.
(e) The fund administrator shall also review all additional required documentation provided with the application and shall notify the person who submitted the application on behalf of the plaintiff or claimant of any information still needed to complete the application within 15 business days from receipt of the application. No application will be deemed to have been submitted until all required documentation has been provided to the fund administrator.
(f)
(1) Upon determining that the court-approved settlement or the judgment deems or finds the plaintiff or claimant to have sustained a birth-related neurological injury and provides that the fund shall be the payer of all future medical expenses for the plaintiff or claimant in lieu of that portion of the settlement or award that provides for payment of future medical expenses; and
(2) the receipt of all required documentation as set forth in subdivision (b) of the section, the fund administrator shall enroll the qualified plaintiff within five business days of such determination; and provide written notification of enrollment to the qualified plaintiff or a person who is authorized to act on the qualified plaintiff’s behalf, if known to the fund administrator, and to the defendant. The fund will reimburse all appropriate costs incurred to meet the enrollee’s health care needs between the date the court approved the settlement or judgment for the qualified plaintiff and the date the qualified plaintiff becomes a fund enrollee.
(g) Upon enrolling a qualified plaintiff, the fund administrator shall assign the enrollee to a case manager and notify the enrollee of the name of and contact information for such case manager within seven business days from the date of enrollment.
(h) The fund administrator shall provide each enrollee with an enrollment card that contains a unique enrollment identification number.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.21 Social services
(a) This functional reporting center must contain all the expenses associated with obtaining, analyzing and interpreting social and economic information to assist in diagnosis, treatment and rehabilitation of patients, including counseling of staff and patients in case units and group units, participating in the development of community social and health education programs, coordinating the admission and transfer of patients, coordinating discharges, and providing religious counseling and services. Additional activities include but are not limited to the following: filling out admission forms; scheduling admission times; accompanying patients to rooms or service areas after admission and arrangement of admission details; interviewing patients and relatives in order to obtain social history relevant to medical problems and planning; interpreting problems of social situations as they relate to the medical condition and/or hospitalization of the patient; arranging for post-discharge care of chronically ill patients; and collecting and revising information on community health and welfare resources.
(b) Standard unit of measure.
None.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.109 Bedford Farms Water Co., Inc
(a) Application.
The rules and regulations hereinafter set forth, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the wells which comprise the source of the public water supply of the Bedford Farms Water Co., Inc., Westchester County, New York. Said wells are located on land owned by Bedford Farms Water Co., Inc. and are situated approximately one-half mile south of the Bedford Village Green, at the intersection of Route 22 and the Farms Road.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the well.
(5) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(6) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(7) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(8) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(9) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(10) Water supply shall mean the public water supply of the Bedford Farms Water Co., Inc., Westchester County, New York.
(11) Well shall mean the wells now used as a source of this public water supply or to any additional well which may be constructed at this point as a source for this public water supply.
(c) General prohibition.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Chapter.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a linear distance of 250 feet.
(2) Chloride salt.
No chloride salt storage area shall be located within a linear distance of 500 feet except in weather-proof buildings or watertight vessels.
(3) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within a linear distance of 100 feet.
(ii) No human excreta shall be deposited or spread upon or beneath the surface of the ground within a linear distance of 100 feet.
(iii) Sewage. No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground (except into watertight pipes connected to a sewage disposal system, a permit for which shall have been granted by the appropriate State agency having jurisdiction over such facility) within a linear distance of 100 feet. It is provided, however, that no such watertight pipe shall be located within a linear distance of 15 feet of the well.
(4) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16 of this Title shall be disposed of by burial in soil within a linear distance of 500 feet.
(5) Solid waste.
(i) Junkyards. No junkyard shall be located within a linear distance of 250 feet.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a linear distance of 250 feet.
(iii) Refuse disposal area. No refuse disposal area shall be located within a linear distance of 500 feet.
(6) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil or toxic chemicals shall be buried beneath the surface of the ground within a linear distance of 500 feet.
(7) Trespassing.
No trespassing shall be allowed upon the property of the Bedford Farms Water Co., Inc. upon which the well is located and no person or persons shall enter in or upon such property except the person or persons as may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the supply or except such other persons as may be authorized to enter said property by the Bedford Farms Water Co., Inc.
(e) Inspections.
The board of directors, or any person or persons as may be charged with the maintenance or supervision of the water supply, shall make regular and thorough inspections of the area surrounding the well as to ascertain whether this Part is being complied with. It shall be the duty of the aforesaid board of directors to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of directors to promptly notify the State Commissioner of Health of such violations. The aforesaid board of directors shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 708 APPROPRIATENESS REVIEW
10 CRR-NY 708.5 Specific review criteria
In the review of the following specific hospital and home care services, in order to arrive at a determination regarding the appropriateness thereof, the following criteria shall be applied:
(a) [ Reserved ]
(b) Burn care services.
(1) All services.
(i) The standards of this Chapter shall be applicable to the extent that such standards relate to the service under review or to the physical location in which the service is being provided.
(ii) Every hospital has and follows a prescribed protocol for burn triage, emergency burn care, and referral. The protocol includes as a minimum:
(a) the Lund-Browder chart or a similar chart for estimating total body surface area;
(b) a provision that major burn injury is to be treated, to the extent possible, in a burn unit/center except for emergency care prior to referral to such unit/center; and
(c) a provision that moderate uncomplicated burn injury is to be treated, to the extent possible, in a burn program or burn unit/center.
(iii) The burn unit/center is responsible for training facility and other personnel within the service area on emergency treatment procedures, assessment of total body surface area affected, and the classification of burns and triage protocols.
(iv) A burn service is provided by a financially viable facility.
(v) Reviews of each patient with major burn injury or moderate uncomplicated burn injury are undertaken on a weekly basis by the burn care team.
(2) Burn unit/center.
(i) Each burn unit/center has a minimum of six beds.
(ii) Each burn unit/center treats a minimum of 50 patients with major burn injury to moderate uncomplicated burn injury per year.
(iii) The burn unit/center refers patients for whom there are no available beds to another burn unit/center which can provide the care needed.
(iv) The three-year average occupancy of a burn unit/center is at least 75 percent.
(v) There is no more than one burn unit/center bed for every 225,000 in population. As appropriate, the standard may be adjusted to reflect actual incidence in a health service area.
(vi) Each burn unit/center has available either through direct control or through a network of clearly identified relationships, a system of land and/or air transport which will bring severely burn victims to the unit/center.
(vii) A burn unit/center has a designated director who is: a board-certified or board-eligible general or plastic surgeon with one additional year of specialized training in burn therapy or equivalent experience in burn patient care
(viii) Staff for the burn unit/center includes:
(a) a head nurse of the facility who is a registered nurse, with two years intensive care unit or equivalent training and a minimum of six months burn experience;
(b) one nurse for every two intensive care patients at all times;
(c) one nurse for every three non intensive care patients at all times;
(d) a designated field-trained and licensed and/or registered physical therapist and occupational therapist with a minimum of three months training or six months experience in burn treatment available as needed;
(e) a designated registered dietician available as needed;
(f) a designated medical social worker responsible for referral and follow-up care and individual and group counseling available as needed; and
(g) a psychologist and/or psychiatrist available as needed.
(xi) A burn unit/center has a designated area for providing specialized intensive care and an operating room easily accessible within the hospital.
(3) Burn program.
(i) A burn program treats a minimum of 75 patients with moderate uncomplicated burn injuries per year.
(ii) There is no more than one burn program for every 326,000 in population. As appropriate, the standard may be adjusted to reflect actual incidence and number of patients per program in a health service area.
(iii) The average length of stay per patient in a burn program is no more than 14 days.
(iv) Staff for a facility with a burn program includes:
(a) a board-certified or board-eligible general or plastic surgeon with experience in burn care (preferably a three-month period of burn training) who is responsible for a written plan of burn therapy, maintains and periodically reviews the burn program's admissions and transfer protocols for burn patients having major burn injury, moderate uncomplicated burn injury, or minor burn injury;
(b) a registered nurse with six months intensive care unit experience (preferably three months burn nursing experience) who is responsible for nursing care protocol for burn patients, coordination of care for in-patients requiring burn care, and training of nursing personnel involved in burn care;
(c) a licensed and/or registered occupational therapist or physical therapist with splinting experience available as needed;
(d) on staff or through formal arrangement, a medical social worker responsible for referral and follow-up and individual and group counseling available as needed;
(e) on staff or through formal arrangement, a registered dietician, available as needed; and
(f) on staff or through formal arrangement, a psychologist or psychiatrist, available as needed.
(v) A burn program has these support services:
(a) general surgery;
(b) internal medicine;
(c) pediatrics;
(d) respiratory services;
(e) infectious disease control; and
(f) anesthesiology.
(d) End stage renal disease services.
(1) All services.
(i) The standards of Chapter V of this Title shall be applicable to the extent that such standards relate to the service under review or to the physical location in which the service is being provided.
(ii) Any facility providing services to ESRD patients must comply with Federal regulations for ESRD services.
(iii) The ESRD service is provided by a financially viable facility.
(2) Dialysis services.
(i) Dialysis services are provided to patients at their convenience whenever feasible and arrangements are made to accommodate employed patients who wish to be dialyzed during nonworking hours, either through extended shifts or cooperative arrangements among facilities.
(ii) Medical care for emergencies on a 24-hour day, seven-day week basis is provided. There is posted at the nursing/monitoring station a roster with the names of the physicians on duty to be called for emergencies and instructions as to how they can be reached.
(iii) Ninety-five percent of the total population of each health region is within a one hour mean travel time, adjusted for permitting weather conditions, of a renal dialysis center/facility providing dialysis services.
(iv) Each renal dialysis center/facility (except those located in New York City) is working toward a goal of at least 15 percent of its patients on home dialysis. As appropriate, a center/facility having less than 15 percent of its total patient load on home dialysis submits its plan and protocols for increasing home dialysis and a statement as to why the minimum goal cannot be attained. In New York City each renal dialysis center/facility is working toward a goal of at least 11 percent of its patients on home dialysis. As appropriate, a center/facility having less than 11 percent of its total patient load on home dialysis submits its plan and protocols for increasing home dialysis and a statement as to why the minimum goal cannot be attained.
(v) Each facility providing dialysis services has a written protocol to screen candidates for transplantation, institutional dialysis, home dialysis, early identification of home dialysis patients, and the training of patients and family in home dialysis training. This protocol would require at a minimum that:
(a) the facility has a goal of increasing its current home dialysis patient load, including criteria for identifying appropriate candidates for home dialysis; and
(b) each patient has been informed of all treatment options and has signed an informed consent document to be placed in his/her medical records file acknowledging his/her choice of modalities.
(vi) Each facility providing dialysis services shall provide directly or by formal arrangements, home training and supervision.
(vii) All personnel of the facility participate in educational programs for initial orientation, continuing in-service training and procedures for infection control on a regular basis.
(viii) Each facility maintains and reviews for each patient a written long-term program and a written patient care plan. The care plan includes at a minimum an annual evaluation of the dialysis patient by a transplant surgeon, where available, nephrologist, nurse, social worker, nutritionist, and medical director of the home dialysis training program.
(ix) Each renal dialysis center/facility maintains complete medical records for all patients, including self dialysis patients within the self dialysis unit and home dialysis patients whose care is under the supervision of the facility.
(x) Each renal dialysis center/facility reports to the Kindey Disease Institute, as required, patient information, including up-to-date information on medical and socioeconomic status.
(xi) A home dialysis care plan provides for periodic monitoring of the patient's home adaption, including provisions for visits to the home by qualified personnel to the extent possible and a back-up for the patient's emergency needs.
(xii) The medical director of a renal dialysis center/facility:
(a) is board-eligible or board-certified in internal medicine or pediatrics by a professional board and has at last 12 months combined experience and/or training in the care of patients at ESRD facilities; or
(b) has during the five-year period prior to September 1, 1976, served for at least 12 months as director of a dialysis or transplantation program.
(xiii) The responsibilities of the physician-director shall include:
(a) selection of a suitable treatment modality;
(b) development of adequate training of facility personnel in dialysis procedures and techniques;
(c) monitoring of the patients and the dialysis process including periodic assessment of patient performance of dialysis tasks;
(d) development and implementation of a patient care policy and procedure manual; and
(e) provision of self dialysis or home dialysis patients with teaching materials for self dialysis or home dialysis training.
(xiv) A renal dialysis center/facility has on staff:
(a) a licensed registered nurse who:
(1) has at least 12 months of experience in clinical nursing and an additional six months of experience in nursing care of patients with permanent kidney failure or who are undergoing or have undergone kidney transplantation, including training in and experience with the dialysis process; or
(2) has at least 18 months of experience in nursing care of patients on maintenance dialysis or in nursing care of patients with kidney transplant, including training and experience with the dialysis process; and
(b) a nurse responsible for self care dialysis who has as part of her total ESRD experience at least three months of experience in training self-care patients.
(xv) A renal dialysis center/facility has available on staff or through formal arrangement:
(a) a certified social worker, whose services include social services to patients and their families directed at supporting and maximizing the social functioning and adjustment of patients. The social worker's responsibilities include:
(1) conducting psychosocial evaluations;
(2) participating in team review of patient progress;
(3) recommending changes in treatment based on the patient's current psychosocial needs;
(4) providing casework and group services; and
(5) identifying community social agencies and resources; and
(b) a dietition who is eligible for registration by the American Dietetic Association and has one year of experience in clinical nutrition, or a bachelor of arts or advanced degree with major studies in food and nutrition or dietetics and one year experience in clinical nutrition. The dietitian's services include:
(1) evaluating nutritional needs of patients in consultation with attending physicians;
(2) recommending the nutritional and dietetic programs;
(3) developing therapeutic diets;
(4) counseling patients on the importance of diet; and
(5) monitoring the diets.
(xvi) A renal dialysis center performs a minimum of nine dialyses per station per week.
(xvii) A renal dialysis facility performs a minimum of 10.8 dialyses per station per week.
(3) Renal transplantation center.
(i) A renal transplantation center performs at least 15 renal transplants annually.
(ii) Each renal transplant center participates in research of renal disease of related areas.
(iii) Each renal transplant center provides access to the full range of diagnostic and therapeutic services necessary to support its function including medical, surgical, radiological, and radio-isotopic services.
(iv) Each renal transplant center has access, either within the facility or through formal contract arrangement, to laboratory services, including tissue typing.
(v) The renal transplantation center participates in a patient registry program for patients who are awaiting cadaveric donor transplantation.
(vi) If a renal transplantation center utilizes the services of an organ procurement agency to obtain donor organs, it has a written agreement covering these services.
(vii) Transplantation shall be performed by physicians trained in the disciplines of general or vascular surgery and urology and who have at least 12 months training or experience in the performance of renal transplant and the care of patients with renal transplants.
(viii) Transplantation teams consist of:
(a) a surgeon or urologist trained in general and vascular surgery with documented experience in renal transplantation;
(b) an internist with subspecialty training in nephrology and hemodialysis and with documented experience in the management of renal transplant patients;
(c) a physician who is assigned the primary responsibility for post-operative management of patients and whose experience in management of such patients must be documented;
(d) consultants for immunology and infectious disease who must be associated with the transplantation center; and
(e) a pediatrician, when the renal transplant of a child is performed, who is trained in the subspeciality of pediatric nephrology and who has documented experience in the management of renal-transplant pediatric patients.
(e) Computed tomography services.
(1) The standards of Chapter V of this Title shall be applicable to the extent that such standards relate to the service under review or to the physical location in which the service is being provided.
(2) Each facility providing computed tomography services does not refuse treatment of a patient on the basis of the referring physician or his/her facility affiliation. All referrals from outside the provider facility will be reviewed by a board-eligible or board-certified radiologist at the provider facility prior to the scan being performed.
(3) Institutions will accommodate patients who require computed tomography diagnostic or treatment planning services outside normal working hours.
(4) Ninety-five percent of the total population of each health region is within 45 minutes mean travel time, adjusted for permitting weather conditions, of a facility providing computed tomography services.
(5) Each facility providing computed tomography services must accept referrals from other institutions. Facilities that are members of a computed tomography service consortium have a written plan which describes the shared service and the participation of each facility within the shared service plan. The written plan provides at a minimum, the following information:
(i) the identification of the host facility and satellite facilities in the shared service;
(ii) stated commitment of the provider facility to give priority to bona fide medical emergencies independent of referral source, and equal consideration to inpatients and outpatients independent of referral source;
(iii) the process used by the provider facility to determine instances of bona fide medical emergency;
(iv) the process used by a certified radiologist at the provider facility to determine, prior to the procedure being performed, the necessity and appropriateness of the procedure;
(v) the availability of the computed tomography services unit, on a 24-hour basis, seven day-a-week basis, for the diagnosis of emergency conditions;
(vi) clear delineation of the patient information which is to accompany a patient from a referral facility; and
(vii) assignment of nursing care responsibility for patients referred from other institutions.
(6) A facility offering computed tomography services has available, either directly or through formal arrangement, a full range of diagnostic services including, at a minimum, diagnostic and therapeutic radiology services, nuclear medicine and diagnostic ultrasound.
(7) A facility offering computed tomography services has available, either on staff or through formal arrangements, individuals for the treatment of neurological, thoracic, cardiac, abdominal, medical and radiological oncological, gynecological, neurosurgical and genitourinary conditions, as well as any other conditions diagnosed by computed tomography.
(8) A facility offering computed tomography services is responsible for guiding physicians and other staff at the host and referral facilities in order to encourage that physicians and other staff become familiar with the safe and appropriate use of the service.
(9) A computed tomography service is provided by a financially viable facility.
(10) On an individual basis, each C.T. scanner's utilization is at a minimum of 2,000 patient procedures or 3,400 head equivalent computed tomography (HECT) units per year at the end of the second year of operation.
(11) On a regional basis, C.T. scanner utilization is at a minimum average of 2,500 patient procedures or 4,250 head equivalent computed tomography (HECT) units per year.
(12) Based on the recognition that not all of the additional scanner time required for teaching can be obtained through expanded operation of equipment, a maximum variance of 25 percent from current utilization standards cited in this subdivision is established for teaching hospitals. In order to qualify for the variance, the teaching hospital must be able to:
(i) document its affiliation with a qualified medical school; and
(ii) document the existence of a diagnostic radiology program which averages a total of four residents per year for a period of at least three years.
(13) Variances from scanner utilization standards for research usage are recommended only for those units in teaching hospitals which can provide at a minimum:
(i) documentation of levels of past research;
(ii) copies of written protocols describing current research; and
(iii) proof that research funding from all sources exceeds $50,000 annually.
(14) The director of the service in which a C.T. scanner is located is a board-eligible or hoard-certified radiologist.
(15) The C.T. scanner is staffed by at least one full-time New York State licensed radiological technician per staff shift.
(16) A facility with a C.T. scanner has on staff, or through formal arrangements, a radiological physicist holding a degree in physics who is either certified or eligible for certification by the American Board of Radiology or the American Board of Health Physicists.
(f) [ Reserved ]
(g) Comprehensive inpatient physical medicine and rehabilitation.
(1) The standards of Chapter V of this Title shall be applicable to the extent that such standards relate to the service under review or to the physical location in which the service is being provided.
(2) The following general standards address the distribution of services and issues related to all facilities which provide comprehensive inpatient physical medicine and rehabilitation:
(i) The beds shall be in a designated area which is organized, staffed, and equipped for the specific purpose of providing a comprehensive physical medicine and rehabilitation program.
(ii) A free-standing inpatient facility devoted exclusively to providing a comprehensive physical medicine and rehabilitation program shall contain a minimum of 30 beds. Comprehensive physical medicine and rehabilitation units within a general hospital shall contain a minimum of 15 beds.
(iii) The comprehensive inpatient program shall maintain a minimum occupancy rate of 75 percent.
(iv) The program shall be directed by a chief of physical medicine and rehabilitation who dedicates full-time to the facility's rehabilitation services. The chief of physical medicine and rehabilitation shall be a board-certified physiatrist, or a physician who by training and experience is knowledgeable in physical and rehabilitative medicine.
(v) The physician of record for a patient in the program must be a rehabilitation physician, a physician who is board-certified in physical medicine and rehabilitation or a physician who by training and experience is knowledgeable in physical medicine and rehabilitation.
(vi) Nursing care shall be under the direction of a registered professional nurse with certification in rehabilitation nursing, or its equivalent, and progressive leadership experience.
(vii) The program shall include the following services which are provided by full-time staff whose training and experience are consistent with New York State licensure/certification/registration requirements: rehabilitation nursing, physical therapy, occupational therapy and social work. Psychologists and speech-language therapists shall be available as needed.
(viii) Dependent upon the needs of those served, the program shall provide to make formal arrangements for the following services: vocational rehabilitation, education, orthotics, prosthetics, rehabilitation engineering, driver education, audiology, and therapeutic recreation.
(ix) The following support services shall be available: dietetics, diagnostic radiology, laboratory, dentistry, chaplaincy; and pharmacy.
(x) Physician consultive services shall include, but not be limited to: general surgery, internal medicine, neurology, neurosurgery, ophthalmology, orthopedic surgery, otorhinolaryngology, pediatrics, physical medicine and rehabilitation, plastic surgery, psychiatry, pulmonary medicine, urology.
(xi) Services shall be offered through a coordinated inter-disciplinary team approach, which shall include a comprehensive evaluation upon admission followed by regularly scheduled conferences. These conferences shall result in a documented decision on feasible rehabilitation goals, identification of services needed to progress toward those goals, and evaluation of progress toward meeting established goals.
(xii) Each facility shall have written guidelines that identify procedures to follow for the following areas: intake and orientation, assessment and evaluation, program management, referral discharge, and follow-up.
(xiii) The program shall establish formalized relationships with other area hospitals which shall include provision for consultation, inservice education, and the sharing of common treatment protocols.
(xiv) All facilities shall have written transfer agreements in place for the transfer of patients who need medical or specialty care not available at the facility of admission. Transfer agreements shall be mutually agreed upon by both the transferring and receiving facility and shall be reviewed on a annual basis.
(xv) There shall be an organized outpatient physical medicine and rehabilitation program at the facility which shall provide a range of services equal in scope to that of the inpatient program.
(xvi) There shall be an organized program for follow-up care to maintain and/or improve health status following discharge.
(xvii) The service area for determining public need for comprehensive inpatient physical medicine and rehabilitation shall be the designated health systems agency regions.
(xviii) The maximum number of comprehensive inpatient physical medicine and rehabilitation beds in each health systems agency required to meet public need shall be determined by dividing the projected annual patient days for the service by 365, and dividing the result by.90 to allow for 90 percent occupancy. The projected comprehensive inpatient physical medicine rehabilitation patients days used in this calculation shall be determined as follows:
(a) The diagnostic categories used in computing the need for comprehensive inpatient physical medicine and rehabilitation shall be: brain dysfunction, traumatic brain dysfunction, orthopedic disorders, spinal cord dysfunction, traumatic spinal cord dysfunction, stroke, amputation of limb, congenital deformities, neurological conditions, and arthritis.
(b) The annual number of potential comprehensive inpatient physical medicine and rehabilitation candidates shall be determined by calculating the total number of annual general hospital discharges from categories considered, excluding the number of discharges in these categories with a length of stay less than two days, and multiplying the resulting figure by.25.
(c) The number of potential comprehensive inpatient physical medicine and rehabilitation candidates shall be multiplied by a 34-day rehabilitation length of stay to project the annual number of comprehensive inpatient physical medicine and rehabilitation patient days.
(3) The following general standards address the distribution of services and issues related to all facilities which provide a spinal cord injury program.
(i) The spinal cord injury program shall be an organized program within a comprehensive physical medicine and rehabilitation program or a distinct comprehensive physical medicine and rehabilitation program for the spinal cord injured.
(ii) The spinal cord injury program shall maintain a minimum of 10 beds and/or 30 new admissions per year.
(iii) The spinal cord injury program shall maintain a minimum occupancy rate of 75 percent.
(iv) The spinal cord injury program shall be a designated unit for spinal cord injured people with a designated staff to serve the spinal cord injured patients.
(v) The spinal cord injury program shall be directed by a physician with special interest and competence in the area of those with spinal cord injury.
(vi) The nurse supervisor shall be a registered professional nurse with certification in rehabilitation nursing, or its equivalent, and clinical experience in the care of spinal cord injury.
(vii) The following services shall be available seven days a week, 24 hours per day: rehabilitation nursing, trained personnel capable of providing intermittent catheterization, and respiratory therapy.
(viii) In addition to the services previously identified, there shall be a formally organized program for patient/family spinal cord injury education regarding: bladder management, bowel management, pulmonary care, skin care, instruction in medications, nutrition, access to follow-up medical care, care of equipment, and sexual counseling.
(ix) There shall be an organized outpatient physical medicine and rehabilitation program which shall offer a range of services equal in scope to those of the inpatient spinal cord injury program.
(x) There shall be an organized program of follow-up care to maintain and/or improve health status following discharge.
(4) The following general standards address the distribution of services and issues related to all facilities which provide a brain injury program.
(i) The brain injury program shall be organized as a specialized unit within a comprehensive physical medicine and rehabilitation program or as a distinct comprehensive physical medicine and rehabilitation program for the brain injured.
(ii) The brain injury program shall maintain a minimum of 10 beds and/or 30 new admissions per year.
(iii) The brain injury program shall have formalized relationships with area hospitals which include provision for consultation, in-service education, the sharing of common treatment protocols, and transfer agreements.
(iv) The brain injury program shall be a designated unit with a designated staff to serve the brain injured.
(v) The brain injury program shall be directed by a physician with advanced training and experience in the care of the brain injured.
(vi) The nurse supervisor shall be a registered professional nurse with certification in rehabilitation nursing, or its equivalent, and clinical experience in the care of the brain injured.
(vii) The following diagnostic services shall be available: electrodiagnostic services, including EEG, EMG and evoked potentials, and CT scanner.
(viii) In addition to services previously identified, there shall be an integrated treatment program that addresses the following areas: medical and neurological issues, nutrition, sensorimotor capacity, cognitive, perceptual, and communicative capacity, affect and mood, activities of daily living, educational and/or vocational capacities, sexuality, family counseling and community reintegration.
(ix) There shall be an organized outpatient physical medicine and rehabilitation program which offers a range of services equal in scope to those in the inpatient brain injury program.
(x) There shall be an organized program of follow-up care to maintain and/or improve health status following discharge.
(h) Emergency department and emergency services.
(1) The standards of this Chapter shall be applicable to the extent that such standards relate to the service under review or to the physical location in which the service is being provided.
(2) A hospital with a minimum volume of 15,000 emergency visits a year must meet the requirements for an emergency department. Those hospitals providing emergency care with less than 15,000 emergency visits per year may meet the requirements of an emergency department if they elect to provide these services, but at a minimum must meet the requirements of an emergency service.
(3) The following standards apply to emergency departments:
(i) A person presenting oneself to the emergency department for emergency care shall be promptly seen and evaluated by a physician.
(ii) Every emergency department shall have written policies and procedures for initial assessment of patients in the emergency department.
(iii) At least one emergency physician shall be on duty in the emergency department 24 hours a day, seven days a week.
(iv) The emergency department staff physicians must be licensed to practice medicine in New York State; and:
(a) be board certified in emergency medicine; or
(b) have three years post graduate experience in emergency medicine, surgery, internal medicine, family practice or pediatrics in addition to current certification in advance cardiac life support (ACLS), and advanced trauma life support (ATLS) or equivalent training and experience.
(v) The emergency department shall have a designated physician director qualified as an emergency department staff physician.
(vi) Emergency physicians shall be assigned exclusively to the emergency department. The number of patients seen by the emergency department physician shall not, on an annual average, exceed 20 patients per eight-hour period.
(vii) All nurses in the emergency department shall be registered professional nurses with New York State licensure and current registration. The nurse must have at least one year of clinical experience, have successfully completed the emergency nursing orientation program and be able to demonstrate skills and knowledge necessary to perform basic life support measures. Within one year of assignment to the emergency department, all emergency department staff nurses must obtain current advanced cardiac life support (ACLS) certification or the equivalent.
(viii) There shall be a nurse manager in the emergency department who is a registered professional nurse with New York State licensure and current registration who possesses all of the qualifications required of a staff nurse and who becomes a certified emergency nurse, or its equivalent, within one year of appointment. The nurse manager shall have at least three years clinical experience, two of which are in emergency nursing, and shall be assigned exclusively to that department.
(ix) On annual average there shall be a nurse to patient ratio of 1:10 unscheduled visits per eight-hour period, with a minimum of two nurses assigned to the emergency department on each shift. If, on average, the volume of patients per eight-hour shift is over 25, there shall be a charge nurse in addition to the minimum of two nurses per shift. If, on average, the volume exceeds 50 patients per shift, there shall be an assessment nurse in addition to the charge nurse and regular shift nurse. Staffing for scheduled visits shall be in addition to the staffing required for unscheduled visits.
(x) There shall be at least one person on duty at all times to perform patient registration, reception and other clerical duties as required. The clerical staff shall be responsible to, and function under the direction of, the emergency department staff.
(xi) There shall be sufficient support personnel, exclusive of the professional staff, available at all times to perform messenger service, acquisition of supplies and equipment, delivery of lab specimens, obtaining records, patient transport, and other duties as required.
(xii) All personnel working in the emergency department must complete a hospital and department orientation program.
(xiii) An emergency department must have immediate access to laboratory services that are staffed and equipped 24 hours a day.
(xiv) X-ray capability, using both fixed and mobile equipment, must be immediately available in close proximity to the emergency department 24 hours a day.
(xv) The hospital's medical staff must have a schedule for every specialty represented on the hospital's medical staff, to provide back-up support to the emergency department in a timely manner, 24 hours a day, seven days a week. At a minimum, these specialties shall include general surgery, internal medicine, orthopedics, anesthesiology, radiology and pediatrics.
(xvi) Each emergency department must make provision for referral for needed follow-up care.
(xvii) The specific equipment and pharmacologic/therapeutic drugs and agents needed in the emergency department shall be determined jointly by the medical director and nurse manager by consulting recommendations such as the guidelines of the American College of Emergency Physicians. These requirements shall be reviewed every two years.
(xviii) Each emergency department shall have written protocols and agreements for the treatment, triage and transfer of patients who cannot receive definitive care at the receiving hospital. These shall include, but not be limited to, burn patients, spinal-cord injury patients, brain injury patients, cardiac patients, patients with behavioral problems, multiple injury patients, replantation patients, neonatal and pediatric patients, and patients in need of hemodialysis.
(xix) Each emergency department shall adopt and implement written policies and procedures for the following:
(a) provision for triage of patients and transfer to the most appropriate hospital;
(b) medical control and direction of prehospital emergency medical services;
(c) review of quality of patient care on a regular basis (at least quarterly) with prehospital providers, emergency department personnel, and physicians, in order to improve field operations and make recommendations for continuing education;
(d) clinical and continuing education in emergency medical services, for prehospital providers;
(e) provision of liaison and direction for the supply of medications, fluids, and other items utilized by ambulance organizations; and
(f) provision of patient utilization data for the State EMS Data System. Where there is an established regional emergency medical services system, the emergency department shall coordinate its performance of these functions with the other participants in the regional system.
(xx) The emergency department shall establish and implement written policies and procedures for:
(a) the provision of appropriate social services 24 hours a day;
(b) consultation with a poison control center; and
(c) the maintenance of sexual offense evidence as part of the hospital-wide provisions required by this Title.
(xxi) All cases of suspected child abuse or neglect shall be reported immediately to the New York State Central Register of Child Abuse and Maltreatment and with respect to such cases the hospital shall comply with article 6, title 6 of the Social Services Law.
(xxii) The emergency department personnel shall give information regarding community resources and the Domestic Violence Hotline telephone number to those persons whom are suspected or confirmed victims of domestic violence.
(4) The following standards shall apply to emergency services:
(i) A person presenting to the emergency service for emergency care shall be promptly seen by a physician (or a nurse practitioner or a physician's assistant operating under the direction of the emergency services physician director), or evaluated by a registered nurse and seen by a physician, nurse practitioner or physician's assistant prior to discharge.
(ii) Every emergency service shall have written policies and procedures for initial assessment of patients presenting to the emergency service.
(iii) At least one physician, nurse practitioner, or registered physician assistant shall be on duty in the emergency service 24 hours a day, 7 days a week. In addition, a licensed physician shall be available within 30 minutes when a registered physician assistant or nurse practitioner is on duty in the absence of licensed physician.
(iv) Emergency service staff physicians must be licensed to practice medicine in New York State and have:
(a) board certification in emergency medicine or family practice; or
(b) two years post graduate experience in emergency medicine, surgery, internal medicine, family practice or pediatrics in addition to current certification in advanced cardiac life support (ACLS), and advanced trauma life support (ATLS) or equivalent training and experience.
The registered physician assistants must have current certification in advanced cardiac life support (ACLS) or the equivalent training and experience, as well as training in trauma management equivalent to ATLS.
(v) The emergency service shall have a designated physician director qualified as an emergency service staff physician.
(vi) All nursing staff in the emergency service shall be registered professional nurses with New York State licensure and current registration who possess current, comprehensive knowledge and skills in emergency health care. They must have at least one year of clinical experience, have successfully completed an emergency nursing orientation program and be able to demonstrate skills and knowledge necessary to perform basic life support measures. Within one year of assignment to the emergency service, all emergency service staff nurses must obtain current advanced cardiac life support (ACLS) certification or the equivalent.
(vii) There shall be a nurse manager in the emergency service who is a registered professional nurse with New York State licensure and current registration who possesses all the qualifications required of a staff nurse, who becomes a certified emergency nurse, or its equivalent, within one year of appointment, and who has at least three years clinical experience, two of which in emergency nursing.
(viii) On annual average, there shall be a nurse-to-patient ratio of 1:10 per eight-hour period, with a minimum of one nurse assigned to the emergency service and an additional nurse available on each shift. If, on average, the volume of patients per eight-hour shift is over 25, there shall be a charge nurse in addition to a minimum of two nurses per shift. If, on average, the volume exceeds 50 patients per shift, there shall be an assessment nurse counted separately in addition to the charge nurse and regular shift nurses.
(ix) There shall be sufficient support personnel to perform patient registration, reception, messenger service, acquisition of supplies, equipment, delivery of lab specimens, obtaining records, patient transport and other functions as required.
(x) All personnel working in the emergency service must complete a hospital orientation program.
(xi) Laboratory and X-ray capability must be available within 20 minutes, 24 hours a day.
(xii) The specific equipment and pharmacologic/therapeutic drugs and agents needed in the emergency service shall be determined jointly by the medical director and the nurse manager by consulting recommendations such as the guidelines of the American College of Emergency Physicians. These requirements shall be reviewed every two years.
(xiii) Each emergency service shall have written protocols and agreements for the treatment, triage and transfer of patients who cannot receive definitive care at the receiving hospital. These shall include but not be limited to burn patients, spinal cord injury patients, brain injury patients, cardiac patients, patients with behavioral problems, multiple injury patients, replantation patients, neonatal and pediatric patients.
(xiv) All emergency services shall adopt and implement written policies and procedures for:
(a) provision for triage and transfer of patients to the most appropriate hospital;
(b) medical control and direction of prehospital emergency medical services;
(c) review of quality of patient care on a regular basis (at least quarterly) with prehospital providers, emergency services personnel, and physicians, in order to improve field operations and make recommendations for continuing education;
(d) continuing education in emergency medical services;
(e) provision of liaison and direction for the supply of medications, fluids, and other items utilized by ambulance organizations; and
(f) provision of patient outcome data to the State EMS Data System.
Where there is an established regional emergency medical services system, the emergency service shall coordinate its performance of these functions with the other participants in the regional system.
(xv) The emergency service shall establish and implement written policies and procedures for:
(a) the provision of appropriate social services 24 hours a day;
(b) consultation with a poison control center; and
(c) the maintenance of sexual offense evidence as part of the hospital-wide provisions required by this Title.
(xvi) All cases of suspected child abuse or neglect shall be reported immediately to the New York State Central Register of Child Abuse and Maltreatment and the hospital shall comply with article 6, title 6 of the Social Services Law.
(xvii) The emergency service personnel shall give information regarding community resources and the Domestic Violence Hotline telephone number to those persons who are suspected or confirmed victims of domestic violence.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.36 Hospital physician billing
(a) With the exception of hospitals designated under the Medicare program as meeting the criteria set forth in section 1861(b)(7) of the Federal Social Security Act, for discharges occurring on and after February 1, 2010, hospitals may bill for physician services in accordance with the applicable Medicaid physician fee schedule in addition to billing the applicable DRG.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.329 Triage
The process of screening patients to determine the severity of the medical emergency and type of care necessary.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 42.2 Approval of application
Each application shall be reviewed by the State Department of Health. The application may be approved in whole or in part and the municipality shall be informed of the amount approved by the State Department of Health.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 156 WYOMING COUNTY
10 CRR-NY 156.2 Village of Attica
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Crow Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the village of Attica, Wyoming County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoir on Crow Creek, which is tributary to or which serves as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Attica.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 40 feet of any watercourse tributary to the public water supply of the village of Attica.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the village of Attica.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or within 200 feet of any watercourse tributary to the public water supply of the village of Attica.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Attica, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Attica.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Attica, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraph [4] and [5] of subdivision [c]) within 150 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the village of Attica.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Attica.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animals or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Attica. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Attica.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the village of Attica, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 30 feet from any watercourse tributary to the public water supply of the Village of Attica.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Attica, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or 200 feet of any watercourse tributary to the public water supply of the Village of Attica; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 30 feet of any watercourse tributary to the public water supply of the Village of Attica.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 30 feet from any watercourse tributary to the public Water supply of the Village of Attica.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Village of Attica.
(g) Fishing, boating and ice cutting.
The Village of Attica may authorize fishing at the village reservoir by permit only. No other ice cutting or other trespassing shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Village of Attica, except as allowed by said permit and except by duly authorized employees of the Village of Attica and the performance of their duties of supervision and maintenance of the public water supply of the Village Attica.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Attica.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the Village of Attica.
(j) Inspections.
The board of trustees of the Village of Attica or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Attica or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-4.60 Transportation
During transportation, food utensils, equipment and tableware are to be protected from contamination, including maintenance of hot or cold temperature requirements. Original individual packages do not need to be over-wrapped or covered if the original package has not been torn or broken.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.3 Funding application
A plan submitted to the commissioner by the program director for approval shall consist of the following:
(a) A copy of the application for program approval which was submitted to the Residency Review Committee of the American Medical Association or the American Osteopathic Association.
(b) A copy of the current program review report and letter of approval received from the Liaison Committee on Graduate Medical Education or the American Osteopathic Association.
(c) The budget for operation of the program for the current 12-month period, showing:
(1) with respect to the total cost of the program:
(i) compensation of each of the following personnel categories, both full-time and part-time: physician (excluding residents), other professional and administrative clerical;
(ii) total salaries paid residents in the program;
(iii) fringe benefits of all personnel. including residents;
(iv) rent;
(v) equipment;
(vi) medical and other supplies; and
(vii) all other expense items;
(2) with respect to total revenues of the program, receipts or other financial support from the following resources:
(i) hospital(s);
(ii) third-party payors;
(iii) self-pay patients;
(iv) grants and contracts;
(v) gifts and endowments; and
(vi) other; and
(3) the proposed allocation of State funding to continuation of the present program and to expansion thereof; and
(d) An acknowledgement that funding is contingent upon the residents' practicing medicine in New York State for at least two years following completion of their residency.
(e) With respect to all residents in the program:
(1) the salary paid a resident in each year of the program; and
(2) a list of residents, indicating name, medical school or osteopathic college of graduation, year in residency program, New York State medical license or limited permit number, or ECFMG number, and Social Security number;
(3)
(i) a copy of the agreement between the program and resident wherein the resident agrees to practice medicine in New York State for at least two years following completion of the residency (hereafter the “two year service obligation agreement”.)
(ii) such written agreement shall state whether the resident agrees to practice medicine in the State of New York for at least two years immediately following the completion of the family practice residency training program or immediately following completion of another medical training program or immediately following some other service obligation which the resident is legally committed to undertake. If such a commitment prevents the resident from fulfilling the two year service obligation immediately following the completion of the family practice residency training program, the agreement shall specify the date the resident expects to satisfy that commitment.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.3 Application
(a) The requirements of this Subpart shall apply to all swimming pools except:
(1) a swimming pool, or other bathing facilities, owned and/or maintained by an individual for the use of his family and friends;
(2) spa pools used under medical supervision or associated with hospitals; and
(3) float tank or relaxation tank used for solitary body immersion in skin-temperature salt water.
(b) Section 6-1.5 of this Subpart shall not apply to swimming pools maintained and operated in connection with a temporary residence or children's camp subject to the regulations of Subpart 7-1 or 7-2 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.13 Notification of change of address or place of employment
A duly licensed and currently registered nursing home administrator shall notify the board of any change of his or her title, place of employment, home address or home telephone number within 10 days of such change.
Chapter I STATE SANITARY CODE
Part 10 BARBER SHOPS AND BEAUTY PARLORS
EQUIPMENT EQUIPMENT
10 CRR-NY 10.17 Refuse
Covered containers for hair droppings, paper and other waste material shall be provided and maintained so that they are not offensive.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.190 Lease
A conveyance of land or of the use of a building or a part of a building or equipment from one person (lessor) to another (lessee) for a specified period of time, in return for rent or other compensation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.3 Selection of recipients
(a) Process.
The Commissioner of Health shall select recipients based on the criteria and preferences described in subdivisions (b) and (c) of this section.
(b) Preference.
Preference shall be given to persons in the following categories, in the order of priority stated:
(1) holders of a prior Primary Care Service Corps scholarship award who have maintained an acceptable academic performance;
(2) a New York State resident attending or planning to attend a New York State primary care practitioner program;
(3) a New York State resident attending or planning to attend a primary care practitioner program located out-of-state.
(c) Selection criteria.
All eligible applications will be reviewed competitively using the following criteria:
(1) the need, as determined the Commissioner of Health, for an individual(s) qualified to practice the profession for which a scholarship is being sought in the underserved areas of the region(s) where the applicant is willing to work;
(2) academic performance and academic awards or honors;
(3) special training and education relevant to the needs of underserved populations;
(4) work experience relevant to the chosen health profession;
(5) work or volunteer experience with underserved populations or in underserved areas;
(6) demonstrated interest or commitment to working with underserved populations or in underserved areas;
(7) civic or community awards and honors; and
(8) special skills or abilities, background or experience which will facilitate working with underserved populations or in underserved areas.
(d) Number of awards.
The Commissioner of Health shall make as many awards as available funding permits. The Commissioner of Health may make fewer awards than available funding permits if it is determined that there are not a sufficient number of eligible applicants who meet minimum qualifications, based on such criteria as those listed in subdivision (c) of this section.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.5 Disclosure: other health or health related items or services
(a) With respect to referrals for health or health related items or services other than clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services, and except as provided in subdivision (c) of this section, a practitioner may not make a referral to a health care provider for the furnishing of health or health related items or services where such practitioner or immediate family member of such practitioner has any of the following financial relationships without disclosing to the patient such financial relationship:
(1) an ownership or investment interest with such health care provider; or
(2) a compensation arrangement with such health care provider which is in excess of fair market value, or which provides for compensation that varies directly or indirectly based on the volume or value of any referrals of business between the parties.
(b) The disclosure shall provide notice of any such financial relationship and shall also inform the patient of his or her right to utilize a specifically identified alternative health care provider if any such provider is reasonably available, and shall be in the form specified in section 34-1.6 of this Subpart. Such form shall also be posted prominently in the practitioner's office.
(c) Disclosure pursuant to this section shall not be required for a referral for the furnishing of any health or health related items or services under circumstances for which a referral for clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services would not be prohibited pursuant to section 238-a of the Public Health Law, provided that any disclosure required by section 34-1.4 of this Subpart for clinical laboratory services, pharmacy services, radiation therapy services, or X-ray or imaging services remains applicable to referrals for other health, or health related items or services under comparable circumstances.
(d) A practitioner shall maintain documentation of each instance of disclosure to a patient pursuant to this section.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 84.1 Purpose
The purpose of these rules is to ensure equitable treatment of persons employed in positions the principal duty of which is the teaching or instruction of patients, or the direct supervision of such teaching or instruction, and to provide uniformity in matters of attendance and leave for such persons, insofar as practicable and consistent with the efficient conduct of the department's business, who are employed on the basis of an annual school calendar year adopted by the department which shall be consistent with the school calendar year of public school teachers in New York State.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.10 State Environmental Quality Review Act (SEQRA)
(a) The following activities are deemed by the department to be Type II actions under SEQRA and its implementing regulations, and the department shall not require an environmental impact statement or any other determination or procedure under SEQRA for these activities:
(1) Installation of a new individual sewage treatment system on an individual lot which is not within a subdivision, or within a subdivision which has been approved as of the effective date of these rules and regulations.
(2) Any alteration or modification of an existing individual sewage treatment system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.7 School survey
Every school, shall annually provide the Commissioner of Health, or in the city of New York the New York City Commissioner of Health, by a date determined by the applicable commissioner, a summary regarding compliance with the provisions of this section. For all schools, excluding public schools within New York City, the summary will be provided in the form of the yearly school survey conducted by the Department of Health.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.6 Annual cost adjustment
Prior to calculating fees for the next permit year, the department shall review and finalize the actual annual cost of the environmental laboratory approval program for the previous fiscal year and compare that cost to the fees collected or anticipated to be collected for that previous fiscal year. Any difference will be reflected in an adjustment to the next annual billing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.72 Control
The process by which the activities of an organization are conformed to a desired plan of action and the plan is conformed to the organization's activities.
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.4 Medical staff
The hospital shall have an organized medical staff that operates under bylaws approved by the governing body.
(a) Medical staff accountability.
The medical staff shall be organized and accountable to the governing body for the quality of the medical care provided to all patients.
(1) The medical staff shall establish objective standards of care and conduct to be followed by all practitioners granted privileges at the hospital. Those standards shall:
(i) be consistent with prevailing standards of medical and other licensed health care practitioner standards of practice and conduct; and
(ii) afford patients their rights as patients in accordance with the provisions of this Part.
(2) The medical staff shall establish mechanisms to monitor the ongoing performance in delivering patient care of practitioners granted privileges at the hospital, including monitoring of practitioner compliance with bylaws of the medical staff and pertinent hospital policies and procedures.
(3) The medical staff shall review and, when appropriate, recommend to the governing body, the limitation or suspension of the privileges of practitioners who do not practice in compliance with the scope of their privileges, medical staff bylaws, standards of performance and policies and procedures, and assure that corrective measures are developed and put into place, when necessary.
(4) The medical staff shall adopt, implement, periodically update and submit to the department evidence-based protocols for the early recognition and treatment of patients with severe sepsis and septic shock (“sepsis protocols”) that are based on generally accepted standards of care. Sepsis protocols must include components specific to the identification, care and treatment of adults, and of children, and must clearly identify where and when components will differ for adults and for children. These protocols must include the following components:
(i) a process for the screening and early recognition of patients with sepsis, severe sepsis and septic shock;
(ii) a process to rapidly identify and document individuals appropriate for treatment through severe sepsis and septic shock protocols, including explicit criteria defining those patients who should be excluded from the protocols, such as patients with certain clinical conditions or who have elected palliative care;
(iii) guidelines for hemodynamic support, including monitoring, therapeutic endpoints and timeframe goals;
(iv) for infants and children, guidelines for fluid resuscitation with explicit timeframes for vascular access and fluid delivery consistent with current, evidence-based guidelines for severe sepsis and septic shock with defined therapeutic goals for children; and
(v) a procedure for identification of infectious source and delivery of early antibiotics with timeframe goals.
(5) The medical staff shall ensure that professional staff with direct patient care responsibilities and, as appropriate, staff with indirect patient care responsibilities, including, but not limited to laboratory and pharmacy staff, are periodically trained to implement sepsis protocols required pursuant to paragraph (4) of this subdivision. Medical staff shall ensure updated training when the hospital initiates substantive changes to the protocols.
(6) Hospitals must update sepsis protocols required pursuant to paragraph (4) of this subdivision based on newly emerging evidence-based standards. Protocols are to be submitted to the department at the request of the department.
(7) Collection and reporting of sepsis measures.
(i) The medical staff shall be responsible for the collection, use, and reporting of quality measures related to the recognition and treatment of severe sepsis for purposes of internal quality improvement and hospital reporting to the department. Such measures shall include, but not be limited to, data sufficient to evaluate each hospital’s adherence to timeframes and implementation of all protocol components for adults and children.
(ii) Hospitals shall submit data specified by the department to permit the department to develop risk-adjusted severe sepsis and septic shock mortality rates in consultation with appropriate national, hospital and expert stakeholders. Hospitals shall submit data to the department or the department’s designee in the form and format, and according to such specifications as may be required by the department.
(iii) Such data shall be reported annually, or more frequently at the request of the department, and shall be subject to audit at the discretion of the department.
(8) Definitions.
Sepsis is a life threatening medical emergency that requires early recognition and intervention. For the purposes of hospital data collection, the following terms shall have the following meanings:
(i) sepsis shall mean a confirmed or suspected infection accompanied by two systemic inflammatory response syndrome (SIRS) criteria;
(ii) severe sepsis shall mean sepsis complicated by organ dysfunction; and
(iii) for adults, septic shock shall mean sepsis-induced hypotension persisting despite adequate IV fluid resuscitation and/or evidence of tissue hypoperfusion; for pediatrics, septic shock shall mean sepsis and cardiovascular organ dysfunction.
(b) Organization.
(1) The medical staff shall be organized in a manner appropriate to the size of the institution and the services provided.
(2) The responsibility for organization and conduct of the medical staff shall be developed and defined in writing in consultation with the medical staff and assigned to the medical director who is a physician appointed by the governing body in accordance with section 405.2(e)(2) of this Part, based upon written qualifications for the position.
(3) The medical staff shall be composed of persons practicing medicine as defined in article 131 of title 8 of the State Education Law, and may also be composed of other licensed and currently registered health care practitioners appointed by the governing body.
(4) The medical staff shall examine credentials of candidates for medical staff membership and make recommendations to the governing body on the appointment of the candidates in accordance with the provisions of this Part and the New York State Public Health Law. Following the initial appointment of medical staff members, the medical staff shall conduct periodic reappraisals of its members, on at least, a biennial basis.
(5) Medical staff appointments, and reappointments shall be made in accordance with the privilege review procedures of the hospital's quality assurance committee, as contained in section 405.6 of this Part.
(6) In order that the working conditions and working hours of physicians and postgraduate trainees promote the provision of quality medical care, the hospital shall establish the following limits on working hours for certain members of the medical staff and postgraduate trainees:
(i) In hospitals with over 15,000 unscheduled visits to an emergency service per year, assignment of postgraduate trainees and attending physicians shall be limited to no more than 12 consecutive hours per on-duty assignment in the emergency service. The commissioner may approve alternative schedule limits of up to 15 hours for attending physicians in a hospital emergency service upon a determination that:
(a) the alternative schedule contributes to the hospital's ability to meet its community's need for quality emergency services;
(b) the volume of patients examined and treated during the extended period is substantially less than for other hours of the day; and
(c) adequate rest time is provided between assignments and during each week to prevent fatigue.
(ii) Effective July 1, 1989, schedules of postgraduate trainees with inpatient care responsibilities shall meet the following criteria:
(a) the scheduled work week shall not exceed an average of 80 hours per week over a four week period;
(b) such trainees shall not be scheduled to work for more than 24 consecutive hours;
(c) for departments other than anesthesiology, family practice, medical, surgical, obstetrical, pediatric or other services which have a high volume of acutely ill patients, and where night calls are infrequent and physician rest time is adequate, the medical staff may develop and document scheduling arrangements other than those set forth in clauses ( a ) and ( b ) of this subparagraph; and
(d) “on call” duty in the hospital during the night shift hours by trainees in surgery shall not be included in the 24-limit contained in clause ( b ) of this subparagraph and the 80-hour limit contained in clause ( a ) of this subparagraph if:
(1) the hospital can document that during such night shifts postgraduate trainees are generally resting and that interruptions for patient care are infrequent and limited to patients for whom the postgraduate trainee has continuing responsibility;
(2) such duty is scheduled for each trainee no more often than every third night;
(3) a continuous assignment that includes night shift “on call” duty is followed by a nonworking period of no less than 16 hours; and
(4) policies and procedures are developed and implemented to immediately relieve a postgraduate trainee from a continuing assignment when fatigue due to an unusually active “on call” period is observed.
(iii) The medical staff shall develop and implement policies relating to postgraduate trainee schedules which prescribe limits on the assigned responsibilities of postgraduate trainees, including but not limited to, assignment to care of new patients, as the duration of daily on-duty assignments progress.
(iv) In determining limits on working hours of postgraduate trainees as set forth in subparagraphs (i) and (ii) of this paragraph, the medical staff shall require that scheduled on- duty assignments be separated by not less than eight nonworking hours. Postgraduate trainees shall have at least one 24 hour period of scheduled nonworking time per week.
(v) Hospitals employing postgraduate trainees shall adopt and enforce specific policies governing dual employment. Such policies shall require at a minimum, that each trainee notify the hospital of employment outside the hospital and the hours devoted to such employment. Postgraduate trainees who have worked the maximum number of hours permitted in subparagraphs (i)-(iv) of this paragraph shall be prohibited from working additional hours as physicians providing professional patient care services.
(c) Medical staff bylaws.
The medical staff shall adopt and enforce bylaws to carry out its responsibilities. The bylaws shall at a minimum:
(1) be approved by the governing body;
(2) include a statement of the obligations and prerogatives of each category of medical staff membership;
(3) describe the organization of the medical staff;
(4) describe the qualifications and performance standards to be met by a candidate in order for the medical staff to recommend that the candidate be appointed by the governing body;
(5) set forth criteria and procedures for recommending the privileges to be granted to individual practitioners, contain a procedure for applying the criteria and procedures to individuals requesting privileges, and be consistent with the requirements contained in section 405.6 of this Part;
(6) set forth criteria and procedures for determining the need for consultation with a specialist physician to provide for the diagnosis and treatment of patient conditions in accordance with generally accepted standards of patient care. Such criteria and procedures shall not preclude postgraduate trainees, nurses, or other health care practitioners involved in the care of the patient from requesting such consultations in an emergency;
(7) describe the responsibilities of members of the medical staff for participation in the malpractice prevention program and the quality assurance program;
(8) exempt from the requirement to obtain medical staff privileges those practitioners from outside organ procurement organizations designated by the Secretary, U.S. Department of Health and Human Services, engaged solely at the hospital in the harvesting of tissues and/or other body parts for transplantation, therapy, research or educational purposes pursuant to the Federal Anatomical Gift Act and the requirements of section 405.25 of this Part;
(9) exempt from liability by the hospital any physician who shall inform a patient that he or she refuses to give advice with respect to, or participate in, any induced termination of pregnancy; and
(10) set forth criteria and procedures that ensure appropriate and confidential use of electronic or computer transmissions and authentications, including the identification of those categories of practitioners and hospital personnel who are authorized to utilize electronic or computer generated transmissions, if the hospital elects to utilize an electronic or computer system for transmitting or authenticating medical records entries, orders and/or other patient specific records.
(d) Dental services.
(1) The attending dentist shall be responsible for the admission, management and discharge of dental patients, including all related written documentation.
(2) The admission history and physical examination for dental patients shall be completed by a dentist qualified to perform a history and physical examination or by another member of the medical staff so qualified. A dentist qualified to perform a history and physical examination shall mean a dentist who:
(i) has successfully completed a postgraduate program of study incorporating training in physical diagnosis at least equivalent to that received by one who has successfully completed a postgraduate program of study in oral and maxillofacial surgery accredited by a nationally recognized body approved by the United States Education Department; and
(ii) as determined by the medical staff, is currently competent to conduct a complete history and physical examination to determine a patient's ability to undergo a proposed dental procedure.
(3) Dental patients with medical comorbidities or complications present upon admission or arising during hospitalization shall be referred to appropriate medical staff for consultation and/or management.
(e) Registered physician's assistants and registered specialist's assistants.
Hospitals employing or extending privileges to registered physician's assistants or registered specialist's assistants shall comply with the provisions of this subdivision and Part 94 of this Title.
(1) General standards. Hospitals shall:
(i) employ or extend privileges only to registered physician's assistants and registered specialist's assistants who are currently registered with the New York State Education Department;
(ii) designate in writing the licensed and currently registered staff physician or physicians responsible for the supervision and direction of each registered physician's assistant and registered specialist's assistant employed or extended privileges:
(a) no physician shall be designated to supervise and direct more than six registered physician's assistants or registered specialist's assistants or a combination thereof;
(b) when more than one physician is designated as responsible for registered physician's assistants or registered specialist's assistants, written policies and procedures shall delineate the specific physician charged with supervision of care of each patient for whom the registered physician's assistant or registered specialist's assistant is to render care;
(iii) employ or extend privileges only to registered physician's assistants and registered specialist's assistants whose training and experience are within the scope of practice for which the physician or physicians to whom they are assigned are qualified; and
(iv) be approved for providing the specialized medical services for which the registered specialist's assistant is employed or extended privileges and employ and extend privileges only to registered specialist's assistants whose training and experience are appropriate to the delivery of the specialized service.
(2) Medical staff responsibility. The medical staff shall adopt, with governing body approval, bylaws, rules and regulations:
(i) which provide formal procedures for the evaluation of the application and credentials of registered physician's assistants and registered specialist's assistants applying for employment or privileges in the facility for the purpose of providing medical services under the supervision of a physician; and
(ii) which set forth in writing, the mechanism or mechanisms by which the supervising physicians shall exercise continuous supervision over the registered physician's assistants or registered specialist's assistants for whom he or she is responsible.
(f) Postgraduate trainees.
Patient care services may be provided by physicians in postgraduate training programs accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association or an equivalent accrediting agency approved by the New York State Education Department, only if the following conditions are met:
(1) all postgraduate trainees prior to entering a postgraduate training program, have received adequate and appropriate medical education as defined in subparagraphs (i) and (ii) of this paragraph:
(i) effective January 1, 1986 and thereafter, hospitals shall permit only the following to be assigned into a postgraduate training position:
(a) a graduate of a medical school offering a medical program accredited by the Liaison Committee on Medical Education or the American Osteopathic Association or registered with the New York State Education Department or by an accrediting organization acceptable to the New York State Education Department; or
(b) a graduate of a foreign medical school who has been certified by the Educational Commission for Foreign Medical Graduates (ECFMG) as meeting the requirements of the ECFMG and has been awarded the ECFMG certificate;
(ii) except for individuals eligible for licensure under section 6528 of the State Education Law, a graduate of a foreign medical school who enrolled in such medical school after October 1, 1983 shall have completed the clinical component of a program of medical education which:
(a) included no more than 12 weeks of clinical clerkships in a country other than the country in which the medical school is located;
(b) included clinical clerkships of greater than 12 weeks in a country other than the country in which the medical school is located if the clinical clerkships were offered by a medical school approved by the State Education Department for the purposes of clinical clerkships;
(2) the medical staff shall review the licensure, education, training, physical and mental capacity, and experience of individuals in approved postgraduate medical training programs in relation to the patient care services to be provided by such individuals in such training programs where such individuals do not otherwise have active medical staff privileges.
(i) such individuals may provide patient care services only as part of a training program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association, or an equivalent training program approved by the State Education Department;
(ii) the medical staff shall, based on written criteria, recommend privileges that are specific to treatments/procedures for each individual in such program prior to delivery of patient care services;
(iii) the medical staff shall develop and implement written policies and procedures which set forth a clear set of principles governing medical practice by postgraduate trainees, including guidelines on circumstances requiring supervision and consultation;
(iv) postgraduate trainee privileges, regardless of whether the individual is full-time, part-time, or rotating status, shall be modified based upon written criteria and individual review and approval of each trainee;
(v) the specific treatments/procedures that each individual is authorized to perform shall be stated in writing and that authorization shall specify:
(a) those treatments/procedures that may be performed under the general control and supervision of the patient's attending physician or another physician credentialed to provide the specific treatment/procedures; and
(b) those that may only be performed under direct visual supervision of the patient's attending physician or another physician credentialed to provide the specific treatment/procedures; and
(3) the medical staff monitors and supervises postgraduate trainees assigned patient care responsibilities as part of an approved medical training program including:
(i) providing written documentation of privileges granted to such individuals to appropriate medical and other hospital patient care staff;
(ii) continuously monitoring patient care services provided by such individuals to assure provision of quality patient care services within the scope of privileges granted;
(iii) effective July 1, 1989 for postgraduate trainees in the acute care specialties of anesthesiology, family practice, medicine, obstetrics, pediatrics, psychiatry, and surgery, supervision shall be provided by physicians who are board-certified or admissible in those respective specialties or who have completed a minimum of four postgraduate years of training in such specialty. There shall be a sufficient number of these physicians present in person in the hospital 24 hours per day, seven days per week to supervise the postgraduate trainees in their specific specialities to meet reasonable and expected demand. In hospitals that can document that the patients' attending physicians are immediately available by telephone and readily available in person when needed, the onsite supervision of routine hospital care and procedures may be carried out in accordance with paragraph (2) of this subdivision by postgraduate trainees who are in their final year of postgraduate training, or who have completed at least three years of postgraduate training;
(iv) supervision by attending physicians of the care provided to surgery patients by postgraduates in training must include as a minimum:
(a) personal supervision of all surgical procedures requiring general anesthesia or an operating room procedure;
(b) preoperative examination and assessment by the attending physician; and
(c) postoperative examination and assessment no less frequently than daily by the attending physician;
(v) taking disciplinary action and other corrective measures against the individual providing service and/or the attending/supervising physician when services provided exceed scope of privileges granted; and
(vi) taking disciplinary action or other corrective measures against any individual providing service in violation of the physician's working hour limits set forth in subparagraph (b)(6)(iv) of this section.
(g) Unlicensed physicians.
Patient care services may be provided by unlicensed physicians only under the following circumstances:
(1) physicians not licensed by New York State but who practice within the exemptions authorized by section 6526 of the State Education Law; or
(2) physicians who possess limited permits to practice medicine issued by the New York State Education Department pursuant to section 6525 of the State Education Law if such physicians are under the supervision of a physician licensed and currently registered to practice medicine in the State of New York and if the physicians possessing limited permits are:
(i) graduates of medical school offering a medical program accredited by the Liaison Committee on Medical Education or the American Osteopathic Association, or registered with the State Education Department or accredited by an accrediting organization acceptable to the State Education Department, and have satisfactorily completed one year of graduate medical education in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association, their predecessors or successors or an equivalent accrediting agency acceptable to the State Education Department;
(ii) graduates of a foreign medical school and have satisfactorily completed three years of graduate medical education in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association, their predecessors or successors or an equivalent accrediting agency acceptable to the State Education Department; or
(iii) graduates of a foreign medical school who have satisfactorily completed three years in a postgraduate training program and who are receiving advanced training as part of an official exchange visitor program approved by the United States Information Agency and the Educational Commission for Foreign Medical Graduates (ECFMG);
(3) the medical staff shall:
(i) review the licensure, education, training, physical and mental capacity, and experience of individuals practicing under the provisions of this subdivision;
(ii) based on written criteria, recommend privileges that are specific to treatments/procedures for each individual prior to delivery of patient care services;
(iii) continuously monitor patient care services provided by such individuals to assure provision of quality patient care services within the scope of privileges granted; and
(iv) take disciplinary action or other corrective measures against the individual providing service and/or the attending/supervising physician when services provided exceed the scope of privileges granted.
(h) Medical students.
Medical students, in the course of their educational curriculum, may take patient histories, perform complete physical examinations and enter findings in the medical record of the patient with the approval of the patient's attending physician. All medical student entries must be countersigned within 24 hours by an appropriately privileged physician. Medical students may be assigned and directed to provide additional patient care services under the direct in person supervision of an attending physician or authorized postgraduate trainee. The hospital, in cooperation with the medical staff and the medical school, shall provide such appropriate supervision and documentation of all procedures performed by medical students. In addition, specific identified procedures may be performed by medical students under the general supervision of an attending physician or authorized senior postgraduate trainee provided that the medical staff and the medical school affirm in writing each individual student's competence to perform such procedures. Documentation of supervision and competence of medical students shall be incorporated into the quality assurance program of the hospital and its affiliation agreement with the medical school. In all such patient care contacts, the patient shall be made aware that the individual performing the procedure is a student.
(i) Autopsies.
The medical staff shall attempt to secure permission for autopsies in all cases of unusual deaths and deaths of medical-legal and educational value. The mechanism for documenting permission to perform an autopsy shall be defined in writing. There shall be a system for notifying the medical staff, and specifically the attending physician, when an autopsy is to be performed.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 136 OTSEGO COUNTY
CITIES CITIES
10 CRR-NY 136.1 City of Oneonta
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Oneonta Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the City of Oneonta, Otsego County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake and impounding reservoirs on Oneonta Creek and to that part of Oneonta Creek between said reservoirs, which are tributary to or which serve as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basin), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Oneonta.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the City of Oneonta.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the City of Oneonta.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified, and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 400 feet from any reservoir or 250 feet from any watercourse tributary to the public water supply of the City of Oneonta.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the City of Oneonta, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [c][4] and [5] of this section) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the City of Oneonta.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the City of Oneonta, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [c][4] and [5] of this section) within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the City of Oneonta.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the City of Oneonta.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the City of Oneonta. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the City of Oneonta.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile of compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the City of Oneonta, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the City of Oneonta.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled, or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the City of Oneonta, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the City of Oneonta; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the City of Oneonta.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the City of Oneonta.
(f) Dead animals, offal, industrial wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the City of Oneonta nor shall any such material or refuse be thrown or placed on the watershed unless disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as to effectively prevent their being washed into any reservoir or watercourse without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the City of Oneonta.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind or any trespassing whatever shall be allowed in or upon the waters of any reservoir tributary to the public water supply of the City of Oneonta, except by duly authorized employees of the City of Oneonta in the performance of their duties of supervision and maintenance of the public water supply of the City of Oneonta. No ice cutting shall be allowed on any reservoir tributary to the public water supply of the City of Oneonta, except by written permission and in direct compliance with regulations for the protection from contamination of the supply to be adopted by the board of water commissioners of the city of Oneonta.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the city of Oneonta.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or watercourse tributary to the public water supply of the city of Oneonta.
(j) Inspections.
The board of water commissioners of the city of Oneonta or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the city of Oneonta or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.3 Applicability
(a) The provisions of this Part shall apply to providers seeking approval to provide integrated care services at a single outpatient site (host site). This includes:
(1) locations licensed under article 28 of the Public Health Law as diagnostic and treatment centers, extension clinics as defined in section 401.1(g) of this Title and general hospital outpatient programs as defined by this Part;
(2) substance use disorder outpatient services certified under MHL article 32; and
(3) clinic treatment programs licensed under MHL article 31.
(b) The standards apply to providers certified or licensed by at least two of the said participating agencies or in the process of pursuing licensure or certification by the Department of Health, the Office of Mental Health, or the Office of Alcoholism and Substance Abuse Services.
(c) The requirements of this Part shall be in addition to the requirements of the State agency that licensed or certified the proposed host site.
(d) An integrated services provider shall continue to ensure documentation as required per 18 NYCRR sections 504.3, 517.3(b), 518.1(c) and 518.3(b).
(e) Integrated services providers of mental health services shall continue to ensure compliance with 14 NYCRR Part 599.
(f) Integrated services providers of substance use disorder services shall continue to ensure compliance with 18 NYCRR section 505.27.
(g) With respect to billing for medical assistance, an integrated services provider shall continue to ensure compliance with 18 NYCRR sections 540.6(a) and 540.6(e).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.10 Disqualification of tribunal representatives
Hearing shall be conducted in an impartial manner. Upon the filing in good faith by a party of a timely and sufficient affidavit of personal bias or disqualification of a tribunal representative, the tribunal shall determine the matter as a part of the record in the case, and its determination shall be a matter subject to judicial review at the conclusion of the hearing. Whenever a tribunal representative is disqualified or it becomes impractical for the representative to continue a hearing, another representative will be assigned to continue with the case.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 707 PHYSICIAN'S ASSISTANTS AND SPECIALIST'S ASSISTANTS
10 CRR-NY 707.1 Medical staff applicability
All hospitals as defined under article 28 of the Public Health Law shall be subject to the provisions of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.10 Computation of average monthly nursing home rates
(a) Computation of average monthly nursing home service (SNF) or health related services in an intermediate care facility (HRF) rates used to establish patient eligibility caps pursuant to section 86-5.9 of this Subpart shall be based on average Medicaid rates for each social services district for SNF or HRF levels of care weighted by patient days.
(b) Average monthly rates calculated pursuant to subdivision (a) of this section shall be based on skilled nursing facility or health-related facility rates in effect on January 1, 1992 trended forward to the rate year by the trend factor for the facilities in each social service district. Such trend factors shall be established pursuant to section 86-2.12 of this Title. The average monthly rates established pursuant to subdivision (a) of this section will be adjusted annually utilizing the latest January 1, 1992 rate available, including any rate adjustments made prior to the calculation of the patient eligibility caps for the following year. No other adjustments will be made to the average monthly rates established pursuant to subdivision (a) of this section.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.4 Filing of reports
(a)
(1) All determinations or diagnoses of human immunodeficiency virus (HIV) infection, HIV-related illness and acquired immune deficiency syndrome (AIDS) shall be reported to the commissioner by physicians and other persons authorized to order diagnostic tests or make medical diagnoses or their agents as soon as possible but no later than 14 days after the provider's receipt of a positive laboratory result or after diagnosis, whichever is sooner.
(2) All determinations of HIV infection, HIV-related illness and AIDS shall be reported to the commissioner by blood banks as defined in article 5, title V of the Public Health Law, by tissue banks and organ procurement organizations as defined by article 43-B of the Public Health Law as soon as possible but no later than 14 days after receipt of a confirmed positive laboratory result. Such banks and organizations shall report confirmed positive HIV antibody test results and reactive nucleic acid test results.
(3) Pathologists, coroners and medical examiners or other persons determining from examination of a corpse or from the history of the events leading to death, that at the time of death the individual was apparently affected with HIV infection, HIV-related illness or AIDS shall also make such report to the commissioner within 14 days after receipt of a test result or determination.
(4) Laboratories performing tests for screening, diagnosis or monitoring of HIV infection for New York State residents and/or New York State health care providers shall report to the commissioner cases of determinations or diagnoses of HIV infection, HIV-related illness and AIDS on a schedule to be specified by the commissioner. Laboratories shall report the following: any reactive test result from an antigen or antibody test performed as an initial screen for HIV infection and the results from all supplemental tests performed to verify HIV infection, all HIV nucleic acid (RNA or DNA) test results, all CD4 lymphocyte counts and percents unless the test was known to be performed for reasons other than HIV infection or HIV-related illness, HIV subtype and antiviral drug resistance testing in a format designated by the commissioner, and the results of other tests as may be determined by the commissioner to indicate a diagnosis of HIV infection, HIV-related illness or AIDS.
(b) Reports, including names and addresses of the protected individual, all contact and locating information and other information including demographic, and identifying information as may be specified by the commissioner, shall be made in a manner and format as prescribed by the commissioner. For the requesting provider and facility, the following information shall be included: provider and facility name, complete provider and facility address and telephone number, and provider and facility National Provider Identification. Information reported shall also include names and addresses, if available, of contacts, including spouses, known to the physician or other person authorized to order diagnostic tests or make medical diagnoses, or provided to them by the protected individual, and the date each contact was notified if contact notification has already been done; and information, in relation to each reported contact, required by an approved domestic violence screening protocol. After receiving the report, the commissioner or designated representative may request the individual making the report or the person who ordered the diagnostic tests to provide additional information as may be required for the epidemiologic investigation, case finding and analysis of HIV infection, HIV-related illness and acquired immune deficiency syndrome (AIDS) and to implement Public Health Law article 21, title III. Notwithstanding this subdivision, test results from New York State approved anonymous test sites shall not be reported to the commissioner unless the test subject chooses to supply identification and convert the anonymous test result to a confidential test result.
(c) Confidentiality.
Such reports and additional information maintained by the commissioner or designated representative, including all information generated by contact notification and domestic violence screening activities, shall be kept confidential as required by Public Health Law, article 21, title III, and shall not be disclosed except when in the judgment of the public health official, necessary to other authorized public health officials for conducting accurate and complete epidemiological monitoring of the HIV/AIDS epidemic and for conducting contact notification activities, except that information may be disclosed to public health officials in other jurisdictions when necessary to notify the contact or for purposes of de-duplication; no information about the protected individual will be released to any person in the contact notification process. Reports and information may be used in the aggregate in programs approved by the commissioner:
(1) for the improvement of the quality of medical care provided to persons with HIV/AIDS;
(2) with patient identifiers when used within the State or local health department by public health disease programs to assess co-morbidity or completeness of reporting and to direct program needs, in which case patient identifiers shall not be disclosed outside the State or local health department; or
(3) when used for purposes of linkage to and retention in care, in which case the protected individual’s individually identifiable health information may be shared among State health departments, local health departments, health care providers as defined in section 63.1(k) of this Part, and entities engaged in care coordination that have a clinical, diagnostic, or public health interest in the patient. For purposes of this section, care coordination shall mean managing, referring to, locating, coordinating, and monitoring health care services for the individual to assure that all medically necessary health care services are made available to and are effectively used by the individual in a timely manner, consistent with patient autonomy. Care coordination shall be conducted by or with the participation of the individual’s health care provider to the extent possible.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 116 FULTON COUNTY
CITIES CITIES
10 CRR-NY 116.2 City of Johnstown
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the wells located just off Maple Avenue, Keck Center Reservoir, Cold Brook Reservoir, and those tributaries which now serve or which may be developed in the future to serve as sources of the water supply of the City of Johnstown, Fulton County, New York.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse, or to the extension of the centerline of a well.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(8) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(9) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(10) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the City of Johnstown water supply.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil, or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the City of Johnstown, Fulton County, New York.
(16) Watercourse shall mean every spring, stream, marsh, or channel of water of any kind which flows or may flow into the City of Johnstown water supply.
(17) Watershed shall mean the entire drainage area contributing water to the City of Johnstown water supply.
(18) Well shall mean the well now used as a source of water supply for the City of Johnstown or to any additional well which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir, watercourse of well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir, watercourse or well except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir, watercourse or well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed, or allowed to remain within 250 feet of a well.
(ii) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed or within 250 feet of a well.
(iii) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within a 50 foot linear distance of any reservoir or watercourse except ( a ) watertight receptacles; ( b ) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and ( c ) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 50-foot linear distance of any reservoir or watercourse or within 250 feet linear distance of a well.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(ix) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of the ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet linear distance of any reservoir or watercourse or within 250 feet linear distance of any well. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility. It is provided, however, that no such watertight pipe shall be located within 15 linear feet of a well.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir, watercourse or well nor within a 1,000-foot linear distance of any reservoir, watercourse or well unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing or swimming shall be allowed in any reservoir or watercourse owned by the City of Johnstown.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Johnstown except by duly authorized employees of the community in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the City of Johnstown within a 1,000-foot linear distance of the water supply intakes except by duly authorized employees of the City of Johnstown in the performance of their duties of supervision and maintenance of the water supply. Also, no trespassing shall be allowed upon the property of the City of Johnstown upon which a well is located and no person or persons shall enter in or upon such property except such persons as may be authorized to enter said property by the said city.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any well, reservoir or watercourse.
(ii) Refuse. No refuse shall be maintained or allowed to remain within a 250-foot linear distance of any reservoir, watercourse or well.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir, watercourse or well.
(9) Miscellaneous.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the City of Johnstown.
(e) Inspections.
The Common Council of the City of Johnstown or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the reservoir, watercourses, watershed and areas surrounding the wells to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Common Council of the City of Johnstown to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Common Council of the City of Johnstown to promptly notify the State Commissioner of Health of such violations. The aforesaid Common Council of the City of Johnstown shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed and area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
ROLES AND RESPONSIBILITIES ROLES AND RESPONSIBILITIES
10 CRR-NY 61-1.33 Principal investigator; responsibilities
On behalf of the institution, the PI is responsible for complying fully with this Subpart in conducting any recombinant DNA activity.
(a) PI: general.
As part of this general responsibility, the PI shall:
(1) initiate or modify no recombinant DNA activity requiring approval by the IBC prior to initiation (section 61-1.20 of this Subpart: class III-A or III-B) until that activity, or the proposed modification thereof, has been approved by the institutional biosafety committee (IBC) and has met all other requirements of this Subpart;
(2) determine whether recombinant DNA activity is covered by section 61-1.20 of this Subpart: class III-C;
(3) report within 30 days to the IBC and the commissioner all significant problems with and violations of this Subpart and all significant recombinant DNA activity-related accidents and illnesses;
(4) report to the IBC and to the commissioner new information bearing on provisions of this Subpart;
(5) be adequately trained in good microbiological techniques;
(6) adhere to IBC-approved emergency plans for dealing with accidental spills and personnel contamination; and
(7) comply with shipping requirements for recombinant DNA molecules.
(b) Submissions by the PI to NIH.
The PI shall:
(1) submit information to NIH (ORDA) in order to have new host-vector systems certified;
(2) petition NIH, with notice to the IBC, for exemptions to the NIH guidelines (see section 61-1.20 of this Subpart: class III-D);
(3) petition NIH, with concurrence of the IBC, for approval to conduct experiments specified in section 61-1.20 of this Subpart: class III-A;
(4) petition NIH for determination of containment for experiments requiring case-by-case review; and
(5) petition NIH for determination of containment for experiments not covered by this Subpart or the NIH guidelines.
(c) Submissions by the PI to the IBC.
The PI shall;
(1) make the initial determination of the required levels of physical and biological containment in accordance with this Subpart or the NIH guidelines;
(2) select appropriate microbiological practices and laboratory techniques to be used in the recombinant DNA activity;
(3) submit the initial recombinant DNA activity protocol if covered under section 61-1.20 of this Subpart: class III-A, III-B or III-C (and also subsequent changes— e.g., changes in the source of DNA or host-vector system) to the IBC for review and approval or disapproval; and
(4) remain in communication with the IBC throughout the conduct of the recombinant DNA activity.
(d) PI responsibilities prior to initiating the activity.
The PI is responsible for:
(1) making available to the laboratory staff copies of the protocols that describe the potential biohazards and the precautions to be taken;
(2) instructing and training staff in the practices and techniques required to ensure safety and in the procedures for dealing with accidents; and
(3) informing the staff of the reasons and provisions for any precautionary medical practices advised or requested, such as vaccinations or serum collection.
(e) PI responsibilities during the conduct of the activity.
The PI is responsible for:
(1) supervising the safety performance of the staff to ensure that the required safety practices and techniques are employed;
(2) investigating and reporting in writing to the commissioner, the biological safety officer (where applicable) and the IBC any significant problems pertaining to the operation and implementation of containment practices and procedures;
(3) correcting work errors and conditions that may result in the release of recombinant DNA materials; and
(4) ensuring the integrity of the physical containment ( e.g., biological safety cabinets) and the biological containment ( e.g., purity, and genotypic and phenotypic characteristics).
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.11 Termination of service
The Division of Health Care Financing in the department shall be notified immediately of the deletion of any previously offered service or of the withholding of services from patients paid for by government agencies. Such notification shall include a statement indicating the date of the deletion or the withholding of such service and the cost impact on the medical facility of such action. Any overpayments by reason of such deletion of previously offered service shall bear interest and be subject to penalties both in the manner provided in section 86-1.4(f) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.5 Recommended cost allocation bases—listing
(a) Cost allocation utilizes statistics to make the distribution of the costs of nonrevenue producing cost centers to each other and to revenue producing cost centers. The purpose of cost allocation is to determine the total or full costs of operating the revenue producing centers of the hospital.
(b) The recommended statistical bases for cost allocation are listed below for each cost center. It is advisable to develop a written procedure for the collection of these statistical data to meet the reporting requirements. The definitions and sources of the recommended statistics for cost allocations are provided in section 446.6 of this Part.
| | Functional Cost Center | Account Number | | | | --- | --- | --- | --- | --- | | Basis of Allocation | | | | | | | | | Medicaid | Medicare | | (1) DAILY HOSPITAL SERVICES | | | | | | (i) | Acute Care: | | | | | | Medical/Surgical | 6010 | None | None | | | Pediatric | 6170 | None | None | | | Psychiatric | 6210 | None | None | | | Obstetrics | 6250 | None | None | | | Definitive Observation | 6280 | None | None | | | Other Acute Care | 6290 | None | None | | (ii) | Intensive Care Services: | | | | | | Medical/Surgical | 6310 | None | None | | | Coronary | 6330 | None | None | | | Pediatric | 6350 | None | None | | | Neo-Natal | 6370 | None | None | | | Burn | 6380 | None | None | | | Psychiatric | 6390 | None | None | | | Other Intensive Care I | 6410 | None | None | | | Other Intensive Care II | 6420 | None | None | | | Other Intensive Care III | 6430 | None | None | | (iii) | Nursery Services: | | | | | | Newborn Nursery | 6510 | None | None | | | Premature Nursery | 6520 | None | None | | (iv) | Sub-Acute Care Services: | | | | | | Skilled Nursing Care— | | | | | | Medicare/Medicaid Certified | 6610 | None | None | | | Medicaid Certified | 6620 | None | None | | | Psychiatric Long-Term Care | 6630 | None | None | | | Tuberculosis Long-Term Care | 6640 | None | None | | | Intermediate Care— | | | | | | Mentally Retarded | 6650 | None | None | | | Other | 6660 | None | None | | | Residential Care | 6670 | None | None | | | Other Sub-Acute Care | 6680 | None | None | | | Other Sub-Acute Care Hospital Services | 6680 | None | None | | | Other Sub-Acute Care Non-Hospital Services | 6690 | None | None | | (2) AMBULATORY SERVICES | | | | | | | Emergency Services | 6710 | None | None | | | Clinic Services | 6720 | None | None | | | Home Program Dialysis: | | | | | | Equipment—100% | 6810 | None | None | | | Equipment-Other | 6820 | None | None | | | Ambulatory Surgery | 6830 | None | None | | | Psychiatric Day/Night | 6840 | None | None | | | Ambulance Services | 6850 | None | None | | | Other Ambulatory Services | 6860 | None | None | | | Free Standing Clinic: | | | | | | Free Standing Clinic I | 6870 | None | None | | | Free Standing Clinic II | 6880 | None | None | | | Free Standing Clinic III | 6890 | None | None | | | Home Health Services: | | | | | | Skilled Nursing Care | 6910 | None | None | | | Medical Social Services | 6920 | None | None | | | Home Health Aides | 6930 | None | None | | | Other Home Health | 6990 | None | None | | (3) ANCILLARY SERVICES | | | | | | (i) | Labor and Delivery Services: | | | | | | Labor and Delivery | 7010 | No. of Procedures | Ratio of Cost to Charges Applied to Charges (RCCAC) | | (ii) | Surgical Services Group: | | | | | | Surgery Services | 7040 | No. of Surgery Minutes | RCCAC | | | Recovery Services | 7060 | No. of Recovery Minutes | RCCAC | | | Anesthesiology | 7080 | No. of Anesthesia Minutes | RCCAC | | (iii) | Medical Supplies and Equipment Group: | | | | | | Medical Supplies Sold | 7110 | Dept. Charges | RCCAC | | | Durable Medical Equipment— | | | | | | Sold | 7130 | Dept. Charges | RCCAC | | | Leased/Rented | 7140 | Dept. Charges | RCCAC | | (iv) | Drugs Sold: | | | | | | Drugs Sold | 7150 | Dept. Charges | RCCAC | | (v) | Laboratory Services Group: | | | | | | Laboratory Services: | | | | | | Clinical Services | 7210 | C.A.P. Workload | RCCAC | | | Pathological Services | 7230 | C.A.P. Workload | RCCAC | | | Whole Blood & Packed Red Cells | 7250 | C.A.P. Workload | RCCAC | | | Blood Storing & Processing | 7260 | C.A.P. Workload | RCCAC | | (vi) | Electrocardiology: | | | | | | Electrocardiology | 7290 | C.A.P. Workload | RCCAC | | (vii) | Cardiac Catherization: | | | | | | Cardiac Catherization Lab | 7310 | Dept. Charges | RCCAC | | (viii) | Radiology Services Group: | | | | | | Radiology-Diagnostic | 7320 | California R.V.U. | RCCAC | | | CT Scanner | 7340 | No. of Procedures | RCCAC | | | Radiology-Therapeutic | 7360 | California R.V.U. | RCCAC | | | Nuclear Medicine | 7380 | California R.V.U. | RCCAC | | (ix) | Respiratory Therapy: | | | | | | Respiratory Therapy | 7420 | Dept. Charges | RCCAC | | (x) | Pulmonary Function: | | | | | | Pulmonary Function Testing | 7440 | California R.V.U. | RCCAC | | (xi) | Neurology-Diagnostic: | | | | | | Neurology-Diagnostic | 7460 | California R.V.U. | RCCAC | | (xii) | Therapy Services Group: | | | | | | Physical Therapy | 7510 | Dept. Charges | RCCAC | | | Occupational Therapy | 7530 | Dept. Charges | RCCAC | | | Speech/Language Pathology | 7550 | Dept. Charges | RCCAC | | | Recreational Therapy | 7570 | Assigned Time | RCCAC | | | Audiology | 7580 | Dept. Charges | ROCAC | | | Other Physical Medicine | 7590 | No. Of Treatments | RCCAC | | | Psychiatric/Psychological | 7670 | Dept. Charges | RCCAC | | (xiii) | Renal Dialysis: | | | | | | Renal Dialysis | 7710 | No. of Treatments | RCCAC | | (xiv) | Organ Acquisition and Other: | | | | | | Kidney Acquisition | 7730 | None | RCCAC | | | Other Organs Acquired | 7750 | None | RCCAC | | | Other Ancillary Services | 7910 | Specify | RCCAC | | (4) OTHER OPERATING EXPENSES | | | | | | (i) | Research Expenses: | | | | | | Research | 8010 | None | None | | (ii) | Education Expenses: | | | | | | Nursing Education | 8220 | Assigned Time of Nursing Students | Assigned Time of Nursing Students | | | Post Graduate Medical Education Primary Care Teaching Programs | | | | | | Approved—Internal Medicine | 8240 | Assigned Time of Students | To be Determined | | | Approved—Family Practice | 8250 | Assigned Time of Students | To be Determined | | | Approved—Pediatrics | 8260 | Assigned Time of Students | To be Determined | | | Post Graduate Medical Education Other Approved Teaching Program | 8270 | Assigned Time of Students | Assigned Time of Students | | | Post Graduate Medical Education Non-Approved Teaching Program | 8280 | Assigned Time of Students | None | | | Other Health Professional Education | 8290 | Assigned Time of Students | None | | (iii) | General Services: | | | | | | Dietary Services | 8310 | Patient Meals Served | Meals Served | | | Non-Patient Food Service | 8320 | Adjusted F.T.E. Employees | F.T.E. Employees | | | Laundry and Linen | 8330 | Pounds Distributed | Pounds of Laundry | | | Social Work Services | 8350 | Time Spent | Daily Hospital and Ambulatory Services Gross Patient Revenue | | | Housing | 8360 | Rooms Occupied by Department | Number Housed | | | Plant Operations and Maintenance | 8410 | Net Square Feet | Square Feet | | | Plant Maintenance | 8400 | Net Square Feet Maintained | Square Feet | | | Plant Operation | 8410 | Net Square Feet | Square Feet | | | Security | 8430 | Net Square Feet | Square Feet | | | Parking | 8440 | Net Square Feet | Square Feet | | | Housekeeping | 8450 | Assigned Time | Hours of Service | | | Central Services and Supplies | 8460 | Central Services Costed Requisitions and Cost of Sales | Central Services Costed Requisitions and Cost of Sales | | | Pharmacy | 8470 | Pharmacy Costed Requisitions and Cost of Sales | Pharmacy Costed Requisitions and Cost of Sales | | (iv) | Fiscal Services: | | | | | | General Accounting | 8510 | Accumulated Cost | Direct Cost | | | Patient Accounts, Admitting and Registration | 8520 | Accumulated Cost | Gross Patient Charges | | | Admitting | 8530 | Accumulated Cost | To be Determined | | | Registration | 8540 | Accumulated Cost | To be Determined | | (v) | Administrative Services: | | | | | | Hospital Administration | 8610 | Accumulated Cost | Direct Cost | | | Purchasing and Stores | 8690 | Direct Cost of Supplies Expensed | Direct Cost of Supplies Expensed | | | Medical Records | 8710 | Hours of Service | Gross Patient Charges | | | Medical Staff Administration | 8720 | Percent of Effort | Direct Cost | | | Medical Staff Services | 8730 | Professional Component by Cost Center | None | | | Medical Care Review | 8740 | Number of Inpatient Discharges (exclude Newborn) | None | | | Nursing Administration | 8750 | Hours of Total Direct Nursing Service | Assigned Time | | | Medical Photography and Illustration | 8760 | Time Spent | Direct Cost | | | Fund Raising | 8780 | None | None | | (vi) | Unassigned Expenses: | | | | | | Depreciation and Amortization—Fixed Assets | 8810 | Dollars of Depreciation | Square Feet | | | Leases and Rentals— | 8815 | Dollars of Lease/Rent | Square Feet | | | Fixed Assets | | | | | | Depreciation and Amortization—Movable Equipment | 8820 | Dollars of Depreciation | Square Feet or Dollar Value | | | Leases and Rentals— Movable Equipment | 8823 | Dollars of Lease/Rent | Square Feet or Dollar Value | | | Employee Benefits—Non-Payroll-Related | 8830 | F.T.E. Employees | F.T.E. Employees | | | Insurance—Hospital and Professional | | | | | | Malpractice | 8840 | Accumulated Cost | None | | | Insurance—Other | 8850 | Accumulated Cost | None | | | Licenses and Taxes (Other than Income Taxes) | 8860 | Accumulated Cost | None | | | Interest—Short-Term | 8870 | Accumulated Cost | None | | | Interest—Long-Term | 8880 | Dollars of Interest | None |
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.17 Enforcement provisions
(a) It is unlawful for any temporary food service establishment to be operated without a permit. Failure to obtain a permit is cause for immediate closure. Only an individual, partnership, corporation, association or similar legal entity complying with requirements of this Subpart, after making application on forms provided by the permit-issuing official, is entitled to receive and retain such a permit.
(b) The application for permit is to be fully completed.
(c) The permit-issuing official or his authorized representative may suspend a permit and order a temporary food service establishment closed and all food operations discontinued immediately when, in his judgment, continued operation is a danger to public health and it appears prejudicial to the public interest to delay action. The permit-issuing official may order immediate closure for deliberate refusal to correct a violation. The permit-issuing official is to provide the operator of any establishment ordered closed an opportunity for a hearing within 15 days of such an action.
(d) The permit-issuing official or his representative is to be permitted access for purposes of inspection at all times while the temporary food service establishment is in operation, whether open to the public for service of food or not. Refusal of admittance is cause for permit revocation and order to close.
(e) Embargo.
(1) The permit-issuing official or his designated representative may, by written order, place an embargo order on food which he determines or has reason to believe to be contaminated, unfit for human consumption, or from an unapproved source. Such food may not be used, sold, donated, discarded, repackaged or otherwise disposed of until such embargo is lifted by the permit-issuing official, his designated representative, or court of competent jurisdiction. The permit-issuing official shall provide the owner of the food embargoed, or the representative of the owner, an opportunity to be heard within 15 calendar days after the date of the order of embargo. The hearing officer, based on the evidence produced at such hearing, will make a recommendation to the permit-issuing official that he vacate the order of embargo, or may, by written order, direct the embargoed food, or any part of it, (i) to be continued to be held under embargo pending further testing, analysis or court action, (ii) to be destroyed, (iii) to be denatured and rendered inedible, (iv) to be released for return to a food processing plant for further processing, (v) to be released to another regulatory agency, or (vi) to other appropriate action. The permit-issuing official will consider the hearing officer's recommendation in determining the disposition of the embargoed food. The owner of the food embargoed shall be deemed to have received notice of embargo and hearing at the time the notice of embargo and hearing is delivered to any of his employees or agents.
(2) The permit-issuing official or his designated representative may take representative samples of the suspected food for analysis upon payment of the retail value of the sample taken.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.6 Definitions
(a) The following terms shall have the stated meanings when used in this Part, except where otherwise specifically provided:
(1) Access road means an impervious private or public road, other than a driveway, which connects a parcel to an existing public or private road and which is necessary in order to enable the parcel to be developed. Access road does not include an internal road within a subdivision or within an area of common development involving two or more parcels.
(2) Affiliate means any agency or person controlled by, controlling, or under common control with an applicant.
(3) Agency means any local, State or Federal department, agency, board, public benefit corporation, public authority, commission, district, or governing body, including any city, county, and other political entity of the State.
(4) Agricultural activity means an activity that occurs on land used in agricultural production as that term is defined in section 301(4) of the Agriculture and Markets Law.
(5) Alteration or modification means any change in physical configuration, intensity of use, location, plans, design, site, capacity, treatment standard or method, or other change in a regulated activity or in a noncomplying regulated activity. This term shall not include routine repairs or maintenance of structures and equipment.
(6) Approval means any final decision by an agency to issue a permit, certificate, license, lease, renewal or other entitlement or to otherwise authorize a proposed project or activity.
(7) Area zoned for commercial or industrial uses means a commercial or industrial zoning district, hamlet zoning district, or highway business zoning district. Areas zoned for commercial or industrial uses shall not include agricultural zoning districts.
(8) Base flow means visible sustained or fair weather runoff of water, including groundwater.
(9) Best management practices (BMPs) means methods, measures or practices determined to be the most practical and effective in preventing or reducing the contamination to or degradation of the water supply. Best management practices include, but are not limited to, structural and nonstructural controls and operations and maintenance procedures, that can be applied before, during or after regulated activities to achieve the purposes stated herein.
(10) Best treatment technology (BTT) means methods, measures or practices determined to be the most practical and effective in reducing amounts of phosphorus in both surface and subsurface point source discharges which occur within the New York City watershed. BTT will vary with the size of the wastewater treatment plant, but is generally understood to consist of secondary treatment and chemical removal (usually accomplished by the addition of aluminum salts, iron salts, polymers, or pH adjustments with lime), with media filtration as a final step if necessary to achieve higher removal rates.
(11) CFR means the Code of Federal Regulations.
(12) City means the City of New York.
(13) Clear cutting means cutting all of the trees, not just selected trees, within a specified boundary designated by the owner of the property.
(14) Coliform restricted basin means the drainage basin of a reservoir or controlled lake in which the coliform standards as set forth in section 128-4.1(a)(1) or (b)(1) of this Part are exceeded as determined by the department pursuant to its annual review conducted under section 128-4.1(c) of this Part.
(15) Combined sewerage system means a structure used for conveying both sewage and stormwater.
(16) Commissioner means the Commissioner of the New York City Department of Environmental Protection or its successors.
(17) Construction or construction activity means any building, demolition, renovation, replacement, restoration, rehabilitation or alteration of any new or existing structure or road.
(18) Construction and demolition debris means uncontaminated solid waste resulting from the construction, remodeling, repair and demolition of structures and roads; and uncontaminated solid waste consisting of vegetation resulting from land clearing and grubbing, utility line maintenance and seasonal and storm related cleanup.
(19) Contamination means the introduction of any pollutant to the water supply.
(20) Controlled lake means a lake from which the city may withdraw water pursuant to rights acquired by the city or as a right of ownership. The controlled lakes are: Kirk Lake, Lake Gleneida and Lake Gilead.
(21) Croton System means Middle Branch, Bog Brook, East Branch, Croton Falls, Diverting, Titicus, Amawalk, Muscoot, New Croton, and Cross River Reservoirs, Kirk Lake, Lake Gleneida and Lake Gilead, and their respective drainage basins.
(22) Degradation means a process of reduction or deterioration of the water quality of the water supply, including the process of eutrophication.
(23) Department means the New York City Department of Environmental Protection or its successors.
(24) Design capacity means the approved flow limit of the physical apparatus of a wastewater treatment plant as specified in its SPDES permit.
(25) Designated main street area means a defined area of limited size located within the east of Hudson watershed which is an existing center of commercial, industrial, residential, or mixed use and which has been defined and designated by a local government in the east of Hudson watershed and approved by the department pursuant to these rules and regulations.
(26) Designated village center means an area in the Croton System described by the metes and bounds of a village center, whether or not located in an incorporated village, designated by a local government(s) in a Comprehensive Croton Water Quality Protection Plan prepared and agreed to in accordance with section 128-8.2 of this Part by submitting to the department a description of the metes and bounds of such proposed designated village center, a map of the described area, and a statement of the features which qualify the area as a designated village center. A designated village center must be an existing center of commercial, residential or mixed uses.
(27) Design professional means a professional engineer or a registered architect who is licensed to practice in the State of New York, or a land surveyor with an exemption under section 7208(n) of the Education Law.
(28) Discharge means the intentional or unintentional disposal, deposit, injection, emission, application, dumping, spilling, leaking, washing off, release, running off, draining or placing of any solid, semi-solid, liquid, or any other non-gaseous waste or other substance into or onto any land or water or into any sewerage system so that such waste or other substance may directly or indirectly enter into any watercourse, wetland, reservoir, reservoir stem, controlled lake or groundwater.
(29) Disturbed area means the portion of a site for which the imperviousness of the ground has changed from pre-construction conditions as a result of any land clearing, land grading or construction activity. Disturbed areas may include lawns and landscaped areas.
(30) Drainage basin means the land area which contributes surface water to a reservoir or controlled lake.
(31) Driveway means a route accessible by a motor vehicle between a residential building and a public or private road to provide ingress and egress from the residential building.
(32) East of Hudson watershed means West Branch, Boyd's Corner, Bog Brook, East Branch, Croton Falls, Diverting, Titicus, Amawalk, Muscoot, New Croton, Cross River, Middle Branch and Kensico Reservoirs, Kirk Lake, Lake Gleneida and Lake Gilead, and their respective drainage basins.
(33) Effective date means May 1, 1997, the date on which these rules and regulations became effective pursuant to the approval issued by the New York State Department of Health pursuant to section 1100(1) of the Public Health Law; publication of these rules and regulations pursuant to section 1100(2) of the Public Health Law; and completion of the requirements of the New York City Administrative Procedure Act.
(34) Effluent means water or wastewater that flows out from a wastewater treatment plant or other treatment process.
(35) Epilimnion means the uppermost, warmest, well-mixed layer of a lake during thermal stratification.
(36) Erosion means the wearing away or the movement of soil by such physical agents as wind or water, that is exacerbated by such practices as the disturbance of ground cover by stripping or removing vegetation, construction activity, or tilling.
(37) Exfiltration means wastewater that leaks out of a sewerage system into the surrounding environment, through faulty joints, defective pipes, cracks in pipes, connections, or at manholes.
(38) Existing means physically constructed, functioning and operational prior to the effective date of these rules and regulations.
(39) Expansion means an increase in the permitted flow limit for a wastewater treatment plant as specified in the SPDES permit and/or an increase in the design capacity of a wastewater treatment plant.
(40) Facility means a structure, room or other physical feature designed to perform a particular function and that makes possible some activity.
(41) Fertilizer means any commercially produced mixture, generally containing phosphorus, nitrogen and/or potassium, except compost, that is applied to the ground to increase the supply of nutrients to plants.
(42) Galley system means any subsurface system for treating sewage that employs structural chambers in a horizontal or vertical arrangement for the storage of effluent until it can be absorbed into the soil that is utilized following a septic tank as an alternative to a standard absorption field.
(43) Gasoline station means an establishment at which gasoline is sold or offered for sale to the public for use in motor vehicles.
(44) Groundwater means any water beneath the land surface in the zone of saturation. The zone of saturation is where water fills all available pore spaces.
(45) Hamlet means a population center designated as a hamlet by a Town Board in the west of Hudson watershed pursuant to a Water Supply Permit issued by the New York State Department of Environmental Conservation for Project No. 0-9999-00051/00001.
(46) Hazardous substance means any substance defined or listed in Part 597 of Title 6 NYCRR except that hazardous substance does not mean any petroleum product, including those listed in section 597.2, Table 1 of Title 6 NYCRR, and also does not mean any hazardous waste.
(47) Hazardous waste means any solid waste, defined or listed as a hazardous waste in Part 371 of Title 6 NYCRR.
(48) Hypolimnion means the lower, cooler layer of a lake during thermal stratification.
(49) Impervious means resistant to penetration by moisture. Impervious materials include, but are not limited to, paving, concrete, asphalt, roofs, or other hard surfacing material. Impervious surfaces do not include dirt, crushed stone or gravel surfaces.
(50) Individual residence means a building consisting of one residential unit.
(51) Individual sewage treatment system means an on-site subsurface sewage treatment system serving residential properties and receiving sewage without the admixture of industrial wastes or other wastes, as defined in the Environmental Conservation Law, section 17-0701, in quantities of less than 1,000 gallons per day.
(52) Industrial waste means any liquid, gaseous, solid or waste substance or a combination thereof resulting from any process of industry, manufacturing, trade or business, or from the development or recovery of any natural resources, which may cause or might reasonably be expected to cause contamination to or degradation of the water supply.
(53) Infiltration means water, other than wastewater, that enters a sewerage system, including sewer service connections, from the ground through such means as defective pipes, pipe joints, connections, or manholes. Infiltration does not include, and is distinguished from, inflow.
(54) Inflow means water other than wastewater that enters a sewerage system, including sewer service connections, from sources such as, but not limited to, roof leaders, cellar drains, yard drains, area drains, foundation drains, drains from springs and swampy areas, manhole covers, cross connections between storm sewers and sanitary sewers, catch basins, cooling towers, storm waters, surface runoff, street wash waters, or drainage. Inflow does not include, and is distinguished from, infiltration.
(55) In situ soil means naturally occurring glacial soil; it does not include fill or stabilized fill.
(56) Intake means the points in the New York City water supply located prior to the point of disinfection where the water is no longer subject to surface runoff.
(57) Intermediate sized sewage treatment system means a subsurface sewage treatment system, typically with a treatment process utilizing a septic tank followed by subsurface disposal, treating sewage or other liquid wastes for discharge into the groundwater of the State and where a SPDES permit is required for such a system. Intermediate sized sewage treatment systems shall not include wastewater treatment plants as defined in these rules and regulations.
(58) Intermittent stream means a watercourse that during certain times of the year goes dry or whose lowest annual mean discharge during seven consecutive days with a recurrence interval of 10 years (MA7CD/10) is less than 0.1 cubic foot per second and which periodically receives groundwater inflow. A drainage ditch, swale or surface feature that contains water only during and immediately after a rainstorm or a snow melt shall not be considered to be an intermittent stream.
(59) Junkyard means any place of storage or deposit, whether in connection with another business or not, where four or more unregistered, old, or second hand motor vehicles, no longer intended or in condition for legal use on the public highways, are held, whether for the purpose of resale of used parts, for the purpose of reclaiming for use some or all of the materials such as metal, glass, or fabric for the purpose of disposing of the same, or for any other purpose.
(60) Land clearing means the exposure of soil by devegetation or the exposure of soil to the forces of erosion.
(61) Land grading means the removal, addition or alteration of surface or subsurface conditions of land by excavation or filling.
(62) Limiting distance means the shortest horizontal distance from the nearest point of a structure or object to the edge, margin or steep bank forming the ordinary high water mark of a watercourse, wetland, reservoir, reservoir stem or controlled lake or to the contour line coinciding with the reservoir spillway elevation.
(63) Metalimnion means an intermediate zone between the epilimnion and hypolimnion where the water temperature drops rapidly with increasing depth.
(64) Microfiltration means a process in which treated effluent passes through a membrane filter having a molecular weight cutoff rate of 500,000 or less.
(65) Multi-family residence means a building containing three or more residential units.
(66) Municipal solid waste landfill means a landfill, as defined in section 360-1.2 of Title 6 NYCRR, which is owned or operated by a municipality.
(67) New means any regulated activity that is not an existing or noncomplying regulated activity, as defined herein.
(68) Noncomplying regulated activity means any regulated activity or existing activity which does not conform to the standards set forth in these rules and regulations, but has obtained all discretionary approvals necessary for construction and operation, prior to the effective date of these rules and regulations.
(69) Nonpoint source pollution means pollution sources which are diffuse and do not have a single point of origin or are not introduced into a receiving stream from a point source.
(70) NYCRR means the Official Compilation of Codes, Rules and Regulations of the State of New York.
(71) Offset means a reduction in the discharge of phosphorus into a drainage basin which is surplus, quantifiable, permanent, and enforceable, as defined herein:
(i) Surplus means that the reduction in phosphorus is not otherwise required by Federal, State or local law, including these rules and regulations, or pursuant to the terms of any judgment, decree or order of any court, administrative tribunal or governmental agency, or pursuant to any watershed protection program funded by the department, except as provided in sections 128-8.3(a)(3) and 128-8.4(a)(3) of this Part.
(ii) Quantifiable means that a reasonable basis exists for calculating and verifying the amount of the reduction in phosphorus.
(iii) Permanent means that the reduction in phosphorus is ongoing and of unlimited duration, as opposed to a temporary reduction.
(iv) Enforceable means that the actions and performance standards proposed by the applicant leading to the reduction in phosphorus are incorporated into a legally valid and binding agreement which may be enforced by the city in a court of competent jurisdiction.
(72) One hundred-year flood plain means the land susceptible to being inundated by a flood that has a one percent or greater chance of recurring in any given year.
(73) Operator means any person who leases, operates, controls or supervises a facility.
(74) Owner means any person who has legal or equitable title to a facility.
(75) Pathogenic means capable of causing disease from organisms, including but not limited to: bacteria, fungi, viruses, and protozoa (such as Giardia and Cryptosporidium).
(76) Person means any individual, public or private corporation, political entity, agency, municipality, industry, co-partnership, association, firm, trust, estate or any other legal entity whatsoever, except that person shall not mean the State of New York or any State department, agency, board, public benefit corporation, public authority or commission.
(77) Perennial stream means a watercourse that flows throughout the year from source to mouth.
(78) Pesticide means:
(i) any substance or mixture of substances intended for preventing, destroying, repelling, or mitigating any insects, rodents, fungi, weeds, or other forms of plant or animal life or viruses, except viruses on or in living humans, or other animals, which the Commissioner of the New York State Department of Environmental Conservation shall declare to be a pest; or
(ii) any substance or mixture of substances intended as a plant regulator, defoliant or desiccant.
(79) Petroleum product means oil or petroleum of any kind and in any form including, but not limited to, oil, petroleum, fuel oil, oil sludge, oil refuse, oil mixed with other wastes and crude oils, gasoline and kerosene.
(80) Phosphorus restricted basin means the drainage basin of a reservoir or controlled lake in which the phosphorus load to the reservoir or controlled lake results in the phosphorus water quality values established by the New York State Department of Environmental Conservation and set forth in its Technical and Operational Guidance Series (TOGS) 1.1.1, Ambient Water Quality and Guidance Values (October 22, 1993) being exceeded as determined by the department pursuant to its annual review conducted under section 128-4.1(c) of this Part.
(81) Photic zone means the region of a lake that receives light, where photosynthesis takes place. The photic zone extends down to a depth where photosynthetic activity and respiration are balanced due to the available light, or to one percent surface illumination.
(82) Point source means any discernible, confined and discrete conveyance, including but not limited to any pipe, ditch, channel, tunnel, conduit, well, discrete fissure, container, rolling stock, or vessel or other floating craft, or landfill leachate collection system, from which pollutants are or may be discharged.
(83) Pollutant means unpermitted dredged spoil, solid waste, incinerator residue, sewage, effluent, garbage, sewage sludge, munitions, chemical waste, biological material, radioactive material, heat, wrecked or discarded equipment, rock, sand, and industrial and municipal waste discharged into water.
(84) Principal means an agency or person that owns 10 percent or more of the voting stock or has the ability to control a corporation, partnership or other entity.
(85) Radioactive material means any material in any form that emits radiation spontaneously.
(86) Regulated activity means any activity to which these rules and regulations apply, as described in section 128-1.4(a)-(d) of this Subpart.
(87) Remediation means the repair or replacement of a subsurface sewage treatment system.
(88) Reservoir means any natural or artificial impoundment of water owned or controlled by the city which is tributary to the city water supply system.
(89) Reservoir stem means any watercourse segment which is tributary to a reservoir and lies within 500 feet or less of the reservoir.
(90) Residential lot(s) means any parcel of land of five acres or less, any point on the boundary line of which is less than one-half mile from any point on the boundary line of another such lot in the same tract, unless any such lot may not legally be used for residential purposes. Without limiting the generality of the foregoing, the term residential shall include temporary, seasonal and permanent residential use.
(91) Sediment means organic or mineral solids or colloids that are transported by the process of hydrologic, hydraulic, or atmospheric transport, including but not limited to erosion.
(92) Sewage means the water-carried human or animal wastes from residences, buildings, industrial establishments or other places, together with such groundwater infiltration and surface water as may be present. The admixture of sewage with industrial waste or any other waste as herein defined, shall also be considered sewage within the meaning of these rules and regulations.
(93) Sewerage system means pipe lines or conduits, pumping stations, and force mains, and all other constructions, devices, and appliances appurtenant thereto, used for conducting sewage, industrial waste or other wastes to a point of ultimate disposal.
(94) Silvicultural activity means the removal of selected trees within a specified boundary designated by the owner of the property so that adequate numbers of trees are left to provide seed and partial shade for the development of new tree seedlings, and when such activity is in accordance with Federal, State and local laws.
(95) Small quantity generator has the meaning set forth in section 370.2(b)(154) of Title 6 NYCRR.
(96) Solid waste means all putrescible and non-putrescible materials or substances that are discarded, abandoned, or rejected as being spent, useless, worthless or in excess to the owners at the time of such discard or rejection, including but not limited to garbage, refuse, industrial and commercial waste, sludges from air or water treatment facilities, rubbish, tires, ashes, contained gaseous material, incinerator residue, construction and demolition debris, discarded automobiles and offal, except where exempt from compliance with Part 360 of Title 6 NYCRR as described in section 360-1.2(a)(4) of Title 6 NYCRR.
(97) Solid waste management facility means any facility employed beyond the initial solid waste collection process and managing solid waste including but not limited to: storage areas or facilities; transfer stations; rail-haul or barge-haul facilities; landfills; construction and demolition processing facilities; disposal facilities; solid waste incinerators; landspreading facilities; composting facilities; surface impoundments; waste oil storage, reprocessing and rerefining facilities; recyclables handling and recovery facilities; and waste tire storage facilities, as defined in section 360-1.2 of Title 6 NYCRR.
(98) SPDES flow parameter violation means two or more violations of a permitted State Pollutant Discharge Elimination System (SPDES) flow parameter limit during a consecutive six-month period. A facility that operates less than six months per year will be deemed to have a SPDES flow parameter violation if the permitted SPDES flow parameter limit is violated one or more times during any consecutive four-month period.
(99) State Pollutant Discharge Elimination System (SPDES) permit means a permit issued pursuant to titles 7 and 8 of article 17 of the Environmental Conservation Law.
(100) Stormwater means that portion of precipitation that is in excess of the evaporative or infiltrative capacity of soils, or the retentive capacity of surface features, that flows off the land by surface runoff or by subsurface interflow to watercourses, wetlands, reservoirs, reservoir stems and controlled lakes, i.e., that portion of the water supplied to surface drainage that is not groundwater or base flow.
(101) Stormwater Project Review Committee (“committee”) means a committee formed in each town or village in the watershed to assist the department in implementing section 128-3.9(b) and (c) of this Part, and consisting of the following four committee members: a representative of the department, who shall act as chairperson; a representative of the New York State Department of Environmental Conservation from the region in which the activity requiring a Stormwater Pollution Prevention Plan is proposed to be located; a representative of the town or village in which the activity requiring a Stormwater Pollution Prevention Plan is proposed to be located or if no one is designated by the town, or if the activity is proposed for a village, the village, a representative of the appropriate County Planning Department; provided, however, that a town, or if the activity is proposed for a village, the village, may at any time designate a representative to replace the one designated by the County Planning Department; and a representative of the County Department of Health from the county in which the activity requiring a Stormwater Pollution Prevention Plan is proposed to be located, or in a county without a County Department of Health, a representative of the County Soil and Water Conservation Service.
(102) Stratification means the physical condition caused primarily by temperature-created differences in water density, which results in the formation of a warm, surface layer (epilimnion), a zone of transition (metalimnion), and a cooler, deep layer of water (hypolimnion).
(103) Subdivision means any tract of land which is divided into five or more parcels of five acres or less, along an existing or proposed street, highway, easement or right-of-way, for sale or for rent as residential lots. A tract of land shall constitute a subdivision upon the sale, rental or offer for sale or lease of the fifth residential lot therefrom within any consecutive three-year period.
(104) Subsurface discharge means discharge to a seepage unit or an absorption field, i.e., a process designed to allow filtered, treated sewage effluent to be discharged into the ground as a means of ultimate disposal.
(105) Subsurface sewage treatment system means any underground system used for collecting, treating, and disposing of sewage into the ground including, but not limited to, individual and intermediate sized sewage treatment systems, as defined in these rules and regulations.
(106) Terminal reservoir means Kensico, West Branch, New Croton, Ashokan and Rondout Reservoirs.
(107) Two-year, twenty-four hour storm means the storm, with a 24-hour duration, that has a 50 percent chance of occurring in any given year.
(108) Twenty-five year storm means the storm that has a four percent chance of occurring in any given year.
(109) Ulster County Fill System means a subsurface sewage treatment system used in Ulster County which has been approved by the New York State Department of Health for use in Ulster County and which is built upon two feet of in situ soil that has a percolation rate between 3 to 60 minutes/inch, and which uses at least four feet of fill material, including at least three feet between the bottom of the trench and the in situ soil, that has a percolation rate between 3 and 10 minutes/inch. Ulster County Fill System shall include the Ulster County Fill System when used in a county other than Ulster if the New York State Department of Health has approved the system for use in such other county.
(110) Village means a territory which has been incorporated as a village pursuant to article 2 of the New York State Village Law.
(111) Village extension means an area immediately adjoining a main road extending a maximum distance of one quarter mile outside an existing village which has been designated as a village extension by the town board of the town in which the village is located in the west of Hudson watershed pursuant to a water supply permit issued by the New York State Department of Environmental Conservation for Project No. 0-9999-00051/00001.
(112) Wastewater treatment plant means any facility which treats sewage or discharges treated effluent in the watershed, and which requires a permit under title 7 or 8 of article 17 of the Environmental Conservation Law, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage by removal of contaminants accomplished by unit operations or processes or by a combination of such operations and processes, including any combination of the following: preliminary treatment, flow equalization, primary settling, biological treatment, chemical treatment, secondary settling, filtration, aeration, disinfection, sludge processing, or any other processes as may be applicable to a given design for a wastewater treatment plant. Wastewater treatment plants shall not include intermediate sized sewage treatment systems as defined in these rules and regulations.
(113) Water supply means the New York City public water supply system, and includes all watercourses, wetlands, reservoirs, reservoir stems and controlled lakes tributary thereto.
(114) Watercourse means a visible path through which surface water travels on a regular basis, including an intermittent stream, which is tributary to the water supply. A drainage ditch, swale or surface feature that contains water only during and immediately after a rainstorm or a snowmelt shall not be considered to be a watercourse.
(115) Watershed means the land area contributing surface water to the New York City water supply.
(116) West of Hudson watershed means the Ashokan, Cannonsville, Pepacton, Neversink, Rondout, and Schoharie Reservoirs and their drainage basins.
(117) Wetland means any area mapped as a wetland by the New York State Department of Environmental Conservation pursuant to the Environmental Conservation Law, which is at least 12.4 acres in size or has been designated as a wetland of unusual local importance.
(118) Winter highway maintenance materials means the solid compounds or the solutions that are commonly used for traction on, or for the abatement of, winter road ice, including, but not limited to, chloride compounds, mixtures of sand and chloride compounds, sand and coal combustion bottom ash and ash from solid waste incinerators that meet the requirements of section 360-3.5(h) of Title 6 NYCRR.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.5 Priority ranking and intended use plan
(a) With the exception of category G projects, all completed pre-applications received by the department will be evaluated and assigned a score based on the priority ranking scoring system described in section 53.4 of this Part, provided, however, that:
(1) the department will not assign a score to any project it has determined to be ineligible for assistance; and
(2) after review of a pre-application the department may determine that one or more proposed project components are not essential to addressing critical public water system deficiencies. In that event, the department will sever any non-essential components from the essential project component and score them as separate projects.
(b) Projects receiving scores will additionally be assigned to one of three categories:
(1) Category A: Public water systems serving a population of 10,000 or fewer.
(2) Category B: Public water systems serving a population exceeding 10,000.
(3) Category C: Public water systems which have been qualified by the corporation for financial hardship assistance.
(c) The department shall prepare annually an intended use plan that describes how the department and the corporation intend to allocate fund resources available for that annual funding cycle. The intended use plan will list all potentially eligible projects for assistance from the fund. A project must be listed in an intended use plan to be eligible for fund assistance. The intended use plan will also include the following:
(1) Multi-year list: The multi-year list shall include all proposed projects which have been reviewed by the department and received a numerical score pursuant to subdivision (a) of this section. New projects may be added to this list on a continuous basis.
(2) Project readiness list: The project readiness list shall include all projects from the multi-year list which the department has determined are sufficiently developed to proceed with long-term fund assistance during the funding cycle covered by the intended use plan. Applicants for these projects are expected to make applications for fund assistance to the corporation during that annual funding cycle. Projects shall be listed in descending order of their priority ranking system score.
(3) Funding list: The funding list shall include all projects from the project readiness list and all projects from the hardship list expected to qualify for long-term loans within the annual funding cycle covered by the intended use plan.
(4) Hardship list: Upon written confirmation from the corporation that a project qualifies for financial hardship assistance, that project will be placed on the hardship list. Such written confirmation shall remain valid for two consecutive annual funding cycles. If a project has not received funding during this period, it shall be removed from the hardship list and relisted on the multi-year List unless the project receives another written confirmation from the corporation that the project qualifies for financial hardship.
(5) Category G list: The category G list shall include projects or portions thereof that address green infrastructure including, without limitation, water and energy efficiency improvements or other environmentally innovative activities or that qualify as a demonstration project of new green infrastructure technology as provided in the IUP. Such projects or portions thereof shall be determined based on an evaluation of benefits to the public and positive (or least negative) impacts on the environment and that shall include, without limitation: economic benefits generated; public health and safety; protection of water quality and the environment; demonstrated readiness; green energy production and/or reduction in energy consumption; regional distribution of projects, or water conservation as provided in the IUP.
(d) The department and the corporation will annually publish a draft intended use plan which contains the department's initial plan for the allocation of annual fund resources and the project priority ranking system scores of each eligible project. The department will specify a period for review and comment after the publication of the draft intended use plan during which the public may submit written comments directly to the department or provide oral statements at public hearings held jointly by the department and the corporation. Notice of the hearings and availability of the draft intended use plan will be published in the State Register. Project applicants may use this opportunity to address any concerns they have regarding project scores and advance any reasonable arguments in support of having their respective scores adjusted. Such plan may, after a public comment period, be amended after the close of the comment and review period the department will issue the intended use plan.
(e) The department shall develop the intended use plan subject to the following requirements:
(1) A minimum of 15 percent of the annual Federal capitalization funds credited to the fund in any fixed year, shall be allocated to public water systems serving populations of 10,000 or fewer. The actual fund assistance rendered to such systems will occur to the extent there are sufficient allowable project costs to finance in a given annual funding cycle.
(2) No more than 30 percent of the annual Federal capitalization funds shall be used to give loan subsidies to disadvantaged systems as determined by the corporation, except a greater percent of the annual Federal capitalization funds may be used to give additional subsidization to eligible recipients when required or authorized by Federal laws or regulations. Such additional subsidization shall be provided in accordance with the act and shall include forgiveness of principal, a negative interest loan or a grant.
(3) No more than 50 percent of fund resources shall be received annually by a particular applicant. In addition, the corporation may, on its own initiative or at the direction of the department, limit fund assistance to the demonstrated annual cash flow needs of any single applicant.
(f) Projects shall be selected for placement on the funding list in the following manner:
(1) Any category C project which receives a score greater than or equal to the project with the lowest score (excluding additional points awarded pursuant to section 53.4 of this Part) receiving fund assistance in the annual funding cycle in which the category C project received its current financial hardship qualification shall be placed on the funding list.
(2) Category A projects from the project readiness list shall be selected in priority order and placed on the funding list until 15 percent of funds available for the period covered by the IUP have been allocated.
(3) All remaining projects on the project readiness list shall be selected in priority order and placed on the funding list until all remaining annual fund resources have been encumbered. Final project funding selection is subject to the restrictions and project by-pass criteria in subdivision (g) of this section.
(g) Projects on the project readiness list may be by-passed, upon written notice to the applicant from the department or the corporation, if any of the following occurs:
(1) the department or corporation receives written notice from the applicant that the project is withdrawn;
(2) the applicant fails to fulfill expectations, perform duties, or conform to deadlines or conditions established in the project schedule or the applicant will not be able to satisfy any other conditions precedent to obtaining funding during the period specified in the IUP;
(3) the applicant has reached the 50 percent annual fund resources cap for fundable projects on the project readiness list. All projects of an applicant that would cause the applicant to exceed the 50 percent cap will be by-passed for that annual funding cycle; or
(4) the department determines that another project better addresses water savings/conservation, or energy efficiency improvements or other environmentally innovative activities that meet green infrastructure mandates of the ARRA.
(h) Projects must be placed on the multi-year list to be eligible for any available short-term loans made by the fund. Short-term loan availability shall be limited to those projects listed on the multi-year list which have a numerical project priority ranking score greater than or equal to the project with the lowest score (excluding points awarded pursuant to section 53.4 of this Part) on the funding list.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
COMMISSIONER OF HEALTH COMMISSIONER OF HEALTH
10 CRR-NY 11.10 Definition
The term commissioner of health for a county, or a city having a population of 50,000 or more and having an established department of health, shall mean the officer who administers and manages public health programs within the county or city and who has the general powers and duties specified for county or city commissioners of health in applicable provisions of the Public Health Law.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.7 Village of Croton-on-Hudson
(a) Application.
The following rules and regulations enacted under the authority of article 11 of the Public Health Law, and of the whole thereof, as last amended by chapter 879 of the Laws of 1953, shall apply to all existing wells and such additional wells and reservoirs which now serve or which may be developed in the future to serve as sources of the public water supply of the village of Croton-on-Hudson and to all watercourses tributary to the Croton River between the existing Croton Dam and the proposed dams of the village of Croton-on-Hudson.
(b) [Definitions.]
(1) The term water supply means the public water supply of the village of Croton-on-Hudson.
(2) The term well means any well now used as a source of the water supply of the village of Croton-on-Hudson or any additional well which may be constructed on the property of the village of Croton-on-Hudson.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The term reservoir includes any natural or artificial lake or pond.
(5) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure of* object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(6) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(7) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) [Human excreta.]
(1) No human excreta shall be deposited, thrown or placed or allowed to escape into the lake or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply, unless deposited in trenches or pits at a distance of not less than 200 feet from any well, reservoir or tributary watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any well or within 50 feet of any reservoir or tributary watercourse except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (1) of subdivision (d), provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of trustees of the village of Croton-on-Hudson and in such manner as effectually to prevent any pollution of the public water supply.
(6) Every privy or receptacle for the storage or deposit of human excreta located within the distances of 50 feet and 200 feet of any well, reservoir or tributary watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(7) Whenever, in the opinion of the board of trustees of the village of Croton-on-Hudson or of the State or Westchester County Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) [Sewage, sink wastes, garbage, etc.]
(1) No sewage shall be discharged or allowed to flow into the lake or any watercourse nor deposited on or beneath the surface of the ground within 50 feet of any reservoir or tributary watercourse except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall not be located within 50 feet of any reservoir or tributary watercourse provided, however, that the property on which the receptacle is built or to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of the property. In such case, the watertight receptacle shall be constructed and maintained as provided for in paragraph (5) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(2) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by paragraph (1) of this subdivision, shall be discharged or allowed to flow into the lake or any watercourse nor be deposited on or beneath the surface of the ground within 50 feet of any reservoir or tributary watercourse.
(3) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof or any other matter than*pollutes water shall be deposited in the lake or watercourse nor on or beneath the surface of the ground within 50 feet of any well, reservoir or tributary watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(e) [Bathing, boating, animals, manure, etc.]
(1) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or tributary watercourse owned by and which is a part of the public water supply of the village of Croton-on-Hudson.
(2) No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse to the public water supply, except by persons duly authorized by the board of trustees of the village of Croton-on-Hudson.
(3) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in the lake or any tributary and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(4) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute the lake or any watercourse.
(5) No manure pile shall be maintained or allowed to remain within 50 feet of any well, reservoir or tributary watercourse.
(f) [General clause.]
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(g) [Inspections.]
The board of trustees of the village of Croton-on-Hudson or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the board shall make regular and thorough inspections of the lake, watercourse and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(h) [Penalty.]
In accordance with section 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.1 Definitions
(a) Synthetic phenethylamine means any of the following chemical compounds, that are not listed as a controlled substance in schedules I through V of section 3306 of the Public Health Law, and are not approved by the Federal Food and Drug Administration (FDA):
3,4-Methylenedioxymethcathinone (Methylone);
4-Methoxymethcathinone;
3-Fluoromethcathinone;
4-Fluoromethcathinone;
Ethylpropion (Ethcathinone);
2-(2,5-Dimethoxy-4-ethylphenyl)ethanamine (2C-E);
2-(2,5-Dimethoxy-4-methylphenyl)ethanamine (2C-D);
2-(4-Chloro-2,5-dimethoxyphenyl)ethanamine (2C-C);
2-(4-Iodo-2,5-dimethoxyphenyl)ethanamine (2C-I);
2-[4-(Ethylthio)-2,5-dimethoxyphenyl]ethanamine (2C-T-2);
2-[4-(Isopropylthio)-2,5-dimethoxyphenyl]ethanamine (2C-T-4);
2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);
2-(2,5-Dimethoxy-4-nitro-phenyl)ethanamine (2C-N);
2-(2,5-Dimethoxy-4-(n)-propylphenyl)ethanamine (2C-P); and
any compound that has a chemical structure that is substantially similar to these compounds.
(b) Synthetic cannabinoid means any manufactured chemical compound that is a cannabinoid receptor agonist and includes, but is not limited to any material, compound, mixture, or preparation that is not listed as a controlled substance in schedules I through V of section 3306 of the Public Health Law, and not approved by the Federal Food and Drug Administration (FDA), and contains any quantity of the following substances, their salts, isomers (whether optical, positional, or geometric), homologues (analogs), and salts of isomers and homologues (analogs), unless specifically exempted, whenever the existence of these salts, isomers, homologues (analogs), and salts of isomers and homologues (analogs) is possible within the specific chemical designation:
(1) Naphthoylindoles. Any compound containing a 3-(1-Naphthoyl)indole structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any extent and whether or not substituted in the naphthyl ring to any extent. (Other names in this structural class include but are not limited to: JWH 007, JWH 015, JWH 018, JWH 019, JWH 073, JWH 081, JWH 98, JWH 122, JWH 164, JWH 200, JWH 210, JWH 398, AM 2201, MAM 2201, EAM 2201 and WIN 55 212.)
(2) Naphthylmethylindoles. Any compound containing a 1 H-indol-3-yl-(1- naphthyl) methane structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any extent and whether or not substituted in the naphthyl ring to any extent. (Other names in this structural class include but are not limited to: JWH-175, and JWH-184.)
(3) Naphthoylpyrroles. Any compound containing a 3-(1-naphthoyl) pyrrole structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the pyrrole ring to any extent and whether or not substituted in the naphthyl ring to any extent. (Other names in this structural class include but are not limited: JWH 307.)
(4) Naphthylmethylindenes. Any compound containing a naphthymethylindenes structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the indene ring to any extent and whether or not substituted in the naphthyl ring to any extent. (Other names in this structural class include but are not limited: JWH-176.)
(5) Phenylacetylindoles. Any compound containing a 3-phenylacetylindole structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any extent and whether or not substituted in the phenyl ring to any extent. (Other names in this structural class include but are not limited to: RCS-8 (SR-18), JWH 201, JWH 250, JWH 203, JWH-251, and JWH-302.)
(6) Cyclohexylphenols. Any compound containing a 2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not substituted in the cyclohexyl ring to any extent. (Other names in this structural class include but are not limited to: CP 47,497 [and homologues (analogs)], cannabicyclohexanol, and CP 55,940.)
(7) Benzoylindoles. Any compound containing a 3-(benzoyl)indole structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methy1-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any extent and whether or not substituted in the phenyl ring to any extent. (Other names in this structural class include but are not limited to: AM 694, Pravadoline [WIN 48,098], RCS 4, AM-2233 and AM-679.)
(8) [2,3-Dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo [1,2,3-de]-1, 4-benzoxazin-6-yl]-1-napthalenylmethanone. (Other names in this structural class include but are not limited to: WIN 55,212-2.)
(9) (6aR,10aR)-9-(hydroxymethyl)-6, 6-dimethyl-3-(2-methyloctan-2-yl)-6a,7,10, 10a- tetrahydrobenzo[c]chromen-1-ol. (Other names in this structural class include but are not limited to: HU-210.)
(10) (6aS, 10aS)-9-(hydrxymethyl)-6,6-demethyl-3-(2-methyloctan-2-yl)-6a,7,10,10a-tetrahydrobenzo{c}chromen-l-ol (Dezanabinol or HU-211.)
(11) Adamantoylindoles. Any compound containing a 3-(1-adamantoyl)indole structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the adamantyl ring system to any extent. (Other names in this structural class include but are not limited to: AM-1248.)
(12) Adamantoylindazoles including but not limited to Adamantyl Carboxamide Indazoles. Any compound containing a 3-(1-adamantoyl)indazole structure with substitution at the nitrogen atom of the indazole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl, or 2-(4-morpholinyl)ethyl group, whether or not further substituted in the adamantyl ring system to any extent. (Other names in this structural class include but are not limited to: AKB-48, MAB-CHMINACA, 5F-AKB-48.)
(13) Tetramethylcyclopropylcarbonylindoles or any compound structurally derived from 3-(2,2,3,3-tetramethylcyclopropylcarbonyl) indole by substitution at the nitrogen atom of the indole ring with alkyl,haloalkyl, alkenyl, cyanoalkyl, hydroxyalkyl, cycloalkylmethyl, cycloalkylethyl, (N-methylpiperidin-2-yl)methyl or 2-(4-morpholinyl)ethyl, whether or not further substituted in the indole ring to any extent, including without limitation the following: UR-11, XLR-11, A-796,260.
(14) Any other synthetic chemical compound that is a cannabinoid receptor agonist that is not listed in schedules I through V of section 3306 of the Public Health Law, or is not an FDA approved drug.
(c) Possession means to have physical possession or otherwise to exercise dominion or control over synthetic phenethylamine or synthetic cannabinoid, or a product containing the same. For purposes of this definition, among other circumstances not limited to these examples, the following individuals and/or entities shall be deemed to possess synthetic phenethylamine or synthetic cannabinoid, or a product containing the same:
(1) any individual or entity that has an ownership interest in a retail, distribution or manufacturing establishment that possesses, distributes, sells or offers for sale a synthetic phenethylamine or synthetic cannabinoid, or a product containing the same; and
(2) any clerk, cashier or other employee or staff of a retail establishment, which establishment possesses, distributes, sells or offers for sale a synthetic phenethylamine or synthetic cannabinoid, or a product containing the same, who interacts with customers or other members of the public.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.6 Animals
(a) No birds, turtles, dogs, cats or other animals exclusive of those required for laboratory purposes shall be allowed in a medical facility, except in a residential health care facility pet therapy program as permitted in subdivisions (b) and (c) of this section. Guide dogs may accompany sightless persons.
(b) A residential health care facility may board one dog or one cat, provided:
(1) the health, safety, welfare and rights of all patients/residents are assured;
(2) a staff member has been designated to be responsible for the care and management of the animal;
(3) the animal is free from disease and has received all immunizations as recommended by a licensed veterinarian; and
(4) the animal shall not be allowed in laundry, utensil storage or food preparation areas.
(c) Pet visitations are permitted in a residential health care facility, provided:
(1) the visit is prescheduled and approved by the operator;
(2) the health, safety, welfare and rights of all patients/residents are assured;
(3) all animals are free from disease and have received all immunizations as recommended by a licensed veterinarian;
(4) the animal shall not be allowed in laundry, utensil storage or food preparation areas; and
(5) the animal will at all times be accompanied by a person familiar with and capable of controlling the animal's behavior.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.56 Immunizations administered by individuals other than health care practitioners as permitted by their license under title 8 of the Education Law
(a) During the course or as part of any public immunization program, individuals other than health care practitioners licensed under title 8 of the Education Law may administer immunizations involving oral, intramuscular, subcutaneous or intradermal administration, including but not limited to immunizations against rubella, polio, pertussis, measles, diphtheria and tetanus, when so authorized by the State Commissioner of Health or local health officer.
(b) Before an individual may administer immunizations as provided in subdivision (a) of this section, he must have received training satisfactory to the State Commissioner of Health or local health officer to include indications, precautions and contraindications in the use of the agent or agents and techniques of administration.
(c) The State Commissioner of Health or local health officer shall maintain a current list of all individuals whose training is satisfactory to him for the administration of immunizations under his direction.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.40 General requirements and action levels
(a) Applicability.
The requirements of sections 5-1.40 through 5-1.48 of this Subpart shall apply to all community water systems and nontransient, noncommunity water systems serving 15 or more service connections or serving 25 or more persons.
(b) Lead and copper action levels.
(1)
| Analyte | Action Level1,2 | | | --- | --- | --- | | Lead | 0.015 mg/L | | | Copper | 1.3 mg/L | |
(2) The lead action level is exceeded if the concentration of lead in more than 10 percent (90th percentile) of the tap water samples collected in accordance with section 5-1.42 of this Subpart during any monitoring period exceeds 0.015 mg/L.
(3) The copper action level is exceeded if the concentration of copper in more than 10 percent (90th percentile) of the tap water samples collected in accordance with section 5-1.42 of this Subpart during any monitoring period exceeds 1.3 mg/L.
(4) The 90th percentile lead and copper levels shall be computed as follows:
(i) Place the results of all lead and copper samples taken during a monitoring period in ascending order from the sample with the lowest concentration to the sample with the highest concentration. Each sampling result will be assigned a number, ascending by single integers beginning with the number one for the sample with the lowest contaminant level. The number assigned to the sample with the highest contaminant level will be equal to the total number of samples taken.
(ii) Multiply the number of samples taken during the monitoring period by 0.9.
(iii) The contaminant concentration of the numbered sample obtained by the calculation in subparagraph (ii) of this paragraph is the 90th percentile contaminant level.
(iv) For water systems serving fewer than 100 people that collect 5 samples per monitoring period, the 90th percentile is computed by taking the average of the highest and second highest concentration.
(v) For a public water system that has been allowed by the State to collect fewer than five samples under section 5-1.42(a)(3) of this Subpart, the sample result with the highest concentration is considered the 90th percentile value.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
COMPANIES COMPANIES
10 CRR-NY 127.103 Sea Cliff Water Company
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such additional wells as may be developed in the future on the property of Sea Cliff Water Company, Nassau County, New York, such wells being the sources of public water supply of the village of Sea Cliff and the adjacent area in the town of Oyster Bay, Nassau County, New York.
(b) [Definitions.]
(1) The term well whenever used in this section means any well now used as a source of this public water supply or any additional well which may be constructed on the property of the Sea Cliff Water Company for the purpose of this water supply.
(2) Wherever the linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) [Privies, human excreta, sewage, etc.]
(1) No privy, cesspool, septic tank, subsurface leaching tile or receptacle of any kind for the storage, deposit or disposal of human excreta or sewage except a cast iron sewer laid with leaded joints, plans for which sewer shall first have been approved by the State Department of Health, shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(2) No human excreta or sewage shall be so stored, disposed of or discharged onto the surface of the ground so that the material will drain or be washed by rain or melting snow to points within 100 feet of any well.
(3) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(4) No cesspool, pit or receptacle of any kind for the storage, deposit or disposal of bath water, sink or laundry wastes, garbage, refuse, manure or putrescible matter shall be constructed, placed, maintained or allowed to remain within 100 feet of any well.
(5) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 100 feet of any well.
(d) [Trespassing.]
No trespassing shall be allowed upon the property of the Sea Cliff Water Company upon which the wells of the public water supply are located, and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter such property by the said company.
(e) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Sea Cliff Water Company.
(f) [Inspections.]
The Sea Cliff Water Company, its officers or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid company to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Sea Cliff Water Company to promptly notify the State Commissioner of Health of such violations. The Sea Cliff Water Company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(g) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 54 REQUIREMENTS FOR SELF-DEFENSE SPRAY DEVICES
10 CRR-NY 54.2 Definitions
(a) Camouflaged means designed to have the appearance of an object other than a self-defense spray device.
(b) Net weight means the weight of the contents of a self-defense spray device.
(c) Oleoresin capsicum means the oleoresin extracted from fruits or plants of the genus Capsicum. The oleoresin contains the active ingredient capsaicin and related compounds classified as capsaicinoids.
(d) Safety device means a self-defense spray device feature that is designed to prevent unintentional discharges.
(e) Self-defense spray device means a pocket-sized spray device which contains and releases a chemical or organic substance which is intended to produce temporary physical discomfort or disability through being vaporized or otherwise dispensed in the air or any like device containing tear gas, pepper or similar disabling agent.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-12 OUTPATIENT SERVICES LICENSED UNDER THE MENTAL HYGIENE LAW
10 CRR-NY 86-12.3 Utilization limits on OASAS licensed clinics
(a) Effective for services provided on and after April 1, 2011 Medicaid payments for outpatient alcoholism and substance abuse services provided in outpatient clinic facilities licensed by the Office of Alcoholism and Substance Abuse Services (OASAS) pursuant to article 32 of the Mental Hygiene Law shall reflect applicable provisions of regulations promulgated by OASAS and shall be adjusted relative to 2009 service utilization and payment levels in accordance with the following:
(1) The 76th through 95th visits in a State fiscal year shall be subject to a 25 percent reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 32 of the Mental Hygiene Law or regulations promulgated thereunder.
(2) Visits in excess of the 95 visits in a State fiscal year shall be subject to a 50 percent reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 32 of the Mental Hygiene Law or regulations promulgated thereunder.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.5 Disposition
(a) Documents, containing personal health related information shall be disposed of in a manner in which the confidentiality will not be compromised. Supervisors of units are responsible for control and security of documents until destroyed or control is transferred to an appropriate disposal service.
(b) Records scheduled for long-term storage by the Department of Education shall be subject to special provisions in the inter-agency records disposition document for security during storage and ultimate transfer to the archives or destruction.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.59 Pon Quogue Water Corporation
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well, located on the plot of land approximately three and three-quarters acre in area, owned by the Pon Quogue Water Corporation in the hamlet of Pon Quogue, lying east of Foster Avenue and about 400 feet north of Pon Quogue Avenue, which forms the source of the public water supply of the Pon Quogue Water Corporation, Suffolk County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from the well of the public water supply of the Pon Quogue Water Corporation.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of the well of the public water supply of the Pon Quogue Water Corporation, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from the well of the public water supply of the Pon Quogue Water Corporation.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of the well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(g) Trespassing.
No trespassing shall be allowed upon the property upon which the well of the public water supply of the Pon Quogue Water Corporation is located and no person or persons shall enter in or upon such property except the duly authorized officials or employees of said company in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the Pon Quogue Water Corporation.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the well of the public water supply of the Pon Quogue Water Corporation.
(j) Inspections.
The Pon Quogue Water Corporation or such other corporation, person or persons as may be charged with the maintenance or supervision of the public water supply of the Pon Quogue Water Corporation or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Pon Quogue Water Corporation to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Pon Quogue Water Corporation to promptly notify the State Commissioner of Health of such violations. The Pon Quogue Water Corporation shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.3 Access
(a) Employees or agents of the Department of Health are not to have access to personal health-related information except as part of their official duties.
(b) Access to personal health-related information by an employee is to be authorized by supervisors only after such employee has been trained in the responsibilities associated with access to the information; and has read this Subpart and Public Officers Law, section 74.3(c).
(c) Agents of the Department may be authorized to have access to specific personal health-related information only when reasonably necessary to perform the specific activities for which they have been designated as agents of the Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.282 Reporting manual
A handbook of accounting policies, principles and concepts, including a chart of accounts with definitions and standard units of measure, which establishes a foundation for uniform reporting for health services institutions.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
LAUNDRY AND BATHING FACILITIES LAUNDRY AND BATHING FACILITIES
10 CRR-NY 15.12 Laundry and bathing facilities
(a) Bathing facilities.
Shower facilities, separate for each sex, shall be provided. There shall be at least one shower head provided for each 15 occupants or fraction thereof, in the camp. Facilities shall provide an adequate supply of tempered water or both hot and cold running water at every shower head. Shower room floors shall be constructed and maintained with nonabsorbent, skid materials and sloped to floor drains. Adequate dry dressing space shall be provided in common use facilities. Separate facilities for each sex are not required when the facilities are located in individual dwelling units.
(1) All housing constructed after May 1, 1997, shall have showers provided in the ratio of one shower for every 10 occupants, or fraction thereof.
(b) Mechanical clothes washers, laundry trays, tubs, and sinks.
Laundry trays, wash tubs, or sinks supplied with hot and cold running water shall be provided in the ratio of one for each 25 persons, or fraction thereof residing at the facility. If mechanical washers are provided, they must be supplied with hot and cold water, and may be provided in the ratio of one for each 50 persons, or fraction thereof, residing at the facility. When mechanical washers are provided there must also be a minimum of one laundry tray, tub, or sink for each 100 persons, or fraction thereof, residing at the facility. Adequate provisions for drying clothes must be provided.
(c) Handwashsing facilities.
Handwashing facilities shall be provided and supplied with both hot and cold running water, in the ratio of one lavatory sink for each 15 persons, or fraction thereof, in the camp.
(1) All housing constructed after May 1, 1997, shall have handwash sinks provided in the ratio of one per family shelter, or one per six persons, or fraction thereof, in shared facilities.
(d) All shower, laundry, and handwash facilities shall be installed, and be maintained in adequate repair and sanitary condition.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.1 Statement
The improper construction, operation, maintenance or abandonment of water wells and the improper installation of water well pumps and pumping equipment represent a potential hazard to public health and safety. More than two million people in New York State depend upon private or individual water well supplies as their only sources of drinking water because public water supply systems are not available to serve them. To assure such consumers that the ground waters available to them will be reasonably and sanitary for drinking, culinary or food processing purposes, the following regulations for water well construction have been promulgated.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.31 Recalibration
(a) For rate years 1989, 1990 and 1991, notwithstanding any other provision of this Subpart and subject to the provisions of paragraph (1) of this subdivision, payment rates shall be adjusted in accordance with this subdivision to reflect a percentage recalibration adjustment based on the change in each facility's case mix which has been determined by the department to be due to factors other than changes in patient population or condition. Such payment rate adjustments shall be implemented utilizing the direct component of facility rates for such rate years determined in accordance with sections 86-2.10 and 86-2.11 of this Subpart.
(1) The percentage recalibration adjustment provided for in this subdivision shall neither exceed 3.035 percent nor be less than 0 percent.
(2) The percentage recalibration adjustment shall be calculated as follows for each facility.
(i) A statewide distribution of patients in each patient classification group shall be determined by utilizing the patient data for the assessment of all patients obtained in the patient assessment period March 1, 1985 through September 30, 1985 (the 1985 period) conducted pursuant to section 86-2.30 of this Subpart.
(ii) The statewide distribution of patients in each patient classification group shall be further segregated by the following length of stay (LOS) groups.
(a) less than or equal to 90 days;
(b) greater than 90 days but less than or equal to one year;
(c) greater than 1 year but less than or equal to two years;
(d) greater than two years but less than or equal to three years;
(e) greater than three years but less than or equal to four years;
(f) greater than four years but less than or equal to five years; or
(g) greater than five years.
(iii) A statewide average initial case mix index for each LOS group for the 1985 period shall be calculated by multiplying the initial distribution of patients in each patient classification group within each LOS group times the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the total number of patients in all patient classification groups within each LOS group.
(iv) For each facility, a 1985 distribution of patients in each patient classification group and a 1985 distribution of patients by the LOS groups specified in subparagraph (ii) of this paragraph shall be determined by utilizing the patient data for the assessment of all patients obtained in the 1985 period, conducted pursuant to section 86-2.30 of this Subpart. In the event a facility commenced operations after the patient assessment period, March 1, 1985 through September 30, 1985 (the 1985 period) but prior to January 1, 1988, or if the facility has the lesser of ten cases or twenty percent of its patients in the distributions as determined in this subparagraph for the 1985 period, or if the facility had undergone the appointment of a receiver or the establishment of a new operator subsequent to the 1985 period but prior to January 1, 1988 and had filed a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which was used in the calculation of the payment rate, the distribution of patients to be used for the purposes of this subparagraph shall be that distribution pertaining to the earliest full patient assessment period conducted pursuant to section 86-2.30 of this Subpart subsequent to the 1985 period or subsequent to the effective date of the appointment of a receiver or the change in operator (the “substituted 1985 period”), and such distribution shall be deemed the facility's “substituted 1985 distribution” of patients for the calculations in subparagraphs (vi) and (vii) of this paragraph. For purposes of this subparagraph, the only patients to be included in the distributions shall be patients that have been identified by the department as also having been included in the patient assessment period July 1, 1988 through December 31, 1988.
(v) For each facility, a 1988 distribution of patients in each patient classification group and a 1988 distribution of patients by the LOS groups specified in subparagraph (ii) of this paragraph shall be determined by utilizing the patient data obtained in the patient assessment period July 1, 1988 through December 31, 1988. For purposes of this subparagraph, the only patients to be included in the distributions shall be patients that were admitted to the facility in which they are presently residing before October 1, 1985 and have been identified by the department as also having been included in the patient assessments during the 1985 period. In the event a facility commenced operations after the patient assessment period, March 1, 1985 through September 30, 1985 (the 1985 period) but prior to January 1, 1988, or if the facility had the lesser of ten cases or twenty percent of its patients in the distributions for the 1985 period as determined pursuant to subparagraph (iv) of this paragraph, or if the facility had undergone the appointment of a receiver or the establishment of a new operator subsequent to the 1985 period but prior to January 1, 1988 and had filed a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which was used in the calculation of the payment rate, the facility's substituted 1985 period, as defined in subparagraph (iv) of this paragraph, shall be used in lieu of the 1985 period for the purposes of this subparagraph, and the only patients to be included shall be patients that were admitted to the facility in which they are presently residing before the end date of the facility's substituted 1985 period and have been identified by the department as also having been included in the patient assessments during the substituted 1985 period.
(vi) A percentage increase in case mix attributable to LOS shall, for each facility, be determined as follows:
(a) A 1985 aggregate case mix index shall be determined by multiplying the facility's 1985 distribution of patients, or a substituted 1985 distribution of patients where applicable, within each LOS group, determined pursuant to subparagraph (iv) of this paragraph by the statewide average initial case mix index for each LOS group for the 1985 period, as determined pursuant to subparagraph (iii) of this paragraph, and dividing the sum of the results by the facility's total number of patients in all LOS groups, as determined pursuant to subparagraph (iv) of this paragraph.
(b) A 1988 LOS adjusted case mix index shall be determined by multiplying the facility's 1988 distribution of patients within each LOS group determined pursuant to subparagraph (v) of this paragraph by the statewide average initial case mix index for each LOS group for the 1985 period, as determined pursuant to subparagraph (iii) of this paragraph, and dividing the sum of the results by the facility's total number of patients in all LOS groups, as determined pursuant to subparagraph (v) of this paragraph.
(c) The 1985 aggregate case mix index shall be subtracted from the 1988 LOS adjusted case mix index and the result divided by the 1985 aggregate case mix index to arrive at the percentage increase in case mix attributable to LOS.
(vii) An actual percentage increase in case mix shall, for each facility, be determined as follows:
(a) A 1985 actual case mix index shall be determined by multiplying the facility's 1985 distribution of patients, or a substituted 1985 distribution of patients where applicable, in each patient classification group, as determined pursuant to subparagraph (iv) of this paragraph, by the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the facility's total number of patients in all patient classification groups, as determined pursuant to subparagraph (iv) of this paragraph.
(b) A 1988 actual case mix index shall be determined by multiplying the facility's 1988 distribution of patients in each patient classification group, as determined pursuant to subparagraph (v) of this paragraph, by the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the facility's total number of patients in all patient classification groups, as determined pursuant to subparagraph (v) of this paragraph.
(c) The 1985 actual case mix index shall be subtracted from the 1988 actual case mix index and the result divided by the 1985 actual case mix index to arrive at an actual percentage increase in case mix.
(viii) Except as provided in subparagraph (ix) of this paragraph, a percentage recalibration adjustment shall be determined by annualizing the result obtained by subtracting the percentage increase in case mix attributable to LOS determined pursuant to subparagraph (vi) of this paragraph from the actual percentage increase in case mix determined pursuant to subparagraph (vii) of this paragraph.
(ix) If a facility had undergone the appointment of a receiver or the establishment of a new operator on or after January 1, 1988 but prior to January 1, 1992, and filed a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which was used in the calculation of a revised payment rate, or for new facilities who received an initial operating certificate on or after January 1, 1988 but prior to January 1, 1992, the percentage recalibration adjustment provided for in this subdivision shall be 0 percent for such revised rate or such new facilities.
(3) The operating portion of each residential health care facility's rate of payment, as defined pursuant to section 86-2.10(a)(7) of this Subpart, shall be reduced by a per diem recalibration adjustment which shall be determined as follows:
(i) The percentage recalibration adjustment identified in subparagraph (2)(viii) of this subdivision shall be applied to the direct component of the rate determined in accordance with sections 86-2.10 and 86-2.11 of this Subpart, to arrive at each facility's per diem recalibration adjustment in 1983 base year dollars.
(ii) Each facility's per diem recalibration adjustment in 1983 base year dollars shall then be trended to the rate year by the applicable roll factor as defined in section 86-2.10(a)(8) of this Subpart.
(b) For rate years 1992 and thereafter, notwithstanding any other provision of this Subpart and subject to the provisions of paragraph (1) of this subdivision and subdivision (c) of this section, payment rates shall be adjusted in accordance with this subdivision to reflect a percentage recalibration adjustment based on the change in each facility's case mix which has been determined by the department to be due to factors other than changes in patient population or condition. Such payment rate adjustments shall be implemented utilizing the direct component of facility rates for such rate years determined in accordance with sections 86-2.10 and 86-2.11 of this Subpart.
(1) The percentage recalibration adjustment provided for in this subdivision shall not be less than 0 percent nor greater than 150 percent of the statewide weighted average percentage recalibration adjustment obtained by utilizing the facility-specific percentage recalibration adjustments as determined pursuant to this subdivision.
(2) The percentage recalibration adjustment shall be calculated as follows for each facility:
(i) A statewide distribution of patients in each patient classification group shall be determined by utilizing the patient data for the assessment of all patients obtained in the patient assessment period March 1, 1985 through September 30, 1985 (the 1985 period) conducted pursuant to section 86-2.30 of this Subpart.
(ii) The statewide distribution of patients in each patient classification group shall be further segregated by the following length of stay (LOS) groups:
(a) less than or equal to 90 days;
(b) greater than 90 days but less than or equal to one year;
(c) greater than one year but less than or equal to two years;
(d) greater than two years but less than or equal to three years;
(e) greater than three years but less than or equal to four years;
(f) greater than four years but less than or equal to five years; or
(g) greater than five years;
(iii) A statewide average initial case mix index for each LOS group for the 1985 period shall be calculated by multiplying the initial distribution of patients in each patient classification group within each LOS group times the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the total number of patients in all patient classification groups within each LOS group.
(iv) For each facility, a 1985 distribution of patients in each patient classification group and a 1985 distribution of patients by the LOS groups specified in subparagraph (ii) of this paragraph shall be determined by utilizing the patient data for the assessment of all patients obtained in the 1985 period, conducted pursuant to section 86-2.30 of this Subpart. In the event a facility commenced operations after the patient assessment period, March 1, 1985 through September 30, 1985 (the 1985 period) but prior to January 1, 1988, or if the facility has the lesser of ten cases or twenty percent of its patients in the distributions as determined in this subparagraph for the 1985 period, or if the facility had undergone the appointment of a receiver or the establishment of a new operator subsequent to the 1985 period but prior to January 1, 1988 and had filed a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which was used in the calculation of the payment rate, the distribution of patients to be used for the purposes of this subparagraph shall be that distribution pertaining to the earliest full patient assessment period conducted pursuant to section 86-2.30 of this Subpart subsequent to the 1985 period or subsequent to the effective date of the appointment of a receiver or the change in operator (the “substituted 1985 period”), and such distribution shall be deemed the facility's “substituted 1985 distribution” of patients for the calculations in subparagraphs (vi) and (vii) of this paragraph. For purposes of this subparagraph, the only patients to be included in the distributions shall be patients that have been identified by the department as also having been included in the patient assessment period July 1, 1988 through December 31, 1988.
(v) For each facility, a 1988 distribution of patients in each patient classification group and a 1988 distribution of patients by the LOS groups specified in subparagraph (ii) of this paragraph shall be determined by utilizing the patient data obtained in the patient assessment period July 1, 1988 through December 31, 1988. For purposes of this subparagraph, the only patients to be included in the distributions shall be patients that were admitted to the facility in which they are presently residing before October 1, 1985 and have been identified by the department as also having been included in the patient assessments during the 1985 period. In the event a facility commenced operations after the patient assessment period, March 1, 1985 through September 30, 1985 (the 1985 period) but prior to January 1, 1988, or if the facility had the lesser of ten cases or twenty percent of its patients in the distributions for the 1985 period as determined pursuant to subparagraph (iv) of this paragraph, or if the facility had undergone the appointment of a receiver or the establishment of a new operator subsequent to the 1985 period but prior to January 1, 1988 and had filed a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which was used in the calculation of the payment rate, the facility's substituted 1985 period, as defined in subparagraph (iv) of this paragraph, shall be used in lieu of the 1985 period for the purposes of this subparagraph, and the only patients to be included shall be patients that were admitted to the facility in which they are presently residing before the end date of the facility's substituted 1985 period and have been identified by the department as also having been included in the patient assessments during the substituted 1985 period.
(vi) A percentage increase in case mix attributable to LOS shall, for each facility, be determined as follows:
(a) A 1985 aggregate case mix index shall be determined by multiplying the facility's 1985 distribution of patients, or a substituted 1985 distribution of patients where applicable, within each LOS group, determined pursuant to subparagraph (iv) of this paragraph by the statewide average initial case mix index for each LOS group for the 1985 period, as determined pursuant to subparagraph (iii) of this paragraph, and dividing the sum of the results by the facility's total number of patients in all LOS groups, as determined pursuant to subparagraph (iv) of this paragraph.
(b) A 1988 LOS adjusted case mix index shall be determined by multiplying the facility's 1988 distribution of patient within each LOS group determined pursuant to subparagraph (v) of this paragraph by the statewide average initial case mix index for each LOS group for the 1985 period, as determined pursuant to subparagraph (iii) of this paragraph, and dividing the sum of the results by the facility's total number of patients in all LOS groups, as determined pursuant to subparagraph (v) of this paragraph.
(c) The 1985 aggregate case mix index shall be subtracted from the 1988 LOS adjusted case mix index and the result divided by the 1985 aggregate case mix index to arrive at the percentage increase in case mix attributable to LOS.
(vii) An actual percentage increase in case mix shall, for each facility, be determined as follows:
(a) A 1985 actual case mix index shall be determined by multiplying the facility's 1985 distribution of patients, or a substituted 1985 distribution of patients where applicable, in each patient classification group as determined pursuant to subparagraph (iv) of this paragraph, by the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the facility's total number of patients in all patient classification groups, as determined pursuant to subparagraph (iv) of this paragraph.
(b) A 1988 actual case mix index shall be determined by multiplying the facility's 1988 distribution of patients in each patient classification group, as determined pursuant to subparagraph (v) of this paragraph, by the case mix index for each patient classification group as contained in Appendix 13-A herein and dividing the sum of the results by the facility's total number of patients in all patient classification groups, as determined pursuant to subparagraph (v) of this paragraph.
(c) The 1985 actual case mix index shall be subtracted from the 1988 actual case mix index and the result divided by the 1985 actual case mix index to arrive at an actual percentage increase in case mix.
(viii) Except as provided in subparagraph (ix) of this paragraph, a percentage recalibration adjustment shall be determined by annualizing the result obtained by subtracting the percentage increase in case mix attributable to LOS determined pursuant to subparagraph (vi) of this paragraph from the actual percentage increase in case mix determined pursuant to subparagraph (vii) of this paragraph.
(ix) If a facility undergoes the appointment of a receiver or the establishment of a new operator on or after January 1, 1992 and files a new cost report in accordance with the provisions of section 86-2.10(k) of this Subpart which is used in the calculation of a revised payment rate, or for new facilities who receive an initial operating certificate on or after January 1, 1992, the percentage recalibration adjustment provided for in this subdivision shall be 0 percent for such revised payment rate or for such new facilities.
(3) The operating portion of each residential health care facility's rate of payment, as defined pursuant to section 86-2.10(a)(7) of this Subpart, shall be reduced by a per diem recalibration adjustment which shall be determined as follows:
(i) The percentage recalibration adjustment identified in subparagraph (2)(viii) of this subdivision shall be applied to the direct component of the rate determined in accordance with sections 86-2.10 and 86-2.11 of this Subpart, to arrive at each facility's per diem recalibration adjustment in 1983 base year dollars.
(ii) Each facility's per diem recalibration adjustment in 1983 base year dollars shall then be trended to the rate year by the applicable roll factor as defined in section 86-2.10(a)(8) of this Subpart.
(c) For a residential health care facility receiving a percentage recalibration adjustment greater than 0 percent, as determined in subdivision (b) of this section, the percentage recalibration adjustment may be modified as provided in this subdivision.
(1) In order to be eligible for a modification, a facility shall meet all of the following conditions.
(i) A modification request shall be submitted by a facility as an appeal application and shall be submitted within the time limit set forth in section 86-2.13(a) of this Subpart.
(ii) A facility shall document that the percentage change in the facility's reported case mix index (CMI) from the annual rate period 1985 through 1988, such percentage reduced by the percentage recalibration adjustment as determined by subdivision (b) of this section, is at least 10 percent. The percentage change in the facility's reported CMI, for purposes of this subparagraph, shall utilize the CMI calculated from the facility's patient data obtained during the patient assessment period, March 1, 1985 through September 30, 1985, to the patient assessment period July 1, 1988 through December 31, 1988, conducted pursuant to section 86-2.30 of this Subpart, and shall be calculated by subtracting from the reported 1988 CMI, the reported 1985 CMI and the result divided by the reported 1985 CMI.
(iii)
(a) Except as provided in clause (b) of this subparagraph, a facility shall document that the percentage change in direct care cost over trend from the annual rate period 1985 through 1988, as defined by those cost centers listed in section 86-2.10(c) of this Subpart, is at least 10 percent. The percentage change in direct care cost over trend for purposes of this subparagraph shall be calculated by subtracting from the 1988 annual reported direct care cost, the 1985 annual reported direct care cost trended to 1988 by the applicable trend factors promulgated by the department for 1986, 1987 and 1988, and the result divided by the trended 1985 direct care cost. The annual reported direct care costs for 1985 and 1988, for purposes of this subparagraph, shall be those which the facility has submitted using the result of the single step-down method of cost allocation as defined in section 451.29 of this Title.
(b) In the event a facility's facility-specific cost based direct price per day exceeds the facility-specific ceiling direct price per day, as determined pursuant to section 86-2.10(c)(4) of this Subpart, for the annual rate period 1988, such excess percentage shall be used to determine a credit to be added to the facility's percentage change in direct care cost over trend as determined in clause ( a ) of this subparagraph for the purposes of meeting the required percentage change in direct care cost over trend identified in clause ( a ) of this subparagraph. The amount of the credit shall be equal to such excess percentage if the facility documents that its percentage change in indirect care cost over trend from the annual rate period 1985 through 1988, as defined by those cost centers listed in section 86-2.10(d) of this Subpart, does not exceed its percentage change in direct care cost over trend for this period, as determined in clause ( a ) of this subparagraph, and if the facility cannot so document, the credit identified in this clause shall be reduced (but not be less than 0 percent) by the extent to which the percentage change in indirect care cost over trend exceeds the percentage change in direct care cost over trend. The percentage change in indirect care cost over trend for purposes of this subparagraph shall be calculated by subtracting from the 1988 annual reported indirect care cost, the 1985 annual reported indirect care cost trended to 1988 by the applicable trend factors promulgated by the department for 1986, 1987 and 1988, and the result divided by the trended 1985 indirect care cost. The annual reported indirect care costs for 1985 and 1988, for purposes of this subparagraph, shall be those which the facility has submitted using the result of the single stepdown method of cost allocation as defined in section 451.29 of this Title.
(iv) Documentation shall be included in an appeal filed by the facility to the department that supports the reasons for the direct care cost increase which shall be based on increases in staffing levels and/or range and/or types of patient services. Increased direct care cost resulting solely from an increase in the bed complement of a facility shall not constitute sufficient justification for granting a modification pursuant to this subdivision.
(2) For a facility meeting all conditions specified in paragraph (1) of this subdivision, the modified percentage recalibration adjustment shall be determined as follows.
(i) The modification to the percentage recalibration adjustment shall be determined by annualizing the result obtained by subtracting the percentage change in the facility's reported CMI reduced by the percentage recalibration adjustment, as determined in subparagraph (1)(ii) of this subdivision, from the percentage change in direct care cost over trend, as determined in subparagraph (1)(ii) of this subdivision.
(ii) The modified percentage recalibration adjustment shall be equal to the result obtained by subtracting the modification to the percentage recalibration adjustment, as determined in subparagraph (1) of this paragraph, from the percentage recalibration adjustment identified in subparagraph (b)(2)(viii) of this section.
(iii) The modified percentage recalibration adjustment, as determined in subparagraph (ii) of this paragraph, shall not be less than 0 percent.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.11 Miscellaneous
(a) Refuse storage and disposal.
Adequate and sanitary facilities shall be provided and maintained for the storage and disposal of refuse. Sanitary methods shall be used for the temporary storage, collection, handling and disposal of refuse. Any on-premise refuse processsing, treatment, and disposal facilities shall meet the requirements of the State Commissioner of Environmental Conservation.
(1) The operator shall provide for refuse pickup or central refuse storage.
(2) If refuse pickup is not provided, the occupant shall be responsible for transporting refuse to the central refuse storage.
(3) The occupant shall be responsible for the proper maintenance and storage of refuse on each site.
(b) Insect and rodent control.
Grounds, buildings and structures shall be maintained in such a manner as to control noxious insect and rodent infestations. Extermination methods and other measures to control insects and rodents shall conform with the requirements of the agency having jurisdiction.
(c) Weed control.
The growth of ragweed, poison ivy, poison oak, poison sumac and other noxious weeds shall be controlled. Control measures and materials shall conform with requirements of the agency having jurisdiction. The elimination of such weeds where the growth is limited to a single site shall be the responsibility of the occupants.
(d) Toxic materials.
Agricultural pesticides and toxic chemicals shall not be stored in an area accessible to park residents. If any pesticides or toxic chemicals are stored or made available, they shall be used as directed on the package and in accordance with any applicable requirements established by the Department of Environmental Conservation, and stored so as not to cause air, surface water or ground water pollution.
(e) Other duties.
(1) The operator shall provide a suitable and responsible individual to be in charge of the property and who shall be readily available while the property is occupied.
(2) The operator shall comply with the provisions of this Part and with all conditions stated in the permit, and shall allow the permit-issuing official or his representative to enter the premises at any reasonable time to ascertain compliance with this Part.
(3) The operator shall be responsible for traffic control measures that will preclude hazards to vehicular and pedestrian traffic, and to insure ready access to any and all sites by emergency vehicles at all times.
(4) The operator shall be responsible for immediately reporting the following to the permit-issuing official: interruption in the treatment of supply of drinking water; all fires resulting in a report or call to a fire department or police; the existence of inadequately treated sewage on the surface of the ground.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.10 Pool operation
(a) Every swimming pool shall be maintained and operated in a clean, safe and sanitary manner at all times. Swimming pool recirculation and disinfection equipment shall be operated continuously.
(b) Swimming pool equipment and appurtenances shall be operated and maintained in accordance with approved plans and specifications.
(c) Cracks in the pool walls, floors, perimeter overflow systems, and decks shall be repaired when determined to be potential leakage or tripping hazards.
(d) A four-inch stripe of contrasting color shall be provided and maintained at the slope breakpoint or five-foot depth point on the pool bottom, and at submerged step edges and ledges. Plainly visible depth markings shall also be provided and maintained in accordance with the provisions of section 6-1.29, item 6.1.1, of this Subpart. A floating line shall be provided at the slope breakpoint or five-foot depth point.
(e) Main drain grates shall be secured in place at all times. Broken or missing main drain grates shall be repaired or replaced before the pool is used.
(f) Inlets shall be adjusted to produce uniform circulation of water and to facilitate the maintenance of a uniform disinfectant residual throughout the swimming pool.
(g) The overflow system shall be maintained to continuously remove floating matter and surface water.
(h) Skimmer weirs and throttle valves shall be maintained in working order and the skimmer covers shall be secure. Skimmer baskets shall be cleaned at least daily.
(i) The water level in the swimming pool shall be maintained to provide: (1) adequate skimming of the entire pool surface; and (2) required depths in areas for diving as set forth in this section.
(j) The deck shall be unobstructed for at least a five-foot width around the entire pool. The deck shall be kept clean and free of puddled water. Glass containers are prohibited from the swimming pool and all deck areas.
(k) The pool walls and bottom shall be vacuumed or brushed daily or as needed to remove visible settleable material. Ladders, handrails, diving equipment, lifeguard chairs, slides and other deck equipment shall be kept firmly secured to the deck, and maintained in good repair. A minimum of one ladder or set of steps shall be provided in any pool over two feet deep.
(l) Diving depth requirements.
(1) Swimming pools equipped with diving boards prior to the effective date of this Subpart [March 30, 1988] shall meet the minimum water depth and swimming pool and diving board dimensions listed in columns (1) to (4) in the following table:
| | (1) | (2) | | (3) | (4) | | --- | --- | --- | --- | --- | --- | | Board height above water | Minimum board overhang over water | Minimum water depth in diving area | Minimum diving area forward of board tip: | Maximum slope to 5′ water depth | | | | | | Width | Length | | | Up to 24″ | 2′ 6″ | 8′ | 4′ | 13′ 6″ | 1:3 | | *24″ - 26″ | 2′ 6″ | 8½′ | 8′ | 10′ | 1:3 | | *26″ - 30″ | 3′ | 9′ | 16′ | 10′ | 1:3 | | *30″-1 meter | 4′ | 11′ | 16′ | 20′ | 1:2 | | | or 4′ | 11′ | 16′ | 16′ | 1:3 | | *1 meter- 3 meters | 6′ | 12′ | 20′ | 20′ | 1:2 |
*
= Greater than.
(2) Diving boards shall be prohibited in all pools in existence prior to the effective date of this Subpart that do not meet the criteria in paragraph (1) of this subdivision, except one-meter boards used only for competitive use and training and/or used in physical education instruction at schools. Such one-meter diving boards must meet criteria in columns (2), (3) and (4) for 26″ - 30″ boards listed in paragraph (1) of this subdivision.
(3) Swimming pools equipped with diving boards after the effective date of this Subpart must meet the criteria reflected in Table 1 of section 6-1.29 of this Subpart.
(4) Head first diving from the pool deck is prohibited in water depths less than eight feet except during competitive swimming or swimmer training activities.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.7 Petition for admission to examination
(a) Prior to submission of a petition under subdivision 2 of section 2896-c of article 28-D of the Public Health Law, an applicant shall be required to have been denied admission to examination after formal application under section 2896-c.
(b) The board may decline to entertain such petition on the basis of a finding that the applicant, either
(1) fails to meet the requirements of paragraphs (a) or (b) of subdivision 1 of section 2896-c of article 28-D of the Public Health Law; or
(2) has practiced in violation of or otherwise has violated any provision of article 28-D of the Public Health Law.
(c) The board, in the review of a petition, shall consider among other factors:
(1) the length and quality of the petitioner's training and experience in his or her field;
(2) the extent of the petitioner's administrative and supervisory duties in his or her relevant employment;
(3) the extent to which the petitioner has taken refresher or advanced coursework or otherwise evidenced a continuous effort to maintain or improve his or her technical skill; and
(4) the professional reputation of the petitioner as evidenced by books and articles published, offices held in professional organizations, and professional honors received.
(d) The petitioner shall complete such forms, prepare such affidavits, and obtain such documents in support of his or her petition as the board deems necessary. The board may require the petitioner to appear personally before the board or a committee thereof.
(e) Immediately upon the granting of a petition for admission to examination and the payment of the prescribed fee, a petitioner shall be subject to all of the provisions pertaining to an applicant contained in article 28-D of the Public Health Law.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 150 TOMPKINS COUNTY
INSTITUTIONS INSTITUTIONS
10 CRR-NY 150.2 Cornell University at Ithaca
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Fall Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of Cornell University at Ithaca, Tompkins County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding reservoir on Fall Creek, which is tributary to or which serves as a source of this public water supply and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of Cornell University.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 50 feet of any reservoir or 15 feet of any watercourse tributary to the public water supply of Cornell University, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (d) provided, however, that the property on which the privy, privy vault, pit or any other receptacle intended for the deposit of human excreta is built or is to be built, is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in paragraph (1) of this subdivision cannot be obtained within the limits of such property shall be placed as far as possible from any reservoir or watercourse and specially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of trustees of Cornell University and so located that the tops of such receptacles shall be above the highest known water level of the reservoirs or watercourses.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind or any vessel, can or other container, used for either the temporary storage or the permanent disposal of human excreta, is specially constructed and made watertight and located nearer any reservoir or watercourse than the distances named in paragraph (1) of this subdivision, such receptacle shall be emptied at regular intervals and disinfected as often as may be necessary to maintain them in a proper sanitary condition and effectually to prevent any overflow. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the directions of the board of trustees of Cornell University and in such manner as to effectually prevent any pollution of the water supply of the university.
(4) No privy, privy vault, pit, cesspool or other receptacle which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of Cornell University.
(5) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (4) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (6) and (7) of this subdivision.
(6) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(7) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (5) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of Cornell University.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant, as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or watercourse tributary to the public water supply of Cornell University, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of Cornell University.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into Fall Creek or any watercourse tributary to the public water supply of Cornell University, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the board of trustees of Cornell University.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant as provided by paragraph (2) of this subdivision, shall be thrown or discharged directly or indirectly into any reservoir or watercourse tributary to the public water supply of Cornell University nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 25 feet of any reservoir or watercourse tributary to the public water supply of Cornell University.
(4) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir tributary to the public water supply of Cornell University.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe nor shall any animal or poultry be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir of the public water supply of Cornell University. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any stream tributary to the public water supply of Cornell University.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 25 feet of any reservoir or watercourse tributary to the public water supply of Cornell University and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet from any reservoir or watercourse tributary to the public water supply of Cornell University.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of Cornell University, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil or within a distance of 100 feet of any reservoir or watercourse tributary to the public water supply of Cornell University; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 25 feet of any reservoir or watercourse tributary to the public water supply of Cornell University.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet from any reservoir or watercourse tributary to the public water supply of Cornell University.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 75 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of Cornell University.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 200 feet of any reservoir or watercourse tributary to the public water supply of Cornell University.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of any reservoir tributary to the public water supply of Cornell University.
(i) Inspections.
The board of trustees of Cornell University or their duly appointed representatives shall make regular and thorough inspections of reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 1 GENERAL PROVISIONS
GENERAL POWERS AND DUTIES OF HEALTH OFFICERS GENERAL POWERS AND DUTIES OF HEALTH OFFICERS
10 CRR-NY 1.10 Local health officer to file monthly report
The local health officer of each county, part-county, and city of 50,000 population or over shall submit to the State regional health director a monthly report of activities conducted during the previous month. Except in county or part-county health districts, local health officers of towns, villages, cities of less than 50,000 population and consolidated health districts shall submit a report of activities conducted during the previous month on a form prescribed by the State Commissioner of Health to their respective district State health officer. Local health officers of cities, towns, villages and consolidated health districts serving as deputies to county or part-county health commissioners shall submit such reports to the county or part-county health commissioner as may be required by such commissioner. Monthly reports of local health officers shall be forwarded on or before the fifth day of the succeeding month.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.42 Storage of food removed from original containers or packages
Food removed from the original container or package is to be protected from contamination by storing in clean, covered, sanitized containers maintained at temperatures.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.8 Liability and property damage insurance
The applicant shall provide evidence of liability and property damage insurance in such form and amount as shall be determined by the permit-issuing official to be reasonable in relation to the risks and hazards involved and in relation to or in any way arising out of the proposed activity, together with a written hold-harmless agreement to the public at large for any loss or damage above and beyond insurance coverage.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.8 Security
This functional reporting center must contain all the expenses associated with maintaining the safety and well-being of residential health care facility patients, personnel and visitors, and protecting the facility by patrolling and guarding designated areas.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.6 Collection and handling of blood for subsequent allogeneic or autogeneic transfusion
(a) Phlebotomy apparatus and blood containers shall be clean, pyrogen-free and sterile. Anticoagulants shall be placed in containers prior to sterilization.
(b) Phlebotomy sites shall be prepared by a procedure found by the department to meet medical standards generally accepted in New York State.
(c) Blood collection systems shall meet the following minimum requirements:
(1) Blood shall be collected under aseptic conditions using an approved closed system or a vented system if adequately protected against contamination.
(2) Anticoagulant solutions shall be sterile and pyrogen-free F.D.A.-approved formulae such as anticoagulant citrate dextrose (ACD) (21-day storage), citrate phosphate dextrose (CPD) (21-day storage), trisodium citrate (48-hour storage), heparin (48-hour storage), citrate phosphate dextrose adenine-1 (CPDA-1) (35-day storage), and other safe and effective formulae and storage periods, of such length as to assure the blood' s continued effectiveness for transfusion and retention of its safety, purity and potency, as approved by the department, may be employed.
(3) Labeling requirements.
(i) For allogeneic collection, the container and the attached pilot blood specimens shall be legibly labeled at the time of collection with the associated unit's identification code. The container label shall indicate the date of expiration. As soon as available, the results of ABO and Rh grouping tests shall be affixed to the component containers.
(ii) With the exception of units collected in an operating room which never leave the immediate proximity of the patient, for autogeneic collection, the following information shall appear on a label or tag attached to the blood container:
(a) the identification of the collecting facility;
(b) the patient's name and if available, the name of the hospital where the patient is to be transfused and the patient's hospital registration number or, if unavailable, social security number, birth date or similar identifying information. This tag shall be removed if the unit is subsequently used for allogeneic transfusion;
(c) ABO and Rh group;
(d) date of expiration;
(e) if the unit does not qualify for allogeneic transfusion, a prominent label to read “ For autologous use only” or similar wording;
(f) an autogeneic unit from a donor who has tested positive or reactive on any of the tests required in section 58-2.3(a) of this Subpart within the previous 30 days shall be labeled as a biohazard unless confirmatory testing has been negative. The exterior of the shipping container shall not contain any information identifying the donor; and
(g) a label bearing the donor classification statement “Autologous donor” shall be permanently affixed to the unit.
(d) Blood in transit shall be refrigerated at one to 10 degrees Celsius, preferably at four to six degrees Celsius, with the exception of units from which platelets will be separated, which may be stored at room temperature.
(e) Labeling requirements.
(1) For allogeneic collection, the container and the attached pilot blood specimens shall be legibly labeled at the time of collection with the associated unit’s identification code. The container label shall indicate the date of expiration. As soon as available, the results of ABO and Rh grouping tests shall be affixed to component containers.
(2) With the exception of units collected in an operating room which never leave the immediate proximity of the patient, for autogeneic collection, the following information shall appear on a label or tag attached to the blood container:
(i) the identification of the collecting facility;
(ii) the patient's name and if available, the name of the hospital or limited transfusion service where the patient is to be transfused and the patient's birth date or identifier. This tag shall be removed if the unit is subsequently used for allogeneic transfusion;
(iii) ABO and Rh group;
(iv) date of expiration;
(v) if the unit does not qualify for allogeneic transfusion, a prominent label to read “For autologous use only" or similar wording;
(vi) an autogeneic unit from a donor who has tested positive or reactive on any of the tests required in section 58-2.3(a) of this Subpart, with the exception of anti-HBc, within the previous 30 days shall be labeled as a biohazard unless confirmatory testing has been negative. The exterior of the shipping container shall not contain any information identifying the donor; and
(vii) a label bearing the donor classification statement "Autologous donor" shall be permanently affixed to the unit.
(f) The blood shall be collected in the manner appropriate for the container employed. Following collection, the container shall be sealed securely. If a container is opened or entered in any way, the blood component must be transfused within 24 hours or discarded, unless a sterile connecting device which maintains a functionally closed system has been utilized for entry.
(g) Until issued, whole blood and red cell components shall be stored continuously in a refrigerator either with a fan for circulating air, or of a capacity and design to ensure that the proper temperature is maintained throughout, and equipped with automatic temperature recording and an audible alarm. Periodic verification of alarm function, in accordance with the manufacturer’s recommendations, shall be documented. Storage shall be at one to six degrees Celsius. No items other than specimens, tissue, or reagents shall be stored in a refrigerator in which whole blood and red blood cell components are stored. Temperature records shall be available for inspection for at least five years. Autogeneic units shall be stored in a separate, specifically designated portion of the refrigerator.
(h) Until issued, cryoprecipitate, fresh frozen plasma, FP24, and cryoprecipitate-poor plasma shall be stored continuously at a temperature not higher than minus 18 degrees Celsius for up to one year or, with F.D.A. approval, at a temperature not higher than minus 65 degrees Celsius for up to seven years, in a freezer equipped with automatic temperature recording and an audible alarm. Periodic verification of alarm function, in accordance with the manufacturer’s recommendations, shall be documented. Such frozen components shall not be relabeled as different components and released for transfusion, but may be used for fractionation into derivatives. After thawing, plasma shall be transfused immediately or stored at one to six degrees Celsius. Cryoprecipitate intended for factor VIII replacement shall be transfused within six hours after thawing. Freezer temperature records shall be available for inspection for at least five years.
(i) Until issued, platelets shall be stored at 20 to 24 degrees Celsius and shall be continuously rotated on a rotator designed for such use. Temperature records shall be available for inspection for at least five years.
(j) Until issued, frozen red blood cells shall be stored at a temperature not higher than minus 65 degrees Celsius in a freezer equipped with automatic temperature recording and audible alarm, or in liquid nitrogen. Liquid nitrogen levels must be mechanically or visually monitored daily. Periodic verification of alarm function, in accordance with the manufacturer’s recommendations, shall be documented. Storage time shall not exceed 10 years. Freezer temperature or liquid nitrogen level records shall be available for inspection for at least five years. After thawing, red blood cells shall be transfused or refrozen within 24 hours or discarded, unless deglycerolized using a closed system that allows a 14-day expiration date, as approved by the F.D.A. If a refrozen unit is subsequently rethawed and deglycerolized, a notation indicating such previous thawing and deglycerolizing shall be made on a label or tag attached to the blood unit, or on accompanying paperwork.
(k) Whenever blood is irradiated, a protocol for such irradiation, approved by the director of transfusion services or the director of the blood bank, must be followed. Maintenance and operation of blood irradiators must conform to the manufacturer' s instructions. Whenever irradiation of blood is medically indicated because of a blood relationship between donor and recipient, such irradiation shall be performed by the blood bank collecting the blood unless the hospital notifies in writing the facility collecting the blood that the hospital will be responsible for irradiation in which case such blood shall be identified as requiring irradiation on a tag or paperwork accompanying the units. Blood that has been irradiated shall be identified as “Irradiated” on a label or tag attached to the unit.
(l) Fresh frozen plasma, cryoprecipitate, FP24 and frozen red blood cells shall be thawed only in a water bath at a temperature not exceeding 38 degrees Celsius, with entry ports protected from water contamination by positioning or a protective overwrap, or in another device specially designed for such thawing. If a water bath is used for thawing, its temperature shall be recorded each day of such use. Temperature records shall be available for inspection for at least five years. Maintenance and operation of all equipment for processing or preparation of blood components shall conform to the manufacturer's instructions and shall follow a protocol approved by the director of transfusion services.
(m) Except for blood recovered intraoperatively or postoperatively, or collected for use in a reinfusion procedure, all blood intended for transfusion shall, upon collection, become the responsibility of the blood collection service. Disposition of blood collected by phlebotomy shall be at the discretion of the director of the collection service until the blood is transferred to a transfusion service, at which time its disposition shall be at the discretion of the director of transfusion services. The director of the blood bank shall ensure that during any transport blood is packed and handled appropriately, and only by authorized individuals. No directed or autogeneic blood unit or component shall be transported to a transfusion service unless the director of the receiving transfusion service or his/her designee has authorized such transport. A transfusion service which has granted standing authorization for receipt of blood shall be given specific notice prior to each shipment. Disposition of blood recovered intraoperatively or postoperatively shall be at the discretion of the intraoperative or postoperative blood collection service, unless the blood is transferred to the hospital blood bank for storage, at which time its disposition shall be at the discretion of the director of transfusion services. Blood banks shall not release blood or blood components intended for transfusion to any site or entity in New York State not holding a department permit as a collection service or transfusion service, or approved by the department as a limited transfusion service or an ambulance transfusion service.
(n) The premises, equipment, procedure manuals, records, circulars of information, and all blood, blood components and derivatives shall be available for inspection, review and approval by the department during normal business hours.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.14 Housekeeping
(a) The entire facility, including, but not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment and furnishings shall be maintained in good repair, clean and free of insects, rodents and trash.
(b) Dusting, mopping and vacuum cleaning shall be done in a manner which will not spread dust or other particulate matter.
(c) Adequate supplies and equipment for housekeeping functions shall be provided; cleaning compounds and hazardous substances shall be properly labeled and stored.
(d) Solid wastes, including garbage, rubbish and other refuse, biological wastes and infectious material, shall be collected, stored and disposed of in a manner that will prevent the transmission of disease and not create a nuisance or fire hazard, nor provide a breeding place for insects or rodents.
(e) Adequate measures shall be instituted for the handling and disposal of infectious wastes, including needles and syringes, dressings, surgical and biological wastes.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.11 Treatment
All swimming pools shall be equipped with a recirculation system which includes filtration and disinfection facilities to provide water quality consistent with the bacteriological, chemical and physical standards required in section 6-1.19 of this Subpart.
(a) Turnover rate.
The entire volume of pool water must be recirculated and treated in six hours. Pools constructed prior to March 31, 1973 may have an eight-hour turnover rate. Pools with approved design rate of less than six hours shall be operated at the design rate.
(b) Filtration.
(1) Sand filters.
(i) Gravity and pressure-type sand filters shall be operated at a filter rate not to exceed three gallons per minute per square foot (gpm/sf). High-rate sand filters (pressure or vacuum) can be operated at a filter rate up to 15 gpm/sf.
(ii) Filter air release valves shall be opened daily, or more frequently if necessary to remove air which collects in the filters.
(iii) Sand filters shall be backwashed at a flow rate of 12 to 15 gpm/sf or at the design rate recommended by the manufacturer.
(2) Diatomaceous earth filters.
(i) Diatomaceous earth filters shall be properly maintained and operated according to the manufacturer's instructions and at a filter rate not to exceed two gpm/sf with body feed or 1.5 gpm/sf without body feed.
(ii) Diatomaceous earth filter backwash water must discharge to the sewer system through a separation tank. The separation tank sludge shall be disposed of or treated as a solid waste material in accordance with local and State laws, rules and regulations.
(3) Cartridge filters.
(i) Cartridge filters shall be operated at a filter rate not to exceed the design rate or a maximum of 0.375 gpm/sf.
(ii) Cleaning of cartridge filters must be in accordance with the manufacturer's recommendations. One complete spare set of cartridges shall be available at all times to facilitate cleaning.
(4) Flow measurement.
All flow meters shall be maintained in accordance with provisions in section 6-1.29, item 9.8, of this Subpart.
(c) Disinfection.
(1) Disinfection with chlorine.
When chlorine gas, calcium hypochlorite or sodium hypochlorite is used to disinfect a swimming pool and the pool water pH is less than or equal to 7.8, the dose of chlorine or chlorine compound shall be sufficient to maintain a concentration of at least 0.6 mg/l free chlorine throughout the swimming pool. When the pH is between 7.8 and 8.2, a concentration of at least 1.5 mg/l free chlorine residual shall be maintained. A free chlorine residual of 5.0 mg/l or a pH of 8.2 shall not be exceeded in any swimming pool during use. All chlorine solutions shall be added to the pool water by chemical feed equipment conforming with standards contained in section 6-1.29, item 11.1, of this Subpart.
(i) Handling of chlorine gas. When chlorine gas is used as a disinfectant, the chlorinators and any cylinders containing chlorine gas used therewith shall be housed in an enclosure separated from other equipment rooms, including the swimming pool, corridors, dressing rooms and other space used by the bathers, by a tight partition wall or by a tight partition wall with a door so installed as to prevent gas leakage and equipped with an inspection window. Chlorine cylinders shall be secured from falling and cylinders in use shall be secured on a suitable platform scale. A separate vent opening to the exterior shall be provided. An electric motor-driven fan shall take suction from near the floor level of the enclosure and discharge at a suitable point to the exterior above the ground level. The fan switch shall be able to be operated from outside of the enclosure. All pools using chlorine gas shall be equipped with a self-contained breathing apparatus which is kept in a closed cabinet, outside of the room in which the chlorinator is maintained. The breathing apparatus shall be maintained in working order and checked monthly. Additional precautions shall be taken in the handling and storage of chlorine gas at pools as required by the permit-issuing official to safeguard public health. Any person who operates such chlorinating equipment shall be familiar with the use of self-contained breathing apparatus.
(ii) Handling of calcium hypochlorite. When calcium hypochlorite is used as a disinfectant, extreme caution must be taken in the handling and mixing of the chemical to avoid possible fire and explosion hazards. A dry, aboveground, locked storage area shall be provided. Clean inert materials shall be used, and mixing must be by pouring the chemical into water and never by pouring water into the chemical.
(2) Disinfection with bromine. When bromine is used as the disinfectant, the following shall be followed:
(i) Bromine shall be fed on a continuous basis.
(ii) The pool pH shall be maintained between 7.2 and 7.8.
(iii) A concentration of at least 1.5 mg/l bromine residual shall be maintained throughout the pool water at all times. A maximum of six mg/l bromine residual shall be permitted in any swimming pool during use.
(iv) Solid-stick or tablet-type bromine (brom-chlor-dimethyl-hydantoin) shall be used with feed equipment conforming to the standards contained in section 6-1.29, item 11.4, of this Subpart.
(3) Other disinfectants. Disinfectants other than those listed above may be used only if the State Commissioner of Health determines they are safe and effective when used in accordance with the manufacturer's directions.
(4) Use of cyanuric acid-based chlorine (or any other chlorine stabilizer) is prohibited. Pools found using or containing any cyanuric compound shall be closed, drained and refilled prior to continued use.
(5) Test kits/testing. DPD test kits with reagents no more than one year old capable of measuring pH and chlorine or bromine residuals, shall be available at each pool. Tests shall be conducted and recorded for pH and free and total chlorine or bromine residual at the beginning, during, and at the end of each swimming period. Where required, reagents for alkalinity and hardness tests shall be available. Where ozone generating equipment is installed, ozone testing shall be conducted in accordance with section 6-1.29, item 11.5.1 of this Subpart.
(d) Chemicals.
When the permit-issuing official determines that pH is not consistently maintained within the required limits, positive feed equipment shall be used to maintain the pH at levels required in this section. The methods for addition of pool water treatment chemicals must be specified and approved in the safety plan. The method of chemical addition must protect the bather from contact with concentrated chemicals. The method must provide adequate distribution of the chemical throughout the pool and distribution must be verified by pool water testing prior to bather exposure. Only chemicals approved for water supply use by the U.S. Environmental Protection Agency, as food additives by the U.S. Food and Drug Administration, or by the State Commissioner of Health, shall be used in swimming pools. Where equipment for chemical addition is required it shall be installed and operated in accordance with section 6-1.29, item 11.0, of this Subpart. All chemical containers, including those used with chemical feeders, must be clearly labeled regarding their contents.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.185 Invested capital
(a) The amount of capital contributed to a business by its owners; capital.
(b) The amount so contributed, plus retained earnings (or less accumulated losses) and appropriated surplus.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.4 Persons from whom records may be obtained
All requests from the public or members of the news media, to inspect and/or copy records subject to public disclosure as provided by this Subpart are to be made to the appropriate records access officer as follows:
(a) With respect to records maintained in the central offices of the department in Albany, he/she shall be the department records access officer whose business address is: Empire State Plaza, Corning Tower, Albany, NY 12237.
(b) With respect to records maintained in the area offices of the Office of Health Systems Management, he/she shall be the area administrator whose business addresses are:
(1) New York City Area Office
Office of Health Systems Management
116 West 32nd Street
New York, NY 10001
(2) Albany Area Office
Office of Health Systems Management
Building No. 7A, State Campus
Albany, NY 12226
(3) Buffalo Area Office
Office of Health Systems Management
584 Delaware Avenue
Buffalo, NY 14202
(4) Rochester Area Office
Office of Health Systems Management
Bevier Building
42 South Washington Street
Rochester, NY 14608
(5) Syracuse Area Office
Office of Health Systems Management
677 South Salina Street
Syracuse, NY 13202
(6) New Rochelle Area Office
Office of Health Systems Management
145 Huguenot Street
New Rochelle, NY 10801
(c) With respect to records maintained in the regional or area offices of the Office of Public Health, he/she shall be the regional health director or area public health director whose business addresses are:
(1) New York City Regional Office
Office of Public Health
8-10 East 40th Street
New York, NY 10016
(2) Northern Regional Office
Office of Public Health
Building No. 7A, State Campus
Albany, NY 12226
(3) Southern Regional Office
Office of Public Health
145 Huguenot Street
New Rochelle, NY 10801
(4) Western Regional Office
Office of Public Health
584 Delaware Avenue
Buffalo, NY 14202
(5) Rochester Area Office
Office of Public Health
Bevier Building
42 South Washington Street
Rochester, NY 14609
(6) Syracuse Area Office
Office of Public Health
351 South Warren Street
Syracuse, NY 13202
(d) With respect to records maintained in the State institutions in the department, he/she shall be the director of such facility whose business address is as follows:
(1) Helen Hayes Hospital
West Haverstraw, NY 10993
(2) New York State Veterans' Home
Oxford, NY 13830
(3) Roswell Park Memorial Institute
666 Elm Street
Buffalo, NY 14263
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.2 Contents of complaint
The complaint shall set forth the name and address of the complainant, his professional qualifications, the name and address of the hospital whose governing body is alleged to have committed the unlawful discriminatory practice complained of, the staff membership or the professional privileges sought by the complainant, a statement in detail of the alleged unlawful discriminatory practice, and the medical group practice or nonprofit health insurance plan participated in by the complainant.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.15 Radiologic and nuclear medicine services
(a) General provisions for diagnostic and therapeutic radiologic services.
The hospital shall maintain or have available diagnostic radiologic services defined for purposes of this subdivision as imaging services utilizing diagnostic radiation equipment or devices which emit radiation by virtue of the application of high voltage. If therapeutic services are provided, they shall meet the requirements established in subdivision (b) of this section in addition to the requirements of this subdivision. In addition, the hospital shall meet the standards of Part 16 of the State Sanitary Code.
(1) The hospital shall maintain or have available radiologic services according to the needs of the patients as determined by the governing body in consultation with the medical staff and the administration.
(2) Radiologic services shall be provided in accordance with generally accepted standards of practice only on the order of physicians or, consistent with State law, of those other practitioners authorized by the medical staff and governing body to order such services.
(3) Safety for patients and personnel.
Written policies and procedures shall be developed and implemented and available for review. The policies and procedures regarding imaging studies for newborns and pediatric patients shall include standards for clinical appropriateness, appropriate radiation dosage and beam collimation, image quality and patient shielding. A policy and a procedure shall be developed to ensure that the practitioner’s order for an imaging study is specific as to the body part(s) that are to be imaged.
Quality improvement audits shall verify that these policies and procedures are being followed. Quality improvement activities shall include a review of the adequacy of diagnostic images and interpretations.
(i) Proper safety precautions shall be maintained against fire and explosion hazards, electrical hazards and radiation hazards. This includes adequate shielding for patients and personnel, as well as appropriate storage, use and disposal of radioactive materials.
(ii) Any existing or potential hazards identified through periodic inspection by local or State health authorities shall be corrected promptly.
(iii) Personnel shall be instructed in radiation safety principles and practices. The radiation safety principles shall be adequate to ensure compliance with all generally accepted standards of practice as well as pertinent laws, rules and regulations. Policies and procedures shall be developed to minimize the radiation exposure that is necessary to produce high quality imaging studies on patients of all ages.
(iv) Radiologic procedures requiring the use of contrast media or fluoroscopic interpretation and control shall be performed with the active participation of a qualified specialist in diagnostic radiology or a physician qualified in a medical specialty related to the radiographic procedure. Emergency equipment and staff trained in its use shall be available for anaphylactic shock reactions from contrast media.
(4) Personnel.
The hospital shall provide qualified personnel adequate to supervise and conduct the services. For radiologic tests, the following personnel standards shall apply for the purposes of this subdivision:
(i) a full-time or part-time radiologist who is board certified or board admissible in radiology shall direct the clinical aspects of the organization and delivery of radiologic services. That radiologist or another individual qualified by education and experience shall direct the administrative aspects of the services;
(ii) radiologic tests shall be interpreted by a board certified or board admissible radiologist, except that radiologic tests may be interpreted by practitioners within their field of specialization who are granted privileges to interpret such tests by the governing body and the medical staff in consultation with the director of radiologic services pursuant to the credentialing process in the hospital;
(iii) the services of qualified radiologists, qualified practitioners, and licensed radiologic technologists shall be sufficient and available to meet the needs of the patients. A licensed technologist shall be on duty or available at all times and function in accordance with article 35 of the Public Health Law and Part 89 of this Title;
(iv) use of the radiologic equipment and administration of radiologic procedures shall be limited to personnel who are currently licensed and designated as qualified by the hospital in accordance with any applicable licenses and regulations.
(v) The chief of radiology, in conjunction with the radiation safety officer, shall ensure that all practitioners who utilize ionizing radiation equipment within the hospital are properly trained in radiation safety procedures for patients of all ages.
(5) Records.
Records of radiologic services including interpretations, consultations and therapy shall be filed with the patient's record, and duplicate copies shall be kept in the radiology department/service. All films, scans and other image records shall be referenced in the patient's medical record and retained in the patient's medical record, radiology department/service or in another central location accessible to appropriate staff. All electronic images shall have a duplicate storage either offsite or in another area of the hospital separate from the primary storage devices.
(i) Requests by the attending practitioner for X-ray examination shall contain a concise statement of reasons for the examination which shall be authenticated by the requestor.
(ii) The radiologist or other practitioner who performs radiology services shall authenticate reports of his or her interpretations.
(iii) The hospital shall retain films, scans and other image records which have not been incorporated in the medical record for at least six years or three years after a minor patient reaches the age of majority.
(b) Therapeutic radiology or radiation oncology.
Therapeutic radiology or radiation oncology services shall be provided in accordance with the following:
(1) no hospital providing the service shall refuse treatment of a patient on the basis of the referring practitioner or practitioner's facility affiliation, if known;
(2) institutions shall provide services for patients who cannot attend treatment sessions during normal day shift working hours;
(3) therapeutic radiology or radiation oncology services shall utilize six or more megavoltage (MEV) units with a source-axis distance of 100 or more centimeters as the primary unit in a multi-unit radiation oncology service;
(4) a therapeutic radiology service shall be headed by a board admissible or board certified radiation oncologist or a general radiologist who devotes at least 80 percent of his/her time to the practice of therapeutic radiology and who treats not fewer than 175 patients per year;
(5) a therapeutic radiology service shall have on staff:
(i) a full-time New York State licensed radiation therapists sufficient to meet the needs of the service; and
(ii) a full-time registered professional nurse with appropriate education and experience;
(6) a hospital with a therapeutic radiology service shall have on staff or through formal arrangements:
(i) a board admissible or board certified medical oncologist, hematologist or other specialist who devotes at least 80 percent of his/her practice to medical oncology and who treats not fewer than 175 oncology patients per year; and
(ii) A New York State licensed radiation therapy physicist who will be involved in treatment, planning and dosimetry as well as calibrating the equipment. The hospital shall provide for the services of a licensed radiation therapy physicist(s) in sufficient quantity to adequately meet the needs of its patients of all ages.
(iii) A physicist in training must be supervised by a licensed radiation therapy physicist.
(7) the therapeutic radiology service shall be part of a multidisciplinary approach to the management of cancer patients, involving a variety of specialists in a joint treatment program, either through formal arrangement or in the facility;
(8) each patient shall have a treatment plan in his/her medical records;
(9) each therapeutic radiology service shall have access, either through formal arrangements or in the facility, to a full range of diagnostic services, including hematology, pathology, and medical imaging procedures;
(10) each facility providing therapeutic radiology services shall have access to the full range of rehabilitation therapies, including but not limited to physical therapy, occupational therapy, vocational training, and psychological counseling services for its radiotherapeutic patients;
(11) a radiation therapy program operating a linear accelerator with photon or electron beam energies greater than 10 MEV's must be a part of a comprehensive program of cancer care which includes surgical oncology, medical oncology, pathology and diagnostic radiology. In addition such program shall meet the following standards:
(i) there shall be two full-time equivalent radiation oncologists on staff who are board-certified in radiation oncology or have equivalent training and experience and whose professional practices are limited to radiation oncology;
(ii) there shall be a full-time medical radiation physicist assigned to the radiation therapy program for the treatment planning of patients; and
(iii) a CT scanner shall be available within the radiation therapy program that is equipped for radiation oncology treatment planning or arrangements shall be made for access to a CT scanner on an as needed basis.
Provisions shall be made for access to an MRI scanner for treatment planning purposes on an as needed basis.
(c) Nuclear medicine services.
If the hospital provides nuclear medicine services, those services shall meet the needs of the patients in accordance with generally acceptable standards of practice. Nuclear medicine services shall be ordered only by a physician whose Federal or State licensure and staff privileges allow such referrals.
(1) Organization and staffing.
The organization of the nuclear medicine service shall be appropriate to the scope and complexity of the services offered.
(i) The clinical aspect of the organization and delivery of nuclear medicine services shall be directed by a physician who is qualified in nuclear medicine and named in the facility's New York State Health Department or New York City Health Department radioactive materials license as authorized to use radioactive materials in humans. The administrative aspects of these services shall be directed by that physician or another individual qualified for such duties by education and experience.
(ii) The qualifications, training, functions and responsibilities of all nuclear medicine personnel shall be specified by the clinical service director in accordance with applicable regulations and approved by the medical staff and the hospital.
(2) Delivery of service.
Radioactive materials shall be prepared, labeled, used, transported, stored, and disposed of in accordance with generally acceptable standards of practice and pertinent laws, rules and regulations.
(i) In-house preparation of radiopharmaceuticals shall be by, or under the direct supervision of, an appropriately trained registered pharmacist or a physician whose use of radioactive materials is authorized in the facility's New York State Health Department or New York City Health Department radioactive materials license.
(ii) If clinical laboratory tests are performed in the nuclear medicine service, the service shall meet the requirement for clinical laboratories with respect to management, adequacy of facilities, proficiency testing and quality control in accordance with the requirements of section 405.16 of this Part.
(3) Facilities.
The hospital shall provide equipment and supplies which are appropriate for the types of nuclear medicine services offered and shall maintain such for safe and effective performance. The equipment shall be:
(i) maintained in safe operating condition; and
(ii) inspected, tested, and calibrated at least annually by qualified personnel and at the intervals specified in the hospital's quality assurance program.
(4) Records.
The hospital shall maintain authenticated and dated reports of nuclear medicine interpretations, consultations and procedures.
(i) The hospital shall maintain copies of nuclear medicine reports which have not been incorporated into the patient's medical record for at least six years or three years after the patient reaches the age of majority.
(ii) Interpretation of the results of nuclear medicine procedures shall be made by a physician authorized in the facility's New York State Health Department or New York City Health Department radioactive materials license, or a physician under his/her tutelage. Interpretations may be made in consultation with the referring practitioner or other practitioners. The authorized physician, or physicians in tutelage, shall authenticate and date the interpretations of these tests.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.112 Definition of sanitization; general requirements
(a) Sanitization is effective bactericidal treatment by heat or chemical means, acceptable to the permit-issuing official, which destroys pathogens on surfaces treated.
(b) The following are acceptable methods of sanitizing:
(1) immersion for at least one-half minute in clean hot water at a temperature of not less than 170°F (76.7°C);
(2) immersion for at least one minute in a clean solution containing at least 50 parts per million of available chlorine at a temperature of at least 75°F (23.9°C);
(3) immersion for at least one minute in a clean solution containing at least 12.5 parts per million of available iodine and having pH not higher than 5.0, and at a temperature of at least 75°F (23.9°C);
(4) immersion in a clean solution containing any other chemical sanitizing agent, acceptable to the State Commissioner of Health, that will provide the equivalent bactericidal effect of a solution containing at least 50 parts per million of available chlorine as hypochlorite at a temperature of at least 75°F (23.9°C) for one minute; or
(5) swabbing with a solution of at least twice the strength required for that sanitizing solution when used for immersion.
(c) Chemicals used for sanitizing are not to have concentrations which will leave toxic residues on surfaces treated. A test kit or other device is to be provided and used that accurately measures the parts-per-million concentration of the solution used.
(d) Chemicals, heat or other process used for sanitizing is to produce an average plate count per utensil surface examined of not more than 100 colonies and free from coliform organisms.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.5 Decisions
A copy of the decision shall be provided to the provider and qualified person. The record of a meeting will include notices, written statements, any other information submitted and a copy of the decision.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.116 Error
Deviation, inaccuracy or incompleteness in the measurement or representation of fact.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 121 JEFFERSON COUNTY
CITIES CITIES
10 CRR-NY 121.1 City of Watertown
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to that artificial impounding reservoir or sedimentation basin formed by the construction of two dams across the northerly channel of the Black River between Huntington Island and the northerly bank of the river and to that section of the Black River tributary thereto for a distance of some 800 feet above the intake of the aforementioned reservoir and extending in an easterly direction to the mouth of the small tributary entering the river from the northeast, these bodies of water being sources of the public water supply of the city of Watertown, Jefferson County, NY.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding reservoir or sedimentation basin, including that section of the Black River tributary thereto within 800 feet above the intake to said reservoir previously described, which is tributary to or which serves as a source of this aforesaid public water supply.
(2) Wherever a linear distance of a structure or object from a reservoir is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the reservoir.
(c) Privies adjacent to the reservoir.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 50 feet of the reservoir tributary to the public water supply of the city of Watertown.
(2) No privy, privy vault, pit, cesspool or other receptacle which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the reservoir tributary to the public water supply of the city of Watertown.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container, which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 200 feet from the reservoir tributary to the public water supply of the city of Watertown.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the reservoir, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any matter, either directly or indirectly, into the reservoir tributary to the public water supply of the city of Watertown, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to removed as provided by paragraphs [4] and [5] of subdivision [c] of this section) within 150 feet of the reservoir tributary to the public water supply of the city of Watertown.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into the reservoir tributary to the public water supply of the city of Watertown; nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 50 feet of the reservoir tributary to the public water supply of the city of Watertown.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in the reservoir tributary to the public water supply of the city of Watertown.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in the reservoir tributary to the public water supply of the city of Watertown. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter, the reservoir tributary to the public water supply of the city of Watertown.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 50 feet of the reservoir tributary to the public water supply of the city of Watertown, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the reservoir without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from the reservoir tributary to the public water supply of the city of Watertown.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into the reservoir nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the city of Watertown, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 200 feet of the reservoir tributary to the public water supply of the city of Watertown; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet of the reservoir tributary to the public water supply of the city of Watertown.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into the reservoir nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into the reservoir without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from the reservoir tributary to the public water supply of the city of Watertown.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into the reservoir nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach the reservoir without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 100 feet from the reservoir tributary to the public water supply of the city of Watertown.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir tributary to the public water supply of the city of Watertown, except by duly authorized employees of the city of Watertown in the performance of their duties of supervision and maintenance of the public water supply of the city of Watertown.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of the reservoir tributary to the public water supply of the city of Watertown.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the reservoir tributary to the public water supply of the city of Watertown.
(j) Inspections.
The department of water, light and power of the city of Watertown or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the city of Watertown or their duly appointed representative shall make regular and thorough inspections of the reservoir and drainage area tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said department of water, light and power to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the department of water, light and power to promptly notify the State Commissioner of Health of such violations. The department of water, light and power shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.22 Adult beds
Those beds assigned for regular use by inpatients who are 14 years of age or over, and which are maintained in areas allotted for adult or adolescent lodging, even though in some instances utilized by children.
10 CRR-NY 441.188 Invoice cost
Cost incurred by a buyer and reflected on an invoice which, unless otherwise specified, is net after deducting trade discounts.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.9 Water
Enough potable water from an approved source is to be available in the establishment for food preparation, cleaning and sanitizing utensils and equipment, and handwashing. If not otherwise readily available, a heating facility capable of producing enough hot water for these purposes shall be provided in the establishment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.187 Invoice
A document showing the character, quantity, price, terms, nature of delivery, and other particulars of goods sold or of services rendered.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.19 Wage equalization factor (WEF)
(a) The statewide base price per discharge shall be adjusted by a facility-specific wage equalization factor (WEF) to reflect differences in labor costs between hospitals. Such WEF adjustment shall be used to adjust for the level of wage and fringe benefit costs for each hospital in accordance with the following:
(1) the WEF shall be based on each hospital's occupational mix and wages for registered nurses, licensed practical nurses, surgical technologists, nursing aides, orderlies, attendants and medical assistants as reported and approved by the Federal Medicare program, and the hospital's proportion of salaries and fringe benefit costs to total operating costs as reported to the institutional cost report. The WEF shall be computed as follows:
(i) for each occupation described in this paragraph, a statewide average salary shall be calculated by dividing the statewide sum of hospitals' total dollars paid by the statewide sum of hospitals' hours paid; and
(ii) for each hospital an actual weighted average salary shall be calculated by dividing the total dollars paid for such occupations by the total hours paid for such occupations; and
(iii) an initial WEF shall be calculated for each hospital by dividing the hospital-specific actual weighted average salary as calculated pursuant to subparagraph ( ii) of this paragraph by the statewide average salary calculated pursuant to subparagraph (i) of this paragraph; and
(iv) the final WEF shall be calculated using the following formula:
(1 / ((Labor Share/initial WEF) + Non-Labor Share))
where "Labor Share" is calculated by dividing the hospital's total salary cost plus the hospital's total fringe benefits by the hospital's total operating costs as reported in the institutional cost report for the same calendar year used to calculate the statewide base price for the applicable rate period. The "Non-Labor Share" equals total operating costs less the "Labor Share" of costs.
(2) A hospital may submit updated occupational service data as approved by the Federal Department of Health and Human Services prior to January 1st of a rate year for use in calculating the WEF in accordance with this section.
(3) For those hospitals that are in bankruptcy proceedings in the base year and that have subrogated their labor contracts, the commissioner shall use the higher of the hospital-specific or regional average WEF. These regions will be consistent with those used in the development of the exempt unit cost ceilings.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.11 Infection control
The hospital shall provide a sanitary environment to avoid sources and transmission of nosocomial infections and of communicable diseases which may lead to morbidity or mortality in patients and hospital personnel. The hospital shall establish an effective infection control program for the prevention, control, investigation and reporting of all communicable disease and increased incidence of infections, including nosocomial infections, consistent with current acceptable standards of professional practice. The hospital-wide infection control program shall be reviewed as frequently as necessary but not less than once per year, and updated as necessary to promote optimal effectiveness.
(a) Organization.
The hospital shall designate an infection control professional who is responsible for the development and implementation of a hospital-wide infection control program. This individual shall be qualified by training in infection surveillance, prevention and control and also have knowledge or job experience in epidemiological principles, infectious diseases and infection control practices.
(b) Nosocomial surveillance, prevention and control.
The hospital-wide infection control program shall include processes designed to reduce the risk of endemic and epidemic nosocomial infections and communicable diseases in patients and hospital personnel. Such processes shall include methods to:
(1) collect and analyze surveillance data including case findings and identification of epidemiologically important nosocomial infections and communicable disease;
(2) prevent or reduce the risk of nosocomial infections; and
(3) control the spread of infection and communicable diseases and epidemiologically important organisms.
(c) Reporting of infections and communicable diseases.
There shall be written policies and procedures for identifying, reporting and investigating infections, and communicable disease of patients and hospital personnel both community acquired and nosocomial. The professional responsible for the hospital-wide infection control program shall report to the Department of Health, in a manner specified by the Commissioner of Health, any increased incidence of nosocomial infections, as designated in section 2.2 of this Title and defined by the department, or nosocomially acquired communicable disease designated in section 2.1 of this Title. This individual shall also report, immediately, the presence of any communicable disease as defined in section 2.1 of this Title, to the city, county, or district health officer.
(d) Integration with the quality assurance program.
The professional responsible for the hospital-wide infection control program shall ensure that all hospital infection control activities are integrated with the quality assurance program required by section 405.6 of this Part, including identification, assessment and correction of problems related to infection and communicable disease control.
(e) Infection control education.
The hospital shall require compliance with written requirements for orientation and ongoing education programs that are relevant to the hospital's infection control program for all personnel whose activities are such that they are at risk of directly or indirectly contributing to the transmission of infection or communicable disease from or to patients, other health care personnel or themselves.
(f) Corrective action plans.
The hospital shall be responsible for the implementation of acceptable corrective action plans related to infection control and resulting from problems identified through quality assurance or regulatory oversight activities and the professional responsible for the hospital-wide infection control program shall report to the chief executive officer progress in correcting identified problems.
(g)
(1) The hospital shall possess and maintain a supply of all necessary items of personal protective equipment (PPE) sufficient to protect health care personnel, consistent with federal Centers for Disease Control and Prevention guidance, for at least 60 days, by August 31, 2021.
(2) The 60-day stockpile requirement set forth in paragraph (1) of this subdivision shall be determined by the department as follows for each type of required PPE:
(i) for single gloves, 15 percent, multiplied by the number of the hospital’s staffed beds as determined by the department, multiplied by 550;
(ii) for gowns, 15 percent, multiplied by the number of the hospital’s staffed beds as determined by the department, multiplied by 41;
(iii) for surgical masks, 15 percent, multiplied by the number of the hospital’s staffed beds as determined by the department, multiplied by 21; and
(iv) for N95 respirator masks, 15 percent, multiplied by the number of the hospital’s staffed beds as determined by the department, multiplied by 9.6.
(3) The commissioner shall have discretion to increase the stockpile requirement set forth in paragraph (1) of this subdivision from 60 days to 90 days where there is a State or local public health emergency declared pursuant to section 24 or 28 of the Executive Law. Hospitals shall possess and maintain the necessary 90-day stockpile of PPE by the deadline set forth by the commissioner.
(4) Failure to possess and maintain the required supply of PPE may result in the revocation, limitation, or suspension of the hospital’s license; provided, however, that no such revocation, limitation, or suspension shall be ordered unless the department has provided the hospital with a fourteen day grace period, solely for a hospital’s first violation of this section, to achieve compliance with the requirement set forth herein.
(h) COVID-19 confirmatory testing.
(1) Any patient who has been exposed to COVID-19 shall be tested for the COVID-19 virus along with any other clinically appropriate testing.
(2) Whenever a person expires while in the hospital, or while enroute to the hospital, and in the professional judgment of the attending clinician there is a clinical suspicion that COVID-19 was a cause of death, but no such test was performed in the 14 days before death, the hospital shall administer a COVID-19 test within 48 hours after death, along with any other clinically appropriate testing. Such COVID-19 test shall be performed using rapid testing methodologies to the extent available. The facility shall report the death to the department immediately after and only upon receipt of such test results through the Health Emergency Response Data System (HERDS). Notwithstanding the foregoing, no test shall be administered if the next of kin objects to such testing. Should the hospital lack the ability to perform such testing expeditiously, the hospital should request assistance from the State Department of Health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.2 Responsibilities of health care providers attending pregnant women
At the time a health care provider attending a pregnant woman takes a blood sample to be tested for syphilis (see section 2803 of the Public Health Law) or at another time when blood is drawn during prenatal care, the provider shall:
(a) submit or cause to be submitted to a clinical laboratory from such a woman, a blood sample to be tested for HBsAg;
(b) record the HBsAg test result, including the date of specimen collection, prominently in the pregnant woman's medical record at or before the time of admission to a health care facility for delivery;
(c) report all positive HBsAg test results to the local health officer in accordance with section 2.10 of this Title.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.45 Condiments
Condiments provided in conjunction with food dispensing by a vending machine are to be:
(a) packaged in individual portions in single-service containers;
(b) dispensed from sanitary dispensers which are cleaned, rinsed, sanitized and filled at the commissary, or at the machine location if sanitary facilities are provided; or
(c) made available from condiment self-service dispensing equipment at those locations having an on-duty attendant.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.10 Reimbursement
(a) In the event that funds are appropriated in any given fiscal year for reimbursement for the costs of obtaining criminal history information required by this Part, reimbursement shall be made available in an equitable and direct manner for the projected cost of the fee established pursuant to law by the division for processing a criminal history information check, the fee imposed by the FBI for a national criminal history check, and costs associated with obtaining the fingerprints to all providers licensed, but not certified, under article 36 of the Public Health Law, and all adult homes, enriched housing programs, and residences for adults licensed under article 7 of the Social Services Law, including those that are subject to this Part and are unable to access direct reimbursement from State and/or federally funded health programs.
(b) Residential health care facilities licensed pursuant to article 28 of the Public Health Law, certified home health care agencies and long-term home health care programs certified or approved pursuant to article 36 of the Public Health Law, and hospice programs certified pursuant to article 40 of the Public Health Law, may, subject to the availability of Federal financial participation, claim as reimbursable costs under the Medical Assistance Program, costs reflecting the fee established pursuant to law by the division for processing a criminal history information check, the fee imposed by the FBI for a national criminal history check, and costs associated with obtaining the fingerprints, provided, however, that for the purposes of determining rates of payment pursuant to article 28 of the Public Health Law for residential health care facilities, such reimbursable fees and costs shall be reflected as timely as practicable in such rates within the applicable rate period.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.14 Reporting
(a) Early intervention officials shall report to the department of Health such data as the department may require.
(b) Approved early intervention evaluators, service providers, and service coordinators will provide to early intervention officials all the data necessary to complete required reports in a timely manner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.326 Transaction
An event or condition the recognition of which gives rise to an entry in accounting records.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-8 HUMAN IMMUNODEFICIENCY VIRUS (HIV) TESTING
10 CRR-NY 58-8.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the terms below shall have the following meanings:
(a) Department means the New York State Department of Health.
(b) Donor means a human being, living or dead, who is the source or potential source of a body, organ, tissue or fluid for transfusion, transplantation, transfer, artificial insemination or implantation.
(c) FDA means the Food and Drug Administration of the United States Department of Health and Human Services.
(d) HIV antibody screening means the performance of tests to detect HIV antibodies, which tests are not sufficiently specific to ensure definitive evidence of HIV infection.
(e) HIV identification testing means the performance of tests or characterize HIV or HIV viral components, including, but not limited to, HIV protiens and HIV nucleic acid. HIV identification testing shall also include cultivation of the infectious virus.
(f) HIV confirmatory testing means the performance of one or more supplemental tests to substantiate or refute results of HIV testing procedures that are not sufficiently specific to ensure definitive evidence of HIV infection.
(g) HIV diagnostic testing means the performance of HIV tests for purposes of diagnosing, assessing or monitoring HIV infection in persons who may have been exposed to HIV, are at risk of exposure to HIV, or are known to be HIV-infected, but shall not include testing of donors. HIV testing of individuals in conjunction with an application for insurance shall be considered HIV diagnostic testing whenever test results are communicated to the applicant or his/her medical provider by the insurance company's medical director or a consulting physician or a physician under the medical director's supervision.
(h) Preliminary finding of HIV infection means results of antibody screening that have been neither substantiated nor refuted by HIV confirmatory testing.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-2 UMBILICAL CORD BLOOD TESTING
10 CRR-NY 69-2.3 Responsibilities of the chief executive officer
The chief executive officer shall ensure that:
(a) a satisfactory specimen is submitted to an approved laboratory for each infant born in the responsible institution;
(b) specimens shall be taken from the cord immediately after birth, or if a specimen is taken from the mother, the specimen shall be taken upon entry to the responsible institution for the purpose of delivery. Body blood taken from the infant in response to a positive syphilis serology in the mother must be drawn and submitted for testing within 24 hours of receipt of the mother's test result; and
(c) the date and time of cord blood or body blood collection and the test results of such specimens shall be recorded in the infant's permanent health record. The same information for the mother's blood shall be entered in the mother's permanent health record. Bloods submitted for testing must be marked clearly as cord, newborn, or mother/delivery in order to facilitate reporting to the local health unit within 24 hours of receipt of test results.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.168 Hospital-based physician
A physician who spends the predominant part of his practice time within one or more hospitals instead of in an office setting, or providing services to one or more hospitals or their patients. Such physicians have either a special financial arrangement with the hospital (salary or percentage of fees collected), or bill patients separately for their services. Such physicians include directors of medical education, pathologists, anesthesiologists and radiologists, as well as physicians who staff emergency rooms and outpatient departments.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
GENERAL GENERAL
10 CRR-NY 61-1.1 Definitions
As used in this Subpart:
(a) Commissioner means Commissioner of Health of the State of New York.
(b) Department means Department of Health of the State of New York.
(c) Guidelines means the recombinant DNA research guidelines of the National Institutes of Health of the Department of Health and Human Services, as amended and revised from time to time.
(d) NIH means the National Institutes of Health.
(e) P1, P2, P3, P4 designate levels of physical containment in order of increasing safeguards against the escape of organisms.
(f) EK1, EK2, EK3 designate levels of biological containment for E. coli K-12 host-vector systems in order of increasing inability of organisms to survive outside of laboratory conditions.
(g) Class 1, class 2, class 3, class 4, class 5 designate classes of etiologic agents in order of increasing hazard according to Classification of Etiologic Agents on the Basis of Hazard issued by the Public Health Service of the Department of Health and Human Services, as revised by NIH.
(h) Institution means any public or private entity other than an individual, including State and local government agencies.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
COMPANIES COMPANIES
10 CRR-NY 148.36 Callicoon Water Company
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all natural and artificial reservoirs, watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, serving as sources of the public water supply operated by the Callicoon Water Company and furnished to the unincorporated village of Callicoon in the town of Delaware, Sullivan County, N. Y.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Callicoon Water Company.
(2) The term reservoir means any naturally or artificially impounded body of water serving as a source of the aforesaid water supply and to any additional reservoir which may be constructed or used for this water supply.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh or channel of any kind, the waters of which flow or may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 200 feet from any reservoir or watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta located between the distances of 200 feet and 100 feet from any reservoir or watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 200 feet of any reservoir or watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (3) of subdivision (c). If such watertight receptacles are used, they shall be located not less than 100 feet from any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes shall be allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 75 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(f) Bathing.
No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainings, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any watercourse nor in such a manner as to pollute said reservoir or watercourse.
(i) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(k) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply of the Callicoon Water Company.
(l) Inspections.
The Callicoon Water Company or such other person or persons as may be charged with the maintenance or supervision of the public water supply of the unincorporated village of Callicoon or the duly appointed representatives of that company shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said water company to promptly notify the State Commissioner of Health of such violations. The Callicoon Water Company shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(m) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 453 MANDATORY REPORTING LEVELS
10 CRR-NY 453.1 General
(a) The listing of mandatory reporting levels that follows is a system of aggregating accounting information for the purposes of uniform reporting mandated in this Article. Definitions for the mandatory reporting levels are contained within the listing for all items other than the functional reporting centers which are specifically addressed in Part 455 of this Article. The names of all such functional reporting centers are included in the listing and are designated with an asterisk (*).
(b) The listing of mandatory reporting levels is not required to be formally adopted as a residential health care facility's chart of accounts. However, such levels are mandated nonetheless, and the crosswalk between a facility's chart of accounts and the mandated levels must be considered a permanent part of the facility's records and must contain sufficient audit trails to demonstrate the reliability of the information.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 42.3 Board of managers
All laboratories shall be under the supervision, direction and control of either a board of managers or the board of health appointed in accordance with section 523 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 708 APPROPRIATENESS REVIEW
10 CRR-NY 708.3 Procedures
(a) Any person or entity subject to review under this Part shall, at the request of the commissioner, submit data relating to criteria developed for review in a manner and format specified by the commissioner to effectuate his review. Any such person or entity shall, in response to such request, furnish any information or documentation as is required to effectuate the review by the commissioner within 30 days of such request.
(b) The commissioner shall provide to the applicable health systems agency that information which he has collected and which is relevant to the review and the preparation of a recommendation with regard to the appropriateness of the hospital service or home care service being reviewed.
(c) The commissioner shall establish procedures to be followed by health systems agencies for transmittal of recommendations to the commissioner.
(d) The commissioner shall commence his review by providing written notice to affected persons of the beginning of such review.
(e) No review by the commissioner shall, to the extent practicable, take longer than 180 days from the date of notification of the beginning of a review to the date of the commissioner's proposed finding. The commissioner shall not make a proposed finding until the health systems agency has had 180 days to make a recommendation to the commissioner.
(f) During the course of his review, the commissioner shall provide an opportunity for affected persons to present their views about the service under review in a public hearing.
(g) The commissioner shall, upon the written request of persons or entities subject to appropriateness review, make available information relative to such review to such persons or entities.
(h) The commissioner shall prepare an analysis of the service being reviewed, and shall forward the health systems agency recommendation, together with his analysis and recommendation, to the State Hospital Review and Planning Council. The State Hospital Review and Planning Council shall review the commissioner's analysis and recommendation and the health systems agency recommendation regarding the appropriateness of the service being reviewed, and, in accordance with the criteria established pursuant to this Part, make a recommendation to the commissioner with regard to the appropriateness of the service. Where the State Hospital Review and Planning Council recommends that the commissioner make a finding that a service is not appropriate, such a recommendation shall include a recommendation for remedial action.
(i) After consideration of the recommendations made by a health systems agency and by the State Hospital Review and Planning Council, the commissioner shall, in accordance with the procedures and criteria set forth in this Part, make a written finding as to the appropriateness of the service reviewed, subject to the provisions of subdivisions (j), (k) and (l) of this section, and make such finding public.
(j) The commissioner shall afford to any affected person, for good cause shown, within 30 days of making his proposed finding, a public hearing respecting such proposed finding. For purposes of this section, “good cause” shall require such person to establish that a public hearing is required for:
(1) presentation of significant, relevant information not previously considered by the commissioner; or
(2) demonstration that there have been significant changes in factors or circumstances relied upon by the commissioner in reaching his decision. “Good cause” shall not be deemed to be established where information or documentation was previously available and could reasonably have been submitted to the commissioner.
(k) Where the commissioner proposes to make an institution-specific finding that a service is not appropriate, the commissioner shall provide written notification of such proposed finding, by certified or registered mail, to the person or entity whose service is being reviewed. Within 30 days of receipt of such written notification, such person or entity may file a notice of appeal with the commissioner by registered or certified mail.
Such notice shall set forth the reasons for disagreement with the proposed finding. The appeal shall be reviewed by the appropriateness review administrative review board, which shall make a recommendation to the commissioner based upon the data and information previously submitted and on any written arguments submitted with such notice of appeal. The appropriateness review administrative review board shall consist of such members as designated by the commissioner. At least one of these members shall be a member of the State Hospital Review and Planning Council. The commissioner shall make his finding upon consideration of the recommendation of the appropriateness review administrative review board.
(l) Where the commissioner proposes to make an appropriateness review finding which is inconsistent with a recommendation made by the respective health systems agency, he shall provide written notification of his proposed decision to such health systems agency and provide an opportunity for administrative review, in accordance with the provisions of subdivision (k) of this section, prior to making his finding.
(m) Written findings shall be based on an areawide review and shall address the appropriateness of the service over the health service area or the entire State. Where a health systems agency recommendation in regard to a particular service is institution-specific, the commissioner shall also make an institution-specific finding. Where a health systems agency recommendation is not institution-specific, the commissioner shall, where practicable, make an institution-specific finding. Where the health systems agency has made an areawide recommendation and the commissioner proposes to make an institution-specific finding, the commissioner shall request the health systems agency to provide, within 60 days, an institution-specific recommendation or a written statement of the reasons for not making an institution-specific recommendation.
(n) Where the commissioner makes a written finding that a service is not appropriate, such a finding shall be accompanied by a statement that the service does not meet one or more of the criteria for appropriateness established pursuant to this Part which shall address the ways in which the service failed to meet the criteria. In addition, such a finding shall, to the extent practicable, be accompanied by a written recommendation for remedial action.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.52 Physicians' offices and other rentals
This functional reporting center must contain all the expenses associated with the provision of rental space to physicians and other professional persons, and with other rental activities engaged in by the residential health care facility, such as the rental of movable equipment.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.33 Water supply emergency plans
(a) All community water systems that supply drinking water to more than 3,300 people shall submit a water supply emergency plan to the State. The plan shall identify and outline the steps necessary to ensure that potable water is available during all phases of a water supply emergency.
(b) The water supply emergency plan shall include:
(1) procedures to notify consumers during all phases of a water supply emergency;
(2) criteria and procedures for determining, and the subsequent reporting of, critical water levels or safe yield of the source or sources of water;
(3) the identification of existing and future sources of water available during normal nonemergency and water supply emergency conditions;
(4) the identification of all available water storage. Available water storage includes source, transmission and distribution system storage;
(5) the identification, capacity and location of existing inter-connections. Identification of additional inter-connections needed to provide potable water during a water supply emergency;
(6) a specific action plan outlining all the steps to be carried out, taken or followed during a water supply emergency. The plan shall include a process for State notification, emergency notification rosters of key water supply personnel with current telephone numbers both business and home, and details of the follow-up corrective action process to minimize the reoccurrence of an emergency;
(7) the identification and implementation of procedures for water conservation and water use restrictions to be put in place during a water supply emergency;
(8) the identification of and the procedures for prioritization of potable water users during a water supply emergency;
(9) the identification and availability of emergency equipment needed during a water supply emergency;
(10) the system's capacity and ability to meet peak water demands and fire-flow conditions concurrently during a water supply emergency.
(c) An all-hazard vulnerability analysis, including an analysis of vulnerability to terrorist attack and cyber attack, shall be performed on all components of the water system. System components include but are not limited to: the source or sources of water supply; water treatment plants; disinfection stations; pipes and valves; storage tanks; and system operations and management. The system shall take whatever steps are necessary to ensure that potable water can be and is available during a water supply emergency.
(d) Before the final submission of the water supply emergency plan to the State, the system shall publish a notice in a newspaper of general circulation in the area served by the community water system stating that the proposed water supply emergency plan is available for review and comment. The notice shall be printed at least once in each of two successive weeks. Public comment shall be accepted for at least 14 days following the date of first publication. All public comment shall be submitted with the water supply emergency plan to the State.
(e) The water supply emergency plan shall be submitted to the State for review at least once every 5 years and within 30 days after major water facility infrastructure changes have been made. The system shall keep the emergency plan up to date, and shall provide updated communication and notification information to the State by December 31st of each year.
(f) Community water systems that supply drinking water to 3,300 or fewer people, non-transient noncommunity water systems, and noncommunity water systems may be required to prepare, update and submit to the State, a written water supply emergency plan for providing potable water during a water supply emergency.
(g) If more than one system is responsible for providing potable water to a community water system, the water supply emergency plan shall be prepared and submitted jointly by the systems.
(h) Information shall be exempt from public disclosure for public review and comment if it is determined by the water supplier that the information will pose a security risk to the operation of the water system. Upon the commissioner’s request, the system shall provide a copy of the exempt information and justification for why said information should not be subject to public review and comment. A person who, without authorization, discloses any such assessment or information to another person who has not been authorized to receive such assessment or information shall be subject to criminal penalties pursuant to section 1125 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.13 Hearing rights
No certificate of public advantage shall be revoked without affording the applicant an opportunity to request a hearing pursuant to Part 51 of this Title.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.3 Administration
The hospital shall be managed effectively and efficiently in accordance with hospital bylaws and policies and procedures. The daily management and operational affairs of the hospital shall be the responsibility of the chief executive officer.
(a) The chief executive officer shall be responsible for the development, submission and implementation of all plans to correct operational deficiencies identified by regulatory agencies on a timely basis and shall report to the governing body progress in developing and carrying out plans of correction.
(b) Personnel.
The chief executive officer develops and implements personnel policies and practices with regard to at least the following:
(1) the employment of personnel, without regard to sex, race, creed, sexual orientation, disability, or national origin, whose qualifications are commensurate with anticipated job responsibilities;
(2) the identification of all hospital personnel, including students and volunteers, through the use of identification name tags which are clearly visible and are worn at all times;
(3) the orientation of all new employees to the hospital and to hospital and personnel policies;
(4) the development and implementation of a written plan for inservice training, including orientation and training for the governing body;
(5) effective July 1, 1989, the provision, at all times, of intravenous services, phlebotomy services, messenger services, transporter services, nurse aides, housekeeping services and other ancillary support services in a manner sufficient to meet patient care needs and to prevent adverse impact on the delivery of medical and nursing care;
(6) the maintenance of an accurate, current, and complete personnel record for each hospital employee;
(7) the verification of all applicable current licensure/certification;
(8) a periodic performance evaluation, based on a written job description, of each employee;
(9) the provision of employee health services, in consultation with the medical staff; and
(10) the provision for a physical examination and recorded medical history for all personnel including all employees, members of the medical staff, contract staff, students and volunteers, whose activities are such that a health impairment would pose a potential risk to patients. The examination shall be of sufficient scope to ensure that no person shall assume his/her duties unless he/she is free from a health impairment which is of potential risk to the patient or which might interfere with the performance of his/her duties, including the habituation or addiction to depressants, stimulants, narcotics, alcohol or other drugs or substances which may alter the individual's behavior. The hospital is required to provide such examination without cost for all employees who are required to have such examination. For personnel whose activities are such that a health impairment would neither pose a risk to patients nor interfere with the performance of his/her duties, the hospital shall conduct a health status assessment in order to determine that the health and well-being of patients are not jeopardized by the condition of such individuals. The hospital shall require the following of all personnel, with the exception of those physicians who are practicing medicine from a remote location as a condition of employment or affiliation:
(i) a certificate of immunization against rubella which means:
(a) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of rubella antibodies; or
(b) a document indicating one dose of live virus rubella vaccine was administered on or after the age of 12 months, showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization; or
(c) a copy of a document described in clause ( a ) or ( b ) of this subparagraph which comes from a previous employer or the school which the employee attended as a student; and
(ii) a certificate of immunization against measles for all personnel born on or after January 1, 1957 which means:
(a) a document prepared by a physician, physician's assistant, specialist's assistant, nurse practitioner, licensed midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58 of this Title, demonstrating serologic evidence of measles antibodies; or
(b) a document indicating two doses of live virus measles vaccine were administered on or after the age of 12 months and the second dose administered more than 30 days after the first dose but after 15 months of age showing the product administered and the date of administration, and prepared by the health practitioner who administered the immunization; or
(c) a document, indicating a diagnosis of the employee as having had measles disease prepared by the physician, physician's assistant/specialist's assistant, licensed midwife or nurse practitioner who diagnosed the employee's measles; or
(d) a copy of a document described in clause ( a ), ( b ) or ( c ) of this subparagraph which comes from a previous employer or the school which the employee attended as a student;
(iii) if any licensed physician, physician's assistant, specialist's assistant, licensed midwife or nurse practitioner certifies that immunization with measles and/or rubella vaccine may be detrimental to the employee's health, the requirements of subparagraph (i) and/or (ii) of this paragraph relating to measles and/or rubella immunization shall be inapplicable until such immunization is found no longer to be detrimental to such employee's health. The nature and duration of the medical exemption must be stated in the employee's employment medical record and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the American Academy of Pediatrics and the Immunization Practices Advisory Committee of the U.S. Department of Health and Human Services);
(iv) for all personnel prior to employment or affiliation, except for personnel with no clinical or patient contact responsibilities who are located in a building or site with no patient care services, an initial individual tuberculosis (TB) risk assessment, symptom evaluation, and TB test (either tuberculin skin test or Food and Drug Administration [FDA] approved blood assay for the detection of latent tuberculosis infection), and annual assessments thereafter. Positive findings shall require appropriate clinical follow-up. The medical staff shall develop and implement policies regarding positive findings, including procedures for facilitating and documenting treatment for latent TB infection where indicated. Annual TB assessment shall include education, individual risk assessment, and follow-up tests as indicated;
(v) documentation of vaccination against influenza, or wearing of a surgical or procedure mask during the influenza season, for personnel who have not received the influenza vaccine for the current influenza season, pursuant to section 2.59 of this Title;
(vi) documentation of COVID-19 vaccination or a valid medical exemption to such vaccination, pursuant to section 2.61 of this Title, in accordance with applicable privacy laws, and making such documentation immediately available upon request by the department, as well as any reasonable accommodation addressing such exemption;
(11) the reassessment of the health status of all personnel as frequently as necessary, but no less than annually, to ensure that personnel are free from health impairments which pose potential risk to patients or personnel or which may interfere with the performance of duties;
(12) the provision for emergency health care for all personnel;
(13) the maintenance of medical records for all personnel including the dates, extent and results of all health assessments and physical examinations; the results of laboratory tests and X-ray reports; and records of immunizations, illnesses or injuries;
(14) the requirement that all personnel report immediately to their supervisor any signs or symptoms of personal illness. All personnel making such report shall be referred to an appropriate health care professional for assessment of the potential risk to patients and personnel. Based on this assessment, the hospital shall authorize appropriate measures to be taken, including but not limited to removal, reassignment or return to duty;
(15) the safety and protection of all personnel and advice to personnel concerning the nature of toxic substances which they may encounter in the workplace in the course of their employment or affiliation, in accordance with article 28 of the New York State Labor Law; and
(16) a policy that no hospital employee or member of a hospital medical staff shall be required by the hospital or a member of the hospital staff to participate in an induced termination of pregnancy who has informed the hospital of his or her decision not to participate in such act or acts;
(c) The hospital shall have a written agreement which defines the respective roles and responsibilities of the hospital and any educational program which utilizes the clinical facilities of the hospital for the education of students. Such agreement shall recognize the responsibility of the hospital for activities of the educational program and students which affect the care of patients.
(d) Records and reports.
Any information, records or documents provided to the department shall be subject to the applicable provisions of the Public Health Law, Mental Hygiene Law, Education Law, and the Public Officers Law in relation to disclosure. The hospital shall maintain and furnish to the Department of Health, immediately upon written request, copies of all documents, including but not limited to:
(1) all records related to patient care and services;
(2) the certificate of incorporation or the partnership agreement and, the certificate of conducting business under an assumed name as required by General Business Law, section 130;
(3) the reports of hospital inspections and surveys of outside agencies with statements attached specifying the steps taken to correct any hazards or deficiencies or to carry out the recommendations contained therein;
(4) all contracts, leases and other agreements entered into by the governing authority pertaining to the ownership of the land, building, fixtures and equipment used in connection with the operation of the hospital;
(5) all licenses, permits and certificates required by law for the operation of the hospital and also for those departments and staff members, where required;
(6) operating procedure manuals for all services or units of the hospital organization. These manuals shall be reviewed at least biennially by the hospital or more frequently as determined appropriate by each service or unit and be made available to all services and units of the hospital;
(7) all bylaws, rules and regulations of the hospital and all amendments thereto; a listing of the names and addresses and titles of offices held for all members of the governing authority and revisions thereof; a copy of the bylaws, rules and regulations of the medical staff and all amendments of the medical staff and revisions thereof; a copy of the current annual report and financial statements of the hospital;
(8) copies of complaints received regarding patient care and documentation of the follow-up actions taken as a result of the investigation of these complaints;
(9) copies of all incident reports completed pursuant to section 405.8 of this Part;
(10) a listing of the names and titles of the members of each committee of the hospital;
(11) written minutes of each committee's proceedings. These minutes shall include at least the following:
(i) attendance;
(ii) date and duration of the meeting;
(iii) synopsis of issues discussed and actions or recommendations made;
(12) whenever the commissioner determines that there exists an outbreak of a highly contagious communicable disease pursuant to Part 2 of this Title or other public health emergency, such syndromic surveillance data as the commissioner deems appropriate, which the hospital shall submit in the manner and form determined by the commissioner; and
(13) any record required to be kept by the provisions of this Part.
(e) Other reporting requirements.
(1) The hospital shall report in writing to the Office of Professional Medical Conduct with a copy to the appropriate area administrator of the department's Office of Health Systems Management within 30 days of the occurrence of denial, suspension, restriction, termination or curtailment of training, employment, association or professional privileges or the denial of certification of completion of training of any physician, registered physician's assistant or registered specialist's assistant licensed/registered by the New York State Department of Education for reasons related in any way to any of the following:
(i) alleged mental or physical impairment, incompetence, malpractice, misconduct or endangerment of patient safety or welfare;
(ii) voluntary or involuntary resignation or withdrawal of association or of privileges with the hospital to avoid the imposition of disciplinary measures;
(iii) the receipt of information concerning a conviction of a misdemeanor or felony. The report shall contain:
(a) the name and address of the individual;
(b) the profession and license number;
(c) the date of the hospital's action;
(d) a description of the action taken; and
(e) the reason for the hospital's action or the nature of the action or conduct which lead to the resignation or withdrawal and the date thereof; and
(iv) the hospital shall establish policies and implement procedures to ensure compliance with these reporting requirements.
(2) The hospital shall furnish to the Department of Education or the Department of Health for individuals licensed by the department within 30 days of occurrence, a written report of any denial, withholding, curtailment, restriction, suspension or termination of any membership or professional privileges in, employment by, or any type of association with a hospital relating to an individual who is a health profession student serving in a clinical clerkship, an unlicensed health professional serving in a clinical fellowship or residency, or an unlicensed health professional practicing under a limited permit or a state licensee, such as an audiologist, licensed master social worker (LMSW), licensed clinical social worker (LCSW), dental hygienist, dentist, medical laboratory technologist, nurse, occupational therapist, ophthalmic dispenser, optometrist, pharmacist, physical therapist, podiatrist, psychologist, radiologic technologist, radiologist assistant, respiratory therapist, respiratory therapy technician or speech-language pathologist for reasons related in any way to any of the following reasons:
(i) alleged mental or physical impairment, incompetence, malpractice, misconduct or endangerment of patient safety or welfare;
(ii) voluntary or involuntary resignation or withdrawal of association, employment or privileges with the hospital to avoid imposition of disciplinary measures; or
(iii) the receipt of information concerning a conviction of a misdemeanor or felony. The report shall contain:
(a) the name and address of the individual;
(b) the profession and license number;
(c) the date of the hospitals action;
(d) a description of the action taken; and
(e) the reason for the hospital's action or the nature or the action or conduct which lead to the resignation or withdrawal and the date thereof.
(3) At the time that a physician on a hospital's staff is granted admitting privileges or before or at the time the physician admits his or her first patient, each hospital shall furnish to such physician the following notice, which each physician on the hospital staff must sign and date. The signed notices shall be kept on file by the hospital. The notice to physicians shall state:
"Notice to physicians. Payment to hospitals for inpatient services is based in part on each patient's principal and secondary diagnoses and the major procedures performed on the patient, and for neonates, upon birthweight or admission weight as well. This data must be documented by the patient's medical record. Anyone who misrepresents, falsifies, or conceals this information may be subject to fine, imprisonment, or civil penalty under applicable Federal and New York State laws."
(4) At the time of discharge, for categories of patients determined by the commissioner, the chief executive officer shall provide the department information in a manner and on a form specified by the department.
(f) Hospital management contracts.
(1) For the purposes of this Part, a management contract is an agreement between a hospital governing body and a contracting entity for the contracting entity to assume the primary responsibility for managing the day-to-day operations of an entire facility or a defined patient care unit of the facility. A management contract shall not include:
(i) a contract solely for the provision of professional clinical services;
(ii) an employment contract; or
(iii) a contract for the provision of administrative services to a defined patient care unit of a facility where all of the following factors are present:
(a) the hospital retains responsibility for the day-to-day operations of the defined patient care unit;
(b) the contracting entity has no authority to hire or fire any hospital employee;
(c) the contracting entity does not maintain and control the books and records of the defined patient care unit;
(d) the contracting entity has no authority to incur any liability on behalf of the facility; and
(e) the contracting entity has no authority to adopt or enforce policies regarding the operation of the defined patient care unit.
(2) Management contracts shall be effective only with the prior written consent of the commissioner and shall include the following:
(i) a description of the proposed roles of the governing body during the period of the proposed management contract. The description shall clearly reflect retention by the governing authority of ongoing responsibility for statutory and regulatory compliance;
(ii) a provision that clearly recognizes that the responsibilities of the facility's governing body are in no way obviated by entering into a management contract and that any powers not specifically delegated to the contracting entity through the provisions of the contract remain with the governing body; and
(iii) a plan for assuring maintenance of the fiscal stability, the level of services provided and the quality of care rendered by the facility during the term of the management contract.
(3) The governing body shall retain sufficient authority and control to discharge its responsibility under this Part. The following elements of control shall not be delegated to a managing authority:
(i) direct independent authority to appoint and discharge the chief executive officer or other key management employees;
(ii) independent control of the books and records;
(iii) authority over the disposition of assets and the authority to incur on behalf of the facility liabilities not normally associated with the day-to-day operation of a facility; and
(iv) independent adoption of policies affecting the delivery of health care services.
(4) A governing body wishing to enter into a management contract shall submit a proposed written contract to the department, at lest 60 days prior to the intended effective date, unless a shorter period is approved in writing by the commissioner, due to extraordinary circumstances. In addition, the governing body shall also submit, within the same time frame, the following:
(i) documentation demonstrating that the proposed managing authority holds all necessary approvals to do business in New York State;
(ii) documentation of the goals and objectives of the management contract including a mechanism for periodic evaluation by the governing body of the effectiveness of the arrangement in meeting those goals and objectives;
(iii) evidence of the managing authority's financial stability;
(iv) information necessary to determine that the character and competence of the proposed managing authority, and its principals, officers and directors, is satisfactory, including evidence that all facilities it has managed in New York State have provided a substantially consistent high level of care in accordance with section 600.2 of this Title, during the term of their management contract or operating certificate; and
(v) evidence that it is financially feasible for the facility to enter into the proposed management contract for the term of the contract and for a period of one year following expiration, recognizing that the costs of the contract are subject to all applicable provisions of Part 86 of this Title. To demonstrate evidence of financial feasibility, the facility shall submit projected operating and capital budgets for the required periods. Such budgets shall be consistent with previous certified financial statements and be subject to future audits.
(5) During the period between a facility's submission of a request for initial approval of a management contract and disposition of that request, a facility may not enter into any arrangement for management contract services other than a written interim consultative agreement with the proposed managing authority. Any interim agreement shall be consistent with the provisions of this section and shall be submitted to the department no later than five days after its effective date.
(6) The term of a management contract shall be limited to three years and may be renewed for additional periods not to exceed three years only when authorized by the commissioner. The commissioner shall approve an application for renewal provided that compliance with this section and the following provisions can be demonstrated:
(i) that the goals and objectives of the contract have been met within specified time frames;
(ii) that the quality of care provided by the facility during the term of the contract has been maintained or has improved; and
(iii) that the level of service to meet community needs and patient access to care and services has been maintained or improved.
(7) A contract for which an application for renewal has been submitted on a timely basis to the commissioner may be extended on an interim basis until the commissioner approves or disapproves the application for renewal.
(8) A facility's governing body shall, within the terms of the contract, retain the authority to discharge the managing authority and its employees from their positions at the facility with or without cause on not more than 90 days' notice. In such event, the facility shall notify the department in writing at the time the managing authority is notified. The facility's governing body shall provide a plan for the operation of the facility subsequent to the discharge to be submitted with the notification to the department.
(g) Whenever the commissioner determines that there exists an outbreak of a highly contagious communicable disease pursuant to Part 2 of this Title or other public health emergency, the commissioner may direct general hospitals, as defined in article 28 of the Public Health Law, and consistent with the Federal Emergency Medical Treatment and Labor Act (EMTALA), to accept patients pursuant to such procedures and conditions as the commissioner may determine appropriate.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.190 Permits, application, fees, issuance, inspection
(a) A valid permit issued by the permit-issuing official having jurisdiction is required for lawful operation of a food service establishment. This permit is to be prominently displayed at each food service establishment where it can be seen by the consumer. At establishments that serve retail frozen desserts, the $25 permit fee imposed by Public Health Law, section 225(5)(s) shall be paid at the time any other permit fees related to the operation of the food service establishment are collected by the permit-issuing official and the establishment's permit shall indicate that the facility can manufacture and sell retail frozen desserts.
(b) The term permit-issuing official means the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, a public health director or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, or such grade I or grade II public health administrator or public health director or county health director may designate the director of environmental health of such district; and the State regional health director. or area director may designate the district director as additional persons authorized to issue permits required by this Subpart.
(c) Not less than 21 days before starting operation of a food service establishment, an application for a permit is to be submitted to the permit-issuing official having jurisdiction. This application is to be completed in full on forms acceptable to the permit-issuing official.
(d) A permit will be issued subject to the food service establishment being constructed, maintained and operated in compliance with this Subpart and not presenting a danger to the health of the consumer or to the public. An applicant's past history of compliance or noncompliance will be a consideration in evaluating each of the previously mentioned criteria. The condition of the establishment, its equipment, utensils, personnel, mode of operation, surroundings, water supply, sewage disposal, waste handling, furnishings, food and appurtenances are all factors in determining whether its continued operation may affect public health. After making the preliminary inspection, a permit may be issued or the operator advised of violations prohibiting issuance of such permit by the permit-issuing official.
(e) It is unlawful for a food service establishment to operate without a permit during the 21 days from the time a permit has been requested. In the event the permit-issuing official or his designated representative does not make an inspection of the establishment during this 21-day period, operations may commence without a permit on the 22nd day and may be continued without being in violation of this Subpart until such time as the permit-issuing official or his designated representative makes an inspection and issues a permit or issues an order to cease operation for cause.
(f) The designated representative of the permit-issuing official is a person authorized to perform inspections of food service establishments on behalf of the permit-issuing official.
(g) Adult proprietary care facilities and day care centers approved to operate by the New York State Department of Social Services, hospitals and nursing homes approved to operate pursuant to the Public Health Law, and the State-owned/operated facilities do not require a separate permit for food service operations, unless such operations are conducted by a third party. In that event, the third party is responsible to make application and to obtain a permit from the permit-issuing official, subject to the requirements of this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.2 Administrative determinations
(a) Each administrative program submitted by a local government under this Subpart shall contain provisions governing the extent and frequency of department review and approval of administrative determinations made by the local government, as the department shall agree upon.
(b) Pursuant to each administrative program submitted by a local government under this Subpart, the local government shall provide the department (Attention: Chief, Sources Division) with a copy of each administrative determination made by such local government, at the same time that the determination is made available to the applicant.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.73 Water treatment plant laboratory
Every supplier of water shall provide, or have available environmental laboratory facilities approved by the New York State Environmental Laboratory Approval Program (ELAP). Tests for the control of the operation of such public water system shall be made daily or more frequently as required by the State. The results of such tests shall be recorded on forms pursuant to section 5-1.72(d) of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.206 Medical staff classification—house staff (paid staff)
Licensed physicians who are employed by the hospital to provide service to all patients, according to need, and are subject to the approval of the patients' own physicians.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 130 ONEIDA COUNTY
CITIES CITIES
10 CRR-NY 130.2 City of Utica
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all bodies of water (wherever located) now in existence or that may be hereafter developed which serve as a source of the public water supply of the city of Utica and the adjacent communities which derive their water supply through the mains of the bureau of water of the city of Utica.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the city of Utica and adjacent communities.
(2) The term reservoir means any natural or artificially impounded body of water serving as a source of water supply of Utica and adjacent communities and to any additional reservoir which may be constructed or used for said water supply.
(3) The term watercourse means every spring, pond (other than reservoir), stream, marsh or channel of any kind, the waters of which flow or may flow into the water supply of Utica and adjacent communities.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of such watercourse.
(c) Watersheds.
These rules shall apply to the drainage area of the Graffenburg or No. 1 Reservoir, south of the city of Utica, and to that portion of the watershed of West Canada Creek which lies above the concrete dam at Hinckley in the towns of Russia, Remsen, Webb, Norway, Ohio and Salisbury in Herkimer County, the towns of Arietta and Morehouse in Hamilton County, and the town of Trenton, Oneida County, including all the tributaries of West Canada Creek.
(d) Human excreta.
(1) No human excreta shall be deposited, thrown or placed in or allowed to escape into any reservoir or watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 130 feet from any reservoir or watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be placed, maintained or allowed to remain within 25 feet of any reservoir or watercourse, except a properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (1) of subdivision (f)*, provided, however, that the property on which the privy or receptacle is built or is to be built is so located, bounded or otherwise placed that the distances above named can be obtained within the limits of such property.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta, built or to be built on property which is so located, bounded or otherwise placed that the distances named in paragraph (4) of this subdivision cannot be obtained, shall be placed as far as possible from any reservoir or watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the bureau of water of the city of Utica and in such manner as effectually to prevent any pollution of the public water supply.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(e) Sewage.
No sewage shall be discharged or allowed to flow into any reservoir or watercourse nor deposited on or beneath the surface of the ground within 150 feet of any reservoir or watercourse, except into watertight receptacles, the contents of which shall be disposed of as provided by paragraph (3) of subdivision (d). If such watertight receptacles are used, they shall be located not less than 75 feet from any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(f) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor be deposited on or beneath the surface of the ground within 100 feet of any reservoir or watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited in any reservoir or watercourse nor on or beneath the surface of the ground within 100 feet thereof nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(g) Bathing, boating, fishing, etc.
(1) No person shall bathe or swim or be allowed to bathe or swim in any reservoir or watercourse and no bathing or swimming shall be allowed within 1000 feet of the intake at Hinckley on the West Canada Creek.
(2) No boating of any kind or fishing from the shore, from boats or through the ice or any trespassing whatever shall be allowed in or upon the reservoirs tributary to this public water supply known as reservoirs 1, 2, 4, 5, 6, 8, 10, and 11, except by duly authorized employees of the bureau of water in the performance of their duties of supervision and maintenance of the public water supply; nor shall any ice cutting or other operations incident thereto be allowed on any part of these reservoirs except by permission and under rigid inspection and supervision of the bureau of water. Notices relative to the foregoing restrictions shall be posted conspicuously at each of these reservoirs by the bureau of water. The waters of these reservoirs and the lands surrounding them, owned by the city of Utica, shall not at any time be used for picnicking, playgrounds, horseback riding, public meetings or any other assembly or congregation.
(h) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in any reservoir and no watering place shall be maintained in such a way as to pollute any watercourse with exremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may directly pollute any reservoir or watercourse.
(i) Manure.
No manure pile shall be maintained or allowed to remain within 100 feet of any reservoir or watercourse nor in such a manner as to pollute said reservoir or watercourse.
(j) Camps.
No camp, tent, building or other structures for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or watercourse tributary to the water supply.
(k) Cemeteries.
No interment of a human body shall be made within a distance of 200 feet of any reservoir or watercourse tributary to the water supply.
(l) General clause.
In addition to observing the foregoing requirements all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(m) Inspections.
The board of water commissioners of the city of Utica or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representatives of the bureau of water shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(n) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 94 PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS
10 CRR-NY 94.1 Definitions
As used in this Part:
(a) Licensed physician assistant means an individual who is currently licensed as a physician assistant by the New York State Department of Education.
(b) Registered specialist assistant means an individual who is currently registered as a specialist assistant by the New York State Department of Education.
(c) Hospital means an institution or facility possessing a valid operating certificate issued pursuant to article 28 of the Public Health Law and authorized to employ physician assistants pursuant to part 707 of the State Hospital Code.
(d) Physician means a practitioner of medicine licensed to practice medicine pursuant to article 131 of the Education Law.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-2 UMBILICAL CORD BLOOD TESTING
10 CRR-NY 69-2.4 Responsibilities of the approved laboratory
The approved laboratory shall report any positive results from cord, newborn, or mother's blood to the responsible physician or birth attendant and local health unit within 24 hours of completion of testing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.86 Deductions from revenue
Reductions in gross revenue arising from bad debts, contractual adjustments, uncompensated/charity care, administrative, courtesy, policy discounts, adjustments and others.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 118 GREENE COUNTY
10 CRR-NY 118.2 Village of Catskill
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on the west branch of Potuck Creek (Cob Creek on U. S. Geological Survey Sheet) and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the village of Catskill, Greene County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the impounding and storage reservoir on Potuck Creek, which serves as the source of the aforesaid public water supply, and to any additional reservoir which may hereafter be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond, lake (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Catskill.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the highwater mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Catskill, except a properly constructed and operated sewage disposal plant, as hereinafter set forth in paragraph (2) of subdivision (d), provided, however, that the property on which the privy, privy vault, pit or any other receptacle intended for the deposit of human excreta is built or is to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(2) Every privy, privy vault, pit or other receptacle, used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance prescribed in paragraph (1) of this subdivision cannot be obtained within the limits of such property, shall be placed as far as possible from any reservoir or watercourse and specially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from any reservoir or watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the board of water commissioners of the village of Catskill and so located that the top of such receptacles shall be above the highest known water level of the reservoir or watercourse.
(3) Whenever a privy, privy vault, pit or other receptacle of any kind or any vessel, can or other container, used for either the temporary storage or the permanent disposal of human excreta, is specially constructed and made watertight and located nearer any reservoir or watercourse than the distances prescribed in paragraph (1) of this subdivision, such receptacles shall be emptied at regular intervals and disinfected as often as may be necessary to maintain them in a proper sanitary condition and effectually to prevent any overflow. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the direction of the board of water commissioners and in such manner as to effectually prevent any pollution of the water supply of the village of Catskill.
(4) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Catskill.
(5) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (4) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (6) and (7) of this subdivision.
(6) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(7) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (5) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 400 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the village of Catskill.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and operated sewage disposal plant as hereinafter provided by paragraph (2) of this subdivision, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Catskill, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Catskill.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into the west branch of Potuck Creek or any watercourse tributary to the public water supply of the village of Catskill, shall be constructed, enlarged, altered or put in operation until plans for the same have been approved and a permit issued by the State Commissioner of Health and a copy of the plans, as approved, filed with the board of water commissioners of the village of Catskill.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind, except the effluent from a properly constructed and operated sewage disposal plant as provided to paragraph (2) of this subdivision, shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Catskill, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [6] and [7] of subdivision [c]) within 100 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Catskill.
(4) No clothing bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir of the public water supply of the village of Catskill.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir of the public water supply of the village of Catskill. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Catskill.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Catskill, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the village of Catskill.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Catskill, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Catskill; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 25 feet of any watercourse tributary to the public water supply of the village of Catskill.
(4) No decayed or fermented fruit, vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the village of Catskill.
(f) Dead animals, offal, industrial wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse tributary to the public water supply of the village of Catskill, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or one hundred feet from any watercourse tributary to the public water supply of the village of Catskill.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir of the public water supply of the village of Catskill except by duly authorized employees of the village of Catskill in the performance of their duties of supervision and maintenance of the public water supply of the village of Catskill.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Catskill.
(i) Cemeteries.
No interment of a human body shall be made nor shall any interred human body be allowed to remain within 300 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Catskill.
(j) Inspections.
The said board of water commissioners of the village of Catskill or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Catskill or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the said board of water commissioners to promptly notify the State Commissioner of Health of such violations. The said board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.106 Renewal or amendment of specific licenses
Any application by a licensee for the renewal or amendment of his license shall be considered as an application for a license and shall be filed in accordance with section 16.102 of this Part; and any such application for amendment shall set forth the reasons for such requested amendment. In considering any such application for renewal or amendment, the department will apply the requirements set forth in section 16.103 of this Part as appropriate corrective amendment of a license may be issued by the department at any time upon its initiative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.3 Recordkeeping, reports and audits
(a) General hospitals whose rates of payments are governed by this Subpart shall:
(1) continue to maintain financial and statistical data and records in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-1 of this Part;
(2) continue to submit to the department all cost reports and other information in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-1 of this Part;
(3) continue to have all books and records subject to audit in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-1 of this Part.
(b) Diagnostic and treatment centers and free-standing ambulatory surgery centers whose rates of payments are governed by this Subpart shall:
(1) continue to maintain financial and statistical data and records in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-4 of this Part;
(2) continue to submit to the department all cost reports and other information in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-4 of this Part;
(3) continue to have all books and records subject to audit in accordance with otherwise applicable statutes and regulations, including, but not limited to, regulations as set forth in Subpart 86-4 of this Part.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.1 Course work or training
Course work or training in infection control and barrier precautions for physicians, registered physician assistants (SAs) and specialist assistants (PAs) as sufficient to satisfy the requirement of Public Health Law section 238, shall contain the core content which is specified in a syllabus prepared by the Department of Health (DOH) in consultation with the Department of Education, including course work or training in basic concepts of disease transmission, scientifically accepted principles and practices for infection control and engineering and work practice controls.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.11 Food service
Any food service operated by the campground operator or other food vendor shall meet the requirements of Part 14 of this Title. If the food service is operated by a food vendor other than the operator of the campground, a permit to operate in accordance with the appropriate Subpart of Part 14 of this Title must be obtained.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.6 Safeguarding controlled substances
(a) Controlled substances shall at all times be properly safeguarded and securely kept at the address on file with the Drug Enforcement Administration and which is used in the ordering of the controlled substances, where they will be available for inspection by properly authorized officers, agents and employees of the New York State Department of Health, Bureau of Narcotic Enforcement.
(b) Access to controlled substances stocks shall be limited to the minimum number of employees actually required to efficiently handle the manufacture, distribution, custody, dispensing, administration or other handling of such substances.
(c) The administrative head of a licensee hospital, laboratory, dispensary, nursing home and health-related facility and the supervisor of a manufacturer or distributor is responsible for the proper safeguarding and handling of controlled substances within the hospital or other facility. An administrative head or supervisor is not relieved of his responsibility to detect and correct any diversion or mishandling of controlled substances by a delegation of responsibility.
(d) Persons operating pharmacies and supervising pharmacists of such pharmacies are responsible for the proper safeguarding and handling of controlled substances within the pharmacy. Persons operating pharmacies and supervising pharmacists are not relieved of their responsibility to detect and correct any diversion of mishandling of controlled substances by a delegation of responsibility.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
APPLICATION AND PURPOSE APPLICATION AND PURPOSE
10 CRR-NY 14-4.1 Application of Subpart
This Subpart is applicable to mobile food service establishments and pushcarts notwithstanding any other Subpart of this Part.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.2 Definitions
(a) As used in these regulations, these terms have the definitions set forth below:
(1) A1 means the maximum activity of special form radioactive material permitted in a Type A package. A2 means the maximum activity of radioactive material, other than special form radioactive material, permitted in a Type A package. These values are either listed or may be derived in accordance with the procedure prescribed in Appendix 16-B, Table 1 of this Part.
(2) Absorbed dose means the energy imparted by ionixing radiation per unit mass of irradiated material. The units of absorbed dose are the gray (Gy) and the rad.
(3) Accelerator-produced material means any material made radioactive by a particle accelerator.
(4) Activity means the rate of disintegration or transformation or decay of radioactive material. The units of activity are the becquerel (Bq) and the curie (Ci).
(5) Adult means an individual 18 years, or more, or age.
(6) Agreement state means any state with which the United States Nuclear Regulatory Commission or the United States Atomic Energy Commission has entered into an effective agreement under section 274b of the Atomic Energy Act of 1954, as amended (73 Stat. 689).
(7) Airborne radioactive material means any radioactive material dispersed in the air in the form of dusts, fumes, particulates, mists, vapors, or gases.
(8) Airborne radioactivity area means a room, enclosure, or area in which airborne radioactive materials exist in concentrations:
(i) in excess of the derived air concentrations (DACs) specified in Appendix 16-C, Table 1, Column 3, infra; or
(ii) to such a degree that an individual present in the area without respiratory protective equipment could exceed, during the hours an individual is present in a week, an intake of 0.6 percent of the annual limit on intake (ALI) or 12 DAC-hours.
(9) Aluminum equivalent means the thickness of aluminum affording the same attenuation, under specified conditions, as the material in question.
(10) Annual limit on intake (ALI) means the derived limit for the amount of radioactive material taken into the body of an adult worker by inhalation or ingestion in a year. ALI is the smaller value of intake of a given radionuclide in a year by the reference man that would result in a committed effective dose equivalent of 0.05 Sv (5 rem) or a committed dose equivalent of 0.5 Sv (50 rem) to any individual organ or tissue. ALI values for intake by ingestion and by inhalation of selected radionuclides are given in Appendix 16-C, Table 1, Columns 1 and 2, infra.
(11) As low as is reasonably achievable (ALARA) means making every reasonable effort to maintain exposures to radiation as far below the dose limits in these regulations as is practical, consistent with the purpose for which the licensed or registered activity is undertaken, taking into account the state of technology, the economics of improvements in relation to state of technology, the economic of improvements in relation to benefits to the public health and safety, and other societal and socioeconomic considerations, and in relation to utilization of nuclear energy and licensed or registered sources of radiation in the public interest.
(12) Background radiation means radiation from cosmic sources; naturally occurring radioactive materials, including radon, except as a decay product of source or special nuclear material, and including global fallout as it exists in the environment from the testing of nuclear explosive devices. Background radiation does not include sources of radiation from radioactive materials regulated by the department.
(13) Becquerel (Bq) means the SI unit of activity. One becquerel is equal to one disintegration or transformation per second (s-1).
(14) Bioassay means the determination of kinds, quantities or concentrations, and, in some cases, the locations of radioactive material in the human body, whether by direct measurement, in vivo counting, or by analysis and evaluation of materials excreted or removed from the human body. For purposes of these regulations, “radiobioassay” is an equivalent term.
(15) Byproduct material shall include:
(i) any radioactive material, except special nuclear material, yielded in or made radioactive by exposure to the radiation incident to the process of producing or utilizing special nuclear material;
(ii) the tailings or wastes produced by the extraction or concentration of uranium or thorium from ore processed primarily for its source material content, including discrete surface wastes resulting from uranium or thorium solution extraction processes; however, ore bodies depleted by these solution extraction operations do not constitute “byproduct material” within this definition;
(iii) any discrete source of radium-226 that is produced, extracted, or converted after extraction for use for a commercial, medical, or research activity;
(iv) any material that has been made radioactive by use of a particle accelerator and is produced, extracted, or converted after extraction for use for a commercial, medical, or research activity;
(v) any discrete source of naturally occurring radioactive material, other than source material, that is extracted or converted after extraction for use in a commercial medical or research activity that the Nuclear Regulatory Commission, in consultation with the Administrator of the Environmental Protection Agency, the Secretary of Energy, the Secretary of Homeland Security, and the head of any other appropriate Federal agency, determines would pose a threat similar to the threat posed by a discrete source of radium-226 to the public health and safety or the common defense and security.
(16) Calendar quarter means not less than 12 consecutive weeks nor more than 14 consecutive weeks. The fibst calendar quarter of each year shall begin in January and subsequent calendar quarters shall be so arranged such that no day is included in more than one calendar quarter and no day in any one year is omitted from inclusion within a calendar quarter. No licensee or registrant shall change the method used to determine calendar quarters for purposes of these regulations except at the beginning of a calendar year.
(17) Calibration means the determination of:
(i) the response or reading of an instrument relative to a series of known radiation values over the range of the instrument; or
(ii) the strength of a source of radiation relative to a standard.
(18) Certified radiation equipment safety officer means an individual who holds an unexpired certificate as a radiation equipment safety officer issued by the department.
(i) The requirements for certification as a radiation equipment safety officer are as follows:
(a) at least 18 years of age at the time of application; and
(b) good moral character; and
(c) graduation from a regionally accredited college or university, or one recognized by New York State, with a bachelor's degree in physical or natural science, mathematics or engineering; or four years of satisfying full-time paid experience in radiation protection or control; or an equivalent combination of the education and experience specified in this clause; and
(d) successful completion, after meeting the requirements of clauses ( a ), ( b ), and ( c ) of this subparagraph, of an examination prescribed by the department: and
(e) at least three years of satisfactory full-time paid experience in radiation protection or control including at least one year of experience dealing with radiation equipment, with the provision that up to two years of graduate training in physical or natural science, mathematics or engineering, may be substituted on a year for year basis for the required experience except for the one year of experience in radiation protection or control dealing with radiation equipment.
(ii) The department may accept in lieu of the requirements of clauses (i)( c ) and ( d ) of this paragraph a certificate in radiation protection or control issued by the American Board of Health Physics, the American Board of Radiology or the American Board of Medical Physics.
(iii) A person meeting all requirements of subparagraph (i) of this paragraph except the experience or experience substitute requirement of clause (i) ( e ) of this paragraph may be certified as a radiation equipment safety officer with the restriction that he/she perform surveys only under the supervision of a certified radiation equipment safety officer who meets the requirements of said clause ( e ).
(iv) A certification as a radiation equipment safety officer shall be issued by the department for a period not to exceed two years. Eligibility for renewal of a certificate shall be based on a work record as a certified radiation equipment safety officer that is in conformance with the regulations of the department. The certificate may be revoked for cause by the department on due notice.
(19) CFR means Code of Federal Regulations.
(20) Class means a classification scheme for inhaled material according to its rate of clearance from the pulmonary region of the lung. Materials are classified as D, W, or Y. which applies to a range of clearance half-times: for Class D, Days, of less than 10 days, for Class W, Weeks, from 10 to 100 days, and for Class Y, Years, of greater than 100 days. For purposes of these regulations, “lung class” and “inhalation class” are equivalent terms.
(21) Collective dose means the sum of the individual doses received in a given period of time by a specified population from exposure to a specified source of radiation.
(22) Collimator means a device or mechanism by which the X-ray or gamma-ray beam is restricted in size.
(23) Commissioner means the Commissioner of Health of the State of New York.
(24) Committed dose equivalent (HT,50) means the dose equivalent to organs or tissues of reference (T) that will be received from an intake of radioactive material by an individual during the 50-year period following the intake.
(25) Committed effective dose equivalent (H E,50) is the sum of the products of the weighing factors applicable to each of the body organs or tissues that are irradiated and the committed dose equivalent to each of these organs or tissues (HE, = Σ WT HT,50).
(26) Cone means a device used to indicate beam direction and to establish a minimum source-surface distance. It may or may not incorporate a collimator.
(27) Controlled area means any area the access to which is controlled for the purpose of protecting individuals from exposure to radiation and radioactive material, but shall not mean any area used as residential quarters. “Controlled area” as used in this Part is synonymous to “restricted area”.
(28) Curie means a unit of activity. One curie (Ci) is that quantity of radioactive material which decays at the rate of 3.7 × 1010; transformations per second (tps).
(29) Declared pregnant woman means a woman who has voluntarily informed her employer, in writing, of her pregnancy.
(30) Deep dose equivalent (Hd), which applies to external whole body exposure, means the dose equivalent at a tissue depth of one centimeter (1000 mg/cm2).
(31) Department means the New York State Department of Health and shall include its duly authorized representatives.
(32) Depleted uranium means the source material uranium in which the isotope uranium-235 is less than 0.711 weight percent of the total uranium present.
(33) Derived air concentration (DAC) means the concentration of a given radionuclide in air which, if breathed by the reference man for a working year of 2,000 hours under conditions of light work, results in an intake of one ALI. For purposes of these regulations, the condition of light work is an inhalation rate of 1.2 cubic meters of air per hour for 2,000 hours in a year. DAC values are given in Appendix 16-C, Table 1, Column 3, infra.
(34) Derived air concentration-hour (DAC-hour) means the product of the concentration of radioactive material in air, expressed as a fraction or multiple of the derived air concentration for each radionuclide, and the time of exposure to that radionuclide, in hours. A licensee or registrant may use 2,000 DAC-hours to represent one ALI, equivalent to a committed effective dose equivalent of 0.05 Sv (5 rem).
(35) Diagnostic type protective tube housing means X-ray tube housing so constructed that the leakage radiation at a distance of one meter from the source does not exceed 100 milliroentgens in one hour when the tube is operated at its maximum continuous rated current for the maximum rated tube potential.
(36) Diaphragm means a device or mechanism by which the X-ray or gamma-ray beam is restricted in size.
(37) Dose is a generic term that means absorbed dose, dose equivalent, effective dose equivalent, committed dose equivalent, committed effective dose equivalent, or total effective dose equivalent. For purposes of these regulations, “radiation dose” is an equivalent term.
(38) Dose equivalent (H T) means the product of the absorbed dose in tissue, quality factor, and all other necessary modifying factors at the location of interest. The units of dose equivalent are the sievert (Sv) and rem.
(39) Dose limits means the permissible upper bounds of radiation doses established in accordance with these regulations. For purposes of these regulations, “limits” is an equivalent term.
(40) Dosimetry processor means a person that processes and evaluates individual monitoring devices in order to determine the radiation dose delivered to the monitoring devices.
(41) Effective dose equivalent (HE) means the sum of the products of the dose equivalent to each organ or tissue (HT) and the weighting factor (W T) applicable to each of the body organs or tissues that are irradiated (HE = Σ WT HT).
(42) Embryo/fetus means the developing human organism from conception until the time of birth.
(43) Entrance or access point means any opening through which an individual or extremity of an individual could gain access to radiation areas or to licensed or registered radioactive materials. This includes entry or exit portals of sufficient size to permit human entry, irrespective of their intended use.
(44) Explosive material means any chemical compound, mixture, or device which produces a substantial instantaneous release of gas and heat spontaneously or by contact with sparks or flame.
(45) Exposure means either:
(i) being exposed to ionizing radiation or to radioactive material; or
(ii) the quotient of dQ by dm where“dQ” is the absolute value of the total charge of the ions of one sign produced in air when all the electrons (negatrons and positrons) liberated by photons in a volume element of air having mass “dm” are completely stopped in air. The special unit of exposure is the roentgen (R). One roentgen is equal to 2.58 × 10−4 coulomb per kilogram of air.
(46) Exposure rate means the exposure per unit of time, such as roentgen per minute and milliroentgen per hour.
(47) External dose means that portion of the dose equivalent received from any source of radiation outside the body.
(48) Extremity means hand, elbow, arm below the elbow, foot, knee, and leg below the knee.
(49) Eye dose equivalent means the external dose equivalent to the lens of the eye at a tissue depth of 0.3 centimeter (300 mg/cm2).
(50) Former U.S. Atomic Energy Commission (AEC) or U.S. Nuclear Regulatory Commission (NRC) licensed facilities means nuclear reactors, nuclear fuel reprocessing plants, uranium enrichment plants, or critical mass experimental facilities where AEC or NRC licenses have been terminated.
(51) Gray (Gy) means the SI unit of absorbed dose. One gray is equal to an absorbed dose of one joule/kilogram. One gray is equal to 100 rad.
(52) Half value layer (HVL) means the thickness of a specified substance which, when introduced into the path of a given beam of radiation, reduces the exposure rate by one-half.
(53) Health officer having jurisdiction means the commissioner or his/her designee, or the chief executive officer of the appropriate county or part-county health department or the New York City Department of Health, or the director of a state, regional, area or district office of public health.
(54) High radiation area means any area, accessible to individuals, in which radiation levels could result in an individual receiving a dose equivalent in excess of one mSv (0.1 rem) in one hour at 30 centimeters from any source or radiation or from any surface that the radiation penetrates. For purposes of these regulations, rooms or areas in which diagnostic X-ray systems are used for healing arts purposes are not considered high radiation areas.
(55) Human use means the internal or external administration of radiation of radioactive material to human beings.
(56) Image receptor shall mean any device, such as fluoroscopic input phosphor or radiographic film which transforms incident X-ray photons either into a visible image or into another form which can be made into a visible image by further transformation.
(57) Individual shall mean any human being.
(58) Individual monitoring means the assessment of:
(i) dose equivalent
(a) by the use of individual monitoring devices; or
(b) by the use of survey data; or
(ii) committed effective dose equivalent
(a) by bioassay; or
(b) by determination of the time-weighted air concentrations to which an individual has been exposed, that is, DAC-hours.
(59) Individual monitoring devices means devices designed to be worn by a single individual for the assessment of dose equivalent. For purposes of these regulations, individual monitoring equipment and personnel monitoring equipment are equivalent terms. Examples of individual monitoring devices are film badges, thermoluminescent dosimeters (TLDs), pocket dosimeters, and personal air sampling devices.
(60) Inherent filtration means the filtration permanently in the useful beam; it includes the window of the X-ray tube and any permanent tube or source enclosure.
(61) Inspection means an official examination or observation including, but not limited to, reviews of records, tests, surveys, and monitoring to determine compliance with rules, regulations, orders, requirements, and conditions of the department.
(62) Interlock means a device arranged or connected such that the occurrence of an event or condition is required before a second event or condition can occur or continue to occur.
(63) Internal dose means that portion of the dose equivalent received from radioactive material taken into the body.
(64) Kilovolt (kV) means a unit of electrical potential equal to 1000 volts. Kilovolt peak (kVp) means the crest value in kilovolts of the potential difference of a pulsating generator. When only one-half of the wave is used, the value refers to the useful half of the wave.
(65) Lead equivalent means the thickness of lead affording the same attenuation, under specified conditions, as the material in question.
(66) Leakage radiation means all radiation coming from within the source or tube housing except the useful beam.
(67) License means a radioactive material license issued by the department in accordance with the regulations adopted by the department. There are two types of licenses: general and specific. A general license means a license issued pursuant to the terms and conditions of Appendix 16-A, Table 6, infra. General licenses are effective without the filing of an application with or the issuance of a licensing document by the department. A specific license shall mean a license evidenced by a licensing document issued by the department to a licensee. A specific license also means a similar license issued by the State Department or Labor, the New York City Department of Health, the United States Nuclear Regulatory Commission or any agreement state. Unless otherwise specified, the type of license referred to in this Part will be a specific license.
(68) Licensed material means radioactive material received, possessed, used, transferred or disposed of under a general or specific license issued by the department.
(69) Licensee means any person who is licensed by the department in accordance with these regulations or one who possesses any radioactive material which is subject to the licensure requirements of this Part.
(70) Lost or missing licensed material means licensed material whose location is unknown. This definition includes licensed material that has been shipped but has not reached its planned destination and whose location cannot be readily traced in the transportation system.
(71) Member of the public means any individual, except an individual who is performing assigned duties for the licensee or registrant involving exposure to sources of radiation.
(72) Minor means an individual less than 18 years of age.
(73) Monitoring means the measurement or radiation, radioactive material concentrations, surface area activities or quantities of radioactive material and the use of the results of these measurements to evaluate potential exposures and doses. For purposes of these regulations, radiation monitoring and radiation protection monitoring are equivalent terms.
(74) NARM means any naturally occurring or accelerator-produced radioactive material. It does not include byproduct, source, or special nuclear material.
(75) Natural radioactivity means radioactivity of naturally occurring nuclides.
(76) Nuclear Regulatory Commission (NRC) means the U.S. Nuclear Regulatory Commission or its duly authorized representatives.
(77) Nonstochastic effect means a health effect, the severity of which varies with the dose and for which a threshold is believed to exist. Radiation-induced cataract formation is an example of a nonstochastic effect. For purposes of these regulations, a deterministic effect is an equivalent term.
(78) Occupational dose means the dose received by an individual in the course of employment in which the individual's assigned duties involve exposure to sources of radiation, whether in the possession or the licensee, registrant, or other person. Occupational dose does not include doses received: from background radiation, as a patient from medical practices, from voluntary participation in medical research programs, or as a member of the public.
(79) Operator means any person conducting the business or activities carried on within the radiation installation or having by law the administrative control of a radiation source whether as owner, lessee, contractor, or otherwise.
(80) Package means the packaging, together with its radioactive contents as presented for transport.
(81) Particle accelerator means any machine capable of accelerating electrons, protons, deuterons, or other charged particles in a vacuum and of discharging the resultant particulate or other radiation into a medium as energies usually in excess of 1 MeV.
(82) Person means any individual, corporation, partnership, firm, association, trust, estate, public or private institution, group, agency, political subdivision of this State, any other state or political subdivision or agency thereof, and any legal successor, representative, agent, or agency of the foregoing, but shall not include Federal government agencies.
(83) Personnel monitoring equipment (See individual monitoring devices).
(84) Professional practice means the practice of medicine, dentistry, podiatry, osteopathy or chiropractic.
(85) Professional practitioner means any person licensed or otherwise authorized under the State Education Law to practice a proressional practice.
(86) Protective apron means an apron made of radiation attenuating material(s), used to reduce exposure to radiation.
(87) Protective barrier means a barrier of radiation absorbing material(s) used to attenuate the useful beam and/or stray radiation to the degree required to assure compliance with sections 16.6 and 16.7 of this Part.
(88) Protective glove means a glove made of radiation absorbing material(s) used to reduce radiation exposure.
(89) Public dose means the dose received by a member of the public from exposure to sources of radiation. It does not include occupational dose, dose received from background radiation, dose received as a patient from medical practices. or dose from voluntary participation in medical research programs.
(90) [ Reserved ]
(91) Qualified expert means an individual having the knowledge and training to measure ionizing radiation, to evaluate safety techniques, and to advise regarding radiation protection needs, for example, individuals certified in the appropriate field by the American Board of Radiology or the American Board of Health Physics, or those having equivalent training and experience. With reference to the calibration of radiation therapy equipment, an individual having, in addition to the above qualifications, training and experience in the clinical applications of radiation physics to radiation therapy, for example, individuals certified in Therapeutic Radiological Physics or X-Ray and Radium Physics by the American Board of Radiology, or those having equivalent training and experience.
(92) Quality factor (Q) means the modifying factor, that is used to derive dose equivalent from absorbed dose.
(i) As used in these regulations, the quality factors for converting absorbed dose to dose equivalent are shown in Table I.
Table I
Quality Factors and Absorbed Dose Equivalents
| Type of radiation | Quality factor (Q) | Absorbed dose equal to a unit dose equivalent a | | --- | --- | --- | | X, gamma, or beta radiation and high-speed electrons | 1 | 1 | | Alpha particles, multiple-charged particles, fission fragments and heavy particles of unknown charge | 20 | 0.05 | | Neutrons or unknown energy | 10 | 0.1 | | High-energy protons | 10 | 0.1 |
a Absorbed dose in rad equal to 1 rem or the absorbed dose in gray equal to1 Sv.
(ii) If it is more convenient to measure the neutron fluence rate than to determine the neutron dose equivalent rate in sievert per hour or rem per hour, as provided in Table I, 0.01 Sv (1 rem) of neutron radiation of unknown energies may, for purposes of these regulations, be assumed to result from a total fluence or 25 million neutrons per square centimeter incident upon the body. If sufficient information exists to estimate the approximate energy distribution or the neutrons, the licensee or registrant may use the fluence rate per unit dose equivalent or the appropriate Q value from Table II to convert a measured tissue dose in gray or rad to dose equivalent in sievert or rem.
Table II
Mean Quality Factors, Q, and Fluence per Unit Dose Equivalent for Monoenergetic Neutrons
| Neutron energy (MeV) | Quality factor a | Fluence per unit dose equivalent b | Fluence per unit dose equivalent b | | --- | --- | --- | --- | | (thermal) 2.5 × 10−8 | 2 | 980 × 106 | 980 × 108 | | 1 × 10−7 | 2 | 980 × 106 | 980 × 108 | | 1 × 10−6 | 2 | 810 × 106 | 810 × 108 | | 1 × 10−5 | 2 | 810 × 106 | 810 × 108 | | 1 × 10−4 | 2 | 840 × 106 | 840 × 108 | | 1 × 10−3 | 2 | 980 × 106 | 980 × 108 | | 1 × 10−2 | 2.5 | 1010 × 106 | 1010 × 108 | | 1 × 10−1 | 7.5 | 170 × 106 | 170 × 108 | | 5 × 10−1 | 11 | 39 × 106 | 39 × 108 | | 1 | 11 | 27 × 106 | 27 × 188 | | 2.5 | 9 | 29 × 106 | 29 × 108 | | 5 | 8 | 23 × 106 | 23 × 108 | | 7 | 7 | 24 × 106 | 24 × 108 | | 10 | 6.5 | 24 × 106 | 24 × 108 | | 14 | 7.5 | 17 × 106 | 17 × 108 | | 20 | 8 | 16 × 106 | 16 × 108 | | 40 | 7 | 14 × 106 | 14 × 108 | | 60 | 5.5 | 16 × 106 | 16 × 108 | | 1 × 102 | 4 | 20 × 106 | 20 × 108 | | 2 × 102 | 3.5 | 19 × 106 | 19 × 108 | | 3 × 102 | 3.5 | 16 × 106 | 16 × 108 | | 4 × 102 | 3.5 | 14 × 106 | 14 × 108 |
a Value of quality factor (Q) at the point where the dose equivalent is maximum in a 30-cm diameter cylinder tissue-equivalent phantom.
b Monoenergetic neutrons incident normally on a 30-cm diameter cylinder tissue-equivalent phantom.
(93) Quarter (See Calendar quarter).
(94) Rad means the special unit of absorbed dose. One rad is equal to an absorbed dose of 100 erg/gram or 0.01 jouie/kilogram (0.01 gray). One millirad equals 0.001 rad.
(95) Radiation means alpha particles, beta particles, gamma rays, X-rays, neutrons, high-speed electrons, high-speed protons, and other particles capable of producing ions. For purposes of these regulations, ionizing radiation is an equivalent term. Radiation, as used in these regulations, does not include non-ionizing radiation, such as radiowaves or microwaves, visible, infrared, or ultraviolet light.
(96) Radiation area means any area, accessible to individuals, in which radiation levels could result in an individual receiving a dose equivalent in excess or 0.05 mSv (0.005 rem) in 1 hour at 30 centimeters from the source of radiation or from any surface that the radiation penetrates.
(97) Radiation equipment means any equipment or device which can emit radiation by virtue of the application thereto of high voltage.
(98) Radiation installation means place, facility or mobile unit where radiation equipment, in operable condition or intended to be used, is located or used, or where radioactive material is transferred, received, possessed or used including generally a hospital; medical, dental, chiropractic, osteopathic, podiatric, or veterinarian institution, clinic or office; educational institution; commercial, private or research laboratory performing diagnostic procedures or handling equipment or material for medical use; or any trucking, storage, messenger or delivery service establishment. Radiation installation shall include, whether or not it is specifically stated above, any place, facility or mobile unit where radiation is applied intentionally to a human. The limits of the radiation installation area shall be as designated by the operator.
(99) Radiation safety officer shall mean an individual who, under the authorization of the operator or a radiation installation, administers a radiation protection program in accordance with section 16.5 of this Part and who is qualified by training and experience in radiological health to evaluate the radiation hazards of such installation and administer such radiation protection program.
(i) For human use radiation equipment installations, the radiation safety officer (RSO) shall be:
(a) a professional practitioner as defined in paragraph (85) of this subdivision, practicing within his/her professional practice as defined in paragraph (84) of this subdivision; or
(b) a physicist certified by the American Board of Health Physics or the American Board of Radiology in a branch of physics related to the type of use of radiation sources in the installation, or, an individual with equivalent training and experience.
(ii) For non-human use radiation equipment installations, the radiation safety officer shall be:
(a) a veterinarian for veterinary installations; or
(b) a physicist certified by the American Board or Health Physics, the American Board of Radiology, or, an individual with equivalent training and experience; or
(c) a researcher determined by the institution as qualified by training and experience for installations using only X-ray diffraction and fluorescence analysis equipment.
(iii) For licensed radioactive materials installations, the radiation safety officer shall be:
(a) an authorized user named on the radioactive materials license issued by this department; or
(b) a physicist certified by the American Board of Health Physics or the American Board of Radiology in a branch of physics related to the type of use of radioactive material in the installation, or, an individual with equivaient training and experience.
(100) Radiation source means any radioactive material or any radiation equipment.
(101) Radioactive material means any solid, liquid, or gas which emits radiation spontaneously.
(102) Radioactivity means the transformation of unstable atomic nuclei by the emission of radiation.
(103) Radiobioassay (See Bioassay).
(104) Reference man means a hypothetical aggregation of human physical and physiological characteristics determined by international consensus. These characteristics may be used by researchers and public health workers to standardize results of experiments and to relate biological insult to a common base.
(105) Registrant means any person who is registered with the department or is legally obligated to register with the department pursuant to these regulations.
(106) Registration means registration with the department in accordance with these regulations.
(107) Rem means the special unit of any of the quantities expressed as dose equivaient. The dose equivalent in rem is equal to the absorbed dose in rad multiplied by the quality factor (one rem = 0.01 sievert).
(108) Research and development means:
(i) theoretical analysis, exploration, or experimentation; or
(ii) the extension of investigative findings and theories of a scientific or technical nature into practical application for experimental and demonstration purposes, including the experimental production and testing of models, devices, equipment, materials, and processes. Research and development does not include the internal or external administration of radiation or radioactive material to human beings.
(109) Respiratory protective equipment means an apparatus, such as a respirator, used to reduce an individual's intake of airborne radioactive material.
(110) Restricted area means any area, access to which is limited by the licensee or registrant for the purpose of protecting individuals against undue risks from exposure to sources of radiation. A restricted area does not include areas used as residential quarters, but separate rooms in a residential building may be set apart as a restricted area.
(111) Roentgen means the special unit or exposure. One roentgen (R) equals 2.58 × 10−4 coulombs/kilogram of air (See Exposure).
(112) Sanitary sewerage means a system of public sewers for carrying off waste and refuse, but excluding sewage treatment facilities, septic tanks, and leach fields owned or operated by the licensee or registrant.
(113) Scattered radiation means radiation whose direction has been altered during passage through matter. (It may have been modified also by a decrease in energy.)
(114) Sealed source means radioactive material that is permanently bonded or fixed in a capsule or matrix designed to prevent release and dispersal of the radioactive material under the most severe conditions which are likely to be encountered in normal use and handling.
(115) Shallow dose equivalent (H5), which applies to the external exposure of the skin or an extremity, means the dose equivalent at a tissue depth of 0.007 centimeter (7 mg/cm 2) averaged over an area of one square centimeter.
(116) Shutter means:
(i) in beam therapy equipment, an adjustable device, generally of lead, fixed to the X- or gamma-ray source housing to intercept or collimate the useful beam; or
(ii) in diagnostic equipment, an adjustable device used to collimate the useful beam.
(117) SI means an abbreviation of the International System of Units.
(118) Sievert means the SI unit of any of the quantities expressed as dose equivalent. The dose equivalent in sievert is equal to the absorbed dose in gray multiplied by the quality factor (one Sv = 100 rem).
(119) Site boundary means that line beyond which the land or property is not owned, leased, or otherwise controlled by the licensee or registrant.
(120) Source material means:
(i) uranium or thorium, or any combination thereof, in any physical or chemical form; or
(ii) ores that contain by weight one-twentieth of one percent (0.05 percent) or more of uranium, thorium, or any combination of uranium and thorium. Source material does not include special nuclear material.
(121) Source of radiation means any radioactive material or any device or equipment emitting, or capable of producing, radiation.
(122) Source-skin distance (source-surface distance) means the distance measured along the central ray from the center of the front surface of the source (X-ray focal spot or sealed radioactive source) to the surface of the irradiated object.
(123) Special form radioactive material means radioactive material which satisfies the following conditions:
(i) it is either a single solid piece or is contained in a sealed capsule that can be opened only by destroying the capsule;
(ii) the piece or capsule has at least one dimension not less than five millimeters (0.197 inch); and
(iii) it satisfies the additional requirements specified in section 71.4, special form radioactive material, of 10 CFR 71 (see section 16.200 of this Part).
(124) Special nuclear material means:
(i) plutonium, uranium-233, uranium enriched in the isotope 233 or in the isotope 235, and any other material that the U.S. Nuclear Regulatory Commission, pursuant to the provisions of section 51 of the Atomic Energy Act of 1954, as amended, determines to be special nuclear material, but does not include source material; or
(ii) any material artificially enriched by any of the foregoing but does not include source material.
(125) Special nuclear material in quantities not sufficient to form a critical mass means uranium enriched in the isotope U-235 in quantities not exceeding 350 grams of contained U-235; uranium-233 in quantities not exceeding 200 grams; plutonium in quantities not exceeding 200 grams; or any combination or them in accordance with the following formula: For each kind of special nuclear material, determine the ratio between the quantity of that special nuclear material and the quantity specified above for the same kind of special nuclear material. The sum of such ratios for all of the kinds of special nuclear material in combination shall not exceed one. For example, the following quantities in combination would not exceed the limitation and are within the formula:
175 (grams contained U-235)/350+ 50 (grams U-233)/200+ 50 (grams Pu)/200 = 1
(126) State means the State of New York, unless the context of this Part clearly indicates that a different meaning is intended.
(127) Stochastic effect means a health effect that occurs randomly and for which the probability of the effect occurring, rather than its severity, is assumed to be a function of dose without threshold. Hereditary effects and cancer incidence are examples of stochastic effects. For purposes of these regulations, probabilistic effect is an equivalent term.
(128) Stray radiation means the sum of leakage and scattered radiation.
(129) Supervision as used in radioactive materials licenses means the training of persons in the use of radioactive materials in other than medical procedures. Such training must include at least 30 hours of instruction in the principles and practices of radiation protection, radioactivity measurement standardization and monitoring techniques and instruments, mathematics and calculations basic to the use and measurement of radioactivity, and biological effects of radiation.
(130) Survey means an evaluation of the radiological conditions and potential hazards incident to the production, use, transfer, release, disposal, or presence of sources of radiation. When appropriate, such evaluation includes, but is not limited to, tests, physical examinations, and measurements of levels of radiation or concentrations of radioactive material present.
(131) Therapeutic type protective tube housing means:
(i) for X-ray therapy equipment not capable of operating at 500 kVp or above, an X-ray tube housing so constructed that the leakage radiation at a distance of one meter from the source does not exceed one roentgen in an hour when the tube is operated at its maximum rated continuous current for the maximum rated tube potential; or
(ii) for X-ray therapy equipment capable of operation at 500 kVp or above, an X-ray tube housing so constructed that leakage radiation at a distance of one meter from the source does not exceed 0.1 percent of the useful beam dose rate at one meter from the source for any of its operating conditions.
(132) These regulations mean all parts of Part 16 of the State Sanitary Code.
(133) Total effective dose equivalent (TEDE) means the sum of the deep dose equivalent for external exposures and the committed effective dose equivalent for internal exposures.
(134) [ Reserved ]
(135) U.S. Department of Energy means the Department of Energy established by Public Law 95-91, August 4, 1977, 91 Stat. 565, 42 U.S.C. 7101 et seq., to the extent that the department exercises functions formerly vested in the U.S. Atomic Energy Commission, its chairman, members, officers and components and transferred to the U.S. Energy Research and Development Administration and to the administrator thereof pursuant to sections 104(b), (c) and (d) of the Energy Reorganization Act of 1974 (Public Law 93-438, October 11, 1974, 88 Stat. 1233 at 1237, 42 U.S.C. 5814, effective January 19, 1975) and transferred to the Secretary of Energy pursuant to section 301(a) of the Department of Energy Organization Act (Public Law 95-91, August 4, 1977, 91 Stat. 565 at 577-578, 42 U.S.C. 7151, effective October 1, 1977.)
(136) Unrefined and unprocessed ore means ore in its natural form prior to any processing, such as grinding, roasting, beneficiating, or refining.
(137) Use as used in radioactive materials licenses means to employ or apply radioactive materials for the licensed purpose. It shall include instruction of, and responsibility for, technical and support staff members. It does not include training others in the techniques of use of radioactive materials for the purpose of qualifying for licensure. In licenses authorizing human use of radioactive materials use will also include:
(i) ordering or directing the administration of radiation of radioactive materials to humans, including the method or route of administration;
(ii) actual use of, or direction of technologists or other paramedical personnel in the use of, radioactive material;
(iii) interpretation of results of diagnostic procedures; and
(iv) regular view or the progress of patients receiving therapy and modification of the originally prescribed dose as warranted by the patient's reaction to radiation therapy.
(138) Useful beam means the radiation which passes through the source or tube-housing port and the aperture of the collimating device when the exposure switch or timer is activated.
(139) Very high radiation area means an area, accessible to individuals, in which radiation levels could result in an individual receiving an absorbed dose in excess of five Gy (500 rad) in one hour at one meter from a source of radiation or from any surface that the radiation penetrates.3
(140) Waste handling licensees mean persons licensed to receive and store radioactive wastes prior to disposal and/or persons licensed to dispose of radioactive wastes.
(141) Week means seven consecutive days starting on Sunday.
(142) Weighting factor WT for an organ or tissue (T) means the proportion or the risk of stochastic effects resulting from irradiation or that organ or tissue to the total risk or stochastic effects when the whole body is irradiated uniformly. For calculating the effective dose equivalent, the values of WT are:
Organ Dose Weighting Factors
| Organ or tissue | WT | | --- | --- | | Gonads | 0.25 | | Breast | 0.15 | | Red Bone Marrow | 0.12 | | Lung | 0.12 | | Thyroid | 0.03 | | Bone Surfaces | 0.03 | | Remainder | 0.30 a | | Whole Body | 1.00 b |
a 0.30 results from 0.06 for each of five “remainder” organs, excluding the skin and the lens of the eye, that receive the highest doses.
b For purposes of weighting the external whole body dose, for adding it to the internal dose, a single weighting factor, W T = 1.0, has been specified. The use of other weighting factors for external exposure will be approved on a case-by-case basis until such time as specific guidance is issued.
(143) Whole body means, for purposes of external exposure, head, trunk (including male gonads), arms above the elbow, or legs above the knee.
(144) Worker means an individual engaged in work under a license or registration issued by the department and controlled by a licensee or registrant, but does not include the licensee or registrant.
(145) Working level (WL) means any combination of short-lived radon daughters in 1 liter of air that will result in the ultimate emission of 1.3 × 105 MeV of potential alpha particle energy. The short-lived radon daughters, are — for radon-222: polonium-218, lead-214, bismuth-214, and polonium-214; and for radon-220: polonium-216, lead-212, bismuth-212, and polonium-212.
(146) Working level month (WLM) means an exposure to one working level for 170 hours —2,000 working hours per year divided by 12 months per year is approximately equal to 170 hours per month.
(147) Year means the period of time beginning in January used to determine compliance with the provisions of these regulations. The licensee or registrant may change the starting date of the year used to determine compliance by the licensee or registrant provided that the change is made at the beginning of the year and that no day is omitted or duplicated in consecutive years.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.77 Practitioners; control and reporting of official New York State prescription forms and electronic prescribing credentials
(a) Adequate safeguards and security measures shall be undertaken by practitioners holding official New York State prescription forms to assure against the loss, destruction, theft or unauthorized use of the forms. Practitioners shall maintain a record of the disposition of all forms, including but not limited to use as a prescription, cancellation, return, loss, destruction, unauthorized use and nonreceipt. The forms may be used only by the practitioner to whom they are issued and are not transferable.
(b) Practitioners shall immediately notify the department, upon forms supplied by the department, of the loss, destruction, theft or unauthorized use of any official New York State prescription forms issued to them, as well as the failure to receive official New York State prescription forms within a reasonable time after ordering them from the department.
(c) Practitioners shall retain sole possession and safeguard credentials used to sign electronic prescriptions for controlled substances and shall not share such credentials with any other person. The practitioner shall not allow any other person to use such credentials to sign prescriptions for controlled substances.
(d) Practitioners shall immediately notify the Bureau of Narcotic Enforcement that his or her credentials used to sign electronic prescriptions for controlled substances have been lost, stolen or compromised.
(e) Practitioners shall immediately notify the Bureau of Narcotic Enforcement upon discovery that one or more prescriptions issued under that practitioner’s DEA registration were prescriptions the practitioner had not signed or were not consistent with the prescription the practitioner signed.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-4.51 Refrigerated storage
Enough conveniently located refrigeration facilities or effectively insulated facilities are to be provided and used to maintain potentially hazardous food at required temperatures during storage. Each facility storing potentially hazardous food is to have a numerically scaled indicating thermometer, accurate to plus or minus 2°F (1.1°C), which measures air temperature in the warmest part of the unit.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 121 JEFFERSON COUNTY
VILLAGES VILLAGES
10 CRR-NY 121.2 Village of West Carthage
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Pleasant Lake and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Village of West Carthage, Jefferson County, New York and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of West Carthage public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial wastes or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the Village of West Carthage public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Village of West Carthage public water supply.
(16) Water supply shall mean the public water supply of the Village of West Carthage, Jefferson County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 25 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or on transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 25 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyard.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Herbicides, pesticides, and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction over such facility.
(i) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(j) General clause.
No person including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the following standards for raw water quality:
| Items | Specifications | | --- | --- | | 1. Floating solids; settleable solids; oil; sludge deposits; tastes or odor producing substances | Nonattributable to sewage, industrial wastes or other wastes. | | 2. Sewage or wastes effluents | None which are not effectively disinfected. | | 3. pH | Range between 6.5 and 8.5. | | 4. Dissolved oxygen | For trout waters, greater than 5.0 parts per million; for nontrout waters greater than 4.0 parts per million. | | 5. Toxic wastes, oil, deleterious substances, colored or other wastes or heated liquids | None alone or in combination with other substances or wastes in sufficient amounts or at such temperatures as to make the waters unsafe or unsuitable as a source of water supply for drinking, culinary or food processing purposes. Provided further, that the concentration or quantity of the constituents or characteristics hereinafter set forth shall not exceed the allowable limits established therefor. |
| Constituent or Characteristic | Allowable Limits | | --- | --- | | Physical | 5 units | | Turbidity | | | Microbiological | | | Coliform organism | 50 per 100 ml. | | Inorganic chemicals | (Concentration in mg/1) | | Ammonia (NH3) | <2.0 | | Arsenic (As) | 0.05 | | Barium (Ba) | 1.0 | | Boron (B) | 1.0 | | CCE | 0.2 | | Cadmium (Cd) | 0.01 | | Chloride (Cl) | 250. | | Chromium (Hexavalent) (Cr + 6) | 0.05 | | Copper (Cu) | <0.2 | | Cyanide (CN) | <0.1 | | Fluoride (F) | <1.5 | | Lead (Pb) | 0.05 | | Mercury (Hg) | 0.005 | | Nitrates (No2) Nitrites (NO2) | 10. | | Selenium (Se) | 0.01 | | Silver (Ag) | 0.05 | | Sodium (Na) | <20. | | Sulfate (SO4) | 250. | | Total dissolved solids | 500. | | Uranyl ion | <5.0 | | Zinc (Zn) | <0.3 | | Organic Chemicals | (Concentraton in mg/1) | | Organic nitrogen | 0.5 | | Oxygen consumed | 2.0 | | Phenols | 0.001 | | Pesticides | | | Aldrin | 0.017 | | Chlordane | 0.008 | | DDT | 0.042 | | Dieldrin | 0.017 | | Endrin | 0.001 | | Heptachlor | 0.018 | | Heptachlor epoxide | 0.018 | | Herbicides | 0.1 | | Lindane | 0.056 | | Methoxychlor | 0.085 | | Organic phosphates + carbamates | 0.1 | | Toxaphene | 0.005 | | Radioactivity | (Concentration in pc/1) | | Gross beta | 1000. | | Radium-226 | 8. | | Strontium-90 | 10. |
(k) Inspections.
The board of trustees of the Village of West Carthage or any duly appointed person or persons as may be charged with maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses, and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid board of trustees of the Village of West Carthage or any such duly appointed person or persons as may be charged with maintenance or supervision of the water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notice of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees of the Village of West Carthage or any such duly appointed person or persons as may be charged with maintenance or supervision of the water supply to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees of the Village of West Carthage or any duly appointed person or persons as may be charged with maintenance or supervision of the water supply shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(l) Penalty.
Penalties for violations of these rules and regulations shall be those prescribed by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.5 Fees for copying records
(a) Fees for certification of copies and supplying transcripts of all documents and records under the seal of the State Commissioner of Health shall be the fees as prescribed by the Public Health Law or applicable regulation of the department.
(b) Fees for photocopies or data printouts of records available pursuant to this Subpart shall be 25 cents per page and $60 for transfer of computer files to a requestor's computer tape.
(c) Except where fees are established by law, rule or regulation, no fee shall be charged for:
(1) inspection of a record;
(2) record searches;
(3) certification pursuant to this Subpart; and
(4) publications of the department provided free to residents of the State of New York.
(d) Fees shall be paid in full or a valid offer made to pay established fees prior to issuance of copies, transcripts or certification of records.
(e) Payment shall be made in the form of a check, bank draft, or money order payable to the New York State Department of Health, or if personally delivered may be made in cash for which a receipt shall be given.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.17 Compliance with application conditions
The operator of a medical facility shall comply with all conditions, limitations or other requirements imposed by the Public Health Council or commissioner in conjunction with the approval of any application for establishment or construction for such medical facility pursuant to the provisions of sections 2801-a and 2802 of the Public Health Law and this Chapter.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.85 Product thermometers
Metal stem-type, numerically scaled, indicating thermometers accurate to plus or minus two degrees Fahrenheit (1.1 degrees Celsius) are to be provided and used to determine that proper internal cooking, holding or refrigeration temperatures of all potentially hazardous foods are obtained and maintained.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.3 Informed consent
(a) Nontransplant anatomic banks that recover bodies, body segments, organs or tissues from deceased donors, including whole body acquisition services, shall obtain documented informed consent to the donation from a person authorized to consent to such donation in accordance with Public Health Law, section 4301, or, for recoveries outside New York State, applicable statutes in the state where the nontransplant anatomic parts were recovered.
(b) Nontransplant anatomic banks that recover body segments, organs or tissues from living donors shall obtain documented informed consent from the donors.
(c) If specific direction is not provided in the consent document, it shall be presumed that whole bodies, body segments, and other nontransplant anatomic parts have been donated to entities authorized to receive the bodies of deceased persons pursuant to subdivision (1) of Public Health Law section 4211 and in accordance with the priorities established therein. Such entities may transfer or authorize the transfer of whole bodies, body segments and other nontransplant anatomic parts to other donees specified in subdivisions (1) and (2) of Public Health Law section 4302 for purposes of:
(1) medical or dental education;
(2) medical or dental research; and/or
(3) the advancement of medical or dental science, therapy or transplantation.
(d) The documentation of informed consent to a donation shall identify the donee, indicate whether the gift is of the whole body or is limited to specified identifiable body segments, organs or tissues, and clearly specify the authorized uses of such donated body, body segments, organs, and/or tissues. Consent obtained by telephone shall be electronically recorded or documented in writing by the nontransplant anatomic bank. Electronically recorded telephone consent shall be put in the form of written documentation of consent for donation prior to using whole bodies, body segments, organs and tissues in education and/or research.
(e) Except as provided in subdivision (c) of this section, no nontransplant anatomic bank shall use or transfer bodies, body segments or other nontransplant anatomic parts for any purpose not specified in the consent.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
COMPANIES COMPANIES
10 CRR-NY 148.38 Lake Louise Marie Water Company, Inc
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Lake Louise Marie and its tributaries and to any reservoirs which now serve or which may be developed in the future to serve as sources of the public water supply of the Lake Louise Marie Water Company, Inc., Sullivan County, New York and to all watercourses tributary thereto or ultimately discharging into Lake Louise Marie or said reservoirs.
(b) Definitions.
(1) Herbicides shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the water supply of the Lake Louise Marie Water Company, Inc.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the water supply of the Lake Louise Marie Water Company, Inc.
(15) Watershed shall mean the entire drainage area contributing water to the water supply of the Lake Louise Marie Water Company, Inc.
(16) Water supply shall mean the public water supply of the Lake Louise Marie Water Company, Inc., Sullivan County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or water course and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except:
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle, or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in Lake Louise Marie within 500 feet of the water supply intakes.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of Lake Louise Marie.
(j) Boating.
No boats with motors utilizing fossil fuel shall be allowed in or upon the waters of Lake Louise Marie or upon the waters of any reservoir serving as a source of the water supply of the Lake Louise Marie Water Company, Inc., except by duly authorized employees of the Lake Louise Marie Water Company, Inc., in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon Lake Louise Marie or upon any reservoir serving as a source of the water supply of the Lake Louise Marie Water Company, Inc. within 500 feet of the water supply intakes except by duly authorized employees of the Lake Louise Marie Water Company, Inc., in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemical.
No herbicides, pesticides or toxic chemical shall be discharged, applied or allowed to enter into Lake Lorries Marie or any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of Lake Louise Marie or any reservoir or watercourse serving as a source of the water supply of Lake Louise Marie Water Company, Inc.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The Lake Louise Marie Water Company, Inc., shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Lake Louise Marie Water Company, Inc., to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. The aforesaid Lake Louise Marie Water Company, Inc., shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.15 Rates for residential health care facilities without adequate cost experience
(a)
(1) This subdivision shall apply where the fiscal and statistical data of the facility are unavailable through no fault of the provider or its agents, and due to circumstances beyond its control, or when there is a new facility without adequate cost experience as set forth in section 86-2.2(e) of this Subpart.
(2) The appointment of a receiver or the establishment of a new operator for an ongoing facility shall not be considered a new facility for the purposes of this section. Reimbursement for such receiver or new operator shall be in accordance with sections 86-2.10 and 86-2.11 of this Subpart.
(b) The rates certified for such residential health care facilities as set forth in subdivision (a) of this section, shall be determined in accordance with the following:
(1) Except as identified in paragraphs (5), (6) and (7) of this subdivision, for the first three months of operation, the direct component of the rate shall be equivalent to the statewide mean direct case mix neutral cost per day after application of the RDIPAF as determined pursuant to section 86-2.10 of this Subpart. The facility shall perform an assessment of all patients, pursuant to section 86-2.30 of this Subpart, at the beginning of the fourth month of operation and at the beginning of each third month thereafter until the end of the 12-month cost report period referred to in section 86-2.2(e) of this Subpart or if applicable, the six-month cost report period identified in subdivision (e) of this section. The direct component of the rate shall be adjusted pursuant to section 86-2.10 of this Subpart, effective the first day of the month of each assessment period, based on the facility's case mix.
(2) Except as identified in paragraphs (5), (6) and (7) of this subdivision, for the first three months of operation, the indirect component of the rate shall be equivalent to a blended mean price for the applicable affiliation group as identified in section 86-2.10(d) of this Subpart. The blended mean price shall be established using a proportion of 60 residents in the high case mix index peer group and 40 residents in the low case mix index peer group both as identified in section 86-2.10(d) of this Subpart, adjusted by the RIIPAF. Effective on the first day of the fourth month, the indirect component shall be the mean price determined using the facility's PRI's and adjusted by the RIIPAF.
(3) The noncomparable component of the rate shall be determined on the basis of the generally applicable factors, including but not limited to the following:
(i) satisfactory cost projections:
(ii) allowable actual expenditures; and
(iii) an anticipated average utilization of no less than 90 percent.
(4) Rates established pursuant to this subdivision shall also include an adjustment pursuant to section 86-2.10(u) of this Subpart.
(5) Acquired Immune Deficiency Syndrome (AIDS). Except as identified in subparagraph (v) of this paragraph, a facility which is approved as a distinct AIDS facility or has a discrete AIDS unit pursuant to Part 710 of this Title, shall have rates established pursuant to this subdivision as follows:
(i) The direct component of the rate shall be determined in accordance with paragraph (1) of this subdivision provided, however, that the direct mean rate for the first three months of operation shall be determined pursuant to an approved facility's projection of case mix. The direct component of the rate shall be enhanced by an increment which shall be determined on the basis of the difference between budgeted costs of care and staffing levels for AIDS patients in specific patient classification groups and the costs of care and staffing levels for non-AIDS patients which are classified in the same patient classification groups based on data submitted by a facility. The increment to be included in the facility's rate pursuant to this subparagraph shall be approved by the commissioner, but in no event shall the increment be greater than 1.0. The direct component of the rate shall also be increased by an occupancy factor of 1.225.
(ii) The indirect component shall be determined in accordance with paragraph (2) of this subdivision provided, however, that the indirect mean price for the first three months of operation shall be determined pursuant to an approved facility's projection of case mix. The indirect component of the rate shall be increased by the AIDS factor as determined pursuant to section 86-2.10(p) of this Subpart.
(iii) The allowable costs for the central service supply functional cost center as listed in section 86-2.10(c)(1) of this Subpart shall be considered a noncomparable cost.
(iv) Rates developed pursuant to this paragraph shall remain in effect until a facility submits 12-month financial and statistical data pursuant to section 86-2.2(e) of this Subpart.
(v) Notwithstanding the provisions of subparagraphs (i), (ii) and (iii) of this paragraph, any facility which prior to April 1, 1991 has a rate approved and certified by the commissioner pursuant to section 2807 of the Public Health Law, which includes AIDS specific adjustments pursuant to this Subpart, or has been approved as an AIDS specific facility by the Public Health Council, and/or has had a certificate of need application approved or conditionally approved pursuant to Part 710 of this Title for the operation of a discrete AIDS unit shall have its rate determined in accordance with the following:
(a) The direct component of the rate shall be based on the statewide ceiling direct case mix neutral cost per day after application of the RDIPAF as determined pursuant to section 86-2.10 of this Subpart and a case mix proxy for AIDS patients established by this subparagraph, and increased by an occupancy factor of 1.225. The case mix proxy for AIDS patients shall be determined as follows:
(1) A facility which was approved based on a written application for establishment and/or construction which indicated that a majority of its AIDS patients would fall into patient classification groups with a case mix index exceeding 0.83 prior to application of any AIDS factors or increments identified in this subdivision shall be assigned a case mix proxy as determined by the following:
(i) For its first three months of operation, the facility shall be assigned a case mix proxy of 2.32.
(ii) Beginning with the start of the fourth month of operation, and pursuant to the facility's performance of patient assessments referred to in paragraph (b)(1) of of this section, an AIDS patient shall be assigned a case mix proxy based on the sum of responses to section III - Activities of Daily Living (ADL's), questions 19, 21, and 22 of the patient review instrument (PRI) as contained in section 86-2.30(i) of this Subpart as follows:
| ADL TOTAL | CASE MIX PROXY | | --- | --- | | 3-6 | 2.18 | | 7-8 | 2.32 | | 9 | 2.64 |
(2) A facility which was approved based on a written application for establishment and/or construction which indicated a majority of its AIDS patients would fall into patient classification groups with a case mix index equal to or less than 0.83 prior to application of any AIDS factors or increments identified in this subdivision shall have a case mix proxy equal to 1.55. This case mix proxy shall remain in effect until a facility submits financial and statistical data pursuant to section 86-2.2(e) of this Subpart.
(3)
(i) The indirect component of the rate for facilities identified in subclause ( 1 ) of this clause shall be equivalent to the indirect ceiling price per day of the high intensity peer group established pursuant to section 86-2.10(d)(2) of this Subpart after application of the RIIPAF as determined pursuant to section 86-2.10 of this Subpart and increased by the indirect AIDS factor as determined pursuant to section 86-2.10(p) of this Subpart.
(ii) The indirect component of the rate for facilities identified in subclause ( 2 ) of this clause shall be equivalent to the ceiling indirect price per day of the low intensity peer group established pursuant to section 86-2.10(d)(2) of this Subpart after application of the RIIPAF as determined pursuant to section 86-2.10 of this Subpart and increased by the indirect AIDS factor as determined pursuant to section 86-2.10(p) of this Subpart.
(4) For purposes of this subparagraph, the allowable costs for the central service supply functional cost center as listed in section 86-2.10(c)(1) shall be considered a noncomparable cost.
(5) Rates developed pursuant to this subparagraph shall remain in effect until a facility submits financial and statistical data pursuant to section 86-2.2(e) of this Subpart.
(6) Long-term inpatient rehabilitation program for traumatic brain-injured residents (TBI).
A facility which is approved to operate discrete units for the care of residents under the long-term inpatient rehabilitation program for TBI patients established pursuant to section 415.36 of this Title shall have separate and distinct payment rates established pursuant to this subdivision as follows:
(i) For the first three months of operation, the direct component shall be equivalent to the statewide mean direct case mix neutral cost per day established pursuant to subparagraph (c)(3)(iii) of section 86-2.10 of this Subpart increased by a factor of 3.28 and adjusted by the RDIPAF pursuant to section 86-2.10 of this Subpart. The direct component shall be further increased by an occupancy factor of 1.225 for the first six months of operation. The facility shall perform an assessment of all residents, pursuant to section 86-2.30 of this Subpart, at the beginning of the fourth month of operation and at the beginning of each third month for the period set forth in paragraph (1) of this subdivision. Effective on the first day of the month of each assessment period, the direct component of the rate shall be adjusted pursuant to section 86-2.10(c) of this Subpart based on the facility's case mix. The case mix index which is used to establish the facility specific mean direct price per day for each patient classification group pursuant to section 86-2.10(c)(4) of this Subpart for TBI residents shall be increased by an increment of 1.49.
(ii) The indirect component of the rate shall be equivalent to the mean indirect price developed pursuant to section 86-2.10(d) of this Subpart for the applicable peer group established for high intensity case mix identified in section 86-2.10(d)(2) of this Subpart, adjusted by the RIIPAF pursuant to section 86-2.10(d) of this Subpart. The indirect component shall be further adjusted by an occupancy factor of 1.225 for the first six months of operation.
(iii) The noncomparable component of the rate shall be determined as follows:
(a) For an existing facility that opens a discrete unit for the care of patients under the long-term inpatient rehabilitation program for TBI patients, the noncomparable component of the rate shall be equal to the noncomparable component of the existing residential health care facility's rate computed pursuant to section 86-2.10(f) of this Subpart plus approved budgeted costs for personnel required by section 415.36 of this Title that would be reported in the functional cost centers identified in section 86-2.10(f) of this Subpart.
(b) For a new facility without a residential health care facility rate computed pursuant to section 86-2.10 of this Subpart, the noncomparable component of the rate shall be determined in accordance with paragraph (3) of this subdivision.
(iv) Rates established pursuant to this paragraph shall also include an adjustment pursuant to section 86-2.10(u) of this Subpart.
(7) Long-term ventilator dependent residents. A facility which is approved to operate discrete units for the care of long-term ventilator dependent patients as established pursuant to section 415.38 of this Title shall have separate and distinct payment rates established pursuant to this subdivision as follows:
(i) For the first three months of operation, the direct component shall be equivalent to the statewide mean direct case mix neutral cost per day established pursuant to section 86-2.10(c)(3)(iii) of this Subpart increased by a factor of 2.89 and adjusted by the RDIPAF pursuant to section 86-2.10 of this Subpart. The direct component shall be further increased by an occupancy factor of 1.225 for the first six months of operation. The facility shall perform an assessment of all residents, pursuant to section 86-2.30 of this Subpart, at the beginning of the fourth month of operation and at the beginning of each third month for the period set forth in paragraph (1) of this subdivision. Effective on the first day of the month of each assessment period, the direct component of the rate shall be adjusted pursuant to section 86-2.10(c) of this Subpart based on the facility's case mix. The case mix index which is used to establish the facility specific mean direct price per day for each patient classification group pursuant to section 86-2.10(c)(4) of this Subpart for long-term ventilator dependent residents shall be increased by an increment of 1.15.
(ii) The indirect component of the rate shall be equivalent to the mean indirect price developed pursuant to section 86-2.10(d) of this Subpart for the applicable peer group established for high intensity case mix identified in section 86-2.10(d)(2) of this Subpart, adjusted by the RIIPAF pursuant to section 86-2.10(d) of this Subpart. The indirect component shall be further adjusted by an occupancy factor of 1.225 for the first six months of operation.
(iii) The noncomparable component of the rate shall be determined as follows:
(a) For an existing facility that is approved to operate discrete units for the care of long-term ventilator residents, the noncomparable component of the rate shall be equal to the noncomparable component of the existing residential health care facility's rate computed pursuant to section 86-2.10(f) of this Subpart plus approved budgeted costs as identified in clauses ( c ) and ( d ) of this subparagraph plus approved budgeted costs for personnel required by section 415.38 of this Title that would be reported in the functional cost centers identified in section 86-2.10(f) of this Subpart.
(b) For a new facility without a residential health care rate computed pursuant to section 86-2.10 of this Subpart, the noncomparable component of the rate shall be determined in accordance with paragraph (3) of this subdivision and include approved budgeted costs identified in clauses ( c ) and ( d ) of this subparagraph.
(c) The approved budgeted costs for the central service supply functional cost center as listed in section 86-2.10(c)(1) of this Subpart shall be considered a noncomparable cost reimbursed pursuant to section 86-2.10(f) of this Subpart.
(d) The approved budgeted costs for prescription drugs, specifically required by generally accepted standards of professional practice for long-term ventilator dependent residents, that are administered at a frequency and volume exceeding those of prescription drugs included in the direct component of the rate pursuant to subdivision (c) of this section shall be considered a noncomparable cost pursuant to section 86-2.10(f) of tis Subpart.
(iv) Rates established pursuant to this paragraph shall also include an adjustment pursuant to section 86-2.10(u) of this Subpart.
(8) Specialized programs for residents requiring behavioral interventions. A facility which is approved to operate discrete units specifically designated for the purpose of providing specialized programs for residents requiring behavioral interventions as established pursuant to section 415.39 of this Title shall have separate and distinct payment rates established pursuant to this subdivision as follows:
(i) For the first three months of operation, the direct component shall be equivalent to the statewide mean direct case mix neutral cost per day established pursuant to section 86-2.10(c)(3)(iii) of this Subpart increased by a factor of 2.65 and adjusted by the RDIPAF pursuant to section 86-2.10 of this Subpart. The direct component shall be further increased by an occupancy factor of 1.225 for the first six months of operation. The facility shall perform an assessment of all residents, pursuant to section 86-2.30 of this Subpart, at the beginning of the fourth month of operation and at the beginning of each third month for the period set forth in paragraph (1) of this subdivision. Effective on the first day of the month of each assessment period, the direct component of the rate shall be adjusted pursuant to section 86-2.10(c) of this Subpart based on the facility's case mix. The case mix index which is used to establish the facility specific mean direct price per day for each patient classification group pursuant to section 86-2.10(c)(4) of this Subpart for residents requiring behavioral interventions shall be increased by an increment of 1.40.
(ii) The indirect component of the rate shall be equivalent to the mean indirect price developed pursuant to section 86-2.10(d) of this Subpart for the applicable peer group established for high intensity case mix identified in section 86-2.10(d)(2) of this Subpart, adjusted by the RIIPAF pursuant to section 86-2.10(d) of this Subpart. The indirect component shall be further adjusted by an occupancy factor of 1.225 for the first six months of operation.
(iii) The noncomparable component of the rate shall be determined as follows:
(a) For an existing facility that is approved to operate discrete units specifically designed for the purpose of providing specialized programs for residents requiring behavioral interventions, the noncomparable component of the rate shall be equal to the noncomparable component of the existing residential health care facility's rate computed pursuant to section 86-2.10(f) of this Subpart plus approved budgeted costs for personnel required by section 415.39 of this Title that would be reported in the functional cost centers identified in section 86-2.10(f) of this Subpart.
(b) For a new facility without a residential health care rate computed pursuant to section 86-2.10 of this Subpart, the noncomparable component of the rate shall be determined in accordance with paragraph (3) of this subdivision.
(iv) Rates established pursuant to this paragraph shall also include an adjustment pursuant to section 86-2.10(u) of this Subpart.
(c) The rates developed pursuant to this section shall remain in effect until a facility submits a 12-month cost report in accordance with section 86-2.2(e) of this Subpart for a 12-month period during which the facility had an overall average utilization of at least 90 percent of bed capacity. This cost report shall be used to adjust the direct, indirect, noncomparable and capital components of the rate effective on the first day of the cost report period.
(d) All rates of reimbursement certified pursuant to this section shall be subject to audit pursuant to section 86-2.7 of this Subpart. After audit, the facility shall receive a rate based upon actual allowable costs incurred during the rate period, and computed in accordance with section 86-2.10 of this Subpart. Except as described in section 86-2.19(d)(2) of this Subpart, an occupancy rate of not less than 90 percent shall be used when calculating the capital and noncomparable components in the rate calculation.
(e) Notwithstanding the provisions of this section, an operator of a facility which has had an overall average utilization of at least 90 percent of bed capacity for a six-month period which began prior to April 1, 1993 but after the date on which the operator began operations shall submit a six-month cost report for that period. Such six-month cost report shall be utilized for purposes of this section in lieu of the 12-month cost report identified in section 86-2.2(e) of this Subpart.
Subchapter I ENVIRONMENTAL HEALTH
Part 75 STANDARDS FOR INDIVIDUAL ONSITE WATER SUPPLY AND INDIVIDUAL ONSITE WASTEWATER TREATMENT SYSTEMS
10 CRR-NY 75.6 Waivers; general, specific and local
(a) General waiver.
(1) The State Commissioner of Health may on written application supported by documentation grant a general waiver from a provision of this Part, subject to appropriate conditions, where such waiver is consistent with the general purpose and intent of this Part, to a full-time city, county or part-county health department.
(2) Such waiver shall include the effective date, the time period, if any, for which the waiver is granted, the requirement(s) being waived and any other limiting conditions such as types of systems, local conditions or geographical areas where the waiver can be used.
(b) Specific waiver.
The State Commissioner of Health, his designated representative or the designated full-time city, county or part-county health department official, may on written application grant a specific waiver from a provision of this Part, where such waiver is consistent with the general purpose and intent of this Part. The applicant receiving such waiver must be advised in writing if the design or conditions approved do not meet State standards and the potential consequences of such deviations. Systems with a surface discharge are prohibited and are not eligible for a waiver.
(c) Local waiver.
(1) The State Commissioner of Health or his designated representative may on written application from a municipality, in areas where a city, county or part-county health department does not exist, grant a local waiver to allow the use of an alternative-type sewage treatment system as shown in Appendix 75-A of this Title.
(2) Such waiver shall indicate the limitations and conditions of installation, and require that the installation be certified by the municipality, a licensed professional engineer, registered architect, or other person authorized under the Education Law to design such a system as complying with the standards and waiver.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.21 Other operating expenses description
[3280]
(a) Research Expenses
[3281]
(1) 8010 RESEARCH.
(i) Function. This cost center administers, manages, and carries on research projects funded by outside donations, grants and/or the hospital. Additional activities include: Maintenance of animal house and administration of specific research projects.
(ii) Description. This cost center contains the direct expenses incurred in overseeing all research and in carrying on research in the hospital. Separate cost centers should be maintained for each research activity for which separate accounting is required, either by a grant agreement, contract, or because of restrictions made upon donations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(b) Education Expense
[3282]
(1) 8220
NURSING EDUCATION
8221
Registered Nurses
8222
Licensed Vocational (Practical) Nurses
(i) Function. Hospitals may either operate a School of Nursing or provide the clinical training activities for student nurses when the degree is issued by a college or university. Nursing Education is a school for educating Registered Nurses and/or Licensed Vocational (Practical) Nurses. Additional activities include, but are not limited to, the following:
Selecting qualified nursing students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems; selecting faculty personnel; assigning and supervising students in giving nursing care to selected patients; and administering aptitude and other tests for counseling and selection purposes.
(ii) Description. This cost center shall be used to record the direct expenses incurred in, or providing clinical facilities for, the education of Registered Nurses and/or Licensed Vocational (Practical) Nurses. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of FTE nursing students. The number of FTE nursing students in the Nursing Education cost center is defined as the sum of the percentage of time each student nurse is enrolled in the school during the year divided by 100.
(iv) Data source. The number of FTE nursing students in this educational program shall be the actual count maintained by the Nursing Education cost center.
(2) 8240
POSTGRADUATE MEDICAL EDUCATION—APPROVED PRIMARY TEACHING PROGRAM—INTERNAL MEDICINE
8250
POSTGRADUATE MEDICAL EDUCATION—APPROVED PRIMARY TEACHING PROGRAM—FAMILY PRACTICE
8260
POSTGRADUATE MEDICAL EDUCATION—APPROVED PRIMARY TEACHING PROGRAM—PEDIATRICS
8270
POSTGRADUATE MEDICAL EDUCATION—OTHER APPROVED TEACHING PROGRAMS
(i) Function. A Postgraduate Medical Education Teaching Program provides an organized program of postgraduate medical clinical education to interns and residents. To be approved, a medical internship or residency training program must be approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry in a hospital or osteopathic hospital must have the approval of the Council on Dental Education of the American Dental Association. Additional activities include, but are not limited to, the following:
Selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems; and assigning and supervising students.
(ii) Description. This cost center shall be used to record the direct expenses incurred in providing an approved organized program of postgraduate medical clinical education. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. All salaries and stipends paid to interns and residents in approved teaching programs must be reflected in this cost center, in the “Salaries and Wages” natural expense classification (.07).
(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Postgraduate Medical Education Approved programs is defined as the sum of the percentage of time each student is enrolled in such programs during the year divided by 100.
(iv) Data source. The number of FTE students in these educational programs shall be the actual count maintained in each such program.
(v) Effective dates. For the reporting of accounts 8240 through 8270, relative to approved teaching programs, cost reporting periods beginning on or after January 1, 1981. The Standard Unit of Measure (FTE students) for accounts 8240 through 8260 must be collected beginning July 1, 1981. For cost reporting periods beginning in 1980, report all Approved Postgraduate Medical Education programs (including the Standard Unit of Measure) under account 8270.
(3) 8280 POSTGRADUATE MEDICAL EDUCATION—NON-APPROVED TEACHING PROGRAM
(i) Function. A Postgraduate Medical Education program provides an organized program of postgraduate medical clinical education to interns and residents. To be non-approved means that a medical internship or residency training program is not approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, is not approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry in a hospital or osteopathic hospital are non-approved unless the approval of the Council on Dental Education of the American Dental Association has been received. Additional activities include, but are not limited to, the following:
Selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems, and assigning and supervising students.
(ii) Description. This cost center shall be used to record the direct expenses incurred in providing an organized program of postgraduate medical clinical education. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. All salaries or stipends paid to interns and residents in non-approved teaching programs must be reflected in this cost center, in the “Salaries and Wages” natural expense classification (.07).
(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Postgraduate Medical Education Non-Approved programs is defined as the sum of the percentage of time each student is enrolled in such programs during the year divided by 100.
(iv) Data source. The number of FTE students in these educational programs shall be the actual count maintained by each such program.
(4) 8290
OTHER HEALTH PROFESSION EDUCATION
8291
School of Medical Technology
8292
School of X-Ray Technology
8293
School of Respiratory Therapy
8294
Administrative Intern Program
8295
Medical Records Librarian Program
(i) Function. Other Health Profession Education is the provision of organized programs of medical clinical education other than for nurses (RN and LVN) and doctors, and the provision of organized education programs for administrative interns and externs, Medical Records Librarians, and other health professionals. Additional activities include, but are not limited to, the following:
Selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems; selecting faculty personnel; assigning and supervising students in giving medical care to selected patients; and administering aptitude and other tests for counseling and selection purposes.
(ii) Description. These cost centers contain the direct expenses relative to operating health education programs other than nursing and postgraduate medical programs, such as a School of Medical Technology, School of X-Ray Technology, School of Respiratory Therapy, and other non-inservice education programs such as those listed above. A separate cost center should be established for each program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Other Health Profession Education programs is defined as the sum of the percentage of time each student is enrolled in an Other Health Profession Education Program during the year divided by 100.
(iv) Data source. The number of FTE students in such programs shall be the actual count maintained by each such program.
(c) General Services.
[3283]
(1) 8310 DIETARY SERVICES
(i) Function. Dietary Services includes the procurement, storage, processing and delivery of food and nourishments to patients in compliance with Public Health regulations and physicians' orders. Additional activities include, but are not limited to, the following:
Nutritional assessment;
Teaching patients and their families nutrition and modified diet requirements; determining patient food preferences as to type and method of preparation; preparing selective menus for various specific diet requirements; preparing or recommending a diet manual, approved by the medical staff, for use by physicians and nurses; and delivering food trays to, and collecting food trays from, patient service areas for meals and nourishments; and incidental activities such as cleaning up of spills in preparing food.
(ii) Description. This cost center contains the direct expenses incurred in preparing food for patients and delivering food to patient service areas. Infant formula must be reported in the using cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. Also included is Dietary Service's share of common costs of the Non-Patient Food Service and Dietary Services cost centers.
Examples of common costs include: salaries of cooks who prepare food for both cost centers, common food costs, common minor equipment costs, if expensed, common administrative costs, etc. These common costs shall be distributed to the Dietary and Non-Patient Food Service cost centers, based upon the ratio of number of meals served in each cost center. A detailed explanation of the method to be used in computing the number of nonpatient meals served by the Non-Patient Food Service cost center is included in the explanation of the Non-Patient Food Service Standard Unit of Measure.
(iii) Standard Unit of Measure: number of patient meals. Count only regularly scheduled meals (3-meal schedules only) and exclude snacks and fruit juices served between regularly scheduled meals. Also excluded are tube feedings and infant formula.
(iv) Data source. The number of patient meals must be the actual count of patient meals maintained by the Dietary cost center.
(2) 8320 NON-PATIENT FOOD SERVICE
(i) Function. Non-Patient Food Service includes the procurement, storage, processing and delivery of food to employees and other nonpatients in compliance with Public Health regulations.
(ii) Description. This cost center contains all directly identifiable expenses incurred in preparing and delivering food to employees and other nonpatients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. Also included is the Non-Patient Food Service's share of common costs of the Non-Patient Food Service and Dietary Services cost centers. The cost of edible supplies for vending machines serviced by the health facility must be included in this cost center. Vending machine revenue is to be included in other operating revenue account 5820 (Vending Machine Commissions).
(iii) Standard Unit of Measure: equivalent number of meals served. To obtain an equivalent meal in a pay cafeteria, divide total Non-Patient Food Service revenue by the average selling price of a full meal. The average full meal should include meat, potato, vegetable, salad, beverage and dessert. When there is a selection of entrees, desserts and so forth, that are available at different prices, use an average in calculating the selling price of a full meal. Count a free meal served as a full meal.
(iv) Data source. Non-Patient Food Service revenue must be taken from the general ledger.
(3) 8330 LAUNDRY AND LINEN
(i) Function. Laundry and Linen activities include picking up, storing, issuing, mending, washing, distributing and processing of in-service linens. The services include uniforms, special linens and disposable linen substitutes.
(ii) Description. This cost center shall contain the direct expenses incurred in providing laundry and linen services for hospital use, including student, nonpaid worker, and employee quarters. Cost of disposable linen must be recorded in this cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of dry and clean pounds processed. Record the weight of linen processed (laundered and dried) plus the equivalent weight of disposable linen substitutes used. Linen is weighed after it has been cleaned and processed. Include uniforms and linen from personnel quarters and employee housing. If linen is not weighed, a conversion from pieces to pounds is allowed. If soiled linen is weighed, divide by 1.1.
(iv) Data source. The number of dry and clean pounds processed (laundered and dried) must be taken from actual counts maintained in the Laundry and Linen cost center. If the hospital uses an outside laundry service, the number of dry and clean pounds processed must be maintained and reported.
(4) 8350 SOCIAL SERVICES
(i) Function. The Social Work Services cost center obtains, analyzes, and interprets psychosocial, environmental and economic information to assist in diagnosis, treatment and rehabilitation of patients. These services include: counseling of patients and families in individual and group units; collaboration with health care staff; mobilizing resources on behalf of patients both within a given hospital and in various agencies outside the hospital; and participation in the development of social and health programs in the community. Other tasks involve collecting and revising information on community health and welfare resources, departmental management and being accountable to responsible external organizations. Major activities include but are not limited to: screening, which is the process whereby a determination is made concerning the necessity for further professional assessment and services; assessment (including family members or significant others), which is the explication of a patient's problem or problems and the initial determination of a course of action for resolving the problem or problems; and the provision of problem-focused services (such as dealing with psychosocial problems as they relate to a patient's health and/or hospitalization, and arranging for post-discharge care of patients), which are directed toward the resolution of identified problems.
(ii) Description. This cost center contains the direct expenses incurred in providing social services to patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(5) 8360
HOUSING
8361
Employee Housing
8362
Nonpaid Worker Housing
8363
Student Housing
(i) Function. Housing is the provision of living quarters to hospital employees and nonpaid workers; and maintenance of residences for students, including interns and residents, participating in education programs carried on by the hospital.
(ii) Description. This cost center shall contain the direct expenses incurred in providing living quarters for hospital employees, nonpaid workers, and students involved in educational programs carried on by the hospital. Expenses of on-call rooms shall be included in this cost center only if they are not directly identifiable to another cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: average number of persons housed. Record the number of days each person is in the facility. Accumulate the monthly totals and divide by 12 to obtain the average number of persons housed.
(iv) Data source. The average number of persons housed shall be determined from the record of employees housed maintained in the Housing cost center.
(6) 8410
PLANT OPERATIONS AND MAINTENANCE
8410
Plant Operations
8412
Plant Maintenance
8413
Grounds
(i) Function. Plant Operations and Maintenance includes the maintenance and service of utility systems such as heat, light, water, air conditioning and air treatment; the maintenance and repair of buildings, parking facilities, and equipment; painting; elevator maintenance; vehicle maintenance; performance of minor renovation of buildings and equipment; and maintenance of grounds of the institution, such as landscaped and paved areas, streets on the property, sidewalks, fenced areas and fencing, external recreation areas, and parking facilities. Additional activities include, but are not restricted to, the following:
Trash disposal; boiler operation and maintenance; service and maintenance of water treatment facilities, drainage systems and utility transmission systems. Including all maintenance performed under contract; technical assistance on equipment purchases and installation; coordinating construction; establishing priorities for repairs and utility projects.
(ii) Description. This cost center shall contain the direct expenses incurred in the operation and maintenance of the hospital plant and equipment except the maintenance, repair and renovation of renal dialysis equipment used for Home Dialysis for which the hospital has been 100 percent reimbursed by Medicare. Such costs must be reported in the Home Program Dialysis Equipment—100 Percent cost center (account 6810). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, utilities (except telephone and telegraph), other direct expenses and transfers.
(iii) Standard Unit of Measure: number of gross square feet. Gross square feet is defined as the total interior floor area of the hospital facility, including common areas (hallways, stairways, elevators, lobbies, closets, etc.), measured to the center of interior walls.
(iv) Data source. The number of gross square feet shall be taken from current blueprints of the hospital facility, or from actual measurement if blueprints are not available.
(v) Expiration date. This cost center will be replaced by account 8400 (Plant Maintenance) and account 8410 (Plant Operation) effective with cost reporting periods beginning in 1982.
(7) 8400
PLANT MAINTENANCE
(i) Description. Maintenance and repair of buildings, grounds and fixed equipment; painting; vehicle operation (except operation of ambulances) and maintenance; care of grounds; and performance of minor renovations of buildings, fixed equipment, grounds, drainage systems and utility transmission systems, including all such maintenance performed under contract. Also included are expenses associated with technical assistance on equipment purchases and installations; coordinating construction; establishing priorities for repairs and utility projects; and operation, service and repair of parking lots. Exclude the costs of maintenance, repair and renovation of renal dialysis equipment used for Home Dialysis for which the hospital has been 100 percent reimbursed by Medicare. Such costs must be reported in the Home Program Dialysis Equipment—100 Percent cost center (account 6810). Examples of job titles include chief engineer, stationary engineer, carpenter, plumber, electrician, painter, dispatcher, driver, groundskeeper, plasterer, parking lot attendant, guard, mechanic, electromedical equipment repairman, clerk and secretary.
(ii) Standard Unit of Measure: gross square feet. Gross square feet is defined as the total interior floor area of the hospital facility, including common areas.
(iii) Data source. Square feet shall be determined from the blueprints of the hospital facility, or actual measurement if blueprints are not available.
(iv) Effective date. Cost reporting periods beginning 1982 and thereafter.
(8) 8410
PLANT OPERATION
(i) Description. Maintenance and service of utilities, such as heat, light, water, air conditioning and air treatment; trash disposal; hourly operation and maintenance; service and maintenance of water treatment facilities and drainage systems. Examples of job titles include: director of plant operations, foreman, elevator operator, tool crib operator, incinerator and mechanic. This cost center also includes the direct expense of utilities such as: electricity, natural gas, liquid propane or butane gas, oil coal, purchased steam and hot water and water and sewage. Telephone and telegraph service are not considered utilities but are included in the Hospital Administration cost center (account 8610).
(ii) Standard Unit of Measure: gross square feet. Gross square feet is defined as the total interior floor area of the hospital facility, including common areas.
(iii) Data source. Square feet shall be determined from the blueprints of the hospital facility, or actual measurement if blueprints are not available.
(iv) Effective date. Cost reporting periods beginning in 1982 and thereafter.
(9) 8430 SECURITY
(i) Function. The Security cost center maintains the safety and well-being of hospital patients, personnel and visitors, and protects the hospital's facilities.
(ii) Description. This cost center shall include the direct expenses incurred maintaining the safety and well-being of hospital patients, employees, visitors, and protection of the hospital facilities. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(10) 8440 PARKING
(i) Function. Parking includes the provision of parking facilities to patients, physicians, employees and visitors.
(ii) Description. This cost center shall contain the direct expenses of parking facilities owned and/or operated by the hospital. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(11) 8450 HOUSEKEEPING
(i) Function. This cost center is responsible for the care and cleaning of the interior physical plant, including the care (washing, waxing, stripping) of floors, walls, ceilings, partitions, windows (inside and outside), furniture (stripping, disinfecting and making beds upon discharge), fixtures (excluding equipment) and furnishings and emptying of room trash containers, as well as the costs of similar services purchased from outside organizations
(ii) Description. This cost center shall contain the direct expenses incurred for maintaining general cleanliness and sanitation throughout the hospital and other areas serviced (such as student and employee quarters). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of square feet serviced. Square feet serviced is the interior floor area routinely serviced by housekeeping personnel.
(iv) Data source. The number of square feet serviced by the housekeeping unit should be taken from blueprints of the hospital and other buildings serviced (such as student and employee quarters), or from actual measurement if no blueprints are available.
(12) 8460 CENTRAL SERVICES AND SUPPLIES
(i) Function. Central Services and Supplies prepares and issues medical and surgical supplies and equipment to patients and to other cost centers. Additional activities include, but are not limited to, the following:
Requisitioning and issuing of appropriate supply items required for patient care; preparing sterile irrigating solutions; collecting, assembling, sterilizing and redistributing reusable items; cleaning, assembling, maintaining and issuing portable apparatuses.
(ii) Description. This cost center contains the direct expenses incurred in preparing and issuing medical and surgical supplies and equipment to other cost centers and to patients. Also included is the expense related to reusable patient-chargeable items. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. The invoice/inventory cost of nonchargeable supplies and equipment issued to other cost centers shall be reported in the using cost centers. The invoice/inventory cost of chargeable medical and surgical supplies shall be reported in the Medical Supplies Sold cost center (account 7110). The invoice/inventory cost of durable medical equipment leased and rented must be reported in the Durable Medical Equipment Leased/Rented cost center (account 7140).
(iii) Standard Unit of Measure: none required; not applicable.
(13) 8470 PHARMACY
(i) Function. The Pharmacy procures, preserves, stores, compounds, manufactures, packages, controls, assays, dispenses, and distributes medications (including I.V. solutions and blood derivatives, except packed red cells) for inpatients and outpatients under the jurisdiction of a licensed pharmacist. Pharmacy services include maintaining separate stocks of commonly used items in designated areas. Additional activities include, but are not limited to, the following:
Development and maintenance of formulary(ies) established by the medical staff; consultation and advice to medical staff and nursing staff on drug therapy; adding drugs to I.V. solutions; determining incompatibility of drug combinations; stocking floor drugs and dispensing machines; preparing patient medication histories; monitoring drug therapy; counseling patients; making patient rounds.
(ii) Description. This cost center contains the direct expenses incurred in maintaining a pharmacy under the jurisdiction of a licensed pharmacist. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. The invoice cost of nonchargeable pharmaceuticals, I.V. solutions and blood derivatives issued to other cost centers shall be transferred to the using cost centers. The invoice cost of chargeable pharmaceuticals, I.V. solutions and blood derivatives shall be transferred to the Drugs Sold cost center (account 7150).
(iii) Standard Unit of Measure: none required; not applicable.
(d) Fiscal Services
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(1) 8510 GENERAL ACCOUNTING
(i) Function. This cost center performs general accounting ( i.e., nonpatient billing and accounting) activities of the hospital, such as the preparation of ledgers, budgets and financial reports, payroll accounting, accounts payable accounting, plant and equipment accounting, inventory accounting, nonpatient accounts receivable accounting (tuition, sales to other institutions), etc.
(ii) Description. This cost center shall include the direct expenses incurred in providing the general accounting requirements of the hospital, and in providing other fiscal services not related to patient accounting activities. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(2) 8520 PATIENT ACCOUNTS, ADMITTING, AND REGISTRATION
8521
Patient Accounting
8522
Credit and Collection
8523
Cashiering
8524
Inpatient Admitting
8525
Emergency Room Registration
8526
Clinic Registration
8527
Referred Ambulatory Registration
8528
Other Outpatient Registration
(i) Function. The processing of patient charges, including processing charges to patients' accounts, preparing claims, extending credit, collecting accounts receivable, cashiering, and other patient-related billing and accounting activities, is handled by this cost center. Additional activities include interviewing patients and others relative to the extension of credit, checking references and using outside collection agencies.
The admitting of inpatients for hospital services, including filling out admission forms, scheduling admission times, accompanying patients to room or service areas after admission and arrangement of admission details, is performed by this cost center. All outpatient registration activities are also included here, including emergency, clinic, and referred patients.
(ii) Description. This cost center shall include the direct expenses incurred in patient-related credit, billing and accounting activities; inpatient admitting; and outpatient activities registration. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(iv) Effective date. Commencing with cost reporting periods beginning in 1982, this cost center will be replaced by Patient Accounts (account 8520), Admitting (account 8530), and Registration (account 8540).
(3) 8520
PATIENT ACCOUNTS
8521
Patient Accounting
8522
Credit and Collection
8523
Cashiering
(i) Description. The processing of patient charges, including posting charges to patients' accounts, preparing claims, extending credit, collecting accounts receivable, cashiering, and other patient-related billing and accounting activities, is handled by this cost center. Additional activities include interviewing patients and others relative to the extension of credit, checking references and using of outside collection agencies.
(ii) Standard Unit of Measure: none required. Consideration is being given to the development of a SUM for this cost center.
(iii) Effective date. Cost reporting periods beginning in 1982.
(4) 8530
ADMITTING
(i) Function. The admitting of inpatients for hospital services, including filling out admission forms, scheduling admission times, accompanying patients to room or service areas after admission, and arrangement of admission details, is performed by this cost center.
(ii) Description. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.
(iii) Standard Unit of Measure: none required. Consideration is being given to the development of a SUM for this cost center.
(iv) Effective date. Cost reporting periods beginning in 1982.
(5) 8540
REGISTRATION
8541
Emergency Room Registration
8542
Clinic Registration
8543
Referred Ambulatory Registration
8549
Other Outpatient Registration
(i) Function. the registration of hospital outpatients, including filling out registration forms, scheduling of appointments, accompanying patients to room or service areas after registration, and arrangment of registration details, is performed by this cost center.
(ii) Description. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.
(iii) Standard Unit of Measure: none required. Consideration is being given to the development of a S.U.M. for this cost center.
(iv) Effective date. Cost reporting periods beginning in 1982.
(e) Administrative Services
[3285]
(1) 8610
HOSPITAL ADMINISTRATION
8611
Office of Hospital Administrator
8612
Governing Board
8613
Public Relations
8614
Spiritual Care
8615
Communications
8616
Personnel
8617
Management Engineering
8618
Health Sciences Library
8619
Auxiliary Groups
8621
Data Processing
(i) Function. Hospital Administration performs overall management and administration of the institution. This function also includes the following activities: public relations, spiritual care, communications, personnel, management engineering, health sciences library, auxiliary groups, and data processing. The functions of cost centers 8615 through 8621 are described on the following pages.
(ii) Description. This cost center contains the direct expenses associated with the overall management and administration of the institution, including those of the Governing Board. The expenses associated with furnishing information for public use in maintaining the hospital's position in the community must be included here. The expenses associated with spiritual care (chaplaincy), communications, personnel, management engineering, health sciences library, and auxiliary groups must be included here. Care should be taken to ascertain that all costs included in this cost center do not properly belong in a different cost center. For example, expenses chargeable to hospital administration do not include legal fees incurred in connection with the purchase of property (which should be capitalized), nor fund raising costs which should be included in Fund Raising (account 8780). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(2) 8615 COMMUNICATIONS
(i) Function. The Communications cost center operates the communications systems within and outside the hospital, including the telephone system, radio and telemetry communications systems, public address systems, closed-circuit television, messenger services and mail processing.
(iii) Description. This cost center shall include the direct expenses incurred in carrying on communications (both in and out of the hospital), including the telephone switchboard and related telephone services, messenger activities, internal information systems and mail services. Specific expenses include postage and telephone company charges for equipment and monthly services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(3) 8616 PERSONNEL
(i) Function. Personnel provides adequate staffing of hospital departments and maintains employee satisfaction and morale. Activities include recruitment, employee selection, salary and wage administration, employee health services, fringe benefit program administration, and procurement of temporary help (including fees paid to temporary help agencies).
(ii) Description. This cost center shall be used to record the direct expenses incurred in carrying out the personnel function of the hospital. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(4) 8617 MANAGEMENT ENGINEERING
(i) Function. Management Engineering is an administrative service which assists hospital administrators in performing their managerial functions by providing specialized knowledge and skill in the mathematical, physical and social sciences, together with the principles and methods of engineering analysis, development and implementation. Management Engineering performs a wide variety of services, including but not limited to the following: productivity analysis and improvement; cost containment; planning and control procedures; systems analysis and design; facilities layout; computer science; operations research.
(ii) Description. This cost center contains the direct expenses incurred by the management engineering function. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(5) 8618 HEALTH SCIENCES LIBRARY
(i) Function. The Health Sciences Library procures, stores, indexes, classifies, annotates and abstracts books, catalogs, journals and other related published materials principally for medical staff use and reviews library records for completeness and compliance with established standards.
(ii) Description. This cost center contains the direct expenses incurred in maintaining health sciences library. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(6) 8619 AUXILIARY GROUPS
(i) Function. Costs incurred in connection with hospital-related auxiliary groups, including coordinator of auxiliary group activities and special meetings of auxiliary groups conducted by the hospital, are maintained in this cost center.
(ii) Description. This cost center contains the direct expenses incurred in connection with hospital auxiliary or volunteer groups. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(7) 8621 DATA PROCESSING
(i) Function. The Data Processing cost center performs the operation of the hospital's electronic data processing system, including keypunching of input, storage and safeguarding of data, operating data processing equipment, data processing job scheduling, distributing output and identifying and solving hardware and software problems.
(ii) Description. This cost center shall contain the costs incurred in operating an electronic data processing center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. Expenses incurred in the operation of terminals of the EDP center throughout the hospital shall be included in the Data Processing cost center. However, outside service bureau costs directly chargeable to a specific cost center shall be included in that specific cost center in the “Purchased Services—Data Processing” natural classification (.75). Outside service bureau costs benefiting more than one cost center shall be included in the Data Processing cost center. All data processing expenses not directly charged to the using cost centers must be distributed, for reporting purposes, to individual cost centers. The only expense remaining in this cost center is the expense related to data processing service provided to outside organizations. The related revenue is to be reported in account 5620, Data Processing Services Revenue.
(8) 8690 PURCHASING AND STORES
(i) Function. Purchasing and Stores includes the procuring of supplies, equipment and services necessary to hospital operations, the receipt of supplies and materials from vendors and their routing and distribution to specific using areas, and the receipt and central storage of all non-pharmaceutical supplies and materials prior to their issue to using departments. Additional activities include, but are not limited to, the following:
Receipt and processing of requisitions; monitoring of perpetual supply items; obtaining of quotes from selected vendors; and monitoring of receipt of supplies.
(ii) Description. This cost center shall contain the direct expenses incurred in procuring supplies, equipment and services necessary to hospital operations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(9) 8710 MEDICAL RECORDS
(i) Function. Medical Records includes the maintenance of a records system for the use, transportation, retrieval, storage and disposal of patient medical records; and the production of indexes, abstracts and statistics for hospital management and medical staff uses. This function also includes tumor registry activities.
(ii) Description. This cost center contains the direct expenses incurred in maintaining the medical records function. Also, costs associated with microfilming of medical records shall be included in this account. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of inpatient discharges and number of outpatient visits. The number of inpatient discharges should exclude routine newborns (those newborn who are discharged with the mother). The number of outpatient visits should exclude referred ambulatory and sold services visits.
(iv) Data source. The number of visits shall be the actual count maintained in the Ambulatory Services cost centers, excluding referred ambulatory and sold services visits. The number of discharges shall be the actual count maintained by Medical Records
(10) 8720 MEDICAL STAFF ADMINISTRATION
(i) Function. This cost center is used to record certain general expenses associated with medical staff administration, such as the salary and related expenses of the Chief of the Medical Staff and assigned non-physician employees.
(ii) Description. This cost center contains the direct expenses associated with medical staff administration (as described above). Interns' and residents' salaries (or stipends) must not be included here, but rather in the Postgraduate Medical Education—Approved Teaching Program (account 8240) or Postgraduate Medical Education—Non-Approved Teaching Program (account 8250) cost center, as appropriate. Compensation paid to physicians (other than Chief of the Medical Staff) must not be included here, but rather in the cost center where the physicians' services are rendered. Included as direct expenses are: salaries and wages, employee benefits, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required, not applicable.
(11) 8730 MEDICAL STAFF SERVICES
(i) Function. This cost center is used to report the professional component expenses associated with services to hospital patients provided by hospital-based physicians.
(ii) Description. This cost center contains the professional component expenses associated with hospital-based physicians. Interns' and residents' salaries (or stipends) must not be included here but rather in the Postgraduate Medical Education—Approved Teaching Program (account 8240) or Postgraduate Medical Education—Non-Approved Teaching Program (account 8250) as appropriate.
(12) 8740
MEDICAL CARE REVIEW
8741
PSRO
8749
Other Medical Care Review
(i) Function. This cost center conducts ongoing evaluation of the quality of care given and includes periodic review of the utilization of the bed facilities, and of the diagnostic, nursing and therapeutic resources of the hospital, with respect to both the availability of these resources to all patients in accordance with their medical need and the recognition of the medical practitioner's responsibility for the costs of health care. This review should cover necessity of admission, length of stay, level of care, quality of care, utilization of ancillary services, professional services furnished, effectiveness of discharge planning and the availability and alternate use of out-of-hospital facilities and services. Three review programs may be included in the Medical Care Review cost center: pre-admission screening, concurrent review (including admission certification and continued stay review) and retrospective medical care evaluation studies. The review committee should include medical staff, hospital administration, nurses and home health planners.
(ii) Description. This cost center shall contain the costs incurred in providing peer review, quality assurance, utilization review, professional standards review and medical care evaluation functions. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of inpatient discharges (exclude newborn). The number of inpatient discharges should exclude routine newborns (those newborn who are discharged with the mother). Also exclude intrahouse transfers.
(iv) Data source. The number of inpatient discharges shall be the actual count maintained by the Admitting Office.
(13) 8750
NURSING ADMINISTRATION
8751
Inservice Education—Nursing
8759
Nursing Administration—Other
(i) Function. Nursing Administration performs the administration and supervision of the nursing function in the hospital, including scheduling and transfer of nurses among the services and units, nursing staff supervision, evaluation and discipline. This cost center also includes continuing education of hospital-employed nursing personnel ( i.e., RNs, LVNs, aides and orderlies), including regularly scheduled classes, in-house seminars and special training sessions.
(ii) Description. This cost center shall contain the direct expenses associated with nursing administration and with conducting a nursing inservice education program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. Supervisors assigned to specific cost centers shall be included in those cost centers on a direct basis.
The salaries, wages and fringe benefits paid float personnel shall be recorded in the cost center in which they work. This may be done directly, or they may be recorded originally in the Float Nursing Personnel cost center (account 8992) and distributed (preferably at the end of each payroll period) to using cost centers based upon hours worked. If the latter method is used, all salaries, wages and fringe benefits of float personnel must be transferred out of the Float Nursing Personnel cost center. Any idle time would be allocated together with actual hours worked. Scheduling and other administrative functions relative to float nursing personnel are considered costs of Nursing Administration.
If hospital employees work part-time in the inservice education program and part-time in other nursing activities, their salaries, wages and fringe benefits shall be separated based upon number of hours spent in each activity and distributed to the appropriate cost centers, preferably after each payroll period. This cost center shall not include costs related to inservice student time. These costs must remain in the cost center in which the student works.
(iii) Standard Unit of Measure: weighted average daily census. The weighted average census is calculated as follows: (inpatient days [exclude newborns] + 1/4 emergency room visits + 1/3 all other outpatient visits) + number of days in the year.
(iv) Data source. General accounting and statistical records (daily census, emergency room log, clinic registration log, etc.).
(14) 8760 MEDICAL PHOTOGRAPHY AND ILLUSTRATION
(i) Function. This cost center provides medical photography and illustration services for other cost centers of the hospital.
(ii) Description. This cost center shall include the direct expenses incurred in providing medical photography and illustration services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(15) 8780 FUND RAISING
(i) Function. Fund Raising carries on fund-raising activities such as special luncheons and other meetings and special mailings.
(ii) Description. This cost center contains the direct expenses associated with fund raising (both restricted and unrestricted). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none required; not applicable.
(f) Unassigned Expenses
[3286]
(1) 8810
DEPRECIATION AND AMORTIZATION—FIXED ASSETS
8811
Land Improvements
8812
Buildings and Improvements
8813
Leasehold Improvements
8814
Fixed Equipment
Intangibles
(i) Function. Depreciation and Amortization is a cost center for recording depreciation and amortization expenses on land improvements, buildings and improvements, leasehold improvements, fixed equipment and intangibles.
(ii) Description. This cost center contains depreciation and amortization expense on land improvements, buildings and improvements, leasehold improvements, fixed equipment, and intangibles. All such expenses must remain in this cost center.
(iii) Standard Unit of Measure: none required; not applicable.
(2) 8815
LEASES AND RENTALS—FIXED ASSETS
8816
Land
8817
Buildings and Improvements
8818
Fixed Equipment
(i) Function. Leases and Rentals is a center for the recording of leases and rental expenses on land, buildings and improvements, and fixed equipment.
(ii) Description. This cost center contains all lease and rental expenses relating to land, buildings and improvements, and fixed equipment. All such expenses must remain in this cost center.
(iii) Standard Unit of Measure: none required; not applicable.
(3) 8820
DEPRECIATION AND AMORTIZATION—MOVABLE EQUIPMENT
(i) Function. Depreciation and Amortization—Movable Equipment is a cost center for recording depreciation and amortization expenses on movable equipment. All such expenses must be reported in this cost center.
(ii) Effective Date. Cost reporting periods beginning in 1980.
(4) 8825
LEASES AND RENTALS—MOVABLE EQUIPMENT
(i) Function. Leases and Rentals—Movable Equipment is a cost center for recording lease and rent expense on movable equipment. All such expenses must be reported in this cost center.
(ii) Effective date. Cost reporting periods beginning in 1980.
(5) 8830
EMPLOYEE BENEFITS—NON-PAYROLL-RELATED
(i) Description. This cost center must be used to report all non-payroll-related employee benefits. Included in non-payroll-related employee benefits are such costs as personal education, recreation and cultural activities, and day care.
(ii) Standard Unit of Measure: FTE employees. To calculate the number of full-time equivalent employees, sum all hours for which employees were paid (whether worked or not) during the year and divide by 2080.
(iii) Data source. Payroll records.
(iv) Effective date. Cost reporting periods beginning in 1980.
(6) 8840
INSURANCE—HOSPITAL AND PROFESSIONAL MALPRACTICE
(i) Function. This cost center is used to record all hospital and professional malpractice insurance expenses.
(ii) Description. This cost center is used to report all hospital and professional malpractice insurance expenses incurred in maintaining hospital and professional liability insurance policies. Also included is the self-insurance expense related to malpractice claims.
(iii) Standard Unit of Measure: none required; not applicable.
(7) 8850 INSURANCE—OTHER
(i) Function. This cost center is used to record all insurance expenses except those insurance expenses which are required in the Account Distribution Index (see chapter IV of this manual), to be charged to specific cost centers.
(ii) Description. This cost center is used to record all insurance expenses incurred in maintaining all insurance policies except professional and hospital malpractice insurance and employee benefit insurance. For example, fire, theft, employee fidelity bonds, liability (non-professional), property damage, auto, boiler, and business interruption insurance expense would be included here. Also included is the expense associated with self-insurance of such losses.
(iii) Standard Unit of Measure: none required; not applicable.
(8) 8860 LICENSES AND TAXES (OTHER THAN INCOME TAXES)
(i) Function. This cost center is used to record all business license expenses incidental to the operation of the hospital, all other license expense, and all taxes (other than on income).
(ii) Description. This cost center contains the business license expense, other license expense (including unassigned permits) and tax expense which are incidental to the operation of the hospital. Fees paid to a city and/or county (or other governmental unit, except State taxes) for doing business in city and/or county must be recorded in this cost center.
(iii) Standard Unit of Measure: none required; not applicable.
(9) 8870 INTEREST—SHORT-TERM
(i) Function. This cost center is used to record all interest incurred on borrowings for working capital purposes.
(ii) Description. This cost center contains the interest expense relating to borrowings for hospital operations. Interest incurred on mortgage notes and other borrowings for the acquisition of equipment must not be included in this cost center.
(iii) Standard Unit of Measure: none required; not applicable.
(10) 8880 INTEREST—LONG-TERM
(i) Function. This cost center contains all interest incurred on capital, mortgages and other loans for the acquisition of property, plant and equipment.
(ii) Description. This cost center contains all interest expense incurred on capital, mortgages and other loans for the acquisition of property, plant and equipment. This includes the interest on the current portion of long-term debt.
(iii) Standard Unit of Measure: none required; not applicable.
(g) Holding Accounts
[3287]
(1) 8991 CENTRAL PATIENT TRANSPORTATION
(i) Function. Central Patient Transportation is the transporting of patients between services in and about the hospital. This does not include the transportation of patients to the hospital.
This holding cost center is provided for those hospitals wishing to identify the cost of this service. However, all costs in this cost center must be transferred to the appropriate Ancillary Services cost center for reporting purposes.
(ii) Description. This cost center shall contain the direct expenses incurred in Central Patient Transportation only if there is an established Central Patient Transportation cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees supplies, purchased services, other direct expenses and transfers. These costs shall then be reclassified to Ancillary Services cost centers. See section 1619 for a further discussion.
(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.
(2) 8992 NURSING FLOAT PERSONNEL
(i) Function. To record the expenses of nursing personnel who work in more than one cost center on a “float” basis.
(ii) Description. The expenses of nursing personnel who work in more than one cost center on a “float” basis must be reported in the cost center in which they work. This may be done directly or may be recorded originally in this account and distributed (preferably at the end of each payroll period) to using cost centers based upon hours worked in each cost center. Any expenses attributable to nursing float personnel, including on-call and paid time-off, must be distributed based upon actual hours worked by the individual nurses during the applicable payroll period. Scheduling and other administrative functions relative to float personnel are considered costs of nursing administration.
(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.
(3) 8993 EMPLOYEE BENEFITS—PAYROLL-RELATED
(i) Function. This cost center may be used to record all employee benefits and other benefits which can be specifically identified as belonging to a particular cost center. This cost center is provided for those hospitals wishing to identify the cost of this service. However, all costs in this cost center must be closed out for reporting purposes to the other functional cost centers.
(ii) Description. Included in Employee Benefits—Payroll-Related are such costs as FICA, SUI, vacation, holiday and sick leave, group health insurance, group life insurance, pension and retirement, and workers' compensation insurance.
(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
TOXIC MATERIALS TOXIC MATERIALS
10 CRR-NY 14-4.70 Poisonous and toxic materials; restrictions; storage
(a) In pushcarts, poisonous and toxic materials are restricted to hand and utensil cleaners and utensil sanitizers.
(b) In mobile food service establishments, poisonous and toxic materials are restricted to hand, utensil and equipment cleaners, and utensil and equipment sanitizers. Vehicle maintenance materials must not be stored in parts of the vehicle where food is stored, prepared or served.
(c) Poisonous and toxic materials are to be stored in areas designated for such use separate from food storage.
(d) Bactericides, cleaning compounds and sanitizers used on food-contact surfaces are not to leave toxic residues on such surfaces.
(e) First-aid supplies and personal medications are to be restricted to designated locations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.38 Funded depreciation calculation
(a) Calculation to determine extent of depreciation funding.
(1) Total depreciation expense for reporting period:
(i) Depreciation and Amortization—Fixed Assets (account 8810), plus
(ii) Depreciation and Amortization—Movable Equipment (account 8820).
(2) Source and amount of cash disbursed for capital assets:
(i) Unrestricted Fund (exclude borrowed from outside sources).
(ii) Specific purpose funds.
(iii) Plant replacement and expansion funds.
(iv) Endowment funds.
(3) Payments made during year to reduce capital debt (principal only).
(4) Change in composition of depreciation fund balance.
Subtract balance at the end of the prior reporting period from balance at the end of the current reporting period for total assets, total liabilities and fund balances.
(5) Maximum allowable depreciation expense:
(i) Take the total amount of cash disbursed for capital assets.
(ii) Add payments made to reduce capital debt.
(iii) Add or subtract increase or decrease in depreciation fund balance.
(6) Depreciation not funded:
(i) If maximum allowable depreciation expense exceeds or is equal to total depreciation expense reported, depreciation has been fully funded.
(ii) If maximum allowable depreciation expense is less than total depreciation expense reported, the depreciation funding requirement has not been met.
(b) Total depreciation expense for the reporting period (paragraph [a][1] of this section) should reflect Medicaid adjustments (section 446.37 of this Part).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.43 Storage of food; general requirements
(a) Containers of food are to be stored a minimum of six inches (14.24 centimeters) above the floor to protect the food from splash and other contamination, and at a height to permit easy cleaning of storage area.
(b) Food and containers of food and food wrapping materials are not to be stored under exposed or unprotected sewer lines. The storage of same in toilet rooms is prohibited.
(c) Food not subject to further washing or cooking is to be stored and protected against cross-contamination from food requiring washing and cooking.
(d) Packaged food is not to be stored in contact with water or undrained ice. Ice intended for human consumption is not to be used as a medium for cooling stored food, food containers or food utensils.
(e) Food which is not readily identifiable is to be stored in properly labeled original product containers or in containers labeled to identify the food by common name.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.25 Capital expense reimbursement
(a) The allowable costs of fixed capital (including but not limited to depreciation, rentals and interest on capital debt), and major movable equipment shall be reimbursed based on budgeted data and shall be reconciled to total actual expense for the rate year and shall be determined and computed in accordance with the provisions of subdivisions (f), (g) and (h) of this section.
(b) General hospitals shall submit a schedule of anticipated inpatient capital-related expenses for the forthcoming year to the commissioner at least 120 days prior to the beginning of the rate year.
(c) The following principles shall apply to budgets for inpatient capital-related expenses:
(1) The basis for determining capital-related inpatient expenses shall be the lesser of actual cost or the final amount specifically approved for construction of the capital asset.
(2) Any capital-related inpatient expense generated by a capital expenditure which requires or required approval pursuant to article 28 of the Public Health Law, must have received such approval for the capital-related expense to be included in the rate calculation.
(3) The submitted budget may include the capital-related inpatient expense of all existing capital assets, as well as estimates of capital-related inpatient expenses for capital assets to be acquired or placed in use prior to the commencement of the rate year.
(4) Any capital-related expense generated by a capital expenditure acquired or placed in use during a rate year shall be carried forward to the subsequent rate year, provided all required approvals have been obtained. In instances where such approvals have been obtained or where approval is not required and such assets are acquired or placed in use during a rate year, the budget may include estimates for capital-related expenses relating to these assets.
(d) Allocation of budgeted capital costs.
In each rate year budgeted capital costs shall be allocated to exempt units and hospitals (including certified substance abuse detoxification services) to DRG case-payment rates based on reported capital trace back statistics for the two years prior to the rate year.
(e) Payment for budgeted allocated capital costs.
(1) Capital per diems for exempt units and hospitals shall be calculated by dividing the budgeted capital costs allocated to such rates in subdivision (d) of this section by the budgeted exempt unit days, reconciled to actual rate year days and actual rate year exempt unit or hospital-approved capital expense. Effective on or after April 1, 2020 and thereafter, the budgeted and actual capital per diem rates shall be reduced by five percent. Additionally, for capital per diem rates reconciled on or after April 1, 2020, if the difference between the budgeted and actual capital per diem rate results in a positive rate adjustment, that rate adjustment shall be reduced by ten percent 10 percent. Conversely, if the difference between the budgeted and actual capital per diem rate results in a negative rate adjustment, that rate adjustment shall be increased by 10 percent.
(2) Capital payments for acute DRG case rates shall be determined by dividing the budgeted capital allocated to such rates in subdivision (d) of this section by the hospital's budgeted acute discharges, reconciled to actual rate year discharges and actual rate year acute or hospital-approved capital expense. Effective on or after April 1, 2020 and thereafter, the budgeted and actual capital acute DRG case rates shall be reduced by five percent. Additionally, for acute DRG case rates reconciled on or after April 1, 2020, if the difference between the budgeted and actual capital acute DRG case rate results in a positive rate adjustment, that rate adjustment shall be reduced by 10 percent. Conversely, if the difference between the budgeted and actual capital acute DRG case rate results in a negative rate adjustment, that rate adjustment shall be increased by 10 percent.
(3) Capital payments for transferred patients shall be determined by dividing the budgeted capital allocated to the DRG case payment rates by the budgeted nonexempt hospital's unit days, reconciled to rate year days and actual rate year nonexempt unit or hospital approved capital expense.
(f) Depreciation.
(1) Reported depreciation based on historical cost is recognized as a proper element of cost. Useful lives shall be the higher of the reported useful life or those useful lives from the Estimated Useful Lives of Depreciable Hospital Assets, American Hospital Association, consistent with title XVIII provisions. Copies of this publication are available from the American Hospital Association, One North Franklin, Chicago, IL 60606-3421, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237.
(2) In the computation of rates for voluntary facilities, depreciation shall be included on a straight line method on plant and nonmovable equipment. Depreciation on movable equipment may be computed on a straight line method or accelerated under a double declining balance or sum-of-the-years' digit method. Depreciation shall be funded unless the commissioner determines, upon application by the facility, and after inviting written comments from interested parties, that the requested waiver of the requirements for funding is a matter of public interest and necessity. In instances where funding is required, such fund may be used only for capital expenditures with approval as required for the amortization of capital indebtedness. Funding for plant and fixed equipment shall mean that the transfer of monies to the funded accounts shall occur by the end of the fiscal period in which the depreciation is recorded. Board-designated funds and the accrual of liabilities to the funded depreciation accounts (due to/from accounts) shall not be recognized as funding of depreciation. Deposits to the funded depreciation accounts must remain in such accounts to be considered as valid funding transactions unless expended for the purpose for which it was funded.
(3) In the computation of rates for public facilities, depreciation is to be included on a straight-line method on plant and nonmovable equipment. Depreciation on movable equipment may be computed on a straight-line method or accelerated under a double declining balance or sum-of-the-years' digits method.
(4) Medical facilities financed by mortgage loans pursuant to the Nursing Home Companies Law or the Hospital Mortgage Loan Construction Law shall conform to the requirements of this Subpart. In lieu of depreciation and interest, on the loan-financed portion of the facilities, the commissioner shall allow level debt service on the mortgage loan, for all loans approved for financing prior to January 1, 1990, together with such required fixed charges, sinking funds and reserves as may be determined by the commissioner as necessary to assure repayment of the mortgage indebtedness. For loans approved for financing on or after January 1, 1990, medical facilities shall receive reimbursement in the form of interest and depreciation in accordance with the remainder of this Subpart.
(5) Article IX-C corporations may elect to include in their reimbursement rates depreciation computed by a method other than that used in paragraphs (2) and (3) of this subdivision, subject to approval by the commissioner.
(6) With respect to outpatient facilities, capital cost reimbursement may include an amount for rent, provided the following conditions are met:
(i) the lease is reviewed and approved by the department or any other appropriate State agency;
(ii) the space rented is in a multi-purpose, multi-use building not specifically constructed for the purpose of housing an outpatient facility;
(iii) the rental, if the lease is a sublease, is the same or less than comparable leases in the geographic area;
(iv) the applicant has no interest, direct or indirect, beneficial or of record, in the ownership of the building or any over lease; and
(v) the rental per square foot, in the judgment of the department, is the same as or is comparable to other rentals in the building in which the outpatient service is to be located, and the rental per square foot is comparable to the rental of similar space in other comparable buildings in the area when such comparisons can be made.
(g) Interest.
(1) Necessary interest on both current and capital indebtedness is an allowable cost for all medical facilities.
(2) To be considered as an allowable cost, interest shall be incurred to satisfy a financial need, and at a rate not in excess of what a prudent borrower would have had to pay in the money market at the time the loan was made and exclude costs and fees incurred as a result of an interest rate swap agreement. Also, the interest shall be paid to a lender not related through control, ownership, affiliation or personal relationship to the borrower, except in instances where the prior approval of the commissioner has been obtained. Financial need for capital indebtedness relating to a specific project shall exist when all available restricted funds designated for capital acquisition of that type have been considered for equity purposes.
(3) Interest expense shall be reduced by investment income with the exception of income from funded depreciation, qualified pension funds, trusteed malpractice insurance funds, or in instances where income from gifts or grants is restricted by donors. Interest on funds borrowed from a donor restricted fund or funded depreciation is an allowable expense. Investment income shall be defined as the aggregate net amount realized from dividends, interest, rental income, interest earned on temporary investment of withholding taxes, as well as all gains and losses. If the aggregate net amount realized is a loss, the loss shall not be allowable. Rate year investment income shall reduce rate year interest expense allowed for reimbursement as follows:
(i) for all medical facilities, investment income shall first be used to reduce operating interest expense for that year;
(ii) any remaining amount of investment income, after application of paragraph (i), shall be used to reduce capital interest expense reimbursed that year for medical facilities; and
(iii) any remaining amount of investment income after application of paragraph (ii) shall not be considered in the determination of allowable costs.
(4) Interest on current indebtedness shall be treated and reported as an operating, administrative expense.
(5) Interest on capital indebtedness is an allowable cost if the debt generating the interest is approved by the commissioner, incurred for authorized purposes, and the principal of the debt does not exceed either the approval of the commissioner or the cost of the authorized purposes. Capital indebtedness shall mean all debt obligations of a facility that are:
(i) evidenced by a mortgage note or bond and secured by a mortgage on the land, building or nonmovable equipment; a note payable secured by the nonmovable equipment of a facility; a capital lease;
(ii) incurred for the purpose of financing the acquisition, construction or renovation of land, building or nonmovable equipment;
(iii) found by the commissioner to be reasonable, necessary and in the public interest with respect to the facility. Interest related to refinancing indebtedness shall be considered an allowable cost only to the extent that it is payable with respect to an amount equal to the unpaid principal of the indebtedness then being refinanced. However, interest incurred on refinanced debt in excess of the previously unpaid balance of there financed indebtedness will be allowable on acceptable demonstration to the commissioner that such refinancing will result in a debt service savings over the life of the indebtedness; or
(iv) incurred for the purpose of advance refunding of debt. Gains and losses resulting from the advanced refunding of debt shall be treated and reported as a deferred charge or asset. This deferred charge or asset is to be amortized on a straight-line basis over the period to the scheduled maturity date of the refunding debt.
(6) Where a public finance authority has established a mortgage rate of interest such that sufficient cash flows exist to retire the mortgage prior to the stated maturity, the amount of the mortgage to be forgiven, at the time of such forgiveness, shall be capitalized as a deferred asset and amortized over the remaining mortgage life, as a reduction to the facility's capital expense.
(7) Voluntary facilities shall report mortgage obligations financed by public finance authorities for their benefit and which they are responsible to repay, as liabilities in the general fund, when such mortgage obligations are incurred.
(h) Sales, leases and realty transactions.
(1) If a medical facility is sold or leased or is the subject of any other realty transaction before a rate for the facility has been determined and certified by the commissioner, the capital cost component of such rate shall be determined in accordance with the provisions of this section.
(2) If a medical facility is sold or leased or is the subject of any other realty transaction after a rate for the facility has been determined and certified by the commissioner, the capital cost component of such rate shall be considered to be continuing with the same force and effect as though such sale, lease or other realty transaction had not occurred. This subdivision shall not be construed as limiting the powers and rights of the commissioner to change rate computations generally or specifically when based upon previous error, deceit or any other misrepresentation or misstatement that has led the commissioner to determine and certify a rate which he would otherwise not have determined or certified. Further, this subdivision shall not be construed as limiting the powers and rights of the commissioner to reduce rates when one or more of the original property right aspects related to such a facility is terminated.
(3) An arms length lease purchase agreement with a nonrelated lessor involving plant facilities or equipment which meets any one of the four following conditions, establishes the lease as a virtual purchase.
(i) The lease transfers title of the facilities or equipment to the lessee during the lease term.
(ii) The lease contains a bargain purchase option.
(iii) The lease term is at least 75 percent of the useful life of the facilities or equipment. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the facilities or equipment.
(iv) The present value of the minimum lease payments (payments to be made during the lease term including bargain purchase option, guaranteed residual value and penalties for failure to renew) equals at least 90 percent of the fair market value of the leased property. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the facilities or equipment. Present value is computed using the lessee's incremental borrowing rate, unless the interest rate implicit in the lease is known and is less than the lessee's incremental borrowing rate, in which case the interest rate implicit in the lease is used.
(4) If a lease is established as a virtual purchase under subdivision (d) of this section, the rental charge may be included in capital-related costs to the extent that it does not exceed the amount that the provider would have included in capital-related costs if it had legal title to the asset (the cost of ownership). The cost of ownership shall be limited to depreciation and interest. Further, the amounts to be included in capital-related costs are determined as follows:
(i) The difference between the amount of rent paid and the amount of rent allowed as capital-related costs is considered a deferred charge and is capitalized as part of the historical cost of the asset when the asset is purchased.
(ii) If an asset is returned to the owner instead of being purchased, the deferred charge may be included in capital-related costs in the year the asset is returned.
(iii) If the term of the lease is extended for an additional period of time at a reduced lease cost and the option to purchase still exists, the deferred charge may be included in capital-related costs to the extent of increasing the reduced rental to an amount not in excess of the cost of ownership.
(iv) If the term of the lease is extended for an additional period of time at a reduced lease cost and the option to purchase no longer exists, the deferred charge may be included in capital-related costs to the extent of increasing the reduced rental to a fair rental value.
(v) If the lessee becomes the owner of the leased asset (either by operation of the lease or by other means), the amount considered as depreciation for the purpose of having computed the limitation on rental charges under subdivision (e) of this section, must be used in calculating the limitation on adjustments for the purpose of determining any gain or loss upon disposal of an asset.
(vi) In the aggregate, the amount of rental or lease costs included in capital-related costs may not exceed the amount of the costs of ownership that the provider could have included in capital-related costs had the provider legal title to the asset.
(5) If a facility enters into a sale and lease back agreement involving plant facilities or equipment, the amounts to be included in capital-related costs both on an annual basis and over the useful life of the asset shall not exceed the costs of ownership which shall be limited to depreciation and interest, and shall be determined as follows:
(i) If the annual rental or lease costs in the early years of the lease are less than the annual costs of ownership, but in the later years of the lease the annual rental or lease costs are more than the annual costs of ownership, in the years that the annual rental or lease costs are more than the annual costs of ownership, the facility may include in capital-related costs annually the actual amount of rental or lease costs, except that in any given year, the amount included in capital related costs is limited to an amount which would not cause the aggregate rental or lease costs included up to that year in capital-related costs to exceed the costs of ownership that would have been included in capital-related costs up to that year if the provider had retained legal title to the asset.
(ii) If the annual rental or lease costs in the early years of the lease exceed the annual costs of ownership, but in the later years of the lease the annual rental or lease costs are less than the annual costs of ownership, the facility may carry forward amounts of rental or lease costs that were not included in capital-related costs in the early years of the lease due to the costs of ownership limitation, and include these amounts in capital-related costs in the years of the lease when the annual rental or lease costs are less than the annual costs of ownership, provided, however, in any given year the amount of actual annual rental or lease costs plus the amount carried forward to that year may not exceed the amount of the costs of ownership for that year.
(iii) In the aggregate, the amount of rental or lease costs included in capital-related costs may not exceed the amount of the costs of ownership that the provider could have included in capital-related costs if the provider had retained legal title to the asset.
(iv) If a facility enters into a sale and lease back agreement involving land, the incurred rental for the cost of land may not be included in allowable costs.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.22 X-ray screening; general requirements; mammography
(a) General requirements.
This applies to each person or operator that provides X-ray screening to a target population when there is no individual order for each procedure.
(1) All screening shall be performed under the supervision of a licensed practitioner pursuant to section 89.4(a) of this Title.
(2) The screening program operator shall establish and maintain a referral system for communicating findings to the patient's primary care provider in a timely fashion.
(3) The screening program operator shall establish and maintain a referral system for patients with suspicious findings or disease when the patient does not report having a primary care provider.
(4) The screening program operator shall annually review the program to determine the appropriateness of continuing screening and report the findings of that review to the department.
(5) A prospective screening program operator shall apply to the department and submit information prior to operation indicating how the operator will comply with paragraphs (1) through (4) of this subdivision.
(6) The screening program operator shall prepare and submit to the department within 15 days of a request a report that includes the following information for a requested time period:
(i) the total number of patients screened by diagnosis;
(ii) the total number of suspicious findings or disease;
(iii) the total number of patients referred for follow-up for each suspicious finding or disease diagnosed.
(b) Mammography.
The following requirements for mammography screening are in addition to those in paragraphs (a)(1) through (5) of this section.
(1) All mammographic images shall be interpreted by a qualified physician.
(2) Baseline mammography images shall be maintained for 10 years.
(3) Palpation and the teaching of breast self-examination shall be provided.
(4) The screening program operator shall perform an annual analysis of false positive and false negative findings for cases where the data can be obtained.
(5) The facility shall prepare and submit to the department an annual report including:
(i) total number of individuals screened by age group;
(ii) total number of patients referred for follow-up by age group; and
(iii) results of the analysis of false positive findings.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.7 District operation
The water quality treatment district shall comply with all conditions detailed in the written approval from the State, and all provisions of this Subpart.
(a) All treatment systems in the water quality treatment district shall be under responsible charge of an operator with demonstrated knowledge and experience with the type of treatment systems in use in the district, as determined by the State.
(b) The water quality treatment district shall monitor treated and untreated water for the parameters and at the frequency stated in the written approval. Samples taken to demonstrate compliance with water quality standards or guidelines shall be analyzed in an approved laboratory as defined by section 5-1.74 of this Part. Analysis of operational samples shall be made by an analyst with demonstrated competence using appropriate equipment, as determined by the State.
(c) The water quality treatment district shall report all available sample results to the State quarterly within 15 days of the end of a quarter, except when treated water exceeds a standard or guideline requiring State notification. Results exceeding a standard or guideline requiring State notification shall be reported to the State and to the impacted consumers in the water quality treatment district within 48 hours of learning the results.
(d) The water quality treatment district shall submit an annual report covering the previous calendar year to the State on or before July 1st each year. The annual report shall contain, but not be limited, to the following applicable items:
(1) number, type and location of treatment systems in service, and the number and type of treatment systems added or deleted during the year;
(2) effective life of units;
(3) treatment system failures;
(4) maintenance problems;
(5) operational problems;
(6) supply problems;
(7) changes in types of treatment devices in service;
(8) consumer complaints;
(9) summary and trends in monitoring test results;
(10) changes in water quality treatment district boundary;
(11) changes in water quality treatment district operational and/or administrative procedure; and
(12) list of names, addresses and telephone numbers of administrators and operators of the water quality treatment district.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.4 Reporting requirements
(a) Each hospice provider shall complete and file with the New York State Department of Health and/or its agent, financial and statistical reports as deemed necessary by the Commissioner of Health on forms supplied by the department. In instances where the hospice is a component part of a larger organization, the cost and statistics related to the operation of the hospice shall be separately maintained from the operator's other activities.
(b) Completion of such financial and statistical reporting forms shall be in accordance with generally accepted accounting principles as applied to the hospice, unless the reporting instructions authorize specific variation in such principles.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.1 Applications for establishment
(a) An application to the Public Health Council for its approval, as required by law, shall be in writing on application forms provided by the State Department of Health; and subscribed by the chief executive officer or other officer duly authorized by the board of a corporate applicant, a general partner or proprietor of the proposed medical facility, or, where an application is to be submitted by a local governmental applicant, the president or chairman of the board of the proposed facility or the chief executive officer if there is no board; and accompanied by a certified copy of a resolution of the board of a corporate applicant authorizing the undertaking which is the subject of the application, and the subscribing and submission thereof by an appropriate designated individual. In the event that an application is to be submitted by an entity which necessarily remains to be legally incorporated, it shall be subscribed and submitted by one of the proposed stockholders or directors. If a local governmental applicant submitting an application has not designated a president, chairman or chief executive officer for the proposed facility, the application shall be subscribed by the chairman or president of the local legislature or board of supervisors having jurisdiction, or other appropriate executive officer. An original application and eight copies thereof shall be prepared. The original and eight copies shall be filed with the council through the project management unit in the department's central office in Albany which shall transmit one copy to the health systems agency having geographic jurisdiction.
(b) Applications to the council shall contain information and data with reference to:
(1) the public need for the existence of the facility or the proposed facility at the time and place and under the circumstances proposed;
(2) the character, experience, competency and standing in the community of the proposed incorporators, directors, stockholders, sponsors, individual operators or partners;
(3) the financial resources and sources of future revenue of the facility to be operated by the applicant;
(4) the fitness and adequacy of the premises and equipment to be used by the applicant for the proposed facility;
(5) the following documents shall be filed:
(i) a certified copy of the applicant's certificate of doing business;
(ii) where the applicant is a partnership, full and true copies of all partnership agreements, which shall include the following language:
“By signing this agreement, each member of the partnership created by the terms of this agreement acknowledges that the partnership and each member thereof has a duty to report to the New York State Department of Health any proposed change in the membership of the partnership. The partners also acknowledge that the prior written approval of the Public Health Council is necessary for such change before such change is made, except that a change resulting from an emergency caused by the severe illness, incompetency or death of a member of the partnership shall require immediate notification to the New York State Department of Health of such fact and application shall be made for the approval by both the Public Health Council and the New York State Department of Health of such change within 30 days of the commencement of such emergency. The partners also acknowledge that they shall be individually and severally liable for failure to make the aforementioned reports and/or applications”;
(iii) such additional pertinent information or documents necessary for the council's consideration, as requested.
(c) Any person filing a proposed certificate of incorporation or an application for establishment of a hospital as defined in article 28 of the Public Health Law shall file with the commissioner information on the ownership of the property interests in such facility, including the following:
(1) the name and address and a description of the interest held, or proposed to be held, by each of the following persons:
(i) any person who, directly or indirectly, beneficially owns any interest in the land on which the facility is located;
(ii) any person who, directly or indirectly, beneficially owns any interest in the building in which the facility is located;
(iii) any person who, directly or indirectly, beneficially owns any interest in any mortgage, note, deed of trust or other obligation secured in whole or in part by the equipment used in the facility, or by the land on which or the building in which the facility is located;
(iv) any person who, directly or indirectly, has any interest as lessor or lessee in any lease or sublease of the land on which or the building in which the facility is located; and
(v) any person who, directly or indirectly has any interest as a lessor or lessee in any lease or sublease of the equipment used in the building in which the facility is located;
(2) if any person named in response to paragraph (1) of this subdivision is a partnership, then the name and address of each partner;
(3) if any person named in response to paragraph (1) of this subdivision is a corporation, other than a corporation whose shares are traded on a national securities exchange or are regularly quoted in an over-the-counter market or which is a commercial bank, savings bank or savings and loan association, then the name and address of each officer, director, stockholder and, if known, each principal stockholder and controlling person of such corporation;
(4) if any corporation named in response to paragraph (1) of this subdivision is a corporation, whose shares are traded on a national securities exchange or are regularly quoted in an over-the-counter market or which is a commercial bank, savings bank or savings and loan association, then the name and address of the principal executive officers and each director and, if known, each principal stockholder of such corporation;
(5) such additional pertinent information and documents necessary for the council's consideration, as requested.
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 458 NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 458.2 Salaries and wages
(a) General.
(1) If management is to have maximum control over labor costs, close control of the number of man-hours paid is essential. Man-hours are a more stable measure of labor utilization than dollars, because man-hours are not affected by inflation. Also, when man-hours are compared to units of service, they can provide management with information that is useful both for internal control and external comparisons.
(2) A record of man-hours paid that exactly parallels the record of salaries and wages paid by department must be maintained. This requires that the residential health care facility establish a record of paid man-hours by department for all personnel whose compensation is included on the payroll, including exempt personnel. These man-hour records must include separate records of worked man-hours and nonworked man-hours. Worked man-hours should include regular hours worked, overtime hours worked, hours worked when on call or on standby, hours spent in in-service education, orientation, breaks, paid social functions (such as Christmas parties), and so forth. Nonworked man-hours should include paid vacations, holidays, sick pay, military leave, educational leave, (including continuing education) bereavement or funeral leave, jury duty, benefit hours paid but not taken as leave, and so forth.
(3) Overtime hours are hours for which an overtime pay rate is used. The actual overtime hours are not treated differently from regular worked hours; it is the rate that changes. This is preferable to the common but undesirable practice of adding additional hours to the records when calculating the payroll so that the regular pay rate can be used instead of the overtime rate.
(4) On-call and/or standby pay is compensation to an employee for being available to work. During the period when the employee is on call or on standby, he might or might not actually perform work. The Fair Labor Standards Act differentiates between restricted and unrestricted on-call situations. All restricted on-call hours are compensable and contribute to the total hours used for determining overtime pay. Unrestricted on-call hours do not contribute to total hours, but unrestricted on-call compensation does contribute to the salary base used for calculating overtime premiums only. Thus all restricted on-call hours must be accounted for, but only those hours worked need be accounted for when employees are on unrestricted on-call duty.
(5) Salaries and wages are defined as all remuneration, payable in cash, for services performed by an employee for the residential health care facility, and the fair market value of services donated to the facility by persons performing in an employee relationship. Reimbursement of independent contractors, such as private duty nurses, should be excluded.
(b) Specific classifications of salaries and wages follow:
(1) Management and Supervision. Employees included in this classification are primarily involved in the direction, supervision and coordination of residential health care facility activities. Salaries and wages for this classification would usually include, but are not limited to, the following job titles: president; chief executive officer; administrator; manager; department head; supervisor; director; and foreman. These employees may be exempt from Federal wage and hour laws. Lead positions of chief, head, and so forth must be classified as Management and Supervision if they provide direct supervision to five or more other employees, except for Registered Nurses and Licensed Practical Nurses which must be classified as detailed in paragraphs (b)(3) and (4) of this section. Positions supervising fewer than five employees may be classified as Management and Supervision if the activities performed otherwise meet the Management and Supervision criteria.
(2) Technicians, Specialists and Non-Physician Medical Pratitioners. Employees included in this classification usually perform activities of a creative or complex nature. Also included are those employed to consult, diagnose and prescribe and provide treatment to patients under the direction of a physician. Salaries and wages for this classification would usually include, but are not limited to, the following job titles: coordinator; chef; programmer; technologist; technician; therapist; instructor; nurse practitioner; physician assistant; clinical specialist and accountant. These employees are often licensed or registered. Some of these positions are exempt from Federal wage and hour laws because they are administrative or professional in nature. Lead positions of chief, head, and so forth must be classified as Management and Supervision if they provide direct supervision to five or more other employees. Positions supervising fewer than five employees may be classified as Management and Supervision if the activities performed otherwise meet the Management and Supervision criteria.
(3) Registered Nurses.
This classification includes all registered nurses employed to provide direct nursing care to patients, except the following specific job titles: RN -Supervisor (supervising two or more units), Health Services Supervisor, Director of Nursing Services and Assistant Director of Nursing Services. These specific job titles are to be reported under the classification Management and Supervision in accordance with paragraph (b)(1) of this section.
(4) Licensed Practical Nurses.
This classification includes all licensed practical nurses employed to provide direct nursing care to patients, except the following specific job titles: RN - Supervisor (supervising two or more units), Health Services Supervisor, Director of Nursing Services and Assistant Director of Nursing Services. These specific job titles are to be reported under the classification Management and Supervision in accordance with paragraph (b)(1) of this section.
(5) Aides, Orderlies and Assistants. Included in this classification are nontechnical personnel employed to provide direct nursing care to patients. Salaries and wages for this classification would usually include, but are not limited to, the following job titles: aide; orderly; and nurse assistant. These employees are subject to Federal wage and hour laws.
(6) Clerical and Other Administrative Employees. Included in this classification are nontechnical personnel employed in the performance of recordkeeping, communication and other administrative functions, who are subject to Federal wage and hour laws. Salaries and wages for this classification would usually include, but are not limited to the following job titles: accounting clerk; admitting clerk; messenger; keypunch operator; secretary; telephone operator; clerk-typist; cashier; and receptionist.
(7) Environment, Hotel and Food Service Employees. This classification includes personnel employed to provide basic services related to food and accommodations. They perform routine work of a nontechnical nature and are subject to Federal wage and hour laws. Salaries and wages for this classification would usually include, but are not limited to, the following job titles: maintenance man; housekeeping aide; cook's helper; flatwork finisher; guard; food service worker; wall washer; washperson; carpenter and plumber.
(8) Physicians Salaries.
Employees included in this classification are employed to consult, diagnose, and prescribe and provide treatment for patients. Physicians are also employed to provide education. These employees must possess Doctor of Medicine or Doctor of Osteopathy degrees and be licensed to practice medicine.
(9) Interns, Residents and Fellows.
Employees included in this classification are employed to consult, diagnose, and prescribe and provide treatment for patients. Salaries and wages for this classification would usually include, but are not limited to, the following job titles: intern; resident and fellow.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.3 Abuse by patients
Reports of abuse of one patient or resident by another may be reported to the New York State Department of Health, Office of Health Systems Management, but such reports are not a requirement of this Part. Only the provisions of sections 81.8 and 81.9, subdivisions (a), (b) and (c) of section 81.1, subdivision (a) of section 81.5, and subdivision (b) of section 81.7 of this Part shall apply to reports of abuse of one patient or resident by another.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.102 Due to other funds
A payable for money borrowed, stores received, work performed, or services from another fund.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.5 Legionella culture analysis
All Legionella culture analyses must be performed by a laboratory that is approved to perform such analysis by the New York State Environmental Laboratory Approval Program (ELAP).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
FACILITY OPERATIONS FACILITY OPERATIONS
10 CRR-NY 72-1.8 Patron identification and acknowledgment requirements
(a) Age verification.
(1) The operator shall require each patron to provide a driver’s license or other photo identification issued by a government entity or educational institution indicating that the patron is at least 18 years of age.
(2) No person under eighteen (18) years of age shall be permitted to use an ultraviolet radiation device.
(b) The operator shall provide to all patrons the department’s Tanning Hazards Information Sheet which advises of health risks and conditions under which the use of ultraviolet radiation is contraindicated, such as the use of photosensitizing drugs. Prior to initial exposure, each patron shall also be provided the opportunity to read a copy of the warning sign specified in section 72-1.9(a)(2) of this Subpart.
(c) Statement of acknowledgment.
(1) During the initial visit to the tanning facility, the operator shall require that each patron sign a statement that the warning sign and Tanning Hazard Information Sheet has been read and understood prior to using any ultraviolet radiation device, and that the patron agrees to wear adequate protective eyewear.
(2) No person shall undergo ultraviolet radiation exposure without such a signed statement on file.
(3) The operator or a designated employee shall also sign and date the statement.
(d) Consent form.
The operator shall not permit persons 17 years of age to 18 years of age to use ultraviolet radiation devices until such persons provide the tanning facility operator or an employee responsible for the operation of the ultraviolet radiation device of such facility (per section 3555[2] of PHL) with the written consent form, prescribed by the commissioner, indicating the following conditions have been met:
(1) Prior to the initial ultraviolet radiation exposure, the parent or legal guardian shall sign and date the consent form in the presence of the operator or an employee responsible for the operation of the ultraviolet radiation device of such facility (per section 3555[2] of PHL).
(2) By signing the consent form, the parent or legal guardian and persons 17 years of age to 18 years of age acknowledges that they have read the warnings required in section 72-1.9(a) of this Subpart and have received the information specified in subdivision (b) of this section.
(3) By signing the consent form, the parent or legal guardian acknowledges that the person(s) 17 years of age to 18 years of age has agreed to wear protective eyewear.
(4) The operator or a designated employee shall also sign and date the form.
(5) The written consent form signed by a parent or legal guardian shall expire 12 months from the date it was signed.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.2 Definitions
(a) Summer day camp shall mean a property consisting of a tract of land and any tents, vehicles, buildings, or other structures that may be pertinent to its use, any part of which may be occupied on a scheduled basis at any time between June 1st and September 15th in any year by children under 16 years of age, under general supervision, for the purpose of indoor or outdoor organized group activities, involving two or more activities of which at least one is a nonpassive recreational activity with significant risk of injury, as defined in subdivision (l) of this section, for a period of less than 24 hours on any day the property is so occupied and/or which no provisions are made for overnight occupancy by such children.
(b) A traveling summer day camp shall mean a summer day camp which regularly operates in a period between May 15th and September 15th, and which regularly transports children under 16 years of age on a regular schedule to a facility, site or property, including any tract of land, beach, park, stadium, building, tents or other structures pertinent to its use, and primarily for the purpose of organized group activity.
(c) A children's overnight camp shall mean a property consisting of a tract of land and any tents, vehicles, buildings or other structures that may be pertinent to its use, any part of which may be occupied by persons under 18 years of age for the purpose of outdoor or indoor organized activities and on which provisions are made for overnight occupancy of children.
(d) A developmental disability is a severe, chronic disability of a person which is attributable to mental retardation, cerebral palsy, epilepsy, autism or neurological impairment, or is attributable to any other condition of a person similar to mental retardation, cerebral palsy, epilepsy, autism or neurological impairment because such condition results in similar impairment of general intellectual functioning and/or adaptive behavior and requires treatment and services similar to those required for such persons; originates before 18; is likely to continue indefinitely.
(1) Camp for children with developmental disabilities shall mean a children’s camp with 20 percent or more enrollment of campers with a developmental disability as defined by this subdivision.
(e) Uniform Code shall mean the 19 NYCRR Chapter XXXIII, Subchapter A - State Uniform Fire Prevention and Building Code.
(f) Potable water shall mean water used for human consumption, food preparation, handwashing, culinary, bathing or laundry purposes.
(g) A camp trip shall mean times when campers and staff are off camp property, except camp trips shall not include travel off camp property for medical or dental appointments, or travel to a store to purchase personal items, by a group of five or fewer campers accompanied by staff.
(h) A wilderness swimming site shall mean a remote beach site which is established for temporary use by a children's camp for the purpose of swimming at a location that is not readily accessible for inspection by the camp's permit issuing official.
(i) Incidental water immersion shall mean intentional entry into a body of water for a purpose, other than swimming, which is ancillary to the primary activity being conducted. Such immersion including partial immersion shall include but not be limited to stream crossing or entering water for personal hygiene, but shall exclude boating, water skiing, sail boarding and similar water sports where participants wear U.S. Coast Guard approved lifejackets.
(j) Aquatic amusement park activities shall include but not be limited to lazy rivers, activity pools, wave pools and water slides where patrons are partially or totally immersed in water.
(k) Adequate shall mean sufficient to accomplish the purpose for which something is intended and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(l) Nonpassive recreational activities with significant risk of injury are those that pose a significant risk of traumatic brain injury, injury to neck or spine, bone fractures or dislocations, lacerations requiring treatment to close, second or third degree burns to five percent or more of the body, loss of vision, or death. These may include diving, boating, horseback riding, rock climbing, shooting sports and other activities determined by the State Department of Health based on such characteristics as height, speed, water depth, physical contact with another participant or object, and/or use of equipment associated with the activity.
(m) Acceptable training in first aid shall mean certification in a first aid training program determined by the State Department of Health to provide the knowledge and skills necessary to sustain life from injury and sudden illness, which are likely to occur at children's camps. A training program shall include but not be limited to instruction about traumatic brain injury, injury to the neck or spine, bone fractures and dislocations, lacerations, burns; injury to the eye, and medical emergencies such as allergic reactions, seizures, strokes, shock, cardiac and diabetic emergencies, poisoning and heat related illness. A sufficient time shall be provided to cover all topics. First aid certificates shall be valid as specified by the provider, but shall not exceed three years from the date of course completion.
(n) Acceptable training in cardiopulmonary resuscitation (CPR) shall mean a CPR training program determined by the State Department of Health to provide an adequate level of knowledge and skills necessary to perform two rescuer CPR skills for all ages (infant, child, and adult). A sufficient time shall be provided to cover all topics. CPR certificates shall be valid as specified by the provider, but shall not exceed one year from the date of course completion.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 72-1.2 Application
(a) The requirements of this Subpart shall apply to all tanning facilities except where ultraviolet radiation devices are used by a qualified health care professional for treatment of medical conditions.
(b) A county or other local jurisdiction may apply to the department for approval of a program for the regulation of tanning facilities within its jurisdiction. When such approval is given, the Department of Health, or equivalent agency of such county or other local jurisdiction, may enact and enforce local regulations governing such program.
(c) Any local regulations issued pursuant to subdivision (b) of this section must be at least as protective as any related requirements in this Subpart, and may include, but are not limited to, provisions relating to the following:
(1) the conspicuous posting of the tanning facility's permit and appropriate warning signs;
(2) the required provision of informational materials by tanning facilities, which may include, but need not be limited to, an advisory to customers of conditions, such as the use of photosensitizing drugs, under which the use of ultraviolet radiation is contraindicated;
(3) standards for cleanliness, hygiene and safety;
(4) the requirement that each tanning facility provide adequate protective eyewear to customers without additional charge therefor;
(5) the reporting of injury or illness related to the use of ultraviolet radiation devices;
(6) requiring tanning facilities to maintain specified records;
(7) requiring patrons to provide identification and sign a statement of acknowledgment prior to undergoing ultraviolet radiation exposure at a tanning facility;
The requirements of sections 72-1.1 and 72-1.3 et seq . of this Subpart shall not apply within a local jurisdiction that has established and been approved for a program pursuant to subdivision (b) of this section when such program is in effect.
(8) requiring tanning facilities to prohibit the use of ultraviolet radiation devices by persons under eighteen (18) years of age.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.9 Periodic reports
(a) A report of activities pursuant to the cooperative agreement or the planning process shall be filed with the department in such form as the department, in consultation with the Attorney General and the mental hygiene agencies as appropriate, may require. Such report of activities shall be provided by the department to the Attorney General and, as appropriate, the mental hygiene agencies. Subject to the terms of the certificate of public advantage and any extensions thereof, such reports shall be filed annually after the issuance of the certificate of public advantage, on or before the anniversary date on which the certificate was issued, for each year that the certificate is in effect and at such other times as the department, in consultation with the Attorney General and the mental hygiene agencies as appropriate, may require.
(b) Such report shall include the following, unless waived by the department:
(1) A description of the activities conducted pursuant to the cooperative agreement or planning process.
(2) Price, cost, and savings information, including efficiencies achieved and additional information requested by the department, the Attorney General or the mental hygiene agencies as appropriate, related to conditions required under section 83-2.6(c)(9) of this Subpart.
(3) The nature and scope of the activities expected to be undertaken pursuant to the cooperative agreement or planning process during the next two years or for the remainder of the certificate of public advantage, if the balance of the certificate’s term is less than two years, and the likely effect of those activities.
(4) Data concerning the utilization of services in the communities served by the cooperative agreement and quality of care delivered by the health care provider parties to the agreement, including any data on progress in achieving quality benchmarks or targets for reducing preventable hospital admissions or readmissions or sub-optimal emergency department use specified by the department.
(5) Most recent available data concerning population health in the communities served by the agreement and progress in meeting any population health benchmarks.
(6) Data concerning health care professional recruitment and retention under the cooperative agreement or planning process.
(7) An analysis of the benefits and/or expected benefits of the cooperative agreement or planning process under the certificate of public advantage, taking into account any conditions imposed by the department, and how they outweigh the disadvantages or likely disadvantages of any reduction in competition from the agreement.
(8) A description of the measures taken to comply with conditions imposed by the department in issuing the certificate of public advantage, along with an assessment of compliance with, and the effectiveness of, such measures.
(9) Any additional information requested by the department, the Attorney General or, as appropriate, the mental hygiene agencies.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.4 End stage renal dialysis service
(a) This methodology will be utilized in the evaluation of certificate of need applications involving the construction or establishment of new or replacement dialysis stations used in the treatment of end stage renal disease. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of basic principles and planning/decisionmaking tools for guiding and directing the development of dialysis stations for end stage renal disease services throughout the State. Additionally, it is intended that the methodology will provide the health systems agencies and potential applicants with sufficient flexibility to consider the unique characteristics of their respective areas in determining need. The goals and objectives of the methodology expressed herein are expected to ensure that an adequate supply of dialysis stations are available to provide access to care to all those in need of in-facility dialysis.
(b) The factors to be considered in determining the public need for dialysis stations shall include, but not be limited to, the following:
(1) evidence that the proposed dialysis services capacity proposed will be utilized sufficiently to be financially feasible as demonstrated by a five-year analysis of projected costs and revenues associated with the program;
(2) evidence that the proposed service or additional capacity will enhance access to services by patients including members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to health services (for example, low- income persons, racial and ethnic minorities, women, and handicapped persons), and/or appropriate rural populations;
(3) evidence that the facility's hours of operation and admission policies will promote the availability of services which are acceptable to those in need of such services, in particular, operational hours that permit individuals in dialysis to continue employment;
(4) the facility's willingness and ability safely to serve dialysis patients; and
(5) when an existing provider proposes to add 12 or more stations, evidence, derived from analysis of factors including but not necessarily limited to both existing patient referral and use patterns and projected referral and use patterns which would result from addition of the proposed stations, indicating that approval of such stations will not jeopardize the quality of service provided at or the financial viability of other existing dialysis facilities or services within the applicant's planning area. However, a finding that the proposed facility would jeopardize the financial viability of such existing facilities will not, of itself, require a recommendation of disapproval of the application.
(c) Public need for a proposed facility or station shall be deemed to exist when review and consideration of evidence concerning each of the five factors set forth in subdivision (b) of this section results in an affirmative finding.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.15 Children in care
(a) Definitions.
The following terms shall have the following meanings:
(1) foster child shall mean a child in the care, custody or guardianship of a commissioner of a local social services district;
(2) homeless child shall mean a child placed in a hotel, motel, shelter, or other temporary housing arrangement by a social services district because of the unavailability of permanent housing;
(3) municipality of current location shall mean a municipality in which a child lives which is different from the municipality in which a child or such child's family lived at the time a social services district assumed responsibility for the placement of such child or family or at the time the child was admitted for care or treatment in a facility licensed or operated by a State agency other than the department of Health;
(4) municipality of residence shall mean the municipality in which a child or such child's family lived at the time the local social services district assumed responsibility or custody for such child or family or at the time the child was admitted for care or treatment in a facility licensed or operated by a State agency other than the department of Health; and
(5) child in residential care shall mean an infant or toddler living in a residential facility licensed or operated by a State agency. For the purposes of subdivisions (b), (c) and (d) of this section, a child in residential care shall be deemed a homeless child.
(b) Evaluation and IFSP responsibility.
The municipality of current location of a foster child or homeless child shall be responsible for the evaluation and IFSP procedures prescribed for an infant or toddler suspected of having a disability. For reimbursement purposes, the municipality of current location shall identify to the Commissioner of Health each eligible foster child or homeless child. The municipality of current location of such child shall also transmit a copy of the IFSP and cost of service of such child to the municipality of residence.
(c) Contract and payment responsibility.
The municipality of current location shall be the municipality of record for an eligible foster child or homeless child, provided that the State shall reimburse 100 percent of the approved costs paid by such municipality which shall be offset by the local contribution.
(d) Local contribution.
The municipality of residence shall be financially responsible for the local contribution in the amount of fifty percent of the approved costs.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Batch means a specific quantity of tissue that is intended to have uniform characteristics and quality within specific limits, and is produced according to the same processing protocol and during the same processing cycle.
(b) Musculoskeletal tissue donor means a human being, living or dead, who is the source of musculoskeletal tissue, including autogeneic tissue, for transplantation.
(c) Critical work area means an area where sterile tissue containers or aseptically retrieved tissue are exposed to the environment.
(d) Critical surface means a surface which comes into contact with aseptically retrieved tissue, sterile tissue containers or sterile container covers.
(e) Controlled work area means an area where unsterilized tissue, in-process materials and tissue containers are handled.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.7 Patients' rights
PCHs/CAHs shall comply with the provisions of section 405.7 of this Title with regard to patients' rights. However, for PCHs/CAHs that participate in a rural health network, requirements for skilled interpreters and personnel skilled in communicating with vision and hearing impaired individuals may be met through effective communication within the network including telephone, radio or electronic communications.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.15 Wallet-size certification of birth; fee
Each applicant for a wallet-size certification of birth shall remit to the commissioner with such application a fee of $15 in payment for the search of the files and records and the furnishing of the wallet-size certification if such record is found or for a certification that a search discloses no record of a birth.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.45 Blood bank transfusions
The number of whole blood and packed red cell units prepared for transfusion. A unit is considered to be 500 cc.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.10 Effective dates
The provisions of sections 22.6 and 22.7 of this Part shall be effective on December 1, 1981; the provisions of sections 22.4 and 22.5 of this Part shall be effective on April 1, 1982; the provisions of section 22.8 of this Part, which require the annual reporting of certain occupational exposures not later than September 1st of each year, shall be effective September 1, 1982 for the initial reporting period January 1, 1982 through June 30, 1982; and the provisions of sections 22.1, 22.2 and 22.3 of this Part shall be effective on October 1, 1982.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.7 Documentation of HIV-related information and disclosures
(a) Confidential HIV-related information shall be recorded in the medical record such that it is readily accessible to provide proper care and treatment.
(b) All disclosures of confidential HIV-related information must be noted in the record, except:
(1) only initial disclosures to insurance institutions must be noted;
(2) notation is not required for disclosure to agents or employees of health facilities or health care providers authorized under section 63.6(a)(3) of this Part; and
(3) notation is not required for persons engaged in quality assurance, program monitoring or evaluation, nor for governmental payment agents acting pursuant to contract or law.
(c) Confidential HIV-related information may be noted, as appropriate, in a certificate of death, autopsy report or related documents prepared pursuant to Public Health Law, article 41 or other laws relating to documentation of cause of death.
(d) The protected person shall be informed of disclosures of HIV information upon request of the protected person.
(e) Confidential HIV-related information shall not be disclosable pursuant to Public Officers Law, article 6 (the Freedom of Information Law).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.186 Investor-owned (proprietary) hospital
A hospital owned by a person, an unincorporated group of people, or a corporation. Operation of this type of hospital is usually intended to return a monetary gain to the investors; but may include instances where individuals own and operate hospitals primarily for community benefit.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 41 GRANTS FOR SCHOOL HEALTH PROJECTS
10 CRR-NY 41.2 Grant applications
(a) State grants shall be based on the prior approval of specific school health project proposals after application by the governing authority of not-for-profit or publicly operated facilities licensed pursuant to article 28 of the Public Health Law. Review and approval of such applications shall be by the State Commissioner of Health with the consent of the State Commissioners of Education and Social Services.
(b) The submission of a memorandum of understanding and support between the governing authority of the school district serving the area in which the schools proposing to participate in the facility's project are located and the applicant—article 28 facility shall be a condition of eligibility for a grant under this Part. For those projects to be located in any nonpublic school, the submission of a memorandum of understanding and support between the governing authority of such nonpublic school and the applicant—article 28 facility shall also be a condition of eligibility for a grant under this Part. Services funded by these State grants shall be available to all pupils enrolled in participating schools regardless of ability to pay. Only article 28 facilities proposing projects based in schools located in cities exempt from the requirements of State mandated public school pupil medical inspections and examinations under article 19 of the Education Law will be eligible to receive grant funds. Grant funds received pursuant to this Part must be used solely for a school health project approved pursuant to this Part. Selection of applications for grants shall be based upon criteria which, at a minimum, shall include:
(1) the extent of need and high risk in the community to be served based upon health indicators relating to children;
(2) the degree of participation by, and the commitment of, the schools and school districts proposing to participate in the project;
(3) the quality, scope and feasibility of the project proposal; and
(4) the qualifications, experience and commitment to the proposal of the applicant.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.102 Applications for specific licenses
(a) An application for a license for any radioactive material shall be filed in triplicate on, and shall contain completely and accurately all information called for by, a written form prescribed by the department. The application may incorporate by clear and specific reference information contained in any previous application, supplementary statement, notification or report filed with the department.
(b) At any time subsequent to the filing of an application for a license and before the termination of a license issued in response thereto, the department may require the applicant to submit one or more supplementary statements containing additional information to enable the department to determine whether such application should be approved or denied, or whether a previously issued license should be amended, suspended or revoked.
(c) Each application or supplementary statement shall be signed by either the applicant personally or a person duly authorized by the applicant to sign for and on the applicant's behalf.
(d) A single application may apply for more than one license or for a license covering more than one radioactive material.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.5 Service obligation
(a) Service obligation start date.
A recipient is required to begin providing primary care in an underserved area in New York State no later than 60 days after completion of his/her Primary Care Residency Program or obtaining his/her medical license, which ever is later, except that such date shall not exceed four months from completion of residency training.
(b) Practice requirements.
A recipient must provide at least 35 hours per week of primary care services for at least 48 weeks per year for each annual award received. If the recipient receives two awards under this Subpart, the service obligations shall run consecutively.
(c) Alternate service.
If a recipient fails to satisfactory complete the Primary Care Residency Program or fails to obtain a New York State license to practice medicine, the commissioner may permit the recipient to provide alternate service which involves the provision of health or human services in an underserved area and which is consistent with the intent of the Resident Loan Repayment Program.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.7 Decisions
(a) Copies of the resolution of the Public Health Council approving or disapproving an application shall be transmitted to the applicant, the State Hospital Review and Planning Council, the appropriate Regional Hospital Review and Planning Council and the Commissioner of Health.
(b) Copies of a notice that the council is considering the disapproval of an application or action contrary to the recommendation of the State Hospital Review and Planning Council or a regional council and affording an opportunity to request a public hearing shall be transmitted to the applicant, to the State Hospital Review and Planning Council, the appropriate Regional Hospital Review and Planning Council and the Commissioner of Health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.1 Authority, purpose and policy
(a) The State Environmental Quality Review Act (“SEQR”) of 1975 (article 8, Environmental Conservation Law), provides that all agencies shall prepare, or cause to be prepared by contract or otherwise an enviromental impact statement (“EIS”) on any action they propose or approve which may have a significant effect on the environment. Subdivisions (1) and (2) of section 8-0113 of the Environmental Conservation Law require that, after consultation with other agencies subject to the provisions of said article 8, including State agencies and representatives of local governments, and after conducting public hearings and review of any other comments submitted, the Commissioner of Environmental Conservation shall adopt rules and regulations of statewide applicability that implement the provisions of SEQR.
(b) Rules and regulations of statewide applicability were adopted on March 19, 1976 by the Commissioner of Environmental Conservation and filed with the Secretary of State on March 22, 1976 as Part 617 of Title 6 of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(c) This Part is adopted pursuant to subdivision (3) of section 8-0113 of the Environmental Conservation Law which requires agencies to adopt and publish such additional procedures as may be necessary for the implementation by them of SEQR, consistent with the statewide rules and regulations (6 NYCRR Part 617) adopted by the Commissioner of Environmental Conservation pursuant to subdivision (1) of section 8-0113 of the Environmental Conservation Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.16 Laboratory services
The hospital shall provide laboratory services that meet the needs of the patients as determined by the medical staff and the hospital.
(a) The hospital shall ensure that all clinical laboratory services provided or arranged for by the hospital comply with article 5, title V of the New York State Public Health Law and with Subpart 58-1 (Clinical Laboratories) of this Title, or for facilities located in New York City, with article 13 of the New York City Health Code. Hospitals shall ensure that all blood banks and transfusion services comply with article 31 of the New York State Public Health Law and Subpart 58-2 (Blood Banks) of this Title.
(b) The hospital shall maintain an adequately organized and supervised clinical laboratory with the necessary staff, space, facilities and equipment to meet the needs of its patients.
(1) Emergency laboratory services shall be available 24 hours a day, seven days a week, including holidays.
(2) For emergency situations, the hospital shall have immediately available a minimum blood supply.
(3) A written description of all laboratory services provided shall be available to the medical staff.
(4) The laboratory shall make provision for the proper receipt and reporting of tissue specimens.
(c) Personnel.
The hospital shall provide personnel qualified to direct and staff the laboratory.
(1) The hospital shall ensure that all laboratory services are conducted under the supervision of a director who holds a certificate of qualification issued by the New York State Department of Health or, where applicable, the New York City Department of Health.
(2) The laboratory director shall:
(i) provide technical supervision of all laboratory services, regardless of site;
(ii) assure that all tests, examinations and procedures are properly performed, recorded and reported;
(iii) assure that all tests for hospital patients are ordered by a practitioner so authorized by the hospital;
(iv) assure that appropriate signatures are on all cytology and histopathology reports and that all reports are filed with the patient's medical record and duplicate copies kept in a manner which permits ready identification and accessibility;
(v) assure that the laboratory staff:
(a) have appropriate education, experience, and training to perform and report laboratory tests promptly and proficiently;
(b) are sufficient in number for the scope and complexity of the services provided; and
(c) receive inservice training appropriate to the type and complexity of the laboratory services offered; and
(vi) assure that there is a documented quality control program in effect for all laboratory services in accordance with the requirements outlined in Part 58 of this Title and in conjunction with the hospital-wide quality assurance program required by section 405.6 of this Part.
(d) Tissue examination.
Tissue pathology services shall be provided by and under the direction of a pathologist possessing a certificate of qualification issued by the New York State Department of Health or, where appropriate, the New York City Department of Health. The medical staff and the pathologist shall identify which tissue specimens require a macroscopic examination only and which tissue specimens require both macroscopic and microscopic examinations. Policies and procedures pertaining to the receipt and holding of tissue specimens shall be developed and implemented and shall, at a minimum, include the following:
(1) a pathologist shall be responsible for verifying the receipt of tissues for examinations;
(2) a plan is established in the absence of a pathologist for sending all tissues requiring examination to a qualified pathologist outside the hospital; and
(3) provisions for maintaining a tissue file in the hospital.
(e) Blood, blood products and transfusion services.
The hospital shall ensure that there are facilities provided or readily available for the acquisition, safekeeping, transfusion and distribution of blood and that storage and use of blood products is under the direction of a blood bank director possessing a certificate of qualification issued by the New York State Department of Health, or where applicable, the New York City Department of Health.
(1) The hospital shall maintain, as a minimum, proper blood storage facilities under control and supervision of the blood bank director.
(2) In the case of services provided by an outside blood bank, the hospital shall have an agreement governing the acquisition, transfer and availability of blood and blood products, including plasma derivatives, that is reviewed and approved by the blood bank director, transfusion committee and administration.
(3) There shall be provision for prompt blood grouping, antibody detection, and compatibility testing, and for laboratory investigation of transfusion reactions.
(4) Blood storage facilities in the hospital shall have a temperature alarm system that is regularly inspected.
(5) Records shall be kept on file indicating the receipt and disposition of all blood and blood products acquired by the hospital.
(6) Samples of each unit of transfused blood and blood products, including plasma derivatives, shall be retained for further testing the event of reactions. The hospital shall promptly dispose of all blood not retained for further testing that has exceeded its expiration date.
(7) The hospital, according to its established procedure, shall review all transfusions of blood or blood derivatives and promptly investigate and report all transfusion reactions. Procedures shall be established and implemented for ensuring that reports of all acute hemolytic transfusion reactions are made to the hospital-wide quality assurance program and to the department pursuant to section 405.8 of this Part and that, as appropriate, recommendations are made to the medical staff regarding improvements in transfusion procedures and practices.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.3 Medical service plan
Facilities providing ambulatory services shall submit to the department a plan governing the provision of medical services to patients, which has been approved by the governing authority and the medical staff, including, as a minimum, the following:
(a) a comprehensive medical evaluation for such patients on a periodic basis indicating the method of selection of patients for annual or other periodic examination;
(b) continuity of care when such patients require hospitalization, home care or emergency care when such services in the facility are not available;
(c) the method of scheduling patient visits to physicians with general scheduling of not more than five patients per hour with an allowance of at least 30 minutes for the first complete patient workup;
(d) where a specific provision of the plan required cannot be implemented immediately, a plan of implementation shall be included, with the anticipated time limit for achieving each phase of the objective specified; and
(e) where it is deemed necessary that any provision of the plan required should be waived indefinitely because of practical difficulties or unnecessary hardships in complying therewith, where such waiver is in the community interest and does not adversely affect the protection of the health of the patient, a request for such waiver and the reasons therefor.
Chapter I STATE SANITARY CODE
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.2 Possession, manufacture, distribution, sale or offer of sale of synthetic phenethylamines and synthetic cannabinoids prohibited
It shall be unlawful for any individual or entity to possess, manufacture, distribute, sell or offer to sell any synthetic phenethylamine or synthetic cannabinoid or product containing the same, except as expressly exempted by this Part.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PLUMBING PLUMBING
10 CRR-NY 14-5.140 Plumbing
Plumbing is to be sized, installed and maintained to carry potable water to all parts of the food vending operation in quantities and at pressures needed for satisfactory operation. Sewage and liquid wastes are to be handled and disposed of in a manner which protects the premises, personnel and contents within the establishment and surroundings from contamination. All plumbing is to be constructed and maintained to prevent contamination of the potable water supply, food, equipment, utensils, the premises, contents, employees and patrons. There is to be no direct connection between the sewage system and any drains originating from fixtures and equipment used for storage, preparation or processing of food or drink. Waste lines from equipment requiring indirect drains are to be installed so as to prevent backflow from sewers and drains from other fixtures.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 143 SCHOHARIE COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 143.7 Jefferson Water District, Town of Jefferson
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to the distributing reservoir and to all existing springs and such springs as may be developed in the future discharging into said reservoir which are located on what is known as the Ploof farm in Jefferson Town, and to any springs or reservoirs which may be constructed in the future and which serve as sources of the public water supply of the Jefferson Water District, Jefferson Town, Schoharie County, and shall also apply to the pond used as an emergency source of supply for fire protection in said district and any watercourse discharging into that pond.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Jefferson Water District, Jefferson Town, Schoharie County, New York.
(2) The term reservoir means distributing reservoir which is used to collect water from all of the springs.
(3) The term pond means the body of water surrounding this reservoir which may be used as an emergency source of water for fire purposes.
(4) The term watercourse means any stream, marsh or channel of any kind, the waters of which flow or may flow into said pond.
(5) The linear distance of a structure or object from a spring, reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the structure of the spring or reservoir or to the ordinary high-water mark of the pond or watercourse.
(6) The term human excreta means feces, urine and other excretions, commonly disposed of by the so-called dry system as typified by the ordinary privy.
(7) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the springs, reservoir, pond or any watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point between the springs and the top of the hill on which they are located nor on the watershed of the pond.
(3) No human excreta shall be buried in the soil on the watershed of the pond nor in the area surrounding the springs unless deposited in trenches or beds at a distance of not less than 500 feet from the springs or 200 feet from the pond or any watercourse and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 300 feet of the springs or within 100 feet of the pond or any watercourse.
(5) Every privy or receptacle for the storage or deposit of human excreta located between the distances of 500 feet and 300 feet from the springs or between the distances of 200 and 100 feet from the pond or any watercourse shall be arranged so that all excreta will be received in a suitable watertight receptacle or removable container which shall be emptied when filled to within six inches of the top and the contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision.
(6) Whenever, in the opinion of the State Commissioner of Health, excremental matter from aforesaid privy, receptacle, trench or place of disposal and sewage or wastes from any place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any spring, pond or watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the springs, the pond or any watercourse nor deposited on or beneath the surface of the ground within 500 feet of the springs or within 200 feet of the pond or any watercourse except into watertight receptacles, the contents of which shall be deposited as provided by paragraph (3) of subdivision (c). If such watertight receptacles are used, they should be located not less than 300 feet from the springs or 100 feet from the pond or any watercourse.
(e) Wastes, refuse and garbage.
(1) No bath water, sink or laundry wastes shall be allowed to flow into the springs, pond or watercourse nor be discharged or deposited or allowed to be discharged or deposited on or beneath the surface of the ground within 300 feet of the springs and 100 feet of the pond and watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material or wastes that pollute water shall be deposited in the springs or in the pond or watercourse nor on or beneath the surface of the ground within 200 feet of the springs or within 50 feet of the pond and watercourse nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into the springs, pond or watercourse.
(f) Bathing, boating, fishing and ice cutting.
(1) No person shall bathe or swim or be allowed to bathe or swim in the springs, pond or any watercourse.
(2) No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the pond.
(g) Places for animals.
(1) No animal or poultry shall be allowed to stand, wade, wallow or swim nor be washed or watered in the springs or pond or watercourse and no watering place shall be maintained in such a way as to pollute any spring, pond or watercourse with excremental matter.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 300 feet of the springs or within 100 feet of the pond or watercourse.
(h) Manure.
No manure pile shall be maintained or allowed to remain within 300 feet of the springs or within 50 feet of the pond or the watercourse nor in such manner as to pollute said springs, pond and watercourse.
(i) Camps.
No camp, tent, building or other structures for occupancy by transients nor for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet from the springs and 200 feet from the pond or watercourse.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the springs.
(k) Trespassing.
No trespassing shall be allowed upon the property of the Jefferson Water District upon which the springs of the public water supply of said district are located and no person or persons shall enter in or upon such property except such persons or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the said district.
(l) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(m) Inspections.
The Jefferson Water District or such other person or persons as may be charged with the maintenance or superversion of the water supply or the duly appointed representative of that district shall make regular and thorough inspections of the area surrounding the springs, the pond and the watercourse and the drainage area tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforementioned district to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violation, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Jefferson Water District to promptly notify the State Commissioner of Health of such violations. The aforementioned water district shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the springs, pond and watercourse at the time of the last inspection.
(n) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.18 Confidentiality
When an applicant submits a completed EAF, draft or final EIS, or otherwise provides information concerning the environmental impact of a proposed project, the applicant may request that specifically identified information be held confidential upon a showing by the applicant that such information constitutes a trade secret. Prior to divulging any such information, the department shall notify the applicant of its determination of whether or not it will hold the information confidential.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 157 YATES COUNTY
10 CRR-NY 157.1 Village of Penn Yan
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of the Public Health Law shall apply to Keuka Lake which serves as a source of the public water supply of the village of Penn Yan, Yates County, New York.
(b) Definitions.
(1) The term water supply means the public water supply of the village of Penn Yan.
(2) The term Keuka Lake means that portion of the easterly branch of Keuka Lake within Yates County, which body of water serves as the source of the water supply of the village of Penn Yan.
(3) The term watercourse means every spring, stream, pond (other than Keuka Lake) or channel of any kind which flows or eventually may flow into that portion of the easterly branch of Keuka Lake within Yates County.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(7) For the purpose of graduating the severity of the subdivisions in their application to different parts of the drainage areas so as to conform to the varying degrees of danger to the water supply, the drainage area is divided into the following zones:
(i) Zone 1 shall comprise the east branch of Keuka Lake and tributaries thereto, from the northern end of the lake southward to the boundary line between the towns of Barrington and Milo as extended westerly to the west shore of the east branch of Keuka Lake.
(ii) Zone 2 shall comprise that portion of the east branch of Keuka Lake and tributaries thereto which is south of zone 1 and which is located entirely within Yates County and easterly of a line due south from the southernmost extremity of Bluff Point.
(c) Human excreta.
(1) No human excreta shall be deposited, thrown, placed or allowed to escape into the lake or any watercourse in zones 1 and 2.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the lake in zones 1 and 2.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 250 feet from the lake or any watercourse in zone 1 or 100 feet from the lake or any watercourse in zone 2 and covered with not less than 12 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain, or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of the lake or any watercourse in zone 1 or within 50 feet of the lake or any watercourse in zone 2, except as hereinafter provided in paragraphs (5) and (6) of this subdivision.
(5) Every privy or receptacle of any kind for the storage or deposit of human excreta built or to be built on property which is so located, bounded or otherwise placed that the distance named in paragraph (4) of this subdivision cannot be obtained shall be placed as far as possible from the lake or any watercourse and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight containers are provided, they shall be located as far as practicable from the lake or any watercourse. All privies or receptacles referred to in this paragraph shall be constructed or installed only with the approval and under the supervision of the municipal board of the village of Penn Yan and in such a manner as to effectually prevent any pollution of the public water supply.
(6) No privy or receptacle of any kind for the storage or deposit of human excreta that is not watertight shall be constructed, placed, maintained or allowed to remain within 150 feet of the lake or any watercourse in zone 1 or within 100 feet of the lake or any watercourse in zone 2.
(7) Every privy or receptacle of any kind or place used for the temporary storage of human excreta located between the limiting distances prescribed by paragraphs (4) and (6) of this subdivision shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top. The contents, if disposed of on the watershed, shall be buried as set forth in paragraph (3) of this subdivision, and the receptacle shall be thoroughly cleansed and deodorized as often as may be found necessary to maintain these receptacles in a proper sanitary condition and shall be so removed as to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In the case of properties occupied only during the summer, the said receptacles shall be emptied when necessary and also at the end of the summer season disinfected and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done in such a manner as to effectually prevent any pollution of the public water supply.
(8) Whenever, in the opinion of the State Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into the lake or any watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
No sewage shall be discharged or allowed to flow into the lake or any watercourse nor deposited on the surface of the ground nor deposited beneath the surface of the ground within 75 feet of the lake or any watercourse in zone 1 or within 50 feet of the lake or any watercourse in zone 2, except into watertight receptacles, the contents of which shall be disposed of as provided for by paragraph (3) of subdivision (c). These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State Commissioner of Health.
(e) Waste, refuse, and garbage.
(1) No bath water, sink or laundry waste or polluted liquid of any kind shall be discharged or allowed to flow into the lake or any watercourse nor be deposited on or beneath the surface of the ground within 50 feet of the lake or any watercourse in zone 1, or within 25 feet of the lake or any watercourse in zone 2, nor in such a manner that it can be washed by rain or melting snow or otherwise over the surface of the ground into the lake or a watercourse.
(2) No garbage, refuse or putrescible matter shall be deposited in the lake or watercourse nor on or beneath the surface of the ground within 50 feet of the lake or of any watercourse in zone 1, or within 25 feet of the lake or any watercourse in zone 2, nor in such a manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or watercourse.
(3) No manure pile shall be maintained or allowed to remain within 50 feet of the lake or any watercourse in zone 1, nor within 25 feet of the lake or any watercourse in zone 2, nor in such a condition as to pollute the lake or watercourse.
(f) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of the lake or any watercourse in either zone 1 or zone 2.
(g) General clause.
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act though not heretofore specified which may result in contamination of any portion of the water supply.
(h) [Inspections.]
The municipal board of the village of Penn Yan or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of the board shall make regular and thorough inspections of the lake, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the person violating the same, together with notices of such violation. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said board to promptly notify the State Commissioner of Health of such violations. The municipal board shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
PATIENT CLASSIFICATION PATIENT CLASSIFICATION
10 CRR-NY 446.16 Source of payment defined
(a) Medicare.
(b) Blue Cross.
(c) Medicaid.
(d) Workers' Compensation.
(e) Commercial insurance.
(f) Free.
(g) Self-pay in full.
(h) Other.
Part 441 DEFINITIONS
10 CRR-NY 441.264 Prepaid expense
An expenditure, often recurrent, for future benefits; a type of deferred charge. Examples: prepaid operating expenses, prepaid rent, taxes, royalties, commissions; unexpired insurance premiums; stationery and office supplies. Such items are classifiable as current assets and constitute a part of working capital; they are charged to future operations on the basis of measurable benefits or on a time or period-charge basis.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.64 South Bay Consolidated Water Company, Inc. at Patchogue
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue, Suffolk County, New York.
(b) [Interpretation.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid watertight receptacles shall be removed and the receptacles cleansed and disinfected as often as may be found necessary in order to maintain the privy or receptacle in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or receptacle to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such a manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health. It is provided, however, that no such watertight receptacle shall be within 100 feet nor any such watertight iron pipe shall be within 50 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue, except into watertight receptacles, the contents of which are removed and disposed of in the manner provided by paragraphs (4) and (5) of subdivision (c).
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to remain upon the surface of the ground nor shall such human excreta or compost or other matter containing human excreta be buried in the soil within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the South Bay Consolidated Water Company at Patchogue.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or maintained or allowed to remain upon the surface of the ground or beneath the surface within 300 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue nor shall any such matters be so placed or maintained that the washings therefrom may reach any well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(g) Trespassing.
No trespassing shall be allowed upon the property upon which the wells of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue are located and no person or persons shall enter in or upon such property except the officers or employees of the company in the official performance of their duties of supervision and maintenance of the public water supply or except authorized public officials or except such other persons as may be authorized to enter said property by the officials of the South Bay Consolidated Water Company, Inc.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the South Bay Consolidated Water Company, Inc. at Patchogue.
(j) Inspections.
The duly authorized officials of the South Bay Consolidated Water Company, Inc. or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.57 Sold services
This functional reporting center must contain all the expenses related to the sale of services to individuals or enterprises outside of and unrelated to the ordinary functions of the residential health care facility. Activities would include but are not limited to the following: housekeeping services; laundry and linen services; data processing; management services; education services; janitorial services; purchasing; laboratory, etc.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 101 ALLEGANY COUNTY
10 CRR-NY 101.4 Houghton Water District, Town of Caneadea
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the two wells which comprise the source of the public water supply of the Houghton Water District, town of Caneadea, Allegany County, N.Y. One of the said wells, known as the old well or “well #1”, is located on the Houghton College Campus. This well is approximately a 20-foot linear distance west of York Drive and a 500-foot linear distance northwest of the science building in the hamlet of Houghton. It is leased to the water district for a period of 99 years from January 1, 1970. The other well, known as the new well or “well #2”, is approximately a 210-foot linear distance southeast of North River Road (Route 19), approximately a 100-foot linear distance northwest of Rochester Gas and Electric (R.G.&E.) right-of-way, and a 65-foot linear distance east of R.G.&E. pole 2-AE. This well is on land owned by the water district, near the north end of said hamlet of Houghton.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Houghton Water District, Town of Caneadea, Allegany County, NY.
(16) Wells shall mean wells now used as a source of this water supply or to any additional wells which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specified prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the wells.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Houghton Water District, Town of Caneadea, Allegany County, NY, upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by said district.
(e) Inspections.
The town board of the Town of Caneadea, Allegany County, NY, or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or its duly appointed representative, make regular and thorough inspections of the area surrounding the wells to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of said violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. The aforesaid superintendent, Houghton Water District, shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.14 Financial relationship
A financial relationship between any entity and a referring health services purveyor, or any immediate family member of a referring health services purveyor, which relationship was secured or facilitated either directly or indirectly by or through the efforts of a clinical laboratory, shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 456 COST-FINDING PRACTICES AND PROCEDURES
10 CRR-NY 456.3 Mandated statistical bases for cost allocation
The following represent the minimum mandated statistical bases for cost allocation.
(a) Nonrevenue support services.
| | Functional reporting center | Allocation basis | | --- | --- | --- | | (1) | Depreciation, Leases and Rentals | Depreciation by building, by department | | (2) | Depreciation on Major Movable Equipment | For assets acquired prior to 1/1/78, depreciation may be allocated to departments based on square feet, net. | | | | For major movable equipment acquisitions subsequent to 1/1/78, depreciation on such assets must be assigned based on the physical location of the equipment. | | (3) | Interest on Capital Debt | Square feet of building for which debt incurred and actual depreciation of major movable equipment | | (4) | Fiscal Services | Accumulated costs | | (5) | Administrative Services | Accumulated costs | | (6) | Plant Operation and Maintenance | Square feet, net | | (7) | Grounds | Square feet, net | | (8) | Security | Square feet, net | | (9) | Laundry and Linen | Dry and clean pounds distributed, includes the equivalent weight of disposable linens distributed | | (10) | Housekeeping | Assigned time | | (11) | Patient Food Service | Dietary meals served | | (12) | Cafeteria | Average number of employees | | (13) | Nursing Administration | Total hours of direct nursing service | | (14) | Activities Program | Number of participants, by program | | (15) | Non-Physician Education | Assigned time of students | | (16) | Medical Education | Assigned time—interns and residents | | (17) | Medical Director's Office* | Time spent | | (18) | Housing | Number of rooms occupied by department assigned | | (19) | Medical Records* | Hours of service | | (20) | Utilization Review | Number of cases reviewed, by program area | | (21) | Social Services* | Hours of service | | (22) | Transportation* | Number of users, by program |
(b) Ancillary service revenue centers.
| | Functional reporting center | Allocation basis | | --- | --- | --- | | (1) | Laboratory Services | CAP workload measurement units | | (2) | Electrocardiology | CAP workload measurement units | | (3) | Electroencephalogy | CAP workload measurement units | | (4) | Radiology | Relative value units | | (5) | Inhalation Therapy | Number of treatments | | (6) | Podiatry | Number of visits | | (7) | Dental | Number of visits | | (8) | Psychiatric | Number of visits | | (9) | Physical Therapy | Number of treatments | | (10) | Occupational Therapy | Number of treatments | | (11) | Speech and Hearing Therapy | Number of treatments | | (12) | Medical Staff Services* | Hours of service by physician | | (13) | Pharmacy** | Costed requisitions | | (14) | Central Service Supply** | Costed requisitions |
(c) Exceptions .
*(1) For facilities with a single program service classification the cost allocation bases indicated in subdivisions (a) and (b) of this section by an asterisk (*) are waived.
**(2) In Pharmacy and Central Services Supply cost centers, indicated by (**) in subdivision (b) of this section, for facilities with a single program service classification the cost allocation bases are waived. However, requisitions for these cost centers for the sample periods must be retained as an audit trail showing that such supplies were not utilized in areas other than the program area. Also, for Pharmacy costs in multicare facilities, see section 456.5(p) of this Part for alternate pricing out of requisitions allowable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.12 Adjustments to basic rate
(a) To the allowable basic rate prior to the addition of capital costs and depreciation and interest related to movable equipment, there will be added a factor to project allowable cost increases during the effective period of the reimbursement rate. Such factor shall be determined as follows:
(1) The elements of a residential health care facility's cost shall be weighted based upon data for the following categories:
(i) salaries;
(ii) employee health and welfare expense;
(iii) nonpayroll administrative and general expense;
(iv) nonpayroll household and maintenance expense;
(v) nonpayroll dietary expense; and
(vi) nonpayroll professional care expense.
(2) Each weight shall be adjusted by the appropriate price index for each category noted in paragraph (1) of this subdivision, as well as for subcategories. Included among these cost indicators are elements of the United States Department of Labor consumer and wholesale price indices and special indices developed by the State Commissioner of Health for this purpose.
(3) Geographic differentials may be established where appropriate.
(b) The cost indicators used in determining the projection factors shall be compared, on a semiannual basis with available data on such indicators, and any other economic indicators as deemed appropriate by the Commissioner of Health. Based upon such review the commissioner may, in his discretion, either certify new rates or adjust subsequent rates for any period or portion thereof when he determines that such new rates or adjusted rates are necessary to avoid substantial inequities arising from the use of previously certified rates.
(c) Beginning April 1, 1991, the commissioner, in accordance with the methodology developed pursuant to subdivisions (d), (e) and (f) of this section, shall establish trend factors for residential health care facilities to project allowable cost increases for the effects of inflation during the effective period of the reimbursement rate. The allowable basic rate prior to the addition of capital costs and depreciation and interest related to movable equipment shall be trended, beginning on April 1, 1991, to the applicable rate year by the trend factors developed in accordance with subdivisions (d) through (f) of this section.
(d) The methodology for developing the trend factors shall be established by a panel of four independent consultants with expertise in health economics appointed by the commissioner.
(e) The methodology for developing the trend factors shall include the appropriate external price indicators and the data from major collective bargaining agreements as reported quarterly by the Federal Department of Labor, Bureau of Labor Statistics, for nonsupervisory employees.
(f)
(1) On or about September 1st of each year, the consultants shall provide to the commissioner and the state hospital review and planning council, the methodology to be used to determine the trend factors for the rate period, commencing on the next January 1st. The commissioner shall monitor the actual price movements during these periods of the external price indicators used in the methodology, shall report the results of the monitoring to the consultants and shall implement the recommendations of the consultants for one prospective interim annual adjustment to the initial trend factors to reflect such price movements and to be effective on January 1st, one year after the initial trend factors were established and one prospective final annual adjustment to the revised trend factors to reflect such price movements and to be effective on January 1st, two years after the initial trend factors were established.
(2) Notwithstanding the dates specified in paragraph (1) of this subdivision, the consultants shall provide as soon as possible to the commissioner and the state hospital review and planning council, the methodology to be used to determine the trend factors for the rate period April 1, 1991 to December 31, 1991. One prospective interim annual adjustment for this rate period shall be made on January 1, 1992 and one prospective final annual adjustment for this rate period shall be made January 1, 1993.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.4 Collection of blood
(a) Collection of blood for transfusion shall be performed under the direction of the medical director. Medical services for emergency care of the donor shall be available. Blood for transfusion shall be collected only on the premises of a blood bank, at a blood donation center approved by the department, in a self-contained blood collection vehicle operated by a blood bank, or at a temporary collection operation conducted by a blood bank. Each blood bank shall inform the department, upon request, of the location of all blood collection activities and the provisions made for the handling of medical emergencies. Prior to collection of blood for testing, a signed form must be obtained from the donor or person legally authorized to consent on behalf of such donor, in which the donor or the person legally authorized to consent acknowledges that he/she has been provided with written materials stating that HIV testing for donor screening purposes shall be performed in conjunction with all donations.
(b) Quantity limitations.
Allogeneic and autogeneic donors may give a maximum of 550 milliliters of whole blood in addition to pilot samples sufficient for all testing to be performed.
(c) Frequency limitations.
No allogeneic blood donor may donate more than 550 milliliters of whole blood within an eight-week period, unless approved to do so by a physician who examines the potential donor at the time of the proposed second donation. In no event may an allogenic blood donor donate more than twice within a 16-week period. The foregoing prohibition on donations does not apply to allogeneic blood donors diagnosed with hemochromatosis. For autogeneic collections, the frequency of donation shall be as specified in section 58-2.2(e)(3) of this Subpart.
(d) Persons collecting blood for transfusion shall be trained, under the direction of the medical director, to recognize donor reactions. Whenever donor collection procedures are performed, a nurse or other qualified person specially trained to recognize and address donor reactions shall be immediately available, and a physician shall be available by telephone for consultation.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-1.184 Religious, fraternal and charitable organizations
The provisions of this Subpart for equipment, plan review and pre-operational notification applicable to commercial food service operations shall not apply to food service establishments open to the public which are operated by religious, fraternal and charitable organizations.
(a) A permission to operate a food service issued to such organizations hereunder shall be for a term of two years and shall not require payment of a fee.
(b) Plan review requirements are waived for all such organizations.
(c) Such organization shall notify the permit-issuing official or the department of its intention to engage in food service operations over the course of the next two years. The mailing of such notice will satisfy all requirements of this Part for the two-year period.
(d) The provisions of this section shall not prohibit the commissioner from actions necessary to assure that the public health is not endangered.
(e) This section shall not apply to continuing food services provided by such organizations operated more often then weekly.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.60 Submission of claims
(a) Quarterly claims for State aid reimbursement must be accompanied by supporting documentation to enable calculation of State aid amounts as shall be determined by the commissioner or his or her designee. Such documentation shall include, but not be limited to:
(1) a duly certified State aid claim form;
(2) a clear statement of expenditures for each service included in the State aid application; and
(3) a clear statement of each item of revenue earned during the reporting period.
(b) All expenses for which a claim is submitted shall be accounted for and reported using the cash basis method of accounting.
(c) Claims shall be prepared in accordance with 2 CFR part 200 – “Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.”
(d) A claim shall be deemed complete if it complies with subdivisions (a), (b) and (c) of this section.
(e) Complete claims for the first three quarters of a program year must be submitted by the local health department for State aid no later than two months after the end of the quarter in which the expenditures claimed occurred. Complete fourth quarter claims must be submitted no later than three months from the end of the program year in which expenditures claimed occurred. Claims received later than such prescribed time limits may be returned unpaid by the commissioner. Returned claims may not be resubmitted.
(f) In the event that a local health department submits any quarterly claim later than six months after the end of the program year in which the expenditures claimed occurred, the commissioner may accept such claim only if the local health department has submitted a written statement which, in the commissioner’s discretion, adequately explains the extraordinary circumstances justifying the delay.
(g) Claims for State aid reimbursement must be supported by expenditure and revenue records, to be retained and made available to facilitate concurrent or post audit, until concurrent or post audit is completed. Records supporting actual revenues and costs incurred shall be maintained by the municipality for the period of six years after the close of the fiscal year to which they pertain and are subject to audit and review by the State.
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.10 Decisionmaking and findings requirements
(a) If the department is lead agency it shall, prior to any decision on an action which has been the subject of a final EIS, afford agencies and the public a reasonable time period (not less than 10 calendar days) in which to consider the final EIS.
(b) In the case of an action involving an applicant, the department's decision, if it is lead agency, on whether or not to approve or fund an action which has been the subject of a final EIS, shall be made within 30 calendar days after the filing of the final EIS and completion of other required reviews, except for good cause.
(c) The department shall not make a final decision to commence, engage in, fund or approve an action that has been subject of a final Federal or a final SEQR EIS until it has:
(1) given consideration to the final EIS;
(2) made a written finding that the requirements of this Part have been met; and
(i) consistent with social, economic and other essential considerations from among the reasonable alternatives thereto, the action to be carried out or approved is one which minimizes or avoids adverse environmental effects to the maximum extent practicable, including the effects disclosed in the relevant environmental impact statement; and
(ii) consistent with social, economic and other essential considerations, to the maximum extent practicable, adverse environmental effects revealed in the environmental impact statement process will be minimized or avoided by incorporating as conditions to the decision those mitigative measures which were identified as practicable;
(3) prepared a written statement of facts and conclusions relied upon in the EIS, supporting its decision and indicating the social, economic and other factors and standards which formed the basis of its decision.
(d) Prior to making a decision not to approve an action, the department must prepare a written statement of the facts and conclusions relied on in making that decision, including reference to matters in the EIS or comments provided thereon.
(e) Health Department actions in the coastal area, shall be consistent with the applicable policies of Executive Law, article 42, as contained in 19 NYCRR 600.5, so as to achieve a balance between the protection of natural resources and the need to accommodate social and economic considerations as provided in such policies. When the State agency action in the coastal area is within the boundaries of an approved local waterfront revitalization program and the action is one identified by the Secretary of State pursuant to section 916(1)(a) of the Executive Law, the action shall be consistent to the maximum extent practicable with the applicable policies of such local waterfront revitalization program.
Subchapter B STATE AID AND FUNDING
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.5 Funding
(a) Funds will be distributed among eligible programs in the same ratio as the number of full-time residents who have two year service obligation agreements on file with the commissioner in each program is to the total number of residents in all programs who have two year service agreements on file with the commissioner. Funds allocated shall not exceed $15,000 per family practice resident.
(b) Funds will be recouped for any residents who have not complied with their two year service obligation agreement.
(c) Distributed funds which must be recouped because former residents have not complied with their two year service obligation agreement shall be recouped by withholding funds from future distributions to the program.
(d) The amount recouped from the amount originally funded shall be in the same ratio as the time left unfulfilled to the two-year service obligation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
REPORTING PRINCIPLES REPORTING PRINCIPLES
10 CRR-NY 442.15 Long-term security investments
[ 1350 ] Long-term security investments are to be valued at hospital cost if purchased or, if acquired by donation, at the fair market value at the date of the gift. If there is evidence of a permanent decline in value, an appropriate reduction in carrying value must be made by charging the necessary expense account(s). The market value of long-term security investments at year-end must be disclosed.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.1 Engineering and maintenance
(a) Water supplies of medical facilities shall be operated in conformance with the following requirements:
(1) all water used in operation shall be provided from a public water supply or from an alternate source, in either event, as approved by the department;
(2) no changes shall be made in the source or treatment of the water supply without approval of the department;
(3) water shall be adequate in volume and pressure for all medical purposes;
(4) the water system shall not be operated with physical connections to other piping systems or connections to fixtures that may permit contamination of the water supply;
(5) the water system shall be operated with a hot water system adequate for all medical purposes; and
(6) the hot water supply shall be regulated by thermostatic or other control devices which shall be either locked or located in places not accessible to patients or the general public so that the hot water used by patients and by the public is maintained at an even temperature which cannot cause personal injury.
(b) Waste systems shall be operated so that all sewage and other liquid wastes are disposed of by connection to a public sewer system or by an alternate method, in either event, as approved by the department.
(c) Plumbing and plumbing fixtures shall be properly maintained.
(d) Ventilation, heating, air conditioning, and air changing systems shall:
(1) be maintained in good repair and shall be operated in a manner which will prevent the spread of infection and provide for patient or resident health and comfort;
(2) be maintained and operated in such manner that air shall not be circulated from operating rooms, patient isolation rooms, laboratories in which work is done in pathology, virology, or bacteriology, autopsy rooms, kitchen and dishwashing areas, toilet and bathrooms, janitors' closets, and soiled linen rooms to any other part of the facility;
(3) be provided, as needed, with acceptable air filtration equipment that is cleaned and serviced at adequate intervals; and
(4) assure that the relative humidity is maintained at a minimum of 50 percent in those areas where conductive floors are required.
(e) Grounds and buildings shall be maintained:
(1) in a clean condition free of safety hazards;
(2) in such manner as will prevent standing water, flooding or leakage; and
(3) free of excessive noise, odors, pollens, dusts, or other environmental pollutants and such nuisances as may adversely affect the health or welfare of patients or residents.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.26 Respiratory protection and controls to restrict internal exposure in restricted areas
(a) Use of process or other controls.
The licensee shall use, to the extent practicable, process or other engineering controls, such as, containment or ventilation to control the concentrations of radioactive material in air.
(b) When it is not practicable to apply process or other engineering controls to control the concentrations of radioactive material in air to values below those that define airborne radioactivity area, the licensee or registrant shall, consistent with maintaining the total effective dose equivalent ALARA, increase monitoring and limit intakes by one or more of the following means:
(1) control of access; or
(2) limitation of exposure times; or
(3) use of respiratory protection equipment; or
(4) other controls.
(c) Use of individual respiratory protection equipment.
(1) If the licensee or registrant uses respiratory protection equipment to limit intakes pursuant to subdivision (b) of this section:
(i) Except as provided in subparagraph (ii) of this paragraph the licensee or registrant shall use only respiratory protection equipment that is tested and certified or had certification extended by the National Institute for Occupational Safety and Health Administration and the Mine Safety and Health Administration.
(ii) If the licensee wishes to use equipment that has not been tested or certified by the National Institute for Occupational Safety and Health and the Mine Safety and Health Administration, has not had certification extended by the National Institute for Occupational Safety and Health and the Mine Safety and Health Administration, or for which there is no schedule for testing or certification, the licensee or registrant shall submit an application for authorized use of that equipment, including a demonstration by testing, or a demonstration on the basis of reliable test information, that the material and performance characteristics of the equipment are capable of providing the proposed degree of protection under anticipated conditions of use.
(iii) The licensee shall implement and maintain a respiratory protection program that includes:
(a) air sampling sufficient to identify the potential hazard, permit proper equipment selection, and estimate exposures; and
(b) surveys and bioassays, as appropriate, to evaluate actual intakes; and
(c) testing of respirators for operability immediately prior to each use; and
(d) written procedures regarding selection, fitting, issuance, maintenance, and testing of respirators, including testing for operability immediately prior to each use; supervision and training of personnel; monitoring, including air sampling and bioassays; and recordkeeping; and
(e) determination by a physician prior to initial fitting of respirators, and at least every 12 months thereafter, that the individual user is physically able to use the respiratory protection equipment.
(iv) The licensee or registrant shall issue a written policy statement on respirator usage covering:
(a) the use of process or other engineering controls, instead of respirators; and
(b) the routine, nonroutine, and emergency use of respirators; and
(c) the length of periods of respirator use and relief from respirator use.
(v) The licensee or registrant shall advise each respirator user that the user may leave the area at any time for relief from respirator use in the event of equipment malfunction, physical or psychological distress, procedural or communication failure, significant deterioration of operating conditions, or any other conditions that might require such relief.
(vi) The licensee or registrant shall use equipment within the equipment manufacturer's expressed limitations for type and mode of use and shall provide proper visual, communication, and other special capabilities, such as adequate skin protection, when needed.
(2) When estimating exposure of individuals to airborne radioactive materials, the licensee or registrant may make allowance for respiratory protection equipment used to limit intakes pursuant to subdivision (b) of this section, provided that the following conditions, in addition to those in subdivision (c) of this section, are satisfied:
(i) The licensee selects respiratory protection equipment that provides a protection factor greater than the multiple by which peak concentrations of airborne radioactive materials in the working area are expected to exceed the values specified in Appendix 16-C, Table 1, Column 3, infra. However, if the selection of respiratory protection with a protection factor greater than the peak concentration is inconsistent with the goal specified in subdivision (b) of this section of keeping the total effective dose equivalent ALARA, the licensee or registrant may select respiratory protection equipment with a lower protection factor provided that such a selection would result in total effective dose equivalent that is ALARA. The concentration of radioactive material in the air that is inhaled when respirators are worn may be initially estimated by dividing the average concentration in air, during each period of uninterrupted use, by the protection factor. If the exposure is later found to be greater than initially estimated, the corrected value shall be used; if the exposure is later found to be less than initially estimated, the corrected value may be used.
(ii) The licensee or registrant shall obtain authorization from the department before assigning respiratory protection factors in excess of those specified in Appendix 16-A, Table 8, infra. The department may authorize a licensee or registrant to use higher protection factors upon receipt of an application that:
(a) describes the situation for which a need exists for higher protection factors; and
(b) demonstrates that the respiratory protection equipment provides these higher protection factors under the proposed conditions of use.
(3) In an emergency, the licensee shall use as emergency equipment only respiratory protection equipment that has been specifically certified or had certification extended for emergency use by the National Institute for Occupational Safety and Health and the Mine Safety and Health Administration.
(4) The licensee shall notify the department in writing at least 30 days before the date that respiratory protection equipment is first used pursuant to subdivision (c) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.4 Requirements for continued school attendance
A principal or person in charge of a school shall not permit a child to continue to attend such a school for more than 14 days unless a person in parental relation to the child has furnished the school with one of the documents specified in section 66-1.3 of this Subpart. Such 14 calendar day period may be extended to not more than 30 calendar days for an individual student who is transferring from out-of-state or from another country and can show a good faith effort to get the necessary evidence of immunization.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.270 Program
Daily hospital or ambulatory service category of the patient.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.11 Tables
TABLE 1—BOTTLED WATER SAMPLING REQUIREMENTS
| Number of Samples | | | | | | --- | --- | --- | --- | --- | | Contaminant | Maximum Contaminant Levels | Frequency of Samples | Source Water | Finished Product 1 | | Microbiological: | | See Table 1A | | | | —Heterotrophic | | | | | | —Microrganisms | * | | | | | —Total Coliform | Less than 1 organism per 100 ml3 | | | | | Radiological: | | | | | | —Gross Alpha Particle Activity (including Radium 226 but excluding Radon and Uranium) | 15 picocuries per liter | Yearly | 1 6 | 16 | | —Combined Radium 226 and Radium 228 | 5 picocuries per liter | Yearly | 16 | 16 | | —Beta particle and photon activity from manmade radio-nuclides | 4 millirems per year | Yearly | 16 | 16 | | Physical: | | Yearly | 1 | 1 | | —Turbidity | 5 units | | | | | —Color | 15 units | | | | | —Odor | Threshold Odor No. 3 | | | | | Inorganic chemical: | | Yearly 4 | 1 56 | 156 | | Arsenic (As) | 0.05 | | | | | Barium (Ba) | 1.0 | | | | | Cadmium (Cd) | 0.01 | | | | | Chloride (Cl) | 250.0 | | | | | Chromium (Cr) | 0.05 | | | | | Copper (Cu) | 1.0 | | | | | Fluoride (F) | 2.2 | | | | | Iron (Fe) | 0.3 | | | | | Lead (Pb) | 0.05 | | | | | Manganese (Mn) | 0.3 | | | | | Mercury (Hg) | 0.002 | | | | | Nitrate (N) | 10.0 | | | | | Selenium (Se) | 0.01 | | | | | Silver (Ag) | 0.05 | | | | | Sulfate (S04) | 250.0 | | | | | Zinc (Zn) | 5.0 | | | | | Alkalinity | 2 | | | | | Corrosivity | *2 | | | | | Hardness | * 2 | | | | | pH | * 2 | | | | | Sodium (Na) | * 2 | | | | | Total dissolved solids | * 2 | | | |
*
No maximum contaminant level established.
| | Maximum Contaminant Levels in Milligrams/Liter | Number of Samples | | | | --- | --- | --- | --- | --- | | Contaminant | | Frequency of Samples | Source Water | Finished Product | | | Organic Chemical: | | | | | Pesticides/Herbicides | | Yearly4 | 15 6 | 15 6 | | Endrin | 0.0002 | | | | | Lindane | 0.004 | | | | | Methoxychlor | 0.050 | | | | | Toxaphene | 0.005 | | | | | 2,4-D | 0.050 | | | | | 2,4,5-TP (Silvex) | 0.01 | | | | | Trihalomethanes | | Yearly | | 156 | | Total Trihalomethane | 0.10 | | | | | (TTHM) | | | | | | General Organic Chemicals | | | | | | Principal Organic Contaminant (See Table 1B for listing of monitored contaminants.) | 0.005 | Yearly4 | 15 6 | 15 6 | | Unspecified Organic Contaminants | 0.050 | None specified | | | | Total of all POCs and UOCs | 0.10 | None specified | | | | Vinyl Chloride | 0.002 | Yearly | 15 6 | 15 6 |
1 Samples shall be collected and analyzed for each production line and product type. If more than one container size is bottled at the facility, a plan to rotate sampling of contaner sizes shall be submitted to and approved by the department.
2 No maximum contaminant level established.
3 No positive total coliform result.
4 All monitoring samples shall be collected and analyzed in the first quarter of the calendar year, unless otherwise specified by the State.
5 Every third year, beginning in 1992, or in the first full calendar year following certification, four quarterly monitoring samples shall be collected and analyzed.
6 The owner or operator of a bottled water facility shall require the approved laboratory performing the anlayses to send a copy of the laboratory report directly to the department. The owner or operator of a bottled water facility shall submit with the next monthly monitoring report following receipt of the laboratory report a letter to the department, certifying that the aforementioned laboratory report accurately represents the quality of the described bottled water product and that the bottled water product complies with the organic, inorganic, radiological and other water quality standards in this Subpart.
TABLE 1-A—MICROBIOLOGICAL SAMPLING FREQUENCY
| Minimum Number of Samples | | | | | | | | --- | --- | --- | --- | --- | --- | --- | | Total gallons produced per month | Uncarbonated bottled water | Carbonated bottled water | Bulk water | | | | | | Finished product per week | Source water per month | Finished product per month | Source water per month | Finished product per month | Source water per month | | 1 to 39,999 | 1 | 1 | 1 | 1 | 1 | 1 | | 40,000 to 79,999 | 2 | 2 | 1 | 1 | 1 | 1 | | 80,000 to 299,999 | 3 | 2 | 1 | 1 | 1 | 1 | | 300,000 to 699,999 | 4 | 3 | 1 | 1 | 1 | 1 | | 700,000 and more | 5 | 3 | 1 | 1 | 1 | 1 |
TABLE 1-B—PRINCIPAL ORGANIC CHEMICALS
benzene
bromobenzene
bromochloromethane
bromomethane
n-butylbenzene
sec-butylbenzene
tert-butylbenzene
carbon tetrachloride
chlorobenzene
chloroethane
chloromethane
2-chlorotolune
4-chlorotoluene
dibromomethane
1,2-dichlorobenzene
1,3-dichlorobenzne
1,4-dichlorobenzene
dichlorodifluoromethane
1,1-dichloroethane
1,2-dichloroethane
1,1-dichloroethane
cis-l,2-dichloroethene
trans-1,2-dichloroethene
1,2-dichloropropane
1,3-dichloropropane
2,2-dichloropropane
1,1-dichloropropene
cis-l,3-dichloropropene
trans-1,3,-dichloropropene
ethylbenzene
hexachlorobutadiene
isopropylbenzene
p-isopropyltoluene
methylene chloride
n-propylbenezene
styrene
1,1,1,2-tetrachloroethane
1,1,2,2-tetrachloroethane
tetrachloroethene
toluene
1,2,3-trichlorobenzene
1,2,4-trichlorobenzene
1,1,1-trichloroethane
1,1,2-trichloroethane
trichloroethene
trichlorofluoromethane
1,2,3-trichloropropane
1,2,4-trimethylbenzene
1,3,5-trimethylbenzene
m-xylene
o-xylene
p-xylene
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 74 APPROVAL OF REALTY SUBDIVISIONS
10 CRR-NY 74.3 Plan submissions
(a) All plans submitted for approval shall be in conformance with the relevant provisions of department Bulletin 40* entitled Planning the Subdivision as Part of the Total Environment—An Engineering Guide to the Preparation and Submission of Plans for Realty Subdivisions.
(b) Plans other than those for community water and sewerage systems shall not propose to furnish water to more than one lot and/or to dispose of sewage from more than one lot.
(c) Where a developer proposes to obtain and furnish water supply and/or sewerage facilities for a subdivision by connection to an existing community water and/or sewerage system, the developer shall supply the commissioner with a certification in writing by the owner of the utility that such facilities will be furnished and kept available and in good operating condition for the subdivision.
(d) The commissioner at his discretion may require the developer to furnish a performance bond to the owner of such utility conditioned upon the developer's making connection to the utility within a specified period of time.
(e) The proposals for realty subdivision development shall conform with all applicable comprehensive studies, including air, water, sewerage and solid wastes.
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.7 Pre-hearing procedures
At a pre-hearing conference or at any other time on motion of any party, or on motion of the hearing officer, on notice to the parties, and upon such terms and conditions as in the discretion of the hearing officer may seem proper, the hearing officer may:
(a) order or allow a party to serve an amended complaint or answer;
(b) direct pre-trial disclosure of evidence and discovery and inspection of books, records and documents;
(c) permit the taking of depositions for use at the hearing;
(d) limit or restrict the number of experts to be heard as witnesses;
(e) clarify and define the issues to be tried;
(f) adjourn the hearing to such times and places as he shall deem proper.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.24 Proceedings involving the approval of an individual or agency
(a) An agency's or individual's approval to deliver evaluations, service coordination services and Early Intervention Program services may be revoked, suspended, limited or annulled by the commissioner upon a finding that the agency or individual provider:
(1) has failed to comply with the provisions of title II-A of article 25 of the Public Health Law or rules and regulations promulgated thereunder;
(2) no longer meets one of the criteria for approval or reapproval as set forth in section 69-4.5 of this Subpart;
(3) does not have current licensure, registration or certification to deliver services in the Early Intervention Program;
(4) for agency providers, use of personnel, whether by contract or under employment, to deliver evaluations, service coordination services or Early Intervention Program service who did not hold a license, registration or certification to provide such service;
(5) falsely represented or omitted material fact in an application submitted to the department for approval or re-approval;
(6) is, or ever has been, excluded or suspended as a provider under Medicaid, Medicare, or any governmental or private medical insurance program;
(7) has been the subject of one or more actions taken against the provider by another State agency which approves, licenses, certifies, or registers the applicant for any purpose;
(8) has been convicted of an offense in an administrative or criminal proceeding;
(9) has failed to provide unobstructed access to and examination of facilities, child records, or any other documents relevant to Early Intervention Program services as requested and within the timeframes required by the department or a municipality or an agent of any of these entities, for purpose of monitoring, auditing, or investigating the provider's participation in the Early Intervention Program;
(10) has failed to submit required corrective action plans or other information or documents requested by the department, or a municipality to address findings of noncompliance identified through monitoring, systems complaint investigations, audits, or other Early Intervention Program oversight activities, or to correct non-compliance within one year of any finding of non-compliance;
(11) has failed to pay recoupment due, or to implement any actions required, on the basis of a State or municipal audit within the timeframes specified in such audit report;
(12) has failed to pay any fines or penalties assessed against the applicant or provider within timeframes specified by the department;
(13) through action, or act of omission, has placed children, parents, or staff in danger, or otherwise violated Early Intervention Program health and safety standards issued by the department;
(14) has submitted improper or fraudulent claims to a third party payor or the municipality for payment, including but not limited to submission of claims for services not rendered.
(b) No approval shall be revoked, suspended, limited or annulled without first providing the individual or agency an opportunity to be heard. The department shall notify the individual or agency in writing of the proposed action and shall afford the individual or agency an opportunity to be heard.
(c) Approval may be temporarily suspended or limited, prior to granting an opportunity to be heard, for a period not exceeding 120 days upon written notice to the provider following a finding by the department that the health or safety of a child, parents or staff of the agency or municipality is in imminent risk of danger or there exists any condition or practice or a continuing pattern of conditions or practices which poses imminent danger to the health or safety of such children, parents or staff of the agency or municipality. Upon such a finding and notice the department may also:
(1) prohibit or limit the assignment of children to the provider;
(2) remove or cause to be removed some or all of the children the provider currently serves; and
(3) suspend or limit or cause to be suspended or limited payment for services to the provider.
(d) The provider shall be afforded an opportunity to be heard to contest the department's findings.
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-6 PRIMARY CARE PRACTITIONER SCHOLARSHIP PROGRAM
10 CRR-NY 47-6.9 Administration
(a) Acceptance and service agreement.
Prior to being certified for payment, successful applicants must sign a written acceptance of the award and a service agreement describing the conditions of the award, the service obligation, and the terms of repayment in the event of rescission or default.
(b) A recipient is required to comply with all administrative and reporting requirements established by the Department of Health and the Higher Education Services Corporation.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.18 Tuberculosis records.*
In any action or prosecution for violation of any of the provisions of the Public Health Law, of this Chapter, or of the ordinances or regulations of any local board of health, the person in charge of tuberculosis records or reports made in pursuance of the provisions of sections 2220 and 2221 of the Public Health Law may in obedience to a duly issued and served subpoena produce and allow to be placed in evidence the whole or any part of such records insofar as the same shall be deemed relevant by the court or by the judge presiding.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRENATAL CARE SERVICES PRENATAL CARE SERVICES
10 CRR-NY 85.41 Approval of residential health care facility (RHCF) admission and continued stay
(a) For purposes of this section:
(1) An RHCF shall mean any health care provider with an operating certificate as a skilled nursing facility (SNF) or health related facility (HRF) issued by the department.
(2) Level of care approval shall mean a determination that the care and services furnished by an RHCF are necessary and adequate to meet a patient's clinical needs.
(3) Commissioner's designee shall mean:
(i) an RHCF utilization review agent, as specified in Section 416.9 or 421.13 of this Title; or,
(ii) an agency of local government which has a written Memorandum of Understanding (MOU) with the commissioner for making Medicaid payment determinations with respect to RHCF admission and/or continued stay.
(b) Approval by the commissioner or the commissioner's designee, is required for Medicaid reimbursement (see title 11 of article 5 of the Social Services Law) of care and services provided in an RHCF.
(c) Level of care approval shall be granted by the commissioner or the commissioner's designee in accordance with patient assessment criteria and standards contained in sections 400.12, 400.13, and 86-2.30(i) of this Title.
(d)
(1) The commissioner may at his/her sole discretion terminate the designee status of any agency of local government or RHCF utilization review agent on 30 days advance written notice to the designee. Reasons for termination may include, but shall not be limited to, decisions by the commissioner's designee which are not in substantial compliance with the patient assessment criteria and standards specified in section 400.12, 400.13, and 86-2.30(i) of this Title.
(2) For agencies of local government, reasons for termination shall also include failure to comply with the terms and standards specified in any written MOU between the commissioner and the local government agency which prescribes the conditions for commissioner's designee status.
(e) For RHCFs, the scope of commissioner's designee authority shall be limited to patients seeking admission to, or continued stay in, the particular facility. Designee status shall be further limited to those individuals who have established or are in the process of establishing Medicaid eligibility (see title 11 of article 5 of the Social Services Law).
(f)
(1) For agencies of local government, the scope of commissioner's designee authority shall be limited to admission and continued stay review determinations with respect to patients who have established or are in the process of establishing Medicaid eligibility (see title 11 of article 5 of the Social Services Law) who are seeking admission or continued stay in New York State RHCFs within 50 miles of the patient's residence or within 50 miles of the medical facility in which the individual is currently a patient if no current legal residence exists.
(2) For all other patients, level of care approval shall be made by the commissioner.
(g) When the commissioner terminates pursuant to this section the level of care approval function of any RHCF or agency of local government, the commissioner shall assume responsibility for placement and/or continued stay review determinations.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
TRANSPORTATION TRANSPORTATION
10 CRR-NY 14-5.51 Temperature requirements
Transport vehicles are to be provided with heated and refrigerated facilities that will maintain potentially hazardous food at 140°F (60°C) or above, or 45°F (7.2°C) or below, while in transit. Thermometers accurate to plus or minus 2°F (1.1°C) are to be provided to show the temperature in the coldest part of the hot storage facility and the warmest part of the cold storage facility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 126 MONTGOMERY COUNTY
CITIES CITIES
10 CRR-NY 126.1 City of Amsterdam
Public Health Law, § 1100
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Glen Wild watershed and Brookside reservoir and all watercourses tributary thereto or which may ultimately discharge into said Glen Wild watershed and Brookside reservoir or which may be developed in the future to serve as sources of the water supply to the city of Amsterdam.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or the solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(6) Pesticide shall mean any substance used to destroy or inhibit pests, such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits ratiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the city of Amsterdam water supply.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including, but not limited to, gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the city of Amsterdam.
(17) Watercourse shall mean every spring, stream, marsh or channel of water of any kind which flows or may flow into the city of Amsterdam water supply.
(18) Watershed shall mean the entire drainage area contributing water to the city of Amsterdam water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 50-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse, unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the city of Amsterdam.
(ii) Boating. No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the city of Amsterdam, except by duly authorized employees of the city of Amsterdam in the performance of their duties of supervision and maintenance of the water supply.
(iii) Fishing and trespassing. No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the city of Amsterdam within a 1,000-foot linear distance of the water supply intakes, except by duly authorized employees of the city of Amsterdam in the performance of their duties of supervision and maintenance of the water supply.
(7) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of any reservoir or watercourse.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500 foot linear distance of any reservoir or watercourse.
(8) Toxic chemicals.
No container used for the storage of toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of any reservoir or watercourse.
(9) Miscellaneous.
(i) Structures. No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the city of Amsterdam.
(ii) Other wastes. No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The commissioner of public works of the city of Amsterdam or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourse and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid commissioner of public works to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid commissioner of public works to promptly notify the State Commissioner of Health of such violations. The aforesaid commissioner of public works shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.1 Definitions
(a) Approved asbestos safety training program.
A program approved by the Commissioner of Health offered in a specific discipline, which provides through qualified instructors training in such areas as the handling, evaluation, and removal of asbestos containing material (ACM), education concerning safety and health risks inherent in such handling and removal, and training in techniques for minimizing the exposure of the public to asbestos fibers, which shall include, but not be limited to instruction in all applicable Federal, State and local laws and regulations.
(b) Asbestos.
Any naturally occurring hydrated mineral silicate separable into commercially usable fibers, including chrysotile (serpentine), amosite (cumingtonite-grunerite), crocidolite (riebeckite), termolite, anthophyllite and actinolite.
(c) Asbestos handler.
An individual who removes, encapsulates, repairs, or encloses asbestos containing material or who disturbs asbestos containing material.
(d) Asbestos project.
Work undertaken by a contractor which involves the installation, removal, encapsulation, application or enclosure of any asbestos containing material, or the disturbance of asbestos containing material except for work in an owner-occupied single family dwelling performed by the owner of such dwelling. Where all asbestos work on a project is subcontracted to a contractor with an asbestos-handling license, only that part of the work involving asbestos containing material shall be deemed to be an asbestos project.
(e) Asbestos safety training program evaluation form.
A form provided by the asbestos safety training provider to be completed by the trainees allowing them to evaluate all aspects of the training received.
(f) Asbestos safety training provider.
The provider or operator of an approved asbestos safety training program.
(g) Asbestos supervisor.
The individual who supervises the asbestos project and ensures that proper asbestos work procedures as well as individual safety procedures are being adhered to.
(h) Contractor.
The State, any political subdivision of the State, a public authority or any other governmental agency or instrumentality thereof, self-employed person, company, unincorporated association, firm, partnership, or corporation and any owner or operator thereof, which engages in an asbestos project or employs persons engaged in an asbestos project.
(i) Department.
The Department of Health.
(j) Health professional.
A person having a degree in community health, environmental health science, industrial hygiene or other related science or a person the commissioner determines is qualified on the basis of knowledge, experience and communication skills to effectively communicate the health effects of asbestos and the risks associated with unsafe handling practices.
(k) Large asbestos project.
An asbestos project involving the installation, removal, disturbance, enclosure, or encapsulation of 160 square feet or more of asbestos or asbestos material or 260 linear feet or more of asbestos or asbestos material.
(l) Small asbestos project.
An asbestos project involving the installation, removal, disturbance, repair, encapsulation or enclosure of more than 10 and less than 160 square feet of asbestos or asbestos material, or more than 25 and less than 260 linear feet of asbestos or asbestos material.
(m) Minor asbestos project.
An asbestos project involving the installation, removal, disturbance, repair, encapsulation or enclosure of 10 square feet or less of asbestos or asbestos material, or 25 linear feet or less of asbestos or asbestos material.
(n) Allied trades.
Any person performing any limited or special tasks in preparation of or ancillary to an asbestos abatement project, such as a carpenter, electrician, plumber, cable puller, one who installs or repairs heating and ventilation systems or one engaged in a similar occupation or any other person who may incidently disturb asbestos during the course of an asbestos project.
(o) Asbestos project air sampling technician.
Any person performing air sampling as required by 12 NYCRR section 56-17.4
(p) Inspector.
Any person performing the limited tasks involved in the survey, identification, recording and reporting of asbestos material or collecting bulk samples of suspected asbestos materials for laboratory analysis.
(q) Management planner.
Any person responsible for using data gathered by inspectors to assess the asbestos containing materials hazard in buildings, determine the appropriate response actions, and develop a schedule for implementing response actions.
(r) Abatement project designer.
Any person responsible for designing asbestos abatement projects.
(s) Project monitor.
Any person who serves as an on-site representative of the building owner to oversee asbestos abatement work.
(t) Training day.
The duration of a day of training is eight hours of which six and one half hours must be contact hours.
(u) Contact hour.
A contact hour is sixty minutes of asbestos safety training provided by an approved asbestos safety training provider.
(v) Training director.
The individual, designated by the asbestos safety training provider and approved by the department, who is responsible for ensuring that the training program complies with all provisions of this Part. In addition, the training director is the individual who monitors the performance and qualifications of the instructors and the quantity and quality of all of the instruction provided.
(w) Interactive/participatory teaching methods.
Instruction where there is active interaction and/or participation of the students during training, as opposed to passive instruction such as lecture. Examples of interactive/participatory teaching methods include, but are not limited to, hands-on workshops, demonstration and practice, small group problem-solving, games, discussions, risk mapping, field visits, walk-throughs, problem-posing, group work assignments, homework and review sessions, question and answer period, skits, and role-playing sessions.
(x) New York State Department of Health certificate of asbestos safety training completion.
A certificate issued by the department to an approved training provider to be completed by the training provider and given to trainees who successfully complete a New York State accredited asbestos safety training program. The certificate is the official record of successful completion of New York State accredited asbestos safety training.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.104 Treatment program
Persons conducting treatment programs pursuant to article 23 of the Mental Hygiene Law shall keep records required by section 3352 of the Public Health Law and submit a monthly methadone usage report on a form furnished by the department.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.16 Sleeping quarters
(a) Every bed, mattress, and related sleeping accessories provided by the operator, shall be clean and in good condition at the time of issue; clean sheets and pillowcases shall be provided weekly. Laundry facilities shall be available when campers and staff provide their own linens.
(b) A minimum clear space of 27 inches above the sleeping surface of a bed, and six feet between heads of sleepers, shall be maintained; triple-decker beds are prohibited. Unobstructed space for aisles between beds and access to exits must be provided. Bunk beds shall be structurally sound. The upper bed of bunk beds must, by May 15, 2005, be provided with adequate guardrails.
(c) In sleeping quarters housing more than four persons, 40 square feet of floor area per occupant shall be provided, when single beds are provided. When double-deck bunk beds are provided, 30 square feet of floor area shall be provided for each occupant. Floor area includes space within the occupied structure to accommodate: the bed, storage for personal belongings, aisles and exitways, and associated assembly space. Space for toilets, lavatories and showers shall not be used to calculate a sleeping quarter's floor area. For structures built prior to 1975, the required minimum floor area for single beds is 36 square feet. Effective July 1, 2011, construction of sleeping quarters not meeting the definition of a summer camp cabin, as defined in section 7-2.12(b)(3) of this Subpart, 50 square feet of floor area per occupant shall be provided in each sleeping room.
(d) An undivided room shall not have more than 36 occupants.
(e) A sleeping room shall have a minimum clear height of five feet above the floor area, and at least 80 percent of the floor area shall have a continuous minimum clear height above it of seven feet. The walls shall extend from the floor to the ceiling or roof, or to a minimum height of eight feet.
(f) At least one adult counselor shall be present during sleeping hours on every level of a building used for sleeping.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.8 Bone marrow transplantation (BMT) services
(a) This methodology will be utilized to evaluate certificate of need applications involving the initiation of allogeneic bone marrow transplantation services. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of bone marrow transplantation services. The goals and objectives of the methodology expressed herein are expected to insure that an adequate number of BMT services are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors and methodology for determining the public need for allogeneic BMT services shall include, but not be limited to, the following:
(1) The need for BMT services shall be planned on a statewide basis.
(2) Based on the current status of BMT technology, the number of people expected to be candidates for BMT therapy is 13.2 per million population per year. This will be reviewed on an annual basis to determine if any adjustment is indicated.
(3) The capacity of each BMT bed is six patients/year.
(4) A BMT service shall have a minimum of four beds.
(5) Priority consideration will be given to applicants that propose to provide this service within the facility's current capacity.
(6) Where public need is established herein, priority consideration will be given to applicants that agree to serve the medically indigent and patients regardless of the source of payment.
(7) In addition, each applicant applying to initiate a BMT service must meet the following standards:
(i) Each applicant must demonstrate the availability of a bone marrow transplant team under the direction of a full-time medical director with training in immunology or hematology who had advanced training and experience in bone marrow transplantation.
(ii) The bone marrow transplant team shall include specialists in the following areas: chemotherapy, radiation therapy, social work, nursing, infectious disease control, immunology, oncology, hematology, and expertise in intensive cardiopulmonary medicine.
(iii) The transplant program shall be supported by a blood bank with a capacity to support four to six patients/day. This requires the availability of a blood separator, a central blood repository, and an irradiator for blood products.
(iv) The bone marrow transplantation program shall provide or make arrangements for the harvesting of bone marrow.
(v) The services of an immunogeneticist and a cytogeneticist shall be available to the transplant program.
(vi) The transplant program shall have available clinical laboratories possessing permits issued under article 5, title 5 of the Public Health Law, in the categories of: virology, diagnostic immunology, bacteriology, mycology, mycobacteriology, parasitology, cytogenetics, cellular immunology and histocompatibility.
(vii) There shall be an organized follow-up program for transplant patients following discharge, including data management resources to maintain records on the long-term survival of transplant patients.
(viii) Each facility providing BMT services shall agree to provide annual reports to the Department of Health on utilization levels and patient origin data.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.84 Machine cleanability
Food vending machines are to be constructed to be cleanable:
(a) without being disassembled;
(b) by disassembling without the use of tools; or
(c) by disassembling with the use of only simple tools, such as a mallet, a screwdriver or an open-end wrench kept available near the equipment, unless designed for in-place cleaning.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.44 Validity
If any clause, sentence, paragraph or section of this Part shall be adjudged by any court of competent jurisdiction to be invalid, such judgment shall not affect, impair or invalidate the remainder thereof, but shall be confined in its operation to the clause, sentence, paragraph or section thereof directly involved in the controversy in which such judgment shall have been rendered.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.275 Radiology diagnostic films
The total number of films used, including cardiac angiography exposures, mammography and xerography. Consideration should be given to the size of film used.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.2 Application
(a) The requirements of this Subpart shall apply to a campground where five or more campsites are occupied or maintained for occupancy except:
(1) those portions of a campground occupied by the owner(s) or operator(s) thereof, or their immediate family; and
(2) a campground occupied for less than 60 hours in any calendar year.
(b) The requirements of this Subpart shall not apply to:
(1) a children's camp as defined in Subpart 7-2 of this Part, migrant farm worker housing as defined in Part 15 of this Title, or a mobile home park as defined in Part 17 of this Title; and
(2) any other type of operation, occupancy or use of a property determined by the State Commissioner of Health as not being within the intent of regulation by this Subpart.
(c) The requirements in this Subpart supercede the provisions in Subpart 7-1 of this Part for travel vehicle parks and campsite operators.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 95 DISCRIMINATION IN PHYSICIAN STAFF APPOINTMENTS AND PRIVILEGES BASED ON PARTICIPATION IN A MEDICAL GROUP PRACTICE OR NON-PROFIT HEALTH INSURANCE PLAN
10 CRR-NY 95.11 Decision of hearing officer
The hearing officer shall state his findings of fact in a written decision based upon a consideration of all the evidence in the record. The hearing officer shall file his decision with the commissioner within 30 days of the conclusion of the hearing.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.2 Permit
(a) A temporary food service establishment shall obtain and display a valid permit from an issuing official authorized by the State Commissioner of Health. At establishments that serve retail frozen desserts the $25 permit fee imposed by Public Health Law, section 225(5)(s) shall be paid at the time any other permit fees related to the operation of the food service establishment are collected by the permit-issuing official and the establishment's permit shall indicate that the facility can manufacture and sell retail frozen desserts.
(b) The term permit-issuing official means the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, a public health director or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, or such grade I or grade II public health administrator or public health director or county health director may designate the director of environmental health of such district; and the State regional health director, or area director may designate the district, or area director may designate the district director as additional persons authorized to issue the permits required by this Subpart.
(c) A permit will be issued subject to the temporary food service establishment being constructed, maintained and operated in compliance with this Subpart and not presenting a danger to the health of the consumer or to the public. An applicant's past history of compliance or noncompliance will be a consideration in evaluating each of the previously mentioned criteria. The condition of the establishment, its equipment, utensils, personnel, mode of operation, surroundings, water supply, sewage disposal, waste handling, furnishings, food and appurtenances are all factors in determining whether its continued operation may affect public health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.1 Definitions
(a) Administrative officer means the chief executive officer of the hospital, as defined in section 405.3 of this Title.
(b) Audiologic evaluation means the use of physiologic and behavioral procedures to evaluate and diagnose hearing loss.
(c) Hearing problems (hearing loss) shall mean a permanent unilateral or bilateral hearing loss of mild (30 to 40 dB HL) or greater degree in the frequency region (500-4000 Hz) important for speech recognition and comprehension.
(d) Institution caring for infants (facility) means all general hospitals having maternity and infant services or premature infant services as defined in section 405.21 of this Title, primary care hospitals and critical access hospitals as defined in section 407.1 of this Title, birthing centers as defined in section 754.1 of this Title, and midwifery birth centers as defined in section 795.1 of this Title.
(e) Newborn infant (infant) means a minor child who is less than 90 days of age.
(f) Newborn infant hearing screening (infant hearing screening) means the use of an objective electrophysiologic or otoacoustic measurement of the auditory system using equipment approved by the United States department of Health and Human Services, Food and Drug Administration (FDA), to identify infants at risk for hearing loss.
(g) Parent means a parent by birth or adoption, legal guardian, or any other person legally authorized to consent to medical services for the infant.
(h) Article 28 facility shall mean a health care facility established under article 28 of the Public Health Law.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 447 STANDARD UNIT OF MEASURE REFERENCES
10 CRR-NY 447.4 Physical therapy services
(a) ACCOUNT NUMBER
COST CENTER TITLE
7510
Physical Therapy
(1) The standard unit of measure will be the relative value units developed by the American Physical Therapy Association. Relative value units shall be counted during a patient visit for all cost center activities for which a charge is made. A patient visit is the occasion for service during which the resources of the physical therapy cost center are used. A visit is one appearance of a patient regardless of the number of evaluation, therapeutic, patient education activities performed during that appearance.
(2) The two major components of the relative value unit are: personnel time associated with the activity, and other direct and appropriate indirect department resources used in providing the activity. Fifteen minutes has been established as the least increment of time for which a unit of service ( e.g., evaluation, therapeutic, or patient educational activity) can occur. The unit of service which requires the least amount of the physical therapy department's total resources is a modality. This activity is used to establish the basic relative value unit of 1.0. Since the basic relative value unit of 1.0 does not require the continuous attendance of physical therapy personnel, the initial unit value for those services that do require the continuous attendance of physical therapy personnel is adjusted upward. An additional.4 of a unit will be added to the initial increment for those activities requiring continuous attendance by physical therapy personnel. When subsequent 15-minute increments of service are provided, some of the initial direct and indirect costs do not recur or are reduced. Therefore, relative value units for subsequent increments of time are approximately 10 percent less than the initial unit value.
(3) The recording of 15-minute increments of service begins with the initiation of the evaluation, therapeutic, or patient educational activity. Although time may have been spent transporting the patient to the department or making entries in the medical record, RVU's are not counted for these activities. Patient transportation, treatment preparation and cleanup, and recordkeeping costs are incorporated in the weighting of the initial 15-minute increment of service and additional RVU's cannot be added for these activities. However, the time required to complete a separate formal report for patient evaluations or aftercare planning can be counted.
(4) Therapeutic or evaluation activities performed in the home shall have a unit value equivalent to that for the appropriate therapeutic or evaluation activity rendered plus an allowance for travel time to and from the home. Travel time for home visits is valued the same as those activities requiring continuous attendance by physical therapy personnel with the patient.
(b) RELATIVE VALUE UNITS
| | Description | Initial 15 minutes | Additional 15 minutes (round to nearest 15 minutes) | | | --- | --- | --- | --- | --- | | (1) | EVALUATION ACTIVITIES | | | | | | Evaluation activities are assessments of patients' performance to assist in establishing diagnoses or to establish or reevaluate treatment plans. | 1.4 | 1.3 | | | (2) | THERAPEUTIC ACTIVITIES | | | | | | (i) Modalities | | | | | | A modality does not require the continuous attendance of physical therapy personnel during a therapeutic activity | 1.0 | 0.9 | | | | (ii) Procedures | | | | | | A procedure does require the continuous attendance of physical therapy personnel during a therapeutic activity. | 1.4 | 1.3 | | | (iii) Hydrotherapy | | | Continuous attend attendance of personnel | | | | | | required | not required | | | Extremity or Body Whirlpool | 1.4 | 1.3 | 0.9 | | | Hubbard Tank or Therapeutic Pool | 2.5 | 1.3 | 0.9 |
| | | Initial 15 minutes | Additional 15 minutes (round to nearest 15 minutes) | | | --- | --- | --- | --- | --- | | (3) | PATIENT EDUCATIONAL ACTIVITIES | | | | | | Patient educational activities are used to instruct the patient or his attendant, family or their substitute in maintaining and improving the patient's condition. | 1.4 | 1.3 | | | (4) | COMBINATION OF EVALUATION, THERAPEUTIC OR PATIENT EDUCATIONAL ACTIVITIES | | | | | | Multiple evaluation, therapeutic, patient educational activities performed during a patient visit will be reported as a combination. | | | | | | (i) Any number of modalities in combination | 1.0 | 0.9 | | | | (ii) Any number of evaluation, therapeutic, or patient educational activities in combination | 1.4 | 1.3 | | | | (iii) Hydrotherapy in combination with other activities: | | | | | | Extremity or Body Whirlpool | 1.4 | 1.3 | | | | Hubbard Tank or Therapeutic Pool | 2.5 | 1.8 | | | (5) | HOME VISITS | | | | | | A home visit is provided to an individual patient in a setting other than the physical therapist's office or work facility. The standard unit of measure for home visits includes the number of relative value units for the evaluation, therapeutic, or patient educational activity and for travel time. | | | | | | (i) Evaluation, Therapeutic, or Educational Activities | 1.4 | 1.3 | | | | (ii) Travel Time Travel time for home visits is the actual time spent by physical therapy personnel going to and from the home. Travel time for multiple home visits during a single trip is calculated by dividing the total number of relative value units for travel time by the number of patients treated during that trip. | 1.3 | 1.3 | | | (6) | GROUP ACTIVITIES | | | | | | A group activity is the occasion for service during which two or more patients simultaneously receive a therapeutic, evaluation, or patient educational activity. Group activities will be reported by counting the number of RVU's for one patient participating in the group activity session, and adding 0.1 RVU per session for each patient participating in the group activity. | 1.3 | 1.3 | |
(7) Notes
(i) For further explanation of how to use the relative value units see the accompanying Schedule of Unit Values and Examples of Relative Value Unit Computations for Combination Activities.
(ii) When multiple personnel are used during an entire activity period, additional 1.3 RVU's are recorded for each person for each 15-minute increment.
(iii) The units of measure do not include wound dressing, debridement, exercise or other activities performed in conjunction with hydrotherapy.
(iv) When computing an indiviudal's RVU's, the value should be rounded to the nearest one-tenth ( e.g., 0.62 = 0.6, 0.68 = 0.7).
(c) SCHEDULE OF UNIT VALUES
| UNIT VALUE | | | | | | | --- | --- | --- | --- | --- | --- | | Description | Initial 15 min. | Additional 15 min. | 30 min. | 45 min. | 60 min. | | (1) Evaluation Activities | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | (2) Therapeutic Activities | | | | | | | (i) Modalities | 1.0 | 0.9 | 1.9 | 2.8 | 3.7 | | (ii) Procedures | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | (iii) Hydrotherapy | | | | | | | Extremity or Body Whirlpool | | | | | | | Continuous attendance of personnel | | | | | | | required | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | not required | 1.4 | 0.9 | 2.3 | 3.2 | 4.1 | | Hubbard Tank or Therapeutic Pool | | | | | | | Continuous attendance of personnel | | | | | | | required | 2.5 | 1.3 | 3.8 | 5.1 | 6.4 | | not required | 2.5 | 0.9 | 3.4 | 4.3 | 5.2 | | (3) Patient Educational Activities | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | (4) Combination of Evaluation, Therapeutic, or Patient Educational Activities | | | | | | | (i) Any Number of Modalities in Combination | 1.0 | 0.9 | 1.9 | 2.8 | 3.7 | | (ii) Any Number of Evaluation, Therapeutic, or Patient Educational Activities in Combination | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | (iii) Hydrotherapy in Combination with Other Activities | | | | | | | Extremity or Body Whirlpool | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | Hubbard Tank or Therapeutic Pool | 2.5 | 1.3 | 3.8 | 5.1 | 6.4 | | (5) Home Visits | | | | | | | (i) Evaluation, Therapeutic, or Patient Educational Activities | 1.4 | 1.3 | 2.7 | 4.0 | 5.3 | | (ii) Travel Time | 1.3 | 1.3 | 2.6 | 3.9 | 5.2 | | (6) Group Activities (total RVU's plus 0.1 per session for each patient) | 1.3 | 1.3 | 2.6 | 3.9 | 5.2 |
Note:
Activities that exceed 60 minutes are recorded by adding the appropriate values from the “additional 15 minutes” column.
(d) EXAMPLES OF RELATIVE VALUE UNIT COMPUTATIONS FOR COMBINATION ACTIVITIES
| Description | Calculations | RVU's | | --- | --- | --- | | (1) MODALITIES | | | | A patient is in the department for 60 minutes. The patient waits 30 minutes before receiving 30 minutes of hot packs and cervical traction to the neck. | 1.0 + 0.9 = | 1.9 | | Description | Calculations | RVU's | | (2) PROCEDURES | | | | Therapeutic exercise to the right leg and gait training for 45 minutes. | 1.4 + 1.3 + 1.3 = | 4.0 | | (3) EVALUATION AND MODALITIES/ PROCEDURE | | | | Evaluation, hot pack, ultrasound, and massage to the left shoulder for 75 minutes. | 1.4 + 1.3 + 1.3 + 1.3 + 1.3 = | 6.6 | | (4) HYDROTHERAPY | | | | (i) Extremity whirlpool, not requiring continuous attendance of physical therapy personnel, 30 minutes. | 1.4 + 0.9 = | 2.3 | | (ii) Therapeutic pool, requiring continuous attendance of physical therapy personnel, 45 minutes. | 1.4 + 1.3 + 1.3 = | 4.0 | | (5) HYDROTHERAPY COMBINATIONS | | | | (i) Extremity whirlpool massage and exercise to the left arm for 60 minutes. | 1.4 + 1.3 + 1.3 + 1.3 = | 5.3 | | (ii) Body whirlpool and exercise to both legs and back for 60 minutes. | 1.4 + 1.3 + 1.3 1.3 = | 5.3 | | (iii) Hubbard tank and burn debridement to upper torso for 60 minutes with one staff member required; | 2.5 + 1.3 + 1.3 + 1.3 = | 6.4 | | with two staff members required. | (2.5 + 1.3 + 1.3 + 1.3) + (1.3 +1.3 + 1.3 + 1.3) = | 11.6 | | (6) HOME VISIT | | | | (i) A visit is made to a patient's home and 25 minutes of diathermy is provided. A visit is then made to another patient's home and 35 minutes of gait training is provided. Travel time to and from the hospital as well as between the two homes is 45 minutes. | | | | (ii) The RVU's for travel time per home visit are the total number of RVU's for travel time divided by the total number of home visits. | 1.3 + 1.3 + 1.3 = 3.9 3.9 - 2.0 =1.95 or 2.0 | 2.0 | | (iii) First visit: Diathermy treatment for 25 minutes. | 1.4 + 1.3 = | 2.7 | | Total RVU's for first home visit. | 2.0 + 2.7 = | 4.7 | | (iv) Second visit: Gait training for 35 minutes. | 1.4 + 1.3 = | 2.7 | | Total RVU's for second home visit | 2.0 + 2.7 = | 4.7 | | (7) GROUP ACTIVITIES | | | | (i) Ten patients received exercise instruction and patient education. The activity session was 35 minutes in Duration. | | | | (ii) One staff member required. | (1.3 + 1.3) + (0.1 x 10) = (Average RVU's per patient =0.36 or 0.4 | 3.6 | | (iii) Two staff members required. | (1.3 + 1.3) + (1.3 + 1.3) + (10 x 0.1) = (Average RVU's per patient = 0.62 or 0.6) | 6.2 |
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SANITARIAN PUBLIC HEALTH SANITARIAN
10 CRR-NY 11.112 Supervisory level qualifications
A supervising public health sanitarian must meet the qualifications for a public health sanitarian and have two years of experience as a public health sanitarian.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.12 Social services
The operator must:
(a) provide social services in conformance with section 415.5(g) of this Subchapter except that the use of a full- or part-time social worker in an adult day health care program must be in conformance with the approved application for operation and, with respect to section 415.5(g)(2)(ii) and (iii), regular access may be directly with a master's prepared or certified social worker or through a contract which meets the provisions of section 415.26(e);
(b) either directly or through the managed long term care plan or care coordination model that referred the registrant to the adult day health care program, ensure that psycho-social needs are assessed, evaluated and recorded, and that services are provided to meet the identified needs as part of the coordinated care plan; and
(c) ensure that staff members arrange for the use of and/or access to other community resources as needed and coordinate the needs of the registrants with services provided by the adult day health care program and other health care providers, community social agencies and other resources; provided, however, with respect to registrants referred to the adult day health care program by a managed long term care plan or care coordination model, this shall be the responsibility of the managed long term care plan or care coordination model.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
SERVICES PROVIDED AND GOODS USE SERVICES PROVIDED AND GOODS USE
10 CRR-NY 446.26 Organized Drug Addiction Program
(a) Please indicate the types of patients treated:
(1) Inpatient:
(i) Adult.
(ii) Adolescent.
(2) Ambulatory:
(i) Adult.
(ii) Adolescent.
(b) Please indicate the type of unit you have:
(1) Inpatient:
(i) Detoxification.
(ii) Maintenance.
(2) Ambulatory:
(i) Detoxification.
(ii) Maintenance.
(c) Please provide the following statistics:
(1) Inpatient:
(i) Number of beds.
(ii) Number of admissions during the reporting period.
(iii) Number of patient days during the reporting period.
(2) Ambulatory:
(i) Register of patients on last day of reporting period.
(ii) Total number of different patients treated during the reporting period.
(iii) Total number of visits during the reporting period.
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.21 Confidentiality of records
The operator shall keep confidential and make available only to authorized persons all medical, social, personal and financial information relating to each registrant.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.12 Fair hearings involving food vendors and local agencies where no contemporaneous penalty is sought
(a) A food vendor, upon request, shall be entitled to a fair hearing under this section if its application to supply supplemental foods to WIC program participants is denied, or if it is disqualified during the contract period from the WIC program for violation of its contract with the local agency or for high prices or low volume as defined in the vendor's contract and no contemporaneous monetary penalty under the authority of section 12 of the Public Health Law is sought against it. A fair hearing shall not be required when a vendor contract has expired and has not been renewed. Neither the local agency nor the department shall accept an application for WIC participation from a vendor whose contract has not been renewed, for one year from the date of the contract expiration.
(b) A local agency, upon request, shall be entitled to a fair hearing under this section if its application to serve as a local WIC agency is denied or if it is disqualified. A fair hearing shall not be required when a local agency's contract with the State agency has expired and has not been renewed.
(c) If a local agency or a food vendor is denied, or disqualified from, participation in the WIC program, such vendor or agency shall be given written notice promptly of such action, the reasons therefore, the rules and regulations governing food vendor or local agency participation in the WIC program, the right to a fair hearing, and that such hearing may be obtained by the local agency or vendor by petitioning, orally or in writing, the Director, Investigative Services Unit, Bureau of Nutrition, New York State Department of Health, Tower Building, Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237, (518) 474-3343 within 15 days from the date the notice of agency action is served. Failure to request a hearing within the required 15-day period will result in a waiver of the food vendor or local agency's right to a hearing.
(d) A written notice of hearing shall be sent by certified mail to the applicant and other parties involved at least 10 days prior to the scheduled date of the hearing. Such notice shall:
(1) specify the date, time and place of the hearing;
(2) state briefly the issues which are to be the subject of the hearing;
(3) explain the manner in which the fair hearing will be conducted;
(4) apprise the petitioner of its right to be represented by an attorney, to testify, present documentary evidence, produce witnesses, cross-examine adverse witnesses, and to examine prior to and during the hearing the documents and records supporting the action under appeal; and
(5) state that failure to appear at the hearing shall constitute waiver of the petitioner's right to a hearing and that an order will be issued denying or disqualifying the petitioner from participation in the WIC program.
(e) The administrative law judge, in rendering a decision on the food vendor's application for participation in the WIC program shall be bound by section 60-1.13 of this Subpart.
(f) Under this section, the burden of proof to participate or remain in the WIC program shall be on the local agency or vendor denied participation or disqualified for violations of the vendor's contract with the local agency or of this Subpart.
(g) The provisions of section 60-1.6(d) and (h) of this Subpart concerning hearings, hearing officers, and record of hearings shall apply to fair hearings for food vendors and local agencies conducted pursuant to this section.
(h) A copy of the fair hearing decision shall be sent to the petitioner, his/her attorney, if any, and other parties involved, within 60 days following the date on which the State agency received the request for a hearing.
(i) Following a hearing denying a vendor participation in the WIC program for lack of need, neither the local agency nor the department shall accept from a vendor, for at least one year from the date of the order denying participation, an application to participate in the WIC program. In cases of vendor abuse, neither the local agency nor the department shall accept an application for the period of disqualification up to a maximum of three years from the date of vendor's disqualification.
(j) Nothing in this section shall prevent the department from immediately disqualifying any vendor or local agency from participating in the WIC program provided that written notice of disqualification is given to the vendor at least 15 days before the effective date of the disqualification and to the local agency at least 60 days before the effective date of disqualification, respectively. The disqualification may not be stayed during the pendency of the hearing by the administrative law judge without the consent of the department's representative at the hearing. The disqualification shall remain in effect unless an order is issued at the conclusion of the hearing which reinstates the vendor or local agency.
(k) This section shall not preclude the department from commencing a subsequent proceeding to assess a civil penalty against the vendor or the local agency pursuant to section 60-1.11 of this Subpart.
(l) This section shall not preclude the department from ordering a WIC vendor to immediately cease and desist from depositing WIC checks in the bank. If the department takes such action, it shall immediately notify the vendor. The vendor may request a hearing in the matter set forth in subdivision (c) of this section. This section shall govern the conduct of such a hearing.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 107 CHENANGO COUNTY
VILLAGES VILLAGES
10 CRR-NY 107.4 Village of Sherburne
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 72 of the Public Health Law, heretofore set forth, shall apply to those portions of the drainage areas of Mad Brook and all other streams which form or are tributary to the sources of water supply of the village of Sherburne, Chenango County, and to the impounding and distributing reservoirs and to all other lakes, ponds and reservoirs whose waters form or are tributary to the sources of water supply of the village of Sherburne.
(b) [Definitions.]
(1) The term reservoir whenever used in this section is intended to mean and refer to any natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter the public water supply of the village of Sherburne.
(2) The term watercourse wherever used in this section is intended to mean and refer to any spring, stream, ditch, gutter or other watercourse of any kind, the waters of which, when running whether constantly or occasionally, eventually flow or may flow into the public water supply of the village of Sherburne.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercouse.
(c) Privies adjacent to any reservoir of*watercourse.
(1) No privy, privy vault, pit, cesspool of* any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained with its nearest point within 75 feet of any reservoir or watercourse of the public water supply of the village of Sherburne.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 150 feet of any reservoir or watercourse of the public water supply of the village of Sherburne.
(3) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 150 feet, horizontal measurement, of the water line of any reservoir or the edge, margin or precipitous bank of any watercourse of the public water supply of the village of Sherburne, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 300 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 200 feet from the edge, margin or precipitous bank of any watercourse of the public water supply of the village of Sherburne.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height of flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage or excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the public water supply of the village of Sherburne, nor shall any such matters be placed, led discharged or allowed to escape onto the surface of the ground or into the ground below the surface within 200 feet of any such reservoir or watercourse.
(2) No garbage, putrescible matter, house slops, bath water, kitchen or sink wastes, refuse or waste water from creameries, cheese factories, laundries nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the public water supply of the village of Sherburne; nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any any reservoir or watercourses of the public water supply of the village of Sherburne within 100 feet of any such reservoir or within 75 feet of any such watercourse.
(3) No clothing, bedding, carpets, harness, vehicle, receptacle, utensils or anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the public water supply of the village of Sherburne.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the public water supply of the village of Sherburne, nor shall any animals or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor shall be washed therein.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 150 feet from any reservoir or 75 feet from any watercourse of the public water supply of the village of Sherburne; and none of the above named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainings, leachings or washings from the same may enter any such reservoir or watercourses without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for the distance of not less than 150 feet before entering any such reservoir nor less than 75 feet before entering any such watercourse.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 300 feet from any reservoir or 200 feet from any watercourse of the public water supply of the village of Sherburne; and no manure or compost of any kind shall be placed, piled or spread upon the ground within 150 feet of any such reservoir or 75 feet of any such watercourse.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the public water supply of the village of Sherburne without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any such reservoir or 50 feet before entering any such watercourse.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof or any offal or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the public water supply of the village of Sherburne; nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any such reservoir or 100 feet before entering any such watercourse.
(g) Fishing and boating and ice cutting.
(1) No fish shall be taken from any reservoir, nor shall any person fish in any reservoir or through ice upon the same nor trespass upon the waters of any reservoir or the ice thereon nor maintain or use any boat or boats thereon, except the officials or duly authorized employees of the public water supply of the village of Sherburne in the exercise of their duties in the management and operation of the reservoirs.
(2) No person or persons shall cut or remove any ice from any of the reservoirs which form or are tributary to the sources of the public water supply of the village of Sherburne.
(h) Cemeteries.
No interment of a human body shall be made within 100 feet of any watercourse or within 200 feet of any reservoir of the public water supply of the village of Sherburne.
(i) Inspections.
The board of water commissioners of the village of Sherburne, through its superintendent or other duly authorized official, shall maintain systematic and thorough inspection of the reservoirs, streams and of the entire drainage area tributary thereto for the purpose of determining whether the above rules are being complied with. At least three such inspections shall be made each year, preferably about the first of the months of March, July and November, and such others as may be directed by the State Commissioner of Health. A full and detailed report of each such inspection, including a statement of each violation or noncompliance with the rules, shall be submitted in writing to the State Commissioner of Health within 10 days of the completion of such inspection and a duplicate copy of each report shall at the same time be furnished to the board of health of the village of Sherburne.
(j) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.4 Assessment
Rates shall include the assessment described in section 43.04 of the Mental Hygiene Law.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.3 Requirements for approval
(a) The application must be in proper form and complete.
(b) The applicant must satisfactorily demonstrate to the council:
(1) that the incorporators, members of the board of directors and officers are of such character, experience, competence and standing in the community as to give reasonable assurance of their ability to conduct the affairs of the corporation in its best interests and in the public interest; and
(2) that, with respect to each incorporator, director and officer of the proposed central services facility rural health network corporation who is already or within the past 10 years has been an incorporator, director, sponsor, principal stockholder or operator of any facility or plan licensed or certfied pursuant to article 28, 36, 40 or 44 of the Public Health Law, a substantially consistent high level of care has been rendered in each such facility or plan with which the applicant is or has been affiliated during the past 10 years in accordance with section 600.2(b)(4)and (c) of this Title.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
MEDICAL DIRECTOR OF COUNTY CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS SUPPORT SERVICES PROGRAMS MEDICAL DIRECTOR OF COUNTY CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS SUPPORT SERVICES PROGRAMS
10 CRR-NY 11.15 Definition
The term medical director of a county children and youth with special health care needs support services program shall mean a physician appointed pursuant to the provisions of the Public Health Law by the board of supervisors of a county lacking a county health district to authorize medical service for children and youth with special health care needs and otherwise administer the county children and youth with special health care needs support services program.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.35 Available beds
Health facility beds which are maintained and staffed for the provision of patient care.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
COMPANIES COMPANIES
10 CRR-NY 127.102 New York Water Service Corporation (city of Glen Cove)
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells located on a tract of land situated in the valley of Glen Creek, a short distance north of the southern boundary of the city of Glen Cove, owned and operated by the New York Water Service Corporation, and serving the city of Glen Cove, Nassau County, N. Y.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well forming the source of the public water supply of the city of Glen Cove.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well forming the source of the public water supply of the City of Glen Cove.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container, which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well forming the source of the public water supply of the city of Glen Cove.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered said* and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with leaded joints connected to a sewage disposal system, a permit for which shall have been granted by the State Commissioner of Health) within 200 feet of any well forming the source of the public water supply of the city of Glen Cove. It is provided, however, that no such watertight receptacle shall be within 75 feet nor any such watertight iron pipe shall be located within 15 feet of any well forming the source of the public water supply of the city of Glen Cove.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well forming the source of the public water supply of the city of Glen Cove.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 75 feet of any well forming the source of the public water supply of the city of Glen Cove, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well forming the source of the public water supply of the city of Glen Cove.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well forming the source of the public water supply of the city of Glen Cove.
(f) Dead animals, offal, manufacturing wastes.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well forming the source of the public water supply of the city of Glen Cove.
(g) Trespassing.
No trespassing shall be allowed upon the property of the New York Water Service Corporation upon which the wells forming the source of the public water supply of the city of Glen Cove are located, and no person or persons shall enter in or upon such property except the representative of the New York Water Service Corporation or any person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the water supply or except such other persons as may be authorized to enter said property by the New York Water Service Corporation.
(h) No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well forming the source of the public water supply of the city of Glen Cove.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well forming the source of the public water supply of the city of Glen Cove.
(j) Inspections.
The New York Water Service Corporation or any person or persons as may be charged with the maintenance or supervision of the public water supply of the city of Glen Cove or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said water company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the New York Water Service Corporation to promptly notify the State Commissioner of Health of such violations. The New York Water Service Corporation shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) [General clause.]
In addition to observing the foregoing requirements all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the public water supply of the city of Glen Cove.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relates to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.139 Fund
A self-contained accounting entity set up to account for a specific activity or project.
Chapter I STATE SANITARY CODE
Part 4 PROTECTION AGAINST LEGIONELLA
Subpart 4-1 COOLING TOWERS
10 CRR-NY 4-1.2 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) Bacteriologic culture sampling and analysis.
The term bacteriologic culture sampling and analysis means the collection of a water sample for the measurement of live culture growth of the aerobic bacterial populations by heterotrophic plate count (HPC), dip slides, or similar method used by the industry and according to the manufacturer’s directions.
(b) Building.
The term building means any structure used or intended for supporting or sheltering any use or occupancy. The term shall be construed as if followed by the phrase “structure, premises, lot or part thereof” unless otherwise indicated by the text.
(c) Cooling tower.
The term cooling tower means a cooling tower, evaporative condenser, fluid cooler or other wet cooling device that is capable of aerosolizing water, and that is part of, or contains, a recirculated water system and is incorporated into a building’s cooling process, an industrial process, a refrigeration system, or an energy production system.
(d) Legionella culture sampling and analysis.
The term Legionella culture sampling and analysis means the collection of a water sample for the measurement of the live culture of Legionella involving the use of specialized media and laboratory methods for growth to determine the species and serogroup.
(e) Owner.
The term owner means any person, agent, firm, partnership, corporation or other legal entity having a legal or equitable interest in, or control of, a cooling tower or the premises where the cooling tower is located. In all instances, the legal owner of the building shall be deemed an owner within the meaning of the Subpart. Further, where a tenant owns a cooling tower that services the tenant’s leased premises, the tenant is an “owner” within the meaning of this Subpart. Additionally, if a tenant does not own the cooling tower but has a lease or contractual arrangement to maintain the cooling tower, the tenant shall be deemed an agent having control of the cooling tower, and thus an “owner,” for purposes of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.231 Organization cost (or expense)
Any cost incurred in establishing a corporation or other form of organization; as, incorporation, legal and accounting fees, promotional costs incident to the sale of securities, security qualification expense, and printing of stock certificates. These and similar costs constitute, theoretically, an intangible asset of value which continues throughout the life of the corporation and hence, strictly, do not constitute a deferred charge. The organization costs must be amortized over a period of time not less than 60 months.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.2 Definitions
Whenever used in this Subpart, the following terms shall have the following meanings:
(a) Agent means an individual who agrees, pursuant to a written agreement with another, the principal, to act on behalf of, instead of, and subject to the authority and control of, the principal with regard to acts described in the agreement and to perform such acts with individual good faith, loyalty and fidelity to the principal.
(b) Clinical laboratory means a facility for the microbiological, immunological, chemical, hematological, biophysical, cytological, pathological, genetic or other examination of materials derived from the human body, for the purpose of obtaining information for the diagnosis, prevention or treatment of disease, or the assessment of a health condition, or for identification purposes. Such examinations shall include procedures to determine, measure, or otherwise describe the presence or absence of various substances, components or organisms in the human body. Clinical laboratory does not mean any facility or activity specifically excluded by section 579 of the Public Health Law.
(c) Clinical laboratory services means examinations, tests and/or analyses performed by a clinical laboratory.
(d) Consideration means anything of value or benefit, in cash or in kind.
(e) Contract for laboratory management services means a legally enforceable written agreement between a clinical laboratory under department permit and a hospital or a health maintenance organization, whereby the contracting clinical laboratory:
(1) agrees to provide laboratory management services at fair market value at a facility of a contracting hospital;
(2) agrees to provide laboratory management services at fair market value at a facility of a contracting health maintenance organization; or
(3) agrees to provide clinical laboratory services at the laboratory's facility, and directly related services, all at fair market value, pursuant to a referral by the contracting hospital or health maintenance organization.
(f) Department means the New York State Department of Health.
(g) Directly related equipment and supplies means equipment and supplies provided by a clinical laboratory to a referring health services purveyor of a size, type and quantity reasonably related to the type and number of specimens being referred by the health services purveyor to the clinical laboratory, and which are used by the referring health services purveyor solely and exclusively for the collection, processing, storage, preservation, transport, or disposal of specimens, and which have no generally accepted use in health care practices other than solely for the collection, processing, storage, preservation, transport, or disposal of specimens.
(h) Directly related services means the following services, which are or can be performed by a clinical laboratory and are integral to the clinical laboratory services performed on referred specimens:
(1) the collection, processing, storage, preservation, transport, acceptance, or disposal of referred specimens;
(2) the reporting of test results to the referring health services purveyor; or
(3) the receipt, storage and transmittal of information between the clinical laboratory and the health services purveyor necessary for test ordering, requisitioning, reporting or billing.
(i) Fair market value means that value, calculated in monetary terms and not by bartering, in arms' length transactions, consistent with general market value. The fair market value of clinical laboratory services is deemed to include the value of directly related equipment and supplies, and directly related services. With respect to rentals or leases of property and space, fair market value shall be:
(1) consistent with the value of rental property for general commercial purposes, not taking into account the property's intended use; and
(2) not adjusted to reflect the additional value the prospective lessee or lessor would attribute to the proximity or convenience to the lessor, where the lessor is a potential source of patient referrals to the lessee.
(j) Financial relationship means an ownership interest, investment interest or compensation arrangement, as those terms are defined or used in Public Health Law, sections 238 and 238-a.
(k) Functions directly related to clinical laboratory operations means functions which are necessary and integral to, and have as their sole and exclusive purpose, the operation of a clinical laboratory, and may include clinical laboratory services and directly related services.
(l) Governmental agency means a department. board, bureau, division, office, agency, public benefit or other corporation, or any other unit, however described, of a state or of a political subdivision of a state, or the Federal government.
(m) Health maintenance organization (HMO) means an organization operating in accordance with article 43 of the Insurance Law or article 44 of the Public Health Law, and includes an agent of the health maintenance organization.
(n) Health or health-related services includes, but is not limited to, items and services available under the New York State Medical Assistance Program (Medicaid).
(o) Health services purveyor (HSP) means any person, firm, partnership, group, association, business corporation, not-for-profit corporation, professional corporation, limited liability company, or any agent, employee, fiduciary, employer or representative thereof, including, but not limited to, an entity that provides health-related services, a physician, dentist, podiatrist, chiropractor, either in individual practice, group practice or employed in a facility owned by any person, group, association, firm, partnership, business corporation, not-for-profit corporation, professional corporation, limited liability company, hiring any one of the aforementioned practitioners who provides health or health related services.
(p) Hospital means a facility or institution defined in Public Health Law, section 2801(1).
(q) Immediate family member means any of the following, whether natural or adoptive: spouse; parent; child and sibling; stepparent, stepchild and stepsibling; father-in-law, mother-in-law, brother-in-law, sister-in-law, son-in-law and daughter-in-law; or grandparent and grandchild.
(r) Industrial firm means any employer, including, but not limited to:
(1) an agent of an employer;
(2) an employer or employers who establish(es) or maintain(s) a single-employer or multi-employer employee benefit plan under the Employee Retirement Income Security Act of 1974 as amended (ERISA); or
(3) or an agent of an employee benefit plan.
(s) Insurance carrier includes, but is not limited to:
(1) an insurance carrier used by an employer; or
(2) the agent of an insurance carrier.
(t) Laboratory management services means some or all services necessary for the operation of a clinical laboratory, including but not limited to:
(1) directly related services; or
(2) services performed by a clinical laboratory employee, provided the services are directly related to clinical laboratory operations, and, provided that phlebotomy services, if rendered, are accompanied by actual clinical laboratory services by the laboratory providing the employee.
(u) Legal relative means an individual with legal authority to act on behalf of the recipient of services.
(v) Patient service center (PSC) is synonymous with collecting station or collecting depot, and means a facility, fixed or mobile, operated by a clinical laboratory for the collection, drawing and temporary storage of materials derived from the human body until such material is forwarded to a clinical laboratory for clinical laboratory services.
(w) Purveyor, as used in section 586 of the Public Health Law, means a clinical laboratory that does not receive from any health care practitioner or private medical practice having an ownership interest in the clinical laboratory any referrals for clinical laboratory services for patients of such health care practitioner or private medical practice. Notwithstanding any provision to the contrary, the term purveyor shall include any clinical laboratory owned by a hospital licensed pursuant to article 28 of the Public Health Law or any clinical laboratory that is owned and operated by a publicly traded corporation.
(x) Residence means the location at which a test subject resides, whether on a temporary or permanent basis, and whether or not the living arrangement is voluntary, and is not necessarily the subject's legal residence.
(y) Trade union health facility means:
(1) a facility owned and operated by trade union to provide health or health related services to its members or their families; or
(2) an agent of a trade union health facility.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.19 Reporting of foodborne disease
Any food service operator having actual or constructive knowledge of the occurrence of illness allegedly due to the consumption of food served at the establishment, shall report the same within 24 hours by telephone, telegram or in person to the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.6 Breath analysis permit program
Training agencies shall submit an application for approval of a breath analysis permit program or a training program for breath analysis to the commissioner. Other agencies seeking approval of such programs shall submit an application to the commissioner through the Office of Public Safety of the Division of Criminal Justice Services. The application shall include:
(a) a description of the techniques and methods to be utilized;
(b) the make and model of the breath analysis instruments used;
(c) an outline of the material presented in the breath analysis instrument operator and technical supervisor training program;
(d) the name of the individual primarily responsible for each training program and for the breath analysis program;
(e) the name and qualifications of one or more individuals meeting the requirements for technical supervisor under section 59.9 of this Part; and
(f) such other information as the commissioner shall require.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 35 VITAL RECORDS
10 CRR-NY 35.3 Fetal death; confidential information
(a) The information contained on a fetal death certificate shall be disclosed by the State Commissioner of Health only to the mother, her lawful representative and to authorized personnel of the department.
(b) The confidential information for medical and health use only furnished with a fetal death certificate shall not be copied and shall not be detached except as herein provided. Data thereon, as determined by the State Commissioner of Health, shall be recorded on appropriate storage media for scientific, medical and health research only. Following such recording the portion containing such confidential information shall be detached from the original certificate by the State Commissioner of Health or other person authorized by him who shall then destroy such portion. No copy of a certificate issued pursuant to sections 4173 and 4174 of the Public Health Law shall contain such information.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.132 Fixed assets
(a) Assets of a relatively permanent nature held for continuous use in hospital operations and not intended to be converted into cash through sales.
(b) A balance sheet classification denoting capital assets other than intangibles and investments in affiliated companies or other long-term investments.
(c) Included in the usual fixed-asset categories are land (from which the flow of services is seemingly permanent), land improvements, buildings, fixed equipment, tools, leasehold improvements, major movable and minor movable equipment; generally excluded are goodwill, patents, and other intangibles. The characteristic fixed asset has a limited life (land is the one important exception), and, in organizations where expenses are accounted for, its cost, less estimated salvage at the end of its useful life, is distributed over the periods it benefits by means of provisions for depreciation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.14 Prior approval requests for experimental treatment
(a) A request for prior approval for experimental treatment must be accompanied by a letter from the treating physician explaining why the enrollee needs the experimental treatment being requested and documentation that either no standard treatment has been effective in treating the enrollee or there is no standard treatment available to treat the enrollee’s condition, injury or impairment.
(b) All requests for prior approval for experimental treatment involving the use of an experimental medication will be reviewed by the fund administrator’s pharmacy benefits manager.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.130 Toxic solvents
(a) All glue, cement or other adhesives containing one or more of the following chemical compounds are designated as glue substances containing a solvent having the property of releasing toxic vapors or fumes: acetone, cellulose acetate, benzene, butyl alcohol, ethyl alcohol, ethylene dichloride, ethylene trichloride, isopropyl alcohol, methyl alcohol, methyl ethyl ketone, pentachlorophenol, petroleum ether, and toluene, or such other similar material as the commissioner shall by regulation prescribe.
(b) No person shall sell or offer to sell, to any person, any tube or container of glue containing a solvent having the property of releasing toxic vapors or fumes:
(1) if he has knowledge that the product sold or offered for sale will be used in violation of article 33 of the Public Health Law;
(2) unless there has been added to such glue a sufficient quantity of an additive approved by the commissioner which shall act as a deterrent to inhalation and not be harmful or toxic to the human body. This provision shall not apply to glue manufactured and sold for industrial use.
(i) Industrial use shall mean glue packaged in a container of more than four ounces by volume.
(ii) Approval as an additive, which shall act as a deterrent to inhalation of allyl isothiocynate (oil of mustard) when added at a level of not less than 0.25 nor more than 0.35 per centum by weight of total product is withdrawn for any glue manufactured 180 days after the effective date of this Part; a request for approval of any other such additive shall be made to the Bureau of Narcotic Enforcement of the department.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 37 HANDLING OF BODIES OF PERSONS DYING ON COMMON CARRIERS
10 CRR-NY 37.2 Investigation of death; preparation of death certificate
A physician accompanying a person who dies on a common carrier, or a physician who is traveling on the same carrier who is called to give medical aid, may certify to the cause of death and sign the certificate as the physician last in attendance on the deceased. If death occurs without medical attendance, the coroner of the county or, if there be more than one, the coroner having jurisdiction of the district in which the body is removed, or the medical examiner or, in the County of Erie, the medical director, shall be notified and shall certify to the cause of death and sign the certificate.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.70 Oral prescriptions for schedule III, IV and V substances
(a) Except as provided in sections 80.67 and 80.68 of this Part, a practitioner may orally prescribe and a pharmacist may dispense, to an ultimate user, controlled substances in schedule III, IV or V; provided, however, the pharmacist shall:
(1) contemporaneously reduce such prescriptions to written memoranda, or to the extent authorized by Federal requirements, to an electronic record, indicating the name and address of the prescriber and the practitioner's Drug Enforcement Administration registration number, name and address of ultimate user, date on which the controlled substance was ordered, name and quantity of controlled substances prescribed, directions for use and the fact that it is a telephone order. The memoranda for such oral prescriptions shall be filed in the schedule III, IV and V prescription file, or in the case of an electronic record, shall be filed electronically. The pharmacist filling such oral orders shall indicate on the memoranda the date filled, the signature of the pharmacist filling the prescription and the pharmacy prescription number under which it is recorded in the pharmacy prescription file;
(2) dispense the substance in conformity with the labeling requirements applicable to a written prescription; and
(3) make a good faith effort to verify the identity of both the practitioner and the ultimate user.
(b) No oral prescription shall be filled for a quantity of controlled substances which would exceed a five-day supply, or with respect to schedule IV substances a 30-day supply or 100 dosage units whichever is less, if the substances were used in accordance with the directions for use; provided, however, that this provision shall not apply to any schedule IV controlled substance limited to a five day supply by section 80.68 of this Part.
(c) Within 72 hours after authorizing such an oral prescription, the prescribing practitioner shall cause to be delivered to the pharmacist a written, or an electronic prescription. The electronic prescription, in addition to the information otherwise required, shall also have upon it the words: “Follow-up prescription to oral order.” If the pharmacist fails to receive such prescription, he shall record on the memorandum for said oral prescription this notation: "Follow-up prescription not received", the name of the pharmacist and the date of the recording.
(d) Follow-up prescriptions from prescribers for schedule III, IV and V controlled substances shall be attached to or otherwise stored with the corresponding oral orders, and shall be filed in the schedule III, IV and V controlled substances file.
(e) The pharmacist receiving such follow-up prescriptions shall endorse on such prescription his or her signature, the date of filling, the number of the prescription under which it is recorded in the pharmacy prescription file and the fact that such prescription is a follow-up to the prior oral order. In addition, he or she shall place on the follow-up prescription the date of receipt, the pharmacy prescription number and the date the oral order was filled, as follows: “Follow-up prescription to oral order, pharmacy prescription number _____, oral order filled on _____, follow-up prescription received _____”. In the case of electronic prescriptions and where the pharmacy maintains such records electronically, such information may be created and maintained by the pharmacy in electronic form.
(f) The prescription information shall be filed with the department in accordance with section 80.73(f) of this Part.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.4 Infection control and reporting
Medical facilities shall:
(a) Establish an infection control committee, composed of representative staff, which shall be responsible for establishing policies and procedures for investigating, controlling and preventing infections in the facility. The policies and procedures shall include those for the isolation of patients with communicable or infectious diseases or patients suspected of having such diseases, for training all personnel rendering care to such patients in the employment of standard infection control techniques, and for obtaining periodic reports of nosocomial infections. Nosocomial infections shall include an increased incidence or outbreak of disease due to biological, chemical or radioactive agents or their toxic products occurring in patients or persons working in the hospital.
The committee shall establish methods to ensure that policies and procedures are executed and the infection control program is effective.
(b) Assure that written effective procedures is aseptic and isolation techniques are followed by all personnel. Procedures are to be reviewed annually and revised if appropriate for effectiveness and improvement.
(c) Report immediately to the regional health director or associate commissioner for New York City affairs the presence of nosocomial infections.
(d) Report immediately to the city, county, or district health officer the presence of any communicable disease as defined in section 2.1 of this Title (State Sanitary Code).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.197 Suspension of permits
Permits may be suspended temporarily by the permit-issuing official, after notice and an opportunity to be heard, for failure of the permit holder to comply with the requirements of this Subpart, or with any lawful notice or order issued by the permit-issuing official or his designated representative.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.12 Quality of care
Each resident shall receive and the facility shall provide the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being, in accordance with the comprehensive assessment and plan of care subject to the resident's right of self-determination.
(a) Activities of daily living.
Based on the comprehensive assessment of a resident, the facility shall ensure that:
(1) a resident's abilities in activities of daily living do not diminish unless circumstances of the individual's clinical condition demonstrate that diminution was unavoidable. This includes the resident's ability to:
(i) bathe, dress and groom;
(ii) transfer and ambulate;
(iii) toilet;
(iv) eat; and
(v) use speech, language or other functional communication systems;
(2) a resident is given the appropriate treatment and services to maintain or improve his or her abilities specified in paragraph (1) of this subdivision; and
(3) a resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.
(b) Vision and hearing.
To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility shall, if necessary, assist the resident:
(1) in making appointments;
(2) by arranging for transportation to and from the office of a medical practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices if such services are not provided on-site; and
(3) by promoting the safekeeping, maintenance, and use of vision or hearing assistive devices which the resident needs.
(c) Pressure sores.
Based on the comprehensive assessment of a resident, the facility shall ensure that:
(1) a resident who enters the facility without pressure sores does not develop pressure sores unless the individual's clinical condition demonstrates that they were unavoidable despite every reasonable effort to prevent them; and
(2) a resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing.
(d) Urinary incontinence.
Based on the resident's comprehensive assessment, the facility shall ensure that:
(1) a resident who is incontinent of bladder receives the appropriate treatment and services to prevent urinary tract infections and to restore as much normal bladder function as possible; and
(2) a resident who enters the facility without an indwelling catheter is not catheterized unless the resident's clinical condition demonstrates that catheterization was necessary.
(e) Range of motion.
Based on the comprehensive assessment of a resident, the facility shall ensure that:
(1) a resident who enters the facility without a limited range of motion does not experience reduction in range of motion unless the resident's clinical condition demonstrates that a reduction in range of motion is unavoidable; and
(2) a resident with a limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.
(f) Mental and psychosocial functioning.
Based on the comprehensive assessment of a resident, the facility shall ensure that:
(1) a resident who displays mental or psychosocial adjustment difficulty receives appropriate treatment and services to correct the assessed problem; and
(2) a resident whose assessment did not reveal a psychosocial adjustment difficulty does not display a pattern of decreased social interaction and/or increased withdrawn, angry, or depressive behaviors, unless the resident's clinical condition demonstrates that such a pattern was unavoidable.
(g) Enteral feeding tubes.
(1) Based on the comprehensive assessment of a resident, the facility shall ensure that a resident who has been able to eat alone or with assistance is not fed by an enteral feeding tube unless the resident's clinical condition demonstrates that use of such a tube was unavoidable.
(2) A resident who is fed by an enteral feeding tube shall receive the appropriate treatment and services to prevent aspiration pneumonia, diarrhea, significant regurgitation, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers and to restore, if possible, normal feeding function.
(3) Following consideration of possible alternatives for short-term nutritional therapy, nasogastric tubes and feeding formulations may be used for feeding purposes when determined clinically appropriate by the attending physician and interdisciplinary care team which includes a health care professional with training in diagnosis and management of swallowing disorders. Nasogastric tube feedings shall be used to promote a therapeutic program to maintain adequate nutrition and hydration and include a plan to help the resident develop or regain eating skills.
(4) Residents receiving nasogastric tube feedings shall be reassessed at a minimum by the registered professional nurse, social worker, and dietitian as needed, but no less than once every six weeks, for the ability to return to normal feeding function. If the nasogastric feeding is continued, the reasons for continuation shall be documented in the resident's clinical record. If nasogastric feedings are to be continued longer than 95 days, permanent enteral feeding procedures such as surgical gastrostomy or jejunostomy shall be considered.
(5) Nasogastric tube feeding formulations shall be given in accordance with the manufacturer's instructions or at a rate appropriate to the physical size of the resident and the amount of fluid and nutrients necessary to meet the assessed caloric and fluid needs of the resident.
(6) To minimize resident discomfort, nasogastric tubes used for resident feeding purposes shall:
(i) be the smallest gauge appropriate for the patient and shall not exceed 3.96 millimeters (#12 French) in outside diameter unless medically indicated;
(ii) be made of a soft, flexible material such as medical grade polyurethane or silicone; and
(iii) be specifically manufactured for nasogastric feeding purposes.
(7) The facility shall develop and follow policies and procedures for nasogastric tube feedings which are written in accordance with prevailing standards of professional practice and in consultation with the medical, nursing, dietary and pharmacy services of the facility. Medical practitioners shall be informed of such policies and procedures governing the use of nasogastric tubes for resident feeding. The policies and procedures shall address as a minimum:
(i) types and sizes of nasogastric tubes and the various types of feeding formulations available at the facility;
(ii) the need to assess each resident's clinical and nutritional status to determine the size of the nasogastric tube and type of feeding appropriate for that individual;
(iii) standard techniques for inserting a nasogastric tube and confirming the correct placement of the tube;
(iv) procedures for administering nasogastric feedings including positioning the resident and the need for resident observation and monitoring before, during and following the feeding; and
(v) infection control policies related to tube feedings.
(h) Accidents.
The facility shall ensure that:
(1) the resident environment remains as free of accident hazards as is possible; and
(2) each resident receives adequate supervision and assistive devices to prevent accidents.
(i) Nutrition.
Based on a resident's comprehensive assessment, the facility shall ensure that a resident:
(1) maintains acceptable parameters of nutritional status, such as body weight and protein levels, unless the resident's clinical condition demonstrates that this is not possible; and
(2) receives a therapeutic diet when there is a nutritional problem.
(j) Hydration.
The facility shall provide each resident with sufficient fluid intake to maintain proper hydration and health.
(k) Special needs.
The facility shall ensure that residents receive proper treatment and care for the following special services:
(1) injections;
(2) parenteral and enteral fluids;
(3) colostomy, ureterostomy or ileostomy care;
(4) tracheostomy care;
(5) tracheal suctioning;
(6) respiratory care;
(7) podiatric care; and
(8) prostheses.
(l) Drug therapy.
(1) Unnecessary drugs.
Each resident's drug regimen shall include only those medications prescribed to treat a specific documented illness or condition and not otherwise contraindicated for a given resident. The drug regimen shall be monitored for evidence of both adverse actions and therapeutic effect. Dose changes or discontinuation of the drug must be made if the drug is ineffective and/or is causing disabling or harmful side effects and/or the condition for which it was prescribed has resolved.
(2) Psychotropic drugs.
Based on a comprehensive assessment of a resident and consistent with the provisions of subdivision (a) of section 415.4 of this Part, the facility shall ensure that:
(i) the use of psychotropic drugs shall:
(a) meet all conditions of paragraph (1) of this subdivision;
(b) be ordered by a physician who, in accordance with generally accepted standards of care and services, specifies the problem for which the drug is prescribed;
(c) be used, except in emergencies, only as an integral part of a resident's comprehensive care plan and only after alternative methods for treating the condition or symptoms have been tried and have failed; and
(d) be discontinued if harmful effects of the medication outweigh the beneficial effects of the drug.
(ii) residents who use psychotropic drugs receive gradual dose reductions and behavioral interventions, unless clinically contraindicated, in an effort to discontinue these drugs and assist the resident to attain and maintain optimum physical and emotional functioning.
(m) Medication errors.
The facility shall ensure that:
(1) it is free of medication error rates of five percent or greater; and
(2) residents are free of any significant medication errors.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-3 REQUIREMENTS FOR AUTOCLAVES USED TO TREAT REGULATED MEDICAL WASTE
10 CRR-NY 70-3.1 Validation testing
(a) Prior to using an autoclave to treat regulated medical waste, a facility shall conduct validation testing under conditions, including, but not limited to load configuration, composition and volume, that simulate conditions anticipated during actual waste treatment. Validation testing protocols shall be included in the facility's autoclave operation plan submitted to the department pursuant to section 70-3.2 of this Subpart.
(b)
(1) Validation testing shall employ spores of Geobacillus stearothermophilus at a minimum concentration of 6 log10 spores per indicator unit placed in the center of the load or otherwise coldest point in the autoclave chamber as identified by the manufacturer; provided, however, the department may require alternative and/or supplemental indicators as necessary to demonstrate effectiveness of treatment.
(2) Effective treatment of regulated medical waste shall be demonstrated by a 4 log10 reduction in viable Geobacillus stearothermophilus spore concentration, or other measure of effectiveness for alternative and/or supplemental indicators as specified by the department.
(c) No autoclave that fails to meet the criteria for effective treatment pursuant to subdivision (b) of this section upon validation testing at the site of installation shall be used to treat regulated medical waste.
(d) A facility that seeks to operate an autoclave at other than the generally accepted operating parameters ( i.e. , time, temperature and pressure) provided in section 70-3.3(a) and (b) of this Subpart shall request and obtain department approval for operation of the autoclave as an alternative treatment system pursuant to Subpart 70-5 of this Part.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.1 Definitions
(a) Adequate means sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(b) Agricultural fairground means a property where a fair has been conducted, or is proposed to be conducted, in 2001 or any subsequent year by an agricultural society and/or other entities eligible in 2001, or any subsequent year, to receive premium reimbursement pursuant to section 286 of the Agriculture and Markets Law, including the parcel or tract of land, buildings or other structures, campsites, and food service establishments, temporary or permanent, pertaining thereto.
(c) Agricultural fairground water system means a water system at an agricultural fairground which provides piped water to the public for potable purposes. Such a system may include collection, treatment, storage and/or distribution facilities under the control of the agricultural fairground owner.
(d) Animal waste means any waste product discharged by an animal, including fecal material, urine, other bodily fluid and any wash water, discarded milk, hay, straw, feed and bedding material that has been in contact with or contaminated by such waste product.
(e) Campground means any parcel or tract of land at an agricultural fairground, including buildings or other structures under the control of any person, where five or more campsites are available for temporary overnight occupancy.
(f) Campsite means a portion of an agricultural fairground, with or without connections to water supply, electrical service or sewage systems, used by one camping unit.
(g) Nonpublic agricultural fairground water system means an agricultural fairground water system that does not receive water from an off-site public water system.
(h) Permit-issuing official means the State Health Commissioner, the health commissioner or health officer of a city of 50,000 population or more, the health commissioner or health officer of a county or part-county health district, or the State district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law.
(i) Person means an individual, group of individuals, partnership, firm, corporation, association, political subdivision, governmental agency, municipality, industry, estate or any other legal entity.
(j) Potable water means water used for human consumption, food preparation, or handwashing, culinary, bathing or laundry purposes.
(k) Refuse means all putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanup, dead animals, offal and solid commercial waste.
(l) Sewage means excreta and the waste from a toilet, privy, bath, shower, sink, lavatory, dishwashing or laundry machine.
(m) Uniform Code means the State Uniform Fire Prevention and Building Code, 9 NYCRR Volume B, Subtitle S, Chapter I.
(n) Water treatment plant shall mean any plant or equipment which, through the addition of chemicals or through aeration, ion exchange, demineralization, coagulation, sedimentation or filtration, or through any other means or combinations of treatment, shall change the physical, chemical, radiological or microbiological quality of water.
(o) Camping cabin means a hard sided tent or shelter less than 400 square feet in area which is on skids or otherwise designed to be readily moveable and which does not have cooking facilities, sinks, showers, laundry or toilet facilities.
(p) Camping unit means a tent, camping cabin, recreational vehicle or other type of portable shelter intended, designed or used for temporary human occupancy.
(q) Recreational vehicle means a vehicular camping unit primarily designed as temporary living quarters for recreational, camping, travel or seasonal use that either has its own motive power or is mounted on or towed by another vehicle. Recreational vehicles include, but are not limited to, camping trailers, fifth wheel trailers, motor homes, park trailers, travel trailers and truck campers.
(r) Scavenger equipment means a combination of a portable holding tank, pumping or other waste transfer method, and water tight hose connections, whereby a water tight seal can be made between the sewer connection of a recreational vehicle and a portable holding tank to empty the contents of the recreational vehicle sewage holding tank for transport to an approved sewage disposal system.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
LEAVES WITHOUT PAY LEAVES WITHOUT PAY
10 CRR-NY 84.31 Successive leaves of absence
Where a leave of absence without pay has been granted for a period which aggregates two years, or more if extended pursuant to section 84.30 of this Part, a further leave of absence without pay shall not be granted unless the employee returns to his position and serves continuously therein for six months immediately preceding the subsequent leave of absence.
Subchapter B STATE AID AND FUNDING
Part 42 STATE AID FOR PUBLIC HEALTH LABORATORY SERVICES: COUNTIES AND CITIES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 42.4 Director of laboratories
All laboratories shall have a director whose qualifications are in accordance with section 19.2 of this Title.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-11 SURROGACY PROGRAMS AND ASSISTED REPRODUCTION SERVICE PROVIDERS
10 CRR-NY 69-11.6 Gestational surrogacy guidelines
(a) Each surrogacy program shall, as a condition of licensure, ensure that all assisted reproduction service providers who work with surrogacy programs are registered with the department in accordance with this Subpart.
(b) Policies and procedures for screening of gestational surrogates must be consistent with the department’s guidelines and best practices, which shall be published on the department’s website.
(c) Policies and procedures for screening and evaluation of intended parents must be consistent with clinical best practices.
(d) The department shall develop, and make available in electronic form maintained on the department’s website, informational material relating to gestational surrogacy, which shall be made available in hard copy by the surrogacy program and at no cost to all prospective surrogates and prospective intended parents who contact the surrogacy program or seek to enter into a surrogacy agreement with the surrogacy program.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 113 ERIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 113.6 Village of Springville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the well located or municipally owned land situated in the northern part of the village, above* 350 feet west of Buffalo Street, 550 feet north of Eaton Street, and 700 feet east of the Baltimore and Ohio Railroad, forming the source of the public water supply of the Village of Springville, Erie County, New York.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain with 200 feet of any well of the public water supply of the Village of Springville.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well of the public water supply of the Village of Springville.
(3) Every privy, privy vault, pit or other receptacle of any kind for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any well of the public water supply of the Village of Springville.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any well of the public water supply of the Village of Springville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any well of the public water supply of the Village of Springville.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well of the public water supply of the Village of Springville, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet from any well of the public water supply of the Village of Springville.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any well, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 300 feet of any well of the public water supply of the Village of Springville.
(f) Trespassing.
No trespassing shall be allowed upon the property upon which the well of the public water supply of the Village of Springville is located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the Village of Springville.
(g) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the Village of Springville.
(h) General clause.
In addition to observing the foregoing requirements all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the Village of Springville.
(i) Inspections.
The board of trustees of the Village of Springville or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Springville or their duly appointed representative shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of cantamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.19 General structural equipment and safety standards
(a) Compliance with local laws and regulations.
Shared health facilities shall conform with all local laws, regulations and codes relating to fire and safety, sanitation, plumbing and other health requirements, where such laws, regulations and codes impose standards in addition to those required by this Part.
(b) Shared health facilities shall comply with pertinent provisions of the American National Standard Institute (ANSI) Standard No. A117.1, American Standard Specifications for making buildings and facilities accessible to, and usable by, the physically handicapped (1961). Copies of this publication are available from the publisher, American National Standards Institute, Inc., 1430 Broadway, New York, NY, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(c) Office space and public areas.
There shall be:
(1) a lobby which shall include:
(i) an information counter or desk;
(ii) adequate waiting space; however, no corridor, subcorridor or passageway shall be used as waiting space; and
(iii) public toilet facilities;
(2) suitable storage facilities for sterile supplies, clinical laboratory specimens, pharmaceutical supplies, housekeeping supplies, and equipment.
(d) Clinical facilities shall include:
(1) general purpose examination room(s) for medical, dental, obstetrical and similar examinations shall have a minimum floor area of 64 square feet excluding such spaces as vestibule, toilet and closet. A lavatory or sink equipped for handwashing and a counter for shelf space for writing shall be provided. Room sizes for specialized examinations or procedures, such as eye, dental, and ear, nose and throat, shall provide sufficient space for treatment of patients and accommodation of equipment.
(2) a drug distribution center, if required by facility needs, which shall include double-locked storage for controlled substances; and
(3) sterilizing facilities for the sterilization of equipment and supplies if supplies, or equipment requiring sterilization are used.
(e) Diagnostic facilities shall meet the following requirements:
(1) Radiographic installations, when provided, shall conform to the applicable requirements of Part 16 of the State Sanitary Code, and shall include:
(i) dressing areas with convenient access to a public toilet;
(ii) radiographic room(s);
(iii) film processing facilities;
(iv) viewing and administrative areas; and
(v) film storage facilities.
(2) Laboratory facilities shall contain at least a specimen collection room, which may be a public toilet that contains a water closet and lavatory.
(f) Janitor's closet or area.
Each facility shall have at least one janitor's closet or separate area for the storage of housekeeping equipment and supplies, and a floor receptor or service sink.
(g) Details and finishes.
(1) Toilet rooms which may be used by patients shall be equipped with hardware which will permit access from the outside in any emergency.
(2) Soap and towel dispensers and waste receptacles shall be provided at all handwashing fixtures. Handwashing sinks in examination rooms shall be provided with other than hand controls and with hot and cold water.
(3) Cubicle curtains and draperies shall be noncombustible and shall pass both the large and small scale tests of the National Fire Protection Association, Standard 701, Standard Methods of Fire Tests for Flame-Resistant Textiles and Films, 1969 edition. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(4) Floor materials shall be easily cleanable and have wear resistance appropriate for the location involved.
(5) Wall finishes shall be washable and, in the immediate area of plumbing fixtures, shall be smooth and moisture resistant.
(h) Construction, including fire safety requirements.
Shared health facilities shall comply with the National Fire Protection Association No. 101, Chapter 13, Life Safety Code for Business Occupancies, 1973 Edition. The Life Safety Code is published by the National Fire Protection Association, Batterymarch Park, Quincy, MA, and a copy of the 1973 edition is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(i) Mechanical requirements.
(1) The facility shall maintain a minimum temperature of 65 degrees Fahrenheit during operating hours.
(2) Toilet rooms shall be provided with mechanical exhaust of air or screened windows which open to the outside.
(3) Vacuum breakers shall be provided on all plumbing fixtures to which hoses or tubing can be attached.
(j) Electrical requirements.
(1) Adequate electrical outlets shall be provided in all areas of the facility to accommodate necessary equipment without the use of receptacle adapters which allow multiple appliances to be plugged into a single outlet or which adapt three-pronged, grounded plugs to two-wire, ungrounded circuits.
(2) Sufficient lighting to permit normal operation and to avoid any hazards to personal safety shall be provided.
(k) The commissioner may, upon application, waive the specific requirements of section 83.19 of this Part for any shared heath facility, upon a satisfactory showing by the applicant and a determination that:
(1) there are specified practical difficulties in conforming with the pertinent provisions of section 83.19 of this Part;
(2) the waiver of such requirement does not adversely affect the health and safety of the patients, visitors or staff;
(3) the construction of the facility when reviewed in its entirety provides adequate protection to the health and safety of the patients, visitors and staff.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
CONSTRUCTION CONSTRUCTION
10 CRR-NY 6-3.9 Construction compliance certificate
The operator shall submit, prior to public use of new facilities or equipment, a construction compliance certificate to the permit-issuing official. This certificate shall be prepared and signed by a professional engineer or architect licensed to practice in New York State. The certificate shall include a statement that the spray ground and the appurtenances have been constructed in accordance with approved plans and specifications.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.1 Definitions
As used in this Part:
(a) Bone marrow means the human tissue filling cavities of bone, consisting of fully mature and precursor hematopoietic cells intended for transplantation.
(b) Hematopoietic progenitor cells means human precursor hematopoietic cells derived from bone marrow, peripheral blood or other tissue sources, such as cord blood obtained from the placenta or umbilical cord.
(c) Hematopoietic progenitor cell bank means hematopoietic progenitor cell procurement service, hematopoietic progenitor cell processing facility or hematopoietic progenitor cell transplantation facility.
(d) Hematopoietic progenitor cell procurement service means a facility which performs donor selection and bone marrow aspiration or other hematopoietic progenitor cell collection, and pre-processing storage of hematopoietic progenitor cells from autogeneic and/or allogeneic donors.
(e) Hematopoietic progenitor cell processing facility means a facility which processes bone marrow or other hematopoietic progenitor cell samples, including purging, storage, and distribution of hematopoietic progenitor cells from autogeneic and/or allogeneic donors.
(f) Hematopoietic progenitor cell transplantation facility means a facility which temporarily stores and transplants hematopoietic progenitor cells, and includes facilities which infuse autogeneic hematopoietic progenitor cells and bone marrow transplantation services approved by the commissioner pursuant to section 709.8 of this Title.
(g) Hematopoietic progenitor cell transplantation service means a specific unit conducting hematopoietic progenitor cell transplantation within a hematopoietic progenitor cell transplantation facility. Such a service shall be independently supervised by a qualified director.
(h) Department means the New York State Department of Health.
(i) Commissioner means the commissioner of the New York State Department of Health.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.3 Qualifications of donors
(a) A comprehensive or limited tissue procurement service shall obtain a signed informed consent from the living donor of tissue for clinical use.
(b) For potential cadaveric donors who have not left a signed, witnessed organ/tissue donor card (see section 4303 of the Public Health Law) or a will, the procurement service shall obtain informed consent to an anatomical gift from the next of kin or guardian of the decedent, as required by section 405.25 of this Title, before retrieving tissue. Informed consent forms shall clearly specify the tissues and/or nontransplant anatomic parts to be retrieved. Consent obtained by telephone shall be recorded or documented in writing by the tissue procurement service requesting the donation.
(c) The acceptability of a cadaveric donation shall be determined by medical history information obtained from medical records, attending physicians on other health care professionals, and from interviewing a family member and/or other person close to the decedent. In the event that no family member or other person close to the decedent is available, eye tissue may be accepted, providing that the final tissue container or accompanying paperwork is clearly labeled to alert the transplanting surgeon that such interview was not conducted. An evaluation of the donor's condition shall be made by a qualified tissue retrieval team member, including an examination for signs of injected drug use, infection, or trauma at the site of donation that may affect the quality of the donated tissue.
(d) The acceptability of a donation from a living donor shall be determined by a physical examination of and health history interview with the donor.
(e) A trained, qualified supervisor shall determine whether a donor is suitable for tissue retrieval on the day of the retrieval, according to criteria developed by the medical director in consultation with the medical advisory committee. The medical director, as defined in Subpart 52-1 of this Part, shall be responsible for determining whether:
(1) the living donor and his/her donated tissue are acceptable, prior to the retrieval of the tissue, according to criteria developed by the medical director in consultation with the medical advisory committee; and
(2) the cadaveric donor and his/her donated tissue are acceptable, prior to the release of tissue, according to criteria developed by the medical director in consultation with the medical advisory committee.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.8 Modification and termination
(a) Any material modification of a cooperative agreement or planning process which is the subject of a certificate of public advantage issued pursuant to this Subpart shall be subject to the prior review and approval of the department in consultation with the Attorney General, the mental hygiene agencies as appropriate, and the public health and health planning council, and the receipt of a recommendation from the public health and health planning council.
(b) Any party to a cooperative agreement covered by a certificate of public advantage that terminates such agreement shall file a notice of termination with the department at least 30 days prior to termination of the agreement, in addition to any other notices or approvals required by applicable law or regulations. Such notice of termination shall be provided by the department to the Attorney General and, as appropriate, the mental hygiene agencies, and shall be deemed a voluntary surrender of a certificate of public advantage pursuant to section 83-2.14 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 705 NEW MEDICAL TECHNOLOGY AND HEALTH SERVICES DEMONSTRATION PROJECTS
10 CRR-NY 705.8 Demonstration project requirements
(a) Demonstration projects shall be limited to such period of time as the commissioner deems appropriate consistent with the nature of the project.
(b) During the course of a demonstration project, the medical facility shall submit, every six months, written progress reports to the department in a format prescribed by department.
(c) Upon completion of a demonstration project, the medical facility shall submit a final written report to the department in a format prescribed by the department.
(d) Patient medical records and data shall be afforded confidential treatment consistent with applicable Federal and State statutes, regulations and policies.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.14 Lists of department actions
(a) The purpose of this action is to simplify the tasks of determining whether or not a proposed action may have a significant effect on the environment by identifying actions or classes of actions that are likely to have a significant effect and those which will not have a significant effect. Because of the complex and varied nature of department actions, the lists in this section are not all-inclusive. The omission from the list of an action does not mean that it is exempt from this Part, nor does it mean that it is automatically an action requiring environmental impact statement preparation. The criteria set forth in 6 NYCRR 617.11 and section 97.13 of this Part shall be used to determine significance with respect to actions not listed in this section. The following system is used in this section:
(1) Type I.
Actions or classes of actions that are more likely to require preparation of environmental impact statements.
(2) Type II.
Actions or classes of actions which have been determined not to have a significant effect on the environment and which do not require environmental impact statements under this Part.
(3) Unlisted.
Actions or classes of actions, not excluded or exempt, not listed as a type I or type II action in this Part.
(b) Lists.
Note:
This Part does not apply to actions by private persons where ministerial department action is involved. The following lists are intended to cover only actions of the department or actions which must be approved, funded or otherwise acted upon by the department.
TYPE I
Type I actions or classes of actions are likely to, but will not necessarily, require preparation of environmental impact statements. The following are type I department actions or classes of actions:
(1) Project approval and/or construction funding of a facility subject to article 28 of the Public Health Law which meets or exceeds any of the following thresholds; or the expansion of a facility subject to article 28 of the Public Health Law by more than 50 percent of any of the following thresholds, providing that the expansion and existing facilities, when combined, meet or exceed any threshold contained in this section:
(i) a project or action which involves the physical alteration of 10 acres;
(ii) a project or action which would use ground or surface water in excess of 2,000,000 gallons per day;
(iii) parking for 1,000 vehicles;
(iv) in a city, town or village having a population of 150,000 persons or less, a facility with more than 100,000 square feet of gross floor area;
(v) in a city, town or village having a population of more than 150,000 persons, a facility with more than 240,000 square feet of gross floor area.
(2) Initial plan approval:
(i) public water systems, community and noncommunity;
(ii) realty subdivisions;
(iii) mobile home parks;
(iv) public swimming pools;
(v) public bathing beaches;
(vi) children's camps (summer day and overnight);
(vii) hotel/motel;
(viii) mass gathering;
(ix) travel vehicle parks and campsites.
(3) Approval or funding of insect control programs.
(4) Any action (unless the action is designated for the preservation of the facility or site) occurring wholly or partially within, or contiguous to, any facility or site listed on the National Register of Historic Places, or any historic building, structure or site, or prehistoric site, that has been proposed by the Committee on the Registers for consideration by the New York State Board for Historic Preservation for a recommendation to the State Historic Officer for nomination for inclusion in said National Register.
(5) Any structure exceeding 100 feet above original ground level in a locality without any zoning regulation to height.
TYPE II
The following type II actions or classes of action by the department are ministerial or have been determined not to have a significant effect on the environment and do not require environmental impact statements under this Part:
(1) issuance of any permit, certification or registration which does not relate to construction;
(2) license and permit renewals where there will be no material change in permit conditions or the scope of permitted activities;
(3) issuance of a birth or death certificate, or other vital record;
(4) replacement of a facility, in kind, on the same site unless such facility meets any of the criteria set forth to section 97.13 of this Part;
(5) construction or placement of minor structures accessory or appurtenant to existing facilities, including garages, carports, patios, home swimming pools, fences, barns or other buildings not changing land use or density;
(6) maintenance of existing landscaping or natural growth;
(7) information collection, including basic data collection and research, master plan study components, water quality and pollution studies, traffic counts, engineering studies, boring studies, surveys and soils studies that are not a preliminary step towards any given type I project;
(8) minor temporary uses of land having negligible or no permanent effect on the environment;
(9) the extension of utility distribution facilities to serve new or altered single- or two-family residential structures or to render service in approved subdivisions;
(10) approval of an establishment, and/or construction application, submitted by or for a facility subject to article 28 of the Public Health Law, involving a change of name or ownership only, or a transfer of stock only, or involving reduction in the number of existing beds or the conversion of existing beds to the same or a lesser number of different level of care beds; and
(11) review or approval of a certificate of incorporation, certificate of authority, amendment thereto, or similar document, when such review or approval is mandated by the Not-for-Profit Corporation Law or other similar law and when the certificate of incorporation, certificate of authority, amendment thereto, or similar document is not part of an establishment application.
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.2 Definitions
(a) Terms used in this Part or to be used in complying with this Part have the following meanings:
(1) Act means title XIV of the Public Health Service Act (commonly known as the “Safe Drinking Water Act”) 42 USC section 300-f et seq. ; and as supplemented by the American Recovery and Reinvestment Act of 2009 (ARRA).
(2) Administrator means the administrator of the United States Environmental Protection Agency or the chief executive officer of such agency or any successor agency or department or any authorized representatives of the administrator.
(3) Allowable costs means all costs of a project which the department and/or corporation determines:
(i) are properly allocable to that project; and
(ii) are not annual facility operation costs, including, but not limited to, those for maintenance, or replacement and repair of minor equipment.
(4) Annual fund resources means the funds available for project assistance within an annual funding cycle.
(5) Annual funding cycle means the period of time covered by a single Intended Use Plan.
(6) Commissioner means the Commissioner of the New York State Department of Health.
(7) Comptroller means the Comptroller of New York State.
(8) Construction means the erection, building, acquisition, alteration, reconstruction, improvement, enlargement or extension of a project; the inspection and supervision thereof; and the engineering, architectural, legal, fiscal, and economic investigations and studies, surveys, designs, plans, working drawings, specifications, procedures, and other actions necessary thereto.
(9) CT disinfection means the product of the free residual disinfectant concentration (C) in milligrams per liter determined before or at the first customer, and corresponding disinfectant contact time (T) in minutes, expressed by the formula (C) × (T) = CT.
(10) Corporation means the New York State Environmental Facilities Corporation or its successor.
(11) Department means the New York State Department of Health.
(12) Design means necessary design calculations and decisions and the preparation of construction drawings and specifications.
(13) Disadvantaged system means a public water system which has been qualified by the corporation as being eligible for financial hardship assistance.
(14) DWSRF or fund means the New York State Drinking Water State Revolving Fund, established pursuant to chapter 413 of the Laws of 1996.
(15) DWSRF assistance or fund assistance means financial assistance from the DWSRF, or other available sources, provided by the corporation to a recipient for an eligible project, including, without limitation, loans or hardship assistance.
(16) E. coli means Escherichia coli , a species of coliform bacteria that is indicative of fecal pollution and the possible presence of enteric pathogens.
(17) Eligible project means a project for construction of a water supply facility which is intended to improve drinking water facilities, including a project that would be eligible for financing under or designed to comply with the requirements of the act, which the commissioner has certified, in writing:
(i) is necessary for the objectives and goals of the State Sanitary Code or the act to assure safe public drinking water;
(ii) represents a reasonable effort to develop a viable water supply that can consistently meet drinking water standards;
(iii) takes into consideration the water resources management strategy pursuant to title 29 of article 15 of the Environmental Conservation Law; and
(iv) is a project for which financial assistance is available from the fund.
(18) Emergency means a situation that results in an imminent threat to public health. Imminent threats to public health include situations that result in the unavailability of a source of potable drinking water for an extended period of time.
(19) Engineering report means the document or documents incorporating the results of preliminary project planning and technical and fiscal studies to determine the technical and economic feasibility of the project.
(20) Federal capitalization funds are funds deposited in the DWSRF pursuant to a Federal capitalization grant according to the provisions of the act or any lesser amount which the administrator shall determine is subject to the limitations imposed by the act.
(21) Hardship assistance or financial hardship assistance means DWSRF assistance, including, without limitation, an additional reduced interest rate loan, a principal subsidy, and/or State assistance payments, provided by the corporation to a recipient in those instances where the corporation, in its discretion, determines financial hardship exists.
(22) HUD means the United States Department of Housing and Urban Development.
(23) Intended Use Plan (IUP) means a plan identifying the intended uses of the amounts available in the fund, including but not limited to: a list of potentially eligible projects; a description of the short-term and tong-term goals and objectives of the fund; and information on the activities to be supported including a description of project categories, terms of fund assistance, recipients, and the criteria and methods established for the distribution of funds.
(24) Median Household Income (MHI) means the MHI published by the U.S. Department of Commerce, Bureau of the Census, as adjusted to the most recent biennium for which income data is available from the Bureau of the Census. For special districts and other areas for which accurate census data is not available, other income data may be considered by the corporation.
(25) Maximum Contaminant Level (MCL) means the maximum permissible level of a contaminant in water which is delivered to any user of a public water system as specified in Subpart 5-1 of this Title.
(26) Nephelometric Turbidity Unit (NTU) means the unit in which measured turbidity is reported.
(27) Planning means the orderly development of a project concept from the original statement of need or purpose through the evaluation of alternatives to a final recommendation on a course of action and measures to implement the selected alternative.
(28) Principal Organic Contaminant (POC) means any organic chemical compound belonging to specific chemical classes as described in Subpart 5-1 of this Title.
(29) Project Financing and Loan Agreement (PFLA) means an agreement, or agreements, between the corporation and one or more recipients with respect to the financing of an eligible project or projects.
(30) Project plans and specifications means any technical data, information, designs, plans, analyses, engineering reports or other material required to be submitted by an applicant for approval by the department prior to installation or construction of a public water system or any addition or deletion or modification of a public water system.
(31) Public water system means any water system as defined in section 5-1.1 of this Title.
(32) Segment of a project, project component or project phase means one or more construction contracts and associated costs that the department and corporation determine constitute a discrete portion of a project which may be financed and constructed separately from other project segments.
(33) State Act means chapter 413 of the Laws of 1996 of the State of New York.
(34) State Sanitary Code means Parts 1 through 24 of this Title.
(35) Surface Water Treatment Rule means parts 141 and 142 of title 40 of the Code of Federal Regulations which require that all surface water be treated in accordance with section 5-1.30 of the State Sanitary Code.
(36) Unspecified Organic Contaminant (UOC) means any organic chemical compound not otherwise specified in Subpart 5-1 of this Title.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.2 Scope
Minimum requirements are hereby prescribed governing the location, construction and abandonment of water wells used for drinking, culinary and food processing purposes other than municipal or public sources, together with procedures relating thereto, in implementation of this Subpart. No person shall construct or abandon or cause to be constructed or abandoned, any water well, nor shall any person install or cause to be installed, any pump or pumping equipment contrary to this Subpart. Distribution of water beyond the point of discharge from the storage or pressure tank, or beyond the point of discharge from the pump if no tank is employed and to wells used or intended to be used as a source of water supply for public water supply systems, or to any pump, well, or other equipment used temporarily for de-watering purposes shall comply with all other applicable State and local regulations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.95 Discharge
The termination of lodging and the formal release of an inpatient by the institution. Since deaths are a termination of lodging, they are also inpatient discharges.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.4 Accredited hospitals
Payment for care in hospitals will be made only if the hospital appears on the department's list of accredited hospitals, and the care is supervised by a consultant listed in the department's file of clinical consultants as set forth in section 46.3 of this Part.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.10 Conferences for food vendors
(a) If a local agency has reasonable grounds for believing that a participating vendor has committed an abuse of the WIC program, it shall send written notice to the department advising it of its findings together with any documentation.
(b) Upon receipt of the notice of suspected abuse, or on its own initiative, the department shall investigate the matter. If the department determines that an abuse has been committed and that a conference is advisable, it shall send a written notice to the vendor of the following:
(1) the specific abuse;
(2) that the vendor may have a conference with a designee of the commissioner at a specified date, time and place to discuss the matter;
(3) that the vendor may be represented by legal counsel at the conference;
(4) that the vendor will be given an explanation of the charges and an opportunity to refute, explain or acknowledge the alleged abuse;
(5) that upon either the department's or the vendor's request a verbatim record or tape recording of the conference will be maintained; and
(6) that if the vendor fails to appear at the conference or to respond in writing to the notice of conference within 15 days to arrange for an alternate date, the vendor will be disqualified from the program.
A copy of the notice of conference shall be sent to the local agency together with a statement that a representative of such agency may participate in the conference.
(c) The matter may be resolved at the conference if the designee of the commissioner and the vendor agree than an abuse was not committed or that it was committed and both parties agree upon the corrective action to be taken and/or penalties to be assessed.
(d) If the matter is not resolved at the conference, the commissioner or his designee shall send a written notice to the food vendor informing the vendor of the following:
(1) it has been determined that the specific abuse charged was committed;
(2) that the vendor is disqualified from the WIC program, effective on a specific date for a specified period of time not exceeding three years;
(3) that the vendor has a right to request a fair hearing by contacting, orally or in writing, the Director, Investigative Services Unit, Bureau of Nutrition, New York State Department of Health, Tower Building, Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237, (518) 474-3343, within 15 days of the date of the notice of suspension; and
(4) if a fair hearing is requested, the commissioner may stay the suspension until a decision is rendered after the hearing.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.5 Permit for operation
(a) No municipality, school district, person, group of persons, firm, corporation, association, organization or institution shall operate or maintain or permit the use of any swimming pool and other related facilities without a permit from the permit-issuing official to be issued subject to the provisions of this Chapter and such additional sanitary or safety safeguards as may be required by the permit-issuing official. The permit shall be posted conspicuously at the facility.
(b) Application for a permit shall be made to the permit-issuing official at least 30 days before the expiration of a permit or at least 30 days before the opening of any swimming pool.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.13 Assurance of access to care
(a) All covered services must be directly provided or arranged for within the approved provider network pursuant to written contracts developed and maintained in a form and manner prescribed by the commissioner, except that when services are unavailable within the provider network, such services must be arranged for outside of the approved provider network. An MCO shall establish a process for the resolution of requests for medically necessary services to be provided by out-of-network providers when such services are not available in network. Such process shall require the approval of the commissioner prior to implementation and shall thereupon be included in the member handbook. Emergency services do not require prior authorization; no MCO or utilization review agent may require enrollees to obtain prior authorization for the provision of such services.
(b) The limitation in subdivision (a) of this section, and other limitations imposed on accessing the entire approved network, must be clearly transmitted to eligible persons and enrollees via marketing materials, member handbooks and subscriber contracts.
(c)
(1) Prior approval of the commissioner is required for assignment of an IPA or institutional network provider contract, or of a medical group provider contract that serves five percent or more of the enrolled population in a county.
(2) A minimum of 45 days prior written notice to the commissioner is required for termination or non-renewal of an IPA or institutional network provider contract, or of a medical group provider contract that serves five percent or more of the enrolled population in a county or when the termination or non-renewal of the medical group provider will leave fewer than two participating providers of that type within the county. The notice shall include an impact analysis of the termination or non-renewal with regard to enrollee access to care.
(3) All provider contracts assigned by an MCO or an IPA prior to, and which remain in effect following, the effective date hereof shall be amended within one year of such effective date or upon renewal, whichever first occurs, to achieve compliance with the provisions of this subpart and guidelines for provider and IPA contracts established by the commissioner.
(d) An MCO which provides primary care services shall make available to each enrollee a primary care practitioner to supervise and coordinate the health care of the enrollee. In the case of an HIV SNP, the primary care practitioners for enrollees with HIV infection must meet HIV specialist requirements as defined by the commissioner; the qualifications of HIV specialist primary care practitioners shall be reassessed annually to assure the requirements for HIV specialist status are met. The HIV SNP member-to-primary care practitioner ratios shall be developed to reflect HIV SNP patient caseload characteristics as prescribed by the commissioner. When required by Federal and/or State law or regulation, an enrollee of an MCO who is dissatisfied with the assigned or selected primary care practitioner shall be allowed to select another. However, the MCO may impose a reasonable waiting period to accomplish this transfer. Waiting times for enrollees eligible for benefits under title XIX shall be consistent with section 364-j of the Social Services Law.
(e) The HIV SNP shall ensure all enrollees access to a full continuum of HIV-specific care, treatment and prevention through:
(1) access to the services of facility and community based case managers with expertise in prevention and care needs of persons with HIV infection;
(2) access to designated AIDS center hospitals or other hospitals with proven experience in HIV care and treatment and to community based HIV prevention and health care providers, including community health centers and, where geographically accessible, co-located substance abuse and HIV primary care programs;
(3) access to health and social services providers that support members' ability to sustain wellness and to adhere to treatment regimens;
(4) development and implementation of written agreements with community based social services providers to facilitate enrollee access to the full continuum of services needed by HIV-infected individuals, including access to care for vulnerable populations, such as those who are homeless, substance users or others; and
(5) mechanisms for monitoring referrals to care, treatment and supportive services and for documenting the outcome of the referral process for enrollees referred to organizations with which the HIV SNP is affiliated through a linkage agreement or memorandum of understanding.
(f) The MLTCP shall assure that all covered services are available and accessible by:
(1) establishing standards for timeliness of access to care and member services and frequent and consistent monitoring of the extent to which it meets such standards;
(2) implementing a process for selection and retention of network providers; and
(3) making care management and health care services available 24 hours a day, seven days a week.
(g) The MLTCP shall promote continuity of care and integration of services through:
(1) designation of a health care professional(s) responsible for care management. Services provided or arranged to address the care needs of such enrollee shall be in accordance with a current plan of care developed in consultation with the enrollee;
(2) coordination of covered health and long term care services with non-covered services and other community resources; and
(3) systematic and timely communication of clinical information among providers and maintenance of a care management record. Such records, which shall be retained for six years after the date of service rendered to enrollees, shall include but shall not be limited to:
(i) assessments and reassessments;
(ii) a plan of care which identifies health care goals of enrollees and covered services to be provided;
(iii) medical orders, as applicable;
(iv) documentation of non-covered services arranged and coordinated by the plan;
(v) advance directives;
(vi) signed enrollment agreement and disenrollment agreement; and
(vii) contacts with enrollees and their representatives, providers of covered and non- covered services, physicians, local social service districts and other agencies or facilities with whom the plan coordinates services.
(h) The MCO, or the primary care practitioner on behalf of the MCO, shall be responsible for the management of care for enrollees, including the identification and selection of an appropriate provider of care in each individual instance where services are determined to be necessary for the enrollee. An MCO shall provide, or make arrangements for the provision of the full range of comprehensive health services as defined in section 98-1.2(g) of this Subpart and as covered in the approved benefit package to enrollees. MCOs shall provide such comprehensive health services without exclusion of any appropriately registered, certified or licensed type of provider as a class from participation in such MCO.
(i) When an enrollee is referred by an MCO or by an MCO primary care practitioner or MCO provider authorized by the MCO to make such referrals to a participating or nonparticipating specialist for services included in the enrollee contract with such MCO, the enrollee shall incur no financial liability other than required co-payments.
(j) An MCO shall have a written procedure describing coverage for emergency health services received by an enrollee outside of the MCO's service area. The MCO coverage for emergency health services shall be consistent with article 49 of the Public Health Law and, in the case of an entity providing services to Medicare beneficiaries, consistent with Federal law and regulation, and clearly described in both the enrollee contract and the enrollee handbook.
(k) Medical offices and premises not subject to the jurisdiction of article 28 of the Public Health Law, in which primary ambulatory care services are provided to MCO enrollees, shall conform to professional and generally accepted standards of medical practice.
(l) The MCO shall establish procedures to obtain consent from each enrollee for release of such enrollee's medical records to ensure that it has access to the medical records of enrollees upon request for review by the MCO and the department for the purposes authorized by law. This shall be assured through an explicit provision in the contracts between the MCO and providers, the MCO and an IPA, and an IPA and providers.
(m) MCOs shall require that network providers comply with all HIV confidentiality requirements pursuant to title 27-F and section 2784 of the Public Health Law, through express provision in contracts with providers and express reference in provider manuals. An HIV SNP shall establish procedures for assuring the confidentiality of medical information of all enrolled HIV-infected individuals, including mechanisms to address breaches of confidentiality and a training program for all HIV SNP employees regarding confidentiality and disclosure of HIV-related information.
(n) Utilization review program standards for retrospective review of a pre-authorized treatment, service, or procedure. An MCO may reverse a pre-authorized treatment, service or procedure on retrospective review pursuant to section 4905(5) of the Public Health Law only when:
(1) the relevant medical information presented to the MCO or utilization review agent upon retrospective review is materially different from the information that was presented during the pre-authorization review; and
(2) the relevant medical information presented to the MCO or utilization review agent upon retrospective review existed at the time of the pre-authorization but was withheld from or not made available to the MCO or utilization review agent; and
(3) the MCO or utilization review agent was not aware of the existence of the information at the time of the pre-authorization review; and
(4) had the MCO or utilization review agent been aware of the information, the treatment, service, or procedure being requested would not have been authorized. This determination is to be made using the same specific standards, criteria or procedures as used during the pre-authorization review.
(o) An MCO shall have written procedures for the implementation of the transitional period provisions set forth in sections 4403(6)(e) and (f) and 4408(4) of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
OPERATION AND QUALITY CONTROL OPERATION AND QUALITY CONTROL
10 CRR-NY 5-1.70 Applicability
Sections 5-1.70 through 5-1.79 of this Subpart shall be applicable to all public water systems, provided the systems serve 15 or more service connections or serve 25 or more persons. Sections 5-1.71(c) and (d), 5-1.72(c), and 5-1.78(a)(4) of this Part apply to all public water systems.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.5 Optional pre-application conference
(a) If a proposed regulated activity requires one or more department reviews or approvals, or the preparation of an environmental impact statement pursuant to the State Environmental Quality Review Act, the prospective applicant may request an optional pre-application conference with the appropriate department staff as a means of clarifying application procedures to be followed in order to comply with the requirements set forth in these rules and regulations.
(b) The request for a pre-application conference should be made at the earliest possible stage of the applicant's planning process. Such request shall be made in writing to the department representative for the area where the regulated activity is to be undertaken, as set forth in section 128-1.5 of this Part. A mutually agreed upon time and place shall be scheduled for the pre-application conference.
(c) In order to assist the prospective applicant, prior to the pre-application conference, the prospective applicant shall submit to the department representative the following information:
(1) a description of the proposed regulated activity, a site plan or sketch showing the location and topography of the area of the activity, identification of any existing structures at the location, and any engineering, construction or other plans which describe the methods to be used to meet the requirements of these rules and regulations;
(2) a statement of the prospective applicant's timetable and financial plans for carrying out the proposed regulated activity, if known;
(3) a statement of any governmental financial aid, facilities, or other assistance which the prospective applicant expects to be provided or plans to request for the regulated activity; and
(4) such other information as the department deems reasonably necessary.
(d) At the pre-application conference, the proposed project will be informally discussed. Based on information provided by the applicant, review and approval requirements will be identified and the applicant will be provided with guidance concerning the application and review process. Participation in the pre-application process shall not relieve an applicant from the requirements of obtaining all approvals otherwise necessary under these rules and regulations or any other law or rules and regulations, prior to commencing the regulated activity.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.11 Personnel monitoring
(a) External radiation sources.
Each person who possesses any radiation source shall supply and require the proper use of appropriate, calibrated and operable individual monitoring devices by:
(1) adults likely to receive, in one year from sources external to the body, a dose in excess of 10 percent of the limits in section 16.6(a)(1) of this Part; and
(2) minors and declared pregnant women likely to receive, in one year from sources external to the body, a dose in excess of 10 percent of any of the applicable limits in section 16.6(g) or 16.6(h) of this Part; and
(3) individuals entering a high or very high radiation area.
(b) A person supplying personnel monitoring devices to individuals as required by subdivision (a) of this section shall ensure that the individuals wear such devices as follows:
(1) An individual monitoring device used for monitoring the dose to the whole body shall be worn at the unshielded location of the whole body likely to receive the highest exposure.
(2) An individual monitoring device used for monitoring the dose to an embryo/fetus of a declared pregnant woman, pursuant to section 16.6(h)(1) of this Part, shall be located at the waist under any protective apron worn by the woman.
(3) An individual monitoring device used for monitoring the eye dose equivalent shall be located at the neck outside any protective apron worn by the individual, or at an unshielded location closer to the eye.
(4) An individual monitoring device used for monitoring the dose to the extremities shall be worn on the extremity likely to receive the highest exposure. The device shall be oriented to measure the highest dose to the extremity being monitored.
(c) All personnel monitoring devices, except for direct and indirect reading dosimeter and those dosimeters used to measure the dose to any extremity, that require processing to determine the radiation dose and which are supplied pursuant to subdivision (a) of this section, or with conditions specified in a license or registration shall be processed and evaluated by a dosimetry processor:
(1) holding current personnel dosimetry accreditation from the National Voluntary Laboratory Accreditation Program (NVLAP) of the National Institute of Standards and Technology; and
(2) approved in this accreditation process for the type of radiation or radiations included in the NVLAP program that most closely approximate the type of radiation or radiations for which the individual wearing the dosimeter is monitored.
(d) Intake of radioactive material.
Each licensee shall perform all appropriate measurements of those specified in section 16.6(d)(1) of this Part which will enable him/ her to determine the occupational intake of radioactive material by and assess the committed effective dose equivalent to:
(1) adults likely to receive, in one year, an intake in excess of 10 percent of the applicable ALI in Appendix 16-C, Table 1, Columns 1 and 2, infra; and
(2) minors and declared pregnant women likely to receive, in one year, a committed effective dose equivalent in excess of 0.50 mSv (0.05 rem).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.8 Employee Attestation
Each employee, upon receiving training, in conformance with section 50-4.7 of this Subpart, shall sign a statement acknowledging receipt of sections 50-4.3(b) and 50-4.7(b) of this Subpart and acknowledging that violation of confidentiality statutes and rules may lead to disciplinary action, including suspension or dismissal from employment and criminal prosecution. Each employee's signed attestation is to be centrally maintained in the employee's personal history file.
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.7 Employees
(a) Except as provided in subdivision (b) of this section, employees, agents or other fiduciaries of any clinical laboratory, when supplied by the clinical laboratory to a referring health services purveyor to perform functions and duties in the facility of the health services purveyor, shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited.
(b) Nothing in Public Health Law, section 587 or in this Subpart shall be construed as prohibiting a hospital or an HMO and a clinical laboratory from entering into a contract for laboratory management services, including provision of technical services and employees for the performance of functions directly related to clinical laboratory operations.
(c) Payment or reimbursement by a clinical laboratory to a health services purveyor for clinical laboratory services and/or directly related services, which had been rendered by the health services purveyor or such purveyor's employees, agents or fiduciaries, shall be deemed consideration given for referral of specimens for performance of clinical laboratory services, and is prohibited. However, a clinical laboratory may enter into a written contract with a hospital, HMO or another clinical laboratory for the provision of phlebotomy services, clinical laboratory services, or directly related services to the contracting clinical laboratory, provided such services are rendered at fair market value and not in connection with individuals who are patients or clients of the hospital, HMO or other clinical laboratory.
(d) Nothing in this Subpart shall prohibit the employees, agents or fiduciaries of a clinical laboratory from visiting a residence for the purpose of drawing blood, or otherwise obtaining or collecting specimens, provided that:
(1) such visits shall not result in a substantially permanent presence and shall be established according to a schedule, available in the laboratory, or upon specific request of the health care provider or other authorized person responsible for care of the patient, and documented by the laboratory;
(2) while at the residence, the employees, agents or fiduciaries of the laboratory do not provide any supplies, services or assistance, directly or indirectly, to the operators, nursing or medical staff or other individuals other than as stated in this Subpart; and
(3) during such visits, the activities of the employees, agents or fiduciaries of the laboratory are limited to:
(i) reviewing the orders for laboratory tests from the patient's health services purveyor, without reviewing the patient's chart;
(ii) scheduling the collection of specimens for future tests, without reviewing the patient's chart;
(iii) collecting specimens;
(iv) labeling the collected specimens;
(v) recording the number and kinds of specimens collected;
(vi) taking steps necessary to ensure that the test requisition forms are properly completed pursuant to orders from the patient's health care provider;
(vii) centrifuging blood specimens;
(viii) causing adequate and sanitary equipment and supplies to be maintained, when appropriate, at a residence, solely for the collection, preservation and transport of specimens; and
(ix) taking steps necessary to ensure the integrity of specimens which are stored, when appropriate, at a residence awaiting transport to the clinical laboratory; and
(4) no rent is paid by the clinical laboratory for the storage of equipment and supplies or specimens, or for any other purpose.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-12 OUTPATIENT SERVICES LICENSED UNDER THE MENTAL HYGIENE LAW
10 CRR-NY 86-12.2 Utilization limits on OMH licensed clinics
(a) Effective for services provided on and after April 1, 2011 Medicaid payments for outpatient mental health services provided in outpatient facilities licensed by the Office of Mental Health (OMH) pursuant to article 31 of the Mental Hygiene Law shall reflect applicable provisions of regulations promulgated by OHM and shall be adjusted relative to 2009 service utilization and payment levels in accordance with the following:
(1) For persons 21 years of age or older, the 31st through 15th visit in a State fiscal year shall be subject to a 25 percent reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 31 of the Mental Hygiene Law or regulations promulgated thereunder.
(2) For persons 21 years of age or older, visits in excess of 50 visits in a State fiscal year shall be subject to a 50 percent reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 31 of the Mental Hygiene Law or regulations promulgated thereunder.
(3) For persons less than 21 years of age at the start of the State fiscal year, visits in excess of 50 visits in that State fiscal year shall be subject to a 50 percent reduction in the otherwise applicable payment amount as computed in accordance with applicable provisions of article 31 of the Mental Hygiene Law or regulations promulgated thereunder.
(4) Off-site visits, medical visits and crises visits, when billed under their applicable rate codes, shall be disregarded in computing the number of visits pursuant to paragraphs (1), (2) and (3) of this subdivision.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.47 Adult day health care
This functional reporting center must contain all the expenses associated with the provision of organized treatment on a scheduled basis for ambulatory patients. This unit is used to provide medical supervision and evaluation to patients who require a minimal amount of nursing supervision.
(a) Standard unit of measure: number of visits.
Enter all visits to the day care center. Each visit is counted as one.
(b) Data source.
The number of visits shall be the actual count maintained by day care.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-3 REQUIREMENTS FOR AUTOCLAVES USED TO TREAT REGULATED MEDICAL WASTE
10 CRR-NY 70-3.4 Recordkeeping
(a) Each facility shall retain for three years records of: validation testing and challenge testing, including protocols and test results; routine system's monitoring; and, where applicable, department approval as an alternative treatment technology.
(b) Each facility shall document each employee's participation in training and/or retraining in autoclave operations, and shall retain such records for three years.
(c) Documentation of corrective action, including that required by section 70-3.2 of this Subpart, shall be retained for three years.
(d) Documentation of any modification to an approved operation plan, regardless of whether the modification is subject to department approval pursuant to this section, shall be retained three years from discontinuance of the modified plan.
(e) Documentation of the residence time, pressure and temperature of each load treated shall be retained for three years.
(f) All records required pursuant to this section shall be made available for inspection and copying by the department.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.1 Definitions
(a) HIV-infection means infection with the human immunodeficiency viruses that are the cause of AIDS or as the term may be defined from time to time by the Centers for Disease Control and Prevention of the United States Public Health Service.
(b) AIDS means acquired immune deficiency syndrome, as may be defined from time to time by the Centers for Disease Control and Prevention of the United States Public Health Service.
(c) HIV-related illness means any clinical illness that may result from or be associated with HIV infection.
(d) HIV-related test or HIV-related testing means any laboratory test, tests or series of tests approved for the diagnosis of HIV.
(e) Rapid HIV test or testing means any HIV-related test or tests approved for detecting antibodies or antigens to HIV, that produce results in 60 minutes or less, and encompasses a supplemental test to confirm the HIV-related test if the screening test is reactive. The 60 minutes does not include the time needed for confirmation or delivery of results to the patient.
(f) Capacity to consent means an individual's ability, determined without regard to the individual's age, to understand and appreciate the nature and consequences of a proposed health care service, treatment, or procedure, or of a proposed disclosure of confidential HIV-related information, and to make an informed decision concerning the service, treatment, procedure or disclosure.
(g) Protected individual means a person who is the subject of an HIV-related test or who has been diagnosed as having HIV infection, AIDS or HIV-related illness.
(h) Confidential HIV-related information means any information, in the possession of a person who provides health or social services or who obtains the information pursuant to a release of confidential HIV-related information, concerning whether an individual has been the subject of an HIV-related test, or has HIV infection, HIV-related illness or AIDS, or information which identifies or reasonably could identify an individual as having one or more of such conditions, including information pertaining to such individual's contacts.
(i) Health or social service means any care, treatment, clinical laboratory test, counseling or educational service for adults or children, and acute, chronic, custodial, residential, outpatient, home or other health care; public assistance, including disability payments available pursuant to the Social Security Act; employment-related services, housing services, foster care, shelter, protective services, day care or preventive services; services for the mentally disabled; probation services; parole services; correctional services; detention and rehabilitative services; and the activities of the Health Care Worker HIV/HBV Advisory Panel (see Public Health Law article 27-DD), all as defined in section 2780(8) of the Public Health Law.
(j) Health facility means a hospital as defined in section 2801 of the Public Health Law, blood bank, organ procurement organization, tissue bank, clinical laboratory, or facility providing care or treatment to persons with a mental disability.
(k) Health care provider or provider means any physician, nurse, licensed or certified provider of diagnostic medical services, including a nurse practitioner, a midwife and physician assistant, provider of services for the mentally disabled or other person involved in providing medical, nursing, counseling, or other health care or mental health service, including those associated with, or under contract to, a health maintenance organization or medical services plan. Diagnostic providers include physicians, nurse practitioners, physician assistants and midwives who are authorized to order diagnostic tests and to make clinical diagnoses.
(l) Primary care means the medical fields of family medicine, general pediatrics, primary care, internal medicine, primary care obstetrics, or primary care gynecology, without regard to board certification or setting where primary care is provided.
(m) Contact means an identified spouse or sexual contact of the protected individual or a person identified as having shared hypodermic needles or syringes with protected individual, or a person whom the protected individual may have exposed to HIV under circumstances that present a risk of transmission of HIV, as noted in section 63.8(m) of this Part.
(n) Contact tracing shall mean the process of notifying known contacts of protected individuals as reported by the physician or as disclosed by the protected individuals themselves, and of seeking the cooperation of protected individuals to name contacts, as described in section 63.8 of this Part. For the purposes of this Part, the terms contact notification, partner notification, partner assistance and partner counseling and referral services shall be synonymous with contact tracing. In all cases of contact tracing authorized in this Part, the name or other identifying information regarding the protected person shall not be disclosed to contacts and the name of contacts shall not be disclosed to other contacts.
(o) Person includes any natural person, partnership, association, joint venture, trust, public or private corporation or State or local government agency.
(p) Release of confidential HIV-related information means a written authorization for disclosure of confidential HIV-related information which is signed by the protected individual, or if the protected individual lacks capacity to consent, a person authorized pursuant to law to consent to health care for the individual. Such release shall be dated and shall specify to whom disclosure is authorized, the purpose for such disclosure and the time period during which the release is to be effective. A general authorization for the release of medical or other information shall not be construed as a release of confidential HIV-related information, unless such authorization specifically indicates its dual purpose as a general authorization and an authorization for the release of confidential HIV-related information and complies with this definition.
(q) Insurance institution means any corporation, association, partnership, reciprocal exchange, interinsurer, fraternal benefits society, agent, broker or other entity in the business of providing health, life and disability coverage including, but not limited to, any health maintenance organization, medical service plan, or hospital plan which:
(1) is engaged in the business of insurance;
(2) provides health services coverage plans; or
(3) provides benefits under, administers, or provides services for, an employee welfare benefit as defined in 29 USC 1002(1).
(r) Municipal health commissioner shall mean, for purposes of this Part, a county health commissioner, except, in New York City, the term shall mean the New York City health commissioner. Such county health commissioner and New York City health commissioner shall conduct reporting, counseling and contact notification activities consistent with guidelines acceptable to the commissioner in compliance with article 21, title III and article 27-F of the Public Health Law.
(s) District health officer shall mean, for the purposes of this Part, the commissioner or his/her designee.
(t) For the purposes of this Part, commissioner shall mean the New York State Commissioner of Health.
(u) For the purposes of this Part, authorized public health official shall mean New York State Commissioner of Health, a municipal health commissioner or a district health officer, or their designee.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-7 ADMINISTRATION AND ENFORCEMENT BY LOCAL GOVERNMENTS
10 CRR-NY 128-7.7 Decertification or modification of enforcement programs
(a) The enforcement program of a certified local government shall be continued unless decertified or modified by the commissioner. A preliminary determination to decertify or modify shall be made at any time if the commissioner determines that the local government's administration of any element of the program is inadequate to protect the water supply.
(b) Where the commissioner has made a preliminary decision to decertify or modify a local government's enforcement program pursuant to subdivision (a) of this section, a notice of proposed decertification or modification, and the reasons therefor, shall be sent by certified mail to the designated representative of the certified local government. The certified local government may, within 10 business days of the sending of such notice, submit information addressing the reasons for decertification or modification stated in the notice. After receipt and consideration of any information submitted by the certified local government, the commissioner shall make a final determination to continue, modify, or decertify the program within thirty business days of sending of the notice of proposed decertification or modification. Upon decertification of an enforcement program, the enforcement of the rules and regulations set forth herein shall be the sole responsibility of the department.
(c) A local government which has received a determination of decertification may reapply for certification after one year.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-11 RATE SETTING FOR NON-STATE PROVIDERS: INTERMEDIATE CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
10 CRR-NY 86-11.2 Definitions
As used in this Subpart, the following terms shall have the following meanings:
(a) Allowable costs.
Costs that are allowable under 14 NYCRR Subpart 635-6 or 14 NYCRR section 681.14(f).
(b) Base year.
The consolidated fiscal report period from which the initial period rate will be calculated. Such period shall be January 1, 2011 through December 31, 2011 for providers reporting on a calendar year basis and July 1, 2010 through June 30, 2011 for providers reporting on a fiscal year basis.
(c) Base operating rate.
Reimbursement amount calculated by dividing annual reimbursement by applicable annual units of service, both in effect on June 30, 2014.
(d) Budget neutrality adjustment.
Factor applied to adjust the proposed amount so that it is equivalent to the base amount of dollars.
(e) Capital cost.
Costs that are related to the acquisition, lease, construction and/or long-term use of land, buildings and fixed equipment, leasehold improvements and vehicles.
(f) Department of Health (DOH) regions.
Regions as defined by the department, assigned to providers based upon the geographic location of the provider’s headquarters as reported on the consolidated fiscal report. Such regions are as follows:
(1) downstate: 5 boroughs of New York City, Nassau, Suffolk and Westchester;
(2) Hudson Valley: Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster;
(3) upstate Metro: Albany, Erie, Fulton, Genesee, Madison, Monroe, Montgomery, Niagara, Onondaga, Orleans, Rensselaer, Saratoga, Schenectady, Warren, Washington, Wyoming;
(4) upstate Non-Metro: Any counties not listed in paragraph (1), (2) or (3) of this subdivision.
(g) Depreciation.
The allowable cost based on historical costs and useful life of buildings, fixed equipment, capital improvements and/or acquisition of real property. The useful life shall be based on “The Estimated Useful life of Depreciable Hospital Assets (2008 edition).”
(h) Facility.
The site or physical building where ICF/DD services are provided.
(i) Financing expenditures.
Interest expense and fees charged for financing of costs related to the purchase/acquisition, alteration, construction, rehabilitation and/or renovation of real property.
(j) Individual.
Person receiving ICF/DD services.
(k) ICF/DD.
An intermediate care facility for persons with developmental disabilities, as such term is used in 14 NYCRR Part 681.
(l) Initial period.
July 1, 2014 through June 30, 2015.
(m) Lease/rental and ancillary payments.
A provider’s annual rental payments for real property and ancillary outlays associated with the property such as utilities and maintenance.
(n) Provider.
An individual, corporation, partnership or other organization to which OPWDD has issued an operating certificate pursuant to article 16 of the Mental Hygiene Law to operate an ICF/DD, and for which the NYS Department of Health has issued a Medicaid provider agreement.
(o) Rate sheet capacity.
The certified capacity of the ICF/DDs operated by a provider.
(p) Reimbursable cost.
The final allowable costs of the rate year after all audit and/or adjustments are made.
(q) Start-up costs.
Those costs associated with the opening of a new facility or program. Start-up costs include pre-operational rent, utilities, staffing, staff training, advertising for staff, travel, security services, furniture, equipment and supplies.
(r) Target rate.
The final rate in effect at the end of the transition period for each provider.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.276 Real estate (or property)
Land and land improvements, including buildings and appurtenances.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.17 Violations
Violations of this Subpart may subject the owner or operator of the bottled or bulk water facility to civil penalties of up to $2,000 per violation, revocation of their certificate of approval to distribute bottled or bulk water within New York State and/or a recall of all products on the market in New York State.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 148.25 Livingston Manor Water District, Town of Rockland
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Hardenburg and Houghtaling Brooks and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the Livingston Manor Water District in the Town of Rockland, Sullivan County, New York.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoirs on Hardenburg and Houghtaling Brooks, which are tributary to or which serve as a source of the aforesaid public water supply, and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the Livingston Manor Water District.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 150 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified, and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the Livingston Manor Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the Livingston Manor Water District; nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c] of this section) within 300 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Livingston Manor Water District nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the Livingston Manor Water District.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the Livingston Manor Water District. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the Livingston Manor Water District.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the Livingston Manor Water District.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Livingston Manor Water District, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the Livingston Water District.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 500 feet from any reservoir or 200 feet from any watercourse tributary to the public water supply of the Livingston Manor Water District.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the Livingston Manor Water District, except by duly authorized employees of the Livingston Manor Water District in the performance of their duties of supervision and maintenance of the public water supply of the Livingston Manor Water District.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged in construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the Livingston Manor Water District.
(j) Inspections.
The board of water commissioners of the Livingston Manor Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Livingston Manor Water District or the duly appointed representative of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
GARBAGE AND REFUSE GARBAGE AND REFUSE
10 CRR-NY 14-4.152 Debris and consumer litter—operator responsibility
The operator of a mobile food service establishment or pushcart is responsible for cleanup of debris caused by the operation and consumer littering.
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.191 Waiver
The permit-issuing official may waive, in writing, any of the requirements of this Subpart, and the waiver included as a condition of the permit to operate, when it reasonably appears that the public health will not be endangered by such waiver. All such waivers are to be only for the same period as the term of the permit.
Part 2 COMMUNICABLE DISEASES
INVESTIGATIONS AND DETERMINATIONS INVESTIGATIONS AND DETERMINATIONS
10 CRR-NY 2.5 Physician to submit specimens for laboratory examination in cases or suspected cases of certain communicable diseases
A physician in attendance on a person affected with or suspected of being affected with any of the diseases mentioned in this section shall submit to an approved laboratory, or to the laboratory of the State Department of Health, for examination of such specimens as may be designated by the State Commissioner of Health, together with data concerning the history and clinical manifestations pertinent to the examination:
Anthrax
Babesiosis
Botulism
Brucellosis
Campylobacteriosis
Chlamydia trachomatis infection
Cholera
Congenital rubella syndrome
Conjunctivitis, purulent, of the newborn (28 days of age or less)
Cryptosporidiosis
Cyclosporiasis
Diphtheria
E. coli 0157:H7 infections
Ehrlichiosis
Giardiasis
Glanders
Gonococcal infection
Group A Streptococcal invasive disease
Group B Streptococcal invasive disease
Hantavirus disease
Hemophilus influenzae (invasive disease)
Hemolytic uremic syndrome
Herpes infection in infants aged 60 days or younger (neonatal)
Legionellosis
Listeriosis
Malaria
Melioidosis
Meningitis
Hemophilus
Meningococcal
Meningococcemia
Monkeypox
Plague
Poliomyelitis
Q Fever
Rabies
Rocky Mountain spotted fever
Salmonellosis
Severe or novel coronavirus
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), including Pediatric Multi-system Inflammatory Syndrome, or any other complication suspected of being associated with SARS-CoV-2 infection
Severe Acute Respiratory Syndrome (SARS)
Middle East Respiratory Syndrome (MERS)
Other (specify type)
Shigellosis
Smallpox
Staphylococcal enterotoxin B poisoning
Streptococcus pneumoniae invasive
Syphilis
Tuberculosis
Tularemia
Typhoid
Viral hemorrhagic fever
Yellow Fever
Yersiniosis
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.25 Organ and tissue donation (anatomical gifts)
(a) Definitions.
For the purposes of this section, the following terms shall have the following meanings:
(1) designated requestor shall mean a person selected by the hospital to discharge the responsibilities of requesting the spouse, next of kin or guardian of the decedent to consent to an anatomical gift. The designated requestor shall be a trained hospital employee, or an employee of an organ procurement organization, eye bank or other tissue bank. Designated requestors, at a minimum, must complete a course, that meets the criteria set forth in subdivision (e) of this section, provided or approved by an organ procurement organization and designed in consultation with the eye bank or other tissue bank community, whichever is applicable, on how to approach potential donor families and request organ, eye or other tissue donation. The hospital administrator may select more than one designated requestor;
(2) suitability for organ, eye and other tissue donation shall mean that the organ procurement organization, eye bank or other tissue bank in consultation with the hospital, after appropriate medical screening (which may include serological testing if applicable) determines that the patient meets the medical criteria for donation;
(3) organ procurement organization (OPO) shall mean an organization which is designated by the Secretary, U.S. Department of Health and Human Services, to perform or coordinate the performance of retrieving, preserving and transporting organs and to maintain a system of locating prospective recipients for available organs; and
(4) tissue bank shall mean a tissue bank licensed under Part 52, which includes eye banks.
(b) The hospital shall assure that written policies and procedures are established, implemented and maintained for notifying an organ procurement organization and/or appropriate tissue banks including eye banks, licensed pursuant to Part 52 when death of a patient has occurred or is imminent, designating the requestor(s) to approach the family, selecting eye bank(s) and other applicable tissue bank(s) for referrals, causing a timely request to be made by the designated requestor and monitoring the implementation of these functions. These policies and procedures shall be developed in consultation with organ procurement organizations and licensed eye banks and other tissue banks selected by the hospital. Written policies and procedures to be established shall include:
(1) protocol for notification of the organ procurement organization, eye bank or other tissue bank upon the death or imminent death of every patient, including provisions specifying that for ventilator patients declared brain dead, the organ procurement provider must be notified and able to determine suitability for donation prior to removal of such patients from the ventilator;
(2) procedures for seeking consent by the designated requestor so that requests are made only when the candidate meets the medical criteria for screening potential donors, and that no requests are made when the conditions listed in paragraph (d)(1), (2) or (3) of this section are present;
(3) a procedure for documenting in the patient's medical record notification of the organ procurement organization, eye bank or other applicable tissue bank(s), and the results of such notification and requests for consent or absence of a request;
(4) an ongoing system for monitoring compliance with routine referral of potential donors including the outcomes of such referrals and any resulting requests. When a hospital contracts with an outside organization to review hospital policies, procedures, patient records and outcomes to assess compliance with this section, the contract shall be written and executed in accordance with section 400.4 of this Title and shall require the contractor to be held to the same standards of patient confidentiality as the hospital; and
(5) a method for hospitals to select at least one eye bank(s) and all applicable tissue bank(s) for the procurement of tissue and any policies and procedures the hospital has adopted concerning the rotation of referrals.
(c)
(1) Where a patient is a suitable candidate for organ, eye or other tissue donation and where the patient has not properly executed an organ donor card, or other authorization for organ, eye or other tissue donation, the designated requestor shall, in a timely manner, at the time of death of a hospital patient, request the persons listed below, in the order of priority stated, to consent to the gift of all useful organs, tissues and/or other body parts of the decedent's body:
(i) the spouse;
(ii) a son or daughter 18 years of age or older;
(iii) either parent;
(iv) a brother or sister 18 years of age or older; or
(v) a guardian of the person of the decedent at the time of his/her death.
(2) Consent or refusal need only be obtained from any person in the highest priority class available when persons in prior classes have been sought with due diligence and are not available at the time of death. Any consent to an anatomical gift by a person designated in this subdivision shall be given by a document signed by him/her or given by his/her telegraphic, recorded telephonic or other recorded message.
(3) A designated requestor may also request consent to an anatomical gift from any other person who is authorized or under the obligation to dispose of the body including, but not limited to, a person named in a decedent's will, a commissioner of a social services district, a coroner, a medical examiner, or a hospital administrator.
(d) Anatomical donations shall not be requested when any one of the following conditions are present:
(1) actual notice of contrary intentions by the decedent;
(2) actual notice of opposition by a member of the highest priority class available specified in subparagraphs (c)(1)(i)-(v) of this section; or
(3) other reason to believe that an anatomical gift is contrary to the decedent's religious or moral beliefs. The medical record shall document the evidence that served as the basis for the “reason to believe.”
(e) The designated requestor shall be selected by the hospital based on his/her ability to relate to families in a sensitive and caring manner and shall complete a course provided by a tissue bank and approved by the organ procurement organization, or provided by the organ procurement organization and designed in consultation with community eye bank or other tissue bank, whichever is applicable, to have demonstrated proficiency in the following areas:
(1) psychological and emotional considerations when dealing with bereaved families and particularly with individuals with diminished mental capacity;
(2) social, cultural, ethical and religious factors affecting attitudes toward organ donation;
(3) general medical concepts involved in organ and tissue transplantation and the use of organs and tissues in research and education;
(4) procedures for declaring death, and collecting and preserving organs, tissues and/or other body parts and how these procedures are most appropriately explained to the decedent's family;
(5) the cost implications to the family for organ and tissue donation, if any;
(6) the existing networks for the procurement of organs and the systems for allocating donated organs, tissues and other body parts to suitable recipients; and
(7) the routine referral law and the hospital's policies and procedures regarding requests for consent to anatomical gifts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.2 Administrative requirements and practices for asbestos safety training providers
The following administrative requirements and their application in the training program must be met and maintained by all asbestos safety training providers. Plans and procedures for meeting these requirements must be part of any application submitted by a training provider for accreditation of an asbestos safety training program.
(a) Training director. Each asbestos safety training provider must have designated at all times a training director who is approved by the department. The name and credentials of the training director shall be submitted for department review with each application for accreditation of an asbestos safety training program and whenever a new training director is designated. The training director shall have experience in designing, implementing and evaluating either employee educational programs in asbestos safety or vocational educational programs related to asbestos. The training director shall be directly involved in the program.
(1) Duties. The training director will be responsible for ensuring that the training program complies at all times with all of the requirements of this Part and the procedures for meeting said requirements submitted as part of the application for accreditation and shall be directly involved in the asbestos safety training program. Such duties shall include, but not be limited to:
(i) development and/or revision of asbestos safety training program;
(ii) review of instructor qualifications and determination of foreign language fluency of proposed instructors for training programs conducted in languages other than English;
(iii) development and/or revision of final examination;
(iv) monitoring the performance of instructors;
(v) monitoring the quantity and quality of all asbestos safety training provided;
(vi) maintenance of training records; and
(vii) all other functions of training directors as described in this Part.
(b) All instructors for approved programs must meet the minimum qualifications as described in section 73.4 of this Part. Only instructors approved by the department may be used to give instruction in a program accredited by the Commissioner of Health.
(c) The training provider shall ensure that all facilities and equipment necessary to conduct programs are adequate for and appropriate to the delivery of such programs and shall certify the adequacy of the facilities and equipment in the initial application for accreditation and with every requested change in facility and equipment. Equipment shall be available in sufficient quantity to accommodate students' needs and shall be maintained in proper working order. Training equipment that reflects current work practices must be provided.
(d) The training provider shall use, but is not limited to using, any materials, information or audio-visual aids which are required by the Department of Health (DOH). Materials, information or audio-visual aids not required, but which are to be used by the training provider, must first be approved by the Department of Health.
(e) The training provider will put in place a quality assurance program that will:
(1) ensure that training is updated to include new information and practices;
(2) include a general evaluation of the program by the students. The general evaluation shall be formatted to allow the students to evaluate each instructor with regard to effectiveness of presentation and knowledge of topic area. Copies of the general evaluation of the program shall be maintained as part of the program file;
(3) assess student program evaluations and implement actions to address legitimate deficiencies noted by students;
(4) ensure the validity and integrity of the program test;
(5) evaluate and ensure the continued adequacy of facilities and equipment; and
(6) provide for evaluation of instructors by the training director to determine the effectiveness of presentation and knowledge of topic area.
(f) The training provider shall send a minimum of one delegate to any meeting as required by the Department of Health.
(g) The training provider shall administer an examination, specific for each accredited training program, which is provided by or approved by the Department of Health and as described in section 73.7 of this Part.
(h) The training director or other representative of the training provider with supervisory authority over the training program shall inform the Department of Health in writing two weeks in advance of any asbestos safety training program to be conducted by the training provider and shall permit a representative(s) from the Department of Health or the Department of Labor to attend, without charge. The representative(s) will observe the program to insure compliance with this Part. Training notification received with less than two weeks notice but at least 72 hours notice from the proposed date of training must be accompanied by a roster of students scheduled to attend. The department will not recognize any program presented with less than 72 hours advance notice unless the program is being presented in response to an environmental emergency. Cancellation of any scheduled program must be communicated to the department by telephone or by fax no later than 10:00 a.m. of the first day on which the training program was to be held.
(i) The training provider must notify the department in writing of any changes in any aspect of an approved training program prior to implementing such change. Changes may not be implemented unless they are in accordance with the requirements of this Part and have been approved by the department. Changes include, but are not limited to, changes in training director, instructor(s), program topics, teaching methods, language in which the program is given, training date, location of scheduled training, or any other aspect of the training program as described in this Part.
(j) If any revision in State or Federal asbestos safety training regulations occur, or any other revisions (changes) occur which necessitate a change in an approved asbestos safety training program, the Department of Health will notify the approved training providers. Approved training providers must incorporate the changes into the next scheduled training program unless otherwise specified by the Department of Health.
(k) The training provider shall present an asbestos safety training program only in the language specified in the application submitted to the Department of Health for accreditation. The use of interpreters in the presentation of the program is not permitted. A training provider must submit a separate application for each language in which the asbestos safety training program will be presented. The application for a language other than English must include all of the elements specified in section 73.3 of this Part and, in addition, include an accurate translation of all training materials into the language in which the training program is to be presented, the equivalent English version if not already approved, a notarized letter from the translator attesting to the accuracy of the translation from English into the foreign language and evidence that all instructors to be used in the program's presentation are fluent in that language.
(l)
(1) The training provider shall provide at no charge to each student successfully completing a New York State Department of Health accredited initial or refresher asbestos safety training program, a New York State Department of Health certificate of asbestos safety training completion (DOH 2832). The training provider may also provide each such student with a diploma or other letter of training completion in addition to the certificate. Each New York State Department of Health certificate of asbestos safety training completion issued must contain specific information that details a unique certificate number, name, address and telephone number of the training provider, the name of accredited person, program discipline, date(s) of the training program, date of the examination, an expiration date of one year after the date upon which the person successfully completed the program and examination and a statement that the person receiving the certificate has completed the requisite training for asbestos accreditation under the Toxic Substance Control Act (TSCA) Title II. Any diploma or letter must clearly state that the official record of successful training completion is the New York State Department of Health certificate of asbestos safety training completion. All students completing New York State Department of Health approved initial or refresher asbestos safety training must be informed by the training provider how to obtain New York State Department of Labor asbestos abatement certification. Students shall also be informed of Environmental Protection Agency (EPA) accreditation requirements, including the expiration date of their accreditation and the grace period to complete refresher training. A student receiving a training completion certificate must be informed in writing of any other costs that would be imposed by the training provider if he/she were to request additional copies of his/her training completion certificate. Successful completion of training will be based upon the following criteria:
(i) complete attendance at all sessions of training; and
(ii) successful completion of a final examination.
(2) At the completion of each program offered, the program provider shall deliver to the department the Health Department's copy of each of the New York State Department of Health certificates of asbestos safety training completion (DOH 2832) which were distributed to individuals who successfully completed training requirements.
(m) All training programs must be completed within a period of two weeks. Attendees shall not be required to attend more than eight hours of training in any single 24 hour period. Evening sessions shall not exceed a maximum of four hours for any single session. The number of hours of training required for each training program, which must be completed within a two week time period by the individual seeking a New York State Department of Health certificate of asbestos safety training completion (DOH 2832), shall be as follows:
(1) Initial asbestos handler training shall be a minimum of 32 hours, of which 16 hours will be dedicated to hands-on training. This represents 26 contact hours of training, of which 13 contact hours will be specific to hands-on activities.
(2) Asbestos handler refresher training shall be a minimum of eight hours. This represents six and one-half contact hours of training.
(3) Initial contractor/supervisor training shall be a minimum of 40 hours, of which 16 hours will be dedicated to hands-on training. This represents 32.50 contact hours, of which 13 contact hours will be specific to hands-on activities.
(4) Contractor/supervisor refresher training shall be a minimum of eight hours. This represents six and one-half contact hours of training.
(5) Initial operations and maintenance training shall be a minimum of 16 hours, of which four hours will be dedicated to hands-on training. This represents 13 contact hours, of which four contact hours will be specific to hands-on activities.
(6) Operations and maintenance refresher training shall be a minimum of four contact hours of training.
(7) Initial allied trades training shall be a minimum of 12 hours, of which four hours will be specific to hands-on activities. This represents 10.50 contact hours, of which four hours will be specific to hands-on training.
(8) Allied trades refresher training shall be a minimum of four contact hours of training.
(9) Initial asbestos project sampling technician training shall be a minimum of 16 hours, of which five hours will be specific to hands-on activities. This represents 13 contact hours, of which five contact hours will be specific to hands-on activities.
(10) Asbestos project air sampling technician refresher training shall be a minimum of four contact hours of training.
(11) Initial inspector training shall be a minimum of 24 hours, of which four hours will be specific to hands-on training. This represents 19.50 contact hours, of which four contact hours will be specific to hands-on activities.
(12) Inspector refresher training shall be a minimum of four contact hours of training.
(13) Initial management planner training shall be a minimum of 16 hours. This represents 13 contact hours of training. A trainee must first complete an inspector training program as defined in section 73.5(f) of this Part.
(14) Management planner refresher training shall be a minimum of eight contact hours of training, which shall include the four hour inspector refresher training program.
(15) Initial project designer training shall be a minimum of 24 hours. This represents 19.50 contact hours of training.
(16) Project designer refresher training shall be a minimum of eight hours of training. This represents six and one-half contact hours of training.
(17) Initial project monitor training shall be a minimum of 40 hours, of which six hours will be specific to hands-on training. This represents 32.50 contact hours, of which six contact hours will be specific to hands-on activities.
(18) Project monitor refresher training shall be a minimum of eight hours of training. This represents six and one-half contact hours of training.
(n) The classroom and hands-on ratio of students to instructors shall not exceed the following:
(1) Classroom - 25 to 1.
(2) Hands-on - 8 to 1.
(o) A person seeking accreditation in any one of the disciplines cannot attend two or more programs concurrently but may attend such programs sequentially. Trainees must complete all portions of the training to successfully complete the program.
(p) The training provider must verify initial and refresher training credentials submitted by individuals prior to their enrollment into a refresher program. Verification of training credentials to ensure valid accredited training is a prerequisite for admittance into a New York State Department of Health approved refresher training program. Receipt of these credentials and verification that the training credentials meet USEPA or model accredited State plan requirements must occur before the individual is allowed to take the refresher training program. New York State Department of Health approved training providers must respond to requests for such verification when requested by other approved training providers.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.181 Intern
A graduate of a medical/osteopathic/dental school serving a first-year period of graduate clinical training.
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.28 Social services
The hospital shall provide appropriate supportive services to meet the psychosocial needs of its patients. The services shall be oriented to assist patients and their families with personal and environmental difficulties which predispose illness or interfere with obtaining maximum benefits from hospital care.
(a) Each patient shall be screened prior to or upon admission to determine the need for social services. All patients and families identified through such screening, and all patients and families subsequently identified as needing social services by medical, nursing or other clinical staff, shall be provided with the support they require.
(b) Social services shall be provided under the direction of a qualified social worker who is licensed and registered by the New York State Education Department to practice as a licensed master social worker (LMSW) or licensed clinical social worker (LCSW), with the scope of practice defined in article 154 of the Education Law.
(c) Personnel providing social services shall be qualified by training and experience to:
(1) recognize the psychosocial needs of patients and their families;
(2) evaluate crisis situations and disability resulting from the emotional, social and economic stresses of illness;
(3) counsel patients and families to deal with the particular stresses affecting them;
(4) participate in hospital care planning and assist patients and families to understand, accept and follow medical and other professional recommendations to restore patients to optimum social and health adjustments; and
(5) arrange for specialized assistance from other sources within the hospital from community resources for patients and families who need such assistance. Such arrangements shall include, but not be limited to, educational and tutorial services with the patient's school district in accordance with section 3202(6) of the Education Law for inpatients between the ages of 5 and 21 who:
(i) are physically and mentally capable of benefitting from such services;
(ii) are expected to be hospitalized for a period of time sufficient to interrupt their normal educational program; and
(iii) if over age 16, are still enrolled in school.
(d) All hospitals except rural hospitals and hospitals outside an urban area shall have an organized social work department, which shall be directed by a qualified social worker. The department shall be integrated with other departments of the hospital, and shall participate in appropriate education, training and orientation programs for medical, nursing and other clinical staff, and for administrative personnel.
(e) The hospital shall implement, in conjunction with the quality assurance committee, a systematic process for the monitoring and evaluation of the quality and appropriateness of social services provided to patients and families and for the resolution of identified problems.
(f) The hospital shall develop and implement written policies and procedures relating to the long term care ombudsman program as provided for in section 545 of the Executive Law and section 2803-c of the Public Health Law which provide the following:
(1) The hospital shall permit and not restrict or prohibit access to the hospital by duly designated ombudsman who are performing their official duties on behalf of hospital inpatients who have been admitted from, or who are awaiting readmission to, a residential health care facility licensed under article 28 of the Public Health Law, or an adult care facility licensed under section 461-b of the Social Services Law.
(2) The hospital and the hospital staff shall permit and not interfere with confidential visits and communications between such inpatients and such ombudsman except in the case of in-person visits which are medically contraindicated. Such medical contraindication shall be documented for that patient by the attending practitioner in the patient's medical record.
(3) The hospital and the hospital staff shall not retaliate or take reprisals against any patient, employee or other person, who has filed a complaint with, or provided information to, such ombudsmen.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.132 Hypodermic syringes and needles; designation of persons or classes of persons
(a) The following persons or classes of persons may obtain hypodermic syringes and hypodermic needles without prescription for use within the scope of their professions or activities:
(1) physicians;
(2) dentists;
(3) veterinarians;
(4) undertakers;
(5) nurses;
(6) podiatrists;
(7) registered pharmacists;
(8) hospitals;
(9) sanitariums;
(10) clinical laboratories;
(11) medical institutions;
(12) manufacturers or dealers in medical, pharmaceutical, surgical or dental supplies or their agents;
(13) resident physicians or interns of hospitals, sanitariums or other medical institutions;
(14) a duly authorized agent of an incorporated society for the prevention of cruelty to animals or a municipal animal control facility for the limited purpose of purchasing, possessing and dispensing:
(i) sodium pentobarbital to registered or certified personnel to euthanize animals; and
(ii) ketamine hydrochloride to registered and certified personnel to anesthetize animals prior to euthanasia;
(15) persons engaged in an agricultural activity, provided that the manufacturer, distributor or supplier of the hypodermic syringe or hypodermic needle or of any product pre-packaged in a hypodermic syringe has an established needle and syringe return program in compliance with any applicable law;
(i) for purposes of this section, agricultural activity shall mean the production of food for human consumption and fiber through crops, livestock and livestock products;
(16) an advanced life support agency;
(17) persons certified by the New York State Department of Environmental Conservation as wildlife rehabilitators. Wildlife rehabilitators are responsible for the proper safeguarding and handling of hypodermic syringes and needles and must comply with section 80.133(h)-(j) of this Part. All needles and syringes shall be stored in compliance with section 80.133(g) of this Part;
(18) licensed respiratory therapists and licensed respiratory therapy technicians;
(19) certified home health agencies, licensed home care services agencies and long term home health care programs approved under article 36 of the Public Health Law; and
(20) certified hospices licensed under article 40 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH ENGINEER PUBLIC HEALTH ENGINEER
10 CRR-NY 11.102 Supervisory level qualifications
A supervising public health engineer must be licensed and register to practice professional engineering and have two years, experience as a public health engineer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.202 Medical staff classification—associate
New applicants are generally appointed as associate staff members for a period of two to four years, after which they become members of the attending staff.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.23 Reporting emergencies
(a) The supplier of water shall not take, use, or cause to be taken for use water from any emergency source or stop or alter disinfection or other treatment processes without first having notified by telephone or telegram, and received the approval of, the State. On receipt of such notification, the State shall advise the supplier of water and interested local officials of the approved action or proposed action by the supplier of water to protect the public health during the emergency.
(b) The supplier of water must make State notification when he determines that the delivery of water is interrupted to a minimum of 25 individuals or 15 service connections, or to a minimum of one percent of the total number of individuals served or service connections, whichever is larger, for a period of four hours or more.
(c) A printed copy of this section shall be conspicuously posted in the office used by the supplier of water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 93 IMPROPER PRACTICES IN HOSPITAL STAFF APPOINTMENTS AND EXTENSION OF PROFESSIONAL PRIVILEGES
10 CRR-NY 93.5 Action by the Public Health Council
(a) If the Public Health Council shall determine, after investigation, that cause exists for crediting the allegations of the complaint, the Public Health Council shall promptly advise the complainant and the governing body of the hospital, against which the complaint was made, of its findings, the reasons for crediting the allegations of the complaint and direct the governing body of the hospital to review its actions.
(b) If the Public Health Council shall determine after investigation, that cause does not exist for crediting the allegations of the complaint, the Public Health Council shall promptly notify the complainant and the governing body of the hospital against which the complaint was made of its findings and reasons for not crediting the allegations of the complaint.
Chapter III PUBLIC WATER SUPPLIES
Subchapter C WATER SUPPLY SOURCES
Part 170 SOURCES OF WATER SUPPLY
10 CRR-NY 170.4 Standards of raw water quality
Every source of water supply to which this Part is applicable shall meet the standards of quality hereinafter set forth and shall be protected from and free of contamination.
| Items | Specifications | | --- | --- | | 1. Floating solids: settleable solids; oil; sludge deposits; tastes or odor producing substances | None attributable to sewage, industrial wastes or other wastes. | | 2. Sewage or waste effluents | None which are not effectively disinfected. | | 3. pH | Range between 6.5 and 8.5. | | 4. Dissolved oxygen | For trout waters, greater than 5.0 parts per million; for nontrout waters greater than 4.0 parts per million. | | 5. Toxic wastes, oil, deleterious substances, colored or other wastes or heated liquids | None alone or in combination with other substances or wastes in sufficient amounts or at such temperatures as to make the waters unsafe or unsuitable as a source of water supply for drinking, culinary or food processing purposes. Provided further, that the concentration or quantity of the constituents or characteristics hereinafter set forth shall not exceed the allowable limits established therefor. |
| Constituent or characteristic | Allowable Units | | --- | --- | | Physical | | | Turbidity | 5 units | | Microbiological | | | Coliform organism | 50 per 100 ml. | | Inorganic chemicals | (Concentration in mg/1) | | Ammonia (NH2) | <2.0 | | Arsenic (As) | 0.05 | | Barium (Ba) | 1.0 | | Boron (B) | 1.0 | | CCE | 0.2 | | Cadmium (Cd) | 0.01 | | Chloride (Cl) | 250. | | Chromium (Hexavalent) (Cr+6) | 0.05 | | Copper (Cu) | <0.2 | | Cyanide (CN) | <0.1 | | Flouride (F) | <1.5 | | Lead (Pb) | 0.05 | | Mercury (Hg) | 0.005 | | Nitrates (NO3) + Nitrates (NO2) | 10. | | Selenium (Se) | 0.01 | | Silver (Ag) | 0.05 | | Sodium (Na) | <20. | | Sulfate (SO4) | 250. | | Total dissolved solids | 500. | | Uranyl ion | <5.0 | | Zinc (Zn) | <0.3 | | Organic Chemicals | (Concentration in mg/1) | | Organic nitrogen | 0.5 | | Oxygen consumed | 2.0 | | Phenols | 0.001 | | Pesticides | | | Aldrin | 0.007 | | Chlordane | 0.003 | | DDT | 0.042 | | Dieldrin | 0.017 | | Endrin | 0.001 | | Heptachlor | 0.013 | | Heptachlor epoxide | 0.013 | | Herbicides | 0.1 | | Lindane | 0.053 | | Methoxychlor | 0.065 | | Organic phosphates + carbamates | 0.1 | | Toxaphene | 0.005 | | Radioactivity | (Concentration in pc/1) | | Gross beta | 1000. | | Radium-226 | 3. | | Strontium-90 | 10. |
Chapter IV HEALTH INFORMATION SYSTEMS
Part 360 SURGE AND FLEX HEALTH COORDINATION SYSTEM ACTIVATION DURING A STATE DISASTER EMERGENCY DECLARATION
10 CRR-NY 360.3 Hospital emergency Surge and Flex response plans
(a) Every general hospital (hereinafter, hospital) shall adopt a detailed emergency Surge and Flex Response Plan (hereinafter, plan) that, at a minimum, includes the following elements:
(1) Bed surge plan.
The plan shall explain how the hospital will increase the number of current staffed acute care operational beds to a number set by the commissioner, which shall be up to a 50 percent increase of such beds within 7 days from the date of the declaration of the State disaster emergency, and up to a 100 percent increase within 30 days. For the purposes of this Part, an acute care operational bed means a bed that is staffed and equipped with appropriate infrastructure such that it can be used to deliver health care services to a patient. The commissioner may further define the type of acute care operational beds for a given State disaster emergency, which may include isolation beds, intensive care (ICU) beds, pediatric and/or acute care beds.
(2) PPE surge plan.
The plan shall explain how the hospital will increase its supply of personal protective equipment (PPE) appropriate for use in a pandemic to achieve continuous maintenance of its required 90-day supply of PPE within 30 days, based on a usage rate determined by the commissioner, pursuant to section 405.11(g) of this Title. The plan shall list the contracted entities or other supply chain agreements executed by the hospital. Such plan shall further include, as appropriate, how the hospital will repurpose existing equipment, replenish the inventory from other areas of the health system, and establish cooperative agreements to obtain PPE to accommodate supply chain interruptions.
(3) Mass casualty plan.
The plan shall explain how the hospital will receive and treat mass casualty victims, in the event of a secondary disaster arising from the interruption of normal services resulting from an epidemic, earthquake, flood, bomb threat, chemical spills, strike, interruption of utility services, nuclear accidents and similar occurrences, while addressing the continued need for surge capacity for the underlying State disaster emergency declaration.
(4) Staffing plan.
The plan shall explain how the hospital will: identify and train backups for employees who may be unable to report to work during a pandemic; institute employee overtime protocols; and increase staffing by inter- and intra-system loan, cross-training, and volunteer programs, which would be operational on seven days’ notice.
(5) Capital plan.
The plan shall explain how the hospital shall ensure continuous operation of facilities and access to utilities, materials, electronic devices, machinery and equipment, vehicles, and communication systems. The plan shall ensure that the hospital routinely performs all required maintenance and peak load testing of its infrastructure systems, including: electrical, heating, ventilation and air conditioning (HVAC), and oxygen supply.
(b) The Chief Executive Officer (CEO) of the hospital, or system, if authorized by the commissioner to report on a system-wide basis, shall certify to the review and approval of the plan and including an attestation that it can be implemented and achieved in the event of a declared disaster emergency. The CEO shall be responsible for ensuring that the plan is reviewed and updated, as necessary, every six months and shall re-certify that it is able to be implemented and achieved upon each review.
(c) The department may require the hospital to submit its disaster emergency response plan and history of semi-annual certifications for review, and may require the hospital to make such amendments to the plan as the commissioner deems appropriate, to ensure that the plan will achieve the requirements established in subdivision (a) of this section, including increases in bed capacity.
(d) In the event of a declared State disaster emergency, any or all hospitals shall execute their plans immediately upon the direction of the commissioner.
(e) Additional preparedness requirements.
(1) PPE.
Every hospital shall, at all times, continue to maintain the required 90-day supply of PPE appropriate for use in a disaster emergency including a pandemic, based on a usage rate and determined by the commissioner, and pursuant to section 405.11(g) of this Title.
(2) Information technology.
Every hospital shall ensure that non-essential staff who are capable of working remotely in the event of an emergency are equipped and trained to do so, and that infrastructure is in place to allow for the repurposing of existing workspaces as needed when activating the Surge and Flex System.
(f) Reporting requirements during the activation of the Surge and Flex System.
(1) In the event of a declared State disaster emergency, upon the commissioner’s direction, hospitals shall report to the department all data requested by the commissioner, in a manner determined by the commissioner under section 360.2 of this Part. Such data may include, but shall not be limited to:
(i) bed availability, both in total and by designated service;
(ii) bed capacity, meaning acute care operational beds as defined in paragraph (a)(1) of this section;
(iii) patient demographics;
(iv) other health statistics, including deaths;
(v) PPE and other supplies, in stock and ordered;
(vi) PPE and other supply usage rates.
(2) Such reports shall be submitted every 24 hours, except and unless otherwise directed by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.53 Gift shop
This functional reporting center must contain all the expenses associated with the operation of a gift shop maintained on the premises of the residential health care facility. This would include the provision of space for the maintenance of a gift shop, as well as direct salaries and incurred expenses in gift shop operations.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-3 HEALTH MAINTENANCE ORGANIZATIONS
10 CRR-NY 86-3.3 Rates for hospital services
Hospitals certified under article 28 of the Public Health Law may not deny admission solely on grounds of HMO membership. This section applies to the general prepaid membership of an HMO; Medicare and Medicaid reimbursement for such services shall be as described in subdivision (h) of this section. Reimbursement to be paid by HMO's to hospitals for these services shall be determined as follows:
(a) Hospitals certified under article 28 of the Public Health Law shall be reimbursed for the inpatient care of HMO members at a rate which does not exceed the DRG case based rates of payment, adjusted for noncovered services determined pursuant to section 86-1.51(a) of this Title, or equivalent mechanism for the local area if rates are not being used. Hereafter these rates shall be called DRG case based rates. No supplementary charges may be made by a hospital except as specified in subdivision (c) or (d) of this section.
(b) When there is more than one DRG case based rate in effect at a hospital, the rate covering the most comprehensive range of services utilized by HMO patients shall be the HMO rate, unless the difference between the comprehensive rate and a less inclusive rate is due to categories of services not utilized in care of HMO inpatients, in which case the less inclusive rate shall be utilized.
(c) When the HMO inpatient utilizes physician or ancillary services whose allowable costs are not included in the DRG case based rate being utilized, for example, anesthesiologist services if not included in the DRG case based rate, reimbursement for such services shall be negotiated by the HMO and the hospital or provider.
(d) In cases of nonmedically ordered patient comfort or amenity services not covered by the DRG case based rate, a hospital may bill an HMO member or HMO plan according to local practice or agreement with the HMO.
(e) Health maintenance organizations, except those affected by outpatient rate provisions certified pursuant to hospital reimbursement formulas submitted under Subpart 86-1 of this Part, shall submit proposed outpatient reimbursement formulas which are reasonable and adequate to meet the costs which must be incurred by efficiently and economically operated facilities. In order to enable the full exchange of information between health maintenance organizations and hospitals, as may be necessary for submission and consideration of the proposed outpatient reimbursement formulas as required hereunder and to minimize potential litigation resulting from approval hereunder of any reimbursement formula and rates submitted without benefit of such full information from hospitals, each such health maintenance organization or a group of health maintenance organizations may confer with a hospital, group or association of hospitals, prior as well as subsequent to submission of its proposed reimbursement formula and rates, concerning the reimbursement formula and rates to be submitted for consideration and approval hereunder. Concerning any such conference with any group or association of hospitals, the State Commissioner of Health may require from any such health maintenance organizations such report, by way of summary minutes or otherwise, as may be reasonably necessary to the discharge of the responsibilities of the commissioner under this subdivision. However, nothing in this subdivision shall prohibit an individual HMO and an individual hospital from mutually agreeing to any other manner of payment for outpatient services, provided the commissioner first approves such alternate method of payment.
(f) Notwithstanding the provisions of sections 86-1.51 and 86-1.57 of this Part, health maintenance organizations operating in accordance with the provisions of article 43 of the Insurance Law, or article 44 of the Public Health Law may arrange special payment rate methodologies with hospitals provided that the commissioner has been notified of the proposed arrangement, has reviewed such proposed arrangement and has approved the arrangement in writing. Such an arrangement shall not be approved if it will result in payments to the hospital for inpatient services provided to subscribers of health maintenance organizations which in the aggregate are less than what the hospital would have otherwise received under the provisions of this Subpart and Subpart 86-1 of this Part, unless the health maintenance organization demonstrates that lower payments are justified because the arrangement will result in lower hospital costs and the payments approximate cost. Notwithstanding any inconsistent provision of this section, for the period January 1, 1988 through December 31, 1990, negotiated agreements between health maintenance organizations and general hospitals which were approved by the commissioner in accordance with the provisions of chapter 906 of the Laws of 1985 and which were in effect on June 1, 1987 may continue.
(g) Nothing in this Subpart shall prohibit article 44 HMO's from contracting with article 43 hospital service plans for hospital reimbursement and/or other services, subject to the requirements of the Superintendent of Insurance.
(h) Notwithstanding any inconsistent provisions of this section, health maintenance organizations operating in accordance with the provisions of article 43 of the Insurance Law or article 44 of the Public Health Law, having enrollees eligible for inpatient general hospital payments as beneficiaries of title XVIII of the Federal Social Security Act (Medicare) shall reimburse general hospitals for inpatient services for these enrollees in accordance with the provisions contained in title XVIII of the Federal Social Security Act (Medicare). Hospitals shall receive Medicaid rates of payment for the care of HMO/Medicaid clients.
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.17 Appeal process
(a) An application by a facility for review of a certified or approved rate pursuant to section 86-4.16 of this Subpart shall be submitted to the bureau for staff review and shall set forth the basis for the appeal and the issues of fact. Documentation shall accompany the application, where appropriate, and the department may request such additional documentation as is necessary for determination of the issues. The affirmation or revision of the rate based upon such staff review shall be final unless, within 30 days of its receipt, a hearing before a rate review officer is requested by registered or certified mail. The request shall contain a statement of the factual issues to be resolved. The facility may submit memoranda on legal issues which it deems relevant to the appeal.
(b) Where the rate review officer determines that there is no actual issue, the request for a hearing shall be denied and the facility shall be notified of such determination. No administrative appeal shall be available from this determination. Where the rate review officer determines that there is a factual issue, a notice of hearing shall be issued establishing the date, time and place of the hearing and setting forth the factual issues as determined by such officer. The hearing shall be held in conformity with the provisions of section 12-a of the Public Health Law and the State Administrative Procedure Act.
(c) The recommendation of the rate review officer shall be submitted to the Commissioner of Health for final approval or disapproval and recertification of the rate where appropriate.
(d) In reviewing appeals for revisions to certified or approved rates, the commissioner may refuse to accept or consider an appeal from a facility:
(1) which is providing an unacceptable level of care as determined after review by the State Hospital Review and Planning Council;
(2) which is operated by management determined by the department to be providing an acceptable level of care in one of its facilities as determined after review by the State Hospital Review and Planning Council;
(3) where it has been determined by the commissioner that the operation is being conducted by a person or persons not properly established in accordance with the Public Health Law; or
(4) where a fine or penalty has been imposed on the facility and such fine or penalty has not been paid.
(e) If an appeal or application by a facility affects only the facility's article 43 rate, the facility must appeal or make application to the article 43 corporation for a change or revision in its article 43 rate within the time periods set forth in this Subpart. If the article 43 corporation recommends that such appeal or application be granted, it shall forward such recommendation to the commissioner for determination. If the article 43 corporation denies such appeal or application, the facility may, within 30 days after receipt of the denial, appeal such determination to the commissioner. The basis upon which a facility may appeal or make application for a change or revision in its article 43 rate shall be the same as the basis for an appeal or application set forth in this Subpart.
(f) If an appeal or application by a facility for a change or revision in its rate of reimbursement paid by government agencies and determined pursuant to this Subpart also affects the facility's approved article 43 rate, the facility shall forward a copy of its appeal or application to the article 43 corporation at the same time the facility submits the appeal or application to the commissioner. The article 43 corporation shall forward any recommendation for a determination of such appeal or application to the commissioner. Upon the commissioner's determination, the article 43 corporation shall send a copy of such determination to the facility.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.5 Revocation, limitation or annulment of approvals of establishment
(a) An approval of establishment may be revoked, limited or annulled by the Public Health Council if the council finds:
(1) that the established operator has been guilty of fraud or deceit in procuring such approval of establishment or has made statements or furnished information in support of the application which were not true, accurate, or complete in any material respect;
(2) that the operating certificate of a hospital has been revoked, limited or annulled pursuant to the applicable provisions of law;
(3) that a hospital caused or allowed a patient to be subjected to violence or abuse by an employee, consultant, volunteer or other person serving in any capacity in the hospital or that a hospital has failed to comply with the provisions of article 28 of the Public Health Law or the rules and regulations promulgated thereunder;
(4) that the established operator has had such a change in his financial condition or in the fiscal aspects of the proposed institution since the approval of establishment as to render the project economically unfeasible or render unsatisfactory the financial resources of the proposed institution and its sources of future revenue;
(5) that the established operator has been convicted in a court of competent jurisdiction, either within or without the State, of a crime;
(6) that the established operator is an habitual drunkard or is addicted to the use of morphine, cocaine or other drugs having similar effect; or has become mentally disabled;
(7) that the established operator has transferred his ownership interest in the operation of the facility without Public Health Council approval, and that such person has terminated his participation in the operation of the facility;
(8) that there has been a violation of section 610.4(a) of this Title;
(9) that the established operator has granted any person convicted of a crime relating to hospital activities the authority to direct or cause the direction of the operations, management or policies of the facility;
(10) that the established operator has failed to comply fully with any condition, limitation or other requirement imposed as part of, or in conjunction with, the approval of establishment; or
(11) that the applicant has failed to commence and complete construction within the time period determined under Part 710 of this Title.
(b) For purposes of this section, established operator shall include any person, partnership or partner thereof, and any corporation or stockholder, officer or director thereof, actual or proposed, whose application for establishment has been approved, regardless of whether an operating certificate has been issued.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.5 Responsibility for radiation safety
No person shall operate or permit the operation of a radiation installation nor shall the person operate, transfer, receive, possess or use or permit the operation, transfer, receipt, possession or use of any radiation source unless that person:
(a) achieves occupational doses and doses to members of the public as low as is reasonably achievable (ALARA). Such effort shall include, to the extent practicable, the use of procedures and engineering controls which are based on sound radiation protection principles;
(b) develops, documents and implements a radiation protection program commensurate with the scope and extent of the radiation activities engaged in by the radiation installation. This program shall be designed to ensure compliance with the provisions of this Part;
(c) provides a radiation safety officer as described in section 16.2(a)(99) of this Part. The radiation safety officer shall be delegated authority to ensure the implementation of this radiation protection program and shall be responsible for the day-to-day conduct of the program. For licensed radioactive materials installations either the radiation safety officer, or an authorized user designated to act in his/her absence, shall be present on the premises at least 50 percent of the time that radioactive material is being handled or equipment containing radiation sources is being operated;
(d) provides for a radiation safety committee to administer the radiation protection program in hospitals and institutions of higher education. The committee shall include the facility operator or a person with the authority to act on behalf of the facility operator, and representation from departments within the facility where radiation sources are used. The committee shall approve all uses of radiation-producing equipment and radioactive materials within the facility, shall review the activities of the radiation safety officer, and shall review the radiation protection program at least annually. The committee, or a subcommittee, shall also oversee the administration of a quality assurance program, as required by subdivision (e) of this section;
(e) provides a quality assurance program for diagnostic and therapeutic uses of radiation producing equipment and radioactive materials pursuant to section 16.23 and other applicable sections of this Part;
(f) ensures that all personnel involved in planning for or administering radiation doses to humans, or in the use of radiation-producing equipment or radioactive materials for other purposes, are supervised, and are instructed, as described in section 16.13(c) of this Part, and competent to safely use such radiation equipment or other radiation sources and services;
(g) ensures that radiation equipment is used only for those procedures for which it is designed; and
(h) ensures that acceptance testing of all medical and chiropractic diagnostic equipment, and treatment and planning equipment for radiation therapy, is performed before first use of such equipment on humans by an individual competent to perform such testing.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-1.198 Closure
When action is taken to order closure and cessation of operations, the permit-issuing official or his designated representative is to:
(a) conspicuously post a notice or placard at each entrance of the establishment stating the existence of such order and the authority for such order. This order is not to be concealed, mutilated or altered by any person, or removed without permission of the permit-issuing official; and
(b) publish notice of the order, with the reasons for the order, in one or more newspapers in the county or city in which the food service establishment is located.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.9 Confidentiality
(a) Except as hereinafter provided, any report, record of the investigation of such report and all other information related to such report shall be confidential and shall be exempt from disclosure under article 6 of the Public Officers Law.
(b) Information relating to a report made pursuant to this Part shall be disclosed under any of the following conditions:
(1) pursuant to article 6 of the Public Officers Law, after expungement or amendment, if any, is made in accordance with a hearing conducted pursuant to this Part, or at least 45 days after a written determination is made by the commissioner concerning such report, whichever is later, provided, however, that the identity of the person who made the report, the victim, or any other person named, except a person who the commissioner has determined committed an act of physical abuse, neglect or mistreatment, shall not be disclosed unless such person authorizes such disclosure;
(2) as may be required by the Penal Law or any lawful order or warrant issued pursuant to the Criminal Procedure Law; or
(3) to a person who has requested a hearing pursuant to this Part, information relating to the determination upon which the hearing is to be conducted; provided, however, that the identity of the person who made the report or any other person who provided information in an investigation of the report shall not be disclosed unless such person authorizes such disclosure.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-1 SCHOOL IMMUNIZATION REQUIREMENTS
10 CRR-NY 66-1.6 Certificate of immunization
The certificate of immunization required in section 66-1.3(a) of this Subpart shall be prepared and signed by a health practitioner licensed in New York State and shall specify the products administered and the dates of administration. It may also show physician, nurse practitioner, or physician assistant-verified history of varicella disease and/or positive serologic tests for measles, mumps, rubella, varicella, and/or Hepatitis B and/or laboratory confirmation of disease for measles, mumps, rubella and/or varicella. Certificates of immunization issued prior to September 1, 2019 may also show positive serologic tests for all three serotypes of poliomyelitis contained in the polio vaccines. A record issued by NYSIIS, the CIR, an official immunization registry from another state, an electronic health record, and/or an official record from a foreign nation may be accepted as a certificate of immunization without a health practitioner’s signature.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
GARBAGE AND REFUSE GARBAGE AND REFUSE
10 CRR-NY 14-1.150 Garbage and refuse storage and disposal
Garbage and refuse are to be stored, handled and disposed of in a manner that protects food and food-contact surfaces from contamination and the premises from litter.
(a) Garbage and refuse is to be kept in durable, easily cleanable, insect-proof and rodent-proof containers. Plastic and wet-strength paper bags may be used to line garbage and refuse containers and for storage inside the food service establishment.
(b) Garbage and refuse containers in food preparation and utensil washing areas are to be covered when not in use, and after they are filled.
(c) Garbage and refuse containers stored outside the establishment, and dumpster, compactors and compactor systems, are to be easily cleanable, provided with tight-fitting lids, doors or covers, and kept covered when not in actual use. In containers designed with drains, drain plugs are to be in place at all times except during cleaning.
(d) A sufficient number of containers are to be provided to hold all the garbage and refuse that accumulates between periods of pickup and removal. Containers are to be cleaned at a frequency to prevent insect and rodent attraction.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.134 Fixed cost (or expense)
An operating expense, or operating expense as a class, that does not vary with business volume. Examples: interest on bonds; rent; property tax; depreciation (sometimes in part); minimal amounts of general overhead. Fixed costs are not fixed in the sense that they do not fluctuate or vary; they vary, but from causes independent of volume.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.2 Definition
For the purpose of this Subpart, personal health-related information means any information concerning the health of a person which identifies or could reasonably be used to identify a person.
Chapter III PUBLIC WATER SUPPLIES
Subchapter B MISCELLANEOUS
Part 158 INTERSTATE WATERS
10 CRR-NY 158.1 Greenwich Water Company (Mianus River)
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 602 of the Laws of 1927, shall apply to all those portions of the Mianus River which are situated within the State of New York (Westchester County) lying above the intake of the Greenwich Water Company of Greenwich, Connecticut, as well as to every spring, stream, ditch, gutter, drain or watercourse of any kind, the waters of which when running eventually flow into the Mianus River within this State above such intake.
(b) [Definitions.]
(1) The term watercourse wherever used in this section is intended to mean and refer to any spring, stream, ditch, gutter or other channel, permeable pipe, conduit or watercourse of every kind, the water of which when running, whether continuously or occasionally, eventually flow* or may flow into the water supply of the Greenwich Water Company.
(2) Wherever a linear distance of a structure or object from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any watercourse.
(1)
(i) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, maintained or allowed to remain within 50 feet of any watercourse tributary to the public water supply of the Greenwich Water Company, except the properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (f), provided, however, that the property on which the privy, privy vault, pit, cesspool or any other receptacle intended for the deposit of human excreta is built or to be built is so located, bounded or otherwise placed that the distance above named can be obtained within the limits of such property.
(ii) Every privy, privy vault, pit or other receptacle used or intended for either the temporary storage or the permanent deposit of human excreta and built on property which is so located, bounded or otherwise placed that the distance named in subparagraph (i) of this paragraph cannot be obtained within the limits of such property shall be placed as far as possible from any watercourse tributary to the public water supply of the Greenwich Water Company and especially constructed of masonry, concrete or metal to form a watertight receptacle from which no outward percolation can take place. Where removable watertight vessels or receptacles are provided, they shall be placed in watertight concrete or masonry receptacles and shall be located as far as practicable from any watercourse tributary to the public water supply of the Greenwich Water Company. All receptacles referred to in this subparagraph shall be constructed only with the approval of and under the supervision of the Greenwich Water Company and so located that the tops of such receptacles shall be above the highest known water level of the tributary watercourse.
(iii) Whenever a privy, privy vault, pit or other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta is especially constructed and made watertight and located nearer any watercourse tributary to the public water supply of the Greenwich Water Company than the distance named in subparagraph (i) of this paragraph, such receptacle shall be emptied at regular intervals and disinfected as often as may be necessary to maintain it in a proper sanitary condition and to effectually prevent any overflow and, in the case of the properties occupied by the owners during the summer only, the said receptacles shall be emptied at least once every fall at the end of the summer season, disinfected with lime and left empty during the winter. The work of emptying and disinfecting these receptacles shall be done under the supervision of or in accordance with the directions of the Greenwich Water Company and in such a manner as to effectually prevent any pollution of the public water supply of the Greenwich Water Company.
(2) No privy, privy vault, pit, cesspool or any other receptacle which is not watertight, placed or used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 70 feet of any watercourse tributary to the public water supply of the Greenwich Water Company, except the properly constructed and operated sewage disposal plant as hereinafter set forth in paragraph (2) of subdivision (f).
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall at all times be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 200 feet from any reservoir or watercourse tributary to the public water supply of the Greenwich Water Company.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or of surface wash or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or receptacle aforesaid or from any trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any watercourse tributary to the public water supply of the Greenwich Water Company, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered by the State Commissioner of Health to be safe and proper.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes or other excremental matter from any water closet, privy, cesspool or other source, except the effluent from a properly constructed and maintained sewage disposal plant as hereinafter provided under paragraph (2) of subdivision (f), shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any watercourse tributary to the public water supply of the Greenwich Water Company nor shall any liquid or solid matter be thrown, placed, led, conducted, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 50 feet of any watercourse tributary to the public water supply of the Greenwich Water Company.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, milk station, laundry, nor water in which milk cans, utensils, clothes, bedding, carpets or harness have been washed or rinsed, nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any watercourse tributary to the public water supply of the Greenwich Water Company.
(3) No clothing, bedding, carpets, harness, vehicle, receptacle, utensil nor anything that in any way pollutes water shall be washed, rinsed or placed in any watercourse tributary to the public water supply of the Greenwich Water Company.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogpen, hogyard, poultry yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 40 feet, horizontal measurement, along the line of surface drainage from any watercourse tributary to the public water supply of the Greenwich Water Company, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain at such points or in such manner that the drainage, leachings or washings therefrom may enter any watercourse tributary to the aforementioned supply without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 40 feet before entering any watercourse of the public water supply of the Greenwich Water Company.
(2) No manure or compost of any kind shall be placed, piled or spread upon the ground within 25 feet of any watercourse of the public water supply of the Greenwich Water Company.
(3) No human excrement or compost containing human excrement shall be thrown, placed or allowed to escape into any watercourse nor be placed, piled or spread upon the ground nor dug or buried in the soil within a distance of 200 feet from any watercourse tributary to the public water supply of the Greenwich Water Company.
(f) Dead animals, offal, manufacturing wastes, etc.
(1) No dead animal, bird, fish or any part thereof nor any offal or refuse from any slaughterhouse nor any decomposable or putrescible refuse or waste matter of any kind shall be thrown, placed in or allowed to pass into any watercourse tributary to the public water supply of the Greenwich Water Company nor shall any such material be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any watercourse tributary to the public water supply of the Greenwich Water Company without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any watercourse tributary to the public water supply of the Greenwich Water Co.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any watercourse tributary to the public water supply of the Greenwich Water Company, shall be constructed, enlarged, altered or put in operation until plans for the same shall have been approved by and a permit secured from the State Commissioner of Health allowing the discharge of such effluent and a copy of the plans approved filed with the Greenwich Water Company.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 100 feet of any watercourse tributary to the public water supply of the Greenwich Water Company.
(h) Inspections.
The duly authorized officials of the Greenwich Water Company or any other person or persons who may be charged with the maintenance or supervision of the public water supply of said company or its duly appointed representative shall make regular and thorough inspections of the watershed to which these rules and regulations apply for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the company to promptly notify the State Commissioner of Health of such violations. The company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with, any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.7 References
(a) The following laws, guidance documents, regulations or technical material have been incorporated by reference in this Part. These references are available for inspection and copying at the Department of Environmental Protection, Bureau of Water Supply, Quality and Protection, 465 Columbus Avenue, Valhalla, NY, 10595, and at the New York State Department of Health, Office of Regulatory Affairs, Tower Building, Room 2415, Empire State Plaza, Albany, NY 12237, or can be directly obtained from the sources listed for the given reference.
(1) Federal Categorical Pretreatment Standards, 40 CFR part 403, 1992, Superintendent of Documents, United States Government Printing Office, Washington, DC 20402.
(2) USDA Soil Conservation Service Soil Type Boundaries, USDA SCS, Room 771, Federal Building, 100 South Clinton Street, P.O. Box 7248, Syracuse, NY 13261-7248.
(3) Standard Methods for the Examination of Water and Wastewater, 12th edition, 1965, Table 18, Qualitative Description of Odors, page 306, American Public Health Association, American Water Works Association, and Water Pollution Control Federation, 2626 Pennsylvania Avenue NW, Washington, DC 20037.
(4) Standard Methods for the Examination of Water and Wastewater, 18th edition, 1992, American Public Health Association, American Water Works Association, and Water Environment Federation, 2626 Pennsylvania Avenue NW, Washington, DC 20037.
(5) Methods for Chemical Analysis of Water and Wastes , 1979, Environmental Protection Agency (EPA), Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402.
(6) State Environmental Quality Review Act, New York State Environmental Conservation Law, article 8 (ECL section 8-0101, et seq. ), Department of State, 41 State Street, Albany, NY 12231.
(7) New York State Fire Prevention and Building Code, New York State Executive Law (Executive Law, section 370, et seq. ), Department of State, 41 State Street, Albany, NY 12231.
(8) Public Water Supplies; Sewerage and Sewage Control, New York State Public Health Law, article 11 (PHL section 1100, et seq. ), Department of State, 41 State Street, Albany, NY 12231.
(9) Classifications and Standards of Quality and Purity, 6 NYCRR Parts 701 and 703, Department of State, 41 State Street, Albany, NY 12231.
(10) Standards for Individual Water Supply and Wastewater Treatment Systems, 10 NYCRR Part 75 and Appendix 75-A, Department of State, 41 State Street, Albany, NY 12231.
(11) New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.1.1, Ambient Water Quality and Guidance Values (October 22, 1993), New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12233.
(12) New York State Department of Environmental Conservation of Technical and Operational Guidance Series (TOGS) 1.3.1, Total Maximum Daily Loads and Water Quality-Based Effluent Limits (July 8, 1996).
(13) New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.3.1 B. Total Maximum Daily Loads and Water Quality-Based Effluent Limits, Amendments-Low and intermittent Stream Standards (July 8, 1996), New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12233.
(14) New York State Environmental Conservation SPDES General Permit for Storm Water Discharges from Construction Activities, Permit No. GP-93-06, Dated July 14, 1993, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12233.
(15) Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities, 1988, New York State Department of Environmental Conservation, 50 Wolf Road, Albany, NY 12233.
(16) Recommended Standards for Wastewater Facilities, Great Lakes—Upper Mississippi River, 1990, Board of State Public Health and Environmental Managers, Health Education Services, P.O. Box 7126, Albany, NY 12224.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 40-2.1 General provisions concerning State aid eligibility
(a) Core public health services are eligible for State aid reimbursement only if such services are included in an approved State aid application and only if performed in accordance with this Subpart.
(b) Local health departments may contract for core public health services provided, however, that:
(1) to remain eligible for State aid, any contract for core public health services must require that:
(i) core public health services shall be performed under the general supervision and control of the local health department commissioner or public health director;
(ii) if a contract relates to a core public health service for which a fee must be collected pursuant to section 40-1.51 of this Part, the contractor shall make every reasonable effort to collect such fee and, for clinic health services, the contractor shall make every reasonable effort to collect third-party reimbursement and any relevant co-payments; and
(iii) the contractor shall report to the local health department all fees, co-payments, and third-party reimbursement collected;
(2) pursuant to section 616 of the Public Health Law, the local health department shall not claim as State aid eligible expenses any portion of the contract cost relating to indirect costs or fringe benefits, including but not limited to retirement funds, health insurance and Federal old age and survivors insurance; and
(3) when the local health department provides clinic services pursuant to section 40-2.2 of this Subpart through a contract with another provider, the commissioner has discretion to review and approve or disapprove the contract. When exercising such discretion, the commissioner shall examine factors including, but not limited to, the quality of the proposed contractor’s services, the ability the local health department to oversee the contracted services, and the contractor’s efficiency in delivering services.
(c) The following costs related to the facility space used by the local health department are eligible for State aid:
(1) rent paid to a person, a private entity, or a public entity other than the municipality that operates the local health department;
(2) for space owned by the municipality that operates the local health department, the cost of maintenance of space in lieu of rent (MILOR).
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-4.50 Food protection; potentially hazardous food, temperature and refrigeration requirements
(a) Food is to be protected from contamination during storage, preparation, display, service and transportation. The temperature of potentially hazardous food is to be 45°F (7.2°C) or below, or 140°F (60°C) or above, at all times except during necessary times of preparation. Intact shell egg temperatures shall be considered acceptable if ambient storage temperature is 45°F (7.2°C) or less.
(b) Packaged food is not to be stored in contact with water or undrained ice. Ice intended for human consumption is not to be used as a medium for cooling stored food, food containers or food utensils.
(c) Food which is not readily identifiable is to be stored in properly labeled original product containers or in containers labeled to identify the food by common name.
(d) Shell eggs or foods containing shell eggs are to be heated to 145°F (62.8°C) or greater unless an individual consumer requests preparation of a shell egg or food containing shell eggs in a style such as raw, poached or fried which must be prepared at a temperature less than 145°F in order to comply with the request.
(e) Every part of ground meat or foods containing ground meat are to be heated to 158°F (69.4°C) unless a consumer requests preparation of a single order of ground meat or food containing ground meat which must be prepared at a temperature less than 158°F in order to comply with the request.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.15 Shipment of recombinant DNA.*
Recombinant DNA molecules contained in an organism or virus shall be shipped only as an etiologic agent under requirements of the U.S. Public Health Service and the U.S. Department of Transportation (section 72.3, part 72, title 42, and sections 173.386-.388, part 173, title 49, U.S. Code of Federal Regulations) as specified in this section:
(a) Recombinant DNA molecules contained in an organism or virus requiring P1, P2, or P3 physical containment, when offered for transportation or transported, are subject to all requirements of section 72.3(a)-(e), part 72, title 42 CFR, and sections 173.386-.388, part 173, title 49 CFR.
(b) Recombinant DNA molecules contained in an organism or virus requiring P4 physical containment, when offered for transportation or transported, are subject to the requirements listed under subdivision (a) of this section and are also subject to section 72.3(f), part 72, title 42 CFR.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.6 Village of Florida
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law), as amended by chapter 510 of the Laws of 1921, shall apply to the entire drainage area of Glenmere Lake which forms the source of the public water supply of the village of Florida, Orange County, N. Y.
(b) [Definitions.]
(1) The term lake wherever used in this section is intended to mean Glenmere Lake.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond, stream, ditch, gutter or other channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into Glenmere Lake.
(3) Wherever a linear distance of a structure or object from the lake or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of the lake or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to lake or watercourse.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be placed, maintained or allowed to remain within 75 feet of the lake or any watercourse tributary to the public water supply of the village of Florida.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 500 feet of the lake or 250 feet of any watercourse tributary to the public water supply of the village of Florida.
(3) Every privy, privy vault, pit or other receptacle of any kind or place, used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all such excreta shall be received in suitable watertight receptacles and shall at all times be disposed of as hereinafter set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and deodorized as often as may be found necessary to maintain the privy in a proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape in being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to the occupants of the premises or of the adjoining premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall, when removed be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet of the lake or 250 feet of any watercourse tributary to the public water supply of the village of Florida.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil into the lake or any watercourse tributary to the public water supply of the village of Florida, then the said privy or receptacle for excreta or the trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or excremental matter from any water closet, privy or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into the lake or any watercourse tributary to the public water supply of the village of Florida, nor shall any such matter be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 500 feet of the lake and 250 feet of any watercourse tributary to the public water supply of the village of Florida.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged into the lake or any watercourse tributary to the public water supply of the village of Florida, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within a distance of 100 feet of the lake or any watercourse tributary to the public water supply of the village of Florida.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil, nor anything that pollutes water shall be washed, rinsed or placed in the lake or any watercourse tributary to the public water supply of the Village of Florida.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in Glenmere Lake within 1,000 feet of the intake of the public water supply of the Village of Florida, nor shall any animal or poultry be allowed to stand, wallow, wade or swim in Glenmere Lake or any watercourse tributary thereof nor be washed therein. No watering place of any kind shall be maintained in such a way as to pollute with muddy leachings or excremental matter the waters of the lake or any stream tributary to the public water supply of the Village of Florida.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet of the lake or any watercourse tributary to the public water supply of the Village of Florida, and none of the above-named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the lake or any tributary watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that the proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet of the lake or any watercourse tributary to the public water supply of the Village of Florida.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into the lake or tributary watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Florida, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 12 inches below the surface of the ground nor within a distance of 500 feet of the lake or 250 feet of any watercourse tributary to the public water supply of the Village of Florida, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet of the lake or any watercourse tributary to the public water supply of the Village of Florida.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into the lake or any tributary watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such place that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into the lake or any tributary watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above-mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering the lake or watercourse tributary to the public water supply of the Village of Florida.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into the lake or any watercourse tributary to the public water supply of the Village of Florida, nor shall any such material or refuse be so placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach the lake or tributary watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from the lake or any watercourse tributary to the public water supply of the Village of Florida.
(g) Fishing, boating, ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of Glenmere Lake, within 300 feet of the water supply intake of the Florida Water Works Company. Strict sanitary supervision shall be maintained by the water company over all ice-cutting operations on Glenmere Lake beyond the above-specified distance in order to prevent pollution of the supply from the workmen or horses engaged in the ice cutting.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from the lake or any watercourse tributary to the public water supply of the Village of Florida.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of the lake or any watercourse tributary to the public water supply of the Village of Florida.
(j) Inspections.
The Florida Water Works Company or such other board as may be charged with the maintenance or supervision of the public water supply of the Village of Florida or its duly appointed representative shall make regular and thorough inspections of Glenmere Lake and all streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violation, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the water company to promptly notify the State Commissioner of Health of such violations. The water company shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (the Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-1 TEMPORARY RESIDENCES (HOTELS, MOTELS AND CABIN COLONIES)
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 7-1.3 Permits to operate a temporary residence required; application, issuance, revocation, posting, inspection, access
(a) No person shall operate a temporary residence or cause or allow the same to be operated, without a permit from the permit-issuing official.
(b) Application for a permit shall be made on a form specified by the department, by the operator to the permit-issuing official at least 60 days before operation or the expiration of an existing permit or a change in name, owner or operator. For new construction, such application shall include a copy of the certificate of occupancy issued by the local code enforcement official.
(c) The permit-issuing official shall issue a permit if the temporary residence conforms or will conform at the time of operation to the requirements of this Subpart and will not present a danger to the health and safety of the occupants and general public. An applicant's past history of compliance or non-compliance will be a consideration in evaluating the previously mentioned criteria.
(d) A permit may be denied, revoked or suspended by the permit-issuing official or the State Commissioner of Health if the temporary residence is maintained, operated or occupied in violation of the Public Health Law, this Title or other applicable provisions of the uniform code. Before denial, suspension or revocation of a permit, or after receipt of a notice of violation, the operator shall have the right to appeal to the permit-issuing official, except that when a public health hazard exists, a permit may be temporarily suspended pending a hearing. A permit will also be revoked upon request of the operator or upon abandonment of the temporary residence operation. Following the revocation, an application shall be filed for a new permit before resumption of operation.
(e) A permit for a temporary residence shall be issued for a period of not more than three years from the date of issue. A permit shall not be transferable or assignable and shall expire upon a change of the operator of the temporary residence or upon the date specified by the permit-issuing official.
(f) The permit-issuing official or representative shall be allowed entry at any time for the purposes of inspection to any property operated as a temporary residence as defined by this Subpart.
(g) A permit issued for the operation of a temporary residence shall be posted in a conspicuous place on the premises.
(h) A separate permit shall be required to operate a children’s camp. A bathing beach, swimming pool, recreational aquatic spray ground or a food service establishment operated as part of a temporary residence, for which a permit is required under the provisions of this Subpart, shall not require the issuance of a separate permit.
(i) The permit-issuing official may establish procedures for the exchange of information with other State or local governmental agencies having responsibility for making health or safety inspections of buildings, including temporary residences as defined in this Subpart, and may utilize the information provided by any such agency in making a determination regarding the issuance, denial or revocation of a permit required by this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.48 Home health care
This functional reporting center must contain all the expenses associated with the provision of nursing care and professional and nonprofessional services to patients at their place of residence. Activities include but are not limited to the following functions which can be performed to patients outside the residential health care facility: nursing care; intravenous therapy; inhalation therapy; electrocardiology; physical therapy; occupational and recreational therapy; speech and hearing therapy; social services; dietary services; and housekeeping services.
(a) Standard unit of measure: number of home health patient visits.
The number of home health patient visits shall be the number of home health patients visited at their place of residence by representatives of the home health program.
(b) Data source.
The number of home health patient visits shall be the actual count obtained from home health services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.26 Exceptions
(a) When, for indications generally accepted by the medical community, an allogeneic donor who would not otherwise qualify to donate blood or blood components is found to be uniquely suited to meet a given patient's needs, exceptions may be made to the requirements in sections 58-2.2(b) and (c), 58-2.3(a), 58-2.4(c), and 58-2.15(c), (d) and (e) of this Subpart. Such exceptions shall be approved in writing by both the medical director of the blood bank collecting the blood or his/her physician designee, and the director of the transfusion service transfusing the blood or his/her physician designee. If donation under such circumstances presents an increased risk to the donor's health or safety, the donor shall be informed of the risk and must consent in writing to such donation. If the donation presents an increased risk to the recipient's health or safety, the written authorizations of the recipient's health care provider and the recipient or person legally authorized to consent on behalf of the recipient are also required. All such exceptions granted shall be reported to the department annually in a format designated by the department.
(b) Exceptions to the requirements of this Subpart, other than the exception specified in subdivision (a) of this section, may be granted by the department on a case-by-case basis and for a limited time only, if necessitated by a medical emergency or special medical conditions. Persons seeking an exception shall apply to the department as soon as possible and shall describe the nature of the emergency or special medical conditions and the exception requested. All such emergencies or special medical conditions must be documented in the medical record, and any action taken in response which is contrary to the requirements of this Subpart must be approved by the director of transfusion services. If it is not possible to request an exception in advance or if the department has not responded before an action contrary to the requirements of this Subpart had to be taken, the director of transfusion services must report the action taken to the department as soon as possible thereafter but not later than the end of the next business day after the action was taken.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
BASIC CONCEPTS BASIC CONCEPTS
10 CRR-NY 442.8 Full disclosure
[ 1170 ] The concept of full disclosure requires that all significant data be clearly and completely reflected in accounting reports. If, for example, a hospital were to change its method of accounting for certain transactions, within the limitations of this manual, and if the change had a material effect on the reported financial position or operating results, the nature of the change in method and its effect must be disclosed when reporting costs to any agency. No fact that would influence the decisions of management, the governing board, or other users of financial statements should be omitted from or concealed in accounting reports.
Part 441 DEFINITIONS
10 CRR-NY 441.128 Fiduciary
Any person responsible for the custody or administration, or both, of property belonging to another; as, a trustee.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.10 Related organizations
(a) A related organization shall be defined as any entity which the medical facility is in control of or is controlled by, either directly or indirectly, or an organization or institution whose actions or policies the facility has the power, directly or indirectly, to significantly influence or direct, or a special purpose organization, or where an association of material interest exists in an entity which supplies goods and/or services to the medical facility, or any entity which is controlled directly or indirectly by the immediate family of the operator. Immediate family shall include each parent, child, spouse, brother, sister, first cousin, aunt and uncle, whether such relationship arises by reason of birth, marriage or adoption. A special purpose organization shall be defined as an organization which is established to conduct certain of the facility's patient-care-related or non-patient-care-related activities. The special purpose organization shall be considered to be related if:
(1) the facility controls the special purpose organization through contracts or other legal documents that allow direct authority over the organization's activities, management and policies; or
(2) the facility is, for all practical purposes, the sole beneficiary of the special organization's activities. The facility shall be considered the special purpose organization's sole beneficiary if one or more of the three following circumstances exist:
(i) a special purpose organization has solicited funds in the name of and with the expressed or implied approval of the facility, and substantially all the funds solicited by the organization were intended by the contributor or were otherwise required to be transferred to the facility or used at its discretion or direction;
(ii) the facility has transferred some of its resources to a special purpose organization, substantially all of whose resources are held for the benefit of the facility; or
(iii) the facility has assigned certain of its functions (such as the operation of a dormitory) to a special purpose organization that is operating primarily for the benefit of the facility.
(b) The costs of goods and/or services furnished to a medical facility by a related organization are includable in the computation of the basic rate at the lower of the cost to the related organization or the market price of comparable goods and/or services available in the medical facility's region within the course of normal business operations.
(c) If the medical facility has incurred any costs in connection with a related organization, the final payment rate shall include the costs of such goods and/or services.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.58 Turtle-associated salmonellosis and other bacteriological contamination which may cause disease in humans
(a) On and after the effective date of this section, no person shall bring into the State of New York or sell or offer for sale or distribute at wholesale, retail, or as gifts to the public, a live turtle or turtles with a carapace length of less than four inches.
(b) The New York State Department of Health or any designated representative thereof, or any local health officer or his representative may at any time take samples of tank water or any other appropriate samples from turtles offered for sale or distribution, test the same, and order the immediate humane destruction of any lot of turtles found contaminated with salmonella or other bacteriological contamination which may cause disease in humans.
(c) The following warning must be posted conspicuously at every display of turtles for retail sale or distribution or where the public may handle turtles, unless the requirement is waived in writing by the State Commissioner of Health:
“CAUTION: Turtles may transmit bacteria causing disease in humans. It is important to wash your hands thoroughly after handling turtles or material in a turtle bowl; not to allow water or any other substance from a turtle bowl to come in contact with your food or areas where your food is prepared; and to make sure that these precautions are followed by children or others handling turtles.”
(d) Pursuant to the Executive Law the Attorney General may seek injunctive relief or any other remedy therein for violation of this section.
(e) Turtles of any size may enter the State for teaching use in educational institutions, or for delivery to research institutions approved by the New York State Department of Health pursuant to the provisions of article 5 of the Public Health Law, as amended.
INVESTIGATIONS AND DETERMINATIONS INVESTIGATIONS AND DETERMINATIONS
10 CRR-NY 2.9 COVID-19 reporting in schools
In addition to all other reporting requirements in this Part, every kindergarten, elementary, intermediate, or secondary school as well as any pre-kindergarten programs and school districts, as identified by the department, shall report to the Department of Health, on a daily basis, in a form and manner to be determined by the commissioner, all COVID-19 testing, positive test results reported in any manner to the school, and related information among students, teaching staff, and any other employees or volunteers. Such daily report shall include any other data elements as the commissioner determines to be appropriate to track outbreaks of COVID-19 within such schools and school districts.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.5 Enforcement
(a) Permits and placarding.
(1) Operation of a campground without a permit is a violation of this Subpart. The permit-issuing official may order any facility operating without a permit to close and remain closed until a valid permit for operation of the facility is obtained.
(2) Where a public health hazard as defined in subdivision (b) of this section is found, the portion of the campground constituting the hazard may be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of the occupants. When a placard is used, it shall be conspicuously posted at each entrance or walkway leading to the portion of the property where the hazard exists. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law.
(3) As soon as possible, and in any event within 15 days after placarding a facility, the operator shall be provided with an opportunity to be heard and present evidence that continued operation of the facility does not constitute a danger to the health or safety of the public. The hearing shall be conducted by the permit-issuing official or designated hearing officer.
(4) The permit-issuing official or designated representative shall inspect the premises within two working days of notification that the hazard has been eliminated, and remove the placard(s) after verifying correction.
(b) Public health hazards.
(1) A public health hazard is any condition which could be reasonably expected to be responsible for illness, physical injury or death. Any of the following violations are public health hazards which require the permit-issuing official or designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(i) the condition of the electric service, wiring or electrical system components is such that an imminent fire or shock hazard exists;
(ii) the potable water system serving the campground contains contaminants in excess of the maximum contaminant levels prescribed in applicable sections of Part 5 of this Title or section 7-3.13(b) of this Subpart;
(iii) use of an unapproved water supply source;
(iv) insufficient quantity of water to meet drinking or sanitary demands;
(v) the treatment of the campground water system, when required for disinfection or removal of contaminants, is not continuous;
(vi) disinfection which is inadequate to destroy harmful microorganisms or to maintain a specified chlorine residual;
(vii) the presence of cross connections or other faults in the water distribution or plumbing systems which result, or may result, in the contamination of the potable water supply;
(viii) inadequately treated sewage discharging on the ground surface in an area accessible to campground occupants or which may result in pollution of a ground or surface water supply or bathing beach;
(ix) if food service is provided upon the campground by the operator or a food vendor, the presence of any of the public health hazards defined in section 14-1.10(b) and (c) of this Title;
(x) where pools or beaches are provided, the presence of any of the public health hazards defined in section 6-1.4(b) or 6-2.4(b) of this Title; and
(xi) any other condition determined to be a public health hazard, by the permit-issuing official.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.1 Definitions
The following terms shall have the following meanings for purposes of this Subpart:
(a) Attorney General means the Attorney General of the State of New York.
(b) Certificate of public advantage or certificate means a certificate issued by the department pursuant to this Subpart signifying the approval of a cooperative agreement or of a planning process.
(c) Cooperative agreement means an executed agreement among a health care provider and one or more persons or entities, including other health care providers, governing any of the following:
(1) the sharing, allocation, or referral of patients, personnel, instructional programs, information technology resources, support services and facilities, or medical, diagnostic, or laboratory facilities or equipment, or procedures or other services traditionally offered by health care providers or health care-related entities, including but not limited to, the implementation of clinical integration programs and payment mechanisms that involve the sharing of data and resources to develop, implement, and monitor the effectiveness of, and adherence to, performance standards, clinical protocols and evidence-based practices; or
(2) a merger, consolidation, purchase of stock or assets, partnership, joint venture, or any other transaction or affiliation by which ownership or control over all or substantially all of the stock, assets, or activities of one or more health care providers, or health care-related entities, is transferred to another entity who controls a health care provider or health care-related entity.
Cooperative agreement shall not include any agreement that would permit a health care provider to act in a manner which would be otherwise prohibited by law, except as authorized pursuant to article 29-F of the Public Health Law.
(d) Federal or State antitrust laws means any and all Federal or State laws prohibiting monopolies or agreements in restraint of trade, including the Federal Sherman Act, Clayton Act, Federal Trade Commission Act and laws set forth in article 22 of the New York General Business Law, including amendments thereto.
(e) Health care provider shall include, but not be limited to, a facility, agency or program licensed or certified pursuant to article 28, 36, or 40 of the Public Health Law; a health care professional licensed pursuant to title 8 of the Education Law or a lawful combination of such health care professionals; or an entity licensed, certified or funded pursuant to article 16, 31, 32 or 41 of the Mental Hygiene Law.
(f) Mental hygiene agency means one of the autonomous offices of the State Department of Mental Hygiene established under section 5.01 of the Mental Hygiene Law.
(g) Person means any individual, firm, partnership, corporation, association, public or private institution, political subdivision, or government agency.
(h) Planning process means a process, including a process convened and overseen by a planning entity approved by the department, intended to plan for and result in a cooperative agreement.
(i) Primary service area means the lowest number of postal zip codes from which the party draws at least 75 percent of its patients for each service or group of services provided.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.61 Personal use
A person authorized by law to obtain controlled substances for professional use shall not use such drugs for the treatment of his own addiction, or habitual use.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-4.42 Ice
Ice that is consumed or that touches food is to be made from potable water, from sources in compliance with Part 5 of this Title, in a manner that protects it from contamination. Such ice is to be obtained only in chipped, crushed or cubed form and in single-use safe plastic or wet-strength paper bags filled and sealed at the point of manufacture. The ice is to be held in these bags until it is dispensed in a way that protects it from contamination.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.6 Certification by operator or officer
(a) The financial and statistical reports shall be certified by the operator of a proprietary medical facility, an officer of a voluntary medical facility or the public official responsible for the operation of a public medical facility.
(b) The form of the certification required in subdivision (a) of this section shall be as prescribed in the annual fiscal and statistical report forms provided by the State Commissioner of Health.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-3.21 Inspections
The permit-issuing official and his/her designated representatives shall have the right of entrance and inspection of any spray ground facility as authorized under section 1.11 of this Title. The most recent report of inspection shall be available at every spray ground facility.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
MEDICAID SUPPLEMENTAL DATA MEDICAID SUPPLEMENTAL DATA
10 CRR-NY 446.41 Hospital-based home health agencies
(a) Hospitals desiring rates for HHS services must:
(1) Provide the Home Health Agency NYS Operating Certificate Number; and
(2) Ratio of Charges to Charges Applied to Costs (RCCAC) information.
(b) RCCAC information.
(1) Statistics required:
(i) Number of hours of service.
(ii) Number of home health visits.
(iii) Charge per visit at the hospital's established rates.
(iv) Multiply number of home visits by the charge per visit.
(2) Specific home health services for which statistics above are required:
(i) Skilled Nursing Care (account 6910).
(ii) Medical Social Services (account 6920).
(iii) Home Health Aides (account 6930).
(iv) Physical Therapy (account 7510).
(v) Occupational Therapy (account 7530).
(vi) Speech/Language Pathology (account 7550).
(vii) Other Home Health Services (account 6990).
(3) The total charges calculated in paragraph (b)(1) of this section must be summed for all services in paragraph (b)(2) of this section.
(4) A percentage of each service in paragraph (b)(2) of this section to the total charges in paragraph (b)(3) of his section must be calculated (to the nearest tenth of a percent).
(c) Show visits and charges only for approved HHA services.
(d) Does your hospital contract for any HHA services?
(1) If so, is charge dependent on the amount charged by the contracting agency?
(2) If so, detail the visits and charges according to each contract under paragraph (b)(2) of this section.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.11 Continuation education requirements
(a) In order to qualify for registration for each biennial registration period beginning on or after January 1, 2008, a licensed nursing home administrator shall attain 48 clock hours of continuation or continuing education credit acceptable to the board, which shall be attained during the two-year period immediately preceding the registration period or, attained during the preceding two-year period prior to the registration effective date, if registration is requested during an ongoing registration period.
(b) The licensed nursing home administrator is responsible for participating in continuation education programs acceptable to the board and maintaining records of programs attended for at least two-years past the end of the subsequent registration period.
(c) The licensed nursing home administrator shall provide documentation, in the form and manner established by the board, of the acceptable continuation education attended during each biennial registration period during the two-year period immediately preceding the registration period or the effective registration date, if registration is requested during an ongoing registration period.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.2 General requirements
(a) A hematopoietic progenitor cell procurement service shall possess a license issued under Subpart 52-2 of this Title in the category of either limited tissue procurement service or comprehensive tissue procurement service, and operate under standards established by this Subpart, Subpart 52-2 except section 52-2.9, and one or more licensed hematopoietic progenitor cell transplantation facilities. Unless the procurement service and the transplantation facility are operated by the same institution, a hematopoietic progenitor cell procurement service shall have a written agreement with the transplantation facility, which specifies that hematopoietic progenitor cells collected and stored by the hematopoietic progenitor cell procurement service are acceptable for transplantation by the hematopoietic progenitor cell transplantation facility. Collection of hematopoietic progenitor cells performed at facilities outside New York State shall follow policies and procedures consistent with this Subpart. Documentation of such policies and procedures shall be maintained by each associated hematopoietic progenitor cell transplantation facility. Hematopoietic progenitor cells collected outside New York State shall be approved for use in New York State, in writing, by the director of the hematopoietic progenitor transplantation facility or by a physician designated by the director.
(b) A hematopoietic progenitor cell processing facility shall possess a license issued under Subpart 52-2 of this Title in the category of tissue processing facility, and be associated with and operating under standards established by one or more licensed hematopoietic progenitor cell transplantation services.
(c) A hematopoietic progenitor cell transplantation facility shall possess a license issued under Subpart 52-2 of this Title in the category of tissue transplantation facility.
(d) Hematopoietic progenitor cell procurement services, hematopoietic progenitor cell processing facilities and hematopoietic progenitor cell transplantation facilities may operate independently, or together as part of the same organization.
(e) The director of a hematopoietic progenitor cell procurement service and/or processing facility shall ensure the development and implementation of policies and procedures consistent with this Subpart for the operation of the service and the appointment of a medical director and a medical advisory committee.
(1) The director of a hematopoietic progenitor cell procurement service collecting hematopoietic progenitor cells from peripheral blood shall be a physician and have at least one year's experience in apheresis, including or supplemented by experience in the performance or supervision of at least 25 peripheral blood hematopoietic progenitor cell collection procedures. The director of a hematopoietic progenitor cell procurement service collecting bone marrow shall be a physician and have at least one year's experience in bone marrow collection, including or supplemented by experience in the performance or supervision of at least 12 bone marrow collection procedures. The director of a hematopoietic progenitor cell procurement service collecting cord blood only shall be a physician and have at least one year's experience in hematopoietic progenitor cell collection, including or supplemented by experience in the performance or supervision of at least 25 hematopoietic progenitor cell collection procedures. Such director shall also demonstrate satisfactory knowledge in the area of hematopoietic progenitor cell collection, with particular emphasis on the unique characteristics of cord blood collection. A person who has been approved by the department to direct a hematopoietic progenitor cell procurement service as of the effective date of these amendments shall be deemed to qualify as director.
(2) The director of a hematopoietic progenitor cell processing facility shall possess a doctoral degree in the biological sciences and have at least three years' laboratory experience, including at least six months' experience in a clinical laboratory or blood bank. In addition, the director of a hematopoietic progenitor cell processing facility shall have one year's experience in hematopoietic progenitor cell processing, including or supplemented by experience in the performance or supervision of at least 25 hematopoietic progenitor cell processing procedures. A person who has been approved by the department to direct a hematopoietic progenitor cell processing facility as of the effective date of these amendments shall be deemed to qualify as director.
(f) Medical direction of a hematopoietic progenitor cell procurement service and/or processing facility shall be provided by a physician in consultation with the medical advisory committee. Such physician shall be licensed and currently registered with the New York State Education Department or in the state or jurisdiction of practice. The medical director of a hematopoietic progenitor cell procurement service shall have two years' experience or training in clinical hematology/oncology that includes experience in bone marrow transplantation or two years' experience or training in transfusion medicine, in addition to either one year's experience in hematopoietic progenitor cell collection, or performance or supervision of at least 25 hematopoietic progenitor cell collection procedures for each anatomic site (bone marrow, peripheral blood, cord blood or other site) to be used as a source of hematopoietic progenitor cells. The medical director of a hematopoietic progenitor cell processing facility shall have two years' experience in clinical hematology/oncology that includes bone marrow transplantation experience, or two years' experience or training in laboratory medicine or transfusion medicine, in addition to either one year's experience in hematopoietic progenitor cell processing, or experience in the performance of supervision of at least 25 hematopoietic progenitor cell processing procedures. A person who has been approved by the department as medical director of a hematopoietic progenitor cell bank as of the effective date of these amendments shall be deemed to qualify as medical director.
(g) The hematopoietic progenitor cell transplantation service director shall be a physician who shall be responsible for compliance with section 52-2.8 of this Title, and shall monitor the medical efficacy of the hematopoietic progenitor cell transplantation program.
(h) The medical advisory committee, which may be the in-house transfusion committee or transplantation committee, shall include experts in the areas of infectious disease, hematology, oncology, histocompatibility and transfusion medicine, as well as physicians representing associated hematopoietic progenitor cell transplantation facilities. The committee shall meet at least annually.
(i) The medical director of a hematopoietic progenitor cell procurement service, in consultation with the medical advisory committee shall monitor the medical efficacy of the program, and in conjunction with the associated hematopoietic progenitor cell transplantation facility shall, as a minimum, develop medical criteria for donor participation.
(j) The medical director of a hematopoietic progenitor cell procurement service shall be responsible for all aspects of donor qualification, as described in section 58-5.4 of this Subpart.
(k) The director of a hematopoietic progenitor cell procurement service and/or processing facility shall be responsible for the technical and scientific operation of the facility, and shall develop quality standards for hematopoietic progenitor cells.
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.5 Breath analysis; techniques and methods
The following breath analysis techniques and methods shall be a component of breath analysis instrument operator training provided by training agencies and shall be used by operators performing breath analysis for evidentiary purposes:
(a) A breath sample shall be collected at the direction and to the satisfaction of a police officer and shall be analyzed with breath analysis instruments meeting the criteria set forth in section 59.4 of this Part.
(b) The subject shall be observed for at least 15 minutes prior to the collection of the breath sample, during which period the subject must not have ingested alcoholic beverages or other fluids, regurgitated, vomited, eaten, or smoked, or have placed anything in his/her mouth; if the subject should regurgitate, vomit, smoke or place anything in his/her mouth, an additional 15-minute waiting period shall be required.
(c) A system purge shall precede both the testing of each subject and the analysis of the reference standard.
(d) The result of an analysis of a reference standard with an alcoholic content greater than or equal to 0.08 percent must agree with the reference standard value within the limits of plus or minus 0.01 percent weight per volume, or such limits as set by the commissioner. An analysis of the reference standard shall precede or follow the analysis of the breath of the subject in accordance with the test sequence established by the training agency. Readings for the reference standard, a blank and the subject's breath, shall be recorded.
(e) Results of an analysis of breath for alcohol shall be expressed in terms of percent weight per volume, to the second decimal place as found; for example, 0.237 percent found shall be reported as 0.23 percent.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 127.66 West Hempstead-Hempstead Gardens Water District
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 309 of the Laws of 1926, shall apply to all wells of the public water supply of the West Hempstead-Hempstead Gardens Water District, Nassau County, New York.
(b) [Definition.]
Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in suitable watertight receptacles and shall, at all times, be deposited as set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleaned and disinfected as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of the adjoining premises.
(5) Unless othewise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid receptacles shall be disposed of by burying in trenches or pits at a depth of not less than 12 inches below the surface of the ground and in such a manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at a distance not less than 500 feet from any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or other special local condition, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any well of the public water supply of the West Hempstead-Hempstead Gardens Water District, then the said privy or receptacle for excreta or the trench or place of disposal, shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface within 200 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), or into suitable watertight iron pipes with leaded joints connected to a sewer system, a permit for which has been secured from the State Commissioner of Health.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy, cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown, discharged or allowed to escape or remain upon or percolate into or through the ground below the surface within a distance of 100 feet from any well of the public water supply of the West Hempstead-Hempstead Gardens Water District, except into watertight receptacles, the contents of which are removed and disposed of in the manner provided by paragraphs (4) and (5) of subdivision (c).
(3) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point within 75 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District, and none of the above named objects or soures of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(4) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to remain upon the surface of the ground, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil within a distance of 500 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 75 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(e) Dead animals, offal, manufacturing wasts, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or maintained or allowed to remain upon the surface of the ground or beneath the surface within 300 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District, nor shall any such matters be so placed or maintained that the leachings or washings therefrom may reach any well without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of at least 300 feet.
(f) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained with a distance of 500 feet of any well of the public water supply of West Hempstead-Hempstead Gardens Water District.
(g) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well of the public water supply of the West Hempstead-Hempstead Gardens Water District.
(h) Inspections.
The board of water commissioners of the West Hempstead-Hempstead Gardens Water District or their duly appointed representatives shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.7 Service of papers
All notices and papers connected with a hearing, other than the notice of hearing and statement of charges, if any, may be served by ordinary mail. Except where otherwise provided, service by mail shall be deemed complete three days after mailing.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.7 Village of Goshen
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply Prospect and Greenhills Reservoirs and all watercourses tributary thereto or which may ultimately discharge into said Prospect and Greenhills Reservoirs and Burrow Swamp or which may be developed in the future to serve as sources of the water supply to the Village of Goshen.
(b) Definitions.
(1) Agricultural-associated animal waste shall mean manure from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(3) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(4) Human excreta shall mean human feces and urine.
(5) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(6) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or steep bank forming the ordinary high-water line of a watercourse.
(7) Manure shall mean animal feces and urine.
(8) Nonagricultural-associated animal waste shall mean manure obtained from nonagricultural industries.
(9) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(10) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial and municipal waste, and agricultural- and nonagricultural-associated animal waste.
(11) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared or ultraviolet light.
(12) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(13) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(14) Refuse disposal area shall mean land used for the depositing of refuse, except that is shall not include the land used for depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(15) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Goshen water supply.
(16) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(17) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(18) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(19) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(20) Water supply shall mean the public water supply of the Village of Goshen.
(21) Watercourse shall mean Burrow Swamp, and every spring, stream, marsh or channel of water of any kind which flow or may flow into the Village of Goshen water supply.
(22) Watershed shall mean the entire drainage area contributing water to the Village of Goshen water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of any reservoir or watercourse.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of any reservoir or watercourse, except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No human excreta or sewage shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(ii) No human excreta or sewage shall be deposited or spread upon the surface of the ground at any point on the watershed.
(iii) No human excreta or sewage shall be buried in the soil on the watershed unless deposited in trenches or pits at a linear distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(iv) No privy receptacle or facilities of any kind for the deposit, movement, treatment or storage of human excreta or sewage shall be constructed, placed, maintained or allowed to remain within a 150-foot linear distance of any reservoir or watercourse except:
(a) watertight receptacles;
(b) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities; and
(c) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency or any local municipal agency having jurisdiction over such facility.
(v) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within a 100-foot linear distance of any reservoir or watercourse.
(vi) Every watertight receptacle used for containing human excreta or sewage shall be emptied when the receptacle is filled to within six inches of the top.
(vii) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with subparagraph (iii) of this paragraph or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State and/or local municipal agency having jurisdiction over such facility.
(viii) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate town or village agency. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and subparagraph (v) of this paragraph shall comprise the criteria to approve any proposed sewage disposal system.
(ix) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground on the watershed, except in watertight pipes connected to a sewage disposal system or treatment works approved in accordance with subparagraph (iv) of this paragraph.
(5) Junkyards.
No junkyard shall be located within a 250-foot linear distance of any reservoir or watercourse.
(6) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of any reservoir or watercourse and not within a 1,000-foot linear distance of any reservoir or watercourse unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(7) Recreation.
(i) Bathing and swimming. No bathing and swimming shall be allowed in any reservoir or watercourse owned by the Village of Goshen.
(ii) Boating. No gasoline-powered engines will be permitted on the village reservoir. A permit must be obtained for boating from the Village of Goshen.
(iii) Fishing. No fishing shall be allowed in or upon any reservoir or watercourse owned by the Village of Goshen within a 1,000-foot linear distance of the water supply intakes.
(8) Refuse.
No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of any reservoir or watercourse.
(9) Refuse disposal area.
No refuse disposal area shall be located within a 500-foot linear distance of any reservoir or watercourse.
(10) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 1,000-foot linear distance of any reservoir or watercourse.
(11) Trespassing.
No trespassing shall be allowed upon the property of the Village of Goshen upon which the Prospect Hill Reservoir, Greenhills Reservoir, or Burrow Swamp are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter such property by the Village of Goshen.
(12) Other wastes.
No pollutant of any kind shall be discharged or allowed to flow into any reservoir or watercourse or on or beneath the surface of the ground on the watershed within 500 feet of any reservoir or watercourse. This restriction shall not apply to the effluent from a treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(e) Inspections.
The Board of Trustees of Village of Goshen or any other person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees of village to promptly notify the State Commissioner of Health of such violations. Further steps to abate the said violations shall be taken in accordance with provisions of section 1102 of the Public Health Law. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(f) Penalties for violation.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.8 Administration
(a) Acceptance and service agreement.
Prior to being certified for payment, a recipient must sign a written acceptance of the award and a service agreement describing the conditions of the award, the service obligation, and the terms of repayment in the event of rescission or default.
(b) A recipient is required to comply with all administrative and reporting requirements of the Department of Health and the Higher Education Services Corporation.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.70 Contributed capital
The payments in cash or property made to a corporation by its stockholders in exchange for capital stock, in response to an assessment or the capital stock, or as a gift; paid-in capital.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.1 Definitions
For purpose of this Subpart, the following terms shall have the following meanings:
(a) Adequate.
Sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted, or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(b) Campground.
Any parcel or tract of land including buildings or other structures, under the control of any person, where five or more campsites are available for temporary or seasonal overnight occupancy.
(c) Camping cabin.
A hard sided tent or shelter less than 400 square feet in area which is on skids or otherwise designed to be readily moveable and which does not have cooking facilities, sinks, showers, laundry or toilet facilities.
(d) Camping unit.
A tent, camping cabin, recreational vehicle or other type of portable shelter intended, designed or used for temporary human occupancy.
(e) Campsite.
A portion of a campground, with or without connections to water supply, electrical service or sewage systems, used by one camping unit.
(f) Permit-issuing official.
The State Health Commissioner, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, or the State district director having jurisdiction, or any county or public health director having all the powers and duties prescribed in section 352 of the Public Health Law.
(g) Person.
An individual, group of individuals, partnership, corporation, association, political subdivision, State or local governmental agency, municipality, or any other legal entity.
(h) Potable water.
Water fit for human consumption, food preparation, lavatory, culinary, bathing or laundry purposes.
(i) Recreational vehicle.
A vehicular camping unit primarily designed as temporary living quarters for recreational, camping, travel or seasonal use that either has its own motive power or is mounted on or towed by another vehicle. Recreational vehicles include, but are not limited to, camping trailers, fifth wheel trailers, motor homes, park trailers, travel trailers, and truck campers.
(j) Refuse.
All putrescible and nonputrescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanup, dead animals, offal and solid commercial waste.
(k) Scavenger equipment.
A combination of a portable holding tank, pumping or other waste transfer method, and water tight hose connections, whereby a water tight seal can be made between the sewer connection of a recreational vehicle and a portable holding tank to empty the contents of the recreational vehicle sewage holding tank for transport to an approved sewage disposal system.
(l) Seasonal campsite.
A campsite intended to be occupied by the same individual or group for 30 days or more.
(m) Self-contained recreational vehicle.
A recreational vehicle equipped with at a minimum a toilet, a holding tank for sewage, a holding tank for drinking water and/or a connection through which the vehicle can be connected to the campground's water supply. These vehicles may also have electrical connections, showers, or other appliances.
(n) Sewage.
Excreta and the waste from a toilet, privy, bath, shower, sink, lavatory, dishwashing or laundry machine, or the water carried waste from any other fixture or equipment or machine.
(o) Uniform code.
Chapter 1, Subtitle S, Volume B of Title 9 of the Official Compilation of Codes, Rules and Regulations of the State of New York, known as the "State Uniform Fire Prevention and Building Code".
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.3 Responsibilities of health care facilities
(a) The health care facility shall assure that the HBsAg test result for every woman admitted for delivery is recorded in the newborn child's medical record.
(b) When a woman who has not been tested for HBsAg during pregnancy is admitted for delivery or if a woman's HBsAg test result is not available at the time of admission for delivery, the health care facility shall:
(1) submit immediately a satisfactory blood specimen from such a woman to a clinical laboratory that will test it for HBsAg and make the test result available within 24 hours of admission, or as soon thereafter as practicable, but in no event longer than 48 hours of admission. Blood specimens submitted for testing must be marked clearly as “mother/delivery” in order to facilitate reporting of test results; and
(2) record the date and time of the blood collection and the HBsAg test results of such specimens in the medical records of the woman and her newborn child or children.
(c) Report the HBsAg test results for all women with newborn children to the State department of Health on the Newborn Screening Blood Collection Form and report all positive HBsAg test results for women with newborn children within 24 hours of receipt to the local health officer in accordance with section 2.10 of this Title;
(d) Respond to inquiries from the local health officer to provide pertinent information from the medical records of pregnant women with positive HBsAg test results and their newborn children regarding diagnosis and therapy of hepatitis B provided within the health care facility.
(e) In the case of the inter-facility transfer of a newborn child, the transferring facility shall provide written notification to accompany the child to the receiving hospital indicating:
(1) the HBsAg test result for the child's mother;
(2) that the HBsAg test result is pending, in which case the test result should be transmitted when it becomes available immediately by telephone and in writing to the receiving hospital; or
(3) that the HBsAg test result is unknown and a blood sample has not been submitted for testing, in which case this testing shall be the responsibility of the facility where the child's mother is located or of her health care provider if she is not within a health care facility.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.21 Limited transfusion services
(a) No person shall own or operate a limited transfusion service in New York State unless approved by the department. An inspection may be conducted prior to departmental approval. Limited transfusion services shall comply with the provisions in this Part governing transfusions in general.
(b) Limited transfusion services shall have a written agreement with an issuing facility holding a permit in blood services-transfusion. The agreement shall specify the division of responsibilities for ensuring compliance with the provisions of this Part. The agreement shall be subject to the prior approval of the department. The agreement shall include:
(1) the written approval of the issuing facility's director of transfusion services and the director of the limited transfusion service;
(2) the procedures for transport and storage of blood and means to ensure compliance with such procedures;
(3) a description of the transfusion committee of the issuing facility, its responsibilities and composition;
(4) procedures for training of personnel at the limited transfusion service;
(5) requirements for handling adverse reactions, including training of personnel, availability of a physician, 24-hour coverage, and reporting and investigation of such reactions;
(6) procedures for administration of transfusions, including staffing requirements; and
(7) recordkeeping procedures as required in sections 58-2.18 and 58-2.19 of this Subpart, clearly describing responsibilities for maintenance of records and their location.
(c) Transfusions may be performed outside of hospitals only if the patient is cooperative, is able to respond to verbal commands and give informed consent and does not have a history of hemolytic or anaphylactic reactions. The initial transfusion for a given patient shall not be performed in the home setting, and subsequent transfusions may be performed in a patient's home only if physical limitations or hardships exist which would impede transportation to or transfusion in a hospital or ambulatory care setting.
(d) A qualified licensed physician must supervise personnel administering transfusions by limited transfusion services and must be responsible for ensuring that such personnel have adequate training and experience.
(e) A licensed physician, physician assistant, or nurse practitioner must be immediately available for personal or telephone consultation during the transfusion and for 30 minutes afterward.
(f) Any site at which a transfusion is performed by a limited transfusion service must have available an accessible working telephone to allow communication in case of an adverse reaction. All medications, equipment and supplies necessary for the management of adverse reactions must be immediately available on the premises. Infectious waste disposal must be undertaken using containers and procedures found acceptable by the department pursuant to Part 70 of this Title.
(g) Referral of a patient for out-of-hospital transfusion therapy must be approved by the director of the limited transfusion service or his/her designee. Each such transfusion must be ordered by a licensed physician, physician assistant, or nurse practitioner, and a copy of the order must be provided to both the limited transfusion service and the facility issuing the blood.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.27 Termination of service
The Division of Health Care Financing in the Department of Health shall be notified immediately of the deletion of any previously offered service or of the withholding of services from patients paid for by government agencies. Such notifications shall include a statement indicating the date of the deletion or withholding of such service and the cost impact on the residential health care facility of such action. Any overpayments by reason of such deletion of previously offered service shall bear interest and be subject to penalties both in the manner provided in section 86-2.7 of this Subpart.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 133 ORANGE COUNTY
VILLAGES VILLAGES
10 CRR-NY 133.8 Village of Harriman
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 395 of the Laws of 1928, shall apply to the well located on land, owned by the village, and situated approximately a mile southwest of the Village of Harriman, which forms the source of the public water supply of the Village of Harriman, Orange County, NY.
(b) Definitions.
(1) The term well wherever used in this section is intended to mean and refer to the well now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to the well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of the well of the public water supply of the Village of Harriman.
(2) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface within 100 feet of the public water supply of the Village of Harriman.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory, nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed, nor any polluted water or liquid of any kind, shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface within 75 feet of the well of the public water supply of the Village of Harriman.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 75 feet of the well of the public water supply of the Village of Harriman, and none of the above-named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter the well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet from the well of the public water supply of the Village of Harriman.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with at least 12 inches of soil nor within a distance of 300 feet of the well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet of the well of the public water supply of the Village of Harriman.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of the well of the public water supply of the Village of Harriman.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village upon which the well of the public water supply of the Village of Harriman is located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the Village of Harriman.
(h) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet of the well of the public water supply of the Village of Harriman.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of the well of the public water supply of the Village of Harriman.
(j) Inspections.
The board of trustees of the Village of Harriman or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Village of Harriman or their duly appointed representatives shall make regular and thorough inspections of the area surrounding the well for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the well at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-9 STANDARD INFANT AUTOPSY PROCEDURES
10 CRR-NY 69-9.2 Use of New York State Infant Autopsy Protocol
When an autopsy is performed on a person under the age of one year who dies under circumstances in which death is not anticipated by medical history or the cause is unknown, such autopsy must be performed in accordance with the New York State Infant Autopsy Protocol. This provision shall be subject to the limitations of section 4210-c of the Public Health Law.
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.11 The hearing
(a) Appearances.
(1) A party may appear in person or by an attorney. If a party appears by an attorney, service of papers shall be made upon the attorney.
(2) Any person appearing on behalf of a party in a representative capacity may be required to show his authority to act in such capacity.
(3) If a party fails to appear at the hearing, issues on which the absent party has the burden of proof may be resolved against that party.
(4) At any time before a report is submitted to the commissioner, or to the appropriate board or council, the hearing officer may open a default or relieve any party of the consequences of any default upon good cause shown.
(b) Consolidation and severance.
(1) In proceedings which involve common questions of fact, the hearing officer, upon his own initiative or upon motion of any party, may order a consolidation of actions or a joint hearing of any or all issues to avoid unnecessary delay and cost.
(2) The hearing officer, to avoid prejudice or inconvenience, may order a severance of the hearing and hear separately any issue in the proceeding.
(c) Intervention.
(1) At any time after the institution of a proceeding, the hearing officer may, upon a verified petition and for good cause shown, and upon notice to the parties, permit a person to intervene as a party, except in proceedings brought pursuant to Public Health Law, section 230.
(2) The petition of any person desiring to intervene as a party shall state with precision and particularity:
(i) the petitioner's interest in the matter at issue;
(ii) the nature of the evidence petitioner intends to present and the names of witnesses, if any;
(iii) the nature of the argument petitioner intends to make; and
(iv) any other reason that petitioner should be allowed to intervene.
(d) Conduct of hearing and evidence.
(1) Each witness shall be sworn or given an affirmation.
(2) The rules of evidence need not be observed.
(3) Each party shall have the right to present evidence and to cross-examine witnesses.
(4) Official notice may be taken of all facts of which judicial notice could be taken and of other facts within the specialized knowledge of the department.
(5) All evidence, including records, documents and memoranda in the possession of the department of which it desires to avail itself, shall be offered and made a part of the record. All such documentary evidence may be received in the form of copies or excerpts, or by incorporation by reference. In case of incorporation by reference, the materials so incorporated shall be available for examination by the parties before being received in evidence.
(6) The department has the burden of proof and of going forward in all enforcement cases. The petitioner/applicant has the burden of proof and of going forward in all other cases.
(7) In administrative proceedings relating to violation of Public Health Law, section 2803-d, the hearing officer may not compel the disclosure of the identity of the person who made the report or any person who provided information in an investigation of any such report.
(8) Complaints relating to matters governed by Public Health Law, section 230 may not be introduced into evidence by either party and their production may not be required by the hearing officer even if the complainant is a witness.
(9) In matters governed by Public Health Law, section 230, a hearing may proceed if at least two members of the hearing committee are present. At the conclusion of the hearing each member shall affirm that he or she has read and considered evidence introduced at and transcripts of any hearing days at which he or she was not present.
(10) Claims that an administrative hearing has been unreasonably delayed shall be raised only pursuant to this section and claims of unreasonable delay not permitted by this section shall not be entertained in a hearing.
(i) Claims of unreasonable delay occurring after hearing is requested or noticed. Any claim that a hearing has been delayed unreasonably shall be treated as an affirmative defense pursuant to section 51.5 of this Part or otherwise as part of the claimant's case and shall be argued as part of the claimant's case. The burden of proving and the burden of going forward on the issue of unreasonable delay shall be on the claimant.
(a) In reviewing a claim of unreasonable delay, the hearing officer shall first calculate the time period that has elapsed between the date the hearing was requested or noticed, whichever is earlier, and the first day of hearing (the “time period”). For purposes of this section, the time period for cases brought pursuant to Public Health Law, section 2803-d or 230, or Subpart 60-1 of this Title, shall be from the date the hearing was noticed to the first day of hearing.
(b) If the time period is one year or less, the claim of unreasonable delay shall be denied.
(c) If the time period is more than one year, the claimant shall then have the burden of showing that the claimant has been handicapped significantly and irreparably in mounting a case or defense by the time period. A mere assertion of handicap shall not suffice.
(d) If the claimant meets such burden, the hearing officer must then determine whether the time period is unreasonable under the circumstances. In making that determination, the hearing officer shall weigh at least the following factors:
(1) whether there is a causal relationship between the conduct of the department and the time period, and whether the conduct of the claimant was responsible in whole or in part for the time period;
(2) the public policy sought to be effected through the administrative action which is the subject of the administrative hearing;
(3) the availability of department resources to pursue the case consistent with other department responsibilities.
(e) The hearing officer shall include in the report to the decisionmaker any findings, conclusions and recommendations with respect to unreasonable delay. The report shall also include findings, conclusions and recommendations that will allow the decisionmaker to dispose of the case if the decisionmaker does not follow the recommendation for dismissal on the basis of unreasonable delay.
(ii) Claims of unreasonable delay occurring before hearing is requested or noticed.
(a) Claimant may make a record in connection with a claim of an unreasonable delay by the department occurring prior to a request for, or notice of, a hearing that has resulted in substantial prejudice to the claimant's defense due to the passage of time. The department may make a record in opposition to such a claim. A separate hearing on this issue shall not be provided.
(b) Neither a hearing officer nor, in a case of alleged professional misconduct, a hearing committee, shall consider, sustain or reject a claim of unreasonable delay occurring before a hearing is requested or noticed. After a final determination has been rendered, in the event that such determination is adverse to the claimant, and the claimant wishes to pursue the claim of an unreasonable delay occurring prior to a hearing request or notice, the claimant may do so in a proceeding pursuant to article 78 of the CPLR.
(e) Record.
(1) A verbatim record of the proceedings shall be made by whatever means the department deems appropriate.
(2) The record of the hearing shall include: the notice of hearing, statement of charges, if any, answer and any other responsive pleadings; motions and requests submitted, and rulings thereon; the transcript or recording of the testimony taken at the hearing; exhibits; stipulations, if any; a statement of matters officially noticed, except matters so obvious that a statement of them would serve no useful purpose; briefs or objections as may have been submitted and filed in connection with the hearing and any decision, determination, opinion, order or report rendered.
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.6 HIV antibody testing and notification
No tissue bank shall inform any tissue donor or consenting next-of-kin of the results of HIV antibody testing solely on the basis of the enzyme-linked immunosorbent assay (ELISA) or other screening test for HIV antibodies unless such results are negative. Any reactive screening test shall be repeated in duplicate. If two or more separate screening tests are reactive, the sample shall be considered repeatedly reactive. Notification that a donor is positive shall be made only if the results have been reactive or equivocal for more than one screening test and the confirmatory HIV test has been unequivocally reactive. HIV test results that are substantiated as positive shall be reported to living donors. Equivocal or negative results based on confirmatory testing may be reported to the donor, if living, or person legally authorized to consent on behalf of such donor, provided that the person is not informed that the donor is seropositive. Appropriate counseling of living donors or the consenting next-of-kin regarding the significance of all test results shall be made available or arranged for by the comprehensive tissue procurement service. Reporting of any HIV results to living donors or consenting next-of-kin, other than results of negative screening tests, shall be conducted in person, unless repeated efforts to encourage the individual(s) to come in have failed, in which case notification may be made by certified restricted delivery mail.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.16 Fencing
(a) All swimming pools shall be enclosed within a fence or other barrier, at least four feet high, which can only be entered by bathers through self-closing and positive self-latching doors or gates. The knob or handle controlling the latch shall be at least 40 inches above grade. The gate or door shall be locked and access to pool prevented when the pool is not supervised.
(b) Swimming pool fences constructed after the effective date of this Subpart [March 30, 1988] shall meet the requirements of the Uniform Code. For existing swimming pool fences, no opening shall exceed four inches.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.9 Testing to be done on premises except in certain instances
All specimens accepted by a laboratory for specified tests shall be tested on its premises. However, specimens for infrequently performed tests or those not included within specialties or subspecialities stated on its permit or those requiring specialized equipment and skill may be forwarded to and accepted by another laboratory under permit issued by the commissioner or to a laboratory which is operated by a government agency or a nonprofit research institution or to any other laboratory approved by the department. The reports of the results of such tests shall be sent by the testing laboratory to the forwarding laboratory, except that the forwarding laboratory may authorize the testing laboratory to send the report as provided in section 58-1.8 of this Subpart, in which event the testing laboratory shall send a duplicate of the said report to the forwarding laboratory. Where the results of a test have been reported to it by the testing laboratory, the forwarding laboratory shall send a transcript of such report as provided in section 58-1.8 of this Subpart and shall indicate thereon the name of the laboratory actually performing the test.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.55 Public health nuisances; performance standards
The local health department shall:
(a) respond to all reported nuisances which may affect public health and safety; and
(b) maintain a program, consistent with Part 8 of this Title, as applicable, for responding to public health nuisances and ensuring abatement of such public health nuisances; provided, however, that abatement, remediation, management in place or any action that removes the public health nuisance from a property or relocating persons exposed to public health nuisances shall not be eligible for State aid.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.95 Definitions relating to equipment and utensils
(a) Approved means that, under conditions of use, the State Commissioner of Health, based on evaluation of the physical characteristics and usual usages, has determined it to be in conformance with good public health practices.
(b) Easily cleanable means readily accessible and of material and finish fabricated so that residues may be completely removed by normal cleaning methods.
(c) Equipment is all food vending machines, food heating devices, tables, counters, refrigerators, sinks, ovens and similar items, other than utensils, used in the operation of a food vending operation.
(d) Food-contact surfaces are the surfaces of equipment, utensils, food vending machines and single-service items which are normally contacted by food or which food may contact and drain back into food or onto food-contact surfaces.
(e) Kitchenware is all multi-use utensils, other than tableware, used in the storage, preparation, transfer, conveyance or service of food.
(f) Nonfood-contact surfaces are surfaces other than food-contact surfaces.
(g) Single-service articles are items intended by the manufacturer to be discarded after using item once for eating or drinking.
(h) Utensil is any tableware or kitchenware used in the storage, preparation, transfer or service of food.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.290 Repair
(a) The restoration of a capital asset to its full productive capacity, or a contribution thereto, after damage, accident or prolonged use, without increase in its previously estimated service life or productive capacity.
(b) The charge to operations representing the cost of such restoration.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.115 Mechanical dishwashing machines
Mechanical dishwashing machines are to be equipped with thermometers to check their operation. Chemical test kits are to be present in the establishment and used to assure adequate chemical concentrations to achieve sanitization in machines using chemicals. One-quarter inch iron pipe size pressure test cocks are to be provided on machines to permit checking flow pressure of the final rinse water where needed. Pressures are to be maintained within the range specified by the manufacturer.
Part 9 PROHIBITED SUBSTANCES
Subpart 9-1 SYNTHETIC PHENETHYLAMINES AND SYNTHETIC CANNABINOIDS PROHIBITED
10 CRR-NY 9-1.6 Severability
If any provisions of this Part or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Part or the application thereof to other persons, entities, and circumstances.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 5 HIV/AIDS HEALTH SERVICES
Part 420 COMPREHENSIVE AMBULATORY HIV PROGRAMS
10 CRR-NY 420.3 Operating standards
(a) Consistent with generally accepted standards of clinical care, the program shall provide directly onsite or through referral arrangements a full range of clinical services appropriate for the continuous care of patients. For the purposes of this Part, the provision of services through referral arrangements shall entail the establishment of linkages with qualified service providers and the development of a mechanism to track the delivery of such services.
(1) The CAHP shall provide the following core diagnostic, treatment and monitoring services onsite as clinically appropriate: age appropriate, confidential HIV counseling and testing, initial and annual comprehensive medical evaluation including substance use history and mental health assessments, cognitive function testing ongoing clinical HIV disease monitoring, HIV-specific therapies and prophylactic treatments, routine gynecological care and follow-up (including reproductive counseling, pelvic examination and pap smears), case management, patient health education including HIV risk reduction, and nutrition screening and counseling.
(2) The CAHP shall provide onsite if authorized or arrange through written referral agreements with other health care providers the provision of the following services:
(i) consultations by specialists in infectious diseases. If not provided onsite, formal linkages with local resources of infectious disease expertise such as designated AIDS centers as defined in section 405.22(g) of this Title shall be developed to promote the timely delivery of these essential consultative services;
(ii) core diagnostic and therapeutic services: laboratory, including early diagnostic methods to establish the infection status of children; radiology, including MRI; dental services; mental health services, to include clinical social work, clinical psychology and psychiatry as clinically appropriate;
(iii) other primary care, specialty and subspecialty services: obstetrics; pediatrics, adolescent medicine and pediatric subspecialties; ophthalmology; dermatology; neurology; outpatient surgery; clinical pharmacy; subspecialties of internal medicine including gastroenterology, hematology, pulmonology and oncology;
(iv) acute inpatient care where required; and
(v) chronic care aervices where required.
(b) A primary care pracitioner shall be assigned principal responsibility for the continuous care and coordination of care for each patient.
(1) Program staff shall assist all patients with arrangements for all off-site medical services, facilitate receipt of those services, monitor reported results of these off-site services and integrate results into patient records.
(2) In those instances where the primary care practitioner does not have hospital admitting privaleges, the CAHP shall have backup arrangements with hospitals for prompt hospital admission of patients and transfer of information between the hospital and the program.
(c) A CAHP shall provide patients prompt access on a 24-hour basis to a clinical staff member who can respond to emergencies.
(d) Comprehensive ambulatory care services for women, including gynecological specialty care, shall be provided directly onsite or through referral arrangements.
(1) Core services to be provided onsite include:
(i) routine gynecological care and follow-up including pelvic examinations and pap smears; and
(ii) routine family planning services including pregnancy testing and reproductive counseling.
(2) Services to be provided either onsite or through referral arrangements with other health care providers shall include:
(i) special diagnostic and treatment procedures for HIV-related gynecological conditions such as cervical dysplasia;
(ii) obstetrical care for pregnant women that addresses the HIV-related needs of both the mothers and their fetuses during pregnancy; and
(iii) health education for pregnant and postpartum women to include the latest generally accepted recommendations regarding breastfeeding.
(e) consistent with generally accepted standards of medical care for these age groups, the special needs of HIV exposed infants and HIV infected infants, children and adolesents shall be addressed by the CAHP with services provided either directly onsite or through referral arrangements. Such programs shall provide or arrange for comprehensive services that address the unique medical, psycological and developmental needs of these age groups.
(1) For children, comprehensive ambulatory health care shall combine HIV-related comprehensive evaluations and follow-up monitoring, routine pediatric care, care for acute illnesses, and continuous care for chronic conditions, incorporating the following special considerations:
(i) Routine pediatric care shall be provided for HIV antibody positive infants and children in accordance with generally established standards of medical care and shall include immunizations, monitoring of growth and development, routine screening, health education and guidance to help parents anticipate normal changes and problems associated with growth and development.
(ii) For HIV infected children, the following shall be provided directly onsite or through referral arrangement as clinically indicated:
(a) comprehensive developmental assessment;
(b) early intervention services including physical, speech and occupational therapies;
(c) access to intravenous infusions; and
(d) referral to clinical trials.
(2) For adolescents, providers shall tailor individual care to puberty status, adolescent health benefits, education level, HIV-related knowledge base, living situation and compliance patterns. Providers of care to adolescents, including HIV counselors and case managers, shall have training and/or experience regarding adolescent development and methods of effective communication with this age group.
(f) A CAHP shall provide each eligible patient, with the patient's written consent, case management services either onsite or through referral arrangements with other case management providers, including at a minimum a comprehensive age-appropriate assessment of medical, social and psychological needs and a plan for appropriate follow-up services, coordinated by a desigbated case manager and developed in consultation with the patient and/or patient designee or family and the patient's primary care practitioner or team. Such services shall include:
(1) intake/assessmentl
(2) coordination of services;
(3) service plan development, implementation, monitoring and periodic reassessment; and
(4) crisis intervention, which must be provided onsite.
(g) Substance use assessment and referral for treatment as clinically appropriate shall be provided and integrated into treatment planning.
(1) Comprehensive substance use assessment services to be provided onsite shall include:
(i) substance use history and referral for laboratory screening as appropriate;
(ii) crisis intervention; and
(iii) referral to the available treatment modality appropriate to the patient's needs.
(2) Services to be provided either onsite or through referral arrangements with other qualified service providers shall include:
(i) substance use counseling;
(ii) support group programs;
(iii) inpatient drug and alcohol detoxification;
(iv) methadone maintenance treatment programs;
(v) residential drug or alcohol treatment programs;
(vi) work rehabilitation programs; and
(vii) harm reduction, recovery readiness and needle exchange services.
(h) Dental services, including preventative care, peridontics, oral surgery and pediatric dentistry shall be provided directly or through referral arrangements.
(1) Such routine services shall be provided onsite to the extent that they are currently offered to all other patients treated by the facility.
(2) Specialty services shall be readily available with referral arrangements developed to promote their timely delivery.
(i) Mental health services shall be provided directly or through referral arrangements.
(1) A mental health assessment shall be completed in conjunction with the medical and social history to establish a baseline for further care, including psychiatric diagnosis and treatment and to monitor changes in mental health status.
(2) For children, services to help them cope with progressive disease and/or the loss of a parent or other family members shall be made available.
(3) Mental health services for adolescents shall deal with issues of emerging sexuality, identity consolidation, experimentation with drugs, violence, school, family relationships and responses to authority.
(j) The CAHP shall provide onsite nutrition screening and counseling including a baseline nutritional evaluation and continuing nutrition risk assessment.
(1) Screening for specific nutrition risk conditions shall begin at the initial visit with continuing reassessment as needed.
(2) Proffesional nutrition counseling shall be available, either onsite or though referral arrangement, to all patients at nutritional risk.
(3) A consultant in clinical nutrition, qualified by training and experience, shall serve as an information resource to staff, patients and their families regarding the nutritional aspects of managing HIV infection.
(k) A CAHP shall facilitate access to clinical research programs, including those for investigational new drugs (IND's). Programs shall have policies for managing patients on protocols, including notification of the investigator.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.3 Uniform system of accounting and reporting
(a) Residential health care facilities shall maintain their records in accordance with:
(1) section 414.13 of Article 3 of Subchapter A of Chapter V of this Title; and
(2) for the 1980 calendar year in substantial compliance, and thereafter in full compliance, with Article 9 of Subchapter A of Chapter V of this Title. Substantial compliance shall be defined as the result that would be expected from a good-faith effort taken by an informed, responsible person.
(b) For purposes of rate setting, the report required for the fiscal year beginning on or after January 1, 1980 by residential health care facilities shall be made in accordance with the policies and instructions as set forth in Article 9 of Subchapter A of Chapter V of this Title for financial presentation purposes.
(c) Failure of residential health care facility to file the reports required in accordance with this section will subject the residential health care facility to a rate reduction as set forth in the provisions of section 86-2.2(c) of this Subpart. However, there may be instances where a facility is not in compliance with Article 9 of Subchapter A of Chapter V of this Title, resulting in reports which are inaccurate, incomplete or incorrect, and the area of noncompliance cannot, for the reporting period, be corrected. In such instances a rate reduction shall begin on the first day of the calendar month following the original due date of the required report and continue until the last day of the calendar month in which the required reports are filed.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 103 CATTARAUGUS COUNTY
CITIES CITIES
10 CRR-NY 103.1 City of Olean
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth, shall apply to that portion of the Olean Creek and its tributary watercourses for a linear distance of 10 miles upstream from the intake of the public water supply of the City of Olean, Cattaraugus County, NY, these streams being sources of the public water supply of the City of Olean.
(b) Definitions.
(1) The term watercourse wherever used in this section, is intended to mean and include every spring, pond, reservoir, stream, ditch, gutter or other channel of any kind located within 10 miles upstream from the intake of the City of Olean, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Olean.
(2) Wherever a linear distance of a structure or object from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 25 feet of any watercourse tributary to the public water supply of the City of Olean.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remian within 50 feet of any watercourse tributary to the public water supply of the City of Olean.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 100 feet from any watercourse tributary to the public water supply of the city of Olean.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any watercourse tributary to the public water supply of the city of Olean, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 50 feet of any such watercourse tributary to the public water supply of the city of Olean.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which clothing, bedding or carpets have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any watercourse within a distance of 25 feet from any watercourse tributary to the public water supply of the city of Olean.
(3) No clothing, bedding, carpets nor anything that pollutes water shall be washed, rinsed or placed in any watercourse tributary to the public water supply of the city of Olean.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any watercourse nor be washed therein within 500 feet above the intake of the Olean water supply. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the city of Olean.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 25 feet from any watercourse tributary to the public water supply of the city of Olean, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or watchings* from the same may enter any such watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings, or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet before reaching any watercourse tributary to the public water supply of the city of Olean.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any watercourse nor to be placed, piled or spread upon the surface of the ground within 200 feet from any watercourse tributary to the public water supply of the city of Olean, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface not within a distance of 100 feet from any watercourse tributary to the public water supply of the city of Olean and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 15 feet from any watercourse tributary to the public water supply of the city of Olean.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such place that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 25 feet before entering any watercourse tributary to the public water supply of the city of Olean.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any watercourse. Nor shall any such material or refuse to be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 50 feet before entering any watercourse tributary to the public water supply of the city of Olean.
(g) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 100 feet from any watercourse tributary to the public water supply of the city of Olean.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 100 feet from any watercourse tributary to the public water supply of the city of Olean.
(i) Inspections.
The board of water commissioners of the city of Olean shall make regular and thorough inspections of Olean Creek and the streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notice of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violation. The commissioners shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general conditions of the watershed at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
NATURAL CLASSIFICATION OF EXPENSE NATURAL CLASSIFICATION OF EXPENSE
10 CRR-NY 444.23 Natural classification of expense
[3300]
(a) General.
(1) The fifth and sixth digits of the hospital's expense accounts are used to record the Natural Classification of Expense. There are nine major account classification categories with subaccounts. The required level of reporting for the natural classification of expense is the major natural account classification categories ending in zero, except for salaries and wages. Salaries and wages subaccounts must be reported. While the reporting of the remaining subaccounts is not required, they are recommended to achieve greater uniformity in accounting and reporting.
(2) The major categories are as follows:
.00-.19 Salaries and Wages
.20-.29 Employee Benefits
.30-.39 Professional Fees
.40-.49 Medical and Surgical Supplies
.50-.59 Non-Medical and Non-Surgical Supplies
.60-.69 Utilities
.70-.79 Purchased Services
.80-.89 Other Direct Expense
.90-.97 Depreciation/Rent/Transfers
(3) A hospital desiring a more detailed identification of expenses may at its option use an additional digit or digits to obtain the desired detail.
(b) .00, .10 Salaries and Wages. [3310]
(1) Salaries and wages and full-time equivalent (FTE) employees must be reported by 12 sub-classification of salaries and wages for both paid employees and nonpaid workers. The hospital is required to report salaries and wages and paid FTE's for all personnel whose compensation is included on the payroll, including exempt personnel, and for nonpaid workers. FTE's are computed by dividing total paid hours by 2080. Paid hours include both worked and nonworked hours for which employees are compensated.
(2) Overtime hours are hours for which an overtime pay rate is used. The actual overtime hours are not treated differently from regular worked hours; it is the rate that changes.
(3) On-call and/or standby pay is compensation to an employee for being available to work. During that period when the employee is on call or on standby, he might or might not actually perform work. The Fair Labor Standards Act differentiates between restricted and unrestricted on-call situations. All restricted on-call hours are compensable and contribute to the total hours used for determining overtime pay. Unrestricted on-call hours do not contribute to total hours, but unrestricted on-call compensation does contribute to the salary base used for calculating overtime premiums only. Thus all restricted on-call hours must be accounted for, but only those hours worked need be accounted for when employees are on unrestricted on-call duty.
(4) In those instances where the hospital has a policy to pay for a minimum number of hours whenever an employee is called back to work, and the employee works less than the minimum number of hours, the worked time recorded will include only the number of hours actually worked. For example, a four-hour minimum is guaranteed; the employee works two hours and returns home. The hospital will record only two hours as worked time.
(5) Salaries and wages are defined as (i) all remuneration, payable in cash, for services performed by an employee for the hospital, and (ii) the fair market value of donated services when there is the equivalent of an employer-employee relationship. The value of donated services may be evidenced by a contractual relationship which may provide the basis for valuation. If persons donating the services are not paid (or are paid less than fair market value of their services), the lay-equivalent salaries (or the difference between lay-equivalent salaries and salaries paid) must be reported as expense with the offsetting amount reported as nonoperating revenue in account 9030, Donated Services. Do not include services rendered by persons such as candy stripers unless the hospital would actually hire someone to perform such services. Reimbursement of independent contractors such as private duty nurses must be excluded.
(6) The classifications of salaries and wages are defined below. See Part 445 of this Article for a list of job titles and the natural classification to which assigned.
(i) .01 Management and Supervision. Employees included in this classification are primarily involved in the direction, supervision and coordination of hospital activities. Usually included here are job titles such as Administrator, Manager, Department Head, Supervisor, Director and Foreman.
(ii) .02 Technician and Specialist. Employees included in this classification usually perform activities of a creative or complex nature. Includes such job titles as Coordinator, Technologist, Technician, Therapist, Instructor and Accountant. These employees are often licensed or registered. Some of these positions are exempt from Federal wage and hour laws as administrative or professional. Lead positions of Chief, Head, etc. must be classified as Management and Supervision (.01) if they provide direct supervision of five or more other employees.
(iii) .03 Registered Nurses. This classification includes only Registered Nurses employed in the performance of direct nursing care to patients. Registered Nurses performing supervisory functions must be classified as Management and Supervision (.01). Those functioning as instructors and coordinators must be classified as Technical (.02). Lead nurses must be classified as Management and Supervision (.01) if they provide direct supervision of five or more other employees.
(iv) .04 Licensed Vocational (Practical) Nurses. This classification includes Licensed Vocational (Practical) Nurses employed in the performance of direct nursing care to patients. Those Licensed Vocational (Practical) Nurses not providing direct patient care should be classified as Technical (.02).
(v) .05 Aides, Orderlies and Attendants. Included in this classification are nontechnical personnel employed for providing direct nursing care to patients. Included are job titles such as aide, orderly and nurse assistant. These employees are subject to Federal wage and hour laws.
(vi) .06 Physicians. Include in this classification all salaries paid to physicians. This employee must possess a Doctor of Medicine or Doctor of Osteopathy degree and be licensed to practice medicine. Include physicians as Management and Supervision (.01) if they provide direct supervision to five or more other employees.
(vii) .07 Dentists. Include in this classification all salaries paid to dentists. This employee must possess a doctoral degree in dentistry and be licensed to practice dentistry. Include dentists as Management and Supervision (.01) if they provide direct supervision to five or more other employees.
(viii) .08 Resident and Fellow. Employees included in this classification are employed for consulting, diagnosing, prescribing and providing treatment for patients. Also included would be stipends paid to residents, which would be reported only in the Postgraduate Medical Education—Approved Teaching Program (account 8240) or Postgraduate Medical Education—Non-Approved Teaching Program (account 8250).
(ix) .09 Non-Physician Medical Practitioners. Employees included in this classification are employed to consult, diagnose, prescribe and treat patients under the direction of, or in consultation and collaboration with a physician. Includes such job titles as nurse practitioner, physician's assistant, licensed midwife or medic.
(x) .11 Environment, Hotel, and Food Service Employees. This classification includes personnel employed in providing basic services related to food and accommodations. They perform routine work of a non-technical nature and are subject to Federal wage and hour laws. Examples of job titles are maintenance man, housekeeping aide, cooks' helper, flatwork finisher, guard, food service worker, wall washer, and wash person.
(xi) .12 Clerical and Other Administrative Employees. Included in this classification are non-technical personnel employed in the performance of recordkeeping, communication and other administrative functions. Examples of job titles are accounting clerk, admitting clerk, messenger, keypunch operator, secretary, telephone operator, clerk-typist, cashier and receptionist. These employees are subject to Federal wage and hour laws.
(xii) .19 Other Employee Classifications. This classification includes personnel not included in the job classes described above.
(c) Employee Benefits. [3320]
(1) The following employee benefits are to be included as direct costs of all cost centers whose employees received such benefits:
(i) .21 FICA.
(ii) .22 SUI and FUI. These classifications are charged with the employer's portion of the Social Security tax, State Unemployment Insurance, and Federal Unemployment Insurance.
(iii) .23 Group Health Insurance
(iv) .24 Group Life Insurance
(v) .25 Pension and Retirement
(vi) .26 Workers' Compensation Insurance
(vii) .27 Union Health and Welfare
(viii) .28 Other Payroll-Related Employee Benefits
(ix) .29 Employee Benefits (Non-Payroll-Related)
(2) Classifications.23 -.28 are to be charged with the cost of employee benefits specified by the respective account titles. Classification.29, non-payroll-related employee benefits, are to be reported in the Employee Benefits—Non-Payroll-Related cost center (account 8830).
(d) Professional Fees. [3330]
(1) Fees and other amounts (almost exclusively labor- related expense) paid for professional services of people who are not on the hospital payroll include the following classifications: physicians, therapists and other medical non-physician personnel (such as registry nurses), consulting and management fees, legal fees, audit fees, accounting fees and other professional fees. Management Fees paid to related organizations are to be reported as Purchased Services in the appropriate functional cost centers.
(2) .31 Medical—Physicians. Include in this classification all fees paid to physicians. See section 1680 (Physician Remuneration).
(3) .32 Medical—Therapists and Other Non-Physicians. This classification is charged with amounts paid to medical personnel, other than physicians, not on the payroll, such as registered physical therapists and registry nurses.
(4) .33 Consulting and Management Fees. This classification is charged with amounts paid to consultants and management firms when such consultants and firms are not a related organization. Amounts paid to related organizations are charged to natural classification “Management and Contracted Services” (.76).
(5) .34 Legal Fees.
.35 Audit Fees.
.39 Other Fees.
These classifications are to be charged with the amount of legal fees, audit fees, and other fees not included elsewhere.
(e) .40 MEDICAL AND SURGICAL SUPPLIES. [3340]
(1) The following classifications are used to record the costs of the various types of medical and surgical supplies used by a hospital. The fair market value of donated supplies is charged to these classifications if the commodity otherwise would be purchased by the hospital, An offsetting credit is made to “Donated Commodities” (account 5760).
(2) .41 Prostheses. The cost of replacements for parts of the body, and substitutes or aids to permanently impaired functions of the body, is charged to this classification. This includes such items as artificial limbs and eyes, dentures, bone plates, permanent braces, eyeglasses, implanted pacemakers, corrective footwear, etc. Also included are components used in the assembling and fitting of such items.
(3) .42 Surgical Supplies—General. The cost of sutures, surgical needles, surgical packs and sheets and all other surgical supplies not described elsewhere is charged to this classification.
(4) .43 Anesthetic Materials. This classification should be charged with the cost of gaseous and volatile agents used in inhalation anesthesia such as cyclopropane, fluothane, halothane, nitrous oxide, ether and chloroform.
(5) .44 Oxygen and Other Medical Gases. The cost of gases, other than anesthesia gases, used in treatment of patients, such as oxygen and carbon dioxide mixtures, should be charged to this classification. Oxygen used to drive equipment such as fog generators and atomizers should be also charged here.
(6) .45 I.V. Solutions
.46 Pharmaceuticals
.47 Radioactive Materials
.48 Radiology Films
.49 Other Medical Care Materials and Supplies
These classifications (.45 -.49) should be charged with the cost of I.V. solutions, pharmaceutical supplies, radioactive materials, radiology films, and other medical care materials and supplies, respectively.
(f) .50 NON-MEDICAL AND NON-SURGICAL SUPPLIES [3350]
(1) .51 Food—Meats, Fish and Poultry
.52 Food—Other
Food purchased for dietary, kitchen or the cafeteria should be charged to these classifications.
(2) .53 Tableware and Kitchen Utensils
.54 Linen and Bedding
.55 Cleaning Supplies
.56 Office and Administrative Supplies
.57 Employee Wearing Apparel
These classifications should be charged with the cost of tableware and kitchen utensils, linen and bedding, cleaning supplies, office and administrative supplies, and employee wearing apparel
(3) .58 Instruments and Minor Equipment.
The cost of minor equipment, as previously defined in section 1385, is charged to this classification.
(4) .59 Other Non-Medical and Non-Surgical Supplies.
This classification should be charged with the cost of non-medical and non-surgical supplies not included elsewhere. Included here is the cost of miscellaneous supplies used for the personal care of patients.
(g) .60 UTILITIES [3360] .61 Electricity
.62 Fuel
.63 Water
.64 Disposal Service
.65 Telephone/Telegraph
.66 Purchased Steam
.67 Utilities—Other
All utilities except Telephone/Telegraph are to be charged to Plant Operations and Maintenance (account 8410).
(h) .70 PURCHASED SERVICES [3370] .71 Medical
.72 Maintenance and Repairs
.73 Medical School Contracts
.74 Laundry and Linen
.75 Data Processing
.76 Management and Contracted Services
.77 Collection Agency
.78 Transcription Services
.79 Other Purchased Services
These classifications should be used to record the costs of purchased services. For instance, if the laboratory function is purchased outside the hospital, the expense would be charged to classification.71—Medical in Laboratory Services—Clinical (account 7210) or Laboratory Services—Pathological (account 7230), as appropriate. Medical School Contracts natural classification would only appear in the Education cost centers. The Management and Contracted Services Account (.76) is to include only fees paid to related organizations. Include expenses incurred for temporary help services in classification.79, Other Purchased Services.
(i) .80 OTHER DIRECT EXPENSES. [3380] .81 Insurance
82 Interest
.83 Licenses and Taxes (Other than on Income)
.84 Dues, Books and Subscriptions
.85 Outside Training Sessions (including Travel)
.86 Travel—Other
.87 Postage
.88 Printing and Duplicating
.89 Other Expenses
Other direct expenses such as those indicated above are included in these classifications.
(j) .90 DEPRECIATION/RENT [3390] .91 Depreciation and Amortization—Buildings and Building Improvements
.92 Depreciation—Fixed Equipment
.93 Depreciation—Movable Equipment
.94 Depreciation and Amortization—Land Improvements and Other
.95 Lease/Rentals—Buildings, Improvements and Fixed Equipment
.96 Lease/Rentals—Movable Equipment
.97 Lease/Rentals—Other
(k) Interdepartmental transfers of direct expense..
In order to maintain the integrity of the Natural Classifications, all transfers of direct expenses to cost centers must be debited and credited to the appropriate Natural Classification within the cost center expense accounts. The effect of this entry is the same as if the initial charge was incorrect and the cost center is then charged.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.2 Definitions
As used in this Subpart, the following words and terms shall have the stated meaning:
(a) Abatement includes all actions necessary to discontinue a condition conducive to lead poisoning and may include encapsulation, replacement, enclosure, or removal.
(b) Accessible mouthable surfaces are those surfaces located within five feet of the floor or ground that form a protruding corner or similar edge, or protrude one-half inch or more from a flat wall surface, or are located so that a child may place his or her mouth on a protruding surface.
(c) Area of high risk means an area designated as such by the commissioner or his designated representative and may consist of one or more dwellings in which a condition conducive to lead poisoning of children exists.
(d) Approved laboratory means the New York State Department of Health's Wadsworth Center for Laboratory and Research or a laboratory certified by the New York State Department of Health pusuant to the department's Environmental Laboratory Approval Program.
(e) child care facilities means any facility licensed by the State Department of Social Services to offer or provide day care services or child care and any public or private schools attended by children six years old or younger.
(f) Commissioner means the State Commissioner of Health
(g) Condition conducive to lead poisoning means:
(1) the presence of lead paint or other similar surface coating on any accessible mouthable surface or any other surface in a condition accessible for ingestion or inhalation, where peeling, cracking, blistering, flaking, chipping or powdering of such paint or similar surface coating material occurs or is likely to occur; and/or
(2) the presence of other environmental conditions which may result in significant lead exposure.
(h) Designated representative means the health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law, or any individual so designated by the commissioner pursuant to section 206(8) of the Public Health Law.
(i) Dwelling means all buildings or structures or portions thereof that are on or appurtenant to a property, which is occupied in whole or in part as the home, residence or sleeping place, of one or more human beings, including child care facilities for children under six years of age, kindergartens and nursery schools.
(j) Encapsulation means a method of abatement that makes lead paint inaccessable by covering or sealing surfaces with durable coatings specifically formulated to be elastomeric, long lasting, and resistant to cracking, peeling, algae and fungus. Paint is not an encapsulant.
(k) Enclosure means a method of abatement that involves covering of surfaces with durable rigid materials affixed to the surface and sealed or caulked to prevent lead paint or other lead containing material from such surfaces from becoming accessible to children.
(l) High efficiency particulate air (HEPA) filter means a filter capable of filtering at least 99.97% by weight, of particles 0.3 microns or greater in diameter from air passed through the filter.
(m) Lead paint means paint, plaster or other surface coating material containing more than one half of one percent of metallic lead based on the total weight of the contained solids or dried film of the paint or plaster or other similar surface coating material.
(n) Removal means a method of abatement that results in the dislocation, stripping or scraping of paint or plaster or other coating material from a surface.
(o) Replacement means a method of abatement that involves removing components such as doors, windows and trim that contain lead paint and installing new or deleaded components.
(p) Risk reduction efforts mean any temporary action designed to reduce a child's exposure to lead and may include, but are not limited to: encapsulation, temporary relocation, clean-up of paint chips and dust and on-going maintenance of intact paint.
(q) X-ray fluorescence (XRF) analyzer means any instrument which measures lead concentrations in milligrams per square centimeter by measuring emission of x-ray photons activated by a radioactive source within the instrument.
(r) ud/dL means micrograms per decileter.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 147 SUFFOLK COUNTY
COMPANIES COMPANIES
10 CRR-NY 147.65 Suffolk County Water Authority at Kings Park
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 391 of the Laws of 1933, shall apply to all existing wells and such wells as may be developed in the future on the properties of the Suffolk County Water Authority at its Kings Park well field, such wells being the sources of public water supply of said Suffolk County Water Authority.
(b) Definition of terms.
Wherever used in this section:
(1) The term water supply means the public water supply of the Suffolk County Water Authority at its Kings Park well field.
(2) The term wells means the wells now used as sources of this public water supply or any wells developed in the future as additional sources of this public water supply, which are located on land now owned by the Suffolk County Water Authority at the Kings Park well field in Suffolk County, New York.
(3) The linear distance of a structure or object from a well is the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Human excreta.
(1) No human excreta shall be buried in the soil at a distance of less than 500 feet from any well.
(2) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any well.
(3) Every privy or receptacle for the storage or deposit of human excreta, located between the prescribed 75 feet and 150 feet from any well, shall be arranged so that all excreta will be received in suitable watertight receptacle or removable container, which shall be emptied when filled within six inches of the top and the contents disposed of so that no nuisance will be created.
(4) Whenever, in the opinion of the State Commissioner of Health, excremental matter from any aforesaid privy, receptacle, trench or place of disposal may be washed through the soil in an imperfectly purified condition into any well, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage.
(1) No sewage shall be discharged nor deposited on or beneath the surface of the ground within 150 feet of any well except into watertight receptacles, the contents of which shall be removed before overflowing in such a manner as to prevent the pollution of the ground about the receptacle, or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health. It is provided, however, that no such watertight iron pipe shall be located within 75 feet of any well.
(2) No bath water, sink or laundry wastes shall be discharged or deposited on or beneath the surface of the ground within 150 feet of any well.
(e) Wastes, refuse and garbage.
No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animal or other material that pollutes water shall be deposited on or beneath the surface of the ground within 100 feet of any well nor in such a manner that it can be washed by rain, melting snow or otherwise through the ground into the wells.
(f) Places for animals.
No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be located within 75 feet of any well.
(g) Manure.
No manure or manure pile shall be maintained or allowed to remain within 150 feet of any well.
(h) Trespassing.
No trespassing shall be allowed upon the property of the Suffolk County Water Authority upon which the wells of the public water supply of said authority are located and no person or persons shall enter in or upon such property except such person or persons as may be charged with the maintenance of the supply in the official performance of their duties or such other persons as may be authorized to enter said property by the Suffolk County Water Authority.
(i) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well.
(j) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any well.
(k) Inspections.
The Suffolk County Water Authority, its officers or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of the aforesaid authority to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Suffolk County Water Authority to promptly notify the State Commissioner of Health of such violations. The aforesaid authority shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 391 of the Laws of 1933, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-2 MANAGEMENT OF REGULATED MEDICAL WASTE
10 CRR-NY 70-2.5 Recordkeeping
(a) A record of regulated medical waste by quantity and categories as defined in Public Health Law 1389-aa and for disposition of treated waste on-site shall be maintained and retained on-site by the generator for three years from the date of disposition of the waste, and shall be available for inspection and copying by the department. Documentation of corrective action related to a commingling incident shall be retained three years.
(b) A report of the regulated medical waste generated annually, by quantities and categories as defined in Public Health Law 1389-aa shall be submitted to the Commissioner of Environmental Conservation upon request.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.45 Unlicensed activity
(a) No person shall act as an institutional dispenser or institutional dispenser limited of controlled substances in this State without first having obtained a license from the department.
(b) Licensees shall register with the appropriate Federal agency or agencies in the comparable controlled substance schedule provided for under Federal regulations.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.29 Cardiac services
(a) Definitions.
For the purposes of this section, the following terms shall have the following meanings:
(1) adult patient means a patient 18 years of age or older at the time of admission;
(2) pediatric patient means a patient who has not reached their 18th birthday at the time of admission to the hospital;
(3) cardiac surgery center means a general hospital that is approved through the certificate of need process to perform surgery on the heart and great vessels, and is approved for and provides cardiac diagnostic and interventional services including, but not limited to percutaneous coronary interventions (PCI) and diagnostic cardiac angiography procedures. Heart transplant procedures may only be performed at cardiac surgery centers that are also approved as heart transplant centers in accordance with standards at section 709.9 of this Title and approved for organ sharing by the United Network for Organ Sharing (UNOS). Cardiac surgery centers must operate in compliance with this section, and must meet the construction provisions of Part 711 and Part 712 of this Title. Cardiac surgery centers may be approved to serve adult patients (adult cardiac surgery centers) and or pediatric cardiac patients (pediatric cardiac surgery centers). However, separate certificate of need approvals are required for adult and pediatric cardiac surgery centers in accordance with standards at section 709.14 of this Title.
(4) cardiac catheterization laboratory center means a general hospital approved through the certificate of need process to perform catheter based procedures in specially equipped laboratories. Such laboratories are rooms with specialized radiological equipment and supplies used primarily to perform cardiac based angiographic or electrophysiological (EP) procedures on the heart or great vessels. Cardiac catheterization laboratory centers may be approved to serve adult and or pediatric cardiac patients, but separate certificate of need approvals are required in accordance with standards at section 709.14 of this Title for each service. Cardiac catheterization laboratory centers must operate in compliance with standards set forth in this section. Cardiac catheterization laboratory centers are further categorized by the procedures performed as defined below:
(i) a PCI capable cardiac catheterization laboratory center performs percutaneous coronary and other percutaneous procedures to diagnose and treat abnormalities of the heart or great vessels in adult patients. Such PCI capable cardiac catheterization laboratory centers may be approved with or without cardiac surgery at the same hospital site, however, those with no cardiac surgery on site must meet additional criteria at subparagraph (c)(8)(i) of this section;
(ii) a diagnostic cardiac catheterization service performs catheter based angiographic procedures on the heart or great vessels and is strictly limited to the diagnosis of abnormalities in adult patients. Such hospitals must maintain an affiliation with a cardiac surgery center as specified in subparagraph (c)(8)(i) of this section, and are subject to annual review by DOH to determine the continuing operation of the center. Catheter based interventional procedures, such as percutaneous coronary intervention, are prohibited at diagnostic cardiac catheterization service hospitals;
(iii) a cardiac EP laboratory program shall be located in a cardiac catheterization laboratory center and is approved through the certificate of need process to perform catheter based cardiac electrophysiology (EP) procedures. Such programs may be approved with or without cardiac surgery at the same hospital site, however, those with no cardiac surgery on site must meet additional criteria at paragraph (e)(5) of this section;
(iv) a pediatric cardiac catheterization laboratory center shall be located at a cardiac surgery center approved through the certificate of need process to provide cardiac surgery to pediatric patients and is approved to perform catheter based diagnostic and interventional procedures on pediatric patients; and
(5) cardiac reporting system is a New York State reporting system that gathers demographic, clinical, procedural and outcomes information from cardiac surgery centers and cardiac catheterization laboratory centers on every patient who has undergone a surgical procedure or a percutaneous interventional procedure on the heart or great vessels. The cardiac reporting system includes separate reporting modules to capture procedure specific data elements for the procedure (cardiac surgery or percutaneous interventions) and age group (adult or pediatric) involved.
(b) State cardiac advisory committee. There shall be a State cardiac advisory committee consisting of physicians and other professionals with expertise in cardiac care appointed by the Commissioner of Health. The State cardiac advisory committee shall, at the request of the commissioner, consider any matter relating to cardiac services including, but not limited to review of existing and prospective services, and shall advise the commissioner thereon.
(c) General provisions.
(1) Cardiac catheterization laboratory center services shall be limited to general hospitals.
(2) Hospitals shall not admit patients for cardiac surgery or cardiac catheterization laboratory procedures unless the hospital is approved to provide such services.
(3) Hospitals that provide cardiac surgery, diagnostic cardiac catheterization service, interventional cardiac laboratory services including percutaneous coronary intervention (PCI) and other percutaneous cardiac interventions, or cardiac electrophysiology (EP) must comply with section 405.22(a) of this Part.
(4) Review and approval. Site visits to and or data and record reviews from existing and prospective new centers by the department, members of the cardiac advisory committee or other designees of the commissioner shall be made as indicated, as an adjunct to initial approval and or for consideration of continued approval. Such site visits and reviews shall include, but not be limited to, evaluation of data, review of service specific quality of care, and compliance with minimum workload standards as set forth in this section.
(5) Closure.
(i) Failure to meet one or more statutory or regulatory requirements or inactivity in a program for a period of six months may result in actions to include: probationary status, withdrawal of approval as a cardiac surgery center and or cardiac catheterization laboratory center.
(ii) Voluntary closure. The hospital must give written notification, including a closure plan to the department at least 60 days prior to planned discontinuance of cardiac surgery or cardiac catheterization laboratory center services. No cardiac surgery center and no cardiac catheterization laboratory center shall discontinue operation without first obtaining written approval from the department.
(6) Notification of significant changes. A hospital must notify the Department of Health in writing within seven days of any significant changes in its cardiac surgery center or cardiac catheterization laboratory center services including, but not limited to, any temporary or permanent suspension of services; departure of or change in the physician program director; if the program is without a physician credentialed to perform one or more of the procedures or services of the cardiac surgery center or cardiac catheterization laboratory center; or inability to meet workload requirements.
(7) Data collection and reporting. Data as deemed necessary by the commissioner shall be maintained for cardiac patients treated by the hospital and submitted upon request to the Department of Health in a format specified by the department. Such data shall include, but not be limited to data documenting appropriate case selection and or appropriate access to care and, cardiac reporting system data for cardiac surgery centers and cardiac catheterization laboratory centers.
(8) Quality assurance. There shall be an organized quality assurance program for cardiac surgery and cardiology that requires participation by all clinical members of the cardiac surgery team and or cardiac laboratory team and includes: monitoring of volume and outcomes; morbidity and all case mortality review; regular multidisciplinary conferences including all health professionals involved in the care of cardiac patients; medical/nursing audit; utilization review, pre hospital and post hospital care review, and a system that assesses pre-operative risk and evaluates outcome trends. Quality improvement efforts must recognize that patients move through multiple systems of care (EMS, emergency department, catheterization laboratory etc.) and optimum quality improvement efforts must include participation from as many systems as possible to address those issues at the juncture of systems of care.
(i) In addition, cardiac catheterization laboratory centers located in hospitals with no cardiac surgery on-site must enter into and comply with a fully executed written clinical sponsorship agreement with a New York State cardiac surgery center. The agreement will include provisions that address, at a minimum:
(a) cardiac surgery center representatives shall participate in the affiliated cardiac catheterization laboratory center hospital's quality assurance committee and other reviews of the quality of cardiac care provided by the affiliated cardiac catheterization laboratory center and in the provision of recommendations for quality improvement of cardiac services. Each cardiac surgery center and each affiliated cardiac catheterization laboratory center hospital shall take actions necessary, including but not limited to entering into a written agreement to authorize such participation by the cardiac surgery center representatives in the affiliated cardiac catheterization laboratory center hospital's quality assurance committee and for purposes of such participation, the cardiac surgery center representative or representatives shall be deemed members of the affiliated cardiac catheterization laboratory center hospital's quality assurance committee. Cardiac surgery center representatives may only access confidential patient information for quality assurance committees as set forth in the affiliation agreements and these regulations. Members of hospitals' quality assurance committees must maintain the confidentiality of patient information and are subject to the confidentiality restrictions of Public Health Law section 2805-m and other applicable confidentiality restrictions as provided by law. The cardiac surgery center representative(s) shall participate in the review of information and data for quality improvement purposes as described in the agreement which may include:
(1) statistical data and reports used in quality improvement activities;
(2) the affiliated cardiac catheterization laboratory center hospital's quality improvement program, policies, and procedures;
(3) care provided by medical, nursing, and other health care practitioners associated with the cardiac services;
(4) appropriateness and timeliness of patient referrals and of patients retained at the affiliated cardiac catheterization laboratory center hospital who met criteria for transfer to the cardiac surgery center hospital; and
(5) adverse events or occurrences including death and major complications for patients receiving cardiac care at the affiliated cardiac catheterization laboratory center hospital;
(b) joint cardiology/cardiac surgery conferences to be held at least quarterly, with a focus on continuous quality improvement to include review of: all cardiac laboratory related morbidity and mortality, review of a random selection of uncomplicated routine cases, patient selection, rates of normal outcomes for diagnostic studies performed, rates of studies needed to be repeated prior to intervention, quality of the studies conducted, rates of patients referred for and receiving interventional procedures subsequent to the diagnostic cardiac catheterization procedure, and the number and duration of cardiac catheterization laboratory system failures;
(c) a mechanism for a telemedicine link between the cardiac catheterization laboratory center and the cardiac surgery center that provides the capability for off-site review of digital studies, and a commitment on the part of each hospital to provide timely treatment consultation by appropriate physicians on an as needed basis;
(d) the cardiac surgery center's involvement in developing privileging criteria for physicians performing cardiac catheterization procedures at the hospital with no cardiac surgery on-site;
(e) development and ongoing review of patient selection criteria and review of implementation of those criteria. The process shall include a comprehensive review of the appropriateness of treatment for a random selection of cases;
(f) consultation on equipment, staffing, ancillary services, and policies and procedures for the provision of cardiac catheterization laboratory procedures;
(g) a pre-procedure risk stratification tool which ensures that high risk and or complex cases are treated at a cardiac surgery center;
(h) procedures to provide for appropriate patient transfers between facilities;
(i) an agreement to notify the department of any proposed changes to the initial agreement and to obtain department approval prior to the change;
(j) an agreement to jointly sponsor and conduct annual studies of the impact that the cardiac catheterization laboratory center service has on costs and access to cardiac services in the hospital's service area;
(k) a plan for how the proficiency of physicians, nurses and other staff at the affiliated cardiac catheterization laboratory center will be maintained through rotational or other training opportunities; and
(l) a plan for how the cardiac catheterization laboratory center will maintain the capacity to provide PCI services on a 24 hour a day, 365 days a year basis and be capable of assembling a dedicated team within 30 minutes of the activation call to provide coronary interventions 24 hours a day and 365 days each year.
(ii) The department's cardiac surgery center reviews, as specified at paragraph (4) of this subdivision, shall include review of the quality of the services the cardiac surgery center has provided to each of the cardiac catheterization laboratory centers with which it has a written agreement as specified at subparagraph (i) of this paragraph; and
(iii) cardiac surgery centers with one or more affiliated cardiac catheterization laboratory centers shall provide professional education and training for physicians, nurses and other staff of the affiliated centers for which it provides quality of care review. Education and training shall be designed to update and enhance staff knowledge and familiarity with relevant procedures and technological advances.
(9) The hospital must have written policies and procedures clearly delineating medical equipment vendor activities in the hospital including restrictions on vendor participation in clinical services.
(10) Cardiac surgery centers shall be approved to operate as PCI capable cardiac catheterization laboratory centers without a separate certificate of need (CON) approval, but must operate in compliance with standards at paragraphs (e)(1) and (2) of this section.
(11) Hospitals with approved cardiac catheterization laboratories approved prior to July 1, 2009 to perform PCI with no cardiac surgery on site shall be approved to operate as PCI capable cardiac catheterization laboratory centers without a certificate of need approval but must operate in compliance with standards at paragraphs (e)(1) and (2) of this section.
(12) Hospitals with approved cardiac catheterization laboratories approved prior to July 1, 2009 to perform cardiac electrophysiology procedures shall be approved to operate as cardiac EP laboratory programs without a certificate of need approval but must operate in compliance with standards at paragraphs (e)(1) and (5) of this section.
(d) Cardiac surgery center criteria . The following criteria apply to cardiac surgery centers approved to perform adult and or pediatric cardiac surgery. The cardiac surgery services must be provided in a manner which protects the health and safety of the patients in accordance with generally accepted standards of medical practice:
(1) direction. The physician director is responsible for the overall quality of the cardiac surgical program and carries out this responsibility through the administrative structure of the institution, including but not limited to the governing body. The hospital must notify the Department of Health within seven days of any change in the cardiac surgery program director, together with the name and curriculum vitae of the new director. The director shall be a qualified physician board certified in thoracic surgery or meet accepted equivalent training and experience.
(i) The director shall:
(a) Continuously monitor the performance of all surgeons working in the cardiac surgical program, including each individual surgeon's annual case load and level of competence. The director shall advise the chief of service, hospital medical director and credentials committee on requirements for credentialing and privileging within the cardiac surgery department and will provide assessments of compliance with standards of care, policies and guidelines as part of the credentialing and privileging process;
(b) in conjunction with the medical staff, monitor the quality and appropriateness of cardiac related patient care and ensure that identified problems are reported to the quality assurance committee and are resolved; and
(c) assure the timely and accurate reporting of the cardiac surgery component of cardiac reporting system data to the department.
(2) structure and service requirements. Hospitals providing cardiac surgery services shall be adequately staffed and equipped for cardiac diagnostic and therapeutic services including, but not limited to cardiac surgery, percutaneous coronary interventions (PCI) and diagnostic cardiac catheterization and, in addition, provide the following:
(i) for adult cardiac surgery centers:
(a) cardiac surgical intensive care, organized, staffed and available on a 24 hour basis by clinical personnel trained in the care of critical care patients and equipped to provide the specialized care required by adult cardiac surgery patients;
(b) coronary care organized, staffed and available on a 24-hour basis by clinical personnel trained in the care of critical care patients and equipped to provide the specialized care required of complex cardiac conditions; and
(c) PCI capable cardiac catheterization laboratory center services meeting standards at paragraphs (e)(1) and (2) of this section.
(ii) for pediatric cardiac surgery centers: age appropriate intensive care, organized, staffed and available on a 24-hour basis by clinical personnel trained and equipped to meet the needs of pediatric patients undergoing cardiac surgery, and pediatric cardiac catheterization laboratory center services meeting standards at paragraphs (e)(1) and (4) of this section.
(iii) for all cardiac surgery centers:
(a) operating rooms adequately staffed and equipped for the needs of the cardiac surgery patient;
(b) preoperative and post operative care areas to serve the needs of the surgery patient;
(c) a qualified cardiac surgeon must be immediately available for consultation. The surgeon must remain available (arrive on-site within 20 minutes of being called) after each cardiac surgery procedure. The surgeon must remain available until at least such time that the patient is evaluated on post operative day one and for a clinically appropriate period of time thereafter to handle cardiac surgery emergencies;
(d) the hospital must assure that a cardiac surgery team is immediately mobilized for handling cardiac surgery emergencies. In the event that a patient must return on an emergency basis to the operating room, appropriate resources shall be immediately available in order to have the patient in the operating room and the team ready within 20 minutes of an identified surgical emergency. There shall be written documentation of a triage protocol including identification of specific responsibilities;
(e) non-invasive cardiac diagnostic equipment and capabilities;
(f) in addition, the hospital shall provide clinical support services in keeping with generally accepted standards. Such services shall be integrated and available on an inpatient basis, but there shall also be adequately and appropriately organized outpatient services to preclude unnecessary hospitalization and ensure continuity of care;
(g) cardiac surgery conferences shall be held no less than 10 times per year at which the staff reviews the studies of a statistically significant number of cases. Records of these conferences indicating attendance, cases reviewed and decisions on patient management shall be maintained; and
(h) the hospital shall attempt to determine and document the status of the patient at 30 days post surgery for those who are no longer inpatient and throughout the hospital stay for those who are discharged from the cardiac surgery service to another service within the hospital. Status shall include living or deceased and other pertinent criteria as determined by the commissioner.
(3) staffing. All personnel shall be qualified for their responsibilities through appropriate training and educational programs.
(i) Physicians shall all be residency trained and board certified, or meet accepted equivalent training and experience for physicians in their respective specialty and shall be appropriately credentialed and privileged as part of the medical staff, and shall be available in sufficient numbers and on a 24 hour basis to meet the needs of the cardiac surgery patients. Such specialists shall, at a minimum include:
(a) cardiothoracic surgeons in sufficient numbers to meet the ongoing needs of the patients, and each of whom performs a minimum of 50 cardiac surgeries per year. Review by the physician director shall be conducted and provided to the chief of service, hospital medical director and medical staff credentials committee for all physicians whose annual volume is below 50 cardiac surgeries to determine what actions are deemed necessary. In addition, for programs approved to perform pediatric cardiac surgery, cardiac surgeons with advanced training and or with significant experience in pediatric cardiac surgery to meet the needs of the pediatric patients;
(b) anesthesiologist(s), who have acceptable minimum experience with cardiac surgical procedures;
(c) specialists with expertise in critical care and the care of post cardiac surgery patients;
(d) cardiologists to care for adults and, for programs approved to care for pediatric patients, pediatric cardiologists, with expertise in children's cardiovascular diseases, each of whom meet qualifications in accordance with generally accepted standards from recognized specialty organizations; and
(e) complement of additional physicians shall be in keeping with generally accepted standards to meet the needs of cardiac surgery patients and shall include, but not be limited to practitioners, readily available for consultation in additional specialties, including hematology, pulmonology, neurology, nephrology and clinical pharmacology.
(ii) Nurses. Nursing personnel shall be certified in advanced cardiac life support (ACLS) or meet acceptable equivalent training and experience and shall include:
(a) a registered professional nurse, with 24-hour accountability, in charge of coordinating the care of post cardiac surgery patients and in charge of staffing levels for the unit;
(b) registered professional nurses, licensed practical nurses and nursing assistants in such ratios that are commensurate with the type and amount of nursing needs of the patients.
(iii) Nurse practitioners, advanced practice nurses and or registered physician assistants may be utilized when these specialists are appropriately credentialed and privileged on the medical staff.
(iv) The cardiac surgery center shall have perfusionists who have special training and experience in an active program of open heart surgery, including a thorough background in sterile techniques, perfusion physiology, and the use of monitoring equipment and must demonstrate, through a formal review process, competencies in these areas. The operator may be a specially trained physician, nurse, or technician, at the discretion of the director of the center.
(v) The cardiac surgery center shall have a data manager who has special training in the clinical criteria used in the cardiac surgery module of the cardiac reporting system as provided by the department or its designee, is designated and authorized by the hospital and shall work in collaboration with the physician director to ensure accurate and timely reporting of cardiac reporting system data to the department. In addition to the data manager, relevant medical and administrative staff must be trained in the use of the cardiac reporting system and the specific data element definitions involved.
(4) patient selection criteria and limitations. Criteria shall be adopted by the cardiac surgery center to be used as indications of appropriate case selection. Such criteria shall be in keeping with generally accepted standards and, at a minimum, shall provide the following limitations:
(i) the hospital shall not perform heart transplantation unless the hospital is a cardiac surgery center approved for heart transplantation and approved for organ sharing by UNOS;
(ii) the hospital shall not electively admit patients for implantable ventricular assist devices unless the hospital is a cardiac surgery center approved for heart transplantation or has an agreement with at least one New York State heart transplantation center that provides for appropriate consultation and expertise for such cases;
(iii) the hospital shall not admit patients under the age of 18 for cardiac surgery unless the hospital is a cardiac surgery center approved for pediatric cardiac surgery or unless the patient's diagnosis indicates a condition, such as acquired heart disease, that can be most appropriately treated in an adult program with pediatric trained personnel and pediatric consultative services. Such exceptions must be supported by written documentation of consultation with a pediatric cardiologist; and
(iv) cardiac surgery centers approved to perform pediatric cardiac surgery that are not also approved as adult cardiac surgery centers shall not admit patients over the age of 18 for cardiac surgery unless the procedure will be performed to treat a congenital anomaly and the hospital can meet the additional clinical needs of the patient.
(5) minimum workload standards. There shall be sufficient utilization of a cardiac surgery center to insure both quality and economy of services, as determined by the commissioner. An institution seeking to maintain approval shall present evidence that the annual minimum workload standards have been achieved and maintained. The following annual minimum workload standards must be achieved within two years following initiation of the service to ensure both quality and economy of services:
(i) adult cardiac surgery centers shall maintain an annual minimum of 100 procedures on adult patients; and
(ii) pediatric cardiac surgery centers shall maintain an annual minimum of 75 pediatric cardiac surgery procedures excluding the number of isolated patent ductus arteriosus (PDA) repairs. The annual minimum volume shall be deemed to be met when two or more pediatric cardiac surgery centers, at least one of which must perform a minimum of 75 pediatric cardiac surgery procedures a year (excluding isolated PDA repairs), join in a coordinated program based on a fully executed written agreement, approved by the commissioner, and the combined volume of the collaborating pediatric cardiac surgery centers (excluding the number of PDA repairs) is greater than 100 procedures a year. The agreement between the collaborating hospitals must include, at a minimum, information on: quality improvement, peer review and coordination of care of patients between the coordinated pediatric cardiac surgery centers. The agreement must specify that the department will be provided 60 day prior written notice of any proposed change, termination or expiration of the agreement. Changes must be found acceptable to the department prior to implementation and any proposed termination or expiration of the agreement will result in termination of the coordinated pediatric cardiac surgery center program.
(6) waiver of minimum workload standards. The commissioner may waive the workload requirements upon a satisfactory showing by a cardiac surgery center as determined by the commissioner upon seeking advice from cardiac advisory committee representatives that the quality of care provided is adequate as supported, at a minimum, by a review of cases and outcome trends conducted by the department, and:
(i) there are extenuating circumstances precluding compliance with the workload requirements; and or
(ii) there is documented evidence that need for cardiac surgery in the hospital's geographical service area would be substantially unmet if the program were closed.
(e) Cardiac catheterization laboratory center criteria.
(1) The following criteria apply to all cardiac catheterization laboratory centers. Cardiac catheterization laboratory center services must be provided in a manner which protects the health and safety of the patients in accordance with generally accepted standards of medical practice.
(i) Direction. The physician director is responsible for the overall quality of the cardiac catheterization laboratory center and must have the appropriate authority to carry out those responsibilities through the support of the chief of cardiology, the medical director of the hospital and the hospital administration. The hospital must notify the department within seven days of a change in the directorship of the cardiac catheterization laboratory center, together with the name and curriculum vitae of the new director.
(ii) Qualifications of the director. The director must be board certified in internal medicine and the subspecialty of cardiac disease or meet equivalent standards, be experienced in the performance of procedures specific to type of cardiac catheterization laboratory center services provided, have good management skills and must be appropriately credentialed and privileged as a member of the medical staff.
(iii) The director shall:
(a) continuously monitor the performance of all cardiologists working in the cardiac catheterization laboratory center, including but not limited to, each cardiologist's annual case load requirement and level of competence. The director shall advise the chief of service, the hospital medical director and the credentials committee on requirements for credentialing and privileging in the cardiac catheterization laboratory center and shall provide assessments of compliance with standards of care, policies and guidelines as part of the credentialing and privileging process;
(b) in conjunction with the medical staff, monitor the quality and appropriateness of cardiac related patient care and ensure that identified problems are reported to the quality assurance committee and are resolved; and
(c) for centers approved as PCI capable cardiac catheterization laboratory centers, assurance of the timely and accurate reporting the cardiac catheterization laboratory center module of the cardiac reporting system data to the department.
(iv) Structure and service requirements:
(a) all cardiac catheterization laboratory centers must provide diagnostic services, including but not limited to diagnostic radiology, clinical laboratory, and invasive and noninvasive cardiac diagnostic procedures. Such services shall be available on an inpatient and outpatient basis;
(b) all cardiac catheterization laboratory centers must have a process in place that allows for appropriate transfer of cases to a higher level of care to handle cardiac emergencies;
(c) cardiac catheterization laboratory centers approved to provide care to adult patients must provide coronary care organized, staffed and available on a 24-hour basis by clinical personnel trained in the care of critical care patients and equipped to provide the specialized care required of complex cardiac conditions;
(d) cardiac catheterization laboratory centers approved to perform pediatric procedures must provide age appropriate intensive care, organized, staffed and available on a 24-hour basis by clinical personnel trained and equipped to meet the needs of pediatric patients undergoing cardiac laboratory procedures;
(e) cardiology conferences shall be held no less than 10 times per year at which the staff reviews the studies of a statistically significant number of cases. Records of these conferences indicating attendance, cases reviewed and decisions on patient management shall be maintained;
(f) records of the disposition of the cases shall be maintained in compliance with standards set forth in section 405.10 of this Part;
(g) the number of patients referred annually for surgery and the center(s) to which they are referred shall be maintained and readily available upon request from the Department of Health;
(h) statistics shall be kept on the number of normal invasive cardiac diagnostic studies performed, and written criteria shall be adopted and used for determining when a study is to be considered abnormal. Such criteria shall be in keeping with generally accepted standards of medical practice; and
(i) the hospital shall ensure high quality imaging and radiation protection for patients and personnel in accordance with section 405.15 of this Part.
(j) in addition to standards at subparagraph (c)(8)(i) of this section, for cardiac catheterization laboratory centers approved under a clinical sponsorship agreement as set forth in section 709.14(d)(5) of this Title, the written and signed clinical sponsorship agreement between a cardiac surgery center and the cardiac catheterization laboratory center without cardiac surgery on site must be maintained and must specify that the department shall be provided 60 day prior written notification of any proposed change, termination or expiration of the agreement, any changes must be found acceptable to the department prior to implementation and any proposed termination or expiration shall require prior submission of a plan of closure to the department. The agreement shall provide for an integration of expertise and resources from the cardiac surgery center that would support a high quality program at the hospital without cardiac surgery on site, and shall delineate responsibilities of each institution. The agreement shall further provide that the parties agree that termination or expiration of the agreement shall result in closure of the co-operated cardiac catheterization laboratory center.
(v) Staffing. All personnel shall be qualified for their responsibilities through appropriate training and educational programs.
(a) physicians shall all be board certified, or meet accepted equivalent training and experience for physicians in their respective specialty, and shall be appropriately credentialed and privileged as part of the medical staff. Such specialists shall, at a minimum, include a cardiologist and or pediatric cardiologist depending upon the age group(s) served; a cardiac angiographer whose basic medical training is in keeping with generally accepted standards;
(b) nurses with appropriate education and training shall be regularly assigned to the center; and
(c) additional healthcare personnel as needed, each of whom is qualified through appropriate training and education to serve the needs of cardiac catheterization laboratory center patients.
(vi) Patient selection criteria.
(a) the hospital shall not admit patients under the age of 18 for a cardiac laboratory procedure unless the hospital is an approved pediatric cardiac catheterization laboratory center or unless the patient's diagnosis indicates a condition, such as acquired heart disease, that can be most appropriately treated in an adult program with pediatric trained personnel and pediatric consultative services, or except as provided in clause (5)(iii)( c ) of this subdivision. Such exceptions must be supported by written documentation of consultation with a pediatric cardiologist;
(b) pediatric cardiac catheterization laboratory centers that are not also approved as adult cardiac services programs shall not admit patients over the age of 18 for a cardiac laboratory procedure unless the procedure will be performed to diagnose or treat a congenital anomaly and the hospital can meet the additional needs of the patient;
(c) the hospital shall not admit adult patients for percutaneous coronary intervention or other percutaneous cardiac interventions unless it is an approved PCI capable cardiac catheterization laboratory center; and
(d) the hospital shall not provide cardiac EP laboratory program services unless it is an approved cardiac catheterization laboratory center with an approved cardiac EP laboratory program.
(2) PCI capable cardiac catheterization laboratory centers. PCI capable cardiac catheterization laboratory centers must meet the following standards:
(i) structure and service requirements:
(a) PCI capable cardiac catheterization laboratory centers must be appropriately staffed and equipped for diagnostic and therapeutic services including but not limited to diagnostic cardiac catheterization and percutaneous coronary and other percutaneous interventions;
(b) PCI capable cardiac catheterization laboratory centers must maintain capabilities to perform emergency percutaneous coronary interventions including, but not limited to percutaneous coronary intervention for the treatment of ST elevation Myocardial Infarction (STEMI) on a 24 hour a day, 365 days a year basis and must be capable of assembling a dedicated team within 30 minutes of the activation call to provide coronary interventions 24 hours a day and 365 days each year. Exception to this standard shall be made only for temporary and extenuating circumstances and when:
(1) local emergency medical services have been notified and documentation is in place for triaging patients in need of emergency PCI; and
(2) the Department of Health has been provided with a specific description of the circumstances, documentation of the revised triage arrangements and a timeline for return to the 24 hour provision of services, and has approved the arrangement.
(c) the hospital must insure that once an ambulance calls to indicate transport of an emergency cardiac patient, the PCI team is immediately mobilized;
(d) the hospital must effectively and efficiently identify patients in need of an emergency percutaneous coronary intervention and must transfer those patients rapidly (within 30 minutes) from the emergency department to the cardiac laboratory; and
(e) the hospital must have a system documented and in place to ensure effective and efficient identification and transfer of a patient from the cardiac laboratory to a cardiac surgical program either in the hospital or at another hospital.
(ii) staffing.
(a) physicians shall all be board certified, or meet accepted equivalent training and experience for physicians in their respective specialty and shall be appropriately credentialed and privileged as members of the medical staff and in sufficient numbers to meet the care needs of the patients;
(b) a minimum of three interventional cardiologists, at least one of whom dedicates the majority of his or her professional time at the facility, must be credentialed and privileged on the medical staff to perform percutaneous coronary interventions. Each interventional cardiologist shall maintain sufficient volume on-site to maintain familiarity with the laboratory and shall perform a minimum of 75 total percutaneous coronary intervention cases per year of which 11 are emergency percutaneous coronary intervention cases, and not all 75 minimum cases or 11 minimum emergency cases must be performed at one site. Review by the physician director shall be conducted and provided to the chief of service, hospital medical director and medical staff credentials committee for all physicians whose volume falls below these minimum volumes to determine actions deemed necessary; and
(c) the PCI capable cardiac catheterization laboratory center shall have a data manager who has special training in the clinical criteria used in the PCI module of the cardiac reporting system as provided by the department or its designee, is designated and authorized by the hospital and shall work in collaboration with the physician director to ensure accurate and timely reporting of cardiac reporting system data to the department. In addition to the data manager, relevant medical and administrative staff must be trained in the use of the cardiac reporting system and the specific data element definitions involved. For PCI capable cardiac catheterization laboratory centers that have a co-operated parent cardiac surgery center, responsibilities related to the cardiac reporting system may be performed by the cardiac surgery center on behalf of the data manager of the PCI capable cardiac catheterization laboratory center as long as all data is delineated at the facility level;
(iii) patient selection criteria. PCI capable cardiac catheterization laboratory centers shall adopt criteria for appropriate coronary artery diagnostic and interventional procedures in accordance with generally accepted standards for cardiac patients. For centers with no cardiac surgery on site and not co-operated with a New York State cardiac surgery center, patient selection criteria shall be reviewed and approved annually by the affiliated sponsored cardiac surgery center in accordance with subparagraph (c)(8)(i) of this section;
(iv) minimum workload standards. Each PCI capable cardiac catheterization laboratory center must maintain a minimum volume of at least 36 emergency percutaneous coronary intervention cases per year. For hospitals that are part of a co-operated article 28 network and multi-site facilities with more than one approved PCI capable cardiac catheterization laboratory center, and for PCI capable cardiac catheterization laboratory centers operating under a clinical sponsorship agreement pursuant to section 709.14(d)(5) of this Title, minimum volume standards for emergency PCI procedures are site specific and may not be combined for purposes of achieving minimum workload standards.
(a) PCI capable cardiac catheterization laboratory centers with an annual volume below 150 percutaneous coronary intervention cases a year for two consecutive calendar years, or a volume below 36 emergency percutaneous coronary intervention cases a year for two consecutive calendar years, must procure the services of an independent physician consultant, acceptable to the department, who shall conduct an annual review of the appropriateness and quality of the percutaneous coronary intervention cases performed at the facility and shall provide a copy of the findings directly to the department. Findings will be used by the department to determine whether continued approval or withdrawal of approval best meets the needs of the patients in the planning area.
(v) PCI capable cardiac catheterization laboratory centers with no cardiac surgery on-site must enter into a formal relationship documented by a fully executed written agreement with a cardiac surgery center meeting standards at subparagraph (c)(8)(i) of this section.
(3) Diagnostic cardiac catheterization services. No additional diagnostic cardiac catheterization services shall be approved. Diagnostic cardiac catheterization services hospitals are not approved to perform percutaneous coronary intervention or cardiac surgery, are subject to annual reviews of volume, appropriateness of cases and other quality indicators for diagnostic cardiac catheterization, and must meet the following standards:
(i) affiliation agreement. The hospital must enter into and maintain a fully executed written agreement with a cardiac surgery center with demonstrated high volume and high quality interventional cardiac services (cardiac surgery and percutaneous coronary interventions). The agreement, must be approved by the commissioner, and must provide, at a minimum, for the standards at subparagraph (c)(8)(i) of this section.
(ii) Patient selection criteria. Written criteria shall be adopted by the diagnostic cardiac catheterization service hospital to be used as indications for coronary angiography and or other cardiac invasive diagnostic procedures and shall be available for review during site visits.
(iii) minimum workload standards. There shall be sufficient utilization of a diagnostic cardiac catheterization service to ensure both quality and economy of services, as determined by the commissioner. For hospitals that are part of an article 28 network and for multi-site facilities with more than one approved cardiac catheterization laboratory center, minimum volume standards are site specific and may not be combined for purposes of achieving minimum workload standards. Any institution seeking to maintain approval shall present evidence that the annual minimum workload standards have been achieved and maintained. Diagnostic cardiac catheterization services shall achieve and maintain an annual minimum volume of 200 angiographic diagnostic cardiac catheterization procedures within two years of initial approval. Such procedures include left and or right heart catheterization with or without the use of contrast visualization and with or without coronary arteriograms, and such procedures exclude:
(a) placement of permanent or temporary pacemaker or automatic implantable cardioverter defibrillator (AICD);
(b) any floating type catheter;
(c) bundle of his study;
(d) balloon septostomy;
(e) radionuclide study;
(f) right heart catheterization without contrast visualization in adults;
(g) placement of intra-aortic balloon pump; and
(h) non-coronary studies.
(iv) Waiver of minimum workload standards. The commissioner may temporarily waive the workload requirements upon a satisfactory showing by the hospital that the quality of care provided is adequate as supported, at a minimum, by a review conducted by the department of cases, outcome trends and appropriateness of care, and that:
(a) there are extenuating circumstances temporarily precluding compliance with the workload requirements; and
(b) there is a documented unmet need in the center's geographical service area that cannot be met by existing PCI capable cardiac catheterization laboratory center laboratory centers.
(4) Pediatric cardiac catheterization laboratory centers. In addition to the standards at paragraph (1) of this subdivision, pediatric cardiac catheterization; laboratory centers must meet the following standards:
(i) pediatric cardiac catheterization laboratory centers are limited to hospitals approved to perform pediatric cardiac surgery and that meet standards at subdivision (d) of this section; and
(ii) during any interventional pediatric cardiac catheterization procedure and for a clinically appropriate period of time following such a procedure, a qualified pediatric cardiac surgeon must be immediately available for consultation and available on-site within 30 minutes, when requested, to perform procedures as needed to meet the patient's needs.
(5) Cardiac EP laboratory programs. In addition to the standards at paragraph (1) of this subdivision, cardiac EP laboratory programs must meet the following standards:
(i) structure and service requirements:
(a) cardiac electrophysiology laboratories must be adequately staffed and equipped for providing intracardiac electrophysiology procedures;
(b) an ultrasound (echocardiographic) machine must be readily available to the laboratory during all electrophysiology procedures;
(c) the cardiac EP laboratory program must have written protocols utilized for addressing complications including tamponade; and
(d) cardiac EP laboratory programs serving patients between the ages of 12 and 18 with adult cardiac surgery on site, but no pediatric cardiac surgery on site, must maintain pediatric trained personnel.
(ii) staffing. Staffing for cardiac EP laboratory programs shall include:
(a) electrophysiologists, board certified or with separate equivalent training and experience each of whom shall maintain an average annual volume of 50 adult cardiac electrophysiology procedures based on review of two years of cases, or 20 pediatric cardiac electrophysiology procedures per year depending on the population served. Review by the physician director shall be conducted and provided to the chief of service, hospital medical director and medical staff credentials committee for all physicians whose volume falls below these minimum workload standards to determine what actions are deemed necessary;
(b) physicians, on staff and immediately available to the laboratory with the expertise to perform local exploration and diagnose and treat tamponade; and
(c) registered nurses specifically trained in electrophysiology.
(iii) patient selection criteria.
(a) Written criteria shall be adopted to be used as indications and contraindications for cardiac electrophysiology procedures in accordance with generally accepted standards of medical care for cardiac patients.
(b) Not withstanding clause (1)(vi)( a ) of this subdivision, a hospital with a cardiac EP laboratory program and no cardiac surgery on-site shall not admit patients under the age of 18, patients in need of chronic lead extractions, patients being treated for ventricular tachycardia ablations, and patients being treated for atrial fibrillation ablations for cardiac EP laboratory program services. Additional patient selection criteria for cardiac EP laboratory programs with no cardiac surgery on-site shall be developed in collaboration with a cardiac surgery center with an active cardiac EP laboratory program and the agreed upon criteria shall be documented in writing.
(c) Notwithstanding clause ( a ) of this subdivision, a hospital with a cardiac EP laboratory program and with adult cardiac surgery on-site, but no pediatric cardiac surgery on-site may perform cardiac electrophysiology procedures on patients between the age of 12 and 18 when the patient's diagnosis and condition can be most appropriately treated in an adult program and when pediatric trained personnel are available to meet the additional needs of the patient and when consultation with a pediatric cardiologist is documented in writing for each pediatric patient.
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.9 Laundry and linen services
This functional reporting center must contain all the expenses associated with picking up, sorting, issuing, distributing, mending, washing, and processing in-service linens, including uniforms and special linens. Also included in this reporting center are linen purchases, purchased laundry services and the cost of disposable linen.
(a) Standard unit of measure: dry and clean pounds processed.
The total weight of linen processed for the residential health care facility's use (including patients' personal linen and linen applicable to employee housing). If the facility is presently weighing soiled linen, a conversion to dry and clean pounds must be made by dividing the soiled weight by 110 percent. If the facility is accumulating pieces of linen as a statistic, a conversion by weight of piece must be made. In those instances where disposable linen substitutes are utilized, an equivalent weight statistic in terms of actual linen must be included.
(b) Data source.
The weight should be determined from an actual measurement maintained by the laundry and linen department.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.9 Determining patient eligibility
(a) At the time of the initial assessment, and at the time of each subsequent assessment performed for a long-term home health care program, or more often if the person's need requires it, the local social services district shall establish a monthly budget in accordance with which payment shall be authorized.
(1) The budget shall include all of the services to be provided in accordance with the coordinated health plan of care by the long-term home health care program.
(2) Total monthly expenditures made for a long-term home health care program for an individual who is the sole member of his/her household in the program shall not exceed a maximum of 75 percent of the average monthly rates payable for nursing home services or health-related services in an intermediate care facility in the social services district, whichever is the appropriate level for the individual. Total monthly expenditures made for a long-term home health care program for two members of the same household shall not exceed a maximum of 75 percent of the average monthly rates payable for both members of the household for nursing home services or health-related services in an intermediate care facility in the social services district, whichever is the appropriate level for each person.
(3) When the monthly budget prepared for an individual who is the sole member of his/her household in the program is for an amount less than 75 percent of monthly rates payable for nursing home services or health-related services, a “credit” may be accrued in behalf of the individual. If a continuing assessment of the individual's needs demonstrates that he/she requires increased services, the local social services department may authorize any amount accrued during the previous 12 months over the 75 percent maximum. When the monthly budget prepared for two members of the same household is for an amount less than 75 percent of monthly rates payable for nursing home services or health-related services, “credit” may be accrued in behalf of the household. If a continuing assessment of the household's needs demonstrates that he/she/they require increased services, the local social services department may authorize any amount accrued during the previous 12 months over the 75 percent maximum.
(4) When the monthly budget prepared for an individual or a household is for an amount less than 75 percent of monthly rates payable for nursing home services or health-related services, and the continuing assessment of the person's needs demonstrates that he/she/they require increased services in an amount less than 10 percent of the prepared monthly budget, but totaling no more than 75 percent of the monthly rates payable for nursing home services or health-related services, the long-term home health care program may provide such services without prior approval of the local department of social services.
(5) If an assessment of the person's or household's needs demonstrates that he/she/they require services, the payment for which would exceed such monthly maximum, but it can be reasonably anticipated that total expenditures for required services for such person or household will not exceed such maximum calculated over a one-year period, the social services official may authorize payment for such services.
(b) If a joint assessment by the local social services district and the provider of services indicates that the maximum expenditure permitted under paragraph (4) of this subdivision is not sufficient to provide long-term home health care program (LTHHCP) services to individuals with special needs, social services officials may authorize maximum monthly expenditures for such individuals, not to exceed 100 percent of the average skilled nursing or health-related facility rate established for that district (see 367-c[3-a] of the Social Services Law). In addition, if a continuing assessment of a person with special needs demonstrates that he/she requires increased services, a social services official may authorize the expenditure of any amount which has accrued under this section during the previous 12 months as a result of the expenditures for a person participating in the LTHHCP not having exceeded such maximum. If an assessment of a person with special needs demonstrates that he/she requires increased services, the payment for which would exceed such monthly maximum, the social services official may authorize payment for such services if it can reasonably be anticipated that the total expenditures for the required services for such a person will not exceed the maximum calculated over a one-year period.
(1) As used in this subdivision, the term person with special needs means a person for whom a plan of care has been developed (see subdivision [2] of section 367-c of the Social Services Law):
(i) who needs care including but not limited to respiratory therapy, tube feeding, decubitus care or insulin therapy which cannot be appropriately provided by a provider of personal care services as defined in section 505.14(d) of this Part;
(ii) who has one or more of the following conditions: a mental disability (see section 1.03 of the Mental Hygiene Law), acquired immune deficiency syndrome, or dementias, including Alzheimer's disease.
(2) The number of persons with special needs for whom a social services official may authorize payment for services pursuant to this paragraph is limited to 25 percent of the total number of LTHHCP clients which a social services district is authorized to serve, provided that in any district containing a city having a population of one million or more, such limit is 15 percent.
(3) In the event that a district reaches the limitation specified in this subdivision, the social services official may, upon approval by the social services commissioner, authorize payment for services pursuant to this subdivision for additional persons with special needs.
(4) The social services official must seek approval for authorization to serve additional persons with special needs by submitting to the State Commissioner of Social Services a written request which demonstrates that the provisions of this paragraph have:
(i) met the needs of individuals who could not otherwise be served through the LTHHCP;
(ii) diverted clients from residential health care facility admission; or
(iii) permitted the admission of clients on alternate care status into the LTHHCP.
(c) The provisions of this section shall not apply to patients diagnosed with Acquired Immune Deficiency Syndrome as defined by ICD-9 codes 042, 043 and 044 if such patient is receiving services through a designated AHCP.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.19 Security controls for nonpractitioners; manufacturing areas
All manufacturing activities, including processing, packaging, and labeling, involving controlled substances listed in any schedule shall conform to the following security controls:
(a) All substances in process of manufacture shall be returned to the controlled substances storage area at the termination of the process. If the process is not completed at the end of a workday, except where a continuous process or other normal manufacturing operation should not be interrupted, the processing area or tanks, vessels, bins, or bulk containers containing controlled substances shall be securely locked inside an area or building which affords adequate security.
(b) Manufacturing activities with controlled substances shall be conducted in an area or areas with limited access and shall be kept under surveillance by an employee or employees designated in writing by the licensee to be responsible for the area. The designated employee or employees shall be able to provide continuous surveillance of the area in order that unauthorized persons may not enter or leave the area without his knowledge. Limited access may be accomplished by use of physical dividers such as walls or partitions, by traffic control lines or by restricted space designations.
(c) During the production of controlled substances, the manufacturing area shall be accessible only to those employees necessary for efficient operation. If it is necessary for maintenance personnel, visitors or others to be present or pass through the manufacturing areas during production, the licensee shall have an employee designated in writing as being responsible for providing surveillance of the area.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 114 ESSEX COUNTY
VILLAGES VILLAGES
10 CRR-NY 114.3 Village of Saranac Lake
(a) [Application.]
The rules and regulations hereinafter given, duly made in accordance with the provisions of sections 70, 71 and 72 of the Public Health Law, heretofore set forth, shall apply to the entire drainage area of McKenzie Lake or Pond, situated in the townships of St. Armand and North Elba, Essex County, which forms the source of the public water supply of the village of Saranac Lake, New York.
(b) [Definitions.]
(1) The term lake wherever used in this section is intended to refer to McKenzie Lake or Pond.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, stream, ditch, gutter or other natural channel or permeable artificial pipe or conduit of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into McKenzie Lake or Pond.
(3) Wherever in this section a linear distance of a structure or object from the lake or from a watercourse is mentioned, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of McKenzie Lake or Pond, or to the edge, margin or precipitous bank forming the ordinary normal high-water mark of such watercourses.
(c) Privies adjacent to the lake and watercourses.
(1) No water closet, privy, privy vault, pit or cesspool or other place or receptacle of any kind whatever used for the temporary or permanent deposit, reception or storage of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of the lake or within 200 feet of any watercourse.
(2) No water closet, privy, privy vault, pit, cesspool or other place or receptacle of any kind, used for the temporary or permanent deposit, reception or storage of human excreta, other than the watertight, removable receptacles hereinafter prescribed, shall be located, placed, maintained or allowed to remain within 600 feet of the lake or of any watercourse.
(3) Every water closet, privy or place for the deposit, reception or storage of human excreta which is constructed, located, maintained or allowed to remain within the aforesaid 600 feet of the lake or of any watercourse shall be arranged in such manner that all of said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles shall be removed to the garbage lot of the village of Saranac Lake, New York, or other accessible and suitable place outside of the watershed of the said McKenzie Lake and the receptacles emptied, cleansed and deodorized as often as may be found necessary to maintain the privy in thoroughly sanitary condition and to effectually and strictly prevent any overflow whatever upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal herein specified and that the least possible annoyance or inconvenience be caused to the occupants of the premises or of adjoining premises. The excreta removed shall be thoroughly buried and covered in trenches or thoroughly dug into the soil in such place and manner that no sanitary harm, annoyance or objection may result therefrom.
(5) Whenever it shall be found that, owing to the character of the soil or the surface of the ground or to the height or flow of the subsoil or surface water or other special local condition, the excretal matter from any privy or aforesaid receptacle may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil into the lake or into any watercourse, then the said privy or receptacle for excreta shall, after due notice to the owner, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, offal, garbage, putrescible matter, etc.
(1) No sewage or excremental matter of any kind nor any compost or mixture containing the same shall be thrown, placed, led, conducted or discharged or allowed to escape or pass into the lake or any watercourse nor onto or into the ground within 600 feet of the lake or any watercourse.
(2) No offal, garbage or putrescible animal or vegetable matter of any kind nor any bath water, wash water or other polluted water or liquid shall be thrown, placed, led, conducted, discharged or allowed to escape or pass into the lake or into any watercourse, nor onto or into the ground within 300 feet from the lake or within 200 feet of any watercourse.
(3) No clothing, bedding, carpet, harness, vehicle, utensil nor anything that pollutes water shall be washed, rinsed or placed in the lake or in any watercourse.
(e) Stables, animals, manure, etc.
(1) No stable, cattle pen, pigsty, hog lot, poultry house, poultry yard, barnyard, hitching place or standing place for horses or other animals and no manure pile, compost heap, piles of fermented or decayed fruit, vegetables, roots, grain or other vegetable substances shall be located, placed, maintained or allowed to remain in such place or manner that the washings or drainage therefrom may flow by open, blind or covered drains or channels of any kind into McKenzie Lake or into any pond, reservoir, spring, stream, ditch, gutter or watercourse aforesaid, without first having passed over or through the soil in a scattered, dissipated form and not concentrated in definite lines of flow for a distance of at least 300 feet before entering the lake or at least 200 feet before entering any watercourse, and in no case shall the distance of any of the above named objects, places or material be less than 300 feet from the lake nor less than 200 feet from any watercourse.
(2) No manure or compost of any kind shall be deposited or spread upon the ground so as to be washed in a scattered, dissipated form and not concentrated in definite lines of flow for a distance less than 300 feet before entering the lake nor less than 200 feet before entering any watercourse.
(f) Bathing, boating, camps and cottages.
(1) No person shall wash, bathe or swim in the lake nor in any watercourse within one mile of its mouth at the lake.
(2) No raft, boat, launch or other craft shall be kept or used for any purpose on the lake, except that one row boat may be kept by the water department of the village of Saranac Lake and used only for purposes necessary to the operation, use or maintenance of the lake as a source of water supply to the village of Saranac Lake, and when not so used shall be so kept or fastened as not to be used for any other purpose nor by any other person than the one duly authorized by the said water department.
(3) No person or persons shall erect, maintain, use or occupy any tent, camp, cottage or other structure on any state land within a distance of 300 feet from the shore of the said lake or any watercourse flowing into it; and no person or persons, except representatives of the sewer and water board or board of health for some necessary purpose in connection with the said water supply, shall, when the said lake is frozen, enter upon the ice thereon or travel over the same either on foot or otherwise.
(g) General prohibition.
All persons are hereby forbidden to pollute or defile by any means or to be or become in any manner accessory to the pollution or the defiling by any means of the waters of said McKenzie Lake or any of its tributaries, either on or in the waters of the lake or any watercourse or on the banks or adjacent land, in such manner as thereby to pollute the waters of the lake or any watercourse.
(h) Inspections.
The water department of the village of Saranac Lake shall maintain systematic and thorough inspections of the lake, its watercourses and its drainage area for the purpose of determining whether the above rules are complied with. At least four such inspections shall be made each year, and such other or special inspections shall be made when directed by the State Commissioner of Health. Full and detailed reports of each such regular and special inspection shall be made in writing by the water department to the State Commissioner of Health within five days of the date of completion and within 10 days of the date of beginning each such inspection.
(i) Penalty.
In accordance with the provisions of section 70 of chapter 661 of the Laws of 1893, as finally amended by chapter 484 of the Laws of 1904, the penalty for each and every violation of or noncompliance with any of the above rules or regulations which relate to a permanent source or act of contamination or to a permanent violation is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.10 Compliance with standards
Tissue banks, including tissue transplantation facilities, insemination/implantation sites, human milk transfer stations and nontransplant anatomic banks, shall allow admission to representatives of the department for the purpose of inspecting the premises and evaluating the operating procedures, equipment and records, including financial records and lists of physicians or facilities to whom or to which human tissue is released, to determine compliance with the standards in this Part. No tissue bank or nontransplant anatomic bank may acquire, process, store or distribute tissue or nontransplant anatomic parts in New York State unless the bank has been issued a license by the department, or as otherwise specified in this Part. If the commissioner determines that a bank's failure to comply with the standards set forth in this Part creates a significant likelihood that the health, safety and welfare of potential patients and other persons in contact with tissue or nontransplant anatomic parts from the bank is in jeopardy, the department may require that tissue not be released pending a hearing. The hearing shall commence within 15 days of any suspension pursuant to this section.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 703 AMBULATORY SERVICES
10 CRR-NY 703.4 Extension clinics
Notwithstanding the requirements of this Chapter, extension clinics shall submit to the department a plan acceptable to the commissioner governing the location and objectives of the extension clinic, the relationships to the parent organization and a detailed program of operation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 37 HANDLING OF BODIES OF PERSONS DYING ON COMMON CARRIERS
10 CRR-NY 37.4 Burial or transit permit
Upon receipt of a certificate of death, which shall be filed by the undertaker engaged, or the person in charge of the body, the registrar of vital statistics of the district in which the body has been removed from a common carrier shall issue a burial or transit permit.
Subchapter I ENVIRONMENTAL HEALTH
Part 71 REQUIREMENTS FOR VENT-FREE GAS SPACE HEATING APPLIANCES
10 CRR-NY 71.2 Definitions
(a) Sizing guidelines means printed instructions provided by the manufacturer that contain information on selecting vent-free gas space heating appliance with appropriate heat output.
(b) Vent-free space heating appliance, also known as a gas-fired unvented room heater, means an unvented, self-contained, gas-burning appliance for connection to the house fuel supply system and for furnishing heat to the space in which installed, directly from the appliance without duct connection. These appliances may be free-standing, wall mounted or for insertion in a noncombustible fireplace.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.25 Age
The number of years or other time periods an asset or asset group has remained in service at a given date.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 101 ALLEGANY COUNTY
10 CRR-NY 101.2 Village of Richburg
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the springs, located on land, owned by the village of Richburg and situated approximately one and a half to two and a quarter miles northeast of the village of Richburg and which form the sources of the public water supply of the village of Richburg, Allegany County, N.Y.
(b) [Definitions.]
(1) The term springs wherever used in this section is intended to mean and refer to all springs, infiltration galleries or collecting tiles now used as a source of this public water supply or to any additional spring, infiltration gallery or collecting tile, which may be constructed for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a spring is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the spring, infiltration gallery or collecting tile.
(c) Privies adjacent to any spring.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any spring, forming the sources of the public water supply of the village of Richburg.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any spring forming the sources of the public water supply of the village of Richburg.
(3) Every privy, privy vault, pit or other receptacle of any kind placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any spring forming the sources of the public water supply of the village of Richburg.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any spring, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any spring forming the sources of the public water supply of the village of Richburg.
(2) garbage, putrescible matter, kitchen or sink wasted, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight contained, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any spring forming the sources of the public water supply of the village of Richburg.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any spring forming the sources of the public water supply of the village of Richburg, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any spring without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any spring forming the sources of the public water supply of the village of Richburg.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 300 feet of any spring; and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 100 feet of any spring forming the sources of the public water supply of the village of Richburg.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any spring forming the sources of the public water supply of the village of Richburg.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Richburg upon which the springs forming the sources of the public water supply of the village of Richburg are located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply except such other persons as may be authorized to enter said property by the board of trustees of the village of Richburg.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 300 feet of any spring forming the sources of the public water supply of the village of Richburg.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any spring forming the sources of the public water supply f the village of Richburg.
(j) Inspections.
The board of trustees of the village of Richburg or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Richburg or their duly appointed representative shall make regular and thorough inspections of the area surrounding the springs for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the springs at the time of the last inspection.
(k) [General clause.]
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the public water supply of the village of Richburg.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
VARIANCES AND EXEMPTIONS VARIANCES AND EXEMPTIONS
10 CRR-NY 5-1.93 Variance or exemption requests
(a) All requests for a variance or an exemption shall be in a form prescribed by and submitted in writing to the department. Suppliers of water may submit a joint request for variances or exemptions when they seek similar variances or exemptions under similar circumstances. The department shall act on any request for a variance or an exemption submitted pursuant to section 5-1.90, 5-1.91 or 5-1.92 of this Subpart within 90 days of receipt of the request.
(b) Requests for exemptions to the filtration requirements outlined in section 5-1.30(b) of this Subpart must be made by June 29, 1992, except for systems with groundwater sources determined to be directly influenced by surface water. For systems with groundwater sources directly influenced by surface water the request for an exemption must be submitted no later than six months after notification of the determination of direct influence. Before an exemption to a filtration requirement can be granted, the supplier of water must demonstrate to the department that the granting of the exemption will not pose an unreasonable risk to public health and that the system is in compliance with sections 5-1.30(c)(5), (c)(8), (g) and 5-1.52 tables 3, 6, 9 and 11 of this Subpart.
(c) Systems with unfiltered surface water sources or groundwater sources directly influenced by surface water must have a disinfection capability that achieves at least 99 percent inactivation of Giardia lamblia cysts before an exemption to a filtration requirement can be granted.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
GENERAL GENERAL
10 CRR-NY 415.2 Definitions
The following definitions, unless context clearly requires otherwise shall apply to this Article:
(a) Ambulant resident (see section 415.37[a][3] of this Part).
(b) Certified nurse aide shall mean an individual who is listed in the New York State Nursing Home Nurse Aide Registry as specified in section 415.26(d) of this Part.
(c) Clinical skills evaluator (see section 415.26[d][1][iii] of this Part).
(d) Commissioner shall mean the State Commissioner of Health.
(e) Department shall mean the New York State Department of Health.
(f) Designated representative shall mean the individual or individuals designated in accordance with this subdivision to receive information and to assist and/or act in behalf of a particular resident to the extent permitted by State law; it being understood that a designated representative specified in subparagraph (1)(iii) of this subdivision is not a health care agent as defined in article 29-C of the Public Health Law.
(1) Such individual or individuals shall be designated, with such designation noted in the clinical record:
(i) by a court of law when the designation of an individual, committee or guardian has been sought;
(ii) by the resident if the resident has the capacity to make such designation; or
(iii) by family members and other parties who have an interest in the well-being of the resident who, after discussion with the facility, identify the individual or individuals most personally involved in the resident's care, if the resident lacks the capacity to make such designation.
(2) The designated representative shall:
(i) receive any written and oral information required by this Part to be provided to the resident if such resident lacks the capacity to understand or make use of such information, and also receive any information required to be provided to both the resident and the designated representative; and
(ii) participate to the extent authorized by State law in decisions and choices regarding the care, treatment and well-being of the resident if such resident lacks the capacity to make such decisions and choices.
(g) Governing body shall mean the policy-making body of a government agency, the board of directors or trustees of a corporation or the proprietor or proprietors of a proprietary nursing home to which the department has issued an operating certificate.
(h) Nurse aide (see section 415.13[c][1] of this Part).
(i) Nurse aide trainee shall mean an individual who is participating in a State approved residential health care facility nurse aide training program.
(j) Nurse aide training program coordinator (see section 415.26[d][1][i] of this Part).
(k) Nursing home, also referred to in this Part as a residential health care facility or a facility, shall mean a facility, institution, or portion thereof subject to article 28 of the New York State Public Health Law, providing therein, lodging for 24 or more consecutive hours to three or more nursing home residents who are not related to the operator by marriage or by blood within the third degree of consanguinity, who need regular nursing services or other professional services but who shall not need the services of a general hospital.
(l) Primary instructor (see section 415.26[d][1][ii] of this Part).
(m) Resident, or nursing home resident, shall mean an individual who has been admitted to and who resides in a nursing home and who is entitled to receive care, treatment and services in accordance with the requirements of this Part.
(n) Resident care unit or nursing unit shall mean a designated area including a group of resident rooms with adequate supporting rooms, areas, facilities, services, and personnel providing nursing care and management of residents which is planned, organized, operated and maintained to function as a unit so as to encourage the efficient delivery of resident services and effective observation of and communication with residents.
(o) Resident council shall mean the resident organization created by residents of a nursing home and recognized by the facility as the group that represents the interests of its membership.
(p) Respiratory care and therapy shall mean the care for any portion of the respiratory tract, especially the lungs. This care may include but not be limited to the following: percussion or cupping, postural drainage, positive pressure machine and where appropriate, use of oxygen to administer drugs.
(q) Respiratory therapist or respiratory therapy technician shall mean a person who holds a baccalaureate degree, associate degree, certificate or diploma in respiratory or inhalation therapy from a college, university, institution, hospital school or program accredited by the State Education Department of the Joint Review Committee for Inhalation Therapy Education, or who demonstrates equivalent proficiency to the employing facility by means of an evaluation by two qualified medical specialists.
(r) Qualified specialist shall mean a physician who holds a current license to practice medicine in the State of New York, and who:
(1) is a diplomate of the appropriate American board or who has been certified as a specialist by the American Osteopathic Specialty Board for the respective specialty; or
(2) has been notified of admissibility to examination by such board, or presents evidence of completion of an approved qualifying residency in such specialty; or
(3) holds the rank of attending or associate attending specialist in an accredited voluntary or governmental hospital which is approved for training in the speciality in which the physician has privileges; or
(4) holds an appropriate specialist rating granted by the Workers' Compensation Board after May 1960, provided the award is based on training approved by the respective specialty board.
(s) Sponsor shall mean the agency or the person or persons, other than the resident, responsible in whole or in part for the financial support of the resident, including the costs of care in the facility.
(t) Withdrawal of equity (see section 415.26[h][7] of this Part).
(u) Feeding assistant (see section 415.13[d][1] of this Part).
(v) Local contact agency shall mean an agency designated by the department to accept referrals of nursing home residents that wish to receive information about services in the community. Local contact agencies shall contact referred nursing home residents and provide them with information and counseling on available home- and community-based services. Local contact agencies shall also either assist residents directly with transition services or refer residents to organizations that assist with transition services, as appropriate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.1 Applicability
This Subpart shall be applicable to all persons who propose to establish and/or operate a health maintenance organization (HMO), special purpose health maintenance organization, also known as a prepaid health services plan (PHSP), comprehensive HIV special needs plan (HIV SNP) or, as specified, a primary care partial capitation provider (PCPCP) or managed long term care plan (MLTCP) or who currently operate an HMO, PHSP, HIV SNP or, as specified, a PCPCP or MLTCP certified under article 44 of the Public Health Law within the State of New York, which may hereinafter be referred to individually or collectively as managed care organization (MCOs).
Subchapter B STATE AID AND FUNDING
Part 41 GRANTS FOR SCHOOL HEALTH PROJECTS
10 CRR-NY 41.4 Waivers
The Commissioner of Health may waive any provision of the Public Health Law and regulations promulgated pursuant thereto in order to implement school health projects under this Part. Any such waivers shall only be effective for the duration of the grant contract entered into under this Part.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-4 CLASSIFICATION AND CERTIFICATION OF COMMUNITY AND NONTRANSIENT NONCOMMUNITY WATER SYSTEM OPERATORS
10 CRR-NY 5-4.2 Certification required
(a) Certification required.
(1) Sections 5-4.1 through 5-4.8 of this Subpart shall be applicable to all CWS and NTNC, provided the system serves 15 or more service connections or serves 25 or more persons.
(2) Owners of all CWS and NTNC are required to place the direct supervision of their water system, including each treatment plant and/or the distribution system, under the responsible charge of a water treatment operator(s) holding a valid certification equal to or greater than that required for the classification of the treatment plant and/or distribution system as set forth in Table 5-4.2 of this section. (Population figures will be based on an average of four residents per dwelling unit, unless otherwise demonstrated by the supplier of water.) The owner is required to indicate to the State, within three months of the effective date of this regulation, who the operator(s) in responsible charge is for their facility. If this designation changes, the owner is required to submit written notification to the State within a period not to exceed one month with the information regarding the new operator(s) in responsible charge.
(3) All operating personnel making process control/system integrity decisions about water quality or quantity that effect public health must be appropriately certified as set forth below and be under the direction of an operator in responsible charge.
Table 5-4.2–Plant Classification/Operator Requirements— All water treatment processes must be in accordance with the acceptable methods of treatment outlined in sections 5-1.22 and 5-1.30 of this Part.
| Plant type | System complexity | System classification | Required minimum grade operator Assistant operator | | --- | --- | --- | --- | | Water treatment plant with facilities for filtration which is designed to treat over 2.5 MGD (million gallons per day) | Surface water or ground water systems under the direct influence of surface water that provides filtration. | IA | IA IIA | | Water treatment plant with facilities for filtration which is designed to treat 2.5 MGD or less | Surface water or ground water systems under the direct influence of surface water that provides filtration. | IIA | IIA IIA | | Water treatment plant which is designed to treat over 2.5 MGD | Ground water (excluding ground water under the direct influence of surface water) or surface water systems with filtration avoidance without facilities for clarification. | IB | IB IIB | | Water treatment plant which is designed to treat 2.5 MGD or less | Ground water (excluding ground water under the direct influence of surface water) or surface water systems with filtration avoidance without facilities for clarification. | IIB | IIB C | | Water treatment plant and/or distribution system that is designed to serve 1,000 people or less | Systems with facilities for basic treatment (including bag, cartridge, pressure and/or other basic filtration as outlined in sections 5–1.22 and 5–1.30 of this Part), and/or pressure zones, booster stations, storage tanks, fire protection, disinfection, non-residential consumers, cross-connection potential, demand variations, etc. | C | C none required | | Distribution system serving greater than 1,000 people and/or purchasing water system. | Pressure zones, booster stations, storage tanks, fire protection, disinfection, non-residential consumers, cross-connection potential, demand variations, etc. | D | D none required |
(4) A designated certified operator must be available during plant operation.
(5) The only grades certified to operate distribution systems are grade C for a distribution system that serves 1,000 people or less and grade D for distribution systems that serve greater than 1,000 people and/or purchasing water systems with responsibility for distribution of water only.
(b) Certification procedures.
(1) Any person seeking certification shall submit an application on a form prescribed by the department including all of the information outlined in section 5-4.3 of this Subpart. Upon approval, the department will issue a certificate that specifies the operator grade consistent with the operator's qualifications as outlined in Table 5-4.3 of this Subpart.
(2) Certificates shall be valid for a period of three years unless revoked by the department prior to that time.
(3) Upon issuance of a certificate, the certified operator must inform the department, within 30 days, of any changes in address or employment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-3 PREGNANT WOMEN, TESTING FOR HEPATITIS B, FOLLOW-UP CARE
10 CRR-NY 69-3.6 Responsibilities of health care providers providing follow-up care for newborn children of women with a positive HBsAg test result
Health care providers providing follow-up care for newborn children of women with a positive HBsAg test result shall arrange for follow-up immunizing doses of hepatitis B vaccine to be administered one and six months or one, two and twelve months after the first dose.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
ENVIRONMENTAL HEALTH DIRECTOR ENVIRONMENTAL HEALTH DIRECTOR
10 CRR-NY 11.90 Definitions
(a) The term environmental health director shall mean a person who administers and manages the environmental health programs of a county, or a city having a population of 50,000 or more.
(b) The term natural science shall mean a science such as biology, chemistry or physics that deals with the objects, phenomena, or laws of nature and the physical world. It shall include all physical and biological sciences.
(c) The term applied science shall mean science based courses in environmental technology, sanitation technology, medical technology, public health, infection control or food science.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.123 Facility
A coordinated group of fixed assets—land, buildings, machinery and equipment—constituting a plant.
10 CRR-NY 441.77 Critical care units (type II)
(a) Intensive nursing care.
(b) Intensive nursing care 24 hours a day.
(c) Medical director who has completed residency training in one of the major clinical specialties and has acquired advanced skills and knowledge in life support and patient monitoring techniques.
(d) MD rounds within the unit at least every 24 hours, and available in-house or on call 24 hours a day.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.14 Records
(a) General provisions.
(1) Each licensee or registrant shall use the SI units- becquerel, gray, sievert and coulomb per kilogram, or the special units: curie, rad, rem, and roentgen, including multiples and subdivisions, and shall clearly indicate the units of all quantities on records required by this Part.
(2) The licensee or registrant shall make a clear distinction among the quantities entered on the records required by this Part, such as, total effective dose equivalent, shallow dose equivalent, eye dose equivalent, deep dose equivalent, or committed effective dose equivalent.
(3) Form of records.
Each record required by this Part shall be legible throughout the specified retention period. The record shall be the original or a reproduced copy or a microform, provided that the copy of microform is authenticated by authorized personnel and that the microform is capable of producing a clear copy throughout the required retention period, or the record may also be stored in electronic media with the capability for producing legible, accurate, and complete records during the required retention period. Records, such as letters, drawings, and specifications shall include pertinent information, such as stamps, initials, and signatures. The licensee shall maintain safeguards sufficient to prevent tampering with and loss of records.
(4) The discontinuance of or curtailment of activities does not relieve any person who possesses any radiation source of responsibility for retaining all records required by this Part.
(b) Records of radiation protection programs.
(1) Each licensee or registrant shall maintain records of the radiation protection program, including:
(i) the provisions of the program; and
(ii) audits and other reviews of program content and implementation.
(2) The licensee or registrant shall retain the records required by subparagraph (1)(i) of this subdivision until the department terminates each pertinent license or registration requiring the record. The licensee or registrant shall retain the records required by subparagraph (1)(ii) of this subdivision for three years after the record is made.
(c) Records of surveys.
(1) Each licensee or registrant shall maintain records showing the results of surveys and calibrations required by sections 16.10(a) and 16.16(b) of this Part. The licensee or registrant shall retain these records for three years after the record is made.
(2) The licensee or registrant shall retain each of the following records until the department authorizes the disposition of these records:
(i) records of the results of surveys to determine the dose from external sources of radiation used, in the absence of or in combination with individual monitoring data, in the assessment of individual dose equivalents; and
(ii) records of the results of measurements and calculations used to determine individual intakes of radioactive material and used in the assessment of internal dose; and
(iii) records showing the results of air sampling, surveys, and bioassays required pursuant to section 16.26(c)(1)(iii)( a ) and ( b ) of this Part; and
(iv) records of the results of measurements and calculations used to evaluate the release of radioactive effluents to the environment.
(3) Upon termination of the license or registration, the licensee or registrant shall permanently store records on department form “Cumulative Occupational Radiation Exposure History” or equivalent, until disposition is authorized by the department.
(4) Records of tests for leakage or contamination of sealed sources. Records of tests for leakage or contamination of sealed sources required by section 16.10(a)(4) of this Part shall be kept in units of becquerel or microcuries and maintained for inspection by the department.
(d) Records of prior occupational dose.
(1) The licensee or registrant shall retain the records of prior occupational dose and exposure history as specified in section 16.6(e) of this Part on department form “Cumulative Occupational Radiation Exposure History” or equivalent, and the records used in preparing department form “Cumulative Occupational Radiation Exposure History” until disposition is authorized by the department.
(2) Upon termination of the license or registration, the licensee or registrant shall permanently store records on department form “Cumulative Occupational Radiation Exposure History” or equivalent, or shall make provision with the department for transfer to the department.
(e) Records of planned special exposures.
(1) For each of the provisions of section 16.6(f) of this Part for planned special exposures, the licensee or registrant shall maintain records that describe:
(i) the exceptional circumstances requiring the use of a planned special exposure; and
(ii) the name of the management official who authorized the planned special exposure and a copy of the signed authorization; and
(iii) what actions were necessary; and
(iv) why the actions were necessary; and
(v) what precautions were taken to assure that doses were maintained ALARA; and
(vi) what individual and collective doses were expected to result; and
(vii) the doses actually received in the planned special exposure.
(2) The licensee or registrant shall retain the records until disposition is authorized by the department.
(3) Upon termination of the license or registration, the licensee or registrant shall permanently store records on department form “Cumulative Occupational Radiation Exposure History”, or until disposition is authorized by the department.
(f) Records of individual monitoring results.
(1) Recordkeeping requirement.
Each licensee or registrant shall maintain records of doses received by all individuals for whom monitoring was required pursuant to section 16.11 of this Part, and records of doses received during planned special exposures, accidents, and emergency conditions. Assessments of dose equivalent and records made using units in effect before the effective date of this Part need not be changed. These records shall include, when applicable:
(i) the deep dose equivalent to the whole body, eye dose equivalent, shallow dose equivalent to the skin, and shallow dose equivalent to the extremities; and
(ii) the estimated intake or body burden of radionuclides, see section 16.6(b) of this Part; and
(iii) the committed effective dose equivalent assigned to the intake or body burden of radionuclides; and
(iv) the specific information used to calculate the committed effective dose equivalent pursuant to section 16.6(d) of this Part; and
(v) the total effective dose equivalent when required by section 16.6(b) of this Part; and
(vi) the total of the deep dose equivalent and the committed dose to the organ receiving the highest total dose.
(2) Recordkeeping frequency.
The licensee or registrant shall make entries of the records specified in this subdivision at least annually.
(3) Recordkeeping format.
The licensee or registrant shall maintain the records specified in this subdivision on department form “Occupational Radiation Exposure Record for a Monitoring Period”, or in clear and legible records containing all the information required by such form.
(4) The licensee or registrant shall maintain the records of dose to an embryo/fetus with the records of dose to the declared pregnant woman. The declaration of pregnancy, including the estimated date of conception, shall also be kept on file, but may be maintained separately from the dose records.
(5) The licensee or registrant shall retain each required form or record until disposition is authorized by the department.
(6) Upon termination of the license or registration, the licensee or registrant shall permanently store records on department form “Cumulative Occupational Radiation Exposure History” or equivalent, until disposition is authorized by the department.
(g) Records of dose to individual members of the public.
(1) Each licensee or registrant shall maintain records sufficient to demonstrate compliance with the dose limit for individual members of the public (see section 16.7[a] of this Part).
(2) The licensee or registrant shall retain the records required by this subdivision until disposition is authorized by the department.
(h) Records of testing entry control devices for very high radiation areas.
(1) Each licensee or registrant shall maintain records of tests made pursuant to section 16.12(f)(2)(ix) of this Part on entry control devices for very high radiation areas. These records must include the date, time, and results of each such test of function.
(2) The licensee or registrant shall retain the records required by this subdivision for three years after the record is made.
(i) Records of transfer, or receipt of radioactive materials.
(1) Each licensee shall maintain accurate and complete written records for each transfer or receipt of radioactive materials including radioactive waste.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.57 Environmental and occupational health exposure investigation, assessment and response; performance standards
The local health department shall maintain and conduct a program that includes, at a minimum:
(a) responding to reports of exposure to chemical and non-communicable biological hazards attributable to environmental and occupational settings. Such responses shall include, at a minimum, preliminary evaluation and exposure investigation; appropriate environmental, biological, clinical or epidemiological monitoring; appropriate public health interventions to reduce and/or eliminate exposures; public or professional information and education; and consultation and referral as needed; and
(b) maintaining a log of reported exposures and alleged health effects, including a timeline and description of the response provided.
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-2 MANAGEMENT OF REGULATED MEDICAL WASTE
10 CRR-NY 70-2.3 Treatment and disposal
(a) Except as provided in subdivisions (b) and (c) of this section, treatment of regulated medical waste shall be by:
(1) discharge into a sanitary sewerage system connected to a secondary treatment facility, if the waste is liquid or semi-liquid, except as specifically prohibited by the Commissioner of Health, or by local law or ordinance;
(2) incineration in a regulated medical waste incineration facility under permit pursuant to article 19 of the Environmental Conservation Law;
(3) decontamination by autoclaving in conformance with the requirements of Subpart 70-3 of this Part; or
(4) an alternative regulated medical waste treatment system approved by the Commissioner of Health.
(b) Restrictions on autoclave use.
(1) No autoclave shall be used for treatment of regulated medical waste containing or mixed with hazardous waste and/or toxic drug waste.
(2) No autoclave shall be used for treatment of radiological medical waste.
(3) No autoclave shall be used for treatment of recognizable human body parts.
(4) An autoclave may be used for the treatment of human tissue(s), human organs; animal carcasses or animal body parts provided the department has expressly approved the autoclave model as an alternative treatment technology for such use pursuant to Subpart 70-5 of this Part.
(c) Cultures and stocks.
(1) Cultures and stocks containing select agents or toxins listed in 42 CFR part 73 (Vol. 70, March 18, 2005) shall be treated on-site by incineration, autoclaving or use of alternative treatment system approved for such treatment provided, however, whenever a facility without a predictable need for on-site treatment generates such waste incidental to the delivery of medical care, the generating facility shall arrange for transportation of the select agents and toxins to a facility authorized to treat such material and shall comply with Federal regulations regarding possession, use and transfer of select agents and toxins. Such regulation shall include 42 CFR, part 73 (Vol. 70, March 18, 2005). Federal regulations are published by the Office of the Federal Register, National Archives and Records Administration and may be purchased from the Superintendent of Documents, Government Printing Office, Washington, DC 20402. Copies are available for inspection and copying in the New York State Department of Health, Bureau of Hospital and Primary Care Services, Hedley Park Place, 433 River Street, Troy, NY 12180.
(2) Except where on-site treatment is required by local health code, cultures and stocks containing infectious agents other than those referenced in paragraph (1) of this subdivision may be transported off-site for treatment.
(d) Discarded sharps shall be destroyed prior to disposal. Sharps not coming in contact with infectious agents need not be treated in accordance with subdivision (a) of this section.
(e) Generators of regulated medical waste shall have in place a response plan to be followed in the event the facility is notified that regulated medical waste, known or suspected to be untreated, has been found commingled with solid waste. Such response plan and any corrective action taken shall be documented.
(f) Radiation detection.
(1) Each facility that treats regulated medical waste shall have a radiation detection system to screen waste for radiological medical waste and a contingency plan in the event radiation levels above background are detected in waste loads delivered for treatment. The radiation detection system shall be appropriate for effective screening of the type(s) and volume of waste, and shall be set to alarm whenever ionizing radiation above the local background ionizing radiation level is detected;
(2) no facility shall treat radiological medical waste by autoclaving; and
(3) no facility shall treat radiological waste using an alternative regulated medical waste treatment system unless the system has been approved by the department for such treatment pursuant to Subpart 70-5 of this Part.
(g) Treated regulated medical waste shall be disposed of as solid waste at an incinerator, landfill or other disposal facility authorized by the Department of Environmental Conservation to accept regulated medical waste after treatment.
(h) No facility shall transfer or release treated regulated medical waste that is not accompanied by a Department of Health certificate of treatment.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.16 Disclosure and filing
(a) Every MCO, other than a PHSP that only serves enrollees eligible for benefits under title XIX, HIV SNPs and PCPCPs, shall file in duplicate with both the commissioner and the superintendent a financial statement on or before April 1st of each year, in the form and containing such information as the commissioner and the superintendent shall prescribe, showing its condition at last year-end and containing information required by section 4408 of the Public Health Law and the following information:
(1) a statement of financial condition, including a balance sheet and summary of receipts and disbursements and an income statement;
(2) an analysis of its enrolled population, identifying numbers of enrollees by age groups and sex, and numbers of enrollee contracts by type (family and individual), by contract months, except that for MLTCPs, the analysis may contain other identifying information relevant to the enrolled population; and
(3) an analysis of utilization of services, including all services covered by the MCO.
(b) MCOs that serve enrollees eligible for benefits under title XIX shall file annual financial statements with the commissioner on or before April 1st of each year which shall be in such format and contain such information as prescribed by the commissioner.
(c) Every MCO shall submit annual financial statements together with an opinion of an independent certified public accountant of the financial statement of such MCO, and an evaluation by such accountant of the accounting procedures and internal control systems of the MCO, by April 1st of each year, pursuant to Subpart 98-3 of this Part.
(d) Every MCO shall make available to the general public and its enrollees those items set forth in paragraph (a)(1) of this section, and a summary of those items set forth in paragraphs (a)(2) and (3) of this section.
(e) Every controlled MCO shall file with the commissioner such reports or material as the commissioner, with the advice of the superintendent, may direct for the purpose of disclosing information on the operations within the holding company system which materially affect the operations, management or financial condition of the MCO.
(f) Every MCO, other than a PHSP that only serves enrollees eligible for benefits under title XIX, HIV SNPs and PCPCPs, shall file quarterly statements in duplicate with both the superintendent and commissioner, in the form and containing matters as the commissioner, with the advice of the superintendent, shall prescribe not later than 45 days after the end of each quarter.
(g) MCOs that serve enrollees eligible for benefits under title XIX shall file quarterly statements with the commissioner, in such format and containing such information as prescribed by the commissioner, not later than 45 days after the end of each quarter.
(h) In the event an MCO does not provide substantially complete reports or other information required under this Subpart by the due date, or provide requested information within 30 days of any written request for a specific analysis or report by the superintendent or commissioner, the superintendent or commissioner is authorized to levy a civil penalty, after notice and hearing, pursuant to section 12 of the Public Health Law or sections 307 and 308 of the Insurance Law.
(i) Every MCO shall maintain and update, on a quarterly basis, a listing by specialty of the names, addresses and telephone numbers of all participating providers, including facilities, and in the case of physicians, board certification. Where the MCO contracts with behavioral health facilities rather than directly with behavioral health providers, the provider types available at the facilities must be included in the listing. Members must be notified of updates in writing at least annually in one of the following methods: provide updates in hardcopy; provide a new full listing/directory in hardcopy; provide written notification that a new full listing/directory is available and will be mailed in hardcopy or electronically upon request. New members, and upon request, current and potential members must receive the most current full listing in hardcopy, or electronically at the request of the member or potential member, along with any updates to such listing.
(j) No later than 20 business days after the beginning of each calendar year, every MCO shall submit provider network information in an electronic format and including such information as prescribed by the commissioner. Such information shall reflect all signed and implemented contracts in effect as of the first day of such calendar year for all providers and service centers participating in the MCO's network. In addition, a notarized statement attesting to the accuracy of the electronic provider network information submission shall be required. Any modifications or updates to the provider network information must be communicated to the enrolled population, and upon request to potential enrollees, as prescribed in subdivision (i) of this section. Those MCOs that serve enrollees eligible for benefits under title XIX shall submit provider network information in an electronic format and including such information as prescribed by the commissioner no later than 15 business days after the end of each quarter.
(k) In order to serve enrollees eligible for benefits under title XIX, an MCO must submit a plan for compliance with the Federal Americans with Disabilities Act (ADA). Such ADA compliance plan shall be submitted in a form and manner as prescribed by the commissioner.
(l) An MLTCP shall submit data to the commissioner annually or at such other times as requested and in such manner and form as prescribed by the commissioner regarding enrollee characteristics, utilization of services, enrollments, disenrollments, complaints and grievances and other information deemed necessary to monitor plan operations and care management.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.7 Description of other New York State supplemental data
(a) Because of the data needs of the Office of Health Systems Management and other third-party payors, certain additional data must be reported for use in the health planning process, the rate appeal process, the trend factor determination process, the case mix analysis, the hospital grouping process, and/or to maintain comparability and continuity of data during the transition to functional reporting.
(b) Balance sheet reporting.
(1) Please refer to section 446.8 of this Part, Balance Sheet Reporting, for a complete listing of all balance sheet items that must be reported. In each instance where additional reporting is required, it is shown as a further breakout from an existing mandatory zero-level account.
(2) Appropriate changes in the Statement of Changes in Fund Balance (for voluntary facilities), Reconciliation of Capital and Surplus (for proprietary facilities), and the Statement of Changes in Financial Position, will be made to reflect the reporting requirements.
(c) Other operating revenue reporting.
(1) Additional breakouts in certain mandatory zero-level accounts will be required as follows:
| (2) | Account | Description | | --- | --- | --- | | (i) | 5020 | Transfers from Restricted Funds for Research Expenses Amounts transferred to cover overhead expenses must be reported separately from amounts transferred to cover direct expenses. | | (ii) | 5320 | Cafeteria Sales. Employee Pay Cafeteria and Guest and Special Nurse's Meals must be reported separately. | | (iii) | 5870 | Other Operating Revenue. Provision under this classification must be made for Supplies Sold to Patients, Nurse's Registry Fees, and Air Conditioning Rentals, as applicable. | | (iv) | 5880 | Transfers from Restricted Funds for Other Operating Expenses. Provision must be made to report appropriations from special funds offset against expenses, not offset against expenses, and governmental grants. A detailed supporting document will also be required to indicate the sources of these funds. |
(d) Deductions from revenue.
(1) An additional breakout will be required in the following area:
| (2) | Account | Description | | --- | --- | --- | | | 5970 | Administrative, Courtesy, and Policy Discounts and Adjustments. Employee discounts and adjustments must be reported separately from the remainder of this account. |
(e) Nonoperating revenue and expense.
(1) An additional breakout will be required in the following area:
| (2) | Account | Description | | --- | --- | --- | | | 9130 | Retail Operations Revenue. Provision under this classification must be made for revenue from Public Restaurants, Gift Shops, and any other non-patient-related retail operation conducted by the hospital. |
(f) Further breakdown of certain expenses.
Certain expenses must be reported in more detail than provided for under functional reporting. Please refer to section 446.9 of this Part, Expense Detail Reporting, for a complete listing of all additional reporting of expenses. This reporting will be by Natural Classification of Expenses.
(g) Service contracts.
If applicable, the provider must report the cost of services which are provided under contract by an outside organization, as opposed to being provided by salaried hospital staff. Each functional cost center affected must report its costs by Natural Classification.
(h) Imputed salaries.
For nonpaid employees, the provider must report each employee's name, position, the functional cost center affected, the applicable subclassification of the Natural Classification.00 through.19 (Salaries), and the amount paid to that employee.
(i) Recoveries of expense.
In accordance with current practice and Medicare/Medicaid regulations, recoveries necessary will be applied, either pre-stepdown or post-stepdown (as appropriate), to the applicable functional cost centers.
(j) Hospital personnel.
The average number of full-time equivalent employees (calculated as defined in the Manual) and the standard number of hours in the working week (defined as the number of hours an employee works during the week, not necessarily the number of hours paid, ( i.e., provider pays for 40 hours, employee works 37 1/2 hours with 1/2 hour paid lunch per day, report 37 1/2) must be reported by functional cost center. Reporting by salary subclassification ( i.e., RN, Aides, Physicians, Clerical, etc.) is also required.
(k) Statistical/program supplemental data.
In an effort to eliminate duplicative reporting requirements and to maintain all necessary data reported historically, an analysis of all previous sections of this Manual and the current reporting requirements was made. Please refer to sections 446.10 through 446.44 of this Part for a detailed outline of this supplemental data.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.24 Interest
(a) Necessary interest on both current and capital indebtedness is an allowable cost for all facilities.
(b) To be considered an allowable cost, interest must be incurred to satisfy a financial need, and at a rate not in excess of what a prudent borrower would have had to pay in the money market at the time the loan was made. The interest must be paid to a lender not related through control, ownership, affiliation or personal relationship to the borrower. Financial need for capital indebtedness relating to a specific project shall exist when all available restricted funds designated for capital acquisition of that type have been considered for equity purposes.
(c) Interest expense shall be reduced by investment income with the exception of income from funded depreciation, qualified pension funds, trusteed malpractice insurance funds or in instances where income from gifts or grants is restricted by donors. Interest on funds borrowed from a donor-restricted fund or funded depreciation is an allowable expense. Investment income shall be defined as the aggregate net amount realized from dividends, interest, rental income, interest earned on temporary investment of withholding taxes, as well as all gains and losses. If the aggregate net amount realized is a loss, the loss is not allowable. Investment income shall reduce interest expense allowed for reimbursement as follows:
(1) for all medical facilities, investment income shall first be used to reduce operating interest expense for that year;
(2) any remaining amount of investment income, after application of paragraph (1) of this subdivision, shall be used to reduce capital interest expense reimbursed that year for medical facilities; and
(3) any remaining amount of investment income after application of paragraph (2) of this subdivision shall not be considered in the determination of allowable costs.
(d) Interest on current indebtedness shall be treated and reported as an operating, administrative expense and shall be held to operating cost ceilings.
(e) Interest on capital indebtedness shall be an allowable cost if the debt generating the interest is approved by the commissioner, and incurred for authorized purposes, and if the principal of the debt does not exceed either the amount approved by the commissioner or the cost of the authorized purposes. Capital indebtedness shall mean all debt obligations of a facility that are:
(1) evidenced by a mortgage note or bond and secured by a mortgage on the land, buildings or nonmovable equipment, a note payable secured by the nonmovable equipment of a facility, or a capital lease;
(2) incurred for the purpose of financing the acquisition, construction or renovation of land, building or nonmovable equipment; and
(3) found by the commissioner to be reasonable, necessary and in the public interest with respect to the facility; or
(4) incurred for the purposes of advance refunding or debt. Gains and losses resulting from the advanced refunding of debt shall be treated as a deferred charge or asset. This deferred charge or asset is to be amortized on a straight-line basis over the period of the scheduled maturity date of the debt being refunded.
(f) Interest related to refinancing indebtedness shall be considered an allowable cost only to the extent that it is payable with respect to an amount equal to the unpaid principal of the indebtedness then being refinanced. However, interest incurred on refinanced debt in excess of the previously unpaid balance of the refinanced indebtedness will be allowable upon demonstration by the operator to the commissioner that such refinancing will result in a debt service savings over the life of the indebtedness.
(g) Where a public finance authority has established a mortgage rate of interest such that sufficient cash flows exist to retire the mortgage prior to the stated maturity, the amount of the mortgage to be forgiven, at the time of such forgiveness, shall be capitalized as a deferred asset and amortized over the remaining mortgage life, as a reduction to the facility's capital expense.
(h) Voluntary facilities shall report mortgage obligations financed by public finance authorities for their benefit and which they are responsible to repay, as liabilities in the general fund when such mortgage obligations are incurred.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.7 Initial service coordinators
(a) Upon referral to the early intervention official of a child thought to be an eligible child, the early intervention official shall promptly designate an initial service coordinator, selecting whenever appropriate a service coordinator who has an established relationship with the child or family, and shall promptly notify the parent of such designation in writing.
(1) Upon receipt of the referral, the early intervention official shall make reasonable efforts to promptly forward a copy of the Early Intervention Program parents' handbook to the parent by mail or other suitable means.
(2) For children in care and custody or custody and guardianship of the local social services commissioner, the early intervention official shall notify the local commissioner of social services or designee of the designation of an initial service coordinator.
(b) The initial service coordinator shall promptly arrange a contact with the parent in a time, place and manner reasonably convenient for the parent and consistent with applicable timeliness requirements.
(c) The initial service coordinator shall inform the parent of their rights and entitlement under the Early Intervention Program and shall document the information provided in the child’s record.
(1) At the initial contact with the parent, the initial service coordinator shall ensure the parent has a copy of the Early Intervention Program parents’ handbook, review the handbook, provide an overview of the early intervention system and services, discuss the role of the initial service coordinator, and review the parent's rights, responsibilities and entitlements under the program.
(d) The initial service coordinator shall ascertain if the child and family are presently receiving case management services or other services from public or private agencies. If so, the initial service coordinator shall discuss options for collaboration with the parent and, if appropriate, obtain consent for the release of information for the purpose of collaboration with other case management services.
(e) All information provided to the parent shall be in the parent's dominant language or other mode of communication unless clearly not feasible to do so.
(f) All information obtained from the parent shall be confidential and may only be disclosed upon written consent, unless otherwise required or permitted to be disclosed by law.
(g) The initial service coordinator shall inform the family that services must be at no cost to parents and use of Medicaid and/or third-party insurance for payment of services is required under the Early Intervention Program.
(1) The service coordinator shall inform the parent that any deductible or co-payments will be paid by the municipality.
(2) The service coordinator shall inform the parent that use of third-party insurance for payment of early intervention services will not be applied against lifetime or annual limits specified in their insurance policy, if such policy is subject to New York State law and regulation.
(3) The service coordinator shall inform the parent that the provider shall not obtain payment from their insurer if the insurer is not prohibited from applying, and may apply, payment for early intervention services to the annual and lifetime limits specified in their insurance policy.
(h) The initial service coordinator must obtain, and parents must provide, information about the status of the family's third-party insurance coverage and Medicaid status and promptly notify the early intervention official of such status, including:
(1) Medicaid enrollment status and identification number, if any;
(2) type of health insurance policy or health benefits plan, name of insurer or plan administrator, and policy or plan identification number;
(3) type of coverage extended to the family by the policy; and
(4) such additional information necessary for reimbursement.
(i) The service coordinator shall assist the parent in identifying and applying for benefit programs for which the family may be eligible, including:
(1) the Medical Assistance Program;
(2) Supplemental Social Security Income Program;
(3) Physically Handicapped Children's Program;
(4) Child Health Plus; and
(5) Social Security Disability Income.
(j) The initial service coordinator shall review all options for evaluation and screening with the parent from the list of approved evaluators including location, types of evaluations performed, and settings for evaluations ( e.g., home vs. evaluation agency). Upon selection of an evaluator by the parent, the initial service coordinator shall ascertain from the parent any needs the parent may have in accessing the evaluation.
(k) The initial service coordinator shall at the parent's request assist the parent in arrangement of the evaluation after the parent selects from the list of approved evaluators.
(l) If the parent has accessed an approved evaluator prior to contact by the initial service coordinator, the initial service coordinator shall contact the parent to assure that the parent has received information concerning alternative approved evaluators and ascertain from the parent any needs the parent may have in accessing the evaluation.
(m) If, in consultation with the evaluator, the service coordinator identifies a child that is potentially eligible for programs or services offered by or under the auspices of the Office for People With Developmental Disabilities (OPWDD), the service coordinator shall, with parental consent, notify OPWDD’s developmental disabilities regional office of the potential eligibility of such child for said programs or services.
(n) Upon receipt of the results of the evaluation, the initial service coordinator may with the approval of the early intervention official and with parental consent, require additional diagnostic information regarding the condition of the child, provided that such information is not unnecessarily duplicative or invasive to the child according to guidelines of the department of Health.
(1) Prior to obtaining written consent for additional diagnostic information, the initial service coordinator shall provide the parent with a written explanation which shall include:
(i) diagnostic information requested;
(ii) reasons for obtaining the information, and use of the information;
(iii) location of diagnostic testing;
(iv) source of payment and that no costs shall be incurred by the parent;
(v) a statement that the information shall not be used to refute eligibility; and
(vi) a statement that the meeting to formulate the individualized family service plan shall be held within the 45 day time limit.
(2) The initial service coordinator shall assist the parent in accessing the diagnostic testing as needed and desired by the parent.
(3) The initial service coordinator shall facilitate the parent understanding of the results of the diagnostic information, and with parent consent, incorporate this diagnostic information into the planning and formulation of the individualized family service plan.
(o) Upon the determination of a child as ineligible for early intervention services, the initial service coordinator shall inform the parent of the right to due process procedures as set forth in this Subpart.
(1) The initial service coordinator shall inform the parent of other services which the parent may choose to access and for which the child may be eligible and offer assistance with appropriate referrals.
(p) Upon determination of the child’s eligibility for the Early Intervention Program, the initial service coordinator shall discuss the individualized family service plan process with the parent and shall inform the parent:
(1) of the required participants in the individualized family service plan meeting and the parent’s option to invite other parties;
(2) that the initial service coordinator may invite other participants, provided that the service coordinator obtains the parent’s consent and explains the purpose of this person’s participation;
(3) that inclusion of family assessment information is optional;
(4) that their priorities, concerns and resources shall play a major role in the establishment of outcomes and strategies among the parent, evaluator, service coordinator and early intervention official;
(5) of the opportunity to select an ongoing service coordinator, who may be different from the initial service coordinator, at the individualized family service plan meeting or at any other time after the formulation of the individualized family service plan;
(6) that the final decisions about the services to be provided to the child will be made by the parent and the early intervention official; and
(7) that services can be delivered in a range of settings such as an approved provider’s facility, as well as a variety of natural environments, including the child’s home, child care site or other community settings.
(q) The initial service coordinator shall assist the parent in preparing for the meeting to develop the individualized family service plan, including facilitating their understanding of the child’s multidisciplinary evaluation and identifying their resources, priorities, and concerns related to their child’s development.
(1) The initial service coordinator shall discuss with the parent the options for early intervention services and facilitate the parent’s investigation of various options as requested by the parent.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.3 Application
(a) The requirements of this Subpart shall apply to all spray grounds except:
(1) a facility owned and/or maintained by an individual for the use of his family and friends;
(2) a facility that uses water that complies with Subpart 5-1 of this Title or equivalent standards that discharges to waste without impoundment or recirculation of the water;
(3) where spray features are installed in a swimming pool, wading pool, wave pool or other pool regulated under Subpart 6-1 of this Part.
(b) Section 6-3.5 of this Subpart shall not apply to spray grounds maintained and operated in connection with a temporary residence, children's camp or campground subject to the regulations of Subpart 7-1, 7-2 or 7-3 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.6 Rates for new facilities during the transition period
(a) General hospital outpatient clinics which commence operation after December 31, 2007 and prior to January 1, 2012, and for which rates computed pursuant to Public Health Law section 2807(2) are not available shall have the capital cost component of their rates based on a budget as submitted by the facility and as approved by the department and shall have the operating component of their rates computed in accordance with the following:
(1) for the period December 1, 2008 through November 30, 2009, 75 percent of such rates shall reflect the historical 2007 average payment per visit as calculated by the department, and 25 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(2) for the period December 1, 2009 through December 31, 2010, 50 percent of such rates shall reflect the historical 2007 average payment per visit as calculated by the department, and 50 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(3) for the period January 1, 2011 through December 31, 2011, 25 percent of such rates shall reflect the historical 2007 average payment per visit as calculated by the department, and 75 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(4) for periods on and after January 1, 2012, 100 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(5) for the purposes of this subdivision, the historical 2007 regional average payment per visit shall mean the result of dividing the total facility specific Medicaid reimbursement paid for general hospital outpatient clinic claims paid in the 2007 calendar year in the applicable upstate or downstate region for all rate codes reflected in the APG rate-setting methodology except those specifically excluded pursuant to section 86-8.10 of this Subpart, divided by the total visits on claims paid under such rate codes.
(b) Diagnostic and treatment centers which commence operation after December 31, 2007 and prior to January 1, 2012, and for which rates computed pursuant to Public Health Law section 2807(2) are not available shall have the capital cost component of their rates based on a budget as submitted by the facility and as approved by the department and shall have the operating cost component of their rates computed in accordance with the following:
(1) for the period September 1, 2009 through November 30, 2009, 75 percent of such rates shall reflect the historical 2007 regional average peer group payment per visit as calculated by the department, and 25 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(2) for the period December 1, 2009 through December 31, 2010, 50 percent of such rates shall reflect the historical 2007 regional average peer group payment per visit as calculated by the department, and 50 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(3) for the period January 1, 2011 through December 31, 2011, 25 percent of such rates shall reflect the historical 2007 regional average peer group payment per visit as calculated by the department, and 75 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(4) for periods on and after January 1, 2012, 100% of such rates shall reflect APG rates as computed in accordance with this Subpart;
(5) for the purposes of this subdivision, the historical 2007 regional average peer group payment per visit shall mean the result of dividing the total facility specific Medicaid reimbursement paid for diagnostic and treatment center claims for each peer group, as defined in section 86-4.13 of this Part, paid in the 2007 calendar year in the applicable upstate or downstate region for all rate codes reflected in the APG rate-setting methodology except those specifically excluded pursuant to section 86-8.10 of this Subpart, divided by the total visits on claims paid under such rate codes.
(c) Free-standing ambulatory surgery centers which commence operation after December 31, 2007 and prior to January 1, 2012, and for which rates computed pursuant to Public Health Law section 2807(2) are not available shall have the capital cost component of their rates computed in accordance with section 86-8.4(c) of this Subpart and shall have the operating cost component of their rates computed in accordance with the following:
(1) for the period September 1, 2009 through November 30, 2009, 75 percent of such rates shall reflect the historical 2007 regional average payment per visit as calculated by the department, and 25 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(2) for the period December 1, 2009 through December 31, 2010, 50 percent of such rates shall reflect the historical 2007 regional average payment per visit as calculated by the department, and 50 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(3) for the period January 1, 2011 through December 31, 2011, 25 percent of such rates shall reflect the historical 2007 regional average payment per visit as calculated by the department, and 75 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(4) for periods on and after January 1, 2012, 100 percent of such rates shall reflect APG rates as computed in accordance with this Subpart;
(5) for the purposes of this subdivision, the historical 2007 regional average payment per visit shall mean the result of dividing the total facility specific Medicaid reimbursement paid for free-standing ambulatory surgery centers claims paid in the 2007 calendar year in the applicable upstate or downstate region for all rate codes reflected in the APG rate-setting methodology except those specifically excluded pursuant to section 86-8.10 of this Subpart, divided by the total visits on claims paid under such rate codes.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-4 COVID-19 NURSING HOME AND ADULT CARE FACILITY VACCINATION PROGRAM
10 CRR-NY 66-4.2 Requirements for adult care facilities
(a) Within seven days of the effective date of this regulation, the operator and administrator of every adult care facility regulated pursuant to Parts 487, 488 and 490 of Title 18 of the NYCRR and Part 1001 of this Title shall make diligent efforts to arrange for all consenting, unvaccinated existing personnel and residents to register for a vaccine appointment, and shall document attempts to schedule and methods used to schedule the vaccine in the individual’s personnel file or case management notes, as applicable.
(b) The operator and administrator of every adult care facility regulated pursuant to Parts 487, 488 and 490 of Title 18 of the NYCRR and Part 1001 of this Title must arrange for the COVID-19 vaccination, including the first or any required next dose, of all new personnel, including employees and contract staff, and every new resident and resident readmitted to the facility. The requirement to arrange for COVID-19 vaccination of such personnel and residents shall include, but not be limited to:
(1) For residents:
(i) during the pre-admission screening process, and in no event after the first day of admission or readmission, the adult care facility shall screen the prospective or newly-admitted or readmitted resident for COVID-19 vaccine eligibility, including whether any first doses of the vaccine were previously administered, and whether the resident is interested in obtaining the COVID-19 vaccine. Such information shall be documented with the resident’s pre-admission screening information and, if admitted, retained in the resident’s case management records; and
(ii) within seven days of admission or readmission, the facility shall make diligent efforts to schedule all consenting and eligible new or readmitted residents for the COVID-19 vaccination. The facility must document attempts to schedule and methods used to schedule the vaccine appointment in the resident’s case management notes.
(2) For personnel:
(i) during the pre-employment screening process, the facility shall solicit information from the prospective personnel regarding their vaccination status, including whether any first doses of the vaccine were previously administered, and whether the prospective personnel is interested in obtaining the COVID-19 vaccine. Such information must be documented with the personnel’s pre-employment screening information and, if hired, retained in the personnel file; provided, however, that nothing in this paragraph shall be construed to require an adult care facility to make any hiring determination based upon the prospective personnel’s COVID-19 vaccination status, history, or interest in COVID-19 vaccination; and
(ii) within seven days of hiring new personnel, the facility shall make diligent efforts to schedule all consenting and eligible new personnel for the COVID-19 vaccination. The facility must document attempts to schedule and methods used to schedule the vaccine appointment in the individual’s personnel file.
(c) The facility shall further provide all current and new personnel and residents who decline to be vaccinated a written affirmation for their signature, which indicates that they were offered the opportunity for the facility to arrange for a COVID-19 vaccination, but declined. Such affirmation must state that the signatory is aware that, if they later decide to be vaccinated for COVID-19, it is their responsibility to request the facility arrange for their vaccination. The facility shall maintain signed affirmations on file at the facility and make such forms available at the request of the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.267 Prior-period adjustment
A correction of an error in earlier financial statements or an adjustment that results from realization of income tax benefits of pre-acquisition loss carry-forwards of purchased subsidiaries; all other items of profit or loss recognized in a fiscal year are required to be included in the determination of net income in the year recognized (see FASB Statement No. 16).
10 CRR-NY 441.94 Direct assignment of cost
The process of identifying and assigning costs directly to the functional cost center generating those costs.
Article 1 GENERAL
Part 401 ALL FACILITIES—OPERATING CERTIFICATES
10 CRR-NY 401.3 Changes in existing medical facilities
(a) Proposed changes in physical plant, bed capacity and the extent and kind of services provided shall be submitted to the department in writing, pursuant to the provisions of section 710.1(b) of this Title. Such changes shall not be made until receipt of the appropriate department approval as set forth in section 710.1(b) of this Title. The commissioner may, grant administrative approval to such proposed changes in accordance with the provisions and criteria set forth in section 710.1(c) of this Title.
(1) A medical facility shall submit, for all approved projects involving a capital outlay of $100,000 or more, a schedule of costs at the completion of construction, which shall be certified to the satisfaction of the commissioner and subject to audit.
(2) The schedule of costs shall be submitted either at the time of the final construction inspection or within 120 days of such inspection. The commissioner, upon written request to the Division of Health Care Financing, New York State Department of Health, and good cause being shown therefor, may grant an extension of time for such submission.
(3) Upon receipt of the schedule of certified costs, the department shall review the submission, request substantiating material and/or clarification of such submission, when necessary, and determine that the submitted costs are in conformity with the previously approved project concept, generally accepted accounting principles, the approved estimated project cost, and in the event the schedule of certified costs exceeds the approved estimated project cost, that the excess costs are necessary, justified and consistent with efficient production of services.
(b)
(1) Any proposed change in the name of a business corporation, partnership or governmental subdivision and any proposed initial use of, or change in, an assumed name of a business corporation, not-for-profit corporation, partnership, governmental subdivision or sole proprietor, operating a medical facility or fundraiser under article 28 of the Public Health Law, or any proposed substitution of the individual or individuals constituting the operator or owner of a proprietary medical facility or any proposed change in the rights, privileges or obligations of any such person shall require the prior written approval of the department or, where appropriate, of the Public Health Council, except that in the event that such change or substitution results from an emergency caused by the severe illness, incompetency or death of such individual or individuals, the department shall be notified immediately, and application shall be made for written approval of such change both to the department and, where appropriate, to the Public Health Council, within 30 days of such emergency.
(2) Prior to any proposed change in the name of a business corporation, partnership or governmental subdivision or initial use of, or change in, an assumed name of a business corporation, not-for-profit corporation, partnership, governmental subdivision or sole proprietor which does not require the approval of the Public Health Council in accordance with section 600.11 of this Title, the operator of the facility shall submit a request for approval of such name change together with the following information and documents, as appropriate, to the department's Bureau of Project Management in Albany:
(i) a photocopy of the executed proposed certificate of amendment of the certificate of incorporation, certificate of authority to conduct business in the State of New York, or a certificate or amended certificate of conducting business under an assumed name;
(ii) a letter specifying the current and proposed names and explaining the nature of and the reasons for the requested name change; and
(iii) such other pertinent information and documents necessary for the department's consideration, as requested.
(3) The approval of the department of a proposed name or assumed name may be withheld if the proposed name or assumed name indicates or implies that the corporation, partnership, governmental subdivision or individual is authorized to engage in activities for which it is not authorized, provide a level of care it is not authorized to provide, is misleading, causes confusion with the identity of another facility, or violates any provision of the law.
(4) Nothing contained within this section shall limit the authority of the Public Health Council to approve or disapprove the initial use of a name or assumed name for a not-for-profit corporation, business corporation, partnership, governmental subdivision or sole proprietor when such name or assumed name is before the Public Health Council as part of an application for the establishment of a facility or fundraiser.
(c) No person or party to whom a current operating certificate has been issued authorizing the operation of a medical facility shall transfer his interest in such facility to any other person or party who intends to continue to operate such facility unless such transferee has been approved by the State Public Health Council, for establishment and has also received assurance by the department that the facility complies with the provisions of this Subchapter.
(d) The governing authority or operator of a medical facility to whom a current operating certificate has been issued shall not lease or sublet all or a portion of the facility, unless such facility, its operation, and the service performed conform to and comply with the pertinent provisions of this Subchapter.
(e) To reduce the operation from the certified bed capacity to a specified lesser bed capacity, the operator shall obtain prior written approval of the department, show satisfactory cause for the requested reduction and maintain for the reduced number of patients or residents the required services and personnel. To increase the operation from a specified lesser bed capacity to a greater certified bed capacity, the operator shall employ such additional personnel as are required after approval thereof by the department. To increase the bed capacity above that permitted in the operating certificate, the operator shall apply to the department for a new operating certificate.
(f)
(1) The operator of a medical facility for which a current operating certificate has been issued for health-related facility beds may submit an application, pursuant to the requirements of Part 710 of this Title, for the temporary conversion of health-related facility beds to skilled nursing home care beds. The need for such conversion will be established where it has been determined by the commissioner that the residents within the facility who occupy health-related facility beds actually require a skilled nursing home level of care and there are no skilled nursing home care beds available within the facility to accommodate such residents and the operator is in compliance with applicable provisions of this Subchapter. A facility permanently certified only for health-related facility beds shall not apply for temporary conversion or permanent conversion of beds to the skilled nursing home level of care except in conjunction with an application for prior establishment approval pursuant to article 28 of the Public Health Law and regulations promulgated pursuant thereto. Any approval of such temporary conversion of beds shall be for a maximum period of two years.
(2) If the application for temporary conversion is approved, amended operating certificates shall be issued. The amended operating certificates shall specify the number of beds converted and the duration of the conversion.
(3) At least three months prior to the expiration of the temporary conversion period, the operator of the facility must submit to the department, in writing, an effective, orderly plan, for approval by the commissioner, for returning the temporarily converted beds to their permanent residential health-care facility bed classification status. The plan must be fully implemented by the facility by the expiration of the temporary conversion period or as soon thereafter as is practicable.
(4) At the expiration of the temporary conversion period, the facility shall cease all admissions of patients requiring a skilled nursing home level of care until all beds temporarily converted are returned to their permanent residential health-care facility bed classification status.
(5) With respect to those beds that were temporarily converted because of the need for a skilled nursing home level of care by specific residents in the facility, no additional persons may be admitted to the facility to occupy such beds during the temporary conversion period. This provision will not prohibit the facility from placing in such beds individuals who, at the time of admission to the facility, required only a health-related facility level of care and who were admitted to a health-related facility bed, but whose condition deteriorated so as to require a skilled nursing home level of care.
(6) Any application for an extension of the temporary conversion period shall be subject only to the procedures and requirements of Part 710 of this Chapter.
(7) Immediately after all the temporarily converted beds have returned to their previous permanent classification status as health-related facility beds, the department shall issue the operator appropriately amended operating certificates.
(g) No medical facility shall discontinue operation or surrender its operating certificate unless 90 days' notice of its intention to do so is given to the commissioner and his written approval obtained.
(h) The operator shall notify, and in event of his failure to do so the department shall notify, as appropriate, each patient or resident, his next of kin, his sponsor and his physician, either directly or through the physician's medical society, immediately upon receipt of notification by the department revoking, suspending, limiting, annulling or refusing to issue the operating certificate or approving voluntary surrender of the certificate and shall discharge or transfer all patients or residents to other appropriate facilities prior to discontinuing operation.
(i) No medical facility shall discontinue operation or surrender its operating certificate whether voluntarily or pursuant to judicial or administrative proceedings without first obtaining the commissioner's written approval of a plan for the maintenance, storage and safekeeping of its patients' medical records. The plan shall provide adequate safeguards for these records, make them accessible to the patients and their physicians, and may provide for their ultimate disposition.
(j) An operating certificate shall be promptly surrendered to the department upon discontinuance of operation, determination of the Public Health Council not to approve an emergency change of operator or owner, or expiration, revocation, suspension, limitation, or annulment of the certificate.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.69 Contractual adjustment
The difference between billings at established charges and amounts received or due from third-party payors under contract agreements.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASE CONTROL
10 CRR-NY 40-2.24 Zika Action Plan; performance standards
(a) By April 15, 2016, the local health department shall adopt and implement a Zika Action Plan (ZAP), in accordance with guidance to be issued by the department, and which shall include, but not be limited to, the following activities:
(1) for all local health departments:
(i) human disease monitoring, response and control; and
(ii) education about Zika virus and its prevention; and
(2) in addition, for those local health departments identified by the department as jurisdictions where mosquitoes capable of transmitting the Zika virus are currently located or may be located in the future:
(i) enhanced human disease monitoring, response, control;
(ii) enhanced education about Zika virus and its prevention;
(iii) mosquito trapping, testing and habitat inspections specific to Aedes albopictus , and for such other species as the department may deem appropriate;
(iv) mosquito control; and
(v) identification and commitment of appropriate staff available to join State-coordinated rapid response teams, which may be deployed to those areas where the department determines that there is the potential for transmission of Zika virus by mosquitoes.
(b) Local health departments shall update their ZAPs annually, or as directed by the department, to include activities identified by the department in guidance issued pursuant to subdivision (a) of this section.
(c) Local health departments shall submit such plans to the department as part of the annual application for State aid made pursuant to section 40-1.0 of this Part. State aid shall only be available for activities within ZAPs determined by the department to be necessary and appropriate to control the spread of the Zika virus in guidance issued pursuant to subdivision (a) of this section.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.5 Procedure for applicants and participants obtaining a fair hearing
(a) Every applicant and participant aggrieved by an adverse action of a local agency may request a fair hearing by contacting, either orally or in writing, the department within 60 days from the date of service of the agency determination or adverse action. Requests for a fair hearing may be made on behalf of the applicant or participant by a parent, guardian or other representative.
(b) If a participant being disqualified from the WIC program requests a fair hearing within 15 days from the date of service of the agency determination to terminate, benefits shall be continued until the administrative law judge makes a determination or the certification period expires, whichever occurs first; provided, however, that such benefits shall not be continued when a participant is determined to be categorically ineligible, an initial certification is not granted or a certification period expires.
(c) A request for a fair hearing shall not be denied or dismissed unless:
(1) the request is not received within the required 60-day time limit provided in subdivision (a) of this section;
(2) the petitioner or his/her representative fails to appear at the scheduled date, time and place of the hearing without good cause;
(3) the petitioner or his/her representative withdraws the request for a fair hearing in writing or states for the record at the hearing that he/she wishes to withdraw;
(4) the petitioner or his/her representative cannot be located at his last known address after the request for a fair hearing is received;
(5) the petitioner has been determined to be categorically ineligible. Categorical ineligibility shall be documented and the documentation shall be maintained on file at the local agency;
(6) the petitioner has been denied participation at a previous hearing and cannot provide evidence to the local agency that circumstances have changed since the denial of WIC program eligibility;
(7) the local agency grants the relief requested by the petitioner; or
(8) the sole basis of the hearing is petitioner's request for retroactive benefits.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.18 Housing
This functional reporting center must contain all the expenses associated with the provision of living quarters to residential health care facility employees.
(a) Standard unit of measure: average number of persons housed.
Average number of employees housed in residential health care facility residences. This number should be appropriately weighted for employees housed for periods less than the full year.
(b) Data source.
This average should be calculated from records maintained in the housing office.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.111 Manual facilities
An acceptable manual method of cleaning and sanitizing equipment, utensils and tableware is to use a three-compartment sink; to wash in the first compartment with hot water and a detergent; rinse in clean hot water in the second compartment; and sanitize in the third compartment, using an accepted procedure. Other methods acceptable to the permit-issuing official may be used. The procedure must clean and sanitize the article so as to produce an average plate count of not more than 100 colonies on the surface of the utensils examined, with no coliform bacteria.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.2 Laboratory director
(a) The director shall serve the laboratory full-time, or on a regular part-time basis. Regular part-time basis shall mean assumption of full responsibility for direction and technical operation of the laboratory, including adherence to the department quality control standards and training of personnel performing the testing. If he serves on a regular part-time basis, he shall not serve as director of more than two clinical laboratories, within or outside New York State or more than one clinical laboratory and one blood bank or more than two blood banks. Where a laboratory and a blood bank are on the same premises and are under the supervision of the same director, such laboratory and blood bank shall be deemed one laboratory for the purpose of this subdivision. Notwithstanding the foregoing provisions of this subdivision, if the commissioner finds that more than two laboratories are required to serve the needs of an area and the total volume and the types of laboratory service provided by the several laboratories are not such as to require the services of more than one director, he may authorize an individual to direct more than two laboratories or blood banks or combinations thereof. Such authorization must be renewed at least every two years. The commissioner may also make an exception where the additional directorships involve only blood-holding facilities as defined in section 58-2.1(i) of this Part.
(b) Commensurate with the laboratory workload, scope and complexity of the testing procedures carried out, qualifications of onsite personnel, proximity to another laboratory under identical directorship, and availability of alternate monitoring and communications capabilities, the director shall spend an adequate amount of time in the laboratory to direct and supervise the technical performance of the staff and shall be readily available for personal or telephone consultation. The adequacy of the amount of time a laboratory director is present and in active direction shall be determined by the department based on the factors enumerated above, results of onsite inspections and proficiency testing and documentation of the director's full responsibility for direction and technical operation. Attendance records may be required to document the adequacy of the director's presence.
(c) The director shall be responsible for performance of all tests carried out in the laboratory, adherence to the department's quality assurance standards for such tests, and accurate reporting of the test results.
(d) The director shall be responsible for ensuring the employment of qualified laboratory personnel, evaluation of job performance of such personnel and their in-service training.
(e) If the director's employment terminates or he is temporarily absent, arrangements shall be made for a qualified temporary director, which arrangements must receive the prior approval of the department. An assistant director who holds a certificate of qualification to be a director of a clinical laboratory or blood bank in the appropriate category may act for the director in the director's absence, and at such time shall fully discharge the duties and responsibilities of the director.
(f) When the director's employment terminates, for whatever reason, both the owner and the director of the laboratory, or the chief executive officer of the facility, shall notify the department in writing prior to the termination. In the case of death or physical and/or mental incapacitation of the director, the owner or the chief executive officer must notify the department within 71 hours of each event.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.7 Approval to start construction
(a) The applicant may seek approval to start construction of the project, or one or more phases thereof, upon the filing with the department completed contract documents consistent with all previous approvals.
(b) If documents are not completed, the applicant may request approval to start construction upon submission of a certification by the applicant, construction manager or contractor, and the architect that completed working drawings and specifications shall be submitted within a time period specified in the applicant's request, that such construction shall be undertaken at the applicant's risk and that approval is understood to be contingent upon submission of the completed documents as a no-cost change order.
(c) A request by the applicant pursuant to subdivision (a) or (b) of this section shall include an affidavit by the applicant's architect or engineer that the drawings:
(1) are consistent with schematic and design development drawings previously approved and, if not, the affidavit shall identify the changes and reasons for such changes; and
(2) are in compliance with the applicable provisions of this Title and all applicable local codes, statutes and regulations. In addition, the applicant shall submit an updated functional stack diagram consistent with section 710.2(b)(10)(i)( b ) of this Part.
(d) When the submission under subdivision (a) or (b) of this section is deemed complete by the department, the applicant shall be advised in writing to commence construction pursuant to this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-2 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS REQUIRED USE OF INFECTION CONTROL PRACTICES
10 CRR-NY 92-2.1 Required use of infection control practices
For physicians, registered physician assistants and specialist assistants, the definition of unprofessional conduct shall include the failure to use scientifically accepted infection control practices to prevent transmission of disease pathogens from patient to patient, physician to patient, registered physician or specialist assistant to patient, employee to patient, and patient to employee, as appropriate to physicians, registered physician assistants and specialist assistants. Such practices shall include:
(a) adherence to scientifically accepted standards for: handwashing; aseptic technique; use of gloves and other barriers for preventing bi-directional contact with blood and body fluids; thorough cleaning followed by sterilization or disinfection of medical devices; disposal of nonreusable materials and equipment; and cleaning between patients of objects that are visibly contaminated or subject to touch contamination with blood or body fluids;
(b) use of scientifically accepted injury prevention techniques or engineering controls to reduce the opportunity for patient and employee exposures; and
(c) performance monitoring of all personnel, licensed or unlicensed, for whom the licensee is responsible regarding infection control techniques.
Chapter I STATE SANITARY CODE
Part 23 SEXUALLY TRANSMISSIBLE DISEASES (STD)
10 CRR-NY 23.3 Cases treated by other providers
(a) Every physician, physician assistant, licensed midwife or nurse practitioner providing (as authorized by their scope of practice) gynecological, obstetrical, genito-urological, contraceptive, sterilization, or termination of pregnancy services or treatment, shall offer to administer to every patient treated by such physician, physician assistant, licensed midwife or nurse practitioner, appropriate examinations or tests for STD as defined in this Part.
(b) The administrative officer or other person in charge of a clinic or other facility providing gynecological, obstetrical, genito-urological, contraceptive, sterilization or termination of pregnancy services or treatment shall require the staff of such clinic or facility to offer to administer to every resident of the State of New York coming to such clinic or facility for such services or treatment, appropriate examinations or tests for the detection of sexually transmitted diseases.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.4 Submission for approval
Maps, plans and specifications submitted to the State for approval shall be signed and sealed by an engineer licensed to practice in New York State. Approval will be based on completeness of submission, appropriate treatment for the contaminants, demonstrated effectiveness of treatment units, provision for adequate installation, operation and maintenance of treatment units and protection of the occupants and operators. Submissions shall include, but are not limited to, the following items:
(a) A map of the proposed water quality treatment district. The map or maps shall include:
(1) location of district boundaries;
(2) existing public water system boundaries adjacent to or within the proposed water quality treatment district;
(3) sites of proposed installation of point-of-use treatment systems;
(4) sites of samples collected to determine water quality. Number and distribution shall be adequate to determine extent and degree of contamination; and
(5) sites of existing installations of point-of-use treatment systems.
(b) Plans and specifications of the proposed point-of-use treatment systems.
(c) Plans and specifications of typical installations.
(d) An engineering report detailing the following items:
(1) test results of sampling conducted to determine water quality at water sources within the proposed district;
(2) alternate non-point-of-use treatment solutions considered;
(3) alternate types of point-of-use treatment considered;
(4) results of pilot studies;
(5) recommended alternative showing the type and location of proposed point-of-use treatment systems;
(6) evaluation of existing point-of-use treatment systems and necessary improvements;
(7) operation and maintenance of the point-of-use treatment installations;
(8) operator qualifications and training;
(9) administration and financing of the water quality treatment district. If all or part of the water quality treatment district services are to be subcontracted to another agency, private company or individual by the county or town, the qualifications and responsibilities of the subcontractor shall be included;
(10) monitoring (parameters and frequency) of the point-of-use treatment systems and sources within the water quality treatment district; and
(11) disposal of waste water and materials.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.13 Environmental health and infection control
(a) PCHs/CAHs shall comply with the provisions of section 405.24 of this Title with regard to assuring a safe and suitable environment for patients.
(b) PCHs/CAHs shall comply with the provision of section 405.11 of this Title with regard to infection control requirements.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 127 NASSAU COUNTY
VILLAGES VILLAGES
10 CRR-NY 127.4 Village of Rockville Centre
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to the wells, located on land owned by the village, and situated on a plot of ground in the southeast corner of the village, south of Sunrise Highway (Conduit Boulevard), and east of Ocean Avenue, which form the source of the public water supply of the village of Rockville Centre, Nassau County, New York, and shall apply to all wells, either existing or proposed and used or proposed to be used as a source of public water supply, situated on property of the village of Rockville Centre at the southeast corner of Morris Avenue and Maple Avenue in said village, and shall apply to all wells, either existing or proposed and used or proposed to be used as sources of water supply, situated on property of the village of Rockville Centre known as north well field situated adjacent to the northerly boundary of the village, approximately 300 feet northwesterly from Hempstead Avenue.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from the wells is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 100 feet of any well of the public water supply of the village of Rockville Centre.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Rockville Centre.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents, or the removable containers, while being transported shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well of the public water supply of the village of Rockville Centre.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into the wells, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c], or into suitable watertight iron pipes with tight leaded joints connected to a sewage disposal system, a permit for which has been granted by the State Commissioner of Health) within 200 feet of any well of the public water supply of the village of Rockville Centre. It is provided, however, that no such watertight iron pipe shall be located within 25 feet of any well of the public water supply of the village of Rockville Centre.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 200 feet of any well of the public water supply of the village of Rockville Centre.
(e) Animals, manure, compost, etc.
(1) No manure pile or compost heap shall be located, placed, maintained or allowed to remain within 200 feet of any well of the public water supply of the village of Rockville Centre and no such manure pile or compost heap shall be located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any well of the public water supply of the village of Rockville Centre.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the village of Rockville Centre.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 200 feet of any well of the public water supply of the village of Rockville Centre.
(g) Trespassing.
No trespassing shall be allowed upon the property of the village of Rockville Centre upon which the wells of the public water supply of the village of Rockville Centre are located and no person or persons shall enter in or upon such property except the board of trustees or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of trustees of the village of Rockville Centre.
(h) Inspections.
The board of trustees of the village of Rockville Centre or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Rockville Centre or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(i) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination, is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-9 HUMAN MILK BANKS
10 CRR-NY 52-9.7 Maintenance of records
(a) The human milk bank shall maintain an individual file on each milk donor. For all donated human milk, the donor's name, address and any other information which would directly or indirectly identify the donor shall not be disclosed or released by the human milk bank to any person or entity except upon the written consent of the donor or except to the department. Records to be kept by the human milk bank shall include, but not be limited to, those required in Subpart 52-2 of this Part and documentation of instructions given to the donor for collecting, storing and preserving the wholesomeness of donated milk.
(b) Records of milk donations shall be filed by donor identification number and shall include, but not be limited to:
(1) information from the identification tag affixed to the container at the time of collection, showing the date and time of collection, amount collected, and, if applicable, the identification of the transfer station with recorded date, and time of receipt and transport of the milk;
(2) results of all clinical laboratory tests performed on the donor preparatory to and during participation in the milk banking program;
(3) the date of pasteurization of the milk, if applicable; and
(4) the date the milk was distributed or used, and, if applicable, identifying information regarding milk pooled from multiple donors.
(c) Records shall be maintained on each recipient, including, but not limited to:
(1) the infant's or child's age, birth weight and/or weight history, and diagnosis indicating the medical need for human milk;
(2) the dates the milk banking service began and terminated;
(3) identification by donor identification number of the source of all milk given to the recipient;
(4) documentation that the risks of consumption by an infant or child of donated milk have been disclosed to the person(s) legally responsible for such infant or child;
(5) recipient health status at the time of discontinuation of milk banking service and reason for such discontinuation.
(d) Donor and recipient records shall be maintained for at least three years after a recipient's age of majority (18 years) or for at least six years after a recipient's death.
Subchapter F DISEASE REGISTRY
Part 62 ALZHEIMER'S DISEASE AND RELATED DISORDERS REGISTRY
10 CRR-NY 62.3 Valid scientific research
For the purposes of this Part, valid scientific research shall mean studies conducted for the purposes of etiological research, discovering effective treatment of the disease, determining if there is a genetic factor in disease occurrence, or other basic epidemiological research activities. Research may be undertaken by any person licensed under title VIII of the Education Law to perform diagnosis, treatment, medical services, prescription or therapeutic exercises with regard to or upon human beings, or any person deemed appropriately competent and qualified by a human research review committee as provided by article 24-A of the Public Health Law.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.73 Pharmacists; dispensing schedule II substances and certain other controlled substances
(a) A licensed, registered pharmacist, or a pharmacy intern acting in conformity with the provisions of section 6806 of the Education Law and regulations thereunder in a registered pharmacy, may, in good faith and in the course of his/her professional practice, sell and dispense to an ultimate user schedule II controlled substances or those schedule III or schedule IV controlled substances listed in section 80.67(a) of this Part, provided they are dispensed pursuant to an official New York State prescription, an out-of-state prescription or an electronic prescription delivered within 30 days of the date such prescription was signed by the authorized practitioner or an oral prescription where permitted.
(b) No such substance shall be dispensed or sold unless it is enclosed within a suitable and durable container to which is affixed, in such a manner which would inhibit its removal, an orange label upon which is indelibly typed, printed or otherwise legibly written:
(1) the name and address of the ultimate user for whom the substance is intended, or, if intended for use upon an animal, the species of such animal and the name and address of the owner or person having custody of such animal;
(2) the name, address and telephone number of the pharmacy from which such substance is dispensed;
(3) specific directions for use as stated on the prescription;
(4) the name of the prescribing practitioner;
(5) the legend, prominently marked or printed in either boldface or upper case lettering: “CONTROLLED SUBSTANCE, DANGEROUS UNLESS USED AS DIRECTED”;
(6) the number of the prescription under which it is recorded in the pharmacy prescription file;
(7) the date of filling; and
(8) the name of the controlled substance or such code number assigned by the department for the particular substance pursuant to section 80.24 of this Part.
(c) A licensed, registered pharmacist in a registered pharmacy may, in good faith and in the course of his/her professional practice, sell and dispense, to an ultimate user, controlled substances upon the delivery to such pharmacist, within 30 days of the date such prescription was issued by an authorized practitioner, an official New York State prescription or an out-of-state written prescription transmitted by facsimile in accordance with section 80.67(e) or (f) of this Part.
(d) The pharmacist filling the prescription shall endorse upon the prescription his/her signature, the date of filling, and the number of the prescription under which it is recorded in the pharmacy prescription file.
(e) A pharmacy shall make a good faith effort to verify the identity of any person accepting delivery of a dispensed prescription for a controlled substance by requiring such person, if unknown to the pharmacy, to present appropriate identification.
(f)
(1) The endorsed prescription shall be retained by the proprietor of the pharmacy for a period of five years. The prescription information shall be filed electronically with the Bureau of Narcotic Enforcement, utilizing a transmission format acceptable to the department, not later than 24 hours after the substance was delivered. A waiver allowing a pharmacy to make such filings within a longer period of time may be issued by the commissioner based upon a showing of economic hardship, technological limitations that are not reasonably within the control of the pharmacy, or other exceptional circumstance demonstrated by the pharmacy. Such waiver and any subsequent waiver shall be applied for in the same manner and shall be subject to the same requirements as specified in section 80.63(c)(2)(x) of this Part and, if granted, such waiver shall not provide for a filing period longer than the 15th day of the next month following the month in which the substance was delivered. Pharmacies delivering prescriptions by mail or licensed express delivery services shall file the prescription information with the Bureau of Narcotic Enforcement, utilizing a transmission format acceptable to the department, not later than 72 hours after the substance was shipped from the pharmacy. The information filed with the department shall include but not be limited to:
(i) pharmacy prescription number;
(ii) pharmacy's national identification number;
(iii) patient name, in the case of an animal, the patient name field shall be filled with the name of the animal’s owner;
(iv) patient address, including street, city, state, ZIP code;
(v) patient date of birth;
(vi) patient's sex;
(vii) date prescription filled;
(viii) metric quantity;
(ix) national drug code number of the drug;
(x) number of days supply;
(xi) prescriber's Drug Enforcement Administration number;
(xii) date prescription issued;
(xiii) serial number of official prescription form, or an identifier designated by the department;
(xiv) payment method;
(xv) number of refills authorized;
(xvi) refill number;
(xvii) species code; and
(xviii) name of animal, if applicable.
(2)
(i) When applicable, pharmacies and dispensing practitioners shall file a zero report with the Bureau of Narcotic Enforcement in a format acceptable to the department. For the purposes of this Part, a zero report shall be a report that no controlled substances were dispensed by a pharmacy or dispensing practitioner during the relevant period of time. A zero report shall be submitted no later than 14 days following the most recent previously reported dispensing of a controlled substance, the submission of a prior zero report, or the termination of a waiver of the requirement to file a zero report.
(ii) A waiver of the requirement to file a zero report may be issued by the commissioner based upon a showing that a pharmacy or practitioner does not dispense controlled substances within the State of New York. The request for a waiver shall include a sworn statement of facts detailing the circumstances in support of a waiver, and should be accompanied by any and all other information which would be relevant to the commissioner’s determination, as well as any information which would tend to negate the need for a waiver. A waiver granted by the commissioner shall be for a specified period of time, but in no event for more than two years. Subsequent waivers shall be applied for in the same manner and shall be subject to the same requirements set forth above. A pharmacy or practitioner who has been granted a waiver shall notify the department in writing within five business days of any change in circumstances that would result in the possible dispensing of a controlled substance. The waiver granted to the pharmacy or practitioner shall be terminated effective the date of notification, and the pharmacy or practitioner shall comply with all reporting requirements of this Part until or unless a subsequent waiver is granted.
(g) Emergency oral prescriptions for schedule II controlled substances or those schedule III or schedule IV controlled substances listed in section 80.67(a) of this Part may be dispensed by a pharmacist to an ultimate user in an emergency situation, provided the pharmacist shall:
(1) contemporaneously reduce such prescriptions to written memoranda or, to the extent authorized by Federal requirements, to an electronic record and shall indicate on such memoranda the name and address of the prescriber and his/her Drug Enforcement Administration registration number, name and address of the ultimate user, date on which it is ordered, name and quantity of drugs prescribed, directions for use and the fact that it is a telephone order. The memoranda or electronic record for such emergency oral prescription shall be filed in the same manner as is otherwise required for such prescription. The pharmacist filling such oral orders shall indicate on the face of such telephone order his/her signature, the date filled and the number of the prescription under which it is recorded in the pharmacy prescription file;
(2) dispense the substance in conformity with labeling requirements applicable to the type of prescription which would be required but for the emergency; and
(3) make a good-faith effort to verify the identity of both the practitioner and the ultimate user;
(4) no emergency oral prescription shall be filled for a quantity of controlled substances which would exceed a five-day supply if the substance were used in accordance with the directions for use;
(5) within 72 hours after authorizing an emergency oral prescription, the prescribing practitioner shall cause to be delivered to the pharmacist a written or an electronic prescription. Such prescription shall, in addition to the information otherwise required, also have written or typed upon its face the words: “Authorization for emergency dispensing”. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(h) Within 72 hours after transmitting a prescription to a pharmacist by facsimile in accordance with section 80.67(e) or (f) of this Part, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or an original out-of-state written prescription. Such original prescription shall be attached to any prescription transmitted by facsimile. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(i) Such prescriptions shall be endorsed, retained and filed in the same manner as is otherwise required for such prescriptions. The follow-up prescriptions shall be attached to, or otherwise associated with, the corresponding memoranda of oral orders or to prescriptions transmitted by facsimile. The information required in section 80.68(d)(2) of this Part shall be filed electronically with the New York State Department of Health, not later than 24 hours after the substance was delivered. The pharmacy must submit this information electronically to the department utilizing a transmission format acceptable to the department. A waiver allowing a pharmacy to make such filings within a longer period of time may be issued by the commissioner based upon a showing of economic hardship, technological limitations that are not reasonably within the control of the pharmacy, or other exceptional circumstance demonstrated by the pharmacy. Such waiver and any subsequent waiver shall be applied for in the same manner and shall be subject to the same requirements as specified in section 80.63(c)(2)(x) of this Part and, if granted, such waiver shall not provide for a filing period longer than the 15th day of the next month following the month in which the substance was delivered.
(j) A pharmacist may partially fill an official New York State prescription for a schedule II controlled substance or those schedule III or schedule IV controlled substances listed in section 80.67(a) of this Part provided that:
(1) the pharmacist does not have a sufficient quantity to fill a prescription and he/she makes a notation of the quantity supplied on the prescription. The remaining portion of the prescription may be filled within 72 hours of the first partial filling. However, if the remaining portion is not or cannot be filled within the 72-hour period, the pharmacist shall so notify the prescribing practitioner. No further quantity may be supplied beyond 72 hours without a new prescription;
(2) the patient is a resident in a residential health care facility ("RHCF") which is licensed or approved by the department; or
(3) the patient has been diagnosed as being terminally ill;
(4) when such prescription is partially filled in accordance with paragraph (2) or (3) of this subdivision, the pharmacist shall:
(i) record on the prescription whether the patient is "terminally ill" or is a "RHCF patient"; and
(ii) record on the prescription the date of the partial filling, quantity dispensed, quantity remaining and the signature of the dispensing pharmacist;
(5) the prescription shall be valid for a period not to exceed 30 days from the date the prescription was issued by the practitioner unless terminated sooner upon notification from the practitioner of the discontinuance of medication. All partial fillings filled under subdivision (l) of this section must occur within 30 days from the date the prescription was issued, except that partial fillings of prescriptions issued for more than a 30 day supply for patients residing in a residential healthcare facility or for patients enrolled in a hospice program that is licensed or approved by the department must occur within 60 days from the date the prescription was issued.
(6) the date of filling on the prescription shall be the date when the prescription has been filled to completion or the date when the pharmacy is notified by the practitioner that the prescription has been discontinued.
(k) When an official New York State prescription or an out-of-state written prescription prepared by a practitioner is incomplete, the practitioner may orally furnish the missing information to the pharmacist and authorize him or her to enter such information on the prescription. The pharmacist shall write the date he or she received the oral authorization on the prescription and shall affix his or her signature. This procedure shall not apply to unsigned or undated prescriptions or where the name and/or quantity of the controlled substance is not specified or where the name of the ultimate user is missing. The pharmacist is not required to obtain authorization from the practitioner to enter the patient's address, sex or age if the pharmacist obtains this information through a good-faith effort.
(l) A practitioner may orally authorize a pharmacist to change information on an official New York State prescription or an out-of-state written prescription. This procedure shall not apply to the practitioner's signature, date the prescription was signed by the practitioner, drug name or name of the ultimate user. The pharmacist shall write the date he or she received the oral authorization on the prescription, reason for the change and his or her signature. The pharmacist shall also indicate the change on the prescription and initial the change.
(m) When a pharmacist fills a prescription in a manner that would require, under subdivision (k) or (l) of this section, the pharmacist to make a notation on the prescription if the prescription were written, the pharmacist shall make the same notation electronically when filling an electronic prescription and retain the annotation electronically in the prescription record.
(n) When a pharmacist receives a written or an oral prescription for a schedule II controlled substance or those schedule III or schedule IV controlled substances listed in section 80.67(a) of this Part that indicates that it was originally transmitted electronically to the pharmacy, the pharmacist shall conduct a reasonable search of the pharmacy records to ensure that the electronic version was not received and the prescription dispensed. If both prescriptions were received, the pharmacist shall mark one as void.
(o) When a pharmacist receives a written or an oral prescription for a schedule II controlled substance or those schedule III or schedule IV controlled substances listed in section 80.67(a) of this Part that indicates that it was originally transmitted electronically to a separate pharmacy, the pharmacist shall confer with the separate pharmacy to determine if the separate pharmacy received that prescription and if the separate pharmacy dispensed upon that electronic prescription. If the separate pharmacy that received the original electronic prescription had not dispensed the prescription, that pharmacy shall mark the electronic version as void or cancelled. If the pharmacy that received the original electronic prescription dispensed the prescription, the pharmacy receiving the written or oral version shall not dispense the prescription and shall mark it as void.
(p) A pharmacist shall use a pharmacy computer application that meets Federal security requirements to process electronic controlled substance prescriptions and shall register such pharmacy computer application with the New York State Department of Health, Bureau of Narcotic Enforcement.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.3 Residential health care facility beds
(a) Notwithstanding the provisions of section 709.1(a), (b), and (c) of this Part, the methodology and procedures in this section will be used in the evaluation of certificate of need applications involving the construction of new or replacement residential health care facility beds, the renovation of residential health care facilities, the sale or transfer of residential health care facility beds between facilities, or the establishment of residential health care facilities, including changes of ownership subject to review by the Public Health Council.
(b)
(1) For purposes of this methodology, the base year shall be 2006 and the planning target year shall be 2016. The planning area shall be the county except as otherwise provided for in this section.
(2) Notwithstanding any other provision of this section, the estimates of public need for residential health care facility beds determined under this section for the planning target year shall continue to be the estimates of public need for such beds for years subsequent to the planning target year until a new bed need methodology is promulgated.
(c) The methodology uses the following steps to estimate the need for residential health care facility beds in the planning target year:
(1) The population age 0-64 is estimated by county for the base year and planning target year in paragraph (d)(1) of this section.
(2) The number of functionally dependent individuals in the population age 65 and older is estimated by county for the base year and the planning target year in paragraph (d)(2) of this section.
(3) The population age 0-64 and the number of functionally dependent individuals aged 65 and older in each county for the base year is summed in paragraph (d)(3) of this section to derive the statewide totals for each age group.
(4) Statewide normative use rates for residential health care facilities, long term community based care and supportive housing are calculated in paragraphs (d)(4), (5) and (6) of this section for the population age 0-64 and for the functionally dependent population age 65 and older.
(5) The statewide pattern need estimates for residential health care facility beds, long term community based services and supportive housing in the planning target year are calculated in paragraph (d)(7) of this section by county by multiplying the statewide normative use rates by the appropriate population group.
(6) The need estimates for residential health care facility beds, long term community based services and supportive housing are summed to determine total long term care need for each county in paragraph (d)(8) of this section.
(7) Local pattern need estimates for residential health care facility beds, long term community based services and supportive housing in the planning target year are calculated based on the local pattern distribution of long term care services in the base year in paragraph (d)(9) of this section.
(8) The statewide pattern need estimates and the local pattern need estimates are averaged in paragraph (d)(10) of this section to derive the blended need estimate for residential health care facility beds, long term community based care and supportive housing.
(9) The blended need estimates for residential health care facility beds are adjusted to reflect a 99 percent occupancy rate in paragraph (d)(11) of this section.
(10) The residential health care facility bed need estimates are adjusted to reflect migration between counties in the State, to facilities outside the State and for patients migrating from other states to New York in paragraph (d)(12) of this section.
(11) The relationship of the need estimates for residential health care facility beds to special populations is addressed in paragraphs (d)(13) and (14) of this section.
(12) The requirement for the department to evaluate the residential health care facility bed need methodology and the appropriateness of certain assumptions set forth in this section is addressed in paragraph (d)(15) of this section.
(13) The development of long term care plans by the health systems agencies and the types of adjustments to the need estimates that may be recommended in these plans is addressed in subdivision (e) of this section.
(14) Subdivision (f) of this section provides that the bed need estimates for the planning target year shall constitute the public need for residential health care facility beds in the planning area.
(15) Remaining need for construction of additional residential health care facility beds is calculated by county in subdivision (g) of this section.
(16) Factors which could be considered by the department to modify the need estimates developed in accordance with subdivision (d) of this section are described in subdivision (h) of this section.
(d) The methodology for determining the public need for residential health care facility beds and the estimates of projected need by county for the planning target year shall be as follows:
(1) The population age 0-64 shall be estimated by county for the base year and the planning target year using New York State Data Center projections.
(2)
(i) The population age 65-74 and 75 and older shall be estimated by county for the base year and the planning target year using New York State Data Center projections.
(ii) The total number of functionally dependent individuals age 65 and older shall be estimated by county for the base year and planning target year based on the percentage of such individuals found in the population age 65 and older derived from U.S. Census Bureau data which identified those with a self-care limitation as those who resided in the community but report having a condition that makes activities of daily life difficult, plus those who resided in residential health care facilities. Estimating the functionally dependent population age 65 and older identifies a sub-set of the population age 65 and older of which a further sub-set will need long term care services from the formal support system, such as residential health care facility beds, supportive housing and long term community based services.
(3) The population estimates for those age 0-64 derived in accordance with paragraph (1) of this subdivision in each county and the population estimates of the functionally dependent individuals age 65 and older derived in accordance with paragraph (2) of this subdivision in each county for the base year shall be summed to derive the State total for each age group.
(4) The average daily census of persons served with long term care services in the base year shall be determined by age for the 0-64 age group and for those age 65 and older. Such data shall include, but not be limited to, the following long term care services:
(i) residential health care facility patients by county of origin including New York State residents served in out-of-state facilities;
(ii) persons served in the personal care program;
(iii) persons served in adult care facilities serving the frail elderly;
(iv) persons served by certified home health agencies with a length of stay of 90 days or longer;
(v) persons served by long term home health care programs;
(vi) persons served by managed long term care plans; and
(vii) patients in general hospitals on alternate level of care status with a length of stay on such status of seven days or more.
(5) For purposes of calculating appropriate normative use rates, the number of long term care patients served in the base year shall be summed by age group for the three long term care categories of residential health care facilities, long term community based care (including long term home health care programs, certified home health agency services to long term care patients, managed long term care plans and personal care programs) and supportive housing (including adult care homes and enriched housing programs. The number of patients on alternate level of care status shall be allocated between long-term community based care services and residential health care facilities.
(6) Statewide normative use rates shall be calculated for residential health care facilities, long term community based care and supportive housing for the population age 0-64 and for the functionally dependent population age 65 and older. Such statewide normative use rates shall be calculated by dividing the total patient population for residential health care facilities, long term community based services and supportive housing determined in accordance with paragraph (5) of this subdivision by the estimated base year population age 0-64 and the number of the functionally dependent age 65 and older.
(7) The statewide normative use rates derived in paragraph (6) of this subdivision shall be multiplied by the estimated county level population age 0-64 and estimated number of the functionally dependent age 65 and older for the planning target year to derive county level estimates of the need for residential health care facility beds, persons to be served in supportive housing and long term community based services needs. These need estimates shall be referred to as the statewide pattern need estimates.
(8) The total long term care need for each county is calculated by summing the need for residential health care facility beds, long term community based care and supportive housing. This sum represents an estimate of the total number of people in need of long term care services on a daily basis as represented by the statewide normative use rates.
(9) The local pattern of distribution of long term care services shall be calculated by county using the percentage distribution of resources in the county for residential health care facility beds, supportive housing and long term community based services in the base year. These percentages are multiplied by the total long term care need for the county derived in paragraph (8) of this subdivision to calculate the local pattern need estimates for residential health care facility beds, supportive housing and long term community based care.
(10) The need for residential health care facility beds calculated using the statewide pattern and the local pattern shall be averaged to estimate the blended need for each service category in the county for the planning target year.
(11) The residential health care facility beds in each county resulting from blending the statewide pattern need and the local pattern need in paragraph (10) of this subdivision shall be adjusted to reflect a 99 percent occupancy rate.
(12) The residential health care facility beds in each county resulting from the occupancy adjustment in paragraph (11) of this subdivision shall be adjusted to reflect migration between counties and to and from other states. In general, migration is estimated to be 50 percent voluntary and likely to continue regardless of the availability of resources in the county of origin and 50 percent involuntary resulting from the unavailability of resources in the county of origin. Migration adjustments shall be based on base year data and shall include:
(i) Migration from the county of origin to other New York State counties. Such migration adjustment shall be equal to 50 percent of the number of residential health care facility beds that would be required in the planning target year for residents who have migrated from another county for residential health care facility services calculated based on the proportion of county of origin patients migrating to the county of destination in the base year multiplied by the planning target year county of origin residential health care facility need.
(ii) Migration to facilities outside New York State. Such migration adjustment shall be equal to 50 percent of the Medicaid patients served outside New York State calculated based upon Medicaid claims data concerning out-of-state placements in the base year.
(iii) Out-of-state migration to New York State facilities. Such migration adjustment shall be equal to 100 percent of the patients reported by residential health care facilities in the base year.
(13) The estimates of need for residential health care facility beds determined in accordance with this subdivision do not include estimates of need for residential health care facility beds for special pediatric beds, ventilator beds, patients with acquired immune deficiency syndrome or those in need of long term rehabilitation for head injury. Need for residential health care facility beds to serve such patients shall be in addition to the estimates of need determined in accordance with paragraphs (1) through (12) of this subdivision.
(14) The estimates of need for residential health care facility beds determined in accordance with this subdivision include beds needed for dementia patients, e.g., Alzheimers disease and related disorders.
(15) The department shall conduct an evaluation of the residential health care facility bed need methodology set forth in this section by December 31, 2013.
(e)
(1) The estimates of need for residential health care facility beds, supportive housing and long term community based services developed in accordance with subdivision (d) of this section shall serve as the basis for development of long term care plans by the health systems agencies that are operational. These need estimates may be modified in accordance with paragraph (4) of this subdivision.
(2) The long term care plans shall describe the steps that will be taken on a regional basis to develop the long term care system to meet the needs for residential health care facilities, long term community based services and supportive housing. These plans should be developed by the health systems agency in consultation with providers, consumers, local governments and other entities within the health systems agency region having an interest in long term care services. To be used by the department in reviewing certificate of need applications, the long term care plan must be approved by the Commissioner of Health with the advice of the State Hospital Review and Planning Council, provided, however, that if a long term care plan has not been developed by the health systems agency and approved by the Commissioner of Health with the advice of the State Hospital Review and Planning Council at the time an application is considered by the department, the need estimates shall be determined in accordance with subdivision (d) of this section without a long term care plan adjustment.
(3) The long term care plans developed by the health systems agencies shall include but need not be limited to:
(i) Designation of long term care planning areas. Long term care planning areas may include a single county or two or more counties grouped together but may not include portions of a county. The criteria for establishing long term care planning areas shall be reflective of at least the following:
(a) voluntary patient migration patterns;
(b) travel patterns including driving time.
(4) The health systems agency long term care plans may make recommendations for amending the need estimates developed in accordance with subdivision (d) of this section to reflect local characteristics. Factors that may be considered in this analysis include, but are not limited to, the following:
(i) Adjustments for additional migration between health systems agency regions that is documented and agreed upon in writing by the affected health systems agencies.
(ii) Adjustments to the allocation of long term care services between components of the long term care service system-residential health care facilities, long term community based services and supportive housing. Factors that may be considered in reallocation of the need between components of the long term care service system may include issues related to geographic considerations or manpower availability. All such recommendations should clearly demonstrate why these adjustments are necessary and how they will benefit the planning area.
(f)
(1) The bed need estimates developed pursuant to subdivision (d) of this section, together with any approved adjustments developed in accordance with subdivision (e) of this section, shall constitute the public need for residential health care facility beds in the planning areas defined subject to further adjustments in accordance with subdivision (h) of this section.
(2) For purposes of determining public need for residential health care facility beds in the City of New York, the public need estimates for each county in the City of New York, determined in accordance with this section, shall be summed. For purposes of determining public need for residential health care facility beds in the counties of Nassau and Suffolk, the public need estimates for each of these two counties, determined in accordance with this section, shall be summed.
(3) Notwithstanding that there is an indication of need in a planning area for additional residential health care facility beds as determined in accordance with subdivision (d) or (e) of this section, there shall be a rebuttable presumption that there is no need for any additional residential health care facility beds in such planning area if the overall occupancy rate for existing residential health care facility beds in such planning area is less than 97 percent based on the most recently available data. It shall be the responsibility of an applicant in such instances to demonstrate that there is a need for additional residential health care facility beds despite the less than 97 percent occupancy rate in the applicant's planning area utilizing the factors set forth in subdivision (h) of this section.
(g) The evaluative procedure for determining public need for residential health care facility beds in a planning area for the planning target year shall include, but not be limited to:
(1) identification of existing residential health care facility beds in the planning area;
(2) identification of residential health care facility beds that have been approved for construction but are not in operation in the planning area;
(3) identification of resulting total residential health care facility beds that will be available in the planning area;
(4) identification of remaining need in the planning area, based upon public need for residential health care facility beds in the planning area determined in accordance with subdivision (d) or (e) of this section or adjusted in accordance with subdivision (h) of this section.
(h) Notwithstanding any other provisions of this section, when the estimates of need for residential health care facility beds developed in accordance with subdivision (d) or (e) of this section indicate the need for additional residential health care facility beds, such estimates of additional need may be modified, based on information and data gathered from relevant sources relating to significant local factors pertaining to an applicant's service/planning area, or on statewide factors, where relevant, which factors may include, but not necessarily be limited to, those set forth in paragraphs (1) through (7) of this subdivision. When making recommendations to the State Hospital Review and Planning Council and Public Health Council concerning the impact of the factors set forth in this subdivision, the department shall, to the extent practicable, indicate the relative priority of such factors.
(1) The impact of requirements pertaining to placing persons with disabilities into the most integrated setting appropriate so as to enable persons with disabilities to interact with nondisable persons to the fullest extent possible.
(2) The growth, availability and cost-effectiveness of long-term home and community-based services, other non-institutional residential programs and of other programs and services that may serve as a substitute for or prevent the need for residential health care facility placement.
(3) Occupancy rates, and the trend of those rates of existing residential health care facilities in the planning area and in contiguous counties.
(4) Patient migration patterns that vary from those included in the methodology set forth in subdivision (d) of this section.
(5) The health status of residents of the planning area or the State, as applicable.
(6) Recommendations made by the local health systems agency, if applicable.
(7) Documented evidence of the unduplicated number of patients on waiting lists who are appropriate for and desire admission to a residential health care facility who experience a long waiting time for placement and who cannot be served adequately in other settings.
(i) An applicant for residential health care facility beds should anticipate that the review of the certificate of need application will be on a competitive basis. Therefore, all information and factors that the applicant deems relevant to the department's determination of public need must be included in the applicant's certificate of need submission. Review of the proposal as submitted by the applicant shall include:
(1) the proposal's responses to and consistency with priority considerations specified in any requests for proposals issued by the department or the health systems agency;
(2) the relationship of the residential health care facility beds being proposed to any applicable regional or statewide plans;
(3) the proposal's consistency with the provisions of section 709.1(d) of this Part;
(4) the availability of less costly or more effective alternative methods of providing the residential health care facility beds being reviewed;
(5) whether the proposed residential health care facility beds would provide improvements or innovations in the financing and delivery of health services and serve to promote quality assurance and cost effectiveness;
(6) the quality of care provided by the residential health care facility in the past;
(7) in cases involving the reduction or elimination of residential health care facility beds including those cases involving the relocation of a facility or service, the extent to which need will be met adequately and the effect of the reduction, elimination, or relocation of the facility on the ability of low income persons, racial and ethnic minorities, and other underserved groups, to obtain needed long term care services;
(8) in cases involving a proposed service area which includes a neighboring planning area, the ability of residents of such neighboring planning area to access the residential health care facility beds proposed;
(9) the contribution the proposed residential health care facility would make in meeting the health needs of members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to residential health care facility beds (for example, low-income persons, racial and ethnic minorities, and patients on alternate level of care status in general hospitals). For the purpose of determining the extent to which the proposed facility will be accessible to such persons, the following shall be considered:
(i) the extent to which medically underserved populations currently use the applicant's services, where the applicant currently provides residential health care facility services, in comparison to the percentage of all users of the service in the applicant's planning area or to which they are found in the population in general, and the extent to which medically underserved populations are expected to use the proposed residential health care facility beds if approved;
(ii) the performance of the applicant, where the applicant currently provides residential health care facility services, in meeting its obligation under the applicable civil rights statutes prohibiting discrimination on the basis of race, color, national origin, handicap, sex and age; and
(iii) the extent to which Medicaid and medically indigent patients are or would be served by the applicant;
(10) when the remaining public need identified in subdivision (g) of this section is not sufficient to permit the approval of all applications for residential health care facility beds which are considered in the batch under consideration which otherwise meet all statutory and regulatory criteria specified under the Public Health Law, the proposals will be competitively reviewed. In the competitive review process consideration will be given to those proposals which meet any or all of the following:
(i) make a commitment to admit a percentage of patients who are Medicaid eligible or Medicare/Medicaid eligible in excess of that required under subdivision (m) of this section;
(ii) make a commitment to admit a percentage of patients who have been on alternate level of care status in a general hospital for more than 90 days. Additional consideration will be given to applications that:
(a) identify and agree to meet special program requirements for such patients; and
(b) demonstrate that they have written agreements with general hospitals for admission of alternate level of care patients;
(iii) agree in writing to participate in available local long term care case management programs. Existing written agreements with local case management programs should be documented in the application;
(iv) propose to establish or expand adult care facility beds or other supportive housing programs;
(v) provide an architectural design, as demonstrated through room-by-room single line drawings and project narrative, that offers innovative designs and other factors (such as interior finishes, lighting, decorating and furnishings) to enhance quality of life in the facility.
(j) Notwithstanding any inconsistent provision of this section, the applicant may propose a service area that includes a long term care planning area outside of that in which the facility or proposed facility is located. If any application is approved on this basis, the number of residential health care facility bed resources available in the external planning area determined in accordance with subdivision (g) of this section will be adjusted to reflect that portion of the facility's bed complement which will serve residents of the external planning area.
(k) Any application for construction wherein a determination of public need is made pursuant to this section shall be subject to the provisions of section 709.1(e) of this Part.
(l) Notwithstanding any other provision of this section to the contrary, up to 300 additional residential health care facility beds for the State as a whole may be approved, which shall be in additional to the total statewide number of residential health care facility beds otherwise estimated to be needed under this section. Such additional beds may be approved in response to applications to add a single bed or multiple beds to an existing facility, to add an extension unit to an existing facility or to construct a new facility. Such additional beds may be approved only to meet emergency situations or other unanticipated circumstances, which shall include, but not necessarily be limited to, the following:
(1) natural disasters, such as floods, fires and disease outbreaks;
(2) unanticipated changes in population migration patterns or census growth;
(3) unanticipated reduction in availability of alternative placement settings; and
(4) unanticipated changes in population health or age group characteristics.
(m) Any residential health care facility or general hospital filing an application to add residential health care facility beds shall be subject to the following requirements which shall apply to all of the facility's existing and proposed certified residential health care beds:
(1) In determining the need for residential health care facilities, beds and services, consideration shall be given to the needs of persons who receive or are eligible to receive medical assistance benefits at the time of admission to a facility pursuant to title XIX of the Federal Social Security Act and title 11 of article 5 of the Social Services Law, hereafter referred to as Medicaid patients, and the extent to which the applicant serves or proposes to serve such persons, as reflected by factors including, but not necessarily limited to, the applicant's admissions policies and practices. An application by an applicant that is or will be a provider that participates in the medical assistance (Medicaid) program shall not be approved unless the applicant agrees to comply with the requirements of this subdivision. An applicant that, at the time of consideration of its application by the commissioner, proposes not to participate in the Medicaid program may be approved, provided all other review criteria have been met, upon the condition that if, in the future, it does participate in the Medicaid program, it would comply fully with the requirements of this subdivision.
(2) To ensure that the needs of Medicaid patients in an applicant's service area are met and that such patients have adequate access to appropriate residential health care facilities, beds and services, applicants shall be required to accept and admit at least a reasonable percentage of Medicaid patients as determined pursuant to this subdivision. Such reasonable percentage of Medicaid patient admissions, also referred to herein as the Medicaid patient admissions standard, shall be equal to 75 percent of the annual percentage of all residential health care facility admissions, in the long term care planning area in which the applicant facility is located, that are Medicaid patients. The calculation of such planning area percentage shall not include admissions to residential health care facilities that have an average length of stay of 30 days or less. If there are four or fewer residential health care facilities in a planning area, the applicable Medicaid patient admissions standard for such planning area shall be equal to 75 percent of the planning area annual percentage of all residential health care facility admissions that are Medicaid patients or 75 percent of the annual percentage of all residential health care facility admissions, in the health systems agency area in which the facility is located, that are Medicaid patients, whichever is less. In calculating such percentages, the department will use the most current admissions data which have been received and analyzed by the department. An applicant will be required to make appropriate adjustments in its admissions policies and practices so that the proportion of its own annual Medicaid patient admissions is at least equal to 75 percent of the planning area percentage or health systems agency area percentage, whichever is applicable.
(3) The proportion of an applicant's admissions that must be Medicaid patients, as calculated under paragraph (2) of this subdivision, may be increased or decreased based on the following factors:
(i) the number of individuals within the planning area currently awaiting placement to a residential health care facility and the proportion of total individuals awaiting such placement that are Medicaid patients, provided that patients awaiting placement include, but need not be limited to, alternate level of care patients in general hospitals;
(ii) the proportion of the facility's total patient days that are Medicaid patient days and the length of time that the facility's patients who are admitted as private paying patients remain such before becoming Medicaid eligible;
(iii) the proportion of the facility's admissions who are Medicare patients or patients whose services are paid for under provisions of the Federal Veterans' Benefit Law;
(iv) the facility's patient case mix based on the intensity of care required by the facility's patients or the extent to which the facility provides services to patients with unique or specialized needs; and
(v) the financial impact on the facility due to an increase in Medicaid patient admissions.
(4)
(i) An applicant shall submit a written plan, subject to the approval of the department, for reaching the Medicaid patient admissions standard required by this subdivision. The plan shall provide for reaching the standard within no longer than a two-year period and the facility shall give preference, as necessary, to Medicaid patients in order to reach the admissions standard within the prescribed time period.
(ii) Once the Medicaid patient admissions standard is reached, the facility shall not reduce its proportion of Medicaid patient admissions so as to go below the standard unless and until the applicant, in writing, requests the approval of the department to adjust the standard and the department's written approval is obtained. In reviewing requests to adjust a facility's Medicaid patient admissions standard, the department shall consider factors which may include, but need not be limited to, those factors set forth in paragraphs (2) and (3) of this subdivision.
(iii) After a facility's initial Medicaid patient admissions standard has been reached, the department may increase such facility's Medicaid patient admissions standard, based on the criteria set forth in this subdivision, if the percentage of Medicaid patients admitted by residential health care facilities in the facility's planning area or health systems agency area, as appropriate, increases due to factors other than an increase in Medicaid patient admissions by the applicant.
(5)
(i) Subject to the provisions of subparagraph (ii) of this paragraph, after the phase-in period provided for in paragraph (4) of this subdivision, a facility shall be prohibited from failing, refusing or neglecting to accept or admit a Medicaid patient for whom it is otherwise able to provide care, regardless of whether the level of reimbursement received for such patient is less than the rate the facility charges private pay patients, unless the facility has reached and is maintaining compliance with the Medicaid patient admissions standard imposed by this subdivision. Compliance with the requirements of this subdivision shall be determined on the basis of a facility's total annual admissions, so that a facility may exercise its discretion in determining when during a year it will admit a sufficient number of Medicaid patients to maintain its Medicaid patient admissions standard.
(ii) A facility may be exempt from the requirement of admitting a Medicaid patient in order to meet or maintain its Medicaid patient admissions standard if it can demonstrate in writing to the satisfaction of the commissioner that the Medicaid patient was denied admission solely in order to admit another patient who had a greater need of residential health care facility services, as determined by the intensity of care anticipated to be required by such patient, and that there was only one bed available in the facility at the time of the admission decision to accommodate a new admission. Facilities shall not be required to obtain prior department approval in order to accept a non-Medicaid patient in place of a Medicaid patient pursuant to this subparagraph, but shall maintain sufficient documentation including, but not necessarily limited to, a copy of the patient review instrument for the patient admitted and the Medicaid patient denied admission in order to justify the admission decision. Copies of such documentation shall be provided to the department upon request.
(6) If any provision of this subdivision or the application thereof is held invalid, the remainder of this subdivision and the application thereof to other circumstances shall not be affected by such holding and shall remain in full force and effect.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-4 REQUIREMENTS FOR ALTERNATIVE REGULATED MEDICAL WASTE TREATMENT SYSTEMS
10 CRR-NY 70-4.2 Operational requirements
(a) Each facility seeking to operate an alternative regulated medical waste treatment system shall develop an operation plan, and shall submit such plan to the department for review and approval prior to using the system to treat regulated medical waste. Any change in procedures related to the operation of the system shall be reflected in a modified plan, which shall be dated with each revision.
(b) No alternative regulated medical waste treatment system shall be used to treat regulated medical waste without department approval of the facility's operation plan and any modifications made to such plan on or after the effective date of this regulation. The operation plan shall be submitted to the department for approval at least 60 days prior to the anticipated start-up date of the system.
(c) The operation plan shall be designed to promote safe and effective operation of the alternative treatment system. The operation plan shall include, minimally, procedures to ensure:
(1) the system as situated on-site of the facility meets department criteria for effective treatment of regulated medical waste ( i.e. , the protocol for validation testing and a summary of the results);
(2) loads contain only those items or types of waste for which effective treatment by the system has been demonstrated by efficacy testing and verified by validation testing; and exclude waste materials for which effective treatment by the system has not been demonstrated and/or is prohibited pursuant to section 70-2.3 of this Part, and materials expressly excluded in the commissioner's notice of approval treatment;
(3) each load is treated using operating parameters that have been demonstrated as effective for the treatment of regulated medical waste, and conditions of treatment are monitored and documented for each load;
(4) the effectiveness of treatment is maintained, by including, as applicable, procedures for and frequency of calibration verification and recalibration of parametric controls; monitoring by challenge testing or other demonstration that treatment has been attained; and preventive maintenance of engineering controls ( e.g. , charcoal and/or HEPA filters) and diagnostic procedures for electronic controls ( e.g. , integrated computers and mechanical components);
(5) occupational exposure is minimized and physical injury to operators is prevented during loading, the cycle, and unloading of the system; and
(6) personnel are knowledgeable about routine operation of the system, are kept current with system manufacturer recommendations for operation, and have been instructed in emergency procedures for handling malfunctioning systems and untreated waste. Training programs shall mandate initial training and retraining at least once per calendar year and as necessary for presenting updates on operational information.
(d) Any modification of an approved operation plan altering treatment efficacy shall be submitted to the department for approval prior to implementation. Prior to approving a modified plan, the department may require efficacy and/or validation testing, using a protocol approved pursuant to section 70-4.3(b) of this Subpart. The department may require the submission of additional information and data specific to the alternative treatment system as may be pertinent to a demonstration of ongoing safety and efficacy.
(e) No alternative regulated medical waste treatment system shall be placed into operation prior to implementation of an approved operation plan.
(f) An alternative regulated medical waste treatment system shall be operated in accordance with the system manufacturer's instructions and the approved operation plan. Should a system fail during operation, the operating facility shall:
(1) discontinue use of the system, using emergency shutdown procedures if appropriate, until corrective action is taken and verified through parametric controls; validation testing, including but not limited to, biological indicators; or other demonstration that treatment has been attained;
(2) handle as untreated all regulated medical waste processed by the system since the last previous run under documented compliance with such requirements;
(3) document the failure, including date and system identifier;
(4) document the facility response, including corrective action;
(5) whenever a facility has reason to believe untreated waste certified as treated waste has left the facility; notify the waste transporter immediately upon discovery of the incident, at least within a maximum of two business days and notify the department within 72 hours of the waste's leaving the facility.
(g) For systems that employ parametric controls for automatic and continuous monitoring, the facility shall generate a record of monitoring that identifies operating parameters throughout the cycle. In the absence of such controls, the operational performance of an alternative regulated medical waste system shall be monitored by challenge testing pursuant to a protocol included in the facility's operation plan and approved by the department.
(h) No person shall load, operate and/or unload an alternative regulated medical waste treatment system without documented training and retraining in the activities performed. Documentation shall include the date, location and content of all training sessions, as well as an attestation, by signature of trainer and trainee, that such training or retraining was conducted.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS MONITORING AND CONTROL OF DISINFECTION BYPRODUCTS AND DISINFECTION BYPRODUCT PRECURSORS
10 CRR-NY 5-1.62 Alternative compliance criteria for enhanced coagulation
Systems may use one of the following alternative compliance criteria instead of enhanced coagulation. Systems using the alternative compliance criteria shall still comply with the monitoring requirements stated in section 5-1.61 of this Subpart.
)
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
EMERGENCY PREPAREDNESS AND RESPONSE EMERGENCY PREPAREDNESS AND RESPONSE
10 CRR-NY 40-2.70 Emergency preparedness and response; performance standards
The local health department shall conduct a program designed to ensure readiness to respond to health emergencies, whether naturally occurring or deliberate, to protect the health of its residents. The program shall include at a minimum:
(a) development and maintenance of an All Hazards Health Emergency Preparedness and Response Plan;
(b) activities designed to maintain readiness to provide appropriate medical countermeasures to the public in response to an emergency;
(c) ensure training and health education to local health department staff, health care providers and the community on health emergency preparedness;
(d) participation and implementation of exercises and drills that include appropriate response partners; and
(e) responding to emergencies as described in the All Hazards Health Emergency Preparedness and Response Plan.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.5 Sterilization of instruments
For both allogeneic and autogeneic transfusions, syringes, needles, lancets, or other blood- letting devices capable of transmitting infection from one person to another, shall either be licensed by the F.D.A. for single use or be heat-sterilized prior to each use. Heat sterilization shall be by autoclaving at 121.5 degrees Celsius for 15 minutes after the chamber of the autoclave has been evacuated and has reached that temperature, or by dry heat for two hours at 170 degrees Celsius or by such other procedure as may be approved by the department.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 68 POISON CONTROL NETWORK
10 CRR-NY 68.2 Selection of regional poison control centers
(a) The commissioner shall review poison control activities at general hospitals in New York State and shall designate no more than one such facility in each health systems agency (HSA) region as a regional poison control center, based upon the following criteria:
(1) record of compliance with the rules and regulations of this Title and expected compliance with the poison control provisions of this Part;
(2) location within the geographical distribution of persons to be served;
(3) the need for expanded poison control services in the area to be served;
(4) the extent to which current activities performed by the facility relate to the provision of poison control services; and
(5) the capacity of the provider to deliver and coordinate poison prevention information and poison treatment services in the region.
(b) Hospitals wishing to be considered for such designation shall file a request to the commissioner in a format prescribed by the department.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-1 HELEN HAYES HOSPITAL
DISCHARGE OF PATIENTS DISCHARGE OF PATIENTS
10 CRR-NY 88-1.20 Discharges
Patients shall be discharged when they shall have achieved maximum benefits from the services of the hospital, short of domiciliary or custodial care, as determined by the director. Patients desiring to leave before achieving maximum benefits shall sign or have signed by their legal guardians a statement releasing the hospital, the New York State Department of Health, and the State of New York from any liability which might result from such discharge. Patients may be discharged for noncompliance with hospital rules, misbehavior, or noncooperation, as determined by the director.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 620 INCORPORATIONS AND TRANSFERS OF PROPRIETARY BUSINESSES
10 CRR-NY 620.2 Transfers of interest by sole proprietors or partnerships
(a) An individual or partnership seeking Public Health Council approval of transfer of all or part of the ownership of the business shall file information, documents and data as follows:
(1) A certified copy of the applicant's certificate of doing business, or where the applicant proposes to continue the partnership name, a photocopy of the executed proposed certificate of doing business.
(2) Where the applicant is a partnership, full and true copies of all partnership agreements.
(3) A declaration of the percentage of the business to be transferred.
(4) A financial statement setting forth the purchase price of the interest in the business being sold and the financial resources available to make such purchase, or the basis on which such transfer is to be financed.
(5) Where any transfer is to be by gift, a statement of the relationship between the donor and donee.
(6) Information as to the character, experience, competence and standing in their community of the proposed proprietor or partners.
(7) Where the applicant proposes a change of name by which the facility is doing business, a photocopy of the executed proposed certificate of doing business.
(8) Such additional pertinent information or documents necessary for the council's consideration, as requested.
(b) In addition to meeting the applicable requirements of subdivision (a) of this section, an application for the transfer of less than a 20 percent interest in a partnership shall be processed as follows:
(1) The local health systems agency may waive review, but, if such review is not waived, it shall make its recommendation within 90 days from the date a complete application is received by the department.
(2) The department shall process an application subject to this subdivision and submit it to the State Hospital Review and Planning Council for a recommendation and to the Public Health Council for a decision within 150 days from the date a complete application is received by the department, provided that such time period may be extended for a time not to exceed the time the department awaited a response from the applicant to requests for additional documentation and information. The Public Health Council shall act on the application within the same such time period. If the Public Health Council defers the application, the council shall advise the applicant in writing of the reasons for such deferral. A deferred application shall be returned to the Public Health Council, and the council shall propose to approve or disapprove such application no later than the second council meeting following the meeting at which the application was deferred.
(3) In accordance with subdivision (4) of section 2801-a of the Public Health Law, an application solely for a transfer of interest in an existing established partnership shall not be subject to a public need review.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-2 IMMUNIZATION AGAINST MEASLES, MUMPS AND RUBELLA FOR POST SECONDARY STUDENTS
10 CRR-NY 66-2.4 Immunization for students not in compliance
In the event that a student registers at an institution and has not provided the documentation listed in section 66-2.2(b) or (c) of this Subpart the institution shall:
(a) notify the student of the necessity to be immunized, and that such immunizations may be administered by a health practitioner or public health officer in the county where the student resides or in which the institution is located; and
(b) notify the student that immunization is required for attendance at the institution unless the student provides valid reason for lack of immunization due to medical or religious exemption according to section 66-2.2(d) or (e) of this Subpart.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CLASSES OF RECOMBINANT DNA ACTIVITY CLASSES OF RECOMBINANT DNA ACTIVITY
10 CRR-NY 61-1.20 Classes of recombinant DNA activity
This section discusses activities involving recombinant DNA. The activities are divided into four classes corresponding to those set forth in part III of the revised NIH guidelines effective August 27, 1982. The words experiment and experiments are to be read as referring to recombinant DNA activity as defined in article 32-A of the Public Health Law. The classes and their respective requirements are:
(III-A) Experiments which require specific NIH and institutional biosafety committee (IBC) approval before initiation of the experiment.
(III-B) Experiments which require IBC approval before initiation of the experiment.
(III-C) Experiments which require IBC notification at the time of initiation of the experiment.
(III-D) Experiments which are exempt from the NIH guidelines and as such may come under section 61-1.3(c) of this Subpart.
If an experiment fall into both class III-A and one of the other classes, the rules pertaining to class III-A must be followed. If an experiment falls into class III-D and into either class III-B or III-C as well, it can be considered as a class III-D activity.
Changes in containment levels from those specified here may not be instituted without the express approval of the Director, NIH.
(III-A) Experiments that require NIH and institutional biosafety committee (IBC) approval before initiation. Experiments in this category cannot be initiated without specific approval by NIH. The containment conditions for such experiments will be set by NIH at the time of approval. Such experiments also require the approval of the IBC before initiation. Specific experiments already approved in this category and the appropriate containment conditions are listed in appendices D and F of the NIH guidelines. If an experiment is similar to those listed in appendices D and F, NIH Office of Recombinant DNA Activities (ORDA) may determine appropriate containment conditions according to case precedents.
(III-A-1) Deliberate formation of recombinant DNAs containing genes for the biosyntheses of toxic molecules lethal for vertebrates at an LD50 of less than 100 nanograms per kilogram body weight ( e.g., microbial toxins such as the botulinum toxins, tetanus toxin, diphtheria toxin, Shigella dysenteriae neurotoxin). Specific approval has been given for the cloning in E. coli K-12 of DNAs containing genes coding for the biosynthesis of toxic molecules which are lethal to vertebrates at 100 nanograms to 100 micrograms per kilogram body weight. Containment levels for these experiments are specified in appendix F of the NIH guidelines.
(III-A-2) Deliberate release intto the environment of any organism containing recombinant DNA.
(III-A-3) Deliberate transfer of a drug resistance trait to microorganisms that are not known to acquire it naturally, if such acquisition could compromise the use of the drug to control disease agents in human or veterinary medicine or agriculture.
(III-B) Experiments that require institutional biosafety committee (IBC) approval before initiation. Investigators performing experiments in this category must submit to their IBC, prior to initiation of the experiments a registration document that contains a description of: (a) the source(s) of DNA; (b) the nature of the inserted DNA sequences; (c) the hosts and vectors to be used; (d) whether a deliberate attempt will be made to obtain expression of a foreign gene, and, if so, what protein will be produced; and (e) the containment conditions specified in the NIH guidelines. This registration document must be dated and signed by the investigator and filed only with the local IBC. The IBC shall review all such proposals prior to initiation of the experiments. Requests for lowering of containment for experiments in this category will be considered by NIH.
(III-B-1) Experiments using human or animal pathogens (Class 2, Class 3, Class 4 or Class 5 agents) as host-vector systems.
(III-B-1-a) Experiments involving the introduction of recombinant DNA into Class 2 agents can be carried out at P2 containment.
(III-B-1-b) Experiments involving the introduction of recombinant DNA into Class 3 agents can be carried out at P3 containment.
(III-B-1-c) Experiments involving the introduction of recombinant DNA into Class 4 agents can be carried out at P4 containment.
(III-B-1-d) Containment conditions for experiments involving the introduction of recombinant DNA into Class 5 agents will be set on a case-by-case basis following ORDA review. A USDA permit is required for work with Class 5 agents.
(III-B-2) Experiments in which DNA from human or animal pathogens (Class 2, Class 3, Class 4 or Class 5) agents is cloned in nonpathogenic prokaryotic or lower eukaryotic host-vector systems.
(III-B-2-a) Recombinant DNA experiments in which DNA from Class 2 or Class 3 agents is transferred into nonpathogenic prokaryotes or lower eukaryotes may be performed under P2 containment. Recombinant DNA experiments in which DNA from Class 4 agents is transferred into nonpathogenic prokaryotes or lower eukaryotes can be performed at P2 containment after demonstration that only a totally and irreversibly defective fraction of the agent's genome is present in a given recombinant. In the absence of such a demonstration, P4 containment should be used. Specific lowering of containment to P1 for particular experiments can be approved by the IBC. Many experiments in this category will be exempt from the NIH guidelines (see III-D). Experiments involving the formation recombinant DNAs for certain genes coding for molecules toxic for vertebrates require NIH approval (see III-A-1), or must be carried out under NIH specified conditions as described in appendix F of the NIH guidelines.
(III-B-2-b) Containment conditions for experiments in which DNA from Class 5 agents is transferred into nonpathogenic prokaryotes or lower eukaryotes will be determined by ORDA following a case-by-case review. A USDA permit is required for work with Class 5 agents.
(III-B-3) Experiments involving the use of infectious animal or plant viruses or defective animal or plant viruses in the presence of helper virus in tissue culture systems. Caution: Special care should be used in the evaluation of containment levels for experiments which are likely to either enhance the pathogenicity ( e.g., insertion of a host oncogene) or to extend the host range ( e.g., introduction of novel control elements) of viral vectors under conditions which permit a productive infection. In such cases, serious consideration should be given to raising the physical containment by at least one level. Note: Recombinant DNA molecules which contain less than two thirds of the genome of any eukaryotic virus (all virus from a single family being considered identical) may be considered defective and can be used, in the absence of helper, under the conditions specified in III-C.
(III-B-3-a) Experiments involving the use of infectious Class 2 animal viruses, or defective Class 2 animal viruses in the presence of helper virus, can be carried out at P2 containment.
(III-B-3-b) Experiments involving the use of infectious Class 3 animal viruses, or defective Class 3 animal viruses in the presence of helper virus, can be performed at P3 containment.
(III-B-3-c) Experiments involving the use of infectious Class 4 viruses, or defective Class 4 viruses in the presence of helper virus, may be carried out under P4 containment.
(III-B-3-d) Experiments involving the use of infectious Class 5 viruses, or defective Class 5 viruses in the presence of helper virus, will be determined on a case-by-case basis following ORDA review. A USDA permit is required for work with Class 5 pathogens.
(III-B-3-e) Experiments involving the use of infectious animal or plant viruses, or defective animal or plant viruses in the presence of helper virus, not covered by III-B-3-a, III-B-3-b, III-B-3-c or III-B-3-d may be carried out under P1 containment.
(III-B-4) Recombinant DNA experiments involving whole animals or plants.
(III-B-4-a) DNA from any source except for greater than two thirds of a eukaryotic viral genome may be transferred to any nonhuman vertebrate organism and propogated under conditions of physical containment comparable to P1 and appropriate to the organism under study. It is important that the investigator demonstrate that the fraction of the viral genome being utilized does not lead to productive infection. A USDA permit is required for work with Class 5 agents.
(III-B-4-b) For all experiments involving whole animals or plants and not covered by III-B-4-a, the appropriate containment will be determined by the IBC.
(III-B-5) Experiments involving more than 10 liters of culture. The appropriate containment will be decided by the IBC. Where appropriate, the large-scale containment recommendations of the NIH should be used (45 FR 24968).
(III-C) Experiments that require institutional biosafety committee (IBC) notice simultaneously with initiation of experiments. Experiments not included in III-A, III-B, III-D and their subsections are to be considered in III-C. For example, experiments in which all components derive from nonpathogenic prokaryotes and nonpathogenic lower eukaryotes fall under III-C. All such experiments can be carried out at P1 containment. For experiments in this category, a registration document as described in III-B must be dated and signed by the investigator and filed with the local IBC. The IBC shall review all such proposals, but IBC review prior to initiation of the experiment is not required. Caution: Experiments involving formation of recombinant DNA molecules containing no more than two thirds of the genome of any eukaryotic virus. Recombinant DNA molecules containing no more than two thirds of the genome of any eukaryotic virus (all viruses from a single family being considered identical) may be propagated and maintained in cells in tissue culture usng P1 containment. For such experiments, it must be shown that the cells lack helper virus for the specific families of defective viruses being used. If helper virus is present, procedures specified under III-B-3 should be used. The DNA may contain fragments of the genome of viruses from more than one family but each fragment must be less than two thirds of a genome. (It is the responsibility of the institution and those associated with it to adhere to the intent of this Subpart and the NIH guidelines as well as to their specifics.)
(III-D) Experiments exempt from the NIH guidelines and specified in section 61-1.3 of this Subpart. As provided in section 61-1.3(c) of this Subpart, an institution may be issued a certificate to engage in recombinant activity limited to recombinant DNA molecules specified in section 61-1.3(c) (class III-D molecules) without being required to comply with the provisions of sections 61-1.30 and 61-1.31 of this Subpart pertaining to the establishment and functioning of an institutional biosafety committee (IBC).
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.41 Computation of basic rates for day health care services for AIDS/HIV patients
Computation of basic rates for day health care services provided by freestanding ambulatory care facilities to patients with acquired immune deficiency syndrome (AIDS), other human immunodeficiency virus (HIV) related illnesses and other high-need populations that, regardless of their HIV status and in the discretion of the commissioner, would benefit from receiving adult day health care services. Effective April 1, 1994 and thereafter, reimbursement for adult day health care services that are provided to registrants with acquired immune deficiency syndrome (AIDS), other human immunodeficiency virus (HIV) related illnesses and, effective April 1, 2017, that are provided to registrants who are otherwise considered at the discretion of the commissioner to be part of a high-need population that, regardless of their HIV status, would benefit from receiving these adult day health care services shall be established pursuant to this section.
(a) For payments made pursuant to this section for day health care services rendered to patients who have AIDS or HIV-related illness and other high-need registrants, reimbursement shall be a single price per visit, with not more than one reimbursable visit per day per patient. For 1993 an initial price shall be determined taking into consideration reasonable projections of necessary costs, and the costs and statistics contained in proposed annual budgets for this service as defined in section 759.1(d) of this Title, including, but not limited to, utilization, staffing and salaries. For subsequent rate periods the price established pursuant to this section shall be adjusted by the trend factor described in subdivision (e) of this section after considering the actual allowable expenditures and statistics for the year which ended 15 months prior to the rate period.
(b) To be eligible to receive reimbursement pursuant to this section, a free-standing ambulatory care facility must be certified to provide general medical services and day health care services for AIDS/HIV patients and, effective April 1, 2017, to other high-need registrants.
(c) The price established pursuant to this section shall be full reimbursement for the following:
(1) physician services, nursing services, and other related professional expenses directly incurred by the licensed facility, including the provision of triage or sick call services;
(2) space occupancy and plant overhead costs;
(3) administrative personnel, business office, data processing, recordkeeping, housekeeping, food services, transportation, and other related facility overhead expenses;
(4) all ancillary services described in section 759.8 of this Title and laboratory tests and diagnostic X-ray services appropriate to the level of primary medical care required by the patient;
(5) all medical supplies, immunizations, and drugs directly related to the provision of services.
(d) Components of the price may be adjusted for service capacity, urban or rural location, and for regional differences in wage levels, space occupancy, and facility overhead costs, by comparing anticipated utilization and costs with actual experiences. The downstate region shall be defined as the counties of Putnam, Rockland, Westchester, Bronx, Kings, New York, Queens, Richmond, Nassau, and Suffolk and the upstate region shall be defined as all remaining counties in the State.
(e) The commissioner shall establish trend factors to project increases in prices for the effective period of the reimbursement rates. The trend factors shall be developed using available price indices including elements of the United States Department of Labor consumer and producer price indices and special price indices developed by the Commissioner for this purpose. The projected trend factors shall be updated on an annual basis, based upon current and available data.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH SOCIAL WORKER PUBLIC HEALTH SOCIAL WORKER
10 CRR-NY 11.172 Supervisory level qualifications
A supervising public health social worker must meet the qualifications for public health social worker, and have two years' experience in social work.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.23 Initial and continuing eligibility criteria
(a) Initial eligibility for the Early Intervention Program shall be established by medical or other records or a multidisciplinary evaluation conducted in accordance with section 69-4.8 of this Subpart and shall be based on the following criteria:
(1) a diagnosed physical or mental condition with a high probability of resulting in developmental delay; or
(2) the presence of a developmental delay which affects functioning in one or more of the following domains of development: cognition, physical (including vision, hearing and oral motor feeding and swallowing disorders), communication, social-emotional, or adaptive development; and, as measured by qualified personnel using informed clinical opinion, appropriate diagnostic procedures, and/or instruments and documented as:
(i) a 12-month delay in one domain; or
(ii) a 33 percent delay in one domain or a 25 percent delay in each of two domains; or
(iii) if appropriate standardized instruments are individually administered in the evaluation process, a score of at least 2.0 standard deviations below the mean in one domain or a score of at least 1.5 standard deviation below the mean in each of two domains; or
(iv) notwithstanding subdivisions (i)-(iii) of this paragraph for children who have been found to have a delay only in the communication domain, delay shall be defined as a score of 2.0 standard deviations below the mean in the area of communication; or, if no standardized test is available or appropriate for the child, or the tests are inadequate to accurately represent the child's developmental level in the informed clinical opinion of the evaluator, a delay in the area of communication shall be a severe delay or marked regression in communication development as determined by specific qualitative evidence-based criteria articulated in clinical practice guidelines issued by the department, including the following:
(a) for children 18 months of age or older;
(1) a severe language delay as indicated by no single words by 18 months of age, a vocabulary of fewer than 30 words by 24 months of age, or no two-word combinations by 36 months of age; or
(2) the documented presence of a clinically significant number of known predictors of continued language delay at 18-36 months of age, in each of the following areas of speech language and non-speech development:
(i) language production;
(ii) language comprehension;
(iii) phonology;
(iv) imitation;
(v) play;
(vi) gestures;
(vii) social skills; and
(viii) health and family history of language problems; or
(b) for children younger than 18 months of age, documentation that the child has attained none of the normal language milestones expected for children in the next younger age range, and none for the upper limit of the child's current chronological age range, and the presence of a preponderance of established prognostic indicators of communication delay that will not resolve without intervention, as specified in clinical practice guidelines issued by the department.
(b) If there is an observable change in the child's developmental status that indicates a potential change in eligibility, the early intervention official may require a determination to be made of whether the child continues to be eligible for Early Intervention Program services. The early intervention official shall not, however, require that such a determination be made sooner than six months after a child and family's initial IFSP in the program.
(1) Continuing eligibility for the Early Intervention Program shall be established by a multidisciplinary evaluation conducted in accordance with section 69-4.8 of this Subpart which includes the right for the parent to select an approved evaluator, and shall be based on the following criteria:
(i) a delay consistent with the criteria established for initial eligibility as set forth above; or
(ii) a delay in one or more domains, such that the child's development is not within the normal range expected for his or her chronological age, as documented using clinical procedures, observations, assessments, and informed clinical opinion; or
(iii) a score of 1.0 standard deviation or greater below the mean in one or more developmental domains; or
(iv) the continuing presence of a diagnosed physical or mental condition with a high probability of resulting in a developmental delay.
(2) If pursuant to this subdivision, the early intervention official requests a determination of the child's continuing eligibility for the Early Intervention Program, and the parent refuses to consent to a multidisciplinary evaluation to establish the child's continuing eligibility, continuing eligibility has not been established and the child shall no longer be eligible for Early Intervention Program services. The early intervention official shall provide the parent with written notice ten working days before the early intervention official proposes to discharge the child from the Early Intervention Program. The notice must be in sufficient detail to inform the parent about the action that is being proposed, the reasons for taking such action; and, all procedural safeguards available under the Early Intervention Program, including the right of the parent to request mediation or an impartial hearing on the child's ongoing eligibility for the Early Intervention Program.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.1 Scope
(a) This Subpart shall govern Medicaid rates of payments for ambulatory care services provided in the following categories of facilities for the following periods:
(1) outpatient services provided by general hospitals on and after December 1, 2008;
(2) emergency department services provided by general hospitals on and after January 1, 2009;
(3) ambulatory surgery services provided by general hospitals on and after December 1, 2008;
(4) ambulatory services provided by diagnostic and treatment centers on and after September 1, 2009;
(5) ambulatory surgery services provided by free-standing ambulatory surgery centers on and after September 1, 2009; and
(6) hospital-based mental hygiene services on and after July 1, 2010, including:
(i) mental retardation clinics;
(ii) mental health clinics;
(iii) alcoholism and drug abuse clinics and outpatient rehabilitation; and
(iv) methadone clinics.
(b) Notwithstanding subdivision (a) of this section, the provisions of this Subpart shall not apply to the following:
(1) facilities whose Medicaid reimbursement is governed by subdivision 8 of section 2807 of the Public Health Law, except when the provisions of this Subpart are made applicable pursuant to paragraph (f) of such subdivision; and
(2) payments made on behalf of persons enrolled in Medicaid managed care or in the family health plus program.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.7 Sewerage systems, service connections and discharges to sewerage systems
(a) Combined sewerage systems are prohibited from discharging within the watershed.
(b) A new service connection to a sewerage system is prohibited where the wastewater treatment plant to which the sewerage system has been connected and which discharges within the watershed has had a SPDES flow parameter violation in the prior 12 months, or where the additional flow from the new service connection will cause or can be expected to cause such wastewater treatment plant to have a SPDES flow parameter violation.
(c) All new service connections shall be tested as required by and in accordance with the standards set forth in “Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities,” New York State Department of Environmental Conservation (1988), and the standards in “Recommended Standards for Wastewater Facilities,” the Great Lakes—Upper Mississippi River Board of State Public Health and Environmental Managers, Sections 33.92-33.94 (1990). A copy of the results of the tests shall be forwarded to the department as soon as they are available.
(d) Except for the owner of an individual or two-family residence, the owner of any property which will be served by a new service connection to a sewerage system, or by any alteration or modification of a service connection to a sewerage system, shall submit all plans or designs for such service connection or such alteration or modification to the department prior to or simultaneously with the delivery of the notice to the department required under paragraph (1) of this subdivision. The owner of an individual or two-family residence to be served by a new service connection to a sewerage system, or by an alteration or modification of a service connection to a sewerage system, shall not be required to submit the plans or designs for such service connection or such alteration or modification to the department, unless specifically requested by the department. If so requested, such owner shall submit such plans or designs to the department prior to or simultaneously with the delivery of the notice to the department required under paragraph (1) of this subdivision or, if the request is made by the department after such notice has been given, within 10 days after such request has been made.
(1) The owner of any property which will be served by a new service connection to a sewerage system, or by an alteration or modification of a service connection to a sewerage system, shall notify the department 48 hours prior to the installation of such service connection or of such alteration or modification, and provide an opportunity to the department to observe the work. If required or requested pursuant to this subdivision, the owner shall submit to the department all plans or designs for such service connection or for such alteration or modification prior to or simultaneously with the delivery of the such notice to the department.
(e) The design, construction and plans for a new sewerage system shall require the review and approval of the department. Any proposed alteration or modification of a sewerage system, including a sewerage system that is a noncomplying regulated activity, shall require the review and approval of the department.
(1) The department may require an engineering report, construction plans and specifications, and any environmental assessments and determinations in compliance with article 8 of the Environmental Conservation Law when reviewing any application pursuant to this subdivision for a new sewerage system, or a proposed alteration or modification of a sewerage system.
(f) The criteria used by the department to approve any new sewerage system or the portion of any sewerage system which is being altered or modified, shall be all applicable requirements of law, including the standards set forth in the following documents:
(1) “Design Standards for Wastewater Treatment Works, Intermediate Sized Sewerage Facilities,” New York State Department of Environmental Conservation (1988);
(2) “Recommended Standards for Wastewater Facilities,” the Great Lakes—Upper Mississippi River Board of State Public Health and Environmental Managers (1990).
(g) All sewerage systems connected to a wastewater treatment plant which discharges within the watershed shall be designed, operated and maintained in such manner as to prevent inflow or infiltration which causes either:
(1) the SPDES authorized flow limit of the wastewater treatment plant to be exceeded; or
(2) the strength of the sewage influent to the wastewater treatment plant to be diluted to a level that adversely affects the efficacy of the SPDES permitted and department approved treatment process.
(h) All sewerage systems shall be designed, operated and maintained to prevent exfiltration from such systems.
(i) The owner or operator of a facility which disposes of wastes regulated pursuant to the Federal Categorical Pretreatment Standards, 40 CFR part 403, shall submit three copies of the engineering report, plans and specifications, prepared by a licensed design professional, in compliance with 40 CFR parts 403, 406-471 and any applicable local regulations, to the department for its review and approval.
Part 120 HERKIMER COUNTY
VILLAGES VILLAGES
10 CRR-NY 120.4 Village of Herkimer
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Mill Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the village of Herkimer, Herkimer County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to the intake reservoir on Mill Creek, which is tributary to or which serves as a source of the aforesaid public water supply and to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs and filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Herkimer.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit or other receptacle of any kind, placed or used for either the temporary storage or the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 200 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limting distances prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided, in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers while being transported be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises or the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or within 300 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(6) Whenever it shall be found that, owing to the character of the soil or the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or any watercourse tributary to the public water supply of the village of Herkimer, nor shall any such liquid or solid matters be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any reservoir or 200 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Herkimer, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface within 150 feet of any reservoir or 100 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or any watercourse tributary to the public water supply of the village of Herkimer.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse tributary to the public water supply of the village of Herkimer. No animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of Herkimer. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of Herkimer.
(2) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Herkimer, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any reservoir or any watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Herkimer.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Herkimer, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any reservoir or 300 feet of any watercourse tributary to the public water supply of the village of Herkimer; and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 150 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(4) No decayed or fermented fruit or vegetables, roots, grain, cider mill wastes or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in any such place that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the village of Herkimer.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or any watercourse tributary to the public water supply of the village of Herkimer, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainings, leachings or washings therefrom may reach any reservoir or any watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 500 feet from any reservoir or for a distance of 300 feet from any watercourse tributary to the public water supply of the village of Herkimer.
(g) Fishing, boating and ice cutting.
No boating or fishing of any kind and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir tributary to the public water supply of the village of Herkimer, except by duly authorized employees of the village of Herkimer in the performance of their duties of supervision and maintenance of the public water supply of the village of Herkimer.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any reservoir or within 300 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet of any reservoir or within 300 feet of any watercourse tributary to the public water supply of the village of Herkimer.
(j) Inspections.
The municipal commission of Herkimer or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the village of Herkimer or the duly appointed representatives of any such board shall make regular and thorough inspections of the reservoirs, watercourses and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said municipal commission of Herkimer to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the municipal commission of Herkimer to promptly notify the State Commissioner of Health of such violations. The municipal commission of Herkimer shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which related to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.8 Severability
If any provisions of this Part or the application thereof to any person or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or impair the validity of the other provisions of this Part or the application thereof to other persons and circumstances.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.9 Acquisition or retention of control of MCOs
(a) No person shall acquire control of any New York State-certified MCO, whether by purchase of its securities or otherwise, unless it receives the commissioner's prior approval, which shall not be issued until the commissioner has consulted with the superintendent, as appropriate.
(b) The commissioner may disapprove such acquisition if he or she determines, upon notice and an opportunity to be heard, that such disapproval is reasonably necessary to protect the interests of the people of this State. The following factors shall be considered in making such determination:
(1) the financial condition of the acquiring person and the MCO;
(2) the character, competence and standing in the community of the acquiring person and, if the acquiring person is a holding company, the performance of the holding company, its owners, directors, members and managers of a limited liability company and any health care facilities operated by that holding company or its controlled persons; and
(3) the continuing assurance that the MCO's operations will be in compliance with article 44 of the Public Health Law and this Subpart.
(c) The commissioner may require the submission of such information as he or she deems necessary to make the determination required in subdivisions (a) and (b) of this section and may require, as a condition of approval of such acquisition or retention of control, that all or any portion of such information be disclosed to the MCO enrollees.
(d) The commissioner may determine, upon notice and opportunity to be heard, that a person exercises, directly or indirectly, either alone or pursuant to an agreement with one or more other persons, such a controlling influence over the management or policies of a licensed MCO as to make it necessary or appropriate, in the public interest or for the protection of the MCO's enrollees, that the person be deemed to control the MCO. In the event of such a determination, control shall not be exercised pending issuance of an approval pursuant to the provisions of this section.
(e) The commissioner may determine, upon the filing of a request for a ruling, that any person does not or will not, upon the taking of some proposed action, control another person. Such determination shall be made within 30 days, or such further period as the commissioner may prescribe. The filing of the request in good faith by any person shall relieve the requesting person from any obligation or liability imposed by this section, with respect to the subject of the request, until the commissioner has acted upon the request. The commissioner may prospectively revoke or modify his or her determination, after notice and opportunity to be heard, whenever in his or her judgment revocation or modification is consistent with article 44 of the Public Health Law and this Subpart. When the commissioner finds that control would exist upon implementation of the proposal, or does exist, or upon the revocation of an earlier determination that no control was present, no such control shall be exercised, or existing control shall be relinquished or modified as directed by the commissioner pending issuance of approval pursuant to the provisions of this section.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 111 DELAWARE COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 111.13 Hamden Water District No. 1, Town of Hamden
(a) Application.
The rules and regulations set forth in this section, duly made and adopted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the well and springs which comprise the source of the public water supply of the Hamden Water District No. 1. Said well is located on land owned by the Hamden Water District No. 1 and is situated approximately 150 feet east of New York State Route 10. Said springs are located approximately 500 feet west of Daunt Hollow Road.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance), or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the nearest well or spring.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt, industrial municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid and commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic substance shall mean any toxic substance as so defined by subdivision 2 of section 4801 of the Public Health Law.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Hamden Water District No. 1.
(16) Well shall mean well and springs now used as a source of this water supply or to any additional well which may be constructed at these locations as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well except in weatherproof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the well, except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the well.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the well unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyards shall be located within a 250-foot linear distance of the well.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the well.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the well.
(7) Toxic substances.
No container used for the storage of toxic substances shall be buried beneath the surface of the ground within a 500-foot linear distance of the well.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Hamden Water District No. 1 upon which the wells are located, and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property of the Hamden Water District No. 1.
(e) Inspections.
The trustees of the Hamden Water District No. 1 or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representatives, make regular and thorough inspections of the area surrounding the well to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid trustees of the water district to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid trustees of the water district to promptly notify the State Commissioner of Health of such violations. The aforesaid trustees of the water district shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of these rules and regulations shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.5 Accountant's certification
(a) The financial and statistical reports shall be certified by an independent licensed public accountant or an independent certified public accountant. The minimum standard for the term “independent” shall be the standard used by the State Board of Public Accountancy.
(b) Effective with report periods beginning on or after January 1, 1977, the requirements of subdivision (a) of this section shall apply to residential health care facilities operated by units of government of the State of New York heretofore exempt from the requirements of this section except that those medical facilities for which an annual reimbursement audit by a State agency is required by law shall be required to comply herewith effective with report periods beginning on or after January 1, 1978.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.9 Fire safety
Structures not meeting the definition of a camping unit which are available for overnight transient occupancy, shall meet the fire safety requirements contained in Subpart 7-1 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.304 Routine
Regular; customary; ordinary, repetitive; everyday.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.10 Required records of tissue acquisition, testing, processing and storage
In addition to the recordkeeping requirements of Subpart 52-2 of this Part, each musculoskeletal tissue bank shall maintain tissue records which include:
(a) spark testing for vacuum in the case of freeze-dried tissue; and
(b) if the tissue is sterilized by ethylene oxide, amount of ethylene oxide, ethylene glycol and ethylene chlorhydrin residue for each type of musculoskeletal tissue within a batch.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.15 Collection of blood components by apheresis
(a) Notwithstanding any requirements in this Subpart to the contrary for blood collection by means other than apheresis, blood banks collecting blood components by apheresis must comply with applicable requirements in title 21 CFR parts 630 and 640 and any additional requirements in this section.
(b) Direction.
The director of a blood bank collecting, processing, and/or distributing blood components for transfusion shall be a licensed physician who holds a Certificate of Qualification in Blood Banking Collection - Comprehensive pursuant to Part 19 of this Title. The director may serve as the responsible physician for purposes of title 21 CFR part 630; however, if the director is not the responsible physician, the responsible physician shall be a physician licensed in New York State. Except for testing procedures for clinical testing, the director may delegate approval of new or revised standard operating procedure manuals or other procedural guides as required by section 58-2.8 of this Subpart.
(c) Informed consent.
The consent of a prospective donor shall be obtained in writing. The donor shall be informed of the risks of apheresis and the risks of any sedimenting agents or medications to be used. The blood bank director or responsible physician shall approve information provided to the donor regarding risks or hazards of the procedure and such approval may not be delegated.
(d) Qualifications and care of the donor.
(1) Only those persons may be accepted as blood donors for apheresis who are in good health as indicated by the qualifications of a whole blood donor as specified in section 58-2.2 of this Subpart, with the following exceptions:
(i) Ingestion of aspirin-containing medications within two days of donation shall preclude donation of platelets.
(ii) Cytapheresis of donors who do not meet the requirements of this subsection shall be performed only if the harvested cells are expected to be of particular value to an intended recipient, and only if the supervising physician has confirmed in writing the particular value of these cells and has certified that the donor's health permits cytapheresis.
(iii) Medications or sedimenting agents to facilitate cytapheresis shall not be used in donors whose medical history suggests that these may exacerbate previous or intercurrent disease. Guidelines for use of such agents shall be established by the medical director.
(2) All persons performing apheresis procedures shall have completed a training program in apheresis procedure techniques. The training program must include training in donor screening, venipuncture techniques, instrument operation, prevention of and initially addressing donor reactions, and proper documentation of all completed procedures. At the end of the training program, each apheresis operator must be able to:
(i) safely and effectively operate the cell separator systems in use at the facility;
(ii) harvest blood components which meet quality standards;
(iii) manage fluid volumes safely; and
(iv) prevent, and when necessary, initially address adverse reactions.
(3) A responsible physician, physician substitute, or other person who is specifically trained in recognizing and addressing reactions that may occur in association with the procedures being performed, shall be immediately available on the premises at all times during an apheresis procedure.
(4) The blood bank shall establish, maintain and follow standard operating policies and procedures for management of donor adverse reactions, that include using 911 or obtaining other rapid emergency medical services, for donors when medically necessary.
(e) Volume and frequency of apheresis.
All collections shall follow criteria for the F.D.A. approved or cleared apheresis device used. In addition, the following requirements shall apply to:
(1) Plasmapheresis:
(i) donors shall donate plasma no more frequently than twice in seven days, with at least two days between donations; and
(ii) donors shall be weighed at the time of each donation.
(2) Cytapheresis:
(i) platelet, and granulocyte donors shall donate no more frequently than twice in seven days, with at least two days between donations. The total volume of plasma collected must not exceed the maximum for the instrument as cleared by F.D.A.;
(ii) double or triple platelet collections shall occur no more frequently than once in seven days;
(iii) platelet donors may not donate more than 24 times in a 12-month period;
(iv) cytapheresis shall not take place less than eight weeks after a whole blood donation, unless the apheresis instrument has an extracorporeal red cell volume less than 100 ml. When such an instrument is used, cytapheresis shall not take place less than two days after a whole blood donation; and
(v) if red cell loss during apheresis is greater than 200 ml, the next apheresis shall take place no sooner than eight weeks after the first.
(3) Plateletpheresis:
(i) the blood bank shall collect a blood specimen from the donor before each plateletpheresis procedure to determine the donor’s platelet count. This platelet count, if available, shall be used in the qualification of the donor. If this platelet count is not available, the donor’s most recent platelet count may be used in the qualification of the donor, except in the case of triple platelet collections from first time donors. An acceptable platelet count is required for such donors prior to donation; and
(ii) if the blood bank does not have records of a donor’s platelet count from prior donations, and is not able to assess the donor platelet count either prior to or immediately following the initiation of the collection procedure, platelet collection by plateletpheresis may not exceed 9.0x1011 platelets from that donor;
(iii) except as described in sub-paragraph (ii) of this paragraph, the donor’s platelet count must be greater than 150,000 per ul. Donors with fewer than 150,000 per ul must be deferred until the platelet count is acceptable.
(4) two-unit red cell apheresis donors:
(i) a 2-unit red cell apheresis donor shall not donate blood or blood components for at least 16 weeks after the apheresis; and
(ii) the blood bank shall not collect a red cell volume expected to result in a donor hematocrit of 30 percent or lower, or hemoglobin less than 10 g/dl after volume replacement.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-4.172 Lighting
Permanent artificial light sources are to be installed and maintained to provide at least 30 foot-candles of light on all food preparation surfaces and at equipment or utensil washing work levels.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.40 Statewide prices for non-capital reimbursement
The non-capital cost components of residential health care facility (facility) Medicaid rates for inpatient services for periods on and after January 1, 2012, shall be in accord with the following:
(a) Specialty facilities means those facilities or discrete units of facilities described in paragraph (c) of subdivision 2-c of section 2808 of the Public Health Law. Such facilities and such discrete units of facilities shall not be subject to the provisions of this section, other than paragraph (ac)(2) and subdivision (ad) of this section, and the costs and statistical data reported by such facilities and such discrete units of facilities shall not be included in the rate computations otherwise made pursuant to this section, and the term facilities as used in this section shall not be deemed to include such facilities.
(b) The operating component of rates shall be a price and shall consist of the sum of the direct, indirect and non-comparable price components.
(c) For purposes of calculating the direct and indirect price component of the rates, the following peer groups shall be established:
(1) all facilities;
(2) free-standing facilities with certified bed capacities of 300 beds or more and all hospital-based facilities as defined in section 86-2.10(a)(13) of this Subpart (“HBF +300 bed”); and
(3) all free-standing facilities with certified bed capacities of less than 300 beds (“-300 bed”).
(d) The direct component of the price shall consist of a blended rate, to be determined as follows:
(1) 50 percent of the direct price which shall be based upon allowable operating costs and statistical data for the direct component of the price as reported in each facility's cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days; and
(2) 50 percent of either:
(i) the direct price of HBF +300 bed facilities, which shall be based upon allowable operating costs and statistical data for the direct component of the price as reported by each hospital-based facility and each free-standing facility with certified bed capacity of 300 beds or more in its cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days; or
(ii) the direct price of -300 bed facilities, which shall be based upon allowable operating costs and statistical data for the direct component of the price as reported by each freestanding facility with certified bed capacity of less than 300 beds in its cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days.
(e)
(1) The direct component of the price for each peer group shall be as follows:
| | Direct Component of the Price Medicare Ineligible Price, Medicare Part D Eligible Price (HBF +300 Bed Peer Group) | | | | | | --- | --- | --- | --- | --- | --- | | Effective Date of Prices | Direct Price (a) | 50 percent of Direct Price (b) | Direct HBF +300 Bed Price (c) | 50 percent of Direct HBF +300 Bed Price (d) | Total Direct Component of Price for HBF +300 Bed Peer Group (b)+(d) | | January 1, 2012 | $105.79 | $52.90 | $117.48 | $58.74 | $111.63 | | January 1, 2013 | $111.82 | $55.91 | $124.17 | $62.09 | $117.99 | | January 1, 2014 | $116.58 | $58.29 | $129.46 | $64.73 | $123.02 | | January 1, 2015 | $117.94 | $58.97 | $130.97 | $65.49 | $124.46 | | January 1, 2016 | $118.48 | $59.24 | $131.57 | $65.79 | $125.03 | | January 1, 2017 | $119.02 | $59.51 | $132.17 | $66.09 | $125.59 | | | Direct Component of the Price Medicare Part B Eligible Price, Medicare Part B and Part D Eligible Price (HBF +300 Bed Peer Group) | | | | | | Effective Date of Prices | Direct Price (a) | 50 percent of Direct Price (b) | Direct HBF +300 Bed Price (c) | 50 percent of Direct HBF +300 Bed Price (d) | Total Direct Component of Price for HBF +300 Bed Peer Group (b)+(d) | | January 1, 2012 | $104.34 | $52.17 | $115.94 | $57.97 | $110.14 | | January 1, 2013 | $110.28 | $55.14 | $122.54 | $61.27 | $116.41 | | January 1, 2014 | $114.98 | $57.49 | $127.76 | $63.88 | $121.37 | | January 1, 2015 | $116.33 | $58.17 | $129.25 | $64.63 | $122.79 | | January 1, 2016 | $116.86 | $58.43 | $129.84 | $64.92 | $123.35 | | January 1, 2017 | $117.39 | $58.70 | $130.43 | $65.22 | $123.91 | | | Direct Component of the Price Medicare Ineligible Price, Medicare Part D Eligible Price (-300 Bed Peer Group) | | | | | | Effective Date of Prices | Direct Price (a) | 50 percent of Direct Price (b) | Direct -300 Bed Price (c) | 50 percent of Direct -300 Bed Price (d) | Total Direct Component of Price for -300 Bed Peer Group (b)+(d) | | January 1, 2012 | $105.79 | $52.90 | $99.30 | $49.65 | $102.54 | | January 1, 2013 | $111.82 | $55.91 | $104.95 | $52.48 | $108.38 | | January 1, 2014 | $116.58 | $58.29 | $109.43 | $54.72 | $113.00 | | January 1, 2015 | $117.94 | $58.97 | $110.70 | $55.35 | $114.32 | | January 1, 2016 | $118.48 | $59.24 | $111.21 | $55.61 | $114.85 | | January 1, 2017 | $119.02 | $59.51 | $111.71 | $55.86 | $115.37 | | | Direct Component of the Price Medicare Part B Eligible Price, Medicare Part B and Part D Eligible Price (-300 Bed Peer Group) | | | | | | Effective Date of Prices | Direct Price (a) | 50 percent of Direct Price (b) | Direct -300 Bed Price (c) | 50 percent of Direct -300 Bed Price (d) | Total Direct Component of Price for -300 Bed Peer Group (b)+(d) | | January 1, 2012 | $104.34 | $52.17 | $97.90 | $48.95 | $101.12 | | January 1, 2013 | $110.28 | $55.14 | $103.47 | $51.74 | $106.88 | | January 1, 2014 | $114.98 | $57.49 | $107.88 | $53.94 | $111.43 | | January 1, 2015 | $116.33 | $58.17 | $109.14 | $54.57 | $112.73 | | January 1, 2016 | $116.86 | $58.43 | $109.64 | $54.82 | $113.25 | | January 1, 2017 | $117.39 | $58.70 | $110.14 | $55.07 | $113.76 |
(2) As used in this subdivision, Medicare ineligible price shall mean the price applicable to Medicaid patients that are not Medicare eligible, Medicare part B eligible price shall mean the price applicable to Medicaid patients that are Medicare part B eligible, Medicare part D eligible price shall mean the price applicable to Medicaid patients that are Medicare part D eligible and Medicare part B and part D eligible price shall mean the price applicable to Medicaid patients that are Medicare part B and part D eligible.
(3) Subsequent revisions to the peer group prices set forth in paragraph (1) of this subdivision shall be published on the New York State Department of Health website at: http://www.health.ny.gov
(f) The allowable costs percent reduction for the direct component shall be as follows:
| | Effective Date | Allowable Cost Percent Reduction | | | --- | --- | --- | --- | | | January 1, 2012 | 19.545660 percent | | | | January 1, 2013 | 14.963800 percent | | | | January 1, 2014 | 11.339480 percent | | | | January 1, 2015 | 10.305120 percent | | | | January 1, 2016 | 9.893250 percent | | | | January 1, 2017 | 9.485290 percent | |
Subsequent revisions to the allowable costs percent reduction shall be published on the New York State Department of Health website at: http://www.health.ny.gov/
(g) Allowable costs for the direct component of the rate shall include costs reported in the following functional cost centers on the facility's 2007 cost report (RHCF-4), or extracted from a hospital-based facility's 2007 cost report (RHCF-2) and the institutional cost report of its related hospital, from available certified cost reports as determined by the commissioner, after first deducting costs attributable to specialty units, and the hospital by applying appropriate trace back percentages; and capital costs:
(1) nursing administration (013);
(2) activities program (014);
(3) social services (021);
(4) transportation (022);
(5) physical therapy (039) (including associated overhead);
(6) occupational therapy (040) (including associated overhead);
(7) speech/hearing therapy (041) (speech therapy portion only including associated overhead);
(8) central service supply (043);
(9) residential health care facility (051); and
(10) pharmacy (042) (excluding costs allocated to non-comparables).
(h) The direct component of the price shall be adjusted by a wage equalization factor (WEF). The WEF adjustment shall be calculated using cost and statistical data reported in each facility's 2009 cost report (RHCF-4), or extracted from a hospital-based facility's 2009 cost report (RHCF-2) and the institutional cost report of its related hospital as applicable), from available certified cost reports as determined by the commissioner, subject to applicable trace back percentages. The WEF adjustment shall consist of 50 percent of a facility specific direct WEF and 50 percent of a regional direct WEF.
(i) The facility specific direct WEF shall be calculated as follows:
1 ÷ (( Facility Specific Wage Ratio÷ Wage Index) + Facility Specific Non-Wage Ratio)
(1) The facility specific wage ratio shall be calculated by dividing facility-specific total salaries and fringes related to direct cost centers for nursing administration (013), activities program (014), social services (021), transportation (022), physical therapy (039), occupational therapy (040), speech/hearing therapy (041), pharmacy (042), central service supply (043), and residential health care facility (051) by total direct operating expenses from such cost centers.
(2) The wage index shall be calculated by dividing facility specific labor costs per hour by labor costs per hour for RNs, LPNs, aides and orderlies, therapists and therapist aides for all facilities from cost centers physical therapy (039), occupational therapy (040), speech/hearing therapy (041) and residential health care facility (051).
(3) The facility specific non-wage ratio shall be calculated by subtracting from 1 the facility specific wage ratio.
(j) A regional direct WEF shall be calculated for each of the following 16 regions. The county geographic boundaries shall be the sole factor considered in determining which WEF region a facility is located in.
(1) Albany Region, consisting of the counties of Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady and Schoharie.
(2) Binghamton Region, consisting of the counties of Broome and Tioga.
(3) Central Rural Region, consisting of the counties of Cayuga, Cortland, Seneca, Tompkins and Yates.
(4) Elmira Region, consisting of the counties of Chemung, Schuyler and Steuben.
(5) Erie Region, consisting of the counties of Cattaraugus, Chautaugua, Erie, Niagara and Orleans.
(6) Glens Falls Region, consisting of the counties of Essex, Warren and Washington.
(7) Long Island Region, consisting of the counties of Nassau and Suffolk.
(8) New York City Region, consisting of the counties of Bronx, Kings, New York, Queens and Richmond.
(9) Northern Rural Region, consisting of the counties of Clinton, Franklin, Hamilton and St. Lawrence.
(10) Orange Region, consisting of the counties of Chenango, Delaware, Orange, Otsego, Sullivan and Ulster.
(11) Poughkeepsie Region, consisting of the counties of Dutchess and Putnam.
(12) Rochester Region, consisting of the counties of Livingston, Monroe, Ontario and Wayne.
(13) Syracuse Region, consisting of the counties of Madison and Onondaga.
(14) Utica Region, consisting of the counties of Herkimer, Jefferson, Lewis, Oneida and Oswego.
(15) Westchester Region, consisting of the counties of Rockland and Westchester.
(16) Western Rural Region, consisting of the counties of Allegany, Genesee and Wyoming.
(k) The regional direct WEF shall be calculated for each of the 16 regions as follows:
1 ÷ ((Regional Wage Ratio÷Regional Wage Index)+ Regional Non-Wage Ratio)
(1) The regional wage ratio shall be calculated by dividing total salaries and fringes related to direct costs in the region from cost centers for nursing administration (013), activities program (014), social services (021), transportation (022), physical therapy (039), occupational therapy (040), speech/hearing therapy(041), pharmacy (42), central service supply (043), and residential health care facility (051) by total direct operating expenses in the region from such cost centers.
(2) The regional wage index shall be calculated by dividing labor costs per hour in the region by labor costs per hour for RNs, LPNs, aides and orderlies, therapists and therapist aides for all facilities from cost centers physical therapy (039), occupational therapy (040), speech/hearing therapy (041) and residential health care facility (051).
(3) The regional non-wage ratio shall be calculated by subtracting from one the regional wage ratio.
(l) The direct WEF adjustment to the direct component of the price for facilities for which 2009 cost report data is unavailable or insufficient to calculate the WEF as described in this section shall be equal to 100 percent of the applicable regional WEF.
(m) The direct component of the price shall be subject to a case mix adjustment in accordance with the following:
(1) The application of the relative Resource Utilization Groups System (RUGS-III) as published by the Centers for Medicare and Medicaid Services and revised to reflect New York State wage and fringe benefits, and based on Medicaid only patient data.
(2) New York State wages shall be used to determine the weight of each RUG. The cost for each RUG shall be calculated using the relative resources for registered nurses, licensed practical nurses, aides, therapists, and therapy aides and the 1995-97 Federal time study. The minutes from the Federal time study shall be multiplied by the New York average dollar per hour to determine the fiscal resources need to care for that patient type. This amount shall be multiplied by the number of patients in that RUG. RUG weights shall be assigned based on the distance from the statewide average. The RUGS III weights shall be increased by the following amounts for the following categories of residents:
(i) 30 minutes of certified nurse aide time for the impaired cognition A category;
(ii) 40 minutes of certified nurse aide time for the impaired cognition B category; and
(iii) 25 minutes of certified nurse aide time for the reduced physical functions B category.
(3) The case mix adjustment for the direct component of the price effective January 1, 2012 shall be calculated by dividing the Medicaid only case mix calculated using data for January 2011 by the all-payer case mix for the base year 2007.
(4) The all payer case mix for base year 2007 shall be a blend of:
(i) 50 percent of the case mix for all facilities; and
(ii) 50 percent of the case mix for either:
(a) free-standing facilities with certified bed capacities of 300 beds or more and all hospital-based facilities; or
(b) all free-standing facilities with certified bed capacities of less than 300 beds.
(5) The Medicaid only case mix shall mean the case mix for patients where Medicaid is the primary payer.
(6) Subsequent case mix adjustments to the direct component of the price for rate periods effective after January 1, 2012 shall be made in July and January of each calendar year and shall use Medicaid-only case mix data applicable to the previous case mix period.
(i) For the case mix periods beginning on and after July 1, 2021, the case mix adjustment to the direct component of the price shall be made in January and July of each calendar year and shall use all Medicaid-only case mix data submitted to CMS applicable to the previous six-month period ( e.g. , April – September for the January case mix adjustment; October – March for the July case mix adjustment).
(7) Case mix adjustments to the direct component of the price for facilities for which facility specific case mix data is unavailable or insufficient shall be equal to the previous case mix of the peer group applicable to such facility.
(8) The adjustments and related patient classifications for each facility shall be subject to audit review by the Office of the Medicaid Inspector General, and/or other agents as authorized by the Department.
(9) For case mix periods beginning on and after July 1, 2021, the operator of a proprietary facility, an officer of a voluntary facility, or the public official responsible for the operation of a public facility shall submit to the department a written certification, in a form as determined by the department, attesting that all of the "minimum data set" ("MDS") data reported by the facility and submitted to CMS is complete and accurate.
(n) The indirect component of the price shall consist of a blended rate to be determined as follows:
(1) 50 percent indirect price which shall be based upon allowable operating costs and statistical data for the indirect component of the price as reported in each facility's cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days; and
(2) 50 percent of either:
(i) the indirect HBF +300 bed facility price which shall be based upon allowable operating costs and statistical data for the indirect component of the price as reported by each hospital-based facility and each free-standing facility with certified bed capacity of 300 beds or more in its cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days; or
(ii) the indirect -300 bed facility price which shall be based upon allowable operating costs and statistical data for the indirect component of the price as reported by each freestanding facility with certified bed capacity of less than 300 beds in its cost report for the 2007 calendar year, reduced by the allowable costs percent reduction, and divided by total 2007 patient days.
(o)
(1) The indirect component of the price for each peer group shall be as follows:
| | Indirect Component of the Price (HBF +300 Bed Peer Group) | | | | | | --- | --- | --- | --- | --- | --- | | Effective Date of Prices | Indirect Price (a) | 50 percent of Indirect Price (b) | Indirect HBF +300 Bed Price (c) | 50 percent of Indirect HBF +300 Bed Price (d) | Total Indirect Component of Price for HBF +300 Bed Peer Group (b)+(d) | | January 1, 2012 | $53.15 | $26.58 | $61.54 | $30.77 | $57.35 | | January 1, 2013 | $56.18 | $28.09 | $65.04 | $32.52 | $60.61 | | January 1, 2014 | $58.57 | $29.29 | $67.82 | $33.91 | $63.19 | | January 1, 2015 | $59.26 | $29.63 | $68.61 | $34.31 | $63.93 | | January 1, 2016 | $59.53 | $29.77 | $68.92 | $34.46 | $64.23 | | January 1, 2017 | $59.80 | $29.90 | $69.23 | $34.62 | $64.52 | | | Indirect Component of the Price (-300 Bed Peer Group) | | | | | | Effective Date of Prices | Indirect Price (a) | 50 percent of Indirect Price (b) | Indirect -300 Bed Price (c) | 50 percent of Indirect -300 Bed Price (d) | Total Indirect Component of Price for -300 Bed Peer Group (b)+(d) | | January 1, 2012 | $53.15 | $26.58 | $48.49 | $24.25 | $50.82 | | January 1, 2013 | $56.18 | $28.09 | $51.25 | $25.63 | $53.71 | | January 1, 2014 | $58.57 | $29.29 | $53.44 | $26.72 | $56.00 | | January 1, 2015 | $59.26 | $29.63 | $54.06 | $27.03 | $56.66 | | January 1, 2016 | $59.53 | $29.77 | $54.31 | $27.16 | $56.92 | | January 1, 2017 | $59.80 | $29.90 | $54.55 | $27.28 | $57.18 |
(2) Subsequent revisions to the prices set forth in paragraph (1) of this subdivision shall be published on the New York State Department of Health website at: http://www.health.ny.gov
(p) The allowable costs percent reduction for the indirect component shall be as follows:
| | Effective Date | Allowable Cost Percent Reduction | | | --- | --- | --- | --- | | | January 1, 2012 | 19.545660 percent | | | | January 1, 2013 | 14.963800 percent | | | | January 1, 2014 | 11.339480 percent | | | | January 1, 2015 | 10.305120 percent | | | | January 1, 2016 | 9.893250 percent | | | | January 1, 2017 | 9.485290 percent | |
Subsequent revisions to the allowable costs percent reduction shall be published on the New York State Department of Health website at: http://www.health.ny.gov/
(q) Allowable costs for the indirect component of the rate shall include costs reported in the following functional cost centers on the facility's 2007 cost report (RHCF-4), or extracted from a hospital-based facility's 2007 cost report (RHCF-2) and the institutional cost report of its related hospital, from available certified cost reports as determined by the commissioner, after first deducting costs attributable to specialty units, and the hospital by applying appropriate trace back percentages; and capital costs:
(1) fiscal services (004);
(2) administrative services (005);
(3) plant operations and maintenance (006) (with the exception of utilities and real estate and occupancy taxes);
(4) grounds (007);
(5) security (008);
(6) laundry and linen (009);
(7) housekeeping (010);
(8) patient food services (011);
(9) cafeteria (012);
(10) non-physician education (015);
(11) medical education (016);
(12) housing (018); and
(13) medical records (019).
(r) The indirect component of the price shall be adjusted by a wage equalization factor (WEF). The WEF adjustment shall be calculated using cost and statistical data reported in each facility's 2009 cost report ((RHCF-4), or extracted from a hospital-based facility's 2009 costs report (RHCF-2) and the institutional cost report of its related hospital as applicable from available certified cost reports as determined by the commissioner, subject to applicable trace back percentages. The WEF adjustment shall consist of 50 percent of a facility specific indirect WEF and 50 percent of a regional indirect WEF.
(s) The facility specific indirect WEF shall be calculated as follows:
1 ÷ (( Facility Specific Wage Ratio÷Wage Index)+ Facility Specific Non-Wage Ratio)
(1) The facility specific wage ratio shall be calculated by dividing facility-specific total salaries and fringes related to indirect cost centers for fiscal services (004), administrative services (005), plant operation and maintenance (006), grounds (007), security (008), laundry and linen (009), housekeeping (010), patient food service (011), cafeteria (012), non-physician education (015), medical education (016), housing (018), and medical records (019), by total indirect operating expenses for such cost centers.
(2) The wage index shall be calculated by dividing facility specific labor costs per hour by labor costs per hour for RNs, LPNs, aides and orderlies, therapists and therapist aides for all facilities from cost centers physical therapy (039), occupational therapy (040), speech/hearing (041) and residential health care facility (051).
(3) The facility specific non-wage ratio shall be calculated by subtracting from one the facility specific wage ratio.
(t) A regional indirect WEF shall be calculated for each of the following 16 regions. The county geographic boundaries shall be the sole factor considered in determining which WEF region a facility is located in.
(1) Albany Region, consisting of the counties of Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady and Schoharie.
(2) Binghamton Region, consisting of the counties of Broome and Tioga.
(3) Central Rural Region, consisting of the counties of Cayuga, Cortland, Seneca, Tompkins and Yates.
(4) Elmira Region, consisting of the counties of Chemung, Schuyler and Steuben.
(5) Erie Region, consisting of the counties of Cattaraugus, Chautaugua, Erie, Niagara and Orleans.
(6) Glens Falls Region, consisting of the counties of Essex, Warren and Washington.
(7) Long Island Region, consisting of the counties of Nassau and Suffolk.
(8) New York City Region, consisting of the counties of Bronx, Kings, New York, Queens and Richmond.
(9) Northern Rural Region, consisting of the counties of Clinton, Franklin, Hamilton and St. Lawrence.
(10) Orange Region, consisting of the counties of Chenango, Delaware, Orange, Otsego, Sullivan and Ulster.
(11) Poughkeepsie Region, consisting of the counties of Dutchess and Putnam.
(12) Rochester Region, consisting of the counties of Livingston, Monroe, Ontario and Wayne.
(13) Syracuse Region, consisting of the counties of Madison and Onondaga.
(14) Utica Region, consisting of the counties of Herkimer, Jefferson, Lewis, Oneida and Oswego.
(15) Westchester Region, consisting of the counties of Rockland and Westchester.
(16) Western Rural Region, consisting of the counties of Allegany, Genesee and Wyoming.
(u) The regional indirect WEF shall be calculated for each of the 16 regions, calculated as follows:
1 ÷ ((Regional Wage Ratio÷Region Wage Index)+ Regional Non-Wage Ratio)
(1) The regional indirect wage ratio shall be calculated by dividing total salaries and fringes related to indirect cost centers in each region from cost centers for fiscal services (004), administrative services (005), plant operation and maintenance (006), grounds (007), security (008), laundry and linen (009), housekeeping (010), patient food service (011), cafeteria (012), non-physician education (015), medical education (016), housing (018), and medical records (019) for such indirect cost centers, by total indirect operating expenses in the region for such cost centers.
(2) The regional wage index shall be calculated by dividing labor costs per hour in the region by labor costs per hour for RNs, LPNs, aides and orderlies, therapists and therapist aides for all facilities from cost centers physical therapy (039), occupational therapy (040), speech/hearing therapy (041) and residential health care facility (051).
(3) The regional non-wage ratio shall be calculated by subtracting from one the regional wage ratio.
(v) The indirect WEF adjustment to the indirect component of the price for facilities for which 2009 cost report data is unavailable or insufficient to calculate the WEF as described above will be equal to 100 percent of the applicable regional WEF.
(w) The non-comparable component of the price shall be calculated using allowable operating costs and statistical data as reported in each facility's cost report for the 2007 calendar year, or from otherwise available certified cost reports as determined by the commissioner, divided by total 2007 patient days, or divided by patient days derived from otherwise available certified cost reports as determined by the commissioner.
(x) Allowable costs for the non-comparable component of the price shall include costs reported in the following functional cost centers on the facility's annual cost report (RHCF-4), or extracted from a hospital-based facility's annual costs report (RHCF-2) and the institutional cost report of its related hospital, or from otherwise available certified cost reports as determined by the commissioner, after first deducting costs attributable to specialty units, and the hospital by applying appropriate trace back percentages; and capital costs:
(1) laboratory services (031);
(2) ECG (032);
(3) EEG (033);
(4) radiology (034);
(5) inhalation therapy (035);
(6) podiatry (036);
(7) dental (037);
(8) psychiatric (038);
(9) speech and hearing therapy (041) (hearing therapy only, including associated overhead);
(10) medical directors office (017);
(11) medical staff services (044);
(12) utilization review (020);
(13) other ancillary services (045, 046, 047);
(14) costs of utilities associated with plant operations and maintenance; and
(15) pharmacy costs pertaining to administrative overhead and costs of non-prescription drugs and supplies.
(y) The non-comparable component of the price for facilities for which 2007 cost report data is unavailable or insufficient to calculate the non-comparable component as described in this section shall initially receive a noncomparable rate which is calculated using the most recently available certified cost report, as determined by the commissioner, and if no such report is available, the regional average shall be utilized until such time as a certified cost report is available.
(z) Per diem adjustments for certain patients. If applicable, and as updated pursuant to case mix adjustments made pursuant to subdivision (m) of this section, the operating component of the facility's price shall be adjusted to reflect the following:
(1) A per diem add-on in the amount of $8 for each patient that:
(i) qualifies under both the RUG-III impaired cognition and the behavioral problems categories; or
(ii) has been diagnosed with Alzheimer's disease or dementia, is classified in the reduced physical functions A, B, or C or in behavioral problems A or B categories, and has an activities of daily living index score of 10 or less.
(2) A per diem add-on in the amount of $17 for each patient whose body mass index is greater than 35.
(3) A per diem add-on in the amount of $36 for each patient requiring extended care for traumatic brain injury.
(4) Effective for services provided on and after June 1, 2012, rates of payment for residential health care facilities which have received approval by the Commissioner of Health to provide services to more than 25 patients whose medical condition is HIV infection symptomatic, and the facility is not eligible for separate and distinct payment rates for AIDS facilities or discrete AIDS units, shall be adjusted by a per diem adjustment that shall not be in excess of the difference between such facility’s 2010 allowable operating cost per day, as determined by the commissioner, and the weighted average non-capital component of the rate in effect on and after January 1, 2012, and as subsequently updated by case mix adjustments made in July and January of each calendar year as described in subdivision (m) of this section.
(aa) For the calendar year 2012, the operating component of the price of each facility that fails to submit to the department data or reports on quality measures, as required and defined by regulation, shall be subject to a per diem reduction calculated by multiplying 50 million dollars by each facility's share of Medicaid days. Facilities determined by the department to be subject to this adjustment may request an expedited administrative hearing with regard to such adjustment, provided, however, that such adjustment shall not be held in abeyance pending the completion of such a hearing.
(ab) Per diem transition adjustments.
Over the five year period beginning January 1, 2012 and ending December 31, 2016, facilities shall be eligible for per diem transition rate adjustment, to be calculated as follows:
(1)
(i) In each year for each eligible facility computations shall be made by the department pursuant to subparagraphs (ii) and (iii) of this paragraph and per diem rate adjustments shall be made for each year such that the difference between such computations for each year is no greater than the percentage, as identified in subparagraph (iv) of this paragraph, of the total Medicaid revenue received from the facility's July 7, 2011 non-capital rate as communicated to facilities by the department in the letter dated November 9, 2011, and deemed not subject to subsequent reconciliation or adjustment, provided, however, that those facilities which are, subsequent to November 9, 2011, issued a revised non-capital rate for rate periods including July 7, 2011, reflecting a new base year that is subsequent to 2002, shall have such revised non-capital rate as in effect on July 7, 2011 utilized for the purpose of computing transition adjustments pursuant to this subdivision.
(ii) A facility's Medicaid revenue, calculated by summing the direct component, indirect component, non-comparable components of the price in effect for each eligible facility on January 1, 2012, and multiplying such total by the facility's 2010 Medicaid days or the most recently available Medicaid days as of October 24, 2011 as determined by the commissioner.
(iii) A facility's Medicaid revenue calculated by multiplying the facility's July 7, 2011 rate (as determined in accordance with the provisions of subparagraph [i] of this paragraph) by the facility's 2010 Medicaid days or the most recently available Medicaid days as of October 24, 2011 as determined by the commissioner and deemed not subject to subsequent reconciliation or adjustment.
(iv) In year one the percentage shall be 1.75 percent, in year two it shall be 2.5 percent, in year three it shall be 5.0 percent, in year four it shall be 7.5 percent and in year five it shall be 10.0 percent. In year 6, the prices calculated in this section shall not be subject to per diem transition rate adjustments.
(v) Facilities which do not have a July 7, 2011 rate as described above shall not be eligible for the per diem transition adjustment described herein.
(ac) Other provisions:
(1) The appointment of a receiver or the establishment of a new operator or renovation of an existing facility on or after January 1, 2012 shall not result in a revision to the non-capital components of the price.
(2) For rate computation purposes, patient days shall include reserved bed days , defined as the unit of measure denoting an overnight stay away from the facility for which the patient, or the patient's third-party payor, provides per diem reimbursement when the patient's absence is due to hospitalization or therapeutic leave consistent with a plan of care ordered by such patient’s treating health care professional or due to other leaves of absences.
(3) The base year used to calculate the direct and indirect price components, the base year used to calculate the direct and indirect wage equalization factor, and the Resource Utilization Groups System used to calculate case mix and described herein shall be periodically updated as determined by the commissioner.
(4)
(i) Subject to the availability of Federal financial participation, for services provided on and after July 1, 2012, to patients 21 years of age and older, Medicaid payments for reserved bed days, as defined in paragraph (2) of this subdivision, which are related to a patient’s hospitalization shall be reduced from 95 percent to 50 percent of the Medicaid rate otherwise payable to the facility with regard to such days of care.
(ii) Subject to the availability of Federal financial participation, for services provided on and after July 1, 2012, to patients 21 years old or older, Medicaid payments for reserved bed days, as defined in paragraph (2) of this subdivision, which do not involve the patient’s hospitalization and which are:
(a) related to a patient’s therapeutic leave of absence for visits to a health care professional that is expected to improve the patient’s physical condition or quality of life and that is consistent with a plan of care ordered by such patient’s treating health care professional; or
(b) are other leaves of absences, shall be made at 95 percent of the Medicaid rate otherwise payable to the facility with regard to such days of care.
(iii) Medicaid payments for reserved bed days which are otherwise in accordance with the provisions of this paragraph shall be available with regard to each Medicaid patient for any 12 month period for up to a combined aggregate of 14 days for hospitalizations and other therapeutic leaves of absences for visits to a health care professional that are expected to improve the patient’s physical condition or quality of life and that are consistent with a plan of care ordered by the patient’s treating health care professional, and for up to an aggregate of 10 days for other leaves of absence, provided, however, that these limitations shall not apply to patients who are less than of 21 years of age.
(iv) Subject to the availability of Federal financial participation, in the event the commissioner determines, in consultation with the director of the budget, that the reduction in payments for reserved bed days implemented by the provisions of subparagraph (i) of this paragraph shall achieve projected aggregate Medicaid savings, as determined by the commissioner, of less than $40 million for the State fiscal year beginning April 1, 2012, and each State fiscal year thereafter, the commissioner shall establish a prospective per diem rate adjustment, subject to subsequent reconciliation and adjustment, for all nursing homes, other than nursing homes providing services primarily to children under the age of 21, sufficient to achieve such $40 million in savings for each such State fiscal year.
(v) Notwithstanding any other provision of this subdivision, and subject to the availability of Federal financial participation, for services provided to patients 21 years of age and older, Medicaid payments for reserved bed days, as defined in paragraph (2) of this subdivision, which are related to a patient’s hospitalization shall be made: only with respect to patients who are receiving hospice services within the facility; at 50 percent of the Medicaid rate otherwise payable to the facility with regard to such days of care; and for up to a combined aggregate of 14 days for any 12-month period.
(vi) Notwithstanding any other provision of this subdivision, and subject to the availability of Federal financial participation, for services provided to patients 21 years of age and older, Medicaid payments for reserved bed days, as defined in paragraph (2) of this subdivision, which are related to a patient’s leave of absence shall be made: at 95 percent of the Medicaid rate otherwise payable to the facility with regard to such days of care; and for up to a combined aggregate of 10 days for any 12-month period.
(ad)
(1) Effective January 1, 2012, the non-capital components of the rate for specialty facilities shall be the rates in effect for such facilities on January 1, 2009, as adjusted for inflation and rate appeals, in accordance with applicable statutes. Such rates of payment in effect January 1, 2009 for AIDS facilities or discrete AIDS units with facilities shall be reduced by the AIDS occupancy factor, as described in section 12 of part D of chapter 58 of the Laws of 2009.
(2) The non-capital components of rates for new specialty facilities with initial rates issued for periods beginning after January 1, 2009, shall be in accordance with the following:
(i) For specialty facilities with an initial rate issued for periods beginning after January 1, 2009 but before April 1, 2009, the non-capital components of their rate effective for periods on and after January 1, 2012 shall be the rate in effect on the date the facility commenced operation.
(ii) For specialty facilities with an initial rate issued for periods beginning after March 31, 2009, but before July 8, 2011, the non-capital components of their rate effective for periods on and after January 1, 2012 shall be the rate in effect on July 7, 2011.
(iii) For specialty facilities with an initial rate issued for periods beginning after July 7, 2011, the non-capital components of their rate effective for periods on and after January 1, 2012 shall be based on budgeted costs, as submitted by the facility and approved by the department and as issued by the department effective on the facility's first day of operation, provided, however, that such specialty facilities shall file certified cost reports reflecting such specialty facility's first 12 months of operation at an occupancy level of 90 percent or more. The department shall thereafter issue such facilities rates with non-capital components reflecting such cost reports and such rates shall be effective retroactive to the first day of such 12 month cost report. Nothing in this subparagraph shall be understood as exempting specialty facilities which have not yet achieved 90 percent occupancy from the generally applicable requirement to file annual calendar year cost reports.
(iv) Effective April 1, 2016 a neurodegenerative specialty rate shall be established for Huntington’s disease and amyotrophic lateral sclerosis. The rate shall be based on budgeted cost as submitted by the facility and approved by the department and as issued by the department effective on the facility’s first day of operation, provided, however, that such specialty facilities shall file certified cost reports reflecting such specialty facility’s first 12 months of operation at an occupancy level of 90 percent or more. The department shall thereafter issue such facilities rates with non-capital components reflecting such cost reports and such rates shall be effective retroactive to the first day of such 12 month cost report. Nothing in this subparagraph shall be understood as exempting specialty facilities which have not yet achieved 90 percent occupancy from the generally applicable requirement to file annual calendar year cost reports.
(3) Effective for rate periods on and after January 1, 2012, there will be no case mix adjustments to rates for specialty facilities.
(ae) Administrative rate appeals from rates issued pursuant to this section shall be subject to otherwise applicable regulatory provisions of this Subpart and to applicable statutory provisions, including, but not limited to, Public Health Law sections 2808(11) and 2808(17).
Subchapter I ENVIRONMENTAL HEALTH
Part 70 REGULATED MEDICAL WASTE
Subpart 70-4 REQUIREMENTS FOR ALTERNATIVE REGULATED MEDICAL WASTE TREATMENT SYSTEMS
10 CRR-NY 70-4.3 Validation testing
(a) A facility seeking to operate a regulated medical waste treatment system that employs an approved alternative technology shall establish and implement a protocol for validation testing that minimally includes procedures to simulate actual system operation conditions, including, but not limited to, the composition and volume of waste to be treated per load. The validation testing protocol shall be approved by the department prior to initiation of testing.
(b) Validation testing shall be performed using the department-approved protocol at the installation site of an approved alternative regulated medical waste treatment system. Validation testing data shall be submitted for department review and approval along with the operation plan.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
REPORTING OF CASES; RECORDS REPORTING OF CASES; RECORDS
10 CRR-NY 2.17 Reports of tuberculosis cases confidential
A State or local health officer authorized by law to receive laboratory or other reports relating to cases of tuberculosis may disclose information contained in such reports only when in his judgment it will serve the best interest of the patient or his family, or contribute to the protection of the public health. Such officer may, subject to the foregoing purposes, permit access to such reports by representatives of official or non-official agencies concerned with the control of tuberculosis.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.177 Inpatient admission
The formal acceptance by a health facility of a patient who is to be provided with room, board, and continuous nursing service in an area of the health facility where patients generally stay at least overnight.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.35 Podiatry services
(a) Qualified podiatrist.
(1) A podiatrist qualified to participate in the medical assistance program means a podiatrist who is licensed and currently registered to practice podiatry in New York State by the State Education Department.
(2) Podiatry services provided to eligible medical assistance patients while temporarily out-of-state shall be provided by podiatrists qualified to practice podiatry by the appropriate licensing agency of the state in which podiatry services are provided.
(b) Podiatry services included as covered benefits.
(1) Podiatry care, services and supplies shall be made available as medically needed and as an integral part of comprehensive medical care.
(2) Necessary podiatry care, services and supplies means those services provided by qualified podiatrists.
(3) Podiatry care, services and supplies shall also include the provision of, or ordering of, clinical laboratory tests that are related to the scope of podiatric practice permitted under provisions of article 141 (Podiatry) of the State Education Law, book 16, McKinney's Consolidated Laws of New York, West Publishing Co., St. Paul, MN, and the rules and regulations of the State Education Department (8 NYCRR Part 65). Copies of these statutory and regulatory provisions are available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(4) Clinical laboratory tests provided or ordered by qualified podiatrists shall be limited to those tests necessary for the diagnosis or treatment of conditions of the foot. Such tests, when performed in the office of the podiatrist in the course of treatment of his own patients, shall be limited to:
(i) complete blood count or any of the separate components of such analysis, including red cell count, white cell count, or hemoglobin;
(ii) hematocrit;
(iii) sedimentation rate;
(iv) urine analysis, routine chemical; and
(v) urine analysis, routine microscopic.
(5) All other necessary clinical laboratory tests shall be performed in a clinical laboratory holding a valid clinical laboratory permit issued in accordance with provisions of the Public Health Law, in the categories for which payment is requested from medical assistance program funds.
(6) All necessary radiologic procedures shall be made available as a covered benefit. Radiologic procedures mean X-rays used to establish a podiatric diagnosis or foot-related medical problem and may be used in conjunction with necessary treatment of foot conditions.
(c) Podiatry service limitations.
(1) Medical assistance podiatry care, services and supplies shall not include:
(i) routine hygienic care of the feet in the absence of pathology;
(ii) clinical laboratory tests except those permitted in paragraphs (b)(4) and (5) of this section;
(iii) radiologic procedures outside the scope of podiatric practice as per paragraph (b)(6) of this section;
(iv) amputations and bunion operations, unless such procedures are provided in a hospital; or
(v) all podiatric prostheses in excess of $100 unless prior approval of the local professional director and prior authorization of the local social services commissioner is given.
(d) Reimbursement.
Reimbursement for podiatry services shall be made in accordance with fees developed by the New York State Department of Health and approved by the New York State Division of the Budget.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.184 Enforcement
(a) Operation of a food vending commissary or food vending operation without a permit is a violation of this Subpart. The permit-issuing official or his designated representative may order any food vending commissary or food vending operation requiring a permit in his jurisdiction, operating without a valid permit, to close and cease all food operations immediately, and to remain closed until a valid permit has been obtained.
(b) For serious, repeated or persistent violations of any of the requirements of this Subpart, or for interference with the permit-issuing official or his designated representative in the performance of his duties, the permit may be revoked after notice and an opportunity for a hearing has been provided by the permit-issuing official.
(c) The permit-issuing official may suspend a permit and order immediate cessation of operations and service of food at a food vending commissary or food vending operation within his jurisdiction when, in his opinion, continued operation is an imminent hazard to public health. Any person so ordered is to comply immediately, and within 15 days is to be provided with an opportunity to be heard and to present proof that continued operation does not constitute a danger to the public health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.45 Long-term ventilator dependent
This functional reporting center must contain all the expenses associated with the provision of nursing services to long-term ventilator dependent patients in a discrete unit established and approved to provide care to such patients.
(a) Standard unit of measure: number of patient days of care for all patients admitted to this unit.
Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.5 Classification of occupational lund disease
For purposes of reporting occupational lung disease as required by section 22.4 of this Part, occupational lung disease shall be categorized according to the following probable causative agents or nomenclature as applicable.
Coal workers lung disease
Silicosis
Absestosis/Asbestos-related lung disease
Berylliosis
Talcosis
Hard metal diseases (Titanium, Cobalt)
Byssinosis
Bronchitis due to occupational exposure
Hypersensitivity Pneumonitis (occupational)
Occupational asthma
Other occupational lung disease
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH EDUCATOR PUBLIC HEALTH EDUCATOR
10 CRR-NY 11.151 Entry level qualifications
A local public health educator must possess:
(a) a baccalaureate degree in health education, health science, public health, health promotion, community health, or health communications from a regionally accredited or New York State-registered college or university; or
(b) a baccalaureate degree in education, nursing, epidemiology, wellness and fitness, or nutrition from a regionally accredited or New York State-registered college or university and one year experience in health education; or
(c) a baccalaureate degree in marketing, human services, social work or psychology from a regionally accredited or New York State-registered college or university and two years' experience in health education; or
(d) a master's degree in public health or health education from a regionally accredited or New York State-registered college or university.
A local public health educator must satisfactorily complete 15 hours of continuing education in health education related topics approved by the New York State Health Department within one year of appointment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.9 Environmental laboratory approval program difficulty factors
| Analyte | Factor | | --- | --- | | BIOLOGICAL TEST PROCEDURES | | | Coliform, fecal | 0.3 | | Coliform, Total | 0.3 | | Standard Plate Count | 0.3 | | INORGANIC TEST PROCEDURES | | | Acidity | 0.3 | | Alkalinity | 0.3 | | Aluminum, Total | 0.5 | | Ammonia (as N) | 0.5 | | Antimony, Total | 0.5 | | Arsenic, Total | 0.7 | | Barium, Total | 0.5 | | Beryllium, Total | 0.5 | | Biochemical Oxygen Demand | 0.8 | | Boron, Total | 0.5 | | Bromide | 0.8 | | Cadmium, Total | 0.5 | | Calcium, Total | 0.5 | | Carbonaceous BOD | 0.8 | | Chemical Oxygen Demand | 0.4 | | Chloride | 0.5 | | Chromium, VI | 0.8 | | Chromium, Total | 0.5 | | Cobalt, Total | 0.5 | | Copper, Total | 0.5 | | Cyanide, Total or amenable to chlorination | 0.8 | | Fluoride, Total | 0.5 | | Gold, Total | 0.5 | | Hardness, Total | 0.2 | | Calcium Hardness | 0.2 | | Hydrogen Ion (pH) | 0.1 | | Iron, Total | 0.5 | | Kjeldahl Nitrogen, Total | 0.5 | | Lead, Total | 0.5 | | Magnesium, Total | 0.5 | | Manganese, Total | 0.5 | | Mercury, Total | 0.7 | | Molybdenum, Total | 0.5 | | Nickel, Total | 0.5 | | Nitrate (as N) | 0.5 | | Nitrite (as N) | 0.5 | | Nitrogen Dioxide | 1.5 | | Nitrogen Oxide | 1.5 | | Oil and Grease, Total Recoverable | 0.8 | | Organic Carbon, Total | 0.5 | | Orthophosphate (as P) | 0.5 | | Palladium, Total | 0.5 | | Percent Sulfur | 2.0 | | Phenols | 0.8 | | Phosphorus, Total | 0.5 | | Platinum, Total | 0.5 | | Potassium, Total | 0.5 | | Selenium, Total | 0.7 | | Silica, Dissolved | 0.5 | | Silver, Total | 0.5 | | Sodium, Total | 0.5 | | Sulfate (as SO4) | 0.5 | | Sulfide (as S) | 0.7 | | Sulfite (as SO3) | 0.7 | | Sulfur Dioxide | 1.0 | | Surfactants | 0.6 | | Thallium, Total | 0.5 | | Tin, Total | 0.5 | | Titanium, Total | 0.5 | | Vanadium, Total | 0.5 | | Zinc, Total | 0.5 | | NON-PESTICIDE ORGANIC COMPOUNDS | | | Acenaphthene | 0.5 | | Acenaphthylene | 0.5 | | Acetone | 0.5 | | Acrolein | 0.5 | | Acrylonitrile | 0.5 | | Anthracene | 0.5 | | Benzene | 0.5 | | Benzidine | 0.5 | | Benzoic Acid | 0.5 | | Benzo (a) anthracene | 0.5 | | Benzo (a) pyrene | 0.5 | | Benzo (b) fluoranthene | 0.5 | | Benzo (ghi) perylene | 0.5 | | Benzo (k) fluoranthene | 0.5 | | Benzyl Alcohol | 0.5 | | Benzyl Chloride | 0.5 | | Benzyl Butyl Phthalate | 0.5 | | Bis (2-chloroethoxy) methane | 0.5 | | Bis (2-chloroethyl) ether | 0.5 | | Bis (2-ethylhexyl) phthalate | 0.5 | | Bromobenzene | 0.5 | | Bromodichloromethane | 0.5 | | Bromoform | 0.5 | | Bromomethane | 0.5 | | 4-Bromophenylphenyl ether | 0.5 | | 2-Butanone | 0.5 | | n-Butylbenzene | 0.5 | | sec-Butylbenzene | 0.5 | | tert-Butylbenzene | 0.5 | | Carbon Disulfide | 0.5 | | Carbon Tetrachloride | 0.5 | | 4-Chloroaniline | 0.5 | | 4-Chloro-3-methylphenol | 0.5 | | Chlorobenzene | 0.5 | | Chloroethane | 0.5 | | 2-Chloroethylvinyl ether | 0.5 | | Chloroform | 0.5 | | Chloromethane | 0.5 | | 2-Chloronaphthalene | 0.5 | | 2-Chlorophenol | 0.5 | | 4-Chlorophenylphenyl ether | 0.5 | | 2-Chlorotoluene | 0.5 | | 4-Chlorotoluene | 0.5 | | Chrysene | 0.5 | | Dibenzo (a,h) anthracene | 0.5 | | Dibenzofuran | 10.0 | | Dibromochloromethane | 0.5 | | 1,2-Dibromo-3-chloropropane | 0.5 | | 1,2 Dibromoethane | 0.5 | | Dibromomethane | 0.5 | | 1,2-Dichlorobenzene | 0.5 | | 1,3-Dichlorobenzene | 0.5 | | 1,4-Dichlorobenzene | 0.5 | | 3,3-Dichlorobenzidine | 0.5 | | Dichlorodifluoromethane | 0.5 | | 1,1-Dichioroethane | 0.5 | | 1,2-Dichloroethane | 0.5 | | 1,1-Dichioroethene | 0.5 | | 1,2-Dichloroethene (any iosomer or total) | 0.5 | | trans-1,2-Dichloroethene | 0.5 | | 2,4.Dichlorophenol | 0.5 | | 1,2-Dichloropropane | 0.5 | | 1,3-Dichloropropane | 0.5 | | 2,2-Dichloropropane | 0.5 | | 1,1-Dichloropropene | 0.5 | | cis-1,3-Dichloropropene | 0.5 | | trans-1,3-Dichloropropene | 0.5 | | Diethyl phthalate | 0.5 | | 2,4-Dimethyiphenol | 0.5 | | Dimethyl phthalate | 0.5 | | Di-n-butyl phthalate | 0.5 | | Di-n-octyl phthalate | 0.5 | | 2,4-Dinitro-2-methylphenol | 0.5 | | 2,4-Dinitrophenol | 0.5 | | 2,4-Dinitrotoluene | 0.5 | | 2,6-Dinitrotoluene | 0.5 | | Epichlorohydrin | 0.5 | | Ethylbenzene | 0.5 | | Ethylene Glycol | 0.5 | | Fluoranthene | 0.5 | | Fluorene | 0.5 | | Formaldehyde | 0.8 | | Hexachlorobenzene | 0.5 | | Hexachlorobutadiene | 0.5 | | Hexachloroethane | 0.5 | | 2-Hexanone | 0.5 | | Indeno (1,2,3-cd) pyrene | 0.5 | | Isophorone | 0.5 | | Isopropylbenzene | 0.5 | | p-Isopropyltoluene (p-Cymene) | 0.5 | | 2-Methylnaphthalene | 0.5 | | Methylene Chloride | 0.5 | | 2-Methyl-4,6-Dinitrophenol | 0.5 | | 4-Methyl-2-Pentanone | 0.5 | | 2-Methylphenol | 0.5 | | 4-Methylphenol | 0.5 | | Naphthalene | 0.5 | | 2-Nitroaniline | 0.5 | | 3-Nitroaniline | 0.5 | | 4-Nitroaniline | 0.5 | | 2-Nitrophenol | 0.5 | | Nitrobenzene | 0.5 | | 4-Nitrophenol | 0.5 | | N-Nitrosodimethylamine | 0.5 | | N-Nitrosodi-n-propylamine | 0.5 | | N-Nitrosodiphenylamine | 0.5 | | 2,2-oxybis (1-chloropropane) | 0.5 | | PCB-1016 | 0.5 | | PCB-1221 | 0.5 | | PCB-1232 | 0.5 | | PCB-1242 | 0.5 | | PCB-1248 | 0.5 | | PCB-1254 | 0.5 | | PCB-1260 | 0.5 | | Pentachlorophenol | 0.5 | | Phenanthrene | 0.5 | | Phenol | 0.5 | | n-Propylbenzene | 0.5 | | Pyrene | 0.5 | | Styrene | 0.5 | | 2,3,7,8-Tetrachlorodibenzo-p-dioxin | 10.0 | | 1,1,2,2-Tetrachloroethane | 0.5 | | Tetrachloroethene | 0.5 | | Toluene | 0.5 | | 1,2,3-Trichlorobenzene | 0.5 | | 1,2,4-Trichlorobenzene | 0.5 | | 1,1,1-Trichloroethane | 0.5 | | 1,1,2-Trichloroethane | 0.5 | | Trichloroethene | 0.5 | | Trichlorofluoromethane | 0.5 | | 2,4,6-Trichiorophenol | 0.5 | | 1,2,3-Trichloropropane | 0.5 | | 1,2,4-Trimethylbenzene | 0.5 | | 1,3,5-Trimethylbenzene | 0.5 | | Vinyl Acetate | 0.5 | | Vinyl Chloride | 0.5 | | Xylene (any isomer or total) | 0.5 | | PESTICIDES | | | Aldrin | 0.5 | | Atrazine | 0.5 | | Azinphos Methyl | 0.5 | | alpha-BHC | 0.5 | | beta-BHC | 0.5 | | delta-BHC | 0.5 | | Lindane | 0.5 | | Captan | 0.5 | | Carbaryl | 0.5 | | Chlordane (any) | 0.5 | | 2,4-D | 0.5 | | 4,4′-DDD | 0.5 | | 4,4′-DDE | 0.5 | | 4,4′-DDT | 0.5 | | Demeton-O | 0.5 | | Demeton-S | 0.5 | | Diazinon | 0.5 | | Dicamba | 0.5 | | Dichloran | 0.5 | | Dicofol | 0.5 | | Dieldrin | 0.5 | | Disulfoton | 0.5 | | Endosulfan I | 0.5 | | Endosulfan II | 0.5 | | Endosulfan sulfate | 0.5 | | Endrin | 0.5 | | Endrin aldehyde | 0.5 | | Endrin ketone | 0.5 | | Heptachlor | 0.5 | | Heptachlor epoxide | 0.5 | | Isodrin | 0.5 | | Malathion | 0.5 | | Methoxychlor | 0.5 | | Mirex | 0.5 | | Parathion methyl | 0.5 | | Parathion ethyl | 0.5 | | PCNB | 0.5 | | Perthane | 0.5 | | Strobane | 0.5 | | 2,4,5-T | 0.5 | | 2,4,5-TP (Silvex) | 0.5 | | Toxaphene | 0.5 | | Trifluralin | 0.5 | | PHYSICAL TESTS OR PROCEDURES | | | Asbestos (PLM) | 1.5 | | Asbestos (TEM) | 5.0 | | Calorific Value (BTU) | 1.5 | | Color | 0.3 | | Density | 0.3 | | E.P. Toxicity (extraction only) | 0.3 | | Fibers | 1.5 | | Ignitability | 0.6 | | Particulates | 0.3 | | Percent Solids | 0.3 | | Percent Water | 0.3 | | Reactivity | 0.5 | | Specific Conductance | 0.1 | | Suspended Particulates | 0.3 | | Temperature | 0.1 | | Total Dissolved Solids | 0.3 | | Total Solids | 0.3 | | Total Suspended Solids | 0.3 | | Volatile Content | 0.3 | | RADIOLOGICAL TEST PROCEDURES | | | Gross Alpha | 0.5 | | Gross Beta | 0.5 | | Photon Emitters | 0.5 | | Cesium-134 | 0.5 | | Iodine-131 | 0.5 | | Plutonium | 0.5 | | Radium-226 | 0.5 | | Radium-228 | 0.5 | | Radon (any method) | 0.5 | | Strontium-89 | 0.5 | | Strontium-90 | 0.5 | | Tritium | 0.5 | | Uranium | 0.5 |
The Commissioner may grant certification for additional analytes, if necessary for the protection of public health and the environment, assigning a difficulty factor commensurate with similar analytes.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.19 Sick leave at half pay
The department may, in its discretion, grant sick leave at half pay for personal illness to a permanent employee having not less than a year of service after all of his sick leave credits have been used; provided however, that the cumulative total of all sick leave at half pay granted to any employee after January 2, 1957, shall not exceed one pay period for each complete six months of his State service.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 413 CONSUMER INFORMATION SYSTEM
10 CRR-NY 413.3 Appeal process
(a) The facility may appeal the accuracy of the RHCF survey profile summary to the commissioner within 20 days after receipt of such information. An appeal of the accuracy of the RHCF survey profile summary shall be limited to whether such summary accurately reflects the findings set forth in the statement of deficiencies.
(b) The department, in response to an appeal by the facility, shall:
(1) acknowledge the appeal;
(2) review the appeal and any documentation submitted by the facility;
(3) notify the facility in writing of the decision of the appeal; and
(4) issue a new or amended facility survey profile summary, if appropriate.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-5 MUSCULOSKELETAL TISSUE BANKS
10 CRR-NY 52-5.7 Required laboratory tests on donors and donated tissue
All required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state musculoskeletal tissue procurements, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulatory authority, the United States Health Care Financing Administration, or by the department.
(a) Blood samples from all allogeneic musculoskeletal tissue donors shall be tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), and hepatitis C virus (HCV), as well as for hepatitis B surface antigen (HBsAg) and for syphilis, and, unless the tissue is to be virally inactivated, antibodies to human T-lymphotropic virus type I (HTLV- I), for purposes of donor selection.
(b) Testing of each musculoskeletal tissue unit for aerobic and anaerobic contamination shall be performed prior to final packaging, using standard laboratory procedures. Whenever fresh tissue is transplanted, the results of cultures shall be made available to the transplantation surgeon on a daily basis until the final reading has been completed.
(c) All musculoskeletal tissue from living donors intended for allogeneic use shall be quarantined for six months. After such time and prior to distribution of the tissue for transplantation, the donor shall be retested for HBsAg and antibodies to HCV, HIV-1 and HIV-2 and tested for antibodies to hepatitis B core antigen (anti-HBc).
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 80.4 Habit-forming drugs
The following chemical derivatives of barbituric acid, a substance named in section 502(d) of the Federal Food, Drug and Cosmetic Act, are hereby designated as habit-forming:
PARENT SUBSTANCE—BARBITURIC ACID
| Chemical description of derivative | Common or official name of chemical derivative or its salts | Some trade or other names of chemical derivative or its salts | | --- | --- | --- | | 5-Allyl-5-cyclopentenylbabituric acid | | Cyclopal. | | | | Cyclopen. | | 5-Allyl-5-isobutylbarbituric acid | Allylbarbituric acid | Sandoptal. | | | Allylisobutylbarbituric acid | | | | 5-Allyl-5-isopropylbarbituric acid Aprobarbital | Alurate. | | | Allylisopropylbarbituric acid | Numal. | | | Allylisopropylmalonylurea | | | 5-Allyl-5-isopropyl-1-methyl-barbituric acid | | Narconumal. | | 5-(2-Bromoallyl)-5-sopropyl-1- methylbarbituric acid | | Eunarcon. | | 5-(2-Bromoallyl)-5-(1- methylbutyl)-barbituric acid | Bromoallyl sec -amylbarbituric acid | Sigmodal. | | | | Rectidon. | | | | R289. | | 5- sec -Butyl-5-(2-bromoallyl)- barbituric acid | Butallylonal | Pernoston, Pernocton. | | 5, 5-Diallylbarbituric acid | Diallyl barbituric acid | Dial. | | | | Allobarbital. | | | | Allobarbitone. | | | | Curral. | | | | Diadol. | | 5, 5-Diethylbarbituric acid | Barbital | Deba | | | Barbitone | Dormonal. | | | Diethylbarbituric acid | Hypnogene, | | | Diethylmalonylurea | Malonal. | | | | Medinal, | | | | Sedeval. | | | | Veronal. | | | | Uronal. | | | | Vesperal. | | 1, 5-Dimethyl-5-(1-cyclobex-enyl)-barbituric acid | Hexobarbital sodium | Cyclonal Sodium. | | | | Dorico Soluble. | | | | Evipal Sodium. | | | | Evipan Sodium. | | | | Hexanastab. | | | | Hexobarbitone Sodium | | | | Methenexyl Sodium. | | 5, 5-Dipropylbarbituric acid. | Dipropylbarbituric acid | Proponal. | | 5-Ethyl-5-butylbarbituric acid. | Butcthal | Etoval. | | | Butobarbital | Neonal Butobarbital. | | | | Soncryl. | | 5-Ethyl-5- sec -butylbarbituric acid | Butabarbital sodium | Butisol Sodium. | | 5-Ethyl-5-(1-cyclobexenyl)- barbituric acid | Cyclobarbital | Cyclobarbitone. | | | | Namuron. | | | | Palinum. | | | | Phanodorm. | | | | Phanadorn. | | | | Tetrahydrophenobarbital. | | 5-Ethyl-5-cyclopentenyl-barbituric acid | | Pentenal. | | 5-Ethyl-5-hexylbarbituric acid | Hexethal sodium | Hebaral. Ortal Sodium. | | 5-Ethyl-5-isoamylbarbituric acid | Amobarbital | Amytal. | | 5-Ethyl-5-isopropylbarbituric acid | Probarbital | Ipral. | | 5-Ethyl-5-(1-methylbutyl)-barbituric acid | Pentobarbital sodium | 844. | | | Soluble pentobarbital | Embutal. | | | | Nembutal. | | | | Napethal. | | | | Pentyl. | | 5-Ethyl-5-(1-methylbutyl)-2-thiobarbituric acid | Thiopental sodium | Intraval Sodium. | | | Thiopentone sodium | Nesdonal Sodium. | | | | Pentothal Sodium | | | | Thiothal Sodium. | | 5-Ethyl-5-(1-methyl-1-buteynl) -barbituric acid | Vinbarbital | Delvinal Sodium. | | 5-Ethyl-5-phenylbarbituric | Phenebarbital | Barbenyl. | | | Phenobarbitone. | Barbiphanyl. | | | Phenylethylmalonylurea. | Dormical. | | | | Euneryl. | | | | Gardenal. | | | | Luminal. | | | | Numol, | | | | Neurobarb. | | | | Phenonyl. | | | | Somomal. | | 5-Ethyl-5-phenyl-1-methylbarbituric acid | Mephorbarbital | Mebaral. | | | | Phemitone. | | | | Prominal. | | 5-Ethyl-5-(1-piperidyl)-barbituric acid | | Eldoral. | | 5-Isopropyl-5-(2-bromoallyl)-barbitoric acid | Propallylonal | Noctal. | | | | Nostal. | | 5-Methyl-5-phenylbarbituric acid | Phenyimethylbarbituric acid | Rutoual. | | All lithium, sodium, potassium, magnesium, calcium, stronitium, and ammonium salts of the foregoing chemical derivatives of barbituric acid | | | | Sodium-5-allyl-5-(1-methylbutyl)- barbiturate | Secobarbital sodium | Seconal Sodium. | | | Soluble secobarbital | Evronal Sodium. | | All salts of the foregoing formed by replacing the sodium with lithium, potassium, magnesium, calcium, strontium, or ammonium radical. | | |
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.26 Sales, leases and realty transactions
(a) If a facility is sold or leased or is the subject of any other realty transaction before a rate for the facility has been determined and certified by the commissioner, the capital cost component of such rate shall be determined in accordance with the provisions of sections 86-4.20, 86-4.23, 86-4.24 and 86-4.25 of this Subpart.
(b) If a facility is sold or leased or is the subject of any other realty transaction after a rate for the facility has been determined and certified by the commissioner, the capital cost component of such rate shall continue with the same force and effect as if such sale, lease or other realty transaction had not occurred. This subdivision shall not be construed as limiting the powers and rights of the commissioner to change rate computations based upon previous error, deceit or any other misrepresentation or misstatement that has let the commissioner to determine and certify a rate which he would otherwise not have determined or certified. Further, this subdivision shall not be construed as limiting the powers and rights of the commissioner to reduce rates when one or more of the original property right aspects related to a facility is terminated.
(c) If a facility enters into a sale and leaseback agreement with a nonrelated purchaser involving plant facilities or equipment prior to October 23, 1992 the incurred rental specified in the agreement shall be included in allowable costs if the following conditions are met:
(1) the rental charges are reasonable based on consideration of rental charges of comparable equipment and market conditions in the area; the type, expected life, condition and value of the equipment rented and other provisions of the rental agreements;
(2) adequate alternate equipment which would serve the purpose are not or were not available at lower cost; and
(3) the leasing was based on economic and technical considerations.
(4) If all these conditions were not met, the rental charge cannot exceed the amount which the facility would have included in reimbursable costs had it retained legal title to the equipment, such as interest, taxes, depreciation, insurance and maintenance costs.
(5) If a facility enters into a sale and leaseback agreement with a nonrelated purchaser involving land, the incurred rental costs associated with the land are not includable in allowable costs.
(d) An arms length lease purchase agreement with a nonrelated lessor involving plant facilities or equipment entered into on or after October 23, 1992 which meets any one of the four following conditions, establishes the lease as a virtual purchase.
(1) The lease transfers title of the facilities or equipment to the lessee during the lease term.
(2) The lease contains a bargain purchase option.
(3) The lease term is at least 75 percent of the useful life of the facilities or equipment. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the facilities or equipment.
(4) The present value of the minimum lease payments (payments to be made during the lease term including bargain purchase option, guaranteed residual value and penalties for failure to renew) equals at least 90 percent of the fair market value of the leased property. This provision is not applicable if the lease begins in the last 25 percent of the useful life of the facilities or equipment. Present value is computed using the lessee's incremental borrowing rate, unless the interest rate implicit in the lease is known and is less than the lessee's incremental borrowing rate, in which case the interest rate implicit in the lease is used.
(e) If a lease is established as a virtual purchase under subdivision (d) of this section, the rental charge is includable in capital-related costs to the extent that it does not exceed the amount that the provider would have included in capital-related costs if it had legal title to the asset (the cost of ownership). The cost of ownership shall be limited to depreciation and interest. Further, the amounts to be included in capital-related costs are determined as follows:
(1) The difference between the amount of rent paid and the amount of rent allowed as capital-related costs is considered a deferred charge and is capitalized as part of the historical cost of the asset when the asset is purchased.
(2) If an asset is returned to the owner instead of being purchased, the deferred charge may be included in capital-related costs in the year the asset is returned.
(3) If the term of the lease is extended for an additional period of time at a reduced lease cost and the option to purchase still exists, the deferred charge may be included in capital-related costs to the extent of increasing the reduced rental to an amount not in excess of the cost of ownership.
(4) If the term of the lease is extended for an additional period of time at a reduced lease cost and the option to purchase no longer exists, the deferred charge may be included in capital-related costs to the extent of increasing the reduced rental to a fair rental value.
(5) If the lessee becomes the owner of the leased asset (either by operation of the lease or by other means), the amount considered as depreciation for the purpose of having computed the limitation on rental charges under this subdivision, must be used in calculating the limitation on adjustments for the purpose of determining any gain or loss upon disposal of an asset.
(6) In the aggregate, the amount of rental or lease costs included in capital-related costs may not exceed the amount of the costs of ownership that the provider could have included in capital-related costs had the provider legal title to the asset.
(f) If a facility enters into a sale and leaseback agreement involving plant facilities or equipment on or after October 23, 1992, the amounts to be included in capital-related costs both on an annual basis and over the useful life of the asset shall not exceed the costs of ownership, which shall be limited to depreciation and interest, and shall be determined as follows:
(1) If the annual rental or lease cost in the early years of the lease are less than the annual costs of ownership, but in the later years of the lease the annual rental or lease costs are more than the annual costs of ownership, in the years that the annual rental or lease costs are more than the annual costs of ownership, the facility may include in capital-related costs annually the actual amount of rental for lease costs, except that in any given year, the amount included in capital-related costs is limited to an amount which would not cause the aggregate rental or lease costs included up to that year in capital-related costs to exceed the costs of ownership that would have been included in capital-related costs up to that year if the provider had retained legal title to the asset.
(2) If the annual rental or lease costs in the early years of the lease exceed the annual costs of ownership, which shall be limited to depreciation and interest, but in the later years of the lease the annual rental or lease costs are less than the annual costs of ownership, the facility may carry forward amounts of rental or lease costs that were not included in capital-related costs in the early years of the lease due to the costs of ownership limitation, and include these amounts in capital-related costs in the years of the lease when the annual rental or lease costs are less than the annual costs of ownership, provided, however, in any given year the amount of actual annual rental or lease costs plus the amount carried forward to that year may not exceed the amount of the costs of ownership for that year.
(3) In the aggregate, the amount of rental or lease costs included in capital-related costs may not exceed the amount of the costs of ownership that the provider could have included in capital-related costs if the provider had retained legal title to the asset.
(4) If a facility enters into a sale and leaseback agreement involving land, the incurred rental for the cost of land is not includable in allowable costs.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
10 CRR-NY 446.1 Introduction
(a) Public Law 95-142, section 19, requires that for the purposes of reporting the cost of services provided by, of planning and of measuring and comparing the efficiency of and effective use of services in, hospitals, the Secretary of Health and Human Services shall establish by regulation a uniform system for reporting certain types of information. It further states that in reporting under such a system, hospitals shall employ such chart of accounts, definitions, principles and statistics as the Secretary of Health and Human Services may prescribe in order to reach a uniform reconciliation of financial and statistical data for specified uniform reports to the Secretary of Health and Human Services.
(b) First, hospitals must follow a set of uniform reporting policies and practices as specified in Part 442 of this Article. Items such as methods of capitalization and depreciation of assets and direct charging of medical supplies and payroll-related employee benefits to using centers are examples of important policies which must be followed for reporting purposes. When these policies differ from those of the hospital, reconciliations must be made to reflect the required policies in completing the uniform financial report.
(c) Secondly, the principles and concepts utilized in the preparation of the uniform financial report will be based upon a portrayal of the hospital's activities on a functional basis regardless of third-party reimbursement policies. The uniform financial report described in this Manual has been designed to flow directly into the Federal cost reports required for Titles 18 and 19 where the functional trial balance of expenses is subject to grouping, reclassification and adjustment as the data moves to the reimbursement worksheets.
(d) The third key principle affecting the preparation of the uniform financial report is the requirement that costs will be measured at a level where uniformity can be obtained and a standard output measurement applied. For purposes of reporting, it was determined that standard units of measure would be applied to cost centers. Therefore, for uniform functional reporting of revenue and expense there may be a need for reclassification to convert revenue or costs from the responsibility reporting format to a functional reporting format.
(e) Responsibility reporting is defined as the reporting of costs according to organizational units such as departments.
(f) Functional reporting is defined as the reporting of costs according to type of activity.
(g) Total costs are the same with either functional or responsibility reporting. However, because organization structures vary among hospitals, responsibility reporting does not allow the comparability necessary for reasonable evaluation. Therefore, the reporting system for hospitals was developed to allow comparable reporting of hospital costs while hospitals maintain responsibility accounting systems if they so desire.
(h) Hospitals are required to report:
(1) hospital profile data—data identifying the control, type, services offered, certification(s), programs, coverage, etc. of the facility;
(2) assets, liabilities and equity—all balance sheet accounts whose titles are capitalized in the listing of accounts and whose numerical code ends in “0” when such assets, liabilities and equity exist (and certain subaccounts as noted in section 446.8 of this Part);
(3) daily hospital services—all revenue and expense centers whose titles are capitalized in the listing of accounts and whose numerical code ends in “0” when such revenue centers and cost centers exist and are located in a discrete unit of the facility (and certain subaccounts as noted in section 446.9 of this Part). A discrete unit is a separately organized, staffed and equipped unit of the facility;
(4) where two or more daily hospital services, as defined in Part 444 of this Article, are provided in the same unit, the revenue and expense applicable to that unit must be reported in the functional revenue and cost centers which best describe the principal patient service provided in the combined unit. For example, assume that a hospital maintains a combined acute care unit which provides medical/surgical, pediatric and obstetrics acute care. Also assume that principal patient care service provided in this unit is medical/surgical acute care. The hospital in this situation will report the revenue and expense applicable to this unit as being medical/surgical acute care. Furthermore, the hospital, when completing the Services Inventory Worksheet, will indicate that Pediatric Acute Care and Obstetrics Acute Care are being reported as medical/surgical acute care in the reporting forms by entering the Medical/Surgical Acute account number;
(5) all other revenue centers and cost centers—all other revenue centers and cost centers whose titles are capitalized in the listing of accounts and whose numerical code ends in “0” when the services or function exists or is performed in the hospital, irrespective of whether or not it is a discrete unit (and certain subaccounts as noted in section 446.9 of this Part);
(6) units of measure—the required standard unit of measure must be accumulated and reported for all expense centers indicated in Part 444 of this Article;
(7) natural classification of expense—all natural classifications of expense, except salaries and wages, whose numerical code ends in “0”. All of the salaries and wages sub-natural classifications e.g., .01 Management and Supervision, 02 Technician and Specialist, .03 Registered Nurse, etc.) must be reported for each functional cost center, as appropriate;
(8) other supplemental reimbursement reporting—for other third-party reimbursement as described in sections 446.7 through 446.44 of this Part.
(i) All data reported must be presented in accordance with the listing of accounts and definitions, identified in other parts of this Manual. No line or column description may be changed under any circumstances, unless an exception has been granted. For Medicare purposes only, substitute cost reporting forms may be used. All substitute cost reporting forms must be identical in all respects to the Health Care Financing Administration (HCFA) forms, including designation by some distinctive symbol or character of those areas which are shaded on the official HCFA forms. Substitute cost reporting forms may be accepted for use in lieu of the official HCFA forms, subject to review and acceptance by HCFA. HCFA will also accept the report in machine-readable media subject to the specifications to be prescribed by HCFA at a later date.
Chapter I STATE SANITARY CODE
Part 12 MATERNAL AND CHILD HEALTH
PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS PROTECTION OF INFANTS AND CHILDREN AGAINST HAZARDS
10 CRR-NY 12.20 Induced termination of pregnancy
An induced termination of pregnancy with the intent to procure or induce miscarriage may be performed in other than a hospital or treatment center, as such terms are defined in the State Hospital Code (10 NYCRR Chapter V), only up to and including the twelfth week of pregnancy; thereafter it shall be performed in a hospital and only on an in-patient basis.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-3 REGULATED ACTIVITIES
10 CRR-NY 128-3.10 Miscellaneous point sources
(a) Unless otherwise permitted by the rules and regulations, a discharge, or storage which is reasonably likely to lead to a discharge into the environment (including into groundwater), from industrial facilities, including vehicle washing facilities, and which is reasonably likely to cause degradation of surface water quality or of the water supply, is prohibited. It shall be an affirmative defense under this subsection that such discharge, or storage likely to lead to a discharge, is either permitted or not prohibited under Federal law, and is either permitted or not prohibited under State law.
(b) Any new point source, excluding point sources otherwise regulated pursuant to these rules and regulations, is prohibited from discharging into a reservoir or controlled lake, reservoir stem, or wetland.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.13 Continuing eligibility
(a) Participants may be required to establish periodically that they remain eligible for the program.
(b) The applicant/participant must notify the department immediately of any changes in circumstances that may affect eligibility.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-1 CLINICAL LABORATORIES
10 CRR-NY 58-1.3 Clinical laboratory supervision
(a) A clinical laboratory shall have one or more supervisors who, under the general direction of the laboratory director, supervise technical personnel and reporting of findings, perform tests requiring special scientific skills, and, in the absence of the director, are responsible for the proper performance of all laboratory procedures.
(b) A laboratory director who qualifies pursuant to the provisions of section 19.2 of this Title shall also be deemed qualified as a supervisor.
(c) Depending upon the size and functions of the laboratory, the department may authorize the laboratory director to also serve as the supervisor of the laboratory.
(d) The supervisor shall be on the laboratory premises during all hours in which tests are performed. An exception to the on-premises requirement shall be applicable with respect to the performance of procedures required for emergency purposes; provided, that the person performing the test qualifies as a medical technologist pursuant to the provisions of section 58-1.5(b) of this Subpart, the results of his work are reviewed by the supervisor or director during his or her next duty period, and a record is maintained to reflect the actual review.
(e) An individual who qualifies as a supervisor pursuant to provisions of section 58-1.4(d) of this Subpart, shall supervise technical personnel in the specialty of cytology only.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-4 FEE AND REVENUE PLAN FOR DEPARTMENTAL SERVICES
10 CRR-NY 40-4.1 Fees for departmental services
(a) The department must charge a fee for the granting of a permit, inspections, or other services prerequisite to the issuance of a permit, or for other environmental health services. Such fee shall be nonrefundable.
(b) Annual fees for facility inspection and permit issuance services, where such services are provided by the department and not directly by the municipality, are based on the costs of providing such services and shall be revised periodically.
(c) Cumulative fees for a single operator at a single location shall not exceed $1,000 per year.
(d) Definitions.
(1) As used in this Subpart, multipurpose recreational facilities, are defined as large tracts of land upon which a recreational facility owned and operated by a single person, partnership or corporation is located. Such facilities may encompass multiple food, swimming or recreational facilities permittable under the State Sanitary Code. In completing a fee determination schedule, the facility operator may exercise an option to pay either a registration fee as provided for in paragraph (e)(10) of this section or fees separately calculated for each individual activity.
(2) Primary service is defined as the principal or major function of such multipurpose recreational facilities ( e.g., water slides). All such primary services are covered by the base fee. Other services, ( e.g., food) are chargeable as add-ons for each individual facility ( e.g., 10 food booths × $50 = $500 additional fee).
(3) Seasonal facility, for the purpose of determining the annual fee levels for such facility, is defined as a faculty permittable under the provisions of the State Sanitary Code which operates 26 weeks or less in a calendar year. Such seasonal facility must be designated as such on any permit issued to it, which shall also state the starting and ending dates of the seasonal operating period. Such seasonal facility shall be entitled to a 10% reduction from the normal annual fee.
(e) Fees for departmental environmental services, excluding plan review unless otherwise stated, are established as follows:
(1) Food service establishments, taverns, bars (includes $25 frozen dessert fee except for free-standing soft ice cream and slush machine units, etc.).
| Seating Capacity: | | | --- | --- | | 100 or less, including takeout or stand up service | $ 75.00 | | 101 or more | 150.00 | | (2) Caterers and commissaries. | 200.00 | | (3) Temporary food service, mobile vendors. | 30.00 | | (4) Hotels, motels, bungalow colonies, cabins, cottage colonies (Base fee [i] and added fees [ii-iv]). | | | (i) Number of rental units: | | | 1-20 units | 50.00 | | 21-50 | 100.00 | | 51-100 | 150.00 | | 101-200 | 200.00 | | 201+ | 400.00 | | (ii) Food service dining areas (which may include a cocktail lounge, nightclub, etc.) | | | Capacity 1-100 | add 50.00 for each separate area/facility | | Capacity 101 or more | add 100.00 for each separate area/facility | | (iii) Pool | add 30.00 for each separate pool | | (iv) Beach | add 20.00 for each separate beach | | (5) Campgrounds and travel trailer Parks. (Base fee [i] and added fees [ii-iv]). | | | (i) Number of sites: | | | 50 or less | 50.00 | | 51-200 | 75.00 | | 201-500 | 100.00 | | 501-750 | 150.00 | | 751 or more | 250.00 | | (ii) Food service dining areas (which may include a cocktail lounge, nightclub, etc.). | | | Capacity 1-100 | add 50.00 for each separate area/facility | | Capacity 101 or more | add 100.00 for each separate area/facility | | (iii) Pool | 30.00 for each separate pool | | (iv) Beach | add 20.00 for each separate beach | | (6) Mobile home parks. (Base fee [i] and added fees [ii-iv]). | | | (i) Number of sites: | | | Less than 50 | 50.00 | | 50-100 | 100.00 | | 101 or more | 200.00 | | (ii) Food service dining areas (which may include a cocktail lounge, nightclub, etc.). | | | Capacity 1-100 | add 50.00 for each separate area/facility | | Capacity 101 or more | add 100.00 for each separate area/facility | | (iii) Pool | add 30.00 for each separate pool | | (iv) Beach | add 20.00 for each separate beach | | (7) Migrant labor camps. | | | Occupancy | | | 5-50 | 50.00 | | 51 or more | 100.00 | | (8) Swimming pools and common use spa pools. Maximum number of bathers (25 sq. ft./bather) | | | 1-100 | 50.00 | | 101 or more plus wave pools and slides | 100.00 | | (9) Bathing beaches. | | | Less than 5,000 sq. ft. | 30.00 | | 5,000 sq. ft. or more | 70.00 | | (10) Multipurpose recreational facilities. | | | (i) Base fee for primary service (food, pool, beach, etc. as designated by operator) | 500.00 | | (ii) Additional services (other than primary) | | | Food service | add 50.00 for each separate area/facility | | Pool | add 30.00 for each separate area/facility | | Beach | add 20.00 for each separate area/facility | | (11) Community water supplies. | | | Population Served: | | | Less than 1,000 | 100.00 | | 1,000-9,999 | 500.00 | | 10,000 or more | 1,000.00 | | (12) Unpermitted noncommunity water supplies. | 100.00 | | (13) Mass gatherings, including plan review. | 500.00 | | (14) Public functions of over 5,000 people not constituting mass gatherings. | | | Number of emergency health care units: | | | Less than 3 | 100.00 | | 3 or more | 200.00 | | (15) Children's camps. | 100.00 | | (16) Frozen desserts (soft ice cream). | 25.00 |
(f) Plan review fee (per project).
| (1) Food service establishments, caterers, commissaries, etc. | 75.00 | | --- | --- | | (2) Hotels, motels, bungalow colonies, cabins, cottage colonies. | | | Number of stories or structures: | | | 1 or 2 | 50.00 | | 3 or more | 200.00 | | (3)Campgrounds and travel trailer parks. | 100.00 | | (4)Mobile home parks. | 100.00 | | (5)Migrant labor camps. | 50.00 | | (6) Swimming pools and bathing beaches. | | | 100-5000 sq. ft. | 100.00 | | 5001 sq. ft. or more | 150.00 | | wavepools, slides, spa pools | 150.00 | | (7) Realty subdivisions (as prescribed by Public Health Law, section 1119). | 3.50/lot | | (8) Community and noncommunity water supply. Cost of project: | | | Less than $10,000 | 50.00 | | 10,000-100,000 | 100.00 | | More than 100,000 | 200.00 | | (9) Individual sewage system (alternative design). | 50.00 |
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
ENHANCED TREATMENT FOR CRYPTOSPORIDIUM ENHANCED TREATMENT FOR CRYPTOSPORIDIUM
10 CRR-NY 5-1.83 Treatment technique requirements
(a) Bin classification for filtered systems.
(1) Following completion of the initial round of source water monitoring under section 5-1.81(a)(1) of this Subpart, filtered systems shall calculate an initial Cryptosporidium bin concentration for each plant for which monitoring was required, such calculation shall be done in accordance with 40 CFR 141.710(b)(1) through 40 CFR 141.710(b)(5). Calculation of the bin concentration shall use the Cryptosporidium results reported under section 5-1.81 of this Subpart.
(2) Filtered systems shall determine their initial bin classification from the following table and using the Cryptosporidium bin concentration calculated under paragraph (1) of this subdivision:
)
(3) Following completion of the second round of source water monitoring required under section 5-1.81(a)(2) of this Subpart, filtered systems shall recalculate their Cryptosporidium bin concentration using the Cryptosporidium results reported under section 5-1.81(a)(2) of this Subpart, and following the procedures in 40 CFR 141.710(b)(1) through 40 CFR 141.710(b)(4). Systems shall then reevaluate their bin classification using the bin concentration from the second round of monitoring and the table in paragraph (2) of this subdivision.
(4)
(i) Filtered systems shall report their initial bin classification under paragraph (2) of this subdivision to the State for approval no later than six months after the system is required to complete initial source water monitoring based on the schedule referenced in section 5-1.81(a)(3) of this Subpart.
(ii) Systems shall report their bin classification under paragraph (3) of this subdivision to the State for approval no later than six months after the system is required to complete the second round of source water monitoring based on the schedule referenced in section 5-1.81(a)(3) of this Subpart.
(iii) The bin classification report to the State shall include a summary of source water monitoring data and the calculation procedure used to determine bin classification.
(b) Filtered system additional Cryptosporidium treatment requirements.
(1) Filtered systems shall provide the level of additional treatment for Cryptosporidium specified in this paragraph based on their bin classification as determined under subdivision (a) of this section and according to the schedule in subdivision (d) of this section.
)
)
(2)
(i) Filtered systems shall use one or more of the treatment and management options, as approved by the State, to comply with the additional Cryptosporidium treatment required in paragraph (1) of this subdivision.
(ii) Systems classified in Bin 3 and Bin 4 shall achieve at least 1-log of the additional Cryptosporidium treatment required under paragraph (1) of this subdivision using either one or a combination of the following, as approved by the State: bag filters, bank filtration, cartridge filters, chlorine dioxide, membranes, ozone, or UV.
(3) Failure by a system in any month to achieve treatment credit at least equal to the level of treatment required in paragraph (1) of this subdivision is a violation of the treatment technique requirement.
(4) If the State determines during a sanitary survey or an equivalent source water assessment that, after a system completed the monitoring conducted under section 5-1.81(a)(1) or (2) of this Subpart, significant changes occurred in the system’s watershed that could lead to increased contamination of the source water by Cryptosporidium, the system shall take actions specified by the State to address the contamination.
(c) Unfiltered system Cryptosporidium treatment requirements.
(1) Determination of mean Cryptosporidium level.
(i) Following completion of the initial source water monitoring required under section 5-1.81(a)(1) of this Subpart, unfiltered systems shall calculate the arithmetic mean of all Cryptosporidium sample concentrations reported for such monitoring. Systems shall report this value to the State for approval no later than six months after the month the system is required to complete initial source water monitoring based on the schedule referenced in section 5-1.81(a)(3) of this Subpart.
(ii) Following completion of the second round of source water monitoring required under section 5-1.81(a)(2) of this Subpart, unfiltered systems shall calculate the arithmetic mean of all Cryptosporidium sample concentrations reported under that monitoring. Systems shall report this value to the State for approval no later than six months after the month the system is required to complete the second round of source water monitoring based on the schedule referenced in section 5-1.81(a)(3) of this Subpart.
(iii) If the monthly Cryptosporidium sampling frequency varies, systems shall first calculate a monthly average for each month of monitoring. Systems shall then use these monthly average concentrations, rather than individual sample concentrations, in the calculation of the mean Cryptosporidium level in subparagraph (i) or (ii) of this paragraph.
(iv) The report to the State of the mean Cryptosporidium levels calculated under subparagraphs (i) and (ii) of this paragraph shall include a summary of the source water monitoring data used for the calculation.
(2) Cryptosporidium inactivation requirements. Unfiltered systems shall provide the level of inactivation for Cryptosporidium specified in this paragraph, based on their mean Cryptosporidium levels as determined under paragraph (1) of this subdivision and according to the schedule in subdivision (d) of this section.
(i) Unfiltered systems with a mean Cryptosporidium level of 0.01 oocysts/L or less shall provide at least 2-log Cryptosporidium inactivation.
(ii) Unfiltered systems with a mean Cryptosporidium level of greater than 0.01 oocysts/L shall provide at least 3-log Cryptosporidium inactivation.
(3) Inactivation treatment technology requirements. Unfiltered systems shall use chlorine dioxide, ozone, or UV to meet the Cryptosporidium inactivation requirements of this section.
(4) Use of two disinfectants. Unfiltered systems shall meet the combined Cryptosporidium inactivation requirements of this section and Giardia lamblia and virus inactivation requirements of section 5-1.30(c)(3) of this Subpart using a minimum of two disinfectants, and each of two disinfectants must separately achieve the total inactivation required for either Cryptosporidium, Giardia lamblia, or viruses. Systems that fail to install a second disinfectant to treat for Cryptosporidium are in violation of the treatment technique requirement.
(d) Schedule for compliance with Cryptosporidium treatment requirements.
(1) Following initial bin classification under subdivision (a) of this section, filtered systems shall provide the level of treatment for Cryptosporidium required under subdivision (b) of this section, on a schedule approved by the State.
(2) Following initial determination of the mean Cryptosporidium level under subparagraph (c)(1)(i) of this section, unfiltered systems shall provide the level of treatment for Cryptosporidium required under subdivision (c) of this section.
(3) If the bin classification for a filtered system changes following the second round of source water monitoring, as determined under paragraph (a)(3) of this section, the system shall provide the level of treatment for Cryptosporidium required under subdivision (b) of this section on a schedule approved by the State.
(4) If the mean Cryptosporidium level for an unfiltered system changes following the second round of monitoring, as determined under subparagraph (c)(1)(ii) of this section, and if the system shall provide a different level of Cryptosporidium treatment under subdivision (c) of this section due to this change, the system shall meet this treatment requirement on a schedule approved by the State.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-1.41 Reservice of unused potentially hazardous food and unused, unprotected food prohibited
(a) Unused potentially hazardous food which has been served may not be served again.
(b) Unused, unprotected food which has been served may not be served again.
(c) Food is considered served when it has been offered without protection to the consumer.
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE OPERATION FOOD VENDING MACHINE OPERATION
10 CRR-NY 14-5.20 Definition of food vending machine and food vending commissary
(a) A food vending machine is a self-service device which when activated dispenses unit servings of food or beverage without requiring replenishing between each rending operation.
(b) A food vending machine commissary is a place where food, containers or supplies are processed or packaged and prepared for use in food vending machines.
(c) A food vending operation is the place where food vending machines are located and includes the food vending machines, machine servicing equipment, utensils, personnel, single-service articles, tables, chairs, that part of the premises used in connection with the food vending operation and all other appurtenances required and used to operate and maintain the food vending machines.
(d) A controlled-location vending machine is a food vending machine which dispenses only nonpotentially hazardous food, can be serviced in a sanitary manner by an untrained person at the location, and is located where it is protected from environmental contamination, abuse and vandalism.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.16 Claim and prior authorization denial review process
(a) A request for review of a denial of a claim or of a prior approval request shall be made by completing and submitting a review request form provided by the fund administrator for denial of a claim or a prior approval request no later than 30 days from receipt of the denial. The form shall be provided to all enrollees and/or their parent(s), guardian(s) or legal representative(s) and shall be available on the fund administrator’s website; and when completed, shall be submitted electronically, mailed or faxed to the fund administrator's office.
(b) A request for review of a denial of a claim or a prior approval request shall specify the denial that the enrollee is seeking to appeal and include the reason(s) the enrollee believes that the decision was incorrect and whether the requestor wants:
(1) a review based on documents submitted by both parties;
(2) a review in the form of a hearing conducted by telephone; or
(3) a review in the form of a hearing conducted in person.
The review option chosen by the enrollee shall be the only form of review conducted by the commissioner or his or her designee. A hearing officer, assigned by the commissioner or his or her designee, will conduct the review regardless of whether the review is to be a document review or a review in the form of a hearing.
(c) If an enrollee who has had a prior approval request denied requests an informal conference in addition to a formal review, the fund administrator will designate a person to participate in an informal conference with the enrollee and/or his authorized representative to discuss the reason(s) for the denial. Any such conference will be scheduled to occur no later than one week before the formal review is scheduled to be held.
(d) Document based reviews.
If the person representing the enrollee wishes a review based on documents instead of a hearing or if the hearing officer believes that the review can be conducted on the basis of documentation submitted by both parties without a hearing and neither party objects, the hearing officer will confer with both parties and set up a schedule for the submission and exchange of the documents on which each party intends to rely.
(1) No hearing officer shall review a matter toward which he or she has a personal bias. Prior to the submission of any documentation for review, any party may request that hearing officer be removed for personal bias or for other good cause by filing a request for removal accompanied by a supporting affidavit stating the basis for the request.
(2) A hearing officer may disqualify himself or herself for bias on his or her own determination.
(3) Any request for removal of a hearing officer on the basis of personal bias or for other good cause shall be reviewed by the Department of Health’s Chief Administrative Law Judge, and the review shall not proceed until the Chief Administrative Law Judge reaches a decision on the request. Such decision shall be made within 10 business days from receipt of the request for removal. If the Chief Administrative Law Judge determines there is good cause for removal, the review will be assigned to a different hearing officer simultaneously with the Chief Administrative Law Judge’s determination.
(4) After reviewing all of the parties’ submissions, the hearing officer shall render a written recommendation to the commissioner within 30 days of receiving all submissions that includes the issue(s) raised on review, the relevant facts, and the applicable law, regulations, and official policies, if any, upon which the recommendation is based.
(5) The commissioner or his or her designee shall review the documentation submitted by both parties and the hearing officer’s recommendation and issue a decision that contains findings of fact, conclusions of law and the reason(s) for the determination and, when appropriate, directs the fund administrator to take specific action. The decision shall be issued promptly but no later than 30 days from issuance of the hearing officer’s recommendation.
(6) A copy of the written decision shall be mailed to the parties and to the fund administrator. The decision of the commissioner shall be final, provided that the enrollee or the provider may seek judicial review by a court of competent jurisdiction.
(7) The parties may enter into a stipulation to resolve the matter in dispute at any time prior to issuance of the decision. In the event that such a resolution is reached, the hearing officer will issue a consent order that incorporates the parties’ stipulation. Such a consent order shall have the same force and effect as an order issued by the commissioner.
(e) Hearings.
Upon receipt of a request for a hearing, a hearing officer will be assigned; and the commissioner or his or her designee shall serve a notice of hearing upon the party who requested the hearing and the fund administrator. If the requestor is an attorney, the notice will also be sent to the enrollee or, when applicable, his or her parent or other person authorized to act on his or her behalf.
(1) The notice of hearing shall, at a minimum:
(i) specify the date, time and place of the hearing, which, if conducted in person, shall be at a location within a reasonable distance from the requestor;
(ii) briefly state the issues that will be the subject of the hearing;
(iii) explain the manner in which the hearing will be conducted;
(iv) advise the requestor, if not an attorney, of the right to be represented by counsel and to be accompanied by any person of his or her choice. An interpreter may also be present when necessary.
(2) All notices and papers connected with the hearing may be served by ordinary mail, and service will be deemed complete three days after mailing.
(3) The assigned hearing officer shall preside over the hearing and related proceedings. The hearing and related proceedings shall be conducted in an impartial manner in accordance with the following procedures:
(i) No hearing officer shall preside over a matter toward which he or she has a personal bias. Prior to the hearing, any party may request that hearing officer be removed for personal bias or for other good cause by filing a request for removal accompanied by a supporting affidavit stating the basis for the request.
(ii) A hearing officer may disqualify himself or herself for bias on his or her own motion.
(iii) During the hearing, any party may request that the hearing officer be removed for bias by making such a request either orally or in writing on the record and stating the grounds for requesting removal of the hearing officer. The burden of proof shall be on the party seeking disqualification.
(iv) The hearing officer shall rule on the request for disqualification. If the hearing officer denies the request, the hearing shall proceed; but the commissioner or his designee will review the entire record of the proceeding before a decision is issued. A written determination regarding whether the hearing officer should be removed from the proceeding will be issued within 15 business days of the close of the hearing and will be made part of the record.
(4) The hearing officer shall conduct the hearing in a fair and impartial manner and shall have the power to:
(i) rule upon requests by all parties to the hearing, including requests for adjournments;
(ii) administer oaths and affirmations, issue subpoenas requiring the attendance of witnesses and the production of books, records and other evidence pertinent to the hearing;
(iii) admit or exclude evidence;
(iv) limit repetitious examination or cross-examination and the amount of corroborative or duplicative testimony;
(v) hear arguments on facts and law;
(vi) order the parties to present opening statements summarizing why the party believes the fund administrator's position was or was not correct;
(vii) order the parties to appear at a pre-hearing conference in an effort to simplify the issues, expedite the hearing, and/or to ensure that the parties understand the procedure;
(viii) ensure that a written or electronic verbatim record of the proceedings is made and made available to the parties;
(ix) perform such other acts as are necessary for the maintenance of order and the efficient conduct of the hearing unless otherwise prohibited by law or regulation; and
(x) adjourn the hearing to another time upon the request of any party for good cause shown or, upon the hearing officer's own motion, when the hearing officer determines that it would be prejudicial to a party's due process rights to go forward with the hearing on the scheduled date.
(5) The proceedings used to conduct the hearing shall provide the parties with a fair and prompt resolution of any dispute in accordance with the following procedures:
(i) The parties to the hearing may be represented by legal counsel or other individuals with specialized training relevant to the hearing and may be accompanied by a person of his or her choice.
(ii) The hearing shall be closed to the public unless the enrollee, or the enrollee's parent or other person authorized to act on his or her behalf if the enrollee is a minor, requests an open hearing.
(iii) The parties to the hearing and their respective counsel or representative shall have an opportunity to present evidence and to question all witnesses at the hearing.
(iv) Every witness shall be sworn or given an affirmation by the hearing officer.
(v) The hearing officer shall consider all relevant evidence and shall include all records, documents, and memoranda submitted into evidence. The formal rules of evidence shall not apply.
(vi) The parties may enter into a stipulation to resolve the matter in dispute at any time prior to issuance of the decision. In the event that such a resolution is reached, the hearing officer will issue a consent order that incorporates the parties' stipulation. Such a consent order shall have the same force and effect as an order issued by the commissioner.
(6) Upon conclusion of the hearing, the hearing officer shall render a written recommendation to the commissioner within 30 days of the hearing that includes the issue(s) raised at the hearing, the relevant facts, and the applicable law, regulations, and official policies, if any, upon which the recommendation is based.
(7) The commissioner or his or her designee shall review the hearing record and the hearing officer's recommendation and issue a decision that contains findings of fact, conclusions of law and the reason(s) for the determination and, when appropriate, directs the fund administrator to take specific action. The decision shall be issued promptly but no later than 30 days from issuance of the hearing officer's recommendation.
(8) A copy of the written decision shall be mailed to the parties to the hearing and to the fund administrator. The decision of the commissioner shall be final, provided that the enrollee or the provider may seek judicial review by a court of competent jurisdiction.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.315 Stepdown method
The allocation of the accumulated costs of the nonrevenue producing centers to those other nonrevenue producing centers which utilize their services, as well as to the revenue producing centers to which they render service. Once the costs of a nonrevenue producing center have been allocated, that center is considered closed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.9 Standards for the provision of services
(a) For purposes of this section, early intervention providers includes all approved agencies and individuals and Early Intervention Program services means service coordination, evaluations, and early intervention services.
(b) On or before September 1, 2010 and thereafter, all approved providers shall comply with the criteria set forth in section 69-4.5(a)(4) of this Subpart.
(c) Each municipality shall ensure that the Early Intervention Program services contained in individualized family service plans are provided to eligible children, who reside in such municipality, and their families. Municipalities shall make reasonable efforts to ensure that Early Intervention Program services provided to children residing in the municipality are delivered in a manner that protects the health and safety of eligible children, in accordance with this Subpart and with standards and procedures on health, safety, and sanitation developed by the department for the Early Intervention Program.
(1) If an early intervention official reasonably believes that the early intervention provider is out of compliance with this subpart and/or with the department's standards and procedures on health, safety, and sanitation, or otherwise posing an imminent risk of danger to children, parents, or staff, the municipality shall take immediate action to ensure the health and safety of such persons.
(2) Upon the taking of such action by the municipality, the early intervention official shall immediately notify the department, for purposes of the initiation of an investigation which may result in the suspension, limitation or revocation of the early intervention service provider in accordance with procedures set forth in section 69-4.24 of this Subpart.
(i) The department shall notify all early intervention officials in the catchment area of the provider that an investigation has been initiated.
(d) All early intervention providers shall ensure that Early Intervention Program services are delivered in a manner that protects the health and safety of eligible children. Early intervention providers shall:
(1) comply with standards for health, safety, and sanitation issued by the department for the Early Intervention Program, and for early intervention providers who are otherwise required to be approved by another State agency to deliver health or human services, complying with health, safety and sanitation standards issued by such other agency;
(2) ensure that only those individuals who are qualified in accordance with section 69-4.1(al) or 69-4.4 of this Subpart, as applicable, deliver such services to eligible children and their families;
(3) protect the health, safety, and welfare of eligible children during delivery of early intervention services, including with respect to and as applicable:
(i) direct supervision of and interaction with children during the delivery of services;
(ii) infection control;
(iii) handling of food;
(iv) illness;
(v) equipment, materials, or other items used during service delivery; and
(vi) delivery of services in physical environments that protects the health and safety of children during service delivery.
(e) If the provider delivers services in a physical site or setting which is rented, leased, owned, or otherwise managed or operated by the provider, including a provider's home or private office, the provider shall maintain such physical site or setting in a manner that ensures a safe environment for eligible children and their families in accordance with this Subpart, applicable State and local codes, including municipal fire codes, and standards for health, safety, and sanitation issued by the department for the Early Intervention Program. Providers subject to this paragraph shall ensure that the physical site or setting where services are delivered protects the health and safety of Early Intervention Program children with respect to:
(1) sanitation;
(2) handling of medications and food;
(3) illness, injury, or emergencies, including allergic reactions; and
(4) its outdoor environment.
(f) The department and early intervention officials shall make reasonable efforts to ensure that Early Intervention Program services delivered to eligible infants and toddlers:
(1) are family-centered, including parents in all aspects of their child's services and in decisions concerning the provisions of services;
(2) use a child development emphasis in intervention strategies, incorporating quality child development practices with necessary adaptations to enhance the eligible child's development;
(3) use an individualized approach for both children and their families, including consideration and respect for cultural, lifestyle, ethnic, and other individual and family characteristics; and
(4) use a team approach that is multidisciplinary, interdisciplinary, or transdisciplinary, including the expertise of all appropriate qualified personnel.
(g) Providers of Early Intervention Program services shall:
(1) Provide Early Intervention Program services to an eligible child and family as authorized by the early intervention official and in conformance with the child's and family's individualized family service plan.
(2) Provide timely notification of any changes in the provider's ability to deliver Early Intervention Program services to the child and family in conformance with the individualized family service plan.
(i) Providers shall make reasonable efforts to notify the child's parent within a reasonable period prior to the date and time on which a service is to be delivered, of any temporary inability to deliver such service due to circumstances such as illness, emergencies, hazardous weather, or other circumstances which impede the provider's ability to deliver the service.
(ii) Providers shall notify the child's parent and service coordinator at least five days prior to any scheduled absences due to vacation, professional activities, or other circumstances, including the dates for which the provider will be unable to deliver services to the child and family in conformance with the individualized family service plan and the date on which services will be resumed by such provider.
(a) Missed visits may be rescheduled and delivered to the child and family by such provider, as clinically appropriate, agreed upon by the parent and in conformance with the child's and family's IFSP.
(iii) Providers shall notify the child's service coordinator and early intervention official of the intent to permanently cease the delivery of Early Intervention Program services to an individual child and the child's family, for any reason, at least 30 days prior to the date on which the provider intends to cease providing services.
(3) Consult with parents, other service providers (including primary health care providers, family day care homes, and day care centers), and representatives of appropriate community agencies to ensure the effective provision of services.
(4) Provide support, education, and guidance to parents and other caretakers (including other family members, family day care, and day care centers) regarding the provision of those services.
(5) Participate in the multidisciplinary team's assessment of a child and the child's family and in the development of integrated goals and outcomes for the individualized family service plan.
(6) Maintain and make available to the municipality and the department upon request, complete financial records and clinical documentation related to the provision of early intervention services including such information and documentation as necessary to support provider billing to third party payors (including the medical assistance program), the municipality, and the State, and to permit a full fiscal audit by appropriate State and municipal authorities.
(7) Maintain records in accordance with section 69-4.17(a) of this Subpart that document the performance of activities required to be completed by the provider on behalf of an eligible child and the child's family.
(h) To the maximum extent appropriate to the needs of the child, early intervention services shall be provided in natural environments.
(i) The use of aversive intervention in any form is strictly prohibited when providing Early Intervention Program services to an eligible child. For purposes of this section, aversive intervention means an intervention that is intended to induce pain or discomfort to a child for the purpose of modifying or changing a child's behavior or eliminating or reducing maladaptive behaviors, including but not limited to the following:
(1) contingent application of noxious, painful, intrusive stimuli or activities;
(2) any form of noxious, painful, or intrusive spray (including water or other mists), inhalant, or tastes;
(3) contingent food programs that include the denial or delay of the provision of meals or intentionally altering staple food or drink to make it distasteful;
(4) movement limitation used as punishment, including but not limited to helmets and mechanical restraint devices;
(5) physical restraints;
(6) blindfolds; and
(7) white noise helmets and electric shock;
(8) aversives do not include such interventions as voice control, limited to loud, firm commands; time-limited ignoring of a specific behavior; positive reinforcers such as small amounts of food used as a reward for successful completion of a clinical task or token fines as part of a token economy system; brief physical prompts to interrupt or prevent a specific behavior; or interventions prescribed by a physician for the treatment or protection of the child;
(9) nothing in this subdivision shall preclude the use of behavior management techniques to prevent a child who is undergoing episodic behavioral or emotional disturbance from seriously injuring him/herself or others. Emergency physical interventions may be used to prevent a child from seriously injuring him/herself or others. Such interventions, which shall not include mechanical restraints, shall be used only in situations in which alternative procedures and methods not involving the use of physical force cannot reasonably be employed to prevent or minimize injury and shall only be used for as long as the duration of the incident. Emergency physical interventions shall not be used as a punishment or as a substitute for systematic behavioral interventions that are designed to change, replace, modify or eliminate a targeted behavior. Staff who may be called upon to implement emergency physical interventions shall be provided with appropriate training in safe and effective physical restraint procedures. Emergency physical interventions shall be included in a behavior management plan that is developed by qualified personnel with appropriate expertise and documented in the child's record to address persistent, ongoing behavior which is injurious to the child or others.
(i) The behavior management plan shall be in writing and signed by the parent.
(ii) The plan shall be developed in concert with the child's family and providers of early intervention services and with parent consent and other clinical experts as needed.
(iii) The child shall be at significant physical risk (injury, malnutrition, or other physical harm).
(iv) A medical evaluation shall be conducted to address medical conditions.
(v) The plan shall be a result of a thorough assessment of cause or behavioral functions.
(vi) The plan shall include positive strategies to reduce or prevent the occurrence of the behavior including building replacement behaviors, when planned physical restraint is involved.
(vii) The plan shall be based on positive reinforcement approaches, where contingent food programs are involved.
(viii) The plan shall be implemented by appropriately trained individuals.
(ix) The parent shall have the right to revoke approval of the plan at any time, and request that a new behavior management plan be developed in accordance with the requirements of this subsection.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.333 Tuberculosis beds
Beds assigned for the care and treatment of patients suffering from tuberculosis.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.40 Procedure for applying for State aid
Applications for State aid for vector surveillance and vector control activities shall be on a form prescribed by the commissioner and shall be accompanied by a detailed, proposed plan of activity which shall include the following:
(a) an historical and chronological review of arthropod-borne disease activity in the area with evidence of any substantive endemic disease which has occurred during the past decade and to include the number of human cases (confirmed and presumptive), clustering of human cases; and/or isolations of the agents from vector species as well as the presence of vectors with a potential risk to human health;
(b) a detailed description of the geographic area where vector populations have occurred previously or where they could occur; a map of the county identifying these risk areas must be included; and
(c) methods by which vector populations or areas will be monitored.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PLUMBING PLUMBING
10 CRR-NY 14-1.140 Plumbing
(a) Plumbing is to be sized, installed and maintained to carry adequate quantities of potable hot and cold water at satisfactory pressure to all parts of the food service establishment where needed for satisfactory operation. Sewage and liquid wastes are to be carried to the sewer or sewage disposal facility in a manner which protects the premises, personnel and contents within the establishment and surroundings from contamination. All plumbing is to be constructed and maintained to prevent contamination of the potable water supply, food, equipment, utensils, the premises, contents, employees and patrons. There is to be no direct connection between the sewage system and any drains originating from fixtures and equipment used for storage, preparation or processing of food or drink. Waste lines from equipment requiring indirect drains are to be installed so as to prevent backflow from sewers and drains from other fixtures.
(b) Carbonated beverage dispensers connected to a water supply system are to be equipped with an air gap at the water inlet, or a double check valve vented to discharge carbon dioxicide gas to the atmosphere that provides positive protection against the entrance of carbon dioxide or carbonated water into the water supply system. All water contact surfaces downstream from this protective device are to be of materials that will not produce toxic substances when exposed to carbon dioxide or carbonated water.
(c) All lines conducting carbon dioxide gas or carbonated beverages are to be stainless steel, food-grade plastic or other material that will not produce toxic substances when exposed to carbon dioxide or carbonated water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-10 RATES FOR NON-STATE PROVIDERS OF RESIDENTIAL HABILITATION IN COMMUNITY RESIDENCES, INCLUDING INDIVIDUALIZED RESIDENTIAL ALTERNATIVES (IRAS) AND FOR NON-STATE PROVIDERS OF DAY HABILITATION
10 CRR-NY 86-10.9 Severability
If any provision of this Subpart or its application to any person or circumstance is held to be invalid, the remainder of this Subpart and the application of that provision to other persons or circumstances will not be affected.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.9 Responsibilities of health care plans
Health care plans shall be responsible for compliance with all applicable requirements of article 49 of the Public Health Law and with the following:
(a) Enrollee requests for experimental or investigational health care services that would otherwise be a covered benefit except for the health care plan's determination that the health care service is experimental or investigational shall be subject to utilization review pursuant to title I of article 49 of the Public Health Law.
(b) If a health care plan requires information necessary to conduct a standard internal appeal pursuant to section 4904 of the Public Health Law, the health care plan shall notify the enrollee and the enrollee's health care provider, in writing, within 15 days of receipt of the appeal, to identify and request the necessary information. In the event that only a portion of such necessary information is received, the health care plan shall request the missing information, in writing, within five business days of receipt of the partial information. In the case of expedited appeals, the health care plan shall immediately notify the enrollee and the enrollee's health care provider by telephone or facsimile to identify and request the necessary information, followed by written notification. The period of time to make an appeal determination under section 4904 of the Public Health Law begins upon a health care plan's receipt of necessary information.
(c) If a health care plan offers two levels of internal appeals, the health care plan may not require the enrollee to exhaust the second level of internal appeal to be eligible for an external appeal.
(d) Notices of final adverse determinations shall comply with all requirements of article 49 of the Public Health Law and with all applicable Federal laws and rules.
(e) Each notice of a final adverse determination of an expedited or standard utilization review appeal under section 4904 of the Public Health Law shall be in writing, dated and include the following:
(1) a clear statement describing the basis and clinical rationale for the denial as applicable to the enrollee;
(2) a clear statement that the notice constitutes the final adverse determination;
(3) the health care plan's contact person and his or her telephone number;
(4) the enrollee's coverage type;
(5) the name and full address of the health care plan's utilization review agent;
(6) the utilization review agent's contact person and his or her telephone number;
(7) a description of the health care service that was denied, including, as applicable and available, the dates of service, the name of the facility and/or physician proposed to provide the treatment and the developer/manufacturer of the health care service;
(8) a statement that the enrollee may be eligible for an external appeal and the time frames for requesting an appeal; and
(9) for health care plans that offer two levels of internal appeals, a clear statement written in bolded text that the 45-day time frame for requesting an external appeal begins upon receipt of the final adverse determination of the first level appeal, regardless of whether or not a second level appeal is requested, and that by choosing to request a second level internal appeal, the time may expire for the enrollee to request an external appeal.
(f) A written notice of final adverse determination concerning an expedited utilization review appeal under section 4904 of the Public Health Law shall be transmitted to the enrollee within 24 hours of the rendering of such determination.
(g) If the enrollee and the health care plan have jointly agreed to waive the internal appeal process offered by the health care plan, the information required in subdivision (e) of this section must be provided to the enrollee simultaneously with the letter agreeing to such waiver. The letter agreeing to such waiver and the information required in subdivision (e) of this section must be provided to the enrollee within 24 hours of the agreement to waive the health care plan's internal appeal process.
(h) Health care plans shall facilitate the prompt completion of external appeal requests, including but not limited to, the following:
(1) health care plans shall provide the enrollee with a copy of the standard description of the external appeal process as developed jointly by the commissioner and superintendent, including a form and instructions for requesting an external appeal along with a description of the fee, if any, charged to enrollees for an external appeal, criteria for determining eligibility for a waiver of such fees based on financial hardship, and the process for requesting a waiver of such fees based on financial hardship:
(i) simultaneous with a notice of a final adverse determination that a health care service is not medically necessary, including on the grounds that the health care service is experimental or investigational; or
(ii) simultaneous with the written confirmation of agreement between the health care plan and the enrollee to waive the health care plan's internal appeal process; and
(iii) within three business days of a request by an enrollee or an enrollee's designee;
(2) transmitting enrollee medical and treatment records pursuant to an appropriately completed release or releases signed by the enrollee or by a person authorized pursuant to law to consent to health care for the enrollee and, in the case of medical necessity appeals, transmitting the clinical standards used to determine medical necessity for health care services within three business days of receiving notification of the external appeal from the certified external appeal agent to which the subject appeal is assigned, or in the case of an expedited appeal, within 24 hours of receiving notification of the external appeal from the certified external appeal agent to which the subject appeal is assigned;
(3) providing information requested by the assigned certified external appeal agent as soon as is reasonably possible, but in no event shall the health care plan take longer than two business days to provide the requested information for standard appeals. Requests for information relative to expedited appeals must be provided to the certified external appeal agent within 24 hours; and
(4) providing a form and instructions, developed jointly by the commissioner and superintendent, for an enrollee's health care provider to request an external appeal in connection with a retrospective adverse utilization review determination under section 4904 of the Public Health Law, within three business days of a health care provider's request for a copy of the form. For retrospective adverse determinations, health care plans may charge the appealing health care provider up to $50 for each appeal, provided however, that no fee may be charged to an enrollee for a health care provider's external appeal of a retrospective adverse determination and provided further, that in the event a retrospective adverse determination is overturned on external appeal, the full amount of the fee shall be refunded to the appealing health care provider.
(i) In the event an adverse determination is overturned on external appeal, or in the event that the health care plan reverses a denial which is the subject of external appeal, the health care plan shall provide, arrange to provide or make payment for the health care service(s) which is the basis of the external appeal to the enrollee to the extent that such health care service(s) is provided while the enrollee has coverage with the health care plan. Nothing herein shall be construed to require the health care plan to provide any health care services to an individual who is no longer an enrollee of that health care plan at the time of an external appeal agent's reversal of a health care plan's utilization review denial.
(j) Health care plans shall establish the fee, if any, to be charged to enrollees for an external appeal and shall have a methodology for determining an enrollee's eligibility for a waiver of the fee requirement for an external appeal based on financial hardship pursuant to section 4910(3) of the Public Health Law and section 4910(c) of the Insurance Law.
(k) Nothing in this Subpart shall be construed to relieve the health care plan of financial responsibility for external appeals that have been assigned to a certified external appeal agent. In the case of a health care plan reversing a denial which is the subject of an external appeal after assignment of the appeal to a certified external appeal agent, but prior to assignment of clinical peer reviewer(s), the health care plan shall be assessed an administrative fee as prescribed by the commissioner and superintendent.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PERSONNEL PERSONNEL
10 CRR-NY 14-1.73 Personnel training
The permit-issuing official may establish and conduct or designate training programs and require that owners and/or operators of food service establishments attend them.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-1 GENERAL PROVISIONS
10 CRR-NY 128-1.3 Authority
These rules and regulations are promulgated pursuant to article 11 of the New York State Public Health Law by the New York State Department of Health. In addition, these rules and regulations were duly promulgated by the Commissioner of the Department of Environmental Protection of the City of New York and became effective on May 1, 1997, pursuant to article of the New York State Public Health Law and section 24-302 of the the New York City Administrative Code, as approved by the Commissioner of the New York State Department of Health.
Part 155 WESTCHESTER COUNTY
COMPANIES COMPANIES
10 CRR-NY 155.110 Salem Acres Association
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the well which comprises the source of the public water supply of the Salem Acres Association. Said well is located on land owned by the Salem Acres Association and is situated approximately on Lakeview Drive and designated 45A on Map No. Vol. 67 p 60 filed May 10, 1928.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water-softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the well.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse, except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Salem Acres Association.
(16) Well shall mean a well now used as a source of this water supply or to any additional well which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the well.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the well except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the well unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 150-foot linear distance of the well.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 150-foot linear distance of the well.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 150-foot linear distance of the well; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the well.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the well and not within a 500-foot to a 1,000-foot linear distance of the well unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the well.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of the ground within a 250-foot linear distance of the well.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the well.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 150-foot linear distance of the well.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Salem Acres Association upon which the well is located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Salem Acres Association.
(e) Inspections.
The Salem Acres Association or any person or persons charged with the maintenance or supervision of the public water supply system shall, by its officers or their duly appointed representative, make regular and thorough inspections of the area surrounding the well to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid Salem Acres Association to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid Salem Acres Association to promptly notify the State Commissioner of Health of such violations. The aforesaid Salem Acres Association shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the well at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.25 Spa pools; additional requirements
(a) Spa pools shall be operated to meet the specific requirements listed in this section, in addition to other applicable sections of this Subpart.
(b) The maximum water temperature for spa pools shall not exceed 104° F. A thermostatic control for the water shall be provided. An audible alarm system shall be installed and maintained to warn of any temperature over 104°F.
(c)
(1) The pH of water in the spa pool shall be maintained between 7.2 and 7.8, and a minimum free residual chlorine of 1.5 mg/l shall be provided. Spa pools shall be chlorinated to 10 mg/l at least once a week when the pool is not in use. A maximum of 5.0 mg/l of free chlorine residual shall be permitted during use.
(2) Where bromine is used as the disinfectant, a minimum bromine residual shall be maintained between 3 mg/l and 6 mg/l, and the pH shall be maintained between 7.2 and 7.8.
(d) Spa pools shall be drained and cleaned when needed, and at least once every two weeks.
(e) A warning sign with an area of at least three square feet, stating the six caution statements contained in section 6-1.29, item 14.13, of this Subpart, shall be conspicuously posted in the immediate vicinity of the spa pool.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 1 PUBLIC HEALTH NURSE 1
10 CRR-NY 11.40 Definition
The term public health nurse 1 shall mean a nurse who plans, provides, directs and evaluates nursing care in a variety of settings with the goal of improved health outcomes and is actively involved in the planning, development, provision and evaluation of public health programs designed to prevent disease and improve the health of individuals, families, specific populations, high risk groups and/or communities.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD SUPPLIES FOOD SUPPLIES
10 CRR-NY 14-5.31 Food; food sources; hermetically sealed foods
(a) Food furnished by vending machines or in connection with rending machine operations is to be free from adulteration, spoilage, filth or other contamination, and suitable for human consumption.
(b) Food dispensed by vending machines or in connection with vending machine operations is to be from a commissary. A commissary used to service food-vending machines is to be operated under permit and in compliance with Subpart 14-1 of this Part or operated under license or permit of an appropriate regulatory agency. Food is to be labeled in accordance with applicable laws and section 14-5.40(d) of this Subpart.
(c) Hermetically sealed foods dispensed by vending machines, or used in connection with vending machine operations, are to have been processed in commercial food-processing establishments. The use of home-canned food is prohibited.
(d) Only clean, whole eggs, with shell intact and free from cracks or checks, or pasteurized liquid, frozen or dry eggs or pasteurized dry egg products are to be used. All containers in which shell eggs are received must identify the source.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 650 DISSOLUTION OF CORPORATIONS
10 CRR-NY 650.2 Contingencies relative to approval of corporate dissolutions
If the Public Health Council approves the dissolution of the corporation, such approval shall be contingent upon the approval of the plan of dissolution and distribution of assets by a court of competent jurisdiction and the filing of a certified copy of the court order of such approval.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.13 General provisions
Provisions and standards applicable to the construction and location of all water wells, and the installation of all pumps and pumping equipment contained in Appendix 5-B, Standards for Water Wells of this Title shall be used as the basis for issuing or denying a permit.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
OPTIONAL SERVICES OPTIONAL SERVICES
10 CRR-NY 415.40 Extended care of residents with traumatic brain injury
(a) Definitions.
(1) An extended care resident with traumatic brain injury (TBI) shall mean a person who is a least three months post-injury and who has been diagnosed as having a cognitive and/or physical condition that has resulted from traumatically acquired, non-degenerative, structural brain damage, or anoxia, and who in addition:
(i) has participated in an intensive inpatient rehabilitation program for persons with TBI in a hospital or nursing home; and
(ii) has been assessed by a neurologist or physiatrist who determined that the individual would no longer benefit from an intensive rehabilitation program.
(2) TBI residents requiring extended care services may be congregated in one nursing unit or placed with residents in other nursing units, whichever best serves the resident's choice and needs.
(b) Resident care.
(1) The facility shall develop, implement and update admission, resident care, transfer and discharge policies and procedures that promote the delivery of medical, nursing and rehabilitative care services consistent with generally accepted standards of professional practice for the extended care of residents with TBI.
(2) Services shall be provided to maintain each extended care resident with TBI at his or her optimal level of physical, affective, behavioral and cognitive functioning.
(3) There shall be sufficient nursing and social work staff to work with both the extended care resident with TBI and the resident's family.
(4) Rehabilitation therapy services shall be available at the facility to meet the assessed rehabilitative needs of the extended care resident with TBI and shall be utilized to maintain or improve the present level of functioning and to prevent deterioration in the individual's physical, affective, behavioral and cognitive level of functioning.
(5) Resident care staff and other staff members who have regular contact with the extended care resident with TBI shall receive orientation and training concerned with extended care residents with TBI.
(c) Resident assessment and care planning.
Facilities that admit an extended care resident with TBI shall comply with the following:
(1) In accordance with section 415.11 of this Part, the facility shall periodically conduct comprehensive assessments of each resident's needs. For those residents who are assessed as potentially able to benefit from restorative rehabilitation therapy services, the facility shall arrange for those services or shall transfer the resident to an appropriate rehabilitation program for TBI individuals.
(2) A professionally recognized classification system for measuring each brain injured individual's physical, affective, behavioral and cognitive level of functioning shall be consistently used as part of the comprehensive resident assessment and as a basis for the development of the resident's comprehensive care plan.
(3) A physician with training and experience in caring for persons with TBI shall participate in the interdisciplinary team assessments and care planning of each resident.
(4) There shall be sufficient numbers of rehabilitation, nursing, activity, and social work staff to accommodate the needs of these residents.
(5) When potential for discharge to home or a home-like setting is identified, the facility shall initiate an active program of therapy and other supportive services designed to assist the resident and family in the transition to the new setting.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.2 Application
Persons or organizations, other than DOH regulated health care facilities, including home health care agencies, wishing to provide such course work or training to physicians, PAs, and SAs must submit an application to DOH for review and approval, on forms prescribed by the commissioner. The department may request additional information from the applicant and conduct site visits. DOH regulated health care facilities, including home health care agencies, wishing to provide such course work or training to physicians, PAs and SAs must inform the department in a manner as prescribed by the commissioner.
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.8 Disclosure
(a) Except as provided in subdivision (b) of this section or as otherwise agreed to by all parties, there shall be no disclosure, including but not limited to bills of particulars, exchanges of documents and witness lists, depositions, interrogatories, discovery and requests for documents. A hearing officer may not require disclosure. When the parties agree to any form of disclosure, the hearing officer shall ensure that all parties proceed in accordance with the agreement of the parties.
(b)
(1) If the department in a notice of hearing states its intent to seek, or states the possibility of, the revocation of a license or permit, upon the service of such notice, any party to the proceeding may demand in writing from any other party disclosure of any of the following which such other party intends to introduce at the hearing:
(i) names of witnesses; however, a summary of the testimony to be given by the witnesses shall not be required to be disclosed;
(ii) a list of documentary evidence;
(iii) photocopies of documentary evidence listed in subparagraph (ii) of this paragraph in the possession of the party upon whom the demand has been made; and
(iv) a brief description of physical or other evidence which cannot be photocopied.
(2) The demand for disclosure shall be made at least 10 days prior to the first scheduled date of hearing. At least seven days prior to the first scheduled date of hearing, the party upon whom the demand has been made shall make the disclosure described in subparagraphs (1)(i) through (iv) of this subdivision or a statement that the party does not have anything to disclose. If, after such disclosure or statement, a party determines to present witnesses or evidence not previously disclosed, the party shall disclose as soon as practicable.
(3) Upon application of any party, the hearing officer:
(i) upon good cause shown, may allow demands and responses within time periods other than those described in paragraph (2) of this subdivision;
(ii) shall allow a party not to disclose information or material protected by statutory or case law from disclosure, including information and material protected because of privilege or confidentiality;
(iii) upon good cause shown, may limit, condition or regulate the use by the party to whom disclosure is made of information or material disclosed; and
(iv) may preclude a party that unreasonably fails to respond to a timely demand for disclosure or to supplement its disclosure from introducing evidence or witnesses not disclosed.
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-3 GENERAL TECHNICAL STANDARDS FOR TISSUE BANKS
10 CRR-NY 52-3.4 Selection and testing requirements for tissue donors
(a) Except as specifically approved by the medical director of the comprehensive tissue procurement service and in conformance with generally accepted standards of practice, allogeneic tissue for clinical use shall not be released from donors with any of the following conditions:
(1) evidence of infection at the site of donation or generalized sepsis on physical examination, by history or by autopsy;
(2) except for donors of eye tissue, evidence of autoimmune disease or malignant disease;
(3) history of hepatitis B or C, or hepatitis of unknown etiology;
(4) history of a confirmed positive test or treatment for syphilis within the past 12 months;
(5) degenerative or infectious neurological disease, such as Creutzfeldt-Jacob disease, multiple sclerosis and Alzheimer's disease, or encephalitis of unknown etiology;
(6) history of receipt of pituitary-derived human growth hormone;
(7) transfusion within 48 hours, with four or more units of blood or blood components in adults, or any transfusions within 48 hours in children under 12 years of age, unless:
(i) a pretransfusion blood sample is available for testing;
(ii) a testing technology unaffected by plasma dilution and approved by the department is used for all analytes; or
(iii) plasma dilution is determined to be insufficient to alter test results, according to an algorithm submitted to and approved by the department;
(8) history of behavior or factors which place the donor at high risk for human immunodificiency virus (HIV) infection, including:
(i) nontherapeutic injected drug use within the preceding five years;
(ii) men who have engaged in anal intercourse or oral sex with another man at any time within the preceding five years;
(iii) recipients of factor VIII or factor IX concentrate which was not heat-treated or otherwise virally inactivated;
(iv) individuals with evidence of HIV infection;
(v) individuals who have engaged in other behavior determined as high risk for HIV infection by the United States Public Health Service (USPHS);
(vi) individuals who have been inmates of correctional facilities for 72 consecutive hours or longer within the preceding 12 months;
(vii) individuals who, within the preceding 12 months, have been heterosexual partners of HIV-positive individuals or of individuals who fit within any of the above categories; and
(viii) men and women who have engaged in prostitution at any time within the preceding five years, and individuals who have been their heterosexual partners within the past 12 months;
(9) except for donors of eye tissue, significant exposure to a substance that may be transferred in toxic doses, such as lead, mercury and gold;
(10) acquisition, within the previous 12 months, of a tattoo or other skin piercing in which shared instruments which were not sterilized between uses are known to have been used;
(11) within the preceding six months, receipt of a bite from an animal suspect of rabies; and
(12) for living donors, receipt of a blood transfusion within the preceding 12 months.
(b) Individuals with suspected rabies or evidence of HIV infection shall not be accepted as donors under any circumstances.
(c) All required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state tissue acquisitions by New York State- licensed banks, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulatory authority, the United States Health Care Financing Administration or by the department.
(1) Blood samples from all allogeneic donors of tissue for clinical use, except oocyte donors tested in accordance with section 52-8.6(h) of this Part shall be tested for evidence of infection with HIV-1, HIV-2, hepatitis B virus (HBV), including hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) and, except for donors of eye tissue or tissue to be virally inactivated, human T-lymphotropic virus type I (HTLV-I), for purposes of donor selection. If available, aliquots of residual serum or plasma shall be frozen for retrospective testing of donors in the event that new or improved tests become available prior to the distribution of donated tissue.
(2) All laboratory testing and donor medical history reports shall be reviewed and approved by the medical director or by the medical director's designee, according to criteria determined by the medical director, prior to release of tissue for distribution.
(3) Results of required testing shall be affixed to the final tissue product container or included in a product circular for tissue intended for clinical use.
(4) Except in a life-threatening emergency documented and approved by the medical director and the director of the tissue transplantation service using the tissue, tissue shall not be made available for clinical use unless the donor's blood reacts negatively to approved tests for HIV-1, HIV-2, HBsAg, HCV and, except for eye tissue or tissue to be subjected to viral inactivation, HTLV-I.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.335 Unrealized revenue
Revenue attributable to a completed business transaction but accompanied by the receipt of an asset other than cash or other form of current asset; as, an installment sale (gross revenue) or the prospective profit from such a sale (net revenue).
Subchapter B HOSPITAL ESTABLISHMENT
Part 670 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY ESTABLISHMENT
10 CRR-NY 670.1 Determination of public need pursuant to section 2801-a(3) of the Public Health Law
(a) The factors for determining public need for the establishment of medical facilities shall include, but not be limited to:
(1) the current and projected population characteristics of the service area, including relevant health status indicators and socioeconomic conditions of the population;
(2) normative criteria for age and sex specific utilization rates to correct for unnecessary utilization of medical facilities and health services;
(3) standards for facility and service utilization, comparing actual utilization to capacity, taking into consideration fluctuation of daily census for certain services, the geography of the service area, size of units, and specialized service networks;
(4) the patterns of in and out migration for specific services and patient preference or origin;
(5) the need that the population served or to be served has for the services proposed to be offered or expanded, and the extent to which all residents in the area, and in particular low income persons, racial or ethnic minorities, women, handicapped persons, and other underserved groups and the elderly, will have access to those services;
(6) in cases involving the reduction or elimination of a service, including those involving the relocation of a facility or service, the extent to which need will be met adequately and the effect of the reduction, elimination, or relocation of the service or facility on the ability of low income persons, racial and ethnic minorities, women, handicapped persons, and other underserved groups, and the elderly, to obtain needed health care;
(7) the contribution of the proposed service or facility in meeting the health needs of members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to health services (for example, low income persons, racial and ethnic minorities, women, and handicapped persons), particularly for those whose needs are identified in the medical facilities plan. For the purpose of determining the extent to which the proposed service or facility will be accessible to such persons, the following shall be considered:
(i) the extent to which medically underserved populations currently use the applicant's services in comparison to the percentage of the population in the applicant's service area which is medically underserved, and the extent to which medically underserved populations are expected to use the proposed services if approved;
(ii) the performance of the applicant in meeting its obligations under applicable civil rights statutes prohibiting discrimination on the basis of race, color, national origin, handicap, sex, and age;
(iii) the extent to which Medicare, Medicaid and medically indigent patients are or will be served by the applicant; and
(iv) the extent to which the applicant offers a range of means by which a person will have access to its services.
(b) The evaluative procedure for review of public need pursuant to section 2801-a(3) of the Public Health Law shall include, but not be limited to:
(1) description of proposal as submitted by applicant for establishment;
(2) identification of use rates in the service area for the type(s) of facility(s) and service(s) involved;
(3) identification of current and projected user population of the service area;
(4) identification of resulting estimate of future quantitative need as projected for a period of five years from last complete calendar year reported;
(5) identification of existing facility(s) and service(s), which are the same as those proposed by the applicant available in the service area;
(6) identification of existing facility(s) and service(s), which are the same as those proposed by the applicant, which will be available to meet future need in the service area;
(7) identification of facility(s) and service(s), which are the same as those proposed by the applicant and which have been approved for establishment and/or construction but are not in operation in the service area;
(8) identification of resulting resource(s) available in service area five years in future to meet need;
(9) identification of percent of need met for proposed facility(s) and service(s);
(10) description of the current utilization for all facility(s) and service(s) which are the same as those proposed by applicant in the service area;
(11) description of the current utilization for allied or alternate facilities and services in the service area;
(12) description of any migration patterns for health care in the service area;
(13) description of any evidence of inappropriateness of placement in the service area for the subject facility(s), service(s) and related service(s); and
(14) description of the distribution of facility(s) and service(s) in relation to the population's distribution.
(c) The public need analysis for each proposal will include a determination of the appropriate service area. The factors to be considered by the Public Health Council for determining the appropriate service area shall include, but not be limited to, the substantive criteria set forth in subdivision (c) of section 709.1 of this Chapter.
(d) Any application for establishment wherein a determination of public need is made pursuant to this section shall be subject to the following:
(1) The Public Health Council may, during the processing of an application, propose to disapprove the application solely on the basis of a determination of public need in advance of its consideration of the other review criteria required by Public Health Law, section 2801-a(3) without, however, waiving its right to consider such other criteria at a later date.
(2) In the event the Public Health Council proposes to disapprove an application on the basis of a lack of public need and the applicant requests a hearing, the Public Health Council may direct the completion of the other reviews required by Public Health Law, section 2801-a(3). The application shall then be returned to the Public Health Council to consider such reviews, the results of which may then be included as grounds for the proposed disapproval to be considered at the hearing. If the Public Health Council directs the completion of such reviews, a copy of the report containing the results of the reviews shall be mailed to the applicant at least 60 days prior to the date set for hearing.
(3) In the processing of an application, the commissioner may recommend disapproval based on a review limited to a determination of public need. In the event the Public Health Council does not concur with the commissioner's recommendation of disapproval, it shall return the application to the department at which time all other reviews required by Public Health Law, section 2801-a(3) shall be completed. At such time as all reviews are completed, the application shall be returned to the Public Health Council for action.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 117 GENESEE COUNTY
10 CRR-NY 117.1 Village of LeRoy (Little Beard Creek)
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all natural and artificial reservoirs on Little Beard Creek and to all watercourses and drainage areas tributary thereto or ultimately discharging into said reservoirs, such bodies of water being sources of the public water supply of the village of LeRoy, Genesee County, N.Y.
(b) Definitions.
(1) The term reservoir wherever used in this section is intended to mean and refer to all impounding and storage reservoirs on Little Beard Creek which are tributary to or serve as a source of the aforesaid public water supply and to any additional reservoirs which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than artificial reservoirs or filter basins), stream, ditch, gutter or channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flows or may flow into the aforesaid reservoirs forming part of the public water supply of the village of LeRoy.
(3) Whenever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(3) No cesspool, pit or other recptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacle thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal, the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified, and that the contents while being transferred from the privy to the place of disposal shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse tributary to the public water supply of the village of LeRoy, nor shall any such liquid or solid matter be thrown, placed, led, conducted, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface (except into watertight receptacles or removable containers, the contents of which are to be removed as provided by paragraph [4] of subdivision [c]) within 200 feet of any reservoir or 75 feet of any watercourse tributary to the public water supply of the village of LeRoy.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or any watercourse tributary to the public water [ continued ] supply of the village of LeRoy, nor shall any such liquid or solid refuse or waste matter be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight receptables or removable containers, the contents of which are to be removed as provided by paragraph [4] of subdivision [c]) within 100 feet of any reservoir or 50 feet of any watercourse tributary to the public water supply of the village of LeRoy.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in, and no animal or poultry shall be allowed to stand, wallow, wade or swim nor be washed or watered in any reservoir tributary to the public water supply of the village of LeRoy. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matter any watercourse tributary to the public water supply of the village of LeRoy.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 50 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of LeRoy nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 50 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 50 feet before entering any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply of the village of LeRoy.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of LeRoy.
(j) Inspections.
The board of water and light commissioners of the village of LeRoy shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with and it shall be the duty of said board of water and light commissoners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water and light commissioners to promptly notify the State Commissioner of Health of such violations. The board of water and light commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-4.190 Permits; application, issuance, inspection
(a) A valid permit issued by the permit-issuing official having jurisdiction is required for lawful operation of a mobile food service establishment or pushcart. This permit is to be prominently displayed where it can be seen by the consumer. At establishments that serve retail frozen desserts the $25 permit fee imposed by Public Health Law, section 225(5)(s) shall be paid at the time any other permit fees related to the operation of the food service establishment are collected by the permit-issuing official and the establishment's permit shall indicate that the facility can manufacture and sell retail frozen desserts.
(b) The term permit-issuing official means the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or area director having jurisdiction, a grade I or grade II public health administrator qualified and appointed pursuant to Part 11 of this Title, a public health director or any county health director having all the powers and duties prescribed in section 352 of the Public Health Law. The health commissioner or health officer of a city of 50,000 population or over, or the health commissioner or health officer of a county or part-county health district, or such grade I or grade II public health administrator or public health director or county health director may designate the director of environmental health of such district; and the State regional health director, or area director may designate the district director as additional persons authorized to issue the permits required by this Subpart.
(c) Not less than 21 days before starting operation, an application for a permit is to be submitted to the permit-issuing official having jurisdiction. This application is to be completed in full on forms acceptable to the permit-issuing official. This application is to include a complete list of all food which will be served. The permit, when issued, will be valid only for service of the items of food listed thereon.
(d) A permit will be issued subject to the mobile food service establishment or pushcart being constructed, maintained and operated in compliance with this Subpart and not presenting a danger to the health of the consumer or to the public. An applicant's past history of compliance or noncompliance will be a consideration in evaluating each of the previously mentioned criteria. The condition of the mobile food service establishment or pushcart, its equipment, utensils, personnel, mode of operation, surroundings, water supply, sewage disposal, waste handling, furnishings, food and appurtenances are all factors in determining whether its continued operation may affect public health. After reviewing the application and, in the case of a mobile food service establishment making a preliminary inspection, a permit may be issued or the operator advised of reasons prohibiting issuance of such a permit by the permit-issuing official.
(e) It is unlawful for a mobile food service establishment or pushcart to operate without a permit during the 21 days from the time a permit has been requested. In the event the permit-issuing official or his designated representative does not make an inspection of the mobile food service establishment or pushcart during this 21-day period, operations may commence without a permit on the 22nd day and may be continued without being in violation of this Subpart until such time as the permit-issuing official or his designated representative makes an inspection and issues a permit or issues an order to cease operation for cause.
(f) The designated representative of the permit-issuing official is a person authorized to perform inspections of mobile food service establishments or pushcarts on behalf of the permit-issuing official. Persons authorized to make inspections are to complete required inspection report forms and to take mandated enforcement actions required by this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.34 Pharmacy
This functional reporting center must contain all the expenses associated with the procurement, preservation, storage, compounding, manufacturing, packaging, controlling, assaying and dispensing of medications (including intravenous solutions) for in- and out-patients carried out under the jurisdiction of a licensed pharmacist. This functional reporting center should include the cost of drugs charged to patients and the cost of non-billable floor stock distributed to the various departments. Additional activities include but are not limited to the following: developing and maintaining formularies established by the medical staff; consulting and advising medical staff and nursing staff on drug therapy overdoses; adding drugs to I.V. solutions; analyzing incompatibility of drug combinations; and stocking of floor drugs and dispensing machines.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.19 Effective date
This Part shall take effect as provided in article 8 of the Environmental Conservation Law.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH ENGINEER PUBLIC HEALTH ENGINEER
10 CRR-NY 11.100 Definition
The term public health engineer shall mean a person who applies engineering principles for the detection, evaluation, control and management of those factors in the environment which influence the public's health.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE SITE DEVELOPMENT, CONSTRUCTION AND MAINTENANCE
10 CRR-NY 6-2.12 Garbage; refuse
Adequate and sanitary facilities shall be provided for the storage and disposal of garbage and refuse. Sanitary methods shall be used for the collection, temporary storage, handling and disposal of garbage and refuse.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH
10 CRR-NY 40-2.54 Individual water and sewage systems; performance standards
The local health department shall, at a minimum, maintain a program for providing technical assistance to property owners regarding the installation, maintenance and operation of individual water supplies and individual sewage systems.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-13 RATES FOR NON-STATE PROVIDERS OF PREVOCATIONAL SERVICES (SITE-BASED) AND RESPITE (HOURLY AND FREE-STANDING), AND FEES FOR PREVOCATIONAL SERVICES (COMMUNITY-BASED), RESIDENTIAL HABILITATION (FAMILY CARE) AND SUPPORTED EMPLOYMENT
10 CRR-NY 86-13.1 Applicability
On and after July 1, 2015, rates of reimbursement for prevocational services (site based) and respite (hourly and free-standing) and fees for prevocational services (community-based), residential habilitation (family care) and supported employment, other than those provided by the Office for People With Developmental Disabilities, shall be determined in accordance with this Subpart.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.2 Convenience standards for certain cities and counties
(a) Authorized drug take back programs must offer a minimum number of collection receptacles in cities and certain counties with a population of 125,000 or more, according to the following convenience standards:
(1) For the City of Buffalo: at least one on-site collection receptacle per 10,000 population.
(2) For the City of Rochester: at least one on-site collection receptacle per 10,000 population.
(3) For the City of Syracuse: at least one on-site collection receptacle per 10,000 population.
(4) For the City of Yonkers: at least one on-site collection receptacle per 10,000 population.
(5) For New York County: at least one on-site collection receptacle per 10,000 population.
(6) For Richmond County: at least one on-site collection receptacle per 10,000 population.
(7) For Queens County: at least one on-site collection receptacle per 15,000 population.
(8) For Kings County: at least one on-site collection receptacle per 20,000 population.
(9) For Bronx County: at least one on-site collection receptacle per 20,000 population.
(b) On-site collection receptacles shall be evenly distributed throughout the above cities and counties with regard to geography and population density, as approved by the commissioner. Collection receptacles maintained by law enforcement agencies in each of the above jurisdictions shall be eligible for inclusion to meet the applicable convenience standard.
(c)
(1) If a pharmacy with an on-site collection receptacle permanently closes or relocates, or if a law enforcement agency relocates or discontinues its maintenance of a collection receptacle, such that a convenience standard is no longer met, the operator of the drug take back program responsible for the relocated or discontinued collection receptacle shall be required to add an on-site collection receptacle to another pharmacy or law enforcement agency in a manner consistent with this Subpart and appropriate to ensure the applicable convenience standard continues to be met.
(2) The operator shall have 90 days from the date of discontinuance or relocation of the collection receptacle to meet the convenience standard by adding the new collection receptacle.
(3) The operator shall have 15 days from the addition of the new collection receptacle to provide written notice to the department of the change. Such notice shall provide the location of the original collection receptacle and the date of its discontinuance or relocation; the location of the new collection receptacle and the date of its availability to the public; and an affirmation that the operator’s drug take back program continues to meet the applicable convenience standard.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.2 Definitions
(a) Bathing beach shall mean a bathing place, together with any buildings and appurtenances, and the water and land areas used in connection therewith, at a pond, lake, stream or other body of fresh or salt water which is used for bathing or swimming with the express or implied permission or consent of the owner or lessee of the premises or which is operated for a fee or any other consideration or which is openly advertised as a place for bathing or swimming.
(b) Sanitary survey shall mean a survey and an evaluation of the contributory watershed and bathing area for existing and potential sources of pollution and safety hazards, including but not limited to soil conditions, underwater topography, water movement, submerged and other hazardous objects, water depth in diving area; seasonal or anticipated water level variations, and water quality.
(c) Permit-issuing official shall mean the State Commissioner of Health, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, the State regional health director or district director having jurisdiction, or any county public health director having all the powers and duties prescribed in section 352 of the Public Health Law. The permit-issuing official may designate additional persons to act in his behalf to issue permits required by this Subpart.
(d) Bathing shall mean to become partially or totally immersed in water and shall include swimming, wading and diving, but shall exclude fishing, scuba diving and surfboarding.
(e) Adequate shall mean sufficient to accomplish the purpose for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Subpart.
(f) Uniform Code shall mean the New York State Uniform Fire Prevention and Building Code, 9 NYCRR Subtitle S, Chapter 1.
(g) Aquatic supervisory staff shall mean, effective May 15, 1993, an individual possessing the qualifications, as found in section 6-2.20 of this Subpart, for Supervision Level I, II, III, or IV.
(h) Effective May 15, 1993, supervising lifeguard shall mean an individual, at least 18 years of age, who possesses as minimum qualifications Supervision Level IIb, and has at least two seasons of adequate lifeguarding experience.
(i) Public Access Defibrillation (PAD) Program shall mean a program that complies with section 3000-b of the Public Health Law, including the availability of an automated external defibrillator, the identification of an emergency health care provider, the development of a collaborative agreement and successful staff completion of training in the operation of an automated external defibrillator.
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.1 Applicability
The provisions of sections 5-6.2 through 5-6.18 of this Subpart shall apply to bottled and bulk water produced, used and/or sold in New York State.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.37 Average length of stay
The average number of days of service rendered to each inpatient discharged during a given period.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES CONTINUING STAY REVIEWS IN RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 85.16 Review of adverse finding
(a) A nurse reviewer at the area office of the Office of Health Systems Management shall be assigned to review the information forwarded by the utilization review agent, and determine whether all relevant factors were considered in arriving at the adverse finding.
(b) The nurse reviewer may send the case back to the facility for appropriate corrections if the information on the patient review forms (PRI and SCREEN) is not internally consistent, or if the information on the forms is not legible, or if the forms are not fully completed or signed by authorized individuals, or if the information provided is otherwise unacceptable.
(c) If the patient's or resident's attending physician has not supplied the utilization review agent with information concerning the patient's or resident's current clinical status and the patient's or resident's ability to accept transfer, the nurse reviewer shall contact the attending physician and obtain this information.
(d) If the nurse reviewer finds that all written information is acceptable, the reviewer shall contact the facility administrator to schedule an onsite visit. Upon the onsite visit, the nurse reviewer shall:
(1) compare the patient review forms with the patient's or resident's medical record or chart to ensure that the form is reflective of the patient's or resident's current medical condition;
(2) discuss the appropriateness of the adverse finding, including the patient's or resident's physical and psychological response to transfer with the social worker, attending nurse, attending physician and other facility staff directly involved in providing care to the patient or resident;
(3) observe the patient's or resident's physical and emotional condition; and
(4) request the patient's or resident's attending physician to clinically examine the patient or resident if his medical record is not up to date.
(e) If the nurse reviewer believes the transfer is not medically safe and not in the best interest of the patient or resident, and that the proposed transfer is not suited to the particular needs of the patient or resident, then the nurse reviewer shall refer the case back to the Office of Health Systems Management's area office for physician review and certification, indicating whether continued stay at the current level of care is appropriate. If the Office of Health Systems Management's physician certifies that the current level of care is appropriate, the residential health care facility will be notified of this certification.
(f) If the nurse reviewer agrees with the adverse finding, or the Office of Health Systems Management physician upholds the adverse finding as cited in subdivision (e) of this section, the nurse reviewer shall contact the patient or resident and advise him that a recommendation of transfer has been made, and shall determine whether the patient or resident voluntarily agrees to the transfer. If the patient or resident is unable to consent to the transfer because of confusion or impaired judgment, it will be presumed that the patient or resident has not voluntarily agreed to the transfer.
(1) If the patient or resident voluntarily agrees to the transfer, the decision of the utilization review agent shall stand, and the case shall be referred to the Office of Health Systems Management's area office for physician review and certification that he concurs with the adverse finding.
(2) If the patient or resident does not voluntarily agree to the transfer, except that the patient or resident agrees to be transferred to a specific facility or facilities, the decision of the utilization review agent shall stand upon condition that the patient or resident can only be transferred to the specified facility or facilities.
(3) If the patient or resident does not voluntarily agree to the transfer, and the patient or resident is a resident of a multi-level facility and can be transferred within the facility to a lower level of care in accordance with the utilization review agent decision, the decision of the utilization review agent shall stand upon condition that the patient or resident can only be transferred within the multi-level facility.
(4) If the patient or resident does not voluntarily agree to the transfer, and the patient or resident is not a resident of a multi-level facility, the case shall be referred to the Office of Health Systems Management's area office for physician review and certification that continued stay at that level of care is approved.
(g) If the patient or resident voluntarily agrees to the transfer, a dated, written and signed statement shall be obtained from the patient or resident, describing the specific transfer consented to and reciting that the patient or resident understands that the transfer will not be required without his consent. This statement shall also be signed by the nurse reviewer who shall certify that the patient or resident understood and voluntarily signed the statement, and that the patient or resident is not unable to consent to the transfer because of confusion or impaired judgment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.125 FASB
Financial Accounting Standards Board.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.2 Construction
Terms not defined in this Subpart are defined in Subpart 52-1 of this Part. Eye banks shall apply for licensure and otherwise comply with Subpart 52-2 of this Part, and shall meet all general technical standards for tissue banks specified in Subpart 52-3 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.155 Gift
Any voluntary conveyance of assets gratuitously made and not in consideration of any kind of exchange.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.12 Other remedies
The remedies provided in sections 85.1 through 85.11 of this Part shall not be exclusive but shall be cumulative and in addition to existing remedies or remedies hereafter provided by law.
Chapter I STATE SANITARY CODE
Part 23 SEXUALLY TRANSMISSIBLE DISEASES (STD)
10 CRR-NY 23.2 Treatment facilities
Each health district shall provide adequate facilities either directly or through contract for the diagnosis and treatment, including prevention services, of persons living within its jurisdiction who are infected or at risk of being infected with an STD as specified in section 23.1 of this Part.
(a) Such persons shall be examined and shall have appropriate laboratory specimens taken and laboratory tests performed for those diseases designated in this Part as STDs for which such person exhibits symptoms or is otherwise suspected of being infected.
(b) The examinations and laboratory tests shall be conducted in accordance with accepted medical procedures as described in the most recent evidence-based STD guidelines distributed by the New York State Department of Health.
(c) Any persons diagnosed as having any of the STDs in Group A in section 23.1 of this Part shall be treated directly in the facility with appropriate medication in accordance with accepted medical procedures as described in the most recent evidence-based STD guidelines distributed by the department.
(d) Any persons diagnosed as having any of the STDs in Group B in section 23.1 of this Part must be provided treatment either directly in the facility referred to in this section or through a written or electronic prescription or referral.
(e) Any person diagnosed as having the STD in Group C in section 23.1 of this Part may be managed by immediate referral or if outpatient treatment is appropriate as indicated by evidence-based STD guidelines, the person may be treated directly in the facility.
(f) Any person diagnosed as having any of the STDs in Group D in section 23.1 of this Part may be provided treatment directly within the facility referred to in this section or through a written or electronic prescription.
(g) Health districts shall seek third party reimbursement for these services to the greatest extent practicable; provided, however, that no board of health, local health officer, or other municipal health officer shall request or require that such coverage or indemnification be utilized as a condition of providing diagnosis or treatment services. Health care providers that are permitted by the patient to utilize such coverage or indemnification may disclose information to third party reimbursers or their agents to the extent necessary to reimburse health care providers for health services.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.62 Use of controlled substances in treatment
(a) Physicians and other authorized practitioners in the course of their professional practice, may dispense, administer or prescribe controlled substances for legitimate medical purposes or treatment, other than treatment for addiction to controlled substances, when the practitioner regulates the dosage and prescribes or administers a quantity of such drugs no greater than that ordinarily recognized by members of his profession as sufficient for proper treatment in a given case.
(b) Such practitioners shall maintain a written patient record of administration, dispensing and prescription of all controlled substances. The patient record shall contain sufficient information to justify the diagnosis and warrant the treatment. The record shall contain at least the following information: patient identification data; chief complaint; present illness; physical examination as indicated; diagnosis; other data which support the diagnosis or treatment; and the regimen including the amount, strength, and directions for use of the controlled substance. This subdivision shall not be construed to require a record distinct from the medical record of the patient.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
INSECT AND RODENT CONTROL INSECT AND RODENT CONTROL
10 CRR-NY 14-1.160 Insect and rodent control
The premises are to be free of insects, rodents, harborage, and insect or rodent breeding conditions. Openings to the outside are to be protected against the entrance of insects and rodents. Pesticides are not to be used in place of or as a substitute for proper sanitation.
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
MEDICAL DIRECTOR OF COUNTY CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS SUPPORT SERVICES PROGRAMS MEDICAL DIRECTOR OF COUNTY CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS SUPPORT SERVICES PROGRAMS
10 CRR-NY 11.16 Qualifications
The medical director of a county children and youth with special health care needs support services program shall be a physician who is currently registered to practice medicine in New York State.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.5 Designation of CPA
(a) Every MCO that files an annual audited financial report shall inform the commissioner in writing of the name and address of the CPA retained to conduct the annual audit set forth in this Subpart. The MCO shall provide the name, address, telephone number and email address of its CPA to the commissioner by March 1, 2015, and except as otherwise provided in this section, provide updated information within 60 days of any change in CPA thereafter.
(b) The MCO shall obtain a letter from the CPA, and file a copy with the commissioner, stating that the CPA is aware of the provisions of the insurance law and the regulations thereunder of the state of domicile that relate to accounting and financial matters and affirming that the CPA will express his or her opinion on the financial statements in terms of their conformity to the statutory accounting practices prescribed or otherwise permitted by the Department of Financial Services, specifying such exceptions as the CPA may believe appropriate.
(c) If the CPA is dismissed or resigns:
(1) The MCO shall notify the commissioner within five business days of the event.
(2) The MCO shall submit a letter to the commissioner within 15 business days of the event stating whether there were any disagreements at the decision-making level with the former CPA within the previous two years (whether or not resolved to the CPA’s satisfaction) on any matter of accounting principles or practices, financial statement disclosure, or auditing scope or procedure that might or could have been referenced in the CPA’s opinion attached to the audited financial report and detailing with specificity the nature and extent of any such disagreements.
(3) The MCO shall submit, with the letter required by paragraph (2) of this subdivision, a letter from the former CPA to the commissioner stating whether the CPA agrees with the statements contained in the MCO’s letter and, if not, stating the reasons for which the CPA does not agree.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.6 Functions
(a) Health systems agencies shall conduct regional health planning for the purposes of:
(1) improving the health of residents of a health service area;
(2) improving the availability, accessibility, continuity, quality, effectiveness and efficiency of the health services provided;
(3) controlling unnecessary increases in the cost of providing health services;
(4) preventing unnecessary duplication of health resources; and
(5) promoting of the development of health services, manpower, and facilities which meet identified needs, reduce inefficiencies, respond to local health planning priorities and implement the health plans of the agency.
(b) A health systems agency shall perform the following functions on behalf of the State based upon available resources:
(1) assess the health status and health service needs of the population in the health service area, with attention to variations by location, socio-economic category, ethnicity, environment, age and disability and prepare and submit to the commissioner a comprehensive regional health plan which identifies priorities, goals, and implementation strategies for the health care system of the health service area;
(2) convene multiprovider and consumer planning groups for the purpose of identifying unmet needs affecting health status and to examine, at the community level, and report to the appropriate state agency, ways to develop primary and preventive services to meet those needs;
(3) assess health facility construction needs and submit to the commissioner, in a mutually agreed upon format and time frame, priority rankings of the capital expenditure and health service needs identified in its health service area;
(4) convene multifacility planning groups for the purpose of health facilities planning pursuant to Part 710 of Subchapter C of Chapter V of this Title in order to assist the commissioner to identify excess capacity, duplications, and unmet needs for health facilities, equipment, and services;
(5) convene providers of health care for the purpose of developing and implementing plans subject to approval by the appropriate state agency which respond to unmet needs and/or improve the allocation and distribution of health care services;
(6) assist appropriate state agencies, the Public Health Council, the State Hospital Review and Planning Council and appropriate councils under the Mental Hygiene Law in the development of standards and guidelines to determine public need for hospital and other health, including mental health services;
(7) coordinate its activities with other appropriate general or special purpose regional health and human services planning or administrative agencies including area agencies on aging, local and regional alcohol abuse, drug abuse, and mental health planning agencies, social services agencies, county public health departments, and local health officers. The health systems agency shall, as appropriate, obtain data from such other agencies for use in the health systems agency's planning and development activities, enter into agreements with such other agencies, and to the extent practicable, provide technical assistance to such other agencies;
(8) review and comment on the standards, criteria, findings, and recommendations proposed by the Department of Health concerning the appropriateness of selected health services in the health service area; and
(9) conduct public hearings related to applications for the establishment or construction of a hospital as defined in article 28 of the Public Health Law, the certification of home health agencies and the authorization to provide a long term home health care program as defined in article 36 of the Public Health Law, the establishment or construction of a hospice as defined in article 40 of the Public Health Law, and the establishment or construction of mental hygiene services and facilities other than community residences as defined in section 1.03(6) and pursuant to article 31 of the Mental Hygiene Law;
(10) recommend to the commissioner and to the Public Health Council as appropriate approval or disapproval of applications for the establishment or construction of a hospital as defined in article 28 of the Public Health Law, the certification of home health agencies and the authorization to provide a long term home health care program as defined in article 36 of the Public Health Law, the establishment or construction of a hospice as defined in article 40 of the Public Health Law;
(11) recommend to the appropriate state agency approval or disapproval of applications for the establishment or construction of mental hygiene services and facilities other than community residences as defined in section 1.03(6) and pursuant to article 31 of the Mental Hygiene Law;
(12) perform and issue special reports and engage in other planning and implementation activities at the request of the commissioner (or other appropriate state agency), such reports may be related to:
(i) the health status (and its determinants) of the residents of the health service area;
(ii) the status of the health care delivery system in the area and the use of that system by the residents of the area;
(iii) the effect the area's health care delivery system has on the health of the residents of the area;
(iv) the number, type, and location of the area's health resources including health services, manpower, and facilities; and
(v) the patterns of utilization of the area's health resources.
(c) The commissioner shall, in consultation with the health systems agencies, determine what specialized plans and reports are required as well as the time frame and format for the development of such plans and reports.
(d) In addition to the functions described in section 82-1.6(b) of this Subpart, a health systems agency, to carry out its purposes, functions, and activities as described in section 82-1.6(a) of this Subpart, may enter into agreements or contracts with and receive grant funds, contributions or donations from various entities interested in fostering the health planning goals and objectives of this subsection. A health systems agency may enter into agreements and contracts with and receive grant funds, contributions or donations from such entities as:
(1) local, county, and state government;
(2) not-for-profit organizations exempt from taxation pursuant to section 501(c)(3) of title 26 of the United States Code, private industry, insurers of health services, and other organizations, excluding, however, any such entities that are providers of health care operating facilities licensed or certified pursuant to the Public Health Law or Mental Hygiene Law except as may be authorized in accordance with paragraph (e)(1) of this section; and
(3) associations of health facilities or associations of providers of health care.
(e)
(1) A health systems agency shall not engage in any fee for service activity with a provider or potential provider of health care services except local government without prior approval of the State Hospital Review and Planning Council. Approval shall be issued or denied in a timely manner.
(2) The governing body of a health systems agency shall be responsible for developing and periodically revising policies and procedures, governing the agency's ability to sell resources and engage in fee for service activities or other contractual arrangements. Such policies and procedures shall be submitted to the State Hospital Review and Planning Council for review.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.17 Pharmaceutical services
The operator must:
(a) develop and implement written policies and procedures governing medications brought to the program site by registrants;
(b) ensure that pharmaceutical services, when provided for registrants, are in conformance with section 415.18 of this Subchapter, exclusive of the requirements of section 415.18(c);
(c) ensure that each registrant's drug regimen is reviewed at least once every six months by a registered pharmacist in accordance with the registrant's care plan and otherwise modified as needed following consultation with the registrant's attending practitioner. Any modification to the drug regimen must be documented in the registrant's clinical record and included as a revision to the registrant's care plan; and
(d) ensure that written policies and procedures require the pharmacist to report any irregularity in a registrant's drug regimen and recommendations to the registrant's attending practitioner and to the program coordinator, with appropriate documentation in the registrant's clinical record and care plan.
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.6 Criminal history record check process
(a) The provider shall ensure the submission of a request for a criminal history record check for each prospective employee. If a permanent record does not exist for the prospective employee, the department shall be authorized to request and receive criminal history information from the division concerning the prospective employee in accordance with the provisions of section 845-b of the Executive Law. Access to and the use of such information shall be governed by the provisions of such section of the Executive Law. The division is authorized to submit fingerprints to the FBI for a national criminal history record check.
(b) A provider requesting a criminal history record check pursuant to this Part shall do so by completing and submitting a form developed and provided by the department after consultation with the division and transmitting two sets of fingerprints to the department. An authorized person, and only an authorized person, shall complete such form and shall submit the original with the authorized person's signature (not a facsimile signature) and two sets of fingerprints to the department not more than 10 days (excluding Saturdays, Sundays and legal holidays) after taking the fingerprints of the prospective employee. The department shall maintain such form, in the form and format prescribed by the department, which:
(1) identifies the name of each person for whom the provider requests a criminal record check, and attests that each such person is a prospective employee of the provider, and, as such, the person is a subject individual, as defined in this Part;
(2) identifies the specific duties of the subject individual which qualify the provider to request a check of the subject individual's criminal history information;
(3) attests that the results of the criminal history record check will be used by the provider solely for the purposes authorized by law; and
(4) attests that the provider, its agents, and employees are aware of and will abide by the confidentiality requirements and all other provisions of Public Health Law article 28-E and Executive Law section 845-b, as they may from time to time be amended.
(c)
(1) In obtaining fingerprints as required by this Part, the provider shall require that the prospective employee present two forms of identification. One form shall be a government-issued identification containing the prospective employee's signature. Examples of such identification are a valid driver's license or a Department of Motor Vehicle ID, a current passport, valid military identification or valid school identification. At least one of the two forms of identification shall have a photograph of the prospective employee.
(2) If an external entity is used by the provider to obtain fingerprints, the provider shall ensure that the external entity shall require two of the forms of identification listed in paragraph (1) of this subdivision and that the external entity completes its part of the department form and returns the fingerprints and the department form required by this section only to the provider.
(3) If a fingerprint form is rejected by the division or the FBI the provider shall resubmit new prints within 14 days of notice from the department of the rejection.
(d) A provider may temporarily approve a prospective employee while the results of the criminal history record check are pending. The provider shall implement the supervision requirements identified in section 402.4 of this Part, applicable to the provider, during the period of temporary employment.
(e) For subject individuals who have had a previous criminal history record check and determination issued by the department, or for whom a criminal history record check has been submitted to the department and a determination is pending, the provider shall submit a request for an expedited review in lieu of a regular submission provided for in this Part in the form, format and manner required by the department. If the department finds that an expedited request is not warranted, the department will inform the authorized party that a regular submission is required, including fingerprints, so that a new criminal history record check can be conducted.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION EQUIPMENT AND UTENSIL CLEANING AND SANITIZATION
10 CRR-NY 14-5.114 Wiping cloths
(a) Moist cloths used for wiping food-contact surfaces of equipment are to be used only for this purpose. These cloths are to be stored in a sanitizing solution between uses.
(b) Moist cloths used for cleaning nonfood-contact surfaces of equipment are to be stored in a sanitizing solution between uses, and are to be used only for this purpose.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.13 Vendor applicant enrollment criteria
(a) Any food store (excluding pharmacies) which applies for participation in the WIC program shall be enrolled via a State Health Department approved one-year expirable contract if all of the following criteria are met. If all the criteria are not met, the vendor may not be enrolled.
(1) Current and valid food stamp authorization.
(2)
(i) The vendor/participant ratio in the ZIP code area of the applicant vendor is more than 75 participants per vendor, or
(ii) There is a participating WIC vendor within a 10-block or 1/2 mile walking distance of the applicant vendor who redeems more than $3,000 in WIC checks per month, or
(iii) The applicant vendor had annual total sales in the previous calendar year of more than three million dollars in New York State.
(3) If the applicant vendor has assumed ownership of a store that had been participating in the WIC program within 60 days from the date the application is made, the criteria set forth in paragraph (2) of this subdivision will not apply unless the store under the previous owner redeemed fewer than 25 checks per month.
(4) The applicant vendor shall stock WIC acceptable foods, as determined by the New York State Department of Health, in the minimum quantities prescribed in the vendor application document at the time of enrollment.
(5) Applicant vendor's prices shall be reasonable as compared to other vendors contracted with the local agency. Reasonable shall be defined by calculating the applicant vendor's selling price of their most commonly prescribed formula check type for an infant and the two most commonly prescribed check types containing multiple foods for a woman or child. The prices that are used for these calculations should reflect the vendor's average prices for each type of item. Calculations should not be made based solely on the highest priced item. The cost of the checks should be within 10 percent of the project average for these check types as identified on the last project summary by vendor report. The project summary by vendor report identifies the project average for each check type by calculating the cost of each check type redeemed during the reporting month by vendors contracted with the applicant's local agency.
(b) Any pharmacy which applies for participation in the WIC program shall be enrolled if all the following criteria are met. Any vendor who meets these criteria should be enrolled via a State Health Department approved one-year expirable contract.
(1) There are no other pharmacies participating in the WIC program within a ½ mile walking distance of applicant pharmacy.
(2) The applicant pharmacy shall stock formula in the minimum quantities prescribed in the vendor application document at the time of enrollment.
(3) The applicant agrees to order and stock special formulas as requested by the local agency.
(4) The applicant's prices for formula are reasonable. Reasonable shall be defined by calculating the applicant vendor's selling price of an ITA check (eight 13-ounce cans iron-fortified concentrated formula). The total cost should be within 10 percent of the project average for this check type.
(c) The applicant vendor or pharmacy shall have reasonable hours of operation. Reasonable is defined as operating six days per week, eight hours per day.
(d) The local agency shall have the option of not contracting with any vendor who has been previously disqualified from the WIC program or who has abused the WIC program or any other government sponsored program.
(e) If there are no other available participating vendors within three miles of the applicant vendor or there is a demonstrated, documented cultural need ( e.g., Kosher), the local agency may, within its discretion, admit the applicant vendor into the program without first meeting the criteria set forth in paragraphs (a)(1), (2), (3) and (5) or subdivision (b) or (c) of this section.
(f) A local agency does not have to consider a vendor's reapplication for participation in the WIC program if the vendor was denied within the past year.
(g) When requested by the State or local agency, the applicant vendor has attended precontract training.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.296 Responsibility accounting
An accounting system which accumulates and communicates historical and projected monetary and statistical data relating to revenues and controllable expenses, classified according to organizational units producing the revenues and responsible for incurring the expenses.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ABSENCE WITH PAY ABSENCE WITH PAY
10 CRR-NY 84.15 Saturdays, Sundays and holidays
(a) All Saturdays, Sundays and legal holidays shall, so far as practicable, be allowed as days off. Employees required to work on any of these days shall not be entitled to compensatory time off in lieu thereof.
(b) The days prescribed as holidays by the department's annual calendar for the school year shall be observed as holidays.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.2 Definitions
As used in this Subpart, the following words and terms shall have the indicated meanings:
(a) Statistical tabulation means a collection or orderly presentation of numerical data logically arranged in columns, rows or graphic representation. Opinions, policy options and recommendations do not constitute statistical tabulations.
(b) Factual tabulation means a collection of statements of objective information logically arranged and reflecting objective reality, actual existence or an actual occurrence. Opinions, policy options and recommendations do not constitute factual tabulations.
(c) Records access officer means the person designated as responsible for ensuring that the department complies with provisions of the Freedom of Information Law and the regulations herein and coordinates the department's response to requests for access to or copies of records.
(d) Records access appeals officer means the Director, Department of Health, Public Affairs Group, whose business address is: Empire State Plaza, Corning Tower, Albany, NY 12237.
(e) Record means any information kept, held, filed, produced or reproduced by, with or for the department, in any physical form whatsoever, including, but not limited to reports, statements, examinations, memoranda, opinions, folders, files, books, manuals, pamphlets, forms, papers, designs, drawings, maps, photos, letters, microfilms, computer tapes or discs, rules, regulations or codes.
(f) Trade secret means information which, if disclosed, would cause substantial injury to the competitive position of the subject enterprise.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.73 Cost
An expenditure or outlay of cash, other property, capital stock, or services, or the incurring of a liability therefor, identified with goods or services acquired or with any loss incurred, and measured by the amount of cash paid or payable or the market value of other property, capital stock, or services given in exchange or, in other situations, any commonly accepted basis of valuation. Implicit in the concept of cost is the accrual basis of accounting.
10 CRR-NY 441.99 Donated commodities
Gifts of supplies and other materials, such as medicines, blood, linen and office supplies, which are normally purchased by the institution, and are recorded on the books at their fair market value at the time of donation, regardless of when actual receipt takes place.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
PLANNING, SITING, TREATMENT AND APPROVAL PLANNING, SITING, TREATMENT AND APPROVAL
10 CRR-NY 5-1.29 Pumping equipment
Pumping equipment of a public water system, for water which is not subject to later treatment, shall be installed and operated to prevent contamination of the public water system. Whenever priming is necessary, such pump shall be primed with water meeting the requirements of sections 5-1.51 and 5-1.52 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.9 Operating revenue—daily hospital services
[3211] This group of accounts (3000-3990) is used to report the gross revenue, measured in terms of the hospital's full established rates, earned from daily hospital services rendered to inpatients. These revenues must be reported at the hospital's full established rates, regardless of the amounts actually collected.
(b) Daily hospital services generally are those services included by the provider in a daily service charge—sometimes referred to as the “room and board” charge. Included in daily hospital services are the regular room, dietary and nursing services, minor medical and surgical supplies, medical social services, and the use of certain equipment and facilities for which the hospital does not customarily make a separate charge.
(c) Daily hospital services are categorized into broad areas: acute care, intensive care, nursery, and sub-acute care.
(d) Acute Care.
This group of accounts (3010 - 3290) is used to report the gross revenues, measured in terms of the hospital's full established rates earned from daily hospital services provided to patients who are in an acute phase of illness but not to the degree which requires the concentrated and continuous observation and care provided in the intensive care units of a hospital.
(e) Intensive Care.
(1) This group of accounts (3310 - 3490) is used to report the gross revenues measured in terms of the hospital's full established rates earned from inpatients who require extraordinary observation and care on a concentrated basis.
(2) The intensive care unit must meet the following conditions:
(i) The unit must be physically and identifiably separate from other areas. There cannot be a concurrent sharing of nursing staff between an intensive care type unit and units or areas furnishing different levels or types of care. However, two or more intensive care type units that concurrently share nursing staff can be reported as one combined intensive care type unit if all other criteria are met. Float nurses (nurses who work in different units on an as-needed basis) can be utilized in the intensive care type unit.
(ii) There must be specific written policies that include criteria for admission to, and discharge from, the unit.
(iii) Registered nursing care must be furnished on a continuous 24-hour basis. At least one registered nurse must be present in the unit at all times.
(iv) A minimum nurse/patient ratio of one nurse to two patients per patient day must be maintained. Included in the calculation of this nurse/patient ratio are registered nurses, licensed vocational nurses, licensed practical nurses, and nursing assistants who provide patient care. Not included are general support personnel such as ward clerks, custodians and housekeeping personnel.
(v) The unit must be equipped with, or have available for immediate use, lifesaving equipment necessary to treat the critically ill patients for which it is designed. This equipment may include, but is not limited to, respiratory and cardiac monitoring equipment, respirators, cardiac defibrillators, and wall or canister oxygen and compressed air.
(f) Nursery.
These accounts (3510 & 3520) are used to report gross revenues measured in terms of the hospital's full established rates earned from nursery services provided to newborn infants who require routine and/or premature care.
(g) Sub-Acute Care.
This group of accounts (3610 - 3690) is used to report the gross revenues measured in terms of the hospital's full established rates earned from services provided to patients who require a level of nursing care less than acute, including residential care.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
CONTROL OF COPPER AND LEAD IN DRINKING WATER CONTROL OF COPPER AND LEAD IN DRINKING WATER
10 CRR-NY 5-1.44 Monitoring requirements for lead and copper in source water
A water system that exceeds the lead or copper action level based on first draw tap water samples collected in accordance with section 5-1.42 of this Subpart shall collect lead and copper source water samples in accordance with the following requirements:
(a) Sample requirements.
(1) Water systems shall take a minimum of one sample at every entry point to the distribution system which is representative of each source after treatment. The system shall collect each sample at the same sampling point unless conditions make another sampling point more representative of each source or treatment plant. If a system draws water from more than one source and the sources are combined before distribution, the system shall sample at entry point(s) to be representative of normal operating conditions, when water is representative of all sources being used.
(2) The State may reduce the total number of samples which shall be analyzed by allowing the use of compositing. Compositing of samples shall be done by certified laboratory personnel. Composite samples from a maximum of five samples are allowed, provided that the method detection limit (MDL) for lead of 0.001 mg/L is achieved. If the lead concentration in the composite sample is greater than or equal to 0.001 mg/L, or the copper concentration is greater than or equal to 0.160 mg/L, then either:
(i) a follow-up sample shall be taken and analyzed within 14 days at each sampling point included in the composite; or
(ii) if duplicates of or sufficient quantities from the original samples from each sampling point used in the composite are available, the system may use these instead of resampling.
(3) Where the results of sampling indicate an exceedance of State-specified maximum permissible source water levels established under section 5-1.45(a)(4) of this Subpart, the State may require that one follow-up sample be collected as soon as possible after the initial sample was taken (but not to exceed two weeks) at the same sampling point. If a State-required follow-up sample is taken for lead or copper, then the results of the initial and follow-up samples shall be averaged to determine compliance with the State-specified maximum permissible levels. Any sample value below the detection limit shall be considered to be zero. Any value above the detection limit but below the practical quantitation limit (PQL) shall either be considered as the measured value or be considered one-half the PQL.
(b) Standard monitoring.
(1) Monitoring frequency after system exceeds tap water action level. Any system which exceeds the lead or copper action level shall collect one source water sample from each entry point to the distribution system no later than six months after the end of the monitoring period during which the lead or copper action level was exceeded. For monitoring periods that are annual or less frequent, the end of the monitoring period is September 30th of the calendar year in which the sampling occurs, or if the State has established an alternate monitoring period, the last day of that period.
(2) Monitoring frequency after installation of source water treatment. Any system which installs source water treatment pursuant to section 5-1.45 of this Subpart shall collect an additional source water sample from each entry point to the distribution system during the two consecutive six-month monitoring periods immediately following the installation of treatment with the first monitoring period to begin either January 1st or July 1st, whichever comes first.
(3) Monitoring frequency after State specifies maximum permissible source water levels or determines that source water treatment is not needed.
(i) A system shall monitor at the frequency specified below in cases where the State specifies maximum permissible source water levels or determines that the system is not required to install source water treatment under section 5-1.45 of this Subpart.
(a) A water system using only ground water shall collect samples once every three years with the first three year monitoring period to begin January 1st of the year in which the State determination is made under this subparagraph. Such systems shall collect samples once during each subsequent compliance period. Triennial samples shall be collected in the third calendar year.
(b) A water system using surface water (or a combination of surface and ground water) shall collect samples once during each calendar year with the first annual monitoring period to begin January 1st of the year in which the applicable State determination is made under this subparagraph.
(ii) A system is not required to conduct source water sampling for lead and/or copper if the system meets the action level for the specific contaminant in tap water samples during the entire source water sampling period applicable to the system under clause (i)( a ) or ( b ) of this paragraph.
(c) Reduced monitoring.
(1) A water system using only ground water may reduce the monitoring frequency for lead and copper in source water to once every nine-years provided that the samples are collected no later than every ninth calendar year and the system meets one of the following criteria:
(i) the system demonstrates that finished drinking water entering the distribution system has been maintained below the maximum permissible lead and copper concentrations specified by the State under section 5-1.45(a) of this Subpart during at least three consecutive years in which sampling was conducted under subparagraph (b)(3)(i) of this section; or
(ii) the State has determined that source water treatment is not needed and the system demonstrates that the concentration of lead in source water was less than or equal to 0.005 mg/L and the concentration of copper in source water was less than or equal to 0.65 mg/L during at least three consecutive applicable monitoring periods in which sampling was conducted under subparagraph (b)(3)(i) of this section.
(2) A water system using surface water (or a combination of surface water and ground water) may reduce the monitoring frequency for lead and copper in source water to once during each nine-year compliance cycle provided that the samples are collected no later than every ninth calendar year and if the system meets one of the following criteria:
(i) the system demonstrates that finished drinking water entering the distribution system has been maintained below the maximum permissible lead and copper concentrations specified by the State for at least three consecutive years; or
(ii) the State has determined that source water treatment is not needed and the system demonstrates that, during at least three consecutive years, the concentration of lead in source water was less than or equal to 0.005 mg/L and the concentration of copper in source water was less than or equal to 0.65 mg/L.
(3) A water system that uses a new source of water is not eligible for reduced monitoring for lead and/or copper until concentrations in samples collected from the new source during three consecutive monitoring periods in accordance with paragraph (b)(2) or (3) of this section are below the maximum permissible lead and copper concentrations specified by the State.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 116 FULTON COUNTY
CITIES CITIES
10 CRR-NY 116.1 City of Gloversville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Rice, Port, Jackson Summit, Cameron and Dixon Reservoirs and those tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the City of Gloversville, Fulton County, New York, and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and non-putrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the City of Gloversville public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial wastes or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the city of Gloversville public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the City of Gloversville public water supply.
(16) Water supply shall mean the public water supply of the City of Gloversville, Fulton County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except (i) watertight receptacles, (ii) waterflushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility and (iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or on transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All of such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiaton), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyard.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the City of Gloversville.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the City of Gloversville.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the City of Gloversville except by duly authorized employees of the City of Gloversville in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the City of Gloversville within 1000 feet of the water supply intakes except by duly authorized employees of the City of Gloversville in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction over such facility.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the following standards for raw water quality:
| Items | Specifications | | --- | --- | | 1. Floating solids; settleable solids; oil; sludge deposits; tastes or odor producing substances | None attributable to sewage, industrial wastes or other wastes. | | 2. Sewage or wastes effluents | None which are not effectively disinfected. | | 3. pH | Range between 6.5 and 8.5. | | 4. Disolved oxygen | For trout waters, greater than 5.0 parts per million; for non-trout waters greater than 4.0 parts per million. | | 5. Toxic wastes, oil, deleterious substances, colored or other wastes or heated liquids | None alone or in combination with other substances or wastes in sufficient amounts or at such temperatures as to make the waters unsafe or unsuitable as a source of water supply for drinking, culinary or food processing purposes. Provided further, that the concentration or quantity of the constitutents or characteristics hereinafter set forth shall not exceed the allowable limits established therefor. |
| Constitutent or characteristic | Allowable limits | | --- | --- | | Physical | | | Turbidity | 5 units | | Microbiological | | | Coliform organism | 50 per 100 ml. | | Inorganic chemicals | (Concentration in mg/1) | | Ammonia (NH3) | <2.0 | | Arsenic (As) | 0.05 | | Barium (Ba) | 1.0 | | Boron (B) | 1.0 | | CCE | 0.2 | | Cadmium (Cd) | 0.01 | | Chloride (Cl) | 250. | | Chromium (Hexavalent) (Cr + 6) | 0.05 | | Copper (Cu) | <0.2 | | Cyanide (CN) | <0.1 | | Fluoride (F) | <1.5 | | Lead (Pb) | 0.05 | | Mercury (Hg) | 0.005 | | Nitrates (NO3) + Nitrites (NO2) | 10. | | Selenium (Se) | 0.01 | | Silver (Ag) | 0.05 | | Sodium (Na) | <20. | | Sulfate (SO4) | 250. | | Total dissolved solids | 500. | | Uranyl ion | <5.0 | | Zinc (Zn) | <0.3 | | Organic chemicals | (Concentration in mg/1) | | Organic nitrogen | 0.5 | | Oxygen consumed | 2.0 | | Phenols | 0.001 | | Pesticides | | | Aldrin | 0.017 | | Chlordane | 0.003 | | DDT | 0.042 | | Dieldrin | 0.017 | | Endrin | 0.001 | | Heptachlor | 0.018 | | Heptachlor epoxide | 0.018 | | Herbicides | 0.1 | | Lindane | 0.056 | | Methoxychlor | 0.035 | | Organic phosphates + carbamates | 0.1 | | Toxaphene | 0.005 | | Radioactivity | (Concentration in pc/1) | | Gross beta | 1000. | | Radium—226 | 3. | | Strontium—90 | 10. |
(o) Inspections.
The board of water commissioners of the City of Gloversville or any duly appointed person or persons as may be charged with maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses, and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid board of water commissioners of the City of Gloversville or any such duly appointed person or persons as may be charged with maintenance or supervision of the water supply to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notice of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of water commissioners of the City of Gloversville or any such duly appointed person or persons as may be charged with maintenance or supervision of the water supply to promptly notify the State Commissioner of Health of such violations. The aforesaid board of water commissioners of the City of Gloversville or any duly appointed person or persons as may be charge with maintenance or supervision of the water supply shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations of these rules and regulations shall be those prescribed by section 1103 of the Public Health Law.
Part 143 SCHOHARIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 143.3 Village of Middleburgh
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to Little Schoharie Creek and its tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Village of Middleburgh, Schoharie County, New York and to all watercourses tributary thereto or ultimately discharging into said supply. The existing intake diversion dam on Little Schoharie Creek is located approximately 2.75 miles upstream from the confluence of Little Schoharie Creek and Schoharie Creek.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Middleburgh public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial wastes or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the Village of Middleburgh public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Village of Middleburgh public water supply.
(16) Water supply shall mean the public water supply of the Village of Middleburgh, Schoharie County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 50 feet from any reservoir or watercourse and covered with not less than one foot of soil in such manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 25 feet of any reservoir or watercourse except (i) watertight receptables, (ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility and (iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 25 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (except into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facility) within 25 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of any human body shall be made within 100 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Volume (A), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Village of Middleburgh.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Middleburgh.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Middleburgh except by duly authorized employees of the Village of Middleburgh in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Middleburgh within 1,000 feet of the water supply intakes except by duly authorized employees of the Village of Middleburgh in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse, unless a permit to do so has been obtained from the appropriate State agency having jurisdiction over such facility.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the following standards for raw water quality:
| Items | Specifications | | --- | --- | | 1. Floating solids; settleable solids; oil; sludge deposits; wastes or odor-producing substances | None attributable to sewage, industrial wastes or other wastes. | | 2. Sewage or waste effluents | None which are not effectively disinfected. | | 3. pH | Range between 6.5 and 8.5. | | 4. Dissolved oxygen | For trout waters, greater than 5.0 parts per million; for nontrout waters, greater than 4.0 parts per million. | | 5. Toxic wastes, oil, deleterious substances, colored or other wastes or heated liquids | None alone or in combination with other substances or wastes in sufficient amounts or at such temperatures as to make the waters unsafe or unsuitable as a source of water supply for drinking, culinary or food processing purposes. Provided further, that the concentration or quantity of the constituents or characteristics hereinafter set forth shall not exceed the allowable limits established therefor. |
| Constituent or characteristic | Allowable limits | | --- | --- | | Physical | | | Turbidity | 5 units | | Microbiological | | | Coliform organism | 50 per 100 ml. | | Inorganic chemicals | (Concentration in mg/1) | | Ammonia (NH3) | <2.0 | | Arsenic (As) | 0.05 | | Barium (Ba) | 1.0 | | Boron (B) | 1.0 | | CCE | 0.2 | | Cadmium (Cd) | 0.01 | | Chloride (Cl) | 250. | | Chromium (Hexavalent) (Cr + 6) | 0.05 | | Copper (Cu) | <0.2 | | Cyanide (CN) | <0.1 | | Fluoride (F) | <1.5 | | Lead (Pb) | 0.05 | | Mercury (Hg) | 0.005 | | Nitrate (NO3) + Nitrates (NO3) | 10. | | Selenim (Se) | 0.01 | | Silver (Ag) | 0.05 | | Sodium (Na) | <20. | | Sulfate (SO4) | 250. | | Total dissolved solids | 500. | | Uranyl ion | <5.0 | | Zinc (Zn) | <0.3 | | Organic chemicals | | | Organic nitrogen | 0.5 | | Oxygen consumed | 2.0 | | Phenols | 0.001 | | Pesticides | | | Aldrim | 0.017 | | Chlordane | 0.003 | | DDT | 0.042 | | Dieldrin | 0.017 | | Endrin | 0.001 | | Heptachlor | 0.018 | | Heptachlor epoxide | 0.018 | | Herbicides | 0.1 | | Lindane | 0.056 | | Methoxychlor | 0.035 | | Organic phosphates + carbamates | 0.1 | | Toxaphene | 0.005 | | Radioactivity | (Concentration in pc/1) | | Gross beta | 1000. | | Radium-226 | 3. | | Strontium-90 | 10. |
(o) Inspections.
The village board or water superintendent shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board to promptly notify the appropriate State agency having jurisdiction over such facility of such violations. The aforesaid village board shall report to the appropriate State agency having jurisdiction over such facility in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violation of these rules and regulations shall be those prescribed by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.111 Transfer of radioactive material
(a) No licensee shall transfer radioactive material except as authorized pursuant to this section.
(b) Except as otherwise provided in his license and subject to the provisions of subdivisions (c) and (d) of this section, any licensee may transfer radioactive material:
(1) to the department;14
(2) to the United States Nuclear Regulatory Commission;
(3) to any person exempt from the regulations in this Part to the extent permitted under such exemption;
(4) to any person authorized to receive such material under terms of a general license or its equivalent, or a specific license or equivalent licensing document, issued by the department, the United States Nuclear Regulatory Commission, or any agreement state, or to any person otherwise authorized to receive such material by the Federal government or any agency thereof, the department, or any agreement state; or
(5) as otherwise authorized by the department in writing.
(c) Before transferring radioactive material to a specific licensee of the department, the United States Nuclear Regulatory Commission or the licensing agency of an agreement state, or to a general licensee who is required to register with the department, the United States Nuclear Regulatory Commission or the licensing agency of an agreement state prior to receipt of the radioactive material, the licensee transferring the material shall verify that the transferee's license authorizes the receipt of the type, form and quantity of radioactive material to be transferred.
(d) The following methods for the verification required by subdivision (c) of this section are acceptable:
(1) the transferor may have in his possession, and read, a current copy of the transferee's specific license or registration certificate;
(2) the transferor may have in his possession a written certification by the transferee that he is authorized by license or registration certificate to receive the type, form and quantity of radioactive material to be transferred, specifying the license or registration certificate number, issuing agency and expiration date;
(3) for emergency shipments the transferor may accept oral certification by the transferee that he is authorized by license or registration certificate to receive the type, form and quantity of radioactive material to be transferred, specifying the license or registration certificate number, issuing agency and expiration date; provided that the oral certification is confirmed in writing within 10 days;
(4) the transferor may obtain other sources of information compiled by a reporting service from official records of the department, the United States Nuclear Regulatory Commission or the licensing agency of an agreement state as to the identity of licensees and the scope and expiration dates of licenses and registrations; or
(5) when none of the methods of verification described in paragraphs (1) through (4) of this subdivision are readily available, or when a transferor desires to verify that information received by one of such methods is correct or up-to-date, the transferor may obtain and record confirmation from the department, the United States Nuclear Regulatory Commission or the licensing agency of an agreement state that the transferee is licensed to receive the radioactive material.
(e) Preparation for shipment and transport of radioactive material shall be in accordance with the provisions of section 16.17 of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.2 Facility rates
(a) Computation of rates of payment for facility services by government agencies and article 43 corporations shall be governed by the provisions of this Subpart.
(b) Each article 43 corporation shall submit a proposed reimbursement formula not inconsistent with the rules set forth in this Subpart, for approval by the commissioner, no later than 90 days prior to the effective date of rates of payment unless otherwise specified by the commissioner. In order to facilitate the exchange of information necessary for development of the reimbursement formula and rates, each article 43 corporation may confer with any facility, group or association of facilities prior as well as subsequent to submission of its proposed reimbursement formula and rates. The commissioner may require a report of any such contacts, when it is reasonably necessary to the discharge of his or her responsibilities under this Subpart.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-3 RECREATIONAL AQUATIC SPRAY GROUNDS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-3.7 Injury and illness incident reporting
A full report of any injury or illness incident occurring at a spray ground shall be reported by the owner/operator to the permit-issuing official within 24 hours of its occurrence, and a notation recorded in a log book. This shall include all incidents occurring at a spray ground facility which:
(a) result in death;
(b) require resuscitation;
(c) require referral to a hospital or other facility for medical attention; or
(d) is an illness alleged to be associated with the spray ground water quality.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
WATER SUPPLY WATER SUPPLY
10 CRR-NY 14-5.120 Water supply
(a) The water supply is to be adequate, safe, of sanitary quality from an acceptable source that meets the requirements of Part 5 of this Title.
(b)
(1) Water used as a food ingredient is to be piped to the vending machine under pressure, except that in controlled-location vending machines, water obtained from a safe source may be carried to the machines in sanitary containers that protect it from contamination.
(2) External water fill ports or drawers of controlled-location vending machines are to be designed so that covers and drawers are secured to the machine. Where unauthorized persons may have access to these machines, external fill port covers or drawers are to be equipped with locks.
(c) Water filters or other water-conditioning devices are to be approved for such use by the State Commissioner of Health, and are to be disassembled for periodic cleaning or replacement of the active element. Replacement elements are to be handled in a sanitary manner.
(d) Carbonated beverage dispensers connected to a water supply system are to be equipped with an air gap at the water inlet, or a double check valve, vented to discharge carbon dioxide gas to the atmosphere, that provides positive protection against the entrance of carbon dioxide or carbonated water into the water supply system, or other device acceptable to the State Commissioner of Health. All water-contact surfaces downstream from this protection device are to be of materials that will not produce toxic substances when exposed to carbon dioxide or carbonated water.
(e) All lines conducting carbonated beverages or carbon dioxide gas are to be stainless steel, food-grade plastic or other material that will not produce toxic substances when exposed to carbon dioxide or carbonated beverages.
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.27 Neck dusters, powder puffs and sponges
The use of brush neck dusters, powder puffs and sponges is prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
BALANCE SHEETS BALANCE SHEETS
10 CRR-NY 444.3 RESTRICTED FUND ASSETS
[ 3120 ]
(a) PLANT REPLACEMENT AND EXPANSION FUND ASSETS.
[ 3121 ]
(1) 1510
CASH
1511
General Checking Accounts
1513
Other Checking Accounts
1515
Savings Accounts
1516
Certificates of Deposit
1519
Other Cash Accounts
Cash donated for the replacement and expansion of plant assets is included in these accounts.
(2) 1520
INVESTMENTS
1521
U.S.
Government Securities
1522
Other Current Investments
1523
Share of Pooled Investments
1529
Other Investments
The balance of these accounts reflects the cost of investments purchased with Plant Replacement and Expansion Fund cash and the fair market value (at the date of donation) of securities donated to the hospital for the purpose of plant renewal or replacement.
(3) 1550
OTHER TANGIBLE ASSETS
(4) 1560
PLEDGES AND OTHER RECEIVABLES
1561
Pledges Receivable
1562
Allowance for Uncollectible Pledges
1563
Grants and Legacies Receivable
1564
Interest Receivable
1569
Other Receivables
Other tangible assets and the receivable and allowance balances of this fund are reflected in these accounts.
(5) 1570
DUE FROM OTHER FUNDS
1571
Due from Operating Fund
1572
Due from Board-Designated Assets
1574
Due from Specific Purpose Fund
1575
Due from Endowment Fund
The balance in these accounts represents the amount due to the Plant Replacement and Expansion Fund from the other funds. These accounts represent assets of the Plant Replacement and Expansion Fund which are currently accounted for in other funds.
(b) SPECIFIC PURPOSE FUND ASSETS.
[ 3122 ]
(1) 1710
CASH
1711
General Checking Accounts
1713
Other Checking Accounts
1715
Savings Accounts
1716
Certificates of Deposit
1719
Other Cash Accounts
Cash donated for specific purposes, such as research and education, is included in these accounts.
(2) 1720
INVESTMENTS
1721
U.S.
Government Securities
1722
Other Current Investments
1723
Share of Pooled Investments
1729
Other Investments
The balance of these accounts reflects the cost of investments purchased with Specific Purpose Fund cash and the fair market value (at the date of donation) of securities donated to the hospital for specific purposes.
(3) 1750
OTHER TANGIBLE ASSETS
(4) 1760
PLEDGES AND OTHER RECEIVABLES
1761
Pledges Receivable
1762
Allowance for Uncollectible Pledges
1763
Grants and Legacies Receivable
1764
Interest Receivable
1769
Other Receivables
Other tangible assets and the receivable and allowance balances of this fund are reflected in these accounts.
(5) 1770
DUE FROM OTHER FUNDS
1771
Due from Operating Fund
1772
Due from Board-Designated Assets
1773
Due from Plant Replacement and Expansion Fund
1775
Due from Endowment Fund
The balance in these accounts represents the amount due to the Specific Purpose Fund from the other funds. These accounts represent assets of the Specific Purpose Fund which currently are accounted for in other funds.
(c) ENDOWMENT FUND ASSETS.
[ 3123 ]
(1) 1810
CASH
1811
General Checking Accounts
1813
Other Checking Accounts
1815
Savings Accounts
1816
Certificates of Deposit
1819
Other Cash Accounts
Cash restricted for endowment purposes is included in these accounts.
(1) 1820
INVESTMENTS
1821
U.S.
Government Securities
1822
Other Current Investments
1823
Share of Pooled Investments
1824
Real Property
1825
Accumulated Depreciation on Real Property
1826
Mortgages
1829
Other Investments
The balance of these accounts reflects the cost of investments purchased with Endowment Fund cash and the fair market value (at the date of donation) of non-cash donations to the hospital for Endowment Fund purposes. Included would be such assets as Real Property and related accumulated Depreciation and Mortgages.
(3) 1830
INVESTMENT IN NON-OPERATING PROPERTY, PLANT AND EQUIPMENT
(4) 1840
ACCUMULATED DEPRECIATION — INVESTMENTS IN NONOPERATING PROPERTY, PLANT AND EQUIPMENT
(5) 1850
OTHER TANGIBLE ASSETS
(6) Accounts 1830 and 1840 include the cost (or fair market value at date of donation) of restricted property, plant and equipment not used in hospital operations and accumulated depreciation thereon. Other tangible assets not included elsewhere are contained in account 1850.
(7) 1860
PLEDGES AND OTHER RECEIVABLES
1861
Pledges Receivable
1862
Allowance for Uncollectible Pledges
1863
Grants and Legacies Receivable
1864
Interest Receivable
1869
Other Receivables
Other tangible assets and the receivable and allowance balances of this fund are reflected in these accounts. Included in account 1869 would be rent, dividends and trust income receivable.
(8) 1870
DUE FROM OTHER FUNDS
1871
Due from Operating Fund
1872
Due from Board-Designated Assets
1873
Due from Plant Replacement and Expansion Fund
1874
Due from Specific Purpose Fund
The balance in these accounts represents the amount due to the Endowment Fund from the other funds. These accounts represent assets of the Endowment Fund which currently are accounted for in other funds.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter P LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
Part 96 LICENSURE AND PRACTICE OF NURSING HOME ADMINISTRATION
10 CRR-NY 96.8 Courses of study; standards for approval
(a) The applicant shall provide official documentation acceptable to the board of successful completion of a Baccalaureate or higher level degree from an accredited educational institution acceptable to the board including, or supplemented by, a board approved Administrator-in-Training (AIT) Program of at least 12 months full-time experience based upon the standard definition of full-time utilized in the facility but not less than 1,820 clock hours duration and at least 15 credit hours of required course work acceptable to the board, completed at an accredited post-secondary educational institution in the following five areas:
(1) nursing home facility administration (at least three semester credit-hours) at the course level equivalent to 300 or higher:
(2) health care financial management (at least three semester credit-hours) at the course level equivalent to 300 or higher;
(3) legal issues in health care (at least three semester credit-hours);
(4) gerontology (at least three semester credit-hours); and
(5) personnel management (at least three semester credit-hours).
(b) The applicant also shall provide official documentation acceptable to the board of the successful completion of a structured internship conducted in a qualifying nursing home that meets the following requirements:
(1) The internship program is board approved and is completed in a training site that has a valid operating certificate issued by the New York State Department of Health and shall be under the full-time supervision of a New York State licensed and currently registered nursing home administrator.
(i) The training site shall have at least 80 beds that are certified to participate in the title XVIII (Medicare) and title XIX (Medicaid) programs and meet the definition of a nursing home under Public Health Law article 28.
(ii) The nursing home shall have an acceptable surveillance history for the previous two years and have no formal enforcement action pending or in progress against it.
(iii) The applicant shall have no financial interest in the training site or be related to any person that has a financial interest in the training site.
(iv) The applicant may complete his or her internship at a facility where the applicant is employed. In such case, payment of salary or wages by the facility to the employed applicant is not prohibited.
(2) The internship is conducted under the direct supervision of a preceptor who is the AOR of the nursing home.
(i) The preceptor shall have held a New York State nursing home administrator license for at least two years and shall hold a current registration certificate.
(ii) The preceptor shall have had at least three years of full-time experience as the AOR of a nursing home during the last five years, including at least one year in a New York State nursing home eligible for approval as a training site.
(iii) The preceptor shall not have had his or her nursing home administrator license annulled, suspended, revoked, surrendered or forfeited, nor shall the preceptor have otherwise been disciplined by the board or have any formal disciplinary action pending or in progress against him or her.
(iv) The preceptor shall not be related to the applicant.
(3) The approval of the internship shall be withdrawn if the preceptor relinquishes his or her AOR responsibilities at the training site.
(4) The internship must have been completed within the previous 10 years prior to the applicant's eligibility to take the licensure examination.
(5) The applicant can not accept an appointment as acting administrator of any nursing home (residential health care facility) pursuant to section 415.26(a)(3) of this Title during the period inclusively falling within the dates of the internship. The acceptance of such an appointment will result in the disqualification of the internship.
(6) The internship meets or exceeds the requirements and guidelines for the Administrator-in-Training (AIT) Program established and adopted by the board.
(i) The preceptor shall submit the internship to the board for review and approval in the manner and format specified by the board.
(ii) The internship must be approved by the board prior to commencement unless the internship was completed as part of a degree program where the applicant was awarded such degree. In such case, it is the responsibility of the applicant to provide the board with all required documentation and information pertaining to the completed internship necessary to conduct the review of the degree program internship.
(7) The applicant may, at the discretion of the board, substitute the internship with two years of verified full-time qualifying field experience in a licensed nursing home.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.6 Variance and waivers
(a) In order to allow time to comply with a provision of this Subpart, an operator may submit a written request to the permit-issuing official for a variance. A request for a variance will not be considered unless the operator demonstrates that the health and safety of the public will not be prejudiced by the variance, and that there are practical difficulties or hardships in immediate compliance with the provision. An operator must meet all terms and conditions of an approved variance.
(b) In order to obtain a waiver permitting alternative arrangements that do not meet the provisions of this Subpart but do protect the health and safety of the occupants and the public, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Subpart. Such request must demonstrate that the alternate arrangements provide adequate protection of the health and safety of the occupants and public. The permit-issuing official shall obtain and be guided by the recommendation of the State Department of Health prior to granting or denying a waiver. An operator must meet all terms of an approved waiver. A waiver will remain in effect indefinitely unless revoked by the permit-issuing official or the facility changes operators.
Part 16 IONIZING RADIATION
HUMAN USES OF RADIOACTIVE MATERIALS HUMAN USES OF RADIOACTIVE MATERIALS
10 CRR-NY 16.130 Radon testing and reporting
(a) Definitions.
As used in this Part:
(1) Radon means the radioactive noble gas radon-222.
(2) Radon testing firm means a commercial business which uses equipment or provides detectors for testing for radon or radon decay products and which provides the results of such tests to customers.
(3) Radon mitigation firm means a commercial business which evaluates buildings for the purpose of developing plans for reducing indoor air radon levels, and/or implements measures designed to reduce such levels within existing buildings.
(b) General requirements.
(1) A radon testing firm shall report to the department in writing, within 30 days following the end of a reporting period, a summary of all indoor air radon screening and long-term radon tests performed in the State during that reporting period. Reporting periods shall be from January 1st to June 30th and July 1st to December 31st of each year. The report shall include the dates for which the report is made and the number of such measurements performed for the reporting period in each county or ZIP code area in the State.
(2) When any radon screening or long-term testing result exceeds 20 pCi/1 or 0.1 working level as defined in section 16.2(a)(145) of this Part, the radon testing firm shall advise the customer, if a resident of this State, in writing to contact the New York State Department of Health, Bureau of Environmental Radiation Protection, for further technical advice and assistance.
(3) A radon mitigation firm shall report to the department in writing, within 30 days following the end of a reporting period, a summary of the number of homes mitigated in the State during that reporting period. Reporting periods shall be from January 1st to June 30th and July 1st to December 31st of each year. The report shall include the dates for which the report is made and the number of buildings for which mitigation was performed for the reporting period in each county or ZIP code area in the State.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 407 PRIMARY CARE HOSPITALS–MINIMUM STANDARDS
10 CRR-NY 407.2 Designation of PCHs and CAHs
(a) PCHs and CAHs shall be designated by the Commissioner of Health to operate as a primary care hospital pursuant to guidelines developed by the commissioner and the provisions of Part 710 of this Title. The decision to submit an application for designation as either a CAH or a RPCH shall be at the discretion of the hospital seeking designation, The guidelines for designation may be obtained from the commissioner, and shall be published in the New York State Register.
(b) At the time of application to become either a PCH or a CAH, a facility shall be licensed as a general hospital, shall have a Medicare/Medicaid participation agreement in effect and shall be in substantial compliance with all other applicable State and Federal requirements.
(c) Hospitals seeking designation as a CAH pursuant to this section, shall, in addition to complying with the provisions of this Part, comply with the following requirements of 42 CFR section 485.620:
(1) except as permitted for CAHs having Federal swing-bed agreements, the CAH maintains no more than 15 inpatient beds; and
(2) the CAH discharges or transfers each patient within 96 hours after admission, unless transfer to a hospital is precluded because of inclement weather or other emergency conditions.
(d) At the time of application PCHs may provide swing-bed services in accordance with Part 406 of this Title or seek approval to provide swing-bed services following designation as a PCH. CAHs shall comply with the following additional conditions pursuant to 42 CFR section 485.645 regarding swing-bed services:
(1) Federal swing-bed approval must not have been terminated within the two years prior to the facility's application for CAH status; and
(2) a facility that, at the time it applied for designation as a CAH, had in effect a swing-bed agreement for post-hospital skilled nursing facility care may continue to use its inpatient facilities for the provision of post-hospital SNF care, so long as the total number of beds that are used at any time for the furnishing of such services does not exceed 25 beds and the number of beds used at anytime for acute care inpatient services does not exceed 15 beds.
(e) Upon designation, PCHs and CAHs shall remain subject to the provisions of this Part and all other pertinent requirements of this Title and of the Public Health Law applicable to general hospitals, including those pertaining to operating certificates which shall also apply to the proposed revocation, suspension, limitation or annulment of a PCH or CAH designation.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.18 Acute care
Inpatient general routine care provided to patients who are in an acute phase of illness, but not to the degree which requires the concentrated and continuous observation and care provided in the intensive care units of an institution.
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.11 Name changes of operators and medical facilities
(a) Any change in the following shall require the prior approval of the Public Health Council in accordance with the requirements of this section and any other applicable requirements of law:
(1) the name of a not-for-profit corporation operating a medical facility under article 28 of the Public Health Law;
(2) the name of a not-for-profit corporation authorized to solicit contributions for the establishment or maintenance of any hospital pursuant to article 28 of the Public Health Law;
(3) the assumed name of a sole proprietor or a not-for-profit corporation operating a medical facility under article 28 of the Public Health Law or of a not-for-profit corporation authorized to solicit, contributions for the establishment or maintenance of any hospital pursuant to article 28 of the Public Health Law, whenever the prior assumed name was approved by the Public Health Council or its predecessor; and
(4) the name or assumed name of a business corporation, partnership or governmental subdivision operating a medical facility under article 28 of the Public Health Law whenever the prior name or prior assumed name was approved by the Public Health Council or its predecessor.
(b) Applicants requesting Public Health Council approval of a change of name or assumed name shall submit a written request to the executive secretary of the council at the department's central office in Albany, which shall include the following information and documentation as appropriate:
(1) a letter specifying the current and proposed names and explaining the nature of and the reasons for the requested name change;
(2) a photocopy of the executed proposed certificate of amendment of the certificate of incorporation, certificate of authority to conduct business in the State of New York, or certificate of conducting business under an assumed name; and
(3) such other pertinent information and documents necessary for the council's consideration, as requested.
(c) Whenever the name of a business corporation, partnership or governmental subdivision, or the assumed name of a business corporation, not-for-profit corporation, partnership, governmental subdivision or sole proprietor operating a medical facility or fundraiser under article 28 of the Public Health Law was not specifically approved by the Public Health Council or its predecessor, any proposed change in said name or assumed name or initial use of an assumed name shall not require the approval of the Public Health Council but shall require the approval of the department in accordance with section 401.3 of this Title.
(d) The approval of the Public Health Council of a proposed name or assumed name may be withheld if the proposed name or assumed name indicates or implies that the corporation, partnership, governmental subdivision or individual is authorized to engage in activities for which it is not authorized, provide a level of care it is not authorized to provide, is misleading, causes confusion with the identity of another facility, or violates any provision of the law.
(e) Nothing contained within this section shall limit the authority of the Public Health Council to approve or disapprove the initial use of a name or assumed name for a not-for-profit corporation, business corporation, partnership, governmental subdivision or sole proprietor when such name or assumed name is before the Public Health Council as part of an application for the establishment of a facility or fundraiser.
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.6 Extracorporeal shockwave lithotripters
(a) This methodology will be utilized to evaluate certificate of need applications involving the acquisition of extracorporeal shockwave lithotripters (ESWL). It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1 of this Part, become a statement of planning principles and decisionmaking tools for directing the distribution of extracorporeal shockwave lithotripters. The goals and objectives of the methodology expressed herein are expected to insure that an adequate number of ESWL units are available to provide access to care and avoid the unnecessary duplication of resources.
(b) The factors and methodology for determining the public need for ESWL units shall include, but not be limited to the following:
(1) There shall be one ESWL unit for each 2.5 million residents within a health system agency's geographic area with a minimum of one unit in each health systems agency's geographic area.
(2) Each applicant must present evidence that an annual minimum utilization of 750 procedures shall be achieved within two years of initial operation, except those applicants located in a health systems agency whose geographic area contains less than 2.5 million residents.
(3) In addition, each applicant applying to acquire an ESWL unit must meet the following standards:
(i) Each applicant must demonstrate the availability of urologists who meet the definition of a qualified specialist. The applicant must also have competence in the provision of diagnostic, metabolic, and surgical services to patients with kidney stone disease. This shall include experience in the performance of renal surgery, percutaneous procedures and ureteroscopy for the removal of urinary calculi.
(ii) Each applicant must submit a plan to develop referral agreements with all facilities in the relevant service area.
(iii) Each applicant must submit a plan to evaluate ESWL compared to alternative therapeutic modalities in terms of clinical efficacy, utilization and costs.
(iv) Where public need is established herein, priority consideration will be given to applicants that agree to serve the medically indigent and patients regardless of source of payment.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
PERSONNEL PERSONNEL
10 CRR-NY 14-4.80 Personnel
All persons handling food are to be free from infectious disease which can be transmitted by foods and are not to have a boil, infected cut or sore, or respiratory disease. They are to wear clean clothing, not to smoke or use tobacco while handling food or in food preparation areas, and to use hair restraints that minimize hair contact with hands, food and food-contact surfaces. All personnel handling food are to wash their hands with soap and water after using the toilet, smoking, eating, or when soiled.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.17 Transportation
(a) No person shall transport, package for transport, or cause to be transported, outside of the confines of his installation, any radioactive material within this State unless:
(1) such transport conforms to those regulations of the United States Department of Transportation or other agencies of the United States having jurisdiction with respect to packaging of the radioactive material and to the marking and labeling of the package and transporting vehicle which would be applicable if such transport were interstate; and
(2) procedures are established for opening and closing packages in which radioactive material is transported to provide safety and to assure that, prior to delivery to a carrier for transport, each package is properly closed for transport; and
(3) prior to delivery of a package for transport, such person shall assure that any special instructions needed to open the package are sent to, or have been made available to the consignee; or
(4) such transport complies with such requirements as have been approved by the commissioner.
(b) Transport of radioactive material is exempt from the requirements set forth in subdivision (a) of this section provided that all of the following conditions are satisfied:
(1) the package must consist of an outer container and an inner container and must be such that there can be no leakage of radioactive material under conditions normally incident to transportation;
(2) the package must contain not more than 0.01 millicurie of any alpha emitting radioactive material exclusive of fissionable material, or 0.1 millicurie of Argon 41, Barium 133, Bismuth 210, Europium 154, Krypton 87, Lead 210, Lead 212, Strontium 90, or Xenon 135, or one millicurie of any beta-gamma emitting radioactive material;
(3) the package must be such that there is no significant removable surface contamination7 on the exterior of the package and the radiation dose rate at any point on the external surface of the package must be less than 12 milliroentgens for 24 hours; and
(4) the outside of the inner container of the package must bear the marking “RADIOACTIVE”.
(c) Transport of radioactive material by a physician for use in the practice of medicine is exempt from the requirements set forth in subdivisions (a) and (b) of this section, provided that the physician is authorized to use radioactive materials by a license issued by the department under this Part.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD PROTECTION FOOD PROTECTION
10 CRR-NY 14-5.42 Fluid milk and milk products; fluid nondairy products
Fluid milk and fluid milk products and fluid nondairy products (creaming agents) are not to be dispensed in vending machines as additional ingredients in hot liquid beverages or other foods.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.5 Certification requirements
Applicants for certification as external appeal agents shall be required to submit a signed and notarized application to the commissioner, in the form and manner prescribed jointly by the commissioner and the superintendent. Such application shall include the requirements of section 4912 of the Public Health Law and Insurance Law and the following:
(a) A description of the applicant's organizational structure and capability to operate a statewide external appeal program, including:
(1) certificate of incorporation, articles of organization and by-laws or operating agreement of the applicant and, as applicable, the applicant's holding company or parent company;
(2) the applicant's organizational chart; and
(3) any existing or proposed relationships between the applicant and any health care services entities, health care providers and management service organizations. A certified external appeal agent shall not delegate any management function related to external appeal activities pursuant to title II of article 49 of the Public Health Law and the Insurance Law to a management service organization or any other entity.
(b) Identification of management staff and a description of such management staff's responsibilities. Each member of the management staff shall provide personal qualifying information, in the form and manner prescribed jointly by the commissioner and the superintendent.
(c) The chief executive officer of the external appeal agent shall complete an attestation, also described in section 98-2.6(b) of this Subpart, which affirms, under penalty of perjury, that:
(1) the applicant for certification as an external appeal agent does not own or control, is not owned or controlled by and does not exercise common control with any national, State or local illness, health benefit or public advocacy group, society or association of hospitals, physicians or other providers of health care services or association of health care plans; and
(2) the external appeal entity, including the medical director and all owners, officers, directors and management employees of such entity has no material professional affiliation, material familial affiliation, material financial affiliation or other affiliation proscribed by section 98-2.6 of this Subpart with any health care plan, any owner, officer, director or management employee of any health care plan, any health care provider, physician's medical group, independent practice association or provider of pharmaceutical products or services or durable medical equipment, any health care facility, or any developer or manufacturer of health services, except as specifically listed in an attachment to the attestation.
(d) Information concerning the governing board of the applicant, including roles and responsibilities, identification of the board members and a description of their qualifications.
(e) A description of the clinical peer reviewer network, including an assessment of the network's adequacy to provide statewide external appeal services.
(f) The current financial condition of the applicant, including a certified financial statement, a statement of revenues and expenses, a balance sheet and methods to repay any indebtedness, sources of capitalization and documentation of accounts, assets, reserves and deposits.
(g) The process for ensuring that clinical peer reviewers, when making an external appeal determination concerning medical necessity, consider the clinical standards of the health care plan, the information provided concerning the enrollee, the attending physician's recommendation and applicable generally accepted practice guidelines developed by the Federal government, national or professional medical societies, boards and associations.
(h) Policies and procedures for processing external appeals, including:
(1) a description and a chart or diagram of the sequence of steps through which an external appeal will move from receipt of the external appeal by the certified external appeal agent through notification to the enrollee and the enrollee's health care plan regarding the external appeal determination. Such description shall take into account the requirements of section 4914 of the Public Health Law and Insurance Law and section 98-2.10(a)-(h) and (k) of this Subpart; and
(2) procedures for ensuring that no prohibited material affiliation exists with respect to the clinical peer reviewer(s) assigned to each external appeal, pursuant to section 98-2.6 of this Subpart. Such procedures shall include, for each clinical peer reviewer assigned to review the external appeal, a requirement for a duly signed and notarized attestation which affirms, under penalty of perjury, that no prohibited material affiliation exists with respect to such clinical peer reviewer's participation in the review of the external appeal pursuant to section 98-2.6(e), (f) and (h) of this Subpart. Such attestation shall be in such form as prescribed by the commissioner and superintendent and must be maintained on file with the certified external appeal agent.
(i) A description of the fees which shall reflect the total amount that will be charged by the certified external appeal agent for external appeals, inclusive of indirect costs, administrative fees and incidental expenses, and a description of the methodology used to calculate the fees. Fees shall be approved for use for two years. Any proposed change in fees must be prior approved by the commissioner and the superintendent.
(j) A description of the certified external appeal agent's ability to accept requests for external appeals, provide requisite notifications, screen for material affiliations, respond to calls from the State and meet other requirements on a seven day per week basis.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 141 SARATOGA COUNTY
10 CRR-NY 141.1 Village of Corinth
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on the Kendall and Sturdevant creeks and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the village of Corinth, Saratoga County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Kendall and Sturdevant creeks which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), streams, ditch, gutter or other channel of any kind, the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the Village of Corinth.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the public water supply of the Village of Corinth.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the Village of Corinth.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision, unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thorougly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivison shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Corinth, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed, or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Corinth is prohibited, nor shall any such watering be allowed in any watercourse tributary to this water supply within 1000 feet of said reservoir. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Corinth.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Corinth, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 250 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs.
(h) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Corinth.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Corinth.
(j) Inspections.
The board of trustees of the village of Corinth shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first of January, the results of the regular inspection made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.7 Notice of disapproval and appeal
The permit issuing official shall issue a “notice of disapproval” whenever he finds that an application fails to meet the requirements for issuance of a permit as hereinabove provided. Such notice shall:
(a) state the grounds for disapproval; and
(b) be served upon the applicant or his agent, provided, however, that such notice shall be deemed to be properly served upon such applicant or agent, if a copy thereof is sent by registered or certified mail to his last known address, or if he is served by such other methods as are, or may be authorized, under the laws of this State governing personal service of process upon individuals. Such notice may state any remedial action which, if taken, will effect compliance with this Subpart and permit approval of the application.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.50 Meals on wheels
This functional reporting center must contain all the expenses associated with the provision of dietary services to patients at their place of residence.
(a) Standard unit of measure: number of meals.
The number of meals provided by the residential health care facility to participants in the meals on wheels program.
(b) Data source.
The number of meals shall be determined from an actual count maintained by the dietary department at the facility.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.11 Recreational safety
(a) Swimming.
(1) Only locations approved by the permit-issuing official as part of the camp's safety plan can be used for swimming.
(2) Adequate light must be present to effectively supervise swimming activities. Swimming shall be prohibited between sunset and sunrise at wilderness swimming sites. Lighting for indoor and nighttime swimming pool use must comply with Subpart 6-1 of this Title.
(3) Swimming pools and bathing beaches operated as part of a children's camp shall comply with Part 6 of this Title, and the following:
(i) The swimming pool or bathing beach shall be directly supervised by a camp aquatics director.
(ii) Float lines shall be provided in accordance with Subpart 6-1 or Subpart 6-2 of this Title and the swimming area shall have at least non-swimmer and swimmer areas designated. Non-swimmers shall be confined to the area appropriate to their assessed swimming ability. Non-swimmers shall be conspicuously identified to be readily distinguishable from swimmers except where non-swimmers are restricted from entering the swimmer area by a physical barrier such as a swim crib or dock, or are in a separate pool only for non-swimmers. Non-swimmers shall be restricted to water less than chest deep, except:
(a) during learn-to-swim programs that use a supervision protocol determined by the State Commissioner of Health to protect a camper from injury or drowning; or
(b) when counselors are in the water and directly supervise a maximum of three non-swimmers in shallow water in the non-swimmer area.
(iii) Permanent swimming areas shall have supervised entrances and exits, lifeguard station providing an unobstructed view of the swimming area, and lifesaving equipment. Swimming pools shall be protected by fences: entrance gates shall be locked except during periods when a lifeguard is on duty.
(iv) A buddy system and board system of supervising and checking bathers must be described in the camp's approved safety plan and implemented. It must include, as a minimum:
(a) an accounting system which identifies each bather by name, the bather's swimming ability and the swim area to which the bather is assigned;
(b) a method of recording the entry to and exit from the swim area for each bather;
(c) the assignment of each bather to a buddy who must have the same level of swimming ability. If a non-swimmer is paired with a swimmer, both must remain in the non-swimmer area. One threesome is allowed per swim area. Buddies shall be instructed to notify the lifeguard when their partner is in distress or is missing; and
(d) that checks of the bathers are made at least every 15 minutes. These checks are referenced against the accounting system.
When children are unable to comprehend or implement the buddy system, another method which the permit-issuing official has determined provides an equivalent level of bather safety, supervision and accountability for these children may be substituted for the buddy system and board system. The method must be described in the camp's approved safety plan.
A "lost swimmer" plan, which details all procedures to be followed, including clearing the water, searching and supervising campers present, is required and must be included in the camp's approved safety plan. The lost swimmer plan shall be implemented whenever a buddy check fails to account for all bathers and anytime a bather is reported missing.
(v) All piers, floats, platforms, and decking shall be in good repair. Clearly visible depth and other markings shall be provided in accordance with Subpart 6-1 or Subpart 6-2 of this Title.
(vi) The minimum water depth for diving boards shall be in accordance with section 6-1.10(l) or section 6-2.19, item 4.8.2 of this Title. Swimming pool diving boards installed since July 15, 1988, shall be constructed in accordance with section 6-1.29 item 5.6 of this Title. For outdoor diving areas, the bottom shall be cleared of stumps, rocks and other obstacles. Diving boards shall be mounted on a firm foundation and the top surface shall be slip resistant.
(vii) There shall be one qualified lifeguard for every 25 bathers. Each lifeguard shall supervise no more than 3,400 square feet of pool surface area or 50 yards of shoreline at a bathing beach. At a beach where swimming or diving is permitted more than 150 feet from shore, lifesaving patrol boats or offshore lifesaving stations shall be provided.
(viii) The ratio of counselors to campers participating in activities that occur in the water shall be 1:10. For children younger than eight, the ratio shall be 1:8, except that when children are less than six years of age, the ratio shall be 1:6. Counselors shall be assigned to supervise campers and be located at the poolside, beachfront or in the water providing direct visual surveillance for such campers at all times.
(4) When swimming is conducted during camp trips including aquatic amusement park activities at a facility not owned or operated by the camp, each camper shall have a signed statement of permission to participate from a parent/guardian and the following shall be met:
(i) Except for wilderness sites, only those swimming pools and bathing beaches in New York State that have a valid permit to operate issued from the local health department having jurisdiction for the bathing facility, or those be operated by a New York State Agency may be used.
(ii) Residential swimming pool use is prohibited.
(iii) A buddy system and board system of supervising bathers shall be implemented in accordance with subparagraph (3)(iv) of this subdivision. All campers must have their swimming ability assessed by a progressive swimming instructor and the swimming area shall have at least non-swimmer and swimmer areas designated. Non-swimmers shall be confined to the area appropriate to their swimming ability. Non-swimmers shall be conspicuously identified to be readily distinguishable from swimmers except where non-swimmers are restricted from entering the swimmer area by a physical barrier such as a swim crib or dock or are in a separate pool for only non-swimmers. Non-swimmers shall be restricted to water less than chest deep, except:
(a) during learn-to-swim programs that use a supervision protocol determined by the State Commissioner of Health to protect a camper from injury or drowning; or
(b) when counselors are in the water and directly supervise a maximum of three non-swimmers in shallow water in the non-swimmer area.
(iv) When a camp utilizes a pool, bathing beach or an aquatic amusement park activity where the facility provides aquatic supervisory staff level I, IIa or IIb in accordance with Part 6 of this Title, the camp shall provide one qualified lifeguard, or camp staff who possesses training in children's camp swimming program safety as specified in clause ( a ) of this subparagraph, for each 75 campers to supervise camper bathing activities and implement the camp safety plan. A camp supplied lifeguard, or a staff possessing training in children's camp swimming program safety, is not required for aquatic amusement park activities that allow only one or two patrons in the water at a time and the activity water depth does not exceed chest deep for non-swimmers.
(a) A training course will be determined to be acceptable if, after a review by the State Health Department, the materials and training program covering those items set forth below are determined to provide camp staff with adequate training to supervise a camp trip swimming activity.
(b) Training course certification shall be valid for the time period specified by the certifying agency, but may not exceed a consecutive three-year period from course completion.
(c) Training course materials shall be submitted for review by the course sponsor and shall include minimum instructor qualifications to demonstrate that instructors possess adequate experience and knowledge in children's camp swimming program safety to effectively communicate the subject matter of this section:
(1) Injury Prevention including Communicating and Enforcing Rules.
(2) Bather Surveillance Systems for Children's Camps:
(i) Classifying and Identifying Bather Swimming Abilities.
(ii) Swimming Area Selection.
(iii) Buddy System.
(iv) Buddy Board/Accountability Systems.
(3) Types of Emergencies and Emergency Action Plans (EAP).
(v) Pre-arrangement must be made with an off-site facility to ensure that the facility is capable of accommodating the additional bather load associated with the camp, to identify duties of the camp aquatic staff, and to determine whether or not the facility's lifeguards will be present.
(vi) Minimum counselor to camper ratio shall be 1:8 for campers six years of age and older and 1:6 for campers younger than six years of age. Counselors shall be assigned to supervise campers and be located at the poolside, beachfront or in the water providing direct visual surveillance for such campers at all times.
(vii) When the camp utilizes a facility that does not provide aquatic supervisory staff level I, IIa or IIb in accordance with Part 6 of this Title, the camp must provide one qualified lifeguard for every 25 bathers to directly supervise campers participating in bathing activities and to implement the camp safety plan. Each camp supplied lifeguard shall supervise no more than 3,400 square feet of area at swimming pools or no more than 50 yards of shoreline at bathing beaches. Camper swimming is prohibited at a distance of more than 75 feet from shore at bathing beaches when the water depth exceeds chest deep of the shortest camper. When the water depth is less than chest deep of the shortest camper, swimming shall be restricted to no more than 150 feet from shore.
(5) When wilderness swimming is conducted, each participating camper shall have a signed statement of permission to participate from a parent/guardian, and subparagraph (3)(iv) of this subdivision shall be complied with. In addition:
(i) The camp shall provide at lease one qualified lifeguard per 25 bathers. A minimum of two staff members which includes the lifeguard who shall possess a current certificate in an acceptable cardiopulmonary resuscitation (CPR) training program as defined in section 7-2.2(n) of this Supbart.
(ii) Minimum staff to camper ratio shall be 1:8 for campers six years of age and older and 1:6 for campers younger than six years of age. Counselors shall be assigned to supervise campers and be located at the waterfront providing direct visual surveillance for such campers at all times.
(iii) The swimming area shall be adequately marked to identify the perimeter. Water within the swimming area shall not exceed five feet in depth and swimming shall be restricted to an area which is no more than 50 yards of shoreline and 75 feet from shore. Water clarity shall be sufficient to see the bottom or to a minimum of four feet below the surface throughout the swimming area. The bottom slope of the swimming area shall not be steeper than 1:8 and the bottom shall contain no sharp drop-offs. jagged rocks or under water obstructions. Water currents shall not exceed three feet per second in the swimming area.
(iv) All campers must have their swimming ability assessed by a progressive swimming instructor and the swimming area shall have at least non-swimmer and swimmer areas designated. Non-swimmers shall be confined to the area appropriate to their assessed swimming ability. Non-swimmers shall be conspicuously identified to be readily distinguishable from swimmers and be restricted to water less than chest deep.
(v) Safety equipment. One rescue tube. rescue buoy or United States Coast Guard approved life jacket and a pocket face mask to assist with CPR shall be provided for each required lifeguard.
(vi) Safety rules. Head first diving shall be prohibited as shall jumping into the water from cliffs, trees, water flumes or rope swings.
(b) Riflery.
(1) Rifle ranges shall not endanger any person or persons in other activity areas; backstops shall be used to contain bullets within the range. Large warning signs atop the backstop, facing away from the firing line, shall be labeled “keep out.”A red firing flag shall be displayed when the range is in use.
(2) Rifle ranges shall be equipped with a firing line and a ready line; only those ready to fire shall be on the firing line. Those waiting to fire shall remain behind the ready line.
(3) The minimum age to participate in a riflery activity shall be in accordance with the article 265 of the New York State Penal Law and specified in the camp safety plan. Campers shall be instructed in safe rifle range procedures before actual firing.
(4) Single-shot rifles, preferably with slings, shall be used. Persons shall stay behind the firing line at all times, except when ordered by the instructor to retrieve targets.
(5) The instructor shall be on the range at all times during firing sessions and shall be assisted by another counselor who may be trained by the instructor. One staff person shall supervise a maximum of 10 campers on the firing line.
(6) The instructor shall determine that rifles are clean and in good repair, supervise the storage of equipment and control its use by means of a check-out system. Guns and ammunition shall be stored, separately, in locked cabinets.
(c) Archery.
(1) The archery range shall not endanger any person or persons in other program activities and be clearly marked to warn passing campers away from the danger area. The shooting area shall have at least 50 yards of clearance or an archery net behind each target. Bowmen shall fire from a common firing line and a ready line shall be marked behind it.
(2) The bows and arrows shall be stored in a locked cabinet.
(3) An archery staff-camper ratio of one for every 10 campers on the firing line shall be maintained.
(4) All archery staff should possess training in archery.
(d) Horseback riding.
(1) A competent riding instructor shall determine each camper's riding experience and level of skill before assigning horses and deciding whether the camper rides in the ring or on the trail. One experienced instructor shall be assigned for every 10 riders for each trail excursion and a minimum of two staff persons shall accompany such excursion.
(2) Protective headgear containing a permanent label stating that it meets or exceeds the American Society for Testing and Materials standard ASTM F1163 shall be worn at all times.
(3) Children shall wear shoes with heels, or closed stirrups shall be used.
(e) Animals.
No animals suspected of carrying a communicable disease shall be kept in camp. Animals kept in camp shall comply with the Environmental Conservation Law and with the Agriculture and Markets Law.
(f) Equipment.
(1) No personal weapons, bows, rifles or similar equipment shall be brought to camp without the camp operator's knowledge and permission. Such articles permitted in camp shall be kept in a locked cabinet by the operator and used only by the owner in accordance with camp safety regulations.
(2) All equipment shall be free of hazards, securely anchored where necessary, installed and used in accordance with manufacturer's instructions and inspected by the camp operator at frequent intervals for defects.
(g) On-site activities.
An activity leader shall supervise each camp activity occurring on the camp's property. A minimum of one activity leader and one staff member shall supervise activities that occur at locations where additional camp staff assistance is not readily available. A minimum counselor-camper ratio of 1:8 shall be maintained for wilderness, equestrian, boating and similar specialized activities, unless the children are less than six years of age than the ratio shall be 1:6.
(h) Special waterfront activities.
(1) Practices and equipment, including head protection for whitewater canoeing and personal flotation devices for specialty waterfront activities such as water skiing, scuba diving or whitewater canoeing shall be included in the approved camp safety plan.
(2) All motorized boats for use at camp shall: be registered with the Department of Motor Vehicles, display its registration number on its bow, and a current registration and inspection certificates shall be available for examination by the permit-issuing official. Procedures and conditions for the use of nonmotorized boats shall be included in the required written camp safety plan. All boat occupants shall wear a United States Coast Guard-approved life jacket or vest. A lifeguard shall be present in any water craft having a capacity of eight or more persons and carrying nonswimmers unless such watercraft is a public vessel as defined in section 2(6)(a) of the New York State Navigation Law.
(3) Boats may be used only by persons having permission of the camp aquatics director or camp director. Boats carrying passengers shall never be towed behind motorized or nonmotorized boats. All boats are prohibited in the swimming area unless being used in rescue efforts by lifeguards.
(4) All specialized aquatic activities, such as canoeing, sailing, waterskiing and scuba diving, conducted by the camp shall be under the leadership of a counselor trained in the specialty.
(i) Camp trips.
A trip leader and at least one counselor must accompany all camp trips. A minimum counselor-camper ratio of 1:8 shall be maintained for swimming, wilderness, equestrian, boating and similar specialized trips, unless the children are less than six years of age then the ratio shall be 1:6. A minimum counselor-camper ratio of 1:12 shall be maintained when transporting campers via motor vehicles to a specific activity site. Staff supervising a camp trip must review the camp safety plan for each trip within 24 hours prior to departure except when the staff participated in an identical trip or in the pre-camp training within one week prior to the intended trip.
(j) Incidental water immersion.
During a hike or other similar camp activity, entering a stream or body of water for the purpose of crossing or for personal hygiene shall not be considered swimming. Procedures for incidental water immersion in water deeper than mid-calf of the shortest camper must be specified in the camp safety plan and approved by the permit-issuing official. Incidental water immersion shall be prohibited when the water's depth cannot be determined or when the water's depth or current does not ensure a safe crossing. A trip or activity leader shall be familiar with safe water flow characteristics and camp safety plan procedures for any body of water entered. Staff shall test the entire area in which incidental immersion will occur prior to campers entering the water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 79 PRICE INFORMATION
10 CRR-NY 79.8 Comprehension of disclosure
All disclosures required by this Part shall be in a clear and conspicuous manner.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.6 Identification of personnel delivering health care services
All employed personnel, including paraprofessionals and volunteers, who deliver health care services in a medical facility shall be clearly and readily identified as to professional function by means of an insignia or other device worn on his or her person.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.11 Adjustments to direct component of the rate
(a) Payments for 1986 and subsequent rate years for the direct component of the rate as defined in section 86-2.10(c) of this Subpart shall be adjusted periodically as described in this section to reflect changes in the case mix of facilities.
(b) Facilities shall report to the department changes in patient case mix as follows:
(1) Full reassessments. Facilities shall, on a schedule to be established by the department, assess all their patients semiannually and submit patient review instruments pursuant to section 86-2.30 of this Subpart. The department shall consider, in developing such schedule, that for each of the six months in a semiannual period, there would be submitted approximately 1/6of the assessments for all patients in the State.
(2) Assessment of patients admitted since the last assessment period. Three months from the date facilities are scheduled to perform full reassessments, facilities shall assess patients admitted and still residing in the facility since the last full assessment period. Patient review instruments for such patients shall be submitted pursuant to section 86-2.30 of this Subpart on a schedule to be established by the department. The department shall consider, in developing such schedule that for each of the six months in a semiannual period, there would be submitted approximately 1/6 of the assessments of such new admissions.
(3) Notification to department of patients discharged since last assessment period. Facilities shall notify the department of any patients assessed during the previous full reassessment period as described in paragraph (1) of this subdivision and since discharged concurrent with the submission required by paragraph (2) of this subdivision for patients admitted since the last assessment period.
(c) Payment rates for the direct component of the rate as defined in section 86-2.10(c) of this Subpart shall be adjusted, on a facility specific basis for changes in patient case mix retroactive to the beginning date of the month in which the assessment of patients was scheduled by the department and performed by the facility.
(d) Adjusted payment rates shall be determined by recalculating a facility's number of patients in each patient classification group as a result of the submissions in accordance with this section and such results shall be used in the calculation of the facility specific direct adjusted payment price per day pursuant to section 86-2.10(c)(4) of this Subpart.
(e) Trending.
Payment rates for the operating component of the rate as defined in section 86-2.10(b)(2) of this Subpart may be adjusted for changes in the trend factors originally promulgated by the department in accordance with section 86-2.12 of this Subpart.
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.41 Withholding of State aid
(a) State aid may be withheld, in whole or in part, if the commissioner determines, upon program review, that:
(1) core public health services were not performed in accordance with this Part, article 6 of the Public Health Law, or the approved application for State aid; or
(2) the local health department has not made every reasonable effort to collect fees for services set forth in section 40-1.51 of this Part.
(b) If, after notification that State aid will be withheld pursuant this section, the local health department provides written justification within 60 days why such action is not warranted that is satisfactory to the commissioner, the commissioner may, within his or her discretion, adjust or cancel the withholding of State aid.
(c) If the commissioner withholds funds pursuant to this section, the amount withheld shall be based on the cost of providing the missing or inadequate services by another agency or by the State.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.21 Fraud and abuse prevention plans and special investigation units
(a) Pursuant to Public Health Law section 4414, every MCO that participates in public or government sponsored programs with an enrolled population of 10,000 or more persons in the aggregate in any given year shall develop and file with the commissioner within 180 days of the effective date of these regulations a plan for the detection, investigation and prevention of fraudulent activities in this State and those fraudulent and abusive activities affecting policies or State or local department of social services contracts issued or issued for delivery in this State. The plan must include written policies, procedures and standards of conduct that are distributed to all affected employees and appropriate delegated entities, and that articulate the MCO's commitment to comply with all applicable Federal and State standards and identify and address specific areas of risk and vulnerability. The MCO must designate an officer or director who has responsibility and authority for carrying out provisions of the plan, and who reports directly to senior management. Any MCO that has filed and implemented such a plan with the superintendent in compliance with section 409 of the Insurance Law is exempt from the requirements of this section.
(1) For the purposes of this section, fraud means any type of intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person in a managed care setting, including any act that constitutes fraud under applicable Federal or State law, committed by an MCO, contractor, subcontractor, provider, beneficiary or enrollee or other person(s). A provider includes any individual or entity that receives funds in exchange for the provision, or arranging for the provision, of health care services to an MCO enrollee.
(2) For the purposes of this section, abuse means provider practices that are inconsistent with sound fiscal, business or medical practices and result in an unnecessary cost to the State or Federal government or MCO, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care in a managed care setting, committed by an MCO, contractor, subcontractor, provider, beneficiary or enrollee. It also includes enrollee practices that result in unnecessary cost to the State or Federal government, MCO, contractor, subcontractor or provider. For the purposes of this paragraph, provider includes any individual or entity that receives funds in exchange for providing, or arranging for the provision, of a service.
(b) A fraud and abuse prevention plan shall include the following provisions:
(1) the establishment of a full-time special investigation unit, separate and distinct from any other unit or function of the MCO, which shall be responsible for investigation of cases of suspected fraudulent and abusive activity and for implementation of the MCO's fraud and abuse prevention and reduction activities under the MCO's fraud and abuse prevention plan, which shall encompass activities of all contracted providers. All documents related to the activities of the special investigations unit shall be maintained for a period of not less than six years. If the MCO enters into a management contract to perform all or part of this function, the management contract shall be submitted to the department for prior approval and included as part of the fraud and abuse prevention plan. The management contract must provide for specified levels of staffing devoted to the investigation of suspected fraudulent and abusive activities. In the event that investigators employed by the management contractor will be working for more than one MCO or on cases in states other than New York, the plan must apportion and specify the percentage of the investigators' efforts which will be devoted to working for the MCO on its New York cases. The agreement shall also require that the management contractor cooperate fully with the department in any examination of the implementation of the fraud and abuse prevention plan and provide any and all assistance requested by the department, any other law enforcement agency or any prosecutorial agency in the investigation and prosecution of fraud and abuse and related crimes;
(2) a description of the organization of the special investigations unit, including the titles and job descriptions of the various investigators and investigative supervisors, the minimum qualifications for employment in these positions in addition to those required by this regulation, the geographical location and assigned territory of each investigator and investigative supervisor, the support staff and other physical resources, including database access available to the unit and the supervisory and reporting structure within the unit and between the unit and the senior management of the MCO. If investigators employed by the unit will be responsible for investigating cases in more than one state, the plan must apportion that percentage of the investigators' efforts which will be devoted to New York cases;
(3) the rationale for the level of staffing and resources being provided for the special investigations unit which may include, but is not limited to, objective criteria such as number of enrollees, number of claims received with respect to New York MCOs on an annual basis, volume of suspected fraudulent and abusive New York claims currently being detected, other factors relating to the vulnerability of the MCO to fraud and abuse, and an assessment of optimal caseload which can be handled by an investigator on an annual basis;
(4) a description of the relationship between the officer or director responsible for carrying out the provisions of the fraud and abuse prevention plan and the special investigations unit; between such persons and the claims, quality, utilization review and underwriting functions of the MCO; and between such persons and the department, other law enforcement agencies and prosecutors;
(5) procedures for detecting and preventing possible fraud and abuse, as well as procedures for case investigation and detection of patterns of repetitive fraud and abuse involving one or more MCO, including but not limited to the following areas:
(i) provision of preventive services;
(ii) underutilization;
(iii) marketing;
(iv) provision of medically necessary services;
(v) assignment of a PCP; and
(vi) submission of claims for services not provided;
(6) criteria for referral of a case to the special investigation unit for evaluation and designation of the individuals authorized to make such a referral; criteria for referral of a case to the department and designation of the individuals authorized to make such referrals; and a policy to avoid duplication of effort due to concurrent referrals by the officer, director or unit to more than one law enforcement agency;
(7) provisions for confidential reporting which ensure that the identity of individuals reporting violations of the MCO's standards of conduct, policies and procedures and applicable State and Federal standards, is protected. In addition, the MCO must ensure that no individual who reports such violations or suspected fraud and abuse is subjected to retaliation;
(8) for MCOs participating in programs authorized by title XIX, provision for the department and/or the New York State Medicaid Fraud Control Unit (MFCU) to conduct private interviews of MCO personnel, subcontractors and their personnel, witnesses, and enrollees. MCO personnel and subcontractors and their personnel must cooperate fully in making MCO personnel, subcontractors and their personnel available in person for interviews, consultation, grand jury proceedings, pre-trial conference, hearings, trial and in any other process, including investigations at the MCO's and subcontractor's own expense. In addition, the MCO must provide to the department, its authorized representatives, and/or the MFCU, originals and/or copies of all records and information requested, in the form requested, and allow access to the MCO's premises. All copies of records must be provided free of charge;
(9) provision for in-service training programs for investigative, claims, quality, utilization management and other personnel in identifying and evaluating instances of suspected fraud and abuse, including an introductory training session and periodic refresher sessions. This provision shall include course descriptions, the approximate number of hours to be devoted to these sessions and their frequency. In addition, the training and education required for the officer or director responsible for carrying out the provisions of the fraud and abuse prevention plan must be described;
(10) provision for coordination with other units of the MCO to further fraud and abuse investigations, including a periodic review of claims, underwriting, member services, utilization management and complaint procedures and forms for the purpose of enhancing the ability of the MCO to detect fraud and abuse and to increase the likelihood of its successful prosecution, and for initiation of civil actions when appropriate;
(11) provision for prompt response to detected offenses, and for development of corrective action initiatives;
(12) provision for establishment and consistent application of appropriate disciplinary policies for all employees who fail to comply with the MCO's standards of conduct, policies and procedures and applicable State and Federal standards, as well as publication and dissemination of the disciplinary policies and the range of disciplinary actions for improper conduct;
(13) development of a fraud and abuse awareness program, appropriate for the size of the MCO, focused on the cost and frequency of fraud and abuse, and methods by which the MCO's enrollees, providers and other contractors can prevent it;
(14) development of a fraud and abuse detection procedures manual for use by officers, directors, managers, and claims, underwriting, member services, utilization management, complaint, and investigative personnel; and
(15) the timetable for the implementation of the fraud and abuse prevention plan, provided however, that the period preceding implementation shall not exceed six months from the date the plan is submitted.
(c) Persons employed by special investigations units as investigators or by an independent provider of investigative services under contract with an MCO shall be qualified by education or experience, which shall include an associate's or bachelor's degree in criminal justice or a related field, or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance related matters. For the purposes of evaluation of medical related claims, MCOs may employ or retain duly licensed or authorized medical professionals. Notwithstanding these minimum requirements, anyone employed as an investigator in a special investigation unit or by a provider of investigative services under contract to an MCO as of the effective date of these regulations may continue in such employment, provided that the insurer identifies such person in writing to the commissioner, giving the date such employment began and a description of the person's qualifications, employment history and current job duties.
(d) Every MCO required to file a fraud and abuse prevention plan shall file an annual report with the department no later than January 15th of each year on a form approved by the department describing the MCO's experience, performance and cost effectiveness in implementing the plan and its proposals for modifications to the plan, to amend its operations, to improve performance or to remedy observed deficiencies. The MCO must also report at least annually the number of complaints regarding fraud and abuse made to the MCO during the year. In addition, for each confirmed case of fraud and abuse identified through complaints, organizational monitoring, contractors, subcontractors, providers, beneficiaries, enrollees, etc., the following shall be reported to the department on an ongoing basis when the case is confirmed:
(1) the name of the individual or entity that committed the fraud or abuse;
(2) the source that identified the fraud or abuse;
(3) the type of provider, entity or organization that committed the fraud or abuse;
(4) a description of the fraud or abuse;
(5) the approximate range of dollars involved;
(6) the legal and administrative disposition of the case, including actions taken by law enforcement officials to whom the case has been referred; and
(7) other data/information prescribed by the department.
The reports shall be reviewed and signed by an executive officer of the MCO responsible for the operations of the special investigations unit.
Subchapter B STATE AID AND FUNDING
Part 46 STATE AID FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
10 CRR-NY 46.9 Procedures and treatment at approved centers
(a) Heart surgery.
Definitive diagnoses and surgical procedures by open or closed techniques will be approved for State-aid reimbursement by the Bureau of Medical Rehabilitation only when such services are performed at centers specifically approved by the department for the type of heart surgery involved.
(b) Other specific conditions.
Unless specific exception is made by the Commissioner of Health, State-aid reimbursement shall be made for the initial evaluation and recommendations for a treatment program for children with the following conditions only when such services are performed at centers approved by the Commissioner of Health for such care:
(1) amputation;
(2) chronic asthma;
(3) blood dyscrasias;
(4) cancer;
(5) convulsive disorders;
(6) cystic fibrosis;
(7) diabetes mellitus;
(8) impaired hearing;
(9) complicated injuries, particularly to head and back, and mutilating injuries of the face and extremities;
(10) prematurity;
(11) chronic renal disease;
(12) phenylketonuria;
(13) branched-chain ketonuria;
(14) galactosemia;
(15) homocystinuria;
(16) histidinemia;
(17) congenital hypothyroidism.
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.8 Notification
Written notification shall be given of the decision to accept or deny an application. Notification of denial shall clearly set forth the specific reason why the application was denied.
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.5 Department approval of methods
(a) A laboratory shall obtain department approval prior to performing a laboratory-developed method, or other method not otherwise approved or given similar recognition as described in section 55-2.1(e) of this Subpart. The department may approve such a method, provided the laboratory submits data and other information as required supporting the technical merit of the method, and demonstrating that the methods's precision and accuracy are equivalent or superior to that of an approved method. Such data and information shall include, but not be limited to:
(1) a description of the method, including analyte, sample type, working range, reagents and their preparation, equipment specifications, analytical procedures, precision, accuracy, related calculations, intended purpose and pertinent literature citations;
(2) the anticipated date of method implementation;
(3) comparative data, including: sample source(s), dates and times collected, and matrix; whether the sample was spiked, and, if so, the spiking procedure; the approved method used; and analytical results for both the approved method and the method submitted for approval;
(4) data from inter-laboratory comparisons, demonstrating the method's reproducibility;
(5) demonstration of capability data; and
(6) any other information pertinent to the department's determination of the method's technical merit.
(b) Provided all other requirements of subdivision (a) of this section are met, the department may approve a method for which reproducibility has not been demonstrated by inter-laboratory comparisons if the laboratory demonstrates that its performance of the method is technically acceptable for the intended sample types and analytical purpose. Such approval shall be limited to the laboratory which applied for such approval.
(c) In addition to the requirements of subdivisions (a) and (b) of this section, the department may require successful completion of on-site demonstration analysis on samples designed to challenge the procedure.
(d) The department shall respond to a laboratory's request for method approval, notifying the laboratory of method approval, method approval contingent upon approval by the EPA, proposed denial of the request, or the need for further information.
(e) If the department proposes to deny a request for method approval, it shall advise the laboratory of such proposed denial and the reasons for the denial. A proposed denial shall become final 30 calendar days from the date of notice of proposed denial, unless the laboratory submits, within 30 calendar days of the date of such notice, a written request for reconsideration, including all documentation and rationale in support of such request. Within 30 calendar days of the date the department receives a request for reconsideration, the department shall issue a final determination concerning the request for reconsideration.
(f) Notwithstanding the provisions of this Subpart, the department may conduct an independent review of any approved method to substantiate or refute its technical merit. If the method's technical merit is found to be lacking, the department shall notify the affected laboratory(ies) of its proposed determination that the method may not be performed under an New York State environmental laboratory certificate of approval, giving the reasons for such determination. Such proposed determination shall become final 30 calendar days from the date of the notice of proposed determination, unless the laboratory(ies) offering such method submits, within 30 calendar days of the date of the notice, a written request for reconsideration, including all documentation and rationale in support of such request. Within 30 calendar days of the date of department receives of a request for reconsideration, the department shall issue a final decision regarding the request for reconsideration.
(g) All information and data pertinent to method approval shall be documented, and be made available for department review upon on-site assessment or upon request for a minimum of two years after the date of the method's discontinuation.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.182 Nontransferable
(a) Permits are nontransferable from one owner or operator to another, or from one commissary location to another.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.12 Physical containment levels; P2 level
(a) Laboratory practices.
(1) Laboratory doors shall be kept closed while experiments are in progress.
(2) Work surfaces shall be decontaminated daily, and immediately following spills of organisms containing recombinant DNA molecules.
(3) All laboratory wastes shall be steam-sterilized (autoclaved) before disposal. Other contaminated materials, such as glassware, animal cages, laboratory equipment and radioactive wastes, shall be decontaminated by a means demonstrated to be effective before washing, reuse or disposal.
(4) Mechanical pipetting devices shall be used; pipetting by mouth is prohibited.
(5) Eating, drinking, smoking, and storage of food are not permitted in the laboratory area in which recombinant DNA materials are handled.
(6) Persons shall wash their hands after handling organisms containing recombinant DNA molecules, and when they leave the laboratory.
(7) Care shall be exercised to minimize the creation of aerosols. For example, manipulations such as inserting a hot inoculating loop or needle into a culture, flaming an inoculation loop or needle so that it splatters, and forceful ejection of fluids from pipettes or syringes shall be avoided.
(8) Contaminated materials that are to be steam-sterilized (autoclaved) or decontaminated at a site away from the laboratory shall be placed in a durable leak-proof container, which is closed before removal from the laboratory.
(9) Only persons who have been advised of the nature of the research being conducted shall enter the laboratory.
(10) The universal biohazard sign shall be posted on all laboratory access doors when experiments requiring P2 containment are in progress. Freezers and refrigerators or other units used to store organisms containing recombinant DNA molecules shall also be posted with the universal biohazard sign.
(11) An insect and rodent control program shall be instituted.
(12) The use of laboratory gowns, coats, or uniforms is required. Laboratory clothing shall not be worn to the lunch room or outside of the building in which the laboratory is located.
(13) Animals not related to the experiment shall not be permitted in the laboratory.
(14) Use of the hypodermic needle and syringe shall be avoided when alternative methods are available.
(15) The laboratory shall be kept neat and clean.
(16) Experiments of lesser biohazard potential can be carried out concurrently in carefully demarcated areas of the same laboratory.
(b) Containment equipment.
Biological safety cabinets shall be used to contain aerosol-producing equipment, such as blenders, lyophilizers, sonicators, and centrifuges, when used to process organisms containing recombinant DNA molecules, except where equipment design provides for containment of the potential aerosol. For example, a centrifuge may be operated in the open if a sealed head or safety centrifuge cups are used.
(c) Special laboratory design.
An autoclave for sterilization of wastes and contaminated materials shall be available in the same building in which organisms containing recombinant DNA molecules are used.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.11 Enrollee rights and responsibilities
(a) Enrollees shall be responsible for:
(1) exhausting the health care plan's internal appeal process under section 4904 of the Public Health Law, provided however, that if a health care plan has two levels of internal appeals, the enrollee must only exhaust the first level of appeal. In the alternative, the enrollee and the enrollee's health care plan may jointly agree to waive the internal appeal process;
(2) ensuring that requests for external appeals are filed and completed within the time frames provided for in paragraph (4) of this subdivision, except in the case of transmittal of medical and treatment records, which shall be the responsibility of the enrollee's health care plan;
(3) as applicable, providing the attending physician with the documents necessary to complete the physician attestation component of the external appeal request, and, as necessary, providing evidence to the superintendent that such has occurred; and
(4) ensuring that, to the extent possible, all supporting documentation, including but not limited to diagnostic test results and medical literature, is submitted to the assigned certified external appeal agent within the earlier of:
(i) 45 days from the date of the enrollee's receipt of a final adverse determination notice or within 45 days of receiving a letter from the health care plan affirming that both the enrollee and the enrollee's health care plan jointly agreed to waive the internal appeal process; or
(ii) prior to the date the external appeal determination is finalized by the certified external appeal agent; and
(5) responding to the superintendent's requests for information concerning an incomplete external appeal request in a timely manner.
(b) Enrollees whose health benefits are provided through both titles XVIII and XIX of the Federal Social Security Act are eligible to request an external appeal only for those health care services covered through title XIX.
(c) Enrollees whose health benefits are provided through title XIX of the Federal Social Security Act and who request an external appeal pursuant to title II of article 49 of the Public Health Law or the Insurance Law may additionally apply to the Department of Health for a fair hearing pursuant to the terms and within the time frames prescribed by sections 22 and 364-j of the Social Services Law and applicable regulations. Pursuant to section 4910(4) of the Public Health Law and section 4910(d) of the Insurance Law, a fair hearing determination prevails over an external appeal determination; therefore, any appeal for which a determination has been made pursuant to the fair hearing process shall not be considered for external appeal.
(d) Enrollees, except for those whose health benefits are provided through title XIX of the Federal Social Security Act and title 1-A of article 25 of the Public Health Law, are responsible for enclosing a fee with the request for an external appeal to the superintendent in accordance with the fee prescribed by the enrollee's health care plan. The enrollee is responsible for requesting a waiver of the fee requirement from the health care plan if such fee will pose a financial hardship for the enrollee. Enrollees shall not be responsible for paying a fee for any external appeal requested by a health care provider relative to a retrospective adverse determination.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 126 MONTGOMERY COUNTY
VILLAGES VILLAGES
10 CRR-NY 126.2 Village of Canajoharie
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to the reservoir located on Sprite Creek, adjacent to the village of Canajoharie water filtration plant and the Gray Springs, which are located in an area on the north side of Old State Road in the towns of Johnstown and Ephratah and their tributaries, which now serve or which may be developed in the future to serve as sources of the public water supply of the village of Canajoharie, Montgomery County, and to all watercourses tributary thereto or ultimately discharging into said reservoir.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts, or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputescible solid wastes, including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Canajoharie public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works.
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the Village of Canajoharie public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Village of Canajoharie public water supply.
(16) Water supply shall mean the public water supply of the Village of Canajoharie, Montgomery County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities,
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facilities.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 50 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facilities. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facilities and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground in the watershed (except into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the appropriate State agency having jurisdiction over such facilities) within 50 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accordance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facilities.
(d) Refuse disposa1 area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Village of Canajoharie.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Canajoharie.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Canajoharie except by duly authorized employees of the Village of Canajoharie in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Canajoharie within 1000 feet of the water supply intakes except by duly authorized employees of the Village of Canajoharie in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides and toxic chemicals.
No herbicide, pesticide or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The village board of trustees or any person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid village board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid village board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid village board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.3 Required laboratory tests for donated blood
(a) For allogeneic collections under New York State permit, approved tests for syphilis; hepatitis B surface antigen (HBsAg); HIV-1 and hepatitis C virus (HCV) nucleic acid; and antibodies to hepatitis B core antigen (anti-HBc), HCV, HIV-1, HIV-2 and human T-lymphotropic virus types I and II (HTLV-I/II) shall be performed in a New York State-permitted laboratory. For autogeneic collections, such testing shall be performed unless the blood is intended for transfusion at the same facility where it is collected and a system is in place to ensure correct disposition of each blood unit, but the testing need not be performed again if already performed within the previous 30 days or performed on a specimen collected subsequently. Results of a given test run shall not be accepted and reported if results of test kit controls are outside of the predetermined acceptable range. A written report shall be received thereon prior to the release of blood or blood components for transfusion and, if serologic tests are positive, shall preclude release for allogenic transfusion except as described in section 58-2.9(b) of this Subpart. Until such testing is completed, all blood and blood components shall be stored in a separate refrigerator or prominently labeled separate area of the refrigerator reserved for quarantined units. However, in an emergency requiring release for transfusion prior to receipt of such report, the results shall be recorded subsequently on the recipient's chart. Any unacceptable blood unit identified, as well as all of its components, shall be removed immediately from the quarantine area and disposed of or moved to a separate area reserved for such units. Units unacceptable for transfusion, which are retained for other purposes, shall be labeled with pertinent test results.
(b) All test runs for required tests for infectious disease markers that generate numeric readings shall include a weakly reactive control. If the results of this weakly reactive control or any other control do not fall within the predetermined acceptable range, results from that run shall not be reported until the run is repeated. Results of all tests shall be verified by a second staff member to preclude errors in transcription or interpretation. In a manual system, examination of the original instrument tape shall be conducted by the second staff member. Except for results of tests performed on samples from autogeneic donors, as specified in section 58-2.23 of this Subpart, incomplete test results shall not be reported to donors, including any initially reactive test results not yet repeated in duplicate. Release of blood units from quarantine shall be based on examination of a signed and verified hard copy, or electronic equivalent, of all test results. The director of the laboratory conducting the testing shall be responsible for ensuring that testing is performed in accordance with this Subpart. The blood bank director shall be responsible for development of algorithms for test result interpretation and shall approve, in writing, the laboratory procedures to be used.
(c) Plasma collected for fractionation purposes only need not be tested for HTLV-I.
(d) If platelets are donated by the infant’s mother to an infant with alloimmune neonatal thrombocytopenia, the donor’s blood need not be tested as required in subdivision (a) of this section. In such case, the donor requirements specified in section 58-2.2 of this Subpart may also be waived with the written authorization of the medical director of the blood bank or physician designee.
(e) If multiple patient-dedicated blood components are donated by a single donor to support a particular patient, that donor's blood may be screened for all analytes specified in subdivision (a) of this section every 30 days, rather than at each donation. If the clinically useful shelf life of a blood component precludes completion of the required testing prior to component expiration, screening for all analytes specified in subdivision (a) of this section may be performed on a donor blood specimen collected prior to the donation, as permitted by the F.D.A.
(f) For both allogeneic and autogeneic collection, the ABO and Rh groups of every donor shall be determined in accordance with procedures approved by the department. The determination shall be made by:
(1) testing the blood cells with anti-A and anti-B grouping sera; testing the serum or plasma from the blood with known group A and group B red blood cells; and
(2) testing the blood with anti-Rh(o) (anti-D) grouping serum, including, in the case of initially negative testing with anti-Rho (anti-D), a method designed to detect weak D.
(g) For allogeneic collection, required tests for detecting unexpected alloantibodies:
(1) All donor blood shall be tested for unexpected alloantibodies using reagent red blood cells that meet F.D.A. standards and are intended for this purpose.
(2) Methods of testing for alloantibodies shall be those that demonstrate sensitizing and hemolytic antibodies.
(h) Errors or accidents in collecting, testing or processing of donor blood that are not detected prior to distribution and that may affect the safety of any product or health of the donor or recipient shall be reported to the department’s Wadsworth Center within seven calendar days of such an error or its discovery and, if required, to Federal authorities.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-5 AGRICULTURAL FAIRGROUNDS
10 CRR-NY 7-5.11 Food service
All food service operations shall comply with the requirements of Part 14 of this Title.
Part 10 BARBER SHOPS AND BEAUTY PARLORS
MAINTENANCE AND OPERATION MAINTENANCE AND OPERATION
10 CRR-NY 10.21 Walls, ceilings and fixtures
(a) Ceilings shall be kept in repair and cracks in walls, especially around baseboards, shall be filled in so as to prevent the harboring and breeding of insects.
(b) Cabinets, shelves, furniture and fixtures shall be kept clean and free of dust, dirt and hair droppings. Arms, seats and rests of chairs shall be wiped of hair droppings after serving each customer.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.20 Clinical records
The operator must:
(a) provide a clinical record for each registrant in accordance with the clinical records requirements of section 415.22 of this Subchapter;
(b) ensure that all reports and information pertaining to registrant care and planning are entered promptly;
(c) ensure that all entries are dated and authenticated by the person making the entry or ordering the services;
(d) ensure that all clinical records for registrants referred by a managed long term care plan or care coordination model are made available to the referring managed long term care plan or care coordination model;
(e) ensure that the record is kept in a place convenient for use by authorized staff; and
(f) retain intact clinical records and all other records of registrants and keep them readily accessible in a safe and secure place. Such records shall be retained safely and securely for a period of six years following discharge or cessation of operation of services. In the case of a minor, retention shall be for three years after reaching majority (18 years of age).
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.5 Sharing of patient information
(a) General standard.
Qualified entity participants may only exchange patient information as authorized by law and consistent with their participation agreements with qualified entity participants. Under section 18(6) of the Public Health Law, individuals who work for a qualified entity are deemed personnel under contract with a health care provider that is a qualified entity participant. As such, a qualified entity participant may disclose to such a qualified entity necessary patient information without a written authorization from the patient of the qualified entity participant. Qualified entity participants may, but shall not be required to, provide patients the option to withhold patient information, including minor consent patient information, from the SHIN-NY. Except as set forth in paragraph (b)(2) or subdivision (c) of this section, a qualified entity shall only allow access to patient information by qualified entity participants with a written authorization from:
(1) the patient; or
(2) when the patient lacks capacity to consent, from:
(i) another qualified person under section 18 of the Public Health Law;
(ii) a person with power of attorney whom the patient has authorized to access records relating to the provision of health care under General Obligations Law article 5, title 15; or
(iii) a person authorized pursuant to law to consent to health care for the individual.
(b) Written authorization.
(1) Written authorizations must specify to whom disclosure is authorized.
(i) Patient information may not be disclosed to persons who, or entities that, become qualified entity participants subsequent to the execution of a written authorization unless:
(a) the name or title of the individual or the name of the organization are specified in a new written authorization; or
(b) the patient’s written authorization specifies that disclosure is authorized to persons or entities becoming qualified entity participants subsequent to the execution of the written authorization and the qualified entity has documented that it has notified the patient, or the patient has declined the opportunity to receive notice, of the persons or entities becoming qualified entity participants subsequent to the execution of the written authorization.
(ii) Any written authorization shall remain in effect until it is revoked in writing or explicitly superseded by a subsequent written authorization. A patient may revoke a written authorization in writing at any time by following procedures established by the qualified entity.
(2) A minor’s parent or legal guardian may authorize the disclosure of the minor’s patient information, other than minor consent patient information.
(3) Minor consent patient information.
(i) In general, a minor’s minor consent patient information may be disclosed to a qualified entity participant if the minor’s parent or legal guardian has provided authorization for that qualified entity participant to access the minor’s patient information through the SHIN-NY. Such access shall be deemed necessary to provide appropriate care or treatment to the minor. However, if Federal law or regulation requires the minor’s authorization for disclosure of minor consent patient information or if the minor is the parent of a child, has married or is otherwise emancipated, the disclosure may not be made without the minor’s authorization.
(ii) In no event may a qualified entity participant disclose minor consent patient information to the minor’s parent or guardian without the minor’s authorization.
(4) Minor consent patient information includes, but is not limited to patient information concerning:
(i) treatment of such patient for sexually transmitted disease or the performance of an abortion as provided in section 17 of the Public Health Law;
(ii) the diagnosis, treatment or prescription for a sexually transmitted disease as provided in section 2305 of the Public Health Law;
(iii) medical, dental, health and hospital services relating to prenatal care as provided in section 2504(3) of the Public Health Law;
(iv) an HIV test as provided in section 2781 of the Public Health Law;
(v) mental health services as provided in section 33.21 of the Mental Hygiene Law;
(vi) alcohol and substance abuse treatment as provided in section 22.11 of the Mental Hygiene Law;
(vii) any patient who is the parent of a child or has married as provided in section 2504 of the Public Health Law or an otherwise legally emancipated minor;
(viii) treatment that a minor has a constitutional right to receive without a parent’s or guardian’s permission as determined by courts of competent jurisdiction;
(ix) treatment for a minor who is a victim of sexual assault as provided in section 2805-i of the Public Health Law;
(x) emergency care as provided in section 2504(4) of the Public Health Law.
(c) Access without written authorization.
A qualified entity shall, where permitted by law, allow access to patient information without written authorization when:
(1) Prior consent has already been obtained for the disclosure as required by section 6530(23) of the Education Law, and no provision of law requires any additional written authorization.
(2) Disclosure to the individual entity accessing the patient information is:
(i) required by law; or
(ii) authorized by law:
(a) to a public health authority for public health activities;
(b) to a health oversight agency for health oversight activities; or
(c) to a federally designated organ procurement organization for purposes of facilitating organ, eye or tissue donation and transplantation.
(3) The health care provider treating the patient, a person acting at the direction of such health care provider, or other professional emergency personnel has documented that an emergency condition exists and the patient is in immediate need of medical attention, and an attempt to secure consent would result in delay of treatment which would increase the risk to the patient’s life or health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 73 ASBESTOS SAFETY PROGRAM REQUIREMENTS
10 CRR-NY 73.4 Minimum instructor qualifications
(a) Instructors must possess knowledge of the topics that will be taught, which may have been acquired through such means as relevant training or education or relevant field experience in the asbestos abatement industry, and the ability to effectively communicate the topics that will be taught.
(b) An instructor shall have sufficient experience or knowledge in the design and implementation of public health protection programs associated with asbestos to effectively communicate the principles and legal requirements of public health protection to program attendees.
(c) For all approved programs a health professional shall teach the specific topics of the health effects of asbestos and medical monitoring.
(d) The instructor teaching sections of programs involving the hands-on practice sessions shall have one year of actual work experience in the area being taught.
(e) Instructors whose involvement in the program is limited to the specific topics of legal liability, health effects, or medical monitoring are not required to meet the requirements of subdivisions (b) and (d) of this section but must meet all other applicable requirements.
(f) The department may deny instructor approval if an instructor has been found in violation of relevant State or Federal asbestos regulations.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
FOOD PROTECTION AND GARBAGE AND REFUSE DISPOSAL FOOD PROTECTION AND GARBAGE AND REFUSE DISPOSAL
10 CRR-NY 15.11 Garbage; refuse
An adequate number of covered storage receptacles shall be provided and used for the storage of garbage and refuse. The storage receptacles shall be constructed of durable, cleanable materials and be maintained in a sanitary condition and in good repair. Garbage and refuse shall not be allowed to accumulate on the surface of the ground.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.18 Insect, rodent, and weed control
(a) Grounds, buildings and structures shall be maintained in such a manner as to control insect and rodent infestation. Extermination methods and other measures to control insects and rodents shall conform with the requirements of the permit-issuing official or other agency having jurisdiction.
(b) The growth of ragweed, poison ivy, poison oak, poison sumac and other noxious weeds shall be controlled to minimize contact by campground occupants.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.13 Disposition of unused tissue
(a) All tissue unsuitable for transplantation, education, or research purposes authorized by Public Health Law section 4302 shall be discarded pursuant to Part 70 of this Title. Packaging of tissue for destruction shall be designed to obscure the contents.
(b) If tamper-resistant seals are broken or proper temperature has not been maintained, tissue shall not be issued for transplantation.
(c) Tissue returned by the tissue transplantation facility for possible reissuance shall meet all storage and transport requirements of this Part. The tissue bank shall not reissue tissue returned by the tissue transplantation facility, unless written criteria approved by the tissue bank medical director are met.
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-5 HEMATOPOIETIC PROGENITOR CELL BANKS
10 CRR-NY 58-5.9 Quality assurance and safety requirements
(a) Quality assurance.
(1) The hematopoietic progenitor cell procurement service and hematopoietic progenitor cell processing facility shall keep records which indicate that a quality assurance program is maintained in the following areas:
(i) preventive maintenance, periodic inspections and testing for proper operation of equipment;
(ii) monitoring of all temperature-controlled spaces and equipment to ensure proper performance;
(iii) validation of microprocessor-controlled equipment and associated software, including test plan protocols, results of parallel testing, and supervisory review; and
(iv) validation of hematopoietic progenitor cell processing and testing methodologies.
(2) Hematopoietic progenitor cell processing, laboratory and storage facilities shall be maintained in a clean and orderly manner, and shall be of suitable size, construction, and location to assure product and personnel safety.
(3) All reagents and solutions shall be in-date, stored properly, and labeled to indicate identity and, as appropriate, titer, strength or concentration, recommended storage requirements, preparation and/or expiration date, and other pertinent information. All such materials shall be removed from use on the expiration date. Materials of substandard reactivity and deteriorated materials shall be discarded regardless of expiration date.
(4) All specimens accompanying the collected hematopoietic progenitor cells shall be sufficiently stable to provide accurate and precise test results suitable for clinical interpretation. The hematopoietic progenitor cell procurement service shall ensure that specimens are collected, preserved and transported to the laboratory in such a manner as to meet this requirement. Specimens for analysis shall be identified fully and accessioned in a log book. The accessioning system shall be designed to allow tracing of the hematopoietic progenitor cells to a specific donor, and to identify the date and, if applicable, the time of retrieval.
(5) Current standard operating procedure manuals specific to the facility shall be available at all times in the immediate work area of personnel engaged in retrieval, processing, testing, storage, distribution, or other hematopoietic progenitor cell procurement activity. There shall be a written protocol for all procedures performed. Manuals shall contain a protocol for development, maintenance, and periodic review of standard operating procedures by facility personnel and management staff. Procedure manuals shall have the following features:
(i) a standardized format for procedures;
(ii) a system of numbering and/or titling individual procedures;
(iii) a clearly written description of purpose for each procedure;
(iv) a reference section listing appropriate scientific literature and industry and/or corporate standards espoused by the hematopoietic progenitor cell procurement service and/or processing facility;
(v) clearly defined areas of employees or technical staff responsibility by position/title;
(vi) documented approval of procedures and procedural modifications, including annual review by the director of the hematopoietic progenitor cell procurement service and/or processing facility, or authorized supervisor;
(vii) instructions for the completion of reports and forms, including examples;
(viii) effective date and date of review for each procedure; and
(ix) a system for archiving earlier versions of procedures and forms.
(6) The policies and procedures specified in the procedure manual shall be followed at all times. If deviations or deficiencies are identified, appropriate corrective action shall be taken and documented.
(7) The director of the hematopoietic progenitor cell procurement service and/or processing facility shall establish and maintain a planned and periodic internal review program for monitoring and evaluating the quality and appropriateness of the hematopoietic progenitor cell banking services. Included in the program shall be systems for evaluating errors, and designing, implementing and documenting corrective action for any deficiencies identified. Quality assurance deficiencies shall be documented, and evidence shall be available that any operational or procedural problems are reported to supervisory personnel in a timely manner, and that corrective action is implemented, documented and subsequently followed up.
(8) The director of the hematopoietic progenitor cell procurement service and/or hematopoietic progenitor cell processing facility shall be responsible for developing policies, procedures and/or standards for the qualifications, training, certification and continuing education of technical staff. Documentation of compliance with this requirement and with the policies developed shall be maintained.
(b) Safety.
(1) The hematopoietic progenitor cell procurement service and/or processing facility shall implement written safety and infection control policies and procedures to ensure protection from unnecessary physical, chemical and biological hazards, as follows:
(i) Decontamination and disposal techniques for regulated medical waste shall be utilized. All hazardous and regulated medical waste materials shall be handled, stored and discarded pursuant to Part 70 of this Title.
(ii) If sterilization equipment is used, the pressure, temperature and duration of each cycle shall be recorded, and such records maintained for one year. For each run, these parameters shall be within the manufacturer's recommended operating standards. If any one or more of these parameters fall(s) outside the manufacturer's standards, all material shall be resterilized. Chemical, biological and physical detection systems should be used in conjunction with these other measurements of performance.
(iii) Eating, drinking, smoking, or the application of cosmetics or contact lenses shall not be permitted in work areas. Refrigerators or freezers used for storing specimens or reagents shall not be used for any other purpose.
(iv) Gloves and laboratory coats, gowns or other protective clothing shall be worn as necessary while handling blood specimens or hematopoietic progenitor cell tissue. Such protective clothing shall not be worn outside the work area and shall be disposed of in an appropriate receptacle.
(2) The hematopoietic progenitor cell procurement service and/or processing facility shall have written policies and procedures in the following areas:
(i) infection control;
(ii) biosafety;
(iii) chemical and radiological safety;
(iv) emergency response to worksite accidents; and
(v) medical waste disposal.
(3) The safe collection of peripheral blood hematopoietic progenitor cells by apheresis shall be the responsibility of the medical director of the apheresis service. Collection shall be performed in full compliance with section 58-2.15 of this Part.
(4) Hematopoietic progenitor cell transplantation facilities shall report suspected cases of infectious disease transmission in recipients to the hematopoietic progenitor cell bank providing the tissue.
(5) The hematopoietic progenitor cell bank shall have a written procedure for documenting any errors or accidents in retrieval, testing, processing, storage or disposition of hematopoietic progenitor cells that may affect the safety of the cells, and for reporting such errors or accidents to the medical advisory committee of the bank. If the error or accident is detected after issuance of the cells, the error or accident shall be reported to the receiving facility immediately upon detection by the distributing facility. All errors with the potential for serious adverse effects on the recipient shall also be reported to the department's Wadsworth Center within seven calendar days of discovery.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 81 RESIDENTIAL HEALTH CARE FACILITIES; PATIENT ABUSE
10 CRR-NY 81.7 Penalties
(a) In addition to any other penalties prescribed by law, any person who commits an act of physical abuse, mistreatment or neglect or who fails to report such an act may be liable for a penalty pursuant to section 12 of the Public Health Law after an opportunity to be heard.
(b) If upon review of the record, the commissioner determines that a violation of article 28 of the Public Health Law or rules and regulations promulgated pursuant thereto has occurred, the commissioner may pursue remedies against the facility or individual, including but not limited to, those set forth in sections 12, 12-b, 16, and 2803 of the Public Health Law.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.15 Management’s report of internal control over financial reporting
(a) Every MCO required to file an audited financial report pursuant to this Subpart that has annual direct written and assumed premiums, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of $500,000,000 or more shall prepare a report of the MCO’s or group of MCOs’ internal control over financial reporting. This report of internal control over financial reporting, together with any communication about unremediated material weaknesses discovered during the CPA’s audit described under section 98-3.10 of this Subpart shall be submitted to the commissioner upon the filing date upon which each audited financial report is required to be filed. Management’s report of internal control over financial reporting shall be as of December 31st immediately preceding.
(b)
(1) In lieu of the report required by subdivision (a) of this section, a MCO may file its or its parent’s SOX section 404 report with the commissioner, if the MCO is:
(i) directly subject to SOX section 404;
(ii) not directly subject to SOX section 404, but is a SOX compliant MCO; or
(iii) a member of a holding MCO system whose parent is:
(a) directly subject to SOX section 404; or
(b) not directly subject to SOX section 404, but is a SOX compliant MCO.
(2) If a MCO elects to file the SOX section 404 report described in paragraph (1) of this subdivision, the MCO shall submit an addendum that contains:
(i) a statement by the MCO’s chief executive officer and chief financial officer (or equivalent position or title) that no internal controls having a material impact on the preparation of the MCO’s audited statutory financial statements are excluded from the report. If either of these two officers is based in a holding MCO or other entity outside of the United States, the two most senior United States-based officers shall be the signatories; or
(ii) if internal controls of the MCO that have a material impact on the preparation of the MCO’s audited statutory financial statements are not described in the SOX section 404 report, a report that sets forth the impact of these material internal controls on the preparation of the MCO’s audited financial reports that were not included in the report.
(c) Management’s report of internal control over financial reporting shall include:
(1) a statement that the MCO has established and continues to maintain adequate internal control over financial reporting and an assertion, to the best of the MCO’s knowledge and belief, after diligent inquiry, as to whether its internal control over financial reporting is effective to provide reasonable assurance regarding the reliability of financial statements in accordance with statutory accounting principles;
(2) a statement that briefly describes the approach or processes by which the MCO evaluated the effectiveness of its internal control over financial reporting;
(3) a statement that briefly describes the scope of work that is included and whether any internal controls were excluded;
(4) disclosure of any unremediated material weaknesses in the internal control over financial reporting identified by the MCO as of December 31st immediately preceding;
(5) a statement regarding the inherent limitations of internal control systems; and
(6) notarized signatures of the MCO’s chief executive officer and chief financial officer (or equivalent position or title) attesting to the statements and disclosures contained in paragraphs (1) through (5) of this subdivision. If either of these two officers is based in a holding MCO or other entity outside of the United States, the two most senior United States-based officers shall be the signatories.
(d) The MCO shall document the basis upon which the assertions, as required by subdivision (c) of this section, are made. The MCO may base its assertions, in part, upon its review, monitoring and testing of internal controls undertaken in the normal course of its activities. The MCO shall have discretion as to the nature of the internal control framework used, and the nature and extent of documentation, in order to make its assertion in a cost effective manner and, as such, may include assembly of or reference to existing documentation.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.24 Quality assurance programs for the use of radiation for therapy in humans
(a) External beam therapy and brachytherapy.
Each licensee or registrant authorized to administer external beam therapy or brachytherapy to human beings shall implement a quality assurance program to systematically monitor, evaluate and document radiation therapy services to ensure consistent and safe fulfillment of the dose prescription to the target volume, with minimal dose to normal tissues, minimal exposure to personnel and adequate patient monitoring aimed at determining the end result of the treatment. Each such licensee or registrant shall meet or exceed all quality assurance criteria described in this subdivision.
(1) Each licensee or registrant shall adopt and maintain a quality assurance manual that includes policies and procedures that require the following:
(i) Each patient's medical record shall be complete, accurate, legible and shall include the patient's initial clinical evaluation, treatment planning data, treatment execution data, clinical assessments during treatment, a treatment summary and plan for subsequent care. Treatment related data shall be recorded in the patient's medical record at the time of each treatment.
(ii) A written and dated order or prescription for the medical use of radiation or radioactive material shall be made for each patient in accordance with section 16.19(b) and (c) of this Part. The order or prescription shall be signed or approved electronically by a board certified radiation oncologist or qualified physician who restricts his or her practice to radiation oncology.
(iii) The accuracy of treatment plan data and any modifications to treatment plan data transferred to a radiation treatment delivery system shall be verified by qualified clinical staff prior to patient treatment.
(iv) A radiation therapy technologist, physician or other qualified health practitioner shall verify that the patient set up on the treatment machine is in accordance with the treatment plan prior to the first fraction of a course of treatment and prior to treatment for any changes to the initial treatment plan.
(v) Clinical staff shall obtain clarification before beginning a patient's treatment if any element of the order or other record is confusing, ambiguous, erroneous or suspected of being erroneous.
(vi) Each patient’s identification shall be verified by at least two different means by qualified clinical staff prior to each treatment.
(vii) Each patient's response to treatment shall be assessed by a board certified radiation oncologist or other qualified physician in the active practice of external beam therapy and/or brachytherapy. Unusual responses shall be evaluated as possible indications of treatment errors and recorded in the patient's medical record.
(viii) The medical records of patients undergoing fractionated treatment shall be checked for completeness and accuracy by qualified clinical staff at intervals not to exceed six fractions.
(ix) Radiation treatment plans and related calculations shall be checked by qualified clinical staff for accuracy before 25 percent of the prescribed dose for external beam therapy or 50 percent of the prescribed dose for brachytherapy is administered, except the check shall be performed prior to treatment for: any single fraction treatment; any fractional dose that exceeds 300cGy or 700 monitor units; or when the output of a medical therapy accelerator exceeds 600 monitor units per minute during treatment. If a treatment plan and related calculations were originally prepared by a board certified radiation oncologist or an authorized medical physicist possessing the qualifications specified in section 16.123(d)(1) of this Part, it may be rechecked by the same individual using a different calculation method. Treatment plans and related calculations prepared by other qualified clinical personnel must be checked by a second qualified person using procedures specified in the registrant's or licensee's treatment planning procedures manual required pursuant to paragraph (2) of this subdivision, and who has received training in use of the manual pursuant to paragraph (2) of this subdivision.
(x) All equipment and other technology used in planning and administering radiation therapy shall function properly and safely, and shall be calibrated properly and repaired and maintained in accordance with the manufacturer's instructions. The equipment and technology that is subject to such quality control includes but is not limited to: computer software and hardware including upgrades and new releases; equipment used to perform simulation; dosimetry equipment; equipment used to guide treatment delivery, including but not limited to ultrasound units, kV and mV imaging equipment and monitors that are used to view patient imaging studies; and personnel radiation safety equipment. Data communication between various systems, including but not limited to treatment planning systems, treatment delivery systems and data networks/storage media, shall be evaluated and tested to ensure accurate and complete data transfer.
(xi) Quality control tests performed on equipment and technology used in planning and implementing radiation treatment shall be documented, including:
(a) detailed procedures for performing each test;
(b) the frequency of each test;
(c) acceptable results for each test;
(d) corrective actions taken;
(e) recordkeeping and reporting procedures for test results including the tester’s name, signature and date of the test; and
(f) the qualifications are specified for the individual(s) conducting the test and for the person who reviews test data.
(xii) Test results that exceed tolerances/limits shall be immediately reported to the authorized medical physicist.
(xiii) Records for all maintenance, repairs and upgrades of equipment and technology shall be maintained for at least five years.
(xiv) Errors or defects in technology or equipment, including computer hardware and software, shall be reported to the technology or equipment manufacturer and to the United States Food and Drug Administration (MedWatch) as soon as possible and in no event more than 30 days of discovery, and records of equipment errors and reports required by this clause shall be maintained for review by the department for at least three years.
(xv) External beam therapy equipment calibration/output required by section16.60(c)(1) of this Part shall be verified by an independent means and records of such measurements shall be retained for review by the department for at least three years.
(xvi) Patients with permanent brachytherapy implants shall be provided with instructions to take radiation safety precautions, as required by section 16.123(e)(4) of this Part (incorporating 10 CFR 35.75) and the licensee's radioactive materials license, after being released from the licensee’s facility.
(xvii) All personnel involved in planning or implementing radiation therapy shall be credentialed. Credentialing shall include verifying that all professional staff are appropriately licensed, including medical physicists and radiation therapy technologists. Records of credentialing shall be maintained during the period in which the credentialed person provides services to the licensee or registrant and for three years thereafter.
(xviii) Any unintended deviation from the treatment plan that is identified shall be evaluated and corrective action to prevent recurrence shall be implemented. Records of unintended deviations and corrective action shall be maintained for audits required by paragraph (4) of this subdivision and for review by the department.
(xix) There shall be a process to ensure quick and effective response to any radiation therapy related recalls, notices, safety alerts and hazards.
(2) Each licensee or registrant shall adopt and maintain a radiation treatment manual that includes the calculation methods and formulas to be used at the facility (including the methods for performing the checks of treatment plans and related calculations as required in paragraph [1] of this subdivision). The treatment planning manual may be part of the quality assurance manual required by paragraph (1) of this subdivision. The radiation treatment manual shall be included in training given pursuant to section 16.13(c) of this Part to facility staff who will participate in treatment planning. Each licensee or registrant shall ensure that an authorized medical physicist possessing the qualifications specified in section 16.123(d)(1) of this Part prepares or reviews and approves a procedures manual describing how radiation therapy treatment planning is to be performed at the licensee’s or registrant's facility and reviews the treatment planning manual at least annually.
(3) Each licensee or registrant shall ensure that all equipment used in planning and administering radiation therapy is functioning properly, designed for the intended purpose, properly calibrated, and maintained in accordance with the manufacturer's instructions and the quality assurance program described in the licensee or registrant's quality assurance manual.
(4) Each licensee or registrant shall implement written procedures for auditing the effectiveness of the radiation therapy quality assurance program that include the following:
(i) Audits shall be conducted at intervals not to exceed 12 months by an authorized medical physicist possessing the qualifications specified in section 16.123(d)(1) of this Part, and also by a physician, both of whom are in the active practice of the type of radiation therapy conducted by the licensee or registrant.
(ii) The licensee or registrant shall ensure that the individuals who conduct the audit prepare and deliver to the licensee or registrant a report which contains an assessment of the effectiveness of the quality assurance program and makes recommendations for any needed modifications or improvements.
(iii) The licensee or registrant shall promptly review the audit findings, address the need for modifications or improvements, and document actions taken. If recommendations are not acted on, the licensee or registrant shall document the reasons therefor and also alternative actions taken to address the audit findings.
(iv) Each licensee or registrant shall maintain for review and inspection by the department complete written records relating to quality assurance and audit activities. Audit records shall be maintained for at least six years.
(6) Accreditation in radiation oncology.
(i) Effective 90 days from the effective date of this regulation, each registrant or licensee shall have an active application with, or be accredited in radiation oncology by, the American College of Radiology, the American College of Radiation Oncology or another accrediting organization that is equivalent as determined by the department.
(ii) Effective 18 months from the effective date of this regulation, each registrant and licensee shall maintain accreditation in radiation oncology by the American College of Radiology, the American College of Radiation Oncology or another accrediting organization that is equivalent as determined by the department.
(iii) The registrant or licensee shall maintain a record of accreditation, including a copy of the application, all supplemental application information and all correspondence transmitted between the accrediting body and the registrant or licensee. Records shall be maintained for at least six years.
(b) Radiopharmaceutical therapy.
A quality assurance program for radiopharmaceutical therapy is a system of plans, actions, reviews, reports and records whose purpose is to ensure a consistent and safe fulfillment of the dose prescription.
(1) Beginning March 31, 1993, each licensee who uses radiopharmaceuticals for therapy in humans shall implement a quality assurance program which includes at a minimum:
(i) the adoption of a manual containing written policies and procedures designed to assure effective supervision, safety, proper performance of equipment, effective communication and quality control. These must include procedures to assure that:
(a) each patient's evaluation and intended treatment is documented in the patient's record;
(b) a written, signed and dated order for medical use of radioactive material is made in accordance with section 16.19(c) of this Part;
(c) all orders and other treatment records are clear and legible;
(d) staff will be instructed to obtain clarification before treating a patient if any element of the order or other record is confusing, ambiguous or suspected of being erroneous;
(e) each patient's response to treatment is assessed by a physician knowledgeable in radiopharmaceutical therapy and that unusual responses are evaluated as possible indications of treatment errors; and
(f) complete treatment records containing data recorded at the time of each treatment are maintained.
(2) Each licensee shall ensure that all equipment used in planning and administering radiopharmaceutical therapy is designed for the intended purpose and is properly functioning; is properly calibrated and is maintained in accordance with the manufacturer's instructions and the quality assurance program described in the licensee's or registrant's quality assurance manual.
(3) Each licensee shall: audit the radiopharmaceutical quality assurance program at intervals not to exceed 12 months to assess the effectiveness of the program; document the audit and any modifications or improvements found to be needed; and institute corrective actions and improvements as indicated by the audit findings.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-6 HOSPICES
10 CRR-NY 86-6.5 Trend factor
(a) The commissioner shall establish trend factors to project annual increases in the costs of hospice services. Each payment rate for the categories of hospice care, as established pursuant to the provisions of section 86-6.2 of this Subpart, shall be trended each year by the trend factors developed in accordance with the provisions of this section.
(b) The elements of certified home health agencies' costs shall be weighted based upon data for the categories listed below in developing the trend factor that will be applied to the routine and continuous home care rates. The elements of general hospitals' costs shall be weighted based upon data for the categories listed below in developing the trend factor that will be applied to the inpatient and respite care rates:
(1) salaries;
(2) employee health and welfare expense;
(3) nonpayroll administrative and general expense;
(4) nonpayroll household and maintenance expense;
(5) nonpayroll professional care expense.
(c) Each weight shall be adjusted by one or more price indices. Included among these indices are elements of the United States Department of Labor consumer and produce price indices and special indices developed by the commissioner for this purpose.
(d) The projected trend factors shall be updated on an annual basis, based upon current and available data. The commissioner shall adjust subsequent trend factors based upon such update.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.5 Retrieval of tissue
(a) Cardiovascular tissue shall be retrieved using aseptic technique in an operating room or other aseptic premises approved by the tissue bank medical director.
(b) Retrieval of cardiovascular tissue from a cadaveric donor shall occur within a time limit after cessation of cardiac function specified in written policies approved by the medical director of the comprehensive tissue procurement service.
(c) Cardiovascular tissue shall be stored and transported to the tissue processing facility at a temperature between one and 10 degrees Celsius.
(d) Aseptic processing of cardiovascular tissue shall begin within 48 hours of cessation of cardiac function.
(e) If an ante mortem blood sample is not available from a cadaveric donor, a post mortem sample of sufficient quantity to perform required laboratory testing shall be drawn via a cardiac insertion or from a large vein or artery.
(f) Tissue specimen containers and packaging materials shall be sterile and nontoxic.
(g) Each tissue and blood specimen container shall be labeled legibly at the time of retrieval with the tissue bank identification, and donor identification code or unique tissue identification number. The date, time and anatomic site of retrieval shall be recorded on accompanying documents.
(h) Unless a sample for culture is to be collected at the tissue processing facility, a segment or sample of contiguous heart or vascular tissue shall be placed in a separate, appropriately labeled sterile container intended for culturing for aerobic and anaerobic contamination.
(i) Tissue and blood specimen containers shall be labeled so as to maintain cardiovascular tissue identification throughout all phases of processing, storage and distribution, in a manner not subject to significant deterioration under conditions of transport and storage.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.10 Review after issuance of certificate of public advantage
(a) The department shall review each periodic report, application for renewal, and any information submitted in response to a request under this Subpart, and consult with the Attorney General and, as appropriate, the mental hygiene agencies, to determine, based on the factors set forth in section 83-2.5 of this Subpart, whether:
(1) the benefits or likely benefits of the cooperative agreement or the planning process continue to outweigh the disadvantages or likely disadvantages that flow from the cooperative agreement or planning process; and
(2) the parties to the cooperative agreement or planning process are in compliance with the conditions imposed on the certificate of public advantage.
(b) If upon review of a periodic report or application for renewal and any information submitted in response to a request, or at any time following the issuance of a certificate of public advantage, it appears to the department, in consultation with the Attorney General and, as appropriate, the mental hygiene agencies, that the parties to the cooperative agreement or planning process have failed to comply with any condition of the certificate or that the benefits or likely benefits resulting from a cooperative agreement or planning process no longer outweigh the disadvantages or likely disadvantages resulting from the agreement, the department shall advise the parties to the agreement and request any documentation or information necessary to complete a review of the matter.
(c) The parties must supply any additional documentation or information requested by the department within 30 days, or any other stated time frame, of such request, or must obtain from the department an extension of the time in which to provide such documentation or information which is requested. Any request for an extension of time shall set forth reasons why such documentation or information could not be obtained within the prescribed time. The granting of a request for an extension shall be at the discretion of the department. Failure to provide such documentation or information within the time prescribed or as extended by the department may result in revocation of the certificate of public advantage pursuant to section 83-2.12 of this Subpart.
(d) Following a review of a periodic report, an application for renewal, or of information submitted in response to a request made pursuant to this Subpart, if the department determines, in consultation with the Attorney General and, as appropriate, the mental hygiene agencies, that the standards set forth in subdivision (a) of this section are satisfied, the certificate of public advantage shall be continued or, if appropriate, renewed.
(e) The department may, in consultation with the Attorney General and the mental hygiene agencies, as appropriate, at any time following the issuance of a certificate of public advantage, require modifications to the cooperative agreement or the planning process and impose changes in the conditions of the certificate of public advantage to promote the goals of article 29-F of the Public Health Law and assure that the benefits or likely benefits of the cooperative agreement or planning process continue to outweigh the disadvantages or likely disadvantages.
(f) The parties shall be notified in writing of the department's decision and any required modifications to the cooperative agreement or planning process and/or changes in the conditions of the certificate of public advantage and shall be given an opportunity to implement any required modifications by a date set by the department.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.22 Non-operating revenue and expenses description
[3290]
(a) Nonoperating revenue and expenses include those revenues and expenses not directly related to patient care, related patient services, or the sale of related goods. The following accounts are required to be reported.
(b) 9010 GAINS OR LOSSES ON SALE OF HOSPITAL PROPERTY. This account is credited for gains and debited for losses arising as a result of the disposal of hospital property.
(c) 9020 UNRESTRICTED CONTRIBUTIONS. All contributions, donations, legacies and bequests, that are made to the hospital without restrictions by the donors, must be credited to this account. When a hospital receives contributions in significant amounts, such contributions should be clearly described and fully disclosed in the income statement.
(d) 9030 DONATED SERVICES. Many hospitals receive donated services of individuals. Fair value of donated services must be recorded when there is the equivalent of an employer-employee relationship and an objective basis for valuing such services. The value of services donated by organizations may be evidenced by a contractual relationship which may provide the basis for valuation.
Donated services are most likely to be recorded in a hospital operated by a religious group. If members of the religious group are not paid (or are paid less than the fair value of the services rendered), the lay-equivalent value of their services (or the difference between lay-equivalent value of services rendered and compensation paid) must be recorded as an expense in the cost center in which the service was rendered, with the credit to this account.
(e) 9040 INCOME, GAINS AND LOSSES FROM UNRESTRICTED INVESTMENTS. Income, and gains and losses from investments of unrestricted funds must be recorded in this account.
(f) 9050 UNRESTRICTED INCOME FROM ENDOWMENT FUNDS. This account is credited with the unrestricted revenue and net realized gains on investments of endowment funds.
(g) 9060 UNRESTRICTED INCOME FROM OTHER RESTRICTED FUNDS. This account is credited with the revenue and net realized gains on investments of restricted funds (other than endowment funds) if the income is available for unrestricted purposes.
(h) 9070 TERM ENDOWMENT FUNDS BECOMING UNRESTRICTED. When restricted endowment funds become available for unrestricted purposes, they must be reported in this account.
(i) 9080 TRANSFERS FROM RESTRICTED FUNDS FOR NON-OPERATING EXPENSE. This account reflects the amounts of transfers from restricted funds to match non-operating expenses in the current period for restricted fund activities.
(j) 9110 DOCTORS' PRIVATE OFFICE RENTAL REVENUE. This account is credited with the revenue earned from rental of office space and equipment to physicians and other medical professionals for use in their private practice.
(k) 9120 OFFICE AND OTHER RENTAL REVENUE. This account is credited with rentals received from other than doctors, other medical professionals and other non-retail rental activities for office space located in the hospital and for other rental of property, plant and equipment not used in hospital operations.
(l) 9130 RETAIL OPERATIONS REVENUE. This account must be credited with revenue earned from other retail operations such as gift shop, barber shop, beauty shop, drug store or newsstand located in space owned by the hospital.
(m) 9150 OTHER NON-OPERATING REVENUE. This account is credited with non-operating revenue not specifically required to be included in the above accounts, including unrestricted tax revenue and funds appropriated by governmental entities.
(n) 9210 DOCTORS' PRIVATE OFFICE RENTAL EXPENSES. This account contains the expenses incurred in connection with the rental of office space and equipment to physicians, and other medical professionals for use in their private practice.
(o) 9220 OFFICE AND OTHER RENTAL EXPENSE. This cost center contains the expenses incurred in connection with the rental to other than physicians, other medical professionals and non-retail rental activities.
(p) 9230 RETAIL OPERATIONS EXPENSE. This cost center contains the expenses incurred in connection with retail operations such as gift shop, barber shop, drug store, beauty shop or newsstand.
(q) 9240 MAINTENANCE OF NON-PAID WORKERS.
(1) This cost center is used to record the direct costs and accumulate the indirect costs of furnishing to nonpaid workers (as defined and described in 42 CFR 405-424) such fringe benefits, perquisites, maintenance and other items and services that are not furnished to paid employees occupying similar positions, and in situations where comparable fringe benefits, perquisites, maintenance and other items and services are furnished to paid employees occupying similar positions, and if the total cost applicable to nonpaid workers (imputed value of services, fringe benefits, perquisites, maintenance and other items and services) exceeds the total cost (salaries, fringe benefits, etc.) incurred on behalf of comparable paid employees, such excess is included in this cost center.
(2) Effective date for this cost center: cost reporting periods beginning in 1981.
(r) 9250 OTHER NON-OPERATING EXPENSES. This cost center contains non-operating expenses not specifically required to be included in the above accounts.
(s) 9410 PROVISION FOR INCOME TAXES
9411
Federal - Current
9412
Federal - Deferred
9413
State - Current
9414
State - Deferred
9415
Local - Current
9416
Local - Deferred
These cost centers contain income tax expense and related deferred taxes.
(t) 9500 EXTRAORDINARY ITEMS. Cost centers (accounts 9500-9599) should be used to segregate extraordinary items from the results of ordinary operations and to disclose the nature thereof. Each hospital is to follow “Generally Accepted Accounting Principles” (GAAP) to determine when items are to be considered extraordinary.
Part 441 DEFINITIONS
10 CRR-NY 441.253 Personal property
Property or assets of a temporary and movable character as contrasted with real property.
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 711 GENERAL STANDARDS OF CONSTRUCTION
10 CRR-NY 711.2 Pertinent technical standards
All health facilities shall comply with the pertinent provisions of the standards and codes referred to in this section and with local laws relating to zoning, sanitation, fire safety and construction, where such local laws represent standards in addition to those required by this Part. Reference throughout this Chapter to codes and standards shall be those editions listed in this section. If a conflict occurs between the following codes and standards or between them and regulations elsewhere in this Chapter then compliance with the more restrictive regulation is required. If Federal regulatory requirements conflict with the codes and standards referred to in this section, the department may waive compliance with such standards and codes, provided that a health facility fully complies with said Federal regulatory requirements.
(a) The following National Fire Protection Association (NFPA) Codes and Standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. The codes and standards are published by the National Fire Protection Association, and copies are also available from the National Fire Protection Association, One Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101, 1-800-344-3555 or www.nfpa.org. The various codes and standards are available from the NFPA either as individual publications or as contained within the Compilation of NFPA National Fire Codes, 1999 edition.
(1) NFPA 101— Life Safety Code , 2000 edition.
(2) NFPA 101A— Guide on Alternative Approaches to Life Safety , 1998 edition.
(3) NFPA 10— Standard for Portable Fire Extinguishers , 1998 edition.
(4) NFPA 13— Standard for the Installation of Sprinkler Systems , 1999 edition.
(5) NFPA 14— Standard for the Installation of Standpipe, Private Hydrants and Hose Systems , 2000 edition.
(6) NFPA 25— Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems , 1998 edition.
(7) NFPA 30-1996— Flammable and Combustible Liquids Code.
(8) NFPA 31— Standard for the Installation of Oil-Burning Equipment , 1997 edition.
(9) NFPA 45-1996— Standard on Fire Protection for Laboratories Using Chemicals.
(10) NFPA 54— National Fuel Gas Code , 1999 edition.
(11) NFPA 58— Liquefied Petroleum Gases Code , 1998 edition.
(12) NFPA 70— National Electrical Code , 1999 edition.
(13) NFPA 72— National Fire Alarm Code , 1999 edition.
(14) NFPA 80— Standard for Fire Doors and Fire Windows , 1999 edition.
(15) NFPA 82— Standard on Incinerators and Waste and Linen Handling Systems and Equipment , 1999 edition.
(16) NFPA 90A— Standard for the Installation of Air Conditioning and Ventilating Systems , 1999 edition.
(17) NFPA 90B— Standard for the Installation of Warm Air Heating and Air-Conditioning Systems , 1999 edition.
(18) NFPA 91— Standards for Exhaust Systems for Air Conveying of Vapors, Gases, Mists and Noncombustible Particulate Solids , 1999 edition.
(19) NFPA 96— Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations , 1998 edition.
(20) NFPA 99— Standard for Health Care Facilities , 1999 edition.
(21) NFPA 110— Standard for Emergency and Standby Power Systems , 1999 edition.
(22) NFPA 111— Standard on Stored Electrical Energy Emergency and Standby Power Systems , 1996 edition.
(23) NFPA 211— Standard for Chimneys, Fireplaces, Vents, and Solid Fuel-Burning Appliances , 2000 edition.
(24) NFPA 220— Standard on Types of Building Construction , 1999 edition.
(25) NFPA 221— Standard for Fire Walls and Fire Barrier Walls , 1997 edition.
(26) NFPA 241-1996— Standard for Safeguarding Construction, Alteration, and Demolition Operations.
(27) NFPA 251— Standard Methods of Tests of Fire Endurance of Building Construction and Materials , 1999 edition.
(28) NFPA 252— Standard Methods of Fire Tests of Door Assemblies , 1999 edition.
(29) NFPA 253— Standard Method of Test for Critical Radiant Flux of Floor Covering Systems Using a Radiant Heat Energy Source , 2000 edition.
(30) NFPA 255— Standard Method of Test of Surface Burning Characteristics of Building Materials , 2000 edition.
(31) NFPA 256— Standard Method of Fire Tests of Roof Coverings , 1998 edition.
(32) NFPA 257— Standard on Fire Test for Windows and Glass Block Assemblies , 2000 edition.
(33) NFPA 260— Standard Methods of Tests and Classification System for Cigarette Ignition Resistance of Components of Upholstered Furniture , 1998 edition.
(34) NFPA 261— Standard Method of Tests for Determining Resistance of Mock-Up Upholstered Furniture Material Assemblies to Ignition by Smoldering Cigarettes , 1998 edition.
(35) NFPA 265— Standard Methods of Fire Tests for Evaluating Room Fire Growth Contribution of Textile Wall Coverings , 1998 edition.
(36) NFPA 266— Standard Method of Test for Fire Characteristics of Upholstered Furniture Exposed to Flaming Ignition Source , 1998 edition.
(37) NFPA 267— Standard Method of Test for Fire Characteristics of Mattresses and Bedding Assemblies Exposed to Flaming Ignition Source , 1998 edition.
(38) NFPA 286— Standard Methods of Fire Tests for Evaluating Room Fire Contribution of Wall and Ceiling Interior Finish , 2000 edition.
(39) NFPA 418— Standard for Heliports , 1995 edition.
(40) NFPA 701— Standard Methods of Fire Tests for Flame Propagation of Textiles and Films , 1999 edition.
(41) NFPA 703— Standard for Fire Retardant Impregnated Wood and Fire Retardant Coatings for Building Materials , 2000 edition.
(b) The following codes and standards are hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. These codes and standards are available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237. Copies are also available from the publisher or issuing organization at the address listed.
(1) ANSI/ASHRAE Standard 52.2-1999, Method of Testing Air-Cleaning Devices for Removal Efficiency by Particle Size , 1999 edition. American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc., 1791 Tullie Circle NE, Atlanta, GA 30329.
(2) Compressed Gas Association, Inc. (CGA) Pamphlet E-10, Maintenance of Medical Gas and Vacuum Systems in Health Care Facilities , third edition, 2007. Compressed Gas Association, Inc., 4221 Walney Road, Chantilly, VA 20151-2923, www.cganet.com.
(3) National Council on Radiation Protection and Measurements (NCRP) Report No. 102- Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50MeV (1989). National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
(4) National Council on Radiation Protection and Measurements (NCRP) Report No. 147- Structural Shielding Design for Medical X-Ray Imaging Facilities , 2004 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
(5) National Council on Radiation Protection and Measurements (NCRP) Report No. 144- Radiation Protection for Particle Accelerator Facilities , 2003 edition. National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Bethesda, MD 20814-3095, www.ncrppublications.org.
(6) 1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities , 1996 edition. The American Institute of Architects Academy of Architecture for Health, with assistance from the U.S. Department of Health and Human Services, the American Institute of Architects Press, 1735 New York Avenue, N.W., Washington, D.C. 20006. The standards set forth in this paragraph are applicable to construction projects completed pursuant to Subparts 712-2 and 713-2 of this Title and other applicable provisions in this Chapter. Such projects must, at minimum, maintain compliance with these standards.
(7) Guidelines for Design and Construction of Health Care Facilities , 2010 edition. The American Society for Healthcare Engineering, with assistance from the U.S. Department of Health and Human Services, One North Franklin Street, Chicago, IL 60606, and at www.ashe.org.
(c) Design standards for the disabled.
The Americans with Disabilities Act of 1990 (ADA) extends comprehensive civil rights protection to persons with disabilities. Health care facilities must comply with the ADA and the regulations, which implement it. Title 28 of the Code of Federal Regulations, Public Health parts 35, Non-Discrimination on the Basis of Disability in State and Local Government Services , and part 36, Non-Discrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities , including appendix A, Standard for Accessible Design , 2004 edition. These regulations are published by the Office of the Federal Register National Archives and Records Administration. Copies may be obtained from the Superintendent of Documents, United States Government Printing Office, Washington, D.C. 20402.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.8 Standard operating procedures
(a) Current standard operating procedure manuals or other procedural guides specific to the facility shall be available at all times in the immediate work area of personnel engaged in the collection, processing, testing, storage, distribution and administration of blood, blood components or derivatives for autogeneic or allogeneic use, and for therapeutic, prophylactic or diagnostic purposes. There shall be a written protocol for all procedures performed at the facility. Manuals shall contain a protocol for writing, maintaining and periodic review of standard operating procedures by user personnel and management staff. Procedure manuals shall have the following features:
(1) a standardized format;
(2) a system of numbering and/or entitling individual procedures;
(3) a clearly written description of purpose for each procedure;
(4) a reference section listing appropriate scientific literature;
(5) clearly defined areas of personnel responsibility by title;
(6) documented approval of procedures and procedural modifications by the director, and annual review by the director or authorized supervisor;
(7) instructions for the completion of reports and forms, including examples;
(8) effective date and date of review for each procedure; and
(9) a system of archiving earlier versions of procedures and forms.
Discontinued procedure documents and forms shall be retained and be available for inspection for at least seven years. Dates of initial use and discontinuance shall be recorded.
(b) The standard operating procedure manual shall include a written procedure for documenting errors or accidents in collection, testing, processing, storage or distribution that may affect the safety or purity of any product, or health of the donor or recipient. All such errors and accidents not detected prior to product distribution shall also be reported to the department's Wadsworth Center within seven calendar days of discovery and, if required, to Federal authorities.
(c) The standard operating procedure manual shall include written policies and procedures regarding the following, for activities performed at the site:
(1) use and maintenance of blood warming devices;
(2) type of infusion sets and filters for all components;
(3) issuance of components, which must include visual inspection prior to issuance;
(4) type of personnel authorized to issue components;
(5) for collecting facilities, obtaining blood or components from other institutions during emergency situations;
(6) all transfusion-related testing, prenatal testing, and neonatal testing;
(7) prompt evaluation of reported transfusion reactions and other adverse events;
(8) emergency release of uncrossmatched blood, which must include compatibility testing performed after release;
(9) method validation requirements;
(10) professional qualifications of personnel who may collect blood specimens for pretransfusion testing;
(11) specimen and labeling requirements for pretransfusion samples;
(12) release of blood and blood components to limited transfusion services and ambulance transfusion services; and
(13) administration of blood components, including prevention of transfusion reactions.
(d) The policies and procedures specified in the standard operating procedure manual shall be followed at all times. If deviations are identified, appropriate corrective action shall be taken and documented.
(e) The blood bank director or the director of transfusion services shall establish and maintain a planned and periodic internal review program for monitoring and evaluating the quality and appropriateness of standard operating procedures in the performance of blood bank and transfusion service activities. Included in the program shall be a system for designing and implementing corrective action for any problems identified. Quality assurance deficiencies shall be documented, and evidence shall be available that problems are reported to the appropriate individuals in a timely manner and that corrective action is implemented and subsequently followed-up.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.328 Treatment
A procedure performed on a hospital patient.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.20 Transition planning
(a) A transition plan shall be established in the IFSP to ensure a smooth transition for every child exiting the Early Intervention Program.
(1) If the child may be eligible for preschool services under section 4410 of the Education Law, the service coordinator, with parental consent, shall convene a conference among the early intervention official, the parent, and the chairperson of the CPSE or designee, not fewer than 90 days, and at the discretion of all parties, not more than nine months before the child’s third birthday to discuss any services the child may receive under education law.
(2) If the child is not potentially eligible for preschool services under section 4410 of Education Law, the service coordinator, with parental consent, shall make reasonable efforts to convene a conference among the early intervention official, the parent, and providers of other appropriate services for the toddler to discuss appropriate services that the child may receive, including early education, head start, early head start, child care programs or other appropriate services.
(3) All meetings to develop the transition plan, including the transition conference, must be at a time and place mutually convenient to all participants and must meet all requirements pertaining to IFSP meetings in section 69-4.11(a)(2)-(5) of this Subpart.
(4) The transition plan established in the IFSP must be developed with the child’s family and shall include procedures to prepare the child and family for changes in service delivery, including:
(i) a review of program and service options for the child from the child’s third birthday through the remainder of the program year, if appropriate;
(ii) steps for the child and his or her family to exit from the Early Intervention Program;
(iii) steps and services to help the child adjust to and function in a new setting;
(iv) procedures to prepare program staff or individual qualified personnel who will be providing services to the child to facilitate a smooth transition; and
(v) transition services and other activities that the IFSP participants determine are needed by the child and family to support the transition of the child.
(b) For children thought to be eligible for services under section 4410 of the Education Law, not fewer than 90 days prior to the child's potential eligibility for services under the Education Law, section 4410, the service coordinator shall provide written notification to the committee on preschool special education of the local school district in which an eligible child resides of the potential transition of the child.
(1) The service coordinator shall ensure the parent is informed in accordance with procedures in section 69-4.11(a)(10)(xiii) of this Subpart of the opportunity to object to such notification prior to providing notice to the CPSE of the child's potential transition.
(i) The parent shall be afforded at least 30 calendar days to object, either orally or in writing, to written notification to the CPSe of the child's potential transition.
(ii) If the parent objects to such notification, the notification shall not be made, and the parent's objection shall be documented in the child's record.
(iii) If the parent does not object to such notification, the service coordinator shall include the following information in the written notice to the CPSE of the child's potential transition:
(a) the child's name;
(b) the child's date of birth and date of referral to the Early Intervention Program;
(c) the method by which the parent may be contacted, including the parent's name, address, and telephone number; and
(d) the name and contact information for the child's service coordinator who is transmitting the notification.
(iv) if notification in subparagraph (1)(iii) of this subdivision is required the service coordinator must confirm, in written documentation, the transmission of the notification to the CPSE and include such documentation in the child’s and family’s transition plan established under section 69-4.11(a)(10)(xiii) of this Subpart.
(2) For children in the care and custody or custody and guardianship of the commissioner of the local social services district, the service coordinator shall notify the local commissioner of social services or designee of the child's potential transition.
(3) The service coordinator shall review information concerning the transition procedure with the parent and obtain parental consent for the transfer of appropriate evaluations, assessments, individualized family service plans, and other pertinent records.
(4) With parent consent, the service coordinator shall convene a transition conference with the parent, service coordinator, and the chairperson of the CPSE or designee, at least 90 days prior to the child's eligibility for services under Education Law, section 4410, or no fewer than 90 days before the child's third birthday, whichever is first provided, however, that such conference shall not be held more than nine months prior to the child’s third birthday, to review program options and if appropriate, establish a transition plan.
(i) The local social services commissioner may participate in the conference for children in the care and custody or custody and guardianship of the social services commissioner.
(ii) The conference may be combined with:
(a) the initial meeting of the CPSE pertaining to the child, provided, however, that such initial meeting must convene within the required timeframes for the transition conference; or
(b) the IFSP review or annual meeting that occurs closest to the child's second birthday, provided that such meeting is convened no more than nine months before the child’s third birthday.
(iii) The parent may decline a transition conference; provided, however, that the parent shall be informed that the child's eligibility for services under section 4410 of the Education Law must be determined by the child's third birthday to continue receiving early intervention services after the child's third birthday and that if a determination of eligibility for services under section 4410 of the Education Law has not been made by the CPSE prior to the child's third birthday, eligibility for early intervention services will end the day before the child's third birthday.
(a) Declination of a transition conference by the parent shall be documented in the child's record.
(b) The service coordinator shall explain to the parent that if the parent declines a transition conference, the parent may refer the child to the CPSE for determination of eligibility for Education Law, section 4410 services and shall provide information on how the parent may make such referral.
(c) For children thought not to be eligible for programs under Education Law, section 4410, the service coordinator shall assist the parent in the development of a transition plan to other appropriate early childhood and supportive services. The service coordinator shall assist the parent in identifying, locating, and accessing such services.
(d) With parental consent, the service coordinator shall notify the committee on preschool special education of those children potentially eligible for transition to the Preschool Special Education Program but whose parents have selected to continue with early intervention services for the specified period of eligibility for the Early Intervention Program.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
REPORTS AND RECORDS REPORTS AND RECORDS
10 CRR-NY 80.108 Practitioner patient reporting
It shall be the duty of every attending practitioner and every consulting practitioner to report promptly to the commissioner the name and address and such other data as may be required by the commissioner with respect to any person under treatment if he finds that such person is an addict or a habitual user of any narcotic drug. Such report shall be kept confidential and may be utilized only for statistical, epidemiological, or research purposes, except that those reports which originate in the course of a criminal proceeding other than section 210 of the Mental Hygiene Law shall be subject only to the confidentiality requirements of section 3371 of the Public Health Law.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.22 Warning statements
(a) All paper claim forms for health insurance delivered to any person residing or located in this State, in connection with health insurance policies, except health insurance policies for title XVIII of the Federal Social Security Act, or State or local department of social services contracts to be issued or issued for delivery in this State shall, as of the date 90 days from the effective date of these regulations, contain the following statement: "Any person who, knowingly and with intent to defraud any MCO or other person, files a statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, is guilty of committing a fraudulent insurance act, which is a crime and shall be subject to a civil penalty not to exceed $5,000 and the stated value of the claim for each such violation."
(b) Location of warning statements and type size.
(1) The warning statements required by subdivisions (a) and (c) of this section shall be placed immediately above the space provided for the signature of the person executing the claim form and shall be printed in type which will produce a warning statement of conspicuous size. On claim forms which require execution by a person other than the claimant, or in addition to the claimant, the warning statements required by subdivisions (a) and (c) of this section shall be placed at the top of the first page of the claim form or on the page containing instructions, either in print, by stamp or by attachments and shall be in type size which will produce a warning statement of conspicuous size.
(2) Notwithstanding the provisions of paragraph (1) of this subdivision, MCOs may affix the warning statements required by this Subpart to all claim forms by means of labels and/or stamps or by attachment during the 90-day period following the effective date of these regulations.
(c) Notwithstanding the provisions of subdivision (a) of this section, MCOs may use substantially similar warning statements, provided such warning statements are submitted to the commissioner for prior approval.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
LEAVES WITHOUT PAY LEAVES WITHOUT PAY
10 CRR-NY 84.30 Leave of absence; duration
(a) A permanent employee or an employee holding a position by permanent or temporary appointment who requests leave because of pregnancy or childbirth may, in the discretion of the department, be granted a leave of absence from his position, without pay, for a period not exceeding two years. Such leave may be extended beyond two years, for periods aggregating not in excess of an additional two years, only with the approval of the Civil Service Commission. In an exceptional case, a further extension may be permitted by the commission for good cause shown and where the interests of the government would be served. For the purposes of this section, time spent in active service in the military forces of the United States or of the State of New York shall not be considered in computing the period of leave.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.13 COVID-19 confirmatory testing - funeral directors
Whenever the funeral director has been advised by an attending health care practitioner (whether the death was in hospice, an adult care facility, or any another setting where a positive diagnosis was not made) and there is a clinical suspicion that COVID-19 was a cause of death, but no such test was performed within 14 days prior to death in a nursing home or hospital, or by the hospice agency, coroner, or medical examiner, the funeral director shall administer a COVID-19 test within 48 hours after death, whenever the body is received within 48 hours after death. Such test shall be performed using rapid testing methodologies to the extent available. The funeral director shall report the death to the department immediately after and only upon receipt of such test results, through a means determined by the department. Notwithstanding the foregoing, no test shall be administered if the next of kin objects to such testing. Should the funeral director lack the ability to perform such testing expeditiously, the funeral director should request assistance from the State Department of Health.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 2 MEDICAL FACILITY CONSTRUCTION
Part 710 APPROVAL OF MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 710.10 Cancellation, withdrawal and annulment of approvals
The failure, neglect or refusal of the applicant, in manner and detail as required by this Subchapter, to conform to the requirements hereinbelow set forth shall result in the cancellation, withdrawal or annulment of any or all prior approvals issued to the applicant concerning the subject application:
(a) Failure to commence and complete construction, within the time period determined under section 710.2 of this Title, which time period shall commence on the date of approval or contingent approval of the application, project scope and concept, shall constitute an abandonment of the application and any such approval or contingent approval shall be deemed cancelled, withdrawn and annulled without further action of the commissioner.
(b) Any applicant, regardless of reason, requesting to change the date on which construction is to begin or end shall file a request with the commissioner setting forth the change in date and the reasons for the change. The approval of the commissioner must be obtained for any such change. A change in the date of commencement or completion of construction is not an amendment to an application pursuant to section 710.5 of this Title.
(c)
(1) The failure, neglect or refusal of an applicant to submit documentation or information, within the stated time frame, to satisfy a contingency imposed by the commissioner in conjunction with the proposal to approve an application shall constitute and be deemed an abandonment or withdrawal of the application by the applicant without the need for further action by the commissioner.
(2) When an applicant submits documentation or information, within the stated time frame, in an attempt to satisfy a contingency imposed by the commissioner, but the department does not consider the documentation or information sufficient to satisfy the contingency, the department will so notify the applicant in writing and inform the applicant of the reasons why the documentation or information is not considered sufficient to satisfy the contingency. The applicant shall have 30 days from the date or receipt of the department's notice to submit to the department additional or amended documentation or information to correct the deficiencies and satisfy the contingency. The failure to submit such documentation or information within the 30-day time period shall constitute and be deemed an abandonment or withdrawal of the application by the applicant without the need for further action by the commissioner. If additional or amended documentation or information is submitted within the 30-day time period but the department still does not consider it sufficient to satisfy the contingency, the applicant will be so notified in writing, the application shall be proposed for disapproval, and the applicant shall be afforded the opportunity to request a hearing.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 155.55 Thornwood Water District
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, shall apply to all wells located on lands owned by the Thornwood (Water District and situated in the northerly part of the district between Broadway, Carrigan Avenue, Gramercy Place and Claremont Avenue, near a small tributary of Sawmill River, and in the northwesterly part of the district in the valley of the Sawmill River northeast of the Westchester County Parkway, which form or may form sources of the public water supply of the Thornwood Water District.
(b) [Definitions.]
(1) The term well wherever used in this section is intended to mean and refer to the wells now used as a source of this public water supply or to any additional well which may be constructed at this point for the purpose of this public water supply.
(2) Wherever a linear distance of a structure or object from a well is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to any well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit or other receptacle of any kind placed or used for either the temporary storage or the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well forming the source of the public water supply of the Thornwood Water District.
(2) No privy, privy vault, pit, cesspool or other receptacle, which is not watertight, placed or used for the permanent deposit of human excreta, shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well forming the source of the public water supply of the Thornwood Water District.
(3) Every privy, privy vault, pit or other receptacle of any kind, placed or used for the temporary storage of human excreta, located between the limiting distance prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all excreta shall be received in a suitable watertight receptacle or removable container which shall be emptied as set forth in paragraphs (4) and (5) of this subdivision.
(4) Whenever the aforesaid watertight receptacles or removable containers become filled within six inches of the top, said receptacles or containers shall be emptied or removed and the contents disposed of as hereinafter provided in order to maintain the privy or receptacle in proper sanitary condition and effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transported from the privy or receptacle to the place of disposal hereinafter specified and that the contents or the removable containers, while being transported, shall be thoroughly covered, and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles or removable containers permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits and covered with not less than 12 inches of soil in such a manner as effectually to prevent their being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any well forming the source of the public water supply of the Thornwood Water District.
(6) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface of the ground or through the soil in an imperfectly purified condition into any well, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, sink wastes, garbage, etc.
(1) No bath water, laundry wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner upon the surface of the ground or into the ground beneath the surface (except into watertight receptacles, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 300 feet of any well forming the source of the public water supply of the Thornwood Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any garage, dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged upon the surface of the ground or into the ground beneath the surface (except into watertight containers, the contents of which are to be removed as provided by paragraphs [4] and [5] of subdivision [c]) within 100 feet of any well forming the source of the public water supply of the Thornwood Water District.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, no barnyard, hogyard, pigpen, poultry house or yard, no hitching place or standing place for horses or other animals and no manure pile or compost heap shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any well forming the source of the public water supply of the Thornwood Water District, and none of the above named objects or sources of pollution shall be constructed, located, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any well without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the aforesaid drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet from any well forming the source of the public water supply of the Thornwood Water District.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed, piled or spread upon the surface of the ground, nor shall such human excreta, compost or other matter containing human excreta be buried in the soil unless covered with not less than 12 inches of soil nor within a distance of 500 feet of any well; and no manure or compost of any kind, not containing human excreta, shall be placed, piled or spread upon the ground within a distance of 150 feet of any well forming the source of the public water supply of the Thornwood Water District.
(f) Dead animals, offal, industrial wastes.
No dead animal, bird, fish or any part thereof nor any offal or polluted industrial wastes of any kind shall be thrown, placed, discharged, maintained or allowed to remain upon the surface of the ground or buried beneath the surface within 300 feet of any well forming the source of the public water supply of the Thornwood Water District.
(g) Trespassing.
No trespassing shall be allowed upon the property of the Thornwood Water District upon which the wells of the public water supply of the Thornwood Water District are located and no person or persons shall enter in or upon such property except the board of water commissioners or any such board or person or persons who may be charged with the maintenance of the supply in the official performance of their duties of supervision or maintenance of the public water supply or except such other persons as may be authorized to enter said property by the board of water commissioners of the Thornwood Water District.
(h) Camps.
No camp, tent, building or other structure for occupancy by transients or for the housing of laborers engaged in construction work or for any other use, except as a private camp or dwelling maintained by a person for his own personal use or for the use of his family and friends, shall be located, placed or maintained within a distance of 500 feet of any well forming the source of the public water supply of the Thornwood Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet of any well forming the source of the public water supply of the Thornwood Water District.
(j) General clause.
In addition to observing the foregoing requirements, all persons shall refrain from any act, although not heretofore specified, which may result in the contamination of any portion of the water supply of the Thornwood Water District.
(k) Inspections.
The board of water commissioners of the Thornwood Water District or such other board, person or persons as may be charged with the maintenance or supervision of the public water supply of the Thornwood Water District or their duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report to the State Commissioner of Health in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general surroundings of the wells at the time of the last inspection.
(l) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 395 of the Laws of 1928, the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter IV HEALTH INFORMATION SYSTEMS
Part 300 STATEWIDE HEALTH INFORMATION NETWORK FOR NEW YORK (SHIN-NY)
10 CRR-NY 300.1 Definitions
For the purposes of this Part, these terms shall have the following meanings:
(a) Statewide Health Information Network for New York or SHIN-NY means the technical infrastructure and the supportive policies and agreements that make possible the electronic exchange of clinical information among qualified entities and qualified entity participants for authorized purposes to improve the quality, coordination and efficiency of patient care, reduce medical errors and carry out public health and health oversight activities, while protecting patient privacy and ensuring data security.
(b) Qualified entity means a not-for-profit regional health information organization or other entity that has been certified under section 300.4 of this Part.
(c) Qualified entity participant means any health care provider, health plan, governmental agency or other type of entity or person that has executed a participation agreement with a qualified entity, pursuant to which it has agreed to participate in the SHIN-NY.
(d) Health care provider means a health care provider as defined in paragraph (b) of subdivision one of section 18 of the Public Health Law entitled “Access to patient information.”
(e) Statewide collaboration process means an open, transparent process within which multiple SHIN-NY stakeholders contribute to recommendations for SHIN-NY policy guidance.
(f) SHIN-NY policy guidance means the set of policies and procedures, including technical standards and SHIN-NY services and products that are approved by the New York State Department of Health.
(g) Patient information means health information that is created or received by a qualified entity participant and relates to the past, present, or future physical or mental health or condition of an individual or the provision of health care to an individual, and that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.
(h) Minor consent patient information means patient information relating to health care of a patient under 18 years of age for which the patient provided his or her own consent as permitted by law, without a parent’s or guardian’s permission.
(i) Health oversight agency means an agency or authority of the United States, or New York State, or a person or entity acting under a grant of authority from or contract with such public agency, including the employees or agents of such public agency or its contractors or persons or entities to whom it has granted authority, that is authorized by law to oversee the health care system (whether public or private) or government programs in which health information is necessary to determine eligibility or compliance, or to enforce civil rights laws for which health information is relevant.
(j) Public health authority means an agency or authority of the United States, the New York State Department of Health, a New York county health department or the New York City Department of Health and Mental Hygiene, or a person or entity acting under a grant of authority from or contract with such public agency, including the employees or agents of such public agency or its contractors or persons or entities to whom it has granted authority, that is responsible for public health matters as part of its official mandate.
(k) Written authorization means a signed consent that complies with the requirements for written authorizations in this Part. A written authorization may be an electronic record with an electronic signature, as provided by State Technology Law article 3 (Electronic Signatures and Records Act).
(l) Law means a Federal, State or local constitution, statute, regulation, rule, common law, or other governmental action having the force and effect of law, including the charter, administrative code and rules of the City of New York. Required by law means a mandate contained in law that compels a person or entity to make a use or disclosure of patient information and that is enforceable in a court of law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-2 CERTIFICATE OF PUBLIC ADVANTAGE
10 CRR-NY 83-2.3 Public notice
(a) Upon submission of an application for a certificate of public advantage or an application to renew a certificate of public advantage, each party to be covered by the certificate shall conspicuously post on its public website, in a form determined by the department, a description of the application with an electronic link to the section of the department’s public website where applications for certificates of public advantage are summarized. If the party has no public website, it shall provide notice to the public in a manner acceptable to the department.
(b) The department shall publish on the department’s public website a notice of the receipt of each application for a certificate of public advantage, with a brief summary of the application and instructions for persons wishing to provide comments.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.18 Recoveries of expense
(a) Operating costs shall be reduced by the costs of services and activities which are not properly chargeable to patient care. In the event that the State Commissioner of Health determines that it is not practical to establish the costs of such services and activities, the income derived therefrom may be substituted for costs of these services and activities. Examples of activities and services covered by this provision include:
(1) drugs and supplies sold to other than employees for use outside the residential health care facility;
(2) telephone and telegraph services for which a charge is made;
(3) discount on purchases;
(4) living quarters rented to persons other than employees;
(5) meals provided to special nurses or patients' guests;
(6) operation of parking facilities for community convenience;
(7) lease of office and other space of concessionaires providing services not related to residential health care facility service; and
(8) tuitions and other payments for educational service, room and board and other services not directly related to residential health care facility service.
(b) Operating costs shall be reduced by the actual revenue received from services and activities which are provided to employees at less than cost, as a form of fringe benefit. Examples of activities and services covered by this provision include:
(1) drugs and supplies sold or provided to employees;
(2) living quarters rented or provided to employees; and
(3) meals sold or provided to employees.
Chapter I STATE SANITARY CODE
Part 1 GENERAL PROVISIONS
DEFINITIONS DEFINITIONS
10 CRR-NY 1.1 Definitions
Unless otherwise specifically provided herein, the following words and terms used in this Chapter are defined for the purposes thereof as follows:
(a) The term communicable disease means such communicable disease as may be designated in section 2.1, of this Title.
(b) The term municipality means and includes a county, part-county, city, town, village, or consolidated health district or any subdivision or part of the State of New York lawfully established as a separate public health unit.
(c) The term board of health or local board of health means and includes the local board, department, or commissioner of health, or other body or official of a municipality, by whatever title the same may be known, having the usual powers and duties of the board of health of a municipality.
(d) The term health officer or local health officer means and includes the health officer, or other officer of a municipality, by whatever title he may be known, having the usual powers and duties of the health officer of a municipality.
(e) The term approved laboratory or laboratory approved for the examination shall mean a laboratory possessing a certificate of approval for the specified examination, issued by the State Commissioner of Health under the authority of section 502 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.27 Compensation of operators and relatives of operators
(a) Reasonable compensation for operators or relatives of operators for required services actually performed shall be considered an allowable cost. The amount to be allowed shall be equal to the amount normally required to be paid for the same service provided by a nonrelated employee, as determined by the commissioner. Compensation shall not be included in the rate computation for any services which the operator or relative of the operator is not authorized to perform under New York State law and regulation.
(b) In determining a reasonable level of compensation for operators or relatives of operators, the commissioner may consider the quality of care provided to patients by the facility during the year in question.
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.17 Audits and examinations
(a) The commissioner, or his or her representative, and in the case of paragraph (5) of this subdivision, the superintendent, may examine at any time each MCO, and all participating entities through which such MCO offers health services, as to the quality of health care services offered, and the adequacy of its provider arrangements. Such examination may include, but shall not necessarily be limited to:
(1) all records and reports relative to the number and characteristics ( e.g., age and sex) of enrollees;
(2) all records and reports relative to utilization of services, by type;
(3) all records of complaints or grievances submitted by enrollees to the health maintenance organization, and the disposition thereof;
(4) evidence of the operation of a mechanism through which the enrolled population provides advice about the policies of an MCO ( e.g., enrollee representation on the governing board); and
(5) contracts with providers of health services and other vendors.
(b) The superintendent, the commissioner, or their representatives, may examine the financial affairs of each MCO and all participating entities through which such MCO offers health services at any time. Such examination may include, but shall not be limited to, the following:
(1) all financial records, including statements of income and expense, budgets and related documents; and
(2) all books, records, files and other documents relating to the affairs of such organization, which are relevant to the financial examination.
(c) Every holding company and every controlled person within a holding company system shall be subject to examination by order of the commissioner, and except for PHSPs, HIV SNPs and PCPCPs, the superintendent, if he or she has reasonable cause to believe that the operations of such person may materially affect the operations, management or financial condition of any controlled MCO within the system operating in New York State, and that he or she is unable to obtain relevant information from such controlled MCO. The grounds relied upon by the commissioner, or where applicable, the superintendent for such examination shall be stated in his or her order. Such examination shall be confined to matters specified in the order.
(d) All fiscal and statistical records and reports of the MCO shall be subject to audit for a period of six years from the date of their filing with the department. This limitation shall not apply to situations in which fraud may be involved, or where the provider or an agent thereof prevents or obstructs the commissioner or superintendent from performing an audit pursuant to this section. All underlying books, records and documentation which formed the basis for the fiscal and statistical reports, including records of any holding company having a bearing on the operations of the MCO, filed by the MCO with the department, shall be kept and maintained by the MCO and holding company for a period of time not less than six years from the date of filing, or the date upon which the fiscal and statistical records were to be filed, whichever is the later date.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.5 Integrated care models
Integrated services providers will be approved by the appropriate State licensing agency and designated to deliver integrated care services as one of the following models:
(a) Primary care host model.
Given the recognition that the general health care system can serve as a gateway to the behavioral health care system, treatment for substance use disorder and/or mental illness is integrated into a single outpatient physical health setting. In this model, a diagnostic and treatment center or a general hospital outpatient program shall be the host site and the department shall be responsible for monitoring compliance of an integrated services provider with the provisions of this Part.
(b) Mental health behavioral care host model.
Given that persons with mental health disorders frequently have a co-occurring substance use disorder and/or also experience chronic illnesses, treatment for substance use disorder and/or physical health is integrated into a single outpatient mental health setting. In this model, an article 31 clinic treatment program shall be the host site and the Office of Mental Health shall be responsible for monitoring compliance of an integrated services provider with the provisions of this Part.
(c) Substance use disorder behavioral care host model.
Given that persons with substance use disorders frequently have a co-occurring mental health disorder and/or also experience chronic illnesses, treatment for mental illness and/or physical health is integrated into a single outpatient substance use disorder treatment setting. In this model, an article 32 substance use disorder outpatient treatment clinic shall be the host site and the Office of Alcoholism and Substance Abuse Services shall be responsible for monitoring compliance of an integrated services provider with the provisions of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-1 APPLICATION AND PAYMENT
10 CRR-NY 40-1.10 Performance and accountability; reporting
(a) The commissioner shall establish, in consultation with the local health departments and the New York State Association of County Health Officials, uniform statewide performance standards for the services funded pursuant to article 6 of the Public Health Law; provided, however, that upon request the commissioner may approve a modification of a specific standard for a local health department if such local health department demonstrates adequate justification. The commissioner shall recognize the particular needs and capabilities of the various local health departments. The commissioner shall monitor the performance and expenditures of each local health department to ensure that each one satisfies the performance standards.
(b) The commissioner shall establish, in consultation with the local health departments and the New York State Association of County Health Officials, a uniform accounting system for monitoring the expenditures for services of each local health department to which aid is granted and the amount of State aid received including any performance payments pursuant to section 619-a of article 6 of the Public Health Law. Such reporting system shall require information on the amount of public health moneys received from the Federal government, the private sector, grants, and fees.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 702 ENVIRONMENTAL HEALTH
10 CRR-NY 702.5 Linen and laundry
The governing authority or operator shall:
(a) Provide a sufficient quantity of clean linen to meet the requirements of patients and residents; nursing homes and health-related facilities shall maintain a linen inventory equal to at least three times the average daily census and of this one-third shall be in use, one-third in laundry and one-third in reserve.
(b) Maintain linen in proper condition for use, free from rips and tears.
(c) Provide for satisfactory laundering of linens and other washable fabrics.
(d) Handle, store and process laundry in a manner that will prevent the spread of infection and assure the maintenance of clean linen.
(e) Wash all linen, including blankets, between patient use.
(f) Bag or enclose all used linen in suitable containers within the patient care unit for transportation to the laundry.
(g) Separately bag or enclose used linens from isolation rooms, infectious patients and the pathology department in readily identifiable containers distinguishable from other laundry.
(h) Properly maintain space and equipment for laundry storage and transportation.
(i) Launder only in areas and with equipment properly maintained and approved for such purpose by the department.
(j) Launder in a manner designed to prevent contamination of clean linen and to prevent infection.
(k) Transport clean linen in clean covered containers used exclusively for the purpose, and store clean linen in clean storage areas in a manner to prevent its contamination.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRENATAL CARE SERVICES PRENATAL CARE SERVICES
10 CRR-NY 85.44 Minimum standards preferred primary care providers (PPCP)
(a) Purpose.
The purpose of these regulations is to establish minimum standards to qualify as a preferred primary care provider (PPCP). Preferred primary care is a comprehensive range of services aimed at improving access to and availability of comprehensive primary health care to Medicaid eligible and medically indigent persons and persons in underserved areas and assuring that minimum standards of care and services will be upheld.
(b) Eligibility.
(1) Eligibility is extended to providers of comprehensive Primary care services licensed under article 28 of the Public Health Law:
(i) licensed diagnostic and treatment centers which primarily provide a comprehensive range of primary medical services; or
(ii) hospital-based outpatient departments.
(2) Providers included in PPCP shall have an approved provider agreement with the Department of Health and in addition shall meet minimum standards pursuant to this section and the goals and performance standards developed by the program and accepted by the department. In the event the provider fails to abide by the provisions of the provider agreement, the commissioner shall require prompt corrective action, impose sanctions or revoke the provider agreement as the facts may warrant.
(3) The facility shall participate in the child/teen health program.
(c) General requirements.
(1) Continuity of care. Continuity of care shall be assured by:
(i) assigning the same primary care practitioner, or team of such practitioners, to assume the principal responsibility for the care of each patient and follow the patient on each health care encounter;
(ii) provision of a tracking and referral system to document care given to the patient when the patient is sent to an emergency service, hospital, or other provider of health care services. Facility staff shall assist the patient with arrangements or make arrangements for the patient for off-site services, facilitate receipt of those services, monitor reports of results of off-site services, and integrate results into patient records;
(iii) provision for follow-up of missed appointments via telephone, outreach worker visit, letter or telegram, as appropriate, to the urgency of the patient's need; and
(iv) hospitals making specialty services accessible to hospital and diagnostic and treatment center PPCP's and to practitioners enrolled in the Department of Social Services preferred physician and children program in their service area.
(2) PPCP's shall enroll eligible children and their families in a child health insurance plan described in Public Health Law, article 25 and accept such reimbursement for primary care services of the facility.
(3) Scheduling of appointments and hours of operation.
(i) Operational hours of the facility shall be at least five days per week for 40 hours during weekdays with an additional eight hours during evenings or weekends. Alternate scheduling of hours may be established to meet the needs of patients upon written approval of the commissioner.
(ii) The facility shall provide patients prompt access to a clinical staff member who can respond to inquiries regarding health care problems via telephone on a 24-hour-a-day basis.
(iii) Service scheduling shall accommodate personal appointments, walk-in patients and referrals.
(iv) Appointment scheduling shall allow ample time for physical examinations, treatments and patient teaching.
(v) Appointments for nonurgent visits for current patients of the program shall be available in no more than two weeks from the time of request, 90 percent of the time. Appointments for nonurgent visits by new patients shall be available in no more than four weeks from the time of request. Patients shall be triaged to assure that urgent and emergency care patients who can be managed by the facility receive medical care in a timely manner.
(4) Practitioner credentials.
(i) Staff physicians shall have training, experience and qualifications appropriate to the needs of their patients.
(ii) Physician specialists shall be board-certified or admissible or shall have equivalent training and experience to qualify them to practice in the specialty area.
(iii) Sufficient other practitioners duly licensed and qualified to meet the primary medical care needs of patients shall be available.
(iv) A portion of the primary care practitioners members of the medical staff sufficient to meet PPCP patient needs shall have admitting privileges in affiliate hospitals. The PPCP, and its practitioners who are sending or admitting patients to the hospital from the PPCP, shall work to facilitate coordination of care and transfer of information about PPCP patients between the ambulatory care and inpatient facilities. Where diagnostic and treatment center-based primary care practitioners are not able to gain hospital inpatient admission privileges, the facility shall have backup agreements with hospitals for prompt hospital admission and discharge of patients and transfer of patient information to the PPCP.
(5) The facility shall participate in local social service district managed care programs for Medicaid recipients when requested by the local district.
(d) Primary care services.
(1) Primary care services shall include the fields of internal medicine, obstetrics/gynecology, family practice and pediatrics.
(2) The facility shall provide, directly or by contract, diagnostic radiology, pharmacy and clinical laboratory services, in accordance with patient needs; shall make arrangements for and assure receipt of services; and shall ensure prompt receipt of radiology and laboratory reports.
(3) Services the facility provides under contract shall comply with section 400.4 of this Title. Contracts shall:
(i) be available for review and inspection by the Department of Health;
(ii) include provisions grranting the Department of Health access to contractor sites and records to conduct on-site program compliance reviews; and
(iii) require that the contractors provide contracted care and services that meet the minimum standards established in this section and are in accordance with generally accepted standards of practice and patient care.
(4) The PPCP shall provide or arrange for at least the following preventive health services:
(i) immunization;
(ii) healthy lifestyles promotion;
(iii) cervical, breast and colon cancer screening;
(iv) HIV screening and counseling
(v) family planning;
(vi) sexually transmissible disease services; and
(vii) prenatal care and services.
(5) The PPCP shall be organized, equipped and staffed for the effective diagnosis and appropriate management of a wide range of medical conditions such as: otitis media, hypertension control, respiratory infection, chronic obstructive pulmonary disease, pneumonia, diabetes management, bronchitis/asthma, heart disease, and cellulitis and differential diagnosis.
(6) Providers shall conduct a psychosocial assessment of each patient, to identify social, economic, psychological and emotional problems which present obstacles to health and treatment. When problems are identified the PPCP shall make referral, as appropriate to the patient needs, to the local Department of Social Services, community mental health resources, alcohol and substance abuse providers and support groups or social/psychological specialists.
(7) Nutrition promotion services.
The provider shall establish and implement, directly or by referral, a program of nutrition screening and counseling which includes:
(i) individual nutrition risk assessment, including screening for specific nutritional risk conditions at the initial visit and continuing reassessment as needed;
(ii) professional nutrition counseling, monitoring and follow-up of all patients at nutritional risk;
(8) Records.
The facility shall collect such information and make it available in such form as the commissioner shall require.
(e) Quality assurance.
Preferred primary care providers shall monitor provision of quality care through the facility quality assurance program through performance indicators. The program shall include but not be limited to the following activities in addition to the facility-wide activities of the quality assurance program:
(1) determining patient satisfaction with all components of services including those provided through contracts and by arrangement;
(2) determining and documenting the extent to which the PPCP reaches medically underserved populations in the facility services area; and
(3) determining the extent to which services of the facility are successful in managing, on an ambulatory care basis, patient medical conditions which are associated with excess hospital admissions.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.6 Equipment
(a) Equipment is to be constructed, located, and installed in a way that prevents food contamination and facilitates cleaning the establishment.
(b) Food-contact surfaces are to be smooth and free from cracks or pits and are to be easily cleanable. All food-contact surfaces are to be kept clean and sanitized immediately prior to and during use as needed to prevent food contamination.
(c) Non-food-contact surfaces are to be kept free of built-up soil, grease, food encrustations or similar deposits.
(d) Single-service articles are to be furnished consumers at all temporary food service establishments which do not have effective facilities for cleaning and sanitizing tableware.
(e) When food operations are conducted in other than daylight hours, artificial light is to be installed to at least 20 footcandles of light at all food-contact and food preparation surfaces. Artificial lighting fixtures located over or by food preparation and food service facilities are to be protected to prevent broken glass from falling into food or onto food-contact surfaces.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.16 Fees and costs
(a) When an action subject to this Part involves an applicant, the department, if it is lead agency, may charge a fee to the applicant in order to recover the actual costs of preparing or reviewing the EIS; providing, however, that an applicant may not be charged a separate fee for both the preparation and review of an EIS, and provided further, that any fee charged must reflect the actual costs to the lead agency for such preparation or review. Where an applicant does not choose to prepare the EIS, the department shall provide the applicant, upon request, with an estimate of the costs for preparing such statement based on the total cost of the project for which funding or approval is sought.
(b) For residential projects, the total project cost shall be the cost of the land plus the cost of all site improvements required, not including the cost of buildings and structures. In the case of a residential project, the fee charged by the department may not exceed two percent of the total project cost.
(c) For nonresidential construction projects, the total project cost shall be the cost of supplying utility service to the project, the cost of site preparation and the cost of labor and material as determined with reference to a current cost data publication in common usage, such as Building Construction Cost Data by Means. In the case of construction projects, the fee charged may not exceed one half of one percent of the total project cost.
(d) Appeals procedure.
When a dispute arises concerning fees charged to an applicant by the department, the applicant may make a written request setting forth reasons why it is felt that such fees are inequitable. Upon receipt of a request, the chief fiscal officer of the department or his designee shall examine the agency record and prepare a written response to the applicant setting forth reasons why the applicant's claims are valid or invalid.
(e) Any fees paid by the department for the technical services of the Department of Environmental Conservation will be reflected in the fee charged to any applicant pursuant to subdivision (a) of this section.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 600 GENERAL PROVISIONS
10 CRR-NY 600.3 Amendments and modifications to applications
(a) A change to an application before the Public Health and Health Planning Council has approved or contingently approved the application is hereafter referred to as a revision; a change to an application which has been approved or contingently approved by the council but for which an operating certificate has not yet been issued shall be referred to as an amendment if it meets the criteria contained in subdivision (c) of this section, and shall be referred to as a modification approvable pursuant to subdivision (f) of this section if it does not meet the criteria contained in subdivision (c) of this section or does not meet the criteria in subdivision (e).
(b) An application made to the Public Health and Health Planning Council, pursuant to this Part, may be modified before the council has approved or contingently approved the application. Such modifications shall be made on appropriate forms supplied by the department and submitted to the council through the central office of the department in Albany and shall be governed by the following:
(1) any modification in the information contained in the original application must be accompanied by a satisfactory written explanation as to the reason such information was not contained in the original application;
(2) the department, when reviewing a competitive batch of applications, may establish deadlines pursuant to written notification for the submission of any modification to an application; and
(3) if a modification is submitted after any such deadline(s), the application shall be removed from consideration within the competitive batch being reviewed.
(c) After the Public Health and Health Planning Council has approved or contingently approved an application but prior to the issuance of an operating certificate, any change as set forth in paragraphs (1) through (3) of this subdivision shall constitute an amendment to the application, and the applicant shall submit the proposed amendment to the department's central office together with appropriate documentation explaining the reason(s) for the amendment and such additional documentation as may be required in support of such amendment. The amended application shall be referred to the health systems agency having geographic jurisdiction and the Public Health and Health Planning Council for their reevaluation and recommendations. The approval of the Public Health and Health Planning Council must be obtained for any such amendment. Each of the following shall constitute an amendment:
(1) a change in the number and/or types of beds and/or services, other than a reduction of service which would be subject to administrative review;
(2) a change in the location of the site of the construction if outside the facility's service area or adjacent service area; and
(3) any change in the applicant.
(d) For purposes of this section, the following terms shall have the following meanings:
(1) Total project cost means total costs for construction, including but not limited to costs for demolition work, site preparation, design and construction contingencies, total costs for real property, for fixed and movable equipment, architectural and/or engineering fees, legal fees, construction manager and/or cost consultant fees, construction loan interest costs, and other financing, professional and ancillary fees and charges. If any asset is to be acquired through a leasing arrangement, the relevant cost shall be the cost of the asset as if purchased for cash, not the lease amount.
(2) Total basic cost of construction means total project costs less capitalized amount of construction loan interest, and financing fees.
(e)
(1) If the commissioner, acting on behalf of the Public Health and Health Planning Council, determines that increases in total project costs or total basic costs of construction are due to factors of an emergency nature such as labor strikes, fires, floods or other natural disasters or factors beyond the control of the applicant, or modifications to the architectural aspects of the application which are made on the recommendation of the department, the applicant may proceed without the need for the application to be referred back to the health systems agency and the Public Health and Health Planning Council.
(2) If the applicant can document by evidence acceptable to the commissioner, acting on behalf of the Public Health and Health Planning Council, that increases in total project cost or total basic cost of construction were caused by delays in obtaining zoning or planning approvals which were beyond its control, the commissioner may permit review of the application to proceed without the need for the application to be referred back to the health systems agency and the Public Health and Health Planning Council pursuant to this Part. The evidence shall demonstrate clearly that the applicant had timely pursued the zoning or planning permits, has now obtained all such required permits and approvals, and is prepared to proceed with the project.
(3) If the applicant can document by evidence acceptable to the commissioner, acting on behalf of the Public Health and Health Planning Council, that increases in the total basic cost of construction were caused by inflation in excess of that estimated and approved in the application and that such inflation has affected the total basic cost of construction as a result of delays which were beyond the applicant's control, the commissioner may permit review of the application to proceed without the need for the application to be referred back to the health systems agency and the Public Health and Health Plannning Council pursuant to this Part. The evidence shall demonstrate clearly that the increase in inflation exceeds that estimated and approved in the application, and that any delays resulting in such inflationary cost increases were beyond the applicant's control.
(f) Any modification submitted subsequent to the issuance of any approval by the council which does not constitute an amendment pursuant to the provisions of this section shall require only the prior approval of the commissioner.
(g) Failure to disclose an amendment prior to the issuance of an operating certificate shall constitute sufficient grounds for the revocation, limitation or annulment of the approval of establishment.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 61 RESEARCH
Subpart 61-1 RECOMBINANT DNA RESEARCH AND ACTIVITY
CONTAINMENT CONTAINMENT
10 CRR-NY 61-1.10 Containment; general
Good microbiological practices shall be adhered to. All personnel directly or indirectly involved in recombinant DNA activity shall be instructed in aseptic techniques and the biology of organisms used in the activity, in order that they shall be aware of potential biohazards. An emergency plan shall describe the procedures to be followed in the event of an accident contaminating personnel or the environment. The principal investigator must ensure that everyone in the laboratory is familiar with both the potential hazards of the work and the emergency plan. All personnel working with a pathogen for which an effective vaccine is available should be immunized. Serological monitoring, when appropriate, shall be provided.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.24 Definition of frozen desserts
(a) Frozen desserts are ice cream, frozen custard, French ice cream, French custard ice cream, artificially sweetened ice cream, ice milk, artifically sweetened ice milk, fruit sherbet, non-fruit sherbet, water ices, non-fruit water ices, confection frozen without stirring, dairy confection frozen without stirring, manufactured dessert mix, frozen confection, melloream frozen dessert, parevine, frozen yogurt, freezer made shakes, freezer made milk shakes, dietary frozen dessert, whipped cream confection and bisque tortoni, as all such products are commonly known, together with any mix used in making such frozen desserts, and any products which are similar in appearance, odor or taste to such products, or are prepared or frozen as frozen desserts are customarily prepared and frozen, whether made with dairy products or non-dairy products. Any operation producing chips or flakes of ice made from water with or without additives, served to the customer with or without flavorings added by the operator or consumer, is included as a retail frozen dessert within this definition. This operation is commonly known as a slush operation.
(b) Retail frozen desserts are to be manufactured from ingredients and are to be identified in conformance with the applicable requirements of Part 39 of the rules and regulations of the State Department of Agriculture and Markets (1 NYCRR Part 39).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.89 Deferred credit
Revenue received or recorded before it is earned, i.e., before the consideration is given, in whole or in part, for which the revenue is or is to be received.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
INVESTIGATIONS AND DETERMINATIONS INVESTIGATIONS AND DETERMINATIONS
10 CRR-NY 2.7 Reported cases and suspected cases of tuberculosis to be investigated; instruction by physician
(a) Upon receiving a duly signed report of a person who appears to be suffering from tuberculosis pursuant to sections 2100 and 2222 of the Public Health Law, the State or local health officer to whom such cases are reportable shall cause an examination to be made of the case if it has not been previously reported by a physician as a case of pulmonary tuberculosis and shall take such further measures as may be indicated as a result to such examination; if such a person has been reported to him previously by a physician as one suffering from pulmonary tuberculosis, the State or local health officer concerned shall ascertain promptly whether such physician is maintaining proper sanitary supervision.
(b) It shall be the duty of a physician in attendance on a person affected with active pulmonary tuberculosis to instruct such person or a responsible member of his family not to permit personal contact with non-household members or occupational contact with others until the patient is deemed to be non-infectious.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.1 Purpose
The purpose of this Subpart is to assure a sanitary, healthful and safe environment for the public when using bathing beaches.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-2 NEW YORK STATE VETERANS' HOMES
10 CRR-NY 88-2.5 Reports
The director shall submit to the commissioner such narrative and statistical reports at such intervals as may be prescribed by the commissioner.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-11 NONTRANSPLANT ANATOMIC BANKS
10 CRR-NY 52-11.1 Definitions
For the purposes of this Subpart, unless the context indicates otherwise, the following terms shall have the following meanings:
(a) Whole body means the intact corporeal remains of an individual after the time of death.
(b) Whole body acquisition service means a nontransplant anatomic bank that solicits, retrieves, performs donor selection, preserves, transports, allocates, distributes, acquires, processes, stores, or arranges for the storage of whole bodies or body segments, solely for education and/or research purposes.
(c) Whole body user means a nontransplant anatomic bank located in New York State that obtains whole bodies and/or body segments from a whole body acquisition service. A whole body user shall store and/or use whole bodies or body segments solely for education and/or research purposes, under the direct oversight of the legally authorized donee. A whole body user may not transfer whole bodies or body segments to any other entity, except as authorized in writing by the whole body acquisition service.
(d) Body segment means a portion of a whole body detached for purposes of study, evaluation, education and/or research. Body segments consist of contiguous mixed tissues whose relationships have been altered only at the segment boundaries.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 402 CRIMINAL HISTORY RECORD CHECK
10 CRR-NY 402.2 Applicability
This Part shall apply to every provider of services to patients, residents, or clients that is:
(a) residential health care facility licensed under article 28 of the Public Health Law;
(b) a certified home health agency, licensed home care services agency or long term home health care program certified, licensed or authorized under article 36 of the Public Health Law;
(c) an adult home, enriched housing program, or residence for adults licensed under article 7 of the Social Services Law; or
(d) a hospice program licensed, certified, or authorized under article 40 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.1 Definitions
As used in this Subpart:
(a) The term long-term home health care program (LTHHCP) shall mean an organization defined in article 36 of the Public Health Law possessing a valid operating certificate or valid certificate of approval issued by the State Commissioner of Health to operate a LTHHCP.
(b) The term AIDS Home Care Program (AHCP) shall mean a LTHHCP possessing a valid operating certificate or valid certificate of approval issued by the State Commissioner of Health to operate an AHCP.
(c) The term related organization shall be defined as any entity which the LTHHCP is control of or is controlled by, either directly or indirectly, or where an association of material interest exists in an entity which provides goods and/or services to the LTHHCP, or any entity which is controlled directly or indirectly by the immediate family of the operator. Immediate family shall include each parent, child, spouse, brother, sister, first cousin, aunt and uncle, whether such relationship arises by reason of birth, marriage or adoption.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 132 ONTARIO COUNTY
10 CRR-NY 132.5 Village of Rushville
See section 132.1, supra.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.173 Income realization
The recognition of income, the usual test being the passage of title to or delivery of goods, or the performance of services.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 11.0 Purpose, scope and construction
(a) In keeping with the State of New York's responsibility to protect the health of its citizens, this Part establishes basic minimal qualifications for entry level and first supervisory level public health professionals.
(b) This Part is not meant to establish job titles and job classifications within a profession, but rather to establish the minimum qualifications which a person must possess in order to function at the entry and first supervisory level within specific public health professions.
(c) Additional job titles, job classifications ( i.e., career ladder development) within each profession are developed by local and State civil service agencies. In no case may the qualifications for these titles and classifications be less than the minimum standards established by this Part for entry or first supervisory level positions.
(d) All public health professionals in the employ of local health departments on June 2, 2008, and in a title described in this Part at the entry or supervisory level, shall be considered as meeting the qualifications prescribed by this Part for the title held in the entry or supervisory levels, respectively.
(e) Any individual whose qualifications are disapproved by the local civil service agency or the State Commissioner of Health or County Commissioner or Public Health Director may request a review of such disapproval by the Public Health Council. The Public Health Council shall determine whether such disapproval is supported by substantial evidence.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.159 Gross charges (gross revenue)
The total charges at the hospital's full established rates for services rendered and goods sold (including patient-related and non-patient-related).
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.42 Specialty pediatric
This functional reporting center must contain all the expenses associated with the provision of extensive nursing, medical, psychological and counseling support services to children with diverse and complex medical, emotional and social problems in a program recognized and approved by the department to provide specialty pediatric services.
(a) Standard unit of measure: number of patient days.
Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.16 Audits and recovery of overpayments
(a) Recovery of overpayments shall be made only upon a determination by the commissioner, his agents or designees, that such overpayments have been made, and recovery shall be made of all money paid to the provider to which it has no lawful right or entitlement.
(b) Recovery of overpayments pursuant to this subject shall not preclude the commissioner or any other authorized governmental body or agency from taking any other action with respect to the provider, including auditing or reviewing other payments or claims for payment for the same or similar periods, imposing program sanctions, or taking any other action authorized by law.
(c) The commissioner may utilize any lawful means to recover overpayments, including civil lawsuit, participation in a proceeding in bankruptcy, common law set-off, or such other actions or proceedings authorized or recognized by law.
(d) All fiscal and statistical records and reports of providers and prescriptions filled or refilled which are used for the purpose of establishing the provider's right to payment under the program and any underlying books, records, documentation which formed the basis for such fiscal and statistical records and reports shall be subject to audit. All underlying books, records and documentation including all prescriptions filled or refilled shall be kept and maintained by the provider for a period of not less than three years from the date of completion of such reports, or the date upon which the fiscal and statistical records were required to be filed, whichever is later, or the date the prescription was filled or refilled.
(e) All claims made under the program shall be subject to audit by the commissioner, his agents or designees, for a period of six years from the date of their filing, or as required by State law, regulation or funding source. This limitation shall not apply to situations in which fraud may be involved or where the provider or an agent thereof prevents or obstructs the performance of an audit pursuant to this Part.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 154 WAYNE COUNTY
10 CRR-NY 154.4 Village of Newark (Canandaigua Lake)
See section 132.1, supra.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-4 FEE AND REVENUE PLAN FOR DEPARTMENTAL SERVICES
10 CRR-NY 40-4.0 Fee and revenue plan
(a) Fees and revenues received by the department pursuant to section 606 of the Public Health Law shall be deposited in a local public health services program account, and distributed to municipalities as supplemental health services grants.
(b) Such revenues shall include fees for services provided by the department, fines levied and collected by the department from enforcement actions associated with these services, and monies received or recovered as a result of State aid audit exceptions.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.20 Outpatient services
Outpatient services, including ambulatory care services and extension clinics, shall be provided in a manner which safely and effectively meets the needs of the patients.
(a) General requirements.
As a minimum when provided, outpatient services shall comply with the rules and regulations set forth in this Part as well as the outpatient care provisions of Part 751, sections 752.1 and 753.1 and Parts 756, 757 and 758 of Subchapter C of this Title.
(1) The provision of this section shall apply to hospital-sponsored ambulatory services, including part-time and off-site clinics, which accept primary responsibility for health supervision and medical care of patients.
(2) The hospital shall ensure that all care provided by its ambulatory services is in accordance with prevailing standards of professional practice.
(3) The hospital shall conduct periodic reviews of the care rendered by its ambulatory services as part of its overall quality assurance program.
(b) The hospital shall assign a physician to be responsible for the professional services of the outpatient department. Either this physician or an administrator qualified by training and experience shall be responsible for administration of the outpatient services.
(c) Patient care.
The hospital shall effectively meet outpatient patient care needs by:
(1) the provision of patient care in a continuous manner by the same health care practitioner, whenever possible;
(2) the appropriate referral to other health care facilities or health care practitioners for services not available;
(3) the identification, assessment, reporting and referral of cases of suspected child abuse or neglect as required by section 405.9(d) of this Part;
(4) compliance with the domestic violence provisions of section 405.9(e) of this Part;
(5) identification, assessment, and referral of individuals with documented substance use disorders or who appear to have or be at risk for substance use disorders, as that term is defined in section 1.03 of the Mental Hygiene Law, as described in section 405.9(f) of this Part;
(6) compliance with the human trafficking provisions pertaining to the identification, assessment, and appropriate treatment or referral of individuals who are suspected to be human trafficking victims, as described in section 405.9(g) of this Part; and
(7) the development of a written plan of treatment. When treatment is provided it is revised, as necessary, in consultation with other health care professionals.
(d) Hospital-based ambulatory surgery service.
In a hospital maintaining an on-site hospital-based ambulatory surgery service, the following requirements supplement existing applicable requirements of sections 405.12 (Surgical services) and 405.13 (Anesthesia services) of this Part. Hospital-based ambulatory surgery services shall mean a service organized to provide surgical procedures which shall be performed for reasons of safety in an operating room on anesthetized patients requiring a stay of less than 24 hours' duration. These procedures do not include outpatient surgical procedures which can be performed safely in a private physician's office or in an outpatient treatment room.
(1) The hospital-based ambulatory surgery service shall be directed by a physician found qualified by the governing body to perform such duties.
(2) The governing body and the medical staff shall develop, maintain and periodically review a list of surgical procedures which may be performed in the service. The medical staff shall assure that procedures performed in the service conform with generally accepted standards of professional practice, in accordance with the competencies of the medical and professional staff who have privileges in the hospital-based ambulatory surgery service, and are appropriate in the facilities and consistent with the equipment necessary to meet the needs of all patients. The medical staff shall, based upon its review of individual medical staff qualifications, recommend to the governing body specific surgical procedures which each practitioner is qualified to perform in the hospital-based ambulatory surgery service.
(3) Hospital-based ambulatory surgery services may be located at the same site as the hospital (on-site) or apart from the hospital (off-site), pursuant to section 709.5 of this Title.
(i) Recovery rooms adequate for the needs of hospital-based ambulatory surgery patients, conveniently located to the operating room, shall be provided.
(ii) Waiting rooms adequate for the needs of patients and responsible persons accompanying patients shall be provided.
(4) Prior to surgery, each patient shall have a timely history and physical examination, appropriate to the patient's physical condition and the surgical procedure to be performed, which shall be recorded in the patient medical record.
(5) Each postsurgery patient shall be observed for postoperative complications for an adequate time period as determined by the attending practitioner and the anesthesiologist. The service shall have written policies for hospital admission of patients whose postoperative status prevents discharge or necessitates inpatient admission to a hospital capable of providing the appropriate level of care.
(6) Detailed verbal instructions understandable to the patient, or the patient’s parent, legal guardian, or health care agent, confirmed by written instructions, and approved by the medical staff of the hospital-based ambulatory surgery service shall be provided to each patient, or the patient’s parent, legal guardian, or health care agent, at discharge, to include at least the following:
(i) information about complications that may arise;
(ii) telephone number(s) to be used by the patient should complications or questions arise;
(iii) directions for medications prescribed, if any;
(iv) date, time and location of follow-up visit or return visit; and
(v) designated place to go for treatment in the event of an emergency.
(7) The hospital-based ambulatory surgery service staff shall develop written policies, approved by the medical staff, for documentation of the patient's postoperative course of treatment. The policies must be reviewed and adopted by the governing body of the hospital prior to implementation. The policies must provide a mechanism to assure that complications of surgery or anesthesia, which occur before and after discharge, are identified and documented in the patient's medical record.
(8) The hospital-based ambulatory surgery service shall have an organized system of quality assurance approved by the medical staff and the governing body which undertakes investigations into operative results of surgical procedures performed on the service and maintains statistics on operative failures and complications.
(9) Notwithstanding anything herein to the contrary, an off-site hospital-based ambulatory surgery service shall be operated in accordance with the provisions of Part 755 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-2 EXTERNAL APPEALS OF ADVERSE DETERMINATIONS
10 CRR-NY 98-2.8 Random assignment of external appeals
Requests for external appeals that have been determined to be eligible for external appeal shall be randomly assigned by the superintendent to a certified external appeal agent according to a process prescribed by the commissioner and superintendent. Such process must take into account conflicts of interest pursuant to section 4913 of the Public Health Law and Insurance Law and section 98-2.6 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.245 Patient day
A unit of measure denoting lodging facilities provided and services rendered to one inpatient between the census-taking hour on two successive days. The day of admission but not the day of discharge or death is counted as a patient day. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.13 Tissue storage facilities
(a) A facility which stores skin shall be licensed by the department as a tissue storage facility. The skin bank shall keep the department fully informed of the number and type of tissue storage facilities operating under its direction.
(b) All skin shall be stored and monitored in accordance with the provisions of sections 52-6.8, and 52-6.9(b), (c) and (d) of this Subpart.
(c) Temperature records or liquid nitrogen level records shall be available for inspection by the department for the entire period of skin storage and for one year afterwards.
(d) Skin products shall be distributed in accordance with the requirements of this Part, and all records related to the inspection, distribution and transport of skin shall be open to inspection by the department, and shall be kept for at least seven years or six months after the expiration date of the tissue, whichever is the longer time.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-4.182 Animals
Live animals, including birds and turtles are to be excluded from mobile food service operations.
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR FOOD VENDING MACHINE CONSTRUCTION—EXTERIOR
10 CRR-NY 14-5.91 Condenser unit
In vending machines having a condenser unit as an integral part, the condenser unit is to be:
(a) separated from the food and container storage space by a dust-proof barrier when located below these spaces; or
(b) sealed from the food and container storage space when located above these spaces.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.51 Research
This functional reporting center must contain all the expenses associated with the overall administrative management of all research projects carried on by the facility. This would include all expenses associated with all research activities that are specifically funded by internal or external sources.
(a) Standard unit of measure.
None.
(b) Data source.
Not applicable.
10 CRR-NY 455.39 Adult care facility
This functional reporting center must contain all the expenses associated with the provision of supportive, restorative and preventive health care for ambulatory patients who are capable of caring for themselves under supervision.
(a) Standard unit of measure: number of patient days.
Report patient days of care for all patients admitted to this unit. Include the day of admission, but not the day of discharge or death. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
(b) Data source.
The number of patient days shall be taken from daily census counts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.7 General requirements
(a) Recordkeeping requirements.
(1) Manufacturers, drug take back organizations, pharmacies and other authorized collectors shall maintain all records required by this Part for a period of five years.
(2) Records and invoices required by this Part shall be readily available and promptly produced for inspection and copying upon request by authorized representatives of the department’s Bureau of Narcotic Enforcement, or the Department of Environmental Conservation.
(b) Upon request by the department, a wholesaler shall provide the department with a list of manufacturers that produce the covered drugs it sells or distributes for resale in New York State.
(c) A manufacturer must notify the department upon contracting with an organization to operate a drug take back program on its behalf, in a manner and in such form as determined by the department; upon the manufacturer’s discontinuance of participation in a drug take back program; upon the manufacturer’s changing of participation from one drug take back program to another; and upon discontinuance of the sale of the manufacturer’s covered drugs in the state. Such notices to the department shall be in writing and may be electronic, and shall occur within 15 days of the date of the applicable action.
(d) A manufacturer who begins to offer a covered drug must notify the department of its joining an existing approved drug take back program, or submit a proposal for a drug take back program within 90 days following the initial offer for sale of a covered drug.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.15 Heat, light and ventilation
(a) Windows, or skylights having a minimum total area within the casement of at least eight percent of the floor area, shall be maintained in all occupied rooms; natural ventilation shall be provided through openable windows or other exterior openings which are equal in area to four percent or more of the floor area. Artificial in lieu of natural lighting, and mechanical ventilation, may be provided in toilet rooms and assembly space.
(b) Camps occupied between October 1st and May 1st shall have at least one building with heating facilities for emergency use. Unvented fossil fuel-powered heaters are prohibited.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 404 INTEGRATED OUTPATIENT SERVICES
10 CRR-NY 404.11 Quality assurance, utilization review and incident reporting
(a) Quality assurance.
(1) Primary care services.
(i) Integrated services providers which provide primary care shall ensure the development and implementation of a written quality assurance program that includes a planned and systematic process for monitoring and assessing the quality and appropriateness of patient care and clinical performance on an ongoing basis. The integrated care services program shall resolve identified problems and pursue opportunities to improve patient care.
(ii) The integrated care services program shall be supervised by the medical director. This responsibility may not be delegated.
(iii) There shall be a written plan for the quality assurance program which describes the program's objectives, organization, responsibilities of all participants, scope of the program and procedures for overseeing the effectiveness of monitoring, assessing and problem-solving activities.
(iv) The quality assurance plan shall define methods for the identification and selection of clinical and administrative problems to be reviewed. The plan shall include but not be limited to:
(a) the establishment of review criteria developed in accordance with current standards of professional practice for monitoring and assessing patient care and clinical performance;
(b) regularly scheduled reviews of medical charts, patient complaints and suggestions, reported incidents and other documents pertinent to problem identification;
(c) documentation of all quality assurance activities, including but not limited to the findings, recommendations and actions taken to resolve identified problems; and
(d) the timely implementation of corrective actions and periodic assessments of the results of such actions.
(v) The scope of clinical and administrative problems selected to be reviewed for the purpose of quality assurance shall reflect the scope of services provided and the populations served at the center.
(vi) The outcomes of quality assurance reviews shall be used for the revision or development of policies and in granting or renewing staff privileges, as appropriate.
(vii) There shall be participation in the quality assurance program by administrative staff and health-care professionals representing each professional service provided.
(viii) There shall be joint participation in the quality assurance program by representatives from the behavioral health components of an integrated care services program; such participation shall include, but is not limited to, specific identification of quality improvement opportunities with respect to patient concerns and complaints, changes in regulatory requirements, or other factors, no less frequently than once every two years. Documentation shall be kept of all such reviews.
(ix) The findings, conclusions, recommendations and actions taken as a part of the quality assurance program shall be reported to the operator by the medical director. An annual report shall be submitted to the governing authority, which documents the effectiveness and efficacy of the integrated care services program in relation to its goals and quality assurance plan and indicate any recommendations and plans for improvement it its services to patients, as well as recommend changes in its policies and procedures.
(2) Behavioral health services.
(i) Integrated services providers which provide mental health and/or substance use disorder services shall comply with all requirements of 14 NYCRR Part 599 or 822, as applicable, relating to quality assurance.
(ii) Integrated services providers of mental health and/or substance use disorder services shall prepare an annual report and submit it to its governing authority. This report must document the effectiveness and efficiency of the ambulatory care program in relation to its goals and quality assurance plan and indicate any recommendations and plans for improvement in its services to patients, as well as recommended changes in its policies and procedures.
(iii) Utilization review.
(a) Integrated services providers of mental health and/or substance use disorder services shall establish and implement a utilization review plan. The utilization review plan must include participation by all primary care and behavioral health components of the integrated services provider, as applicable.
(b) Integrated services providers of mental health and/or substance use disorder services may use a utilization review process developed by the State licensing agency or may develop its own utilization review process that is subject to approval by the State licensing agency.
(c) Integrated services providers of mental health and/or substance use disorder services may perform its utilization review process internally; or it may enter into an agreement with another organization, competent to perform utilization review, to complete its utilization review process.
(d) Utilization review must be conducted by at least one clinical staff member. No member shall participate in utilization review decisions relative to any patient he or she is treating directly.
(e) The utilization review plan must include procedures for ensuring that retention criteria are met and services are appropriate. The utilization review plan must consider the needs of a representative sample of patients for continued treatment, the extent of the behavioral health problem, and the continued effectiveness of, and progress in, treatment. At a minimum, utilization review must include separate random samples based upon a patient’s length of stay, with larger samples for patients with longer lengths of stay. Utilization review must also be conducted for all active cases within the twelfth month after admission and every 90 days thereafter.
(f) Documentation of utilization review must be maintained providing evidence that the deliberations:
(1) were based on current progress in treatment relative to the applicable functional areas identified in the patient's comprehensive treatment/recovery plan;
(2) determined the appropriateness of continued stay at the outpatient level of care and intensity of services, as well as whether co-occurring disorder(s) require referral to outside services;
(3) determined the reasonable expectation of progress towards the accomplishment of the goals and objectives articulated in the patient's treatment/recovery plan, based on continued treatment at this level of care and intensity of services; and
(4) resulted in a recommendation regarding continuing stay, intensity of care and/or referral of this case.
(b) Incident reporting.
(1) Mental health behavioral care host providers shall report incidents involving patients receiving mental health services in accordance with the provisions of 14 NYCRR Part 524.
(2) Substance use disorder behavioral care host providers shall report incidents involving patients receiving substance use disorder services in accordance with the provisions of 14 NYCRR Part 836.
(3) Primary care host providers shall report incidents in accordance with the provisions of section 405.8 or section 751.10 of this Title, as applicable.
Chapter I STATE SANITARY CODE
Part 2 COMMUNICABLE DISEASES
OTHER MEASURES FOR PUBLIC PROTECTION OTHER MEASURES FOR PUBLIC PROTECTION
10 CRR-NY 2.53 Cleansing, renovation or disinfection, when required
Adequate cleansing, renovation or disinfection of rooms, furniture, clothing and belongings when deemed necessary by the health officer or required by the Public Health Law or by this Chapter shall immediately follow release, death or removal of a person affected with a communicable disease. Such cleansing, renovation or disinfection shall be done under the direction of the health officer. Furniture, bedding, clothing, carpets, rugs or other articles which may have been contaminated with infective material and which are of such nature or in such condition that they cannot, in the opinion of the health officer, be properly cleansed or disinfected, shall upon his order be destroyed in the manner designated by him.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-4 MASS GATHERINGS
10 CRR-NY 7-4.4 Variance and waivers
(a) Variance.
In order to allow time to comply with certain provisions of this Subpart, an operator may submit a written request to the permit-issuing official for a variance from a specific provision(s). The permit-issuing official may grant a variance for a period not to exceed one year when the health and safety of the public will not be prejudiced by the variance and where there are practical difficulties or hardships in immediate compliance with the provision. An operator must meet all terms of an approved variance including the effective date, the time period for which the variance is granted, the requirements being varied and any special conditions the permit-issuing official specifies.
(b) Waiver.
In order to obtain a waiver permitting alternative arrangements that do not meet the provisions of this Subpart but do protect the health and safety of the occupants and the public, an operator may submit a written request to the permit-issuing official for a waiver from a specific provision of this Subpart. Such request must demonstrate to the satisfaction of the permit-issuing official that the alternate arrangements provide adequate protection of the health and safety of the patrons and the public. The permit-issuing official may grant or deny a waiver after obtaining and following the recommendation of the State Department of Health and may set conditions on such waiver. An operator must meet all terms and conditions of an approved waiver. A waiver will remain in effect unless revoked by the permit-issuing official or the facility changes operators.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.31 Aquatic supervisory skill requirements
The New York State Department of Health is responsible for review of training courses and/or certification programs to determine acceptability.
(a) Supervision Level IIa—pool lifeguard only.
(1) The requirements of this subdivision shall take effect May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 16 years (15 years is acceptable if employed at a facility where a supervisory lifeguard is present); and
(ii) possesses a current A.R.C. basic life support for the professional rescuer. CPR or equivalent certification; the certification period must not exceed one year; and
(iii) demonstrates a current ability to swim 300 yards nonstop using various strokes in good form; surface dive to minimum nine foot depth and bring a 10 pound object to surface; and tread water for one minute; and
(iv) possesses a current certificate from a recognized certifying agency acceptable to the State Health Commissioner, or has within not more than a consecutive three-year period of time completed a minimum of 15 hours (19 hours if first aid skills are included) of training acceptable to the commissioner covering those items set forth below (time periods do not include final examination time or conditioning swims):
The training course and recertification program will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and substantially meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguarding to effectively communicate the subject matter required by this section.
(a) program goals and objectives;
(b) preventive lifeguarding;
(c) victim recognition;
(d) equipment:
(1) rescue (buoys, tubes, reach pole);
(2) lifeguarding;
(3) safety;
(4) personal;
(e) types of emergencies:
(1) life-threatening;
(2) nonlife-threatening;
(f) spinal injury management;
(g) special situations:
(1) hypothermia;
(2) heat emergencies;
(3) seizures;
(h) communication systems;
(i) emergency action plans;
(j) physical fitness concepts;
(k) weather and environmental conditions;
(l) records and reports;
(m) skills practice:
(1) water entry;
(2) approaches;
(3) moving victim to safety;
(4) equipment use (reach poles, buoys, tubes);
(5) surface diving and underwater swimming;
(6) underwater search;
(7) lifts and assists;
(8) reaching assists;
(9) throwing assists;
(10) equipment extension;
(11) rescue breathing with flotation;
(12) rescue breathing without flotation;
(13) defense;
(14) escapes;
(15) multiple victim rescues;
(16) spinal injury, shallow water;
(17) spinal injury, deep water;
(n) first aid and emergency care (possession of a valid American Red Cross standard first aid or equivalent certification may be substituted for this segment):
(1) bleeding and shock;
(2) choking;
(3) temperature extremes;
(4) spinal injuries;
(5) diabetic emergencies;
(6) seizures;
(7) heart attacks and strokes;
(8) fractures, dislocations, sprains and strains;
(9) burns;
(10) eye and nose injuries;
(11) alcohol and drug overdoses;
(v) such person must:
(a) correctly answer at least 80 percent of the questions on a written and/or oral test on theory and knowledge; and
(b) successfully perform/demonstrate skills; and
(c) successfully:
(1) demonstrate knowledge of:
(i) approaches;
(ii) escapes;
(iii) carriers/tows;
(iv) spinal (shallow water) entry, approach, turn and support victim;
(v) spinal (deep water) entry, approach, turn and move victim to poolside or shallow end;
(vi) rescue tube swim/use;
(vii) surface dive and underwater swim.
(b) Supervision Level IIb—pool and beach lifeguard.
(1) The requirements of this subdivision shall take effect on May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 16 years (15 years is acceptable if a supervisory lifeguard is present); and
(ii) has a current A.R.C. basic life support for the professional rescuer, CPR or equivalent certification; the certification period must not exceed one year; and
(iii) demonstrates a current ability to swim 300 yards nonstop using various strokes in good form; and surface dive to minimum nine foot depth and bring a 10 pound object to surface; and tread water for one minute; and
(iv) possesses a current certification from a recognized certifying agency acceptable to the State Health Commissioner or has within not more than a consecutive three-year period of time, completed a minimum of 20 hours (24 hours if first aid skills are included) of training acceptable to the commissioner covering those items outlined below (time periods do not include final examination time or conditioning swims);
The training course and recertification program will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and substantially meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguarding to effectively communicate the subject matter required by this section.
(a) program goals and objectives;
(b) preventive lifeguarding;
(c) victim recognition;
(d) equipment:
(1) rescue (buoys, tubes, reach pole, surf board, backboard, boat, mask, fins, snorkel);
(2) safety/lifeguarding (lifelines, lifeguards stands);
(3) personal (uniform/clothing, whistle, sunglasses, binoculars, sunscreen);
(e) orientation;
(f) in-service training;
(g) types of emergencies:
(1) life-threatening;
(2) nonlife-threatening;
(h) spinal injury management;
(i) special situations:
(1) hypothermia;
(2) heat emergencies;
(3) seizures;
(j) communication systems;
(k) emergency action plans;
(l) waterfront areas;
(m) search and recovery equipment and operations;
(n) physical fitness concepts;
(o) weather and environmental conditions;
(p) records and reports;
(q) first aid and emergency care (possession of a valid American Red Cross standard first aid or equivalent certification may be substituted for this segment):
(1) bleeding and shock;
(2) choking;
(3) temperature extremes;
(4) spinal injuries;
(5) diabetic emergencies;
(6) seizures;
(7) heart attacks and strokes;
(8) fractures, dislocations, sprains and strains;
(9) burns;
(10) eye and nose injuries;
(11) alcohol and drug overdoses;
(r) skills practice:
(1) water entry;
(2) moving victim to safety;
(3) equipment use (buoys, tubes, rescue board, back board, boat, mask, fins, snorkel);
(4) surface dive and underwater swimming;
(5) underwater search;
(6) search and recovery;
(7) lifts and assists;
(8) throwing assists;
(9) reaching assists;
(10) equipment extension;
(11) rescue breathing with flotation;
(12) rescue breathing without flotation;
(13) defense;
(14) escapes;
(15) multiple victim rescues;
(16) spinal injury, shallow water;
(17) spinal injury, deep water;
(v) such person must:
(a) correctly answer at least 80 percent of the questions on a written and/or oral test on theory and knowledge; and
(b) successfully perform/demonstrate all skills; and
(c) successfully:
(1) complete a 25 yard freestyle swim in 20 seconds; and
(2) perform a shallow dive, sprint 25 yards, recover 10 pound object from pool edge or gutter, then return 25 yards supporting 10 pound object; and
(3) demonstrate knowledge of:
(i) approaches;
(ii) escapes;
(iii) carries/tows;
(iv) spinal (shallow water) entry, approach, turn and support victim;
(v) spinal (deep water) entry, approach, turn and move victim to poolside or shallow end;
(vi) rescue tube swim/use;
(vii) surface dive and underwater swim;
(viii) tread water for one minute holding a diving brick with both hands.
(c) Supervision Level III.
(1) No person shall be qualified under this subdivision unless such person:
(i) has a minimum age of 18 years; and
(ii) possesses a current A.R.C. community CPR or equivalent certification; the certification period must not exceed one year; and
(iii) is competent to:
(a) understand and apply the rules and regulations of this Part and implement the safety plan; and
(b) evaluate environmental hazards; and
(c) use lifesaving equipment and facility; and
(d) undertake bather/crowd control.
(2) The requirements of this paragraph shall take effect on January 1, 2008. When a Supervision Level III staff assists a Supervision Level II staff with direct supervision of bathers during instruction as specified in section 6-1.23(a)(6) of this Subpart, the Supervision Level III staff shall possess certification in aquatic injury prevention and emergency response. No person shall be qualified under this paragraph unless such a person possesses certification in lifeguard management issued by the American Red Cross or a certificate issued by a certifying agency determined by the State Commissioner of Health to provide an adequate level of training in aquatic injury prevention and emergency response. Certifications shall be valid for the time period specified by the certifying agency, but may not exceed a consecutive three-year period from course completion.
(d) Supervision Level IV.
(1) The requirements of this subdivision shall take effect on May 15, 1993.
(2) No person shall be qualified under this subdivision unless such person:
(i) is at least 18 years of age; and
(ii) possesses a current A.R.C. community CPR or equivalent certification; the certification period must not exceed one year.
(e) Lifeguard supervision and management.
(1) No person shall be qualified under this subdivision unless such person:
(i) Possesses current certification issued by a certifying agency determined by the State Department of Health to provide an adequate level of training in lifeguard supervision and management covering those items set forth below. Certification shall be valid for the time period specified by the certifying agency, but may not exceed a consecutive three-year period from course completion. The training course will be determined to be acceptable if, after a review, all the materials submitted by the program sponsor are determined to be complete and meet the requirements of this section. Instructors shall have sufficient experience and knowledge in lifeguard supervision and management to effectively communicate the subject matter required by this section:
(a) Program Goals and Objectives.
(b) Lifeguard and Lifeguard Supervisor Duties and Responsibilities.
(c) Injury Prevention and Preventative Lifeguarding:
(1) Communication Systems.
(2) Patron Surveillance:
(i) Victim Recognition.
(ii) Effective Scanning.
(iii) Lifeguard Positioning and Rotation.
(iv) Lifeguard Breaks.
(3) Surveillance for Groups:
(i) Instruction Programs.
(ii) Large Groups and Children's Camps:
(A) Coordinating Large Groups and Pre-arrangements.
(B) Buddy and Board Systems.
(C) Swimming Ability Assessment.
(D) Swimming Area Selection.
(iii) Competitive Events.
(4) Facility Operation and Management:
(i) Safety Equipment.
(ii) Hazards.
(iii) Weather Conditions.
(d) Types of Emergencies and Emergency Action Plans (EAP).
(e) Lifeguard Preparedness:
(1) Staff Orientation and Training.
(2) In-service Training.
(f) Risk Management.
(ii) Such person must correctly answer at least 80 percent of the questions on a written and/or oral test on theory and knowledge.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 109 COLUMBIA COUNTY
VILLAGES VILLAGES
10 CRR-NY 109.2 Village of Kinderhook
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 510 of the Laws of 1921, as heretofore set forth, shall apply to all wells of the public water supply of the village of Kinderhook, Columbia County, New York.
(b) [Definition.]
Wherever a linear distance of a structure or object from a well is mentioned in this section it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to such well.
(c) Privies adjacent to any well.
(1) No privy, privy vault, pit, cesspool or any watertight receptacle of any kind used for the temporary storage of human excreta shall be constructed, placed, maintained or allowed to remain within 150 feet of any well of the public water supply of the village of Kinderhook.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta which is not watertight shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any well of the public water supply of the village of Kinderhook.
(3) No privy, privy vault, pit, cesspool or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distance prescribed by paragraph (1) of this subdivision and limiting distance prescribed by paragraph (2) of this subdivision unless said privy, privy vault, pit, cesspool or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage will not overflow and is at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the receptacle or the privy or place in which they are kept in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy or place of temporary storage to the place of final disposal, hereinafter specified, and that the contents while being transferred shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid removable watertight receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any well of the public water supply of the village of Kinderhook.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any well of the public water supply of the village of Kinderhook, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, laundry or garage wastes, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, discharged, allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface except into watertight receptacles the contents of which are to be removed as provided by paragraph (4) of subdivision (c) within a distance of 300 feet from any well of the public water supply of the village of Kinderhook.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any dairy or cheese factory nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid wastes or solid refuse of any kind shall be thrown, discharged, allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 200 feet from any well of the public water supply of the village of Kinderhook.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet from any well of the public water supply of the village of Kinderhook and none of the above named objects or sources of pollution shall be constructed, placed or allowed to remain where or in such manner that the drainings, leachings or washings therefrom may enter the ground water tributary to the public water supply of the village of Kinderhook without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a less distance than 200 feet of any well of the public water supply of the village of Kinderhook.
(2) No human excreta and no compost or other matter containing human excreta shall be placed, piled or spread upon the surface of the ground or be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet of any well of the public water supply of the village of Kinderhook and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet of any well of the public water supply of the village of Kinderhook.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind, shall be thrown, placed, discharged or maintained or allowed to remain on the surface of the ground or beneath the surface of the ground within 300 feet of any well of the public water supply of the village of Kinderhook.
(g) Camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any well of the public water supply of the village of Kinderhook.
(h) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any well of the public water supply of the village of Kinderhook.
(i) Inspections.
The board of water commissioners of the village of Kinderhook or such other board as may be charged with the maintenance of the public water supply of the village of Kinderhook or its duly appointed representative shall make regular and thorough inspections of the area surrounding the wells for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the person violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The said board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the area surrounding the wells at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of a noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-4 LEAD TESTING IN SCHOOL DRINKING WATER
10 CRR-NY 67-4.6 Reporting
(a) As soon as practicable but no later than November 11, 2016, the school shall report to the department, local health department, and State Education Department, through the department’s designated statewide electronic reporting system:
(1) completion of all required first-draw sampling;
(2) for any outlets that were tested prior to September 6, 2016, and for which the school wishes to assert that such testing was in substantial compliance with this Subpart, an attestation that:
(i) the school conducted testing that substantially complied with the testing requirements of this Subpart, consistent with guidance issued by the department;
(ii) any needed remediation, including re-testing, has been performed;
(iii) the lead level in the potable water of the applicable building(s) is currently below the action level; and
(iv) the school has submitted a waiver request to the local health department, in accordance with section 67-4.8 of this Subpart; and
(3) a list of all buildings that are determined to be lead-free, as defined in section 1417 of the Federal Safe Drinking Water Act.
(b) As soon as practicable, but no more than 10 business days after the school received the laboratory reports, the school shall report data relating to test results to the department, local health department, and State Education Department, through the department’s designated statewide electronic reporting system.
Chapter I STATE SANITARY CODE
Part 1 GENERAL PROVISIONS
GENERAL POWERS AND DUTIES OF HEALTH OFFICERS GENERAL POWERS AND DUTIES OF HEALTH OFFICERS
10 CRR-NY 1.2 Commissioner authority to suspend and modify regulations
During the period of a State disaster emergency declared pursuant to section 28 of the Executive Law, the State Commissioner of Health or their designee may suspend or modify any provision, of parts thereof, of this Title, that is not otherwise required by State statute or Federal law, if compliance with such provisions, or parts thereof, would prevent, hinder, or delay action necessary to cope with the State disaster emergency, or if necessary to assist or aid in coping with such disaster. Such suspension or modifications may include any modifications of regulation, exceptions, limitations or other conditions as the commissioner or their designee deems appropriate and necessary to respond to the disaster emergency. Provided, further, that should the Governor declare a State disaster emergency pursuant to section 28 of the Executive Law, which suspends or otherwise modifies State statutes pursuant to the Governor's authority under section 29-a of the Executive Law, the commissioner or their designee may suspend or modify any provision of any regulation that is consistent with the statutory authority as modified or suspended, for the period of such suspension or modification.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.313 Standard unit of measure
The standard unit of measure is used to provide a uniform statistic for measuring and comparing hospital costs and productivity output, not activity.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-8 NEWBORN HEARING SCREENING
10 CRR-NY 69-8.6 Responsibilities of institutions caring for infants in special circumstances
(a) In the event that an infant is transferred from one facility to another such facility, the facility discharging the infant to home shall be responsible for ensuring that infant hearing screening services are provided to the infant in a manner consistent with the applicable provisions set forth in this Part. If the infant fails both an initial and follow-up screening, the infant shall be referred for an evaluation to the early intervention official in his or her county of residence, according to the procedures set forth in section 69-4.3 of this Part unless the parent objects.
(b) Medically unstable infants shall receive infant hearing screening prior to discharge to home and as early as development or medical stability will permit such screening. In instances where the medical condition of the infant contraindicates infant hearing screening, a decision to forego such screening may be made and documented in the medical record.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 143 SCHOHARIE COUNTY
VILLAGES VILLAGES
10 CRR-NY 143.1 Village of Cobleskill
(a) Privies adjacent to reservoirs, springs or watercourses.
(1) No privy or place for the deposit or storage of human excreta shall be constructed, located or maintained within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of the reservoir or of any spring, stream, ditch or watercourse of any kind, the water of which, when running, flows eventually into the reservoir of the Cobleskill public water supply.
(2) No privy vault, pit or cesspool or nontransportable receptacle of any kind for the reception or storage of human excreta shall be constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark of the reservoir or within 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse of any kind, the water of which, when running, flows eventually into the reservoir of the Cobleskill public water supply.
(3) Every privy or place for the deposit of human excreta, which is constructed, located or maintained between the aforesaid limits of 50 feet and 250 feet, horizontal measurement, of the high-water mark or precipitous bank of the reservoir or 50 and 130 feet, horizontal measurement, of the high-water mark or precipitous bank of any spring, stream, ditch or watercourse the water of which, when running, flows eventually into the reservoir of the Cobleskill public water supply, and from which the said excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal beyond the maximum aforesaid limit shall be arranged in such manner that all said excreta shall be received and temporarily retained in suitable vessels or receptacles, which shall at all times be maintained in an absolutely watertight condition and which will admit of convenient removal to some place of ultimate disposal beyond the said maximum limit.
(4) The excreta collected in the aforesaid removable receptacle shall be removed and the receptacles cleaned and deodorized as often as is necessary to keep the receptacles in proper sanitary condition and to prevent an overflow of the excreta upon the soil or the floor of said privy.
(5) The excreta so collected shall be removed in such manner as to cause the least nuisance possible and shall be so disposed of that they can not be washed, either over the surface or through the subsoil, into the reservoir or any spring, stream, ditch or watercourse of any kind, the water of which, when flowing, runs finally into the reservoir of the Cobleskill public water supply and shall be so placed as not to cause an offensive nuisance.
(6) Whenever it shall be found that, owing to the porous character of the soil, the height and flow of the surface and subsoil waters, the steepness of the slopes or other special conditions of the locality, the excremental matter from any privy, cesspool or other receptacle for human excreta may be washed over the surface or through the subsoil into the reservoir or into any spring, stream, ditch or watercourse, the water of which, when running, flows eventually into the reservoir of the Cobleskill public water supply, without having been thereby, in the judgment of the State Board of Health, sufficiently purified, then the said privy, cesspool or other receptacle for human excreta shall, after due notice to the owner thereof, be removed to such greater distance from said high-water marks as shall be considered safe and proper by the State Board of Health.
(b) House slops, sink wastes, laundry water and other similar sewage.
(1) No sewage, house slops, sink wastes, water in which clothes or bedding have been washed or rinsed nor any other polluted water or liquid shall be thrown or discharged directly into the reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such aforesaid liquid or solid matter or other polluted liquid be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into the reservoir or into any spring, stream, ditch or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark or precipitous bank of the reservoir or of any spring, stream, ditch or watercourse aforesaid.
(2) No clothes, animals, vehicles nor anything which pollutes water shall be washed nor shall any person bathe in the reservoir or in any spring, stream or watercourse aforesaid.
(c) Garbage and refuse.
No garbage or putrescible refuse of any kind shall be thrown or discharged directly into the reservoir or into any spring, stream, ditch or watercourse aforesaid, nor shall any such substances be placed upon or below the surface of the ground where they may be washed into the reservoir or into any spring, stream, ditch or watercourse aforesaid within 50 feet of the high-water mark precipitous bank thereof.
(d) Manures, composts and similar matter.
(1) No stable, pigsty, henhouse, barnyard, hogyard, hitching or standing place for horses or cattle or other place where animal manure accumulates and no compost or manure heap shall be located or maintained within or so arranged and maintained that the washings or drainage therefrom shall flow through open or covered drains within 50 feet of the high-water mark or precipitous bank of the reservoir or any spring, stream or watercourse aforesaid.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet of the high-water mark of the reservoir or within 130 feet of the high-water mark of precipitous bank of any spring, stream or watercourse aforesaid, and no manures or composts of any kind shall be so deposited as to be washed a less distance than 50 feet over the surface or through the subsoil into the reservoir or any spring, stream, ditch or watercourse aforesaid without having undergone proper purification.
(e) Dead animals, vegetable refuse and manufacturing wastes.
No dead animal, bird or fish or part thereof nor any filthy or impure matter nor any decayed fruit or vegetable substances nor any waste products, putrescible matter or polluted waters from any slaughterhouses, creameries, cider mills, sawmills or other manufactories shall be thrown or allowed to run into the reservoir or any spring, stream, ditch or watercourse aforesaid, nor shall they be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed on the surface of less than 50 feet through the subsoil, into the reservoir or any spring, stream, ditch of watercourse aforesaid without having undergone proper purification.
(f) [Cemeteries.]
No interment of a human body shall be made within 250 feet of the reservoir or of high-water mark or precipitous bank of any spring, stream or watercourse aforesaid.
(g) Penalty.
In accordance with section 2 of chapter 543 of the Laws of 1885, a penalty of not less than $50 nor more than $100 is hereby imposed upon any corporation, person or persons guilty of a violation of or noncompliance with any of the above given mandatory rules and regulations, to be recovered under said act.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.33 Dementia pilot demonstration projects
(a) Payment rates shall be adjusted by the addition of a per diem amount as determined by the commissioner pursuant to this section for residential health care facilities participating in pilot demonstration projects for the development of additional knowledge and experience in the area of dementia care and to improve the quality of care and treatment of patients with dementia.
(b) The adjustment to payment rates provided for in this section shall be made for qualifying residential health care facilities (RHCF's) applying for and receiving the approval of the commissioner for participation in such projects. Acceptable uses of such adjustments shall include but shall not be limited to:
(1) increasing the availability of programs and resources for dementia patients;
(2) training staff to manage behavior or promote effective care of dementia patients;
(3) arranging the environment in ways that produce positive outcomes for dementia patients; and/or
(4) maintaining and promoting autonomy and decisionmaking on the part of dementia patients.
(c) Individual facilities or groups of facilities may participate in pilot demonstration projects pursuant to this subdivision.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 410 SCHEDULED SHORT-TERM CARE IN A NURSING HOME
10 CRR-NY 410.2 Resident care standards
(a) Services provided to scheduled short-term residents shall comply with the regulations governing nursing homes in Parts 400, 411, 412, 413, 414 and 415 of this Subchapter, as appropriate, except for the following provisions: 400.11, Assessment of long-term care patients; 400.13 Forms (Hospital/Community Patient Review Instrument); 415.3(c)(2)(ii)( a )( 1 )-( 3 ), ( b ) and ( c ), Protection of Legal Rights; 415.3(h)(1)(i)-(vi), (2)(i)-(v) and (3), (4)(i)-(iii), Transfer and Discharge Rights; 415.11(d)(1)-(3), Discharge Summary; 415.17(b) and (c), Dental Services; 415.26(b)(10)(ii)( a ) and ( b ), Governing Body; and 415.26(i)(1)(i)( a )-( c ), (iii) and (v), Admission Policies and Practices.
(b) All facility staff involved with the scheduled short-term care residents shall receive a general orientation to familiarize them with these services. Direct care staff shall receive training to include an overview of scheduled short-term care, the special needs of the elderly living at home, and how facility care practices can be adapted to reflect patterns of care provided by the caregiver.
(c) Scheduled short-term care services shall be provided in a manner that meets the needs of the resident and shall not interfere with, or detract from, the ongoing services provided to the other residents of the facility.
(d) If the potential resident is not already known to the facility through such means as a prior admission for scheduled short-term services or enrollment in the facility's adult day health care services or long-term home health care program, the facility shall arrange for facility staff to visit the prospective resident and caregiver at their home or shall arrange for the prospective resident and caregiver to visit the facility to determine whether scheduled short-term care in a nursing home is appropriate for the individual.
(e) An assessment of each new applicant shall be completed prior to admission in order to establish baseline information about the individual and to establish a plan of care which meets his or her needs for nursing home services.
(f) A history and physical examination shall be completed for each potential scheduled short-term care resident before admission unless: one has been completed within the past year, the results of which are available to the facility, and the resident's condition has remained unchanged.
(g) The nursing home shall admit residents for scheduled short-term care only on a physician's order.
(h) A resident care plan based on the assessment and history and physical examination shall be developed with the resident and caregiver and completed upon admission. Following admission, the resident care plan shall be revised as necessary to reflect any change in the resident's care needs.
(i) Prior to admission, a discharge plan shall be developed with the prospective resident and caregiver. The discharge plan shall provide for return to the resident's home setting. Prior to discharge of the resident, the discharge plan shall be discussed with the caregiver to note any changes in the resident's condition and to discuss any recommendation for provision of care and services after the resident's return to the home setting.
(j) Following discharge, the facility shall contact the former resident and caregiver to obtain their assessment of the scheduled short-term care experience. No less frequently than every six months, the nursing home shall evaluate the findings of these assessments. Based on this evaluation, written policies and procedures and facility practices shall be changed or modified as needed.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-7 EYE BANKS
10 CRR-NY 52-7.10 Required records of tissue acquisition, testing, processing and storage
In addition to the recordkeeping requirements of Subpart 52-2 of this Part, each eye bank must maintain tissue records which include:
(a) documentation of gross ocular tissue evaluation; and
(b) documentation of slit-lamp examination.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.137 Expanded syringe access program
(a) Definitions.
(1) Authorized provider for the purposes of this section shall mean any of the following who have registered with the department:
(i) a pharmacy licensed under article 137 of the Education Law;
(ii) a health care facility licensed under article 28 of the Public Health Law; or
(iii) a health care practitioner who is otherwise authorized to prescribe the use of hypodermic needles or syringes within his or her scope of practice.
(2) Safety insert, for the purposes of this section, shall mean a document that is either developed or approved by the commissioner and shall contain, at a minimum, the following information:
(i) information on the proper use of hypodermic syringes and needles;
(ii) the risk of blood-borne diseases that may result from the use of hypodermic syringes and needles;
(iii) methods for preventing the transmission or contraction of blood-borne diseases;
(iv) proper disposal practices for hypodermic syringes and needles, including information on safe disposal and the relevant provisions of the Environmental Conservation Law relating to the unlawful release of regulated medical waste;
(v) the dangers of injection drug use and how to access drug treatment;
(vi) a toll-free number for information on the human immunodeficiency virus; and
(vii) a statement that it is legal for persons to possess syringes obtained pursuant to article 33 of the Public Health Law.
(b) Registration.
(1) Authorized providers must register with the department in order to sell or furnish hypodermic needles and/or syringes without a prescription pursuant to this section.
(2) Authorized providers must register with the department in order to accept hypodermic needles and/or syringes for purposes of disposal. Failure of an entity to register shall not affect its obligations to accept needles and syringes originating from a private residence when such entity is already obliged to do so pursuant to section 1389-dd of the Public Health Law.
(3) Registration shall be limited to authorized providers in good standing and will consist of submission to the department of a completed application in a form prescribed by the commissioner, and receipt of the acceptance from the commissioner of such registration, prior to the initiation of the selling or furnishing of hypodermic needles and syringes without a prescription and/or accepting hypodermic needles and/or syringes for disposal.
(4) The registration form must include, at a minimum, the following information:
(i) the name, address, license number, telephone number and fax number (if available) of the authorized provider;
(ii) the name, address, telephone and electronic mail address, if available, of the individual designated by the authorized provider to have administrative responsibility for the provider's participation in the expanded syringe access program;
(iii) an attestation that the authorized provider will abide by the provisions of this section and the provisions contained in the registration form with regard to the selling or furnishing of hypodermic needles or syringes without a prescription;
(iv) a description of how the registrant will cooperate in the safe disposal of used hypodermic needles or syringes, or will provide such services (pharmacies and health care practitioners are not required to provide such services); and
(v) the signature of the individual authorized to sign the registration form on behalf of the applicant.
(5) The registration period shall commence upon the acceptance of such registration by the commissioner and shall remain valid for a period to coincide with the maximum allowed at the time of registration under section 3381 of the Public Health Law or until notice of termination by the department. Authorized providers shall notify the department of any changes in the information provided to the department. Changes or corrections to such information shall be submitted to the department by the completion of a revised registration form as soon as possible but no later than 30 days after such change. Should an authorized provider choose to withdraw its registration, written notification of such intent must be provided to the department. Such withdrawal shall not be effective until receipt of such written notice is acknowledged by the department in writing.
(6) The name, address, and telephone number of the authorized provider may be used in the development of, or included in, a registry of authorized providers for the purpose of informing consumers of available authorized providers for the purposes of sale, furnishing, and/or disposal, as specified on the registration form.
(c) Upon the finding of a violation of this section or when a registrant is no longer in good standing, the commissioner may suspend, for a period up to one year, an authorized provider's ability to sell or furnish hypodermic needles or syringes, or to accept hypodermic needles or syringes for disposal under this section. Entities otherwise obliged to accept hypodermic needles or syringes for disposal pursuant to section 1389-dd of the Public Health Law shall not be relieved from such obligation.
(d) Requirements for authorized providers for the purpose of selling and furnishing of hypodermic needles and syringes without a prescription.
(1) After acceptance of the registration by the commissioner, an authorized provider may obtain and possess such hypodermic syringes and needles for such purpose, provided that:
(i) such sale or furnishing shall only be to a natural person 18 years of age or older;
(ii) each sale or furnishing is limited to a quantity of 10 or less; and
(iii) the sale or furnishing shall be accompanied by a safety insert as described in paragraph (a)(2) of this section. Such insert shall be attached to or included in the hypodermic syringe and/or needle packaging, or provided in brochure form, at the point of sale or furnishing.
(2) In addition, a pharmacy:
(i) shall not advertise to the public the availability for retail or furnishing of hypodermic syringes and needles without a prescription; provided, however, that in-store signage indicating that hypodermic syringes and needles may be purchased without a prescription, and which is consistent with guidance issued by the department, shall not be considered advertising to the public; and
(ii) shall, at any location where hypodermic syringes and needles are kept for retail furnishing, store such syringes and needles in a manner that makes them available only to authorized personnel and not openly available to customers.
(e) Authorized providers that accept needles and/or syringes for purposes of disposal shall adhere to State and local public health and environmental conservation laws, rules, and regulations related to the disposal of regulated medical waste.
(f) Possession.
A natural person 18 years of age or older may obtain and possess hypodermic syringes and needles obtained pursuant to this section.
(g) Applicability.
The provisions of this section shall not apply to any sale, furnishing, or possession of hypodermic needles or syringes which is lawful under section 3381(1)(a) or (b) of the Public Health Law.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-4 INTRA-AGENCY ACCESS TO AND DISCLOSURE OF PERSONAL HEALTH-RELATED INFORMATION
10 CRR-NY 50-4.1 Statement of purpose
The purpose of this Subpart is to set forth methods and controls to restrict dissemination and maintain control of confidential personal health related information within the Department of Health.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.172 Cleaning; general requirements
Cleaning is to be done during periods when the least amount of food is exposed, such as after closing or between meals, except during emergencies. Dustless methods are to be used to clean floors and walls. such as vacuum cleaning, wet mopping, or the use of dust-resisting sweeping compounds with brooms. Maintenance and cleaning tools, such as brooms, mops, vacuum cleaners and similar equipment, are to be stored and maintained in a way that does not contaminate food, utensils, equipment or linens, and in an orderily manner, to facilitate the cleaning of the storage location.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 102 BROOME COUNTY
10 CRR-NY 102.3 Water District No. 4, Town of Kirkwood
(a) Application.
The rules and regulations herein set forth, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of Water District No. 4 of the Town of Kirkwood. Said wells are located on land owned by Water District No. 4 of the Town of Kirkwood and are situated and designated as Broome County Tax Map No. 7-1-S1. More particularly, said premises are located on the easterly shore of the Susquehanna River approximately 2,000 feet south of the confluence of Park Creek with said Susquehanna River.
(b) Definitions.
(1) Agricultural associated animal waste shall mean manure obtained from agricultural industries.
(2) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter-road maintenance) or sodium chloride (commonly used for water-softener regenerations).
(3) Construction and demolition dump shall mean a site used for the deposit of wastes resulting from construction, remodeling, repair and demolition of structures, road building and land clearing. Such wastes include, but are not limited to bricks, concrete and other masonry materials, soil, rock and lumber, road spoils, paving material and tree and brush stumps.
(4) Fertilizers shall be any commercially produced mixture generally containing phosphorus, nitrogen and potassium which is applied to the ground to increase nutrients to plants.
(5) Groundwater shall be any water beneath the land surface in the saturated zone that is under atmospheric or artesian pressure and that enters wells and springs.
(6) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(7) Human excreta shall mean human feces and urine.
(8) Junkyard shall mean an area utilized for the collection, storage, burning, dumping, disassembling, dismantling, salvaging, sorting or otherwise handling or arranging for sale, resale, storage or disposal or otherwise of bodies, engines, or parts of autos.
(9) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(10) Manure shall mean animal feces and urine.
(11) Nonagricultural associated animal waste shall mean manure obtained from nonagricultural industries.
(12) Pesticide shall mean any substance used to destroy or inhibit pests, such as rodents and insects.
(13) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, cheemical waste, biological materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial and municipal waste and agricultural and nonagricultural associated animal waste.
(14) Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible infrared, or ultraviolet light.
(15) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(16) Refuse shall mean all putrescible and nonputrescible solid wastes, including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(17) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only agricultural associated animal wastes resulting from the operation of such farm are deposited.
(18) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(19) Sewage disposal system shall mean any system used for disposing of sewage and includes treatment works.
(20) Sludge shall mean any solid, semi-solid or liquid waste generated from a municipal, commercial, or industrial wastewater treatment plant, water supply treatment, or air pollution control facility. Sludge does not include the treated effluent from a wastewater treatment plant.
(21) Toxic substance shall mean any toxic substance as so defined by subdivision two of section 4801 of the Public Health Law.
(22) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary landfill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(23) Water stabilization pond or lagoon shall mean any body of water used for the collection of waste or sewage.
(24) Water district shall mean Water District No. 4 of the Town of Kirkwood.
(25) Water supply shall mean the public water supply of Water District No. 4 of the Town of Kirkwood.
(26) Wells shall mean any well or wells now used as a source of this water supply or any additional well which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the most stringent of standards for water quality as contained in:
(1) Part 170 of this Title;
(2) Part 703 of Title 6 (Environmental Conservation) of the Official Compilation of Codes, Rules and Regulations of the State of New York (6 NYCRR Part 703); and
(3) Subpart 5-1 of Part 5 of this Title, relating to maximum contamination levels for drinking water or any subsequent revision to or replacement of any such codes, rules or regulations.
(d) Specific prohibitions.
(1) Any activity, system or facility, except for physical pumping and treatment facilities and controls, is prohibited within a 400-foot linear distance of the wells. Such prohibited activities include, among other things:
(i) interment of a human body;
(ii) placement of any watertight pipe connected to a sewage disposal system or treatment works;
(iii) disposal or burial of construction demolition debris;
(iv) construction, location, placement or maintenance of any sewage leaching area, privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta;
(v) use of sodium chloride for deicing;
(vi) deposit or spreading of any agricultural or nonagricultural associated animal waste; and
(vii) deposit or spreading of any fertilizer.
(2) The following actions or activities are prohibited within a 750-foot linear distance of the wells:
(i) deposit of any refuse on or beneath the surface of the ground;
(ii) operation or location of any refuse disposal area;
(iii) storage, discharge or application of pesticides or herbicides, except when the property owner or applicator first obtains a permit for such activity from the appropriate Federal, State or local agencies having jurisdiction;
(iv) storaging or stockpiling of any agricultural or nonagricultural associated animal waste, except where provisions have been made for a soil conservation service designed and approved handling system to prevent seepage to the groundwater;
(v) discharging or allowing any sewage or polluted liquid of any kind to flow on or beneath the surface of the ground, except in watertight pipes connected to a sewage disposal system for which a permit has been granted by the appropriate State agency having jurisdiction over such facilities;
(vi) operation or location of any new construction demolition dump, except that any existing construction demolition dump licensed by the New York State Department of Environmental Conservation shall be allowed within a 400-foot linear distance of the wells pursuant to paragraph (c)(1) of this section so long as such license remains in full force and effect;
(vii) placement or location of any container of more than 275 gallons used for the storage of gasoline, kerosene, fuel oil or diesel oil;
(viii) stockpiling or dumping of snow removed from streets, roads and parking areas;
(ix) open storage of fertilizers;
(x) excavations or cut-ins which expose groundwater permanently or during maximum elevation of the water table, or which significantly reduce the thickness of the soil cover and thereby ease the entrance of contaminants into groundwaters.
(xi) the operation of sand and gravel mining or dredging operations, except pursuant to a permit granted by the appropriate State or local agency having jurisdiction over the same; and
(xii) operation or location of any junkyard licensed by the Town of Kirkwood.
(3) The following actions or activities are prohibited within a 1,000-foot linear distance of the wells:
(i) disposal or burial in the soil of any radioactive material;
(ii) placement, location or use of any waste stabilization pond or lagoon, for temporary or permanent storage of wastewater;
(iii) abandonment of drilled water supply wells without filling the same with cement grout;
(iv) the construction of liquefied natural gas lines or pipelines for other materials which can impair water quality;
(v) storage of a chloride salt except in weatherproof buildings or watertight vessels.
(vi) deposit or spreading upon or beneath the surface of the ground of any human excreta, sewage or sludge;
(vii) storage of any toxic substance;
(viii) storage of any pollutant;
(ix) reporting of accidental spills. Spills of one gallon or more of oil or any toxic substance within a 1,000-foot linear distance of the wells shall be reported within two hours of discovery of occurrence to the town commissioner of public works and appropriate health authorities.
(x) trespassing. No trespassing shall be allowed upon the property of the water district upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by said water district;
(xi) inspections. The town board of the Town of Kirkwood shall, by its officers or duly appointed representatives, make regular and thorough inspections, at least monthly, of the area surrounding the wells to ascertain whether these rules and regulations are being complied with. It shall be the duty of the aforesaid town board of the Town of Kirkwood to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board of the Town of Kirkwood to promptly notify the State Commissioner of Health of such violations. The aforesaid town board of the Town of Kirkwood shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated, and the general condition of the area surrounding the wells at the time of the last inspection; and
(xii) penalties for violations. Penalties for violations of these rules and regulations shall be those specified in section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 17 MOBILE HOME PARKS
10 CRR-NY 17.12 Variance; compliance schedule
(a) The permit-issuing official may, on written application and after review, grant a variance from a specific provision of this Part in a specific case subject to appropriate conditions which shall include a time schedule for compliance, where such variance is in harmony with the general purpose and intent of this Part, and where there are practical difficulties or unnecessary hardship in carrying out the strict letter of the provision.
(1) A time schedule for compliance shall not exceed a total of three years.
(2) A variance shall not be issued for more than one calendar year.
(3) If the time schedule for compliance exceeds one calendar year the permit-issuing official may reissue the variance on an annual basis, for not more than three years, if he determines the park is operating in compliance with all other requirements of this Part and the operator is complying with the established time schedule.
(b) A copy of every variance and time schedule for compliance shall be submitted to the State Commissioner of Health at the time of issuance.
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.105 Duration, expiration and termination of specific licenses
(a) Except as otherwise provided in this subdivision, each specific license will expire at the end of the expiration date stated in such license. If any licensee duly files with the department not less than 30 days prior to such expiration date, an application in accordance with section 16.102 of this Part for the renewal of his license or for a new and superseding license, such license shall not be deemed to have expired until the department has finally determined such application.
(b) The department may terminate any specific license upon the written request of the licensee.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
VILLAGES VILLAGES
10 CRR-NY 155.8 Village of Irvington
(a) Application.
The following rules and regulations enacted in accordance with the provisions of sections 1100, 1101, 1102 and 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as finally amended by chapter 879 of the Laws of 1953, shall apply to Harriman Road Reservoir of the village of Irvington and/or to any reservoirs which have been or may be constructed to serve as sources of any part of the public water supply of the village of Irvington, the water from which is tributary to or discharge* into Harriman Road Reservoir or said reservoirs.
(b) Definitions.
(1) The term water supply means the public water supply of the village of Irvington.
(2) The term reservoir means Harriman Road Reservoir serving as the source of the water supply and any reservoir which has been or may be constructed to serve as any part of the water supply of the village of Irvington.
(3) The term watercourse means every spring, pond (other than reservoirs), stream, marsh, ditch, gutter or channel of any kind, the waters of which flow, either continuously or occasionally, or which may flow into this water supply.
(4) The linear distance of a structure or object from a reservoir or watercourse is the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(5) The term human excreta means feces, urine and other excretions commonly disposed of by the so-called dry system as typified by the ordinary privy.
(6) The term sewage means waste liquids containing human excreta and decomposing matter flowing in or from a house drainage system or sewer.
(c) Human excreta.
(1) No human excreta shall be desposited, thrown or placed or allowed to escape into any reservoir or any tributary watercourse.
(2) No human excreta shall be placed or spread upon the surface of the ground at any point on the watershed of the water supply.
(3) No human excreta shall be buried in the soil on the watershed of the water supply unless deposited in trenches or pits at a distance of not less than 500 feet from any reservoir or any tributary watercourse and covered with not less than 18 inches of soil in such a manner as to effectually prevent its being washed over the surface of the ground by rain or melting snow.
(4) No privy or receptacle of any kind for the storage or deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or any tributary watercourse, unless such privy or receptacle shall contain or be a watertight receptacle, removable or otherwise, and no sewage shall be discharged or allowed to flow into any reservoir or any tributary watercourse nor upon the surface of the ground at any point on the watershed of the supply nor disposed beneath the surface of the ground within 100 feet thereof, except into a watertight receptacle, removable or otherwise, from which privy or receptacle no outward percolation can take place, and which shall be emptied when filled up to within six inches of the top. If the contents of any such privy or receptacle shall be disposed of on the watershed, such contents shall be buried as set forth in paragraph (3) of this subdivision. All such privies and receptacles referred to in this paragraph shall be placed as far as possible (within said limiting distances) from any such reservoir or tributary watercourse, as the property to which such privy or receptacle is appurtenant shall permit, and shall be constructed or installed only with the approval and under the supervision of the village of Irvington and in such manner as effectually to prevent any pollution of the water supply. These restrictions and limiting distances shall not apply to sewage treatment plants installed under and in accordance with plans which first have been submitted to and approved by the State or Westchester County Commissioner of Health.
(5) Whenever in the opinion of the State or Westchester County Commissioner of Health, excremental matter from the aforesaid privy, receptacle, trench or place of disposal may be washed over the surface of the ground or through the soil in an imperfectly purified condition into any reservoir or tributary watercourse, the said privy, receptacle, trench or place of disposal shall be removed, after due notice to the owner thereof, to such places as shall be considered safe and proper by the State or Westchester County Commissioner of Health.
(d) Sink wastes, garbage, etc.
(1) No bath water, sink or laundry wastes or polluted liquid of any kind, except the effluent from a properly constructed and operated sewage treatment plant as hereinbefore provided by paragraph (4) of subdivision (c), shall be discharged or allowed to flow into any reservoir or any tributary watercourse nor be deposited beneath the surface of the ground within 50 feet of any reservoir or any tributary watercourse.
(2) No garbage, refuse, putrescible matter, decayed fruits or vegetables, dead animals or parts thereof, oil wastes or any other matter that pollutes water shall be deposited in any reservoir or tributary watercourse nor on or beneath the surface of the ground within 100 feet of any reservoir or any tributary watercourse nor in such manner that it can be washed by rain, melting snow or otherwise over the surface or through the ground into any reservoir or tributary watercourse.
(e) Swimming, boating, animals, etc.
(1) No person or persons shall bathe or swim or be allowed to bathe or swim in any reservoir or in any tributary watercourse except in such bathing places as may be operated in accordance with the State Sanitary Code (Chapter I of this Title) and under the supervision of the State or Westchester County Commissioner of Health.
(2) No boating or fishing of any kind, ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of any reservoir or any tributary watercourse of the public water supply, except by duly authorized officers or employees of the village of Irvington.
(3) No animal or poultry shall be allowed to stand, wade, wallow or swim nor to be washed or watered in any reservoir or any tributary watercourse and no watering place shall be maintained in such way as to pollute any reservoir or tributary watercourse with excremental matter.
(4) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals shall be so located or maintained in such a manner that the drainage, leachings or washings therefrom may pollute any reservoir or any tributary watercourse.
(5) No manure pile shall be maintained or allowed to remain within 150 feet of any reservoir or any tributary watercourse.
(f) Camps, interments.
(1) No camp, tent, building or other structure for the occupancy of laborers engaged in construction work or for other use, except as a private camp or dwelling maintained by a person for his own personal use or for use of family and friends, shall be located, placed or maintained within a distance of 300 feet of any reservoir or any tributary watercourse.
(2) No interment of a human body shall be made within a distance of 200 feet of any reservoir or any tributary watercourse.
(g) [General clause.]
In addition to observing the foregoing requirements, all persons living on or visiting the watershed shall refrain from any act, though not heretofore specified, which may result in contamination of any portion of the water supply.
(h) Inspections.
The village of Irvington or such other person or persons as may be charged with the maintenance or supervision of the water supply or the duly appointed representative of said village shall make regular and thorough inspections of all reservoirs, watercourses and watersheds tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said village to cause copies of any rules and regulations violated to be served upon the person violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of said village to promptly notify the State and Westchester County Commissioner of Health of such violations. The village shall report to the State Commissioner of Health in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general conditions of the watershed at the time of the last inspection.
(i) Penalties.
In accordance with sections 1100 and 1103 of chapter 45 of the Consolidated Laws (Public Health Law), as amended by chapter 879 of the Laws of 1953, the penalty for each and every violation or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
WATER SUPPLY WATER SUPPLY
10 CRR-NY 14-1.121 Bottled water
Bottled and packaged potable water is to be obtained from a source approved by the State Commissioner of Health and handled and stored in a way that protects it from contamination. Bottled and packaged potable water is to be dispensed from the original container.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA DOWNSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.33 Adjustments to expense
| Description of adjustment | Cost center affected | Account number | | | | --- | --- | --- | --- | --- | | (a) | Unrecovered cost of courtesy | Employee Benefits—Non-Payroll-Related | 8830 | | | (b) | Allowances to employees and dependents | | | | | (c) | Collection fees | Patient Accounts, Admitting and Registration | 8520 | | | (d) | Interest on inter-fund borrowing | (1) | Interest—Short-Term, or | 8870 | | | | (2) | Interest—Long-Term | 8880 | | (e) | Grants from governmental or public philanthropic agencies (lower of expense or grant) | Specify | Specify | | | (f) | Depreciation accelerated to straight line | Depreciation and Amortization— Fixed Assets | 8810 | | | (g) | Other (specify) | Specify | Specify | |
(h) The amounts of these adjustments may be expressed as:
(1) increases; or
(2) decreases.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 66 IMMUNIZATIONS AND COMMUNICABLE DISEASES
Subpart 66-4 COVID-19 NURSING HOME AND ADULT CARE FACILITY VACCINATION PROGRAM
10 CRR-NY 66-4.1 Requirements for nursing homes
(a) Within 14 days of the effective date of this regulation, every nursing home regulated pursuant to Part 415 of this Title shall offer all consenting, unvaccinated existing personnel and residents an opportunity to receive the first or any required next dose of the COVID-19 vaccine.
(b) The operator and administrator of every nursing home regulated pursuant to Part 415 of this Title must ensure that all new personnel, including employees and contract staff, and every new resident and resident readmitted to the facility has an opportunity to receive the first or any required next dose of the COVID-19 vaccine within 14 days of having been hired by or admitted or readmitted to such facility, as applicable.
(c) The requirement to ensure that all new and current personnel and residents have an opportunity to receive the COVID-19 vaccination, as set forth in subdivisions (a) and (b) of this section, shall include, but not be limited to:
(1) posting conspicuous signage throughout the facility, including at points of entry and exit and each residential hallway, reminding personnel and residents that the facility offers COVID-19 vaccination; and
(2) providing all personnel and residents who decline to be vaccinated a written affirmation for their signature, which indicates that they were offered the opportunity for a COVID-19 vaccination but declined. Such affirmation must state that the signatory is aware that, if they later decide to be vaccinated for COVID-19, it is their responsibility to request vaccination from the facility. The facility shall maintain signed affirmations on file at the facility and make such forms available at the request of the department.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
PERSONNEL PERSONNEL
10 CRR-NY 14-1.71 Employee cleanliness
Employees are to maintain a high degree of personal cleanliness and are to conform with good hygienic practices when working in food service establishments. Employees are to wash their hands and exposed area of arms thoroughly with soap and warm water before starting work, and as often as may be necessary to remove soil and contamination. Thereafter, employees are to wash hands thoroughly after using the toilet, smoking, sneezing, coughing, eating, drinking or otherwise soiling their hands before returning to work. Employees are to keep their fingernails clean and neatly trimmed.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-2 CHILDREN'S CAMPS
10 CRR-NY 7-2.23 Refuse storage and disposal
(a) Refuse shall mean solid wastes.
(b) Facilities shall be provided and maintained for the storage, handling and disposal of refuse to prevent nuisance conditions, insect and rodent infestations and pollution of air and water.
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.13 Notices, instructions and reports to workers; inspections
(a) Purpose and scope.
This section establishes requirements for notices, instructions and reports by radioactive materials licensees or radiation-producing equipment registrants to individuals engaged in work under a license or registration, and options available to such individuals in connection with inspections of the activities and facilities of licensees or registrants by the department or health officer having jurisdiction to ascertain compliance with the provisions of this Part, orders and licenses issued thereunder regarding radiological working conditions.
(b) Posting of notices to workers.
(1) Each licensee or registrant shall post current copies of the following documents:
(i) the regulations of this Part;
(ii) the radioactive materials license and conditions or documents incorporated into the license by reference and amendments thereto, or the certificate of registration;
(iii) the operating procedures (including emergency procedures) applicable to work under the license or registration; and
(iv) any notice of violation involving radiological working conditions, proposed imposition of civil penalty or order issued pursuant to the provisions of the Public Health Law, and any response from the licensee or registrant.
(2) If posting of a document specified in paragraph (1) of this subdivision is not practicable, the licensee or registrant may post a notice which describes the document and states where it may be examined.
(3) A current copy of “Notice to Employees” shall be posted by each licensee or registrant wherever individuals work in or frequent any portion of a restricted area.6
(4) Documents, notices or forms posted pursuant to this section shall be conspicuous, be replaced if defaced or altered, and appear in a sufficient number of places to permit individuals engaged in work under the license or registration to observe them on the way to or from assigned work locations to which the document applies.
(5) Department documents shall be posted within two working days after receipt of the documents from the department; the licensee's or registrant's response, if any, shall be posted within two working days after dispatch from the licensee or registrant. Such documents shall remain posted for a minimum of five working days or until action correcting violations, if any, has been completed, whichever is later.
(c) Instructions restricted.
All individuals likely to receive an occupational dose or frequenting any portion of a restricted area shall be:
(1) informed of the storage, transfer or use of radioactive material, of radiation-producing equipment or of radiation in such portions of the restricted area;
(2) instructed in the operating procedures applicable to work under the license or registration and the health protection problems associated with exposure to such radioactive material or radiation, in precautions or procedures to minimize exposure, in the purposes and functions of protective devices employed, and required to demonstrate familiarity with such precautions, procedures and devices;
(3) instructed in, and instructed to observe, to the extent within the worker's control, the applicable provisions of this Part and licenses for the protection of personnel from exposures to radiation or radioactive material occurring in such areas;
(4) instructed of their responsibility to report promptly to the licensee or registrant any condition which may lead to or cause a violation of the department regulations and licenses or unnecessary exposure to radiation or radioactive material;
(5) instructed in the appropriate response to warnings made in the event of any unusual occurrence of malfunction that may involve exposure to radiation or radioactive material; and
(6) advised as to the radiation exposure reports which workers must be given or may request pursuant to subdivision (d) of this section.
(7) the extent of the instructions required under this subdivision shall be commensurate with the nature and level of the likely exposure and with potential radiological health problems in the restricted area. Instruction shall be given before an individual begins work likely to result in receiving an occupational dose or before an individual begins work in a restricted area and at least annually thereafter. Records documenting individual worker instruction shall be maintained for inspection by the department for a period of three years.
(d) Notification and reports to individuals.
(1) Radiation exposure data for an individual and the results of any measurements, analyses and calculations of radioactive material deposited or retained in the body of an individual shall be reported to the individual as specified in this subdivision. The information reported shall include data and results as shown in records maintained by the licensee or registrant pursuant section 16.14 (f)(1)(i)-(vi) of this Part. Each notification and report shall be in writing and include appropriate identifying data, such as the name of the licensee or registrant, the name of the individual, the individual's social security number, together with the individual's exposure information and, in addition, contain the following statement: “This report is furnished to you under the provisions of Part 16, New York State Sanitary Code, and should be preserved for further reference.”
(2) Each licensee or registrant shall advise each worker annually of the worker's exposure to radiation or radioactive material as shown in records maintained by the licensee or registrant pursuant to section 16.14(f)(1)(i)-(vi) of this Part.
(3) At the request of a worker formerly engaged in work controlled by the licensee or the registrant, each licensee or registrant shall furnish to the worker a report of the worker's exposure to radiation or radioactive material. Such report shall:
(i) be furnished within 30 days from the time the request is made, or within 30 days after the exposure of the individual has been determined by the licensee or registrant, whichever is later;
(ii) cover, within the period of time specified in the request, each calendar year in which the worker's activities involved exposure to radiation from radioactive material licensed by, or radiation-producing equipment registered with the department;
(iii) contain the results of any planned special exposure dose to the embryo/fetus and include only calculations and analysis of radioactive material deposited in such individual's body, including any bioassay or other medical evaluation services of which records are required by section 16.14(f)(1)(ii)-(vi) of this Part; and
(iv) include the dates and locations of work under the license or registration in which the worker participated during this period.
(4) When a licensee or registrant is required pursuant to section 16.15 of this Part to report to the department any exposure of an individual to radiation or radioactive material, the licensee or the registrant shall also provide to the individual a report on his exposure data included therein. Such reports shall be transmitted at a time not later than the transmittal to the department.
(5) At the request of any worker who has been engaged in a work assignment in an area controlled by a licensee or registrant for purposes of radiation protection, and who is terminating employment in such work assignment in a given calendar quarter, the licensee or registrant shall provide a written report of the radiation dose received by that worker from operations of the licensee or registrant during that specifically identified calendar quarter or fraction thereof. The report shall be provided to the worker or the worker's designee at termination, and if the final determined personnel monitoring results are not available at that time, a written estimate of that dose shall be provided in the interim. Estimated doses shall be clearly indicated as such.
(e) Inspections; presence of representatives of licensees or registrants and workers during inspection.
(1) Each licensee or registrant shall afford the department or health officer having jurisdiction at all reasonable times opportunity to inspect:
(i) the radiation source and the installation, institution, establishment, and premises or facilities at which such source is located, possessed, stored or used;
(ii) each record required to be maintained by this Part.
(2) During an inspection, the licensee or registrant shall conduct, or permit the department or health officer having jurisdiction to conduct, such tests as the department or health officer may require, including but not limited to tests of:
(i) any radiation source and the installation, institution, establishment, premises or facilities at which such radiation source is located, possessed, stored or used; and
(ii) the personnel monitoring equipment referred to in section 16.11 of this Part and any other equipment, instrument or devices used in connection with the location, possession, storage or use of such radiation source.
(3) During an inspection, the department or health officer having jurisdiction may consult privately with workers as specified in subdivision (f) of this section. The licensee or registrant may accompany department inspectors or health officer having jurisdiction during other phases of an inspection.
(4) If, at the time of inspection, an individual has been authorized by the workers to represent them during inspections, the licensee or registrant shall notify the inspectors of such authorization and shall give the worker's representative an opportunity to accompany the inspectors during the inspection of physical working conditions.
(5) Each workers' representative shall be routinely engaged in work under control of the licensee or registrant and shall have received instructions as specified in subdivision (c) of this section.
(6) Different representatives of licensees or registrants and workers may accompany the inspectors during different phases of an inspection if there is no resulting interference with the conduct of the inspection. However, only one workers' representative at a time may accompany the inspectors.
(7) With the approval of the licensee or registrant and the workers' representative, an individual who is not routinely engaged in work under control of the licensee or registrant—for example, a consultant to the licensee or registrant or to the workers' representative—shall be afforded the opportunity to accompany inspectors during the inspection of physical working conditions.
(8) Notwithstanding the other provisions of this section, inspectors are authorized to refuse to permit accompaniment by any individual who deliberately interferes with a fair and orderly inspection. With regard to any area containing proprietary information, the workers' representative for that area shall be an individual previously authorized by the licensee or registrant to enter that area.
(f) Consultation with workers during inspections.
(1) Inspectors may consult privately with workers concerning matters of occupational radiation protection and other matters related to applicable provisions of department regulations and licenses to the extent the inspectors deem necessary for the conduct of an effective and thorough inspection.
(2) During the course of an inspection any worker may privately bring to the attention of the inspectors, either orally or in writing, any past or present condition which he has reason to believe may have contributed to or caused any violations of this Part, or license condition, or an unnecessary exposure of an individual to radiation from licensed radioactive material or registered radiation equipment under the licensee's or registrant's control. Any such notices in writing shall comply with the requirements of paragraph (1) of subdivision (g) of this section.
(3) The provisions of paragraph (2) of this subdivision shall not be interpreted as authorization to disregard instructions provided pursuant to subdivision (c) of this section.
(g) Requests by workers for inspections.
(1) Any worker or representative of workers who believes that a violation of this Part or of license conditions exists, or has occurred in work under a license or registration with regard to radiological working conditions in which the worker is engaged, may request an inspection by giving notice of the alleged violation to the department. Any such notice shall:
(i) be in writing;
(ii) set forth the specific grounds for the notice; and
(iii) be signed by the worker or representative of the workers. A copy shall be provided to the licensee or registrant by the department no later than at the time of inspection, except that, upon the request of the worker giving such notice, his name and the name of individuals referred to therein shall not appear in such copy or on any record published, released, or made available by the department, except for good cause shown.
(2) If, upon receipt of such notice, the Bureau of Environmental Radiation Protection of the department determines that the complaint meets the requirements set forth in paragraph (1) of this subdivision and that there are reasonable grounds to believe that the alleged violation exists or has occurred, the bureau shall cause an inspection to be made as soon as practicable to determine if such alleged violation exists or has occurred. Inspection pursuant to this section need not be limited to matters referred to in the complaint.
(3) No licensee or registrant shall discharge, or in any manner discriminate against, any worker because such worker has filed any complaint or instituted or caused to be instituted any proceeding under these regulations or has testified or is about to testify in any such proceeding, or because of the exercise by such worker on behalf of himself or others of any option afforded by this Part.
(h) Inspections not warranted; informal review.
(1) If the department determines, with respect to a complaint under subdivision (g) of this section, that an inspection is not warranted because there are no reasonable grounds to believe that a violation exists or has occurred, the department shall notify the complainant in writing of such determination. The complainant may obtain an informal review of such a determination by submitting a written statement of position with the Director, Center for Environmental Health of the department who will provide the licensee or registrant with a copy of such statement by certified mail, excluding, at the request of the complainant, the name of the complainant. The licensee or registrant may submit an opposing written statement of position with the Director, Center for Environmental Health, who will provide the complainant with a copy of such statement by certified mail. Upon the request of the complainant, the Director, Center for Environmental Health may hold an informal conference in which the complainant and the licensee or registrant may orally present their views. An informal conference may also be held at the request of the licensee or registrant, but disclosure of the identity of the complainant will be made only following receipt of written authorization from the complainant. After considering all written or oral views presented, the Director, Center for Environmental Health shall affirm, modify or reverse the determination of the department, and furnish the complainant and the licensee or registrant a written notification of his decision and the reason therefor.
(2) If the Bureau of Environmental Radiation Protection determines that an inspection is not warranted because the requirements of paragraph (1) of subdivision (g) of this section have not been met, it shall notify the complainant in writing of such determination. Such determination shall be without prejudice to the filing of a new complaint meeting the requirements of paragraph (1) of subdivision (g) of this section.
(i) Each person who possesses any radiation source shall, when necessary or desirable in order to aid in determining the extent of any individual's occupational exposure to a radiation source, comply with orders from the department directing such person to make available to such individual bioassay services or other appropriate medical evaluations and to furnish to the department and the health officer having jurisdiction a copy of the reports of such services.
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.19 Refuse storage
(a) Adequate facilities shall be provided and maintained for the temporary storage and handling of refuse to prevent nuisance conditions, insect and rodent infestations, and pollution of air and water.
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-1.4 Enforcement
(a) Permits and placarding.
(1) Operation of a swimming pool without a permit is a violation of this Subpart. The permit-issuing official may order any swimming pool operating without a permit to close and remain closed until the facility has obtained and displays a valid permit.
(2) The enforcement procedures delineated in sections 12, 12-a, 12-b, 16, 308, 309, 1303-1305 and 1308 of the Public Health Law may be used, as appropriate. Where a public health hazard is found, the pool shall be placarded to prohibit use until the hazard is corrected in order to protect the public health or safety of bathers. When a placard is used, it shall be conspicuously posted at each entrance leading to the pool. The placard shall state the authority for its placement and indicate that concealment, mutilation, alteration or removal of it by any person without permission of the permit-issuing official shall constitute a violation of this Chapter and the Public Health Law.
(3) Within 15 days of placarding of a facility, the operator of such facility shall be provided with an opportunity to be heard and present proof that continued operation of the facility does not constitute a danger to the public health. The hearing shall be conducted by the permit- issuing official or his designated hearing officer.
(4) The permit-issuing official or his designated representative shall inspect the premises, within two working days of notification that the hazard has been eliminated, to remove the placards after verifying correction.
(b) Public health hazards.
Any of the following violations are public health hazards which require the permit-issuing official or designated representative to order immediate correction or to immediately institute action as provided in the law and in this Subpart:
(1) failure to provide adequate supervision of the swimming pool as prescribed in section 6-1.23 of this Subpart;
(2) failure to provide the minimum disinfectant residual levels listed in various sections of this Subpart;
(3) failure to continuously operate the swimming pool's filtration and disinfection equipment;
(4) use of an unapproved or contaminated water supply source for potable water use;
(5) overhead electrical wires within 20 feet horizontally of the swimming pool;
(6) unprotected electrical circuits or wiring within 10 feet of the swimming pool;
(7) failure to maintain emergency lighting source as required in section 6-1.17(h) of this Subpart;
(8) absence of all lifesaving equipment on swimming pool deck;
(9) swimming pool bottom not visible;
(10) absence of or improper depth markings at a swimming pool;
(11) plumbing cross-connections between the drinking water supply and swimming pool water or between sewerage system and the swimming pool's filter backwash facilities;
(12) failure to provide and maintain an enclosure around the swimming pool area that will prevent access to the swimming pool during the hours in which the pool is not open for use;
(13) use of unapproved chemicals or the application of chemicals by unapproved methods to the swimming pool water;
(14) broken or missing main drain grate in the swimming pool;
(15) overcrowding of the swimming pool that results in poor supervision of bathers;
(16) glass or sharp objects in swimming pool or on deck area; or
(17) any other item determined to be a public health hazard by the permit-issuing official.
(c) Other violations.
Violations of other sections of this Subpart or of other Parts of this Chapter are also subject to a penalty upon conviction.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
INSTITUTIONAL DISPENSERS INSTITUTIONAL DISPENSERS
10 CRR-NY 80.46 Institutional dispensers; additional requirements
(a) Hospitals, veterinary hospitals, mental hospitals, or similar facilities qualified for controlled substances privileges shall first obtain a class 3 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(b) Nursing homes and other facilities having the services of a physician, registered nurses and a licensed and registered pharmacist may qualify for a class 3 license for controlled substances privileges. Such facilities shall first obtain a class 3 license from the department and thereafter, a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(c) Institutional dispensers licensed by the department in class 3 may purchase stocks of controlled substances only from authorized distributors or manufacturers licensed by the department.
(d) Institutional dispenser stocks of controlled substances obtained pursuant to a class 3 license are for inpatient and outpatient use through a registered pharmacy dispenser.
(e) Bulk stocks of controlled substances may be distributed within the institution to wards, floor stocks, operating rooms and emergency rooms and carried as substocks of the hospital.
(1) With each substock of a schedule II controlled substance, an administration sheet or other record as the commissioner may approve shall be furnished.
(2) The administration sheet shall list the type of controlled substance, doses and number of doses furnished to the substock and shall indicate:
(i) date and hour of administration;
(ii) name of patient;
(iii) name of prescribing practitioner;
(iv) quantity administered;
(v) balance on hand after each administration; and
(vi) signature of administering nurse.
(f) Administration of all controlled substances shall be authorized only by written order of an authorized practitioner except that:
(1) In an emergency situation, as defined in this subdivision, a practitioner may have a controlled substance administered by oral order provided that immediately thereafter such order is reduced to writing and that a notation be made of the emergency condition which required the administration of the drug. Such oral order shall be signed by the practitioner within 48 hours.
(2) Emergency means that the immediate administration of the drug is necessary for proper treatment, that no alternative treatment is available and it is not possible for the practitioner to provide a written order before the administration of such drug.
(3) As required orders (P.R.N., pro re nata ) for controlled substances are not valid beyond 72 hours and must be rewritten at least every 72 hours.
(4) Routine orders or an order in which there is no specific order written by a specific physician or other authorized practitioner are not permissible.
(5) Standing orders or specific controlled substances orders for individual patients to be administered at specified times shall not be valid after seven days and for continuing validity shall be rewritten at least every seven days, except that for a stabilized patient with convulsive disorders or chronic spasticity or minimal brain dysfunction in an institutional setting, and for patients in residential health care facilities, or in prisons, which possess class three controlled substances licenses, such orders shall be valid for 30 days but shall be rewritten at least every 30 days.
(6) Written controlled substances orders for hospitalized patients may, if permissible under the bylaws, rules and regulations of the hospital, be signed by a physician's assistant for patients under the care of the physician or physicians to whom the registered physician's assistant is assigned for supervision, subject to compliance by the registered physician's assistant with any of the foregoing conditions set forth in this section that are applicable to his/her supervising physicians. In every case, such written orders shall be countersigned by the supervising physician within 24 hours if deemed necessary and appropriate by the supervising physician or the hospital. Countersignature by the supervising physician is not required before execution of the order.
(7) Doses of controlled substances shall be withdrawn from the container immediately before administration is to be made to the patient.
(g) Institutional dispensers operating an outpatient department pharmacy shall also obtain a registration from the Drug Enforcement Administration, United States Department of Justice, or its successor agency.
(1) Such pharmacy shall be registered by the New York State Board of Pharmacy and under the supervision of a licensed and registered pharmacist.
(2) Controlled substances dispensed through outpatient department pharmacy to patients or employees of the institutional dispenser shall be dispensed only pursuant to prescriptions issued by an authorized practitioner.
(h) Independent out-of-hospital health facilities, such as clinics, may qualify to obtain official New York State institutional prescription forms required for prescribing schedule II controlled substances under the New York State Controlled Substances Act by complying with the following:
(1) Obtain an operating certificate from the New York State Department of Health as required under the New York State Hospital Code (Chapter V of this Title) or license by the New York State Department of Mental Hygiene.
(2) Obtain a registration as a clinic from the Drug Enforcement Administration (schedules II, III, IV and V), United States Department of Justice, or its successor agency.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 447 STANDARD UNIT OF MEASURE REFERENCES
10 CRR-NY 447.1 Laboratory Services
(a)
| (a) ACCOUNT NUMBER | COST CENTER TITLE | | --- | --- | | 7210 | Laboratory Services—Clinical | | 7230 | Laboratory Services—Pathological | | 7250 | Whole Blood and Packed Red Cells | | 7260 | Blood Processing and Storing | | 7290 | Electrocardiology | | 7440 | Pulmonary Function Testing |
(b) The above cost centers use as the basis for the Standard Unit of Measure the Laboratory Workload Recording Method published by the College of American Pathologists (CAP). The college has a policy of revising their publication annually and it is available in January of each year. The latest edition is to be used for determining the standard units of measure for tests and procedures performed. In recording Workload Measurement Units for reporting to the Health Care Financing Administration (HCFA), workload units related to quality control studies, calibration standards, and specimen collection, and repeats and duplicates for which a patient is not charged are not to be counted. Workload units for unlisted tests and procedures should be reasonably estimated based upon work units for other comparable procedures, or estimated by qualified personnel. Workload measurement units shall be maintained and reported for laboratory services obtained from outside laboratories.
(c) Copies of the Laboratory Workload Recording Method can be obtained by writing to:
College of American Pathologists
7400 North Skokie Boulevard
Skokie, Ill. 60076
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.16 Administrative hearings (one-year time frame)
For hearings requested by applicants proposed for disapproval for establishment pursuant to Public Health Law, section 2801-a(2), or for construction pursuant to Public Health Law, section 2802(5), a notice of hearing shall be issued within 365 days of the receipt by the department of the written request for hearing. For hearings requested by applicants seeking increases in reimbursement rates pursuant to Part 86 of this Title, a notice of hearing shall be issued within 365 days of the rate review officer's determination that there are issues of fact which entitle the applicant to a hearing. Failure to comply with this section shall not affect the validity of the action taken.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 139 ROCKLAND COUNTY
VILLAGES VILLAGES
10 CRR-NY 139.1 Village of Nyack
L. 1893, ch. 661; L. 1889, ch. 251
(a) [Application.]
The following rules and regulations apply to that portion of the stream known as Hackensack Creek—a tributary of the Hackensack River—lying above the intake to the filtration works of the Nyack water supply situated at West Nyack, Rockland County, New York, as well as to every spring, stream, ditch, gutter, lake, pond, reservoir or watercourse of any kind, the waters of which when running flow eventually into the aforesaid Hackensack Creek above the aforesaid limits. They also apply to the reservoir of the Nyack water supply situated within the village of Nyack.
(b) Privies adjacent to ponds, lakes, reservoirs or watercourses.
(1) No privy, privy vault, pit or cesspool or any other receptacle of any kind used for the deposit, reception or storage of human excreta shall be constructed, located, placed or maintained with its nearest point within 50 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse of any kind, the waters of which comprise or when running flow eventually into the aforesaid Hackensack Creek above the aforesaid limits.
(2) Every privy, privy vault, pit or cesspool or other receptacle or place used for the deposit, reception or storage of human excreta which is constructed, located or maintained within 150 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind, whose waters comprise or when running flow into the aforesaid Hackensack Creek above the aforesaid limits, and from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(3) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually and strictly prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the least possible annoyance and inconvenience be caused to occupants of the premises or of adjacent premises.
(4) Unless otherwise specifically ordered or permitted by the State Board of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 200 feet, horizontal measurement, from the high-water mark of any lake, pond or reservoir or from the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind, the waters of which comprise or when running flow into the aforesaid Hackensack Creek above the aforesaid limits.
(5) Whenever it shall be found that, owing to the character of the soil or to the surface of the ground or owing to the height or flow of subsoil or surface water or through special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Board of Health, be washed over the surface of the ground or through the soil into any lake, pond or reservoir, spring, stream, ditch, gutter, drain or other watercourse, the waters of which comprise or when running flow into the aforesaid Hackensack Creek above the aforesaid limits, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Board of Health.
(c) House slops, sink waste, laundry water, garbage, refuse, etc.
(1) No sewage, garbage, putrescible matter, house slops, bath water, kitchen or sink wastes, refuse or waste water from creameries, cheese factories or launderies or water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid shall be thrown or discharged directly into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse comprising or flowing into the aforesaid Hackensack Creek within the aforesaid limits, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid within 50 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse aforesaid.
(2) No clothing, bedding, carpets, harness, vehicles, tanks, barrels, receptacles, utensils nor animals nor anything that pollutes water shall be washed or rinsed in, nor shall any person bathe in any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse of any kind aforesaid.
(d) Manures, composts, etc.
(1) No stables for cattle or horses, barnyard, hogyard, poultry yard, cattle pen, pigsty, henhouse, hitching place or standing place for horses or other animals and no manure pile, compost heap, piles of fermented or decayed fruit, apple pumice, cider mill waste, vegetables, roots, grain, leaves or other vegetable substances shall be located, placed or maintained or allowed to remain in such place or manner that the washing or drainage therefrom may flow by open, blind or covered drains or channels of any kind into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid without first having passed over or through such extent of soil as to have become properly purified and in no case shall the above named sources or causes of pollution be so located or allowed to remain that their nearest point is less than 50 feet, horizontal measurement, from the high-water mark of any lake, pond, reservoir or the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind which comprises or when running flows into the Hackensack Creek above the aforesaid limits.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 200 feet, horizontal measurement, of the high-water line of any lake, pond or reservoir or the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind whose waters comprise or when running flow into the aforesaid Hackensack Creek above the aforesaid limits and no manure or compost of any kind shall be spread or deposited upon the ground so as to be washed a less distance than 50 feet over the surface or through the soil before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse aforesaid.
(e) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish nor any part thereof nor any offal or putrescible matter nor any polluted waters or refuse from any slaughterhouse, dairy, creamery, cheese factory, cider mill or other manufactory shall be thrown or allowed to run into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse whose waters comprise or when running flow into the aforesaid Hackensack Creek above the aforesaid limits, nor shall any such refuse or polluted material aforesaid be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed over or through the soil a less distance than 100 feet before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse.
(f) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, the penalty for each and every violation or noncompliance with any of the above rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-2 WATER WELL CONSTRUCTION
10 CRR-NY 5-2.11 Notification of abandonment of a water well
Every abandoned well shall be sealed or closed so as to protect the aquifer from pollution and to prevent a hazard to life or property. If such well is to be sealed or closed the owner of the property shall make application of notification to abandon such water well and provide the following information:
(a) name and address of the applicant;
(b) legal or other description adequate to locate the property and the well;
(c) name and address of the water well contractor employed to perform the work herein required for abandonment;
(d) type and description of well;
(e) reason for abandonment; and
(f) description of work to be performed to effect abandonment.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.299 Retirement
The removal of a fixed asset from service, following its sale or the end of its productive life, accompanied by the necessary adjustment of fixed asset and depreciation-reserve accounts.
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
RESIDENTIAL RIGHTS AND SERVICES RESIDENTIAL RIGHTS AND SERVICES
10 CRR-NY 415.5 Quality of life
The facility shall care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident's quality of life.
(a) Dignity.
The facility shall promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality.
(b) Self-determination and participation.
The resident shall have the right to:
(1) choose activities, schedules, and health care consistent with his or her interests, assessments and plans of care;
(2) interact with members of the community both inside and outside the facility; and
(3) make choices about aspects of his or her life in the facility that are significant to the resident.
(c) Participation in resident and family groups.
(1) A resident shall have the right to organize and participate in resident groups in the facility.
(2) A resident's family shall have the right to meet in the facility with the families of other residents in the facility.
(3) The facility shall provide a resident or family group, if one exists, with private space.
(4) Staff or visitors shall be allowed to attend meetings at the group's invitation.
(5) The facility shall provide a designated staff person responsible for providing assistance and responding to written requests that result from group meetings.
(6) When a resident or family group exists, the facility shall listen to the views and act upon the grievances and recommendations of residents and families concerning proposed policy and operational decisions affecting resident care and life in the facility.
(d) Participation in other activities.
(1) A resident shall have the right to participate in social, religious, and community activities that do not interfere with the rights of other residents in the facility.
(2) The facility shall arrange for opportunities for religious worship and counseling for any residents requesting such services.
(e) Accommodation of needs.
A resident shall have the right to:
(1) reside and receive services in the facility with reasonable accommodation of individual needs and preferences, except when the health or safety of the individual or other residents would be endangered; and
(2) receive notice before the resident's room or roommate in the facility is changed.
(f) Activities.
(1) The facility shall provide for an ongoing program of activities designed to meet, in accordance with the comprehensive resident assessment, the interests and the physical, mental and psychosocial well-being of each resident. The activities program shall:
(i) encourage the resident's voluntary choice of activities and participation; and
(ii) promote and maintain the resident's sense of usefulness to self and others, make his or her life more meaningful, stimulate and support the desire to use his or her physical and mental capabilities to the fullest extent and enable the resident to maintain a sense of usefulness and self-respect.
(2) The activities program shall be directed by a qualified professional who:
(i) is a qualified therapeutic recreation specialist who is eligible for certification as a therapeutic recreation specialist by a recognized accrediting body on or after August 1, 1989; or
(ii) has two years of experience in an age-appropriate social or recreational program within the last five years, one of which was full-time in a patient or resident activities program in a health care setting; or
(iii) is a qualified occupational therapist or occupational therapy assistant.
(3) The activities program director shall be responsible to the administrator or his or her designee for administration and organization of the activities program and shall:
(i) assist in the selection and evaluation of activities program staff and volunteers;
(ii) assign duties and supervise all activities staff and assigned volunteers;
(iii) ascertain, initially from the resident's attending physician, and on an ongoing basis from other appropriate professional staff, which residents are not permitted for specific documented medical reasons, to participate in certain activities;
(iv) develop and prepare with the resident and designated representatives, as appropriate, a written plan for individual, group and independent activities in accordance with his or her needs, interests and capabilities, and in recognition of his or her mental and physical needs and interests, as well as education and experiences;
(v) incorporate the activities into the resident's interdisciplinary care plan;
(vi) periodically, and at least quarterly, review with the resident, designated representative and staff, as appropriate his or her activities program participation and revise the plan as necessary;
(vii) coordinate and incorporate the activities program with the resident's schedule of other services through discussions with the interdisciplinary care team;
(viii) develop a monthly activities schedule based upon individual and group needs, interests and capabilities considering the special needs of residents including but not limited to dementias, physical handicaps, visual, hearing and speech deficiencies and wheelchair or bed restrictions;
(ix) post the current monthly activities schedule where it is accessible to residents and staff and can be easily read and provide a copy to residents upon request; and
(x) include in the resident's clinical record a quarterly assessment of the resident's degree of participation in, response to and benefit from the activities program.
(4) The facility shall:
(i) employ such additional qualified personnel responsible to the activities director, as are needed;
(ii) provide a planned program to include individual, group and independent programs for all residents at various times of the day and evening seven days of the week;
(iii) provide safe and adequate space and an adequate number and variety of equipment and supplies for the conduct of the on-going program; and
(iv) develop, facilitate access and implement programs to encourage residents to establish and maintain community contacts.
(g) Social services.
(1) The facility shall provide for a social service program to meet the psychosocial needs of the individual resident which will provide services, based upon a comprehensive assessment, which will assure the maximum attainable quality of life for the residents, the residents' emotional and physical well-being, self-determination, self respect and dignity. Such services shall include:
(i) conducting an initial admissions assessment and interview with the resident and family to evaluate the appropriateness of placement and identify the need for special services;
(ii) interpreting the residents' rights to family and staff;
(iii) advocating for the resident with personal and social problems and problems involved with institutionalization;
(iv) facilitating needed communication with other disciplines on behalf of the residents, including medical, nursing, dietary, rehabilitation and psychiatric services;
(v) coordinating and monitoring needed available services for individual residents to assure optimum level of emotional, physical and psychological well-being and independence based upon educational background;
(vi) involving the resident, other disciplines and administration as appropriate regarding matters such as bed retention, room change, transfer and discharge;
(vii) interpreting residents' needs and behaviors and extending professional intervention to all levels of staff suggesting positive approaches; such as alternatives to the use of restraints and psychotropic drugs;
(viii) initiating and facilitating small group meetings of residents, family and staff directed at a fuller understanding of the institutionalized resident and fuller joint participation in improving the residents' emotional and physical well-being;
(ix) initiating and participating in interdisciplinary meetings and team conferences;
(x) providing assistance and support to residents' family members;
(xi) arranging for residents and families to meet with Department of Health surveillance staff as necessary;
(xii) participating, if requested by residents, in the organization and on-going functioning of the resident and family councils;
(xiii) making available social work staff at varying schedules, including weekends and evenings;
(xiv) coordinating and facilitating the referral of residents for needed and requested services and outside resources not available in the facility; and
(xv) organizing bereavement counseling for roommates, families and other affected individuals.
(2) The facility shall employ a qualified social worker. Facilities with more than 120 beds shall employ such individual on a full time basis; facilities with 120 beds or fewer shall employ such individual on a full or part time basis. A qualified social worker for purposes of this Part is an individual who:
(i) holds a master's degree in social work or is a certified social worker and has pertinent experience in a health care setting;
(ii) holds a bachelor's degree in social work, or in a related field, and has regular access through a contract which meets the provisions of subdivision (e) of section 415.26 of this Part with a person who meets the requirement of subparagraph (i) of this paragraph; or
(iii) had four years of social work experience in a nursing home in New York State prior to October 1, 1990, as a social work assistant or case aide and has regular access through a contract which meets the provisions of section 415.26(e) of this Part with a person who meets the requirement of subparagraph (i) of this paragraph.
(h) Environment.
The facility shall provide:
(1) a safe, clean, comfortable and homelike environment, allowing the resident to use his or her personal belongings to the extent possible;
(2) housekeeping and maintenance services necessary to maintain a sanitary, orderly and comfortable interior;
(3) clean bed and bath linens that are in good condition;
(4) comfortable and safe temperature levels; and
(5) for the maintenance of comfortable sound levels.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 58 CLINICAL LABORATORIES AND BLOOD BANKS
Subpart 58-2 BLOOD BANKS AND LABORATORIES PERFORMING IMMUNOHEMATOLOGY TESTING
10 CRR-NY 58-2.20 Ambulance transfusion services
(a) No person shall own or operate an ambulance transfusion service in New York State unless approved by the department. An inspection may be conducted prior to departmental approval. Ambulance transfusion services shall comply with the provisions in this Part governing transfusions in general.
(b) Ambulance transfusion services shall have a written agreement with all hospitals issuing blood components to the ambulance transfusion service for possible administration during transport to another hospital, except in cases when no ground or air, as needed, ambulance transfusion service with an agreement in place is available. The agreement shall be subject to the prior approval of the department. The agreement shall:
(1) specify the division of responsibilities for ensuring compliance with the provisions of this Subpart;
(2) include a statement that ambulance transfusion service personnel will have adequately completed training in administering blood components according to a curriculum approved by the department; and
(3) include the written approval of the issuing facility's director of transfusion services and the director of the ambulance transfusion service.
(c) A qualified licensed physician shall provide general supervision of ambulance transfusion service personnel continuing and/or initiating transfusions and shall be responsible for ensuring that such personnel have adequate training and experience.
(d) Any order for a transfusion to be continued and/or initiated in an ambulance shall be documented on an order form approved by the department, and shall specify:
(1) the blood component(s) to be transfused;
(2) the number of units to be transfused;
(3) the rate of infusion;
(4) any special instructions; and
(5) any actions, including transfusion of additional units, to be taken based on circumstances that may arise.
(e) Every transfusion administered in an ambulance must be documented on a transfusion record approved by the department. Such documentation must include:
(1) date of the transfusion;
(2) name of the person who performed the transfusion and who attended the recipient during the transfusion.
(3) for each unit:
(i) blood component transfused;
(ii) unit identification code;
(iii) unit ABO and Rh groups; and
(iv) start time and completion time.
(f) Any adverse reaction shall be documented on a prehospital care report. Such documentation shall include a description of the adverse reaction and actions taken in response.
(g) Any ambulance in which a transfusion is performed by an ambulance transfusion service shall maintain an inventory of isotonic saline and any supplies needed for blood administration and for monitoring transfusion recipients, and have a means to communicate with medical control. All medications, equipment and supplies necessary for the management of adverse reactions shall be immediately available. Medical waste disposal must be undertaken, in collaboration with the receiving hospital, using containers and procedures found acceptable to the department pursuant to Part 70 of this Title.
10 CRR-NY 58-2.7 Immunohematology testing
(a) Blood specimens intended for pre-transfusion testing shall be labeled at the patient’s side at the time of collection. Such labelling shall include the patient's name, patient's identification number, and date of collection. Identification of the person collecting the specimen shall be recorded.
(b) All tests, including, but not limited to, ABO and Rho(D) grouping, antibody detection and identification, and compatibility testing, shall employ methods, techniques or procedures which have been approved or recommended for the particular reagent in use by the F.D.A or the American Association of Blood Banks, and which have been demonstrated to be effective in a manner acceptable to the department, in conformance with generally accepted laboratory principles. All grouping antisera, reagents, devices, methods, and procedures for blood unit processing or transfusion-related testing shall be approved by the F.D.A. or conform to the recommended minimum requirements of the F.D.A.
(c) All reagents shall be stored in labeled containers under conditions appropriate for each reagent as directed by the manufacturer and shall be removed from use after their expiration date. The reactivity and specificity of each reagent shall be determined whenever a new lot is employed. All methods shall conform to manufacturers' instructions unless otherwise approved by the department.
(d) Negative controls run on each day of use are not required for anti-human globulin and antibody screening cells, provided manufacturers’ instructions are followed. New lots of reagents shall be thoroughly evaluated, but antibody identification cell panels need not be tested with a known antibody. All test procedures to be used shall be determined by the blood bank director and shall be documented in the standard operating procedure manual. If no negative reactions are observed on a given test run, an investigation shall be performed and controls run. All quality control records shall be retained for five years.
(e) Centrifuges used for testing of red blood cell agglutination shall undergo revolutions per minute (RPM) and timer checks quarterly. Functional calibration that determines optimal centrifugation conditions shall be performed prior to initial use, after adjustments or repairs, and at least annually thereafter, and shall be documented. The procedure shall specify the speed and duration of centrifugation to be used. A microscope shall be located in the work area designated for immunohematology testing, if use of a microscope is specified by the facility’s standard operating procedure manual or by a test kit manufacturer’s package insert. Microscopic examination shall be performed for red blood cell agglutination tests whenever indicated for the procedure in use.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.67 Schedule II and certain other substances
(a) Prescriptions shall not be refilled for schedule II substances and:
Alprazolam
Bromazepam
Camazepam
Chlordiazepoxide
Clobazam
Clonazepam
Clorazepate
Clotiazepam
Cloxazolam
Delorazepam
Diazepam
Estazolam
Ethyl Loflazepate
Fludiazepam
Flunitrazepam
Flurazepam
Halazepam
Haloxazolam
Ketazolam
Loprazolam
Lorazepam
Lormetazepam
Medazepam
Midazolam
Nimetazepam
Nitrazepam
Nordiazepam
Oxazepam
Oxazolam
Pinazepam
Prazepam
Quazepam
Temazepam
Tetrazepam
Triazolam
(b) Such prescription shall be written with ink, indelible pencil, typewriter, or by other electronic means approved by the department, and shall be signed by the practitioner. Electronic prescriptions may be created, signed, and transmitted electronically provided the practitioner complies with all other requirements for issuing a prescription for a controlled substance in this Part and with Federal requirements for electronic prescribing of controlled substances. The prescription shall contain the following:
(1) name, sex, address and age of the ultimate user for whom the substance is intended, or, if the ultimate user is an animal, the species of such animal and the name and address of the owner or person in custody of such animal;
(2) the printed name, address, Drug Enforcement Administration registration number, telephone number, and handwritten signature of the prescribing practitioner. The printed name of the prescriber who has signed the prescription shall be imprinted or stamped legibly and conspicuously on the prescription, shall appear in an appropriate location on the prescription form and shall not be entered in or upon the space or line reserved for the prescriber's signature. The imprinted or stamped name shall not be a substitute for or fulfill any legal requirement otherwise mandating that the prescription be signed by the prescriber;
(3) specific directions for use, including, but not limited to the dosage and frequency of dosage and the maximum daily dosage;
(4) the date upon which such prescription was prepared and actually signed by the prescribing practitioner. A prescription shall be dated as of, and signed on, the date it is issued; and
(5) the quantity of dosage units prescribed on an official New York State prescription, the quantity of dosage units prescribed shall be indicated in both numerical and written word form.
(6) An electronic prescription shall contain the requirements as provided in paragraphs (1)-(5) of this subdivision except such prescription shall contain an electronic signature and shall be transmitted and received by electronic means. Such electronic signature shall meet the signature requirements set forth in paragraph (2) of this subdivision.
(7) A prescription generated on an electronic system and printed out or transmitted via facsimile is not an electronic prescription and shall be manually signed.
(8) A section wherein prescribers may indicate whether an individual is limited English proficient, as defined in section 6829 of the Education Law; and if the patient is limited English proficient, a specification of the preferred language indicated by the patient. Failure to include such indication on the part of the prescriber shall not invalidate the prescription.
(c) Except as provided for in subdivision (d) of this section, no such prescription shall be made for a quantity of substances which would exceed a 30-day supply if the substance were used in accordance with the directions for use, specified on the prescription. No additional prescriptions for a controlled substance may be issued by a practitioner to an ultimate user within 30 days of the date of any prescription previously issued unless and until the ultimate user has exhausted all but a seven days' supply of that controlled substance provided by any previously issued prescription.
(d)
(1) A practitioner may issue a prescription for up to a three-month supply of a controlled substance, including chorionic gonadotropin, or up to a six-month supply of an anabolic steroid if used in accordance with the directions for use, provided that the prescription has been issued for the treatment of:
(i) panic disorders, designated as code A;
(ii) attention deficit disorder, designated as code B;
(iii) chronic debilitating neurological conditions characterized as a movement disorder or exhibiting seizure, convulsive or spasm activity, designated as code C;
(iv) relief of pain in patients suffering from conditions or diseases known to be chronic or incurable, designated as code D;
(v) narcolepsy, designated as code E; or
(vi) hormone deficiency states in males, gynecologic conditions that are responsive to treatment with anabolic steroids or chorionic gonadotropin, metastatic breast cancer in women, anemia and angioedema, designated as code F.
(2) Such prescription shall specify the condition being treated on the face of the prescription. The practitioner issuing such prescription shall either:
(i) specify the name of such condition on the face of the prescription; or
(ii) specify a code on the prescription to denote the condition for which the prescription has been issued, in accordance with codes designated in paragraph (1) of this subdivision.
(3) Either the name of the condition or one of the designated codes shall fulfill the requirement in:
(i) section 3332(3) of the Public Health Law for the specific condition to be given on the face of the prescription; and
(ii) section 3333(1) of the Public Health Law for the statement that the controlled substance has been prescribed to treat one of the conditions that have been enumerated by the regulations of the commissioner as warranting the prescribing of greater than a 30 days' supply of a controlled substance.
(e) Such official New York State prescription or an out-of-state written prescription for a patient enrolled in a hospice program or for a patient residing in a residential health care facility (RHCF) may be transmitted by the practitioner, or a person authorized by the practitioner, to the dispensing pharmacy by facsimile, provided:
(1) the hospice program or RHCF is licensed or approved by the department;
(2) the dispensing pharmacy has a written agreement or contract with the hospice program or RHCF to dispense controlled substances to a patient of such program or facility;
(3) the practitioner shall note on the prescription that the patient is a "hospice patient" or "RHCF patient"; and
(4) within 72 hours, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or the original out-of-state written prescription. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(f) An official New York State prescription or an out-of-state written prescription for schedule II narcotic substance or for those controlled substances listed in subdivision (a) of this section to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion may be transmitted by the practitioner, or a person authorized by the practitioner, to the dispensing pharmacy by facsimile. Within 72 hours, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or the original out-of-state written prescription. If the pharmacist fails to receive such prescription, he/she shall notify the department in writing or electronically within seven days from the date of dispensing the substance.
(g) When an official New York State prescription or an out-of-state written prescription prepared by a practitioner is incomplete, the practitioner may orally furnish the missing information to the pharmacist and authorize him or her to enter such information on the prescription. The pharmacist shall write the date he or she received the oral authorization on the prescription and shall affix his or her signature. This procedure shall not apply to unsigned or undated prescriptions or where the name and/or quantity of the controlled substance is not specified or where the name of the ultimate user is missing. The pharmacist is not required to obtain authorization from the practitioner to enter the patient's address, sex or age if the pharmacist obtains this information through a good-faith effort.
(h) A practitioner may orally authorize a pharmacist to change information on an official New York State prescription or an out-of-state written prescription. This procedure shall not apply to the practitioner's signature, date the prescription was signed by the practitioner, drug name or name of the ultimate user. The pharmacist shall write the date he or she received the oral authorization on the prescription, the reason for the change and his or her signature. The pharmacist shall also indicate the change on the prescription and initial the change.
(i) When a pharmacist fills a prescription under subdivision (g) or (h) of this section, in a manner that would require the pharmacist to make a notation on the prescription if the prescription were written, the pharmacist shall make the same notation electronically when filling an electronic prescription and retain the annotation electronically in the prescription record.
(j) When a practitioner is notified that an electronic prescription was not successfully delivered, the practitioner shall indicate on any written or oral prescription issued as a replacement of the original electronic prescription that the prescription was originally transmitted electronically, to which pharmacy the prescription was originally transmitted, and that the original transmission failed.
(k) If the content of any of the information required by this Part for a prescription is altered during the transmission of an electronic prescription, the prescription is deemed to be invalid and the pharmacy may not dispense the controlled substance.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 157 YATES COUNTY
10 CRR-NY 157.2 Village of Rushville
See section 132.1, supra.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
BOTH BLUE CROSS PLANS—SUPPLEMENTAL DATA BOTH BLUE CROSS PLANS—SUPPLEMENTAL DATA
10 CRR-NY 446.36 Supplemental data for both upstate and downstate Blue Cross plans
(a) Computation of capital invested tn tangible assets at the beginning of the period.
(1) Applies to proprietary facilities only.
(2) Calculation of balance as of the beginning of the period:
(i) Total assets at the beginning of the period.
(ii) Subtract total liabilities at the beginning of the period.
(iii) Net capital of the facility at the beginning of the period.
(iv) Subtract intangible assets at the beginning of the period.
(v) Capital in tangible assets as at the beginning of the period.
(vi) Add accumulated depreciation on buildings and fixed equipment as at the beginning of the period.
(vii) Balance carried forward to next section.
(b) Return on capital invested in tangible assets.
(1) Applies to proprietary facilities only.
(2) Calculations by month:
(i) Take capital invested in tangible assets at beginning of the month.
(ii) Add capital investments during the month.
(iii) Subtract withdrawals or dividend distributions during the month.
(iv) Add or subtract one twelfth of the increase or decrease due to operations for the year.
(v) Add or subtract other (specify) items.
(vi) The result of the above is capital invested in tangible assets at the end of the month.
(3) Beginning balance for first month of the reporting period equals the results of the calculation in subdivision (a) of this section.
(4) Repeat above for each month of the reporting period.
(5) Average the capital invested in tangible assets at the end of each month.
(6) Increase or decrease due to operations must be reflected net of depreciation on buildings and fixed equipment.
(c) Physician costs.
(1) Amounts paid to physicians must be reported by cost center to which they are assigned.
(2) Applicable physician categories:
(i) Interns and residents;
(ii) Supervising physicians;
(iii) Hospital-based physicians.
(3) Costs to be reported for:
(i) Ancillary Services (accounts 7010-7910).
(ii) Daily Hospital Services (accounts 6010-6690).
(iii) Ambulatory Services (accounts 6710-6990).
(iv) Referred Ambulatory Services.
(v) Sold Services.
(vi) Nonreimbursable areas.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH EPIDEMIOLOGIST PUBLIC HEALTH EPIDEMIOLOGIST
10 CRR-NY 11.198 Supervisory level qualifications
A supervising local public health epidemiologist must meet the qualifications for a public health epidemiologist and have two additional years of experience conducting data collection, analysis and reporting in support of surveillance and epidemiologic investigations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-1 ACCESS TO RECORDS
10 CRR-NY 50-1.8 Trade secrets
Trade secrets regulated under article 48, Toxic Substances, of the Public Health Law are registered under, and subject to, Part 72 of this Title. Documents which contain trade secrets or are maintained for the regulation of commercial enterprise which, if disclosed, would cause substantial injury to the competitive position of an enterprise may be withheld from public disclosure.
(a) Requests of exceptions from disclosure shall:
(1) be in writing to the records access officer;
(2) be submitted at the time the trade secret information is submitted;
(3) include the name, address and telephone number of the manufacturer, producer, formulator, employer or person desiring to register a trade secret;
(4) include the name and title of an individual who may be contacted concerning the request;
(5) include the name or other identification of the trade secret; and
(6) state reasons why the information should be excepted from disclosure.
(b) Information submitted as a trade secret is excepted from disclosure until 15 days after a determination regarding entitlement status has been finally determined or, when entitlement to an exception from disclosure has been granted, until such entitlement has expired, or until such further time as ordered by a court of competent jurisdiction.
(c) Documents pending or granted trade secret status will be assigned a control number by the records access officer.
(d) Department units responsible for collecting trade secret information are responsible for determining trade secret entitlement and safeguarding the information during the review process and until trade secret entitlement no longer exists.
(e) Documents granted trade secret status or pending a trade secret status determination will be filed in envelopes with flaps, or other containers which will effectively maintain the integrity of the documents and which can be marked so as to clearly limit access to the contents. The container is to be marked with the following:
(1) “contains trade secrets”;
(2) the trade secret control number;
(3) bureau identification; and
(4) “access to or use of contents only with bureau director authorization.”
(f) Trade secrets are to be maintained apart from other documents in a locked file cabinet, locked desk drawer or other place secure from general access. Bureau directors assigned custody are responsible for establishing control of trade secret documents and establishing a system of limited access which identifies persons within the department for whose inspection and study the record will be made available so as to prevent intentional or unintentional disclosure of the information.
(g) On the initiative of the department at any time, or upon the request of any person for a record excepted from disclosure, the department will:
(1) inform the person who requested the exception of the department's intention to determine whether such exception should be granted or continued;
(2) permit the person who requested the exception, within 10 business days of receipt of notification from the department, to submit a written statement of the need for continuation of such exception;
(3) within seven business days of receipt of such written statement, or within seven business days of the expiration of the period prescribed for submission of such statement, issue a written determination granting, continuing or terminating such exception and stating the reasons therefor; copies of such determination shall be served upon the person, if any, requesting the record, the person who requested the exception, and the Committee on Open Government.
(h) A denial of exception from disclosure or a denial of access to excepted information may, within seven business days of receipt of written notice of the denial, be appealed to the records access appeals officer. The appeal determination shall be made within 10 business days of the receipt of the appeal. A written notice of the determination shall be served upon the person, if any, requesting access, the person who requested exception and the Committee on Open Government. The notice shall contain a statement of the reasons for the determination.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
UPSTATE BLUE CROSS SUPPLEMENTAL DATA UPSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.31 Lease schedule
(a) For each individual lease arrangement, please provide:
(1) Name of the leasing company.
(2) Description of equipment leased.
(3) Term (from-to) of lease agreement.
(4) Amount of the monthly lease payment.
(5) Total cost recorded on the cost report.
(b) The grand total of cost reported on the cost report should equal the amount reported for account 8825, Leases and Rentals—Movable Equipment.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.7 Definition of sanitization
Sanitization means effective bactericidal treatment by heat or chemical means, acceptable to the permit-issuing official, which destroys pathogens on surfaces treated.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.8 Accredited hospital
Payment for care in hospitals will be made only if the hospital possesses a valid operating certificate from the commissioner if it is located within the State or appears on the Joint Commission on Accreditation of Hospitals list of approved hospitals if it is located out-of-state.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-1 WIC PROGRAM—VIOLATIONS AND HEARINGS INVOLVING APPLICANTS, PARTICIPANTS, FOOD VENDORS AND LOCAL AGENCIES
10 CRR-NY 60-1.3 Conferences for applicants and participants
(a) Within seven days from the date a notice of denial of participation or disqualification is served, the aggrieved person may contact the local agency, either orally or in writing, to request a conference with a representative of the agency to discuss the determination or action of the agency, obtain an explanation of the reasons therefor, inspect any pertinent information in the agency's file and to present information to show that the agency's determination is incorrect.
(b) The local agency shall promptly, after receipt of a request for a conference, send the aggrieved person a notice containing the date, time and place of the conference and informing him/her that he/she may speak for himself/herself or be represented by an attorney, his/her parent or guardian, relative, friend or other spokesperson.
(c) The local agency shall conduct the conference at a date no later than 10 days after receipt of the request for a conference.
(d) If, as a result of a conference, the representative of the local agency finds that the information upon which the local agency based its determination or action is incorrect, or if for any other reason the representative decides that the determination or action is inappropriate, he/she may reverse or modify the local agency's determination. If, however, such representative finds that the determination or action of the agency is appropriate, such determination or action shall become effective as scheduled unless the aggrieved party requests a fair hearing from the department, whereupon the adverse action shall be stayed in appropriate cases until the fair hearing decision is rendered.
(e) The representative of the local agency shall make a decision at the conclusion of the conference and shall at that time inform the aggrieved person and the person's representative, if any, of the decision.
(f) The right to a conference shall not in any way affect the aggrieved person's right to a fair hearing.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
UPSTATE BLUE CROSS SUPPLEMENTAL DATA UPSTATE BLUE CROSS SUPPLEMENTAL DATA
10 CRR-NY 446.32 Statistical data
(a) Sick baby statistics.
(1) Specific statistics required:
(i) Sick baby patient days.
(ii) Sick baby discharges (excluding transfers).
(2) Program services for which statistics are to be reported:
(i) Newborn Nursery (account 6510).
(ii) Premature Nursery (account 6520).
(iii) Pediatric Acute Care (account 6170).
(iv) Pediatric Intensive Care (account 6350).
(v) Neo-Natal Intensive Care (account 6370).
(3) A sick baby is defined as a baby diagnosed sick or premature.
(b) Leave day statistics.
(1) Leave days are defined as days occurring after the admission and prior to the discharge of a hospital inpatient when the patient is not present at the census-taking hour.
(i) Patient is charged for the days he is on leave.
(ii) Bed is reserved for that patient.
(2) If the hospital has leave days, the following information is required:
(i) Were leave days included in the Standard Unit of Measure Statistics for Daily Hospital Services (accounts 6010-6690)?
(ii) If so, please detail where they were reported (refer to section 446.44 [b] of this Part for all program services for which this statistic must be reported).
(iii) If not, please detail how they should be reported (refer to section 446.44 [b] of this Part for all program services for which this statistic must be reported).
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 48 PALLIATIVE CARE CERTIFIED MEDICAL SCHOOLS AND RESIDENCY PROGRAMS
10 CRR-NY 48.20 Certification
(a) Any medical school which has submitted an application with documentation acceptable to the department and which has been determined by the commissioner or his or her designee to have met the definition of a palliative care certified medical school as set forth in section 48.10(b) of this Part shall be certified until such time as the medical school receives written notice of termination from the Commissioner of Health, who, in his/she sole discretion, may terminate when continuation of such certification no longer benefits public health or satisfies the definitional requirements. Medical schools are eligible during the period of certification to apply for grants for undergraduate medical education in palliative care within amounts appropriated for such purpose to enhance the study of palliative care, increase the opportunities for undergraduate medical education in palliative care and encourage the education of physicians in palliative care.
(b) Any residency program which has submitted an application with documentation acceptable to the department and which has been determined by the commissioner or his or her designee to have met the definition of a palliative care certified residency program as set forth in section 48.10(c) of this Part shall be certified until such time as the residency program receives written notice of termination from the Commissioner of Health, who, in his/she sole discretion, may terminate when continuation of such certification no longer benefits public health or satisfies the definitional requirements. Residency programs are eligible during the period of certification to apply for grants for graduate medical education in palliative care, within amounts appropriated for such purpose.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 154 WAYNE COUNTY
10 CRR-NY 154.1 Village of Lyons
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to the Junius ponds and to all watercourses tributary thereto or ultimately discharging into said ponds, these bodies of water being sources of the public water supply of the Village of Lyons, Wayne County, New York.
(b) Definitions.
(1) The term pond wherever used in this section is intended to mean and refer to all of the Junius ponds which serve as sources of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, stream, ditch, gutter or other channel of every kind, the waters of which when running whether continuously or occasionally eventually flow or may flow into the public water supply of the Village of Lyons.
(3) Wherever a linear distance of a structure or object from a pond or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a pond or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any pond or watercourse tributary to the public water supply of the Village of Lyons.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any pond or watercourse tributary to the public water supply of the Village of Lyons.
(3) No cesspool, pit or other receptacle of any kind used for temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at some suitable point off the watershed tributary to the public water supply of the Village of Lyons.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any pond or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any pond or any watercourse tributary to the public water supply of the Village of Lyons nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any pond or watercourse tributary to the public water supply of the Village of Lyons.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any pond or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any pond or watercourse within a distance of 200 feet from any pond or watercourse tributary to the public water supply of the Village of Lyons.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any pond or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any pond or watercourse nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any pond (or watercourse) nor be washed therein. The watering of animals or poultry in any pond of the public water supply of the Village of Lyons is prohibited; nor shall any such watering be allowed in any watercourse tributary to this supply. No watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any streams tributary to the public water supply of the Village of Lyons.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any pond or watercourse tributary to the public water supply of the Village of Lyons, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such pond or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any pond or watercourse tributary to the public water supply of the Village of Lyons.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any pond or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Lyons, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any pond or watercourse tributary to the public water supply of the village of Lyons and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any pond or watercourse tributary to the public water supply of the village of Lyons.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any pond or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any pond or watercourse without first having passed over or through such an extent of soil as to have peen properly purified and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any pond or watercourse tributary to the public water supply of the village of Lyons.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any pond or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such pond or watercourse without first [having] percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from pond or watercourse tributary to the public water supply of the village of Lyons.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the first pond immediately tributary to the intake.
(h) [Camps.]
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any pond or watercourse tributary to the public water supply of the village of Lyons.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any pond or from any watercourse tributary to the public water supply of the village of Lyons.
(j) [Inspections.]
The municipal board of the village of Lyons shall make regular and thorough inspections of the ponds, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said municipal board to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the municipal board to promptly notify the State Commissioner of Health of such violations. The municipal board shall report in writing annually, on the first of January, the results of the regular inspections made during the proceeding* year stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.5 Donor qualifications
(a) The reproductive tissue bank shall initially screen and periodically assess donors for conditions that may adversely affect the quality of reproductive tissue or impair the recipient's and/or the offspring's health. Reproductive tissue donor screening shall, except as provided in section 52-8.6(g) of this Subpart, be performed prior to the initial collection of reproductive tissue for clinical use, and shall include a physical examination, as well as an examination for indications of sexually transmissible diseases.
(b) A complete medical history, both individual and family, including first-degree and second-degree relatives, shall be obtained from each reproductive tissue donor prior to any collection of tissue for clinical use, and shall include, but not be limited to, incidence of the following:
(1) major malformations of complex cause that result in serious functional or cosmetic defects, including, but not limited to spina bifida or heart malformations;
(2) major genetic disorders, including:
(i) autosomal dominant or X-linked disorders for which age of onset extends beyond the age of the donor;
(ii) autosomal dominant disorders with reduced penetrance; and
(iii) autosomal recessive disorders;
(3) for semen donors, systemic disease which may affect the decision to use the semen;
(4) for semen donors, infectious skin disease that may create a risk of contamination of the semen;
(5) history of sexually transmissible disease, including herpes simplex virus type 2;
(6) more than one sexual partner within the last six months;
(7) previous exclusion from blood donation for reasons of infectious disease;
(8) receipt of a blood transfusion within the past year;
(9) for semen donors, known episodes of trichomoniasis in a sexual partner;
(10) history of an occupation with increased risk of radiation or chemical exposure, or known such exposure;
(11) known history of alcohol abuse;
(12) history of behavior or factors which place the donor at increased risk for human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitus C virus (HCV) infection, as determined by the United States Public Health Service (USPHS);
(13) all conditions listed in section 52-3.4(a) of this Part; and
(14) other conditions as determined by the reproductive tissue bank director, medical director and medical advisory committee.
(c) Except for those factors currently identified by the USPHS as posing an increased risk for HIV infection, the factors in subdivision (b) of this section need not necessarily exclude a donor, but the reproductive tissue bank medical director or the attending physician shall counsel the recipient about potential associated risks if such a donor's reproductive tissue is accepted. Persons with an HIV risk factor identified by the USPHS shall not be accepted as anonymous donors.
(d) Recipients' physicians shall be notified if a semen donor's age at the time of donation is older than 44 years. Recipient's physicians shall be notified if an oocyte donor's age at the time of donation is older than 34 years.
(e) Potential anonymous donors with a history of behavior or factors which place them at increased risk for HIV infection or other infectious diseases, pursuant to section 52-3.4(a)(8) of this Part, shall be excluded.
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.8 Procedures governing the correction or amendment of records
The correction or amendment of records shall be made in the following manner:
(a) Records to be corrected or amended shall be reasonably described and must be made in writing.
(b) The records access officer shall, within 30 business days after receipt of a request:
(1) make requested correction or amendment in whole or part and advise the individual that, upon request, parties to which such data has been disclosed will be advised if such data was disclosed in accordance with section 94.3(c) of the Public Officers Law;
(2) deny the request in writing. Such denial should:
(i) explain the reason for the denial;
(ii) set forth the right of appeal to the records access appeals officer; and
(iii) provide the name, title, business address and telephone number of the records access appeals officer.
Subchapter N PROFESSIONAL MEDICAL AND DENTAL SERVICES
Part 91 EXCESS LIABILITY INSURANCE POOL: PHYSICIANS AND DENTISTS
10 CRR-NY 91.4 Pool administration
(a) The Superintendent of Insurance and the Commissioner of Health shall establish and monitor the hospital excess liability pool consisting of funds made available from payments by or on behalf of general hospitals of a portion of general hospital inpatient rates and the amount allocated to charge payors determined in accordance with section 91.3(b) of this Part and from payments by general hospitals determined in accordance with subdivision (e) of this section to reflect the cost of excess malpractice insurance coverage or equivalent excess coverage and for malpractice premiums subsequent to July 1, 1991 including funds made available pursuant to statute (see Chapter 266 of the Laws of 1991 and any amendments thereto).
(b) The pool administrator(s) designated by the Superintendent of Insurance and the Commissioner of Health shall receive funds for the pool and purchase a policy or policies for excess malpractice insurance coverage or equivalent excess coverage for eligible physicians and dentists in accordance with this Part or reimburse the hospital where the hospital purchases equivalent excess coverage for eligible physicians or dentists participating in a voluntary attending physician (channeling) program. The pool administrator(s) shall be reimbursed for reasonable and necessary pool administration costs, as determined by the Superintendent of Insurance and Commissioner of Health, from pool funds including investment income of the pool.
(c)
(1) Prior to July 1, 1991, each of the major third-party payors (Medicaid and Insurance Law article 43 and Public Health Law article 44 corporations) shall contribute monthly to the hospital excess liability pool based on their proportionate share of the costs of excess malpractice insurance coverage or equivalent excess coverage as determined in accordance with this Part.
(2) On and after July 1, 1991, Insurance Law article 43 and Public Health Law article 44 corporations shall contribute monthly to the hospital excess liability pool based on their proportionate share of the costs of excess malpractice insurance coverage or equivalent excess coverage as determined in accordance with this Part.
(d) Upon consultation with the Commissioner of Health or his designee, the Superintendent of Insurance or his designee shall notify general hospitals of payments to be made to the hospital excess liability pool by general hospitals for the amount allocated to charge payors reflecting the cost of excess insurance coverage or equivalent excess coverage certified to general hospitals pursuant to section 91.3 of this Part. Each general hospital shall, subject to the approval of the Superintendent of Insurance, submit a check on the first of the month to the designated pool administrator for one-twelfth of the annual amount determined by the Superintendent of Insurance to be paid by the hospital, with the first payments to be submitted to the pool administrator no later than November 1, 1986; provided, however, that estimated payments of amounts due for patients discharged in a calendar month on or after October 1, 1991 must be made within 60 days of the end of each monthly unless payment of actual amounts due for such calendar months has been made within such 60-day period. The payments shall be based upon the general hospital's prior year costs, adjusted to actual cost upon determination of the amount allocated to charge payors in accordance with section 91.3 of this Part.
(e) The cost of excess insurance coverage or equivalent excess coverage for each of the periods commencing on or after January 1, 1988 certified to a general hospital in accordance with section 91.3(a) of this Part, including costs of administering the pool for such periods, shall be compared to amounts paid or due by or on behalf of such general hospital to the pool for each such period in accordance with subdivisions (c) and (d) of this section. For each such period, any remaining underpayment shall be paid by the general hospital to the pool and any overpayment shall be returned by the pool to the general hospital to be returned to each major third-party payor pursuant to subdivision (g) of this section. Payments to the pool shall be made in accordance with the schedule established by the pool administrator.
(1) Any insurer issuing policies of excess coverage whereby such insurer, notwithstanding any provisions of the insurance law, may return to the hospital excess liability pool, in whole or part, the moneys received from the hospital excess liability pool for specified policy periods, upon a certification to the insurer by the Superintendent of Insurance that such moneys will be derived from the surplus of the insurer.
(2) To the extent funds available to the hospital excess liability pool are insufficient to meet the costs of excess insurance coverage or equivalent excess coverage for coverage during the periods July 1, 1992 to June 30, 1993, and annual periods beginning July 1st, thereafter, allocated or reallocated to rates of payment applicable to State government agencies, each physician or dentist for whom a policy for excess insurance coverage or equivalent excess coverage is purchased for such period shall be responsible for payment to the provider of excess coverage of an allocable share of such insufficiency, based on the ratio of the total cost of such coverage for such physician to the sum of the total cost of such coverage for all physicians applied to such insufficiency.
(f) The Superintendent of Insurance and the Commissioner of Health shall conduct an annual audit of the receipt and distribution of pool funds.
(g) Any funds remaining in the pool after purchase of a policy or policies for excess insurance coverage or equivalent excess coverage shall be distributed proportionately to general hospitals on the basis of hospital contributions to the pool to be returned to each major third-party payor on the basis of its percentage of liability for the cost of excess insurance coverage or equivalent excess coverage.
(h) The pool shall be operated pursuant to a plan approved by the Superintendent of Insurance and the Commissioner of Health.
(i) If any hospital shall fail to timely submit checks in accordance with this section, the hospital shall have 30 days from date of receipt of notification to provide the required checks. Failure to submit the checks within this 30-day time period shall result in the withholding of 10 percent of the hospital's payments from all major third-party payors regulated pursuant to Subpart 86-1 of this Title until such time as the required checks are received by the pool administrator.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 100 ALBANY COUNTY
CITIES CITIES
10 CRR-NY 100.2 City of Watervliet
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on the Normanskill and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the city of Watervliet Albany County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Normanskill which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind the waters of which, when running whether continously or occasionally, eventually flow or may flow into the public water supply of the city of Watervliet.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the city of Watervliet.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the city of Watervliet.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles throughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be cause to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the city of Watervliet.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed sewage disposal plant approved by the State Department of Health, as required by law, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the city of Watervliet, nor shall any such matters be thrown, placed, led, discharged or allowed to escape beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the city of Watervliet.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the city of Watervliet is prohibited. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the city of Watervliet.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or within 25 feet of any watercourse tributary to the public water supply of the city of Watervliet, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has bee secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 25 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the city of Watervliet, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir nor within 100 feet of any watercourse tributary to the public water supply of the city of Watervliet, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet from any reservoir or within 25 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the city of Watervliet.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs.
(h) Labor camps.
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the city of Watervliet.
(j) Inspections.
The board of water commissioners of the city of Watervliet shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of water commissioners to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board of water commissioners shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.21 Allowable costs
(a) To be considered as allowable in determining reimbursement rates, costs must be actual, reasonable and properly chargeable to necessary patient care. Except as otherwise provided in this Part, or in accordance with specific determination by the commissioner, allowable costs shall be determined by the application of the principles of reimbursement developed for determining payments under the title XVIII (Medicare) program.
(b) Allowable costs shall not include costs for services that have not been approved by the commissioner.
(c) Allowable costs shall include a monetary value assigned to services provided under contract by religious orders and to services rendered by an owner and operator of a facility or an operator's relatives in accordance with section 86-4.27 of this Subpart.
(d) Allowable costs may not include amounts in excess of reasonable or maximum title XVIII (Medicare) costs or in excess of customary charges to the general public. This provision shall not apply to services furnished by public providers free of charge or at a nominal fee. Allowable costs shall not include any amount for bad debts.
(e) Allowable costs shall not include expenses or portions of expenses reported by individual facilities which are determined by the commissioner not to be reasonably related to the efficient production of service because of either the nature or amount of the particular item.
(f) Allowable costs shall not include costs which principally afford diversion, entertainment or amusement to facility owners, operators or employees.
(g) Allowable costs shall not include any interest charged or penalty imposed by governmental agencies or courts, or the costs of policies obtained solely to insure against the imposition of such penalties.
(h) Allowable costs shall not include the direct or indirect costs of advertising (except help-wanted ads), public relations and promotion. Reasonable direct and indirect costs of outreach services designed to attract patients in need of medical services shall be allowable.
(i) Allowable costs shall not include costs or contributions or other payments to political parties, candidates or organizations.
(j) Allowable costs shall include only that portion of the dues paid to any professional association which has been determined by the commissioner to be allocable to expenditures other than for public relations, advertising and political contributions.
(k) Allowable costs shall not include any element of cost determined by the commissioner to have been created by the sale of a facility.
(l) Allowable costs shall include the cost of services incurred by the facility's staff to provide offsite services to registered patients of the facility. Allowable costs shall not include the cost of offsite services provided to nonregistered patients or the cost of services provided through arrangements with other facilities. When the cost of such services cannot be established, income from such services shall be used to adjust allowable costs.
(m) Allowable costs shall include the cost of National Health Service Corps personnel, based upon the liability incurred by the facility for the report period, not actual expenditures for the personnel during the report period.
(n) Allowable costs shall not include the cost of ordered ambulatory services. When the cost of such services cannot be determined, income from the services may be used to adjust allowable costs.
(o) Allowable costs may include certain costs not normally covered under Medicare (title XVIII of the Social Security Act), including but not limited to the cost of dental services, patient transportation, prescription drugs, eyeglasses, prosthetic or orthotic devices, podiatry services.
(p) Allowable costs shall not include the costs of education services, including special classroom programs for preschool and school-age children unable to attend public schools, unless such services are medically necessary.
(q) Allowable costs shall include the costs of recreational services rendered in accordance with a physician's plan of treatment. The costs of recreational services that provide leisure activities shall not be allowable.
(r) Allowable costs shall not include costs related to inpatient services rendered by hospitals or services related to living accommodations in a residential treatment program.
(s) All research costs shall be excluded from allowable costs. Research shall include those studies and projects which have as their purpose the enlargement of general knowledge and understanding, are experimental in nature and hold no prospect of immediate benefit to the facility or its patients.
(t) The costs of educational activities for employees, less tuition paid or reimbursed by other than the facility and supporting tuition or related grants, shall be allowable, provided such activities are directly related to patient care services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
INCOME STATEMENTS INCOME STATEMENTS
10 CRR-NY 444.11 Operating revenue—ancillary services
[3213] The group of accounts (4010 - 4990) is used to report the gross revenues, measured in terms of the hospital's full established rates, earned from ancillary services. Ancillary services generally are those special services for which charges are customarily made in addition to daily hospital services charges, and include such services as laboratory, diagnostic radiology, surgery services, etc. Ancillary services are usually billed as separate items when the patient receives these services.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.4 Sources of water
All sources of water must be approved before use.
(a) The sources of all bulk or bottled drinking water located in New York State must be approved by the State. Sources of all bulk or bottled drinking water located outside New York State must be approved by the agency having jurisdiction.
(b) Sources shall, at a minimum, meet the following requirements:
(1) All sources shall be developed in conformity with up-to-date sanitary engineering practices as set forth in Rural Water Supply and Recommended Standards for Water Works.
(2) All sources shall be located, developed and protected so they are not subject to natural or artificial contamination.
(c) All spring sources shall, at a minimum, meet the following requirements:
(1) A watertight wall shall completely surround the spring, not less than 12 inches above the highest point of ground and extend down through the overburden to the water-bearing stratum. On rock, such walls shall be keyed and sealed with cement grout to the rock. The top of the wall shall be level to accommodate a cover.
(2) A tight-fitting, locked cover shall be installed on the top of the encircling wall. The cover shall be constructed so as to provide reliable protection against contamination by animals or humans.
(3) Where the spring is protected by a spring house, the building shall be vermin-proof and shall be kept locked.
(4) A ditch or berm shall be constructed and routinely maintained to divert surface drainage away from the spring.
(5) Spring water shall be collected only at the natural orifice of the spring or through a bore hole that is adjacent to the natural orifice. Spring water collected with the assistance of external force or through a bore hole, or through a spring head that is otherwise altered to protect the water source shall retain all the physical properties of and be of the same composition and quality as the water that flows naturally to the surface of the earth.
(d) All drilled wells shall, at a minimum, meet the following requirements:
(1) A watertight casing shall be installed to the depth necessary to prevent surface contamination and to seal contamination of undesirable strata. The casing shall be sealed by filling the annular opening between the casing and the earth with cement or cement-sand grout or other approved sealant, at least 1 ½ inches thick. This seal shall extend from ground surface to a point not less than six inches below ground water level.
(2) A permanent casing shall be installed to at least 12 inches above the pump house floor or concrete apron surface and at least 18 inches above final ground surface.
(3) Wells shall be located on sites not subjected to flooding or be provided with an earth berm surrounding the casing and terminating at an elevation at least two feet above the highest known flood elevation or have other suitable protection as determined by the State.
(4) Wells shall be equipped with an approved pitless adaptor unit installed at the joint where the discharge pipe passes through the well casing.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.9 Daybook registry
Each shared health facility shall maintain a central daybook registry which shall as a minimum record:
(a) the full name and Medical Assistance Program number of all patients requesting or receiving care or services at the facility;
(b) the chief complaint of each patient;
(c) the names of providers or purveyors whose services the patient requested and the names of all providers and purveyors to whom the patient was directed or assigned; and
(d) the name of the provider, practitioner or purveyor from whom the patient was referred.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.30 Residential health care facilities patient assessment for certified rates
(a) For the purpose of determining reimbursement rates effective January 1, 1986 and thereafter, for governmental payments, each residential health care facility shall, on an annual basis or more often as determined by the department pursuant to this Subpart, assess all patients to determine case mix intensity using the patient review criteria and standards promulgated and published by the department (patient review instrument [PRI] and instructions: patient review instrument) and specified in subdivision (i) of this section.
(b)
(1) The patient review form (PRI) shall be submitted according to a written schedule determined by the department. Such written schedule shall be established by the Commissioner of Health with notice to residential health care facilities. Extension of the time for filing may be granted upon application received prior to the due date of the patient review forms and only in circumstances where the residential health care facility establishes, by documentary evidence, that the patient review forms cannot be submitted by the due date for reasons beyond the control of the facility.
(2) Rate schedules shall not be certified by the Commissioner of Health unless residential health care facilities are in full compliance with the requirements of this section. Compliance with the assessment requirements of this section shall include, but not be limited to, the timely filing of properly certified patient review forms (PRI) which are complete and accurate. Failure of a residential health care facility to file the patient review form (PRI) pursuant to the written schedule established pursuant to this subdivision, shall subject the residential health care facility to the provisions of section 86-2.2(c) of this Subpart.
(c) The operator of a residential health care facility shall ensure:
(1) that the patient review form (PRI) is completed for all patients of the facility pursuant to subdivision (a) of this section;
(2) that the patient review form (PRI) is completed by a registered professional nurse who is qualified by experience and demonstrated competency in long-term care and who has successfully completed a training program in patient case mix assessment approved by the department to train individuals in the completion of the patient review form (PRI) for the purposes of establishing a facility's case mix financial reimbursement; and
(3) that the patient review form (PRI) is certified by the operator and the nurse assessor responsible for completion of the patient review form (PRI). (The form of the certification required shall be as prescribed in the report form provided by the department.)
(d) In order to maximize reliability and accuracy, a limited number of personnel for each residential health care facility may be responsible for completion of the patient review form (PRI) during each assessment period. The maximum number of personnel which may be responsible in each residential health care facility is as follows:
| Bed size of facility | Number of responsible assessors | | --- | --- | | Under 100 | Two | | 101 to 200 | Three | | 201 to 300 | Four | | 301 to 400 | Five | | 401+ | Five plus one additional assessor for each additional 100 beds or part thereof. |
(e)
(1) The department shall monitor and review each residential health care facility's performance of its patient assessment function as described in this section through the following activities which may include, but shall not be limited to:
(i) analysis of patient case mix profiles and statistical data;
(ii) review of information provided by the residential health care facility; and
(iii) on-site inspections.
(2) The purpose of the department's monitoring and review shall be to determine whether the residential health care facility is complying with the assessment requirements contained in this section.
(3) The patient review form (PRI) and any underlying books, records, and/or documentation which formed the basis for the completion of such form shall be subject to review by the department.
(4) The department shall acknowledge, in writing, receipt of the residential health care facilities patient review forms (PRI). In the event that any information or data that the facility has submitted is inaccurate or incorrect, the facility shall correct such information or data in the following manner: the facility shall submit to the department, within five days of receipt of the department's written acknowledgment provided for in this paragraph, such corrections on a form which meets the same certification requirements as the document being corrected. Once receipt of corrected data is acknowledged in writing by the department, a residential health care facility may not correct or amend the patient review form (PRI) or submit any additional information for the assessment period.
(5) The department, in order to ensure accuracy of the patient review form (PRI), may also conduct timely on-site observations and/or interviews of patients/residents and review of their medical records. When an additional on-site review is performed by the department as a result of controverted items found during the initial on-site review, the facility shall be afforded an on-site conference prior to the conclusion of such additional on-site review. Upon completion of a department on-site review pursuant to this subdivision, the department, in order to ensure accuracy of the patient review form (PRI), shall correct, where necessary, a residential health care facility's assessment of its patient case mix intensity. The department's on-site determination shall be considered final for purposes of assessing the residential health care facility's case mix intensity for that assessment period and notwithstanding section 186-2.14 of this Subpart, the residential health care facility may not correct or amend the patient review form (PRI) or submit any additional information after department reviewers have concluded the on-site review. The residential health care facility shall be notified in writing regarding the department determination of any controverted items.
(f)
(1) If the department determines pursuant to this section, that a residential health care facility is not performing its case mix intensity assessment function in a timely and/or accurate manner, as required by subdivision (b) of this section, the department shall, in writing:
(i) notify the residential health care facility;
(ii) require the residential health care facility to perform its patient case mix assessment function through written agreement with a person or entity approved by the department for the completion of the patient review form (PRI) for the purpose of establishing a residential health care facilities case mix reimbursement; and
(iii) any patient case mix assessment performed pursuant to subparagraph (ii) of this paragraph shall also be subject to department monitoring and review pursuant to this section.
(2) The department shall determine that a residential health care facility is not performing its case mix intensity assessment function in an accurate manner where there exists inaccuracies in its case mix assessment which results in a statistically significant modification of the residential health care facility's reimbursement.
(3) The cost of written agreements required by paragraph (1) of this subdivision shall not be considered an allowable cost for determining reimbursement rates pursuant to this Subpart.
(4) Certification. Operators of residential health care facilities completing the department's patient review form (PRI) through written agreement with a department approved nonresidential health care facility person or entity shall have such form certified by such person or entity in lieu of a residential health care facility registered professional nurse as required by paragraph (c)(2) of this section.
(g) Reconsiderations.
(1) Any residential health care facility after one year from the date it has been notified in writing by the department that it must enter into a written agreement pursuant to paragraph (f)(1) of this section, may request, in writing, that the department rescind its withdrawal of the residential health care facility's patient case mix assessment function.
(2) The department shall not rescind its withdrawal of a residential health care facility's patient case mix assessment function unless the residential health care facility satisfies the department that the residential health care facility has the capability to comply with the requirements of the department's patient case mix assessment process which shall include the capability to accurately complete the patient review form (PRI).
(3) The department shall give written notice of its decision and shall, if negative, give a statement of the reasons for its refusal to rescind its withdrawal of the residential health care facility's patient case mix assessment function.
(4) Any residential health care facility after six months from the date it receives a written department decision pursuant to paragraph (3) of this subdivision, may again request in writing that the department rescind its withdrawal of the residential health care facility's patient case mix assessment function.
(i) Forms.
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NEW YORK STATE DEPARTMENT OF HEALTH
DIVISION OF HEALTH CARE FINANCING
INSTRUCTIONS: PATIENT REVIEW INSTRUMENT (PRI)
GENERAL CONCEPTS
1. USING THESE INSTRUCTIONS: These instructions and the training manual should be read before completing the PRI. These instructions should be kept with the PRIs as they are being completed. FREQUENT REFERENCE TO THE INSTRUCTIONS WILL BE NEEDED TO COMPLETE THE PRI ACCURATELY.
2. ANSWER ALL QUESTIONS: Answer all questions using the numeric codes provided. DO NOT LEAVE ANY QUESTIONS TOTALLY BLANK. UNUSED BOXES FOR A QUESTION SHOULD REMAIN BLANK. For example, Medical Record Number should be entered: /9/6/2/1/0/. If there are unused boxes, they should be on the left side of the number as shown in the example.
3. QUALIFIERS: Many of the PRI questions contain multiple criteria which are labeled qualifiers. All qualifiers must be met for a question to be answered yes. These qualifiers take the following forms:
• TIME PERIOD —The time period for the questions is the past four weeks, unless stated otherwise. For patients who have been in the facility less than four weeks (that is, new admissions or readmissions), use the time for admission to PRI completion as the time frame.
• FREQUENCY —The frequency specifies how often something needs to occur to meet the qualifier. For example, respiratory care needs to occur daily for four weeks or the PRI cannot be checked for this patient as receiving this care.
• DOCUMENTATION —Some of the questions require specific medical record documentation to be present. Otherwise, the question cannot be answered “yes” for the patient.
• EXCLUSIONS— Some of the questions specifically state to omit certain types of care or behavior when answering the question. For example, inhalators are excluded from respiratory care.
4. ACTIVITIES OF DAILY LIVING: The approach to measuring ADLs is slightly different from the other PRI questions. Measure the ADLs according to how the activity was completed 60 percent or more of the time during the past four weeks. Read the specific instructions for ADLs to understand the CHANGED CONDITION RULE and other details. PERFORMANCE: Measure what the patient does, rather than what the patient might be capable of doing.
5. CORRECTIONS: Cross out any responses which you wish to change and reenter clearly to the right of the original response. Example: /3/4.
6. Use pen, not pencil.
INSTRUCTIONS: PRI QUESTIONS
I. ADMINISTRATIVE DATA
1. OPERATING CERTIFICATE NUMBER: Enter the 8 character identifier (7 numbers followed by the letter “N”) stated on the facility's operating certificate. The last character “N” indicates Nursing Facility.
2. SOCIAL SECURITY NUMBER: Your PRIs cannot be processed unless this question is accurately entered. Do not leave this question blank, do not enter zero if there is no social security number. Only use the Social Security number that has been specifically designated for the patient and not the spouse of the patient. Only use the number that has been assigned by the federal Social Security Administration. If there is no such number for a patient, a NEW SYSTEM has been developed to enable all facilities in the State to assign a unique ID number to those patients without a Social Security number. If a patient was assigned a computer generated number by the Department, that number should no longer be used. If the patient has no Social Security number, use this method: Enter the first three (3) letters of the patient's last name (starting to the far left), and then enter the six digits of the patient's date of birth. Omit the century in the birthdate, which will be either a “19” or “18” as in 1930 or 1896. As an example, if a patient named Cheryl Brant has no social security number and was born on May 8, 1913, you would enter: /B/R/A/0/5/0/8/1/3 on the PRI.
3. RESIDENT IS LOCATED: Former HRF Area or Former SNF Area. This question has been revised to reflect the Omnibus Budget Reconciliation Act of 1987 (OBRA '87). It is imperative that nursing facilities formerly deemed “dual level” complete this section properly.
4. PATIENT NAME: Enter the patient's name, last name first, in the boxes provided. Enter up to the first 10 letters of the patient's last name.
6. MEDICAL RECORD NUMBER: Enter the unique number assigned by the facility to identify each patient. It is not the Medicaid, Medicare or Social Security number unless that is the number used by the facility to identify each of its patients.
7. ROOM NUMBER: Enter the numbers and/or letters which identify the patient's room in the facility.
8. UNIT NUMBER: Enter the one or the two digit number (01-12) assigned by your facility to each nursing unit for the purpose of this data collection.
11. DATE OF INITIAL ADMISSION: Enter the month, day and year the patient (1) entered the present nursing facility. Use the date of the patient's first admission and not the most recent. If the patient were transferred from another facility, it would be an initial admission to your facility. As another example, consider a patient that was admitted to a hospital from your facility and subsequently loses bed hold. If this patient is eventually readmitted to your facility at the original level of care, use the original admission date to complete this item.
12. MEDICAID NUMBER: Enter these numbers if patient has the coverage available, whether
13. MEDICARE NUMBER: or not the coverage is being used. If not, enter only one zero in the far right box.
14. PRIMARY PAYOR: Enter the one source of coverage which pays for most of the patient's current nursing home stay. Code “Other” only if the primary payor is not Medicaid or Medicare. (Do not code “Other” for a patient with Medicaid coverage supplemented by Medicare Part B Code Medicaid.) Medicaid pending is to be coded as “Medicaid”, if there is no other primary coverage being used for the patient's present stay.
15A. REASON FOR PRI COMPLETION: Select the one reason why the PRI is being completed. Responses 3, 4, and 5 under Utilization Review have been eliminated.
REIMBURSEMENT ASSESSMENT CYCLE:
Indicate whether this assessment is being completed as a part of a full facility assessment or as part of a quality assessment cycle for new admissions only.
1. Biannual Full Facility Cycle—The data collection during which all the patients residing in the facility are assessed. These PRI assessments include patients who were assessed during your previous PRI data collection and any new admissions.
2. Quarterly New Admission Cycle—The “new admission only data collection,” involving only patients who were not assessed at their present level of care during your previous full facility data collection are reviewed. This specific PRI data collection occurs three months after your full facility PRI data collection. A new admission may be a new patient from the hospital, community or another nursing facility; or was hospitalized during your previous full facility assessment (regardless of bedhold).
15B. WAS A PRI SUBMITTED BY YOUR FACILITY FOR THIS PATIENT DURING A PREVIOUS FULL FACILITY AND/OR NEW ADMIT CYCLE: Review your facility's records to determine whether a PRI for reimbursement purposes was ever completed for this patient.
II. MEDICAL EVENTS
16. DECUBITUS LEVEL: Enter the level of skin breakdown (located at pressure points) using the qualifiers stated below:
| Documentation - | For a patient to be cited as level 4, documentation by a licensed clinician must exist which describes the following three components: | | --- | --- | | | • A description of the patient's decubitus. | | | • Circumstance or medical condition which led to the decubitus. | | | • An active treatment plan. | | Definition | | | LEVELS: | #0 No reddened skin or breakdown. | | | #1 Reddened skin, potential breakdown. | | | #2 Blushed skin, dusty colored, superficial layer of broken or blistered skin. | | | #3 Subcutaneous skin is broken down. | | | #4 Necrotic breakdown of skin and subcutaneous tissue which may involve muscle, fascia and bone. | | | #5 Patient is at level 4, but the documentation qualifier has not been met. |
17. MEDICAL CONDITIONS: For a “YES” to be answered for any of these conditions, all of the following qualifiers must be met:
| Time Period - | Condition must have existed during the past four weeks. (The only exception is to use the past twelve weeks for question 17H, urinary tract infection.) | | --- | --- | | Documentation - | Written support exists that the patient has the condition. | | Definitions - | See chart below. (Examples are for clarification and are not intended to be all- inclusive.) |
| DEFINITION | EXAMPLES OF CAUSES | EXAMPLES OF TREATMENTS | | --- | --- | --- | | | | | | 17A. COMATOSE: Unconscious, cannot be aroused, and at most can respond only to powerful stimuli. The coma must be present for at least four days. | Brain insult Hepatic encephalopathy Cerebral vascular accident | Total ADL Care Intake & output Parenteral feeding | | | | | | 17B. DEHYDRATION: Excessive loss of body fluids requiring immediate medical treatment and ADL care. | Fever Acute urinary tract infections Pneumonia Vomiting Unstable diabetes | Intake & output Electrolyte lab tests Parenteral hydration Nasal feedings | | | | | | 17C. INTERNAL BLEEDING: Blood loss stemming from a subacute or chronic condition ( e.g., gastrointestinal, respiratory or genito-urinary conditions) which may result in low blood pressure and hemoglobin, pallor, dizziness, fatigue, rapid respiration. | Use only the causes presented in the definition. Exclude external hemorrhoids and other minor blood loss which is not dangerous and requires only minor intervention | Critical monitoring of vital signs Transfusion Use of blood pressure elevators Plasma expanders Blood likely to be needed every 60 days | | | | | | 17D. STASIS ULCER: Open lesion, usually in lower extremities, caused by decreased blood flow from chronic venous insufficiency. | Severe edema Diabetes PVD | Sterile dressing Compresses Whirlpool Leg elevation | | | | | | 17E. TERMINALLY ILL: Professional prognosis (judgment) is that patient is rapidly deteriorating and will likely die within three months. | End stages of: Carcinoma, Renal disease, and Cardiac diseases | ADL Care Social/emotional support | | | | | | 17F. CONTRACTURES: Shortening and tightening of ligaments and muscles resulting in loss of joint movement. Determine whether range of motion loss is actually due to spasticity, paralysis or joint pain. It is important to observe the patient to confirm whether a contracture exists and check the chart for confirmatory documentation. | | | | To qualify as "YES" on the PRI the following qualifiers must be met: | | | | 1. The contracture must be documented by a physician, physical therapist or occupational therapist. | | | | 2. The status of the contracture must be reevaluated and documented by the physician, physical therapist or occupational therapist on an annual basis. | | | | There does not need to be an active treatment plan to enter "YES" to contractures. | | | | | | | | 17G. DIABETES MELLITUS: A metabolic disorder in which the ability to oxidize carbohydrates is compromised due to inadequate pancreatic activity resulting in disturbance of normal insulin production. This may or may not be the primary problem (Q. 29) or primary diagnosis. It should be diagnosed by a physician. Include any degree of diabetes, stable or unstable, and any manner it is controlled. | Destruction/malfunction of the pancreas Exclude hypoglycemia or hyperglycemia which may be a diabetic condition, but by itself does not constitute diabetes mellitus. | Special diet Oral agents Insulin Exercise | | | | | | 17H. URINARY TRACT INFECTION: During the past twelve weeks symptoms of a UTI have been exhibited or it has been diagnosed by lab tests. Symptoms may include frequent voiding, foul smelling urine, voiding small amounts cloudy urine, sediment and an elevated temperature. May or may not be the primary problem under Q. 29. Include as a UTI if it has not been confirmed yet by lab tests, but the symptoms are present. Include patients who appear asymptomatic, but whose lab values are positive ( e.g., mentally confused or incontinent patients). | Exclude if symptoms are present, but the lab values are negative | Antibiotics Fluids | | | | | | 17I. HIV INFECTION SYMPTOMATIC: HIV (Human Immunodeficiency Virus) Infection, Symptomatic: Includes Acquired Immunodeficiency Syndrome (AIDS) and HIV related illnesses. The patient has been tested for HIV infection AND a positive finding is documented AND the patient has had symptoms, documented by a physician, nurse practitioner (in conformance with a written practice agreement with a physician), or physician assistant as related to the HIV infection. Symptoms include but are not limited to abnormal weight loss, respiratory abnormalities, anemia, persistent fever, fatigue and diarrhea. Symptoms need not have occurred in the past four weeks. Exclude patients who have tested positive for HIV infection and have not become symptomatic, and patients who have not received the results of the HIV test. | | | | | | | | 17J. ACCIDENT: An event resulting in serious bodily harm, such as a fracture, a laceration which requires closure, a second or third degree burn or an injury requiring admission to a hospital. | | | | | | | | To qualify as "YES" on the PRI the following qualifier must be met: | | | | | | | | 1. During the past six months serious bodily harm occurred as the result of one or more accidents. | | | | | | | | 17K. VENTILATOR DEPENDENT: A patient who has been admitted to a skilled nursing facility on a ventilator or has been ventilator dependent within five (5) days prior to admission to the skilled nursing facility. Patients who are in the process of being weaned off of ventilator support will qualify for this category for one month after extubation if they are receiving active respiratory rehabilitation services during that period. Patients in the facility who decompensate and require intubation also qualify for this category. | | |
All services shall be provided in accordance with sections 416.13, 711.5 and 713.21 of Chapter V of Title 10 of the Official Compilation of Codes, Rules and Regulations of the State of New York.
18. MEDICAL TREATMENTS: For a "YES" to be answered for any of these, the following qualifiers must be met:
| Time Period - | Treatment must have been given during the past four weeks in conformance with the frequency requirements cited below and still be required. For medical treatments having a daily frequency requirement, treatment must be provided every day of the four week period, except for residents newly admitted during the period. For residents newly admitted during the four week period, treatments required daily must have been provided each day from admission to the end of the four week period and documentation must support the seriousness of the condition and the probability that treatment will continue for at least four weeks. | | --- | --- | | | | | Frequency - | As specified in the chart below. (The only exception is to use the past twelve weeks for question 18L, catheter.) | | | | | Documentation - | Physician order, nurse practitioner order (in conformance with a written practice agreement with a physician), or appropriately cosigned physician assistant order specifies that treatment should be given and includes frequency as cited below, where appropriate. | | | | | Exclusions - | See chart below. |
| DEFINITION | SPECIFIC FREQUENCY | EXCLUSIONS | | --- | --- | --- | | | | | | | | | | 18A. TRACHEOSTOMY CARE: Care for a tracheostomy, including suctioning. Exclude any self-care patients who do not need daily staff help. | Daily | Self-care patients | | | | | | 18B. SUCTIONING: Nasal or oral techniques for clearing away fluid or secretions. May be for a respiratory problem. | Daily | Any tracheostomy Suctioning | | | | | | 18C. OXYGEN THERAPY: Administration of oxygen by nasal catheter, mask (nasal or oronasal), funnel/cone, or oxygen tent for conditions resulting from oxygen deficiency ( e.g., cardiopulmonary condition). | Daily | Inhalators Oxygen in room, but not in use | | | | | | 18D. RESPIRATORY CARE: Care for any portion of the respiratory tract, especially the lungs (for example COPD, pneumonia). This care may include one or more of the following: percussion or cupping, postural drainage, positive pressure machine, possibly oxygen to administer drugs, etc. | Daily | Suctioning | | | | | | 18E. NASAL GASTRIC FEEDING: Primary food intake is by a tube inserted into nasal passage; resorted to when it is the only route to the stomach. | None | None Gastrostomy not applicable | | | | | | 18F. PARENTERAL FEEDING: Intravenous or subcutaneous route for the administration of fluids used to maintain fluid, nutritional intake, electrolyte balance ( e.g., comatose, damaged stomach). | None | None Gastrostomy not applicable | | | | | | 18G. WOUND CARE: Subcutaneous lesion(s) resulting from surgery, trauma, or open cancerous ulcers. | Care has been provided or is professionally judged to be needed for at least 3 consecutive weeks | Decubiti Stasis ulcers Skin tears Feeding tubes | | | | | | 18H. CHEMOTHERAPY: Treatment of carcinoma through IV and/or oral chemical agents, as ordered by a physician, nurse practitioner (in conformance with a written practice agreement with a physician), or physician assistant when the physician assistant's order is appropriately cosigned. (Patient may have to go to a hospital for treatment.) | None | None | | | | | | 18I. TRANSFUSIONS: Introduction of whole blood or blood components directly into the blood stream. (Patients may have to go to a hospital for treatment.) | None | None | | | | | | 18J. DIALYSIS: The process of separating components, as in kidney dialysis ( e.g., renal failures, leukemia, blood dyscrasia). Patient may have to go to a hospital for treatment. | None | None | | | | | | 18K. BOWEL AND/OR BLADDER REHABILITATION: The goal of this treatment to gain or regain optimal bowel and/or bladder function and to reestablish a pattern. It is much more than just a toileting schedule or a maintenance/conditioning program. Rather it is an intense treatment which is very specific and unique for each patient and is of short term duration ( i.e., usually not longer than six weeks). NOT all patients at level 5 under Toileting Q. 22 may be a "YES" with this question. The specific definition for bladder rehabilitation differs from bowel rehabilitation; refer below: | Very specific and unique for each patient | Maintenance toileting schedule Restorative toileting program but does not meet the treatment requirements specified in the definitions | | | | | | Bladder rehabilitation: Will generally include these step-by-step procedures which are closely monitored, evaluated and documented: (1) mental and physical assessment of the patient to determine training capacity; (2) a 24 hour flow sheet or chart documenting voiding progress; (3) possibly increased fluid intake during the daytime; (4) careful attention to skin care; (5) prevention of constipation; (6) in the beginning may be toileted 8 to 12 times per day with decreased frequency with progress. | | | | | | | | Bowel rehabilitation: A program to prevent chronic constipation/impaction. The plan will generally include: (1) assessment of past bowel movements, relevant medical problems, medication use; (2) a dietary regimen of increased fluids and bulk ( e.g., bran, fruits); (3) regular toileting for purposes of bowel evacuation; (4) use of glycerine suppositories or laxatives; (5) documentation on a worksheet or Kardex. | | Exclude a bowel maintenance program which controls bowel intinence by development of a routine bowel schedule | | | | | | 18L. CATHETER: During the past twelve weeks, an indwelling or external catheter has been needed. Indwelling catheter has been used for any duration during the past twelve weeks. The external catheter was used on a continuous basis (with proper removal and replacement during this period) for one or more days during the past twelve weeks. A physician order is required for an indwelling catheter; for an external catheter a physician order is not required. | | Exclude catheters used to empty the bladder once, secure a specimen or instill medication | | | | | | 18M. PHYSICAL RESTRAINTS: A physical device used to restrict resident movement. Physical restraints include belts, vests, cuffs, mitts, jackets, harnesses and geriatric chairs. | At least two continuous daytime hours for at least 14 days during the past four weeks. | Exclude all of following: • Medication use for the sole purpose of modifying residents behavior | | | | • Application only at night | | | | • Application for less than two continuous daytime hours for 14 days | | | | • Devices which residents can release/ remove such as, velcro seatbelts on wheelchairs | | | | • Residents who are bed bound | | | | • Side rails, locked doors/ gates, domes | | To Qualify as "YES" on the PRI the following qualifiers must be met: | | | | 1. The restraint must have been applied for at least two continuous daytime hours for at least 14 days during the past four weeks. Daytime includes the time from when the resident gets up in the morning to when the resident goes to bed at night. | | | | 2. An assessment of need for the physical restraint must be written by an M.D. or R.N. | | | | 3. The comprehensive care plan based on the assessment must include a written physician's order and specific nursing interventions regarding use of the physical restraint. | | | | NEW ADMISSIONS: If a patient is a new admission and will require the use of a physical restraint for at least two continuous daytime hours for at least 14 days as specified by the physician order, then enter "YES" on the PRI. | | |
III. ACTIVITIES OF DAILY LIVING: EATING, MOBILITY, TRANSFER, TOILETING
Use the following qualifiers in answering each ADL question:
| Time Period - | Past four weeks. | | --- | --- | | Frequency - | Assess how the patient completed each ADL 60 percent or more of the time performed (since ADL status may fluctuate during the day or over the past four weeks). | | | CHANGED CONDITION RULE: When a patient's ADL has improved or deteriorated during the past four weeks and this course is unlikely to change, measure the ADL according to its status during the past seven days. | | Definitions - | SUPERVISION means verbal encouragement and observation, not physical hands- on care. | | | ASSISTANCE means physical hands-on care. | | | INTERMITTENT means that a staff person does not have to be present during the entire activity, nor does the help have to be on a one-to-one basis. | | | CONSTANT means one-to-one care that requires a staff person to be present during the entire activity. If the staff person is not present, the patient will not complete the activity. | | | Note how these terms are used together in the ADLs. For example, there is intermittent supervision and intermittent assistance. |
CLARIFICATION OF ADL RESPONSES
19. EATING:
#3 “Requires continual help. . .” means that the patient requires a staff person's continual presence and help for reasons such as: patient tends to choke, has a swallowing problem, is learning to feed self, or is quite confused and forgets to eat.
#5 “Tube or parenteral feeding. . .” means that all food and drink is given by nursing staff through the means specified.
20. MOBILITY:
#3 “Walks with constant supervision and/or assistance. . .” may be required if the patient cannot maintain balance, has a history of falls, has stress fracture potential, or is relearning to ambulate.
21. TRANSFER: Exclude transfers to bath or toilet.
#4 “Requires two people. . .” may be required for reasons such as: the patient is obese, has contractures, has fractures (or stress fracture potential), has attached equipment that makes transfer difficult (for example, tubes). There must be a logical medical reason why the patient needs the help of two people to transfer.
#5 “Bedfast. . .” may refer to a patient with acute dehydration, severe decubitus, or terminal illness.
22. TOILETING:
Definition - INCONTINENT - 60 percent or more of the time the patient loses control of his/her bladder or bowel functions, with or without equipment.
#1 “Continent. . . . Requires no or intermittent supervision” and #2 “. . . and/or assistance” can refer to the continent patient or the incontinent patient who needs no/little help with his/her toileting equipment (for example, catheter).
#3 “Continent. . . Requires constant supervision/total assistance. . .” refers to a patient who may not be able to balance him/herself and transfer, has contractures, has a fracture, is confused or is on a rehabilitation program. In addition this level refers to the patient who needs constant help with elimination/incontinence appliances (for example, colostomy, ileostomy).
#4 “Incontinent. . . Does not use a bathroom” refers to the patient who does not go to a toilet room, but instead may use a bedpan or continence pads. This patient may be bed bound or mentally confused to the extent that a scheduled toileting program is not beneficial.
#5 “Incontinent. . . Taken to a Bathroom. . .” refers to a patient who is on a formal toileting schedule, as documented in the medical record. This patient may be on a formal bowel and bladder rehabilitation program to regain or maintain control, or the toileting pattern is known and it is better psychologically and physically for the patient to be taken to the toilet (for example, to prevent decubiti).
A patient may have different levels of toileting capacity for bowel and bladder function. To determine the level of such a patient, note that level four and five refer to incontinence of either bladder or bowel. Thus if a patient receives the type of care described in one of these levels for either type of incontinence, enter that level.
Example 1: A patient needs constant assistance with a catheter (level 3) and is incontinent of bowel and is taken to the bathroom every four hours (level 5). In this instance, enter level 5 on the PRI because he is receiving the type of care described in this question for bowel incontinence.
Example 2: The patient requires intermittent supervision for bowel function (level 2) and is taken to the toilet every two hours as part of a bladder rehabilitation program. Enter level 5, as the patient is receiving this type of care for bladder incontinence.
IV. BEHAVIORS - VERBAL DISRUPTION; PHYSICAL AGGRESSION; DISRUPTIVE, INFANTILE/SOCIALLY INAPPROPRIATE BEHAVIOR; AND HALLUCINATIONS
The following qualifiers must be met:
| Time Period - | Past four weeks. | | --- | --- | | Frequency - | As stated in the responses to each behavioral question. | | Documentation - | To qualify a patient as LEVEL 4 or to qualify the patient as a “YES” to HALLUCINATIONS, the following conditions must be met: | | | • Active treatment plan for the behavioral problem must be in current use. | | | • Psychiatric assessment by a recognized professional with psychiatric training/ education must exist to support the fact that the patient has a severe behavioral problem. The problem addressed by this assessment must still be exhibited by the patient. | | Definitions - | The terms used on the PRI should be interpreted only as they are defined below: | | | • PATIENT'S BEHAVIOR: Measure it as displayed with the behavior modification and treatment plan in effect during the past four weeks. | | | • DISRUPTION: Through verbal outbursts and/or physical actions, the patient interferes with the staff and/or other patients. This interference causes the staff to stop or change what they are doing immediately to control the situation. Without this staff assistance, the disruption would persist or a problem would occur. | | | • NONDISRUPTION: Verbal outbursts and/or physical actions by the patient may be irritating, but do not create a need for immediate action by the staff. | | | • UNPREDICTABLE BEHAVIOR: The staff cannot predict when (that is, under what circumstances) the patient will exhibit the behavioral problem. There is no evident pattern. | | | • PREDICTABLE BEHAVIOR: Based on observations and experiences with the patient, the staff can discern when a patient will exhibit a behavioral problem and can plan appropriate responses in advance. The behavioral problem may occur during activities of daily living (for example, bathing), specific treatments (for example, contracture care, ambulation exercises), or when criticized, bumped into, etc. |
CLARIFICATION OF RESPONSES TO BEHAVIORAL QUESTIONS
23. VERBAL DISRUPTION: Exclude verbal outbursts/expressions/utterances which do not create disruption as defined by the PRI.
24. PHYSICAL AGGRESSION: Note that the definition states “with intent for injury.”
25. DISRUPTIVE, INFANTILE OR SOCIALLY INAPPROPRIATE BEHAVIOR: Note that the definition states this behavior is physical and creates disruption.
EXCLUDE the following behaviors:
• Verbal outbursts
• Social withdrawal
• Hoarding
• Paranoia
26. HALLUCINATIONS: For a “YES” response, the hallucinations must occur at least once per week during the past four weeks, in addition to meeting the other qualifiers noted above for an active treatment plan and psychiatric assessment.
V. SPECIALIZED SERVICES
27. PHYSICAL AND OCCUPATIONAL THERAPIES:
• For each therapy these three types of information will be entered on the PRI; “Level”, “Days” and “Time” (hours and minutes).
• For a patient not receiving a therapy at all, the “Level” will always be entered in the answer key as #1 (“does not receive”), the “Days” will be entered 0 (zero) and the “Time” will be 0 (zero).
• Use the chart on this page to understand the qualifiers for each of the three types of information that will be entered. Whether a patient is receiving maintenance or restorative therapy will make a difference in terms of the qualifiers to be used.
SEE CHART THAT FOLLOWS FOR THE SPECIFIC QUALIFIERS.
27.*LEVEL QUESTION:**QUALIFIERS (see level 4 below)
| QUALIFIERS FOR LEVEL | MAINTENANCE THERAPY = LEVEL 2 | RESTORATIVE THERAPY = LEVEL 3 | | --- | --- | --- | | DOCUMENTATION QUALIFIERS: POTENTIAL FOR INCREASED FUNCTIONAL/ADL ABILITY | None. Therapy is provided to maintain and/or retard deterioration of current functional /ADL status. Therapy plan of care and progress notes should support that patient has no potential for further or any significant improvement. | There is positive potential for improved functional status within a short and predictable period of time. Therapy plan of care and progress notes should support that patient has this potential/ is improving. | | PHYSICIAN ORDER, NURSE PRACTITIONER ORDER (IN CONFORMANCE WITH A WRITTEN PRACTICE AGREEMENT WITH A PHYSICIAN), OR APPROPRIATELY COSIGNED PHYSICIAN ASSISTANT ORDER | Yes | Yes, monthly | | PROGRAM DESIGN AND EVALUATION QUALIFIER | Licensed professional person with a 4 year, specialized therapy degree evaluates program on a monthly basis. | Licensed professional person with a 4 year, specialized therapy degree evaluates program on a monthly basis. | | TIME PERIOD QUALIFIER | Treatments have been provided during the past four weeks. | Treatments have been provided during the past four weeks. | | NEW ADMISSION QUALIFIER | Not Applicable | New admissions of less than four weeks can be marked for restorative therapy if: | | | | • There is a physician order, nurse practitioner order (in conformance with a written practice agreement with a physician), or appropriately cosigned physician assistant order for therapy and patient is receiving it. | | | | • The licensed therapist has documented in the care/plan that therapy is needed for at least four weeks. | | | | • A new admission includes readmission to a residential health care facility. |
27. DAYS AND TIME PER WEEK QUESTION: QUALIFIERS***
| QUALIFIERS FOR DAYS AND TIME*** | MAINTENANCE THERAPY ( i.e., level 2 or 4 under "Level" question) | RESTORATIVE THERAPY ( i.e., If level 3 or 4 under "Level" question) | | --- | --- | --- | | TYPE OF THERAPY SESSION | Count only one-to-one care. Exclude group sessions ( e.g., PT exercise session, OT cooking session). | Count only one-to-one care. Exclude group sessions ( e.g., PT exercise session, OT cooking session). | | SPECIALIZED PROFESSIONAL ON-SITE (ON- SITE MEANS WITHIN THE FACILITY) | A certified (2 year) or licensed (4 year) specialized professional is on-site supervising or providing therapy. | A licensed (4 year) specialized professional is on-site supervising or providing care. (Do not include care provided by PT or OT aides.) |
28. NUMBER OF PHYSICIAN VISITS: Enter “0” (zero) unless the patient need qualifiers stated below are met. If, and ONLY if, the patient meets all the patient need qualifiers, then enter the number of physician visits, nurse practitioner visits (in conformance with a written practice agreement with a physician), or physician assistant visits that meet the physician, nurse practitioner, or physician assistant visit qualifiers.
• PATIENT TYPE/NEED QUALIFIERS: The patient has a medical condition that (1) is unstable and changing or (2) is stable, but there is high risk of instability. If this patient is not closely monitored and treated by medical staff, an acute episode or severe deterioration can result. Documentation must support that the patient is of this type (for example, terminally ill, acute episode, recent hospitalization, post-operative).
• PHYSICIAN, NURSE PRACTITIONER, OR PHYSICIAN ASSISTANT VISIT QUALIFIER: If, and only if, the patient meets the PATIENT TYPE/NEED QUALIFIER, then enter the number of physician visits, nurse practitioner visits (in conformance with a written practice agreement with a physician), or physician assistant visits during the past four weeks that meet the following qualifications:
• A visit qualifies only if there is physician, nurse practitioner, or physician assistant documentation that she/he has personally examined the patient to address the pertinent medical problem. The physician, nurse practitioner, or physician assistant must make a notation or documentation in the medical record as to the result of the visit for the unstable medical condition ( e.g., change medications, renew treatment orders, nursing orders, order lab tests).
• Do not include phone calls as a visit nor visits which could have been accomplished over the phone.
• A visit qualifies whether it is on-site or off-site, as long as the patient is not an inpatient in a hospital/other facility.
29. MEDICATIONS
A. Monthly average number of all medications ordered: Enter the monthly average number of different medications for which physician orders were written over the course of the past six months. If the resident has been in the facility less than six months determine the monthly average number of medications ordered based on the number of months since admission. The average should include the total number of ordered medications whether or not they were administered: (PRN medications; injectables, ointments, creams, ophthalmics, short-term antibiotic regimens and over-the-counter medications, etc.)
B. Monthly average number of psychoactive medications ordered: Enter the monthly average number of psychoactive medications for which physician orders were written over the course of the past six months. If the resident has been in the facility less than six months, determine the monthly average of psychoactive medications ordered based on the number of months since admission. The average should include all ordered psychoactive medications whether or not they were actually administered.
A “psychoactive” medication is defined as a medication that is intended to affect mental and/or physical processes, namely to sedate, stimulate, or otherwise change mood, thinking or behavior.
The following are classes of psychoactive medications with several examples listed in each:
• Antidepressants -
Amitriptyline (Elavil); Imipramine (Tofranil); Doxepin (Sinequan); Tranylcpromine (Parnate); Phenelzine (Nardil)
• Anticholinergics -
Benztropine (Cogentin); Trihexyphenidyl (Artane)
• Antihistamines -
Diphenhydramine (Benadryl); Hydroxyzine (Atarax)
• Anxiolytics -
Chlordiazepoxide (Librium); Diazepam (Valium)
• Cerebral Stimulants -
Methylphenidate (Ritalin); Amphetamines (Benzedrine)
• Neuroleptics -
Phenothiazines; Thiothixene (Navane); Haloperidol (Haldol); Chlorpromezine (Thorazine); Thioridazine (Mellaril)
• Somnifacients -
Barbituates (Nembutal); Temazepam (Restoril); Glutethimide (Doriden); Flurazepam (Dalmane)
VI. DIAGNOSIS
30. PRIMARY MEDICAL PROBLEM: Follow the guidelines stated below when answering this question.
• NURSING TIME: The primary medical problem should be selected based on the condition that has created the most need for nursing time during the past four weeks. A review of the medical record for nursing and physician, nurse practitioner, or physician assistant notes during the past four weeks may be necessary.
• JUDGMENT: This decision may require the assessor to use her/his own professional judgment in deciding upon the primary problem.
• ICD-9: Refer to the ICD-9 Codes for Common Diagnoses attached at the end of these instructions for easy access to the most frequently used numbers. An ICD-9 code book containing the complete ICD-9 listing should be available in the nursing and/or medical records office of a facility.
• NO ICD-9 NUMBER: Enter “0” (zero) in the far right box if no ICD-9 number can be found for the patient's primary problem (or if the patient does not have a primary medical problem). If you cannot locate the ICD-9 code for the primary medical problem, PRINT THE NAME OF THE PRIMARY MEDICAL PROBLEM in the space provided on the PRI.
• NOTE: If the patient has AIDS or HIV related illnesses, indicate this in Section II, Medical Events, Item 17F. Do not use AIDS or HIV specific ICD codes (042044). Instead, use the code of the specific problem requiring the most caregiver time. For example, for all patients for whom viral pneumonia (NOS) is the condition requiring the most caregiver time, enter 480.9. Do not enter 042.1 for patients with HIV infection.
31. QUALIFIED ASSESSOR NUMBER: The qualified assessor who is attesting to the accuracy of the assessment must sign the completed form and enter the assessor Identification Number which was assigned at an approved N.Y.S. Department of Health Training Program.
Since the PRI is completed and submitted for the purposes of a reimbursement assessment cycle, the certified assessor must have actually completed the patient assessment, utilizing medical records and/or observations or interviews of the patient. This should be indicated by checking the YES box.
38. RACE/ETHNIC GROUP:
The following definitions are to be utilized in determining race and ethnic groups:
1. WHITE: A person having origins in any of the original peoples of Europe, North Africa or the Middle East.
2. WHITE/HISPANIC: A person who meets the definition of both White and Hispanic (See Hispanic below).
3. BLACK: A person having origins in any of the Black racial groups of Africa.
4. BLACK/HISPANIC: A person who meets the definition of both Black and Hispanic (see below).
5. ASIAN or PACIFIC ISLANDER: A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This includes, for example, China, Japan, Korea, the Philippine Islands and Samoa.
6. ASIAN or PACIFIC ISLAND/HISPANIC: A person who meets the definition of both Asian or Pacific Islander and Hispanic (see below).
7. AMERICAN INDIAN or ALASKAN NATIVE: A person having origins in any of the original peoples of North America and who maintains tribal affiliation or community recognition.
8. AMERICAN INDIAN or ALASKAN NATIVE/HISPANIC: A person who meets the definition of both American Indian or Alaskan Native and Hispanic (see below).
9. OTHER: Other groups not included in previous categories.
HISPANIC: A person of Puerto Rican, Mexican, Cuban, Dominican, Central or South American, or other Spanish Culture or origins.
(j) Residential health care facilities shall submit the data contained in the PRI using an electronic medium, including but not limited to magnetic computer tape, floppy disk or an electronic telecommunication system consistent with the technical specifications established by the department.
(1) The electronically produced data shall be accompanied by a certification statement executed by the operator or a person authorized to sign on the operator's behalf in a format provided or approved by the department.
(2) Facilities shall have an additional 10 days from the time specified pursuant to subdivision (b) of this section to file the required information.
(3) Adjustments to certified rates made pursuant to section 86-2.11 of this Subpart shall be certified by the Commissioner of Health within 90 days from the date upon which a facility's rate was last certified pursuant to this Subpart, or within 90 days from the latest scheduled PRI submission date pursuant to section 86-2.11 of this Subpart, whichever is later. Such 90-day time frames shall not apply in any instance where a facility has been notified that its submitted PRI data is inaccurate or incorrect pursuant to paragraph (e)(4) of this section until such data has been corrected to the satisfaction of the commissioner, or if an additional onsite review has been deemed necessary pursuant to paragraph (e)(5) of this section.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-4.93 Service of milk and milk products, dairy or nondairy creaming and whitening agents, condiments and ice; dispensing utensil use and storage
(a) Milk and milk products served to the consumer are to be in an unopened commercially filled package.
(b) Dairy and nondairy creaming or whitening agents are to be provided in an individual service container.
(c) Condiments, seasoning and dressings are to be provided in individual packages, from protected dispensers or containers or in the original container or pour-type dispenser. Sugar for consumer use is to be provided in individual packages or pour dispensers.
(d) Ice for consumer use is to be dispensed by using scoops, tongs or other ice-dispensing utensils or through automatic self-service dispensing equipment. Ice-dispensing utensils are to be stored on a clean surface or in the ice with the dispensing utensil handle extended out of the ice.
(e) Suitable dispensing utensils are to be used by employees. Between uses, the utensils are to be:
(1) stored in the food with the dispensing utensil handle extended out of the food; or
(2) stored clean and dry.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 57 CONDITIONS UNDER WHICH A DOG ACTIVELY IMMUNIZED AGAINST RABIES MAY BE AT LARGE IN DESIGNATED AREAS CERTIFIED FOR RABIES
10 CRR-NY 57.2 Privilege of vaccinated dogs to run at large in a designated area
The privilege of vaccinated dogs to run at large in a designated area shall not apply:
(a) to any dog until 21 days after rabies vaccination;
(b) to any dog after three years from its last vaccination against rabies with a three-year vaccine;
(c) to any dog which has been bitten by or has been in intimate contact with a rabid animal from the date of such bite or exposure until four months later, except that dogs vaccinated with a three-year vaccine within an interval of three weeks to three years prior to exposure shall be permitted to remain at large, providing a booster injection of a three-year vaccine is given within five days of exposure;***
(d) to any dog which has bitten a person until 10 days after such bite.***
Chapter III PUBLIC WATER SUPPLIES
Subchapter B MISCELLANEOUS
Part 158 INTERSTATE WATERS
10 CRR-NY 158.2 Hackensack and Pascack Rivers
L. 1893, ch. 661; L. 1899, ch. 251
(a) [Application.]
The following rules and regulations apply to all those portions of the Hackensack and Pascack rivers which are situated within the State of New York lying above the intake of the Hackensack Water Company, as well as to every spring, stream, ditch, gutter, drain or watercourse of any kind, the waters of which when running flow eventually into the Hackensack or Pascack rivers within the said State above such intake.
(b) Privies adjacent to ponds, lakes, reservoirs or watercourses.
(1) No privy, privy vault, pit or cesspool or any other receptacle of any kind used for the deposit, reception or storage of human excreta shall be constructed, located, placed or maintained with its nearest point within 50 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse of any kind the waters of which comprise or when running flow eventually into the Hackensack or Pascack rivers within the said State.
(2) Every privy, privy vault, pit or cesspool or other receptacle or place used for the deposit, reception or storage of human excreta which is constructed, located or maintained within 250 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind whose waters comprise or when running flow into the Hackensack or Pascack rivers within the said State and from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal as hereinafter provided shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(3) The excreta collected in the aforesaid removable receptacles shall be removed and the receptacles cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually and strictly prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal none of the contents shall be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified so that the least possible annoyance and inconveniences be caused to occupants of the premises or of adjacent premises.
(4) Unless otherwise specifically ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging into the soil in such place and manner as to effectually prevent them being washed over the surface of the ground by rain or melting snow and at distances not less than 250 feet, horizontal measurement, from the high-water mark of any lake, pond or reservoir or from the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind the waters of which comprise or when running flow into the Hackensack or Pascack rivers within the said State.
(5) Whenever it shall be found that, owing to the character of the soil or to the surface of the ground or owing to the height or flow of subsoil or surface water or through special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Department of Health, be washed over the surface of the ground or through the soil into any lake, pond or reservoir, spring, stream, ditch or gutter, drain or other watercourse the waters of which comprise or when running flow into the aforesaid Hackensack or Pascack rivers within the said State, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Department of Health.
(c) House slops, sink waste, laundry water, garbage, refuse, etc.
(1) No sewage, garbage, putrescible matter, house slops, bath water, kitchen or sink waste, refuse or waste water from creameries, cheese factories or laundries or water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed, nor any polluted water or liquid shall be thrown or discharged directly into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse comprising or flowing into the Hackensack or Pascack rivers within the said State, nor shall any such liquid or solid matter be thrown or discharged upon the surface of the ground or into the ground below the surface in any manner whereby the same may flow into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid within 100 feet, horizontal measurement, of the high-water mark of any lake, pond or reservoir or of the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or other watercourse aforesaid.
(2) No clothing, bedding, carpets, harness, vehicles, tanks, barrels, receptacles, utensils nor animals nor anything that pollutes water shall be washed or rinsed in, nor shall any person bathe in any lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse comprising or flowing into the Hackensack or Pascack rivers within the State of New York.
(d) Manures, composts, etc.
(1) No stable for cattle or horses, barnyard, hogyard, poultry yard, cattle pen, pigsty, henhouse, hitching place or standing place for horses or other animals and no manure pile, compost heap, piles of fermented or decayed fruit, apple pumice, cider mill waste, vegetables, roots, grains, leaves or other vegetable substances shall be located, placed or maintained or allowed to remain in such place or manner that the washing or draining therefrom may flow in open, blind or covered drains or channels of any kind into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse aforesaid without first having passed over or through such extent of soil as to have become properly purified and in no case shall the above-named sources or causes of pollution be so located or allowed to remain that their nearest point is less than 100 feet, horizontal measurement, from the high-water mark of any lake, pond, reservoir or the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind which comprises or when running flows into the Hackensack or Pascack rivers within the State of New York.
(2) No human excreta or compost containing human excreta shall be spread upon the ground within 250 feet, horizontal measurement, of the high-water mark of any lake, pond, or reservoir or the edge, margin or precipitous bank of any spring, stream, ditch, gutter, drain or watercourse of any kind whose waters comprise or when running flow into the Hackensack or Pascack rivers in the said State, and no manure or compost of any kind shall be spread or deposited upon the ground so as to be washed a less distance than 100 feet over the surface or through the soil before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, stream, ditch, gutter, drain or other watercourse.
(e) Dead animals, offal, manufacturing waste, etc.
(1) No dead animal, bird, fish nor any part thereof nor any offal or putrescible matter nor any polluted waters or refuse from any slaughterhouse, dairy, creamery, cheese factory, cider mill or other manufactory shall be thrown or allowed to run into any lake, pond, reservoir, spring, stream, ditch, gutter, drain or watercourse whose waters comprise or when running flow into the Hackensack or Pascack rivers in the said State, nor shall any such refuse or polluted material aforesaid be so deposited that any portion thereof or of the polluted drainage therefrom shall be washed over or through the soil a less distance than 100 feet before reaching the nearest point of any such aforesaid lake, pond, reservoir, spring, steam, ditch, gutter, drain or watercourse.
(2) No dead animals, bird, fish, fowl or reptile or any part thereof shall be buried in the ground within 250 feet of the high-water mark of any said aforesaid lake, pond or reservoir or the high-water mark or precipitous bank of any such aforesaid spring, stream or watercourse.
(3) No live sheep or other animals shall be washed in any lake, pond or reservoir or in any such aforesaid spring, stream or watercourse; neither shall any person swim, bathe or wash in any of said lakes, ponds or reservoirs, streams or watercourses.
(4) The waste liquids which may be polluted with putrescible or deleterious organic matter from any of the operations above indicated shall be all thoroughly filtered or otherwise properly purified before being allowed to escape into any lake, pond or reservoir or into any spring, stream or watercourse tributary thereto.
(f) Cemeteries.
No interment shall be made in any cemetery or other place of burial within 250 feet, horizontal measurement, of the high-water mark or precipitous bank of any lake, pond or reservoir or of any spring, stream or watercourse whose waters comprise or when running flow into the Hackensack or Pascack rivers within the aforesaid State.
(g) Penalty.
In accordance with section 70 of chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, the penalty for each and every violation of or noncompliance with any of the above rules and regulations is hereby fixed at $200.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-2 ACCESS TO OR CORRECTION/AMENDMENT OF RECORDS OF THE DEPARTMENT OF HEALTH SUBJECT TO THE PERSONAL PRIVACY PROTECTION LAW
10 CRR-NY 50-2.9 Appeals of denial of correction or amendment of records
(a) Any person who has been denied correction or amendment of records by the records access officer may appeal such denial in writing within 30 business days to the records access appeals officer.
(b) The time for deciding on an appeal by the records access appeals officer shall commence upon receipt of the written appeal, which shall identify:
(1) the date and location of request for records;
(2) the records to which the requestor was denied correction or amendment to and the requestor's justification for correction; and
(3) the name and return address of the requestor.
(c) The records access appeals officer shall, within 30 business days of the receipt of a written appeal, review the matter and affirm, modify or reverse the denial.
(d) If the records access appeals officer determines that the denial was erroneous, he/she shall instruct the records access officer to allow correction or amendment of the record as requested and notify appropriate parties, if requested, by the requestor.
(e) If the records access appeals officer affirms or modifies the denial, he/she shall communicate the reasons in writing by either first class mail or certified mail, return receipt requested, to the person making the appeal and inform such person of the right of judicial appeal. In addition, the records appeals officer will notify the requestor of right to file with the agency a statement of reasons for disagreement with the agency's determination. This agency will note any portions of the record which are disputed and attach requestor's statement as part of the record. Upon an individual's request, such statement will be provided to parties to which such data has been disclosed in accordance with section 94.3(c) of the Public Officers Law together, if appropriate, with a concise statement of the agency's reasons for not making the requested amendment.
(f) The records access appeals officer shall immediately forward to the Committee on Open Government a copy of such appeal and the determination thereon.
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.3 Ownership or controlling interest reporting requirements
(a) Except for a tissue bank owned and operated by a facility established pursuant to Public Health Law, article 28, any change in the direct or indirect ownership status of five percent or more or in a controlling interest in a tissue bank or nontransplant anatomic bank, shall be reported to the department on a new application within 30 days of the change. Such application shall be reviewed in accordance with section 52-2.5 of this Subpart. Any change in the direct or indirect ownership status or of a person with a controlling interest which requires Public Health Council approval pursuant to Public Health Law, article 28, shall be reported to the department within 30 days of the change.
(b) All changes in tissue bank director, medical director, nontransplant anatomic bank director, or tissue bank compliance officer shall be reported to the department in writing within five days of the change, and a new application reflecting all changes since the prior application must be submitted within 30 days of the change. Such application shall be reviewed in accordance with section 52-2.5 of this Subpart.
(c) If any person or corporation with an ownership or controlling interest in a tissue bank or nontransplant anatomic bank of five percent or more has been convicted of a criminal offense related to the operation of such a bank, a laboratory or of any programs established by title XVIII, XIX or XX of the Federal Social Security Act, such conviction shall be disclosed within 30 days of its occurrence. Conviction does not necessarily bar ownership; the department shall review the conviction under the requirements of the Public Health Law to determine whether the conviction may affect the ability of the bank to operate in compliance with Public Health Law, article 5, title V and article 43-B, and applicable State and Federal regulations regarding the operation of tissue banks.
(d) Ownership of or controlling interest in any other tissue bank, nontransplant anatomic bank, laboratory or health care facility holding a New York State or New York City license shall be disclosed within 30 days of any change in such status.
(e) Failure to comply with the reporting and application requirements of this section shall result in termination of the license.
Part 51 UNIFORM HEARING PROCEDURES
10 CRR-NY 51.14 Final determination and order
(a) After receipt of the hearing officer's report, the commissioner, or the appropriate board or council, shall make a final determination.
(b) The final determination shall be embodied in a written order which shall contain findings of fact and conclusions of law or reasons for the final determination.
(c) A copy of the order shall be served upon the parties.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
FOOD VENDING MACHINE CONSTRUCTION—INTERIOR FOOD VENDING MACHINE CONSTRUCTION—INTERIOR
10 CRR-NY 14-5.85 Equipment construction; in-place cleaning
Food vending machines intended for in-place cleaning are to be constructed so that:
(a) cleaning and sanitizing solutions can be circulated throughout a fixed system, using an effective cleaning and sanitizing regimen;
(b) cleaning and sanitizing solutions contact all interior food-contact surfaces; and
(c) the system is self-draining or can be completely evacuated.
Chapter V MEDICAL FACILITIES
Subchapter B HOSPITAL ESTABLISHMENT
Part 680 CENTRAL SERVICES FACILITY RURAL HEALTH NETWORKS
10 CRR-NY 680.7 Annual statement
(a) Each central services facility rural health network shall file annually with the council a statement identifying the members of the board of directors, the members and the officers of the corporation.
(b) If any change has occured in the members of the board of directors, the members or officers of the corporation, the corporation shall file, for evaluation by the department which shall report to the council, information and data with respect to:
(1) the character, experience, competency and standing in the community of each such new director or officer;
(2) the identity of each new member together with the certificate of incorporation and bylaws of each new corporate member; and
(3) such additional information or documentation as may be required
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-6 BOTTLED AND BULK WATER STANDARDS
10 CRR-NY 5-6.15 Bulk water
All bulk water sources and facilities must be approved and maintained for sanitary quality at all times.
(a) All sources of water for bulk water shipment must be approved by the New York State Health Department and must meet the source requirements outlined in section 5-6.4 of this Subpart and the treatment requirements outlined in section 5-6.5 of this Subpart.
(b) All water storage facilities must be maintained clean and sanitary at all times and must meet the requirements outlined in section 5-6.8 of this Subpart.
(c) Tank trucks, loading and unloading facilities and other equipment used to transport bulk water shall be maintained clean and sanitary at all times. Tanks previously used to transport toxic materials, petroleum products or other deleterious substances shall not be used to haul drinking water.
(d) Bulk transport and transfer procedures shall, at a minimum, meet the following requirements:
(1) Before filling, tank interior shall be cleaned, flushed with potable water, sanitized with not less than 100 ppm chlorine water solution for a contact period of not less than 20 minutes and rinsed with potable water.
(2) Tanks also used for the transport of dairy products must have the interior of the tank inspected with an ultraviolet lamp by the hauler each time water is to be transported. Tanks shall be rejected for use when odors or contaminants are found. The dome cover shall be closed immediately after inspection.
(3) All hoses, connections and fittings shall be sanitized with a concentrated solution of chlorine, 3 ounces of 5 ¼ percent household bleach to 2 gallons of water, by brushing solution on all exposed parts.
(4) The cover shall not be opened after sanitizing.
(5) Notwithstanding the above, the frequency of tank sanitization may be reduced, on approval by the State, based on satisfactory demonstration of sanitary handling for bulk tanks used solely for potable water transport.
(6) Tank trucks or tank trailers may be filled through the fitting on the inner dome cover when the tail pipe cannot be used.
(7) Water quality in the tank, after 20-30 gallons have been delivered into the tank, shall be checked as follows:
(i) stop filling;
(ii) have discharge valve opened;
(iii) inspect water as it discharges. If water has unpleasant odor and/or looks dirty, it shall be rejected for use; and
(iv) when these checks show satisfactory water quality, proceed to fill the tank.
(8) The dome cover shall be closed and sealed after filling to volume desired.
(9) The tank discharge valve cover shall be closed and sealed after filling.
(10) When a fill connection is used, it shall be constructed in a manner to prevent contamination and shall be capped at all times when not in use.
(e) The number and type of samples, frequency and points of sampling shall be in accordance with requirements outlined in section 5-6.11 of this Subpart or a program approved or directed by the State.
(f) Analysis of the samples must be performed for the plant by an approved laboratory as outlined in section 5-6.13 of this Subpart.
(g) Records shall, at a minimum:
(1) include the number of gallons delivered daily, cleansing and sanitizing methods used for tank truck and tank trailer interiors, risers, connections, hoses, etc;
(2) include date, time and location of delivery, concentration of solution, time of contact when applicable, and water quality analysis results as evidence of compliance with the sampling requirements of this Subpart; and
(3) be submitted on a monthly basis to the State.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 63 HIV/AIDS TESTING, REPORTING AND CONFIDENTIALITY OF HIV-RELATED INFORMATION
10 CRR-NY 63.10 Significant risk
(a) The three factors necessary to create a significant risk of contracting or transmitting HIV infection are:
(1) the presence of a significant risk body substance;
(2) a circumstance which constitutes significant risk for transmitting or contracting HIV infection; and
(3) the presence of an infectious source and another person.
(b) Significant risk body substances are blood, semen, vaginal secretions, breast milk, tissue and the following body fluids: cerebrospinal, amniotic, peritoneal, synovial, pericardial, and pleural.
(c) Circumstances which constitute “significant risk of transmitting or contracting HIV infection” are:
(1) sexual intercourse ( e.g., vaginal, anal, oral) which exposes another individual to blood, semen or vaginal secretions of an infected individual;
(2) sharing of needles and other paraphernalia used for preparing and injecting drugs between infected and other individuals;
(3) the gestation, birthing or breast feeding of an infant when the mother is infected with HIV;
(4) transfusion or transplantation of blood, organs, or other tissues from an infected individual to another, provided such blood, organs or other tissues have not tested conclusively for antibody or antigen and have not been rendered noninfective by heat or chemical treatment;
(5) other circumstances not identified in paragraphs (1) through (4) of this subdivision during which a significant risk body substance (other than breast milk) of an infected individual contacts mucous membranes ( e.g., eyes, nose, mouth), nonintact skin ( e.g., open wound, skin with a dermatitis condition, abraded areas) or the vascular system of another person. Such circumstances include, but are not limited to needlestick or puncture wound injuries and direct saturation or permeation of these body surfaces by the infectious body substance.
(d) Circumstances that involve “significant risk” shall not include:
(1) exposure to urine, feces, sputum, nasal secretions, saliva, sweat, tears or vomitus that does not contain blood that is visible to the naked eye;
(2) human bites where there is no direct blood to blood, or blood to mucous membrane contact;
(3) exposure of intact skin to blood or any other body substance; or
(4) occupational settings where individuals use scientifically accepted barrier techniques and preventive practices in circumstances which would otherwise pose a significant risk and such barriers are not breached and remain intact.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 148 SULLIVAN COUNTY
COMPANIES COMPANIES
10 CRR-NY 148.37 Roscoe Water Company
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Wood Brook and all watercourses tributary thereto or ultimately discharging into said reservoir, these bodies of water being sources of the public water supply furnished by the Roscoe Water Company to the hamlets of Roscoe and Rockland and adjacent territory in Sullivan County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on Wood Brook which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel or permeable pipe or conduit of every kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow in the water supply furnished by the Roscoe Water Company.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the highwater mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 75 feet of any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 200 feet of any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(3) Every privy, privy vault, pit or other receptacle or place used for the temporary storage of human excreta which is constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision from which privy or other receptacle the excreta are not at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such a manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convient removal to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent their being washed over the surface of the ground by rain or melting snow and at distances from any reservoir or watercourse of not less than 300 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape in any manner either directly or indirectly into any reservoir or watercourse, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground within 500 feet of any reservoir or watercourse, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow into the ground beneath the surface, except into watertight receptacles, the contents of which shall be removed as provided by paragraph (4) of subdivision (c), within 200 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourses, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 175 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow, wade or swim in any reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogpen, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet of any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(3) No human excreta, compost or other matter containing the same shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the ground within 500 feet of any reservoir or watercourse, nor shall any such matters be dug or buried in the soil within a distance of 300 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or be allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(f) Dead animals, offal, manufacturing waste, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse, nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without first having percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 175 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoirs except by written permission and in strict compliance with the regulations to be adopted by the Roscoe Water Company, nor in any manner that may pollute the waters of this public water supply. All ice cutting shall be done under rigid inspection and supervision of the Roscoe Water Company.
(h) [Camps.]
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 250 feet from any reservoir or from any watercourse tributary to the public water supply furnished by the Roscoe Water Company.
(j) Inspections.
The Roscoe Water Company shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said Roscoe Water Company to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the Roscoe Water Company to promptly notify the State Commissioner of Health of such violations. The Roscoe Water Company shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.240 Paid-in capital
The total amount of cash, property and services contributed to a corporation by its stockholders and constituting a major balance sheet item. It may be reflected in a single account or divided between capital stock and additional paid-in capital accounts.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.11 System updating and incorporation by reference
(a) the following elements of the APG rate-setting system shall be updated no less frequently than annually:
(1) the listing of reimbursable APGs subject to this Subpart and the relative weight assigned to each such APG;
(2) the base rates;
(3) the applicable ICD-9 codes utilized in the APG software system;
(4) the applicable CPT-4/HCPCS codes utilized in the APG software system;
(5) the APG software system
(b) the Current Procedure Code, fourth edition (CPT-4) and the Healthcare Common Procedure Coding System (HCPCS) , published by the American Medical Association, and the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) , published by the United States Department of Health and Human Services, as described in this Subpart, are hereby incorporated by reference, with the same force and effect as if fully set forth herein. Copies of these documents are available for public inspection and copying at the office of Regulatory Reform, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, New York 12237. Copies of the CPT-4 and HCPCS are also available from the American Medical Association, order Department, P.O. Box 930876, Atlanta, Georgia 31193-0876. Copies of the ICD-9-CM are also available from the United States Government Printing office, P.O. Box 371954, Pittsburgh, Pennsylvania 15250-7954.
Subchapter B STATE AID AND FUNDING
Part 49 FUNDING FOR FAMILY PRACTICE RESIDENCY TRAINING PROGRAMS
10 CRR-NY 49.4 Utilization of funds
Funds received by a program may be used to pay the costs necessary to the conduct and operation of a program, including its expansion, provided that State funds allocated to a program shall not be used to pay capital construction costs taken into consideration in the determination and certification of rates by the commissioner pursuant to section 2807 of the Public Health Law.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 120 HERKIMER COUNTY
VILLAGES VILLAGES
10 CRR-NY 120.2 Village of Dolgeville
L. 1893, ch. 661; L. 1899, ch. 251; L. 1904 ch. 484; L. 1906, ch. 582]
(a) [Application.]
The following rules and regulations shall apply to Cold Brook and to the impounding and distributing reservoir of the Dolgeville water supply, supplying the public water supply of the village of Dolgeville, Herkimer County, N. Y., and to all watercourses entering or ultimately discharging into said streams or bodies of water.
(b) [Definitions.]
(1) The term reservoir whenever used in this section is intended to mean and comprise every natural or artificial reservoir, lake or pond which stores or detains water that enters or may enter the public water supply of the village of Dolgeville.
(2) The term watercourse wherever used in this section is intended to mean and comprise every spring, stream, ditch or gutter or other watercourse of any kind, the waters of which when running, whether constantly or occasionally, eventually flow or may flow into the public water supply of the village of Dolgeville.
(c) Privies adjacent to reservoirs or watercourses.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either temporary storage or the permanent deposit of human excreta shall be constructed, placed or maintained within 200 feet, horizontal measurement, of the high-water mark of any reservoir or within 100 feet, of the edge, margin or precipitous bank of any watercourse of the Dolgeville supply.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained with its nearest point within 300 feet, horizontal measurement, of the water line of any reservoir of the Dolgeville water supply or within 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply.
(3) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed or maintained within any mine or mine shaft, the drainage from which, either by gravity or by pumping, flows directly or indirectly into any reservoir or watercourse of the Dolgeville water supply.
(4) Every privy, privy vault, pit, cesspool or other receptacle or place used for the temporary storage of human excreta which is constructed, located or maintained within the aforesaid 300 feet, horizontal measurement, of the high-water mark of any reservoir or within the aforesaid 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply, from which privy or other receptacle the excreta are not at once removed automatically by means of suitable watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely airtight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(5) Every privy, privy vault, pit, cesspool or other receptacle used for the temporary or permanent storage of human excreta which is constructed, located or maintained within any mine or mine shaft, from which privy or receptacle the excreta are not at once removed automatically by means of watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, shall be arranged in such manner that all such excreta shall be received temporarily in suitable vessels or receptacles which shall at all times be maintained in an absolutely watertight condition and which will permit of convenient removal to some place of ultimate disposal as hereinafter set forth.
(6) The excreta collected in the aforesaid receptacles shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary in order to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(7) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid receptacles shall, when removed, be disposed of by burying in trenches or by thoroughly digging it into the soil in such place and manner as to effectually prevent them from being washed over the surface of the ground by rain or melting snow and at distances of not less than 500 feet, horizontal measurement, from the high-water mark of any reservoir or not less than 300 feet from the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply.
(8) Whenever it shall be found that, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, the excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal may, in the opinion of the State Commissioner of Health, be washed over the surface or through the soil into any reservoir or watercourse, then the said privy or receptacle for excreta or the said trench or place of disposal shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Department of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No sewage or excremental matter from any water closet, privy or cesspool shall be led, conducted or discharged by any pipe, drain or ditch into any reservoir or watercourse of the Dolgeville water supply, nor shall any such matter be placed, led, discharged or allowed to escape onto the surface of the ground or into the ground below the surface within 500 feet, horizontal measurement, from the high-water mark of any reservoir or within 300 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply.
(2) No garbage, putrescible matter, house slops, bath waters, kitchen or sink waste, refuse or waste waters from creameries, cheese factories, laundries nor water in which milk cans, utensils, clothes, bedding, carpets or harnesses have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse of the Dolgeville water supply. Nor shall any such liquid or solid refuse or waste be thrown or discharged upon the surface of any ground or into the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse of the Dolgeville water supply within 200 feet, horizontal measurement, of the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply.
(3) No clothing, bedding, carpets, harness, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse of the Dolgeville water supply.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse of the Dolgeville water supply, nor shall any animals or poultry be allowed to stand, wade or swim in said reservoir or watercourse nor be washed therein.
(2) No stable for cattle or horses, barnyard, hogpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile nor compost heap shall be located, placed, maintained or allowed to remain with its nearest point less than 500 feet, horizontal measurement, from high-water mark of any reservoir or less than 300 feet, horizontal measurement, from the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply, and none of the above named objects or sources of pollution shall be so located, placed, maintained or allowed to remain that the drainage, leachings or washings from the same may enter any reservoir or watercourse of the Dolgeville water supply without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 500 feet before entering any reservoir nor less than 300 feet before entering any watercourse of the Dolgeville water supply.
(3) No human excrement or compost containing human excrement shall be placed, piled or spread upon the ground or dug or buried in the soil within a distance of 500 feet from the high-water line of any reservoir nor within a distance of 500 feet from the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply, and no manure or compost of any kind shall be placed, piled or spread upon the ground, within 300 feet of the high-water line of any reservoir nor within 200 feet of the edge, margin or precipitous bank of any watercourse of the Dolgeville water supply.
(4) No decayed or fermented fruit or vegetables, cider mill waste, roots, grain or other vegetable refuse of any kind shall be located, placed, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse of the Dolgeville water supply without first having passed over or through such an extent of soil as to have become properly purified, and in no case shall it be deemed that proper purification has been secured, unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet before entering any reservoir or a distance of not less than 100 feet before entering any watercourse of the Dolgeville water supply.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal nor any refuse from any slaughterhouse nor any decomposable or putrescible refuse or waste matter of any kind shall be thrown, placed in or allowed to pass into any reservoir or watercourse of the Dolgeville water supply without the leachings or drainage from such dead animal, bird, fish, offal, slaughterhouse refuse or such decomposable or putrescible matter shall have first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 300 feet before entering any reservoir and not less than 200 feet before entering any watercourse of the Dolgeville water supply.
(g) Boating, fishing and the harvesting of ice.
(1) The harvesting of ice, skating, boating, fishing from boats, from rafts, from the shore and through the ice are hereby prohibited upon or in any and all of the reservoirs of the Dolgeville water supply.
(2) The board of health of the village of Dolgeville, when necessary to regulate or diminish the number of fish in any of the reservoirs or when in their opinion such privileges may be extended without endangering the purity of the water supply, are hereby authorized to permit boating or fishing or both, under explicit regulations and restrictions. Such permit, regulations and restrictions must first be approved in writing by the State Commissioner of Health.
(3) A violation or noncompliance with any of the restrictions or regulations under which such permit for boating or fishing is issued shall be construed as a violation or noncompliance with this subdivision of the rules and regulations.
(h) Penalty.
In accordance with section 70, chapter 661 of the Laws of 1893, as amended by chapter 251 of the Laws of 1899, chapter 484 of the Laws of 1904 and chapter 582 of the Laws of 1906, the penalty for each and every violation of or noncompliance with any of the above rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $200.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.8 Reporting of certain occupational exposures
Every employer who employs 100 or more persons shall file annually with the State Commissioner of Health a listing of those employees who, in the course of their employment, used, made, or were otherwise exposed to the chemicals and compounds listed in subdivision (a) of this section during the previous year. The listing of employees shall be on such forms as may be prescribed by the State Commissioner of Health.
(a) None.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 400 ALL FACILITIES—GENERAL REQUIREMENTS
10 CRR-NY 400.16 Determination of death
(a) An individual who has sustained either:
(1) irreversible cessation of circulatory and respiratory functions; or
(2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.
(b) A determination of death must be made in accordance with accepted medical standards.
(c) Death, as determined in accordance with paragraph (a)(2) of this section, shall be deemed to have occurred as of the time of the completion of the determination of death.
(d) Prior to the completion of a determination of death of an individual in accordance with paragraph (a)(2) of this section, the hospital shall make reasonable efforts to notify the individual's next of kin or other person closest to the individual that such determination will soon be completed.
(e) Each hospital shall establish and implement a written policy regarding determinations of death in accordance with paragraph (a)(2) of this section. Such policy shall include:
(1) a description of the tests to be employed in making the determination;
(2) a procedure for the notification of the individual's next of kin or other person closest to the individual in accordance with subdivision (d) of this section; and
(3) a procedure for the reasonable accommodation of the individual's religious or moral objection to the determination as expressed by the individual, or by the next of kin or other person closest to the individual.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-1 HEALTH CARE PRACTITIONER REFERRALS
10 CRR-NY 34-1.7 Exceptions from compensation arrangement prohibitions
The following shall not be considered to be compensation arrangements subject to Public Health Law, section 238-a(1)(a) or to section 34-1.3 of this Subpart:
(a) Rental of equipment.
Payments made by a lessee of equipment to the lessor of the equipment for the use of the equipment, if:
(1) the lease is set out in writing, signed by the parties, and specifies the equipment covered by the lease;
(2) the equipment rented or leased does not exceed that which is reasonable and necessary for the legitimate business purposes of the lease or rental and is used exclusively by the lessee when being used by the lessee;
(3) the lease provides for a term of rental or lease of at least one year;
(4) the rental charges over the term of the lease are set in advance, are consistent with fair market value, and are not determined in a manner that takes into account the volume or value of any referrals or other business generated between the parties; and
(5) the lease would be commercially reasonable even if no referrals were made between the parties.
(b) Bona fide employment relationships.
Any amount paid by an employer to a physician (or an immediate family member of such physician) who has a bona fide employment relationship with the employer for the provision of services, if:
(1) the employment is for identifiable services;
(2) the amount of the remuneration under the employment:
(i) is consistent with the fair market value of the services; and
(ii) is not determined in a manner that takes into account (directly or indirectly) the volume or value of any referrals by the referring physician; and
(3) the remuneration is provided pursuant to an agreement which would be commercially reasonable even if no referrals were made to the employer. Subparagraph (2)(ii) of this subdivision shall not prohibit the payment of remuneration in the form of a productivity bonus based on services performed personally by the physician (or an immediate family member of such physician).
(c) Personal service arrangements.
Remuneration from an entity under an arrangement if:
(1) the arrangement is set out in writing, signed by the parties, and specifies the services covered by the arrangement;
(2) the arrangement covers all of the services to be provided by the physician (or an immediate family member of such physician) to the entity;
(3) the aggregate services contracted for does not exceed those that are reasonable and necessary for the legitimate business purposes of the arrangement;
(4) the term of the arrangement is for at least one year;
(5) the compensation to be paid over the term for the arrangement is set in advance, does not exceed fair market value, and is not determined in a manner that takes into account the volume or value of any referrals or other business generated between the parties;
(6) the services to be performed under the arrangement do not involve the counselling or promotion or a business arrangement or other activity that violates any State or Federal law.
(d) Payments by a physician for items and services.
Payment made by a physician:
(1) to a laboratory in exchange for the provision of clinical laboratory services; or
(2) to an entity as compensation for other items or services if the items or services are furnished at a price that is consistent with fair market value.
(e) Remuneration consisting of any of the following:
(1) the forgiveness of amounts owed for inaccurate tests or procedures, mistakenly performed tests or procedures, or the correction of minor billing errors;
(2) the provision of items, devices, or supplies that do not have any generally accepted use in health care practices other than to, and are actually used solely to:
(i) collect, transport, process, or store specimens for the entity providing the item, device or supply; or
(ii) order or communicate the results of tests or procedures for such entity;
(3) a payment made by an insurer or a self-insured plan to a practitioner to satisfy a claim, submitted on a fee for service basis, for the furnishing of health services by that practitioner to an individual who is covered by a policy with the insurer or by the self-insured plan, if:
(i) the health services are not furnished, and the payment is not made, pursuant to a contract or other arrangement between the insurer or the plan and the practitioner;
(ii) the payment is made to the practitioner on behalf of the covered individual and would otherwise be made directly to such individual; and
(iii) the amount of the payment is set in advance, does not exceed fair market value, and is not determined in a manner that takes into account directly or indirectly the volume or value of any referrals.
(f) Payments for services furnished in an ambulatory surgical center or a chronic renal dialysis center facility issued an operating certificate pursuant to article 28 of the Public Health Law, if payment for those services is included in a rate that is substantially similar or equivalent to the ambulatory surgical center (ASC) rate reimbursable by the Medicare program pursuant to 42 CFR part 416 subpart E, or a rate substantially similar to the End Stage Renal Disease composite rate reimbursable by the Medicare program pursuant to 42 CFR part 413 subpart H, respectively.
(g) Payments for services provided by a hospice licensed pursuant to article 40 of the Public Health Law, if payment for those services is included in a rate that is substantially similar or equivalent to the per-diem hospice charge reimbursable by the Medicare program set forth in 42 CFR part 418 subpart G.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.38 Escrow funds
(a) A hospital shall submit annually to the State Department of Health a schedule detailing those amounts that it is required to fund in the reserve escrow account.
(b) The reserve escrow account shall be opened in a Federally insured commercial bank that agrees to the uniform custodial agreement of the State Department of Health.
(c) From the financial occupancy date, a hospital shall deposit monthly in a reserve escrow account one-twelfth of its annual required funding.
(d) A hospital shall establish a separate mortgage repayment escrow account and make deposits and withdrawals into and from the account as required by the mortgage and the mortgagee.
(e) A hospital shall invest excess funds in the reserve escrow account in a manner specifically approved by the State Department of Health. Copies of the records of all transactions shall be promptly submitted to the State Department of Health.
(f) The deposited reserves for replacements shall be available to provide purchase money for necessary material replacements of furnishings and/or equipment and major repairs of construction and equipment.
(g) To obtain the disbursement of reserve escrow account funds, other than in the case of imminent peril, a hospital shall submit in advance to the State Department of Health such documentation as may be necessary for its approval.
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.15 Calculation of trend factor
(a) The commissioner shall establish trend factors to project increases in allowable operating costs during the effective period of the reimbursement rate.
(b) To determine trend factors, the elements of facilities' costs shall be weighted based upon data for salaries, employee health and welfare expense, nonpayroll administrative and general expense, nonpayroll household and maintenance expense, and nonpayroll professional care expense. Each weight shall be adjusted by one or more price indices. Included among these indices are elements of the United States Department of Labor consumer and producer price indices and special indices developed by the commissioner for this purpose.
(c) The projected trend factors shall be updated on an annual basis, based upon then current and available data. The commissioner shall adjust subsequent trend factors based upon such update.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 125 MONROE COUNTY
VILLAGES VILLAGES
10 CRR-NY 125.2 Village of Churchville
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (the Public Health Law) as heretofore set forth shall apply to the Pathfinder Spring and to all the natural and artificial reservoirs used for the collection or storage of the flow from the Pathfinder Spring, which are tributary to or which serve as sources of the public water supply of the Village of Churchville, Monroe County, or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(b) Interpretation.
Wherever a linear distance of a structure or object from the spring or from a reservoir is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to spring or reservoir.
(c) Privies adjacent to any reservoir or spring.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 200 feet of any spring tributary to the public water supply of the Village of Churchville.
(2) No privy, privy vault, pit, cesspool or other receptacle used for the permanent deposit of human excreta shall be constructed, 1ocated, placed, maintained or allowed to remain within 150 feet of any reservoir or within 300 feet of any spring tributary to the public water supply of the Village of Churchville.
(3) Every privy, privy vault, pit or other receptacle of any kind or place, used for the temporary storage of human excreta, located between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distance prescribed by paragraph (2) of this subdivision, shall be arranged in such a manner that all such excreta shall be received in suitable watertight receptacles which shall at all times be disposed of as hereinafter set forth in paragraphs (4) and (5) of this subdivision.
(4) The excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleansed and deodorized as often as may be found necessary to maintain these receptacles or the privy or the place in which they are kept in a proper, sanitary condition and to effectually prevent any overflow upon the soil or upon foundation or floor of the privy or other place. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape in being transferred from the privy or place of temporary storage to the place of disposal hereinafter specified and that the contents, while being transferred, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to the occupants of the premises and the adjacent premises.
(5) Unless otherwise specifically ordered or permitted in writing by the State Commissioner of Health, the excreta collected in the aforesaid watertight receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth not less than 18 inches below the surface, in such place and manner as to effectually prevent the excreta being washed over the surface of the ground by rain or melting snow and at a distance of not less than 500 feet from any reservoir or spring tributary to the public water supply of the Village of Churchville.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into the reservoir or spring tributary to the public water supply of the Village of Churchville, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes, etc.
(1) No house slops, bath water, sewage or other excremental matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface except into watertight vessels or receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 150 feet of any reservoir or within 300 feet of any spring tributary to the public water supply of the Village of Churchville.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or spring nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface within a distance of 100 feet of any reservoir or within 200 feet of any spring tributary to the public water supply of the Village of Churchville.
(3) No clothing, bedding, carpet, harness, vehicle, receptacle, utensil nor anything that pollutes water shall be washed, rinsed or placed in the reservoir or any spring tributary to the public water supply of the Village of Churchville.
(e) Animals, manure, compost, etc.
(1) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from the reservoir or less than 200 feet from any spring tributary to the public water supply of the Village of Churchville, and none of the above named objects or sources of pollution shall be constructed, placed or allowed to remain where or in such manner that the drainings, leachings or washings therefrom may enter the reservoir or spring tributary to the public water supply of the Village of Churchville without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a less distance than 100 feet of any reservoir or 200 feet of any spring tributary to the public water supply of the Village of Churchville.
(2) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into the reservoir or spring tributary to the public water supply nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Village of Churchville, nor shall such human excreta or compost or other matter containing human excreta be buried in the soil at a less depth than 18 inches below the surface nor within the prohibited distance of 500 feet of the reservoir or spring tributary to the public water supply of the Village of Churchville, and no manure or compost of any kind shall be thrown, placed, piled or spread upon the ground within a distance of 100 feet of any reservoir or 200 feet of any spring tributary to the public water supply of the Village of Churchville.
(3) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or spring nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainings, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or spring without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet of any reservoir or spring tributary to the public water supply of the Village of Churchville.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or spring nor shall such material or refuse be so located that the drainings, leachings or washings therefrom may reach any reservoir or any spring tributary to the public water supply without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet of any reservoir or spring tributary to the public water supply of the Village of Churchville.
(g) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet of any reservoir or spring tributary to the public water supply of the Village of Churchville.
(h) Cemeteries.
No interment of a human body shall be made within 500 feet of any reservoir or spring tributary to the public water supply of the Village of Churchville.
(i) Inspections.
The board of trustees of the Village of Churchville or such other board, body or person as may be charged with the maintenance of the public water supply shall make or cause to be made regular and thorough inspections of the reservoir and spring tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations, and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the reservoir, the Pathfinder Spring and the area tributary thereto at the time of the last inspection.
(j) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 709 DETERMINATION OF PUBLIC NEED FOR MEDICAL FACILITY CONSTRUCTION
10 CRR-NY 709.5 Ambulatory surgery services
(a) This methodology will be utilized to evaluate certificate of need applications involving the construction or establishment of new ambulatory surgery centers or services or extension clinics of existing centers. It is the intent of the State Hospital Review and Planning Council that this methodology, when used in conjunction with the planning standards and criteria set forth in section 709.1(a) of this Part, become a statement of basic principles and planning/decisionmaking tools for guiding and directing the development of ambulatory surgery services and facilities throughout the State. This methodology is intended to promote the development of ambulatory surgery programs as a cost-effective alternative to inpatient surgery where appropriate. It is also intended that this methodology will provide potential applicants with sufficient flexibility to consider the unique characteristics of their prospective projects in determining need.
(b) Terms defined.
(1) Ambulatory surgery service, as set forth in section 755.1 of this Title, is a service organized to provide those surgical procedures which need to be performed for safety reasons in an operating room on anesthetized patients requiring a stay of less than 24 hours. A list of procedures appropriate for ambulatory surgery is set forth in section 86-4.40 of this Title. Ambulatory surgery services may be provided in a free-standing ambulatory surgery facility or a hospital-based ambulatory surgery facility. Ambulatory surgery facilities may be either single or multi-specialty.
(2) Hospital-based ambulatory surgery services, as set forth in section 405.20(d) of this Title, may be located at the same site as the hospital (on-site) or apart from the hospital (off- site).
(3) Free-standing ambulatory surgery services and facilities are certified to operate as diagnostic and treatment centers as set forth in section 600.8 of this Title.
(4) Extension clinic shall mean an extension clinic as defined in section 401.1 of this Title.
(c) Minimum requirements for ambulatory surgery services and facilities.
Applicants for free-standing ambulatory surgery services or applicants for hospital-based off-site ambulatory surgery facilities must meet the following minimum requirements:
(1) all facilities must meet the minimum operating standards of free-standing ambulatory surgery services under article 28 of the Public Health Law as set forth in Part 755 of this Title; and
(2) all facilities must meet the minimum construction standards of a diagnostic and treatment center under article 28 of the Public Health Law as set forth in section 715.16 of this Title.
(d) Determination of public need in certificate of need applications.
Factors to be considered in determining the public need for ambulatory surgery services and facilities shall include, but not be limited to, the following factors:
(1) written documentation that the proposed capacity of the ambulatory surgery service or facility will be utilized sufficiently to be financially feasible as demonstrated by a three-year analysis of projected costs and revenues associated with the program. Written documentation of financial feasibility shall also include, but not be limited to, an analysis of expected demand for ambulatory surgery services and an explanation of how current and expected patient referral and use patterns will make the project financially feasible;
(2) written documentation that the proposed service or facility will enhance access to services by patients, including members of medically underserved groups which have traditionally experienced difficulties in obtaining equal access to health service (for example, low income persons, racial and ethnic minorities, women and handicapped persons) and/or rural populations;
(3) written documentation that the facility’s hours of operation and admission policies will promote the availability of services to those in need of such services regardless of their ability to pay. This shall include, but not be limited to, a written policy to provide charity care and to promote access to services regardless of an individual's ability to pay. Charity care shall mean care provided at no charge or reduced charge for the services the facility is certified to provide to patients who are unable to pay full charges, are not eligible for covered benefits under title XVIII or XIX of the Social Security Act or are not covered by private insurance; and
(4) written documentation of the facility’s willingness and ability to safely serve ambulatory surgery patients including, but not limited to, such factors as control of infection, quality assessment and improvement, patient transfer, emergency care, credentialing and medical recordkeeping as set forth in Part 755 of this Title.
(e) Public need for a proposed facility shall be deemed to exist when review and consideration of evidence concerning each of the factors set forth in subdivision (d) of this section results in an affirmative finding.
(f) Determination of need for ambulatory surgery services in a health maintenance organization (HMO).
Notwithstanding anything to the contrary in this section, the addition of ambulatory surgery services to be provided directly to a HMO-enrolled population shall be approved when the HMO can demonstrate to the satisfaction of the commissioner that the provision of services shall be cost-effective and accessible to plan enrollees.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-2 STANDARDS AND PROCEDURES FOR REGULATED ACTIVITIES AND NONCOMPLYING REGULATED ACTIVITIES
10 CRR-NY 128-2.2 Procedures for notification and/or reporting
Where any notification, application or reporting to the department required by these rules and regulations is to be made in writing, it shall be sent by certified mail to both the local department representative in the portion of the watershed in which the regulated activity takes place and to the engineering section. Addresses are listed in section 128-1.5 of this Part.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-3 ENVIRONMENTAL LABORATORY APPROVAL FEE
10 CRR-NY 55-3.5 Suspension or renewal of certificate of approval
Failure to meet at least the quarterly payment requirement shall result in suspension or nonrenewal of the certificate of approval. A laboratory whose approval has been suspended or not renewed pursuant to this section shall be assessed a fee calculated pursuant to section 55-3.7(b) of this Subpart, if it seeks reapproval.
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-4 DRUG TAKE BACK
10 CRR-NY 60-4.1 Definitions
For purposes of this Subpart, the following terms shall have the following meanings:
(a) Authorized collector means:
(1) a person, company, corporation or other entity that is registered with the DEA to collect controlled substances for the purposes of safe disposal and destruction; or
(2) a law enforcement agency; or
(3) a person, company, corporation or other entity authorized by the department to provide alternative collection methods for covered drugs that are not controlled substances.
(b) Covered drug shall have the same meaning as defined in section 290 of the Public Health Law; provided, however, that covered drug shall not include the following:
(1) vitamins or supplements;
(2) herbal-based remedies and homeopathic drugs, products or remedies;
(3) cosmetics, soap (with or without germicidal agents), laundry detergent, bleach, household cleaning products, shampoos, sunscreens, toothpaste, lip balm, antiperspirants or other personal care products that are regulated as both cosmetics and drugs by the FDA;
(4) pet pesticide products contained in pet collars, powders, shampoos, topical applications, or other forms;
(5) drugs that are biological products as defined in subdivision 27 of section 6802 of the Education Law if the manufacturer already provides a take back program;
(6) veterinary biological products regulated by the United States Department of Agriculture;
(7) drugs for which a manufacturer provides a take back program as part of a FDA managed risk evaluation and mitigation strategy;
(8) emptied injector products, emptied medical devices, including dialysis bags and solutions, and their component parts or accessories;
(9) medical marihuana as defined in section 3360 of the Public Health Law; and
(10) drugs that are used solely in a clinical setting.
(c) DEA means the Drug Enforcement Administration of the United States Department of Justice, or its successor agency.
(d) Drug take back organization means an organization designated by a manufacturer or a group of manufacturers to act as an agent on behalf of the manufacturer or group of manufacturers to operate and implement a drug take back program.
(e) FDA means the Food and Drug Administration of the United States Department of Health and Human Services, or its successor agency.
(f) Manufacturer means a person, company, corporation or other entity engaged in the manufacture of covered drugs, or, a person, company, corporation, or other entity using a contract manufacturing organization for the manufacture of covered drugs, sold in the state. Manufacturer includes a virtual manufacturer but does not include a repackager or wholesaler.
(g) Operator means any manufacturer, individually or jointly, or a drug take back organization, that implements or operates an authorized drug take back program.
(h) Pharmacies means all pharmacies registered under section 6808 of the Education Law that are:
(1) part of a group of 10 or more pharmacies under common ownership or management; or
(2) part of a group of 10 or more pharmacies linked to the same company via franchise agreements; or
(3) non-resident pharmacies registered pursuant to section 6808-b of the Education Law that provide covered drugs to state residents by mail; or
(i) Population means the total population of a given city, or a given county in the City of New York, according to the most recent decennial United States Census.
(j) Repackager means an entity that owns or operates an establishment that repacks and relabels a product or package containing a covered drug for further sale or for distribution without further transaction.
(k) Reverse distributor means a person, company, corporation or other entity that is licensed by the New York State Department of Education and Department of Health as a distributor, and registered with the DEA to acquire controlled substances from another DEA registrant or law enforcement agency for the purpose of destruction.
(l) Wholesaler means any person, company, corporation or other entity that sells or distributes drugs and covered drugs for resale to an entity in the state other than a consumer.
Chapter V MEDICAL FACILITIES
Subchapter C STATE HOSPITAL CODE
Article 1 GENERAL PROVISIONS
Part 708 APPROPRIATENESS REVIEW
10 CRR-NY 708.4 General review criteria
(a) The specific review criteria for specific services, as set forth in section 708.5 of this Part, relate to the need, accessibility and availability, financial viability, cost effectiveness and quality of the service as characteristics of appropriateness, and shall consider, where appropriate, the following general considerations:
(1) the relationship of the health service being reviewed to the applicable health systems plans, annual implementation plans, and State Health Plan;
(2) the relationship of the service being reviewed to the long-range development plan, if any, of the person or entity providing such service;
(3) the need that the population served has for the service, and the extent to which low- income persons, handicapped persons, and other underserved groups have access to such service;
(4) the availability of less costly or more effective alternative methods of providing the service being reviewed;
(5) the relationship of the service being reviewed to the existing health care system of the area in which such service is provided;
(6) the availability of resources, including health manpower, management personnel and funds for capital and operating costs, for the provision of the service being reviewed, and the availability of alternative uses of these resources for the provision of other health services.
(7) the special needs and circumstances of those persons or entities which provide a substantial portion of their services or resources, or both, to individuals not residing in the health service areas in which such persons or entities are located, or in adjacent health services areas. These persons or entities may include medical and other health-profession schools, multidisciplinary clinics, and specialty centers;
(8) the special needs and circumstances of Health Maintenance Organizations (HMO's). In the case of areawide reviews which result in institution-specific findings regarding services provided by or through an HMO, the needs and circumstances shall be limited to:
(i) the needs of enrolled members and reasonably anticipated new members of the HMO for the existing institutional health services provided by the organization;
(ii) whether the services can be obtained from non-HMO, or other HMO, providers in a reasonable and cost-effective manner which is consistent with the basic method of operation of the HMO; and
(iii) any other factors which the commissioner may propose, consistent with the National Health Planning and Resources Development Act of 1974, Public Law 93641, as amended;
(9) the special needs and circumstances of biomedical and behavioral research projects which are designed to meet a national need and for which local conditions offer special advantages;
(10) the contribution of the existing institutional health services in meeting the health- related needs of members of medically underserved groups and other groups which have traditionally experienced difficulties in obtaining equal access to health services—for example, low-income persons, racial and ethnic minorities, women and handicapped persons—particularly those needs identified in the applicable health systems plan and annual implementation plan as deserving of priority;
(11) the special circumstances of health service institutions with respect to the need for conserving energy;
(12) the effect of competition on the supply of the health services being reviewed;
(13) improvements or innovations in the financing and delivery of health services which foster competition and serve to promote quality assurance and cost effectiveness; and
(14) the quality of care provided by the services or facilities in the past.
(b) Specific review criteria may vary according to the type of service being reviewed, purpose of the review, and need not address all of the characteristics of appropriateness.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-2 TEMPORARY FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-2.11 Waste
(a) All sewage, including liquid waste, is to be disposed of in a sanitary sewer, an approved subsurface disposal system, or in a holding tank.
(b) Temporary food service establishments and the immediate vicinity of the operation are to be kept clean and free from litter. Trash and rubbish containers with plastic bag liners are to be provided for garbage and refuse disposal.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 442 REPORTING PRINCIPLES AND CONCEPTS
SPECIALIZED REPORTING AREAS SPECIALIZED REPORTING AREAS
10 CRR-NY 442.27 In-service education - nonnursing
[ 1670 ] All expenses, including student and instructor salaries, associated with nonnursing in-service education activities must be included in the functional cost center to which the participating employees' salaries and wages are assigned, as such in-service educational activities will rarely apply to more than one functional activity.
Part 441 DEFINITIONS
10 CRR-NY 441.98 Distribution
(a) Any payment to stockholders or owners of cash, property or shares, including any of the various forms of dividends in noncorporate enterprise; a withdrawal.
(b) A spread of revenue or expenditure or of capital additions to various accounts; an allocation.
(c) Disposal of a product by sale.
Part 446 REPORTING REQUIREMENTS
BASIC INFORMATION BASIC INFORMATION
10 CRR-NY 446.15 Governing authority
(a) A listing of the members of the governing authority.
(b) Name and title of presiding officer of governing authority.
(c) Name and title of the chief executive officer.
(d) Specify type of organizational structure:
(1) Governmental.
(i) State.
(ii) Municipal.
(iii) Public corporation or authority.
(iv) Other (Specify).
(2) Voluntary.
(i) Type A.
(ii) Type B.
(iii) Type C.
(iv) Type D.
(v) Religious corporation.
(vi) Article IX-C corporation.
(vii) Other (Specify).
(3) Proprietary.
(i) Individual.
(ii) Partnership.
(iii) Corporate.
(e) Compensation:
(1) Amounts paid to officers, directors and trustees.
(2) Five highest paid employees earning in excess of $30,000 per year.
(3) If applicable, hospital must provide a copy of Schedule A of IRS Form 990.
(f) A listing of physicians and/or professional corporations providing medical services and receiving money payments from the hospital:
(1) Basic selection criteria:
(i) Governing authority approval.
(ii) Payments exceed 10 percent of the functional cost center's direct cost.
(2) Information to be provided:
(i) Name of physician or professional corporation.
(ii) Number of individuals providing service to the hospital.
(iii) Amount of payments made by the hospital.
(3) Applicable functional cost centers:
(i) Account 6710—Emergency Services.
(ii) Account 7080—Anesthesiology.
(iii) Account 7210—Laboratory Services—Clinical.
(iv) Account 7230—Laboratory Services—Pathological.
(v) Account 7250—Whole Blood and Packed Red Cells.
(vi) Account 7320—Radiology—Diagnostic.
(vii) Account 7340—C.T. Scanner.
(viii) Account 7360—Radiology—Therapeutic.
(ix) Account 7380—Nuclear Medicine.
(x) Account 7420—Respiratory Therapy.
(xi) Account 7510—Physical Therapy.
(g) Medical Staff statistics for the reporting period:
(1) Number of physicians with admitting privileges.
(2) Number of physicians who admitted 20 or more inpatients.
(3) Number of physicians who admitted 100 or more inpatients.
(h) Emergency Room physician contract service (account 6710):
(1) Does the hospital contract for private physician coverage?
(2) If so, is there a guaranteed minimum payment?
(3) If so, what is the amount of this payment for this reporting period?
(4) If so, what is the amount of billed charges for this reporting period?
(5) Do the contract physicians cover on a 24-hour, 7-day-a-week basis?
(6) If not, to what extent is coverage contracted for?
(7) If contract exists, a copy must be submitted.
(i) Residency training program (accounts 8240 and 8250):
(1) Approvals:
(i) American Medical Association; and/or
(ii) American Dental Association.
(2) Data requirements for each specialty for which training is provided:
(i) Length of program.
(ii) Number of residencies offered (excluding first-year trainees).
(iii) Number completing program last year.
(iv) Number of American and/or Canadian graduates receiving training this year.
(v) Number of foreign graduates receiving training this year.
(vi) Number receiving training through an affiliated program.
(j) Student RN training program (account 8220):
(1) Length of course.
(2) Number of students.
(3) Tuition charges:
(i) First year $____.
(ii) Second year $____.
(iii) Third year $____.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.7 Consolidated or combined audits
A MCO may make written application to the a commissioner for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements, if the MCO is part of a group of MCOs that utilizes a pooling or 100 percent reinsurance agreement that affects the solvency and integrity of the MCO’s reserves and the MCO cedes all of its direct and assumed business to the pool. In such cases, a columnar consolidating or combining worksheet shall be filed with the report, as follows:
(a) amounts shown on the consolidated or combined audited financial report shall be shown on the worksheet;
(b) amounts for each MCO subject to this section shall be stated separately;
(c) noninsurance operations must be shown on the worksheet on a combined or individual basis;
(d) explanations of consolidating and eliminating entries shall be included; and
(e) a reconciliation shall be included of any differences between the amounts shown in the individual MCO columns of the worksheet and comparable amounts shown on the annual statements of the MCOs.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-4 EARLY INTERVENTION PROGRAM
10 CRR-NY 69-4.18 Respite services
(a) As appropriate, respite services and models for respite services may be discussed with the parent at the individualized family service plan meeting.
(b) The provision of respite services for an eligible child and family shall be determined in the context of IFSP development, based on the individual needs of the child and family, and with consideration given to the following criteria:
(1) severity of child's disability and needs;
(2) potential risk of out-of-home placement for the child if respite services are not provided;
(3) lack of access to informal support systems ( e.g., extended family, supportive friends, community supports, etc.);
(4) lack of access to other sources of respite ( e.g., family support services under the auspices of the Office of Mental Retardation and Developmental Disabilities and respite provided through other State early intervention service agencies), due to barriers such as waiting lists, remote/inaccessible location of services, etc.;
(5) presence of factors known to increase family stress ( e.g., family size, presence of another child or family member with a disability, etc.); and
(6) the perceived and expressed level of need for respite services by parent.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-1 MEDICAL FACILITIES
10 CRR-NY 86-1.42 Potentially preventable negative outcomes
(a) Effective for discharges occurring on or after July 1, 2011, payments pursuant to this Subpart shall be denied with regard to the following potentially preventable negative outcomes if they are acquired during a patient's inpatient stay at the hospital seeking such payments:
(1) A foreign object retained within a patient's body after surgery.
(2) The development of an air embolism within a patient's body.
(3) A patient blood transfusion with incompatible blood.
(4) A patient's development of stage III or stage IV pressure ulcers.
(5) Patient injuries resulting from accidental falls and other trauma, including, but not limited to:
(i) fractures;
(ii) dislocations;
(iii) intracranial injuries;
(iv) crushing injuries;
(v) burns;
(vi) electric shock.
(6) A patient's manifestations of poor glycemic control, including, but not limited to:
(i) diabetic ketoacidosis;
(ii) nonketotic hyperosmolarcoma;
(iii) hypoglycemiccoma;
(iv) secondary diabetes with ketoacidosis;
(v) secondary diabetes with hyperosmolarity.
(7) A patient's development of a catheter-associated urinary tract infection.
(8) A patient's development of a vascular catheter-associated infection.
(9) A patient's development of a surgical site infection following:
(i) a coronary artery bypass graft–mediastinitis;
(ii) bariatric surgery, including, but not limited to, laparoscopic gastric bypass, gastroenterostomy, and laparoscopic gastric restrictive surgery; or
(iii) orthopedic procedures, including, but not limited to, such procedures performed on the spine, neck, shoulder and elbow.
(10) A patient's development of deep vein thrombosis or a pulmonary embolism in connection with a total knee replacement or a hip replacement, excluding pediatric patients, defined as patients under 18 years of age, and also excluding obstetric patients, defined as patients with at least one primary or secondary diagnosis code that includes an indication of pregnancy.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 116 FULTON COUNTY
VILLAGES VILLAGES
10 CRR-NY 116.3 Village of Broadalbin
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law, shall apply to the wells which comprise the source of the public water supply of the Village of Broadalbin. Said wells are located on land owned by the Village of Broadalbin and are situated at the following three locations:
(1) Well site on South Second Avenue:
(i) well No. 1 approximately 170 feet west of South Second Avenue;
(ii) well No. 2 approximately 475 feet west of South Second Avenue;
(iii) well No. 3 approximately 425 feet west of South Second Avenue;
(iv) well No. 4 approximately 140 feet west of South Second Avenue; and
(v) well No. 4A approximately 130 feet west of South Second Avenue.
(2) Well site on Mill Street approximately 30 feet north of Mill Street;
(3) Well site on North Second Avenue approximately 400 feet west of North Second Avenue.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered. old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of the structure or object to the extension of the centerline of the wells.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation, that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible infrared or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(12) Sewage disposal system shall mean any system used for disposing of sewage.
(13) Toxic chemical shall mean any compound or substance, including, but not limited to: gasoline, kerosene, fuel oil or diesel oil which is or may be harmful or poisonous to humans.
(14) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, construction drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fill or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(15) Water supply shall mean the public water supply of the Village of Broadalbin.
(16) Wells shall mean wells now used as a source of this water supply or any additional wells which may be constructed at this point as a source for this water supply.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Title.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the wells.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the wells except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No pesticides or herbicides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the wells unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either the temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the wells.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the wells.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the wells; except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the wells.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the wells and not within a 500-foot to a 1,000-foot linear distance of the wells unless authorization has been obtained from the appropriate State agency and such burial is in accordance with provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the wells.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the wells.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the wells.
(7) Toxic chemicals.
No container used for the storage of gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the wells.
(8) Trespassing.
No trespassing shall be allowed upon the property of the Village of Broadalbin upon which the wells are located and no person or persons shall enter in or upon such property except the person or persons authorized to enter said property by the Village of Broadalbin.
(e) Inspections.
The board of trustees of the Village of Broadalbin or any person or persons charged with the maintenance or supervision of the public water supply system shall by its officers or their duly appointed representative make regular and thorough inspections of the area surrounding the wells to ascertain compliance with the rules and regulations set forth in this section. It shall be the duty of the aforesaid board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same, together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid board of trustees to promptly notify the State Commissioner of Health of such violations. The aforesaid board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the area surrounding the wells at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter E FOOD AND DRUG PRODUCTS; RESEARCH
Part 60 FOOD AND DRUG PRODUCTS
Subpart 60-3 DIABETES EQUIPMENT AND RELATED SUPPLIES
10 CRR-NY 60-3.1 Equipment and related supplies
(a) equipment and related supplies which may be medically necessary for the treatment of diabetes shall include but not be limited to the following:
(1) lancets and automatic lancing devices;
(2) glucose test strips;
(3) blood glucose monitors;
(4) blood glucose monitors for the visually impaired;
(5) control solutions used in blood glucose monitors;
(6) diabetes data managemeny systems for management of blood glucose;
(7) urine testing products for glucose and ketones
(8) oral anti-diabetic agents used to reduce blood sugar levels;
(9) alcohol swabs;
(10) syringes;
(11) injection aids including insulin drawing up devises for the visually impaired;
(12) cartridges for the visually impaired;
(13) disposal insulin cartridges and pen cartridges;
(14) all insulin preparations;
(15) insulin pumps and equipment for the use of the pump including batteries;
(16) insulin infusion devices;
(17) oral agents for treating hypoglycemia such as glucose tablets and gels; and
(18) glucagon for injection to increase blood glucose concentration.
(b) Nothing in this subpart shall affect the rights or responsibilities of a physician or other licensed health care provider, legally authorized to prescribe under title 8 of the Education Law, to prescribe or recommend an appropriate course of treatment for any patient diagnosed with diabetes.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 87 NURSING HOME COMPANY AND HOSPITAL MORTGAGE LOANS
HOSPITAL MORTGAGE LOANS HOSPITAL MORTGAGE LOANS
10 CRR-NY 87.40 Purchases and contracts
(a) Purchases and contracts for hospital materials and services shall be limited to those items needed for hospital operation. Such purchases and contracts shall be subject to budgetary limitations except where the expenditure is necessary to protect life or property from imminent danger.
(b) Purchases and contracts shall be awarded by a hospital only after every reasonable effort has been made to obtain the lowest possible cost commitment consistent with prudent operation. Substantial construction contracts, as defined in the State Hospital Code (10 NYCRR Part 710) shall require verification of cost by competitive bidding acceptable to the State Department of Health.
(c) Prior to permitting any supplier or contractor to perform, a hospital shall require the contractor to submit satisfactory evidence of any insurance coverages and performance and payment bonds that may be required by the contract or purchase documents.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.74 Pharmacists; dispensing schedule III, IV and V controlled substances
(a) Except as provided in sections 80.67 and 80.73 of this Part, a licensed, registered pharmacist, or a pharmacy intern acting in conformity with the provisions of section 6808 of the Education Law, and regulations thereunder, in a registered pharmacy may, in good faith and in the course of his professional practice, dispense to an ultimate user, controlled substances in schedule III, IV or V provided they are dispensed pursuant to a prescription presented within 30 days of the date such prescription was signed by an authorized practitioner.
(b) Such substances may be dispensed only if packaged and labeled in conformity with provisions set forth in section 80.73(b) of this Part.
(c) A licensed, registered pharmacist in a registered pharmacy may, in good faith and in the course of his/her professional practice, sell and dispense, to an ultimate user, controlled substances for which a prescription is required upon the delivery to such pharmacist, within 30 days of the date such prescription, or official New York State prescription, or an out-of-state written prescription if sent by facsimile in accordance with section 80.69(e) or (f) of this Part was issued by an authorized practitioner.
(d) Within 72 hours after transmitting a prescription to a pharmacist by facsimile in accordance with section 80.69(e) or (f) of this Part, the prescribing practitioner shall cause to be delivered to the pharmacist the original official New York State prescription or the original out-of-state written prescription. Such original prescription shall be attached to the prescription transmitted by facsimile. If the pharmacist fails to receive such original prescription, he/she shall notify the department in writing within seven days from the date of dispensing the substance.
(e) The pharmacist filling the prescription shall endorse on such prescription his/her signature, the date of filling, and the number of the prescription under which it is recorded in the pharmacy prescription file. Such endorsed prescription shall be retained by the proprietor of the pharmacy for a period of five years. Prescription information from the filling of such prescription shall be filed with the department in accordance with section 80.73(f) of this Part.
(f) A pharmacy shall make a good faith effort to verify the identity of any person accepting delivery of a dispensed prescription for a controlled substance by requiring such person, if unknown to the pharmacy, to present appropriate identification.
(g) When a prescription prepared by a practitioner is incomplete, the practitioner may orally furnish the missing information to the pharmacist and authorize him or her to enter the missing information on the prescription. The pharmacist shall write the date he or she received the oral authorization on the prescription and shall affix his or her signature. This procedure shall not apply to unsigned or undated prescriptions or where the name and/or quantity of the controlled substance is not specified or where the name of the ultimate user is missing. The pharmacist is not required to obtain authorization from the practitioner to enter the patient's address, sex or age if the pharmacist obtains this information through a good-faith effort.
(h) A practitioner may orally authorize a pharmacist to change information on a controlled substance prescription. This procedure shall not apply to the practitioner's signature, date the prescription was signed by the practitioner, drug name or name of the ultimate user. The pharmacist shall write the date he or she received the oral authorization on the prescription, reason for the change and his or her signature. The pharmacist shall also indicate the change on the face of the prescription and initial the change.
(i) When a pharmacist fills a prescription in a manner that would require, under subdivision (g) or (h) of this section, the pharmacist to make a notation on the prescription if the prescription were written, the pharmacist shall make the same notation electronically when filling an electronic prescription and retain the annotation electronically in the prescription record.
(j) Except as provided in sections 80.67 and 80.73 of this Part, a pharmacist may partially fill a prescription for a controlled substance provided that:
(1) each partial filling is recorded in the same manner as a refill;
(2) the total quantity dispensed does not exceed the total quantity prescribed for a 30-day period.
(k) When a pharmacist receives a prescription for a schedule III, IV or V controlled substance that indicates that it was originally transmitted electronically to the pharmacy, the pharmacist shall check the records to ensure that the electronic version was not received and the prescription dispensed. If both prescriptions were received, the pharmacist shall mark one as void.
(l) When a pharmacist receives a prescription for a schedule III, IV or V controlled substance that indicates that it was originally transmitted electronically to another pharmacy, the pharmacist shall check with an employee at that pharmacy to determine whether the prescription was received and dispensed. If the pharmacy that received the original electronic prescription had not dispensed the prescription, that pharmacy shall mark the electronic version as void or cancelled. If the pharmacy that received the original electronic prescription dispensed the prescription, the pharmacy with the written version shall not dispense the prescription and shall mark the prescription as void.
(m) A pharmacist shall use a pharmacy computer application that meets federal security requirements to process electronic controlled substance prescriptions, and shall register such pharmacy computer application with the New York State Department of Health, Bureau of Narcotic Enforcement.
Chapter I STATE SANITARY CODE
Part 11 QUALIFICATIONS OF PUBLIC HEALTH PERSONNEL
PUBLIC HEALTH NURSE 2 PUBLIC HEALTH NURSE 2
10 CRR-NY 11.45 Supervisory level qualifications
A supervising public health nurse must meet the qualifications for public health nurse 1 and have two years' experience in public hearing nursing; or a master's degree in nursing from a regionally accredited or New York State-registered college or university and one year of experience in public health nursing. A supervising public health nurse must complete 15 hours of continuing education in public health and management related topics approved by the New York State Department of Health within the first year of employment in this title.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.117 Wiping cloths
(a) Clean, dry cloths used for wiping food spills from tableware, plates or bowls served to the consumer are to be used only for this purpose.
(b) Moist cloths used for wiping food spills on kitchenware and food-contact surfaces of equipment are to be used only for this purpose. These cloths are to be stored in a sanitizing solution between uses.
(c) Moist cloths used for cleaning non-food-contact surfaces of equipment such as counters, dining table tops and shelves are to be stored in a sanitizing solution between uses and are to be used only for this purpose.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 45 CYSTIC FIBROSIS HEALTH CARE PROGRAM—ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
10 CRR-NY 45.1 Medical care and/or insurance premium reimbursement
Reimbursement for medical care for the treatment of cystic fibrosis patients and/or medical insurance premiums for cystic fibrosis patients will be made on behalf of patients enrolled in the Adult Cystic Fibrosis Assistance Program.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-1.113 Mechanical cleaning and sanitizing
(a) Cleaning and sanitizing may be done by spray type or immersion dishwashing machines or by any other type of machine or device demonstrated to thoroughly clean and sanitize equipment and utensils. These machines and devices are to be installed and maintained in good repair and operated in accordance with manufacturers' instructions. Utensils and equipment placed in the machines are to be exposed to all cycles. Automatic detergent dispensers, wetting agent dispensers, and liquid sanitizer injectors, if any, are to be properly installed and maintained.
(b) Machines are to have the wash water and the pumped rinse water kept clean. The final rinse water, when used as the sanitizer, is to be maintained at the temperature required by the manufacturer to sanitize under normal conditions of operation.
(c) All dishwashing machines are to be cleaned at least once a day, or more often when necessary, to maintain them in a satisfactory operating condition.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 446 REPORTING REQUIREMENTS
SERVICES PROVIDED AND GOODS USE SERVICES PROVIDED AND GOODS USE
10 CRR-NY 446.25 Home Medical Care Program
(a) Each functional cost center (6910-6990) must be reported separately.
(b) Report data regardless of participation in AHS program.
(c) Service data to be provided:
(1) Patients on Home Care first day of reporting period.
(2) Admissions to Home Care during the reporting period.
(3) Total patients under care.
(4) Deaths on Home Care.
(5) All other discharges from Home Care.
(6) Total discharges from Home Care.
(7) Patients remaining on Home Care on last day of reporting period.
(8) Total days of care provided during the reporting period.
(d) Do not report this data, under either inpatient or outpatient services, in any other area.
(e) Exclude Home Program dialysis.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.1 Definitions
(a) Council shall mean the New York State Council on Graduate Medical Education.
(b) Primary Care Medical Training Program or Primary Care Residency Program shall mean a residency program approved by the council for up weighting of 1.5 under section 2807-c of the Public Health Law.
(c) Resident loan repayment recipient and recipient shall mean an individual who has signed a service agreement to receive a loan repayment award under this Subpart.
(d) Service agreement shall mean the written agreement prepared by the Department of Health and signed by the resident loan repayment recipient prior to the issuance of an award specifying the terms of the award and the service obligation required.
(e) Award shall mean the funds provided under this Subpart during one residency year, for the purpose of repaying some or all of the qualifying debt of the resident loan repayment recipient.
(f) Qualifying debt shall mean any outstanding, unpaid debt incurred by the recipient from loans to cover tuition and other related educational expenses made by, or guaranteed by, the Federal or State government, or made by a lending or educational institution approved under title IV of the Federal Higher Education Act.
(g) Underserved area shall mean a site, area, or facility designated pursuant to section 47-3.1 of this Part.
(h) License shall mean a license to practice medicine in New York State issued by the State Education Department.
(i) Residency year shall mean the period between July 1st and June 30th of the following year.
(j) Service obligation shall mean the period of time a resident loan repayment recipient must practice primary care in an underserved area after completion of his/her residency training.
(k) Service obligation start date shall mean the date upon which a resident loan repayment recipient is required to begin practicing primary care in fulfillment of his/her service obligation.
(l) Rescission shall mean the withdrawal, cancellation or revocation of an award in accordance with the provisions of section 47-4.4 of this Subpart, after the signing of the service agreement.
(m) Waiver shall mean full or partial release by the commissioner of the service obligation and/or financial obligation for repayment of an award incurred or owed by a recipient.
(n) Deferral shall mean a delay or temporary suspension of an award payment, service obligation, or any financial obligation for repayment of an award by the recipient, which is granted by the commissioner with no resulting reduction in service or financial obligation.
(o) Default shall occur if a recipient has not obtained an approved waiver or deferral and the recipient fails to complete the primary care residency program on which the award is based, or the recipient fails to begin or complete the service obligation within the timeframes prescribed by this Subpart, or an award is rescinded after payment of award monies to the recipient.
(p) Program default rate shall be equal to the number of residents that have completed residency training in a specific program and have defaulted on their service obligation divided by the total number of recipients that completed training in that program.
(q) President shall mean the president of the New York State Higher Education Services Corporation.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.11 Compliance with standards
A reproductive tissue bank shall allow admission to representatives of the department for the purpose of inspecting the premises and evaluating operating procedures, equipment, and records, including lists of physicians or facilities to whom or to which reproductive tissue has been released, to determine compliance with the standards in this Part. If the commissioner determines that a significant likelihood exists that adequate safeguards are not implemented at a reproductive tissue bank, the department may require that reproductive tissue not be released pending a hearing. Such hearing shall commence within 15 days of any suspension pursuant to this section.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES
10 CRR-NY 80.72 Issuance of Official New York State prescription forms
(a) A practitioner shall register with the department to be issued official New York State prescription forms. The registration application shall include, but not be limited to, the requesting practitioner's name, specialty, primary address and other practice site address(s), number of prescriptions requested, the Federal registration number or exemption certificate, the State professional practice license number, and shall be signed by the requesting practitioner.
(b) A practitioner's registration shall be without fee and subject to approval by the department. Such registration shall be valid for a period of two years.
(c) A practitioner registered to be issued official prescription forms shall order such forms in the manner required by the department.
(1) The number of prescriptions requested by practitioners shall be subject to approval by the department and shall be issued free of charges in the manner and quantity approved by the department.
(2) The address of the practitioner to which the forms shall be sent shall be the address of a registered practitioner's Federal Drug Enforcement Administration (DEA) registration.
(3) The commissioner may specify that such forms or series of forms shall be valid for a limited period of time and may be cancelled by the commissioner by giving notice to the practitioner.
(d) The commissioner may revoke, cancel or withhold official New York State prescription forms for prescribing controlled substances upon a finding of willful failure to comply with the Public Health Law or this Title. Notice of such finding shall specify that a formal hearing pursuant to the provisions of the Public Health Law may be granted, provided such person shall request the hearing within five days after receipt of the notice.
(e) Official New York State prescription forms of practitioners who are deceased or who no longer prescribe controlled substances shall be returned to the Bureau of Narcotic Enforcement, NYS Department of Health, Corning Tower, The Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237, or an authorized narcotic enforcement representative of the department, by the practitioner or, if the practitioner is deceased, by the next of kin of the practitioner or, if the next of kin is unable to obtain the prescription forms, by a representative of the estate of the practitioner.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
WATER SUPPLY WATER SUPPLY
10 CRR-NY 14-1.120 Water supply
The water supply is to be adequate, safe, and of sanitary quality from an acceptable source that meets the requirements of Part 5 of this Title. Use of water supply requires prior approval from the permit-issuing official.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.208 Mentally disordered patient
A person with a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. This patient requires continuous supervision and can be expected to benefit from an active rehabilitation program effort designed to improve his adaptive functioning and develop a potential for replacement in a less protected living environment.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
ENFORCEMENT ENFORCEMENT
10 CRR-NY 14-5.187 Suspension of permits
Permits may be suspended temporarily by the permit-issuing official, after notice and an opportunity to be heard, for failure of the permit holder to comply with the requirements of this Subpart, or with any lawful notice or order issued by the permit-issuing official or his designated representative.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 44 STATE AID FOR APPROVED VECTOR SURVEILLANCE AND CONTROL PROGRAMS
10 CRR-NY 44.51 Public health threat; risk assessment and declaration
(a) In evaluating the existence of a public health threat, the commissioner shall assess the risk to human health by taking into account the etiologic agent, the vector species, the size of the specific and secondary vector populations, the vectors' physiological age, density and proximity of human population, the time of year and weather conditions.
(b) When a locality believes that an arthropod-borne disease should be designated as a public health threat, localities should document the information and immediately notify the county health commissioner or responsible regional health director who shall inform the commissioner. The person notifying the Commissioner of Health shall also send a copy of the notification to the Commissioner of Environmental Conservation.
(c) Only the commissioner may make a declaration of public health threat for State aid eligibility.
Part 40 STATE AID FOR PUBLIC HEALTH SERVICES: COUNTIES AND CITIES
Subpart 40-2 PERFORMANCE STANDARDS AND MINIMUM REQUIREMENTS FOR CORE PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED ENVIRONMENTAL HEALTH – ONLY WHERE AUTHORIZED
10 CRR-NY 40-2.62 Authorized tanning facilities licensing and inspection program; performance standards
Where a local health department’s health officer has received authorization to act as a permit-issuing official for the licensing and inspection of tanning facilities pursuant to Subpart 72-1 of this Title, the municipality shall conduct such program consistent with that Subpart or, if applicable, local regulations issued pursuant to section 72-1.2 of this Title.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-2 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS—LICENSURE
10 CRR-NY 52-2.2 Provisional licensure
(a) The department may issue a provisional license which shall be valid for a period determined by the department to be sufficient to enable the department to assess the compliance of the tissue bank or nontransplant anatomic bank with this Part. The provisional license may be renewed pending issuance or denial of a license.
(b) Except for a limited tissue procurement service, a tissue bank initially applying for a license may be issued a provisional license provided it meets the following conditions:
(1) a valid and complete license application has been filed;
(2) unless the site is a tissue transplantation facility or insemination/implantation site or a tissue storage facility whose tissue storage activity is limited to virally inactivated tissue, a medical advisory committee, consisting of at least five individuals with experience in tissue banking and/or transplantation medicine, including at least one member with expertise in infectious diseases, has been designated;
(3) if the tissue bank has been inspected by the department, the tissue bank has provided satisfactory evidence of correction of any deficiencies found; and
(4) the owners and/or persons with a controlling interest, tissue bank director, medical director, tissue bank compliance officer and transplantation service director, as required, meet the requirements of this Part and possess the education and experience necessary to ensure that the tissue bank is operated in substantial compliance with this Part.
(c) A nontransplant anatomic bank or a limited tissue procurement service initially applying for a license may be issued a provisional license provided it submits a complete application.
(d) A provisional license may be withheld if the director, medical director, tissue bank compliance officer, any owner, or any person with a controlling interest applying for a provisional license has ever directed, owned or controlled a health care facility, laboratory, tissue bank, funeral directing firm, or nontransplant anatomic bank which has had its permit or license denied, revoked, suspended, limited or annulled, or which has an enforcement proceeding against it pending at the time of application for a provisional license.
(e) A provisional license may be denied or terminated, without a hearing, if the department finds that the tissue bank or nontransplant anatomic bank is not operated in substantial compliance with the applicable provision of section 52-2.5 of this Subpart.
(f) The valid provisional license shall be conspicuously posted within the facility.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-10 APPENDICES
10 CRR-NY 128-10.2 System specific water quality characteristics
The system specific water quality characteristics of the reservoirs and reservoir stems, as of September 1990, are set forth in Tables 1 and 2 of this section. It is the intention of the department that the system specific characteristics be maintained at the stated levels by implementation and enforcement of these rules and regulations.
TABLE 1
System Specific Characteristics: Reservoir Standards (mg/L)
| | | | Catskill/Delaware | | | --- | --- | --- | --- | --- | | | | | System | | | | Croton System | (including Kensico) | | | | | Annual | | Annual | | | | Mean | S/S/M* | Mean | S/S/M* | | | | | | | | Alkalinity | | | | | | (mg CaCo(3)/L) | ≥40.00 | | ≥10.00 | | | Ammonia Nitrogen | 0.05 | 0.10 | 0.05 | 0.10 | | Chloride | 30.00 | 40.00 | 8.00 | 12.00 | | Nitrite+ | | | | | | Nitrite - N | 0.30 | 0.50 | 0.30 | 0.50 | | Organic Nitrogen | 0.50 | 0.70 | 0.50 | 0.70 | | Sodium | 15.00 | 20.00 | 3.00 | 16.00 | | Sulfate | 15.00 | 25.00 | 10.00 | 15.00 | | Total Diss. Solids | 150.00 | 175.00 | 40.00 | 50.00 | | Total Organic Carbon | 6.00 | 7.00 | 3.00 | 4.00 | | Total Susp. Solids | 5.00 | 8.00 | 5.00 | 8.00 | | Chlorophyll-a | 0.01 | 0.015 | 0.007 | 0.012 | | *S/S/M means Single Sample Maximum | | | | |
TABLE 2
System specific characteristics: Reservoir Stem Standards (mg/L)
| | | | Catskill/Delaware | | | --- | --- | --- | --- | --- | | | | | System | | | | Croton System | (including Kensico) | | | | | Annual | | Annual | | | | Mean | S/S/M* | Mean | S/S/M* | | | | | | | | Alkalinity | | | | | | (mg CaC03/L) | ≥40.00 | | ≥10.00 | | | Ammonia Nitrogen | 0.10 | 0.2 | 0.05 | 0.25 | | Chloride | 35.00 | 100.00 | 10.00 | 50.00 | | Nitrite + | | | | | | Nitrate - N | 0.35 | 1.50 | 0.40 | 1.50 | | Organic Nitrogen | 0.50 | 1.50 | 0.50 | 1.50 | | Sodium | 15.00 | 20.00 | 5.00 | 10.00 | | Sulfate | 15.00 | 25.00 | 10.00 | 15.00 | | Total Diss. Solids | 150.00 | 175.00 | 40.00 | 50.00 | | Total Organic Carbon | 9.00 | 25.00 | 9.00 | 25.00 | | Total Susp. Solids | 5.00 | 8.0 | 5.00 | 8.00 | | *S/S/M means Single Sample Maximum | | | | |
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
HANDWASHING HANDWASHING
10 CRR-NY 14-4.142 Handwashing facilities exemption
Handwashing facilities are not required where the food served is limited to prepackaged, prewrapped items.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter O PHYSICIAN'S ASSISTANTS; PROHIBITED DISCRIMINATION IN HOSPITAL STAFF APPOINTMENTS AND PRIVILEGES
Part 92 INFECTION CONTROL REQUIREMENTS
Subpart 92-1 PHYSICIANS, REGISTERED PHYSICIAN ASSISTANTS AND SPECIALIST ASSISTANTS: REQUIRED COURSE WORK OR TRAINING IN INFECTION CONTROL AND BARRIER PRECAUTIONS EVERY FOUR YEARS
10 CRR-NY 92-1.7 Certificate of retention
In the event that an approved person or organization discontinues offering course work or training, a record of certifications shall be retained in a manner approved by the department for six years from the date of issuance.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.8 Waste disposal
Disposal and transportation of radioactive waste shall be governed by the New York State Department of Environmental Conservation as set forth in 6 NYCRR Parts 380 and 381.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter D LABORATORIES
Part 55 APPROVAL OF LABORATORIES
Subpart 55-2 APPROVAL OF LABORATORIES PERFORMING ENVIRONMENTAL ANALYSIS
10 CRR-NY 55-2.8 Proficiency testing
(a) Environmental laboratories shall examine proficiency test samples supplied by the department or by a proficiency testing provider recognized by the department pursuant to subdivision (i) of this section. Laboratories shall conduct the specified examinations and submit the results to the proficiency sample provider for all analytes for which the laboratories are approved or seeking approval, and for which samples have been supplied.
(1) The department shall announce its schedule for mailed proficiency test sample distribution as soon as practicable after the first day of each approval year. Distribution frequency and dates shall be included in this announcement. The department shall specify, in letters distributed with samples, the department's test result scoring criteria. Laboratories participating in the department's proficiency testing program, shall report test results to the department no later than on the dates specified by the department for each manner of result submission ( i.e., hardcopy or electronic). No extensions shall be granted. Laboratories whose results are received after the deadline shall be considered to have achieved unsatisfactory performance in the proficient test event. Laboratories participating in a recognized proficiency testing provider(s)' proficiency testing program, other than the department's program, shall arrange with that provider to have test results forwarded to the department.
(2) To obtain or maintain approval for a given analyte, an environmental laboratory shall attain satisfactory performance in at least two of three consecutive scheduled or unscheduled proficiency test events in which it has participated. Such events shall take place at least 30 calendar days apart.
(3) To obtain or maintain approval for the potable water - total coliforms analyte, for which proficiency testing requires qualitative analysis, an environmental laboratory shall maintain a score of at least 90 percent, without reporting a false negative result for at least two of three consecutive scheduled or unscheduled proficiency test events in which it has participated. Such events shall take place at least 30 calendar days apart.
(4) To obtain or maintain approval in contract laboratory protocol (CLP) analyses, an environmental laboratory shall be evaluated on both proficiency testing performance and conformity to the contract requirements of the CLP data package submitted.
(b) Performance in examining an individual chemical or physical analyte shall be evaluated as follows, for a natural blank test sample:
(1) Satisfactory performance shall be a result, reported with or without the term “less than,” and having a value less than or equal to the detection limit specified by the department, or, if no detection limit is specified, the method detection limit.
(2) Unsatisfactory performance shall be a result, reported with or without the term “less than,” greater than the detection limit specified by the department, or, if no detection limit is specified, the method detection limit.
(c) Performance in examining an individual chemical or physical analyte shall be evaluated as follows, for a synthetic blank test sample:
(1) Satisfactory performance shall be a result reported with the term “less than,” and having a value less than or equal to the detection limit specified by the department, or, if no detection limit is specified, the method detection limit.
(2) Unsatisfactory performance shall be a result reported with or without the term “less than,” and having a value greater than detection limit specified by the department, or, if no detection limit is specified, the method detection limit.
(d) Performance in examining an individual chemical or physical analyte shall be evaluated as follows, for a spiked or natural test sample:
(1) For data sets examined by the standard statistical procedures described in subdivision (g) of this section and having a relative standard deviation lower than 34 percent:
(i) satisfactory performance shall be a result within the 99-percent confidence interval about the statistical mean; and
(ii) unsatisfactory performance shall be a result outside the 99-percent confidence interval about the statistical mean.
(2) For data sets examined by the standard statistical procedures described in subdivision (g) of this section but having a relative standard deviation of 34 percent or higher, the relative standard deviation of the data set used for determining the 99-percent confidence interval shall be set at 34 percent, or a value derived from the scientific literature. Satisfactory and unsatisfactory performance shall be as described in paragraph (1) of this subdivision.
(3) For data sets evaluated by using a reference laboratory panel, the statistical mean and 99-percent confidence interval shall be derived from the reference laboratory data set, after standard statistical analysis. Satisfactory and unsatisfactory performance shall be as described in paragraph (1) of this subdivision.
(4) For data sets evaluated using an interval about the assigned value and defined by a fixed percentage of the assigned value, fixed percentages shall be set based on the department's determination of the reliability, precision and accuracy of the methods used, and:
(i) satisfactory performance shall be a result within the fixed percentage interval about the assigned value; and
(ii) unsatisfactory performance shall be a result outside the fixed percentage interval about the assigned value.
(5) For data sets evaluated using published linear regression equations to predict the mean and standard deviations:
(i) satisfactory performance shall be a result within the interval of the predictive mean, plus or minus two predictive standard deviations for potable water analytes, or plus or minus three predictive standard deviations for other matrices; and
(ii) unsatisfactory performance shall be a result outside the interval described in subparagraph (i) of this paragraph.
(e) Performance in examining an individual bacteriological analyte for which quantitation is required shall be evaluated as follows:
(1) For negative coliform and/or standard plate count test samples, including sterile samples, samples containing bacteria not detectable by the method and samples containing bacteria not producing positive reactions with the required verification procedures, satisfactory performance shall be a result reported as a value lower than the method detection limit. Unsatisfactory performance shall be any other result.
(2) Performance in examining an individual bacteriological analyte for which quantitation is required shall be evaluated as follows, for a positive inoculated test sample:
(i) Satisfactory performance shall be a result within the 99-percent confidence interval about the statistical mean for Most Probable Number (MPN) and Membrane Filter (MF) coliform data, and within the 95-percent confidence interval about the statistical mean for standard plate count data.
(ii) Unsatisfactory performance shall be a result outside the 99-percent confidence interval about the statistical mean for MPN or MF coliform data, and within the 95-percent confidence interval about the statistical mean for standard plate count data.
(f) The statistical mean and the confidence intervals used to determine satisfactory and unsatisfactory performance for spiked and natural chemical test samples and positive inoculated MF coliform and standard plate count test samples shall be established from statistical analysis of the data set after rejection or weighting of outliers, as described in subdivision (g) of this section. The value assigned to the statistical mean shall be the mean of the resulting data set.
(g) Rejection of outliers in a chemical data set shall be based on the three-standard deviation interval, after eliminating the extreme values in the data set and all values exceeding twice the theoretical value for the test sample. Rejection of outliers in an MF coliform or standard plate count data set shall be based on the three-standard deviation interval, after eliminating the extreme values in the data set. Weighting of outliers, if used in place of rejection of outliers, shall be accomplished using robust analysis. The statistical means and confidence intervals used to determine satisfactory and unsatisfactory performance for positive inoculated MPN coliform test samples shall be based on the log normal distribution.
(h) Performance in examining potable water bacteriological samples qualitatively shall be evaluated based upon the known presence or absence of total coliform group members of Escherichia coli (E. coli). Satisfactory performance shall be a result correctly indicating the presence or absnce of total coliform bacteria, and correctly identifying E. coli, if present. Unsatisfactory performance shall be a result incorrectly identifying the presence or absence of total coliform bacteria or E. coli.
(i)
(1) The department may recognize a proficiency testing provider to offer and score results of proficiency testing samples for purposes of obtaining New York State environmental laboratory accreditation pursuant to this Subpart, provided:
(i) the proficiency testing provider has submitted sufficient documentation to enable the department to determine that the provider adheres to standards for design, production, testing, distribution, data analysis and quality assurance that are at least equivalent to, or more stringent than, the department proficiency testing program's, and applies scoring systems identical to the department's;
(ii) the proficiency testing provider demonstrates it has policies and procedures in place to protect the integrity of its proficiency testing program and prevent fraud in its administration;
(iii) for analytes and sample types with EPA proficiency testing participation standards, the proficiency testing provider possesses a certificate or other documented approval demonstrating compliance with such EPA standards; and
(iv) the proficiency testing provider agrees to supply the department with test scores, and any such other information and documentation requested to resolve any issues concerning compliance with this Subpart.
(2) The recognition granted to a proficiency testing provider pursuant to this subdivision may be withdrawn at any time if the department finds the provider no longer meets the criteria set forth herein, or has failed to provide the department with sufficient information and documentation to permit determination or demonstration of compliance or noncompliance with this Subpart.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.14 Garbage; refuse
Garbage and refuse shall be collected, handled and disposed of in a sanitary manner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-1 MANAGED CARE ORGANIZATIONS
10 CRR-NY 98-1.5 Application for a certificate of authority
(a) No person shall establish or operate an MCO or otherwise hold itself out as an MCO in this State unless it has complied with article 44 of the Public Health Law and this Subpart. However, an applicant may file a certificate of incorporation, articles of organization or amendment thereto, in accordance with section 98-1.4 of this Subpart without violating this subdivision. Except for operating or approved MLTC demonstrations, no person shall initiate enrollment of individuals or deliver prepaid comprehensive health services until it has received a certificate of authority from the commissioner. A foreign corporation or limited liability company shall not be a proper applicant for a certificate of authority. A corporation licensed under the provisions of article 43 of the Insurance Law, which is also certified pursuant to article 44 of the Public Health Law as an HMO to offer a comprehensive health benefit package, shall designate its health maintenance organization as a separate line of business. In the case of such a separate line of business, separate accounting records shall be maintained and separate HMO reporting forms shall be filed with the superintendent and commissioner.
(b) In order to obtain a certificate of authority to operate an MCO, a person shall file an application on forms prescribed by the commissioner. The application shall be signed by the chief executive officer duly authorized by the board of a corporate applicant, a general partner or owner of a proprietary applicant, or the president, the chairman of the board or chief executive officer of a public applicant, or an authorized representative of the applicant. An original and seven copies of the application shall be filed and shall set forth or be accompanied by the following, except that in the case of a PCPCP, the application shall include the information as specified herein and the information prescribed by section 4403-e of the Public Health Law:
(1) copies of the basic organizational documents of the applicant, e.g., the certificate of incorporation, bylaws, articles of organization, partnership agreement, trust agreement, operating agreement or other applicable documents and agreements, and all amendments thereto;
(2)
(i) a list of the names, addresses and official positions of the members of the board of directors, members or managers of a limited liability company, officers, controlling persons, owners or partners and medical director of the proposed MCO, and if the applicant will be a controlled MCO, the same information for the holding company;
(ii) the applicant shall provide written acknowledgment that, once certified, the MCO will provide written notice to DOH immediately upon:
(a) the departure, resignation or termination of any officer, member of the board, member or manager of a limited liability company or the medical director, together with the identity of the individual; and
(b) the hiring of an individual to replace an individual concerning whom notice is required under clause ( a ) of this subparagraph, together with the identity of the individual hired;
(3) copies of the same financial and personal disclosure information required by the department for the members of the board, officers, controlling persons, owners, partners and medical director of the proposed MCO as set forth in subparagraphs (ii) and (iii) of this paragraph.
(i) The applicant shall be responsible for obtaining from the appropriate licensing authorities the information necessary for the determination by the commissioner of character, competence and performance when information adequate to make such determination is not available to the commissioner in the records of the department.
(ii) Disclosure information shall include, but not be limited to: a list of health care entities owned or operated by the applicant, its holding company or other persons in the holding company system or with which an officer, member of the board, member or manager of a limited liability company, controlling person, owner, partner or medical director has been affiliated; the address of each such entity; the dates of ownership or operation of each such entity; and documentation from the appropriate licensing and regulatory authorities indicating that those health care entities are in substantial compliance with applicable laws and regulations.
(iii) In the event that any such health care entity specified in subparagraph (ii) of this paragraph, while under the control or operation of the applicant, its holding company or other persons in the holding company system or with which an officer, member of the board, member or manager of a limited liability company, controlling person, partner, owner or medical director has been affiliated, has been subjected to financial penalties or suspension or revocation of its operating certificate or license because of failure to comply with provisions governing the conduct and operation of the facility, then information must be provided that describes the nature of the violation, the agency or body enforcing the violation (including its name and address), the steps taken by the facility to remedy the violation, and an indication of whether the suspension, revocation or accreditation has since been restored;
(4) except for PCPCPs, statements of the current financial condition of the applicant and any holding company, including:
(i) a balance sheet and a detailed financial plan covering not less than three years' projected operation of the MCOs, demonstrating the basis upon which the plan will become self-supporting and repay indebtedness and specifying the methods and arrangements for assurance and protection of the MCO's solvency, including complying with required reserves and deposits;
(ii) any insurance policies; and
(iii) a plan for enrollee protection and payment of incurred costs of services in the event of insolvency. For purposes of demonstrating compliance with required reserves and deposits prior to commencing operations, the MCO must determine such reserve and deposit based on section 98-1.11(e) and (f) of this Subpart using projected net premium income and estimated expenditures for the first calendar year as indicated in the detailed financial plan described in subparagraph (i) of this paragraph;
(5) if the applicant intends to contract with a management contractor to manage the proposed MCO, information specified in section 98-1.11(i)-(r) of this Subpart shall be required as part of the application;
(6) a copy of any proposed contract or form of contract, and all attachments thereto, to be made between or among hospitals and any other type of providers of covered services and the proposed MCO.
(i) Such contract should specify any risk-sharing arrangements between the proposed MCO and the provider.
(ii) Such contract shall include express provisions indicating that the provider shall hold MCO enrollees harmless from liability, and shall not bill enrollees under any circumstances for the costs of covered services rendered by the contracting provider, except that nothing herein shall prevent collection of applicable co-payments or co-insurance or permitted deductibles.
(iii) Such contact shall include provisions allowing access by the MCO and participating IPAs, as necessary, to the medical records of all health care providers serving the MCO's enrollees provided the consent of the enrollee is first obtained either at the time of initial enrollment or initial visit with a participating provider.
(iv) Such contact shall include provision which require prior approval by the commissioner of any material changes in contracts between the MCO and health services providers. Proposed material changes shall be submitted to the commissioner in advance of their implementation in accordance with guidelines issued by the commissioner as per subparagraph (v) of this paragraph.
(v) The commissioner may issue guidelines, in consultation with regulated parties, with respect to the process for contract review and required contract provisions, and to effectuate the provisions of this Subpart.
(vi) Prior to approval of the certificate of authority, a photocopy of each of the executed contracts with hospitals, a photocopy of one executed contract with each type of provider for approval as to form and content, and a sworn list in affidavit form of all providers with whom contracts have been executed must be submitted by the proposed MCO.
(vii) An MCO shall not enter into a contract with a not-for-profit or business corporation, limited liability company or professional services limited liability company which proposes to provide the services of an (IPA) unless:
(a) the certificate of incorporation or articles of organization of the IPA, which shall include "independent practice association" or "IPA" within the IPA name, contains powers and purposes permitting the arranging by contract for the delivery or provision of health services by individuals, entities and facilities licensed or certified to practice medicine and other health professions, and, as appropriate, ancillary medical services and equipment, by which arrangements such health care providers and suppliers will provide their services in accordance with and for such compensation as may be established by a contract between the IPA and one or more MCOs which have been granted a certificate of authority pursuant to the provisions of article 44 of the Public Health Law of the State of New York, as amended;
(b) the IPA certificate of incorporation or articles of organization contain(s) the following provision: notwithstanding any other provision herein to the contrary, nothing contained herein shall authorize the corporation, limited liability company or professional services limited liability company to establish, operate, construct, lease or maintain a hospital or to provide hospital services or health-related services or to operate a certified home health agency, a hospice, or an MCO, or to provide a comprehensive health services plan as defined and covered by articles 28, 36, 40 and 44, respectively, of the Public Health Law, or to solicit, collect or otherwise raise or obtain any funds, contributions or grants from any source for the establishment or operation of any hospital or to establish, operate, construct, lease or maintain an adult care facility as provided by article 7 of the Social Services Law, or to solicit, collect or otherwise raise or obtain any funds, contributions or grants from any source for any such purposes; and
(c) any general powers and purposes contained in the certificate of incorporation or articles of organization, as authorized by section 202 of either the Business Corporation Law, the Not-for-Profit Corporation Law or the Limited Liability Company Law, are by express provision in the certificate of incorporation or articles of organization to be exercised only as powers and purposes incidental to accomplishing the primary IPA powers and purposes of the corporation or limited liability company; and
(d) the IPA's certificate of incorporation or articles of organization has been reviewed by the Education and Insurance Departments and the commissioner, have been filed with the Secretary of State and, when presented for filing, had annexed thereto the waiver, approval or consent of the Education and Insurance Departments and the commissioner;
(e) An IPA may, as incidental to its primary IPA powers and purposes:
(1) share risk for the provision of medical services with authorized MCOs and subcapitate or otherwise compensate providers and IPAs with which it has contracted, provided, however, that with respect to each proposed risk sharing contract, the IPA has demonstrated to the commissioner and/or, when applicable, the superintendent, that it is financially responsible and capable of assuming such risk and has satisfactory insurance, stop-loss, reserves or other arrangements so that it may be expected to satisfy its obligations to MCOs, providers and enrollees;
(2) enter into management contracts with MCOs to perform management functions permitted to be delegated by this Subpart or guidelines issued by the commissioner from time to time, subject to the prior written approval of any such contract by the commissioner pursuant to section 98-1.11 of this Subpart; provided, however, that the standards applied by the IPA in performing such delegated functions shall be approved in writing by the delegating MCO as being substantially similar to those applied by the MCO directly and/or pursuant to delegation to the MCO's enrollee population as a whole. IPAs performing management functions pursuant to management contracts with MCOs, as authorized by this paragraph, shall comply with all statutory and regulatory requirements, including registration as a utilization review agent, and timeframes applicable to the responsibilities delegated and activities being managed;
(3) contract with other individuals and entities to obtain technical and administrative services; provided, however, that an IPA may not through contract or any other arrangement, delegate to any person authority to exercise the governing authority and responsibilities of the IPA, nor may it delegate, through assignment or otherwise, any IPA authority or responsibility acquired pursuant to a management agreement with an MCO in accordance with this Subpart to any person unless the parties have received the prior approvals of the commissioner and the delegating MCO as required by statute or this Subpart;
(4) contract with other IPAs in order that providers under contact with such other IPA may be made available to the MCOs and/or workers' compensation preferred provider organizations for which the contracting IPA arranges for the delivery of services; and
(5) have access to enrollee medical records to the extent necessary to perform management functions pursuant to a management contract with an MCO in accordance with this Subpart and pursuant to article 44 of the Public Health Law and guidelines issued by the commissioner, subject to applicable State and Federal requirements concerning the confidentiality of records, including those involving HIV and alcohol and substance abuse services;
(f) An IPA, in addition to the powers and purposes allowed under this Part, may seek certification as an Accountable Care Organization (ACO) pursuant to article 29-E of the Public Health Law and Part 1003 of this Title. An IPA certified as an ACO shall comply with all the requirements of Part 1003, including but not limited to the requirements of section 1003.6(e) and (g) of this Title. Upon receiving such certification, an IPA acting as an ACO may contract with the entities listed in section 1003.2(x) of this Title.
(g) An IPA, in addition to the powers and purposes allowed under this Part, may include any and all necessary powers and purposes as authorized, allowed, or required under an approved Delivery System Reform Incentive Payment (DSRIP) program project pursuant to New York’s Partnership Plan section 1115(a) Medicaid demonstration extension, as amended April 14, 2014.
(7) a copy of any proposed contract to be made with a licensed insurer or accredited reinsurer, for the purpose of insuring or reinsuring for individual catastrophic costs or out-of-area emergency care, if applicable. Prior to approval of the certificate of authority, photocopies of the executed contracts must be submitted to the commissioner and superintendent;
(8) draft copies of individual enrollee contracts and group contracts that are to be entered into with employers, unions, trustees or other organizations, if applicable. Prior to approval of the certificate of authority, the final contracts must be submitted to the commissioner and, if applicable, superintendent;
(9) identification of the type of MCO that is proposed and a description of the service delivery system of the proposed MCO, including the location of primary care providers and, if applicable, providers of other services such as ambulatory, ancillary and hospital services;
(10) a description of the staff for the proposed MCO, including the functional titles of staff. The number and type of staff that will be hired should relate to projections of utilization. Except for PCPCPs, the applicant should discuss the basis on which providers and services have been developed to meet the needs of the projected enrolled population initially and up to the break-even point of operation. The PCPCP applicant should discuss the basis on which providers have been developed to meet the needs of the projected enrolled population;
(11) a description of the population to be enrolled, including projections of enrollment on a monthly basis until the break-even point, or for PCPCPs, a description of the population to be enrolled, including projections of enrollment on a monthly basis for the first three years of operations;
(12) a description of the proposed service area, including a description of access to services as it relates to existing transportation modes;
(13) a description of the benefit package, including a description of copayments, if applicable;
(14) a description of the marketing plan, including all draft marketing materials;
(15) a detailed description of the enrollee grievance and appeal system and complaint procedures to be utilized;
(16) a description of the quality assurance program and the quality assessment and performance improvement plan to be implemented;
(17) a description of the data management information system;
(18) the applicant's proposed rates of payment for enrollees, including the basis and manner of calculating those rates. Except for the MCO in-network component of a large group point-of-service (POS) product of MCOs, which may be experience rated consistent with the formula used in rating the out-of-network component of the POS product and in accordance with section 4308(b) of the Insurance Law, such proposed rate shall be consistent with the principles of community rating. For PCPCPs, such information shall be provided upon request by the commissioner;
(19) for HMO applicants, demonstration of a willingness to provide community services that include at least the following: a willingness to enter into a contract with the local social services district to enroll and serve individuals eligible for benefits under title XIX, including the steps and a time frame for entering into such contract; a willingness to provide coverage to Medicare beneficiaries; and demonstration that the HMO offers open enrollment pursuant to articles 32 and 43 of the Insurance Law, including steps and a time frame for offering such coverage. For the purpose of this section, open enrollment shall mean offering enrollment throughout the year to groups consisting of two or more eligible members who elect to enroll, subject to such reasonable limitations as an affiliation or waiting period not to exceed two months from the date of the enrollee's application until the commencement of coverage, provided that coverage may not be excluded based upon a preexisting condition for groups of more than 50; and
(20) such other and additional information as the commissioner may require to make the determinations required in sections 4403, 4403-a, 4403-c, 4403-e, 4403-f and 4408-a of the Public Health Law. Additional information must be provided within 30 days of the date of a request. The applicant may request from the commissioner an extension beyond the 30-day period, the granting of which may be made by the commissioner upon a finding that an extension is justified by the public interest. Failure to provide such additional information within the time prescribed or as extended by the commissioner shall constitute a withdrawal of the application.
(c) An application under this section may be amended while the matter is pending before the commissioner. Any amendment to an application must be accompanied by a written explanation of the reason for the amendment.
(d) Except for PHSPs, HIV SNPs and PCPCPs, upon receipt of the application for a certificate of authority, the commissioner shall transmit copies of such application and accompanying documents to the superintendent for review and comment.
(e)
(1) An MCO or IPA proposing to change its corporate, company or other name, or to use a new assumed name or change an approved assumed name shall submit an executed copy of the required documentation to the commissioner for review and prior written approval. The submission shall include a certification by an MCO or IPA officer, owner or counsel that use of the proposed name or assumed name in New York is not prohibited by law, that it is not already in use and that it is not otherwise unavailable for use.
(2) The commissioner shall, when reviewing a proposed name, consider whether it is reasonably likely that its use could confuse or mislead the public, MCO enrollees or providers to their detriment and, if he/she determines that it could so confuse or mislead, shall withhold approval.
(3) An MCO or IPA which proposes to use an approved assumed name in an additional jurisdiction(s), or to discontinue the use of an approved assumed name completely or in a particular jurisdiction(s), shall provide the commissioner with 30 days' prior notice of such proposed change(s) together with an executed copy(ies) of the required documentation.
(4) The commissioner may consult with the superintendent concerning any proposed name or assumed name and make available copies of any documentation submitted pursuant to this subdivision.
(5) Use of a name of assumed name which has not received the commissioner's prior approval pursuant to this subdivision shall render the MCO or IPA subject to action or civil penalty pursuant to section 12 of the Public Health Law.
(f) Nothing contained in article 44 of the Public Health Law or this Subpart shall be construed to diminish the applicability of the requirements or provisions of any other laws pursuant to which an entity is organized.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-4 CARDIOVASCULAR TISSUE BANKS
10 CRR-NY 52-4.11 Records to be kept by the tissue transplantation facility
(a) The director of each tissue transplantation service shall be responsible for records kept by the tissue transplantation facility. In addition to the records specified in Subpart 52-2 of this Part, the following records shall be kept, separate from recipient records, by the tissue transplantation facility:
(1) if performed, results of testing for bacterial and fungal contamination after tissue thawing and prior to engraftment;
(2) a disposition log allowing accurate tracking of tissue to each recipient; and
(3) records of appropriate storage and temperature monitoring of cardiovascular tissue.
(b) A copy of the order for issuance of the cardiovascular tissue, including the name and signature of the ordering physician or person authorized by law to order such issuance, shall be kept by the tissue transplantation facility. A record in the patient's chart shall be satisfactory documentation of such order for issuance.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
OFFENSES, VIOLATIONS AND ENFORCEMENT OFFENSES, VIOLATIONS AND ENFORCEMENT
10 CRR-NY 80.122 Enforcement
It shall be the duty of the department to enforce all of the provisions of article 33 of the Public Health Law and all of the rules, regulations and determinations made thereunder.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 16.10 Inspections, surveys, checks and tests; vacating installations; securing radiation sources
(a) Each person who possesses any radiation source shall make, or cause to be made, the applicable surveys required under this section and such additional surveys as may be necessary for him/her to comply with other sections in this Part or as the department may direct in order to evaluate the extent of the radiation hazard that may be present.4 Each person who possesses any radioactive material not in a sealed source for which surveys are required shall provide or have available appropriate calibrated and operable instruments capable of detecting and measuring radiation and radioactive contamination.
(1) Any radiation installation subject to the registration requirements of section 16.50(a) of this Part shall be inspected periodically to assure compliance with this Part and the maintenance of radiation exposures as far below the limits set forth in this Part as is reasonably achievable. Except as otherwise provided in subparagraph (ii) of this paragraph, inspections shall be made at a frequency as specified in subparagraph (i) of this paragraph, with the first inspection of an installation to be made at the time of the beginning of operation and subsequent inspections not to exceed the maximum interval specified for such installation in subparagraph (i) of this paragraph. The inspection shall be performed in a manner, and reported in writing on a form, prescribed by the department. The person who makes the inspection shall include in such report all recommendations necessary to accomplish compliance with this Part, and to reduce radiation exposure as far below the limits set forth in this Part as reasonably achievable. The inspection shall be made by the department, the New York City Department of Health or, as the department shall direct, by the appropriate county or part-county health officer having jurisdiction or by a certified radiation equipment safety officer. Such county or part-county health officer or the New York City health commissioner shall make the inspection only under an inspection program that is certified by the department in writing as approved and in effect. He/she may make the inspection or have it made by a duly authorized representative approved for such purpose by both such health officer and the department. The operator of an installation required to be inspected by a certified radiation equipment safety officer, shall be solely responsible for having all such required inspections made.
(i) Hospital, clinic, mammography and radiologist installations shall be inspected at least once every year; dental, podiatric and veterinary installations at least once every three years; and all other installations at least once every two years. Follow-up inspections shall be made at intervals of 60 days or less for the correction of any violation found during an inspection and remaining uncorrected at the conclusion thereof.
(ii) The department may establish a schedule of required inspections of any installation different from the schedule specified in this paragraph.
(iii) The certified radiation equipment safety officer or the health officer having jurisdiction, as the case may be, shall furnish the inspection report, signed by the person who made the inspection, to the operator of the installation and a copy thereof to the department in accordance with the instructions of the prescribed form.
(2) Radiation installations wherein radioactive materials are handled or installed which will have any readily accessible area in which there is reasonable expectation that a radiation level will exist in excess of two millirems per hour shall be surveyed during the initial operation and whenever any change is made in the installation or its use that might increase the radiation level to which a person could be exposed.
(3) Accessible areas and equipment within radiation installations wherein radioactive material not contained in a sealed source is handled or installed shall be surveyed at least once a month for radioactive contamination unless a shorter interval is specified in a license issued pursuant to this Part. Radioactive contamination of surfaces shall be kept ALARA and shall be brought to levels not to exceed the limits specified in Appendix 16-A, Table 7, infra.
(4) Each sealed source, containing radioactive material other than Hydrogen 3, with a half- life greater than 30 days and in any form other than gas shall be tested for leakage prior to initial use and at successive intervals thereafter not to exceed six months, except that each source designed for the purpose of emitting alpha particles shall be tested at intervals not to exceed three months. Notwithstanding the periodic leak test required by this paragraph, any licensed sealed source is exempt from such leak tests when the source contains 100 microcuries or less of beta and/or gamma emitting material or 10 microcuries or less of alpha emitting material. Except for alpha sources, the periodic leak test required by this paragraph shall not apply to sealed sources that are stored and not being used. The sources excepted from this test shall be tested for leakage prior to any use or transfer to another person unless they have been leak tested within six months prior to the date of use or transfer. In the absence of the delivery of a certificate by the transferor to the transferee indicating that a test pursuant to the applicable provisions of this Part was made within six months prior to the transfer, the source shall not be used until tested for leakage. If there is reason to suspect that a sealed source might have been damaged, or might be leaking, such source shall be tested for leakage before further use. The test sample shall be taken from selected accessible surfaces of the sealed source or from the surfaces of the device in which the sealed source is permanently mounted or stored. For teletherapy and/or irradiator sources, the selected accessible surfaces should be those surfaces on which one might expect contamination (if there were to be leakage) to accumulate and shall include the inner surface of the most frequently used treatment cone or beam collimating device. The test sample shall be taken with the source in the “off” position. The leak test technique shall be capable of detecting:
(i) the escape of radon at the rate of 0.001 microcurie or more per 24 hours for sealed radium sources; or
(ii) 0.005 microcurie or more of removable radioactivity from all other sealed sources.
Detection of a leak in any sealed source in excess of the sensitivity levels set forth in this paragraph shall result in immediate suspension in the use of such source until such source is decontaminated and repaired or disposed of in accordance with section 16.8 of this Part. Records of leak test results shall be kept in units of microcuries per test sample and maintained for inspection by the department. A leaking source report shall be submitted to the department for each source found to be leaking in excess of the above sensitivity levels within five days of detection of the leak and shall describe the equipment involved, the test results, and the corrective action taken.
(5) Protective devices such as interlocks, safety switches, fume hoods, filters and trapping devices for radioactive gases, shall be maintained in good repair and proper operating condition.
(b) Each person who possesses any radioactive material shall, no less than 30 days prior to decontrolling a controlled area or vacating, or relinquishing possession or control of premises wherein radioactive material is or has been stored or used shall have the premises surveyed and shall notify the department in writing of his intent to decontrol a controlled area or to vacate and the results of the survey. When deemed necessary by the department, such person shall decontaminate the premises to such radiation levels as the department may specify. Such person shall provide the health officer having jurisdiction, the operator of the installation housed on the premises and the landlord or subsequent tenant with a copy of a report of the results of the survey made pursuant to this subdivision.
(c) Each person who possesses any radiation source shall secure such source against its unauthorized removal from its place of storage or use. The following additional restrictions apply to noncontrolled areas:
(1) Radiation sources stored in a noncontrolled area shall be stored in a locked facility in the original shipping container, or a container providing equivalent radiation protection. Such a facility may be a cabinet, a safe or a room, providing the facility is locked at all times when no activities are in progress relating to the use of the radiation sources.
(2) Radiation sources in a noncontrolled area and not in storage shall be tended under the constant surveillance and immediate control of the licensee or registrant.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 154 WAYNE COUNTY
10 CRR-NY 154.5 Village of Palmyra
See section 132.1, supra.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.15 Rates for LTHHCP without adequate cost experience
(a) This subdivision shall apply where the fiscal and statistical data of the facility are unavailable through no fault of the provider or its agents, and due to circumstances beyond its control, or where there is a new facility without adequate cost experience as set forth in section 86-5.2 of this Subpart.
(b) The rates certified for such LTHHCP's as set forth in subdivision (a) of this section shall be determined on the basis of generally applicable factors, including but not limited to the following:
(1) cost guidelines as defined in section 86-5.12 of this Subpart and
(2) allowable costs as defined in section 86-5.17 of this Subpart.
(c) All rates of reimbursement certified pursuant to this section will be subject to audit pursuant to section 86-5.7 of this Subpart.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
MOBILE FOOD SERVICE ESTABLISHMENTS MOBILE FOOD SERVICE ESTABLISHMENTS
10 CRR-NY 14-4.33 Definition of law
Law means and includes Federal, State and local statutes, ordinances and regulations.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 82 HEALTH SYSTEMS AGENCIES
Subpart 82-1 ORGANIZATION AND FUNCTIONS OF HEALTH SYSTEMS AGENCIES
10 CRR-NY 82-1.3 Legal structure
A health systems agency shall be a corporation organized pursuant to the Not-for-Profit Corporation Law which is incorporated in New York State, which is not a subsidiary of, or otherwise controlled by, any other private or public corporation or other legal entity, and which only engages in health planning and development activities and functions as defined in section 82-1.6 of this Subpart.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.1 Applicability
(a) This Part shall apply to every home care services agency certified, licensed or authorized under article 36 of the Public Health Law, including agencies exempt under Public Health Law section 3619; to every hospice program certified under article 40 of the Public Health Law; to every enhanced assisted living residence licensed under article 7 of the Social Services Law and certified under article 46-B of the Public Health Law; and any education or training program for advanced home health aides or home health aides or personal care aides that is authorized, licensed or approved by either the department or the New York State Education Department; and any person who has successfully completed a State approved education or training program.
(b) Nothing in this Part shall be construed to amend, supersede or otherwise modify any requirements of the regulations of the Department of Health relating to the education or training of advanced home health aides or home health aides or personal care aides by New York State authorized education or training programs.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.111 Manual facilities
(a) The preferred manual method of cleaning and sanitizing equipment and utensils is to use a three-compartment sink; to wash in the first compartment with hot water and a detergent; rinse in clean hot water in the second compartment; and sanitize in the third compartment.
(b) A two-compartment sink is an acceptable method where equipment and utensils are washed in a hot detergent-sanitizer solution kept clean and at the manufacturer's recommended concentration in the first compartment and rinsed in a solution containing the same detergent-sanitizer at a kept concentration recommended by the manufacturer. The detergent-sanitizer must be one acceptable to the Commissioner of Health.
(c) The procedure used to clean and sanitize must produce an average plate count of not more than 100 colonies on the surface of utensils examined and free from coliform bacteria.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.18 Withdrawal or abandonment of review request
(a) A request for review of a claim or prior approval request denial will be considered to have been withdrawn under the following circumstances:
(1) the fund administrator has received a written statement from the enrollee or the enrollee's authorized representative stating that the request for review is withdrawn; or
(2) the enrollee or the enrollee's authorized representative has made a statement withdrawing the request to the hearing officer on the record at the hearing.
(b) A request for review will be considered to have been abandoned if neither the enrollee nor the enrollee's authorized representative appears at the hearing unless the enrollee or the enrollee's authorized representative provides the fund administrator, within 30 days of the scheduled date of the hearing, a good cause explanation for such failure to appear.
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.9 Reports: place of filing
All reports required by section 22.3 of this Part shall be filed with the Director of the Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 443 LISTING OF ACCOUNTS
10 CRR-NY 443.4 Listing of accounts—balance sheet
[2200]
)
)
)
)
)
)
)
)
)
)
)
Chapter I STATE SANITARY CODE
Part 22 ENVIRONMENTAL DISEASES
10 CRR-NY 22.2 Supplementary reports of low birth weights for epidemiological surveillance; filing
Every physician, hospital, and person in attendance at live births shall file a supplementary report with the State Commissioner of Health of each live birth for which the birth weight is 2,500 grams (5.2 pounds) less. Such report shall be filed within 10 days of the birth and shall be on such forms as may be prescribed by the commissioner to facilitate epidemiological investigation and surveillance.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
MISCELLANEOUS MISCELLANEOUS
10 CRR-NY 14-1.182 Laundry facilities
(a) Laundry facilities in a food service establishment are restricted to the washing and drying of linens, clothes, uniforms and aprons necessary to the operation.
(b) A separate room is required for laundry facilities, except that such operations may be conducted in storage rooms containing only packaged foods or packaged single-service articles.
(c) Clean clothes and linens are to be stored, until used, in a clean place protected from contamination.
(d) Soiled clothes and soiled linens are to be stored in nonabsorbent containers or washable laundry bags until removed for laundering.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
OUTPATIENT PSYCHIATRIC CARE OUTPATIENT PSYCHIATRIC CARE
10 CRR-NY 85.33 Nursing service
(a) Where nursing care may be provided.
Nursing service as medically needed shall be provided to medical assistance recipients in the patient's home or in a hospital.
(b) Who may provide nursing care.
(1) Nursing care to patients in New York State shall be provided by a person possessing a license and current registration from the New York State Education Department to practice as a registered professional nurse or licensed practical nurse.
(2) Out-of-state nurses providing care to a New York State Medical Assistance patient who is temporarily located outside New York State, must be licensed and registered in the state in which they are practicing.
(c) Private duty nursing care in the hospital.
Private duty nursing care in the hospital shall be provided on the recommendation of the patient's attending physician when the patient is in need of individual and continuous care beyond that available by the staff of a hospital, including that which is available in a critical care area.
(d) Nursing service in the home.
(1) For necessary nursing service to be provided in the person's home, full and primary use shall be made of the services of an approved home health agency, including a hospital-based home health agency.
(2) Such service shall be provided on a per visit basis and may include not only intermittent or part-time nursing service for the patient but also instructions to members of the patient's family in procedures necessary for the care of the patient.
(3) Service of a registered professional nurse or of a licensed practical nurse on a private practitioner basis may be provided to a patient in his or her own home only under the following circumstances:
(i) when there is no approved home health agency available to provide the intermittent or part-time nursing services need by the patient; and
(ii) when the patient is in need of individual and continuous nursing care beyond that available from an approved home health agency.
(e) Prior approval and prior authorization.
Prior approval by the local professional director and prior authorization by the local social services official shall be required for nursing service provided in a person's home or in a hospital by a private practicing registered professional or licensed practical nurse, except that in an urgent situation the attending physician may order the service of such nurse for no more than two nursing days and immediately notify the local social services official and the appropriate medical director.
(f) Physician's written order required.
All nursing services provided in the patient's home or in a hospital shall be in accordance with the attending physician's written order and plan of treatment; however, in extraordinary circumstances and for valid reasons which must be documented, nursing service in the home may be initiated by a home health agency before the physician sees the patient. A physician's written order is required for all such nursing services in excess of the initial two visits.
(g) Reimbursement.
(1) Reimbursement for nursing services rendered by a registered professional nurse or licensed practical nurse on a private practitioner basis shall be in accordance with fees developed by the Department of Health and approved by the State Budget Director.
(2) Reimbursement shall not be allowed on a fee paid to a legally responsible relative who provides nursing services in the patient's home or in a hospital.
(3) Payment for nursing services provided by an approved home health agency, including a hospital-based home health agency, shall be at rates established by the State Commissioner of Health pursuant to subdivision 7 of section 206 of the Public Health Law and reimbursement for such expenditures shall be at such rates.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 444 DESCRIPTION OF ACCOUNTS
BALANCE SHEETS BALANCE SHEETS
10 CRR-NY 444.2 UNRESTRICTED FUND ASSETS
[3110]
(a) CURRENT ASSETS.
[3111]
(1) 1010
CASH
1011
General Checking Accounts
1012
Payroll Checking Accounts
1013
Other Checking Accounts
1014
Imprest Cash Funds
1015
Savings Account
1016
Certificates of Deposit
1019
Other Cash Accounts
These cash accounts represent the amount of cash on deposit in banks and immediately available for use in financing Unrestricted Fund activities, amounts on hand for minor disbursements, and amounts invested in savings accounts and certificates of deposit.
(2) 1020
INVESTMENTS
1021
U.S. Government Securities
1022
Other Current Investments
1023
Share of Pooled Investments
1029
Other Investments
Current securities and investments, evidenced by certificates of ownership or indebtedness, must be reflected in these accounts.
(3) 1030
ACCOUNTS AND NOTES RECEIVABLES
1031
Inpatient Receivables—Inhouse
1032
Inpatient Receivables—Discharged and Unbilled
1033
Inpatient Receivables—Medicare
1034
Inpatient Receivables—Medicaid
1035
Inpatient Receivables—Other
1036
Outpatient Receivables—Unbilled
1037
Outpatient Receivables—Medicare
1038
Outpatient Receivables—Medicaid
1039
Outpatient Receivables—Other
(i) These accounts shall reflect the amounts due from hospital patients and their third-party sponsors.
(ii) Separate accounts may be maintained for different levels of inpatient care ( i.e., Acute and Intensive, Skilled Nursing, etc.) and outpatient care ( i.e., Emergency Room, Clinic) and for different payors, if desired. This may be accomplished by the inclusion of digits to the right of the decimal point.
(iii) Notes receivable and accounts receivable may also be segregated, but there is usually little to be gained from this practice, as the amount of notes receivable will usually be nominal.
(iv) 1031
Inpatient Receivables—Inhouse
This account shall reflect all charges and credits (at the hospital's full established rates) for medical services rendered to patients still in hospital.
(v) 1032
Inpatient Receivables—Discharged and Unbilled
This account shall reflect all charges and credits (at the hospital's full established rates) for medical services rendered to patients who have been discharged but not yet billed.
(vi) 1033
Inpatient Receivables—Medicare—Discharged and Billed
This account should be used only if the hospital is not on the Periodic Interim Payment Program. The balance in this account reflects all unpaid charges billed to the Medicare intermediary. Direct billings to the Medicare inpatient (or to Medicaid) for deductibles, coinsurance, and other patient-chargeable items would also be included in this account if such billings were not included in Inpatient Receivables—Other (or Inpatient Receivables—Medicaid).
(vii) 1034
Inpatient Receivables—Medicaid—Discharged and Billed
The balance in this account reflects all unpaid charges billed to Medicaid. Direct billings to the Medicaid inpatient (or to the Medicare intermediary) for deductibles, coinsurance, other patient- chargeable items and items under “Part B” Medicare coverage would also be included in this account if such billings were not included in Inpatient Receivables—Other (or Inpatient Receivables—Medicare).
(viii) 1035
Inpatient Receivables—Other—Discharged and Billed
Include in this account all unpaid billings for medical services and supplies provided to all non- Medicare, non-Medicaid inpatients. Direct billings to Medicare and Medicaid inpatients for deductibles, coinsurance, and other patient-chargeable items may also be included if they are not included elsewhere.
(ix) 1036
Outpatient Receivables—Unbilled
This account reflects all unbilled charges and credits (at the hospital's full established rates) for medical services rendered to outpatients.
(x) 1037
Outpatient Receivables—Medicare
The balance in this account reflects all unpaid charges billed to the Medicare intermediary. Direct billings to the Medicare outpatient (or to Medicaid) for deductibles, coinsurance, and other patient-chargeable items would also be included in this account if such billings were not included in Outpatient Receivables—Other (or Outpatient Receivables—Medicaid).
(xi) 1038
Outpatient Receivables—Medicaid
The balance in this account reflects all unpaid charges billed to Medicaid. Direct billings to the Medicaid outpatient (or to the Medicare intermediary) for deductibles, coinsurance, other patient-chargeable items, and “Part B” coverage, would also be included in this account if such billings are not included in Outpatient Receivables—Other (or Outpatient Receivables—Medicare).
(xii) 1039
Outpatient Receivables—Other
Include in this account all unpaid billings for medical services and supplies provided to all non-Medicare, non-Medicaid outpatients. Direct billings to Medicare and Medicaid outpatients for deductibles, coinsurance, and other patient-chargeable items may also be included if they are not included elsewhere.
(4) 1040
ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES
AND THIRD-PARTY CONTRACTUALS
1041
Allowance for Bad Debts
1042
Allowance for Contractual Adjustments—Medicare
1043
Allowance for Contractual Adjustments—Medicaid
1047
Allowance for Contractual Adjustments—Other
1049
Allowance for Other Adjustments
These are valuation (or contra-asset) accounts whose credit balances represent the estimated amount of uncollectible receivables from patients and third-party payors. For details on the computation of the related deductions from revenue, see the account descriptions of the Deductions from Revenue accounts.
(5)
(i) 1050
RECEIVABLES FROM THIRD-PARTY PAYORS
(i) 1051
PIP Clearing Account
During the year, this account reflects the difference between amounts billed to the Medicare intermediary for applicable services rendered, and periodic interim payments received from the Medicare intermediary. At year-end, this account must be closed out, with the balance going to the account entitled Contractual Adjustment—Medicare.
1052
Other Receivables—Third-Party Cost Report
Settlement—Medicare
1053
Other Receivables—Third-Party Cost Report
Settlement—Medicaid
1059
Other Receivables—Third-Party Cost Report
Settlement—Other
(ii) The balance of this account reflects the amount due from third-party reimbursement programs based upon cost reports submitted and/or audited. Sub-accounts may be maintained for each year's settlement if more than one year's settlement is included in an account.
(6) 1060
PLEDGES AND OTHER RECEIVABLES
1061
Pledges Receivable
1062
Allowance for Uncollectible Pledges
1063
Grants and Legacies Receivable
1064
Interest Receivable
1065
Accounts and Notes Receivable—Staff, Employees, etc.
1066
Intercompany Advances, Current
1069
Other Receivables
These accounts reflect other amounts due to the Operating Fund for other than patient services.
(7) 1070
DUE FROM OTHER FUNDS
1072
Due from Board-Designated Assets
1073
Due from Plant Replacement and Expansion Fund
1074
Due from Specific Purpose Fund
1075
Due from Endowment Fund
The balances in these accounts reflect the amounts due from designated assets or restricted funds to the Operating Fund. The balance of these accounts should not be construed as a receivable in the sense that a claim external to the hospital exists. Instead, this balance should be viewed as representing assets of the Operating Fund which are currently accounted for as restricted funds.
(8) 1080
INVENTORY
1081
Inventory—General Stores
1082
Inventory—Pharmacy
1083
Inventory—Central Services and Supplies
1084
Inventory—Dietary
1085
Inventory—Plant Operating and Maintenance
1089
Inventory—Other
These balances reflect the cost of unused hospital supplies. Any generally accepted cost method ( e.g., FIFO, LIFO, etc.) may be used as long as it is consistent with that of the preceding accounting period. The extent of inventory control and detailed record-keeping will depend upon the size and organizational complexity of the hospital.
(9) 1090
PREPAID EXPENSES AND OTHER CURRENT ASSETS
1091
Prepaid Insurance
1092
Prepaid Interest
1093
Prepaid Rent
1094
Prepaid Pension Plan Expense
1095
Prepaid Taxes
1096
Prepaid Service Contracts
1097
Other Prepaid Expenses
1098
Deposits
1099
Other Current Assets
These prepaid asset and other current asset accounts represent costs incurred which are properly chargeable to a future accounting period. Other current assets not included elsewhere are also contained in these accounts.
(b) BOARD DESIGNATED ASSETS.
[ 3112 ]
(1) 1110
CASH
1111
General Checking Accounts
1113
Other Checking Accounts
1115
Savings Accounts
1116
Certificates of Deposit
1119
Other Cash Accounts
(2) 1120
INVESTMENTS
1121
U.S. Government Securities
1122
Other Current Investments
1123
Share of Pooled Investments
1129
Other Investments
(3) 1160
PLEDGES AND OTHER RECEIVABLES
1161
Pledges Receivable
1162
Allowance for Uncollectible Pledges
1163
Grants and Legacies Receivable
1169
Other Receivables
(4) 1170
DUE FROM OTHER FUNDS
1173
Due from Plant Replacement and Expansion Fund
1174
Due from Specific Purpose Fund
1175
Due from Endowment Fund
(5) 1190
PREPAID EXPENSES AND OTHER CURRENT ASSETS
1199
Other Current Assets
(6) Included in these accounts are assets which have been designated (or appropriated) by the governing board for special use.
(c) PROPERTY, PLANT AND EQUIPMENT.
[ 3113 ]
(1) 1200
LAND
The balance of this account reflects the cost of land used in hospital operations. Included here is the cost of offsite sewer and water lines, public utility charges for servicing the land, governmental assessments for street paving and sewers, the cost of permanent roadways and of grading of a nondepreciable nature, the cost of curbs and of sidewalks whose replacement is not the responsibility of the hospital, as well as other land expenditures of a nondepreciable nature. Unlike buildings and equipment, land does not deteriorate with use or with the passage of time; therefore, no depreciation is accumulated.
(2) 1210
LAND IMPROVEMENTS
1211
Parking Lots
1219
Other Land Improvements
All land expenditures of a depreciable nature that are used in hospital operations are charged to this account. This would include the cost of onsite sewer and water lines; paving of roadways, parking lots, curbs and sidewalks (if replacement is the responsibility of the hospital), as well as the cost of shrubbery, fences and walls.
(3) 1220
BUILDINGS
1221
Hospital
1224
Clinic
1225
Student Housing Facility
1226
Employee Housing Facility
1227
Non-Paid Workers Housing Facility
1228
Skilled Nursing Facility
1229
Parking Structure
The cost of all buildings and subsequent additions used in hospital operations shall be charged to this account. Included are all architectural, consulting and legal fees related to the acquisition or construction of buildings. Interest paid during construction financing is a cost of the building and is included in this account.
(4) 1230
FIXED EQUIPMENT
1231
Hospital
1234
Clinic
1235
Student Housing Facility
1236
Employee Housing Facility
1237
Non-Paid Workers Housing Facility
1238
Skilled Nursing Facility
1239
Parking Structure
(i) The cost of all fixed equipment used in hospital operations shall be charged to this account. Fixed equipment has the following general characteristics:
Affixed to the building, not subject to transfer or removal.
A life of two or more years, but less than that of the building to which it is affixed.
Used in hospital operations.
(ii) Fixed equipment includes such items as boilers, generators, elevators, engines, pumps and refrigeration machinery, including the plumbing, wiring, etc. necessary for equipment operations.
(5) 1240
LEASEHOLD IMPROVEMENTS
All expenditures for the improvement of a leasehold used in hospital operations shall be charged to this account.
(6) 1250
EQUIPMENT
(i) 1251
Major Movable Equipment
Equipment to be charged to this account has the following general characteristics:
Ability to be moved, as distinguished from fixed equipment.
A more or less fixed location in the building.
A unit cost large enough to justify the expense incident to control by means of an equipment ledger.
Sufficient individuality and size to make control feasible by means of identification tags.
A minimum useful life at time of acquisition of three years or more.
Used in hospital operations.
Major movable equipment includes such items as automobiles and trucks, desks, beds, chairs, accounting machines, sterilizers, operating tables, oxygen tents and X-ray apparatus.
(ii) 1259
Minor Movable Equipment
Equipment to be charged to this account has the following general characteristics:
Location generally not fixed; subject to requisition or use by various cost centers of the hospital.
Relatively small in size and unit cost.
Subject to storeroom control.
Fairly large number in use.
A useful life of less than three years.
Used in hospital operations.
Minor equipment includes such items as wastebaskets, bedpans, basins, glassware, silverware, pots and pans, sheets, blankets, ladders, and surgical instruments.
(7) 1260
CONSTRUCTION-IN-PROGRESS
1261
Buildings
1262
Fixed Equipment
1263
Major Movable Equipment
1264
Fees
1265
Insurance
1266
Interest
Cost of construction that will be in progress for more than one month and will be used for hospital operations should be charged to these accounts. Upon completion of the construction program, these accounts should be credited and the appropriate asset account(s) debited.
(8) 1270
ACCUMULATED DEPRECIATION —
LAND IMPROVEMENTS
1271
Parking Lots
1279
Other Land Improvements
(9) 1280
ACCUMULATED DEPRECIATION — BUILDINGS
1281
Hospital
1284
Clinic
1285
Student Housing Facility
1286
Employee Housing Facility
1287
Non-Paid Workers Housing Facility
1288
Skilled Nursing Facility
1289
Parking Structure
(10) 1290
ACCUMULATED DEPRECIATION — FIXED
EQUIPMENT
1291
Hospital
1294
Clinic
1295
Student Housing Facility
1296
Employee Housing Facility
1297
Non-Paid Workers Housing Facility
1298
Skilled Nursing Facility
1299
Parking Structure
(11) 1310
ACCUMULATED DEPRECIATION — LEASEHOLD IMPROVEMENTS
(12) 1320
ACCUMULATED DEPRECIATION — EQUIPMENT
1321
Major Movable Equipment
1329
Minor Movable Equipment
(13) The balances in accounts 1270 through 1329 reflect the depreciation accumulated on the above-mentioned assets used in hospital operations.
(d) OTHER TANGIBLE ASSETS.
[ 3114 ]
(1) 1330
INVESTMENT IN NON-OPERATING PROPERTY, PLANT AND EQUIPMENT
(2) 1340
ACCUMULATED DEPRECIATION — INVESTMENTS IN NONOPERATING PROPERTY, PLANT AND EQUIPMENT
(3) 1350
OTHER TANGIBLE ASSETS
1351
Intercompany Advances, Non-Current
(4) Accounts 1330 and 1340 include the cost (or fair market value at date of donation) of property, plant and equipment not used in hospital operations and accumulated depreciation thereon. Other tangible assets not included elsewhere are contained in account 1350.
(e) INTANGIBLE ASSETS.
[ 3115 ]
(1) 1360
GOODWILL
(2) 1370
UNAMORTIZED BORROWING COSTS
(3) 1380
PREOPENING AND OTHER ORGANIZATIONAL COSTS
1381
Preopening Costs
1389
Other Organization Costs
(4) 1390
OTHER INTANGIBLE ASSETS
(5) Accounts 1360-1390 are used to record intangible assets. If such intangibles are being amortized, the amortization may be directly credited to the asset account, or accumulated in a subaccount. Account 1360, Goodwill, contains the excess of the price paid for a business as a whole over the book value, or over the computer or agreed value of all tangible net assets purchased. Account 1370, Unamortized Borrowing Costs, includes such items as legal fees, underwriting fees, etc.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 108 CLINTON COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 108.12 Peru Water District
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on Furnace Brook and to all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of the public water supply of the Peru Water District, Clinton County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on Furnace Brook which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoir), stream, ditch, gutter or other channel of any kind, the waters of which when running, whether continuously or occasionally, eventually flow or may flow into the public water supply of the Peru Water District.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 200 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the Peru Water District.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Peru Water District.
(3) No privy, cesspool, pit or other receptacle of any kind used for the temporary deposit or storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is made watertight and so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Commissioner of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir nor within 300 feet of any watercourse tributary to the public water supply of the Peru Water District and in such a manner and at such a place as to effectually prevent its being washed over the surface of or through the ground in an imperfectly purified condition into any reservoir or watercourse tributary to the public water supply of the Peru Water District.
(6) Whenever, owing to the character of the soil or of the surface of the ground or to the height or flow of subsoil or surface water or to other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink wastes.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the Peru Water District, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow on the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or within 100 feet of any watercourse tributary to the public water supply of the Peru Water District.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape, flow or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow or percolate into any reservoir or watercourse within a distance of 200 feet from any reservoir or within 75 feet from any watercourse tributary to the public water supply of the Peru Water District.
(3) No clothing, bedding, carpets, harnesses, vehicles, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse tributary to the public water supply of the Peru Water District.
(e) Bathing, animals, manure, compost.
(1) No person shall bathe nor shall any animal be allowed to stand, wallow, wade or swim in any reservoir nor be washed or watered in any reservoir of the public water supply of the Peru Water District. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the Peru Water District.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 300 feet from any reservoir or within 75 feet of any watercourse tributary to the public water supply of the Peru Water District, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainage, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet to any reservoir or 25 feet to any watercourse tributary to the public water supply of the Peru Water District, unless special construction, approved or permitted in writing by the State Commissioner of Health, shall be provided in order to prevent pollution of the reservoir or tributary streams from the above named sources of pollution.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the Peru Water District, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir nor within 300 feet of any watercourse tributary to the public water supply of Peru Water District, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 200 feet from any reservoir or within 25 feet from any watercourse tributary to the public water supply of the Peru Water District.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the Peru Water District.
(f) Dead animals, offal, manufacturing wastes.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Peru Water District.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the reservoir.
(h) Labor camps.
No temporary camp, tent, building or other structure for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 500 feet from any reservoir or 300 feet from any watercourse tributary to the public water supply of the Peru Water District.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 500 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the Peru Water District.
(j) Inspections.
The board of water commissioners of the Peru Water District or such other board, body or person as may be charged with the maintenance of the public water supply shall make or cause to be made regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of water commissioners to promptly notify the State Commissioner of Health of such violations. The board shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Part 155 WESTCHESTER COUNTY
CITIES CITIES
10 CRR-NY 155.1 City of Yonkers
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) shall apply to Grassy Sprain Brook, from its sources to the dam forming the Grassy Sprain Reservoir; Sprain Brook, from its sources to a point where it is diverted into the Grassy Sprain Brook, including the diversion canal from Sprain Brook to Grassy Sprain Brook; Nepperham River, also known as Saw Mill River, from its sources to the intake of the filtration plant of the City of Yonkers; the low service distributing reservoir known as Fort Field Reservoir; the small reservoir at the high service pumping station on Lake Avenue and to all natural and artificial reservoirs on the aforementioned streams and all watercourses tributary thereto or ultimately discharging into said streams and reservoirs, these bodies of water being sources of the public water supply of the City of Yonkers.
(b) Definitions.
(1) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of any kind, the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the City of Yonkers.
(2) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or within 50 feet of any watercourse tributary to the public water supply of the City of Yonkers.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 150 feet of any reservoir or within 75 feet of any watercourse tributary to the public water supply of the City of Yonkers.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is made watertight and [ continued ] so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable removable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and disinfected as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundation or floor of the privy. In effecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid removable receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 300 feet from any reservoir or watercourse tributary to the public water supply of the City of Yonkers.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacle or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacle for excreta or the trench or place of disposal or the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excremental matter from any water closet, privy, cesspool or other source, except the purified effluent from a properly constructed and operated sewage disposal plant approved by the State Department of Health, shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner, either directly or indirectly, into any reservoir or watercourse tributary to the public water supply of the City of Yonkers, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 250 feet of any reservoir or 150 feet of any watercourse tributary to the public water supply of the City of Yonkers.
(2) No sewage disposal plant, the effluent from which is to be discharged or allowed to flow directly or indirectly into any watercourse tributary to the public water supply of the City of Yonkers, shall be constructed, enlarged, altered or put in operation until plans for the same shall have been approved by the State Department of Health and a copy of the plans, as approved, filed with the department of public works of the city of Yonkers.
(3) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste matter from any creamery, cheese factory or laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 100 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(4) No clothing, bedding, carpets, harness, vehicle, receptacle, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall bathe nor shall any animals be allowed to swim, wade or stand nor be washed in any reservoir or watercourse tributary to the Nepperham River within six miles measured along the stream above the intake of the filtration works of the city of Yonkers or the Grassy Sprain Brook within six miles above the dam of the Grassy Sprain Reservoir. This shall not, however, be construed to prohibit animals from being watered in any portion of the watercourses tributary to the public water supply of the city of Yonkers, distant at least one mile measured along the stream from the intake of the filtration plant of the city of Yonkers or from the dam of the Grassy Sprain Reservoir, but no watering place shall be maintained in such a way as to pollute with muddy leachings or excremental matters any watercourse tributary to the public water supply of the city of Yonkers.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or stand* place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 100 feet from any reservoir or within 50 feet of any watercourse tributary to the public water supply of the city of Yonkers, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 100 feet from any reservoir or 50 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the city of Yonkers, nor shall such human excreta, compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 300 feet from any reservoir nor within 200 feet of any watercourse tributary to the public water supply of the city of Yonkers, and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or within 50 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainings, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 75 feet before entering any reservoir or 25 feet before entering any watercourse tributary to the public water supply of the city of Yonkers.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animal, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 200 feet from any reservoir or 75 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice and no ice cutting or any trespassing whatever shall be allowed in or upon the waters or ice of the Fort Field Reservoir, the Lake Avenue Reservoir or any natural or artificial pond or reservoir on the Nepperham River or its tributary within one mile above the intake of the filtration plant of the city of Yonkers or on Grassy Sprain Brook within one mile above the dam of the Grassy Sprain Reservoir.
(h) [Camps.]
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance of 300 feet from any reservoir or 100 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or 150 feet from any watercourse tributary to the public water supply of the city of Yonkers.
(j) Inspections.
The department of public works of the city of Yonkers shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said department of public works to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the department of public works to promptly notify the State Commissioner of Health of such violations. The department of public works shall report in writing annually, on the first day of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-8 OUTPATIENT SERVICES: AMBULATORY PATIENT GROUP
10 CRR-NY 86-8.2 Definitions
As used in this Subpart, the following definitions shall apply:
(a) Ambulatory patient group ( APG ) shall mean a defined group of outpatient procedures, encounters or ancillary services, as specifically identified and published by the department, which reflect similar patient characteristics and resource utilization and which incorporate the use of ICD-9-CM diagnosis codes and CPT-4 and HCPCS procedure codes, as defined below.
(b) Allowed APG weight shall mean the relative resource utilization for a given APG after adjusting for consolidation, packaging, and discounting.
(c) APG relative weight shall mean a numeric value that reflects the relative expected average resource utilization (cost) for each APG as compared to the expected average resource utilization for all other APGs. Procedure-based APG weight shall mean a numeric value that reflects the relative expected average resource utilization (cost) for a specific procedure. A procedure that has been assigned its own weight shall have its payment derived from its procedure-specific weight without regard to the weight of the APG to which the procedure groups.
(d) Base rates shall mean the numeric value that shall be multiplied by the allowed APG weight for a given APG, or by the final APG relative weight to determine the total allowable Medicaid operating payment for a visit.
(e) Consolidation , also known as bundling , shall mean the process for determining if a single payment amount is appropriate in those circumstances when a patient receives multiple APG procedures during a single patient visit.
(f) Current Procedural Terminology, fourth edition (CPT-4) is the systematic listing and coding of procedures and services provided by physicians or other related health care providers. It is a subset of the Healthcare Common Procedure Coding System (HCPCS). the CPT-4 and HCPCS are maintained by the American Medical Association and the Federal Centers for Medicare and Medicaid Services and are updated annually.
(g) Discounting shall mean the reduction in APG payment that results when additional procedures do not consolidate. Additional occurrences of the same ancillary APG within a single visit or episode will also discount.
(h) APG software system shall mean the New York State-specific version of the APG computer software developed and published by Minnesota Mining and Manufacturing Corporation (3M) to process CPT-4 and ICD-9 code information in order to assign patient visits to the appropriate APG category or categories and apply appropriate bundling, packaging and discounting to assign the appropriate final APG weight and associated reimbursement.
(i) Final APG weight shall mean the allowed APG weight for a given visit as expressed in the applicable APG software, and as adjusted by all applicable consolidation, packaging and discounting and other applicable adjustments.
(j) International Classification of Diseases, 9th Revision (ICD-9) is a comprehensive coding system maintained by the Federal Centers for Medicare and Medicaid Services in the US Department of Health and Human Services. It is maintained for the purpose of providing a standardized, universal coding system to identify and describe patient diagnoses, symptoms, complaints, conditions and/or causes of injury or illness. It is updated annually.
(k) Packaging shall mean those circumstances in which payment for routine ancillary services or drugs shall be deemed as included in the applicable APG payment for a related significant procedure or medical visit. Medical visits also package with significant procedures, unless specifically excepted in this regulation.
(l) the downstate region shall consist of the five counties comprising New York City, and the counties of Nassau, Suffolk, Westchester, Rockland, orange, Putnam, and Dutchess.
(m) the upstate region shall consist of all counties in the State other than those counties included in the downstate region.
(n) Significant procedure APG shall mean an APG incorporating a medical procedure that constitutes the primary reason for the visit in terms of time and resources expended.
(o) Medical visit APG shall mean an APG representing a visit during which a patient received medical treatment, but did not have a significant procedure performed.
(p) Visit shall mean a unit of service consisting of all the APG services performed for a patient that are coded on the same claim and share a common date of service.
(1) Episode shall mean a unit of service consisting of all services on a claim, regardless of the coded dates of service. Under episode billing, an episode shall consist of all medical visits and/or procedures that are provided by a clinic to a patient on a single date of service plus any associated non-carved-out ancillaries, regardless of the date of service of those ancillaries. for emergency departments, the significant procedures and/or medical visits comprising the non-carved-out ancillary services portion of an episode need not be on a single date of services and may instead be on consecutive dates of service. Multiple episodes shall not be coded on the same claim.
(2) the calculation of the APG payment by the APG software may be either visit-based or episode-based depending on the rate code used to access the APG software logic. References to "visits" in this Subpart shall be deemed to refer also to "episodes" for rate-setting purposes.
(q) Peer group shall mean a group of providers that share a common APG base rate. Peer groups may be established based on facility licensure, geographic region, types of services provided or categories of patients.
(r) Ancillary services APGs shall mean those APGs designated by the department as reflecting those tests and procedures ordered by physicians to assist in patient diagnosis and/or treatment.
(s) Case mix index shall mean the actual or estimated average final APG weight for a defined group of APG visits.
(t) No blend APG shall mean an APG that has its entire payment calculated under the APG reimbursement methodology without regard to the historical average operating payment per visit for the provider.
(u) MR/DD/TBI peer group shall mean a patient-specific peer group consisting of persons appropriately designated in the Medicaid billing system with mental retardation (MR), developmental disabilities (DD) or traumatic brain injuries (TBI).
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.19 Depreciation for voluntary and public LTHHCP
(a) Reported depreciation based on approved historical cost of buildings, fixed equipment and capital improvements made thereto is recognized as a proper element of cost for voluntary and public LTHHCPs. Useful lives shall be the higher of the reported useful life or those useful lives from Estimated Useful Lives of Depreciable Hospital Assets, 1983 edition. Copies of this publication are available from the American Hospital Association, 840 North Lake Shore Drive, Chicago, IL 60611, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY 12237.
(b) In the computation of the rates effective for voluntary LTHHCPs, depreciation shall be included on a straight-line method on plant and nonmovable equipment. Depreciation shall be funded unless the Commissioner of Health shall have determined, upon application by the LTHHCP, and after inviting written comments from interested parties, that the requested waiver of the requirements for funding is a matter of public interest and necessity. In instances where funding is required, such fund may be used only for capital expenditures with approval as required or for the amortization of capital indebtedness. Funding for plant and fixed equipment shall mean that the transfer of monies to the funded accounts shall occur by the end of the fiscal period in which the depreciation is recorded. Board-designated funds and the accrual of liabilities to the funded depreciation accounts (due to/from accounts) shall not be recognized as funding of depreciation. Deposits to the funded depreciation accounts must remain in such accounts to be considered as valid funding transactions unless expended for the purpose for which it was funded.
(c) In the computation of rates for public LTHHCPs, depreciation is to be included on a straight-line method on plant and nonmovable equipment.
Subchapter C ACCESS TO RECORDS
Part 50 ACCESS TO RECORDS
Subpart 50-3 ACCESS TO PATIENT INFORMATION
10 CRR-NY 50-3.6 Confidentiality
All patient information is confidential as provided for in New York State law and regulations. Any patient information, committee records, deliberations, or correspondence sent to the committee or API coordinator will be treated confidentially and all records will be stored in a secure place.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.7 Prior approval requests for emods
(a) An emod may be approved only when made to the enrollee’s primary residence, except that if physical custody is being shared pursuant to a court order, an emod may also be approved pursuant to this section when made to the primary residence of the enrollee’s non-custodial parent. Proof of ownership of the residence to which the modification(s) are being requested must be submitted to the fund administrator. If the requesting party does not own the residence, written permission of the property owner must be provided. A non-custodial parent applying for an emod to his or her primary residence must also provide a certified copy of the court order awarding shared physical custody.
(b) Any emod approved by the fund administrator must meet all applicable State and local building codes.
(c) The fund administrator may not approve any emod that:
(1) constitutes an improvement to the home that is not medically necessary to ensure the health, welfare and safety of the enrollee by enabling him or her to function with greater independence in the community and/or by helping him or her to avoid institutionalization; or
(2) does not comply with Americans with Disabilities Act (ADA) Accessibility Standards or Guidelines or the Fair Housing Act, if applicable, or has not been determined to be safe by a rehabilitative evaluation agency or specialist or a building contractor as required in paragraph (d)(2) of this section.
(d) An emod request must be accompanied by the following documentation:
(1) a written statement from the enrollee's treating physician on the physician's letterhead explaining why the emod requested is medically necessary;
(2) a comprehensive evaluation of the proposed project by a rehabilitative evaluation agency, rehabilitative specialist, or an independent building contractor who has significant experience working with ADA building standards and accessibility guidelines, including pictures of the specific location in which the emod will be built or installed. The evaluation must specify: a description of the proposed emod; the need for the emod, the reason the proposed emod was selected; whether it is the most cost effective approach to fulfilling the enrollee's need for the emod; and whether there are any safety concerns associated with the proposed emod and if so, how they will be addressed. The evaluation must also explain how the materials to be used in constructing the emod are cost effective in comparison to alternative materials.
(e) Once the request has been reviewed by the fund administrator, the fund administrator shall notify the enrollee or person authorized to act on the enrollee’s behalf in writing which services or items have been approved and/or denied and inform the enrollee or person authorized to act on the enrollee’s behalf of the bidding process that is required prior to the fund administrator approving payment for the emod. The enrollee or person authorized to act on the enrollee’s behalf is then required to obtain a minimum of three acceptable bids from qualified contractors.
(f) Once the fund administrator receives from the enrollee or person authorized to act on the enrollee’s behalf a minimum of three acceptable bids from qualified contractors, the fund administrator shall evaluate the qualifications of each bidder and the content of each bid to determine whether each bid is acceptable. In determining whether a bidding contractor is qualified, the fund administrator will take into account whether the contractor has any outstanding judgements on file and whether any complains have been upheld against the contractor by the Better Business Bureau or the New York State Department of Law. If the enrollee lives in another state or in the District of Columbia, the same type of investigation will be undertaken in that jurisdiction.
(g) An acceptable bid is one that includes:
(1) a description of the scope of work and specifications of the emod;
(2) proof of appropriate and adequate insurance for the duration of the project; and
(3) a statement signed by the contractor or a person duly authorized to sign for the contractor that the work will be done in a workmanlike manner, using materials suitable for purposes of the project and the safety of the enrollee and household members, and will comply with all applicable building and zoning laws.
(h) If less than three bids are submitted, a written explanation of why three acceptable bids were not obtained must be provided, as well as a written explanation of how the determination was made that the one or two bids being considered are reasonably priced.
(i) If the two lowest comparable bids are within ten percent of each other, the enrollee or his or her legally authorized representative may choose one of the two lowest bids. If there is more than a 10 percent difference between the two lowest comparable bids, the fund administrator shall choose the bid that represents the best value for both the fund and the enrollee based on factors including not only the price offered by each bidder but also the quality, durability, extent of any warranties provided, safety of the product itself, and workmanship offered by each bidder. The successful bidder will be notified after the fund administrator or a designee of the fund administrator:
(1) discusses the bids received with the enrollee or the person authorized to act on the enrollee’s behalf and the reasons why a particular bid is chosen by the fund administrator; and
(2) obtains the written consent of the enrollee or the person authorized to act on the enrollee’s behalf to have the emod constructed or installed by that bidder.
If the enrollee or the person authorized to act on the enrollee’s behalf disagrees with the fund administrator’s decision, the enrollee or his or her authorized representative can request a review of the fund administrator’s decision.
(j) The fund administrator will authorize payment to the successful bidder of no more than one-third of the accepted bid amount upon acceptance of the bid unless there are extenuating circumstances about which the fund administrator receives advance notice such as a project that can be completed in one day or a project that involves the purchase of a product prior to installation or construction.
(k) Any change from either the specifications in terms of alternative or substitute equipment or the scope of work involved in the modification that will result in a cost increase from the bid price will require approval from the fund administrator.
(l) No additional payment will be authorized until the fund administrator has received a post-modification evaluation stating that the modification meets the participant's functional needs and is in compliance with the initial evaluation, including adherence to safety and all applicable building code standards.
(m) Payment for the emod shall include the cost of the comprehensive evaluation of the proposed project, the evaluation of required bids if the fund administrator finds it necessary to engage an outside expert, the evaluation of the completed emod, a one year maintenance contract, if deemed appropriate by the fund administrator, as well as the cost of construction or installation of the emod itself.
(n) Repairs for emods that are cost effective may be allowed if appropriate. Modifications that have worn out through normal use ( e.g., faucet, controls, ramps, handrails) may be replaced using the same prior approval process required for new emods.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSILS EQUIPMENT AND UTENSILS
10 CRR-NY 14-4.104 Single-service articles; when required
Single-service articles are to be furnished to consumers at all mobile food service establishments and pushcarts. Single-service articles are to be discarded after use.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter A VITAL RECORDS AND PERSONAL INFORMATION
Part 34 HEALTH CARE PRACTITIONER REFERRALS AND LABORATORY BUSINESS PRACTICES
Subpart 34-2 LABORATORY BUSINESS PRACTICES
10 CRR-NY 34-2.4 Prohibited business practices by clinical laboratories
(a) No clinical laboratory, its agent, employee or fiduciary shall make, offer, give, or agree to make, offer or give, any payment or other consideration to a health services purveyor for the referral of specimens for the performance of clinical laboratory services.
(b) No clinical laboratory, its agent, employee or fiduciary, shall participate in the division, transference, assignment, rebate, or splitting of fees with any health services purveyor, or with another clinical laboratory, in relation to clinical laboratory services.
Chapter I STATE SANITARY CODE
Part 7 TEMPORARY RESIDENCES, MASS GATHERINGS AND CHILDREN'S CAMPS
Subpart 7-3 CAMPGROUNDS
10 CRR-NY 7-3.8 Campsite space requirements
(a) The minimum area per site, for campsites that existed prior to the effective date of this Subpart, shall be either: 1,500 square feet; or, in compliance with subdivision (b) of this section.
(b) New campsites constructed and existing campsites modified after the effective date of this Subpart shall be a minimum of 1,250 square feet. These campsites shall be large enough to allow at least a five foot clearance between the boundaries of the campsite and the exterior surfaces of the camping unit placed on it as well as any add-on structures or appurtenances attached to it, so as to provide for a 10 foot separation distance between camping units on adjacent campsites.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
LIMITATION ON HOSPITAL STAY LIMITATION ON HOSPITAL STAY
10 CRR-NY 85.5 Limitation on hospital stay
(a) To be a covered benefit under medical assistance for the needy as provided in section 365-a(2)(b) of the Social Services Law, any hospital stay beyond 20 days per spell of illness, except for rehabilitation care as hereinafter provided, during which all or any part of the cost of such care, services and supplies are claimed as items of medical assistance shall require a prior determination of coverability by a person designated by the Commissioner of Health. Any hospital stay for care under an established plan for rehabilitation of physical disability in a rehabilitation hospital or rehabilitation unit, beyond 40 days shall require such prior determination of coverability. A written request for such determination shall be made by the patient's physician. Such request shall include evidence documented in the patient's medical record showing that in order to preserve life or to prevent substantial risk of continuing disability, an additional period of care is required of such complexity or intensity that it can be provided only in a hospital. Care of such complexity or intensity shall include, but not be limited to:
(1) severe burns requiring continued therapy in a burns unit.
(2) continuing cardiovascular, renal or pulmonary decompensation requiring care in a coronary care unit, intensive care unit, pulmonary care unit or other acute care setting in the hospital.
(3) central nervous system damage with threatened or impaired consciousness.
(4) persistent fever or serious infection.
(5) persistent hemorrhage or threat of recurrent hemorrhage.
(6) life threatening conditions including malignancy when chemotherapy, radiotherapy or other therapy can be provided and monitored effectively only in a hospital.
(7) conditions requiring physical rehabilitation under an established rehabilitation plan when such treatment can be carried out only in a hospital setting.
(b) Such request for determination of coverability for continued care shall be made before the 20th but not before the 16th day of stay. The determination of coverability shall be for an additional period not to exceed 10 days after the 20th day of stay. Determination of coverability shall be made for additional periods of stay not to exceed 10 days each pursuant to written requests submitted as aforesaid prior to expiration of the last period for which there has been a determination of coverability.
(c) In the case of care under an established plan for rehabilitation of physical disability referred to in subdivision (a) of this section, the request for extended coverability determination shall be made before the 40th but not before the 36th day of stay, and determination of coverability shall not exceed 20 days for the initial additonal period of stay and for any additional period thereafter.
(d) Spell of illness, for the purpose of this section, shall begin on the first day of hospital care and shall end 60 days following discharge from the hospital inpatient service. Except in case of emergency or urgency, readmission during said 60- day period shall be subject to the prior approval of the commissioner's designee upon a showing of necessity to preserve life or to prevent substantial risk of disability.
(e) A determination of coverability may be granted by a designated physician or non-physician under the supervision of a physician. A determination of noncoverability shall be made only by a designated physician. Notice of determination shall be given to the patient's physician, the hospital administrator, and if there is a determination of noncoverability to the patient. A written record of determinations made of such coverability or noncoverability shall be entered in the hospital records and made available for review.
(f) The patient's physician or hospital administrator may, within three days of the date of such notification, appeal such determination of noncoverability in writing to the physician or physicians designated by the Commissioner of Health for such purpose. Notification of decision on appeal shall be given to the patient's physician, the hospital administrator and the patient. If there is a determination of noncoverability or such determination of noncoverability is affirmed on appeal, any inpatient hospital care, services or supplies provided during the additional period of stay requested shall not be a covered benefit under medical assistance for the needy.
Subchapter H FAMILY HEALTH
Part 69 FAMILY HEALTH
Subpart 69-10 NYS MEDICAL INDEMNITY FUND
10 CRR-NY 69-10.10 Prior approval requests for assistive technology (AT)
(a) A request for AT, as defined in section 69-10.1 of this Subpart, will be considered to include a request for AT services, which is assistance provided to the enrollee in the selection, acquisition, and use of the appropriate AT device and necessary training of the enrollee, the enrollee's informal supports, and any paid staff who provide assistance to the enrollee at a time when he or she will be using the AT.
(b) Providers of AT to enrollees of the fund must meet one of the following qualifications:
(1) be approved as provider pursuant to 18 NYCRR Part 504;
(2) be a provider of AT services to the home and community based services waiver program administered by the New York State Office for Persons with Developmental Disabilities or, if the enrollee lives in the District of Columbia or a state other than New York, be a provider for a similar waiver program in the district or other state;
(3) be a licensed and registered pharmacist;
(4) be a durable medical equipment (DME) provider; or
(5) for personal emergency response systems (PERS), be an approved PERS provider with existing contracts with local social services districts or if provided in another state, or the District of Columbia be approved by the appropriate state agency in that state or in the District of Columbia.
(c) A person or organization providing assessments must be:
(1) a New York State Acces-VR approved provider of rehabilitation technology or the equivalent in another state;
(2) a present or former independent living skills trainer for one or more of New York State's home and community based services waivers; or
(3) another professional who is knowledgeable about the full range of devices and/or technology available to assist individuals with disabilities.
(d) Any AT device or supply requested from the fund must meet standards established by underwriters laboratory and/or comply with any applicable Federal communications commission requirements, if applicable. Any AT that would constitute a fixture in the enrollee's residence or on the premises of the residence must meet any applicable ADA, Fair Housing Act, or other safety standards or guidelines that apply.
(e) A request for an AT must include:
(1) a written statement from the enrollee's treating physician on the physician's letterhead explaining why the requested AT is medically necessary, including how the specific equipment being requested will meet the needs and goals of the enrollee in terms of maintaining, increasing or improving his or her functional capacities in a safe, efficient, and reasonably cost effective manner;
(2) copies of all assessments made to determine the necessary AT, including an assessment of the enrollee's unique functional needs and the intended purpose and expected use of the requested AT. Any assessment submitted must include:
(i) information about the individual's expressed needs and preferences, functional limitations and prognosis;
(ii) information about the environment in and circumstances under which the AT will be used;
(iii) the basis for selecting the particular AT being requested, including advantages over other options, how it addresses the enrollee's functional limitations, how it meets the enrollee's needs safely, maintenance expenses, and cost/benefits;
(iv) a description of the alternatives to the particular AT that were considered, including a comparison of features, future expansion or adaptation capabilities, the safety of the enrollee, the overall cost, and the reliability, and if less than three options were considered, the reason for considering less than three must be provided; and
(v) a written explanation of why the AT requested was chosen.
(f) Once the request has been reviewed by the fund administrator, the fund administrator shall notify the enrollee or person authorized to act on the enrollee’s behalf in writing which services or items have been approved and/or denied and inform the enrollee or person authorized to act on the enrollee’s behalf of the bidding process that is required prior to the fund administrator approving payment for the requested AT. The enrollee or person authorized to act on the enrollee’s behalf is then required to obtain a minimum of three acceptable bids from qualified providers for the particular AT requested, except as provided in subdivision (i) of this section.
(g) If the enrollee or person authorized to act on the enrollee’s behalf obtains less than three bids for the requested AT, a written explanation of why three acceptable bids were not obtained must be provided as well as a written explanation of how the determination was made that the one or two bids being considered are reasonably priced.
(h) If the two lowest bids are within 10 percent of each other, the enrollee or his or her legally authorized representative may choose one of the two lowest bids. If there is more than a 10 percent difference between the two lowest bids, the fund administrator shall choose the bid that represents the best overall value for the fund and the enrollee based on factors including not only the price offered by each bidder but also the quality, durability, extent of any warranties provided, and safety of the product itself. The successful bidder will be notified after the fund administrator or a designee of the fund administrator:
(1) discusses the bids received with the enrollee or the person authorized to act on the enrollee’s behalf and why a particular bid is chosen by the fund administrator; and
(2) obtains the consent of the enrollee or the person authorized to act on the enrollee’s behalf to purchase that particular AT. If the enrollee or person authorized to act on behalf of the enrollee disagrees with the fund administrator’s decision, the enrollee or person authorized to act for the enrollee can request a review of the fund administrator’s decision.
(i) If the enrollee or the enrollee’s authorized representative is able to obtain the AT equipment for less than $2,500, the enrollee or the enrollee’s authorized representative may submit documentation showing the prices from three different suppliers of the AT equipment in lieu of obtaining formal bids from such suppliers, and the fund administrator will pay the lowest of the three prices. Documentation may include copies of catalog pages, webpages or price lists.
(j) Cost effective repairs may be allowed.
Items that wear out as a result of normal wear and tear (for example, keyboards and switches) may be replaced by submitting a request stating the item that needs to be replaced, the reason the item needs to be replaced, and two or more estimates for the repair. If appropriate, approval for repairs will be made contingent on development of a plan to minimize future loss or damage.
(k) Except for AT equipment priced pursuant to subdivision (i) of this section, payment for the AT equipment cannot be more than the wholesale cost of the equipment plus 50 percent. If deemed appropriate by the fund administrator, the cost of a one year maintenance contract for the AT also may be paid for by the fund. Repairs, including the installation of replacement parts, will be paid for at full cost.
(l) In addition to the cost of AT equipment, payment for AT equipment shall include the cost of the assessment required by subdivision (c) of this section and the cost of the evaluation of required bids if the fund administrator finds it necessary to engage an outside expert.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES CONSTRUCTION AND MAINTENANCE OF PHYSICAL FACILITIES
10 CRR-NY 14-1.175 Ventilation
(a) All rooms are to be provided with sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, odors, smoke and fumes. Ventilation systems, when vented to the outside, are not to create an unsightly or harmful discharge or create a nuisance.
(1) Intake and exhaust air ducts are to be constructed and maintained to prevent the entrance of dust, dirt or other contaminating materials into the establishment.
(2) In new or extensively remodeled establishments, mechanical ventilation is required in all rooms where odors, vapors or fumes originate.
(b) Ventilation hoods and devices are to be constructed and installed to prevent grease or condensation from collecting on walls or ceilings and from dripping into food or onto food-contact surfaces.
Part 15 MIGRANT FARMWORKER HOUSING
FOOD PROTECTION AND GARBAGE AND REFUSE DISPOSAL FOOD PROTECTION AND GARBAGE AND REFUSE DISPOSAL
10 CRR-NY 15.10 Food preparation and service
Adequate facilities to allow safe storage, preparation, and service of food shall be provided.
(a) Central kitchen or commissary.
Wherever meals are furnished or offered for sale in a central kitchen or commissary the provisions of Subpart 14-1 of this Chapter must be met.
(b) Cooking and dining facilities.
When meals are not furnished or sold to the occupants, adequate cooking and dining facilities must be provided. This may be accomplished by providing either a common cooking area consisting of a separate well lighted and ventilated room which is adequately equipped for cooking and dining, or by providing facilities for cooking and dining within each individual dwelling unit. When the required cooking and dining facilities are provided within individual dwelling units, the facilities shall be located either in a separate room, or a separate area of at least 10 square feet per person shall be set aside for this purpose.
(1) In housing constructed after May 1, 1997, where occupants are required to cook, live and sleep in the same room, a minimum of 100 square feet of floor area is required for each occupant.
(c) A cooking area shall be considered adequately equipped when it contains the following items as a minimum:
(1) properly installed cook stoves with a minimum of two burners in each individual dwelling unit. Existing housing facilities with common cooking areas shall have adequate cook stoves providing a ratio of two burners per 5 occupants or fraction thereof, unless the permittee demonstrates to the permit-issuing official that the cooking demands of the camp population are adequately met by the existing ratio of two burners per 10 occupants or fraction thereof. All housing constructed after May 1, 1997, shall have cook stoves providing a ratio of 2 burners per 5 occupants or fraction thereof. Cooking equipment must be maintained in proper operating condition;
(2) an adequate amount of food and utensil storage shelves and counter space for food preparation; shelves and counters shall be constructed of materials that are non-toxic, non-absorbent and easily cleanable, and shall be maintained in good repair;
(3) adequate provisions for safe storage and mechanical refrigeration of food at a temperature of not more than 45 degrees Fahrenheit. Refrigeration equipment must be maintained;
(4) tables and chairs or equivalent seating with adequate capacity for the intended use. The tables and chairs shall be maintained in good repair;
(5) a dishwash sink which is supplied with cold running water, adequate in size for the intended use, and adequately installed and maintained. Hot water should be readily accessible for dishwashing needs;
(6) non-absorbent, easily-cleaned wall and floor surfaces in food preparation, cooking and dishwashing areas; and,
(7) all housing constructed or modified after May 21, 1969 shall be equipped with a sink supplied with hot and cold running water.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.41 Balance sheet
A statement of financial position of any economic unit, or component thereof, reporting as at a given moment of time its assets (at cost, depreciated cost, or other indicated value), its liabilities, and its ownership equities recorded under an accounting system.
Article 3 RESIDENTIAL CARE FACILITIES
Part 412 REPORTING INFORMATION FOR INSPECTIONS
10 CRR-NY 412.3 Inspection
Nothing in this Part shall be construed to limit the authority of the commissioner to inspect residential health care facilities pursuant to subdivision (1) of section 2803 of the Public Health Law and, in the instance of a facility participating in title XVIII and/or title XIX of the Social Security Act, for departmental certification of the facility for title XVIII and/or title XIX provider agreement purposes.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-6 SKIN BANKS
10 CRR-NY 52-6.9 Distribution of tissue products
(a) Except as provided in section 52-3.4 of this Part, skin shall not be made available for allogeneic transplantation if:
(1) the donor's blood tests repeatedly reactive in approved screening tests for HBsAg, or antibodies to HIV-1, HIV-2, HCV, or, unless the tissue is to be virally inactivated, antibodies to HTLV-I; or
(2) the donor's blood reacts positively to approved tests for syphilis, unless confirmatory testing is negative.
(b) Skin shall be transported by the tissue bank or its agents, or by staff or agents of the tissue transplantation facility. A signed form shall be kept on file at the skin bank documenting the identification of tissue distributed, including the names of both the person(s) releasing the tissue and the person(s) receiving the tissue.
(c) Skin in transit from a tissue processing or storage facility to a tissue transplantation facility shall be maintained at the applicable storage temperature specified in section 52-6.8 of this Subpart. Tissue stored at a tissue transplantation facility shall be maintained at a target temperature of minus 40 degrees Celsius or lower until immediately prior to transplantation. Storage shall be in a freezer or liquid nitrogen tank reserved for skin or other tissue intended for transplantation, or blood reserved for transfusion.
(d) Skin and its labeling and packaging shall be visually inspected prior to its release by the tissue processing facility. The tissue shall be inspected by the tissue transplantation facility immediately upon receipt and again after thawing, if frozen. If the physical appearance is abnormal, or there is indication or suspicion of overt microbial contamination, the skin shall not be utilized for transplantation.
(e) Skin shall be issued by the tissue transplantation facility only upon a written order by a licensed physician or other person authorized by law to order tissue. Documentation of such order shall be on a dedicated tracking record or on the recipient's medical record. Issuance of skin shall be recorded in a disposition log and shall allow accurate tracking of tissue to each recipient.
Part 53 DRINKING WATER STATE REVOLVING FUND
10 CRR-NY 53.4 Priority ranking system scoring criteria
(a) The total numerical score for the project or project segment being scored shall be the sum of the scores for technical and non-technical criteria as well as any additional points awarded pursuant to subdivision (d) of this section.
(1) The technical criteria are:
(i) MCL/treatment technique violations;
(ii) other sanitary code violations; and
(iii) system reliability and dependability issues.
(2) The non-technical criteria are:
(i) governmental needs; and
(ii) financial needs.
(b) Eligible projects or project segments shall be scored on the basis of the following:
(1)
Technical Factors
Score
(i) MCL treatment technique violations (more than one item may apply):
(a) Microbiological:
(1) surface water treatment rule:
(i) filtration and/or groundwater wells, interconnection/purchase with adjacent water system in lieu of filtration;
100
(ii) filtration performance criteria (NTU compliance); and
50
(iii) CT disinfection;
30
(2)
E. coli;
80
(3) total coliform;
40
(b) Organics chemicals (POC/UOC) and disinfection by-products;
40
(c) Lead and copper/corrosion (mandated);
30
(d) Radiological;
25
(e) Inorganic/Physical:
(1) nitrates;
50
(2) other health-related;
25
(3) aesthetic.
10
(ii) Other Sanitary Code (Subpart 5-1 of this Title) violations (more than one item may apply). The project need must be adequately supported by technical documentation, data, reports, etc.:
(a) inadequate source capacity (public health hazard);
50
(b) inadequate distribution pressure (public health hazard);
25
(c) uncovered finished water storage (public health hazard).
25
(iii) System Reliability/Dependability Issues (more than one item may apply). The project need must be adequately supported by technical documentation, data, reports, etc.:
(a) complete replacement or major rehabilitation of existing treatment facility for primary contaminants that has exceeded design life and/or does not meet the design standards in Recommended Standards for Water Works, 1987 edition, published by Health Research, Inc., P.O. Box 7126, Albany, NY 12224 and as subsequently revised, in lieu of treatment, replacement with an alternative source of supply, and/or interconnection with, or purchase from, adjacent water system;
20
(b) upgrade, replace and/or install major vulnerable system components to meet the design standards in Recommended Standards for Water Works, 1987 edition, published by Health Research, Inc., P.O. Box 7126, Albany, NY 12224, and as subsequently revised.
Any of the following apply:
10
(1) a principal component integral of an existing filtration process such as sedimentation, flocculation, filtration, chemical feed, or backwashing (can only receive points for paragraphs [1][iii][ a ] or [1][iii][ b ][ 1 ]);
(2) pump stations;
(3) existing wells;
(4) existing disinfection system for a ground water/surface water supply;
(5) transmission main;
(6) finished water or distribution storage; or
(7) other water treatment systems for secondary contaminants only (or replacement of source instead of treatment).
(c) Aged mains and appurtenances.
5
(d) Redundancy of critical components (pumps, valves, chemical feed-systems, etc.).
5
(e) Asbestos main replacement.
5
(f) Control/automation for operational efficiency (computerization, control valves, metering, laboratory upgrading).
5
(g) Inadequate source capacity which is not a public health hazard (can only receive points for paragraphs [1][ii][
a
] or [1][iii][
g
]).
5
(2) Non-Technical Factors
(i) Governmental needs (more than one may apply). Additional points will be assigned to a project on the basis of the following State or local government needs, policies and/or requirements:
(a) development of a water system or extending existing system to service contaminated or insufficient yielding private wells at existing residential housing (new systems are not eligible for points under paragraph 1);
40
(b) consolidation of water systems (can include improving technical, managerial and financial capacity development);
25
(c) system is dependent on an Environmental Protection Agency designated Sole Source Aquifer for its source.
(These points can only be obtained if system scores points from paragraphs [1][i], [1][ii], [1][iii][
a
] or [1][iii][
b
][
7
]);
25
(d) a project that has received written commitment of funding from another governmental source (
e.g.,
co-funded with Clean Water SRF, Rural Development, HUD, etc.).
These points do not apply to refinancing of projects;
10
(e) a project is consistent with Water Resources Management Strategy;
5
(f) a project proposes operational changes that improve and insure adequate technical, managerial and financial capacity of the system in order to insure compliance.
5
(iii) Financial need. The Median Household Income (MHI) of the community in which the water service area is located is used as a numerator and the Statewide MHI is used as the denominator in the following equation to determine the financial need factor.
Community MHI × 100 = Factor Statewide MHI*
| FACTOR | POINTS | | --- | --- | | <= 70 | 25 | | > 70 to <= 77.5 | 20 | | > 77.5 to <= 85 | 15 | | > 85 to <= 92.5 | 10 | | > 92.5 to <= 100 | 5 | | > 100 | 0 |
* 1990 Statewide MHI is $32,965
The MHI of the community which the water service area is located and the statewide MHI will be determined by the department from the income data in the most recent United States census. If an applicant has reason to believe that the census data do not provide a sufficiently accurate representation of the MHI within the area to be served by that applicant's project, the applicant must so notify the department in writing and specifically document the facts which form the basis of this belief. The applicant shall also furnish the department with additional information which the department may use in determining the MHI of the project service area. Information will consist of reliable data from local, regional, State or Federal sources or from an income survey conducted by a reliable impartial source.
(3) Tie Breaking. In the event of a tie score for projects, the higher total score under Technical Factors (paragraph 1) will be used as a tie breaker. If this still results in a tie score, the size of the population served by the system will be used as a tie breaker. The larger population will be given preference.
(c) The department has the sole authority to determine the existence of an emergency. Projects designed to address emergencies shall receive the highest priority ranking.
(d) Additional points may be awarded to an eligible project in the following manner:
(1) A phased project for which additional fund assistance has been conditionally committed in an executed project financing and loan agreement for long-term financing will be assigned 2,000 points in addition to its total project priority ranking system score.
(2) A project for which additional fund assistance has been conditionally committed in an executed project financing and loan agreement for short-term financing will be assigned 1,000 points in addition to its total project priority ranking system score.
(e) Notwithstanding the foregoing, an eligible project or portion thereof listed in category G, as identified in section 53.5(c)(5) of this Part, shall be evaluated based upon criteria set forth in section 53.5(c)(5) of this Part.
Subchapter J FUNERAL DIRECTING, UNDERTAKING AND EMBALMING
Part 77 PRACTICE OF FUNERAL DIRECTING
10 CRR-NY 77.0 Definitions
The following words and phrases as used in this Part shall have the following meanings, unless the context otherwise requires:
(a) Department means the New York State Department of Health.
(b) Commissioner means the Commissioner of Health of the State of New York.
(c) School means any educational institution wherein funeral directing, embalming and related subjects are taught for the purpose of preparing students for licensing and practice as funeral directors.
(d) Curriculum means the complete program of instruction in funeral service education.
(e) Accrediting agency means a duly constituted and departmentally recognized agency which evaluates and accredits curricula in funeral service education.
(f) Common carrier is defined, for the purposes of this Part and Part 13 of this Title, as a carrier licensed or authorized to transport cargo by any of the following:
(1) New York State Department of Transportation;
(2) Interstate Commerce Commission;
(3) Federal Aviation Administration; or
(4) United States Coast Guard.
(g) Customer means the person making arrangements, or the customer's designee, to whom a written statement showing thereon the price of the funeral, including an itemized list of the services and merchandise to be furnished for such price, shall be furnished at the time funeral arrangements are made.
(h) Customer's designee means the person whom the funeral director reasonably believes to be acting on behalf of a customer.
(i) Casket includes coffin and means a rigid container designed for the encasement of human remains and customarily ornamented and lined with fabric.
(j) Outer interment receptacle means any container or enclosure which is placed in the grave around the casket to prevent the collapse of the grave and/or to protect the casket, including but not limited to receptacles commonly known as burial vaults, grave boxes or grave liners.
(k) Actual retail price is the price for which a funeral director regularly sells an item of merchandise to customers.
(l) Direct cremation is the disposition of human remains by cremation, without a formal viewing, visitation or ceremony with the body present.
(m) Direct burial is the disposition of human remains by burial, without formal viewing, visitation or ceremony with the body present, except for a graveside service.
(n) Unfinished wooden box is an unornamented casket made of wood which does not have a fixed interior lining.
(o) Alternative container is a nonmetal receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed for the encasement of human remains and which is made of cardboard, pressed wood, composition materials (with or without an outside covering) or pouches of canvas or other materials.
Subchapter D LABORATORIES
Part 59 CHEMICAL ANALYSES OF BLOOD, URINE, BREATH OR SALIVA FOR ALCOHOLIC CONTENT
10 CRR-NY 59.7 Breath analyzer operator permits
(a) A permit valid for two years shall be issued by the commissioner to breath analysis instrument operators who have completed an approved program based upon standards acceptable to the training agency and certified by the commissioner. Such program shall consist of a minimum of 24 hours of instruction and training with identified learning objectives, supervised by one or more individuals certified as technical supervisors, and shall include:
(1) three hours of instruction on the effects of alcohol on the human body;
(2) five hours of instruction on operational principles of the selected techniques and methods, including a functional description and a detailed operational description of the breath analysis instrument(s) with a demonstration;
(3) five hours of instruction on the legal aspects of chemical tests generally, and of the particular techniques and methods to be employed;
(4) three hours of instruction on supplemental information to include nomenclature appropriate to the field of chemical tests for alcohol;
(5) six hours of laboratory participation using approved breath analysis instruments and simulators, or other reference standards;
(6) a passing score on a one-hour formal examination designed to evaluate whether the operator has met the course learning objectives; and
(7) a demonstration of analytical proficiency on each breath analysis instrument for which the operator is seeking certification.
(b) A permit as a breath analysis instrument operator shall be renewed for a two-year period, provided that, within the 120 calendar days preceding the permit's expiration date, the operator: completes a retraining program that minimally includes an instructional course in breath analysis designed to refresh and update the operator's knowledge in areas described in subdivision (a) of this section; satisfactorily meets the course's learning objectives as determined by a technical supervisor; demonstrates analytical proficiency on each breath analysis instrument for which the operator is seeking permit renewal; and attains a passing score on a formal examination; or, in lieu of such formal retraining, with the concurrence of the responsible training agency, provided that the operator and his/her superior officer submits to the training agency, a written declaration that the operator has performed six or more breath analyses on subjects in accordance with this Part on each breath analysis instrument for which the operator is seeking permit renewal during the 24 months preceding permit expiration. Notwithstanding such a submission, every four years all operators shall participate successfully in the retraining course described in this subdivision.
(c)
(1) Whenever a breath analysis instrument operator's permit is not renewed prior to the expiration date, the commissioner may extend such expiration date for 30 calendar days, provided that the training agency and operator jointly submit a written request for such extension, describing the reasons for the failure to renew in a timely manner. The operator's permit shall remain valid during the 30-day extension period.
(2) If the operator fails to meet the conditions for permit renewal pursuant to subdivision (b) of this section within the extension period authorized pursuant to paragraph (1) of this subdivision, the permit shall become void and not renewable; an operator whose permit becomes void may apply for a new permit by repeating the requirements of subdivision (a) of this section; and the effective date of any such new permit shall be the date of commissioner approval, without back dating to the date on which the prior permit became void.
(d) A training agency shall submit to the commissioner documentation of breath analysis instrument operator training for initial issuance and renewal of a permit in a format designated by the commissioner.
Chapter I STATE SANITARY CODE
Part 16 IONIZING RADIATION
[FN]* [FN*]
10 CRR-NY 16.63 Miscellaneous and special types of radiation producing equipment
Types or uses of radiation producing equipment not specifically covered by this Part and not exempted in section 16.4 of this Part, and such other types or uses of radiation producing equipment as may be designated by the department shall be governed by special inspection or surveys by the department. Such special inspections or surveys by the department shall, with respect to the radiation producing equipment so inspected or surveyed, substitute for the inspections required by paragraph (1) of subdivision (a) of section 16.10 of this Part.
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-4 MOBILE FOOD SERVICE ESTABLISHMENTS AND PUSHCARTS
EQUIPMENT AND UTENSIL CLEANING AND SANITATION EQUIPMENT AND UTENSIL CLEANING AND SANITATION
10 CRR-NY 14-4.115 Wiping cloths
(a) Moist cloths used for wiping food spills on kitchenware and food-contact surfaces of equipment are to be used only for this purpose. These cloths are to be stored in a clean sanitizing solution between uses.
(b) Moist cloths used for cleaning nonfood-contact surfaces of equipment such as counters and shelves are to be stored in a sanitizing solution between uses and are to be used only for this purpose.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 85 MEDICAL ASSISTANCE BENEFITS
PRENATAL CARE SERVICES PRENATAL CARE SERVICES
10 CRR-NY 85.43 Nurse practitioner services
(a) Definitions.
(1) Nurse practitioner means a person who is licensed and currently registered as a registered professional nurse in New York State and who is certified as a nurse practitioner by the Department of Education (see section 6910 of the Education Law and 8 NYCRR sections 64.5 and 64.6).
(b) Scope of care.
Nurse practitioners shall be authorized to provide health care services to eligible medical assistance recipients which fall within the scope of practice for certified nurse practitioners as determined by the Department of Education (see section 6902 of the Education Law and 8 NYCRR sections 52.12, 64.5 and 64.6).
(c) Medicaid enrollment.
(1) In order for a nurse practitioner to provide health care services to eligible medical assistance recipients, he/she must enroll with the Department of Social Services.
(2) The licensed physician in collaboration with the nurse practitioner must also enroll with the Department of Social Services.
(3) As a condition of enrollment, the nurse practitioner and the collaborating physician must agree to make their practice agreements and protocols available for inspection by staff of the Department of Social Services (DSS).
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 3 RESIDENTIAL CARE FACILITIES
Part 415 NURSING HOMES—MINIMUM STANDARDS
CLINICAL SERVICES CLINICAL SERVICES
10 CRR-NY 415.18 Pharmacy services
(a) The facility shall provide pharmaceutical services and develop and implement policies and procedures that assure the accurate acquisition, receipt, dispensing and administering of all drugs and biologicals required to meet the needs of each resident. The facility shall provide routine and emergency drugs and biologicals directly to its residents, or obtain them under a contract as described in section 400.4 of this Title. The facility shall be licensed under article 33 of the Public Health Law and Part 80 of this Title.
(b) Service consultation.
The facility shall employ or obtain the services of a registered pharmacist who:
(1) provides consultation on all aspects of the provision of pharmacy services in the facility;
(2) establishes a system of records of receipt and disposition of all controlled drugs; and
(3) determines that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled consistent with the requirements of article 33 of the Public Health Law and Part 80 of this Title.
(c) Drug regimen review.
(1) The drug regimen of each resident shall be reviewed at least once a month by a registered pharmacist.
(2) The pharmacist shall report any irregularities to the attending physician and the director of nursing, and these reports shall be acted upon promptly. The findings and corrective actions shall be regularly reviewed by the quality assessment and assurance committee established pursuant to section 415.27 of this Part.
(3) Psychotropic drugs may be administered only on the orders of a physician and only as part of a plan of care, developed in accordance with sections 415.4, 415.11 and 415.12 of this Part, designed to eliminate or modify the symptoms for which the drugs are prescribed.
(d) Labeling of drugs and biologicals.
The facility shall label drugs and biologicals in accordance with currently accepted standards of practice and include the appropriate accessory and cautionary instructions and the expiration date. Labeling of all medications shall be in accordance with article 137 of the State Education Law and 8 NYCRR Part 29. Facilities which use a unit dose drug distribution system shall develop and implement an appropriate method of providing accessory and cautionary instructions.
(e) Storage of drugs and biologicals.
(1) The facility shall store all drugs and biologicals in locked compartments under proper temperature controls, and permit access only to authorized personnel.
(2) The facility shall provide separately locked, permanently affixed, compartments for storage of controlled drugs and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected. Storage of controlled substances shall be in accordance with article 33 of the Public Health Law and Part 80 of this Title.
(3) Poisons and medications for “external use only” shall be kept in a locked cabinet and separate from other medications.
(4) Medications whose shelf life has expired or which are otherwise no longer in use shall be disposed of or destroyed in accordance with State and Federal laws and regulations.
(f) Return of unused medications.
(1) When services are provided by a cooperating vendor pharmacy, the facility shall establish policies and procedures which permit either the staff registered pharmacist or consultant registered pharmacist to return to the vendor pharmacy from which it was purchased any unused medications or drug products, provided such medication is sealed in unopened, individually packaged, units and within the recommended period of shelf life for the purpose of redispensing and which are in accord with the following provisions:
(i) Drug products which may be returned are limited to:
(a) oral and parenteral medication in single-dose hermetically sealed containers; and
(b) parenteral medication in multiple-dose hermetically sealed containers from which no doses have been withdrawn.
(ii) The drug products returned show no obvious sign of deterioration.
(iii) Drug products packaged in manufacturer's unit-dose packages may be returned for redispensing provided that they are redispensed in time for use before the expiration date, if any, indicated on the package.
(iv) Drug products repackaged by the pharmacy into unit-dose or multiple-dose “blister packs” may be returned for redispensing provided that:
(a) the date on which the drug product was repackaged, its lot number and expiration date are indicated clearly on the package;
(b) not more than 90 days have elapsed from the date of the repackaging;
(c) a repackaging log is maintained by the pharmacy in the case of drug products repackaged in advance of immediate needs.
(v) “Blister packs.”
(a) Partially used “blister packs” may be redispensed only as returned.
(b) Partially used “blister packs” may not be emptied and repackaged.
(c) Additional units of medication may not be added to partially used “blister packs.”
(vi) No drug product dispensed in bulk in a dispensing container may be returned.
(vii) No medication or drug product defined as a controlled substance in section 3306 of the Public Health Law may be returned.
(2) The vendor pharmacy to which such drug products are returned shall reimburse or credit the nursing home or purchaser of such drug products for the unused medication that is restocked and redispensed and shall not otherwise charge any individual resident or the State, if a resident is a recipient or beneficiary of a State-funded program, for unused medication or drug products returned for reimbursement or credit.
(g) Emergency medications.
The facility shall ensure the provision of (an) emergency medication kit(s) as follows:
(1) The contents of each kit shall be approved by the medical director, pharmacist and director of nursing.
(2) Limited supplies of controlled substances for use in emergency situations may be stocked in sealed emergency medication kits.
(i) Each such kit may contain up to a 24-hour supply of a maximum of 10 different controlled substances in unit dose packaging, three of which may be injectable drugs.
(ii) Controlled substances contained in emergency medication kits may be administered by authorized personnel pursuant to an order of an authorized practitioner to meet the immediate need of a resident. Personnel authorized to administer controlled substances shall include registered professional nurses, licensed practical nurses or other practitioners, licensed/registered under title VIII of the Education Law and authorized to administer controlled substances.
(iii) The facility shall maintain all records of controlled substances furnished or transferred from the pharmacy and the disposition of all controlled substances in emergency kits, as required by article 33 of the Public Health Law and corresponding regulations.
(3) For medications other than controlled substances the medication contents of each kit shall be limited to injectables except that the kit may also include:
(i) sublingual nitroglycerine; and
(ii) noninjectable prepackaged medications not to exceed a 24-hour supply. The total number of noninjectables may not exceed 25 medications for the entire facility.
(4) Each kit shall be kept and secured within or near the nurses' station.
(h) Medications for leaves.
Medication shall be released to discharged residents or to a resident going on temporary leave. The medication supply in the facility may be used to supply the medications needed for a temporary leave of absence.
(i) Verbal orders.
All medications administered to residents shall be ordered in writing by a legally authorized practitioner unless unusual circumstances justify a verbal order, in which case the verbal order shall be given to a licensed nurse, or to a licensed pharmacist, immediately reduced to writing, authenticated by the nurse or registered pharmacist and countersigned by the prescriber within 48 hours. In the event a verbal order is not signed by the prescriber or a legally designated alternate practitioner within 48 hours, the order shall be terminated and the facility shall ensure that the resident's medication needs are promptly evaluated by the medical director or another legally authorized prescribing practitioner.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-5 LONG-TERM HOME HEALTH CARE PROGRAMS
10 CRR-NY 86-5.16 Less expensive alternatives
Reimbursement for the cost of providing services may be the lesser of the actual costs incurred or those costs which could reasonably be anticipated if such services had been provided by operation of joint central services or use of facilities or services which could have served effective alternatives or substitutes for the whole or any part of such services.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 6 ADULT DAY HEALTH CARE IN RESIDENTIAL HEALTH CARE FACILITIES
Part 425 ADULT DAY HEALTH CARE
10 CRR-NY 425.18 Services for registrants with acquired immune deficiency syndrome (AIDS) and other high-need populations
(a) Applicability.
(1) This section applies to an adult day health care program approved by the commissioner pursuant to Part 710 of this Chapter as a provider of specialized services for registrants with AIDS and other high-need populations that in the discretion of the commissioner would benefit from receiving adult day health care services.
(2) For purposes of these regulations, AIDS means acquired immune deficiency syndrome and other human immunodeficiency virus (HIV) related illness.
(b) General requirements.
The program shall provide comprehensive and coordinated health services in accordance with this Article and requirements set forth in Part 759 of this Title and shall receive payment for such services in accordance with section 759.14 of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 83 SHARED HEALTH FACILITIES
Subpart 83-1 SHARED HEALTH FACILITIES
10 CRR-NY 83-1.15 Fire and safety
(a) Buildings and equipment shall be so maintained as to prevent fire and other hazards to personal safety.
(b) Exits, stairways, doors and corridors shall be kept free of obstructions. Corridors or passageways that do not provide a clear, unobstructed path to the outside shall not be marked as exits.
(c) Flammable and nonflammable medical gases shall be labeled, stored, handled and used in compliance with the requirements of the National Fire Protection Association No. 56A Inhalation Anesthetics, 1973 Edition, 56B Respiratory Therapy 1973 Edition, and 56F Non-Flammable Medical Gas Systems, 1973 Edition. These standards were published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy of each of these standards is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(d) Flammable and combustible liquids shall be labeled, stored, handled and used in compliance with the requirements of the National Fire Protection Association No. 30, Flammable and Combustible Liquids Code, 1973 Edition. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
(e) The facility shall exercise proper safeguards for the prevention of accidents to patients, staff and employees.
(f) Portable fire extinguishers shall be provided in accordance with the National Fire Protection Association No. 10, Installation of Portable Fire Extinguishers, 1973 Edition, and shall be inspected at least annually, recharged or repaired as needed and labeled with the date of the last inspection. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
Subchapter G AIDS TESTING, COMMUNICABLE DISEASES AND POISONING
Part 67 LEAD POISONING PREVENTION AND CONTROL
Subpart 67-2 ENVIRONMENTAL ASSESSMENT AND ABATEMENT
10 CRR-NY 67-2.8 Enforcement
When an owner of a dwelling fails to comply with a written notice and demand for discontinuance of a condition conducive to lead poisoning, the proceedures for enforcement, including formal hearings, receivership and cooperation and assistance from those public officers, departments and agencies of the State and its political subdivisions, as provided in sections 1373, 1374, and 1375 of the Public Health Law, shall be followed.
Subchapter C ACCESS TO RECORDS
Part 52 TISSUE BANKS AND NONTRANSPLANT ANATOMIC BANKS
Subpart 52-8 REPRODUCTIVE TISSUE BANKS
10 CRR-NY 52-8.6 Required laboratory tests
(a) For reproductive tissue banks located within New York State, all required clinical laboratory testing shall be performed by a laboratory operating under a permit issued by the department. For out-of-state reproductive tissue banks, all required clinical laboratory testing shall be performed by a laboratory which is approved by that state's regulating authority, the United States Health Care Financing Administration, or by the department.
(b) The following laboratory tests shall be performed prior to donor acceptance and, except as specified in subdivision (g) of this section, initial collection of donor semen for clinical use:
(1) Blood shall be tested for:
(i) determination of ABO and Rh blood groups; and
(ii) antibodies to HIV-1, human immunodeficiency virus type 2 (HIV-2), human T-lymphotropic virus type I (HTLV-I), hepatitis B core antigen (HBc), and to hepatitis C virus (HCV), and for hepatitis B surface antigen (HBsAg) and syphilis.
(2) Semen or a urethral specimen shall be tested for infection with Neisseria gonorrhoeae, and urine or a urethral specimen shall be tested for infection with Chlamydia trachomatis using a method that meets standards generally accepted by leading authorities in laboratory medicine.
(3) Semen shall be tested for sperm quality as measured against criteria set by the director in consultation with the medical director and medical advisory committee, including such parameters as ejaculate volume and sperm motility, concentration, morphology and cryosensitivity, including a post-thaw analysis. Sperm quality tests shall be repeated at a frequency determined by the director.
(c) All tests for infectious diseases shall be repeated at least every six months for as long as a donor is participating in the semen banking program, or whenever a donor reenters the program after an absence of longer than six months.
(d) Any semen stored from a donor testing repeatedly reactive for antibodies to HIV-1, HIV-2, HCV or HTLV-I, for syphilis infection or for HBsAg, shall be destroyed unless such semen is to be used for research studies authorized by section 4302 of the Public Health Law and approved by the appropriate institutional review board, in which case all semen samples from the donor shall be labeled, “For research use only,” and immediately sequestered from other donor samples. Testing for antibody to hepatitis B core antigen (anti-HBc) shall be negative for donor acceptance. For semen donors testing positive for any indicator of HIV infection, the director shall advise the department and the attending physicians of all recipients who received semen that was collected any time after six months prior to the the last negative test.
(e) Subsequent to testing as required in subdivision (b) of this section, all donated semen shall be frozen and quarantined for six months. After such time and prior to release of the semen for artificial insemination or assisted reproductive procedures, the donor shall be retested for HBsAg and antibodies to HIV-1, HIV-2, HCV and HBc. If the semen to be released originates from a directed donor, the recipient may be given the opportunity to waive the quarantine period in writing after being advised by the director, his/her designee, or the physician performing the insemination of the risks involved in doing so. In such cases, each of the tests required in paragraphs (a)(1), (2) and (3) of this section, except tests for ABO and Rh blood groups, must have been performed after a date one month prior to the first donation and every three months thereafter, while the donor is engaged in donation.
(f) Semen shall not be made available for artificial insemination or assisted reproductive procedures if:
(1) the donor's blood is repeatedly reactive in approved screening tests for HBsAg or antibodies to HIV-1, HIV-2, HTLV-I or HCV;
(2) the donor's blood is repeatedly reactive in approved screening tests for antibodies to HBc;
(3) the donor's blood tests positively in approved tests for syphilis, unless a confirmatory test is negative;
(4) the donor's semen or urethral specimen tests positive in approved tests for Neisseria gonorrhoeae ; or
(5) the donor's urine or urethral specimen reacts positively to approved tests for Chlamydia trachomatis.
(g) A client-depositor who wishes to direct stored semen for use by a specific recipient, other than his current or active regular sexual partner, shall first be fully evaluated and tested in accordance with the requirements of section 52-8.5 of this Subpart and subdivisions (b), (c), (d) and (f) of this section. Tissue from such client-depositors shall not be released unless stored for at least six months prior to such testing.
(h) reproductive tissue donors who, based on their racial/ethnic background or family history, have been identified at increased risk of being carriers of Tay-Sachs disease, thalassemia, cystic fibrosis and/or sickle cell disease shall be tested for such carrier states. The reproductive tissue bank medical director, in consultation with the medical advisory committee, shall establish a policy specifying any other conditions that should be tested for, the testing to be performed on donors with particular racial/ethnic backgrounds and family histories, and the analytes to be tested for.
(i) Testing requirements for oocyte donors shall be specified in a written policy approved by the reproductive tissue bank medical director in consultation with the medical advisory committee. At a minimum, donors shall, within one month of each donation, be tested and found negative HBsAg, and for antibodies to HCV, HIV-1 and HIV-2. Oocytes and embryos stored from donors who test repeatedly reactive for antibodies to HIV-1, HIV-2, or HCV or for HBsAg, shall be destroyed, unless such tissue is to be used for research studies authorized by section 4302 of the Public Health Law and approved by the appropriate institutional review board, in which case all tissue samples from the donor shall be labeled, “For research use only,” and immediately sequestered from the donor samples. For donors testing positive for any indicator of HIV infection, the director shall advise the department and the attending physicians of all recipients who received tissue that was collected at any time after six months prior to the last negative test.
(j) Male and female contributors to donated embryos shall be tested as specified in section 52-8.6(i) of this Subpart prior to release of embryos for clinical use by others.
(k) Results of all donor testing shall be made available, upon request, to the donors and to physicians using the donor's reproductive tissue in artificial insemination and assisted reproductive procedures.
(l) Accurate, written donor profiles or other descriptions of pertinent donor characteristics shall be provided upon request to physicians ordering reproductive tissues.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-5 ENFORCEMENT
10 CRR-NY 128-5.1 Enforcement
(a) The city shall enforce the rules and regulations set forth herein, in a manner consistent with applicable Federal, State and local laws.
(b) The city may, in enforcing the rules and regulations set forth herein, exercise all of its rights and remedies under applicable Federal, State and local laws, including, but not limited to: inspecting facilities engaging in regulated activities and sources of the water supply in accordance with applicable Federal and State constitutional requirements; issuing notices of violation or of intention to sue; instituting civil or criminal actions; seeking injunctive relief and legal damages; imposing penalties in accordance with Public Health Law, section 1103; and entering into consent orders and agreements.
(c) Nothing contained in these rules and regulations shall be construed as limiting the city's ability to exercise any of its rights and remedies under any other law, statute, rule, regulation, or order, including, but not limited to, the Federal Water Pollution Control Act (a/k/a the Clean Water Act), 33 U.S.C. sections 1251 et seq. ; the Comprehensive Environmental Response, Compensation, and Liability Act, 42 U.S.C. sections 9601 et seq. ; the Resource Conservation and Recovery Act, 42 U.S.C. sections 6901 et seq. ; the Oil Pollution Act, 33 U.S.C. sections 2701 et seq. ; Federal Insecticide, Fungicide and Rodenticide Act, 7 U.S.C. sections 136 et seq. ; Toxic Substances Control Act, 15 U.S.C. sections 2601 et seq. ; New York State Public Health Law; New York State Environmental Conservation Law; New York State Navigation Law; New York State Department of Health septic system requirements (Appendix 75-A of this Title); New York State Real Property Actions and Proceedings Law; and New York State Penal Law.
(d) Upon completion of the requirements of the State Administrative Procedure Act (SAPA) and the promulgation of these rules and regulations by the New York State Department of Health as State rules and regulations, the requirements of these rules and regulations may also be enforced by the Commissioner of the New York State Department of Health.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
ADMISSION OF PATIENTS ADMISSION OF PATIENTS
10 CRR-NY 88-3.5 Reports
(a) The director shall submit to the Commissioner of Health such narrative and statistical reports at such intervals as may from time to time be prescribed by the commissioner.
(b) The director shall send to district and local health departments, referring physicians and agencies, and insurance companies providing financial sponsorship, and such other individuals and public, private, or voluntary agencies and organizations such professional reports as are in keeping with professional practices and ethics, legal requirements and limitations, and the need of the individual patient.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD SERVICE ESTABLISHMENT FOOD SERVICE ESTABLISHMENT
10 CRR-NY 14-1.21 Definitions of food processing establishment and commissary
(a) A food processing establishment is a commercial establishment operated under license, permit or with the approval of an appropriate regulatory authority, where food is manufactured or packaged for human consumption at another establishment or place.
(b) A commissary is a place where food is stored, processed or packaged and prepared in individual portions for service at a food service establishment. A commissary supplying vending machines, mobile food service establishments, or owned and operated by an owner operating the food service establishment exclusively served by the commissary, is to be operated under permit and in accordance with this Subpart.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-4 RESIDENT LOAN REPAYMENT PROGRAM
10 CRR-NY 47-4.3 Awards
(a) Award schedule.
Awards shall be made during the second and third year of residency training in a Primary Care Residency Program.
(b) Award.
The award shall be up to $15,000 per residency year.
(c) Award payments.
Awards shall be paid directly to the recipients who will be required to apply the funding to reduce their qualifying debt.
(d) Payment of awards.
Payment of awards shall be subject to the availability of funds.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-5 WATER QUALITY TREATMENT DISTRICTS
10 CRR-NY 5-5.6 Water quality
Treated water quality must meet all applicable water quality standards or guidelines for community water systems as defined by Subpart 5-1 of this Part.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.167 Hospital
An establishment that provides, through an organized medical or professional staff, permanent facilities that include inpatient beds, medical services and continuous nursing services, diagnosis and treatment for patients.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter Q STATE ENVIRONMENTAL QUALITY REVIEW
Part 97 REGULATIONS IMPLEMENTING STATE ENVIRONMENTAL QUALITY REVIEW
10 CRR-NY 97.13 Criteria for determining what actions may have a significant effect on the environment
(a) An action may have a significant effect on the environment if it can reasonably be expected to lead to one of the following consequences:
(1) a substantial adverse change to ambient air or water quality or noise levels or in solid waste production, drainage, erosion or flooding;
(2) the removal or destruction of large quantities of vegetation or fauna, the substantial interference with the movement of any resident or migratory fish or wildlife species, impacts on critical habitat areas, or the substantial affecting of a rare or endangered species of animal or plant or the habitat of such species;
(3) the encouraging or attracting of a large number of people to a place or places for more than a few days relative to the number of people who would come to such place absent the action;
(4) the creation of material conflict with a community's existing plans or goals as officially approved or adopted;
(5) the impairment of the character or quality of important historical, archeological, architectural or aesthetic resources or of existing community or neighborhood character;
(6) a major change in the use of either the quantity or type of energy;
(7) the creation of a hazard to human health or safety;
(8) a substantial change in the use, or intensity of use of land or other natural resources or in their capacity to support existing uses except where such a change has been included, referred to, or implicit, in a broad statement prepared pursuant to section 97.17 of this Part;
(9) the creation of a material demand for other actions which would result in one of the above consequences;
(10) changes in two or more elements of the environment, no one of which is substantial, but when taken together result in a material change in the environment; or
(11) two or more related actions no one of which has or would have a significant effect on the environment, but which cumulatively meet one or more of the criteria in this section.
(b) For the purpose of determining whether an action will cause one of the foregoing consequences, the action shall be deemed to include other contemporaneous or subsequent actions (1) which are included in any long-range comprehensive integrated plan of which the action under consideration is a part, (2) which are likely to be undertaken as a result thereof, or (3) which are dependent thereon. The significance of a likely consequence (i.e., whether it is material, substantial, large, important, etc.) should be assessed in connection with its setting (i.e., urban or rural), its probability of occurring, its duration, its irreversibility, its controlability, its geographic scope and its magnitude (i.e., degree of change or its absolute size).
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 155 WESTCHESTER COUNTY
DISTRICTS DISTRICTS
10 CRR-NY 155.56 Pocantico Water District No. 1, Town of Mount Pleasant
(a) Application.
The rules and regulations set forth in this section, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to certain reservoirs located within the boundaries of the Pocantico Water District No. 1, Town of Mount Pleasant, Westchester County, which comprise part of the source of the public water supply of the said Pocantico Water District No. 1, and are situated as follows:
All those certain reservoirs designated as Ferguson's Lake, Lake No. 1, Lake No. 2 and Lake No. 3 shown on that certain map entitled “Map Showing Pocantico Water District No. 1 Situate in the Town of Mount Pleasant, Westchester County, New York” prepared by Chas. H. Sells, Inc. certified as complete on September 21, 1972 and revised on February 23, 1973, March 2, 1973, April 11, 1973 and May 2, 1973 filed in the Office of the Clerk of Westchester County (Division of Land Records) on March 29, 1976 as Map No. 18772, the center of said Ferguson's Lake being approximately north 85° 00′ 00″ east 1290 feet as measured from the westerly boundary line of Bedford Road from its intersection with the southerly boundary line of Raafenberg Road; the center of said Lake No. 1 being approximately south 77° 00′ 00″ east 2550 feet as measured from the westerly boundary line of Bedford Road from its intersection with the southerly boundary line of Raafenberg Road, the center of said Lake No. 2 being approximately south 63° 30′ 00″ east 2130 feet as measured from the westerly boundary line of Bedford Road from its intersection with the southerly boundary line of Raafenberg Road; the center of said Lake No. 3 being approximately south 64° 0′ 00″ east 1660 feet as measured from the westerly boundary line of Bedford Road from its intersection with the southerly boundary line of Raafenberg Road.
(b) Definitions.
(1) Chloride salt shall mean the solid compounds or solutions of potassium chloride (commonly used as fertilizer), calcium chloride (commonly used for winter road maintenance) or sodium chloride (commonly used for water softener regeneration).
(2) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(3) Human excreta shall mean human feces and urine.
(4) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric and/or the like.
(5) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high-water mark of the reservoirs.
(6) Pesticide shall mean any substance used to destroy or inhibit pests such as rodents and insects.
(7) Pollutant shall mean dredge, spoil, solid waste, incinerator residue, sewage, garbage, sewage sludge, chemical waste, biological materials, radioactive materials, heat, wrecked or discarded equipment, rock, sand, cellar dirt and industrial, municipal and agricultural waste discharged into water.
(8) Radioactive material shall mean any material in any form that emits radiation spontaneously. Radiation shall mean ionizing radiation; that is, any alpha particle, beta particle, gamma ray, X-ray, neutron, high-speed proton, and any other atomic particle producing ionization, but shall not mean any sound or radio wave, or visible, infrared, or ultraviolet light.
(9) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, manure, rubbish, ashes, incinerator residue, street cleaning, dead animals, offal and solid commercial and industrial wastes.
(10) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(11) Reservoirs shall mean the reservoirs described in paragraph (a) of this section.
(12) Sewage shall mean any liquid or solid waste matter from a domestic, commercial, private or industrial establishment which is normally carried off in sewers or waste pipes.
(13) Sewage disposal system shall mean any system used for disposing of sewage.
(14) Toxic chemical shall mean any compound or substance, including but not limited to gasoline, kerosene, fuel oil or diesel oil, which is or may be harmful or poisonous to humans.
(15) Treatment works shall mean any treatment plant, sewer, disposal field, lagoon, pumping station, septic system, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fill, or other works not specifically mentioned in this paragraph, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage.
(16) Water supply shall mean the public water supply of the Pocantico Water District No. 1, Town of Mount Pleasant.
(c) General prohibitions.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170 of this Chapter.
(d) Specific prohibitions.
(1) Cemeteries.
No interment of a human body shall be made within a 250-foot linear distance of the reservoir.
(2) Chloride salt.
No chloride salt shall be stored within a 500-foot linear distance of the reservoirs except in weather-proof buildings or watertight vessels.
(3) Herbicides and pesticides.
No herbicides or pesticides shall be stored, discharged, applied or allowed to remain within a 500-foot linear distance of the reservoirs unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(4) Human excreta and sewage.
(i) No privy, privy vault, pit or other receptacle of any kind for either temporary storage or the permanent deposit of human excreta or sewage shall be constructed, located, placed, maintained or allowed to remain within a 250-foot linear distance of the reservoirs.
(ii) No human excreta or sewage shall be deposited or spread upon or beneath the surface of the ground within a 250-foot linear distance of the reservoirs.
(iii) No sewage or polluted liquid of any kind shall be discharged or allowed to flow on or beneath the surface of the ground within a 250-foot linear distance of the reservoirs except in watertight pipes connected to a sewage disposal system or treatment works for which a permit has been granted by the appropriate State agency having jurisdiction over such facility. No such watertight pipe shall be located within a 15-foot linear distance of the reservoirs.
(5) Radioactive material.
No radioactive material shall be disposed of by burial in soil within a 500-foot linear distance of the reservoirs and not within a 500-foot to a 1,000-foot linear distance of the reservoirs unless authorization has been obtained from the appropriate State agency and such burial is in accordance with the provisions of Part 16 of this Title.
(6) Solid waste.
(i) Junkyards. No junkyard shall be located within a 250-foot linear distance of the reservoirs.
(ii) Refuse. No refuse shall be deposited on or beneath the surface of ground within a 250-foot linear distance of the reservoirs.
(iii) Refuse disposal area. No refuse disposal area shall be located within a 500-foot linear distance of the reservoirs.
(7) Toxic chemicals.
No container used for the storage of the gasoline, kerosene, fuel oil, diesel oil or toxic chemicals shall be buried beneath the surface of the ground within a 500-foot linear distance of the reservoirs.
(8) Trespassing.
No trespassing shall be allowed upon the reservoirs and no person or persons shall enter in or upon such reservoirs except the person or persons authorized to enter said reservoirs by the Town Board of the Town of Mount Pleasant.
(e) Inspections.
The Town Board of the Town of Mount Pleasant, or any person or persons charged with the maintenance or supervision of the reservoirs shall by its officers or their duly appointed representative make regular and thorough inspections of the area surrounding the reservoirs to ascertain whether the rules and regulations set forth in this section are being complied with. It shall be the duty of the aforesaid town board to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with the rules and regulations, it shall be the further duty of the aforesaid town board to promptly notify the State Commissioner of Health of such violations. The aforesaid town board shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections which were made, the number of violations found, the number of notices served, the number of violations abated and the general condition of the areas surrounding the reservoirs at the time of the last inspection.
(f) Penalties for violations.
Penalties for violations of this section shall be those specified by section 1103 of the Public Health Law.
Chapter I STATE SANITARY CODE
Part 15 MIGRANT FARMWORKER HOUSING
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 15.1 Definitions
As used in this Part, the following words and terms shall have the indicated meaning:
(a) Potable water shall mean water provided or used for human consumption or for washing, showering or cooking purposes.
(b) Dwelling unit shall mean one or more rooms containing cooking, sleeping, bathing and toilet facilities for the use of the occupants. All the facilities do not need to be in the same structure but shall be readily accessible to, and under the control of the occupants.
(c) Migrant labor camp or migrant farmworker housing shall mean a property which consists of a tract of land and all vehicles, mobile homes, buildings or other structures pertaining thereto, any part of which may be used or occupied by persons employed as migrant farmworkers including sleeping facilities, provided in whole or in part, by the employer of such persons, owner, lessee, or operator thereof, with or without stipulated agreement as to the duration of their stay, whether or not they are supplied with meals but who are supplied with such utility services as are necessary for their habitation of such property.
(d) Farm activities shall mean the activities carried out in connection with the production or processing of agricultural, horticultural, or fur industry products such as: fitting, planting, cultivating, harvesting, vining, sorting, grading, skinning, packing, storing, canning, freezing, dehydrating, bottling and preserving or treating by any method.
(e) Migrant farmworker shall mean an individual who is employed in farm activities of a seasonal or temporary nature.
(f) Permit issuing official shall mean the State Health Commissioner, the health commissioner or health officer of a city of 50,000 population or over, the health commissioner or health officer of a county or part-county health district, or the State district director having jurisdiction, or any county or public health director having all the power and duties prescribed in section 352 of the Public Health Law. A permit issuing official may designate health department staff to act in his behalf to issue the permits required by this Part.
(g) Sewage shall mean the waste from a flush toilet, bath, sink, shower, laundry tray or tub, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(h) Hot water shall mean water heated or tempered to provide a temperature of 110 to 120 degrees Fahrenheit at the point of use.
(i) Adequate shall mean sufficient to accomplish the purposes for which something is intended, and to such a degree that no unreasonable risk to health or safety is presented. An item installed, maintained, designed and assembled, an activity conducted or act performed, in accordance with generally accepted standards, principles or practices applicable to a particular trade, business, occupation or profession, is adequate within the meaning of this Part.
(j) Uniform Code shall mean the New York State Uniform Fire Prevention and Building Code, 9 NYCRR, Subtitle S, Chapter I.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.258 Physician, teaching
Physicians who have primary responsibility for teaching activities related to graduate physicians in training or medical/osteopathic/dental undergraduate students in an identified clinical service.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-1 FOOD SERVICE ESTABLISHMENTS
FOOD PREPARATION AND SERVICE FOOD PREPARATION AND SERVICE
10 CRR-NY 14-1.87 Service of milk and milk products, dairy or non-dairy creaming and whitening agents, condiments and ice; dispensing utensils use and storage
(a) Milk and milk products served to the consumer are to be in a commercially filled package or drawn from a commercially filled dispensing container in a refrigerated bulk milk dispenser.
(b) Dairy or non-dairy creaming or whitening agents are to be provided in an individual service container, protected pour-type pitcher or drawn from a refrigerated dispenser designed for such purpose.
(c) Condiments, seasoning and dressings are to be provided in individual packages, from protected dispensers or containers or in the original container or pour-type dispenser. Sugar for consumer usage is to be provided in individual packages or pour-type dispensers.
(d) Ice for consumer use is to be dispensed by using scoops, tongs or other ice-dispensing utensils or through automatic self-service ice-dispensing equipment. Ice-dispensing utensils are to be stored on a clean surface or in the ice with the dispensing utensil's handle extended out of the ice.
(e) Suitable dispensing utensils are to be used by employees or provided to the consumers who serve themselves. Between uses the utensils are to be:
(1) stored in the food with the dispensing utensil's handle extended out of the food;
(2) stored clean and dry; or
(3) stored in running water dipper well.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 2 HOSPITALS
Part 405 HOSPITALS—MINIMUM STANDARDS
10 CRR-NY 405.19 Emergency services
(a) General.
(1) Emergency services shall be provided in accordance with this subdivision or subdivisions (b) through (e) of this section as appropriate.
(2) If emergency services are not provided as an organized service of the hospital, the governing body and the medical staff shall assure:
(i) prompt physician evaluation of patients presenting with emergencies;
(ii) initial treatment and stabilization or management; and
(iii) transfer, where indicated, of patients to an appropriate receiving hospital. The hospital shall have a written agreement with local emergency medical services (EMS) to accommodate the need for timely inter-hospital transfer on a 24 hours a day, 7 days a week, 365 days a year basis.
(b) Organization.
(1) The medical staff shall develop and implement written policies and procedures approved by the governing body that shall specify:
(i) the responsibility of the emergency services to evaluate, initially manage and treat, or admit or recommend admission, or transfer patients to another facility that can provide definitive treatment. Such policies and procedures shall include a written agreement with one or more local emergency medical services (EMS) to accommodate the need for timely inter-facility transport on a 24 hours a day, 7 days a week, 365 days a year basis;
(ii) the organizational structure of the emergency service, including the specification of authority and accountability for services; and
(iii) explicit prohibition on transfer of patients based on their ability or inability to pay for services.
(2) At least one clinician on every shift must have the skills to assess and manage a critically ill or injured pediatric patient and be able to resuscitate an infant or a child. The emergency service shall be directed by a licensed and currently registered physician who is board-certified or board-admissible for a period not to exceed five years after the physician first attained board admissibility, in emergency medicine, surgery, internal medicine, pediatrics or family practice and who is currently certified in advanced trauma life support (ATLS) or has current training and experience equivalent to ATLS. Such physician shall also have successfully completed a current course in advanced cardiac life support (ACLS) and pediatric advanced life support (PALS) or have had current training and experience equivalent to ACLS and PALS. A licensed and currently registered physician who is board-certified or board-admissible in psychiatry for a period not to exceed five years after the physician first attained board admissibility, in psychiatry may serve as psychiatrist director of a separately operated psychiatric emergency service. Directors of separately operated psychiatric emergency services need not be qualified to perform ATLS, ACLS and PALS or have current training and experience equivalent to ATLS, ACLS and PALS.
(3) An emergency service shall have laboratory and X-ray capability, including both fixed and mobile equipment, available 24 hours a day, seven days a week, to provide test results to the service within a time considered reasonable by accepted emergency medical standards.
(c) General policies and procedures.
(1) The location and telephone number of the State Department of Health designated poison control center, shall be maintained at the telephone switchboard and in the emergency service.
(2) All cases of suspected child abuse or neglect shall be treated and reported immediately to the New York State Central Register of Child Abuse and Maltreatment pursuant to procedures set forth in article 6, title 6 of the Social Services Law.
(3) Domestic violence.
The emergency service shall develop and implement policies and procedures which provide for the management of cases of suspected or confirmed domestic violence victims in accordance with the requirements section 405.9(e) of this Part.
(4) The emergency service shall establish and implement written policies and procedures for the maintenance of sexual offense evidence as part of the hospital-wide provisions required by this Part. An organized protocol for survivors of sexual offenses, including medical and psychological care shall be incorporated into such policies and procedures. These policies, procedures and protocols shall be consistent with the standards for patient care and evidence collection established in section 405.9(c) of this Part.
(5) The emergency service shall provide for the identification, assessment and referral of individuals with documented substance use disorders or who appear to have or be at risk for substance use disorders, as that term is defined in section 1.03 of the Mental Hygiene Law, as described in section 405.9(f) of this Part.
(6) The emergency service shall provide for the identification, assessment, and appropriate treatment or referral of individuals who are suspected to be human trafficking victims, as described in section 405.9(g) of this Part.
(7) The emergency service, in conjunction with the discharge planning program of the hospital, shall develop and implement written policies and procedures, including written patient criteria and guidelines, for transfer of those patients for whom the hospital does not have the capability to care. Such policies and procedures shall specify the circumstances, the actions to be taken, and the appropriate contact agencies and individuals to accomplish adequate discharge planning for persons in need of post emergency treatment or services, but not in need of inpatient hospital care.
(8) An admission and discharge register shall be current and shall include at least the following information for every individual seeking care:
(i) date, name, age, gender, ZIP code;
(ii) expected source of payment;
(iii) time and means of arrival, including name of ambulance service for patients arriving by ambulance;
(iv) complaint and disposition of the case; and
(v) time and means of departure, including name of ambulance service for patients transferred by ambulance.
(9) There shall be a medical record that meets the medical record requirements of this Part for every patient seen in the emergency service. Medical records shall be integrated or cross- referenced with the inpatient and outpatient medical records system to assure the timely availability of previous patient care information and shall contain the prehospital care report or equivalent report for patients who arrive by ambulance. On arrival to emergency services, a patient shall be asked for the name of his or her primary care provider, if known, which shall be documented in the patient’s medical record.
(10) The hospital shall develop and implement written policies and procedures pertaining to the review and communication of laboratory and diagnostic test/service results ordered for a patient while admitted or receiving emergency services to the patient. If the patient lacks medical decision-making capacity, the communication shall be to the patient’s medical decision-maker, if known. The results shall also be provided to the patient’s primary care provider, if known. Such policies and procedures shall be reviewed and updated as necessary and at a minimum shall include:
(i) a requirement that all laboratory and other diagnostic tests/service results be reviewed upon completion by a physician, physician assistant or nurse practitioner familiar with the patient’s presenting condition;
(ii) a requirement that all laboratory and other diagnostic test services results be forwarded to the patient’s primary provider, if known, after review by a physician, physician assistant or nurse practitioner;
(iii) provisions to include in the discharge plan information regarding the patient’s completed and pending laboratory and other diagnostic test/service results, medications, diagnoses, and follow-up care and to review such information with the patient or, if the patient is not legally capable of making decisions, the patient’s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations;
(iv) a requirement that patients may not be discharged from the hospital or the emergency room until any tests that could reasonably be expected to yield “critical value” results – results that suggest a life-threatening or otherwise significant condition such that it requires immediate medical attention– are reviewed by a physician, physician assistant (PA) and/or nurse practitioner (NP) and are communicated to the patient, his or her parents or other decision makers, as appropriate;
(v) a requirement that all information be presented to the patient or if the patient is not legally capable of making decisions, the patient’s parent, legal guardian or health care agent, or surrogate, as appropriate, subject to all applicable confidentiality laws and regulations, in a manner that reasonably assures that the patient, their parents or other medical decision makers understand the health information provided in order to make appropriate health decisions.
(11) Review of the hospital emergency service shall be conducted at least four times a year as a part of the hospital's overall quality assurance program. Receiving hospitals shall report to sending hospitals and emergency medical systems, as appropriate, all patients that die unexpectedly within 24 hours upon arrival at the receiving hospitals. These patient mortalities shall be included in both hospital's quality assurance review.
(d) Staffing.
The following requirements are applicable to all organized emergency services:
(1) Emergency service physician services shall meet the following requirements:
(i) The emergency services attending physician shall meet the minimum qualifications set forth in either clause ( a ) or ( b ) of this subparagraph.
(a) The emergency services attending physician shall be a licensed and currently registered physician who is board-certified in emergency medicine, surgery, internal medicine, pediatrics or family practice and who is currently certified in advanced trauma life support (ATLS) or has current training and experience equivalent to ATLS. Such physician shall also have successfully completed a course and be current in advanced cardiac life support (ACLS) and pediatric advanced life support (PALS) or have had current training and experience equivalent to ACLS and PALS. A licensed and currently registered physician who is board-certified in psychiatry may serve as psychiatrist attending in a separately operated psychiatric emergency service. A licensed and currently registered physician who is board-admissible in one of these specialty areas and is currently certified in ATLS or who has current training and experience equivalent to ATLS and has successfully completed a course and is current in ACLS and PALS or has had current training and experience equivalent to ACLS and PALS, may be designated as attending physician for a period not to exceed five years after the physician has first attained board admissibility. The requirement to be qualified to perform ATLS, ACLS and PALS shall not be applicable to qualified psychiatrist attendings in a separately operated psychiatric emergency service. Physicians who are board-certified or admissible, for a period not to exceed five years after the physician first attained board admissibility, in other specialty areas may be designated as attending physicians for patients requiring their expertise.
(b) The emergency services attending physician shall be a physician who:
(1) is licensed and currently registered;
(2) has successfully completed one year of postgraduate training;
(3) has, within the past five years, accumulated 7,000 documented patient contact hours or hours of teaching medical students, physicians in-training, or physicians in emergency medicine. Up to 3,500 hours of documented experience in hospital-based settings or other settings in the specialties of internal medicine, family practice, surgery or pediatrics may be substituted for the required hours of emergency medicine experience on an hour-for-hour basis;
(4) has acquired in each of the last three years, an average of 50 hours or more per year of continuing medical education pertinent to emergency medicine or to the specialties of practice which contributed to meeting the 7,000 hours requirement specified in subclause ( 3 ) of this clause;
(5) is currently certified in ATLS or has current training and experience equivalent to ATLS; and
(6) has successfully completed a course and is current in advanced cardiac life support (ACLS) and pediatric advanced life support (PALS) or has had current training and experience equivalent to ACLS and PALS.
(ii) There shall be at least one emergency service attending physician on duty 24 hours a day, seven days a week. For hospitals that exceed 15,000 unscheduled visits annually, the attending physician shall be present and available to provide patient care and supervision in the emergency service. As necessitated by patient care needs, additional attending physicians shall be present and available to provide patient care and supervision. Appropriate subspecialty availability as demanded by the case mix shall be provided promptly in accordance with patient needs. For hospitals with less than 15,000 unscheduled emergency visits per year, the supervising or attending physician need not be present but shall be available within 30 minutes of patient presentation, in person or by telemedicine, provided that at least one physician, nurse practitioner, or licensed physician assistant shall be on duty in the emergency service 24 hours a day, seven days a week. The hospital shall develop and implement protocols specifying when physicians must be present.
(iii) Other medical staff practitioner services provided in the emergency service shall be in accordance with the privileges granted the individual.
(iv) Every medical-surgical specialty on the hospital's medical staff which is organized as a department or clinical service and where practitioner staffing is sufficient, shall have a schedule to provide coverage to the emergency service by attending physicians in a timely manner, 24 hours a day, seven days a week, in accordance with patient needs.
(2) Nursing services:
(i) There shall be at least one supervising emergency services registered professional nurse present and available to provide patient care services in the emergency service 24 hours a day, seven days a week.
(ii) Emergency services supervising nurses shall be licensed and currently registered and possess current, comprehensive knowledge and skills in emergency health care. They shall be able to demonstrate skills and knowledge necessary to perform basic life support measures, and be current in ACLS and PALS or have current training and experience equivalent to ACLS and PALS, and meet the competency requirements of section 405.5(a)(7) of this Part;
(iii) Registered professional nurses in the emergency service shall be licensed and currently registered professional nurses who possess current, comprehensive knowledge and skills in emergency health care. They shall have successfully completed an emergency nursing orientation program, be able to demonstrate skills and knowledge necessary to perform basic life support measures and meet the competency requirements of section 405.5(a)(7) of this Part. Within one year of assignment to the emergency service, each emergency service nurse shall be current in ACLS and PALS or have current training and experience equivalent to ACLS and PALS.
(iv) Additional registered professional nurses and nursing staff shall be assigned to the emergency service in accordance with patient needs. If, on average:
(a) the volume of patients per eight-hour shift is under 25, an additional registered professional nurse shall be available as needed to assist the supervising registered professional nurse with delivery of direct patient care; or
(b) the volume of patients per eight-hour shift is over 25, there shall be a minimum of two registered professional nurses per shift assigned to provide direct patient care. As patient volume and intensity increases, the total number of available registered professional nurses shall also be increased to meet patient care needs.
(3) Licensed physician assistants and nurse practitioners:
(i) Patient care services provided by licensed physician assistants shall be in accordance with section 405.4 of this Part.
(ii) Patient care services provided by certified nurse practitioners shall be in collaboration with a licensed physician whose professional privileges include approval to work in the emergency service and in accordance with written practice protocols for these services.
(iii) the licensed physician assistants and the nurse practitioners shall meet the following standards:
(a) the licensed physician assistants and the nurse practitioners in the emergency service shall be current in ACLS and PALS or have had current training and experience equivalent to ACLS and PALS when determined necessary by the hospital to meet anticipated patient needs or when a physician assistant or nurse practitioner is serving as the sole practitioner on duty in a hospital with less than 15,000 unscheduled emergency visits per year;
(b) licensed physician assistants and nurse practitioners in the emergency service shall be current in ATLS or have had current training and experience equivalent to ATLS when determined necessary by the hospital to meet anticipated patient needs or when a physician assistant or nurse practitioner is serving as the sole practitioner on duty in a hospital with less than 15,000 unscheduled emergency visits per year.
(4) Support personnel. There shall be sufficient support personnel assigned to the emergency service to perform the following duties on a timely basis: patient registration, reception, messenger service, acquisition of supplies, equipment, delivery and labeling of laboratory specimens, responsible for the timely retrieval of laboratory reports, obtaining records, patient transport and other services as required.
(e) Patient care.
(1) The hospital shall assure that all persons presenting for emergency services receive emergency health care that meets generally accepted standards of practice.
(2) Every person arriving at the emergency service for care shall be promptly examined, diagnosed and appropriately treated in accordance with triage and transfer policies and protocols adopted by the emergency service and approved by the hospital. Such protocols must include written agreements with local emergency medical services (EMS) in accordance with subparagraph (b)(1)(i) of this section. All patient care services shall be provided under the direction and control of the emergency services director or attending physician. In no event shall a patient be discharged or transferred to another facility, unless evaluated, initially managed, and treated as necessary by an appropriately privileged physician, physician assistant, or nurse practitioner. No later than eight hours after presenting in the emergency service, every person shall be admitted to the hospital, or assigned to observation services in accordance with section 405.32 of this Part, or transferred to another hospital in accordance with paragraph (6) of this subdivision, or discharged to self-care or the care of a physician or other appropriate follow-up service.
(3) Hospitals that have limited capability for receiving and treating patients in need of specialized emergency care shall develop and implement standard descriptions of such patients, and have triage and treatment protocols including consultation and formal written transfer agreements with hospitals that are designated as being able to receive and provide definitive care for such patients. Patients in need of specialized emergency care shall include, but not be limited to:
(i) trauma patients and multiple injury patients;
(ii) burn patients with burns ranging from moderate uncomplicated to major burns as determined by use of generally acceptable methods for estimating total body surface area;
(iii) high risk maternity patients or neonates or pediatric patients in need of higher level care;
(iv) head injured or spinal cord injured patients;
(v) acute psychiatric patients;
(vi) replantation patients;
(vii) dialysis patients; and
(viii) acute myocardial infarction patients including but not limited to patients with ST elevation.
(4) Hospitals shall verbally request ambulance dispatcher services to divert patients with life threatening conditions to other hospitals only when the chief executive officer or designee appointed in writing, determines that acceptance of an additional critical patient would endanger the life of that patient or another patient. Request for diversion shall be documented in writing and, if warranted, renewed at the beginning of each shift.
(5) [ Reserved ]
(6) Patients shall be transferred to another hospital only when:
(i) the patient's condition is stable or being managed;
(ii) the attending practitioner has authorized the transfer; and
(iii) administration of the receiving hospital is informed and can provide the necessary resources to care for the patient; or
(iv) when pursuant to paragraph (2) of this subdivision, the patient is in need of specialized emergency care at a hospital designated to receive and provide definitive care for such patients.
(7) Hospitals located within a city with a population of one million or more persons shall apply, and if accepted, participate to the full extent of their capability, in the emergency medical service which is operated by such city or such city's health and hospitals corporation.
(f) Quality assurance.
(1) Quality assurance activities of the emergency service shall be integrated with the hospital-wide quality assurance program and shall include review of:
(i) arrangements for medical control and direction of prehospital emergency medical services;
(ii) provisions for triage of persons in need of specialized emergency care to hospitals designated as capable of treating those patients;
(iii) emergency care provided to hospital patients, to be conducted at least four times a year, and to include prehospital care providers, emergency services personnel and emergency service physicians; and
(iv) adequacy of staff training and continuing education to meet the needs of patients of all ages presenting for emergency services.
(2) Hospitals as represented by emergency department practitioners and other clinical practitioners relevant to the care provided should also collaborate, as provided under Public Health Law section 3006, in the quality improvement programs of their local EMS to review prehospital care issues including review of specific patient cases.
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.279 Referred ambulatory
A referred ambulatory patient is one who is treated and/or diagnosed in an ancillary service area of a hospital upon referral and who does not meet the definition criteria for an emergency outpatient or the clinical outpatient. A referral of an emergency or clinical outpatient to an ancillary service area does not change the classification of the patient to referred outpatient status.
Chapter I STATE SANITARY CODE
Part 14 FOOD SERVICE ESTABLISHMENTS
Subpart 14-5 VENDING OF FOOD AND BEVERAGES
PUBLIC HEALTH HAZARDS PUBLIC HEALTH HAZARDS
10 CRR-NY 14-5.10 Definition of imminent health hazard
(a) An imminent health hazard is any violation, combination of violations, condition, or combination of conditions making it probable that the food or drink that is or may be vended by a vending machine or its continued operation may injure the health of the consumer or the public.
(b) Any of the following violations are imminent health hazards against the public interest which require the permit-issuing official or his designated representative to order the food vending machine operation to be stopped immediately, the machine removed, and the commissary to cease supplying food to the food vending machine immediately, if not corrected at the time of the inspection while the permit-issuing official or his designated representative is present:
(1) food is present at or in the vending machine which is or may be adulterated, contaminated, or otherwise unfit for human consumption;
(2) potentially hazardous food is held at a temperature greater than 45°F (7.2°C) or less than 140°F (60°C) beyond a period of time required for preparation or the allowed vending machine temperature recovery period;
(3) potentially hazardous food previously served to a consumer or exposed to contamination is offered for service in a food vending machine;
(4) toxic items are improperly stored or used in food vending machine operations;
(5) persons with reportable disease or infections which can be transmitted by food are not restricted to prevent food contamination in food vending machine operations;
(6) a food vending machine is supplied with water which is not in conformance with Part 5 of this Title;
(7) a food vending machine is connected to the potable water system so that backflow from the vending machine can contaminate the potable water system, or to the sewage system so that sewage can contaminate the food vending machine;
(8) waste water or sewage from the vending machine is not disposed of in an approved and sanitary manner; or
(9) the vending machine constitutes an electrical or mechanical hazard to the consumer or public.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 88 HELEN HAYES HOSPITAL, NEW YORK STATE VETERANS' HOME AND ROSWELL PARK MEMORIAL INSTITUTE
Subpart 88-3 ROSWELL PARK MEMORIAL INSTITUTE
DISCHARGE OF PATIENTS DISCHARGE OF PATIENTS
10 CRR-NY 88-3.20 Discharges
Patients shall be discharged when they shall have achieved maximum benefits from the services of the hospital, as determined by the director. Patients desiring to leave before achieving maximum benefits shall sign or have signed by their legal representative a statement releasing the hospital, the New York State Department of Health, and the State of New York from any liability which might result from such discharge. Patients may be discharged for noncompliance with hospital rules, misbehavior, or noncooperation, as determined by the director. The final report on each patient shall make recommendations for further services and supervision which may be required after discharge.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 9 RESIDENTIAL HEALTH CARE FACILITY UNIFORM REPORTING
Part 455 FUNCTIONAL REPORTING CENTERS
10 CRR-NY 455.24 Electrocardiology
This functional reporting center must contain all the expenses associated with the operation of specialized equipment to record electromotive variations in actions of the heart muscle on an electrocardiograph for diagnosis of heart ailments. Additional activities include but are not limited to the following: wheeling portable equipment to patients' bedsides; explaining test procedures to patients; operating electrocardiograph equipment; inspecting, testing and maintaining special equipment; and attaching and removing electrodes to and from patients.
(a) Standard unit of measure: CAP workload measurement units.
Reference: section 455.23(a) of this Part.
(b) Data source.
The number of workload measurement units shall be an actual count maintained by the laboratory.
Article 1 GENERAL
Part 403 HOME CARE WORKER REGISTRY
10 CRR-NY 403.4 Responsibilities of State approved education or training programs
(a) Any entity that offers or provides a State approved education or training program shall, for each trainee who begins a training program:
(1)
(i) Verify the identity of the trainee by examining at least one of the following unexpired documents:
(a) driver’s license or identification card issued by a State or outlying possession of the United States, provided it contains a photograph or information such as name, date of birth, gender, height, eye color and address;
(b) identification card issued by Federal, State or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address;
(c) school identification card with a photograph;
(d) voter’s registration card;
(e) United States military card or draft record;
(f) military dependent’s identification card;
(g) United States coast guard merchant mariner card;
(h) Native American tribal document;
(i) driver’s license issued by a Canadian government authority;
(j) United States passport or United States passport card;
(k) permanent resident card or alien registration receipt card; or
(l) employment authorization document that contains a photograph.
(ii) For any such document examined, information regarding the document title, issuing authority, document number and expiration date, if any, must be recorded and maintained in the permanent records of the program.
(iii) If the trainee fails to provide any of the documents specified in subdivision (a) of this section, the training program must deny participation in the program.
(2) Obtain all of the information required by section 3613(3)(a)-(e) of the Public Health Law and maintain such information in the permanent records of the program.
(3) Within 10 business days of successful completion of the program, enter the information required by section 3613(3)(a)-(e) of the Public Health Law into the registry in the form and manner required by the department.
(4) Upon request of a trainee or a person who has successfully completed an approved education or training offered by the program, and upon proof of identity, provide access to complete registry information relating to such person, including a printed report if requested.
(5) Within 10 business days after a request by a trainee or a person who has successfully completed an approved education or training offered by the program, correct information entered incorrectly into the registry by the program. A program must request verification from the worker supporting the correction.
(6) Within 10 business days after a trainee has successfully completed an approved education or training offered by the program, ensure that a written sworn statement by the senior official of the entity, made under penalty of perjury, has been fully executed and included in the permanent records of the program. The written sworn statement must:
(i) identify each trainee who has successfully completed the program by name, address, date of birth and date of completion of the program;
(ii) describe the nature of the education or training covered in the program;
(iii) certify that the trainee has in fact successfully completed the identified program; and
(iv) certify that the entity has verified the true identity of each trainee who has successfully completed the identified program as required in subparagraph (a)(1) of this section.
(7)
(i) Within 10 business days after the written sworn statement described in subparagraph (a)(6) of this section has been executed by the senior official of the entity, print and sign the certificate of successful completion generated by the department and provide a copy of the signed certificate to the trainee. The original certificate must be maintained in the permanent records of the program.
(b) Any entity that offers or provides a state approved education or training program shall submit information to the registry about each class offered to train or educate home care services workers, before or within 10 business days after the commencement of the class, regarding the following:
(1) name and date of birth of each person attending the program;
(2) the location, dates and times where the classroom portion of the program will be held;
(3) the name, title and qualifications of the person(s) who will be delivering the classroom instruction; and
(4) The anticipated date of graduation.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES TOXIC VAPORS, HYPODERMIC SYRINGES AND NEEDLES
10 CRR-NY 80.135 Authorization to conduct hypodermic syringe and needle exchange programs
(a) Employees or trained volunteers of community-based not-for-profit organizations and government entities engaged in clean hypodermic syringe and needle exchange programs designed to reduce the transmission of human immunodeficiency virus may obtain, possess and furnish hypodermic syringes and hypodermic needles, without prescription, when authorized by the commissioner in connection with the distribution or collection of hypodermic syringes and hypodermic needles for the purpose of preventing the transmission of human immunodeficiency virus in users of injectable drugs. This authorization will be granted only in accordance with a plan submitted by the not-for-profit corporation or government entity and approved by the commissioner, using the standards contained in this section. This authorization will be based upon the plan meeting the requirements of the regulation.
(b) The department will review the plan submitted by the not-for-profit corporation or government entity using the following standards:
(1) the plan demonstrates the need for a hypodermic syringe and needle exchange program in the targeted community(ies) and in targeted populations within those communities;
(2) the plan demonstrates organizational capability and commitment necessary to conduct a hypodermic syringe and needle exchange program, to interact effectively with the community(ies) and with targeted populations within those communities where a hypodermic syringe and needle exchange program is planned, and to enlist support for and to further integration of hypodermic and needle exchange services within the community(ies);
(3) the plan demonstrates an adequacy of the design and protocol for the conduct of a hypodermic syringe and needle exchange program; and
(4) the plan demonstrates organizational capability to provide comprehensive harm reduction services, including HIV prevention education and other appropriate interventions such as counseling for program participants and direct provision of or referral to other health and human services, including drug treatment.
(c) This authorization extends only to those hypodermic needles and hypodermic syringes distributed or collected pursuant to the approved plan and only as long as such employees or trained volunteers of the not-for-profit organizations or government entities are assigned to the program. The organization or entity must develop and maintain a list of employees and trained volunteers who are authorized to obtain, possess and furnish hypodermic syringes and hypodermic needles, and furnish this list to the department. All personnel changes to this list shall be reported to the department in a time period specified by the department.
(d) An approval obtained pursuant to subdivision (a) of this section shall continue until two years from the date of notification by the commissioner of approval of the plan submitted by the not-for-profit organization or government entity or until receipt by the organization or entity of a written notice of termination of the program from the commissioner, whichever shall first occur. The commissioner may approve extensions of the plan for additional two-year periods if the not- for-profit organization or government entity complied with the requirements of this section during the prior two-year period.
(e) Individuals participating in the approved plan may obtain and possess hypodermic syringes and hypodermic needles without prescription from individuals authorized pursuant to subdivision (a) of this section provided that:
(1) this authorization extends only to obtaining or possessing those hypodermic syringes and hypodermic needles which have been distributed or collected pursuant to the approved plan;
(2) this authorization is effective only so long as the person is an active participant in the approved plan; and
(3) this authorization shall be automatically void with respect to any hypodermic syringe or hypodermic needle which is sold or furnished or attempted to be sold or furnished by a participant in violation of State or Federal law.
(f) An approval pursuant to subdivision (a) of this section shall allow a not-for-profit organization or government entity to purchase hypodermic syringes or hypodermic needles as part of a needle exchange plan approved by the commissioner, and designed to reduce the transmission of human immunodeficiency virus.
(g) An organization or entity authorized by the commissioner to conduct a hypodermic syringe and needle exchange program must adhere to policies and procedures developed by the department for the conduct of a hypodermic syringe and needle exchange. An approved plan may propose revisions to the department's policies and procedures to reflect the specific conditions under which the plan is providing services. Any proposed revision must be approved by the department prior to implementation. Such policies and procedures will include, but not be limited to:
(1) requirements for training for staff and volunteers;
(2) procedures to ensure staff security;
(3) policies and procedures for enlisting community support for the program, including development of a community advisory board reflective of the community in which the hypodermic syringe and needle exchange program is located;
(4) procedures and reporting requirements involving community concerns regarding the conduct of a hypodermic syringe and needle exchange program, including those involving law enforcement agencies;
(5) policies and procedures for determining eligibility of individuals for participation in a hypodermic syringe and needle exchange program;
(6) policies and procedures to provide assessment and service referral for injecting drug users under the age of 18;
(7) procedures for enrollment of participants in a hypodermic syringe and needle exchange program and issuance of participant identification cards;
(8) procedures for obtaining and recording participant information;
(9) policies and procedures for distribution and collection of hypodermic syringes and needles, including the number of needles that can be provided to a plan participant in a single transaction;
(10) procedures to ensure that hypodermic syringes and needles are secured properly and that the handling and disposal of hypodermic syringes and needles is safeguarded and in accordance with State and Federal law and regulations;
(11) policies and procedures to terminate program participants;
(12) procedures for developing new sites or expanding or changing existing sites for hypodermic syringe and needle exchange programs;
(13) policies and procedures relating to the provision of HIV prevention education and other appropriate interventions such as counseling for program participants;
(14) policies and procedures for referring program participants to services, including developing formal written agreements with service providers and documenting referral linkages;
(15) procedures for data collection and program reporting; and
(16) policies and procedures for evaluation of hypodermic syringe and needle exchange programs.
(h) The following records of hypodermic syringes, hypodermic needles, participants and transactions shall be maintained by the organization or entity engaged in exchanging hypodermic syringes and hypodermic needles:
(1) an inventory of hypodermic syringes and hypodermic needles, including the number purchased and distributed, and the balance on hand;
(2) a record of the number of hypodermic syringes and hypodermic needles distributed to each participant in each transaction;
(3) a record of the number of used hypodermic syringes and hypodermic needles returned by each participant in each transaction;
(4) the number and manner of disposal of hypodermic syringes and hypodermic needles collected by the program; and
(5) a record of the number of participants provided HIV prevention education and other appropriate interventions such as counseling; a record of the number and types of services directly provided or provided by referral to participants, based upon an assessment of the client's needs, not limited to, referral to HIV antibody testing services, health care services, including evaluation and treatment for HIV infection, sexually transmitted diseases and tuberculosis, family planning, prenatal and obstetrical care, social services and drug abuse treatment services.
(i) An organization or entity functioning under a needle exchange plan approved under subdivision (a) of this section must ensure that hypodermic syringes and needles are secured properly and must safeguard the handling and disposal of hypodermic syringes and needles in accordance with State and Federal law and regulations.
(j) An organization or entity functioning under a needle exchange plan approved under subdivision (a) of this section must provide periodic reports of activities to the department in a format and time period specified by the department which shall include, but not be limited to:
(1) the number of program participants;
(2) aggregate information regarding the characteristics of program participants;
(3) the total number of hypodermic syringes and hypodermic needles distributed, and the average number distributed per participant per transaction;
(4) the total number of hypodermic syringes and hypodermic needles collected, and the average number collected per participant per transaction;
(5) information regarding the service needs of plan participants, based upon the plan's assessment of those needs and the service needs expressed by plan participants. Information regarding the program's response to those needs, including, but not limited to program changes, the establishment of new services, and the provision of onsite referrals and referrals to off-site providers for other services. This information will include the number and types of services directly provided or provided by referral to plan participants, not limited to HIV prevention education and other appropriate interventions such as counseling, HIV antibody testing services, health care services, including evaluation and treatment for HIV infection, sexually transmitted diseases and tuberculosis, family planning, prenatal and obstetrical care, social services and drug abuse treatment services;
(6) a list of employees and trained volunteers who are authorized to obtain, possess and furnish hypodermic syringes and needles;
(7) significant problems encountered and program milestones achieved; and
(8) other information deemed necessary by the department to ensure that the conduct of a hypodermic syringe and needle exchange program adheres to the requirements of this regulation.
(k) The organization or entity functioning under an approved needle exchange plan shall provide an annual report of plan activities to the department, summarizing the information previously provided as contained in subdivision (j) of this section in a format provided by the department. In addition, the report shall contain an evaluation of the organization's progress in attaining the plan's goals. The annual report must be submitted to the department no later than 60 days after the program has been approved for a period of one year and at the same time annually thereafter.
(l) An organization or entity functioning under a needle exchange plan approved under subdivision (a) of this section may be inspected by authorized representatives of the State Commissioner of Health as necessary to ensure compliance with the requirements of this section. An organization or entity found to be in violation of these regulations will receive written notification of the violation from the department and a time period, not to exceed 30 days from the date of written notification, to correct the violation. If the organization or entity continues to be in violation of these regulations after the date required for correction, the commissioner may terminate approval of the plan. The commissioner may also terminate the plan immediately if s/he determines that approval of the plan is no longer in the interest of public health.
An organization or entity will receive notification of the termination from the commissioner or his/her designee, and a time period not to exceed 60 days to appeal the termination by written submission to the commissioner or his/her designee requesting reconsideration of the termination.
(m) Any not-for-profit organization or government entity seeking to obtain, possess and furnish hypodermic syringes and hypodermic needles, without prescription, must submit a plan to the commissioner for approval, which must be in a format specified by the department, and will include, but not be limited to:
(1) the name and address of the not-for-profit organization or government entity;
(2) the name and title of the individual authorized to represent the program in seeking approval;
(3) information regarding organizational capability and commitment relating to the conduct of a hypodermic syringe and needle exchange program;
(4) an assessment of the need for a hypodermic syringe and needle exchange program in the targeted community(ies) and in targeted populations within the communities;
(5) a description of the applicant's previous and planned activities to interact with a community(ies) where a hypodermic syringe and needle exchange program is planned, to enlist support for and to further integration of the hypodermic syringe and needle exchange program within the community(ies) and within targeted populations in those communities;
(6) a description of staffing for the proposed program, including employees or trained volunteers;
(7) a description of training planned for employees and volunteers staffing the proposed program;
(8) a list of employees and trained volunteers staffing the proposed program;
(9) the design and protocols of the project, including the geographic area and the method of program operation; including procedures for determining eligibility of individuals for participation in the program; procedures to provide assessment and service referral to injecting drug users under the age of 18; procedures for enrollment of participants in the program, including issuance of participant identification cards; procedures for obtaining and recording participant information; procedures to ensure staff security; procedures for distribution and collection of hypodermic syringes and needles, including the number of needles that can be provided to a plan participant in a single transaction;
(10) the proposed plans for the proper safeguarding and handling and disposal of hypodermic syringes and needles, including inventory control, and securing injection equipment from theft, adherence to appropriate infection control practices and appropriate disposal of used hypodermic syringes and needles;
(11) the proposed plan to provide program participants with HIV prevention education and other appropriate interventions such as counseling regarding drug and sexual risk behaviors and risk reduction practices, including cleaning of injection equipment, use of condoms, and distribution of bleach kits and condoms, and referral for ongoing HIV prevention education and psychosocial support;
(12) the proposed plan for direct provision or referral to HIV antibody testing services, health services, including evaluation and treatment services for HIV infection, sexually transmitted diseases and tuberculosis, family planning, prenatal and obstetrical care, social services, viral hepatitis and drug treatment services, including the plan to work with service providers and community-based organizations to establish service linkages;
(13) the proposed plan for evaluating program services and goals; and
(14) overdose prevention education that specifically includes information about methods participants should use to prevent any adverse reactions from:
(i) injecting fentanyl; and
(ii) lack of knowledge of the kinds and amounts of substances users are injecting.
(n) The commissioner may approve programs with plans that do not include all of the elements specified in subdivision (m) of this section, provided that:
(1) the not-for-profit organization or government entity does not receive funding to operate such a hypodermic syringe or needle exchange program from the department;
(2) the not-for-profit organization or government entity provides other services to individuals at heightened risk for adverse outcomes;
(3) the plan includes at least the following elements:
(i) a description of staffing and training planned for employees and volunteers working for the proposed program;
(ii) if the plan does not have procedures for enrollment of participants in the program or issuance of participant identification cards, procedures to make it possible for clients to demonstrate that they received syringes from a legally authorized program;
(iii) policies and procedures for the proper safeguarding, handling and disposal of hypodermic syringes and needles, including inventory control, securing injection equipment from theft, adherence to appropriate infection control practices, and appropriate disposal of used hypodermic syringes and needles;
(iv) policies and procedures for enlisting community support for the program, including responding to concerns from the community and law enforcement agencies;
(v) submission of quarterly reports to the department, in a format determined by the department; and
(4) the program is approved by any other State agency that licenses or certifies the operations of the not-for-profit organization or government entity.
Subchapter M X-RAY TECHNOLOGY AND CHIROPRACTIC USE OF X-RAY
Part 89 PRACTICE OF RADIOLOGIC TECHNOLOGY
PRACTICE OF RADIOLOGIC TECHNOLOGY PRACTICE OF RADIOLOGIC TECHNOLOGY
10 CRR-NY 89.2 Practice of radiologic technology
(a) The practice of radiography includes, but is not limited to, the following activities performed under the supervision of a licensed practitioner:
(1) measuring and positioning patients;
(2) selecting and setting up exposure factors on X-ray equipment;
(3) making X-ray exposures;
(4) using fluoroscopy for localization purposes prior to taking a spot film of a mobile organ such as the gall bladder or the duodenal cap;
(5) operating fluoroscopy equipment under the personal supervision of a physician, except where direct supervision is required by this Part;
(6) administering non-intravenous contrast media pursuant to a physician’s order;
(7) performing quality control tests;
(8) for individuals certified under section 89.40 of this Part, the intravascular administration of contrast media under the direct supervision when such administration is an integral part of an X-ray or imaging procedure; and
(9) performing manual air insufflation as a required component of an imaging procedure, such as a virtual colonoscopy procedure or a barium enema procedure, under the supervision of a physician as follows:
(i) initial insertion of the tip of the balloon tube and inflating the balloon at the end of the tube under the direct supervision of a physician; and
(ii) insufflating air into the colon under the personal supervision of a physician.
(b) The practice of radiation therapy includes, but is not limited to, the following activities performed under the supervision of a radiation oncologist:
(1) setting up the treatment position;
(2) delivering the required daily dose prescribed by the physician;
(3) maintaining an accurate record of the technical details of the treatment;
(4) selecting the required filter and treatment distance;
(5) making beam directional shells and molds;
(6) using diagnostic X-ray equipment only for treatment planning and not for diagnostic purposes;
(7) assisting the medical physicist in calibration procedures;
(8) performing quality control tests; and
(9) assisting in treatment planning procedures.
(c) The practice of nuclear medicine technology includes, but is not limited to, the following activities performed under the supervision of an authorized user:
(1) elution of a radiopharmaceutical generator;
(2) dosage preparation;
(3) assay of radiopharmaceutical dosages administered to patients;
(4) use of nuclear medicine equipment on patients;
(5) performance of quality control tests;
(6) administration of radiopharmaceuticals to patients for diagnostic purposes as ordered by an authorized user;
(7) administration of radiopharmaceuticals to patients for therapeutic purposes under the personal supervision of an authorized user; and
(8) the use of technology that merges radiopharmaceutical imaging technology with other forms of medical imaging technology for diagnostic purposes. All nuclear medicine technologists who use X-ray and radiopharmaceutical imaging as part of a merged imaging procedure shall:
(i) be a licensed radiographer, or hold a post primary certification in computed tomography from a national accrediting organization approved by the department; and
(ii) operate the merged imaging technology under the personal supervision of an authorized user until the authorized user acknowledges in writing that the nuclear medicine technologist can operate the merged technology competently without such personal supervision; and
(iii) use only single photon emission computed tomography (SPECT/CT) or positron emission tomography (PET)/CT technology and no other X-ray imaging technology.
(d) Radiologic technologists shall wear, at all times while engaged in the practice of radiologic technology, identification tags giving their name and title as “Licensed Radiographer,” or “Licensed Radiation Therapist” or “Licensed Nuclear Medicine Technologist” or a derivative of such a title. The tag shall not be smaller than ¾” x 3” in dimension, and the lettering shall be in clear contrast to the background color of the tag. The tag shall be prominently displayed while worn. The tag shall not be worn by, or issued to a person not licensed to practice radiologic technology, or not licensed and registered in the category of practice indicated on the tag.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 128 NEW YORK CITY
Subpart 128-4 WATER QUALITY STANDARDS FOR RESERVOIRS AND CONTROLLED LAKES
10 CRR-NY 128-4.1 Water quality standards
(a) The water in all reservoirs, Lake Gilead, and Lake Gleneida, shall meet the following standards of quality:
(1) Parts 701 (narrative standards) and 703 (standards applicable to Class AA waters) of Title 6 NYCRR:
(i) for purposes of determining compliance with this Subpart, the department shall take water samples from the reservoirs; and
(ii) where total coliform standards exceed the standards set forth in Parts 701 and 703 of Title 6 NYCRR, and are determined by the department to be due to a non-perennial, non-anthropogenic source, such exceedances shall not be included in calculating whether a violation of these rules and regulations has occurred.
(2) The New York State Department of Environmental Conservation Technical and Operational Guidance Series (TOGS) 1.1.1, Ambient Water Quality Standards and Guidance Values (October 22, 1993) which sets forth the ambient water quality standards and guidance values for principal organic chemicals and synthetic organic chemicals.
(b) The water within 500 feet of the aqueduct effluent chamber located at a terminal reservoir (Kensico, West Branch, New Croton, Ashokan and Rondout) shall meet the following coliform standard:
(1) Raw water fecal coliform concentrations shall be equal to or less than 20 colonies per 100 milliliters or total coliform concentration shall be equal to or less than 100 colonies per 100 milliliters in at least 90 percent of the measurements made over any consecutive six-month period. For purposes of determining compliance with this Subpart, a minimum of five samples per week will be taken from each reservoir. If both fecal and total coliform analyses are performed, the fecal coliform results shall take precedence over the total conform analysis.
(i) Where fecal coliform standards exceed the above standards, and are determined by the department to be due to non-perennial, non anthropogenic sources, such exceedances shall not be included in calculating whether a violation of these rules and regulations has occurred.
(c) The department shall, on an annual basis, conduct a review of all reservoirs and controlled lakes for the purpose of determining whether each reservoir and controlled lake meets or fails to meet the water quality standards set forth in subdivisions (a) and (b) of this section, as applicable. The results of the department's review, together with the calculations used in arriving at the results for each reservoir, shall be published in a report which shall be made available to the public upon request.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 47 NEW YORK STATE HEALTH SERVICE CORPS/OBSTETRIC AND PEDIATRIC PRACTITIONER INCENTIVE DEMONSTRATION PROGRAM
Subpart 47-5 PHYSICIAN LOAN REPAYMENT PROGRAM
10 CRR-NY 47-5.5 Service obligation
(a) Period.
A recipient shall agree to practice for a minimum of two consecutive years in an underserved area. A recipient shall provide at least 40 hours of service per week for at least 48 weeks per year.
(b) Start date.
A recipient is required to begin practice in an underserved area within 90 days of signing a service agreement.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 141 SARATOGA COUNTY
10 CRR-NY 141.4 Village of Schuylerville
Public Health Law, § 1100
(a) Application.
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 1100-1107 of the Public Health Law shall apply to all Schuylerville reservoirs, in both Saratoga and Washington Counties, and their tributaries which now serve or which may be developed in the future to serve as sources of the public water supply of the Village of Schuylerville, Saratoga County, New York, and to all watercourses tributary thereto or ultimately discharging into said reservoirs.
(b) Definitions.
(1) Herbicide shall mean any substance used to destroy or inhibit plant growth.
(2) Human excreta shall mean human feces and urine.
(3) Junkyard shall mean an area where two or more unregistered, old or secondhand motor vehicles are being accumulated for purposes of disposal, resale of used parts or reclaiming certain materials such as metal, glass, fabric, etc.
(4) Linear distance shall mean the shortest horizontal distance from the nearest point of a structure or object to the high water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high water mark of a watercourse.
(5) Pesticide shall mean any substance used to destroy pests such as rodents and insects.
(6) Radioactive material shall mean any material in any form that emits radiation spontaneously.
(7) Refuse shall mean all putrescible and nonputrescible solid wastes including garbage, rubbish, ashes, incinerator residue, street cleanings, dead animals, offal and solid commercial and industrial wastes.
(8) Refuse disposal area shall mean land used for the depositing of refuse except that it shall not include the land used for the depositing of refuse from a single family, a member of which is the owner, occupant or lessee of said land, or any part of a farm on which only animal wastes resulting from the operation of such farm are deposited.
(9) Reservoir shall mean any natural or artificial lake or pond which is tributary to or serves as a source of the Village of Schuylerville public water supply.
(10) Sewage shall mean the waste from a flush toilet, bath, sink, lavatory, dishwashing or laundry machine, or the water-carried waste from any other fixture or equipment or machine.
(11) Sewage disposal system shall mean a system for disposing of sewage, industrial wastes or other wastes, and including sewers and treatment works
(12) Toxic chemical shall mean any compound or substance which is or may be poisonous to humans.
(13) Treatment works shall mean any plant, disposal field, lagoon, pumping station, constructed drainage ditch or surface water intercepting ditch, incinerator, area devoted to sanitary land fills, or other works not specifically mentioned herein, installed for the purpose of treating, neutralizing, stabilizing or disposing of sewage, industrial waste or other wastes.
(14) Watercourse shall mean every spring, stream, marsh, or channel of any kind, the waters of which flow or may flow into the Village of Schuylerville public water supply.
(15) Watershed shall mean the entire drainage area contributing water to the Village of Schuylerville public water supply.
(16) Water supply shall mean the public water supply of the Village of Schuylerville, Saratoga County, New York.
(c) Human excreta and sewage.
(1) No human excreta shall be deposited or allowed to escape into any reservoir or watercourse on the watershed.
(2) No human excreta shall be deposited or spread upon the surface of the ground at any point on the watershed.
(3) No human excreta shall be buried in the soil on the watershed unless deposited in trenches or pits at a distance of not less than 250 feet from any reservoir or watercourse and covered with not less than one foot of soil in such a manner as to effectually prevent its being washed into any reservoir or watercourse by rain or melting snow.
(4) No privy or receptacle of any kind for the deposit or storage of human excreta shall be constructed, placed, maintained or allowed to remain within 50 feet of any reservoir or watercourse except
(i) watertight receptacles,
(ii) water-flushed toilets connected by a watertight pipe to a sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facilities and
(iii) a properly designed, constructed and operated treatment works that has been approved by the appropriate State agency having jurisdiction over such facility.
(5) No portion of the seepage unit (tile field, seepage pit or equivalent) of a subsurface sewage disposal system shall be constructed, placed or allowed to remain within 100 feet of any reservoir or watercourse.
(6) Every watertight receptacle referred to in paragraph (4) above and paragraph (9) below shall be emptied when filled within six inches of the top of the receptacle.
(7) In emptying a watertight receptacle or in transferring its contents to a transportable receptacle, all necessary care shall be exercised to prevent contamination of any reservoir or watercourse. All such transportable receptacles shall be provided with tightly fitting covers which are securely fastened when transporting wastes to the place of ultimate disposal. The contents of the watertight receptacles shall be disposed of in accordance with paragraph (3) above or at a properly designed, constructed and operated sewage disposal system that has been approved by the appropriate State agency having jurisdiction over such facility.
(8) Before any existing sewage disposal system is altered or any new sewage disposal system is constructed on the watershed, the plans in relation thereto shall have been first approved by the appropriate State agency having jurisdiction over such facility. Standards for waste treatment works as published from time to time by the appropriate State agency having jurisdiction over such facility and paragraph (5) above shall comprise the criteria to approve any proposed sewage disposal system.
(9) No sewage or polluted liquid of any kind shall be discharged or allowed to flow into any reservoir or watercourse nor on or beneath the surface of ground on the watershed (excepting into watertight receptacles or watertight pipes connected to a sewage disposal system approved by the agency having jurisdiction over such facility) within 100 feet of any reservoir or watercourse. These restrictions and limiting distances shall not apply to sewage treatment works installed in accorance with plans which first have been submitted to and approved by the appropriate State agency having jurisdiction over such facility.
(d) Refuse disposal area.
No refuse disposal area shall be located within 250 feet of any reservoir or watercourse.
(e) Cemeteries.
No interment of a human body shall be made within 250 feet of any reservoir or watercourse.
(f) Radioactive material.
No radioactive material in excess of the quantity listed for said material in Table 4, Appendix 1, Part 16, Chapter I (Ionizing Radiation), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York shall be disposed of by burial in soil within 250 feet of any reservoir or watercourse.
(g) Junkyards.
No junkyard shall be located within 100 feet of any reservoir or watercourse.
(h) Bathing and swimming.
Bathing and swimming are prohibited in any reservoir or watercourse owned by the Village of Schuylerville.
(i) Temporary shelters.
No hut, tent, shelter or building of any kind, except a waterworks structure, shall be permitted on the water or ice of any reservoir or watercourse owned by the Village of Schuylerville.
(j) Boating.
No boating shall be allowed in or upon the waters of any reservoir or watercourse owned by the Village of Schuylerville except by duly authorized employees of the Village of Schuylerville in the performance of their duties of supervision and maintenance of the water supply.
(k) Fishing and trespassing.
No fishing or trespassing shall be allowed in or upon any reservoir or watercourse owned by the Village of Schuylerville within 1000 feet of the water supply intakes except by duly authorized employees of the Village of Schuylerville in the performance of their duties of supervision and maintenance of the water supply.
(l) Herbicides, pesticides, and toxic chemical.
No herbicides, pesticides or toxic chemical shall be discharged, applied or allowed to enter into any reservoir or watercourse unless a permit to do so has been obtained from the appropriate State agency having jurisdiction.
(m) Manure.
No manure pile shall be maintained or allowed to remain within 50 feet of any reservoir or watercourse.
(n) General clause.
No person, including State agencies or political subdivisions having jurisdiction, shall perform any act or grant any permit or approval which may result in the contravention of the standards for raw water quality as contained in Part 170, Subchapter C (Water Supply Sources), Chapter III (Public Water Supplies), Title 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York.
(o) Inspections.
The village board of trustees, or any person or persons as may be charged with the maintenance or supervision of the water supply shall make regular and thorough inspections of the reservoir, watercourses and watershed to ascertain whether this Part is being complied with. It shall be the duty of the village board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same together with notices of such violations. If such persons served do not immediately comply with this Part, it shall be the further duty of the village board of trustees to promptly notify the State Commissioner of Health of such violations. The village board of trustees shall report to the State Commissioner of Health in writing annually, prior to the 30th day of January, the results of the regular inspections made during the preceding year. The report shall state the number of inspections made, the number of violations found, the number of notices served and the number of violations abated and the general condition of the watershed at the time of the last inspection.
(p) Penalty.
Penalties for violations shall be in accordance with section 1103 of the Public Health Law.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 76 PUBLIC HEALTH ADMINISTRATIVE TRIBUNAL
10 CRR-NY 76.3 Public health administrative tribunal; establishment, powers and duties
(a) A public health administrative tribunal is established in the department consisting of three executive level staff members as designated by the commissioner. The tribunal will itself, or through delegation to tribunal representatives, have the power and duty to:
(1) accept pleas to hear and determine allegations of violations of the Public Health Law and State Sanitary Code (Chapter I of this Title), and pertinent provisions of the administrative rules and regulations of the department;
(2) examine witnesses and receive evidence for this purpose;
(3) administer oaths and affirmations;
(4) sign and issue subpoenas in the name of the department at the request of any party, requiring attendance and giving of testimony by witnesses and production of books, papers, documents and other evidence; such subpoenas shall be regulated by the Civil Practice Law and Rules;
(5) provide for taking of testimony by deposition;
(6) regulate the course of the hearings, set the time and place for continued hearings, and fix the time for filing of briefs and other documents;
(7) determine whether or not to offer a stipulation as provided in section 76.9 of this Part;
(8) impose fines, penalties, permit revocations, permit suspensions or closure as authorized;
(9) order abatement of violations, and a schedule for such abatement; and
(10) order reinspection of the facility to determine compliance with the State Sanitary Code and orders for abatement.
(b) The tribunal will:
(1) serve as the department's review board with respect to appeals made from the decisions, determinations and orders of designated tribunal representatives;
(2) maintain records relating to appeals;
(3) adopt administrative procedures and guidelines; and
(4) maintain a record of designated tribunal representatives and their decisions.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 8 NEW YORK STATE ANNUAL HOSPITAL REPORT
Part 441 DEFINITIONS
10 CRR-NY 441.252 Perpetual inventory
A book inventory kept in continous agreement with stock on hand by means of a detailed record that may also serve as a subsidiary ledger where dollar amounts as well as physical quantities are maintained. Sections of the stockroom are inventoried at short intervals and the quantities or amounts or both are adjusted, where necessary, to the physical count.
Chapter I STATE SANITARY CODE
Part 8 NUISANCES WHICH MAY AFFECT LIFE AND HEALTH
10 CRR-NY 8.5 State Commissioner of Health may direct local board of health to take certain definite proceedings
If, in the opinion of the State Commissioner of Health, the conditions complained of constitute a nuisance likely to affect health and the abatement or removal thereof is necessary for the public good and for the protection of life and health, the said commissioner may, by notice to the presiding officer of the local board of health, direct him, pursuant to section 1300 of the Public Health Law, to convene such local board to take certain definite proceedings concerning which the said commissioner is satisfied that the action recommended by him is necessary for the public good and is within the jurisdiction of such board of health.
Chapter V MEDICAL FACILITIES
Subchapter A MEDICAL FACILITIES—MINIMUM STANDARDS
Article 5 HIV/AIDS HEALTH SERVICES
Part 420 COMPREHENSIVE AMBULATORY HIV PROGRAMS
10 CRR-NY 420.2 Approval to provide services
(a) Existing article 28 facilities not providing specialized HIV promary care services may receive approval from the department to provice a CAHP. Such facilities seeking such approval may submit to the commissioner a request as required by section 710.1(c)(3) of this Title.
(b) Existing article 28 facilities providing or arranging for specialized HIV primary care services prior to the effective date of this Part may apply to the department for certification as a CAHP. Such application shall demonstrate the facility's current capability to provide or arrange for all care and services required by this Part.
(c) Facilities providing CAHP services intending to add additional services, including the direct provision of additional CAHP services as described in this Part, shall apply to the department for approval to add such additional services pursuant to section 710.1(c)(5)(iv)( c ) of this Title.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter I ENVIRONMENTAL HEALTH
Part 72 TANNING FACILITIES
Subpart 72-1 TANNING FACILITIES
FACILITY OPERATIONS FACILITY OPERATIONS
10 CRR-NY 72-1.9 Physical facilities and equipment
Each tanning facility shall be constructed, operated and maintained in good repair and shall meet the following minimum requirements:
(a) Required warning sign.
(1) The warning sign shall be readily legible, clearly visible, and not obstructed by any barrier, equipment, or other item present so that the patron can easily view the warning sign before energizing the ultraviolet radiation device. This sign is in addition to manufacturer’s signs affixed to the device.
(2) Each warning sign shall be at least 11 inches by 17 inches, and use upper and lower case letters which are at least 10 mm (0.39 inches) and 5 mm (0.20 inches) in height, respectively. Lettering shall be bolded as in the text below. Signs shall have the following wording:
WARNING ULTRAVIOLET RADIATION FOLLOW INSTRUCTIONS.
AVOID OVEREXPOSURE.
The manufacturer’s maximum exposure time for this device is (specify) minutes.
As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated exposure may cause premature aging of the skin and skin cancer.
WEAR PROTECTIVE EYEWEAR. FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYE.
MEDICATIONS OR COSMETICS MAY INCREASE YOUR SENSITIVITY TO ULTRAVIOLET RADIATION. Consult a physician before using tanning equipment if you are using medications or have a history of skin problems or believe yourself to be especially sensitive to sunlight.
IF YOU DO NOT TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM THE USE OF THIS PRODUCT.
(b) Posting of required warning.
A warning sign shall be posted in the immediate proximity (within three feet) of each ultraviolet radiation device. The operator shall enter the manufacturer’s maximum exposure time on the sign for the device it is posted near.
(c) Equipment.
(1) Only ultraviolet radiation devices adequately labeled in accordance with 21 CFR 1040.20 or any successor regulation shall be used in tanning facilities.
(2) Each ultraviolet radiation device shall incorporate a timer system with multiple timer settings as specified on the manufacturer’s label. The maximum timer interval(s) shall not exceed the manufacturer’s maximum recommended exposure time.
(i) No timer interval shall have an error greater than ±10% of the maximum timer interval for the product.
(ii) The operator shall perform annual testing on all timers to ensure that this standard is met.
(iii) The timer must not automatically reset and cause radiation emission to resume for a period greater than the unused portion of the timer cycle, when emission from the ultraviolet lamp has been interrupted.
(3) Each ultraviolet radiation device shall allow the patron using the ultraviolet radiation device to terminate ultraviolet radiation emission manually at any time without disconnecting the electrical plug, removing the ultraviolet lamp or leaving the immediate environs of the ultraviolet radiation device.
(4) Timers shall be set by the operator or by a designated employee; patrons shall not have the ability to reset timers.
(5) All ultraviolet radiation devices, and electrical components of such devices, shall be maintained in good repair.
(6) All ultraviolet lamps must be shielded with an acrylic cover to protect patrons from injury caused by touching or breaking lamps.
(7) Additional requirements for stand-up booths:
(i) There shall be physical barriers or other means such as handrails or floor markings to indicate the recommended exposure distance between ultraviolet lamps and the patron’s skin.
(ii) Doors shall open outwardly. Handrails and non-slip floors shall be provided.
(8) Defective or burned out ultraviolet lamps or filters shall be replaced with a type compatible for use in that device as specified on the product label on the ultraviolet radiation device, or as recommended by the manufacturer.
(9) Equipment maintenance records must be maintained for a minimum of two years. The operator must be able to produce such records upon inspection of the facility by the department or the PIO’s representative.
(d) Sanitation.
(1) Ultraviolet radiation devices shall be cleaned and then sanitized with an adequate disinfectant after each use; protective eyewear shall be cleaned and then disinfected with an adequate disinfectant after each use.
(2) The ultraviolet light produced by the ultraviolet radiation device shall not be considered an adequate sanitizing agent.
(3) When the operator dilutes a concentrated disinfectant in lieu of using a commercially prepared, full strength disinfectant, a test kit or other device that accurately measures the concentration of the disinfectant in parts per million (ppm) shall be used to measure the strength of the solution. The diluted disinfectant shall be tested when initially prepared and at least weekly thereafter to ensure sufficient strength of the disinfectant.
(4) The ultraviolet radiation device shall be cleaned and then sanitized according to the following minimum provisions:
(i) a clean paper or cloth towel shall be used each time the tanning device is cleaned;
(ii) the disinfectant shall be one specifically manufactured for sanitizing ultraviolet light-emitting equipment and shall be prepared and used according to manufacturer’s instructions found on the product label.
(5) Protective eyewear shall be cleaned and then disinfected according to the following minimum provisions:
(i) a clean paper or cloth towel shall be used each time the protective eyewear is cleaned;
(ii) the disinfectant shall be one specifically manufactured for disinfecting protective eyewear and shall be prepared and used according to manufacturer’s instructions found on the product label.
(6) Each container of disinfectant shall be adequately labeled as to its contents. Written procedures maintained at the facility shall include proper mixing and handling instructions for each disinfectant used to ensure proper concentration and safe use of the disinfectant;
(7) Pillows and headrests shall be covered in an easily cleanable material and shall be cleaned and then sanitized with an adequate disinfectant after each use;
(8) If towels or other linens are provided for patron use, they shall be washed with a detergent in hot water, rinsed and thoroughly dried after each use.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 84 ATTENDANCE RULES FOR HOSPITAL TEACHERS
ATTENDANCE ATTENDANCE
10 CRR-NY 84.12 Overtime
Overtime shall not be earned for time worked in excess of the basic workweek during the 10-month period an employee is paid his regular salary. An employee who is required to work in his position or in any other position allocated to a salary grade in section 130 of the Civil Service Law for the two-month period during which his regular salary is not paid shall receive additional compensation for such service.
Chapter I STATE SANITARY CODE
Part 5 DRINKING WATER SUPPLIES
Subpart 5-1 PUBLIC WATER SYSTEMS
SEPARABILITY SEPARABILITY
10 CRR-NY 5-1.100 Separability
If any provisions of this Part are held invalid, such invalidity shall not affect other provisions which can be given effect without the invalid provisions.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter R HEALTH MAINTENANCE ORGANIZATIONS
Part 98 HEALTH MAINTENANCE ORGANIZATIONS
Subpart 98-3 MANAGED CARE ORGANIZATIONS—AUDITED FINANCIAL STATEMENTS
10 CRR-NY 98-3.16 Effective date and special rules
(a) Effective date.
(1) The requirements of this Subpart, subject to subdivision (b) of this section, shall apply beginning with the reporting period ending December 31, 2015.
(2) A MCO acquired in a business combination shall have two calendar years following the date of acquisition or combination to comply with this Subpart.
(b) Special rules.
(1) Changes in required number of independent audit committee members.
(i) A MCO that is required to have a higher number of independent audit committee members due to changes in premium shall have one year following the year the threshold is exceeded to comply with the independence requirements; and
(ii) a MCO that becomes subject to a different independence requirement as a result of a business combination shall have one calendar year following the date of acquisition or combination to comply with the newly effective independence requirements.
(2) Upon written application by any MCO, the commissioner may, if not inconsistent with any statutory requirement to the contrary, extend a filing date or grant an exemption from compliance with any and all provisions of this Subpart if the commissioner finds, upon review of the application, that compliance with this Subpart would constitute a financial or organizational hardship upon the MCO. A MCO shall file an application for a hardship exemption with the commissioner prior to the event or period for which the extension or exemption is being requested. The MCO shall file, with its annual statement filing, both its request for relief and the approval of that request with the states that it is licensed in or doing business in and the NAIC. If a nondomestic state accepts electronic filing with the NAIC, the MCO shall file the approval in an electronic format acceptable to the NAIC.
Subchapter K CONTROLLED SUBSTANCES
Part 80 RULES AND REGULATIONS ON CONTROLLED SUBSTANCES
MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS
10 CRR-NY 80.14 Minimum security standards for nonpractitioner handling; schedule III, IV and V controlled substances
(a) Minimum security standards for storage of schedule III, IV and V controlled substances shall include the following requirements:
(1) the controlled substance shall be separated from all other merchandise except that controlled substances may be stored with other pharmaceuticals in a separate room or storage area within a building if there is limited access to the room or storage area;
(2) during working hours the controlled substances shall be kept under constant surveillance by a supervisor or specific individual who has the responsibility for this duty; and
(3) an alarm system installed on the outer perimeter of the building or on the safe, cabinet, vault, or inside storage area, which shall be equipped to transmit, upon unauthorized entry, a signal to a central station protection company, a local police agency which has a legal duty to respond, or a 24-hour control station operated by the registrant.
(b) Storing the controlled substances in the following manner shall be deemed compliance with this section:
(1) where small quantities permit, in a safe of GSA class 5 rating or its equivalent, which complies with requirements of this Part for storing schedule I and II substances;
(2) in a vault which complies with the security requirements of this Part for storage of schedule I and II substances; or
(3) in a building or area located within a building which has walls or perimeter fences of sufficient height and construction to provide security from burglary and has substantial doors which shall be securely locked during nonworking hours by a multiple position combination or key lock.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-2 RESIDENTIAL HEALTH CARE FACILITIES
10 CRR-NY 86-2.4 Generally accepted accounting principles
The completion of the financial and statistical report forms shall be in accordance with generally accepted accounting principles as applied to the residential health care facility unless the reporting instructions authorized specific variation in such principles.
Chapter III PUBLIC WATER SUPPLIES
Subchapter A MUNICIPALITIES, DISTRICTS, COMPANIES, INSTITUTIONS
Part 146 STEUBEN COUNTY
VILLAGES VILLAGES
10 CRR-NY 146.3 Village of Arkport
(a) [Application.]
The rules and regulations hereinafter given, duly made and enacted in accordance with the provisions of sections 70, 71, 72 and 73 of chapter 45 of the Consolidated Laws (Public Health Law) as heretofore set forth shall apply to all natural and artificial reservoirs on the Lime-Kiln Creek and all watercourses tributary thereto or ultimately discharging into said reservoirs, these bodies of water being sources of public water supply of the village of Arkport, Steuben County, New York.
(b) [Definitions.]
(1) The term reservoir wherever used in this section is intended to mean and refer to all storage and impounding reservoirs on the Lime-Kiln Creek, which are tributary to or which serve as sources of this public water supply or to any additional reservoir which may be constructed or used for the purpose of this public water supply.
(2) The term watercourse wherever used in this section is intended to mean and include every spring, pond (other than the artificial reservoirs and filter basins), stream, ditch, gutter or other channel of every kind the waters of which, when running whether continuously or occasionally, eventually flow or may flow into the public water supply of the village of Arkport.
(3) Wherever a linear distance of a structure or object from a reservoir or from a watercourse is mentioned in this section, it is intended to mean the shortest horizontal distance from the nearest point of the structure or object to the high-water mark of a reservoir or to the edge, margin or precipitous bank forming the ordinary high-water mark of such watercourse.
(c) Privies adjacent to any reservoir or watercourse.
(1) No privy, privy vault, pit, cesspool or any other receptacle of any kind used for either the temporary storage or the permanent deposit of human excreta shall be constructed, placed, maintained or allowed to remain within 100 feet of any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(2) No privy, privy vault, pit, cesspool or any other receptacle used for the permanent deposit of human excreta shall be constructed, located, placed, maintained or allowed to remain within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(3) No cesspool, pit or other receptacle of any kind used for the temporary storage of human excreta or sewage shall be constructed, located, maintained or allowed to remain between the limiting distances prescribed by paragraph (1) of this subdivision and the limiting distances prescribed by paragraph (2) of this subdivision unless said cesspool, pit or other receptacle is so arranged and equipped that the said excreta or sewage are at once removed by pump or other satisfactory means through watertight pipes or conduits to some proper place of ultimate disposal, as hereinafter provided, or unless suitable vessels or receptacles for the temporary storage of said human excreta or sewage are provided and at all times maintained in an absolutely watertight condition and in such manner as to permit of convenient removal of said excreta or sewage to some place of ultimate disposal as hereinafter set forth.
(4) The excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall be removed and the receptacles thoroughly cleaned and deodorized as often as may be found necessary to maintain the privy in proper sanitary condition and to effectually prevent any overflow upon the soil or upon the foundations or floor of the privy. In affecting this removal the utmost care shall be exercised that none of the contents be allowed to escape while being transferred from the privy to the place of disposal hereinafter specified and that the contents, while being transferred from the privy to the place of disposal, shall be thoroughly covered and that the least possible annoyance and inconvenience be caused to occupants of the premises and the adjacent premises.
(5) Unless otherwise specially ordered or permitted by the State Department of Health, the excreta collected in the aforesaid temporary receptacles permitted under paragraph (3) of this subdivision shall, when removed, be disposed of by burying in trenches or pits at a depth of not less than 18 inches below the surface and at a distance not less than 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(6) Whenever, owing to the character of the soil or of the surface of the ground or owing to the height or flow of subsoil or surface water or other special local conditions, it is considered by the State Commissioner of Health that excremental matter from any privy or aforesaid receptacles or from any trench or place of disposal or the garbage or wastes from any dump may be washed over the surface or through the soil in an imperfectly purified condition into any reservoir or watercourse, then the said privy or receptacles for excreta or the trench or place of disposal of the said garbage or waste dump shall, after due notice to the owner thereof, be removed to such greater distance or to such place as shall be considered safe and proper by the State Commissioner of Health.
(d) Sewage, house slops, sink waste, etc.
(1) No house slops, bath water, sewage or other excretal matter from any water closet, privy, cesspool or other source shall be thrown, placed, led, conducted, discharged or allowed to escape or flow in any manner either directly or indirectly into any reservoir or any watercourse tributary to the public water supply of the village of Arkport, nor shall any such matters be thrown, placed, led, discharged or allowed to escape or flow onto the surface of the ground or into the ground beneath the surface, except into watertight receptacles, the contents of which are to be removed as provided by paragraph (4) of subdivision (c), within 300 feet of any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(2) No garbage, putrescible matter, kitchen or sink wastes, refuse or waste water from any creamery, cheese factory, laundry nor water in which milk cans, utensils, clothing, bedding, carpets or harness have been washed or rinsed nor any polluted water or liquid of any kind shall be thrown or discharged directly or indirectly into any reservoir or watercourse, nor shall any such liquid or solid refuse or waste be thrown, discharged or allowed to escape or remain upon the surface of the ground or to percolate into or through the ground below the surface in any manner whereby the same may flow into any reservoir or watercourse within a distance of 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(3) No clothing, bedding, carpets, harnesses, vehicle, receptacles, utensils nor anything that pollutes water shall be washed, rinsed or placed in any reservoir or watercourse.
(e) Bathing, animals, manure, compost, etc.
(1) No person shall be allowed to bathe in any reservoir or watercourse, nor shall any animals or poultry be allowed to stand, wallow wade or swim in any reservoir or watercourse nor be washed therein. The watering of animals or poultry in any reservoir of the public water supply of the village of Arkport is prohibited; nor shall any such watering be allowed in any watercourse tributary to this water supply within 1,000 feet of said reservoirs. No watering place shall be maintained in such a way as to pollute with muddy leachings or excretal matters any streams tributary to the public water supply of the village of Arkport.
(2) No stable for cattle or horses, barnyard, hogyard, pigpen, poultry house or yard, hitching place or standing place for horses or other animals, manure pile or compost heap shall be constructed, placed, maintained or allowed to remain with its nearest point less than 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport, and none of the above named objects or sources of pollution shall be so constructed, placed, maintained or allowed to remain where or in such a manner that the drainings, leachings or washings from the same may enter any such reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that proper purification has been secured unless the above drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 200 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(3) No human excreta and no compost or other matter containing human excreta shall be thrown, placed or allowed to escape into any reservoir or watercourse nor to be placed, piled or spread upon the surface of the ground at any point on the watershed tributary to the public water supply of the village of Arkport, nor shall such human excreta or compost or other matter containing human excreta be dug or buried in the soil at a less depth than 18 inches below the surface nor within a distance of 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport and no manure or compost of any kind shall be placed, piled or spread upon the ground within a distance of 100 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(4) No decayed or fermented fruit or vegetables, cider mill wastes, roots, grain or other vegetable refuse of any kind shall be thrown, placed, discharged or allowed to escape or pass into any reservoir or watercourse, nor shall they be thrown, placed, piled, maintained or allowed to remain in such places that the drainage, leachings or washings therefrom may flow by open, blind or covered drains or channels of any kind into any reservoir or watercourse without first having passed over or through such an extent of soil as to have been properly purified, and in no case shall it be deemed that sufficient purification has been secured unless the above mentioned drainage, leachings or washings shall have percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of not less than 150 feet before entering any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(f) Dead animals, offal, manufacturing wastes, etc.
No dead animals, bird, fish or any part thereof nor any offal or waste matter of any kind shall be thrown, placed, discharged or allowed to escape or to pass into any reservoir or watercourse. Nor shall any such material or refuse be so located, placed, maintained or allowed to remain that the drainage, leachings or washings therefrom may reach any such reservoir or watercourse without having first percolated over or through the soil in a scattered, dissipated form and not concentrated in perceptible lines of drainage for a distance of 250 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(g) Fishing, boating and ice cutting.
No boating of any kind or fishing from boats or through the ice or any trespassing whatever shall be allowed in or upon the water or ice of the reservoirs.
(h) [Camps.]
No temporary camp, tent, building or other structures for housing laborers engaged on construction work or for other purposes shall be located, placed or maintained within a distance 500 feet from any reservoir or watercourse tributary to the public water supply of the village of Arkport.
(i) Cemeteries.
No interment of a human body shall be made within a distance of 300 feet from any reservoir or from any watercourse tributary to the public water supply of the village of Arkport.
(j) [Inspections.]
The board of trustees of the village of Arkport shall make regular and thorough inspections of the reservoirs, streams and drainage areas tributary thereto for the purpose of ascertaining whether the above rules and regulations are being complied with, and it shall be the duty of said board of trustees to cause copies of any rules and regulations violated to be served upon the persons violating the same with notices of such violations; and if such persons served do not immediately comply with the rules and regulations it shall be the further duty of the board of trustees to promptly notify the State Commissioner of Health of such violations. The board of trustees shall report in writing annually, on the first of January, the results of the regular inspections made during the preceding year, stating the number of inspections which have been made, the number of violations found, the number of notices served and the general condition of the watershed at the time of the last inspection.
(k) Penalty.
In accordance with section 70 of chapter 45 of the Consolidated Laws (Public Health Law), the penalty for each and every violation of or noncompliance with any of these rules and regulations which relate to a permanent source or act of contamination is hereby fixed at $100.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-2 UNINSURED CARE PROGRAMS
10 CRR-NY 43-2.6 Decision on eligibility
(a) The department shall make one of the following decisions, based upon the application information:
(1) Accepted for coverage.
This means that eligibility has been established through review and verification to the satisfaction of the department; or
(2) Not accepted for coverage.
Applications are denied when the information given by the applicant establishes that the applicant is ineligible, or when the applicant refuses to comply with any requirement essential to the determination of eligibility.
(b) No decision is required when:
(1) an application is withdrawn by the applicant; or
(2) the department documents that the applicant has died, cannot be located, or has left the State prior to the completion of the review and verification.
Subchapter L HOSPITALS AND RELATED FACILITIES
Part 86 REPORTING AND RATE CERTIFICATIONS FOR FACILITIES
Subpart 86-4 FREE-STANDING AMBULATORY CARE FACILITIES
10 CRR-NY 86-4.40 Computation of case-based rates of payment for licensed free-standing ambulatory surgery centers and hospital-based ambulatory surgery services
(a) Medicaid reimbursement for ambulatory surgery services provided by licensed free-standing ambulatory surgical centers and hospital-based ambulatory surgery services shall be based upon a single payment schedule with a discrete price for each of the separate groupings of surgical procedures set forth in this section.
(b) Reimbursement for ambulatory surgery services shall be based upon the Products of Ambulatory Surgery (PAS) classification system as defined in subdivision (o) of this section. A base price shall be established for each of the payment groups defined in the PAS classification. All procedures within the same payment group shall be reimbursed at a single discrete price.
(c) Each base price shall be adjusted by a wage equalization factor and a space occupancy factor to reflect regional differences in the price of labor and space. The wage equalization factor shall be applied to the operating room and preoperative and postoperative nursing personnel salary components of each base price.
(d) Prices established pursuant to subdivision (b) of this section shall provide full reimbursement for applicable:
(1) nursing services, technician services, and other related professional expenses directly incurred by the licensed facility;
(2) drugs, biologicals, surgical dressings, supplies, splints, appliances and equipment directly related to the provision of the surgical procedures;
(3) diagnostic or therapeutic items and services directly related to the provision of surgical procedures;
(4) materials for anesthesia;
(5) prosthetic and orthotic appliances provided during or integral to an ambulatory surgery procedure;
(6) administrative, personnel, business office, data processing, recordkeeping, housekeeping and other related facility overhead expenses; and
(7) space occupancy and plant overhead costs.
(8) costs associated with graduate medical education programs involved in the provision of ambulatory surgery services; and
(9) costs associated with hospital-based physicians, defined as salaried physicians excluding interns and residents engaged in direct provision of ambulatory surgical services can be included in a facility's payment rates upon appeal to the Department of Health. Such adjustments will be limited to the current schedule of surgical fees, as set forth in section 7.0 of the Medicaid Management Information System Provider Manual, Physicians (revised January, 1985). Copies of the Physicians Manual schedules may be obtained from the Department of Social Services, and are available for inspection and copying at the Department of Health Records Access Office, as indicated in subdivision (h) of this section.
(e) The commissioner shall establish trend factors to project increases in the base year prices during the effective period of the reimbursement rate. To determine trend factors, cost elements shall be weighted based upon data for salaries, employee health and welfare expenses, nonpayroll administrative and general expense, nonpayroll household and maintenance expense, and nonpayroll professional care expense. Each weight shall be adjusted by one or more price indices. Included among these indices are elements of the United States Department of Labor consumer and producer price indices and special indices developed by the commissioner for this purpose.
(f) The projected trend factors shall be updated on an annual basis, based upon then current and available data. The commissioner shall adjust annually subsequent trend factors based upon such update.
(g) Dental procedures included in subdivision (o) of this section performed at facilities for patients requiring the use of an operating room with anesthesia will continue to be paid at current cost based rates.
(h) Reimbursement for physician services rendered in connection with the provision of ambulatory surgical services shall be in accordance with the Medicaid fee schedule set forth in Title 18 (Social Services) of the Official Compilation of Codes, Rules and Regulations of the State of New York at section 533.4 (18 NYCRR 533.4), as amended pursuant to chapter 904 of the Laws of 1984. Copies of the current schedule of fees, as set forth in section 7.0 of the Medicaid Management Information System Provider Manual, Physicians (revised January 1985), may be obtained from the Bureau of Program, Policy and Operations of the Division of Medical Assistance of the New York State Department of Social Services, 40 North Pearl Street, Albany, NY 12243. The current physicians' fee schedule is available for inspection and copying at the Department of Health, Records Access Office, 22nd Floor, Corning Tower Building, Governor Nelson A. Rockefeller Empire State Plaza, Albany, NY 12237-0042.
(i) Reimbursement for durable medical equipment subsequently required as a result of the provision of ambulatory surgical services shall be in accordance with section 4.2 of the Medicaid Management Information System (MMIS) Provider Manual, Durable Medical Equipment, Medical and Surgical Supplies, Prosthetic and Orthotic Appliances (revised March 1984). Copies of the current durable medical equipment schedules may be obtained from the New York State Department of Social Services, and are available for inspection and copying at the Department of Health, Records Access Office, as indicated in subdivision (g) of this section.
(j) Reimbursement for prosthetic and orthotic appliances subsequently required as a result of and necessitated by the provision of ambulatory surgical services shall be in accordance with Part 522 of Title 18 (Social Services) of the Official Compilation of Codes, Rules and Regulations (18 NYCRR Part 522). Copies of current fee schedules for prosthetic and orthotic appliances, as contained in sections 4.6, 4.3 and 4.4, respectively, of the MMIS Provider Manual referenced in subdivision (h) of this section, may be obtained from the New York State Department of Social Services, and are available for inspection and copying at the Department of Health, Records Access Office, as indicated in subdivision (g) of this section.
(k) For any procedure which is not an ambulatory surgical procedure:
(1) facilities with a cost-based all-inclusive Medicaid clinic rate established pursuant to this Part or Subpart 86-1, shall be reimbursed at such rate; provided, however, that the provisions of subdivisions (h) through (j) of this section shall not apply and that the cost for services referred to in these subdivisions shall be considered fully reimbursed through payment of such clinic rate; and
(2) for facilities without a cost-based all-inclusive Medicaid clinic rate established pursuant to this Part or Subpart 86-1, facility costs shall be reimbursed in accordance with section 6.2.5 of the Medicaid Management Information System (MMIS) Clinic Provider Manual, Fees for Hospital-Based Referred Ambulatory Use of the Operating Room (revised December 1984). Copies of the schedule may be obtained from the New York State Department of Social Services, and are available for inspection and copying at the Department of Health, Records Access Office, as indicated in subdivision (h) of this section.
(l) Where multiple procedures are performed, and they appear in more than one PAS group, payment pursuant to this section shall be based upon 100 percent of the group price for the highest priced procedure and 50 percent of the applicable group price for each additional procedure furnished in the same operative session.
(m)-(n) [ Reserved ]
(o) The following table represents the products of ambulatory surgery (PAS) classification system for which reimbursement is available according to group and group price as established in this section. The products of ambulatory surgery classification system, developed by the New York State Department of Health, classifies ambulatory surgery procedures based upon similarities in patient and resource use characteristics. The table includes the PAS classification and PAS name as follows:
| PAS GROUP | GROUP NAME | | --- | --- | | PAS GROUP 1 | Nerve Repair | | PAS GROUP 2 | Eye Therapeutic | | PAS GROUP 3 | Eye Repair | | PAS GROUP 4 | Lens Remove/Replace | | PAS GROUP 5 | Eye Laser Therapeutic | | PAS GROUP 6 | Eye Muscle Repair | | PAS GROUP 7 | Ear Repair | | PAS GROUP 8 | Ear Therapeutic | | PAS GROUP 9 | Nasal/Paranasal Therapeutic | | PAS GROUP 10 | Rhino/Septo Plasty | | PAS GROUP 11 | Tonsil/Adenoid Therapeutic | | PAS GROUP 12 | Nasal/Tracheal Endoscope | | PAS GROUP 13 | Thoracic Diagnostic/Therapeutic | | PAS GROUP 14 | Vascular Diagnostic II | | PAS GROUP 15 | Vascular Repair | | PAS GROUP 16 | Vascular Diagnostic/Therapeutic | | PAS GROUP 17 | UpperGI Diagnostic/Therapeutic | | PAS GROUP 18 | LowerGI Diagnostic/Therapeutic | | PAS GROUP 19 | Rectal Diagnostic/Therapeutic | | PAS GROUP 20 | Hepatic Diagnostic/Therapeutic | | PAS GROUP 21 | Hepatic Endoscopy | | PAS GROUP 22 | Hernia Repair | | PAS GROUP 23 | Cystoscope | | PAS GROUP 24 | Urological Therapeutic | | PAS GROUP 25 | Lithotripsy | | PAS GROUP 26 | Male Genital Diagnostic | | PAS GROUP 27 | Genito-Urinary Repair | | PAS GROUP 28 | Male Genital Therapeutic | | PAS GROUP 29 | Laparoscopy | | PAS GROUP 30 | Oviduct Diagnostic/Therapeutic | | PAS GROUP 31 | Gyn Diagnostic/Therapeutic | | PAS GROUP 32 | Dilation and Curettage | | PAS GROUP 33 | Soft Tissue Repair | | PAS GROUP 34 | Bone Therapeutic | | PAS GROUP 35 | Arthroscopy | | PAS GROUP 36 | Bone Repair | | PAS GROUP 37 | Soft Tissue Therapy | | PAS GROUP 38 | Breast Diagnostic/Therapeutic | | PAS GROUP 39 | Breast Repair | | PAS GROUP 40 | Skin Diagnostic/Therapeutic | | PAS GROUP 41 | Skin Repair | | PAS GROUP 42 | Urological Diagnostic | | PAS GROUP 43 | Oral Surgery | | PAS GROUP 44 | STRB | | PAS GROUP 45 | Eye Implant/Therapeutic (HIV) |
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-1 SWIMMING POOLS
OPERATION, SUPERVISION AND MAINTENANCE OPERATION, SUPERVISION AND MAINTENANCE
10 CRR-NY 6-1.30 Saturation index for swimming pools
Saturation index is equal to the pH plus a temperature factor, plus a calcium hardness factor, plus an alkalinity factor, minus the constant 12.1.
S.I. = pH + TF + CF + AF − 12.1
The optimum saturation index is zero.
Tolerance limits are plus or minus 0.5.
If the index is positive (+), the water is super-saturated with CaCO3 and may deposit a protective coating or scale in the pipeline, particularly metal filters, valves and pumps.
If the index is negative (−), water will dissolve CaCO3 and may be corrosive.
| Temp. (in °F) | TF | Calcium hardness | CF | Total alkalinity | AF | | --- | --- | --- | --- | --- | --- | | 32 | 0.0 | 5 | 0.3 | 5 | 0.7 | | 37 | 0.1 | 25 | 1.0 | 25 | 1.4 | | 46 | 0.2 | 50 | 1.3 | 50 | 1.7 | | 53 | 0.3 | 75 | 1.5 | 75 | 1.9 | | 60 | 0.4 | 100 | 1.6 | 100 | 2.0 | | 66 | 0.5 | 150 | 1.8 | 150 | 2.2 | | 76 | 0.6 | 200 | 1.9 | 200 | 2.3 | | 84 | 0.7 | 300 | 2.1 | 300 | 2.5 | | 94 | 0.8 | 400 | 2.2 | 400 | 2.6 | | 105 | 0.9 | 800 | 2.5 | 800 | 2.9 | | 128 | 1.0 | 1000 | 2.6 | 1000 | 3.0 |
Example:
Given temperature 68°, total hardness 200 mg/l, total alkalinity
20 mg/l, CaCO3 and pH = 7.8 S.I. = pH + TF + *CF + AF − 12.1 *(Calcium hardness - 0.70 × 200 = 140 mg/l.) S.I. = 7.8 + 0.52 + 1.76 + 1.22 − 12.1 = (−)0.8 Therefore, the water is corrosive.
Note: Saturation index must be maintained slightly on the positive side within the tolerance limits.
| Normal Control Levels: | | | --- | --- | | pH: 7.4 - 7.8 | free chlorine: 0.6 (minimum) | | temperature: 78° - 80° (indoor) | saturation index: (−)0.5 - (+)0.5 | | total alkalinity: 80 - 120 mg/l | calcium hardness: 180 - 250 mg/l |
Alkalinity control:
to increase - 1 ½ lb of sodium bicarbonate NaHCO 3 baking soda will raise the alkalinity of 10,000 gallons of water by 10 mg/l.
to lower - add muriatic acid no more than one pint ( ⅛ gallon) per 5,000 gallons of pool water will lower alkalinity by 12 mg/l (or, add 1.25 lb of sodium bisulfate).
pH:
to increase - use soda ash.
to decrease - muriatic acid or sodium bisulfate.
Hardness Control: Calcium hardness is assumed to be 70% of total hardness.
to increase - 1 lb of calcium chloride will raise the calcium hardness of 10,000 gallons of water by 11 mg/l. It should be added in small amounts. To lower, dilute with soft water.
Chapter II ADMINISTRATIVE RULES AND REGULATIONS
Subchapter B STATE AID AND FUNDING
Part 43 STATE AID FOR TUBERCULOSIS AND UNINSURED CARE PROGRAMS
Subpart 43-1 STATE AID FOR TUBERCULOSIS
REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES REQUIREMENTS APPLYING TO PROVIDERS AS A CONDITION TO BEING ENTITLED TO PAYMENT FOR TUBERCULOSIS HEALTH CARE SERVICES
10 CRR-NY 43-1.4 Standards for tuberculosis care and services
The care and treatment by providers of tuberculosis patients shall include health care services which meet prevailing standards of professional practice, including the following:
(a) a licensed and currently registered physician shall be responsible for the tuberculosis health care services furnished to a patient;
(b) tuberculosis suspects shall be confirmed as being or not being tuberculosis cases within 60 days from the date accepted into care by a provider. On or before the 60th day, the provider shall report findings in writing to the local health officials where the patient resides and where the provider is located; and
(c) providers shall comply with applicable utilization review requirements.
Chapter I STATE SANITARY CODE
Part 6 SWIMMING POOLS, BATHING BEACHES AND RECREATIONAL AQUATIC SPRAY GROUNDS
Subpart 6-2 BATHING BEACHES
GENERAL PROVISIONS GENERAL PROVISIONS
10 CRR-NY 6-2.3 Application
(a) The requirements of this Subpart shall apply to all bathing beaches, except:
(1) those owned and/or maintained by an individual for the use of family and friends; and
(2) those, excluding ocean beaches in Nassau County, Suffolk County, and New York City, that are owned and operated by a condominium ( i.e., property subject to article 9-B of the Real Property Law, also known as the Condominium Act), a property commonly known as a cooperative, in which the property is owned or leased by a corporation, the stockholders of which are entitled, solely by reason of their ownership of stock in the corporation, and occupy apartments for dwelling purposes, provided an “offering statement” or “prospectus” has been filed with the Department of Law, or an incorporated or unincorporated property association, all of whose members own residential property in a fixed or defined geographical area with deeded rights to use, with similarly situated owners, a defined bathing beach, provided such bathing beach is used exclusively by members of the condominium, cooperative apartment project or corporation or association and their family and friends.
(b) Section 6-2.5 of this Subpart shall not apply to bathing beaches maintained and operated as part of a temporary residence or children's camp property subject to the regulations of Subpart 7-1 or 7-2 of this Title.
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